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1. Knowledge and Current Practices in Monogenic Uveitis: An International Survey by IUSG and AIDA Network

Author

Carla Gaggiano, Vishali Gupta, Rupesh Agrawal, Marc D. De Smet, Bruno Frediani, Gian Marco Tosi, Maria Pia Paroli, Sudharshan Sridharan, Carlos E. Pavesio, Uwe Pleyer, Ekaterina V. Denisova, Kalpana Babu, Alejandra de-la-Torre, Peizeng Yang, Janet L. Davis, Emmett T. Cunningham, Ester Carreño, Debra Goldstein, Alex Fonollosa, Luca Cantarini, Lucia Sobrin, and Claudia Fabiani

Subjects
Autoinflammatory diseases, Differential diagnosis, Genetic uveitis, Pathogenesis, Rare diseases, Ophthalmology, RE1-994
Abstract

Abstract Introduction This study aims to explore awareness, knowledge, and diagnostic/therapeutic practices in monogenic uveitis (mU) among uveitis experts. Methods This is an explorative, cross-sectional survey study. An anonymous, semi-structured, electronic survey was delivered to uveitis experts from the Autoinflammatory Diseases Alliance (AIDA) Network and International Uveitis Study Group (IUSG). We included respondents answering ≥ 50% of the survey. Results Seventy-seven participants rated their knowledge of mU as proficient (3.9%), adequate (15.6%), sufficient (16.9%), or poor (63.6%). When asked about the first mU gene they thought of, 60.4% mentioned NOD2, 3.9% mentioned NLRP3 or MEFV, and 49.4% provided incorrect or no answers. Success rates in clinical scenarios varied from 15.6% to 55.8% and were higher for ophthalmologists working in multidisciplinary teams (p 0.05). The public healthcare system ensured a higher percentage of tests prescribed were obtained by patients compared to private insurances (p

Published
2023
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2. Advanced endoscopic resection for colorectal dysplasia in inflammatory bowel disease: a meta-analysis

Author

Sonmoon Mohapatra, Kesavan Sankaramangalam, Chawin Lopimpisuth, Oluwatoba Moninuola, Malorie Simons, Julie Nanavati, Leah Jager, Debra Goldstein, Arkady Broder, Venkata Akshintala, Reezwana Chowdhury, Alyssa Parian, Mark G. Lazarev, and Saowanee Ngamruengphong

Subjects
Diseases of the digestive system. Gastroenterology, RC799-869
Abstract

Background and study aims Little is known about outcomes of advanced endoscopic resection (ER) for patients with inflammatory bowel disease (IBD) with dysplasia. The aim of our meta-analysis was to estimate the safety and efficacy of endoscopic mucosal resection (EMR) and endoscopic submucosal dissection (ESD) for dysplastic lesions in patients with IBD. Methods We performed a systematic review through Jan 2021 to identify studies of IBD with dysplasia that was treated by EMR or ESD. We estimated the pooled rates of complete ER, adverse events, post-ER surgery, and recurrence. Proportions were pooled by random effect models. Results Eleven studies including 506 patients and 610 lesions were included. Mean lesion size was 23 mm. The pooled rate of complete ER was 97.9 % (95 % confidence interval [CI]: 95.3 % to 99.7 %). The pooled rate of endoscopic perforation was 0.8 % (95 % CI:0.1 % to 2.2 %) while bleeding occurred in 1.6 % of patients (95 %CI:0.4 % to 3.3 %). Overall, 6.6 % of patients (95 %CI:3.6 % to 10.2 %) underwent surgery after an ER. Among 471 patients who underwent surveillance, local recurrence occurred in 4.9 % patients (95 % CI:1.0 % to 10.7 %) and metachronous lesions occurred in 7.4 % patients (95 %CI:1.5 % to 16 %) over a median follow-up of 33 months. Metachronous colorectal cancer (CRC) was detected in 0.2 % of patients (95 %CI:0 % to 2.2 %) during the surveillance period. Conclusions Advanced ER is safe and effective in the management of large dysplastic lesions in IBD and warrants consideration as first-line therapy. Although the risk of developing CRC after ER is low, meticulous endoscopic surveillance is crucial to monitor for local or metachronous recurrence of dysplasia.

