13 results on '"Christopher L. Edwards"'
Search Results
2. Prognostic Significance of Creatinine Increases During an Acute Heart Failure Admission in Patients With and Without Residual Congestion
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Daniel M. Bloomfield, Beth A. Davison, Christopher L. Edwards, Christopher M. O'Connor, Marco Metra, Gad Cotter, Howard C. Dittrich, Olga Milo, Stefanie Senger, Piotr Ponikowski, Guillermo C. Cursack, John G.F. Cleland, Adriaan A. Voors, Michael M. Givertz, and John R. Teerlink
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Male ,medicine.medical_specialty ,Orthopnea ,Acute decompensated heart failure ,kidney function tests ,heart failure ,Renal function ,030204 cardiovascular system & hematology ,Kidney ,Patient Readmission ,Rolofylline ,03 medical and health sciences ,chemistry.chemical_compound ,0302 clinical medicine ,Internal medicine ,Humans ,edema ,hospitalization ,prognosis ,Medicine ,030212 general & internal medicine ,Aged ,Proportional Hazards Models ,Aged, 80 and over ,Creatinine ,business.industry ,Hazard ratio ,Middle Aged ,medicine.disease ,Confidence interval ,chemistry ,Xanthines ,Heart failure ,Acute Disease ,Cardiology ,Female ,medicine.symptom ,Cardiology and Cardiovascular Medicine ,business - Abstract
Background: The importance of a serum creatinine increase, traditionally considered worsening renal function (WRF), during admission for acute heart failure has been recently debated, with data suggesting an interaction between congestion and creatinine changes. Methods and Results: In post hoc analyses, we analyzed the association of WRF with length of hospital stay, 30-day death or cardiovascular/renal readmission and 90-day mortality in the PROTECT study (Placebo-Controlled Randomized Study of the Selective A1 Adenosine Receptor Antagonist Rolofylline for Patients Hospitalized With Acute Decompensated Heart Failure and Volume Overload to Assess Treatment Effect on Congestion and Renal Function). Daily creatinine changes from baseline were categorized as WRF (an increase of 0.3 mg/dL or more) or not. Daily congestion scores were computed by summing scores for orthopnea, edema, and jugular venous pressure. Of the 2033 total patients randomized, 1537 patients had both available at study day 14. Length of hospital stay was longer and 30-day cardiovascular/renal readmission or death more common in patients with WRF. However, these were driven by significant associations in patients with concomitant congestion at the time of assessment of renal function. The mean difference in length of hospital stay because of WRF was 3.51 (95% confidence interval, 1.29–5.73) more days ( P =0.0019), and the hazard ratio for WRF on 30-day death or heart failure hospitalization was 1.49 (95% confidence interval, 1.06–2.09) times higher ( P =0.0205), in significantly congested than nonsignificantly congested patients. A similar trend was observed with 90-day mortality although not statistically significant. Conclusions: In patients admitted for acute heart failure, WRF defined as a creatinine increase of ≥0.3 mg/dL was associated with longer length of hospital stay, and worse 30- and 90-day outcomes. However, effects were largely driven by patients who had residual congestion at the time of renal function assessment. Clinical Trial Registration : URL: https://www.clinicaltrials.gov . Unique identifiers: NCT00328692 and NCT00354458.
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- 2018
3. Spirituality
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Tracey Hawkins, Daphne Sharp, Christopher L. Edwards, Janice Collins-McNeil, and Melanie McCabe
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Advanced Practice Nursing ,Health Knowledge, Attitudes, Practice ,Primary Health Care ,business.industry ,Advanced practice nursing ,General Medicine ,Primary care ,Christianity ,Team nursing ,Nursing ,Spirituality ,Humans ,Medicine ,Nursing Staff ,Philosophy, Nursing ,Nurse education ,business - Published
