Publications by authors named "Hehir M"

Background And Objectives: Epidemiologic studies suggest increasing incidence and prevalence of myasthenia gravis (MG) among the elderly population outside the United States. We aimed to provide an estimation of MG incidence and prevalence and their trend among the Medicare Fee-For-Service (FFS)-covered elderly US population.

Methods: We performed a retrospective longitudinal study using Medicare claims data (2006-2019).

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Objective: The objective of the study is to characterize the pathomechanisms underlying actininopathies. Distal myopathies are a group of rare, inherited muscular disorders characterized by progressive loss of muscle fibers that begin in the distal parts of arms and legs. Recently, variants in a new disease gene, ACTN2, have been shown to cause distal myopathy.

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Introduction: Chemotherapy-induced peripheral neuropathy (CIPN) is common and disabling among cancer survivors. Little is known about the association of CIPN with other measures of the nervous system's integrity, such as executive dysfunction. We compared measures of executive function in older chemotherapy-treated cancer survivors with and without CIPN.

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Article Synopsis
  • Generalized myasthenia gravis (gMG) causes muscle weakness and is treated traditionally with acetylcholinesterase inhibitors, corticosteroids, and immunosuppressants; severe cases may require intravenous immunoglobulin or plasma exchange.
  • In recent years, four new therapies targeting the immune system have been approved, showing significant symptom improvement in clinical trials, but it remains unclear when and how to incorporate them into existing treatment plans.
  • Choosing a new therapy involves weighing clinical improvement against costs, side effects, and treatment burdens, particularly considering their use as "bridge therapy" for unstable patients or alternatives for those not responding to standard treatments.
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Article Synopsis
  • - Distal myopathies are rare inherited disorders that cause muscle fiber loss starting in the extremities, linked to variants in a new gene previously associated solely with heart conditions, which encodes a key muscle protein.
  • - The study aims to understand the mechanisms behind these disorders by testing various genetic variants in muscle cell models and correlating them with clinical data from affected patients.
  • - Findings indicate that certain genetic changes linked to dominant forms of the disease cause toxic protein aggregates, suggesting these variants should be considered harmful, while also highlighting the need for further research into other potential disease mechanisms.
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Introduction: Balance decrements and increased fall risk in older cancer survivors have been attributed to chemotherapy-induced peripheral neuropathy (CIPN). Cognition is also affected by chemotherapy and may be an additional contributing factor to poor balance through changes in executive functioning. We examined the association of executive function with balance and falls in older cancer survivors who had been treated with chemotherapy.

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Introduction/aims: We developed a patient- and physician-weighted consensus unit called the adverse event unit (AEU) that quantifies and compares adverse event (AE) burden among any group of medications in neurological patients. In this study we evaluated preliminary validity and feasibility of measuring AE burden with the AEU in myasthenia gravis (MG).

Methods: This is a single-center, prospective, 1-year, observational study of adult MG patients presenting for routine care between April 1, 2021 and March 31, 2022.

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Prior to 2021, the neuromuscular medicine fellowship application process suffered from non-standardized timelines and substantial variability. To rectify this, the American Association of Neuromuscular & Electrodiagnostic Medicine (AANEM) established a standardized application timeline and an online application portal in 2020-2021, followed by the introduction of a partial match process. In 2021-2022, AANEM launched a traditional, binding, two-way match system for fellowship positions allocation based on the Gale-Shapley stable matching algorithm.

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Background: The UK and Ireland are facing significant challenges in the recruitment and retention of midwifery staff. Deficiencies in staffing, training and leadership have been cited as contributory factors to substandard care in both regional and global independent maternity safety reports. Locally, workforce planning is critical to maintaining 'one to one' care for all women in labor and to meet the peaks of daily birthing suite activity.

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Uterine rupture is a rare obstetric complication that is associated with maternal and neonatal morbidity and mortality. The aim of this study was to examine uterine rupture and its outcomes in the setting of the unscarred compared with the scarred uterus. A retrospective observational cohort study was performed examining all cases of uterine rupture in three tertiary care hospitals in Dublin, Ireland, over a 20-year period.

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Purpose Of Review: This article reviews updated diagnostic procedures and currently available treatment modalities for myasthenia gravis (MG).

Recent Findings: Patients with MG can be classified based on antibody status and their clinical presentation; treatment responses may differ based on disease subtypes. Improved diagnostic methods and recognition of new antigenic targets such as lipoprotein-related protein 4 have led to improved diagnostic efficiencies.

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Photovoice is a participatory action research method that was founded on mobilizing communities toward action. However, there is limited research detailing the action stages of photovoice that are meant to follow the initial research. In this article, we describe the action stage of a youth photovoice project conducted at the planning phase of a Community Health Needs Assessment of the Latino community in North Philadelphia.

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Introduction/aims: Administrative health data has been increasingly used to study the epidemiology of myasthenia gravis (MG) but a case ascertainment algorithm is lacking. We aimed to develop a valid algorithm for identifying MG patients in the older population with Medicare coverage.

Methods: Local older patients (age ≥65) who received healthcare at the Cleveland Clinic and possessed Medicare coverage in 2014 and 2015 were selected.

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For many years, Neuromuscular Medicine programs lacked a standardized means of handling fellowship applications and offering positions. Programs interviewed applicants and made offers as early as the first half of Post Graduate Year 3 (PGY3), a suboptimal timeline for applicants who may have had little prior exposure to neuromuscular or electrodiagnostic medicine. In 2021, the American Association of Neuromuscular & Electrodiagnostic Medicine (AANEM) developed the Neuromuscular Fellowship Portal to standardize a later timeline and establish a process for fellowship applications and offers.

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Objectives: Respiratory failure in Guillain-Barre syndrome (GBS) is common. Forced vital capacity (FVC) is the gold standard for monitoring respiratory muscle strength in GBS. In some clinical situations, FVC testing could be delayed or unavailable, thus there is a need for accurate, fast, and device-free bedside respiratory evaluation.

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Objective: To design a physician and patient derived tool, the Adverse Event Unit (AEU), akin to currency (e.g. U.

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Objective: To assess the mental health of pregnant women, with reference to anxiety, depression and obsessive-compulsive (OC) symptoms, during the COVID-19 pandemic.

Methods: A cross-sectional survey was conducted in Ireland during the third wave of the pandemic between February and March 2021. Psychiatric, social and obstetric information was collected from pregnant women in a Dublin maternity hospital, alongside self-reported measures of mental health status.

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Introduction/aims: Telemedicine may be particularly well-suited for myasthenia gravis (MG) due to the disorder's need for specialized care, its hallmark fluctuating muscle weakness, and the potential for increased risk of virus exposure among patients with MG during the coronavirus disease 2019 (COVID-19) pandemic during in-person clinical visits. A disease-specific telemedicine physical examination to reflect myasthenic weakness does not currently exist.

Methods: This paper outlines step-by-step guidance on the fundamentals of a telemedicine assessment for MG.

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Article Synopsis
  • Cryptogenic sensory polyneuropathy (CSPN) is a prevalent neurological condition that causes significant pain, with limited effective treatment options currently available.
  • Researchers conducted a clinical trial comparing four medications (pregabalin, duloxetine, nortriptyline, and mexiletine) to determine which was most effective for pain reduction in CSPN.
  • The trial involved 402 participants over about three years, using a randomized approach to evaluate the efficacy and tolerability of each medication.
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