Medical Specialties Commons^™

Impact Of A Cerebrospinal Fluid Diagnostic Stewardship Intervention On Quantity Of Tests, Length Of Stay, Antibiotic Prescriptions, And Cost, Aaron Pathak, Sabra Shay, Todd Lasco, Mayar Al Mohajer

Faculty, Staff and Students Publications

Redundant and low-value cerebrospinal fluid analysis for suspected meningitis can increase costs and antimicrobial use. Our diagnostic stewardship intervention limited available infectious disease cerebrospinal fluid assays to seven common tests, including a multiplex polymerase chain reaction panel. There was no significant difference in the cost of testing or clinical outcomes.

Toward Improving Retention In Hiv Care After Pregnancy: Lessons From A Post-Pandemic Cohort In The United States, Alexandra H Latham, Andrea Lugo Morales, Elizabeth Barba Gutierrez, Michael Jochum, Sarah Conrad, Eva H Clark, Kassandra Goytia, Megan Alam, Jessica Gerard, Jennifer Mckinney

Faculty, Staff and Students Publications

Introduction: People living with HIV (PLWH) often experience low rates of retention in HIV care (RIC) and suboptimal viral suppression postpartum. Understanding contemporary barriers to RIC is crucial to identify risk factors for loss to care and thereby improve support during this vulnerable transition. This work aimed to identify factors associated with adequate RIC, defined as two HIV care visits ≥90 days apart in the first year postpartum.

Methods: Electronic records were retrospectively reviewed for PLWH who delivered from 2019 to 2023 and received prenatal care within a single county health system. Variables were collected related to both maternal and …

Inclusion Of Patient-Centered, Non-Microbiological Endpoints And Biomarkers In Tuberculosis Drug Trials, Andrew R Dinardo, Wilbert Sabiiti, Stephen H Gillespie, Sophia B Georghiou, Norbert Heinrich, Norbert Hittel, Sami Taghlabi, Danna Carrero Longlax, Mikashmi Kohli, Ursula Panzner, Collins Musia, Christoph Lange, Anca Vasiliu, Rob J W Arts, Anna M Mandalakas, Morten Ruhwald, Lieven J Stuyver, Reinout Van Crevel

Faculty, Staff and Students Publications

Tuberculosis drug trials are primarily designed to identify antibiotic regimens with the strongest potency to kill Mycobacterium tuberculosis. However, microbiologic cure is not synonymous with improved health and recovery. Beyond antimicrobial efficacy, parameters such as morbidity and mortality related to lung function, cardiovascular health, and cancer should be prioritized. This narrative review emphasizes the critical need to emphasize clinical outcomes as much, if not more, than microbiological endpoints. We examine the underlying pathophysiological mechanisms and determinants of non-microbiological outcomes in tuberculosis, providing a synthesis of current knowledge. While there is growing evidence for some biomarkers to risk stratify TB …

Urinary Ammonium: A Potential Novel Biomarker For Diarrhea Severity In Patients With Ulcerative Colitis, Jared A Sninsky, L Parker Gregg, Mahbubur Rahman, Adith Ram, Jason K Hou

Faculty, Staff and Students Publications

No abstract provided.

Editorial: Pathogenesis And Clinical Treatment Of Diabetic Nephropathy, Ziyun Xu, Sheng Qiang, Zhaoyong Hu, Haiyong Chen

Faculty, Staff and Students Publications

No abstract provided.

Early Versus Late Initiation Of Dialysis In Ckd Stage 5: Time For A Consensus, Emaad M Abdel-Rahman, Irtiza Hasan, Abdallah S Abdelrazeq, Ali Rawabdeh, Mei Liu, Nasrollah Ghahramani, David Sheikh-Hamad, Mariana Murea, Pradeep Kadambi, T Alp Ikizler, Alaa S Awad

Faculty, Staff and Students Publications

Chronic kidney disease (CKD), a major global public health problem, emerged as one of the leading causes of death, affecting over 800 million individuals worldwide, with significant burden to patients and their caregivers, and may lead to end-stage kidney disease (ESKD). The decision on optimal initiation of chronic dialysis is a common problem faced by nephrologists, patients, and caregivers due to lack of adequate data. Determining the ideal time to initiate maintenance dialysis for individuals struggling with ESKD has remained a puzzle. Currently, there is no consensus among guidelines as to the best time to initiate dialysis. Discrepancies in guidelines …

