708 results match your criteria: "Philadelphia VA Medical Center[Affiliation]"

Importance: Cutaneous chronic graft-vs-host disease (GVHD) is independently associated with morbidity and mortality after allogeneic hematopoietic cell transplant. However, the health-related quality-of-life (HRQOL) domains that are most important to patients are poorly understood.

Objective: To perform a concept elicitation study to define HRQOL in cutaneous chronic GVHD from the patient perspective and to compare experiences of patients with epidermal vs sclerotic disease.

View Article and Find Full Text PDF

Comparison of Liquid to Particle Embolics in a Translational Rat Model of Hepatocellular Carcinoma: Histologic and Radiographic Responses.

J Vasc Interv Radiol

December 2024

Penn Image-Guided Interventions Laboratory, Perelman School of Medicine, University of Pennsylvania; Department of Radiology, University of Pennsylvania; Department of Radiology, Corporal Michael J Crescenz Philadelphia VA Medical Center, Philadelphia, PA; Department of Cancer Biology, Perelman School of Medicine, University of Pennsylvania. Electronic address:

Purpose: To compare the effectiveness of transarterial embolization (TAE) using a liquid embolic (LE) to TAE using a particle embolic (PE) based on radiographic and histologic response in a translational rat model of hepatocellular carcinoma (HCC).

Materials And Methods: HCC was induced in Wistar rats using diethylnitrosamine. Tumor response was determined through RECIST applied to T2-weighted MRI scans.

View Article and Find Full Text PDF

Pearls & Oy-sters: Breaking Bad CIDP: Recognition of Anti-NF155 Autoimmune Nodopathy in Refractory CIDP.

Neurology

November 2024

From the Rutgers New Jersey Medical School (R.S., N.J.B., W.G.H., J.H.P.), Newark; East Orange Veterans Hospital (W.G.H., J.H.P.), NJ; University of Pennsylvania (E.L., M.S.), Philadelphia; and Philadelphia VA Medical Center (E.L.), PA.

View Article and Find Full Text PDF

OMERACT systemic lupus erythematosus domain survey.

Semin Arthritis Rheum

October 2024

Schroeder Arthritis Institute, Krembil Research Institute, University Health Network, Toronto, Canada; University of Toronto Lupus Clinic, Centre for Prognosis Studies in Rheumatic Diseases, Toronto Western Hospital, Toronto, ON, Canada. Electronic address:

Article Synopsis
  • - The study aimed to update the 1998 Systemic Lupus Erythematosus (SLE) Core Outcome Set by evaluating existing domains and generating new ones, involving both patients and collaborators in the process.
  • - A survey collected responses from 100 patients and 145 collaborators, revealing that patients focused on life-impact domains while collaborators emphasized clinical aspects, highlighting a need for balanced input from both groups.
  • - Findings showed agreement on some domains for inclusion in the updated SLE Core Outcome Set, while also identifying areas that need more explanation and suggesting new domains for consideration.
View Article and Find Full Text PDF

Background: The U.S. Preventive Services Task Force (USPSTF) recently changed its recommendation for mammography screening from informed decision making to biennial screening for women aged 40 to 49 years.

View Article and Find Full Text PDF

Patient Preferences for Immediate Compared With Delayed Postpartum Intrauterine Device Placement.

Obstet Gynecol

September 2024

Department of Obstetrics and Gynecology, NYU Grossman School of Medicine, New York, New York; the Division of Complex Family Planning, Department of Obstetrics and Gynecology, and the Department of Medicine, Perelman School of Medicine at the University of Pennsylvania, and the Center for Health Equity Research and Promotion, Philadelphia VA Medical Center, Philadelphia, Pennsylvania; and the DuPont Clinic, Washington, DC.

Objective: To use choice-based conjoint survey methodology to evaluate patient values and decision making regarding immediate compared with delayed placement of postpartum intrauterine devices (IUDs).

Methods: We conducted a cross-sectional study in which we surveyed 200 nonpregnant, parous patients. Participants chose between hypothetical postpartum IUDs varying in multiple attributes (hormonal or nonhormonal IUD type, placement timing, 1-year efficacy, expulsion risk, risk of lost strings, and malposition risk).

