Medicine and Health Sciences Commons^™

Barriers To The Diagnosis, Care, And Management Of Pediatric Patients With Ehlers-Danlos Syndrome In The United States: A Qualitative Analysis., William R. Black, Lora L. Black, Jordan T. Jones

Manuscripts, Articles, Book Chapters and Other Papers

Objectives: Ehlers-Danlos Syndromes (EDS) are a family of heritable connective tissue diseases. Primary practitioners are capable of diagnosing and managing EDS; however, few are knowledgeable and comfortable enough to see patients with EDS, resulting in delays in diagnosis and care. This study explores the barriers physicians experience with diagnosing, managing, and caring for patients with EDS, and potential resolutions to those barriers. Methods: As part of a larger online study, providers (n = 107) in the United States were asked to specify "What information would improve (their) comfort" in diagnosing, caring for, and managing EDS via open-ended questions. Results …

Texas Youth Depression And Suicide Research Network (Tx-Ydsrn) Research Registry And Learning Healthcare Network: Rationale, Design, And Baseline Characteristics, Madhukar H. Trivedi, Abu Minhajuddin, Holli Slater, Regina Baronia, Joseph C. Blader, Jamon Blood, Ryan Brown, Cynthia Claassen, Melissa Defilippis, Cynthia Garza

School of Medicine Publications and Presentations

Highlights

• TX-YDSRN will improve understanding of youth with depression and suicidal behaviors.

• TX-YDSRN consists of the UT Southwestern Network Hub and 12 medical school “Nodes”.

• The Research Registry will follow 2500 Texas youth for 2 years.

• This report includes the first 1000 youth enrolled in the Research Registry study.

Abstract

Background

American youth are seriously impacted by depression and suicide. The Texas Youth Depression and Suicide Research Network (TX-YDSRN) Participant Registry Study was initiated in 2020 to develop predictive models for treatment outcomes in youth with depression and/or suicidality. This report presents the study rationale, design and baseline characteristics of …

Hypertrophic Cardiomyopathy Diagnosis And Treatment In High- And Low-Income Countries: A Narrative Review, Ernesto Calderon Martinez, Nancy Y. Ortiz-Garcia, Domenica A. Herrera Hernandez, David Arriaga Escamilla, Diana L. Diaz Mendoza, Diana Othon, Luz M. Ramirez, Jonathan Reyes-Rivera, Jinal Choudhari, George Michel

School of Medicine Publications and Presentations

Hypertrophic cardiomyopathy (HCM) is a hereditary cardiac condition characterized by unexplained left ventricular hypertrophy without a hemodynamic cause. This condition is prevalent in the United States, resulting in various clinical manifestations, including diastolic dysfunction, left ventricular outflow obstruction, cardiac ischemia, and atrial fibrillation. HCM is associated with several genetic mutations, with sarcomeric mutations being the most common and contributing to a more complex disease course. Early diagnosis of HCM is essential for effective management, as late diagnosis often requires invasive treatments and creates a substantial financial burden. Disparities in HCM diagnosis and treatment exist between highincome and low-income countries. High-income …

Autophagy Modulation And Its Implications On Glioblastoma Treatment, Johnny Chen, Andrea Salinas Rodriguez, Maximiliano Arath Morales, Xiaoqian Fang

School of Medicine Publications and Presentations

Autophagy is a vital cellular process that functions to degrade and recycle damaged organelles into basic metabolites. This allows a cell to adapt to a diverse range of challenging conditions. Autophagy assists in maintaining homeostasis, and it is tightly regulated by the cell. The disruption of autophagy has been associated with many diseases, such as neurodegenerative disorders and cancer. This review will center its discussion on providing an in-depth analysis of the current molecular understanding of autophagy and its relevance to brain tumors. We will delve into the current literature regarding the role of autophagy in glioma pathogenesis by exploring …

The Public Health Impact Of Paxlovid Covid-19 Treatment In The United States, Yuan Bai, Zhanwei Du, Lin Wang, Eric H. Y. Lau, Isaac Fung, Petter Holme, Ben Cowling, Alison Galvani, Robert Krug, Lauren Ancel Meyers

Department of Biostatistics, Epidemiology, and Environmental Health Sciences Faculty Publications

The antiviral drug Paxlovid has been shown to rapidly reduce viral load. Coupled with vaccination, timely administration of safe and effective antivirals could provide a path towards managing COVID-19 without restrictive non-pharmaceutical measures. Here, we estimate the population-level impacts of expanding treatment with Paxlovid in the US using a multi-scale mathematical model of SARS-CoV-2 transmission that incorporates the within-host viral load dynamics of the Omicron variant. We find that, under a low transmission scenario (Re∼1.2) treating 20% of symptomatic cases would be life and cost saving, leading to an estimated 0.26 (95% CrI: 0.03, 0.59) million hospitalizations averted, 30.61 (95% …

