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1. Comparison of Questionnaire and Performance‐Based Physical Frailty Scales to Predict Survival and Health‐Related Quality of Life in Patients With Heart Failure

Author

Joseph Somech, Aayushi Joshi, Rita Mancini, Jessica Chetrit, Caroline Michel, Richard Sheppard, Viviane Nguyen, Mathieu Walker, Nadia Giannetti, Abhinav Sharma, Delina Maghakian, Esther Laforest, and Jonathan Afilalo

Subjects
frailty, health‐related quality of life, heart failure, Diseases of the circulatory (Cardiovascular) system, RC666-701
Abstract

Background Frailty is prevalent in older adults with heart failure and is associated with poor outcomes; however, there remains uncertainty on how to measure frailty in clinical practice. Methods and Results A multicentric prospective cohort study was assembled at 4 heart failure clinics to compare the prognostic value of 3 physical frailty scales in ambulatory patients with heart failure. Outcomes were all‐cause death or hospitalization and health‐related quality of life using the 36‐Item Short Form survey questionnaire (SF‐36) at 3 months. Multivariable regression was adjusted for age, sex, Meta‐Analysis Global Group in Chronic Heart Failure score, and baseline SF‐36 score. The cohort included 215 patients (mean age 77.6 years). All 3 frailty scales were independently associated with death or hospitalization at 3 months; the adjusted odds ratios standardized per 1 SD worsening of the Short Physical Performance Battery; Fried, and strength, assistance with walking, rising from a chair, climbing stairs, and falls scales were 1.67 (95% CI, 1.09–2.55), 1.60 (95% CI, 1.04–2.46), and 1.55 (95% CI, 1.03–2.35), respectively, with C statistics of 0.77 to 0.78. All 3 frailty scales were independently associated with worsening SF‐36 scores, especially the Short Physical Performance Battery, for which 1 SD worsening of frailty translated to a decrement of −5.86 (−8.55 to −3.17) and −5.51 (−7.82 to −3.21) points in the Physical Component Score and Mental Component Score. Conclusions All 3 physical frailty scales were associated with death, hospitalization, and reduced health‐related quality of life in ambulatory patients with heart failure. Questionnaire or performance‐based physical frailty scales can be used to offer prognostic value and a therapeutic target in this vulnerable population. Registration URL: https://www.clinicaltrials.gov; Unique identifier: NCT03887351.

Published
2023
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2. Breastfeeding, Cellular Immune Activation, and Myocardial Recovery in Peripartum Cardiomyopathy

Author

Agnes Koczo, MD, Amy Marino, MD, Arun Jeyabalan, MD, Uri Elkayam, MD, Leslie T. Cooper, MD, James Fett, MD, MPH, Joan Briller, MD, Eileen Hsich, MD, Lori Blauwet, MD, Charles McTiernan, PhD, Penelope A. Morel, MD, Karen Hanley-Yanez, BS, Dennis M. McNamara, MD, MS, Dennis M McNamara, MD, James D. Fett, MD, Jessica Pisarcik, RN, BSN, John Gorcsan, III, MD, Erik Schelbert, MD, Rami Alharethi, MD, Kismet Rasmusson, CRNP, Kim Brunisholz, Amy Butler, BS, CCRP, Deborah Budge, A.G. Kfoury, MD, Benjamin Horne, PhD, Joe Tuinei, Heather Brown, Julie Damp, MD, Allen J. Naftilan, MD, Jill Russell, RN, MSN, Darla Freehardt, LPN, BS, CCRP, Cynthia Oblak, CCRC, Greg Ewald, MD, Donna Whitehead, RN, Jean Flanagan, RN, Anne Platts, Jorge Caro, MPH, Stephanie Mullin, RN, Michael M. Givertz, MD, M. Susan Anello, RN, BS, Navin Rajagopalan, MD, David Booth, MD, Tiffany Sandlin, RN, Wendy Wijesiri, RN, Lori A. Blauwet, MD, Joann Brunner, RN, Mary Phelps, Ruth Kempf, Kalgi Modi, MD, Tracy Norwood, Decebal Sorin Griza, MD, G. Michael Felker, MD, Robb Kociol, MD, Patricia Adams, RN, Gretchen Wells, MD, Vinay Thohan, MD, Deborah Wesley-Farrington, RN, BSN, CCRC, CCA, Sandra Soots, RN, CCRC, Richard Sheppard, MD, Caroline Michel, MD, Nathalie Lapointe, RN, PhD, Heather Nathaniel, Angela Kealey, MD, Marc Semigran, MD, Maureen Daher, RN, John Boehmer, MD, David Silber, MD, Eric Popjes, MD, Patricia Frey, RN, Todd Nicklas, RN, Jeffrey Alexis, MD, Lori Caufield, RN, BSN, CCRC, John W. Thornton, III, MD, Mindy Gentry, MD, Vincent J.B. Robinson, MBBS, Gyanendra K. Sharma, MD, Joan Holloway, BS, Maria Powell, LPN, CCRC, David Markham, MD, Mark Drazner, MD, Lynn Fernandez, RN, Mark Zucker, MD, David A. Baran, MD, Martin L. Gimovsky, MD, Natalia Hochbaum, MD, Bharati Patel, RN, CCRC, Laura Adams, RN, BSN, Gautam Ramani, MD, Stephen Gottlieb, MD, Shawn Robinson, MD, Stacy Fisher, MD, Joanne Marshall, BSN, MS, Jennifer Haythe, MD, Donna Mancini, MD, Rachel Bijou, MD, Maryjane Farr, MD, Marybeth Marks, Henry Arango, Biykem Bozkurt, MD, PhD, FACC, FAHA, Mariana Bolos, Paul Mather, MD, Sharon Rubin, MD, Raphael Bonita, MD, Susan Eberwine, RN, Hal Skopicki, MD, PhD, Kathleen Stergiopoulos, MD, Ellen McCathy-Santoro, MD, Jennifer Intravaia, RN, CCRCII, Elizabeth Maas, Jordan Safirstein, MD, Audrey Kleet, RN, MS, ACNP-BC, CCRN, CCTC, Nancy Martinez, RN, Christine Corpoin, RN, Donna Hesari, RN, Sandra Chaparro, MD, Laura J. Hudson, MA, MPH, CCRC, Jalal K. Ghali, MD, Zora Injic, RN, BSc, MSA, and Ilan S. Wittstein, MD

