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Articles 721 - 750 of 3463
Full-Text Articles in Medicine and Health Sciences
A Multilevel Framework For The Promotion Of Maternal Mental Health And Well-Being During The Perinatal Period, Jenn A. Leiferman, Jessica Walls Wilson, Charlotte V. Farewell, Chelsea Walker-Mao, James F. Paulson
A Multilevel Framework For The Promotion Of Maternal Mental Health And Well-Being During The Perinatal Period, Jenn A. Leiferman, Jessica Walls Wilson, Charlotte V. Farewell, Chelsea Walker-Mao, James F. Paulson
Psychology Faculty Publications
Background: Depression and anxiety are prevalent in the perinatal period and may contribute to adverse maternal and child health outcomes. A focus on multilevel protective factors may be effective in promoting well-being and increasing quality of life (QOL) in the perinatal period while simultaneously reducing or preventing depression and anxiety symptoms. We tested a conceptual model that posits specific personal, social, and community factors affecting depression, anxiety, and QOL among pregnant and postpartum individuals.
Methods: Four hundred and thirty-eight pregnant or postpartum individuals completed a 121-item cross-sectional survey composed of validated tools that assessed multilevel protective factors, health behaviors, and …
Drinking Motives And Alcohol Sensitivity Mediate Multidimensional Genetic Influences On Alcohol Use Behaviors, Jeanne E. Savage, Spit For Science Working Group, Danielle M. Dick
Drinking Motives And Alcohol Sensitivity Mediate Multidimensional Genetic Influences On Alcohol Use Behaviors, Jeanne E. Savage, Spit For Science Working Group, Danielle M. Dick
Psychology Faculty Publications
Background
Genetic influences account for a substantial proportion of individual differences in alcohol use behaviors (AUBs). However, multiple distinct sets of genes are linked to different AUBs via uncertain causal links. Here, we explore whether intermediate neurobiological traits mediate the relationship between polygenic scores (PGSs) and multiple AUBs, with the aim to better understand processes captured by different genetic profiles.
Methods
We derived four alcohol-related PGSs in participants from Spit for Science, a longitudinal study of college students in the United States (n=4549). Using linear regression, we tested the relationship between PGSs and 22 potential mediators, including personality, …
Fabrication Of Palladium Decorated Zinc Oxide Nanostructures For Non-Enzymatic Glucose Sensing, Reagan Aviha, Anju Joshi, Gymama Slaughter
Fabrication Of Palladium Decorated Zinc Oxide Nanostructures For Non-Enzymatic Glucose Sensing, Reagan Aviha, Anju Joshi, Gymama Slaughter
Center for Bioelectronics Publications
The growing global burden of diabetes necessitates the development of glucose sensors that are not only reliable and sensitive but also cost-effective and amenable to point-of-care use. In this work, we report a non-enzymatic electrochemical glucose sensor based on laser-induced graphene (LIG), functionalized with zinc oxide (ZnO) and palladium (Pd) nanostructures. The ZnO nanostructures were systematically optimized on the LIG surface by varying electrochemical deposition parameters, including applied potential, temperature, and deposition time, to enhance the electrocatalytic oxidation of glucose in alkaline medium. Subsequent modification with Pd nanostructures further improved the electrocatalytic activity and sensitivity of the sensor. The performance …
Advanced Nanocomposite-Based Electrochemical Sensor For Ultra-Sensitive Dopamine Detection In Physiological Fluids, Megha Shinde, Gymama Slaughter
Advanced Nanocomposite-Based Electrochemical Sensor For Ultra-Sensitive Dopamine Detection In Physiological Fluids, Megha Shinde, Gymama Slaughter
Center for Bioelectronics Publications
