Older subjective age, or felt age, has been positively associated with being HIV-positive and having less than a high school education, depressive symptoms, diabetes, and medium and low aging satisfaction. To our knowledge, there is no literature exploring the association between subjective aging and depression among people living with HIV. Data from the Multicenter AIDS Cohort Study (MACS) was used to understand the role that subjective aging plays on depression among people who are living with and without HIV. We hypothesized that feeling older will be negatively associated with presenting symptoms of depression among men living with HIV compared to men living without HIV following an adjustment to the model to control for covariates. The MACS is an observational cohort study that follows sexual minority men living with and without HIV in four sites within the United States: Baltimore, Maryland/Washington, DC; Chicago, Illinois; Los Angeles, California; and Pittsburgh, Pennsylvania/Columbus, Ohio. MACS participants attend semiannual visits that collect social, behavioral, medical history, and specimens using an Audio Computer-Assisted Self-Interview and standardized clinical examinations. The study design of the MACS has been described elsewhere. From 1984 to 2018, 7,352 men have been enrolled the MACS. 1,118 of these men were included in this study from the MACS substudy, ‘Understanding Patterns of Healthy Aging Among Men Who Have Sex With Men’, which was administered in six waves between March 2016 and September 2019. We used cross-sectional data from October 2016 to April 2017. Odds ratios (including 95% CIs) were generated using logistic regression models to test the association of subjective age with the presence of depressive symptoms (defined as a score >=16 using the Center for Epidemiological Study Depression scale). Odds ratios were adjusted for age, race/ethnicity, educational attainment, smoking status, history of hypertension, renal disease, dyslipidemia, liver disease, diabetes and HIV status. After adjusting for covariates, older age discrepancy was associated with higher odds of depressive symptoms (vs younger discrepancy; OR: 4.00; 95% CI: 2.39-6.69). Increasing age (5-year increase; OR: 0.81; 95% CI: 0.72-0.91) was associated with lower odds of depressive symptoms. Lower educational attainment was associated with higher odds of depressive symptoms (less than high school degree vs graduate school; OR: 5.33; 95% CI: 1.96-14.53) (high school vs graduate school: OR: 1.93; 95% CI: 1.10-3.37). There was no statistically significant association of HIV status or other covariates with risk of depressive symptoms. Our findings demonstrated a statistically significant positive association between older subjective age (independent of increasing chronological age) and greater risk of depressive symptoms. We also found that having a high school or less than a high school education also increased this risk. Statistical significance was not p
{"title":"Association Between Subjective Age and Depressive Symptoms Among Middle-Aged and Aging HIV-Positive and HIV-Negative Men in the Multicenter AIDS Cohort Study","authors":"Kelvin Blade, Deanna Ware, M. Plankey","doi":"10.52504/001c.36965","DOIUrl":"https://doi.org/10.52504/001c.36965","url":null,"abstract":"Older subjective age, or felt age, has been positively associated with being HIV-positive and having less than a high school education, depressive symptoms, diabetes, and medium and low aging satisfaction. To our knowledge, there is no literature exploring the association between subjective aging and depression among people living with HIV. Data from the Multicenter AIDS Cohort Study (MACS) was used to understand the role that subjective aging plays on depression among people who are living with and without HIV. We hypothesized that feeling older will be negatively associated with presenting symptoms of depression among men living with HIV compared to men living without HIV following an adjustment to the model to control for covariates. The MACS is an observational cohort study that follows sexual minority men living with and without HIV in four sites within the United States: Baltimore, Maryland/Washington, DC; Chicago, Illinois; Los Angeles, California; and Pittsburgh, Pennsylvania/Columbus, Ohio. MACS participants attend semiannual visits that collect social, behavioral, medical history, and specimens using an Audio Computer-Assisted Self-Interview and standardized clinical examinations. The study design of the MACS has been described elsewhere. From 1984 to 2018, 7,352 men have been enrolled the MACS. 1,118 of these men were included in this study from the MACS substudy, ‘Understanding Patterns of Healthy Aging Among Men Who Have Sex With Men’, which was administered in six waves between March 2016 and September 2019. We used cross-sectional data from October 2016 to April 2017. Odds ratios (including 95% CIs) were generated using logistic regression models to test the association of subjective age with the presence of depressive symptoms (defined as a score >=16 using the Center for Epidemiological