Subjects
Diseases of the circulatory (Cardiovascular) system, RC666-701
Abstract

Summary: The etiology of peripartum cardiomyopathy remains unknown. One hypothesis is that an increase in the 16-kDa form of prolactin is pathogenic and suggests that breastfeeding may worsen peripartum cardiomyopathy by increasing prolactin, while bromocriptine, which blocks prolactin release, may be therapeutic. An autoimmune etiology has also been proposed. The authors investigated the impact of breastfeeding on cellular immunity and myocardial recovery for women with peripartum cardiomyopathy in the IPAC (Investigations in Pregnancy Associated Cardiomyopathy) study. Women who breastfed had elevated prolactin, and prolactin levels correlated with elevations in CD8+ T cells. However, despite elevated prolactin and cytotoxic T cell subsets, myocardial recovery was not impaired in breastfeeding women. Key Words: breastfeeding, immune activation, peripartum cardiomyopathy

Published
2019
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3. Revised checklist of New York State plants /

Author

Mitchell, Richard Sheppard, 1938, Tucker, Gordon C. (Gordon Charles), 1957, New York Botanical Garden, LuEsther T. Mertz Library, Mitchell, Richard Sheppard, 1938, and Tucker, Gordon C. (Gordon Charles), 1957

Subjects
New York (State), Plants
Published
1997

4. Portulacaceae through Caryophyllaceae of New York State /

Author

Mitchell, Richard Sheppard, 1938, New York Botanical Garden, LuEsther T. Mertz Library, and Mitchell, Richard Sheppard, 1938

Subjects
Caryophyllaceae, Geographical distribution, Identification, Molluginaceae, New York (State), Plants, Portulacaceae
Published
1993

5. Betulaceae through Cactaceae of New York State /

Author

Furlow, John J. (John Jacob), 1942, Mitchell, Richard Sheppard, 1938, New York Botanical Garden, LuEsther T. Mertz Library, Furlow, John J. (John Jacob), 1942, and Mitchell, Richard Sheppard, 1938

Subjects
Betulaceae, Dicotyledones, Geographical distribution, Identification, New York (State)
Published
1990

6. Identification of plants with fleshy fruits /

Author

Ogden, Eugene Cecil, Mitchell, Richard Sheppard, 1938, New York State Museum, University of the State of New York, New York Botanical Garden, LuEsther T. Mertz Library, Ogden, Eugene Cecil, Mitchell, Richard Sheppard, 1938, New York State Museum, and University of the State of New York

Subjects
Fruit, Identification, Identification guides, Northeastern States
Published
1990

7. Ecosystem management : rare species and significant habitats : proceedings of the 15th Annual Natural Areas Conference /

Author

Natural Areas Conference State University of New York College of Environmental Science and Forestry) 1988, Leopold, Donald Joseph, 1956, Mitchell, Richard Sheppard, 1938, Sheviak, Charles J., New York Botanical Garden, LuEsther T. Mertz Library, Natural Areas Conference State University of New York College of Environmental Science and Forestry) 1988, Leopold, Donald Joseph, 1956, Mitchell, Richard Sheppard, 1938, and Sheviak, Charles J.

