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JOURNAL ARTICLE
William B Ventres, Leslie A Stone, Radeeb Akhtar, Jeffrey M Ring, Lucy M Candib, Erick Messias, Ronald M Epstein, Marc Tunzi, Amy L Lee, Christopher P Morley, Carina M Brown, David Slawson, Jill Konkin, David G Campbell, Ian Couper, Susan Williams, Robert Brooks, Lucie Walters
Storylines of Family Medicine is a 12-part series of thematically linked mini-essays with accompanying illustrations that explore the many dimensions of family medicine, as interpreted by individual family physicians and medical educators in the USA and elsewhere around the world. In 'IV: perspectives on practice-lenses of appreciation', authors address the following themes: 'Relational connections in the doctor-patient partnership', 'Feminism and family medicine', 'Positive family medicine', 'Mindful practice', 'The new, old ethics of family medicine', 'Public health, prevention and populations', 'Information mastery in family medicine' and 'Clinical courage...
April 12, 2024: Family Medicine and Community Health
#2
JOURNAL ARTICLE
Brenna Mossman, Laura M Perry, Hallie M Voss, Paul K Maciejewski, Robert Gramling, Paul Duberstein, Holly G Prigerson, Ronald M Epstein, Michael Hoerger
CONTEXT: Gender and personality may individually impact end-of-life care. Men often receive more aggressive treatments than women near death, and personality - particularly openness - may be associated with increased care utilization when it diverges from traditional treatment norms. However, research has not examined the interaction of these variables in a dyadic context. OBJECTIVES: This study examined the dyadic effects of patient gender and caregiver personality on end-of-life care...
January 24, 2024: Journal of Pain and Symptom Management
#3
JOURNAL ARTICLE
Sehreen Mumtaz, Estephania Candelo, Murli Krishna, Liuyan Jiang, Alok A Bhatt, Margaret Bridges, Andres Cardona, Amy Rutt, Florentina Berianu, Ronald R Butendieck
Epstein-Barr virus (EBV) belongs to the group of human herpes virus and can cause clinical and subclinical infections. Although EBV-related disease presentations are similar, they can lead to oncogenic transformation with various clinical manifestations. A thorough workup with morphology, immunohistochemistry, and molecular studies is crucial for the diagnosis of EBV-positive polymorphic B-cell lymphoproliferative disorder, not otherwise specified (NOS), which is a new entity introduced by International Consensus Classification in 2022...
January 24, 2024: Ear, Nose, & Throat Journal
#4
JOURNAL ARTICLE
Gretchen Roman, Reza Yousefi-Nooraie, Paul Vermilion, Anapaula Cupertino, Steven Barnett, Ronald Epstein
INTRODUCTION: Medical interpreters experience emotional burdens from the complex demands at work. Because communication access is a social determinant of health, protecting and promoting the health of medical interpreters is critical for ensuring equitable access to care for language-minority patients. The purpose of this study was to pilot a condensed 8-h program based on Mindful Practice® in Medicine addressing the contributors to distress and psychosocial stressors faced by medical sign and spoken language interpreters...
2023: Frontiers in Psychology
#5
Andrew Dang Khai Nguyen, Ronald Siu, Grant Kleinschmidt, Bimal Prakash Sood, Ehsan Esmaili Shandiz
KEY CLINICAL MESSAGE: Consider the differential of Epstein-Barr virus (EBV) reactivation in pregnant women who develop progressive meningoencephalitis and transverse myelitis. EBV nucleic acid amplification should be considered in immunosuppressed patients. ABSTRACT: A 32-year-old G10P6M3K22 pregnant female presented to a regional hospital with progressive severe neurological and behavioral deficits. Magnetic resonance revealed cervical transverse myelitis. Lumbar puncture confirmed Epstein-Barr virus (EBV) DNA on a background of IgG-positive EBV serology...
September 2023: Clinical Case Reports
#6
REVIEW
"I don't need your pills, I need your attention:" Steps toward deep listening in medical encounters.
Ronald M Epstein, Mary Catherine Beach
Patients highly value being listened to, taken seriously, heard, and understood; indeed, listening to patients is essential to alleviate suffering. Yet listening as a clinical skill has been virtually ignored in the training of physicians. In this paper, we synthesize literature related to listening in medicine and explore the internal and external challenges and complexity of listening - including the need to listen with a diagnostic as well as a relational ear to take in physical symptoms, emotions, and contexts - often in chaotic and time-pressured environments...