Global Blood Pressure Screening During The Covid-19 Pandemic: Results From The May Measurement Month 2021 Campaign, Thomas Beaney, Wei Wang, Markus P Schlaich, Aletta E Schutte, George S Stergiou, Luis Alcocer, Jafar Alsaid, Alejandro Bimbo Diaz, Rafael Hernandez-Hernandez, Mohammad Ishaq, Jacek Jozwiak, Nadia Khan, Gaia Kiru, Harsha Mccardle, Augustine Nonso Odili, Wook Bum Pyun, Cesar A Romero, Jiguang Wang, Neil R Poulter, Mmm Investigators

Journal Articles

BACKGROUND: Raised blood pressure (BP) remains the biggest risk factor contributing to the global burden of disease and mortality, despite the COVID-19 pandemic. May Measurement Month (MMM), an annual global screening campaign aims to highlight the importance of BP measurement by evaluating global awareness, treatment and control rates among adults with hypertension. In 2021, we assessed the global burden of these rates during the COVID-19 pandemic.

METHODS: Screening sites were set up in 54 countries between May and November 2021 and screenees were recruited by convenience sampling. Three sitting BPs were measured, and a questionnaire completed including demographic, lifestyle and …

Paradoxical Tumor Necrosis Factor-Alpha (Tnf-Α) Inhibitor-Induced Psoriasis: A Systematic Review Of Pathogenesis, Clinical Presentation, And Treatment., Aditi Chokshi, Michelle Demory Beckler, Anita Laloo, Marc M. Kesselman

HPD Articles

Tumor necrosis factor-alpha (TNF-α) inhibitors have been shown to be well tolerated among patients with rheumatoid arthritis, inflammatory bowel disease, and psoriasis. Meanwhile, more recently, clinical practice and research efforts have uncovered increasing cases of psoriatic lesion development tied to initiating treatment with a TNF-α inhibitor. The underlying mechanisms associated with this occurrence have yet to be fully elucidated. A review and analysis of cases of paradoxical psoriasis currently published in the literature is warranted. In addition, exploring possible mechanisms of action and potential treatment options associated with favorable outcomes is much needed. A systematic literature review was performed utilizing …

Group B Streptococcus: A New Perspective, Susan Harris

MSN Capstone Projects

Group B streptococcus (GBS) is a major cause of illness and death in young infants across the nation. Current guidelines suggest pregnant women should be screened from thirty-five-to- thirty-seven-weeks gestation. Although screening may be negative at that time, the expectant mother could become colonized with GBS before delivery. GBS is a pathogen that lives in the gastrointestinal and genitourinary tract of fifteen to twenty percent of women of childbearing age (Moorhead et al., 2019). GBS does not become a problem until it is passed from colonized mothers to the neonate during delivery (Virranniemi et al., 2019). When GBS is passed …

The Building Healthy Eating And Self-Esteem Together For University Students Mobile App To Treat Eating Disorders: User-Centered Research Design And Feasibility Study., Kelsie T. Forbush, Kara A. Christensen Pacella, Marianna L. Thomeczek, Sara R. Gould, Danielle A N Chapa, Brianne N. Richson, Victoria L. Perko, Joseph Ayres, Yiyang Chen, Sonakshi Negi

Manuscripts, Articles, Book Chapters and Other Papers

BACKGROUND: University students are an at-risk group for the development of eating disorders (EDs); however, many college campuses lack sufficient resources to provide ED specialty care. Students report unique reasons for not seeking ED treatment, including the desire to solve the problem on their own (eg, seeking help from friends, self-medicating, or waiting to see if their problems improve), inability to afford treatment, lack of time to participate in the treatment, fear of seeing their primary care physician, and lack of recognition of their issues as an ED. Mobile health (mHealth) apps may be a cost-effective, helpful adjunctive tool to …

The Importance Of Gender-Neutral Terminology In Risk Evaluation And Mitigation Strategy Programs: A Call To Action., Colin Burnette, William Smithy, Daniel Strock, Torunn E. Sivesind, Robert Dellavalle

HPD Articles

The use of risk evaluation and mitigation strategy (REMS) programs is frequently required for prescriptions with potentially teratogenic effects, especially in the field of dermatology. Among these REMS programs, the most well-known example is isotretinoin, an oral retinoid that uses the iPLEDGE system. iPLEDGE has strict regulations and a lengthy approval process, and until recently, patients were grouped into 3 categories: male, female, or female of reproductive potential. This strict grouping has posed problems in the medical community, especially for gender-diverse individuals where their perceived gender conflates with their assigned grouping causing patient-specific distress. The distinction between gender-a multifactorial perception …