Subjects
Conference papers and proceedings, Congresses, Ecology, Ecosystem management, Kongress, Naturschutz, Ökosystem
Published
1990

8. Pain, Analgesic Use, and Patient Satisfaction With Spinal Versus General Anesthesia for Hip Fracture Surgery : A Randomized Clinical Trial

Author

Mark D, Neuman, Rui, Feng, Susan S, Ellenberg, Frederick, Sieber, Daniel I, Sessler, Jay, Magaziner, Nabil, Elkassabany, Eric S, Schwenk, Derek, Dillane, Edward R, Marcantonio, Diane, Menio, Sabry, Ayad, Manal, Hassan, Trevor, Stone, Steven, Papp, Derek, Donegan, Mitchell, Marshall, J Douglas, Jaffe, Charles, Luke, Balram, Sharma, Syed, Azim, Robert, Hymes, Ki-Jinn, Chin, Richard, Sheppard, Barry, Perlman, Joshua, Sappenfield, Ellen, Hauck, Mark A, Hoeft, Ann, Tierney, Lakisha J, Gaskins, Annamarie D, Horan, Trina, Brown, James, Dattilo, Jeffrey L, Carson, Thomas, Looke, Sandra, Bent, Ariana, Franco-Mora, Pamela, Hedrick, Matthew, Newbern, Rafik, Tadros, Karen, Pealer, Kamen, Vlassakov, Carolyn, Buckley, Lauren, Gavin, Svetlana, Gorbatov, James, Gosnell, Talora, Steen, Avery, Vafai, Jose, Zeballos, Jennifer, Hruslinski, Louis, Cardenas, Ashley, Berry, John, Getchell, Nicholas, Quercetti, Gauasan, Bajracharya, Damien, Billow, Michael, Bloomfield, Evis, Cuko, Mehrun K, Elyaderani, Robert, Hampton, Hooman, Honar, Dilara, Khoshknabi, Daniel, Kim, David, Krahe, Michael M, Lew, Conjeevram B, Maheshwer, Azfar, Niazi, Partha, Saha, Ahmed, Salih, Robert J, de Swart, Andrew, Volio, Kelly, Bolkus, Matthew, DeAngelis, Gregory, Dodson, Jeffrey, Gerritsen, Brian, McEniry, Ludmil, Mitrev, M Kwesi, Kwofie, Anne, Belliveau, Flynn, Bonazza, Vera, Lloyd, Izabela, Panek, Jared, Dabiri, Chris, Chavez, Jason, Craig, Todd, Davidson, Chad, Dietrichs, Cheryl, Fleetwood, Mike, Foley, Chris, Getto, Susie, Hailes, Sarah, Hermes, Andy, Hooper, Greg, Koener, Kate, Kohls, Leslie, Law, Adam, Lipp, Allison, Losey, William, Nelson, Mario, Nieto, Pam, Rogers, Steve, Rutman, Garrett, Scales, Barbara, Sebastian, Tom, Stanciu, Gregg, Lobel, Michelle, Giampiccolo, Dara, Herman, Margit, Kaufman, Bryan, Murphy, Clara, Pau, Thomas, Puzio, Marlene, Veselsky, Kelly, Apostle, Dory, Boyer, Brenda Chen, Fan, Susan, Lee, Mike, Lemke, Richard, Merchant, Farhad, Moola, Kyrsten, Payne, Bertrand, Perey, Darius, Viskontas, Mark, Poler, Patricia, D'Antonio, Greg, O'Neill, Amer, Abdullah, Jamie, Fish-Fuhrmann, Mark, Giska, Christina, Fidkowski, Stuart Trent, Guthrie, William, Hakeos, Lillian, Hayes, Joseph, Hoegler, Katherine, Nowak, Jeffery, Beck, Jaslynn, Cuff, Greg, Gaski, Sharon, Haaser, Michael, Holzman, A Stephen, Malekzadeh, Lolita, Ramsey, Jeff, Schulman, Cary, Schwartzbach, Tangwan, Azefor, Arman, Davani, Mahmood, Jaberi, Courtney, Masear, Syed Basit, Haider, Carolyn, Chungu, Ali, Ebrahimi, Karim, Fikry, Andrew, Marcantonio, Anitha, Shelvan, David, Sanders, Collin, Clarke, Abdel, Lawendy, Gary, Schwartz, Mohit, Garg, Joseph, Kim, Juan, Caruci, Ekow, Commeh, Randy, Cuevas, Germaine, Cuff, Lola, Franco, David, Furgiuele, Matthew, Giuca, Melissa, Allman, Omid, Barzideh, James, Cossaro, Armando, D'Arduini, Anita, Farhi, Jason, Gould, John, Kafel, Anuj, Patel, Abraham, Peller, Hadas, Reshef, Mohammed, Safur, Fiore, Toscano, Tiffany, Tedore, Michael, Akerman, Eric, Brumberger, Sunday, Clark, Rachel, Friedlander, Anita, Jegarl, Joseph, Lane, John