Published
2022
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3. Atypical herpes simplex virus type 2 acute retinal necrosis presentation with large subretinal lesion

Author

Daniel Wang, Justin D. Bloomberg, Lucia Sobrin, Debra Goldstein, and Dimitra Skondra

Subjects
Ophthalmology, RE1-994
Abstract

Purpose: To report the unique clinical findings of a case of Herpes Simplex Virus Type 2 herpetic retinitis manifesting as a large elevated subretinal lesion. Observations: A 26-year-old Hispanic male with no significant past medical history presented with a one-week history of right eye pain and endorsement of worsening vision. Ophthalmic examination of the right eye identified a markedly elevated white subretinal lesion with associated findings of vitritis and hypotony. Ultrasound biomicroscopy demonstrated a diffusely thickened choroid and confirmed the observed subretinal mass. Examination of the fellow left eye was largely unremarkable with the exception of lesions suggestive of inactive chorioretinal scars. Diagnostic vitrectomy and vitreous PCR (polymerase chain reaction) was positive only for HSV-2 (herpes simplex virus type 2) and verified by two independent laboratories. The observed subretinal lesion of right eye improved on intravenous acyclovir and intravitreal foscarnet treatment. Conclusions and Importance: Presented here is an unusual, novel clinical presentation of HSV-2 acute retinal necrosis manifesting as an elevated subretinal lesion along with findings of panuveitis. This case suggests that consideration should be given to the diagnosis of HSV ARN (acute retinal necrosis) when a subretinal elevation is concomitantly appreciated in the setting of vitritis and chorioretinal lesions. Keywords: Acute retinal necrosis, Herpes simplex virus type 2, Panuveitis, Polymerase chain reaction

Published
2019
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4. Opioid Use Disorder Increases 30-Day Readmission Risk in Inflammatory Bowel Disease Hospitalizations: a Nationwide Matched Analysis

Author

Kalpit Devani, Chiranjeevi Gadiparthi, Paris Charilaou, Debra Goldstein, Tejas V. Joshi, Capecomorin S. Pitchumoni, and Sonmoon Mohapatra

Subjects
Adult, Male, medicine.medical_specialty, Time Factors, Adolescent, Databases, Factual, Disease, Comorbidity, Logistic regression, Inflammatory bowel disease, Patient Readmission, 03 medical and health sciences, Young Adult, 0302 clinical medicine, Crohn Disease, Risk Factors, Internal medicine, medicine, Prevalence, Humans, 030212 general & internal medicine, Retrospective Studies, business.industry, Hazard ratio, Gastroenterology, Chronic pain, Opioid use disorder, General Medicine, Length of Stay, Middle Aged, medicine.disease, Opioid-Related Disorders, Confidence interval, United States, 030211 gastroenterology & hepatology, Female, business, Readmission risk
Abstract

Background and Aims The opioid epidemic has become increasingly concerning, with the ever-increasing prescribing of opioid medications in recent years, especially in inflammatory bowel disease [IBD] patients with chronic pain. We aimed to isolate the effect of opioid use disorder [OUD] on 30-day readmission risk after an IBD-related hospitalization. Methods We retrospectively extracted IBD-related adult hospitalizations and 30-day, any-cause, readmissions from the National Readmissions Database [period 2010–2014]. OUD and 30-day readmission trends were calculated. Conventional and exact-matched [EM] logistic regression and time-to-event analyses were conducted among patients who did not undergo surgery during the index hospitalization, to estimate the effect of OUD on 30-day readmission risk. Results In total, 487 728 cases were identified: 6633 [1.4%] had documented OUD And 308 845 patients [63.3%] had Crohn’s disease. Mean age was 44.8 ± 0.1 years, and 54.3% were women. Overall, 30-day readmission rate was 19.4% [n = 94,546], being higher in OUD patients [32.6% vs 19.2%; p < 0.001]. OUD cases have been increasing [1.1% to 1.7%; p-trend < 0.001], while 30-day readmission rates were stable [p-trend = 0.191]. In time-to-event EM analysis, OUD patients were 47% more likely (hazard ratio 1.47; 95% confidence interval [CI]:1.28–1.69; p < 0.001) to be readmitted, on average being readmitted 32% earlier [time ratio 0.68; 95% CI: 0.59–0.78; p < 0.001]. Conclusion OUD prevalence has been increasing in hospitalized IBD patients from 2010 to 2014. On average, one in five patients will be readmitted within 30 days, with up to one in three among the OUD subgroup. OUD is significantly associated with increased 30-day readmission risk in IBD patients and further measures relating to closer post-discharge outpatient follow-up and pain management should be considered to minimize 30-day readmission risk.