This study presents a novel point-of-care electrochemical sensor for dopamine (DA) detection, featuring a flexible laser-induced graphene (LIG) modified with a unique nanocomposite comprising Nb4C3Tx MXene, polypyrrole (PPy), and iron nanoparticles (FeNPs). The LIG-Nb4C3Tx MXene-PPy-FeNPs is characterized by scanning electron microscopy to confirm the successful surface modification. The electrochemical performance of the fabricated sensor via cyclic voltammetry showed significant electrochemical activity upon Nb4C3Tx MXene-PPy-FeNPs nanocomposite modification of the LIG surface with an increased peak anodic current (Ipa) from 43 μA to 104 μA. The sensor …
Electrochemical Strategies For Microrna Quantification Leveraging Amplification And Nanomaterials: A Review, Alexander Hunt, Gymama Slaughter
Electrochemical Strategies For Microrna Quantification Leveraging Amplification And Nanomaterials: A Review, Alexander Hunt, Gymama Slaughter
Center for Bioelectronics Publications
MicroRNAs (miRNAs) are small, non-coding RNAs that regulate gene expression and have emerged as critical biomarkers in various diseases, including cancer. Their stability in bodily fluids and role as oncogenes or tumor suppressors make them attractive targets for non-invasive diagnostics. However, conventional detection methods, such as Northern blotting, RT-PCR, and microarrays, are limited by low sensitivity, lengthy protocols, and limited specificity. Electrochemical biosensors offer a promising alternative, providing high sensitivity, rapid response times, portability, and cost-effectiveness. These biosensors translate miRNA hybridization events into quantifiable electrochemical signals, often leveraging redox-active labels, mediators, or intercalators. Recent advancements in nanomaterials and signal amplification …
Association Of Prenatal Exposure To Phthalates And Phenols With Adverse Pregnancy Outcomes, Misa Hayasaka, Diana Aboukhater, George Saade, Tetsuya Kawakita
Association Of Prenatal Exposure To Phthalates And Phenols With Adverse Pregnancy Outcomes, Misa Hayasaka, Diana Aboukhater, George Saade, Tetsuya Kawakita
Department of Obstetrics & Gynecology Faculty Publications
OBJECTIVE:
To evaluate the association between prenatal exposures to phthalates and phenols and adverse pregnancy outcomes, including preterm birth (PTB), small-for-gestational-age (SGA) birth weight, and gestational diabetes mellitus (GDM).
METHODS:
This study analyzed data from the Environmental Influences on Child Health Outcomes consortium, which harmonized longitudinal data on more than 30,000 pregnancies and 57,000 children from 69 cohorts across the United States and Puerto Rico. Pregnancy outcomes included PTB, SGA, and GDM, identified from medical records or self-reports. Generalized estimating equations models with Poisson distribution and robust variance were used to estimate relative risks (RRs) and 95% CIs per interquartile …
Racial Disparities In Maternal Mortality Before, During, And After The Covid-19 Pandemic In The United States: A Difference-In-Difference Analysis, Kyosuke Kamijo, Misa Hayasaka, Tetsuya Kawakita
Racial Disparities In Maternal Mortality Before, During, And After The Covid-19 Pandemic In The United States: A Difference-In-Difference Analysis, Kyosuke Kamijo, Misa Hayasaka, Tetsuya Kawakita
Department of Obstetrics & Gynecology Faculty Publications
Background
This study aimed to examine changes in racial disparities in pregnancy-related and maternal mortality before, during, and after the COVID-19 pandemic in the United States.
Methodology
This was a cross-sectional study using the Centers for Disease Control and Prevention Wide-ranging Online Data for Epidemiologic Research (CDC WONDER) data from January 2018 to June 2024. We focused on pregnancy-related and maternal mortality among Black and White individuals to examine racial disparities. The study periods were defined as pre-pandemic (January 2018-March 2020), pandemic (April 2020-March 2022), and post-pandemic (April 2022-June 2024). We applied interrupted time series analysis and difference-in-difference (DID) models …
Timing Of Delivery In Preeclampsia: Time To Reconsider?, Rebecca Horgan, Ahmed S. Z. Moustafa, Mackenzie Mchugh, Tetsuya Kawakita, Baha Sibai, George Saade
Timing Of Delivery In Preeclampsia: Time To Reconsider?, Rebecca Horgan, Ahmed S. Z. Moustafa, Mackenzie Mchugh, Tetsuya Kawakita, Baha Sibai, George Saade
