Publications by authors named "SILVERBERG M"

Background: The immature lungs of very preterm infants are exposed to supraphysiologic oxygen, contributing to bronchopulmonary dysplasia (BPD), a chronic lung disease that is the most common morbidity of prematurity. While the microbiota significantly influences neonatal health, the relationship between the intestinal microbiome, particularly micro-eukaryotic members such as fungi and yeast, and lung injury severity in newborns remains unknown.

Results: Here, we show that the fungal microbiota modulates hyperoxia-induced lung injury severity in very low birth weight premature infants and preclinical pseudohumanized and altered fungal colonization mouse models.

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Background: The impact of prophylactic medication following ileocecal resection (ICR) for Crohn's disease (CD) merits further elucidation. Prophylactic medication following ileocecal resection (ICR) is recommended in patients with Crohn's disease (CD), particularly in patients at increased risk of recurrence, but the impact on long-term outcomes needs to be further elucidated.

Aim: To evaluate the effect of postoperative prophylactic medication on long-term prognosis.

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Background: Alcohol use is measured in diverse ways across settings. Harmonization of measures is necessary to assess effects of alcohol use in multi-cohort collaborations, such as studies of people with HIV (PWH).

Methods: Data were combined from 14 HIV cohort studies (nine European, five North American) participating in the Antiretroviral Therapy Cohort Collaboration.

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Purpose: To describe a technique involving combined endothelialectomy and trypan blue staining to allow for improved visualization and Descemet membrane (DM) removal during endothelial keratoplasty.

Methods: Endothelialectomy with 2 disposable endothelial irrigating cannulas (Vortex and Sterimedix) and an irrigation-aspiration handpiece are described. Several passes over the desired area are made to ensure adequate endothelialectomy treatment.

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Article Synopsis
  • Doxycycline postexposure prophylaxis (doxyPEP) effectively reduces the incidence of bacterial sexually transmitted infections (STIs) in those assigned male at birth, although practical data is limited.
  • This study analyzed electronic health records of HIV PrEP users from Kaiser Permanente Northern California to assess the uptake of doxyPEP and its impact on STI rates before and after its initiation.
  • Out of 11,551 HIV PrEP users, 19.5% received doxyPEP, with a notable percentage having an STI prior; findings suggest changes in STI positivity rates among those who started doxyPEP versus those who did not.
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Background: The effect of initial antiretroviral therapy (ART) class on cancer risk in people with HIV (PWH) remains unclear.

Setting: Cohort study of 36,322 PWH enrolled (1996-2014) in the North American AIDS Cohort Collaboration on Research and Design.

Methods: We followed individuals from ART initiation (protease inhibitor [PI]-, non-nucleoside reverse transcriptase inhibitor [NNRTI]-, or integrase strand transfer inhibitor [INSTI]-based) until incident cancer, death, loss-to-follow-up, 12/31/2014, 85 months (intention-to-treat analyses [ITT]), or 30 months (per-protocol [PP] analyses).

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The past 2 decades have witnessed extraordinary advances in our understanding of the genetic factors influencing inflammatory bowel disease (IBD), providing a foundation for the approaching era of genomic medicine. On behalf of the NIDDK IBD Genetics Consortium, we herein survey 11 grand challenges for the field as it embarks on the next 2 decades of research utilizing integrative genomic and systems biology approaches. These involve elucidation of the genetic architecture of IBD (how it compares across populations, the role of rare variants, and prospects of polygenic risk scores), in-depth cellular and molecular characterization (fine-mapping causal variants, cellular contributions to pathology, molecular pathways, interactions with environmental exposures, and advanced organoid models), and applications in personalized medicine (unmet medical needs, working toward molecular nosology, and precision therapeutics).

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Objectives: Hurricane Ida delivered record rainfall to the northeast, resulting in 11 deaths in New York City. We review these deaths, identify risk factors, and discuss solutions to prevent recurrence.

Methods: Deaths were confirmed by multiple sources.

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HIV care continuum outcome disparities by health insurance status have been noted among people with HIV (PWH). We therefore examined associations between state Medicaid expansion and HIV outcomes in the United States. Adults (≥18 years) with ≥1 visit in NA-ACCORD clinical cohorts from 2012-2017 contributed person-time annually between first and final visit or death; in each calendar year, clinical retention was ≥2 completed visits > 90 days apart, antiretroviral therapy (ART) receipt was receipt of ≥3 antiretroviral agents, and viral suppression was last measured HIV-1 RNA < 200 copies/mL.

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Article Synopsis
  • Socioeconomic status (SES) affects the well-being of people living with HIV (PWH), and using area-level SES indicators can help when individual data isn't available.
  • ZIP code-level SES indicators were found to relate to viral suppression rates, and racial disparities in viral suppression narrowed by 3%-4% when accounting for SES factors.
  • This study suggests that including ZIP code-based SES can enhance understanding of how social determinants and racial disparities impact health outcomes for PWH.
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  • Hypertension is a significant risk factor for dementia, and the study aims to determine if poorly managed hypertension increases dementia risk in individuals with HIV.
  • The researchers analyzed data from over 69,000 participants (including nearly 3,100 with HIV), evaluating their blood pressure control against dementia risk over several years using a disease management index (DMI).
  • Results indicated that inadequate control of both systolic and diastolic blood pressure was linked to a higher risk of developing dementia, regardless of HIV status, with diastolic pressure control showing particularly strong associations.
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Background: With extended lifespans for people with human immunodeficiency virus (PWH), there is a corresponding increased burden of chronic illnesses, including cancer. Our objective was to estimate the excess mortality among PWH with cancer compared with people without HIV (PWoH), accounting for the higher background mortality in the general PWH population.