Published
2019

5. S0686 A Deeper Look in Hospitalized Older Adults With Inflammatory Bowel Disease: A Nationwide Analysis of Trends, Predictors of Resource Utilization, and Mortality

Author

Debra Goldstein, Kalpit Devani, Sonmoon Mohapatra, Mehak Bassi, Sotirios G. Doukas, Paris Charilaou, Maanit Kohli, and Dhruvil Radadiya

Subjects
medicine.medical_specialty, Hepatology, business.industry, Gastroenterology, Medicine, business, Intensive care medicine, medicine.disease, Inflammatory bowel disease, Resource utilization
Published
2020

6. Guidance on noncorticosteroid systemic immunomodulatory therapy in noninfectious uveitis: fundamentals of care for uveitis (focus) initiative

Author

Dick, Andrew D., Fmedsci, FRCOphth Correspondence information about the author FMedSci, Dick†, FRCOphth Andrew D., Email the author FMedSci, Dick, FRCOphth Andrew D., Rosenbaum, James T., MD†, Al-Dhibi, Hassan A., Rubens Belfort, Jr., Phd, Md, Brézin, Antoine P., Soon Phaik Chee, Frcophth, Frcs, Davis, Janet L., Md, Ma, Ramanan, Athimalaipet V., Frcp, Frcpch, Koh-Hei, Sonoda, Ester, Carreño, Heloisa, Nascimento, Sawsen, Salah, Sherveen, Salek, Jay, Siak, Frcophth, FRCSEd(Ophth), Laura, Steeples, Frcophth, MBChB(Hons) Massimo Accorinti, Nisha, Acharya, Alfredo, Adan, Rupesh, Agrawal, Nurullah, Akkoc, Saed Al Ghamdi, Turki Al Ghamdi, Anood Al Saati, Nasser, Alsabaani, Mohamed, Al-Shamarani, Artur, Bachta, Talin, Barisani-Asenbauer, Nicholas, Beare, Fernanda Belga Ottoni Porto, Ricardo, Blanco, Anita Chan Sook Yee, Vinod, Chandran, Christophe, Chiquet, Hiok Hee Chng, Andrius, Cimbalas, Luca, Cimino, Miguel, Cordero-Coma, Couto, Cristobal, Miguel, Cuevas, João Eurico da Fonseca, Joke de Boer, Alejandra de la Torre, Ilse De Schryver, Larissa, Derzko-Dzulynsky, David, Diaz-Valle, Claudia Eugenia Duran Merino, Andrea, Facsko, Luis, Figueira, Alejandro, Fonollosa, Eric, Fortin, Richard, Gale, Mauro, Galeazzi, Sandra, Garcia, Jose Maria Garcia Ruiz de Morales, Nataša, Gašperšič, Debra, Goldstein, Marta, Guedes, Yan, Guex-Crosier, Ahmet, Gul, Rola, Hamam, Muhammad, Haroon, Kenichi, Hasegawa, Arnd, Heiligenhaus, Claire, Hooper, Yih-Shiou, Hwang, De-Kuang, Hwang, Xavier, Juanola, Toshikatsu, Kaburaki, Sibel, Kadayifcilar, John, Kempen, Takeshi, Kezuka, Amin, Kherani, Maarja, Kirsimäe, Kaisu, Kotaniemi, Aleksandra, Kraut, Agnieszka, Kubicka-Trząska, Lucia, Kuffova, Susan, Lightman, Lyndell, Lim, Wee Kiak Lim, Peter, Mccluskey, Mairide, Mcguire, Pierfrancesco, Mirabelli, Elisabetta, Miserocchi, Marta, Misiuk-Hojło, Cristina, Muccioli, Santiago, Muñoz, Conor, Murphy, Murray, Philip I., Zoltan, Nagy, Kenichi, Namba, Piergiorgio, Neri, Quan, Nguyen, Donncha, O'Gradaigh, Mohammed, Omair, Kati, Otsa, Yilmaz, Ozyazgan, Franco, Pablo, Paroli, Maria Pia, Uwe, Pleyer, Gyula, Poór, Rui, Proença, Theodore, Rabinovitch, Russell, Read, Margarita, Rebrov, Claudia, Recillas-Gispert, Aniki, Rothova, Sergio, Schwartzman, Pascal, Seve, Srilakshmi, Sharma, Joanne, Sims, Nicolette, Sohár, Eric, Suhler, Sándor, Szántó, Zsuzsanna, Szepessy, Christoph, Tappeiner, Jennifer, Thorne, Ilknur Tugal Tutkun, Anna, Turno-Kręcicka, Joachim Van Calster, Irene van der Horst-Bruinsma, Nataša Vidovič Valentinčič, Albert, Vitale, Stephanie Voorduin Ramos, Nenad, Vukojevic, Denis, Wakefield, François, Willermain, Nilufer, Yalcindag, Joyce Hisae Yamamoto, Stephen, Yeh, Reda, Zemaitiene, and Olga, Ziouzina

