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Imad Khojah, Suhui Li, Qian Luo, Griffin Davis, Jessica E Galarraga, Michael Granovsky, Ori Litvak, Samuel Davis, Robert Shesser, Jesse M Pines
STUDY OBJECTIVE: We examine adult emergency department (ED) admission rates for the top 15 most frequently admitted conditions, and assess the relative contribution in admission rate variation attributable to the provider and hospital. METHODS: This was a retrospective, cross-sectional study of ED encounters (≥18years) from 19 EDs and 603 providers (January 2012-December 2013), linked to the Area Health Resources File for county-level information on healthcare resources...
April 6, 2017: American Journal of Emergency Medicine
Jessica E Haberer, Lora Sabin, K Rivet Amico, Catherine Orrell, Omar Galárraga, Alexander C Tsai, Rachel C Vreeman, Ira Wilson, Nadia A Sam-Agudu, Terrence F Blaschke, Bernard Vrijens, Claude A Mellins, Robert H Remien, Sheri D Weiser, Elizabeth Lowenthal, Michael J Stirratt, Papa Salif Sow, Bruce Thomas, Nathan Ford, Edward Mills, Richard Lester, Jean B Nachega, Bosco Mwebesa Bwana, Fred Ssewamala, Lawrence Mbuagbaw, Paula Munderi, Elvin Geng, David R Bangsberg
INTRODUCTION: Successful population-level antiretroviral therapy (ART) adherence will be necessary to realize both the clinical and prevention benefits of antiretroviral scale-up and, ultimately, the end of AIDS. Although many people living with HIV are adhering well, others struggle and most are likely to experience challenges in adherence that may threaten virologic suppression at some point during lifelong therapy. Despite the importance of ART adherence, supportive interventions have generally not been implemented at scale...
March 22, 2017: Journal of the International AIDS Society
Omar Galárraga, Burke Gao, Benson N Gakinya, Debra A Klein, Richard G Wamai, John E Sidle, Rebecca K Papas
BACKGROUND: Among HIV+ patients, alcohol use is a highly prevalent risk factor for both HIV transmission and poor adherence to HIV treatment. The large-scale implementation of effective interventions for treating alcohol problems remains a challenge in low-income countries with generalized HIV epidemics. It is essential to consider an intervention's cost-effectiveness in dollars-per-health-outcome, and the long-term economic impact -or "return on investment" in monetary terms. METHODS: We conducted a cost-benefit analysis, measuring economic return on investment, of a task-shifted cognitive-behavioral therapy (CBT) intervention delivered by paraprofessionals to reduce alcohol use in a modeled cohort of 13,440 outpatients in Kenya...
March 28, 2017: BMC Health Services Research
M E Galarraga-Vinueza, B Passoni, C A M Benfatti, J Mesquita-Guimarães, B Henriques, R S Magini, M C Fredel, B V Meerbeek, W Teughels, J C M Souza
Bioactive glass is an attractive biomaterial that has shown excellent osteogenic and angiogenic effects for oral bone repairing procedures. However, anti-biofilm potential related to such biomaterial has not been completely validated, mainly against multi-species biofilms involved in early tissue infections. The aim of the present study was to evaluate the anti-biofilm effect of 58S bioactive glass embedding calcium bromide compounds at different concentrations. Bioactive glass containing 0, 5, or 10wt% CaBr2 was synthesized by alkali sol-gel method and then characterized by physco-chemical and scanning electron microscopy (SEM)...
March 6, 2017: Journal of Biomedical Materials Research. Part A
Jesse M Pines, Jessica E Galarraga, Michael Granvosky, Ori Litvak, Samuel Davis, Leah Honigman Warner
STUDY OBJECTIVE: Emergency physicians often work in multiple hospital emergency departments (EDs). We study how emergency physician admission decisions vary in different settings. METHODS: We conducted a retrospective, cross-sectional study over two years (2012-3) in six EDs in three states. Included physicians had ≥200 encounters per site in two different EDs. "Admissions" were ED encounters resulting in admission to the hospital or transfer to another hospital...
February 2, 2017: American Journal of Emergency Medicine
M E Galarraga-Vinueza, J Mesquita-Guimarães, R S Magini, J C M Souza, M C Fredel, A R Boccaccini
Bioactive glasses (BGs) are promising materials for bone repair due to their desirable properties such as osteoconductivity, biodegradability, angiogenic potential, and antibacterial activity. Ionic dissolution products from bioactive glasses increase the medium pH inhibiting surrounding bacteria proliferation. The activity of BGs against biofilm formation has been enhanced by incorporating organic antibacterial compounds. The aim of this review was to summarize evidence in literature which assesses the efficacy of antibacterial and anti-biofilm compounds embedded in bioactive glasses to prevent peri-implant infection during bone healing...