Methods: We identified 39,000 PWH and 387,767 demographically matched PWoH in three integrated healthcare systems from 2000 to 2016.

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Background & Aims: Unaffected first-degree relatives (FDRs) from families with ≥2 affected FDRs with Crohn's disease (CD, multiplex families) have a high risk of developing CD, although the underlying mechanisms driving this risk are poorly understood. We aimed to identify differences in biomarkers between FDRs from multiplex vs simplex families and investigate the risk of future CD onset accounting for potential confounders.

Methods: We assessed the Crohn's and Colitis Canada Genetic Environmental Microbial cohort of healthy FDRs of patients with CD.

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Objective: To compare the model-predicted benefits, harms, and cost-effectiveness of cytology, cotesting, and primary HPV screening in US women with HIV (WWH).

Design: We adapted a previously published Markov decision model to simulate a cohort of US WWH.

Setting: United States.

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Background: Anemia is an independent predictor of mortality, which may be utilized as a signal of deteriorating health. We estimated the association between anemia severity categories and mortality following the initiation of antiretroviral therapy (ART) among people with HIV (PWH) in North America.

Methods: Within the NA-ACCORD, annual median hemoglobin measurements between January 01, 2007, and December 31, 2016, were categorized using World Health Organization criteria into mild (11.

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Article Synopsis
  • Anemia is prevalent among people living with HIV (PWH), and categorizing it by mean corpuscular volume (MCV) can help identify its underlying causes while receiving antiretroviral therapy (ART).
  • In a study of nearly 15,000 anemic PWH, 74% had normocytic anemia, while smaller percentages had microcytic or macrocytic types, with distinctions based on sex.
  • The study found that older age and comorbidities increased the likelihood of developing macrocytic anemia; however, the overall rates of macrocytic anemia decreased over time as microcytic anemia rates increased among females.
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Background & Aims: Vedolizumab is indicated for the treatment of chronic pouchitis in the European Union. We assessed whether vedolizumab induced mucosal healing (MH) and if MH was associated with clinical improvements.

Methods: EARNEST, a randomized, double-blind, placebo-controlled study, evaluated vedolizumab efficacy and safety in adults with chronic pouchitis.

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  • The study aimed to evaluate how well the Veterans Aging Cohort Study (VACS) Index 2.0 predicts specific causes of death in people with HIV (PWH) receiving antiretroviral therapy (ART), which could improve targeted healthcare interventions.
  • It involved analyzing data from over 59,000 PWH who started ART between 2000 and 2018, calculating their VACS scores and examining the relationship between these scores and causes of death through various statistical models.
  • Findings revealed that the VACS Index 2.0 was particularly effective at predicting deaths from AIDS-related causes and other measurable health issues, but less reliable for predicting suicides or accidental deaths.
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Purpose: Transgender and gender-diverse (TGD) people may have been disproportionately impacted by the COVID-19 pandemic, yet little is known about vaccination status in this population. This multicenter cohort study of insured adults examined the rates of COVID-19 vaccine initiation and completion in TGD persons compared to matched cisgender persons.

Methods: A cohort of TGD persons and matched cisgender persons enrolled in Kaiser Permanente health plans in Northern and Southern California between 12/1/2020 and 7/31/2021 were analyzed.

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Background: Primary sclerosing cholangitis associated with inflammatory bowel disease (IBD-PSC) carries significant morbidity compared to IBD without PSC. Alterations in microbial composition and bile acid (BA) profiles have been shown to modulate chronic inflammation in IBD, but data in IBD-PSC is scarce. We aimed to assess the differences in gut microbiome composition as well as in the BA profile and BA-related microbial functions between IBD-PSC and IBD-only.

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  • The study analyzed treatment options for uncomplicated streptococcal bloodstream infections (BSI) in adults, focusing on antibiotic duration (5-10 days vs. 11-15 days) and route (oral switch vs. intravenous).
  • The results indicated that shorter 5-10 day antibiotic courses were not worse than longer durations, suggesting they could be an effective treatment alternative.
  • However, oral switch therapy did not prove to be non-inferior compared to complete intravenous treatment, highlighting the need for further randomized controlled trials to confirm these findings and optimize treatment guidelines.
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Background & Aims: Investigating the tissue-associated microbiota after surgically induced remission may help to understand the mechanisms initiating intestinal inflammation in Crohn's disease.

Methods: Patients with Crohn's disease undergoing ileocolic resection were prospectively recruited in 6 academic centers. Biopsy samples from the neoterminal ileum, colon, and rectosigmoid were obtained from colonoscopies performed after surgery.

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Objective: Despite recognition that people with HIV (PWH) are more vulnerable to sleep issues, there is limited understanding of clinically recognized sleep disorders in this population. Our objective was to evaluate the full spectrum of sleep disorder types diagnosed among PWH in care.

Methods: We conducted a retrospective cohort study of PWH, and a comparator group of people without HIV (PWoH), in a large healthcare system.

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Article Synopsis
  • Risk stratification for endoscopic post-operative recurrence (ePOR) in Crohn's disease is crucial for identifying patients who would benefit from preventive treatments and closer monitoring.
  • A comprehensive review of 47 studies highlighted key risk factors for ePOR, such as active smoking, male gender, and previous bowel surgeries, but many factors listed in current guidelines lacked consistent evidence.
  • The findings suggest a need for personalized treatment strategies based on reliable risk factors to improve patient outcomes following ileocolic surgeries for Crohn's disease.
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