Long-Term Anti-Sars-Cov-2 Antibody Trajectories After Neutralizing Monoclonal Antibody Treatment, Elizabeth S Munroe, Greg A Grandits, Robert C Hyzy, Hallie C Prescott, Thomas W Barrett, Robin L Dewar, Nicole Engen, Anna L Goodman, Timothy J Hatlen, Helene Highbarger, Thomas L Holland, Gareth Hughes, Tomas O Jensen, Muhammad A Khan, Ioannis Kalomenidis, Nayon Kang, Sylvain Laverdure, Prasad Manian, Vidya Menon, Ravi Patel, Srikanth Ramachandruni, Tauseef Rehman, Kathryn Shaw-Saliba, Birgit Thorup Røge, David M Vock, Amy C Weintrob, Barnaby E Young, Anne P Frosch, Strive Network And Therapeutics For Inpatients With Covid-19 (Tico) Study Groups

Faculty, Staff and Students Publications

Background: Neutralizing monoclonal antibodies (nMAbs) have been used to treat COVID-19 and are increasingly being used to treat other infections. However, there is concern that by neutralizing the SARS-CoV-2 virus, nMAbs may decrease the availability of antigens to the immune system, potentially impairing the endogenous polyclonal immune response and decreasing long-term immune protection.

Methods: We compared 28 and 90-day anti-SARS-CoV-2 spike protein neutralization activity and anti-SARS-CoV-2 nucleocapsid response for patients hospitalized with COVID-19 infection randomized to receive nMAbs or placebo in the large platform ACTIV-3/TICO trials. We pooled results from four trials of anti-spike nMAbs. For most tested agents, measurements …

Mice With Lymphatic Dysfunction Develop Pathogenic Lung Tertiary Lymphoid Organs That Model An Autoimmune Emphysema Phenotype Of Copd, Barbara Summers, Kihwan Kim, Anjali Trivedi, Tyler M Lu, Sean Houghton, Jade Palmer-Johnson, Joselyn Rojas-Quintero, Juan Cala-Garcia, Tania Pannellini, Francesca Polverino, Raphaël Lis, Hasina Outtz Reed

Faculty, Staff and Students Publications

We have previously shown that mice with a loss of C-type lectin-like type II (CLEC2), which have lymphatic dysfunction due to the role of CLEC2 in platelets for maintaining separation between the venous and lymphatic system, develop lung tertiary lymphoid organ (TLO) formation and lung injury that resembles an emphysema phenotype of chronic obstructive pulmonary disease (COPD). We now sought to investigate whether and how TLOs in these mice may play a pathogenic role in lung injury that is relevant to human disease. We found that inhibiting TLO formation using an anti-CD20 antibody in CLEC2-deficient mice partially blocked the development …

B-Cell Immune Repertoire Sequencing In Tobacco Cigarette Smoking, Vaping, And Chronic Obstructive Pulmonary Disease In The Copdgene Cohort, Matthew Moll, Zhonghui Xu, Adel Boueiz, Min Hyung Ryu, Edwin K Silverman, Michael H Cho, Craig P Hersh, Maor Sauler, Francesca Polverino, Gregory L Kinney, Jeffrey L Curtis, Laura E Crotty-Alexander, Christopher Vollmers, Peter J Castaldi

Faculty, Staff and Students Publications

Rationale: Cigarette smoking (CS) impairs B-cell function and antibody production, increasing infection risk. The impact of e-cigarette use ('vaping') and combined CS and vaping ('dual-use') on B-cell activity is unclear.

Objective: To examine B-cell receptor sequencing (BCR-seq) profiles associated with CS, vaping, and dual-use.

Methods: BCR-seq was performed on blood RNA samples from 234 participants in the COPDGene study. We assessed multivariable associations of B-cell function measures (immunoglobulin heavy chain (IGH) subclass expression and usage, class-switching, V allele usage, and clonal expansion) with CS, vaping, and dual-use. We adjusted for multiple comparisons using the Benjamini-Hochberg method, identifying significant associations at …

Advancing Narcolepsy Advocacy: Bridging Patient Narratives And Systemic Change, Ahmed Salem Bahammam, Lindsay Jesteadt, Hamza Dhafar, Amir Sharafkhaneh