Subjects
biologic agents, immunomodulatory treatment, uveitis
Published
2018

7. Guidance on Noncorticosteroid Systemic Immunomodulatory Therapy in Noninfectious Uveitis

Author

Andrew D. Dick, James T. Rosenbaum, Hassan A. Al-Dhibi, Rubens Belfort, Antoine P. Brézin, Soon Phaik Chee, Janet L. Davis, Athimalaipet V. Ramanan, Koh-Hei Sonoda, Ester Carreño, Heloisa Nascimento, Sawsen Salah, Sherveen Salek, Jay Siak, Laura Steeples, Massimo Accorinti, Nisha Acharya, Alfredo Adan, Rupesh Agrawal, Nurullah Akkoc, Saed Al Ghamdi, Turki Al Ghamdi, Anood Al Saati, Nasser Alsabaani, Mohamed Al-Shamarani, Artur Bachta, Talin Barisani-Asenbauer, Nicholas Beare, Fernanda Belga Ottoni Porto, Ricardo Blanco, Anita Chan Sook Yee, Vinod Chandran, Christophe Chiquet, Hiok Hee Chng, Andrius Cimbalas, Luca Cimino, Miguel Cordero-Coma, Couto Cristobal, Miguel Cuevas, João Eurico da Fonseca, Joke de Boer, Alejandra de la Torre, Ilse De Schryver, Larissa Derzko-Dzulynsky, David Diaz-Valle, Claudia Eugenia Duran Merino, Andrea Facsko, Luis Figueira, Alejandro Fonollosa, Eric Fortin, Richard Gale, Mauro Galeazzi, Sandra Garcia, Jose Maria Garcia Ruiz de Morales, Nataša Gašperšič, Debra Goldstein, Marta Guedes, Yan Guex-Crosier, Ahmet Gul, Rola Hamam, Muhammad Haroon, Kenichi Hasegawa, Arnd Heiligenhaus, Claire Hooper, Yih-Shiou Hwang, De-Kuang Hwang, Xavier Juanola, Toshikatsu Kaburaki, Sibel Kadayifcilar, John Kempen, Takeshi Kezuka, Amin Kherani, Maarja Kirsimäe, Kaisu Kotaniemi, Aleksandra Kraut, Agnieszka Kubicka-Trząska, Lucia Kuffova, Susan Lightman, Lyndell Lim, Wee Kiak Lim, Peter McCluskey, Mairide McGuire, Pierfrancesco Mirabelli, Elisabetta Miserocchi, Marta Misiuk-Hojło, Cristina Muccioli, Santiago Muñoz, Conor Murphy, Philip I. Murray, Zoltan Nagy, Kenichi Namba, Piergiorgio Neri, Quan Nguyen, Donncha O'Gradaigh, Mohammed Omair, Kati Otsa, Yilmaz Ozyazgan, Franco Pablo, Maria Pia Paroli, Uwe Pleyer, Gyula Poór, Rui Proença, Theodore Rabinovitch, Russell Read, Margarita Rebrov, Claudia Recillas-Gispert, Aniki Rothova, Sergio Schwartzman, Pascal Seve, Srilakshmi Sharma, Joanne Sims, Nicolette Sohár, Eric Suhler, Sándor Szántó, Zsuzsanna Szepessy, Christoph Tappeiner, Jennifer Thorne, Ilknur Tugal Tutkun, Anna Turno-Kręcicka, Joachim Van Calster, Irene van der Horst-Bruinsma, Nataša Vidovič Valentinčič, Albert Vitale, Stephanie Voorduin Ramos, Nenad Vukojevic, Denis Wakefield, François Willermain, Nilufer Yalcindag, Joyce Hisae Yamamoto, Stephen Yeh, Reda Zemaitiene, and Olga Ziouzina