View Article and Find Full Text PDF

Importance: Hypertension management has traditionally been based on office visits. Integrating remote monitoring into routine clinical practices and leveraging social support might improve blood pressure (BP) control.

Objective: To evaluate the effectiveness of a bidirectional text monitoring program focused on BP control and medication adherence with and without social support in adults with hypertension.

View Article and Find Full Text PDF

Examining cocaine use reductions and long-term outcomes in two clinical trials of continuing care for cocaine dependence.

J Subst Use Addict Treat

August 2024

Department of Psychology, University of New Mexico, Albuquerque, NM, United States of America; Center on Alcohol, Substance use, And Addictions (CASAA), University of New Mexico, Albuquerque, NM, United States of America.

Background: There is a need to identify clinically meaningful non-abstinent endpoints for cocaine use disorder (CUD) clinical trials. In this study, we sought to replicate and extend prior work validating reductions in cocaine use frequency levels as an endpoint by examining associations between reductions in cocaine use frequency and long-term functioning outcomes.

Methods: We conducted a secondary analysis of two randomized clinical trials (N = 445; 77.

View Article and Find Full Text PDF

Validation of the structured interview section of the penn computerized adaptive test for neurocognitive and clinical psychopathology assessment (CAT GOASSESS).

Psychiatry Res

May 2024

Department of Psychiatry, Brain Behavior Laboratory, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA; Lifespan Brain Institute (LiBI), Children's Hospital of Philadelphia and Penn Medicine, Philadelphia, PA, USA. Electronic address:

Large-scale studies and burdened clinical settings require precise, efficient measures that assess multiple domains of psychopathology. Computerized adaptive tests (CATs) can reduce administration time without compromising data quality. We examined feasibility and validity of an adaptive psychopathology measure, GOASSESS, in a clinical community-based sample (N = 315; ages 18-35) comprising three groups: healthy controls, psychosis, mood/anxiety disorders.

View Article and Find Full Text PDF

Background And Objectives: Hispanic young adults in the United States have consistently high rates of risky drinking, adverse childhood experiences (ACEs), depression, and anxiety. There is a positive association between ACEs and alcohol use among Hispanic populations; it is unknown if mental health symptomatology mediates this relationship. The purpose of this study was to test whether depression and anxiety mediated the relationship between ACEs and risky drinking among Hispanic young adults who engage in risky drinking.

View Article and Find Full Text PDF

Buprenorphine Receipt and Retention for Opioid Use Disorder Following an Initiative to Increase Access in Primary Care.

J Addict Med

June 2024

From the Health Services Research & Development (HSR&D) Seattle Center of Innovation for Veteran-Centered and Value-Driven Care, Veterans Affairs (VA) Puget Sound Health Care System, Seattle, WA (EJH, CAM, ECW, AL, AND, AJS); Center of Excellence in Substance Addiction Treatment and Education, VA Puget Sound Health Care System, Seattle, WA (EJH, CAM, HJH, AL, AND, AJS); HSR&D Center for Care Delivery & Outcomes Research, Minneapolis VA Health Care System, Minneapolis, MN (HJH); HSR&D Center of Innovation: Informatics, Decision-Enhancement, and Analytic Sciences Center, VA Salt Lake City Health Care System, Salt Lake City, UT (AJG); Department of Health Services, University of Washington, Seattle, WA (ECW); Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine, Seattle, WA (EJH, BEB, AJS); Department of Psychiatry, University of Minnesota, Minneapolis, MN (HJH); Program for Addiction Research, Clinical Care, Knowledge and Advocacy, Department of Internal Medicine, University of Utah School of Medicine, Salt Lake City, UT (AJG); Center of Excellence in Substance Addiction Treatment and Education, Corporal Michael J. Crescenz Philadelphia VA Medical Center, Philadelphia, PA (RST).

Objectives: Buprenorphine, a medication for opioid use disorder (OUD), is underutilized in general medical settings. Further, it is inequitably received by racialized groups and persons with comorbidities. The Veterans Health Administration launched an initiative to increase buprenorphine receipt in primary care.

