Buckner‐Petty, Skye

Background/Introduction: More than moderate tricuspid regurgitation (TR) at baseline is associated with worse outcome in MitraClip patients. The presence of iatrogenic ASD (iASD) may cause right-sided volume overload and lead to adverse events. However, the real effects of iASD are not well-investigated in these patients who are vulnerable to right-sided volume overload. Methods: Patients with more than moderate TR who underwent a successful MitraClip procedure in the period from June 2014 to September 2020 were identified from the Mayo institutional NCDR database. Follow-up transthoracic echocardiography (TTE) at about 1 year after the procedure was used to determine the presence of iASD, and speckle-tracking strain analysis was done. Patients were grouped according to the presence of iASD (iASD+ group vs. iASD- group) for statistical analysis. Results: A total of 141 consecutive patients were included for the final analysis (iASD+ group n=44 and iASD- group n=97). The mean age was 79.3 ± 8.8 years, and 72.3% were male. Follow-up echocardiography and speckle-tracking strain data did not show a significant difference in either left or right ventricular function in conventional echocardiographic parameters and strain. LA reservoir strain (13.7 ± 6.9 vs 11.5±7.5, P=0.0418) was the only parameter with significant difference among the two groups. Details are summarized in Table 1 . Conclusion: The presence of iASD can decompress the left atrium, but does not affect left or right ventricular strain function in MitraClip patients with more than moderate baseline TR.

Abstract Purpose: To assess the quantitative and qualitative components of in-person focus groups as a potential intervention for female patients with urinary incontinence.Methods: Women over the age of 18 seeking treatment for UI were randomized to standard care with focus group participation or to standard care alone. All participants completed validated questionnaires: MESA, UDI-6, OAB-SAT-q, PGI-S, PGI-I, SQoL-F, PHQ-9, IPAQ at the beginning and conclusion of the study. Questionnaires were analyzed with repeated measures of ANOVA models in an intention-to-treat manner. Three moderated focus group sessions were held and audio recorded. Recordings were transcribed and categorized by frequency into themes using grounded theory methodology. Results: A total of 10 control and 8 intervention participants agreed to participate. Seven women attended all three focus group sessions and were included in the final analysis. Transcripts from focus group sessions observed women identified most with (1) urinary incontinence (UI) as a chronic disease, (2) shame managing UI, and (3) social constraints of toileting. Participants self-reported appreciation of focus group participation and desire for on-going sessions. Analysis of the questionnaires did not demonstrate statistically significant differences.Conclusion: Data ascertained from questionnaires was unable to demonstrate a meaningful effect in improved treatment outcomes for control and intervention participants. Grounded theory analysis of transcripts identified four primary themes: (1) appreciation of the focus group, (2) UI as a gendered issue, (3) lack of public awareness, and (4) history of negative provider interactions. All focus group participants self-reported interest in attending future focus group sessions.

Abstract Background To assess the feasibility and acceptability of in-person support groups as a potential intervention for female patients with urinary incontinence. Methods Women over the age of 18 seeking treatment for UI were randomized to standard care with support group participation or to standard care alone. All participants completed validated questionnaires at the beginning and conclusion of the study. Questionnaires were analyzed with repeated measures of ANOVA models in an intention-to-treat manner. Three moderated support group sessions were held and audio recorded. Recordings were transcribed and categorized by frequency into themes using grounded theory methodology. Results A total of 10 control and 8 intervention participants agreed to participate. Seven women attended all three support group sessions and were included in the final analysis. Transcripts from support group sessions observed women identified most with (1) urinary incontinence (UI) as a chronic disease, (2) shame managing UI, and (3) social constraints of toileting. Support participants self-reported appreciation of support group participation and desire for on-going sessions. Analysis of the questionnaires did not demonstrate statistically significant differences. Conclusion Data ascertained from questionnaires was unable to demonstrate a meaningful effect in improved treatment outcomes for control and intervention participants. Grounded theory analysis of transcripts identified four primary themes: (1) appreciation of the support group, (2) UI as a gendered issue, (3) lack of public awareness, and (4) history of negative provider interactions. All support group participants self-reported interest in attending future support group sessions.