P, Lyden, Nili, Mehta, Matthew T, Murrell, Nathan, Painter, William, Ricci, Kaitlyn, Sbrollini, Rahul, Sharma, Peter A D, Steel, Michele, Steinkamp, Roniel, Weinberg, David Stephenson, Wellman, Antoun, Nader, Paul, Fitzgerald, Michaela, Ritz, Greg, Bryson, Alexandra, Craig, Cassandra, Farhat, Braden, Gammon, Wade, Gofton, Nicole, Harris, Karl, Lalonde, Allan, Liew, Bradley, Meulenkamp, Kendra, Sonnenburg, Eugene, Wai, Geoffrey, Wilkin, Karen, Troxell, Mary Ellen, Alderfer, Jason, Brannen, Christopher, Cupitt, Stacy, Gerhart, Renee, McLin, Julie, Sheidy, Katherine, Yurick, Fei, Chen, Karen, Dragert, Geza, Kiss, Halina, Malveaux, Deborah, McCloskey, Scott, Mellender, Sagar S, Mungekar, Helaine, Noveck, Carlos, Sagebien, Luat, Biby, Gail, McKelvy, Anna, Richards, Ramon, Abola, Brittney, Ayala, Darcy, Halper, Ana, Mavarez, Sabeen, Rizwan, Stephen, Choi, Imad, Awad, Brendan, Flynn, Patrick, Henry, Richard, Jenkinson, Lilia, Kaustov, Elizabeth, Lappin, Paul, McHardy, Amara, Singh, Joanne, Donnelly, Meera, Gonzalez, Christopher, Haydel, Jon, Livelsberger, Theresa, Pazionis, Bridget, Slattery, Maritza, Vazquez-Trejo, Jaime, Baratta, Michael, Cirullo, Brittany, Deiling, Laura, Deschamps, Michael, Glick, Daniel, Katz, James, Krieg, Jennifer, Lessin, Jeffrey, Mojica, Marc, Torjman, Rongyu, Jin, Mary Jane, Salpeter, Mark, Powell, Jeffrey, Simmons, Prentiss, Lawson, Promil, Kukreja, Shanna, Graves, Adam, Sturdivant, Ayesha, Bryant, Sandra Joyce, Crump, Michelle, Verrier, James, Green, Matthew, Menon, Richard, Applegate, Ana, Arias, Natasha, Pineiro, Jeffrey, Uppington, Phillip, Wolinsky, Amy, Gunnett, Jennifer, Hagen, Sara, Harris, Kevin, Hollen, Brian, Holloway, Mary Beth, Horodyski, Trevor, Pogue, Ramachandran, Ramani, Cameron, Smith, Anna, Woods, Matthew, Warrick, Kelly, Flynn, Paul, Mongan, Yatish, Ranganath, Sean, Fernholz, Esperanza, Ingersoll-Weng, Anil, Marian, Melinda, Seering, Zita, Sibenaller, Lori, Stout, Allison, Wagner, Alicia, Walter, Cynthia, Wong, Denise, Orwig, Maithri, Goud, Chris, Helker, Lydia, Mezenghie, Brittany, Montgomery, Peter, Preston, J Sanford, Schwartz, Ramona, Weber, Lee A, Fleisher, Samir, Mehta, Alisa J, Stephens-Shields, Cassandra, Dinh, Jacques E, Chelly, Shiv, Goel, Wende, Goncz, Touichi, Kawabe, Sharad, Khetarpal, Amy, Monroe, Vladislav, Shick, Max, Breidenstein, Timothy, Dominick, Alexander, Friend, Donald, Mathews, Richard, Lennertz, Robert, Sanders, Helen, Akere, Tyler, Balweg, Amber, Bo, Christopher, Doro, David, Goodspeed, Gerald, Lang, Maggie, Parker, Amy, Rettammel, Mary, Roth, Marissa, White, Paul, Whiting, Brian F S, Allen, Tracie, Baker, Debra, Craven, Matt, McEvoy, Teresa, Turnbo, Stephen, Kates, Melanie, Morgan, Teresa, Willoughby, Wade, Weigel, David, Auyong, Ellie, Fox, Tina, Welsh, Bruce, Cusson, Sean, Dobson, Christopher, Edwards, Lynette, Harris, Daryl, Henshaw, Kathleen, Johnson, Glen, McKinney, Scott, Miller, Jon, Reynolds, B Scott, Segal, Jimmy, Turner, David, VanEenenaam, Robert, Weller, Jineli, Lei, Miriam, Treggiari, Shamsuddin, Akhtar, Marcelle, Blessing, Chanel, Johnson, Michael, Kampp, Kimberly, Kunze, Mary, O'Connor, Jinlei, Li, Duminda N, Wijeysundera, Sachin, Kheterpal, Reneé H, Moore, Alexander K, Smith, Laura L, Tosi, Lee, Fleisher, Christine, Langlois, Samuel, Oduwole, and Thomas, Rose

