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COVID-19 and the Consequences of Anchoring Bias

Horowitz, Harold W; Behar, Caren; Greene, Jeffrey
Suspicion of coronavirus disease in febrile patients might lead to anchoring bias, causing misdiagnosis of other infections for which epidemiologic risks are present. This bias has potentially severe consequences, illustrated by cases of human granulocytic anaplasmosis and Lyme disease in a pregnant woman and human granulocytic anaplasmosis in another person.
PMID: 34287136
ISSN: 1080-6059
CID: 4965362

Experience with faculty supervision of an electronic resident sign-out system

Nabors, Christopher; Peterson, Stephen J; Lee, Wei-Nchih; Mumtaz, Arif; Shah, Tushar; Sule, Sachin; Gutwein, Andrew H; Forman, Leanne; Eskridge, Etta; Wold, Eric; Stallings, Gary W; Burak, Kathleen Kelly; Karmen, Carol; Behar, Caren F; Carosella, Christine; Yu, Shick; Kar, Kausik; Gennarelli, Melissa; Bailey-Wallace, Gail; Goldberg, Randy; Guo, Gary; Frishman, William H
PMID: 20362760
ISSN: 0002-9343
CID: 201022

Intraoral topical nonsteroidal antiinflammatory drug application for headache prevention

Friedman, Mark H; Peterson, Stephen J; Frishman, William H; Behar, Caren F
Recent evidence suggests an association between migraine and tension-type headache and local inflammation occurring in a maxillary nerve segment. This study was designed to evaluate the efficacy of topical ketoprofen for the prevention of migraine, tension-type, and posttraumatic headache. Patients with a headache frequency of at least once a week recorded the frequency, severity, duration, and type of headache for 60 days. After 30 days, patients applied the medication daily for the next 30 days to the periapical area of the maxillary molars on the symptomatic side(s). Headache medications and analgesics were permitted, as needed. Headache burden was defined as the average intensity of each headache (0-10 scale) multiplied by its duration, in hours. The average monthly headache burden score for the 20 patients enrolled in this study decreased from 454.8 (30-day baseline) to 86.5 P < 0.001 during the 30-day treatment phase. Analgesic and headache medication intake were significantly reduced from baseline during the treatment phase, and side effects were minimal.
PMID: 12147180
ISSN: 1521-737x
CID: 201032

Intraoral chilling versus oral sumatriptan for acute migraine

Friedman, M H; Peterson, S J; Behar, C F; Zaidi, Z
Migraine pathophysiology is associated with a dural inflammation. Recent evidence suggests that the primary inflammation occurs in a maxillary nerve segment, accessible intraorally. Local tenderness, related to symptom laterality, has been palpated consistently in asymptomatic migraine patients, and significant migraine relief has been obtained from chilling confined to this area. Thirty-five symptomatic episodic migraine patients were enrolled in this study, comparing 40 minutes of bilateral intraoral chilling, 50 mg of oral sumatriptan, and 40 minutes of sham (tongue) chilling. Hollow metal tubes chilled by circulating ice water were held in the maxillary molar periapical areas by the patient. Pain and nausea were recorded at baseline and 1, 2, 4, and 24 hours after start of treatment, using a numeric symptom-relief scale. Significant mean headache relief was obtained by maxillary chilling and sumatriptan at all four time intervals, with poor relief obtained by placebo. Maxillary chilling was more effective than sumatriptan at all four time intervals. Significant nausea relief was obtained by maxillary chilling and sumatriptan at posttreatment and 2 and 4 hours later. At 24 hours, some headache and nausea recurrence was noted with sumatriptan. The repeated-measures analysis of variance indicated that both treatments, drug (P = 0.024) and maxillary chilling (P = 0.001), reduced the headache, as compared with the control group. Tenderness suggests local inflammation associated with vasodilatation and edema. Because chilling can resolve local edema, these findings raise the possibility that an intraoral inflammation may be a factor in migraine etiology.
PMID: 11975819
ISSN: 1521-737x
CID: 201042

Gentamicin uptake in wild-type and aminoglycoside-resistant small-colony mutants of Staphylococcus aureus

Miller MH; Edberg SC; Mandel LJ; Behar CF; Steigbigel NH
PMID: 7447428
ISSN: 0066-4804
CID: 32886