- 2015
4. Is Worsening Renal Function an Ominous Prognostic Sign in Patients With Acute Heart Failure?
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Barbara Piovanelli, Valentina Lazzarini, Valentina Carubelli, Silvia Bugatti, Christopher L. Edwards, Luca Bettari, Marco Metra, Beth A. Davison, Hengrui Sun, Livio Dei Cas, Gad Cotter, and Carlo Lombardi
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Male ,medicine.medical_specialty ,acute heart failure ,Renal function ,Kidney ,chemistry.chemical_compound ,Internal medicine ,medicine ,Humans ,In patient ,Intensive care medicine ,Survival rate ,renal function, acute heart failure ,Aged ,Retrospective Studies ,Aged, 80 and over ,Heart Failure ,Creatinine ,business.industry ,renal function ,Follow up studies ,Retrospective cohort study ,Middle Aged ,Prognosis ,medicine.disease ,Survival Rate ,chemistry ,Heart failure ,Acute Disease ,Multivariate Analysis ,Cardiology ,Female ,Risk of death ,Cardiology and Cardiovascular Medicine ,business ,Biomarkers ,Follow-Up Studies - Abstract
Background— Worsening renal function (WRF), traditionally defined as an increase in serum creatinine levels ≥0.3 mg/dL, is a frequent finding in patients with acute heart failure (AHF) and has been associated with poorer outcomes in some but not all studies. We hypothesized that these discrepancies may be caused by the interaction between WRF and congestion in AHF patients. Methods and Results— We measured serum creatinine levels on a daily basis during the hospitalization and assessed the persistence of signs of congestion at discharge in 599 consecutive patients admitted at our institute for AHF. They had a postdischarge mortality and mortality or AHF readmission rates of 13% and 43%, respectively, after 1 year. Patients were subdivided into 4 groups according to the development or not of WRF and the persistence of ≥1 sign of congestion at discharge. Patients with WRF and no congestion had similar outcomes compared with those with no WRF and no congestion, whereas the risk of death or of death or AHF readmission was increased in the patients with persistent congestion alone and in those with both WRF and congestion (hazard ratio, 5.35; 95% confidence interval, 3.0–9.55 at univariable analysis; hazard ratio, 2.44; 95% confidence interval, 1.24–4.18 at multivariable analysis for mortality; hazard ratio, 2.14; 95% confidence interval, 1.39–3.3 at univariable analysis; and hazard ratio, 1.39; 95% confidence interval, 0.88–2.2 at multivariable analysis for mortality and rehospitalizations). Conclusions— WRF alone, when detected using serial serum creatinine measurements, is not an independent determinant of outcomes in patients with AHF. It has an additive prognostic value when it occurs in patients with persistent signs of congestion.
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- 2012
5. Psychologic Factors in the Development of Complex Regional Pain Syndrome: History, Myth, and Evidence
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Christopher L. Edwards and Miriam Feliu
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Psychotherapist ,History, 18th Century ,History, 21st Century ,History, 17th Century ,Psychological Theory ,medicine ,Humans ,Zeitgeist ,Evidence-Based Medicine ,business.industry ,Perspective (graphical) ,Chronic pain ,Historical Article ,History, 19th Century ,Evidence-based medicine ,History, 20th Century ,Mythology ,medicine.disease ,Anesthesiology and Pain Medicine ,Complex regional pain syndrome ,History, 16th Century ,Etiology ,Neurology (clinical) ,business ,Neuroscience ,Complex Regional Pain Syndromes - Abstract
Objective: The present paper examines the literature that addresses psychologic aspects involved in complex regional pain syndrome from a historic perspective to provide a rationale for the emergence of psychologic theories to explain its pathogenesis. The support of such perspective is then analyzed through the review of evidencebased studies. Methods: A review of the literature from a historic perspective was presented since its first description to the present time, including the clinical presentation and associated symptoms. An evidence-based approach was used to review the literature on complex regional pain syndrome and psychologic factors associated with the etiology or as predictors in the development of the disorder. Results: After reviewing the literature on the history and the myths associated with complex regional pain syndrome, a hypothesis is provided based on an analysis of the Zeitgeist in the development of the psychologic theory associated with the disorder. We also concluded there is no evidence to support a linear relationship that establishes a psychologic predisposition to develop the disorder. Discussion: An analysis of the Zeitgeist when complex regional pain syndrome was first described helps to understand the long-standing theories associated with a psychological theory of its etiology. This understanding should help to undermine the perpetuation of such claims which may contribute to undertreatment and misdiagnosis. To be consistent with today s Zeitgeist we must incorporate psychologic aspects, which while not causal in nature or exclusive of complex regional pain syndrome, are strongly associated with a wide spectrum of chronic pain disorders.
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- 2010
6. Religiosity/Spirituality and Pain in Patients With Sickle Cell Disease
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Laura DeCastro, Harold G. Koenig, M. Ojinga Harrison, Christopher L. Edwards, Hayden B. Bosworth, and Mary Wood
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Adult ,Male ,Religion and Psychology ,Coping (psychology) ,medicine.medical_specialty ,Adolescent ,Pain ,Anemia, Sickle Cell ,Disease ,Severity of Illness Index ,Religiosity ,Adaptation, Psychological ,Severity of illness ,Spirituality ,Ambulatory Care ,medicine ,Humans ,Psychiatry ,Aged ,Pain Measurement ,Psychiatric Status Rating Scales ,Church attendance ,business.industry ,Middle Aged ,medicine.disease ,Mental health ,humanities ,Sickle cell anemia ,Black or African American ,Religion ,Psychiatry and Mental health ,Quality of Life ,Female ,business ,Stress, Psychological ,Follow-Up Studies - Abstract
Religion/spirituality has been identified by individuals with sickle cell disease (SCD) as an important factor in coping with stress and in determining quality of life. Research has demonstrated positive associations between religiosity/spirituality and better physical and mental health outcomes. However, few studies have examined the influence religiosity/spirituality has on the experience of pain in chronically ill patients. Our aim was to examine three domains of religiosity/spirituality (church attendance, prayer/Bible study, intrinsic religiosity) and evaluate their association with measures of pain. We studied a consecutive sample of 50 SCD outpatients and found that church attendance was significantly associated with measures of pain. Attending church once or more per week was associated with the lowest scores on pain measures. These findings were maintained after controlling for age, gender, and disease severity. Prayer/Bible study and intrinsic religiosity were not significantly related to pain in our study. Positive associations are consistent with recent literature, but our results expose new aspects of the relationship for African American patients. We conclude that religious involvement likely plays a significant role in modulating the pain experience of African American patients with SCD and may be an important factor for future study in other populations of chronically ill pain sufferers.