Faculty, Staff and Students Publications

We introduce the Stigma-to-Structure Advocacy Framework, a novel, evidence-based model designed to transform narcolepsy advocacy by systematically bridging patient narratives with structural change. Narcolepsy remains a profoundly underdiagnosed and misunderstood neurological disorder, with persistent diagnostic delays and pervasive cultural stigma undermining patient well-being and access to care. Despite recent progress in awareness and support, advocacy efforts remain fragmented and insufficiently integrated with health policy, particularly in low- and middle-income countries. This perspective advances a strategic evolution of narcolepsy advocacy through the Stigma-to-Structure Advocacy Framework, which is anchored in three pillars: narrative-driven awareness, clinical system integration, and policy activation. Drawing on …

Baseline Predictors For 28-Day Covid-19 Severity And Mortality Among Hospitalized Patients: Results From The Impacc Study, Jintong Hou, Benjamin Haslund-Gourley, Joann Diray-Arce, Annmarie Hoch, Nadine Rouphael, Patrice M Becker, Alison D Augustine, Al Ozonoff, Leying Guan, Steven H Kleinstein, Bjoern Peters, Elaine Reed, Matt Altman, Charles R Langelier, Holden Maecker, Seunghee Kim, Ruth R Montgomery, Florian Krammer, Michael Wilson, Walter Eckalbar, Steven E Bosinger, Ofer Levy, Hanno Steen, Lindsey B Rosen, Lindsey R Baden, Esther Melamed, Lauren I R Ehrlich, Grace A Mccomsey, Rafick P Sekaly, Joanna Schaenman, Albert C Shaw, David A Hafler, David B Corry, Farrah Kheradmand, Mark A Atkinson, Scott C Brakenridge, Nelson I Agudelo Higuita, Jordan P Metcalf, Catherine L Hough, William B Messer, Bali Pulendran, Kari C Nadeau, Mark M Davis, Ana Fernandez Sesma, Viviana Simon, Monica Kraft, Chris Bime, Carolyn S Calfee, David J Erle, Impacc Network, Lucy F Robinson, Charles B Cairns, Elias K Haddad, Mary Ann Comunale

Faculty, Staff and Students Publications

Introduction: The coronavirus disease 2019 (COVID-19) pandemic threatened public health and placed a significant burden on medical resources. The Immunophenotyping Assessment in a COVID-19 Cohort (IMPACC) study collected clinical, demographic, blood cytometry, serum receptor-binding domain (RBD) antibody titers, metabolomics, targeted proteomics, nasal metagenomics, Olink, nasal viral load, autoantibody, SARS-CoV-2 antibody titers, and nasal and peripheral blood mononuclear cell (PBMC) transcriptomics data from patients hospitalized with COVID-19. The aim of this study is to select baseline biomarkers and build predictive models for 28-day in-hospital COVID-19 severity and mortality with most predictive variables while prioritizing routinely collected variables.

Methods: We analyzed 1102 …

Pengetahuan Dan Persepsi Keluarga Penderita Penyakit Ginjal Tahap Akhir (Pgta) Terhadap Transplantasi Ginjal Di Rs Hasan Sadikin Bandung, Rizqa Adinda Syakira, Helni Mariani, Rizky Andhika

Jurnal Penyakit Dalam Indonesia

Introduction. Kidney transplantation is the best kidney replacement therapy for End Stage Renal Disease (ESRD) patients. The gap between the number of donors and recipients remains a problem contributing to the low rate of kidney transplantation in Indonesia. The families of ESRD patients are the most recommended donor candidates. Knowledge and perception have a crucial role in the decision to donate organs, making it important to know the knowledge and perception of ESRD patients’ families towards kidney transplantation. This study aimed to describe the knowledge and perception of families of ESRD patients undergoing dialysis at Dr. Hasan Sadikin General …

Cultivating Compassion: A Cross-Sectional Evaluation Of Empathy Among Medical Undergraduate Students, Anchu R Nath, Ishika Jindal, Nayanabai Shabadi, Sunil Kumar D

Digital Journal of Clinical Medicine

ABSTRACT:

BACKGROUND: Empathy plays a crucial role in medical practice, profoundly affecting patient outcomes and treatment. Understanding the factors that influence empathy among medical students can help in developing strategies to enhance empathetic skills during medical training. This study aims to evaluate the correlates of empathy among medical undergraduate students using an epidemiological cross-sectional design.

