Page 12 - Mecklenburg_Medicine_April-2020

At the Hospitals
n Levine Children’s Hospital Study to
Guide National Tuberculosis Testing
for Children
Amina Ahmed, MD, professor of pediatric
infectious disease and immunology at Levine
Children’s Hospital, is the lead
author of a recently published
four-year study to evaluate the
effectiveness of blood tests for
tuberculosis in children of all
ages, including those younger
Amina Ahmed,MD than 2.
“For more than 100 years, physicians and
experts have relied on the tuberculin skin test
(TST) to screen for TB infection. However,
it’s important to remember we get a lot of false
positive results with TSTs, especially in the
BCG-vaccinated population,” says Dr. Ahmed.
BCG, or Bacille Calmette-Guerin, is a
vaccine for TB disease, given to children born
in countries with a high prevalence of TB to
prevent meningitis and miliary disease. BCG-
vaccinated children are more likely to receive
a false positive TST result due to cross reaction
between the vaccine and proteins in the TST.
This can lead to treating children unnecessarily.
The American Academy of Pediatrics has
recommended the skin test rather than a blood
test for children under 2 years of age due to lack additional beds being relocated from the current facility. Other floors of the structure will serve
of data on the performance of the blood tests in
this younger population.
Ahmed and a team of researchers, with the
support of the CDC Tuberculosis Epidemiologic
Studies Consortium (TBESC), tested thousands
of children with the skin test and blood tests and
followed them to see who developed disease.
“We enrolled almost 3,600 children under the age
of 15, most of whom were born outside the United
States,” says Ahmed. “We followed the children
tested for a median of four years, and of 533
children whose skin test read positive and blood
test negative who were not treated for infection,
none of them went on to develop disease.”
She continues, “Ultimately, we learned both
types of these tests poorly predict progression
to TB disease in most cases. The negative-
predictive value of the blood tests, however, is
high, meaning we are not likely to miss infection
12 | April 2020 • Mecklenburg Medicine
with negative results. Furthermore, by using identify malnutrition sooner, a malnutrition
the blood tests, we’re less likely to receive false screening tool is incorporated into patients’
positive results as with the TST, with a consequent appointments. If this screening indicates a
reduction in over-diagnosis and over-treatment of patient is potentially malnourished, they are
latent tuberculosis infection in children not born referred to a team of 14 dietitians who specialize
in the United States.” in helping cancer patients.
The study concludes blood tests can be used A dietitian reviews the patient’s chart
on children of all ages. and evaluates their nutrition status based on
phenotypic criteria like weight loss, low BMI
n Helping Cancer Patients Overcome and reduced muscle mass, and on etiologic
Malnutrition With Early Screening criteria such as reduced food intake and
inflammation. This enables the dietitian to
Levine Cancer Institute has launched one of the identify malnutrition, assess its severity and
nation’s first comprehensive programs to prevent schedule one-on-one appointments with
and overcome malnutrition in cancer patients. any patients who need help. The team also
From standardized screening to personalized addresses treatment-related side effects, like
nutrition planning, the effort is spearheading nausea or taste changes, and with support that’s
ways to help patients stay healthier and stronger. tailored to each patient’s unique needs.
Malnutrition can weaken a patient’s response These nutritional interventions can be literal
to treatment, decrease quality of life and make it lifesavers — research shows that patients
harder to fight infections. Making matters worse, who receive nutritional intervention tolerate
it can lead to cancer cachexia (CC) — a disorder chemotherapy better, boosting their chances
characterized by muscle loss, diminished of survival. And nutritional help continues
immune function and impaired physical function. once treatment is over with classes on weight
Some estimates indicate that CC is responsible management, healthy cooking and eating well
for 20 to 30 percent of cancer-related deaths. after cancer.
Recognizing that early screening could help
Atrium Health Breaks Ground on New Hospital, Bed Tower
Groundbreakings recently were held for two new Atrium Health facilities that will expand
quality health care to two rapidly growing areas of metropolitan Charlotte.
In the western Union County community of Stallings, construction began for Atrium
Health Union West, an extension of Atrium Health Union in Monroe. With an expected
completion in early 2022, the 150,000-square-foot hospital will include 40 licensed acute
care beds, 10 emergency department bays, two operating rooms, a gastrointestinal endoscopy
suite, C-section operating room, imaging services, laboratory and pharmacy.
The Stallings site also will be home to a 40,000-square-foot medical office building to
house physician practices, including cardiology, oncology, obstetrics, pulmonology, surgery
and internal medicine.
On the campus of Atrium Health Pineville, ground was broken on a 236,000-square-foot,
eight-story patient tower that’s expected to open in late 2021. The new structure will add
38 additional patient beds to overall bed capacity in Mecklenburg County, as well as house
as future expansion space.
In addition to the new patient tower, within the past year Atrium Health Pineville as added
acute care services, such as an additional MRI (magnetic
resonance imaging) machine, maternal fetal medicine, an
epilepsy monitoring unit, a 12-bed observation unit
and cardiothoracic robotic surgery.
Atrium Health UnionWest artist rendering