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- 2005
7. Reliability, Validity, and Responsiveness of the Short Form 12-Item Survey (SF-12) in Patients With Back Pain
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Ricardo Pietrobon, Xuemei Luo, Mandy Lynn George, Ikey Kakouras, Christopher L. Edwards, Lloyd A. Hey, and William J. Richardson
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Male ,medicine.medical_specialty ,Severity of Illness Index ,Disability Evaluation ,Patient satisfaction ,Physical medicine and rehabilitation ,Quality of life ,Cronbach's alpha ,Surveys and Questionnaires ,Back pain ,Humans ,Medicine ,Orthopedics and Sports Medicine ,Reliability (statistics) ,Academic Medical Centers ,Item analysis ,business.industry ,Reproducibility of Results ,Construct validity ,Middle Aged ,Health Surveys ,United States ,Back Pain ,Patient Satisfaction ,Sample size determination ,Sample Size ,Quality of Life ,Physical therapy ,Female ,Neurology (clinical) ,medicine.symptom ,business ,Follow-Up Studies - Abstract
Study design Secondary analysis of data collected from spine patients' normal clinic visits from 1998 to 2001. Objective To evaluate the reliability, validity, and responsiveness of the short form 12-item survey in patients with back pain. Summary of background data The reliability, validity, and responsiveness of the short form 12-item survey in patients with back pain has not been previously evaluated. Methods Patients were asked to complete a comprehensive computerized survey questionnaire during their regular clinic visits. A total of 2520 patients who indicated in their first surveys that they had back pain were included in the study of the reliability and validity of the short form 12-item survey. Of these, 506 patients completed another survey within 3-6 months of follow-up and were included in the responsiveness evaluation. Results The two summary scales of the short form 12-item survey, physical component summary and mental component summary, demonstrated internal consistency reliability, with Cronbach alpha for both scales exceeding the recommended level of 0.70. Correlation of physical component summary and mental component summary with six other measures theoretically related or unrelated to these scales performed as expected without exception, demonstrating the construct validity of the short form 12-item survey. The responsiveness of the short form 12-item survey was supported by several pieces of evidence. First, the changes in physical component summary and mental component summary scores were correlated with the changes in back pain intensity. Second, for patients whose back pain improved, there was a significant increase in the follow-up physical component summary and mental component summary scores as compared to the baseline. Third, small to moderate effect size was observed for patients whose back pain became improved or became worse. Conclusions The short form 12-item survey demonstrated good internal consistency reliability, construct validity, and responsiveness in patients with back pain.
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- 2003
8. Race, ethnicity and pain
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Christopher L. Edwards, Francis J. Keefe, and Roger B. Fillingim
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Gerontology ,Race ethnicity ,Operational definition ,business.industry ,Culture ,Clinical pain ,Chronic pain ,Ethnic group ,MEDLINE ,Pain ,medicine.disease ,White People ,Black or African American ,Race (biology) ,Anesthesiology and Pain Medicine ,Neurology ,medicine ,Humans ,Pain psychology ,Perception ,Neurology (clinical) ,business - Abstract
The current paper provides a brief overview of research on the effects of race and ethnicity on pain. More specifically, the article reviews the utility of the concepts of race and ethnicity for pain research, suggests operational definitions of race and ethnicity, reviews the literature on the effects of race and ethnicity on laboratory and clinical pain, and provides suggestions for future research.