MATERIALS AND METHODS:

A cross-sectional study was conducted among 270 medical undergraduate students from various academic years at JSS Medical College for four months (September 2023-December 2023). Convenient sampling was used to select study participants. Participants completed a standardized empathy questionnaire, the Jefferson Scale …

Potential Of Right Ventricular Function Assessment With Echocardiography In Transcatheter Aortic Valve Replacement, Yoshihisa Morita, Taro Kariya, Michael Dougherty, Andrew Peters, Nicholas Ruggiero

Division of Cardiology Faculty Papers

BACKGROUND: Right ventricular (RV) function assessment by echocardiography can be challenging due to its complex morphology. Also, increasing use of sedation rather than general anesthesia for transfemoral approach transcatheter aortic valve replacement (TAVR) reduces the need for intraoperative transesophageal echocardiography (TEE). Recent clinical studies have demonstrated the importance of 3-dimensional (3D) echocardiography and a longitudinal strain for RV function assessment. In this study, we compared RV function echocardiographic assessment methodologies in TAVR and investigated its clinical utility.

METHODS: This was a prospective, observational study of TAVR at a large academic hospital. Inclusion criteria were adult patients undergoing TAVR requiring intraoperative …

Double-Blind Randomised Trial Of Saline Solution For Gargling And Nasal Rinsing In Sars-Cov-2 Infection, Sebastian R Espinoza, Lexton Trauffler, Amir Shamshirsaz, Alireza Shamshirsaz, Andres Espinoza, Jimmy Espinoza, Alice O'Brien

Faculty, Staff and Student Publications

Background: Previous studies have shown that hypertonic saline nasal irrigation and gargling reduced the duration of symptoms in upper respiratory infections caused by coronavirus. This study aims to investigate the effects of two saline regimens on symptoms associated with severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2).

Methods: Between 2020 and 2022, individuals aged 18-65 years who tested positive for SARS-CoV-2 infection via polymerase chain reaction (PCR) were randomly assigned to either low- or high-saline regimens for 14 days. The low-saline solutions contained 2.13 g of salt dissolved in eight ounces of warm water, while the high-saline solution contained six grams of …

Orthogonal And Multiplexable Genetic Perturbations With An Engineered Prime Editor And A Diverse Rna Array, Qichen Yuan, Hongzhi Zeng, Tyler C Daniel, Qingzhuo Liu, Yongjie Yang, Emmanuel C Osikpa, Qiaochu Yang, Advaith Peddi, Liliana M Abramson, Boyang Zhang, Yong Xu, Xue Gao

Faculty, Staff and Students Publications

Programmable and modular systems capable of orthogonal genomic and transcriptomic perturbations are crucial for biological research and treating human genetic diseases. Here, we present the minimal versatile genetic perturbation technology (mvGPT), a flexible toolkit designed for simultaneous and orthogonal gene editing, activation, and repression in human cells. The mvGPT combines an engineered compact prime editor (PE), a fusion activator MS2-p65-HSF1 (MPH), and a drive-and-process multiplex array that produces RNAs tailored to different types of genetic perturbation. mvGPT can precisely edit human genome via PE coupled with a prime editing guide RNA and a nicking guide RNA, activate endogenous gene expression …

Evaluasi Ekonomi Total Hip Arthroplasty Protokol Enhance Recovery After Surgery Dibandingkan Konvensional Di Rsup Fatmawati Jakarta, Hanna Elisabet Lumbangaol, Mardiati Nadjib

Jurnal Ekonomi Kesehatan Indonesia

Total hip arthroplasty (THA) is a common orthopedic procedure performed to replace damaged hip joints with prostheses. The demand for this procedure is expected to rise in the future. Enhanced Recovery After Surgery (ERAS) has been introduced as an evidence-based, multidisciplinary approach aimed at optimizing postoperative recovery and reducing hospital length of stay. This study aims to evaluate the costs and effectiveness, including hospital stay duration and surgical success rates, of THA using the ERAS protocol compared to conventional approaches. This cross-sectional study involved data collection from healthcare providers between January 2020 and May 2023. The analysis showed that both …

Factors Affecting Waiting Times To Enter Opioid Use Disorder Treatment In The United States With A Particular Focus On Potential Biological Sex Disparity, Stanley Nkemjika, Kenneth Oforeh, Connie Olwit, Olaniyi Olayinka, Terence Tumenta

Department of Psychiatry and Human Behavior Faculty Papers

AIM: Opioid use disorder (OUD) is the problematic use of licit or illicit opioids. Thus far, the literature on biological sex differences in accessing treatment is scarce. Hence, we hypothesize that biological sex has a moderating effect on OUD treatment accessibility. We aim to explore biological sex differences in treatment disparities and its role in wait time to enter OUD treatment.

