Publications by authors named "Hannah C Karpel"
Assessing Medical Students' Attitudes and Knowledge Regarding LGBTQ Health Needs Across the United States.
J Prim Care Community Health
July 2023
Background: The lesbian, gay, bisexual, transgender, and queer/questioning (LGBTQ) community experiences health disparities. It is thus imperative that medical trainees receive training in the care of LGBTQ community. The objective of this study was to identify gaps in knowledge and comfort among medical school students in providing care for the LGBTQ community.
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- The study aimed to evaluate whether a new protocol for genetic counseling referrals (GCRs) increased the frequency of genetic testing (GT) for Lynch Syndrome (LS) in patients with abnormal mismatch repair (MMR) immunohistochemistry (IHC) results in endometrial cancer.
- Researchers compared GCRs and GT rates before and after the protocol's implementation, finding a significant increase in GCRs from 68.8% to 96.7%, but no statistically significant difference in GT rates.
- Although the protocol improved GCRs, about 15% of patients who qualified for GT still did not receive it, suggesting a need for further measures like universal germline testing in endometrial cancer cases
Article Synopsis
- - The article discusses antibody-drug conjugates (ADCs) in gynecologic cancers, highlighting their structure of a targeted antibody linked to a cytotoxic drug, with manageable toxicity profiles, particularly ocular toxicity.
- - Mirvetuximab soravtansine and STRO-002 are FDA-approved and fast-tracked ADCs targeting ovarian cancer, while tisotumab vedotin is approved for cervical cancer; multiple trials for various new ADCs are ongoing.
- - Although no ADCs are approved for endometrial cancer yet, trastuzumab-deruxtecan shows potential, emphasizing that treatment decisions should be personalized and made collaboratively with the patient's healthcare team.
Treatment options for molecular subtypes of endometrial cancer in 2023.
Curr Opin Obstet Gynecol
June 2023
Purpose Of Review: This article reviews treatment strategies in endometrial cancer by molecular subtype.
Recent Findings: The Cancer Genome Atlas (TCGA) classifies four molecular subtypes of endometrial cancer - mismatch repair-deficient (dMMR)/microsatellite instability-high (MSI-H), copy number high (CNH)/p53abn, copy number low (CNL)/no specific molecular profile (NSMP), and POLEmut - which are validated and highly prognostic. Treatment consideration by subtype is now recommended.
Objective: The real-world management of patients with non-BRCA, homologous recombination repair pathway variants with increased or uncertain risks of ovarian cancer is unknown. The objective was to determine the adoption of risk-reducing salpingo-oophorectomy (RRSO) for carriers of variants with increased or uncertain risks of ovarian cancer beyond BRCA.
Methods: This was a retrospective cohort study of patients at three hospitals with non-BRCA, homologous recombination repair pathway variants with increased risk (BRIP1, RAD51C, RAD51D) and uncertain risk (ATM, BARD1, NBN, PALB2) of ovarian cancer.
Objectives: Patients with germline mutations in mismatch repair genes (MLH1, MSH2, MSH6, PMS2) associated with Lynch syndrome (LS) have an increased lifetime risk of endometrial cancer (EC). Multi-gene panel testing (MGPT) is a recent hereditary cancer risk tool enabling next-generation sequencing of numerous genes in parallel. We determined the prevalence of actionable cancer predisposition gene mutations identified through MGPT in an EC patient cohort.
View Article and Find Full Text PDFBackground: Little is known about long-term recovery from severe COVID-19 disease. Here, we characterize overall health, physical health, and mental health of patients 1 month after discharge for severe COVID-19.
Methods: This was a prospective single health system observational cohort study of patients ≥ 18 years hospitalized with laboratory-confirmed COVID-19 disease who required at least 6 l of oxygen during admission, had intact baseline cognitive and functional status, and were discharged alive.
Unlabelled: To explore demographics, comorbidities, transfers, and mortality in critically ill patients with confirmed severe acute respiratory syndrome coronavirus 2.
Design: Retrospective cohort study.
Setting: Data were collected from a large tertiary care public hospital ICU that is part of the largest public healthcare network in the United States.
Background: Little is known about long-term recovery from severe COVID-19 disease. Here, we characterize overall health, physical health and mental health of patients one month after discharge for severe COVID-19.
Methods: This was a prospective single health system observational cohort study of patients ≥18 years hospitalized with laboratory-confirmed COVID-19 disease who required at least 6 liters of oxygen during admission, had intact baseline cognitive and functional status and were discharged alive.
Background: Vaccine hesitancy, the reluctance or refusal to receive vaccination, is a growing public health problem in the United States and globally. State policies that eliminate nonmedical ("personal belief") exemptions to childhood vaccination requirements are controversial, and their effectiveness to improve vaccination coverage remains unclear given limited rigorous policy analysis. In 2016, a California policy (Senate Bill 277) eliminated nonmedical exemptions from school entry requirements.
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