Publications by authors named "BERK J"

Importance: There is a lack of long-term efficacy and safety data on hereditary transthyretin amyloidosis with polyneuropathy (hATTR-PN) and on RNA interference (RNAi) therapeutics in general. This study presents the longest-term data to date on patisiran for hATTR-PN.

Objective: To present the long-term efficacy and safety of patisiran in adults with hATTR-PN.

View Article and Find Full Text PDF

Limited data exist on cancer screening in carceral facilities. This study evaluates the feasibility and outcomes of a population-based lung cancer screening initiative in a carceral setting. This is a retrospective review of a lung cancer screening event at the Rhode Island Department of Corrections.

View Article and Find Full Text PDF

Background: After release from incarceration, individuals are rarely connected to primary care or to social services despite bearing a disproportionate burden of poor health (e.g., chronic illness) and structural determinants of health (e.

View Article and Find Full Text PDF

Background: The NEURO-TTRansform trial showed that after 66 weeks of treatment, eplontersen significantly reduced neuropathic impairment and improved quality of life (QoL) in patients with hereditary transthyretin-mediated amyloidosis with polyneuropathy (ATTRv-PN). In this secondary analysis from NEURO-TTRansform, autonomic impairment, and the impact of eplontersen on autonomic impairment progression was evaluated through 85 weeks in patients randomised to eplontersen ( = 144) versus external placebo ( = 60; through Week 66 from the NEURO-TTR trial).

Methods: Change from baseline in modified Neuropathy Impairment Score +7 (mNIS+7) composite score, Norfolk Quality of Life-Diabetic Neuropathy (Norfolk QoL-DN) total score, and the Neuropathy Symptoms and Change (NSC) total score was evaluated.

View Article and Find Full Text PDF
Article Synopsis
  • - The study aimed to identify what changes in neuropathic impairment and quality of life (QoL) are important to patients with hereditary transthyretin amyloidosis and to evaluate if the drug eplontersen provides significant improvements compared to a placebo.
  • - Researchers used data from the NEURO-TTRansform trial and various scoring systems to determine thresholds for meaningful differences, finding that eplontersen led to improvements that exceeded these thresholds in neuropathy, QoL, and nutrition measurements.
  • - Results showed eplontersen provided significant clinical benefits, suggesting that these findings could influence future clinical practices and trials regarding treatment effectiveness for patients with this condition.
View Article and Find Full Text PDF

Introduction: Buprenorphine is a highly effective treatment for opioid use disorder (OUD). However, provider observations and preliminary research suggest that the current standard maintenance dose may be insufficient for suppressing withdrawal and preventing cravings among people who use or have used fentanyl. Buprenorphine dosing guidelines were based on studies among people who use heroin and have not been formally re-evaluated since fentanyl became predominant in the unregulated drug supply.

View Article and Find Full Text PDF
Article Synopsis
  • The opioid overdose crisis in the U.S. severely impacts incarcerated individuals, particularly in the two weeks following their release, where their overdose risk is significantly heightened compared to the general population.
  • In response, prisons and jails are beginning to implement medication for opioid use disorder (MOUD) treatments like methadone or buprenorphine, but identifying who needs treatment poses challenges due to imperfect screening methods.
  • The essay introduces an epidemiological framework to categorize assessment outcomes for opioid use disorder (OUD) in carceral settings, discussing the implications for those incarcerated, security staff, and healthcare providers in implementing effective MOUD programs.
View Article and Find Full Text PDF

The participation of incarcerated individuals in research is necessary to appropriately address the health disparities that affect them and to adapt and implement health services for the carceral setting. Incarceration significantly impacts health, leading to negative outcomes including accelerated aging and increased mortality, with these effects disproportionately impacting communities of color. The U.

View Article and Find Full Text PDF

Introduction: Individuals impacted by the criminal-legal system face increased risk of opioid overdose. Medications for opioid use disorder (MOUD) provide a life-saving intervention. Multiple barriers prevent access to MOUD, including federal policies regulating opioid treatment programs (OTPs).

View Article and Find Full Text PDF

Background: The opioid overdose crisis significantly affects marginalized communities, with people of color experiencing higher rates of overdose and barriers to treatment. The syndemic of opioid use disorder and mass incarceration exacerbates racial health disparities. Some carceral facilities offer medication for addiction treatment, though no significant research explores differences in type of treatment uptake by race in these settings.