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- 2001
9. LONG-TERM EFFICACY OF SIMPLE BEHAVIORAL THERAPY FOR DAYTIME WETTING IN CHILDREN
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John S. Wiener, Lowell R. King, Jason Hampton, Christopher L. Edwards, Richard S. Surwit, and Mischca T. Scales
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Male ,medicine.medical_specialty ,Adolescent ,medicine.medical_treatment ,Urology ,Behavioral therapy ,Drinking ,Urination ,Urinary incontinence ,Biofeedback ,Fluid intake ,Patient satisfaction ,Behavior Therapy ,Surveys and Questionnaires ,medicine ,Humans ,Longitudinal Studies ,Child ,Physical Therapy Modalities ,Pelvic floor ,business.industry ,Pelvic Floor ,Clinic visit ,medicine.anatomical_structure ,Treatment Outcome ,Urinary Incontinence ,Patient Satisfaction ,Child, Preschool ,Urinary Tract Infections ,Physical therapy ,Female ,medicine.symptom ,business ,Attitude to Health ,Reinforcement, Psychology ,After treatment ,Follow-Up Studies - Abstract
Behavioral therapy has proved benefit for children with daytime wetting but most studies have used biofeedback techniques and provide no long-term assessment of results. We previously reported similar results using simple behavioral therapy without biofeedback. We report the long-term efficacy of behavioral therapy for daytime wetting.Our program of behavioral therapy included timed voiding, modification of fluid intake, positive reinforcement techniques and pelvic floor (Kegel) exercises to promote pelvic floor strengthening and relaxation. Questionnaires to assess therapeutic efficacy were mailed to patients who had completed therapy more than 1 year previously.A total of 48 patients responded. Mean ages at the time of the initial clinic visit and questionnaire were 8.2 and 12.9 years, respectively. Improvement in symptoms was noted in approximately 74% of the cases during the first year following therapy. At a mean of 4. 7 years after treatment 59.4% of the patients had improved daytime urinary control, 51.1% improved daytime urinary frequency and 45.6% improved daytime urinary urgency. The frequency of urinary tract infections decreased in 56.4% of the cases. Measures of psychological well-being were also noted to be improved in a majority of patients. A total of 77.3% of the patients stated that they would recommend the program to others.Simple behavioral therapy without biofeedback techniques is an effective and durable first line therapy for children with daytime wetting.
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- 2000
10. Response to Letter Regarding Article, 'Is Worsening Renal Function an Ominous Prognostic Sign in Patients With Acute Heart Failure? The Role of Congestion and Its Interaction With Renal Function'
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Carlo Lombardi, Christopher L. Edwards, Gad Cotter, Silvia Bugatti, Barbara Piovanelli, Valentina Lazzarini, Beth A. Davison, Valentina Carubelli, Luca Bettari, Livio Dei Cas, Hengrui Sun, and Marco Metra
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medicine.medical_specialty ,Kidney ,Creatinine ,Poor prognosis ,business.industry ,Hemodynamics ,Renal function ,medicine.disease ,chemistry.chemical_compound ,medicine.anatomical_structure ,chemistry ,Internal medicine ,Heart failure ,Cardiology ,Medicine ,In patient ,Cardiology and Cardiovascular Medicine ,business ,Intensive care medicine ,Perfusion - Abstract
We thank the authors for their interest in our study. Its main message is that short-term increases in serum creatinine, such as those that can be detected in patients undergoing aggressive diuretic treatment for acutely decompensated heart failure, do not necessarily predict a poor prognosis because they may be secondary to hemodynamic mechanisms (renal hypoperfusion and arterial underfilling) related to aggressive diuretic treatment in the absence of a persistent kidney injury.1 Data in the literature are controversial with respect to the prognostic significance of short-term serum creatinine changes. When serum creatinine levels were not assessed prospectively in every patient,2,3 …
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- 2012
11. New directions in research on pain and ethnicity: a comment on Riley, Wade, Myers, Sheffield, Pappas, and Price (2002)
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Christopher L. Edwards and Francis J. Keefe
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Anesthesiology and Pain Medicine ,Psychoanalysis ,Neurology ,Ethnic group ,Neurology (clinical) ,Psychology - Published
- 2002
12. In response to Treatment of central post-stroke pain with oral ketamine by Pamela G. Vick and Tim J. Lamer
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Wendy Webster and Christopher L. Edwards
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Anesthesiology and Pain Medicine ,Neurology ,business.industry ,Anesthesia ,Medicine ,Central post-stroke pain ,Ketamine ,Neurology (clinical) ,business ,medicine.disease ,Stroke ,Response to treatment ,medicine.drug - Published
- 2002
13. LONG TERM EFFICACY OF BEHAVIORAL TREATMENT OF DIURNAL ENURESIS (DE) IN CHILDREN
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John S. Wiener, Lowell R. King, Jason Hampton, Richard S. Surwit, Renee H. Dunn, and Christopher L. Edwards
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Pediatrics ,medicine.medical_specialty ,business.industry ,Urology ,Behavioral treatment ,medicine ,Diurnal enuresis ,medicine.symptom ,business ,Term (time) - Published
- 1999
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