The American Academy of Pediatrics coined the term “medical home” in 1967 for establishing a single source of care and medical record for children with special health care needs. This phenomenon has expanded across multiple disciplines and more...
Intermittent fasting is a process of planned and timed feeding restriction which can be utilized alone or in combination with a caloric deficit. Cardiovascular disease (CVD) refers to a number of conditions relating to the heart and blood vessels....
Background: Most estimates for the prevalence of depression and anxiety predate COVID-19, which has had a detrimental effect on mental health worldwide. While some literature has been published recently on the rise in prevalence of mental health...
Background: Up to 40% of older surgical patients develop postoperative delirium (POD) and/or postoperative cognitive dysfunction (POCD)–objective cognitive deficits occurring 1-12 months after surgery. Although POCD and POD are both associated...
Background
Breast density, or the amount of fibroglandular tissue (FGT) present relative overall breast volume, has been shown in multiple studies to increase the risk of developing breast cancer. Breast density is typically assessed...
Since the approval of Ipilimumab in 2011 use of immune checkpoint inhibitors (ICIs) has become a mainstay of cancer therapy with the potential to dramatically improve outcomes for even patients with advanced disease. Despite the dramatic potential...
Background: Peak-to-peak bipolar voltage varies with electrode orientation, fractionation, and collision events. Novel, omnipolar mapping is less dependent on electrode orientation. While studied in animal models, endocardial omnipolar mapping has...
Optimizing Management of the Central Nervous System in Patients with Acute Lymphoblastic Leukemia Undergoing Allogeneic Stem Cell Transplantation
Background: High-risk acute lymphoblastic leukemia (ALL) patients often undergo allogeneic...
Background: Epigenetic clocks estimate chronologic age using methylation levels at specific loci. Accelerated biologic aging, defined as higher epigenetic age compared with chronologic age, is associated with adverse health outcomes and mortality....
Background: Equity in organ transplantation cannot be fully achieved without an understanding of how social determinants of health (SDOH) mediate patient outcomes. Unfortunately, SDOH variables are currently inconsistently collected across...
Background
Black Americans are disproportionately affected by adverse cardiovascular events (ACEs). Over-the-counter (OTC) non-steroidal anti-inflammatory drugs (NSAIDs) confer increased risk for ACEs, yet racial differences in use of these...
Improved Outcomes in Severe Primary Graft Dysfunction following Heart Transplantation with Donation After Circulatory Death Compared to Donation After Brain Death
Authors: Austin Ayer; Lauren K. Truby, MD; Jacob N. Schroder, MD; Sarah...
Objectives: Despite known differences in electrocardiographic (ECG) findings by sex, only empirical thresholds for both sexes exist in current ECG guidelines for screening athletes for risk of sudden cardiac death (SCD). We hypothesize that our...
Background
Enterobacter sp. is a gram-negative, often drug-resistant bacillus that is classically identified from mucosal surfaces such as pulmonary or urinary tracts. Despite its virulence, Enterobacter represents a less common pathogen in...
Background: There is no consensus on optimum graft sizing for lung transplantation in restrictive lung disease (RLD). Matching based on predicted total lung capacity ratios (pTLCdonor:pTLCrecipient, Ratio 1) has been proposed, but pTLC is...
Background: Socioeconomic and neighborhood factors are associated with large disparities in health including body mass index (BMI) and cardiovascular fitness among pediatric populations. We aim to further characterize these associations in a...
Background: Frailty is prevalent among patients with heart failure (HF) and is associated with increased mortality and worse patient-centered outcomes. Hand grip strength (GS) has been proposed as a single-item marker of frailty and a potential...
Background: Gulf War Illness (GWI) is a chronic, multi-symptom disorder affecting 25-32% of Gulf War veterans. Veterans with GWI disproportionately suffer from gastrointestinal (GI) disorders. Given the increasing evidence supporting a gut-brain...
A Novel Exploration of Faculty Development in LICs: A Multi-Institutional Needs Assessment of Inpatient Preceptors
Emily Hatheway Marshalla*, Deborah L. Englea, Nancy Barrb, Robyn Latessac, Cecil Robinsond, Grier Stewartd, Poonam Sharmaa
aDuke...