Study Depression scale). Odds ratios were adjusted for age, race/ethnicity, educational attainment, smoking status, history of hypertension, renal disease, dyslipidemia, liver disease, diabetes and HIV status. After adjusting for covariates, older age discrepancy was associated with higher odds of depressive symptoms (vs younger discrepancy; OR: 4.00; 95% CI: 2.39-6.69). Increasing age (5-year increase; OR: 0.81; 95% CI: 0.72-0.91) was associated with lower odds of depressive symptoms. Lower educational attainment was associated with higher odds of depressive symptoms (less than high school degree vs graduate school; OR: 5.33; 95% CI: 1.96-14.53) (high school vs graduate school: OR: 1.93; 95% CI: 1.10-3.37). There was no statistically significant association of HIV status or other covariates with risk of depressive symptoms. Our findings demonstrated a statistically significant positive association between older subjective age (independent of increasing chronological age) and greater risk of depressive symptoms. We also found that having a high school or less than a high school education also increased this risk. Statistical significance was not p","PeriodicalId":340325,"journal":{"name":"Georgetown Medical Review","volume":"6 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"121022953","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Despite the Philippines facing the fastest growing HIV epidemic among men who have sex with men (MSM) in the Asia/Pacific region, the Philippines reports slow uptake of HIV testing. We reviewed the epidemiology of the HIV epidemic and the current state of HIV testing and other public health interventions in the Philippines to identify possible reasons behind the reported low rates of testing uptake among MSM. Social factors such as HIV-related stigma, misconceptions of the virus, fear of testing HIV-positive, and financial instability contribute to testing hesitancy among MSM. Further investigation is needed to confirm whether recent responses by the Philippine government has increased HIV testing uptake to mitigate the current epidemic.
{"title":"Identifying Barriers to HIV Testing Among Men Who Have Sex with Men (MSM) in the Philippines","authors":"Justin Bustamante, M. Plankey","doi":"10.52504/001c.36967","DOIUrl":"https://doi.org/10.52504/001c.36967","url":null,"abstract":"Despite the Philippines facing the fastest growing HIV epidemic among men who have sex with men (MSM) in the Asia/Pacific region, the Philippines reports slow uptake of HIV testing. We reviewed the epidemiology of the HIV epidemic and the current state of HIV testing and other public health interventions in the Philippines to identify possible reasons behind the reported low rates of testing uptake among MSM. Social factors such as HIV-related stigma, misconceptions of the virus, fear of testing HIV-positive, and financial instability contribute to testing hesitancy among MSM. Further investigation is needed to confirm whether recent responses by the Philippine government has increased HIV testing uptake to mitigate the current epidemic.","PeriodicalId":340325,"journal":{"name":"Georgetown Medical Review","volume":"10 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"129595210","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
The recent growing awareness of racism as a public health crisis has been hailed as a step in the right direction to addressing racial health disparities. However, the contemporary nature of these declarations and the diversity of responses pose important challenges. Objective: To evaluate whether declaring racism a public health crisis is mere rhetoric or a true catalyst for change. Four public health officials in the Washington, DC/Maryland/Virginia area were recruited to participate in a series of in-depth interviews. Collected interview data were subsequently analyzed qualitatively for common themes. Participants across interviews emphasized the importance of naming and defining racism and characterized racism as an upstream root of racial health disparities. Participants described public health as a framework for achieving health equity by building trust with the community and collaborating with non–health sector partners. Local health agencies have examined new strategies to address health disparities, such as increased hiring into health equity initiatives, expansion of community and non–health sector involvement, and internal workplace inclusivity and unconscious bias training. Future challenges to progress include lack of control over policy as well as funding, staffing, and time constraints. The results of this study indicate a shared understanding among participants regarding the influence of racism on disparate health care delivery and medical outcomes. In their efforts to improve health equity, local health agencies have implemented a variety of strategies, but progress remains incremental. Further, without the engagement of policymakers, non–health sector partners, and the community, public health organizations face substantial obstacles in their efforts to dismantle structural racism.