Department of Obstetrics & Gynecology Faculty Publications
The article discusses the need to reassess the timing of delivery in cases of preeclampsia, a condition affecting 2%–8% of pregnancies and linked to significant maternal and neonatal risks. It highlights that existing guidelines, primarily based on older studies, may not adequately reflect current clinical practices and advancements in neonatal care. The authors suggest that planned delivery at 34–36 weeks of gestation may offer maternal benefits without increasing short-term neonatal morbidity, while also emphasizing the importance of considering long-term outcomes for both mothers and infants. They advocate for further research, including large-scale randomized trials, to better understand the implications of …
Biomedical Mxene-Polymer Nanocomposites: Advancing Photothermal Therapy, Antibacterial Action, And Smart Drug Delivery: A Review, Ali Mohammad Amani, Lobat Tayebi, Ehsan Vafa, Mohammad Javad Azizli, Milad Abbasi, Ahmad Vaez, Hesam Kamyab, Daniel Simancas-Racines, Shreeshivadasan Chelliapan
Biomedical Mxene-Polymer Nanocomposites: Advancing Photothermal Therapy, Antibacterial Action, And Smart Drug Delivery: A Review, Ali Mohammad Amani, Lobat Tayebi, Ehsan Vafa, Mohammad Javad Azizli, Milad Abbasi, Ahmad Vaez, Hesam Kamyab, Daniel Simancas-Racines, Shreeshivadasan Chelliapan
Electrical & Computer Engineering Faculty Publications
MXenes are hydrophilic, conductive, tunable, and biocompatible two-dimensional ceramic materials prepared by etching the 'A' layer from their precursor MAX phases. Although MXenes show exceptional promise in photothermal therapy, biosensing, and regenerative medicine, they face challenges such as oxidative instability in physiological environments, limited drug-loading capacity, and unpredictable immune responses. To address these limitations, MXene/polymer nanocomposites incorporating both synthetic polymers (e.g., polyethylene glycol (PEG), polyvinyl alcohol (PVA), polyvinylpyrrolidone (PVP), and polylactic-co-glycolic acid (PLGA)) and natural biopolymers (e.g., cellulose nanofiber, gelatin, chitosan, hyaluronic acid, and soybean phospholipids) have been developed. These composites enhance functionality for biomedical applications such as photothermal cancer …
The Use Of Motivational Interviewing In Preventing Dental Caries Among Young Children, Denise C. Mckinney, Melissa L. Sullivan, Futun Alkhalifah
The Use Of Motivational Interviewing In Preventing Dental Caries Among Young Children, Denise C. Mckinney, Melissa L. Sullivan, Futun Alkhalifah
Dental Hygiene Faculty Publications
Dental caries is a complex, preventable disease that remains a global health burden. The burden of this disease has been shown to impact young children before the age of 6 years. Discussing dental caries prevention with the mother/caregiver(s) prior to childbirth is an ideal time to influence positive oral health behaviors. Motivational interviewing (MI) is a person-centered, goal-oriented, collaborative communication style that has been used to help individuals modify behaviors. The interrelated principles of partnership, acceptance, compassion, and evocation underpin the MI approach while utilizing communication skills such as asking open-ended questions, affirmation, reflective listening, and summarizing (OARS) to engage …
Examining Low-Income Caregivers' Knowledge And Comprehension Of The Dental Caries Process, Melissa Sullivan, Denise C. Mckinney, Deanne Shuman, Qi Zhang
Examining Low-Income Caregivers' Knowledge And Comprehension Of The Dental Caries Process, Melissa Sullivan, Denise C. Mckinney, Deanne Shuman, Qi Zhang
Dental Hygiene Faculty Publications
Purpose Dental caries among young children remains a public health concern in the United States (US). Children of caregivers with low oral health literacy (OHL) tend to have greater unmet dental needs and poorer oral health status. The purpose of this study was to examine the understanding of pediatric dental terms associated with the dental caries process among low-income caregivers.