Although recent studies have explored the potential of multidomain brain health programs, there is a dearth of literature on operationalizing this research to create a clinical treatment program specifically for subjective cognitive decline (SCD). Patients seen by geriatricians in primary care and by behavioral neurology services at our institution presenting with SCD were recruited via a patient-appropriate flyer. After all participants had a 1-h brain health consultation with a neuropsychologist and were provided with program materials, they were randomized to attend a 10-week intervention designed to support program implementation (N = 10) or the control group of implementing the program on their own (N = 11). The program included (1) a calendar-based executive and memory support system for compensatory training and (2) training in healthy lifestyle. There were no significant differences between groups for any outcomes. Participants across both groups showed significant improvements with moderate effect sizes in compensatory strategy use, anxiety symptoms, and daily functioning, which were sustained through 6-month follow-up. They also increased physical activity by the end of the intervention period but did not sustain this through 6-month follow-up. Our pilot study demonstrates preliminary feasibility of a cognitive compensatory and lifestyle-based brain health program. Additional research is recommended to further develop two potentially scalable implementation strategies—coaching and self-implementation after brief consultation.

Multiple Myeloma (MM) is a hematological malignancy resulting in abnormal plasma cells proliferating in the bone marrow. One of the most common treatment strategies for newly diagnosed MM is the combination of induction therapy followed by autologous stem cell transplant (ASCT). Due to the underlying disease and/or the effect of the treatment regimens administered, immunosuppression is a common clinical consequence. It has been shown that ASCT recipients, treated with traditional compounds, have a reduction in the levels of antibody titers to vaccine-preventable diseases such as measles, mumps and rubella (MMR), between one and four years post-transplant. Therefore, re-vaccination is recommended at least two years after ASCT. Therapeutic options have expanded in the past decade, with the introduction of novel agents that have significantly improved MM patient outcomes; however, this may also arguably have new and different implications on a patient's immune system. In this study we sought to analyze the presence of IgG antibodies against MMR in 110 patients with MM post-ASCT. All patients received ASCT between 2014 and 2019 at Mayo Clinic Arizona. Plasma samples were collected approximately 100 days after ASCT (median 92 days) and the antibody titers were tested using the Bio-Rad MMR IgG multiplex flow immunoassay. Sample antibody index values were compared with the assay-specific calibration to determine positivity. For a control population, we utilized the results of fully vaccinated and presumptively immune healthcare workers (HCWs) that were evaluated for the presence of antibodies to measles (n=199), mumps (n=197) and rubella (n=209), using the same method, instrument and laboratory. Overall, 70% of the MM patients were positive for antibodies against measles, compared with 77.4% of HCWs. For mumps, the MM cohort had a positivity of 49.1% versus 84.8% of HCWs. Finally, rubella antibodies were found in 64.5% and 83.7% of MM and HWCs, respectively. Next, we performed testing on serial samples collected from 45 MM patients, comparing the presence of MMR antibodies pre-ASCT (median 130 days) and post-ASCT. The number of patients with positive titers detected pre- and post-transplant was unchanged for each of the three viruses. In summary, our findings do not indicate a significant reduction in relative MMR antibody levels in ASCT recipients. This suggests that earlier re-vaccination is not required post-ASCT in the era of novel MM compounds. However, further validation studies in larger cohorts are necessary prior to considering a change in current vaccination guidelines. Disclosures Braggio: DASA: Consultancy; Bayer: Other: Stock Owner; Acerta Pharma: Research Funding. Fonseca:Janssen: Consultancy; Takeda: Consultancy; Novartis: Consultancy; Bayer: Consultancy; Sanofi: Consultancy; Merck: Consultancy; Pharmacyclics: Consultancy; Amgen: Consultancy; BMS: Consultancy; Celgene: Consultancy; Juno: Consultancy; Kite: Consultancy; Aduro: Consultancy; OncoTracker: Consultancy, Membership on an entity's Board of Directors or advisory committees; Oncopeptides: Consultancy; GSK: Consultancy; AbbVie: Consultancy; Adaptive Biotechnologies: Membership on an entity's Board of Directors or advisory committees.