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Schwartz center

Daniel W Golden, Gregory E Kauffmann, Ryan P McKillip, Jeanne M Farnan, Yoon Soo Park, Alan Schwartz
PURPOSE: A structured didactic radiation oncology clerkship curriculum for medical students is in use at multiple academic medical centers. Objective evidence supporting this educational approach over the traditional clerkship model is lacking. This study evaluated the curriculum efficacy using an objective knowledge assessment. METHODS AND MATERIALS: Medical students received the Radiation Oncology Education Collaborative Study Group (ROECSG) curriculum consisting of 3 lectures (Overview of Radiation Oncology, Radiation Biology/Physics, and Practical Aspects of Simulation/Radiation Emergencies) and a radiation oncology treatment-planning workshop...
April 26, 2018: International Journal of Radiation Oncology, Biology, Physics
Edenir Inêz Palmero, Dirce Maria Carraro, Barbara Alemar, Miguel Angelo Martins Moreira, Ândrea Ribeiro-Dos-Santos, Kiyoko Abe-Sandes, Henrique Campos Reis Galvão, Rui Manuel Reis, Cristiano de Pádua Souza, Natalia Campacci, Maria Isabel Achatz, Rafael Canfield Brianese, Maria Nirvana da Cruz Formiga, Fabiana Baroni Makdissi, Fernando Regla Vargas, Anna Cláudia Evangelista Dos Santos, Hector N Seuanez, Kelly Rose Lobo de Souza, Cristina B O Netto, Patrícia Santos-Silva, Gustavo Stumpf da Silva, Rommel M R Burbano, Sidney Santos, Paulo Pimentel Assumpção, Izabel Maria Monteiro Bernardes, Taisa Manuela Bonfim Machado-Lopes, Thais Ferreira Bomfim, Maria Betânia Pereira Toralles, Ivana Nascimento, Bernardo Garicochea, Sergio D Simon, Simone Noronha, Fernanda Teresa de Lima, Anisse Marques Chami, Camila Matzenbacher Bittar, Jose Bines, Osvaldo Artigalas, Maria Del Pilar Esteves-Diz, Tirzah Braz Petta Lajus, Ana Carolina Leite Vieira Costa Gifoni, Rodrigo S C Guindalini, Terezinha Sarquis Cintra, Ida V D Schwartz, Pricila Bernardi, Diego Miguel, Sonia Tereza Dos Santos Nogueira, Josef Herzog, Jeffrey N Weitzel, Patricia Ashton-Prolla
The detection of germline mutations in BRCA1 and BRCA2 is essential to the formulation of clinical management strategies, and in Brazil, there is limited access to these services, mainly due to the costs/availability of genetic testing. Aiming at the identification of recurrent mutations that could be included in a low-cost mutation panel, used as a first screening approach, we compiled the testing reports of 649 probands with pathogenic/likely pathogenic variants referred to 28 public and private health care centers distributed across 11 Brazilian States...
June 15, 2018: Scientific Reports
Carolina Barbosa, Brendan Wedehase, Laura Dunlap, Shannon Gwin Mitchell, Kristi Dusek, Robert P Schwartz, Jan Gryzcynski, Arethusa S Kirk, Marla Oros, Colleen Hosler, Kevin E O'Grady, Barry S Brown
OBJECTIVE: Understanding the costs to implement Screening, Brief Intervention, and Referral to Treatment (SBIRT) for adolescent substance use in primary care settings is important for providers in planning for services and for decision makers considering dissemination and widespread implementation of SBIRT. We estimated the start-up costs of two models of SBIRT for adolescents in a multisite U.S. Federally Qualified Health Center (FQHC). In both models, screening was performed by a medical assistant, but models differed on delivery of brief intervention, with brief intervention delivered by a primary care provider in the generalist model and a behavioral health specialist in the specialist model...
May 2018: Journal of Studies on Alcohol and Drugs
Michael H Schwartz, Meghan E Munger
We used the random forest classifier to predict Gross Motor Function Classification System (GMFCS) levels I-IV from patient reported abilities recorded on the Gillette Functional Assessment Questionnaire (FAQ). The classifier exhibited outstanding accuracy across GMFCS levels I-IV, with 83%-91% true positive rate (TPR), area under the receiver operation characteristic (ROC) curve greater than 0.96 for all levels, and misclassification by more than one level only occurring 1.2% of the time. This new approach to GMFCS level assignment overcomes several difficulties with the current method: (i) it is based on a broad spectrum of functional abilities, (ii) it resolves functional ability profiles that conflict with existing GMFCS level definitions, (iii) it is based entirely on self-reported abilities, and (iv) it removes complex age dependence...