Methods This study included 14 caregivers with children enrolled in a Special Supplemental Nutrition Program for Women, Infants and Children (WIC) in the Southeastern US. Through structured phone interviews, the validated Oral Health Literacy Inventory for Parents (OH-LIP) was used …
A Scoping Review Of Population Diversity In The Common Genomic Aberrations Of Clear Cell Renal Cell Carcinoma, Sean S. Kumar, Ninad Khandekar, Komal Dani, Saina R. Bhatt, Vinay Duddalwar, Anishka D' Souza
A Scoping Review Of Population Diversity In The Common Genomic Aberrations Of Clear Cell Renal Cell Carcinoma, Sean S. Kumar, Ninad Khandekar, Komal Dani, Saina R. Bhatt, Vinay Duddalwar, Anishka D' Souza
Department of Medicine Faculty Publications
Introduction: Previous literature has shown that clear cell renal cell carcinoma (ccRCC) is becoming a more prevalent diagnosis and that the incidence and mortality differ both regionally and racially. While the molecular profiles for ccRCC are studied regionally through biopsy and sequencing techniques, the genomic landscape and ccRCC diversity data are not well studied. We conducted a review of the known genomic data on 6 of the most clinically relevant DNA biomarkers in ccRCC: von Hippel-Lindau (vHL), Polybromo-1 (PBRM1), Breast Cancer Gene 1-Associated Protein 1 (BAP1), Histone-Lysine N-Methyltransferase Domain-Containing 2 (SETD2), Mammalian Target of Rapamycin (mTOR), and Lysine-Specific Demethylase 5C …
Generating Real-World Evidence In Early Alzheimer's Disease: Considerations For Applying The Target Trial Emulation Framework To Study The Safety Of Anti-Amyloid Therapies, Xiaojuan Li, Sonal Singh, Bahareh Rasouli, Jennifer Lyons, Noelle M. Cocoros, Richard Platt, Ivan Abi-Elias, Jerry H. Gurwitz
Generating Real-World Evidence In Early Alzheimer's Disease: Considerations For Applying The Target Trial Emulation Framework To Study The Safety Of Anti-Amyloid Therapies, Xiaojuan Li, Sonal Singh, Bahareh Rasouli, Jennifer Lyons, Noelle M. Cocoros, Richard Platt, Ivan Abi-Elias, Jerry H. Gurwitz
Department of Medicine Faculty Publications
Anti-amyloid beta monoclonal antibodies (anti-Aβ mAbs) have received approval from the US Food and Drug Administration for the treatment of patients with mild cognitive impairment or mild dementia due to Alzheimer's disease (collectively known as early AD) based on evidence from clinical trials. However, whether findings from these trials are generalizable to the real world is uncertain. We need reliable evidence on the real-world safety of these treatments to inform decision making for clinicians, patients, and caregivers. Using lecanemab as an exemplar, we outline the key considerations in designing and implementing an observational study on safety and utilization outcomes using …
Real-World Interventional Outcomes For Cardiogenic Shock Complicating Acute Myocardial Infarction, John E. Brush Jr., Ann M. Harper, Luke C. Kohan, Zachary Bouker, Kaivalya Dandamudi, Deepak R. Talreja
Real-World Interventional Outcomes For Cardiogenic Shock Complicating Acute Myocardial Infarction, John E. Brush Jr., Ann M. Harper, Luke C. Kohan, Zachary Bouker, Kaivalya Dandamudi, Deepak R. Talreja
Department of Medicine Faculty Publications
Acute myocardial infarction with cardiogenic shock (AMICS) carries high mortality and remains a major concern. This concern drives use of interventions with marginal benefit and some evidence of harm. The configuration of hospital care and allocation of interventions for AMICS in our health system created a natural experiment to analyze interventional outcomes for patients with AMICS.
Objective
To compare clinical outcomes among AMICS patients treated with mechanical circulatory support (MCS) using a micro-axial left ventricular assist device and intra-aortic balloon counter-pulsation (IABP).
Design, setting, participants, outcome measures
In this observational study in a large health system, we used clinical registry …
Drug-Induced Leukocytoclastic Vasculitis From An Unreported Source: Daptomycin, Jennifer K. Priessnitz, Timothy Kuzel, Lindsay Ackerman, Nelson Nicolasora
Drug-Induced Leukocytoclastic Vasculitis From An Unreported Source: Daptomycin, Jennifer K. Priessnitz, Timothy Kuzel, Lindsay Ackerman, Nelson Nicolasora
Department of Medicine Faculty Publications
