Publications by authors named "M D Rosenbach"
Importance: There is growing awareness of the US health sector's substantial contribution to the country's greenhouse gas (GHG) emissions, exacerbating the health threats from climate change. Reducing health care's environmental impact requires understanding its carbon emissions, but there are few published audits of health systems and fewer comprehensive emissions analyses at the clinic or department level.
Objective: To quantify the annual GHG emissions from a large outpatient dermatology practice, compare relative sources of emissions, and identify actionable targets.
Introduction: The disposal of regulated medical waste (RMW) in the healthcare setting can be both costly and environmentally harmful. Prior studies have found large amounts of waste disposed of in RMW containers are inappropriately placed. Few studies to date have investigated the efficacy of waste reduction practices in the dermatology setting.
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- - Sarcoidosis is a chronic inflammatory disease that arises in genetically susceptible individuals after exposure to certain antigens, primarily affecting the lungs but potentially impacting any organ, including the heart, nervous system, and eyes, which can lead to severe complications.
- - Diagnosis is typically easier when typical symptoms and biopsy findings are present, but it becomes more complex when symptoms manifest in areas outside the lungs without accompanying lung issues.
- - First-line treatment for sarcoidosis involves corticosteroids, while immunosuppressive or biologic medications are used for patients who do not respond to steroids or have refractory disease.
Sarcoidosis is a multiorgan granulomatous disease that lacks diagnostic biomarkers and targeted treatments. Using blood and skin from patients with sarcoid and non-sarcoid skin granulomas, we discovered that skin granulomas from different diseases exhibit unique immune cell recruitment and molecular signatures. Sarcoid skin granulomas were specifically enriched for type 1 innate lymphoid cells (ILC1s) and B cells and exhibited molecular programs associated with formation of mature tertiary lymphoid structures (TLSs), including increased CXCL12/CXCR4 signaling.
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