Subjects
Male, Analgesics, Canada, Pain, Postoperative, Hip Fractures, Pain, General Medicine, Anesthesia, General, Anesthesia, Spinal, Patient Satisfaction, Internal Medicine, Humans, Female, Aged
Abstract

The REGAIN (Regional versus General Anesthesia for Promoting Independence after Hip Fracture) trial found similar ambulation and survival at 60 days with spinal versus general anesthesia for hip fracture surgery. Trial outcomes evaluating pain, prescription analgesic use, and patient satisfaction have not yet been reported.To compare pain, analgesic use, and satisfaction after hip fracture surgery with spinal versus general anesthesia.Preplanned secondary analysis of a pragmatic randomized trial. (ClinicalTrials.gov: NCT02507505).46 U.S. and Canadian hospitals.Patients aged 50 years or older undergoing hip fracture surgery.Spinal or general anesthesia.Pain on postoperative days 1 through 3; 60-, 180-, and 365-day pain and prescription analgesic use; and satisfaction with care.A total of 1600 patients were enrolled. The average age was 78 years, and 77% were women. A total of 73.5% (1050 of 1428) of patients reported severe pain during the first 24 hours after surgery. Worst pain over the first 24 hours after surgery was greater with spinal anesthesia (rated from 0 [no pain] to 10 [worst pain imaginable]; mean difference, 0.40 [95% CI, 0.12 to 0.68]). Pain did not differ across groups at other time points. Prescription analgesic use at 60 days occurred in 25% (141 of 563) and 18.8% (108 of 574) of patients assigned to spinal and general anesthesia, respectively (relative risk, 1.33 [CI, 1.06 to 1.65]). Satisfaction was similar across groups.Missing outcome data and multiple outcomes assessed.Severe pain is common after hip fracture. Spinal anesthesia was associated with more pain in the first 24 hours after surgery and more prescription analgesic use at 60 days compared with general anesthesia.Patient-Centered Outcomes Research Institute