Leukocytoclastic vasculitis (LCV) is a rare small-vessel vasculitis caused by immune-complex-mediated deposition on endothelial cells of dermal capillaries. Common triggers include medications, infections, autoimmune disorders, and malignancies. We present a case of a 58-year-old male who developed daptomycin-induced LCV after being treated for Methicillin-resistant Staphylococcus aureus (MRSA) endocarditis. The patient experienced painful palpable purpura on his lower extremities, which was diagnosed as LCV by skin biopsy. At the time of the biopsy, warfarin and daptomycin were discontinued, and the patient was transitioned to heparin and ceftaroline. MRSA-induced LCV was ruled out, due to negative blood cultures and adequate source control …
Treatment Of Myocardial Infiltration Of Hodgkins Lymphoma: A Catch-22, Jennifer Priessnitz, Erin Biringen, Fadi Khoury, Christina Bergin
Treatment Of Myocardial Infiltration Of Hodgkins Lymphoma: A Catch-22, Jennifer Priessnitz, Erin Biringen, Fadi Khoury, Christina Bergin
Department of Medicine Faculty Publications
Background: Cardiac sequelae in Hodgkin Lymphoma (HL) can manifest as involvement of the heart and pericardium. Direct cardiac involvement is rare, and myocardial infiltration is distinctly unusual.¹ When it does occur, it is often a late manifestation of lymphoma, with a median onset of 20 months after initial diagnosis, and it is usually associated with advanced-stage disease.²
Case: A 34-year-old male was diagnosed with classic HL by lymph node biopsy. During his hospitalization, the patient remained in sinus tachycardia with heart rate up to 150 with no dysrhythmias. Transthoracic echocardiogram (TTE) revealed a reduced ejection fraction (EF) of 36% concerning …
Emergent Transcatheter Tricuspid Edge-To-Edge Repair For Right Ventricular Shock From Tricuspid Regurgitation In Hypertrophic Cardiomyopathy, Nicholas J. Valle, Amin Yehya, Animesh Rathore, Erich L. Kiehl, Matthew R. Summers
Emergent Transcatheter Tricuspid Edge-To-Edge Repair For Right Ventricular Shock From Tricuspid Regurgitation In Hypertrophic Cardiomyopathy, Nicholas J. Valle, Amin Yehya, Animesh Rathore, Erich L. Kiehl, Matthew R. Summers
Department of Medicine Faculty Publications
Background
Transcatheter tricuspid edge-to-edge repair (T-TEER) is an emerging technology used to treat severe tricuspid regurgitation (TR). The pivotal trials demonstrating the safety and efficacy of T-TEER exclude patients with severely reduced left ventricular function (≤20%).
Case Summary
We demonstrate the use of T-TEER in a patient with end-stage hypertrophic cardiomyopathy who suffered acute, torrential TR and subsequently developed cardiogenic shock as a complication of high-risk transvenous lead extraction. Why Beyond the Guidelines Currently, there are no guidelines addressing the nonsurgical emergent management of acute TR.
Discussion
The TriClip system (Abbott) may have certain advantages when used in managing acute …
The Timing For Primary Prevention For Icd In The Current Era Of Pharmacotherapy, Anastasia Shchendrygina, Amin Yehya, Hadi Skouri
The Timing For Primary Prevention For Icd In The Current Era Of Pharmacotherapy, Anastasia Shchendrygina, Amin Yehya, Hadi Skouri
Department of Medicine Faculty Publications
Recent advances in the pharmacological therapy of heart failure with reduced ejection fraction (HFrEF) have significantly impacted the overall survival, heart failure hospitalisations and rates of sudden cardiac death (SCD). In this context, the relevant timing of placing ICDs as primary prevention is a matter of on-going debate. This manuscript provides evidence for an updated view regarding the timing of implanting ICD in eligible patients with HFrEF receiving optimal guideline-directed medical therapy, accounting for the timing to reverse cardiac remodelling (RCR) occurrence and residual SCD risks over time. Clinically significant RCR occurs beyond 3 months of optimal guideline-directed medical therapy, …
Delayed Hypertension Diagnosis And Its Association With Cardiovascular Treatment And Outcomes, Yuan Lu, John E. Brush Jr, Chungsoo Kim, Yuntian Liu, Xin Xin, Chenxi Huang, Mitsuaki Sawano, Patrick Young, Jacob Mcpadden, Mark Anderson, John S. Burrows, Jordan R. Asher, Harlan M. Krumholz
Delayed Hypertension Diagnosis And Its Association With Cardiovascular Treatment And Outcomes, Yuan Lu, John E. Brush Jr, Chungsoo Kim, Yuntian Liu, Xin Xin, Chenxi Huang, Mitsuaki Sawano, Patrick Young, Jacob Mcpadden, Mark Anderson, John S. Burrows, Jordan R. Asher, Harlan M. Krumholz
Department of Medicine Faculty Publications
Importance Hypertension is a major risk factor for cardiovascular disease, yet delays in diagnosis may limit timely treatment initiation and increase cardiovascular risk.
Objectives To examine the timing of clinical hypertension diagnosis, its association with antihypertensive medication prescribing, and its association with long-term cardiovascular outcomes.