Background: Childhood self-control impacts long-term outcomes but is recognized as malleable and thus a focus of interventions. Childhood self-control influences and is influenced by parenting, but there is limited longitudinal research on whether...
Background:
Adoption of the Prostate Imaging Reporting & Data System (PI-RADS) has been shown to increase detection of clinically significant prostate cancer on prostate mpMRI. We propose that a rule-based algorithm based on Regular...
Background: The Modified Checklist for Autism in Toddlers, Revised with Follow-up (M-CHAT-R/F) is a frequently used screening questionnaire for autism in children between 18-30 months. However, in 2016, the US Preventive Services Task Force...
Background: It is difficult for emergency department (ED) providers to evaluate the posterior eye with their standard of care tools (e.g., the direct ophthalmoscope). We have previously described a robotically aligned optical coherence tomography...
Background: Post-operative pain can interfere with healing and recovery and increases the risk
of delirium in older patients. This study examines how measures of pre-operative psychosocial
reserve, which may be modifiable, relate to pain after...
Title: Peripheral nerve blockade delays mobility and increases length of stay in geriatric hip fracture patients
Introduction: Peripheral nerve blockade (PNB) has been increasingly utilized in the care of geriatric hip fracture patients in...
Introduction:
The current American Association of Hips and Knee Surgeons (AAHKS) guidelines recommend pre-operative weight loss before total knee arthroplasty (TKA) in patients with body mass index (BMI) ≥40 kg/m2. There is a paucity of evidence...
Introduction
Early laparoscopic cholecystectomy (LC) for acute cholecystitis (AC) has been associated with improved outcomes and shorter length of stay (LOS). The objective of this study was to compare time to surgery (TTS) between non-Hispanic...
Background:
The risk of preeclampsia, a serious pregnancy complication characterized by high blood pressure and proteinuria, can be reduced with low-dose aspirin (LDA). Since 2014, the USPSTF has recommended LDA based on medical and...
BACKGROUND
Prior studies have demonstrated that long-term Total Knee Arthroplasty (TKA) outcomes are similar in patients with significant versus minimal preoperative coronal plane deformity. Limited short-term outcomes data, which determine...
Background
In patients (pts) with stable or no extracranial disease (ECD) presenting with breast cancer brain metastases (BCBrMs), current guidelines recommend pts receive local therapy with radiation +/- surgery, without changing systemic...
Background
Although two-stage revision arthroplasty is the gold standard for treating chronic prosthetic joint infection (PJI), patients may undergo additional surgeries or amputation for persistent infection, or never proceed with the second...
Background:
Approximately 14 to 19% of the United States population resides in rural counties, which face socioeconomic disadvantages, including higher poverty rates, poorer access to healthcare services, and lower rates of educational...
Purpose:
A transgender individual is someone whose gender identity differs from their assigned birth sex or the societal norms of that assigned sex. There are no formal guidelines regarding prostate specific antigen (PSA) screening in transgender...
Introduction: Glycogen storage disease type IX (GSD IX) results from a deficiency of the enzyme phosphorylase kinase (PhK), a key enzyme in glycogenolysis. The clinical spectrum of hepatic GSD IX varies widely with genetic subtype (GSD IX alpha2,...
BACKGROUND: The Rapid Acceleration of Diagnostics-Underserved Populations (RADx-UP) program is a consortium of community-engaged research projects with the goal of increasing access to Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2)...
Background: Volar locking plates (VLP) have gained popularity for surgical management of distal radius fractures (DRF). Despite the advantages of new plating systems, multiple complications have been recorded in the literature from the use of VLP....
Introduction:
Animal studies have shown that isoflurane versus propofol have differential effects on Alzheimer’s Disease (AD) pathology and memory function, though it is unclear whether these effects occur in humans.
Methods:
This was a...
Background
The Tanzanian National Childhood Cancer Network (NCCN) includes eleven hospitals each with individual clinical databases. To determine the geographic variation of presenting patients and potential regional socioeconomic influences, it...