Published
2022

11. NT-proBNP Response to Sacubitril/Valsartan in Hospitalized Heart Failure Patients With Reduced Ejection Fraction

Author

Domingo Pascual-Figal, Rolf Wachter, Michele Senni, Weibin Bao, Adele Noè, Heike Schwende, Dmytro Butylin, Margaret F. Prescott, Jacek Gniot, Maria Mozheiko, Malgorzata Lelonek, Antonio Reyes Dominguez, Thomas Horacek, Enrique Garcia del Rio, Zhanna Kobalava, Christian Eugen Mueller, Yuksel Cavusoglu, Ewa Straburzynska-Migaj, Miroslav Slanina, Juergen vom Dahl, Alisdair Ryding, Andrew Moriarty, Manuel Beltran Robles, Julio Nunez Villota, Antonio Garcia Quintana, Thorsten Nitschke, Jose Manuel Garcia Pinilla, Luis Almenar Bonet, Said Chaaban, Samia Filali zaatari, Jindrich Spinar, Wlodzimierz Musial, Khaled Abdelbaki, Jan Belohlavek, Wolfgang Fehske, Michael Carlos Bott, Geir Hoegalmen, Marisa Crespo Leiro, Ismail Turkay Ozcan, Wilfried Mullens, Radim Kryza, Riadh Al-Ani, Krystyna Loboz-Grudzien, Lyudmila Ermoshkina, Silvia Hojerova, Alberto Alfredo Fernandez, Lenka Spinarova, Harald Lapp, Efraim Bulut, Filipa Almeida, Alexander Vishnevsky, Margita Belicova, Domingo Pascual, Klaus Witte, Kenneth Wong, Walter Droogne, Marc Delforge, Martin Peterka, Hans-Georg Olbrich, Stefano Carugo, Jadwiga Nessler, Thao Huynh McGill, Burkhard Huegl, Ibrahim Akin, Ilidio Moreira, Andrey Baglikov, Jeetendra Thambyrajah, Chris Hayes, Marcelo Raul Barrionuevo, Zerrin Yigit, Hakki Kaya, Zdenek Klimsa, Martin Radvan, Christoph Kadel, Ulf Landmesser, Giuseppe Di Tano, Malgorzata Buksinska Lisik, Candida Fonseca, Luis Oliveira, Irene Marques, Luis Miguel Santos, Egon Lenner, Peter Letavay, Manuel Gomez Bueno, Paula Mota, Aaron Wong, Kristian Bailey, Paul Foley, Eduardo Hasbani, Sean Virani, Tony Abdel Massih, Shukri Al-Saif, Milos Taborsky, Marta Kaislerova, Zuzana Motovska, Aron Ariel Cohen, Damien Logeart, Dierk Endemann, Daniel Ferreira, Dulce Brito, Peter Kycina, Entela Bollano, Enrique Galve Basilio, Lorenzo Facila Rubio, Marcos Garcia Aguado, Lilia Beatriz Schiavi, Daniel Francisco Zivano, Eva Lonn, Ali El Sayed, Anne-Catherine Pouleur, Alex Heyse, Alexandr Schee, Rostislav Polasek, Marek Houra, Christophe Tribouilloy, Marie France Seronde, Michel Galinier, Michel Noutsias, Peter Schwimmbeck, Ingo Voigt, Dirk Westermann, Giovanni Pulignano, Johnny Vegsundvaag, Jose Alexandre Da Silva Antunes, Pedro Monteiro, Jan Stevlik, Eva Goncalvesova, Beata Hulkoova, Antonio Juan Castro Fernandez, Ceri Davies, Iain Squire, Philippe Meyer, Richard Sheppard, Tayfun Sahin, Karel Sochor, Guillaume De Geeter, Alexander Schmeisser, Joachim Weil, Ana Oliveira Soares, Olga Bulashova Vasilevna, Andrey Oshurkov, Shahid Junejo Sunderland, Jason Glover, Tomas Exequiel, Eric Decoulx, Sven Meyer, Thomas Muenzel, Fernando Frioes, Georgy Arbolishvili, Anna Tokarcikova, Patric Karlstrom, Joan Carles Trullas Vila, Gonzalo Pena Perez, Rajiv Sankaranarayanan, Thuraia Nageh, Diego Cristian Alasia, Marwan Refaat, Burcu Demirkan, Jehad Al-Buraiki, and Shadi Karabsheh

Subjects
medicine.medical_specialty, Ejection fraction, Acute decompensated heart failure, business.industry, medicine.drug_class, 030204 cardiovascular system & hematology, medicine.disease, Sacubitril, 03 medical and health sciences, 0302 clinical medicine, Valsartan, Heart failure, Internal medicine, Natriuretic peptide, Cardiology, Medicine, Decompensation, cardiovascular diseases, 030212 general & internal medicine, Cardiology and Cardiovascular Medicine, business, hormones, hormone substitutes, and hormone antagonists, Sacubitril, Valsartan, medicine.drug
Abstract

Objectives This study examined the effects of sacubitril/valsartan on N-terminal pro–B-type natriuretic peptide (NT-proBNP) levels and determined patient characteristics associated with favorable NT-proBNP reduction response. Background NT-proBNP levels reflect cardiac wall stress and predict event risk in patients with acute decompensated heart failure (ADHF). Methods Post-hoc analysis of the TRANSITION (Comparison of Pre- and Post-discharge Initiation of Sacubitril/Valsartan Therapy in HFrEF Patients After an Acute Decompensation Event) study, including stabilized ADHF patients with reduced ejection fraction, randomized to open-label sacubitril/valsartan initiation in-hospital (pre-discharge) versus post-discharge. NT-proBNP was measured at randomization (baseline), discharge, and 4 and 10 weeks post-randomization. A favorable NT-proBNP response was defined as reduction to ≤1,000 pg/ml or >30% from baseline. Results In patients receiving sacubitril/valsartan in-hospital, NT-proBNP was reduced by 28% at discharge, with 46% of patients obtaining favorable NT-proBNP reduction response compared with a 4% reduction and 18% favorable response rate in patients initiated post-discharge (p Conclusions In-hospital initiation of sacubitril/valsartan produced rapid reductions in NT-proBNP, statistically significant at discharge. A favorable NT-proBNP response over time was associated with a better prognosis and predicted by higher starting dose and predisposing clinical profile. (Comparison of Pre- and Post-discharge Initiation of LCZ696 Therapy in HFrEF Patients After an Acute Decompensation Event [TRANSITION]; NCT02661217)