February 2017: Journal of Biomedical Materials Research. Part A
A I Soipe, H Razavi, D Razavi-Shearer, O Galárraga, L E Taylor, B D L Marshall
We utilized a disease progression model to predict the number of viraemic infections, cirrhotic cases, and liver-related deaths in the state of Rhode Island (RI) under four treatment scenarios: (1) current HCV treatment paradigm (about 215 patients treated annually, Medicaid reimbursement criteria fibrosis stage ⩾F3); (2) immediate scale-up of treatment (to 430 annually) and less restrictive Medicaid reimbursement criteria (fibrosis stage ⩾F2); (3) immediate treatment scale-up and no fibrosis stage-specific Medicaid reimbursement criteria (⩾F0); (4) an 'elimination' scenario (i...
August 5, 2016: Epidemiology and Infection
Eduardo Menti, Denise Zaffari, Thais Galarraga, João Regis da Conceição E Lessa, Bruna Pontin, Lucia Campos Pellanda, Vera Lúcia Portal
BACKGROUND: Excessive weight is a cardiovascular risk factor since it generates a chronic inflammatory process that aggravates the endothelial function. OBJECTIVE: To evaluate the endothelial function in individuals with excess weight and mild dyslipidemia using brachial artery flow-mediated dilation (BAFMD), and the association of endothelial function with anthropometric and biochemical variables. METHODS: Cross-sectional study that included 74 individuals and evaluated anthropometric variables (body mass index [BMI], waist-hip ratio [WHR], waist circumference [AC], and percentage of body fat [PBF]), biochemical (blood glucose, insulinemia, ultrasensitive C-reactive protein, fibrinogen, total cholesterol, HDL-cholesterol, triglycerides, and LDL-cholesterol) and endothelial function (BAFMD, evaluated by ultrasound)...
June 2016: Arquivos Brasileiros de Cardiologia
Andrew R Zullo, Chanelle J Howe, Omar Galárraga
Personal prescription drug importation occurs in the United States because of the high cost of U.S. medicines and lower cost of foreign equivalents. Importation carries a risk of exposure to counterfeit (i.e., falsified, fraudulent), adulterated, and substandard drugs. Inadequate health insurance may increase the risk of importation. We use inverse probability weighted marginal structural models and data on 87,494 individuals from the 2011-2013 National Health Interview Survey to estimate the marginal association between no health insurance and importation within U...
February 2, 2016: Medical Care Research and Review: MCRR
Jessica E Galarraga, Jesse M Pines
BACKGROUND: Emergency department (ED) care is a focus of cost reduction efforts. Costs for acute care originating in the ED, including outpatient and inpatient encounters (i.e. ED episodes), have not been estimated. OBJECTIVE: We estimate total US costs of ED episodes, potentially avoidable costs, and proportional costs of national health expenditures (NHEs). METHODS: We conducted a secondary analysis of 2010 data from the Medical Expenditure Panel Survey, National Hospital Ambulatory Medical Care Survey, and the Healthcare Cost and Utilization Project's Nationwide Inpatient Sample...
March 2016: American Journal of Emergency Medicine
O A Galarraga C, V Vigneron, B Dorizzi, N Khouri, E Desailly
No abstract text is available yet for this article.
2015: Computer Methods in Biomechanics and Biomedical Engineering
Kristen Underhill, Kathleen M Morrow, Christopher Colleran, Richard Holcomb, Sarah K Calabrese, Don Operario, Omar Galárraga, Kenneth H Mayer
Access to biomedical HIV prevention technologies such as pre-exposure prophylaxis (PrEP) requires individuals to disclose risk behavior to clinicians, but experiences of discrimination and medical mistrust may limit disclosure among male sex workers and other MSM. We explored experiences of perceived discrimination, medical mistrust, and behavior disclosure among male sex workers compared to other men who have sex with men (MSM). We conducted 56 interviews with MSM and compared findings about medical mistrust, discrimination, and disclosure for 31 men who engaged in sex work vs...
August 2015: Journal of Urban Health: Bulletin of the New York Academy of Medicine
Ricardo Hernández-Martínez, José J Aceves, Pavel E Rueda-Orozco, Teresa Hernández-Flores, Omar Hernández-González, Dagoberto Tapia, Elvira Galarraga, José Bargas
The external globus pallidus (GPe) is central for basal ganglia processing. It expresses muscarinic cholinergic receptors and receives cholinergic afferents from the pedunculopontine nuclei (PPN) and other regions. The role of these receptors and afferents is unknown. Muscarinic M1-type receptors are expressed by synapses from striatal projection neurons (SPNs). Because axons from SPNs project to the GPe, one hypothesis is that striatopallidal GABAergic terminals may be modulated by M1 receptors. Alternatively, some M1 receptors may be postsynaptic in some pallidal neurons...