October 2023: Current Opinion in Psychology
#7
JOURNAL ARTICLE
Holly G Prigerson, David Russell, Sophia E Kakarala, Heather M Derry-Vick, Manish A Shah, Ashish Saxena, Valerie F Reyna, Allyson Ocean, Ronald Scheff, Paul K Maciejewski, Andrew S Epstein
PURPOSE: Most patients with cancer lack the prognostic understanding necessary to make informed decisions. We tested the feasibility and acceptability of the Oncolo-GIST ("Giving Information Strategically and Transparently, GIST") intervention and explored its associations with patients' improved prognostic understanding. METHODS: The Oncolo-GIST intervention distills prognostic discussions into easy-to-understand talking points. Patients with metastatic cancers that progressed on ≥1 line of chemotherapy and not expected to survive 12 months (n = 31) were recruited from October 2020 through November 2022...
August 8, 2023: Cancer Medicine
#8
JOURNAL ARTICLE
Fahad Saeed, Spencer Dahl, Robert K Horowitz, Paul R Duberstein, Ronald M Epstein, Kevin A Fiscella, Rebecca J Allen
RATIONALE & OBJECTIVE: Many older adults prefer quality of life over longevity, and some prefer conservative kidney management (CKM) over dialysis. There is a lack of patient-decision aids for adults aged 75 years or older facing kidney therapy decisions, which not only include information on dialysis and CKM but also encourage end-of-life planning. We iteratively developed a paper-based patient-decision aid for older people with low literacy and conducted surveys to assess its acceptability...
July 2023: Kidney medicine
#9
JOURNAL ARTICLE
Veronica Derricks, Izzy Gainsburg, Cleveland Shields, Kevin Fiscella, Ronald Epstein, Veronica Yu, Jennifer J Griggs
PURPOSE: Physician burnout is generally associated with worse clinical outcomes. The purpose of this study is to examine the effects of physician burnout on the quality of physicians' pain assessment and opioid prescribing for patients with advanced lung cancer. Moreover, we test whether these relationships are moderated by patient-level factors, such as patient race and activation level, that have a demonstrated impact on clinical encounters. METHODS: We conducted a secondary analysis of data from a multisite randomized field experiment...
July 17, 2023: Supportive Care in Cancer
#10
JOURNAL ARTICLE
Carlos F De La Cruz-Herrera, Michael H Tatham, Umama Z Siddiqi, Kathy Shire, Edyta Marcon, Jack F Greenblatt, Ronald T Hay, Lori Frappier
SUMO modifications regulate the function of many proteins and are important in controlling herpesvirus infections. We performed a site-specific proteomic analysis of SUMO1- and SUMO2-modified proteins in Epstein-Barr virus (EBV) latent and lytic infection to identify proteins that change in SUMO modification status in response to EBV reactivation. Major changes were identified in all three components of the TRIM24/TRIM28/TRIM33 complex, with TRIM24 being rapidly degraded and TRIM33 being phosphorylated and SUMOylated in response to EBV lytic infection...
July 2023: PLoS Pathogens
#11
JOURNAL ARTICLE
Kevin Fiscella, Ronald M Epstein
Policy Points The meaning of health in health care remains poorly defined, defaulting to a narrow, biomedical disease model. A national dialogue could create a consensus regarding a holistic and humanized definition of health that promotes health care transformation and health equity. Key steps for operationalizing a holistic meaning of health in health care include national leadership by federal agencies, intersectoral collaborations that include diverse communities, organizational and cultural change in medical education, and implementation of high-quality primary care...