April 16, 2018: Gait & Posture
S K Cordeiro, R C Daro, H Seung, W Klein-Schwartz, H K Kim
BACKGROUND AND AIMS: New synthetic cannabinoid receptor agonists (SCRAs) are synthesized each year to evade U.S. governmental regulation and sold for recreational use. Our aim was to estimate the changes in the clinical effects and patient disposition associated with SCRA exposure from 2010 to 2015. DESIGN: A retrospective observational cohort study SETTING: National Poison Data System that collects data on reports of poisonings from 55 U.S. poison centers. PARTICIPANTS: 19,388 isolated SCRA cases between January 1, 2010 and December 31, 2015 were identified...
May 28, 2018: Addiction
Sabrina Schwartz, Deborah A Raines
Every day neonates are transported from the birth hospital to a tertiary neonatal care center. Separation of mother and neonate in the hours immediately following birth interrupts the bonding process and can have long-term implications for the mother-child relationship. This article synthesizes the literature focused on mothers' experiences with a neonate being transported to a tertiary NICU and identifies evidence-based practices specific to these situations.
May 1, 2018: Neonatal Network: NN
Ameer Abutaleb, Andrea Buchwald, Kenechukwu Chudy-Onwugaje, Patricia Langenberg, Miguel Regueiro, David A Schwartz, J Kathleen Tracy, Leyla Ghazi, Seema A Patil, Sandra M Quezada, Katharine M Russman, Charlene C Quinn, Guruprasad Jambaulikar, Dawn B Beaulieu, Sara Horst, Raymond K Cross
Background: Effective treatments are available for patients with inflammatory bowel disease (IBD); however, suboptimal outcomes occur and are often linked to patients' limited disease knowledge. The aim of this analysis was to determine if delivery of educational messages through a telemedicine system improves IBD knowledge. Methods: TELEmedicine for Patients with IBD (TELE-IBD) was a randomized controlled trial with visits at baseline, 6 months, and 12 months; patient knowledge was a secondary aim of the study...
May 18, 2018: Inflammatory Bowel Diseases
Nicolas A Yannuzzi, Ninel Z Gregori, Philip J Rosenfeld, Nidhi Relhan, Nimesh A Patel, Nancy Si, Darlene Miller, Sander R Dubovy, William E Smiddy, Stephen G Schwartz, Harry W Flynn
BACKGROUND AND OBJECTIVE: To report the incidence rates, causative organisms, and visual acuity (VA) outcomes in patients with endophthalmitis associated with intravitreal injection of anti-vascular endothelial growth factor inhibitors. PATIENTS AND METHODS: Retrospective case series between 2005 and 2017. RESULTS: The study included 39 eyes of 39 patients, including 27 (69%) referred and 12 (31%) institutional patients. The use of topical antibiotics after an injection was gradually phased out at the authors' institution, where the preinjection rate of all clinically suspected endophthalmitis was 0...
May 1, 2018: Ophthalmic Surgery, Lasers & Imaging Retina
Meltzer Eyal, Keller Shlomit, Shmuel Stienlauf, Schwartz Eli
BACKGROUND: Elevated serum D-dimer levels may reflect endothelial activation, which in malaria may correlate with parasite biomass and disease severity. METHODS: We performed a retrospective chart review of all non-immune travelers hospitalized with malaria during 01/2000-12/2014 at the Sheba Medical Center, Israel. Admission and peak D-dimer levels were compared among malaria patients, according to Plasmodium species and severity. RESULTS: Complete laboratory data was available for 94/168 travelers hospitalized with malaria, with 68...
May 8, 2018: Travel Medicine and Infectious Disease
Josep Marti, Massimo Giacca, Kutaiba Alshebeeb, Sumeet Bahl, Charles Hua, Jeremy C Horn, Jad BouAyache, Rahul Patel, Marcelo Facciuto, Myron Schwartz, Sander Florman, Edward Kim, Ganesh Gunasekaran
PURPOSE: To analyze outcomes of patients with hepatocellular carcinoma (HCC) undergoing preoperative portal vein embolization (PVE). MATERIALS AND METHODS: A retrospective analysis of survival, recurrence, and complications was performed in 82 patients with HCC undergoing preoperative PVE and surgical treatment with curative intention from June 2006 to December 2014. RESULTS: Rate of major adverse events after PVE was 11% with no mortality...
