Faculty Bibliography
Searched for:
school:LISOM
Total Results:
14154
Medical Mistrust and the Patient Experience: A National Survey on What Shapes Engagement in OB/GYN Care
OBJECTIVES/OBJECTIVE:To examine how media, geography, race, and social factors shaped patient experiences to inform strategies for improving trust and care. DESIGN/METHODS:We conducted a cross-sectional online survey of experiences and perceptions of OB/GYN care and medical mistrust using a stratified, randomised sampling approach. SETTING/METHODS:The survey was distributed through Prolific. POPULATION/METHODS:Inclusion criteria included assigned female at birth, age between 18 and 40 years, and residing in the United States. MAIN OUTCOME MEASURES/METHODS:Gender preference of OB/GYN clinician, demographic association with negative OB/GYN experiences, and degree of medical mistrust. RESULTS:Of 579 respondents, 93% identified as women, 33.9% as LGBTQIA+, and 45.2% had a history of pregnancy. Anxiety was the most common (46.4%) emotion experienced when receiving OB/GYN care, and 25.8% reported negative experiences, primarily from minimization of concerns (68.5%). A majority (65.3%) preferred receiving care from a female OB/GYN. Identifying as Republican was associated with higher odds of having had a negative experience with an OB/GYN, whereas Asian race and lower education were linked to lower odds. Black, Asian, and multiracial participants were more likely to have a racial preference for clinicians. Medical mistrust was higher among Black respondents and those with lower education. Feeling heard by a clinician was the strongest predictor of care satisfaction. CONCLUSION/CONCLUSIONS:Anxiety and negative experiences were prevalent among participants. Feeling heard was the strongest predictor of patient satisfaction, highlighting the importance of patient-centred OB/GYN care to reduce mistrust and improve patient experiences, particularly for marginalised groups.
PMID: 41667132
ISSN: 1471-0528
CID: 6002042
Using cognitive testing to predict employment status in multiple sclerosis: A comparative study of the SDMT and a computerized cognitive assessment tool
BACKGROUND:Cognitive impairment (CI) is prevalent in people with multiple sclerosis (PwMS) and influences employment outcomes independent of physical disability. Although associations between multi-domain CI and employment have been established, less is known about the relative clinical utility of brief cognitive screening tools versus time-efficient multi-domain computerized assessments that can be implemented in routine care. OBJECTIVES/OBJECTIVE:To compare the Symbol Digit Modality Test (SDMT) and NeuroTrax computerized cognitive battery (NT) as predictors of self-reported employment status in PwMS. METHOD/METHODS:109 PwMS (Mean age = 48 years, SD = 10.4; 74 % female) completed the oral SDMT and NT as part of routine clinical care. Employment status was self-reported as "employed" or "unemployed" (including early retirement if <55 years). RESULTS:(3) = 17.862, p < .001), with executive function and attention most frequently impaired. CONCLUSION/CONCLUSIONS:While the SDMT remains a useful screening tool, the NT appears clinically feasible for use in routine care and provides incremental and domain-specific information beyond processing speed alone. Extending assessment in routine care beyond a single screening measure may better characterize cognitive profiles associated with unemployment and inform individualized vocational interventions in PwMS.
PMID: 41713333
ISSN: 2211-0356
CID: 6005072
Histology of amiodarone-induced liver injury revisited: A retrospective morphologic analysis
Amiodarone-induced liver injury (AILI) is a known risk of amiodarone therapy, with presentations ranging from asymptomatic aminotransferase elevations to severe or fatal hepatitis and cirrhosis. Due to limited understanding of its histopathologic features, we conducted a retrospective cross-sectional re-analysis of liver biopsy samples from patients on amiodarone from two centers. Of the 48 liver biopsy samples, 42 (87%) exhibited histologic evidence of AILI. All patients showed minimal or mild macrovesicular steatosis. Ballooned hepatocytes were observed in 36 cases (86%), with 25 (69%) displaying a periportal distribution, 8 (22%) centrilobular, and 3 (8%) panacinar in distribution. Mallory-Denk bodies were found in 36 samples (76%)-18 (50%) were numerous and 18 (50%) multiple. Cholestasis was present in 10 patients, 7 (70%) of whom died. In contrast, 10 (31%) of the 32 patients without cholestasis died. This represents a significantly increased mortality risk for patients with AILI and cholestasis (p = 0.03). While AILI shares features with the more generally known metabolic dysfunction-associated steatotic liver disease, our findings indicate that a prominence of periportal distribution of ballooned hepatocytes and Mallory-Denk bodies despite a minimum of macrovesicular steatosis are characteristic of AILI. Furthermore, cholestasis in biopsy samples may suggest a poorer prognosis in patients on amiodarone.
