71 results match your criteria: "Cpl. Michael J. Crescenz VA Medical Center[Affiliation]"

Seasonal variation in mood among individuals with and without bipolar disorder.

J Affect Disord

January 2025

Department of Psychiatry, University of Pennsylvania, 3535 Market St., Philadelphia, PA 19104, United States; Behavioral Health Service, Cpl. Michael J. Crescenz VA Medical Center, 3900 Woodland Ave., Philadelphia, PA 19104, United States. Electronic address:

Introduction: Bipolar disorder is a disorder characterized by cyclic changes in mood, yet limited research has explored longitudinal patterns of seasonality on mood symptoms in this population. This study aimed to examine longitudinal mood symptoms in individuals with bipolar type I and II, and healthy controls to determine if seasonal patterns were present and to validate the Global Seasonality Score as a measure of seasonality.

Methods: Participants from the Prechter Longitudinal Study of Bipolar Disorder were included.

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Importance: Major surgery sometimes involves long recovery or even permanent institutionalization. Little is known about long-term trajectories of postoperative recovery, as surgical registries are limited to 30-day outcomes and care can occur across various institutions.

Objective: To characterize long-term postoperative recovery trajectories.

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Article Synopsis
  • Dementia is a syndrome that causes cognitive changes affecting daily life, with neuropsychiatric symptoms (NPS) often appearing early, even when cognitive decline isn't evident.
  • Primary care teams are crucial in dementia care but often lack adequate training for diagnosis and management, which is essential for achieving good outcomes.
  • The review discusses four dementia types—Alzheimer's, vascular dementia, Lewy body dementia, and behavioral variant frontotemporal dementia—offering clinical guides to help primary care teams identify early signs and manage related symptoms effectively.
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  • Home and community-based services (HCBS) allow frail patients, including Veterans, to stay at home instead of being institutionalized.
  • A study analyzed disparities in HCBS utilization among Veterans based on neighborhood deprivation, race, and rurality, revealing that most Veterans are equitably receiving necessary services.
  • Results showed that while Veterans in deprived neighborhoods had slightly higher HCBS utilization, rural Veterans received less, and Black Veterans had marginally increased access compared to White Veterans, indicating the VA's effective resource allocation for HCBS.
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Using electronic health record metadata to predict housing instability amongst veterans.

Prev Med Rep

January 2024

Applied Mathematics & Computational Research Division, Lawrence Berkeley National Laboratory, US Department of Energy, Berkeley, CA, United States.

Housing instability is considered a significant life stressor and preemptive screening should be applied to identify those at risk for homelessness as early as possible so that they can be targeted for specialized care. We developed models to classify patient outcomes for an established VA Homelessness Screening Clinical Reminder (HSCR), which identifies housing instability, in the two months prior to its administration. Logistic Regression and Random Forest models were fit to classify responses using the last 18 months of document activity.

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Stress fractures are a common and significant source of pain and burden that can require long periods of rest from physical activity to allow adequate healing. Specifically in athletes or those with physically demanding occupations, the prolonged period of rest and the potential for requiring surgical intervention in the case of poor or delayed healing can have devastating impacts on these individuals' careers and socioeconomic well-being. In this population, successful healing, in addition to a quicker healing time and a sooner return to activity, are important outcomes when faced with treating stress fractures.

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Trajectories of care and outcomes of Veterans receiving home-based primary care.

J Am Geriatr Soc

January 2024

Division of Geriatrics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA.

Background: Veterans Affairs (VA) home-based primary care (HBPC) provides comprehensive longitudinal care to patients with complex, chronic disabling disease. While enrollment is associated with lower hospitalization rates and costs, detailed trajectories have not been well described.

Methods: We performed a longitudinal descriptive study of patients newly enrolled in VA HBPC in fiscal year (FY) 2015.

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Antidepressant effects of acute sleep deprivation are reduced in highly controlled environments.

J Affect Disord

November 2023

Department of Psychiatry, University of Pennsylvania, 3535 Market St., Philadelphia, PA 19104, United States; Behavioral Health Service, Cpl. Michael J. Crescenz VA Medical Center, 3900 Woodland Ave., Philadelphia, PA 19104, United States. Electronic address:

Background: Numerous studies summarized in a recent meta-analysis have shown sleep deprivation rapidly improves depressive symptoms in approximately 50 % of individuals with major depressive disorder (MDD), however those studies were typically conducted in clinical settings. Here we investigated the effects of sleep deprivation utilizing a highly controlled experimental approach.

Methods: 36 antidepressant-free individuals with MDD and 10 healthy controls (HC) completed a 5 day/4-night protocol consisting of adaptation, baseline, total sleep deprivation (TSD), and recovery phases.

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Neighborhood disadvantage is associated with sleep disturbance in a sample of trauma-exposed Veterans.

Sleep Health

October 2023

Mental Illness Research, Education, and Clinical Center, Cpl. Michael J. Crescenz VA Medical Center, Philadelphia, Pennsylvania, USA; Department of Psychiatry, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania, USA.

Objectives: This study examined associations among neighborhood disadvantage, all-night respiratory sinus arrhythmia, fear of sleep, nightmare frequency, and sleep duration in a sample of trauma-exposed Veterans.

Methods: Participants completed baseline assessments and slept on a mattress actigraphy system for seven nights. Neighborhood disadvantage was assessed with the Area Deprivation Index, a census-based socioeconomic index.