June 21, 2023: Milbank Quarterly
#12
JOURNAL ARTICLE
Connie A Haley, Marcos C Schechter, David Ashkin, Charles A Peloquin, J Peter Cegielski, Barbara B Andrino, Marcos Burgos, Lori A Caloia, Lisa Chen, Angel Colon-Semidey, Malini B DeSilva, Shireesha Dhanireddy, Susan E Dorman, Felicia F Dworkin, Heidi Hammond-Epstein, Alice V Easton, James T Gaensbauer, Bijan Ghassemieh, Maria E Gomez, David Horne, Supriya Jasuja, Betsy A Jones, Leonard J Kaplan, Asharaf Edward Khan, Elizabeth Kracen, Sarah Labuda, Karen M Landers, Alfred A Lardizabal, Maria T Lasley, David M Letzer, Vinicius K Lopes, Ronald J Lubelchek, C Patricia Macias, Aimee Mihalyov, Elizabeth Ann Misch, Jason A Murray, Masahiro Narita, Diana M Nilsen, Megan J Ninneman, Lynne Ogawa, Alawode Oladele, Melissa Overman, Susan M Ray, Kathleen A Ritger, Marie-Claire Rowlinson, Nadya Sabuwala, Thomas M Schiller, Lawrence E Schwartz, Christopher Spitters, Douglas B Thomson, Rene Rico Tresgallo, Patrick Valois, Neela D Goswami
BACKGROUND: Rifampin-resistant tuberculosis is a leading cause of morbidity worldwide; only one-third of persons initiate treatment and outcomes are often inadequate. Several trials demonstrate 90% efficacy using an all-oral, six-month regimen of bedaquiline, pretomanid, and linezolid (BPaL), but significant toxicity occurred using 1200 mg linezolid. After U.S. FDA approval in 2019, some U.S. clinicians rapidly implemented BPaL using an initial linezolid 600 mg dose adjusted by serum drug concentrations and clinical monitoring...
May 30, 2023: Clinical Infectious Diseases
#13
JOURNAL ARTICLE
Ronald Lai, David Chun Man Yeung, Zenon Wing Chi Yeung, Thomas Sin Chun Hui, Wai Kei Jacky Lam, Kwan Chee Allen Chan, Cherrie Wing Kei Ng, Zion Wing Hei To, Ryan Hung Wai Cho, Catherine Po Ling Chan, Calvin Chee Fung Lai, Natalie Moon Wah Leung, Eddy Wai Yeung Wong, Joseph Chun Kit Chung, Raymond King Yin Tsang, Kenneth Wing Sum Li, James Chung Hang Chow, Ken Ka Man Cheung, Jason Y K Chan
OBJECTIVE: To evaluate the sensitivities and specificities of Epstein-Barr virus (EBV) DNA in the detection of locally recurrent or persistent nasopharyngeal carcinoma (NPC) through nasopharyngeal (NP) brush biopsy and plasma, respectively, and whether a combination of both would be superior to the individual tests. STUDY DESIGN: A case-control study was conducted from September 2016 to June 2022. SETTING: A multicentre study at 3 tertiary referral centers in Hong Kong was conducted by the Department of Otorhinolaryngology, Head and Neck Surgery, The Chinese University of Hong Kong...
May 26, 2023: Otolaryngology—Head and Neck Surgery
#14
JOURNAL ARTICLE
Basil S Kazi, Paul R Duberstein, Benzi M Kluger, Ronald M Epstein, Kevin A Fiscella, Zain S Kazi, Spencer K Dahl, Rebecca J Allen, Fahad Saeed
BACKGROUND: Preference-concordant care is a cornerstone of high-quality medical decision-making, yet the prevalence and correlates of preference-concordant care have not been well-studied in patients receiving dialysis. We surveyed hospitalized people receiving maintenance dialysis to estimate the prevalence and correlates of preference-concordant care among this population. METHODS: We assessed preference concordance by asking participants (223/380, 59% response rate), "How strongly do you agree or disagree that your current treatment plan meets your preference?" We assessed treatment plan preference by asking if patients preferred a plan that focused on (a) extending life, or (b) relieving pain and discomfort...
May 5, 2023: Kidney360
#15
JOURNAL ARTICLE
Edwin Krogh, Ronald Epstein, Álvaro I Langer, Christoph Steinebach
No abstract text is available yet for this article.
May 17, 2023: International Journal for Quality in Health Care
#16
Login S George, Ronald M Epstein, Ayse Akincigil, Biren Saraiya, Kelly M Trevino, Alexandra Kuziemski, Lavanya Pushparaj, Elizabeth Policano, Holly G Prigerson, Kendra Godwin, Paul Duberstein
BACKGROUND: Physicians treating similar patients in similar care-delivery contexts vary in the intensity of life-extending care provided to their patients at the end-of-life. Physician psychological propensities are an important potential determinant of this variability, but the pertinent literature has yet to be synthesized. OBJECTIVE: Conduct a review of qualitative studies to explicate whether and how psychological propensities could result in some physicians providing more intensive treatment than others...