May 5, 2018: Journal of Vascular and Interventional Radiology: JVIR
Marc S Williams, Adam H Buchanan, F Daniel Davis, W Andrew Faucett, Miranda L G Hallquist, Joseph B Leader, Christa L Martin, Cara Z McCormick, Michelle N Meyer, Michael F Murray, Alanna K Rahm, Marci L B Schwartz, Amy C Sturm, Jennifer K Wagner, Janet L Williams, Huntington F Willard, David H Ledbetter
Health care delivery is increasingly influenced by the emerging concepts of precision health and the learning health care system. Although not synonymous with precision health, genomics is a key enabler of individualized care. Delivering patient-centered, genomics-informed care based on individual-level data in the current national landscape of health care delivery is a daunting challenge. Problems to overcome include data generation, analysis, storage, and transfer; knowledge management and representation for patients and providers at the point of care; process management; and outcomes definition, collection, and analysis...
May 2018: Health Affairs
Aaron Parzuchowski, Rizvan Bush, Qinglin Pei, Debra L Friedman, Thomas J FitzGerald, Suzanne L Wolden, Kavita V Dharmarajan, Louis S Constine, Fran Laurie, Sandy K Kessel, Burton Appel, Karen Fernandez, Angela Punnett, Cindy L Schwartz, Jacob Cox, Stephanie A Terezakis
PURPOSE: The presented protocol for pediatric intermediate-risk Hodgkin lymphoma evaluated the use of a dose-intensive chemotherapy regimen (ABVE-PC [doxorubicin, bleomycin, vincristine, etoposide, cyclophosphamide, prednisone]) with response-based therapy augmentation (addition of DECA [dexamethasone, etoposide, cisplatin, cytarabine]) or therapy reduction (elimination of radiation). METHODS AND MATERIALS: A central review of the radiation therapy data for quality assurance was performed, and the association between radiation protocol deviation (RPD) and relapse was assessed in the pediatric group (age <15 years) and adolescent and young adult (AYA) group (age ≥15-21 years)...
April 1, 2018: International Journal of Radiation Oncology, Biology, Physics
Ola Landgren, Rachel Zeig-Owens, Orsolya Giricz, David Goldfarb, Kaznouri Murata, Katie Thoren, Lakshmi Ramanathan, Malin Hultcrantz, Ahmet Dogan, George Nwankwo, Ulrich Steidl, Kith Pradhan, Charles B Hall, Hillel W Cohen, Nadia Jaber, Theresa Schwartz, Laura Crowley, Michael Crane, Shani Irby, Mayris P Webber, Amit Verma, David J Prezant
Importance: The World Trade Center (WTC) attacks on September 11, 2001, created an unprecedented environmental exposure to known and suspected carcinogens suggested to increase the risk of multiple myeloma. Multiple myeloma is consistently preceded by the precursor states of monoclonal gammopathy of undetermined significance (MGUS) and light-chain MGUS, detectable in peripheral blood. Objective: To characterize WTC-exposed firefighters with a diagnosis of multiple myeloma and to conduct a screening study for MGUS and light-chain MGUS...
April 26, 2018: JAMA Oncology
Ankura Singh, Rachel Zeig-Owens, William Moir, Charles B Hall, Theresa Schwartz, Madeline Vossbrinck, Nadia Jaber, Mayris P Webber, Kerry J Kelly, Viola Ortiz, Ellen Koffler, David J Prezant
Importance: Elevated rates of cancer have been reported in individuals exposed to the World Trade Center (WTC) disaster, including Fire Department of the City of New York (FDNY) rescue and recovery workers. Objective: To project the future burden of cancer in WTC-exposed FDNY rescue and recovery workers by estimating the 20-year cancer incidence. Design, Setting, and Participants: A total of 14 474 WTC-exposed FDNY employees who were cancer-free on January 1, 2012; subgroup analyses were conducted of the cohort's white male population (n = 12 374)...