{"title":"Racism as a Public Health Crisis: A Qualitative Case Series of Public Health Responses in the Washington, DC/Maryland/Virginia Area","authors":"M. Lamberti","doi":"10.52504/001c.34716","DOIUrl":"https://doi.org/10.52504/001c.34716","url":null,"abstract":"The recent growing awareness of racism as a public health crisis has been hailed as a step in the right direction to addressing racial health disparities. However, the contemporary nature of these declarations and the diversity of responses pose important challenges. Objective: To evaluate whether declaring racism a public health crisis is mere rhetoric or a true catalyst for change. Four public health officials in the Washington, DC/Maryland/Virginia area were recruited to participate in a series of in-depth interviews. Collected interview data were subsequently analyzed qualitatively for common themes. Participants across interviews emphasized the importance of naming and defining racism and characterized racism as an upstream root of racial health disparities. Participants described public health as a framework for achieving health equity by building trust with the community and collaborating with non–health sector partners. Local health agencies have examined new strategies to address health disparities, such as increased hiring into health equity initiatives, expansion of community and non–health sector involvement, and internal workplace inclusivity and unconscious bias training. Future challenges to progress include lack of control over policy as well as funding, staffing, and time constraints. The results of this study indicate a shared understanding among participants regarding the influence of racism on disparate health care delivery and medical outcomes. In their efforts to improve health equity, local health agencies have implemented a variety of strategies, but progress remains incremental. Further, without the engagement of policymakers, non–health sector partners, and the community, public health organizations face substantial obstacles in their efforts to dismantle structural racism.","PeriodicalId":340325,"journal":{"name":"Georgetown Medical Review","volume":"24 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-05-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"125243062","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Christian X. Lava, Holly Coffey, Mindy Ge, Valerie Rico
Although advancements in antiretroviral therapies have reduced the rates of HIV transmission, HIV remains an international public health concern. Perinatal HIV transmission continues to be one of the most common modes of transmission, with most new pediatric HIV infections beginning in utero. In this review, we provide background on the current standard of care in HIV-positive pregnant women. This includes a discussion of antiretroviral monotherapy vs polytherapy, vaginal delivery vs elective cesarean delivery, and avoidance of breastfeeding in the prevention of perinatal transmission of HIV infection. We also review several methods of HIV treatment that are currently under investigation, including shock and kill, block and lock, and gene editing techniques. Further, we discuss the significance of perinatal HIV transmission from a public health perspective both on a global level and on a local level in Washington, DC.
{"title":"Review of Medical Approaches for the Prevention of Perinatal Transmission of HIV Infection","authors":"Christian X. Lava, Holly Coffey, Mindy Ge, Valerie Rico","doi":"10.52504/001c.34631","DOIUrl":"https://doi.org/10.52504/001c.34631","url":null,"abstract":"Although advancements in antiretroviral therapies have reduced the rates of HIV transmission, HIV remains an international public health concern. Perinatal HIV transmission continues to be one of the most common modes of transmission, with most new pediatric HIV infections beginning in utero. In this review, we provide background on the current standard of care in HIV-positive pregnant women. This includes a discussion of antiretroviral monotherapy vs polytherapy, vaginal delivery vs elective cesarean delivery, and avoidance of breastfeeding in the prevention of perinatal transmission of HIV infection. We also review several methods of HIV treatment that are currently under investigation, including shock and kill, block and lock, and gene editing techniques. Further, we discuss the significance of perinatal HIV transmission from a public health perspective both on a global level and on a local level in Washington, DC.","PeriodicalId":340325,"journal":{"name":"Georgetown Medical Review","volume":"108 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-05-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"116272571","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"The Sacraments of Surgery","authors":"Jonathan Weiss","doi":"10.52504/001c.34723","DOIUrl":"https://doi.org/10.52504/001c.34723","url":null,"abstract":"","PeriodicalId":340325,"journal":{"name":"Georgetown Medical Review","volume":"30 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-05-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"132629584","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Arsalan Bin-Kamran, Ankit Mishra, Srikar Reddy, N. Reddy, Rimla Khan, Annie K. Kruger
Under optimal physiologic conditions, liver resident macrophages, such as Kupffer cells, are abundant in maintaining homeostasis. They orchestrate postinjury inflammatory tissue remodeling, surveil malignant microbial organisms, and remove toxins. Nevertheless, during chronic inflammation and wound healing in the liver, hepatic infiltration of immune cells from the bone marrow, peritoneum, and lymph nodes can promote the maintenance of macrophages subsets that exacerbate liver injury. Depending on the span of the inflammation and the extent of the damage, the liver can undergo acute liver injury or chronic liver injury. In this review, we explain the role of macrophages in the innate immune system, specifically discussing the role of the immune innate system and the description of Kupffer cells. The review also discusses macrophage activity in acute and chronic liver diseases, such as acetaminophen-induced injury, nonalcoholic steatohepatitis/nonalcoholic fatty liver disease, and alcoholic liver disease. Finally, the review also discuss Kupffer cell mechanisms for liver repair and regeneration.