METHOD: Using the 2018 Treatment Episode Data Set Discharge, the national sample representative of OUD patients in the substance use disorder treatment facilities within the 50 states of the United States was 382,547. Univariate and multivariable logistic analysis of …

Development And Evaluation Of An Implementation Strategy To Increase Hpv Vaccination Among Underserved Youth Across Texas: A Protocol Paper, Paula M Cuccaro, Jihye Choi, Lara S Savas, Efrat K Gabay, Mayra Aguilar Mcbride, Amy Montelongo Eldridge, Timothy J Walker

Faculty, Staff and Student Publications

BACKGROUND: All for Them is a theory-based and evidence-informed multilevel, multicomponent program delivered through schools to increase HPV vaccination among medically underserved youth across Texas. Given the potential logistical challenges of program implementation, understanding how to best support the implementation and sustainment of the program is critical. The overall goals of this study are twofold: 1) develop a multifaceted implementation strategy, Implementing All for Them (IM-AFT); and 2) evaluate the impact of IM-AFT on implementation outcomes for schools and healthcare providers to successfully implement All for Them in their respective settings.

METHODS: This study is underpinned by a comprehensive and …

Improving Pediatric Magnetic Resonance Imaging Safety By Enhanced Non-Technical Skills And Team Collaboration, Masashi Uramatsu, Hidekuni Takahashi, Paul Barach, Yoshikazu Fujisawa, Megumi Takahashi, Shiro Mishima, Gaku Yamanaka

College of Population Health Faculty Papers

BACKGROUND: Safe pediatric magnetic resonance imaging (MRI) ideally relies on non-sedative techniques, as avoiding risky sedation is inherently safer. However, in practice, sedation often becomes unavoidable, particularly for younger children or those with anxiety, to ensure motion-free, high-quality imaging. This narrative review explores the current practices and proposes strategies to enhance safety in pediatric MRI examinations.

METHODS: We identified and analyzed 247 studies addressing various aspects of pediatric MRI safety, including sedation protocols, patient monitoring, and team-based management approaches.

RESULTS: Safe sedation requires careful drug selection tailored to individual needs, continuous monitoring, and robust emergency preparedness. While efforts are underway …

Impact Of American Thyroid Association's Revised Cancer Management Guidelines On Thyroid Cancer Incidence Trends: A Retrospective Cohort Study, 2000-2020, Pierre Fwelo, Natalia I Heredia, Ruosha Li, Ayrton Bangolo, Vignesh K Nagesh, Simcha Weissman, Xianglin L Du

Faculty, Staff and Student Publications

Background: The past four decades have seen a steady increase in thyroid cancer in the United States (US). This study investigated the impact of the American Thyroid Association (ATA)'s revised cancer management guidelines on thyroid cancer incidence trends and how the trends varied by socioeconomic, histologic, geographic, and racial and ethnic characteristics from 2000 to 2020.

Methods: We used data from the Surveillance, Epidemiology, and End Results (SEER) database to identify thyroid cancer cases diagnosed among US patients between 2000 and 2020. We employed joinpoint regression software to fit, assess, and compare thyroid cancer incidence trends over time stratified by …

Improved Adherence To Lipid Screening In The Pediatric Cardiology Clinic: A Quality Improvement Project, Rachel Magnan, Thomas Murphy, Lauren Rosenthal, Aparna Prasad, Anjali Chelliah, Stuart Kaufman, Donna Timchak, Lindsey Mcphillips, Saira Siddiqui

Department of Pediatrics Faculty Papers

INTRODUCTION: Lipid screening identifies at-risk patients to facilitate cardiovascular risk reduction. National pediatric guidelines recommend universal lipid screening between 9-11 and 17-21 years of age. We aimed to improve adherence to lipid screening for all age-appropriate outpatient pediatric cardiology visits from a baseline of 35% to 90% between November 2021 and July 2023.