View Article and Find Full Text PDF

Validation of the cognitive section of the Penn computerized adaptive test for neurocognitive and clinical psychopathology assessment (CAT-CCNB).

Brain Cogn

February 2024

Department of Psychiatry, Brain Behavior Laboratory, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA; Lifespan Brain Institute (LiBI), Children's Hospital of Philadelphia and Penn Medicine, Philadelphia, PA 19104, USA.

Background: The Penn Computerized Neurocognitive Battery is an efficient tool for assessing brain-behavior domains, and its efficiency was augmented via computerized adaptive testing (CAT). This battery requires validation in a separate sample to establish psychometric properties.

Methods: In a mixed community/clinical sample of N = 307 18-to-35-year-olds, we tested the relationships of the CAT tests with the full-form tests.

View Article and Find Full Text PDF

This study examined the impact of ongoing substance use during posttraumatic stress disorder (PTSD) and substance use disorder (SUD) treatment on PTSD symptoms and treatment discontinuation. The study represents a secondary analysis of U.S.

View Article and Find Full Text PDF
Article Synopsis
  • Intervertebral disc degeneration is a major cause of chronic low back pain, and cell-based therapies aiming to regenerate the nucleus pulposus (NP) show potential but face challenges in mimicking natural NP cell behavior.
  • The study uses single cell RNA sequencing to identify two types of NP cells in postnatal mice—progenitor cells and mature NP cells—which display different properties and gene expressions related to extracellular matrix (ECM) production.
  • Findings reveal that mature NP cells express higher levels of ECM genes and a novel marker, Cd9, and their numbers decline with disc degeneration severity, suggesting their critical role in maintaining healthy NP tissue and informing future regenerative treatment strategies.
View Article and Find Full Text PDF

Background & Aims: Patients with cirrhosis secondary to chronic hepatitis C virus (HCV) are at risk for hepatocellular carcinoma (HCC) despite a sustained virological response (SVR). We examined whether post-SVR liver stiffness measurement (LSM) could be used to stratify HCC risk.

Methods: This was a retrospective cohort study of 1850 participants identified from the Veterans Health Administration, with HCV cirrhosis and SVR, followed up over 5099 person-years, from the time of post-SVR elastography until death, HCC, or the end of the study.

View Article and Find Full Text PDF

The association between specific narrative elements and patient perspectives on acute pain treatment.

Am J Emerg Med

December 2023

Center for Emergency Care Policy and Research, University of Pennsylvania, Philadelphia, PA, USA; Department of Emergency Medicine, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA; Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia, PA, USA; Penn Injury Science Center, University of Pennsylvania, Philadelphia, PA 19104, USA.

Background: Narratives are effective tools for communicating with patients about opioid prescribing for acute pain and improving patient satisfaction with pain management. It remains unclear, however, whether specific narrative elements may be particularly effective at influencing patient perspectives.

Methods: This study was a secondary analysis of data collected for Life STORRIED, a multicenter RCT.

View Article and Find Full Text PDF

Purpose: Overdiagnosis is a concept central to making informed breast cancer screening decisions, and yet some people may react to overdiagnosis with doubt and skepticism. The present research assessed 4 related reactions to overdiagnosis: reactance, self-exemption, disbelief, and source derogation (REDS). The degree to which the concept of overdiagnosis conflicts with participants' prior beliefs and health messages (information conflict) was also assessed as a potential antecedent of REDS.

View Article and Find Full Text PDF

Introduction: The Brief Addiction Monitor-Revised (BAM-R) is a widely used, 17-item assessment of substance use, risk, and protective factors associated with recovery from substance use disorders. Despite wide adoption in the U.S.

View Article and Find Full Text PDF

Lowering Expectations: Glucocorticoid Tapering Among Veterans With Rheumatoid Arthritis Achieving Low Disease Activity on Stable Biologic Therapy.

ACR Open Rheumatol

September 2023

VA Salt Lake City Healthcare System, Salt Lake City, Utah, and VA Puget Sound Healthcare System, Seattle, Washington.