{"title":"Role of Hepatic Macrophages in Acute and Chronic Injury and Repair","authors":"Arsalan Bin-Kamran, Ankit Mishra, Srikar Reddy, N. Reddy, Rimla Khan, Annie K. Kruger","doi":"10.52504/001c.34718","DOIUrl":"https://doi.org/10.52504/001c.34718","url":null,"abstract":"Under optimal physiologic conditions, liver resident macrophages, such as Kupffer cells, are abundant in maintaining homeostasis. They orchestrate postinjury inflammatory tissue remodeling, surveil malignant microbial organisms, and remove toxins. Nevertheless, during chronic inflammation and wound healing in the liver, hepatic infiltration of immune cells from the bone marrow, peritoneum, and lymph nodes can promote the maintenance of macrophages subsets that exacerbate liver injury. Depending on the span of the inflammation and the extent of the damage, the liver can undergo acute liver injury or chronic liver injury. In this review, we explain the role of macrophages in the innate immune system, specifically discussing the role of the immune innate system and the description of Kupffer cells. The review also discusses macrophage activity in acute and chronic liver diseases, such as acetaminophen-induced injury, nonalcoholic steatohepatitis/nonalcoholic fatty liver disease, and alcoholic liver disease. Finally, the review also discuss Kupffer cell mechanisms for liver repair and regeneration.","PeriodicalId":340325,"journal":{"name":"Georgetown Medical Review","volume":"14 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-05-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"128378878","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Nikita Deshpande, June Futterman, S. Gaudio, William Mualem
Perinatal maternal depression leads to a variety of biochemical and behavioral changes in utero. These alterations are linked to impaired fetal development and may also be detrimental to future neonatal, pediatric, and adolescent health. There is a marked rise in the incidence of atopic triad conditions, such as dermatitis and asthmatic wheezing, in children of pregnant mothers with antepartum depression, possibly due to an aberrant TH2 immunologic response and increased fetal oxidative stress. Maternal antepartum depression may also contribute to small-for-gestational age birth status, anomalous fetal neurotransmitter levels, and depression throughout infancy and adolescence. Cortisol has been implicated as a common causative factor responsible for many of these negative offspring outcomes. Minimal research on untreated major depression in pregnancy has been conducted. However, current studies emphasize the importance of holistically evaluating the risks associated with untreated major depression in pregnancy in order to minimize harmful effects on children.