February 1, 2015: Journal of Neurophysiology
P de Toledo, M Galarraga, I Martinez, L Serrano, J Fernandez, F Del Pozo
The expansion of e-Health solutions is hindered by the high costs and low flexibility of home and mobile telemonitoring systems. This situation may be improved by the use of standards to design open, plug-and-play and interoperable devices. This work describes the joint efforts of three research groups in Spain towards the interoperability of their telemonitoring solutions based on the ISO11073/IEEE1073 family of standards.
August 2006: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
Elizabeth N Kinnard, Lynn E Taylor, Omar Galárraga, Brandon D L Marshall
Although there is a large health, social, and economic burden of hepatitis C virus (HCV) infection in the United States, the number of persons infected with HCV in Rhode Island (RI) is unknown. To inform the expansion of HCV-related public health efforts in RI, and because surveillance data are lacking and national surveys, including the National Health and Nutrition Examination Survey (NHANES), likely underestimate true HCV prevalence, we reviewed published peer-reviewed and grey literature to more accurately estimate the prevalence of HCV in RI...
July 2014: Rhode Island Medical Journal
I Jáuregui Presa, M Varona Peinador, M Pérez Bea, M C Espallargas Ruiz-Ogarrio, P M Gamboa Setién, E García Lirio, A M Soriano Galarraga, I Antépara Ercoreca, M Martínez Ortiz de Zárate
No abstract text is available yet for this article.
2013: Journal of Investigational Allergology & Clinical Immunology
Jessica E Galarraga, Jesse M Pines
STUDY OBJECTIVE: We study how reimbursements to emergency departments (EDs) for outpatient visits may be affected by the insurance coverage expansion of the Patient Protection and Affordable Care Act as previously uninsured patients gain coverage either through the Medicaid expansion or through health insurance exchanges. METHODS: We conducted a secondary analysis of data (2005 to 2010) from the Medical Expenditure Panel Survey. We specified multiple linear regression models to examine differences in the payments, charges, and reimbursement ratios by insurance category...
April 2014: Annals of Emergency Medicine
Víctor Plata, Mariana Duhne, Jesús E Pérez-Ortega, Janet Barroso-Flores, Elvira Galarraga, José Bargas
Physiological and biochemical experiments in vivo and in vitro have explored striatal receptor signaling and neuronal excitability to posit pathophysiological models of Parkinson's disease. However, when therapeutic approaches, such as dopamine agonists, need to be evaluated, behavioral tests using animal models of Parkinson's disease are employed. To our knowledge, recordings of population neuronal activity in vitro to assess anti-Parkinsonian drugs and the correlation of circuit dynamics with disease state have only recently been attempted...
2013: BioMed Research International
Mario A Arias-García, Dagoberto Tapia, Edén Flores-Barrera, Jesús E Pérez-Ortega, José Bargas, Elvira Galarraga
The firing of striatal projection neurons (SPNs) exhibits afterhyperpolarizing potentials (AHPs) that determine discharge frequency. They are in part generated by Ca(2+)-activated K(+)-currents involving BK and SK components. It has previously been shown that suprathreshold corticostriatal responses are more prolonged and evoke more action potentials in direct pathway SPNs (dSPNs) than in indirect pathway SPNs (iSPNs). In contrast, iSPNs generate dendritic autoregenerative responses. Using whole cell recordings in brain slices, we asked whether the participation of Ca(2+)-activated K(+)-currents plays a role in these responses...
2013: Frontiers in Systems Neuroscience
O Hernández-González, T Hernández-Flores, G A Prieto, A Pérez-Burgos, M A Arias-García, E Galarraga, J Bargas
D(1)- and D(2)-types of dopamine receptors are located separately in direct and indirect pathway striatal projection neurons (dSPNs and iSPNs). In comparison, adenosine A(1)-type receptors are located in both neuron classes, and adenosine A(2A)-type receptors show a preferential expression in iSPNs. Due to their importance for neuronal excitability, Ca(2+)-currents have been used as final effectors to see the function of signaling cascades associated with different G protein-coupled receptors. For example, among many other actions, D(1)-type receptors increase, while D(2)-type receptors decrease neuronal excitability by either enhancing or reducing, respectively, CaV1 Ca(2+)-currents...
2014: Purinergic Signalling
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