Subjects
030203 arthritis & rheumatology, medicine.medical_specialty, business.industry, MEDLINE, Retrospective cohort study, noninfectious uveitis, noncorticosteroid systemic immunomodulatory agents, Treatment consensus, Evidence-based medicine, CINAHL, Cochrane Library, medicine.disease, law.invention, 03 medical and health sciences, Ophthalmology, 0302 clinical medicine, Systematic review, Randomized controlled trial, law, Family medicine, 030221 ophthalmology & optometry, Medicine, business, Uveitis
Abstract

Topic: An international, expert-led consensus initiative to develop systematic, evidence-based recommendations for the treatment of noninfectious uveitis in the era of biologics. Clinical relevance: The availability of biologic agents for the treatment of human eye disease has altered practice patterns for the management of noninfectious uveitis. Current guidelines are insufficient to assure optimal use of noncorticosteroid systemic immunomodulatory agents. Methods: An international expert steering committee comprising 9 uveitis specialists (including both ophthalmologists and rheumatologists) identified clinical questions and, together with 6 bibliographic fellows trained in uveitis, conducted a Preferred Reporting Items for Systematic Reviews and Meta-Analyses protocol systematic review of the literature (English language studies from January 1996 through June 2016 ; Medline [OVID], the Central Cochrane library, EMBASE, CINAHL, SCOPUS, BIOSIS, and Web of Science). Publications included randomized controlled trials, prospective and retrospective studies with sufficient follow-up, case series with 15 cases or more, peer-reviewed articles, and hand-searched conference abstracts from key conferences. The proposed statements were circulated among 130 international uveitis experts for review. A total of 44 globally representative group members met in late 2016 to refine these guidelines using a modified Delphi technique and assigned Oxford levels of evidence. Results: In total, 10 questions were addressed resulting in 21 evidence-based guidance statements covering the following topics: when to start noncorticosteroid immunomodulatory therapy, including both biologic and nonbiologic agents ; what data to collect before treatment ; when to modify or withdraw treatment ; how to select agents based on individual efficacy and safety profiles ; and evidence in specific uveitic conditions. Shared decision-making, communication among providers and safety monitoring also were addressed as part of the recommendations. Pharmacoeconomic considerations were not addressed. Conclusions: Consensus guidelines were developed based on published literature, expert opinion, and practical experience to bridge the gap between clinical needs and medical evidence to support the treatment of patients with noninfectious uveitis with noncorticosteroid immunomodulatory agents.