{"title":"Evaluating the Impact of Perinatal Depression on Fetal and Childhood Development","authors":"Nikita Deshpande, June Futterman, S. Gaudio, William Mualem","doi":"10.52504/001c.34629","DOIUrl":"https://doi.org/10.52504/001c.34629","url":null,"abstract":"Perinatal maternal depression leads to a variety of biochemical and behavioral changes in utero. These alterations are linked to impaired fetal development and may also be detrimental to future neonatal, pediatric, and adolescent health. There is a marked rise in the incidence of atopic triad conditions, such as dermatitis and asthmatic wheezing, in children of pregnant mothers with antepartum depression, possibly due to an aberrant TH2 immunologic response and increased fetal oxidative stress. Maternal antepartum depression may also contribute to small-for-gestational age birth status, anomalous fetal neurotransmitter levels, and depression throughout infancy and adolescence. Cortisol has been implicated as a common causative factor responsible for many of these negative offspring outcomes. Minimal research on untreated major depression in pregnancy has been conducted. However, current studies emphasize the importance of holistically evaluating the risks associated with untreated major depression in pregnancy in order to minimize harmful effects on children.","PeriodicalId":340325,"journal":{"name":"Georgetown Medical Review","volume":"160 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-05-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"122798116","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Dylan Sadowsky, K. Delijani, Brenda Asilnejad, J. Choi, Noah Steinberg
Diabetes Mellitus (DM) is a disease with increasing incidence rates and global awareness. Both type 1 (T1D) and type 2 (T2D) diabetes are classifications that require lifetime management. The dysfunction of β islet cells is a primary complication that requires treatment and may lead to several life-threatening complications including blindness, heart disease, and kidney failure. Mesenchymal stem cells (MSCs) are well known for their tissue regenerative action and have shown promising results for restoring β islet cell function as well as ameliorating sequelae of DM. There are several subtypes of MSCs, and each subtype is accompanied by a unique array of pros and cons. This review highlights 3 lineages of MSCs—bone marrow MSCs, adipose-derived (ADSCs), and umbilical cord (UBC-MSCs) - and summarizes the current feasibility and efficacy of each. On evaluation, current primary literature sources suggest that umbilical cord MSCs appear to have the most potential, with particular future implications for exosome research. of islet cell regeneration, an immune modulator. Some these stem cells can act effectively as a for new β islet cells by restoring function, insulin sensitivity, and regulation. acquisition of BM-MSCs involves invasive and painful bone marrow aspiration several contradictory that BM-MSCs lack the ability to differentiate into properly functioning β islet cells, and are not able to express insulin in response to glucose. These indicate BM-MSCs may not most reliable source of in circulation and show a lack of both toxicity and immune reactivity. 28 There is potential feasibility to graduate exosome UBC-MSCs as a diabetes treatment in large scale, indicating fewer legal and ethical concerns due to not transplanting any stem cells. While the future for diabetes treatment using stem cells is moving in the right direction, more work must be conducted to understand the long-term consequences, economic feasibility, and optimal culturing strategies.
{"title":"A Comparison of Mesenchymal Stem Cell Lineages for Treatment of Diabetes Mellitus","authors":"Dylan Sadowsky, K. Delijani, Brenda Asilnejad, J. Choi, Noah Steinberg","doi":"10.52504/001c.31151","DOIUrl":"https://doi.org/10.52504/001c.31151","url":null,"abstract":"Diabetes Mellitus (DM) is a disease with increasing incidence rates and global awareness. Both type 1 (T1D) and type 2 (T2D) diabetes are classifications that require lifetime management. The dysfunction of β islet cells is a primary complication that requires treatment and may lead to several life-threatening complications including blindness, heart disease, and kidney failure. Mesenchymal stem cells (MSCs) are well known for their tissue regenerative action and have shown promising results for restoring β islet cell function as well as ameliorating sequelae of DM. There are several subtypes of MSCs, and each subtype is accompanied by a unique array of pros and cons. This review highlights 3 lineages of MSCs—bone marrow MSCs, adipose-derived (ADSCs), and umbilical cord (UBC-MSCs) - and summarizes the current feasibility and efficacy of each. On evaluation, current primary literature sources suggest that umbilical cord MSCs appear to have the most potential, with particular future implications for exosome research. of islet cell regeneration, an immune modulator. Some these stem cells can act effectively as a for new β islet cells by restoring function, insulin sensitivity, and regulation. acquisition of BM-MSCs involves invasive and painful bone marrow aspiration several contradictory that BM-MSCs lack the ability to differentiate into properly functioning β islet cells, and are not able to express insulin in response to glucose. These indicate BM-MSCs may not most reliable source of in circulation and show a lack of both toxicity and immune reactivity. 28 There is potential feasibility to graduate exosome UBC-MSCs as a diabetes treatment in large scale, indicating fewer legal and ethical concerns due to not transplanting any stem cells. While the future for diabetes treatment using stem cells is moving in the right direction, more work must be conducted to understand the long-term consequences, economic feasibility, and optimal culturing strategies.","PeriodicalId":340325,"journal":{"name":"Georgetown Medical Review","volume":"23 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-01-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"133136629","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Benjamin Hack, S. Ojeniyi, Yakov Mamzhi, Adeeb G Bou-Saba, Louis Saade
eventually recovered with reduced cardiac function at the time of discharge. Conclusions While clinical evidence indicated opioid withdrawal as the likely provoking factor for development of TCM in the first case, the second patient’s symptoms from other clinical complications confounded the cause of her TCM. Twelve similar cases have been reported in the literature, suggesting that opioid withdrawal may be associated with development of TCM. Further quantitative research is required to establish this relationship. Our findings contribute to the theoretical pathophysiology of TCM and offer important considerations for clinical management of opioid withdrawal.