February 2, 2023: Journal of General Internal Medicine
#17
JOURNAL ARTICLE
John B Harley, Saiju Pyarajan, Elizabeth S Partan, Lauren Epstein, Jason A Wertheim, Abhinav Diwan, Christopher W Woods, Victoria Davey, Sharlene Blair, Dennis H Clark, Kenneth M Kaufman, Shagufta Khan, Iouri Chepelev, Alexander Devine, Perry Cameron, Monica F McCann, Mary Cloud B Ammons, Devin D Bolz, Jane K Battles, Jeffrey L Curtis, Mark Holodniy, Vincent C Marconi, Charles D Searles, David O Beenhouwer, Sheldon T Brown, Jonathan P Moorman, Zhi Q Yao, Maria C Rodriguez-Barradas, Shyam Mohapatra, Osmara Y Molina De Rodriguez, Emerson B Padiernos, Eric R McIndoo, Emily Price, Hailey M Burgoyne, Ian Robey, Dawn C Schwenke, Carey L Shive, Ronald M Przygodzki, Rachel B Ramoni, Holly K Krull, Robert A Bonomo
BACKGROUND: The coronavirus disease 2019 (COVID-19) pandemic, caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has demonstrated the need to share data and biospecimens broadly to optimize clinical outcomes for US military Veterans. METHODS: In response, the Veterans Health Administration established VA SHIELD (Science and Health Initiative to Combat Infectious and Emerging Life-threatening Diseases), a comprehensive biorepository of specimens and clinical data from affected Veterans to advance research and public health surveillance and to improve diagnostic and therapeutic capabilities...
December 2022: Open Forum Infectious Diseases
#18
REVIEW
Simon K B Spohn, Cédric Draulans, Amar U Kishan, Daniel Spratt, Ashley Ross, Tobias Maurer, Derya Tilki, Alejandro Berlin, Pierre Blanchard, Sean Collins, Peter Bronsert, Ronald Chen, Alan Dal Pra, Gert de Meerleer, Thomas Eade, Karin Haustermans, Tobias Hölscher, Stefan Höcht, Pirus Ghadjar, Elai Davicioni, Matthias Heck, Linda G W Kerkmeijer, Simon Kirste, Nikolaos Tselis, Phuoc T Tran, Michael Pinkawa, Pascal Pommier, Constantinos Deltas, Nina-Sophie Schmidt-Hegemann, Thomas Wiegel, Thomas Zilli, Alison C Tree, Xuefeng Qiu, Vedang Murthy, Jonathan I Epstein, Christian Graztke, Xin Gao, Anca L Grosu, Sophia C Kamran, Constantinos Zamboglou
Current risk-stratification systems for prostate cancer (PCa) do not sufficiently reflect the disease heterogeneity. Genomic classifiers (GC) enable improved risk stratification after surgery, but less data exist for patients treated with definitive radiation therapy (RT) or RT in oligo-/metastatic disease stages. To guide future perspectives of GCs for RT, we conducted (1) a systematic review on the evidence of GCs for patients treated with RT and (2) a survey of experts using the Delphi method, addressing the role of GCs in personalized treatments to identify relevant fields of future clinical and translational research...
December 31, 2022: International Journal of Radiation Oncology, Biology, Physics
#19
REVIEW
Paul R Duberstein, Michael Hoerger, Sally A Norton, Supriya Mohile, Britt Dahlberg, Erica Goldblatt Hyatt, Ronald M Epstein, Marsha N Wittink
Prior interventions have repeatedly failed to decrease the prescription and receipt of treatments and procedures that confer more harm than benefit at the End-of-Life (EoL); new approaches to intervention are needed. Ideally, future interventions would be informed by a social-ecological conceptual model that explains EoL healthcare utilization patterns, but current models ignore two facts: (1) healthcare is an inherently social activity, involving clinical teams and patients' social networks, and (2) emotions influence social activity...
November 24, 2022: Social Science & Medicine
#20
JOURNAL ARTICLE
Laura A Dwyer, Ronald M Epstein, Brooke C Feeney, Irene V Blair, Niall Bolger, Rebecca A Ferrer
Patient-clinician interactions are critical to patient-centered care, including in cancer care contexts which are often defined by multiple patient-clinician interactions over an extended period. Research on these dyadic interactions has been guided by perspectives in clinical communication science, but the study of clinical communication has not been fully integrated with perspectives on interpersonal interactions from relationship science research. An overlapping concept in both fields is the concept of responsive socialsupport...
November 7, 2022: Social Science & Medicine
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