Publications by authors named "Anthony Perkins"

Article Synopsis
  • The study investigates the effectiveness of the Healthy Aging Brain Care Monitor Self Report (HABC-M SR) in assessing post-intensive care syndrome (PICS) among patients recovering from acute respiratory failure in an ICU.
  • It uses secondary data from a randomized controlled trial, focusing on English-speaking adults who needed prolonged mechanical ventilation, assessing various health metrics at ICU discharge, and 3 to 6 months afterward.
  • Findings show that while overall PICS symptoms improved significantly over time, the HABC-M SR's cognitive subscale was less effective than other standardized tests in measuring cognitive health.
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  • The study investigates how serum albumin levels relate to the duration and severity of in-hospital delirium in critically ill patients.
  • Conducted on 237 adult patients, the findings show that while higher albumin levels (≥3 g/dL) were tied to shorter hospital stays, they did not significantly affect the duration or severity of delirium.
  • Overall, the research suggests that while albumin levels may influence hospital length of stay, they don't have a clear link to how long or severe delirium episodes were for patients.
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Proton pump inhibitors (PPIs) are one of the standards of care of eosinophilic esophagitis (EoE) treatment, though PPI response rates are variable ranging from 23 to 63% in pediatric studies. We sought to determine if expression of select genes in esophageal mucosa can predict PPI responsiveness in EoE. Children with a new diagnosis of EoE (15 or more eosinophils/hpf on esophageal biopsy) were prospectively treated with 8 weeks of PPI therapy before follow-up esophagogastroduodenoscopy (EGD).

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Introduction: The aim of this study was to evaluate the association between placental abnormalities, placental biomarkers, and fetoplacental Dopplers in a cohort of pregnancies complicated by fetal growth restriction (FGR). We also ascertained the risk of perinatal mortality, severe neurological morbidity, and severe non-neurological morbidity by type of placental abnormality.

Methods: This was a prospective cohort study.

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Article Synopsis
  • This study compares the effectiveness and safety of two treatments for Zenker's diverticulum: flexible endoscopic needle-knife septotomy (FENKS) and peroral endoscopic myotomy (Z-POEM).
  • A total of 60 patients underwent these procedures, and while both had a high technical success rate, FENKS resulted in more complications and hospitalizations compared to Z-POEM.
  • Overall, Z-POEM showed to be a safer option with similar clinical success in the short and mid-term follow-ups.
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This study examines whether a key psychosocial factor-perceiving racial discrimination in health care-is associated with worse patient activation, communication self-efficacy, and physical health outcomes for Black veterans with chronic pain. Moreover, we explore the role of physician-patient working alliance as a moderator that may alleviate the potential consequences of perceiving racial discrimination. This work is a secondary analysis of baseline data from a clinical trial with 250 U.

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Linoleic acid (LA) is required for neuronal development. We have previously demonstrated sex-specific changes in cardiovascular and hepatic function in rat offspring from mothers consuming a high-LA diet, with some effects associated with reduced LA concentration in the postnatal diet. At this time, the impact of a high-maternal-LA diet on offspring brain development and the potential for the postnatal diet to alter any adverse changes are unknown.

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Metabolomics is the study of small molecules (metabolites), within cells, tissues and biofluids. Maternal metabolites can provide important insight into the health and development of both mother and fetus throughout pregnancy. This study assessed metabolic profiles in the maternal circulation prior to and at the time of diagnosis of preeclampsia and fetal growth restriction.

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Linoleic acid (LA), an n-6 polyunsaturated fatty acid (PUFA), is obtained from the maternal diet during pregnancy, and is essential for normal fetal growth and development. A maternal high-LA (HLA) diet alters maternal and offspring fatty acids, maternal leptin and male/female ratio at embryonic (E) day 20 (E20). We investigated the effects of an HLA diet on embryonic offspring renal branching morphogenesis, leptin signalling, megalin signalling and angiogenesis gene expression.

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Importance: Older adults with recent injuries can have impaired long-term biopsychosocial function and may benefit from interventions adapted to their needs.

Objective: To determine if a collaborative care intervention, Trauma Medical Home (TMH), improved the biopsychosocial function of older patients in the year after injury.

Design, Setting, And Participants: This was a single-blinded, randomized clinical trial conducted at 4 level I trauma centers in Indianapolis, Indiana, and Madison, Wisconsin.

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Introduction: Previous studies have reported that neonates less than the 25th BWC especially if they were male, were more likely to be associated with birth complications suggesting small neonates often identified as appropriately grown are at risk of adverse outcomes. We have questioned whether smaller neonates not typically categorized as "small for gestational age" may not reach their genetically determined growth due to placental insufficiency.

Methods: RNA-Seq was performed on the Illumina NovaSeq 600 using term placentae from neonates that were less than the 10th birthweight centile (BWC) (n = 39), between the 10th and the 30th BWC (n = 15) or greater than the 30th BWC (n = 23).

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Article Synopsis
  • Birthweight centile (BWC) below the 25th percentile is linked to higher risks of negative pregnancy outcomes, with males being particularly affected.
  • The study utilized RNA sequencing to analyze gene expression in male placentae at term, categorizing them by BWC (<10th, 10th-30th, >30th percentiles).
  • Findings revealed that lower BWC correlates with increased expression of androgen response elements and related gene sets, suggesting impaired placental function that may hinder fetal growth.
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Importance: Over 50% of Acute Respiratory Failure (ARF) survivors experience cognitive, physical, and psychological impairments that negatively impact their quality of life (QOL).