Design, Setting, and Participants This retrospective cohort study analyzed electronic health record (EHR) data from an integrated health care system. Adults aged 18 to 85 years with at least 2 outpatient blood pressure (BP) readings of 140/90 mm Hg or more recorded at least 30 days apart from January 1, 2010, to December 31, 2021, …
Balancing Regeneration And Resistance: Targeting Dclk1 To Mitigate Gastrointestinal Radiation Injury And Oncogenesis, Landon L. Moore, Jerry Jaboin, Milton L. Brown, Courtney W. Houchen
Balancing Regeneration And Resistance: Targeting Dclk1 To Mitigate Gastrointestinal Radiation Injury And Oncogenesis, Landon L. Moore, Jerry Jaboin, Milton L. Brown, Courtney W. Houchen
Department of Medicine Faculty Publications
Ionizing radiation (IR) poses a dual challenge in medicine; while essential for cancer therapy, it inflicts collateral damage to normal tissues, particularly the gastrointestinal (GI) tract. High-dose IR triggers acute radiation syndrome (ARS), characterized by crypt stem cell depletion, mucosal barrier disruption, inflammation, and potential progression to fibrosis and secondary malignancy. Emerging evidence identifies the epithelial kinase doublecortin-like kinase 1 (DCLK1)—highly expressed in GI tuft cells and cancer stem-like cells—as a master regulator of post-IR responses. DCLK1 integrates DNA repair (via p53/ATM), and survival signaling (via NF-κB, TGF-β, and MAPK) to promote epithelial regeneration, yet these same mechanisms contribute to …
Group Antenatal Care Positively Transforms The Care Experience: Results Of An Effectiveness Trial In Malawi, Crystal L. Patil, Kathleen F. Noor, Esnath Kapito, Li C. Liu, Xiaohan Mei, Elizabeth Chodzaza, Genesis Chorwe-Sungani, Ursula Kafuulafula, Elizabeth T. Abrams, Allissa Desloge, Ashley Gresh, Rohan D. Jeremiah, Dhruvi R. Patel, Anne Batchelder, Heidy Wang, Jocelyn Faydenko, Sharon S. Rising, Ellen Chirwa
Group Antenatal Care Positively Transforms The Care Experience: Results Of An Effectiveness Trial In Malawi, Crystal L. Patil, Kathleen F. Noor, Esnath Kapito, Li C. Liu, Xiaohan Mei, Elizabeth Chodzaza, Genesis Chorwe-Sungani, Ursula Kafuulafula, Elizabeth T. Abrams, Allissa Desloge, Ashley Gresh, Rohan D. Jeremiah, Dhruvi R. Patel, Anne Batchelder, Heidy Wang, Jocelyn Faydenko, Sharon S. Rising, Ellen Chirwa
Department of Medicine Faculty Publications
Background
We developed and tested a Centering-based group antenatal (ANC) model in Malawi, integrating health promotion for HIV prevention and mental health. We present effectiveness data and examine congruence with only the Group ANC theory of change model, which identifies key processes as supportive relationships, empowered partners in learning and care, and meaningful services, leading to better ANC experiences and outcomes.
Methods
We conducted a hybrid effectiveness-implementation trial at seven clinics in Blantyre District, Malawi, comparing outcomes for 1887 pregnant women randomly assigned to Group ANC or Individual ANC. Group effects on outcomes were summarized and evaluated using t-tests, Mann-Whitney, …
Left Ventricular Assist Device Destination Therapy: A Journey To Home And Beyond, Mian Z. Munir, Marissa C. Galicia-Castillo, Mia Achitoov, Amin Yehya
Left Ventricular Assist Device Destination Therapy: A Journey To Home And Beyond, Mian Z. Munir, Marissa C. Galicia-Castillo, Mia Achitoov, Amin Yehya
Department of Medicine Faculty Publications
[Case] Mr H is a 74-year-old man with history of end-stage heart failure (ESHF) secondary to hereditary transthyretin cardiac amyloidosis. Our patient underwent placement of a HeartMate II (Abbott) left ventricular assist device (LVAD) as destination therapy (DT) at an outside hospital and later came to us (Sentara Heart Hospital) for continued management because he resided in the area. Over a 2-year period, the patient experienced multiple hospital admissions for acute heart failure (HF) exacerbations, delirium, and recurrent low-flow alarms. During his last hospitalization, the palliative medicine team was consulted to facilitate goals-of-care discussions with the patient and his family, …
Navigating The Complexities In Gender-Diverse Counseling: Understanding The Interplay Of Gender Identity, Racial Inequities, Economic Marginalization, And Aging, C. Gerwe
Department of Medicine Faculty Publications
Gender-diverse individuals continue to face unique challenges in daily life, with intersecting identities related to race, socioeconomic status (SES), and age further compounding these barriers. These overlapping factors profoundly impact mental health and wellbeing, especially within environments that may lack inclusive or responsive frameworks. Despite increasing awareness, limited guidance exists for counselors on implementing practices that validate intersecting identities while addressing the cumulative effects of marginalization (Canvin et al., 2022). This article synthesizes current research and case examples to illuminate these challenges and offers insights for fostering more inclusive and supportive counseling approaches.