Published
2018

8. Unplug : A Simple Guide to Meditation for Busy Skeptics and Modern Soul Seekers

Author

Suze Yalof Schwartz, Debra Goldstein, Suze Yalof Schwartz, and Debra Goldstein

Subjects
Meditation, Self-actualization (Psychology), Cognitive psychology
Abstract

A modernized approach to meditation that will appeal to anyone, even if - especially if - you believe you have no time, you can't sit still, or that'it's just not you.'Whether you're a Fortune 500 CEO or someone bogged down with a never-ending to-do list, the proven secret to being more effective and living a happier, healthier life is to hurry up and slow down, to unplug. Studies show that you can get more done - and do it better - by doing less, just by consciously unplugging for a few minutes each day and meditating. This revolutionary book by the founder and CEO of the groundbreaking LA-based meditation studio Unplug Meditation brilliantly simplifies this powerful practice and shows the overwhelmed and overworked how easy it is to unplug in order to relieve stress, regain focus, and recharge. Schwartz debunks the common misperceptions about meditation, including the notion that you need to sit still for long periods of time, or that you need to'turn off your brain.'She also shares the life-changing benefits you will experience, the proven science of how meditation literally changes your brain, as well as easy techniques and tips to easily incorporate meditation into your daily life.

Published
2017

9. Sa1815 – The Impact of Opioid Abuse/Dependence Disorder on Readmissions After an Index Admission for Inflammatory Bowel Disease: A Matched Study from the US National Readmissions Database (NRD) 2014

Author

Capecomerin Pitchumoni, Debra Goldstein, Kalpit Devani, Paris Charilaou, Tejas V. Joshi, Chiranjeevi Gadiparthi, and Sonmoon Mohapatra

Subjects
medicine.medical_specialty, Index (economics), Hepatology, business.industry, Internal medicine, Gastroenterology, Opioid abuse, Medicine, business, medicine.disease, Inflammatory bowel disease
Published
2019

10. A Triad to Identify an Uncommon Etiology of Gastrointestinal Bleeding

Author

Andrew Korman, Nissy Ann Philip, James Penn, Arkady Broder, and Debra Goldstein

Subjects
Gastrointestinal bleeding, Triad (sociology), medicine.medical_specialty, Hepatology, business.industry, Gastroenterology, Etiology, Medicine, business, medicine.disease, Dermatology
Published
2017

13. 260 - National Estimates of 30-Day Readmissions Among Adult Patients Hospitalized for Constipation in the United States: An Analysis of the Nationwide Readmission Database

Author

Andrew Korman, Sugirdhana Velpari, Capecomerin Pitchumoni, Srikaran Kalahasti, Arkady Broder, Debra Goldstein, Harikrishna Bandla, and Anwar Dudekula

Subjects
medicine.medical_specialty, Constipation, Hepatology, Adult patients, business.industry, Emergency medicine, Gastroenterology, Medicine, medicine.symptom, business
Published
2018

14. Pediatric uveitis

Author

Hemang, Patel and Debra, Goldstein

Subjects
Uveitis, Toxocariasis, Pediatrics, Perinatology and Child Health, Humans, Uveitis, Posterior, Toxoplasmosis, Ocular, Uveitis, Anterior, Arthritis, Juvenile
Abstract

Uveitis in children is an entity most pediatricians and ophthalmologists seldom encounter. It is prevalent in society, however, and the high incidence of sight-threatening complications in untreated children warrants a baseline knowl-edge of the diseases and disorders involved as well as a sense of when to refer to a specialist.

Published
2003

15. Flirtexting : How to Text Your Way Into His Heart

Author

Debra Goldstein, Olivia Baniuszewicz, Debra Goldstein, and Olivia Baniuszewicz

Subjects
Man-woman relationships, Flirting, Text messages (Telephone systems), Cell phones--Social aspects
Abstract

Firtexting (flûr-teksting)Text messages sent between you and someone you are dating, or would like to date; comprised of witty, playful banter that typically leads to a date, and, if you play your cards right, much, much more...Flirtexting is the first step in dating, making it crucial to send the best possible text to get the best possible results. These days, texts, Facebook messages, and quippy emails not only get attention, but, when written strategically,can make or break a budding relationship. Embrace it: Flirtexting is the way to his heart. With sassy—yet classy—advice, playful prepackaged responses, and hilarious real-life dating scenarios, the experts guide you through the digital game of love.Learn to:Read between the lines—how to decode the subtext of his textHold the power in the palm of your hands—what your response time impliesKeep'em coming back for more—learn to craft the best possible textNEW:Insightful tips to successfully navigate sitesExpert advice to create a captivating online profileDirect from the dudes—what they love and hate in your dating profile

Published
2009

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