{"title":"The Connection Between Opioid Withdrawal and Takotsubo Cardiomyopathy: Case Reports of ‘Opioid Octopus Heart’","authors":"Benjamin Hack, S. Ojeniyi, Yakov Mamzhi, Adeeb G Bou-Saba, Louis Saade","doi":"10.52504/001c.31500","DOIUrl":"https://doi.org/10.52504/001c.31500","url":null,"abstract":"eventually recovered with reduced cardiac function at the time of discharge. Conclusions While clinical evidence indicated opioid withdrawal as the likely provoking factor for development of TCM in the first case, the second patient’s symptoms from other clinical complications confounded the cause of her TCM. Twelve similar cases have been reported in the literature, suggesting that opioid withdrawal may be associated with development of TCM. Further quantitative research is required to establish this relationship. Our findings contribute to the theoretical pathophysiology of TCM and offer important considerations for clinical management of opioid withdrawal.","PeriodicalId":340325,"journal":{"name":"Georgetown Medical Review","volume":"98 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-01-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"123049049","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Seema Al-Hiraki, Scott Nichols, Adrian Tran, Kyle O'Connor
This article aims to examine the progressive disparities in health care costs, policies, and medical education pertaining to transgender patients in the United States. Despite improvements in health care, the transgender population experiences numerous social and political barriers, limiting their access to adequate care. The treatment costs for the transition process by hormone therapy and surgery are substantial. Additionally, unfavorable health policies affect various aspects of their mental health. Although several health organizations have gender-affirmative policies, the transgender community faces many problems requiring continuous advocacy; only a few states have passed laws supporting transgender-inclusive health insurance. Transgender patients are also exposed to a myriad of social issues arising from negative experiences due to discrimination. For this reason, a transgender patient may be deterred from seeking treatment if the care provider is not sensitive to the patient’s gender identity. The objective, therefore, is to implement strategies that will improve the outcomes of transgender patients by allocating proper funding, instituting inclusive laws, and standardizing medical school curriculums to ensure that health care providers are knowledgeable and prepared.
{"title":"Addressing the Disparities Transgender Patients Face in the US Health Care System","authors":"Seema Al-Hiraki, Scott Nichols, Adrian Tran, Kyle O'Connor","doi":"10.52504/001c.29779","DOIUrl":"https://doi.org/10.52504/001c.29779","url":null,"abstract":"This article aims to examine the progressive disparities in health care costs, policies, and medical education pertaining to transgender patients in the United States. Despite improvements in health care, the transgender population experiences numerous social and political barriers, limiting their access to adequate care. The treatment costs for the transition process by hormone therapy and surgery are substantial. Additionally, unfavorable health policies affect various aspects of their mental health. Although several health organizations have gender-affirmative policies, the transgender community faces many problems requiring continuous advocacy; only a few states have passed laws supporting transgender-inclusive health insurance. Transgender patients are also exposed to a myriad of social issues arising from negative experiences due to discrimination. For this reason, a transgender patient may be deterred from seeking treatment if the care provider is not sensitive to the patient’s gender identity. The objective, therefore, is to implement strategies that will improve the outcomes of transgender patients by allocating proper funding, instituting inclusive laws, and standardizing medical school curriculums to ensure that health care providers are knowledgeable and prepared.","PeriodicalId":340325,"journal":{"name":"Georgetown Medical Review","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-12-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"121676235","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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