April 26, 2018: JAMA Oncology
Silvan Hämmerli, Alexandra Sabrina Kohl Schwartz, Kirsten Geraedts, Patrick Imesch, Martina Rauchfuss, Monika Maria Wölfler, Felix Haeberlin, Stefanie von Orelli, Markus Eberhard, Bruno Imthurn, Brigitte Leeners
BACKGROUND: Endometriosis-associated pain and dyspareunia influence female sexuality, but little is known about men's experiences in affected couples. AIM: To investigate how men partners experience sexuality in partnership with women with endometriosis. METHODS: A multi-center case-control study was performed between 2010 and 2015 in Switzerland, Germany, and Austria. 236 Partners of endometriosis patients and 236 partners of age-matched control women without endometriosis with a similar ethnic background were asked to answer selected, relevant questions of the Brief Index of Sexual Functioning and the Global Sexual Functioning questionnaire, as well as some investigator-derived questions...
April 26, 2018: Journal of Sexual Medicine
Charlotte Waddell, Christine Schwartz, Caitlyn Andres, Jenny Lou Barican, Donna Yung
QUESTION: Oppositional defiant and conduct disorders (ODD and CD) start early and persist, incurring high individual and collective costs. To inform policy and practice, we therefore asked: What is the best available research evidence on preventing and treating these disorders? STUDY SELECTION AND ANALYSIS: We sought randomised controlled trials (RCTs) evaluating interventions addressing the prevention or treatment of behaviour problems in individuals aged 18 years or younger...
May 2018: Evidence-based Mental Health
Shawn M Kneipp, Todd A Schwartz, Denise J Drevdahl, Mary K Canales, Sheila Santacroce, Hudson P Santos, Ruth Anderson
BACKGROUND: The theoretical landscape of health disparities research now emphasizes health inequities and the role that social determinants of health (SDOH) play in creating and perpetuating them. Whether National Institutes of Health (NIH) funding patterns reflect this theoretical shift is unknown. OBJECTIVES: The aim of this study was to examine the National Institute of Nursing Research's (NINR) funding for research focused on health disparities, health inequities, and SDOH, relative to other key NIH institutes...
May 2018: Nursing Research
Astrid Pechmann, Thorsten Langer, David Schorling, Sabine Stein, Sibylle Vogt, Ulrike Schara, Heike Kölbel, Oliver Schwartz, Andreas Hahn, Kerstin Giese, Jessika Johannsen, Jonas Denecke, Claudia Weiß, Manuela Theophil, Janbernd Kirschner
BACKGROUND: Spinal muscular atrophy (SMA) is a neuromuscular disorder characterized by muscle weakness and muscle atrophy. Nusinersen acts as a splicing modifier and has recently been approved for intrathecal treatment of SMA. OBJECTIVE: Prior to approval, nusinersen was provided to patients with SMA type 1 in Germany within an Expanded Access Program (EAP). In contrast to previous clinical trials, children of different age groups and different stages of the disease were treated with nusinersen...
2018: Journal of Neuromuscular Diseases
Nadia Islam, Thomas Gepts, Isaac Lief, Radhika Gore, Natalie Levy, Michael Tanner, Yixin Fang, Scott E Sherman, Mark D Schwartz
BACKGROUND: Type 2 diabetes mellitus (DM) affects 9.4% of US adults and children, while another 33.9% of Americans are at risk of DM. Health care institutions face many barriers to systematically delivering the preventive care needed to decrease DM incidence. Community health workers (CHWs) may, as frontline public health workers bridging clinic and community, help overcome these challenges. This paper presents the protocol for a pragmatic, cluster-randomized trial integrating CHWs into two primary care clinics to support DM prevention for at-risk patients...
April 19, 2018: BMC Public Health
Victor M Villegas, Stephen G Schwartz, Tina D Hamet, Craig A McKeown, Hilda Capó, Harry W Flynn
BACKGROUND AND OBJECTIVE: This study is designed to illustrate various clinical findings associated with fovea plana in normal children. PATIENTS AND METHODS: A retrospective chart review of pediatric subjects with a diagnosis of fovea plana was conducted to evaluate the characteristics associated with this condition. RESULTS: All eyes had 20/40 or better best-corrected visual acuity (BCVA). In five of six subjects (83%), there was bilateral fovea plana...
April 1, 2018: Ophthalmic Surgery, Lasers & Imaging Retina
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