Background:
Sudden infant death syndrome (SIDS) is a continuing health burden in the United States. There have been numerous risk factors previously associated with SIDS. However, there is a lack of robust, multivariable analyses of independent...
Background: Current management protocols for eosinophilic esophagitis (EoE) call for regular upper endoscopy and histologic reassessment of the esophagus. The benefit of collecting gastric and duodenal biopsies (GDBs) at each follow-up endoscopy...
Background
Digital personal health records (PHR) integrated with electronic health records via Fast Healthcare Interoperability Resources (FHIR) are promising care coordination (CC) tools. Over the past five years, we developed and tested a...
BACKGROUND: Orofacial clefts like cleft lip/palate are among the most common congenital birth defects, affecting 1 out of every 690 liveborn infants, or one baby born in the USA every two hours. Children with orofacial clefts may be functionally...
Importance
Patient-submitted images vary considerably in quality and utility. Studies that characterize patient-submitted images in a real-life setting are lacking.
Objective
To evaluate the quality and utility of patient-submitted images as...
Introduction: Urodynamic studies (UDS) play a fundamental role in guiding optimal neurogenic bladder management in patients with spina bifida. UDS findings correlate with the development of adverse urinary outcomes such as renal scarring,...
Objective: There is no standard way that physicians teach or evaluate surgical residents intraoperatively, and residents are proving to not be fully competent at core surgical procedures upon graduating. The Surgical Autonomy Program (SAP) is a...
Background. Visceral adipose depots such as hepatic steatosis (HS) and epicardial fat (EAT) have been implicated as markers for CVD. Branched chain amino acid (BCAA) metabolism is an important pathway in adiposity and cardiometabolic disease and...
Introduction: Survival rates of out of hospital cardiac arrests (OHCAs) in the United States are around 10%. Survival improves with rapid initiation of CPR and defibrillation with an automated external defibrillator (AED). In North Carolina,...
Background & Objective: Missed infant well-child visits (WCV) result in lost opportunity for critical preventative care. Racial disparities in WCV attendance are widespread and long-standing; in North Carolina, black infants consistently have...
BACKGROUND Patients with alpha-gal syndrome experience an IgE-mediated allergic response to the mammalian cell membrane carbohydrate galactose-alpha-1,3-galactose (alpha-gal). Unlike humans, most mammals, including cows and pigs, express the...
Background: Black individuals have the highest mortality rate of any racial group for most cancers. While research is vital to reduce cancer-related disparities, distribution of funding may lead to unintended effects of exacerbating inequities....
Background: The purpose of this prospective randomized controlled trial is to compare the safety and efficacy of the Baerveldt glaucoma implant (J&J Vision Inc., Santa Ana, CA) to the Ahmed ClearPath (New World Medical Inc., Rancho Cucamonga,...
Background: With continued advances in genomic testing, increased use of whole-exome sequencing in the clinical setting is likely to facilitate the identification of patients with rare genetic disorders who would have previously gone undiagnosed....
There are many terms used to describe gender identity which are often classified into broad umbrellas of “cisgender” versus “transgender.” Transgender indicates a gender identity differing from sex assigned at birth while cisgender refers to a...
Objective: We examined the impact of market competition and surgeon availability on hospital price disclosure for total joint arthroplasty (TJA).
Background: The Centers for Medicare and Medicaid Services (CMS) price transparency rule aims to...
Objectives:
Right ventricular dominance (RVD) is a known risk factor for mortality in patients with single ventricle heart defects undergoing neonatal repair. However, the long-term impact of RVD on patients surviving to Fontan palliation remains...
Background: Despite greater than average need, rural Americans face additional obstacles to accessing health care. Since 2005, over 180 rural hospitals have closed across the United States and nearly 800 rural hospitals remain at high risk of...
Background: Radical hysterectomy is the standard of care treatment for early-stage cervical cancer, making it a mandatory skill for a gynecologic oncologist. High surgical case volume is important both for fellowship training and patient outcomes....
Background: It is unclear what impact the U.S. Department of Health and Human Services’ policy change removing the buprenorphine waiver training requirement had on buprenorphine prescribing in primary care. We assessed attitudes, practices, and...
