8 results on '"Nwosu, Sam"'
Search Results
2. Surgical Predictors of Clinical Outcomes After Revision Anterior Cruciate Ligament Reconstruction
- Author
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Allen, Christina R., Anderson, Allen F., Cooper, Daniel E., DeBerardino, Thomas M., Dunn, Warren R., Haas, Amanda K., Huston, Laura J., Lantz, Brett (Brick) A., Mann, Barton, Nwosu, Sam K., Spindler, Kurt P., Stuart, Michael J., Wright, Rick W., Albright, John P., Amendola, Annunziato (Ned), Andrish, Jack T., Annunziata, Christopher C., Arciero, Robert A., Bach, Bernard R., Jr, Baker, Champ L., III, Bartolozzi, Arthur R., Baumgarten, Keith M., Bechler, Jeffery R., Berg, Jeffrey H., Bernas, Geoffrey A., Brockmeier, Stephen F., Brophy, Robert H., Bush-Joseph, Charles A., Butler, J. Brad, V, Campbell, John D., Carey, James L., Carpenter, James E., Cole, Brian J., Cooper, Jonathan M., Cox, Charles L., Creighton, R. Alexander, Dahm, Diane L., David, Tal S., Flanigan, David C., Frederick, Robert W., Ganley, Theodore J., Garofoli, Elizabeth A., Gatt, Charles J., Jr, Gecha, Steven R., Giffin, James Robert, Hame, Sharon L., Hannafin, Jo A., Harner, Christopher D., Harris, Norman Lindsay, Jr, Hechtman, Keith S., Hershman, Elliott B., Hoellrich, Rudolf G., Hosea, Timothy M., Johnson, David C., Johnson, Timothy S., Jones, Morgan H., Kaeding, Christopher C., Kamath, Ganesh V., Klootwyk, Thomas E., Levy, Bruce A., Ma, C. Benjamin, Maiers, G. Peter, II, Marx, Robert G., Matava, Matthew J., Mathien, Gregory M., McAllister, David R., McCarty, Eric C., McCormack, Robert G., Miller, Bruce S., Nissen, Carl W., O’Neill, Daniel F., Owens, Brett D., Parker, Richard D., Purnell, Mark L., Ramappa, Arun J., Rauh, Michael A., Rettig, Arthur C., Sekiya, Jon K., Shea, Kevin G., Sherman, Orrin H., Slauterbeck, James R., Smith, Matthew V., Spang, Jeffrey T., Svoboda, Steven J., Taft, Timothy N., Tenuta, Joachim J., Tingstad, Edwin M., Vidal, Armando F., Viskontas, Darius G., White, Richard A., Williams, James S., Jr, Wolcott, Michelle L., Wolf, Brian R., and York, James J.
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- 2017
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3. Carotid Adventitial Vasa Vasorum and Intima-Media Thickness in a Primary Prevention Population
- Author
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Sampson, Uchechukwu K. A., Harrell, Frank E., Jr, Fazio, Sergio, Nwosu, Sam, Mercaldo, Nate, Mensah, George A., Davidson, Michael H., Coll, Blai, and Feinstein, Steve B.
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- 2015
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4. Adherence to Disease-Modifying Therapies at a Multiple Sclerosis Clinic: The Role of the Specialty Pharmacist.
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Banks, Aimee M., Peter, Megan E., Holder, Genna M., Jolly, Jacob A., Markley, Brandon M., Zuckerman, Scott L., Choi, Leena, Nwosu, Sam, and Zuckerman, Autumn D.