Comprehensive Review Of Acute Pancreatitis Pain Syndrome, Jacob Beiriger, Adnan Khan, Brian Yan, Heather Ross, Makala Wang, Michael Carducci, Natali Salinas, Salil Chowdhury, Ryan Erwin, Sarah Chen, Alexis Gerber

Jefferson Hospital Staff Papers and Presentations

Pancreatitis is a condition that causes inflammation in the pancreas, an organ located behind the stomach. This condition often presents as neuropathic, inflammatory, and/or visceral pain. Acute pancreatitis is typically characterized by sudden and severe abdominal pain, often in the upper right part of the abdomen. The pain from pancreatitis can be caused by different mechanisms, such as abnormal activation of pancreatic zymogens or NF-κB mediated inflammation in the pancreas. The treatment of pancreatitis depends on its type, severity, and underlying cause. Hospitalization and medications are typically necessary, while in others, surgery may be required. Proper management of pancreatitis is …

Debunking Medical Myths: Detox Cleanses, Cyra Kharas, Robert Leone, Mihika Sridhar, Sophia Gandarillas, Paul Villa

Patient Education Projects

No abstract provided.

Debunking Medical Myths: Is The Panchakarma Cleanse Really The Ultimate Way To Heal And Re-Balance The Body?, Meet Patel, Sohini Pandit, Dhiraj Tadikamalla, Sara Naessig, Neil Garg, Lara Rostomian

Patient Education Projects

No abstract provided.

Debunking Medical Myths: The Chiropractic Myth: The Dangers Of Neck Adjustment, Pranav Gopalakrishnan, Christopher Carter, Neha Chava, William Mcroy, Mai Daigle, Stephanie Schervish

Patient Education Projects

No abstract provided.

Neurological-Type Wilson Disease: Epidemiology, Clinical Manifestations, Diagnosis, And Management, Nathaniel Kipker, Kaitlyn Alessi, Marko Bojkovic, Inderbir Padda, Mayur S. Parmar

HPD Articles

Wilson disease (WD) is a complex metabolic disorder caused by disruptions to copper regulation within the body, leading to an unregulated accumulation of copper within various tissues. A less understood organ affected by the collection of copper is the brain, which further leads to the generation of oxygen-free radicals and resultant demyelination. Healthcare providers must keep the neurological form of WD in their list of differentials when patients present with diverse neurological manifestations. The initial step to diagnosis will be to distinguish the characteristic disease presentation with a thorough history and physical and neurological examination. A high clinical disease suspicion …

Cognitive Behavioral Therapy For Chronic Pain In Veterans, Mari Bones

Honors Projects

This paper is an exploration of the use of Cognitive Behavioral Therapy (CBT) as treatment for chronic pain amongst veterans. CBT has been used as a treatment options for veterans since 2012 in order to decrease the use and misuse of opioids. It focuses on giving the patient tools to control the impact that chronic pain has on their body and mind. The paper explore this treatment, the aspects of it, complementary treatments, and results.

Lipoprotein(A) In Atherosclerotic Cardiovascular Disease And Aortic Stenosis: A European Atherosclerosis Society Consensus Statement, Florian Kronenberg, Samia Mora, Erik S G Stroes, Brian Ference Ference Ference, Benoit J. Arsenault, Lars Berglund, Marc R. Dweck, Marlys Koschinsky, Gilles Lambert, Salim S. Virani

Office of the Provost

This 2022 European Atherosclerosis Society lipoprotein(a) [Lp(a)] consensus statement updates evidence for the role of Lp(a) in atherosclerotic cardiovascular disease (ASCVD) and aortic valve stenosis, provides clinical guidance for testing and treating elevated Lp(a) levels, and considers its inclusion in global risk estimation. Epidemiologic and genetic studies involving hundreds of thousands of individuals strongly support a causal and continuous association between Lp(a) concentration and cardiovascular outcomes in different ethnicities; elevated Lp(a) is a risk factor even at very low levels of low-density lipoprotein cholesterol. High Lp(a) is associated with both microcalcification and macrocalcification of the aortic valve. Current findings do …

Point And Counterpoint: Polatuzumab Vedotin In The Front-Line Therapy For Diffuse Large B- Cell Lymphoma, Colin Thomas, Sameep Thapa, Connor Mclaughlin, Molly Halloran, Porcu Pierluigi

Department of Medical Oncology Faculty Papers

No abstract provided.