Background: Patients with gynecologic cancers and malignant bowel obstruction (MBO) have poor prognoses and quality of life. The Henry score was developed in a gastrointestinal cancer- predominant population to predict 30-day mortality and...
Background
Within the past decade, there have been major advancements in immunotherapy treatment options for melanoma. While disparities in the utilization of immunotherapy for the treatment of melanoma have been documented in the published...
Background
Allogeneic hematopoietic stem cell transplantation (HSCT) is a treatment for hematologic malignancies that can be potentially curative. 1,2 Patients receive a conditioning regimen with total body irradiation (TBI) and/or chemotherapy...
BACKGROUND: Patients with neurodevelopmental disorders (NDD), including those with developmental delay, autism, and childhood-onset psychiatric and seizure disorders, increasingly seek evaluation of new or exacerbated symptoms concerning for...
Background/Objective
Ductal carcinoma in situ (DCIS) is a preinvasive diagnosis for which breast conserving surgery (BCS), breast conserving surgery with adjuvant radiation (BCS+RT), and mastectomy are all approved to be guideline-concordant...
Objective: To assess the relationship between choroidal vascularity index (CVI), subfoveal choroidal thickness (SFCT), and central subfield thickness (CST) in treatment-naïve eyes with cystoid macular edema (CME) due to branch retinal vein...
Background: Fibroepithelial tumors of the breast are a group of biologically heterogeneous biphasic neoplasms that exist on a spectrum from benign fibroadenomas (FA) to malignant phyllodes tumors (PT). Given differences in biological behavior...
Background
Neuromyelitis optica (NMO) is a rare autoimmune neurological disorder commonly presenting with positive serum aquaporin-4 (AQP4) antibody titers. NMO has been thought to follow a progressive disease course, with step-wise accumulation...
Racial and Ethnic Disparities in Survival Outcomes of Patients with Metastatic Breast Cancer
Authors:
Marguerite M. Rooney, BS; Samantha M. Thomas, MS; Tomi Akinyemiju, PhD; Sarah Sammons, MD; Laura Noteware, BS; Laura H. Rosenberger, MD, MS;...
Background:
Studies show it is safe to have multiple sessions of single laser treatment over an appropriate period of time, which allows for the skin to heal between treatments. Waiting to have several sessions may not be realistic for every...
Background: The COVID pandemic has led to decreased care utilization in the general obstetric population. Timely initiation of prenatal care is especially important for patients with high-risk pregnancies, such as a history of preterm birth. Such...
Background. Peripheral artery disease (PAD) affects over 8.5 million Americans who are at increased risk of adverse outcomes including myocardial infarction, stroke, limb amputation, and death. Despite its prevalence, PAD remains underdiagnosed,...
BACKGROUND: In the United States, socioeconomic status (SES), race, and ethnicity has been shown to predict adverse outcomes in various carcinomas as well as in soft tissue sarcoma. However, existing evidence is unclear if race is an independent...
Background: Some older patients have lasting cognitive impairment after anesthesia/surgery though it remains unclear if this cognitive decline is caused by anesthesia/surgery versus whether it simply reflects the natural cognitive trajectory due...
Background: Renal function outcomes between radical nephroureterectomy (RNU) and nephron-sparing surgery (NSS) for upper tract urothelial carcinoma (UTUC) patients are not well established. We sought to compare the incidence and factors associated...
Introduction: Psychological distress has been associated with declining shoulder function and
quality of life for patients with rotator cuff tears. Despite this, there are few published studies that
have examined the impact of rotator cuff tear...
BACKGROUND: Complicated intra-abdominal infections (cIAI) are a leading cause of infant morbidity and mortality. Current antibiotic regimens for cIAI are derived to achieve bactericidal plasma concentrations, but whether these dosing regimens...
Background: Prosthetic valve endocarditis (PVE) is a morbid complication following aortic valve replacement, whether performed using surgical (SAVR) or transcatheter (TAVR) techniques. However, few data exist on occurrence of structural...
Objective: To quantify the rates of specialty care referral completion and identify variables associated with successful completion among a population of low-income, elderly and/or disabled homebound patients with barriers to accessing...