Published
2020

14. Three new books on W. G. Sebald and some afterthoughts

Author

Richard Sheppard

Subjects
Literature, Arts and Humanities (miscellaneous), Cultural pessimism, business.industry, Philosophy, 05 social sciences, Environmental disaster, 0507 social and economic geography, Post modernism, business, 050701 cultural studies
Abstract

Following a discussion of three substantial new books on the writer W. G. Sebald, I reflect upon and try to develop ideas which the authors argue are central to Sebald’s recent published work, notably suffering, natural and humanly created cataclysms, narratorial tact, occlusion, reliability and restitution, and the experience of liberation.

Published
2020

17. Spinal Anesthesia or General Anesthesia for Hip Surgery in Older Adults

Author

Kamen Vlassakov, Trevor Stone, Ki-Jinn Chin, Mark A Hoeft, Charles Luke, Edward R. Marcantonio, Antoun Nader, Derek Dillane, Ellen S. Hauck, Frederick Sieber, Daniel I Sessler, Mark Giska, Robert D Sanders, Brian F S Allen, Eric S Schwenk, Jinlei Li, J Douglas Jaffe, Steven Papp, Richard Sheppard, Lee A. Fleisher, Nabil M. Elkassabany, Susan S. Ellenberg, Ann Tierney, Mark D. Neuman, James Dattilo, Jeffrey L. Carson, Rui Feng, M Kwesi Kwofie, Robert A Hymes, Alisa J. Stephens-Shields, Yatish Ranganath, Samir Mehta, Balram Sharma, Stephen J. Choi, Perlman Bb, Syed Azim, Sabry Ayad, Diane A. Menio, Stephen Kates, Lakisha J. Gaskins, Tiffany Tedore, Joshua W. Sappenfield, Jay Magaziner, Regain Investigators, and Mitchell Marshall

Subjects
Hip surgery, Aged, 80 and over, Male, Hip fracture, business.industry, Hip Fractures, Incidence, MEDLINE, Spinal anesthesia, Delirium, General Medicine, Recovery of Function, Anesthesia, General, medicine.disease, Anesthesia, Spinal, Postoperative Complications, Anesthesia, medicine, Humans, Female, business, Aged
Abstract

The effects of spinal anesthesia as compared with general anesthesia on the ability to walk in older adults undergoing surgery for hip fracture have not been well studied.We conducted a pragmatic, randomized superiority trial to evaluate spinal anesthesia as compared with general anesthesia in previously ambulatory patients 50 years of age or older who were undergoing surgery for hip fracture at 46 U.S. and Canadian hospitals. Patients were randomly assigned in a 1:1 ratio to receive spinal or general anesthesia. The primary outcome was a composite of death or an inability to walk approximately 10 ft (3 m) independently or with a walker or cane at 60 days after randomization. Secondary outcomes included death within 60 days, delirium, time to discharge, and ambulation at 60 days.A total of 1600 patients were enrolled; 795 were assigned to receive spinal anesthesia and 805 to receive general anesthesia. The mean age was 78 years, and 67.0% of the patients were women. A total of 666 patients (83.8%) assigned to spinal anesthesia and 769 patients (95.5%) assigned to general anesthesia received their assigned anesthesia. Among patients in the modified intention-to-treat population for whom data were available, the composite primary outcome occurred in 132 of 712 patients (18.5%) in the spinal anesthesia group and 132 of 733 (18.0%) in the general anesthesia group (relative risk, 1.03; 95% confidence interval [CI], 0.84 to 1.27; P = 0.83). An inability to walk independently at 60 days was reported in 104 of 684 patients (15.2%) and 101 of 702 patients (14.4%), respectively (relative risk, 1.06; 95% CI, 0.82 to 1.36), and death within 60 days occurred in 30 of 768 (3.9%) and 32 of 784 (4.1%), respectively (relative risk, 0.97; 95% CI, 0.59 to 1.57). Delirium occurred in 130 of 633 patients (20.5%) in the spinal anesthesia group and in 124 of 629 (19.7%) in the general anesthesia group (relative risk, 1.04; 95% CI, 0.84 to 1.30).Spinal anesthesia for hip-fracture surgery in older adults was not superior to general anesthesia with respect to survival and recovery of ambulation at 60 days. The incidence of postoperative delirium was similar with the two types of anesthesia. (Funded by the Patient-Centered Outcomes Research Institute; REGAIN ClinicalTrials.gov number, NCT02507505.).