Changes In Cardiovascular Risk Factors And Health Care Expenditures Among Patients Prescribed Semaglutide, Yuan Lu, Yuntian Lu, Tedi Totojani, Chungsoo Kim, Rohan Khera, Hua Xu, John E. Brush Jr., Harlan M. Krumholtz, Jason Abaluck
Changes In Cardiovascular Risk Factors And Health Care Expenditures Among Patients Prescribed Semaglutide, Yuan Lu, Yuntian Lu, Tedi Totojani, Chungsoo Kim, Rohan Khera, Hua Xu, John E. Brush Jr., Harlan M. Krumholtz, Jason Abaluck
Department of Medicine Faculty Publications
Importance Semaglutide, a glucagon-like peptide-1 receptor agonist, has demonstrated substantial weight reduction and cardiovascular benefits in clinical trials. However, its association with clinical outcomes and health care expenditures remains underexplored.
Objective To evaluate changes in cardiovascular risk factors and health care expenditures among patients prescribed semaglutide across multicenter cohorts.
Design, Setting, and Participants This retrospective cohort study included 23 522 adults (≥18 years) who received an initial semaglutide prescription between January 1, 2018, and January 1, 2025, at Sentara Healthcare and between January 1, 2018, and May 1, 2025, at Yale New Haven Health System.
Exposure The first prescription of …
Educational Case: Bullous Pemphigoid, Ryan C. Saal, Alice A. Roberts, Richard M. Conran
Educational Case: Bullous Pemphigoid, Ryan C. Saal, Alice A. Roberts, Richard M. Conran
Department of Medicine Faculty Publications
The following fictional case is intended as a learning tool within the Pathology Competencies for Medical Education (PCME), a set of national standards for teaching pathology. These are divided into three basic competencies: Disease Mechanisms and Processes, Organ System Pathology, and Diagnostic Medicine and Therapeutic Pathology. For additional information, and a full list of learning objectives for all three competencies, see https://www.academicpathologyjournal.org/pcme.1
Arthroscopic Inlay Biceps Tenodesis Using A Tendon-Docking Anchor, Mark G. Soliman, Katherine S. Worcester M.S., Thomas E. Herron, Kevin F. Bonner
Arthroscopic Inlay Biceps Tenodesis Using A Tendon-Docking Anchor, Mark G. Soliman, Katherine S. Worcester M.S., Thomas E. Herron, Kevin F. Bonner
Department of Medicine Faculty Publications
Pathology of the long head of the biceps tendon can be treated surgically with a multitude of tenodesis techniques; however, there is a lack of consensus on which technique provides the most optimal outcomes. Commonly used methods include inlay tenodesis with a bone tunnel and interference screw construct and onlay tenodesis with anchors or unicortical buttons. Although current methods typically provide satisfactory outcomes, many surgeons believe complications and failure rates remain suboptimal across techniques. In this article, we present an arthroscopic suprapectoral biceps tenodesis technique using an anchor device that was developed to address the shortcomings of current techniques, optimize …
Cultures For Acid-Fast Bacilli: Are We Being Good Stewards?, Jennifer Hanrahan, Julie D. Sill, Patricia Ver Schneider, Jessica F. Copeland, Elsie Frimpongmaa Amoako-Kissi, Ogochukwu O. Ilobi, Angela J. Toepp
Cultures For Acid-Fast Bacilli: Are We Being Good Stewards?, Jennifer Hanrahan, Julie D. Sill, Patricia Ver Schneider, Jessica F. Copeland, Elsie Frimpongmaa Amoako-Kissi, Ogochukwu O. Ilobi, Angela J. Toepp
Department of Medicine Faculty Publications
Objective: To describe the use of cultures for acid-fast bacilli (AFB) and situations in which AFB cultures are unlikely to be of clinical benefit.
