Kerri Novak

The University of Calgary, Calgary, Alberta, Canada

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Publications (12)47.67 Total impact

  • Stephanie R. Wilson, Kerri L. Novak
    Ultrasound Clinics 10/2014;
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    ABSTRACT: The frequency at which housestaff need to assess volume status on medical inpatients is unknown. In this brief report, we invited 39 housestaff, over 13 randomly selected dates, to complete a 25-item survey. Participants (n = 31, 79%) logged a total of 455 hours, reporting 197 pages or telephone requests received regarding medical inpatients. Of these, 41 pages (21%) required a volume status assessment. Participants reported their volume status assessment competency to be moderate (median score = 3, interquartile range = 3 to 4, where 1 = not competent to perform independently and 6 = above average competence). In 9 of the 41 assessments (22%), at least 1 barrier was reported in determining volume status. The most commonly reported barriers were conflicting physical examination findings (n = 8, 20%) and suboptimal patient examination (n = 5, 12%). Over 20% of pages regarding admitted medical patients required volume status assessments by medical housestaff. Despite moderate self-reported competence in the ability to assess volume status, barriers such as conflicting physical examination findings and suboptimal patient examinations were present in up to 20% of assessments. Therefore, we urge educators to consider incorporating bedside ultrasound training for volume status into the internal medicine curriculum. Journal of Hospital Medicine 2014. © 2014 Society of Hospital Medicine
    Journal of Hospital Medicine 09/2014; · 2.08 Impact Factor
  • Kerri L Novak, Remo Panaccione
    Gastroenterology 12/2013; · 12.82 Impact Factor
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    ABSTRACT: With the expanding list of medications available to treat patients with inflammatory bowel disease (IBD), it is important to recognise adverse events, including those involving the skin. Dermatological adverse events may be confused with extra-intestinal manifestations of IBD. To review drug-related dermatological manifestations associated with immunosuppressive and anti-tumour necrosis factor (anti-TNF) therapy. The literature was searched on PubMed for dermatological adverse events in IBD. Present thiopurine exposure was associated with a 5.9-fold [95% confidence interval (CI), 2.1-16.4] increased risk of developing non-melanoma skin cancer (NMSC). The peak incidence is highest in Caucasians over the age of 65 years with crude incidence rates of 4.0 and 5.7/1000 patient-years for present and previous use. In anti-TNF-exposed subjects, drug-induced lupus was reported in 1% of the cases and a psoriatic rash in up to 3% of the cases. Anti-TNF monotherapy increases the risk of NMSC ~2-fold to a rate of 0.5 cases per 1000 person-years. Cutaneous lymphomas have been rarely reported in subjects on thiopurine or anti-TNF drug monotherapy. Combination therapy seems to have an additive effect on the risk of developing NMSC and lymphoma. Physicians need to be aware of the wide spectrum of dermatological complications of immunosuppressive and anti-TNF therapy in IBD, especially psoriasis and non-melanoma skin cancer. Vigilance and regular screening for non-melanoma skin cancer is recommended. Case discussions between gastroenterologists and dermatologists should be undertaken to best manage dermatological adverse events.
    Alimentary Pharmacology & Therapeutics 11/2013; 38(9):1002-1024. · 4.55 Impact Factor
  • Kerri L Novak, Stephanie R Wilson
    Seminars in roentgenology 07/2013; 48(3):224-233. · 0.70 Impact Factor
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    ABSTRACT: PURPOSE To determinate the added benefit of contrast enhanced ultrasound (CEUS) to an US study with Doppler in the evaluation of disease activity in patients with inflammatory Bowel Disease (IBD). METHOD AND MATERIALS IRB approved retrospective study of 100 patients with suspect active IBD. All patients had baseline grayscale US and color Doppler imaging (CDI) for assessment of classic features of Crohn’s Disease (CD) and CEUS with quantitative measurements of bowel wall enhancement including time to peak, peak enhancement, and time to half washout. Three blind readers (A, B, C) evaluated and graded disease activity on the baseline US. If discordance was noted between wall thickening and color Doppler imaging, the activity was indeterminate. Subsequently, CEUS parameters were given, and activity again estimated. The impact of CEUS was judged as having no contribution, upgrading or downgrading activity. A confidence level was given for both the baseline and CEUS. RESULTS Two groups were identified after baseline US. A concordant group Reader A= 60/100; B= 60/100; C= 66/100 showed equivalent disease activity based on the classic features and subjective evaluation of blood flow on CDI. CEUS did not significantly change patients activity level, if the disease was moderate to severe A=36/60, B=42/60, C=32/66. An upgrade was observed in a small portion A=23%; B= 23%; C=36%, and clinically significant in only A=7%; B=6%; C=21%. A smaller discordant group A= 40/100; B= 40/100; C=34/100 showed mismatch of Doppler signals with the classic features of CD, limiting the prediction of disease activity, resulting in low confidence levels A= 20%, B=15%, C= 6%. In this group, the performance of CEUS resulted in an upgrade of disease activity A=90%; B=95%; C=88%. Of these, a clinical significant change was observed in A=55%, B=60%, C=30%. The overall confidence level for all readers increased after the addition of CEUS A = 64%, B = 58%, and C = 68% with the overwhelming majority in the discordant group. CONCLUSION CEUS may be selectively performed to determine disease activity in CD. Baseline US with CDI predicting moderate or severe disease will rarely be altered with CEUS. Indeterminate activity predicted in large patients with deep bowel will often be upgraded by CEUS, improving confidence levels. CLINICAL RELEVANCE/APPLICATION CEUS is best used selectively to determinate disease activity in IBD when discordant results are observed in gray-scale and CDI.
    Radiological Society of North America 2012 Scientific Assembly and Annual Meeting; 11/2012
  • Kerri L Novak, Stephanie R Wilson
    Journal of ultrasound in medicine: official journal of the American Institute of Ultrasound in Medicine 08/2012; 31(8):1147-52. · 1.40 Impact Factor
  • Gastroenterology 01/2011; 140(5). · 12.82 Impact Factor
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    Inflammatory Bowel Diseases 10/2008; 14 Suppl 2:S247-8. · 5.12 Impact Factor
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    Kerri Novak, Mark G Swain
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    ABSTRACT: This article examines the therapeutic potential of methotrexate (MTX) in the treatment of cholestatic liver disease, with specific reference to its use in primary biliary cirrhosis (PBC) and primary sclerosing cholangitis (PSC). In PBC patients, evidence suggests that a particular subset of patients may benefit, either biochemically or symptomatically, from the addition of MTX to their therapeutic regimen. How best to define these potential MTX responders remains unclear, but may warrant a "therapeutic trial" in some patients with more aggressive disease or in patients with refractory and disabling PBC-related symptoms. In contrast, PSC continues to be an immensely challenging disease to effectively treat, and the role of MTX for treating PSC patients remains dubious.
    Clinics in Liver Disease 03/2008; 12(1):81-96, viii. · 2.70 Impact Factor
  • Inflammatory Bowel Diseases 01/2008; 14(Supplement):S247-S248. · 5.48 Impact Factor
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    ABSTRACT: Background: If experienced physicians apply clinical rather than biomedical knowledge when diagnosing, why do we use the basic sciences as the foundation for clinical teaching? In this study our objective was to evaluate the contribution of biomedical knowledge to diagnostic performance.