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Comparison of Claims-Based Frailty Indices in U.S. Veterans 65 and Older for Prediction of Long-Term Institutionalization and Mortality.

J Gerontol A Biol Sci Med Sci

October 2023

Geriatrics and Extended Care Data Analysis Center and Center for Health Equity Research and Promotion, Cpl. Michael J Crescenz VA Medical Center, Philadelphia, Pennsylvania, USA.

Background: Frailty is increasingly recognized as a useful measure of vulnerability in older adults. Multiple claims-based frailty indices (CFIs) can readily identify individuals with frailty, but whether 1 CFI improves prediction over another is unknown. We sought to assess the ability of 5 distinct CFIs to predict long-term institutionalization (LTI) and mortality in older Veterans.

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Objective: Despite advances in the treatment of psychiatric diseases, currently available therapies do not provide sufficient and durable relief for as many as 30-40% of patients. Neuromodulation, including deep brain stimulation (DBS), has emerged as a potential therapy for persistent disabling disease, however it has not yet gained widespread adoption. In 2016, the American Society for Stereotactic and Functional Neurosurgery (ASSFN) convened a meeting with leaders in the field to discuss a roadmap for the path forward.

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Rates of major depressive disorder (MDD) are increasing globally, in part due to the coronavirus disease 2019 pandemic, contributing to disease burden. It has long been known that insomnia is intricately connected with depression as indicated by greater depression severity and lower treatment response. Furthermore, insomnia is a significant risk factor for new-onset depression.

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The role of baseline insomnia in moderating the hypnotic properties of quetiapine.

Addict Behav

May 2023

Department of Psychiatry, Cpl. Michael J. Crescenz VA Medical Center, PA 19104, USA; Department of Psychiatry, Perelman School of Medicine, Philadelphia, PA 19104, USA. Electronic address:

Introduction: The primary aim of this study was to investigate the effect of quetiapine on insomnia and alcohol craving (craving) in subjects with co-occurring insomnia and AUD.

Methods: Insomnia was assessed with the Insomnia Severity Index (ISI) and craving with the Penn Alcohol Craving Scale (PACS, primary) and Obsessive-Compulsive Drinking Scale (OCDS, secondary). A multivariable model adjusted for covariates (N = 123) evaluated the relationship between craving (PACS and OCDS total scores) and insomnia (ISI total score).

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The sleep regularity index (SRI) is used to measure an individual's sleep/wake consistency over time. The SRI has been associated with certain health risks; to date, research investigating the relationship between the SRI and relapse in individuals with alcohol use disorder (AUD) is lacking. The aim of this work was to evaluate the SRI and relapse in individuals with AUD following inpatient treatment.

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Introduction:  Nutritional counseling is relevant to physiatry practice. However, physiatrists' nutrition knowledge base and their frequency of incorporating nutritional education into routine clinical encounters are currently unknown. The objective of this study was to assess physiatrists' nutrition education, nutrition knowledge, willingness to implement nutrition counseling in clinical practice, and perceived barriers to providing nutritional counseling to patients, using an online survey.

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Although post-acute sequelae of COVID-19 among adult survivors has gained significant attention, data in children hospitalized for severe acute respiratory syndrome coronavirus 2 is limited. This study of commercially insured US children shows that those hospitalized with COVID-19 or multisystem inflammatory syndrome in children have a substantial burden of severe acute respiratory syndrome coronavirus 2 sequelae and associated health care visits postdischarge.

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We report the case of an African American patient who developed drug-associated acute pancreatitis without hypertriglyceridemia, after being treated with mirtazapine for major depressive disorder (MDD). Acute pancreatitis is characterized by rapid inflammation and autodigestion of the pancreas, which may become life-threatening. Although heavy alcohol use and gallstones are the most common causes of acute pancreatitis, some medications are also known to cause drug-induced acute pancreatitis.

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Article Synopsis
  • A novel distributed penalized quasi-likelihood (dPQL) algorithm is developed to fit generalized linear mixed models (GLMM) for hospital profiling while preserving patient privacy by only using aggregated data instead of individual patient data.
  • The dPQL algorithm has been proven to be lossless, meaning it produces the same results as if all individual patient data were pooled together, while also demonstrating fast convergence with only 5 iterations needed for accurate estimations.
  • This new method effectively allows for the ranking of hospitals based on COVID-19 mortality and other metrics without compromising privacy, offering a practical solution for hospital profiling.
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  • Linear mixed models are useful in healthcare for analyzing data from multiple sites, but sharing sensitive individual patient data is often restricted due to privacy regulations.
  • The proposed algorithm allows for fitting distributed linear mixed models (DLMMs) without needing to share individual patient data, achieving the same results as if pooled data were used.
  • The study demonstrates this algorithm's effectiveness by analyzing factors related to hospital stays in over 120,000 COVID-19 patients from various global sources while only requiring minimal aggregated data from each site.
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Background: Statistically and clinically significant cognitive declines are observed in a small subset of individuals with Parkinson's Disease (PD) following treatment with Deep Brain Stimulation (DBS).

Objectives: We examine the association between multi-domain cognitive decline (MCD) and demographic and baseline clinical variables and the incidence of serious adverse events (SAE) arising within a six-month interval following DBS for PD.

Method: Study participants with PD who displayed MCD at 6-month follow-up evaluation after DBS (n = 18) were contrasted with individuals with PD from the same study who did not show cognitive decline after DBS (n = 146).

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