Mpox (Formally Known As Monkeypox), Molly O'Neill, Tricia Lepage, Vanessa Bester, Henry Yoon, Frederick Browne, Eric C. Nemec

Physician Assistant Studies Student Publications

Mpox originates from the Mpox virus, which belongs to the Orthopoxvirus genus of the Poxviridae family.1, 2, 3 Other Orthopoxvirus species include the variola virus (the now eradicated smallpox virus), vaccinia virus (a virus used in the creation of the smallpox vaccine), and cowpox virus.1, 2, 3 The identified clades consist of the West African clade and the Congo Basin clade, each with varying fatality rates of 1% and 10%, respectively.1, 2, 3, 4 Since the eradication of smallpox in 1980, the Mpox virus has emerged as the most relevant Orthopoxvirus infection in humans.

Incidence And Mortality Of Uveal Melanoma In Australia (1982–2014), Aaron B. Beasley, David B. Preen, Samuel Mclenachan, Elin S. Gray, Fred K. Chen

Research outputs 2014 to 2021

Aims:

We aimed to estimate the incidence and mortality of uveal melanoma (UM) in Australia from 1982 to 2014.

Methods:

Deidentified unit data for all cases of ocular melanoma were extracted from the Australian Cancer Database from 1 January 1982 to 31 December 2014. UM cases were extracted and trends in incidence and disease-specific mortality were calculated. Incidence rates were age-standardised against the 2001 Australian Standard Population. Mortality was assessed using Cox regression.

Results:

From 1982 to 2014, there were 5087 cases of ocular melanoma in Australia, of which 4617 were classified as UM. The average age-standardised incidence rate of …

Prednisolone For Copd Exacerbations: Time For A Rethink, Sanjay Ramakrishnan

Research outputs 2022 to 2026

Prednisolone given universally for COPD exacerbations causes harm without any benefit. Patients deserve blood eosinophil-guided prednisolone treatment for COPD exacerbations.

Systemic Treatment Of Advanced And Metastatic Urothelial Cancer: The Landscape In Australia, Howard Gurney, Timothy D. Clay, Niara Oliveira, Shirley Wong, Ben Tran, Carole Harris

Research outputs 2022 to 2026

The 5-year survival rate of metastatic urothelial carcinoma (mUC) is estimated to be as low as 5%. Currently, systemic platinum-based chemotherapy followed by avelumab maintenance therapy is the only first-line treatment for mUC that has an overall survival benefit. Cisplatin-based chemotherapy (usually in combination with gemcitabine) is the preferred treatment but carboplatin is substituted where contraindications to cisplatin exist. Treatment with immune checkpoint inhibitors, antibody-drug conjugates, and kinase inhibitors has not yet demonstrated superiority to chemotherapy as first-line therapy and remains investigational in this setting. A recent media release indicates that chemotherapy plus nivolumab gives an OS advantage as first-line …

Patient Navigation Across The Cancer Care Continuum: An Overview Of Systematic Reviews And Emerging Literature, Raymond J. Chan, Vivienne E. Milch, Fiona Crawford-Williams, Oluwaseyifunmi A. Agbejule, Ria Joseph, Jolyn Johal, Narayanee Dick, Matthew P. Wallen, Julie Ratcliffe, Anupriya Agarwal, Larissa Nekhlyudov, Matthew Tieu, Manaf Al-Momani, Scott Turnbull, Rahul Sathiaraj, Dorothy Keefe, Nicolas H. Hart

Research outputs 2022 to 2026

Patient navigation is a strategy for overcoming barriers to reduce disparities and to improve access and outcomes. The aim of this umbrella review was to identify, critically appraise, synthesize, and present the best available evidence to inform policy and planning regarding patient navigation across the cancer continuum. Systematic reviews examining navigation in cancer care were identified in the Cochrane Central Register of Controlled Trials (CENTRAL), PubMed, Embase, Cumulative Index of Nursing and Allied Health (CINAHL), Epistemonikos, and Prospective Register of Systematic Reviews (PROSPERO) databases and in the gray literature from January 1, 2012, to April 19, 2022. Data were screened, …

A Mental Health Professional Opinion On Family Involvement During The Treatment Of Severe Mental Illness: A Multiple Case Study, Vanessa Perocier

Antioch University Dissertations & Theses

While severe mental illness (SMI) is extensively studied, less attention focuses on the relationship between people with SMI and their families and the impact this may have on treatment. Bronfenbrenner's (1979) ecological systems theory conceptualized the treatment and recovery of people with SMI and their families. This study proposes that if family members getting social support contribute to a person's treatment plan, the individual's treatment outcome will improve rather than the individual enduring the treatment process individually. By applying ecological systems theory, mental health professionals and policymakers can better grasp the systemic nature of individuals, their family members, and surrounding …