View Article and Find Full Text PDF
Article Synopsis
  • Transthyretin amyloidosis with cardiomyopathy (ATTR-CM) is a serious, progressive disease, and vutrisiran is a new treatment that works by reducing the production of transthyretin in the liver.
  • In a double-blind trial involving 655 patients, those receiving vutrisiran had a lower risk of death and cardiovascular events compared to those on placebo, demonstrating significant efficacy.
  • Vutrisiran also improved patient outcomes, showing less decline in walking distance and quality of life measurements over the study period compared to placebo.
View Article and Find Full Text PDF
Article Synopsis
  • - The phase 3 NEURO-TTRansform trial demonstrated that eplontersen significantly reduced transthyretin (TTR) levels and halted the progression of neuropathy impairment in patients with hereditary TTR-mediated amyloidosis after 65 weeks of treatment.
  • - The study involved patients initially receiving inotersen, who then switched to eplontersen, resulting in a greater reduction of TTR levels and stabilized quality of life and nutritional status during the eplontersen treatment.
  • - Patients who switched to eplontersen experienced fewer treatment-emergent adverse events, restored platelet counts, and overall better tolerability, indicating a favorable benefit-risk profile for this treatment strategy. *
View Article and Find Full Text PDF

Background: Changes in the proximal sesamoid bones (sesamoids) and the insertional region of the adjacent suspensory ligament branch (branch) are of particular importance in young Thoroughbreds sold at public auction. Little is known about the prevalence of concurrent ultrasonographical branch change, relative to the various grades of radiological sesamoid appearance.

Objective: To examine the existence of concurrent radiological and ultrasonographical findings in individual sesamoid-branch units in sales horses; to determine whether there are any radiological findings that are consistently accompanied by a particular degree of insertional branch change, and to provide practical recommendations as to when suspensory branch ultrasonography may be warranted in a sales environment.

View Article and Find Full Text PDF

Background: Equine suspensory ligament branch (branch) ultrasonography is becoming increasingly commonplace presale. No ultrasonographical branch reference data exists for Thoroughbred sales horses.

Objectives: To define the prevalence of ultrasonographical findings in the forelimb suspensory branches of yearling and 2-year-old sales Thoroughbreds and to analyse associations with racing performance.

View Article and Find Full Text PDF

Background: Overdose remains a pressing public health concern in the United States, particularly with the emergence of fentanyl and other potent synthetic opioids in the drug supply. We evaluated trends in recurrent overdose and opioid use disorder (OUD) treatment initiation following emergency department (ED) visits for opioid overdose to inform response efforts.

Methods: This retrospective cohort study used electronic health record and statewide administrative data from Rhode Island residents who visited EDs for opioid overdose between July 1, 2016, and June 30, 2021, a period with fentanyl predominance in the local drug supply.

View Article and Find Full Text PDF

The opioid crisis, particularly the "fourth wave" involving fentanyl and stimulants, has been responsible for an alarming increase in overdose deaths in the United States. Although fentanyl contamination in cocaine has gained significant attention, the converse-cocaine-adulterated fentanyl-has been largely overlooked despite its health implications. The rise in concurrent cocaine and fentanyl overdose deaths could be attributed to various factors, from intentional polysubstance use to unintentional adulterations.

View Article and Find Full Text PDF

Antimicrobial resistance is a global threat that inequitably affects minoritized populations, including Black, Latinx, and Indigenous people-especially in carceral settings-and is largely driven by inappropriate antimicrobial prescribing practices. People whose identities are minoritized are more likely to be incarcerated, and people who are incarcerated experience higher disease risk than people who are not incarcerated. This article draws on a case of dental infection suffered by a woman who is incarcerated to consider key ethical and clinical complexities of antimicrobial prescribing in carceral settings.

View Article and Find Full Text PDF

Background: While the broader medical community grapples with the widely accepted notion that it takes an average of 17 years for research evidence to be incorporated into clinical practice, the implementation of evidence-based interventions in carceral settings (i.e., jails and prisons) faces longer delays, exacerbating health disparities.

View Article and Find Full Text PDF

Study Objectives: Connecting resident physician work hours and sleep deprivation to adverse outcomes has been difficult. Our study explores clinical reasoning rather than outcomes. Diagnostic errors are a leading cause of medical error and may result from deficits in clinical reasoning.

View Article and Find Full Text PDF