Objective: To evaluate the efficacy of a post-intensive care unit (ICU) program, the Mobile Critical Care Recovery Program (m-CCRP) consisting of a nurse care coordinator supported by an interdisciplinary team, in improving the QOL of ARF survivors.

Design, Setting, And Participants: This randomized clinical trial with concealed outcome assessments among ARF survivors was conducted from March 1, 2017, to April 30, 2022, with a 12-month follow-up.

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Linoleic acid (LA), an n-6 polyunsaturated fatty acid (PUFA), is essential for fetal growth and development. A maternal high LA (HLA) diet alters cardiovascular development in adolescent rats and hepatic function in adult rats in a sex-specific manner. We investigated the effects of an HLA diet on adolescent offspring hepatic lipids and hepatic lipid metabolism gene expression, and the ability of the postnatal diet to alter these effects.

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Background: Loneliness is a significant public health challenge in the United States, especially among older adults. The epidemiology of loneliness among older adults in primary care is lacking, and specific research is needed on how loneliness impacts older primary patients' physical, mental, and cognitive health. A large sample of older primary care patients were recruited for a trial during the COVID-19 pandemic to measure the relationship between loneliness and physical and mental quality of life (QOL).

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Background: In response to the aging population, the Department of Veterans Affairs (VA) seeks to expand access to evidence-based practices which support community-dwelling older persons such as the Geriatric Resources for Assessment and Care of Elders (GRACE) program. GRACE is a multidisciplinary care model which provides home-based geriatric evaluation and management for older Veterans residing within a 20-mile drive radius from the hospital. We sought to expand the geographic reach of VA-GRACE by developing a hybrid-virtual home visit (TeleGRACE).

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Gastroesophageal reflux disease (GERD) following peroral endoscopic myotomy (POEM) occurs in 40% to 60% of patients. There are limited data evaluating antireflux surgery or transoral incisionless fundoplication (TIF) for refractory post-POEM GERD. In a single-center prospective cohort study, consecutive patients with medically refractory post-POEM regurgitation and/or GERD treated with TIF or combined laparoscopic hernia repair and TIF (cTIF) were evaluated.

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Article Synopsis
  • The study examines how depression and anxiety impact both older adult patients and their family members, highlighting their interdependence during illness transitions.
  • Using data from 1,808 patient-family dyads in a trial related to Alzheimer's disease, the research identifies the effects of mental health on health-related quality of life (HRQOL).
  • Key findings show that both patients and family members' mental health significantly affects each other's HRQOL, emphasizing that health issues can influence the pair's well-being even before caregiving roles are established.
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Background: Obesity has a negative impact on the physical and psychosocial quality of life of children. As rates of obesity continue to increase, it is important to recognize the widespread effects obesity has on children and their families.

Methods: This clinical investigation evaluated the self-reported quality of life of children with obesity in a weight management program and compared this to a parent/guardian's perspective of the child's quality of life using the Pediatric Quality of Life survey 4.

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In high-income nations, multiple micronutrient (MMN) supplementation during pregnancy is a common practice. We aimed to describe maternal characteristics associated with supplement use and daily dose of supplemental nutrients consumed in pregnancy, and whether guideline alignment and nutrient status are related to supplement use. The Queensland Family Cohort is a prospective, Australian observational longitudinal study.

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Objectives: Endoscopic ultrasound (EUS)-guided injection of cyanoacrylate (CYA) for primary prophylaxis (PP) of gastric varices (GV) is controversial. This study evaluates the safety and efficacy of this intervention.

Methods: Patients treated for PP of GV bleeding by EUS injection of CYA with or without coils were identified.

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Background And Aims: Given the growing utilization of critical care services by an aging population, development of population-level risk models which predict intensive care unit (ICU) survivorship and mortality may offer advantages for researchers and health systems. Our objective was to develop a risk model for ICU survivorship and mortality among community dwelling older adults.

Methods: This was a population-based cohort study of 48,127 patients who were 50 years and older with at least one primary care visit between January 1, 2017, and December 31, 2017.

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Background: Delirium is a complex neuropsychiatric syndrome which consists of acute and varying changes in cognition and consciousness. Patients who develop delirium are at increased risk for a constellation of physical, cognitive, and psychological disabilities long after the delirium has ended. Collaborative care models integrating primary and specialty care in order to address patients with complex biopsychosocial needs have been demonstrated to improve outcomes in patients with chronic diseases.

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Background: Postoperative delirium occurs in up to 80% of patients undergoing esophagectomy. We performed an exploratory proteomic analysis to identify protein pathways that may be associated with delirium post-esophagectomy.

Objectives: Identify proteins associated with delirium and delirium severity in a younger and higher-risk surgical population.

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Racialized disparities in chronic pain care are well-documented and persist despite national priorities focused on health equity. Similar disparities have been observed in patient activation (ie, having the knowledge, confidence, and skills to manage one's health). As such, interventions targeting patient activation represent a novel approach to addressing and reducing disparities in pain care.

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