METHODS: All outpatient visits for patients 9-11 and 17-21 years were included. Chart review and an Epic electronic health record report identified patients screened, lipid test results, and need for further testing. A P-chart was generated. After establishing a baseline for 8 weeks, interventions, including an Epic …

Global Prevalence Of Helicobacter Pylori Antibiotic Resistance Among Children In The World Health Organization Regions Between 2000 And 2023: A Systematic Review And Meta-Analysis, Aryan Salahi-Niri, Ali Nabavi-Rad, Tanya Marie Monaghan, Theodore Rokkas, Michael Doulberis, Amir Sadeghi, Mohammad Reza Zali, Yoshio Yamaoka, Evelina Tacconelli, Abbas Yadegar

Faculty, Staff and Students Publications

Background: Helicobacter pylori infection causes gastritis, peptic ulcers, and gastric cancer. The infection is typically acquired in childhood and persists throughout life. The major impediment to successful therapy is antibiotic resistance. This systematic review and meta-analysis aimed to comprehensively assess the global prevalence of antibiotic resistance in pediatric H. pylori infection.

Methods: We performed a systematic search of publication databases that assessed H. pylori resistance rates to clarithromycin, metronidazole, levofloxacin, amoxicillin, and tetracycline in children. The WHO region classification was used to group pooled primary and secondary resistance estimates along with 95% confidence interval (CI). H. pylori antibiotic resistance rates …

Relative Survival, Conditional Survival, And Causes Of Death In Patients With Early Gastric Cancer, With A Focus On Differences Between Cardia And Non-Cardia Cancer, Anas Elgenidy, Omar Alomari, Mohamed Marey Hesn, Anas Khaled, Sarah A Nada, Mostafa Elsayed, Ali Mahmoud, Mohammed Al-Mahdi Al-Kurdi, Ahmed M Afifi, George Cholankeril

Faculty, Staff and Students Publications

Background: Many researchers believe that cardia (CGC) and non-cardia (NCGC) are two different types of tumors, having different features like incidence rate, risk factors, geographical location, and socioeconomic status. This study aims to investigate the causes of death (COD) survival rates among early gastric cancer patients with a focus on differences between CGC and NCGC.

Methods: This retrospective study employed SEER*stat software (version 8.3.92) to analyze the SEER 17 plus dataset (2000–2019). Standardized mortality ratios (SMR) were computed. Relative survival and conditional survival post-diagnosis were calculated using R software (version 4.1.0) among the different subgroups.

Results: Within the follow-up period, …

Protocol For Culturing Patient-Derived Organoids Of Cervical Cancer, Rui Wang, Timothy Harris, Dalissa Negrón-Figueroa, David Lo, Allison Judge, D'Shaunique Walters, Bo Jiang, Lauren E Colbert

Faculty, Staff and Student Publications

Herein, we present a protocol for culturing patient-derived organoids (PDOs) of cervical cancer that includes workflows for tumor biopsy/resection tissue and cytobrush-sampled cells. We describe steps for PDO culture initiation, including rinsing, gentle dissociation, Lymphoprep separation, and cell assessment, as well as seeding cells from surgical and cytobrush tissue digestion. We then provide guidance on PDO maintenance and passage and techniques for producing conditioned medium. Overall, this protocol serves as a valuable guide for establishing and maintaining cervical cancer PDOs. For complete details on the use and execution of this protocol, please refer to Colbert et al.

The Camden Study - A Pregnancy Cohort Study Of Pregnancy Complications And Birth Outcomes In Camden, New Jersey, Usa., Stephanie Shiau, Xinhua Chen, Ayana April-Sanders, Ellen C Francis, Shristi Rawal, Megan Hansel, Kehinde Adeyemi, Zorimar Rivera-Núñez, Emily S Barrett

Rowan-Virtua School of Osteopathic Medicine Departmental Research

BACKGROUND: Pregnancy is a unique stage of the life course characterized by trade-offs between the nutritional, immune, and metabolic needs of the mother and fetus. The Camden Study was originally initiated to examine nutritional status, growth, and birth outcomes in adolescent pregnancies and expanded to study dietary and molecular predictors of pregnancy complications and birth outcomes in young women.