- Subjects
HOSPITAL pharmacies ,OUTPATIENT services in hospitals ,INTEGRATED health care delivery ,MEDICAL care costs ,MULTIPLE sclerosis ,PATIENT compliance ,OCCUPATIONAL roles ,DESCRIPTIVE statistics - Abstract
Background: Disease-modifying therapy (DMT) delays disease progression and improves quality of life for patients with multiple sclerosis (MS), but adherence to DMT is often suboptimal. Vanderbilt Specialty Pharmacy (VSP) embeds pharmacists within an outpatient MS clinic to provide medication management and address barriers to adherence. Objective: We evaluated rates and predictors of adherence to DMT among patients with MS at an integrated specialty pharmacy. Methods: We included patients with MS who filled ≥3 DMT prescriptions from VSP during the study period. Adherence was defined as medication possession ratio (MPR) or proportion of days covered (PDC) ≥0.8. Reasons for nonadherence were collected from pharmacy claims and electronic medical records. Results: The study included 653 patients. Average MPR and PDC were 0.93 and 0.94, respectively. Eighty-eight percent of patients achieved MPR ≥0.8; 89% achieved PDC ≥0.8. Using financial assistance and having $0 out-of-pocket cost were associated with higher odds of achieving MPR and PDC ≥0.8 (P <.05). Of the 12% of patients who were nonadherent, most were unreachable for refills. Conclusions: Ensuring financial assistance and low out-of-pocket costs are associated with high adherence to DMT within an integrated specialty clinic, but more work is needed to address adherence in unreachable patients. [ABSTRACT FROM AUTHOR]
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- 2020
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5. Increasing success and evolving barriers in the hepatitis C cascade of care during the direct acting antiviral era.
- Author
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Zuckerman, Autumn, Douglas, Andrew, Nwosu, Sam, Choi, Leena, and Chastain, Cody
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HEPATITIS C treatment ,ANTIVIRAL agents ,HEPATITIS C ,OUTPATIENT medical care ,MEDICAID ,PATIENTS - Abstract
Barriers remain in the hepatitis C virus (HCV) cascade of care (CoC), limiting the overall impact of direct acting antivirals. This study examines movement between the stages of the HCV CoC and identifies reasons why patients and specific patient populations fail to advance through care in a real world population. We performed a single-center, ambispective cohort study of patients receiving care in an outpatient infectious diseases clinic between October 2015 and September 2016. Patients were followed from treatment referral through sustained virologic response. Univariate and multivariate analyses were performed to identify factors related to completion of each step of the CoC. Of 187 patients meeting inclusion criteria, 120 (64%) completed an evaluation for HCV treatment, 119 (64%) were prescribed treatment, 114 (61%) were approved for treatment, 113 (60%) initiated treatment, 107 (57%) completed treatment, and 100 (53%) achieved a sustained virologic response. In univariate and multivariate analyses, patients with Medicaid insurance were less likely to complete an evaluation and were less likely to be approved for treatment. Treatment completion and SVR rates are much improved from historical CoC reports. However, linkage to care following referral continues to be a formidable challenge for the HCV CoC in the DAA era. Ongoing efforts should focus on linkage to care to capitalize on DAA treatment advances and improving access for patients with Medicaid insurance. [ABSTRACT FROM AUTHOR]
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- 2018
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6. Meniscal and Articular Cartilage Predictors of Clinical Outcome After Revision Anterior Cruciate Ligament Reconstruction.
- Author
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Wright, Rick W., Huston, Laura J., Nwosu, Sam K., Haas, Amanda K., Allen, Christina R., Anderson, Allen F., Cooper, Daniel E., DeBerardino, Thomas M., Dunn, Warren R., Lantz, Brett A., Mann, Barton, Spindler, Kurt P., Stuart, Michael J., Albright, John P., Amendola, Annunziato, Andrish, Jack T., Annunziata, Christopher C., Arciero, Robert A., Bach, Bernard R., and Baker, Champ L.