PMID: 41671912
ISSN: 1532-8198
CID: 6002282
The International Guideline for the Definition, Classification, Diagnosis and Management of Urticaria
This update and revision of the international guideline for urticaria was developed in accordance with the methods recommended by Cochrane and the Grading of Recommendations Assessment, Development and Evaluation (GRADE) working group. It is an initiative of the Global Allergy and Asthma Excellence Network (GA2LEN) and its Urticaria and Angioedema Centers of Reference and Excellence (UCAREs and ACAREs), with the participation of 210 delegates from 107 national and international societies, from 59 countries. The consensus conference was held on December 6th, 2024. This guideline was acknowledged and accepted by the European Union of Medical Specialists (UEMS). Urticaria is a frequent, mast cell-driven disease, defined by a rapid appearance of wheals, angioedema, or both. The lifetime prevalence of acute urticaria is estimated to be approximately 20%. Chronic urticaria, categorized as either chronic spontaneous urticaria or chronic inducible urticaria, is disabling, impairs quality of life, and affects performance at work and school, however, novel therapies are available. This updated version of the international guideline for urticaria covers the definition and classification of urticaria and outlines expert-guided and evidence-based diagnostic and therapeutic approaches for the different subtypes of urticaria.
PMID: 41649409
ISSN: 1398-9995
CID: 6000592
Exploring Sex Differences in Stroke Outcomes: A Comprehensive Analysis From the SPAN 1 Trial
BACKGROUND:Stroke is a sexually dimorphic disease, with different risk factors, incidence, outcomes, and treatment responses in men and women. While sex differences have been documented in preclinical studies, these findings often come from single-site studies with small sample sizes and require validation across diverse research settings. METHODS:We used data from the SPAN (Stroke Preclinical Assessment Network), a randomized, placebo-controlled, blinded, multilaboratory trial, to determine if sex differences in neurological outcomes are present in preclinical stroke models. We analyzed data from 665 stroke animals treated with saline, including young mice, diet-induced obese mice, aging mice, young rats, and spontaneously hypertensive rats. We compared the corner test index and brain morphology between the sexes using linear random effect models and assessed the mortality rate using Cox proportional hazard regression models. RESULTS:No significant sex differences were found in neurological outcome measured with the corner test on either day 7 or day 30 after stroke, regardless of the mouse or rat stroke model used. Additionally, female and male mice exhibited similar infarct sizes on day 2 magnetic resonance imaging and on brain atrophy measures on day 30 after stroke, indicating a lack of sex differences in brain injury. Similarly, no sex differences were observed in acute or chronic sensorimotor or tissue outcomes in young rats. In 1 subanalysis, sex differences were seen in the spontaneously hypertensive rats cohort. Female rats exhibited a higher corner test index on day 30 than males, indicating more severe sensorimotor injury. CONCLUSIONS:In this multicenter preclinical study, we did not detect sex differences in stroke outcomes in mice, although sex differences in behavioral outcomes were observed in spontaneously hypertensive rats. These findings highlight that sex differences may be model-specific and subtle, emphasizing the need for methodological consistency and thoughtful inclusion of diverse animal models in translational stroke research to better understand if sex-specific responses contribute to stroke outcomes.
PMID: 41631765
ISSN: 2047-9980
CID: 5997812
Enhancing gastroenterology education through e-learning
E-learning has revolutionized medical education by providing flexible, accessible, and interactive learning opportunities. This article explores the transformative impact of e-learning on gastroenterology education, highlighting the advancements and benefits brought by the American Society for Gastrointestinal Endoscopy (ASGE) platforms. ASGE's e-learning platforms offer specialized content, interactive tools, and continuous updates, enhancing the learning experience for gastroenterologists.