METHODS: From 1985-2006, 4765 pregnant participants aged 12 years and older were recruited from Camden, NJ, one of the poorest cities in the US. The cohort reflects a population under-represented in perinatal cohort studies (45% Hispanic, 38% non-Hispanic Black, 17% White …

Influenza Knowledge And Barriers To Vaccination In Immunosuppressed Patients In The Pediatric Rheumatology Clinic., Julia G. Harris, Leslie Favier, Jordan T. Jones, Maria Ibarra, Michael J. Holland, Emily Fox, Kelly Jensen, Ashley K. Sherman, Ashley M. Cooper

Manuscripts, Articles, Book Chapters and Other Papers

BACKGROUND: Most patients with a pediatric rheumatic disease are at increased risk of influenza due to immunosuppressive medication use. Despite initial quality improvement efforts, our influenza vaccination rate plateaued at 72%, which prompted a survey of patients and families to assess provider vaccine recommendations, influenza knowledge, and barriers to influenza vaccination.

METHODS: Patients on immunosuppressive medication or their parent were eligible to complete a survey between July 2019 and January 2020. Survey questions assessed demographics, rheumatology diagnosis, immunosuppressive medication(s), influenza vaccination recommendation, patient/parent influenza knowledge, and barriers to influenza vaccination. Influenza vaccination rates for immunosuppressed patients were acquired each influenza …

Deceased Donor Renal Allograft Utility In Adult Single And Multi-Organ Transplantation In The United States, Peter J. Altshuler, Adam S. Bodzin, Kenneth A. Andreoni, Pooja Singh, Anju Yadav, Jaime M. Glorioso, Ashesh P. Shah, Carlo B. Ramirez, Warren R. Maley, Adam M. Frank

Department of Surgery Faculty Papers

BACKGROUND: Deceased donor multiorgan transplants utilizing kidneys (MOTs) can improve outcomes for multiorgan recipients but reduces kidneys for chronic renal failure patients.

METHODS: We reviewed the Organ Procurement and Transplantation Network database from 2015 through 2019, for adult deceased donor kidney transplants. Recipients were classified as kidney transplant alone (KTA) (n = 62,252) or MOTs pancreas-kidney, simultaneous pancreas-kidney (n = 3,976), liver-kidney, simultaneous liver-kidney (n = 3,212), heart-kidney, simultaneous heart-kidney (n = 808), and "other"-kidney, simultaneous "other" kidney (n = 73).

RESULTS: Liver, heart, and lung-alone transplants were at least 7 times more frequent than their MOT correlate, whereas the …

Utility Of Colposcopy For The Screening And Management Of Cervical Cancer In Africa: A Cross-Sectional Analysis Of Providers’ Training And Practices, Joël Fokom Domgue, Issimouha Dille, Freddy Gnangnon, Sharon Kapambwe, Celine Bouchard, Nomonde Mbatani, Elodie Gauroy, Nathalie Ledaga Ambounda, Robert Yu, Fatoumata Sidibe, Joseph Kamgno, Bangaly Traore, Pierre-Marie Tebeu, Gregory Halle-Ekane, Mohenou Isidore Diomande, Jean-Marie Dangou, Fabrice Lecuru, Isaac Adewole, Marie Plante, Partha Basu, Sanjay Shete

Faculty, Staff and Student Publications

Introduction: Cervical cancer is a public health issue in Africa with devastating socioeconomic consequences due to the lack of organized screening programs. The success of screening programs depends on the appropriate investigation and management of women who test positive for screening. Colposcopic assessment following positive screening results is a noteworthy issue in Africa. This study aimed to assess the utilization of colposcopy by providers in the region.

Methods: A cross-sectional study was conducted in 2021-2022 among healthcare providers involved in cervical cancer prevention activities in Africa. They were invited to report prior colposcopy training, whether they performed colposcopy and the …

The Revised Cdc Chronic Pain Guidelines And Payer Opioid Analgesic Policies In Michigan, Victoria Tutag Lehr, Cynthia L. Arfken

Michigan Journal of Public Health

Abstract

The 2016 publication of A Guideline for Prescribing Opioids for Chronic Pain by the Centers for Disease Control and Prevention motivated commercial and Medicaid payers to restrict their opioid prescribing policies including the imposition of hard limits on opioid daily dosages and duration. One result of these policies was an increase in abrupt opioid discontinuation and rapid tapering events for patients receiving long-term opioid therapy. Responding to this misapplication of the 2016 guideline, the 2022 revised guidelines emphasized individualized opioid therapy and exclusion of certain chronic diseases. However, it is not known if the payers changed their policies to …