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ANTERIOR cruciate ligament surgery ,MENISCUS (Anatomy) ,ARTICULAR cartilage ,MENISCECTOMY ,HEALTH outcome assessment ,DIAGNOSIS - Abstract
Background: Revision anterior cruciate ligament (ACL) reconstruction has been documented to have worse outcomes compared with primary ACL reconstructions. Purpose/Hypothesis: The purpose of this study was to determine if the prevalence, location, and/or degree of meniscal and chondral damage noted at the time of revision ACL reconstruction predicts activity level, sports function, and osteoarthritis symptoms at 2-year follow-up. The hypothesis was that meniscal loss and high-grade chondral damage noted at the time of revision ACL reconstruction will result in lower activity levels, decreased sports participation, more pain, more stiffness, and more functional limitation at 2 years after revision surgery. Study Design: Cohort study; Level of evidence, 2. Methods: Between 2006 and 2011, a total of 1205 patients who underwent revision ACL reconstruction by 83 surgeons at 52 hospitals were accumulated for study of the relationship of meniscal and articular cartilage damage to outcome. Baseline demographic and intraoperative data, including the International Knee Documentation Committee (IKDC) subjective knee evaluation, Knee injury and Osteoarthritis Outcome Score (KOOS), Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), and Marx activity score, were collected initially and at 2-year follow-up to test the hypothesis. Regression analysis was used to control for age, sex, body mass index, smoking status, activity level, baseline outcome scores, revision number, time since last ACL reconstruction, incidence of having a previous ACL reconstruction on the contralateral knee, previous and current meniscal and articular cartilage injury, graft choice, and surgeon years of experience to assess the meniscal and articular cartilage risk factors for clinical outcomes 2 years after revision ACL reconstruction. Results: At 2-year follow-up, 82% (989/1205) of the patients returned their questionnaires. It was found that previous meniscal injury and current articular cartilage damage were associated with the poorest outcomes, with prior lateral meniscectomy and current grade 3 to 4 trochlear articular cartilage changes having the worst outcome scores. Activity levels at 2 years were not affected by meniscal or articular cartilage pathologic changes. Conclusion: Prior lateral meniscectomy and current grade 3 to 4 changes of the trochlea were associated with worse outcomes in terms of decreased sports participation, more pain, more stiffness, and more functional limitation at 2 years after revision surgery, but they had no effect on activity levels. Registration: NCT00625885 [ABSTRACT FROM AUTHOR]
- Published
- 2016
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7. Medication Nonadherence Before Hospitalization for Acute Cardiac Events.
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Kripalani, Sunil, Goggins, Kathryn, Nwosu, Sam, Schildcrout, Jonathan, Mixon, Amanda S., McNaughton, Candace, McDougald Scott, Amanda M., and Wallston, Kenneth A.
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PATIENT compliance ,MYOCARDIAL infarction risk factors ,ACUTE coronary syndrome ,HEART failure patients ,HEALTH literacy ,PATIENTS ,HEART failure treatment ,MENTAL depression ,TREATMENT of acute coronary syndrome ,HEART failure ,ACADEMIC medical centers ,AGE distribution ,DRUGS ,HEALTH attitudes ,LONGITUDINAL method ,RESEARCH funding ,SELF-evaluation ,INFORMATION literacy ,SOCIAL support ,EDUCATIONAL attainment ,PSYCHOLOGY - Abstract
Medication nonadherence increases the risk of hospitalization and poor outcomes, particularly among patients with cardiovascular disease. The purpose of this study was to examine characteristics associated with medication nonadherence among adults hospitalized for cardiovascular disease. Patients in the Vanderbilt Inpatient Cohort Study who were admitted for acute coronary syndrome or heart failure completed validated assessments of self-reported medication adherence (the Adherence to Refills and Medications Scale), demographic characteristics, health literacy, numeracy, social support, depressive symptoms, and health competence. We modeled the independent predictors of nonadherence before hospitalization, standardizing estimated effects by each predictor's interquartile range. Among 1,967 patients studied, 70.7% indicated at least some degree of medication nonadherence leading up to their hospitalization. Adherence was significantly lower among patients with lower health literacy (0.18-point change in adherence score per interquartile range change in health literacy), lower numeracy (0.28), lower health competence (0.30), and more depressive symptoms (0.52) and those of younger age, of non-White race, of male gender, or with less social support. Medication nonadherence in the period before hospitalization is more prevalent among patients with lower health literacy, numeracy, or other intervenable psychosocial factors. Addressing these factors in a coordinated care model may reduce hospitalization rates. [ABSTRACT FROM PUBLISHER]
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- 2015
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8. Predictors of Patient-Reported Outcomes at 2 Years After Revision Anterior Cruciate Ligament Reconstruction: Response.
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Wright, Rick W., Huston, Laura J., and Nwosu, Sam
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ANTERIOR cruciate ligament surgery ,HEALTH outcome assessment ,REOPERATION - Abstract
The authors convey their response to a feedback about their report on predictors of patient-reported outcomes at two years after revision anterior cruciate ligament reconstruction. Topics mentioned include the use of a proportional odds multivariable model in the report, the use of the lrm function for binary and proportional odds ordered logistic regression, and the use of a Wald test to examine whether or not the continuous predictors modeled nonlinearly have more of a nonlinear form.
- Published
- 2020
- Full Text
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