Design: Retrospective descriptive study of AFB cultures submitted to Sentara Health microbiology laboratory from December 1, 2021, to December 1, 2023. Data were collected from the electronic medical record and included patient demographics, the service line that ordered the culture, specimen source, and culture results.
Setting: Sentara Healthcare System.
Patients: All patients who had specimens submitted to the microbiology laboratory during the study period were included.
Results: A total of 13,944 AFB cultures from 8,243 …
Preliminary Validity Of A Daily Functional Status Pain Assessment Tool, Wally R. Smith, Rehan Qayyum, Alexandra Ulbing, Margaret S. Guy, Daniel M. Sop, Yue May Zhang
Preliminary Validity Of A Daily Functional Status Pain Assessment Tool, Wally R. Smith, Rehan Qayyum, Alexandra Ulbing, Margaret S. Guy, Daniel M. Sop, Yue May Zhang
Department of Medicine Faculty Publications
Objectives: Readiness for discharge for a sickle cell disease vaso-occlusive crisis is dictated by factors far beyond pain control, including physical function/activity. We therefore designed and tested a functional status-based pain assessment questionnaire in SCD patients hospitalized with vaso-occlusive crises.
Methods: Sickle cell disease patients on a preselected nursing unit rated 10 draft Functional status-Based Pain Assessment items of activities of daily living on a 5 point Likert scale (0-5) from “very easy” to “very difficult” daily on each day of their admission until discharge, at approximately the same time. Concurrently, they reported Numeric Rating Scale (0-10) pain intensity. …
Patient-Self Inflicted Lung Injury (P-Sili): An Insight Into The Pathophysiology Of Lung Injury And Management, Himanshu Deshwal, Ahmed Elkhapery, Rudra Ramanathan, Deepak Nair, Isha Singh, Ankur Sinha, Rishik Vashisht, Vikramjit Mukherjee
Patient-Self Inflicted Lung Injury (P-Sili): An Insight Into The Pathophysiology Of Lung Injury And Management, Himanshu Deshwal, Ahmed Elkhapery, Rudra Ramanathan, Deepak Nair, Isha Singh, Ankur Sinha, Rishik Vashisht, Vikramjit Mukherjee
Department of Medicine Faculty Publications
Acute respiratory distress syndrome (ARDS) is a heterogeneous group of disease entities that are associated with acute hypoxic respiratory failure and significant morbidity and mortality. With a better understanding and phenotyping of lung injury, novel pathophysiologic mechanisms demonstrate the impact of a patient’s excessive spontaneous breathing effort on perpetuating lung injury. Patient self-inflicted lung injury (P-SILI) is a recently identified phenomenon that delves into the impact of spontaneous breathing on respiratory mechanics in patients with lung injury. While the studies are hypothesis-generating and have been demonstrated in animal and human studies, further clinical trials are needed to identify its impact …
Fiber Photometry Analysis Of Spontaneous Dopamine Signals: The Z-Scored Data Are Not The Data, Conner W. Wallace, Clare Y. Slinkard, Rachael Shaughnessy, Katherine M. Holleran, Samuel W. Centanni, Christopher C. Lapish, Sara R. Jones
Fiber Photometry Analysis Of Spontaneous Dopamine Signals: The Z-Scored Data Are Not The Data, Conner W. Wallace, Clare Y. Slinkard, Rachael Shaughnessy, Katherine M. Holleran, Samuel W. Centanni, Christopher C. Lapish, Sara R. Jones
Department of Medicine Faculty Publications
Fluorescent sensors have revolutionized the measurement of molecules in the brain, and the dLight dopamine sensor has been used extensively to examine reward- and cue-evoked dopamine release, but only recently has the field turned its attention to spontaneous release events. Analysis of spontaneous events typically requires evaluation of hundreds of events over minutes to hours, and the most common method of analysis, z-scoring, was not designed for this purpose. Here, we compare the accuracy and reliability of three different analysis methods to identify pharmacologically induced changes in dopamine release and uptake in freely moving C57BL/6J mice. The D1-like receptor antagonist …