Objective: In the Steroid EliMination In Rheumatoid Arthritis (SEMIRA) trial, 65% of patients with rheumatoid arthritis (RA) in low disease activity (LDA) on stable biologic therapy successfully tapered glucocorticoids. We aimed to evaluate real-world rates of glucocorticoid tapering among similar patients in the Veterans Affairs Rheumatoid Arthritis registry.

Methods: Within a multicenter, prospective RA cohort, we used registry data and linked pharmacy claims from 2003 to 2021 to identify chronic prednisone users achieving LDA after initiating a new biologic or targeted synthetic disease-modifying antirheumatic drug (b/tsDMARD).

View Article and Find Full Text PDF

Objective: The objective of this study was to explore diet patterns in children with tympanostomy tube placement (TTP) complicated by postoperative tympanostomy tube otorrhea.

Study Design: Cross-sectional survey and retrospective cohort study.

Methods: Caregivers of children (0-12 years old), at a tertiary-care pediatric hospital who underwent TTP within 6 months to 2 years prior to enrollment were included.

View Article and Find Full Text PDF

Construction of a computerized adaptive test (CAT-CCNB) for efficient neurocognitive and clinical psychopathology assessment.

J Neurosci Methods

February 2023

Department of Psychiatry, Brain Behavior Laboratory, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA; Lifespan Brain Institute (LiBI), Children's Hospital of Philadelphia and Penn Medicine, Philadelphia, PA 19104, USA.

Background: Traditional paper-and-pencil neurocognitive evaluations and semi-structured mental health interviews can take hours to administer and score. Computerized assessment has decreased that burden substantially, and contemporary psychometric tools such as item response theory and computerized adaptive testing (CAT) allow even further abbreviation.

New Method: The goal of this paper was to describe the application of CAT and related methods to the Penn Computerized Neurocognitive Battery (CNB) and a well-validated clinical assessment in order to increase efficiency in assessment and relevant domain coverage.

View Article and Find Full Text PDF
Article Synopsis
  • A 66-year-old male with hypertension experienced elevated intraocular pressure (IOP) and visual symptoms after consuming a water bolus before radiation treatment for prostate cancer.
  • The patient exhibited increased IOP in both eyes, particularly notable in the left eye, and responded positively to IOP-lowering medications.
  • The findings suggest that drinking large amounts of water can raise IOP, potentially putting individuals at risk for glaucoma, and that the water-drinking test can help assess this risk in patients with normal IOP levels.
View Article and Find Full Text PDF

Study protocol: Behavioral economics and self-determination theory to change diabetes risk (BEST Change).

Contemp Clin Trials

January 2023

Department of Internal Medicine, University of Michigan Medical School, Ann Arbor, MI, United States of America; VA Center for Clinical Management Research, VA Ann Arbor Healthcare System, Ann Arbor, MI, United States of America; University of Michigan Institute for Healthcare Policy and Innovation, Ann Arbor, MI, United States of America; Department of Health Management and Policy, University of Michigan School of Public Health, Ann Arbor, MI, United States of America.

Background: The Diabetes Prevention Program (DPP) and metformin can prevent or delay the onset of type 2 diabetes mellitus (T2DM) among patients with prediabetes. Yet, even when these evidence-based strategies are accessible and affordable, uptake is low. Thus, there is a critical need for effective, scalable, and sustainable approaches to increase uptake and engagement in these interventions.

View Article and Find Full Text PDF

Fibromuscular Dysplasia and Abdominal Aortic Aneurysms Are Dimorphic Sex-Specific Diseases With Shared Complex Genetic Architecture.

Circ Genom Precis Med

December 2022

Department of Internal Medicine, Division of Cardiovascular Medicine (A.E.K., M.-L.Y., K.H., H.H., S.K.G.), University of Michigan, Ann Arbor.

Background: The risk of arterial diseases may be elevated among family members of individuals having multifocal fibromuscular dysplasia (FMD). We sought to investigate the risk of arterial diseases in families of individuals with FMD.

Methods: Family histories for 73 probands with FMD were obtained, which included an analysis of 463 total first-degree relatives focusing on FMD and related arterial disorders.

View Article and Find Full Text PDF