PMID: 41632049
ISSN: 1097-6779
CID: 5999722
Against the Current: Celebrating Dr. Judah Folkman (1933-2008)
PMID: 41622510
ISSN: 1538-4683
CID: 5999432
Journal of the American Academy of Orthopaedic Surgeons. Global research & reviews. 2026:10(2).DOI: 10.5435/JAAOSGlobal-D-25-00187
Practice Patterns in Body Mass Index Optimization Among US Arthroplasty Surgeons: Results of a National American Association of Hip and Knee Surgeons Survey
INTRODUCTION/BACKGROUND:As total hip arthroplasty and total knee arthroplasty procedures are increasingly performed on younger patients with obesity, the optimal approach to preoperative weight management remains undefined. This study explores national trends among US arthroplasty surgeons regarding body mass index (BMI) cutoffs, weight optimization strategies, and weight loss medication usage. METHODS:A 28-question national survey was distributed through e-mail to members of the American Association of Hip and Knee Surgeons and shared on professional social media platforms (Facebook, ResearchGate, and LinkedIn) between January 1 and August 5, 2024. RESULTS:Regarding arthroplasty reconstruction fellowship training, 82.58% (441/534) of respondents were fellowship trained, 11.42% (61/534) were not fellowship trained, and 5.99% (32/534) trained in other specialties. In terms of BMI optimization strategies, 82.84% (n = 444/536) recommended structured diet and exercise programs, 77.99% (n = 418/536) recommended dietitian or weight loss specialist programs, and 52.61% (n = 282/536) advocated for bariatric surgery. For total hip arthroplasty, 45.13% of surgeons used a BMI cutoff <40 kg/m2 (n = 241/534), followed by 23.97% advocating for no strict cutoff (n = 128/534). For total knee arthroplasty, 41.65% reported using a cutoff of <40 kg/m2 (n = 222/533), with 24.39% (n = 130/533) reporting no strict BMI cutoff. In addition, 27.62% (n = 58/210) reported that their patients used weight loss medications such as GLP-1 agonists. Notably, 68.0% (n = 356/526) of surgeons allowed up to 1 to 2 years for BMI optimization before surgery. CONCLUSION/CONCLUSIONS:Although many arthroplasty surgeons use BMI cutoffs, many accommodate patients through nonsurgical interventions to facilitate weight loss. These findings indicate that many respondents report a multidisciplinary approach to preoperative BMI optimization.
PMCID:12915733
PMID: 41706617
ISSN: 2474-7661
CID: 6004762
Hidden Burden of Fallopian Tube Endometriosis: Prevalence and Associations with Pelvic Pathology
PMCID:12898751
PMID: 41682817
ISSN: 2077-0383
CID: 6002512
Effect of Delayed Parathyroidectomy on Risk of Future Cardiovascular and Nephrolithiasis Interventions in Adults with Primary Hyperparathyroidism [Original Study]
OBJECTIVE:To determine whether the timing of parathyroid surgery impacts the risk of renal stone retreatment and cardiovascular interventions. SUMMARY BACKGROUND DATA/BACKGROUND:Long-term, untreated primary hyperparathyroidism is associated with significant morbidity including nephrolithiasis and cardiovascular disease. METHODS:We conducted a Population-based Cohort study of New York and California state-wide data from 2000-2020. Adult patients who underwent renal stone treatment and subsequently diagnosed with primary hyperparathyroidism (pHPT) and underwent parathyroidectomy (PTX) were included. Patients were excluded if PTX was prior to index stone procedure, they underwent second stone treatment within 6 months, with stage V CKD, with secondary or tertiary hyperparathyroidism, with prior kidney transplant or hemodialysis, or with prior cancer diagnosis. Rate of renal stone retreatment and cardiovascular interventions after PTX in pHPT patients with nephrolithiasis who underwent parathyroid surgery at ≤ 2 years and >2 years after index stone procedure was measured. RESULTS:We identified 2,093 patients who underwent first-time stone treatment and subsequent PTX. The median time to PTX was 560 days (IQR 187-1477) and follow-up was 7.4 years (IQR 4.5-13.1). Delaying PTX for more than 2 years increased the risk of renal stone retreatment by 59% (HR 1.59; P<0.001), increased the risk of experiencing coronary disease or associated interventions by 118% (HR=2.18; P=0.01), and increased the risk of experiencing an overall cardiovascular event by 52% (HR 1.52; P<0.01). CONCLUSIONS AND RELEVANCE/CONCLUSIONS:In symptomatic pHPT, delaying PTX significantly increases the risk of requiring future stone retreatment and cardiac/vascular surgical interventions. This highlights the importance of early surgical referral and multidisciplinary approaches to optimize outcomes and resource utilization in pHPT.
PMID: 39176567
ISSN: 1528-1140
CID: 5865572