Published
2021

19. Genetic and Phenotypic Landscape of Peripartum Cardiomyopathy

Author

Denise Hilfiker-Kleiner, Zolt Arany, Quentin McAfee, Kenneth B. Margulies, Rami Alharethi, Eileen Hsich, Lisa D. Levine, Sorel Goland, Christine E. Seidman, Peter Damm, Jonathan G. Seidman, Sarosh Rana, Daniel Jacoby, Thomas P. Cappola, Chizuko Kamiya, Julie B. Damp, Anne S Ersbøll, Jeff Brandimarto, Steven R. DePalma, Rahul R. Goli, Richard Sheppard, Imac, Uri Elkayam, Ipac Investigators, Valerie Riis, John P. Boehmer, Finn Gustafsson, George A. Macones, Dennis M. McNamara, Jeffrey D. Alexis, Alireza Haghighi, Daniel P. Judge, and Jian Li

Subjects
Adult, 0303 health sciences, medicine.medical_specialty, Peripartum cardiomyopathy, Obstetrics, business.industry, 030204 cardiovascular system & hematology, medicine.disease, Article, 03 medical and health sciences, 0302 clinical medicine, Phenotype, Pregnancy, Physiology (medical), medicine, Peripartum Period, Humans, Female, Cardiology and Cardiovascular Medicine, business, Cardiomyopathies, 030304 developmental biology, Retrospective Studies
Abstract

Background: Peripartum cardiomyopathy (PPCM) occurs in ≈1:2000 deliveries in the United States and worldwide. The genetic underpinnings of PPCM remain poorly defined. Approximately 10% of women with PPCM harbor truncating variants in TTN (TTNtvs). Whether mutations in other genes can predispose to PPCM is not known. It is also not known if the presence of TTNtvs predicts clinical presentation or outcomes. Nor is it known if the prevalence of TTNtvs differs in women with PPCM and preeclampsia, the strongest risk factor for PPCM. Methods: Women with PPCM were retrospectively identified from several US and international academic centers, and clinical information and DNA samples were acquired. Next-generation sequencing was performed on 67 genes, including TTN , and evaluated for burden of truncating and missense variants. The impact of TTNtvs on the severity of clinical presentation, and on clinical outcomes, was evaluated. Results: Four hundred sixty-nine women met inclusion criteria. Of the women with PPCM, 10.4% bore TTNtvs (odds ratio=9.4 compared with 1.2% in the reference population; Bonferroni-corrected P [ P *]=1.2×10 –46 ). We additionally identified overrepresentation of truncating variants in FLNC (odds ratio=24.8, P *=7.0×10 –8 ), DSP (odds ratio=14.9, P *=1.0×10 –8 ), and BAG3 (odds ratio=53.1, P *=0.02), genes not previously associated with PPCM. This profile is highly similar to that found in nonischemic dilated cardiomyopathy. Women with TTNtvs had lower left ventricular ejection fraction on presentation than did women without TTNtvs (23.5% versus 29%, P =2.5×10 –4 ), but did not differ significantly in timing of presentation after delivery, in prevalence of preeclampsia, or in rates of clinical recovery. Conclusions: This study provides the first extensive genetic and phenotypic landscape of PPCM and demonstrates that predisposition to heart failure is an important risk factor for PPCM. The work reveals a degree of genetic similarity between PPCM and dilated cardiomyopathy, suggesting that gene-specific therapeutic approaches being developed for dilated cardiomyopathy may also apply to PPCM, and that approaches to genetic testing in PPCM should mirror those taken in dilated cardiomyopathy. Last, the clarification of genotype/phenotype associations has important implications for genetic counseling.

Published
2021

21. Engaging patients as partners in a multicentre trial of spinal versus general anaesthesia for older adults

Author

Jennifer Hruslinski, Diane A. Menio, Robert A. Hymes, J. Douglas Jaffe, Christine Langlois, Lolita Ramsey, Lakisha J. Gaskins, Mark D. Neuman, Thomas Looke, Sandra Bent, Ariana Franco-Mora, Pamela Hedrick, Matthew Newbern, Rafik Tadros, Karen Pealer, Edward Marcantonio, Kamen Vlassakov, Carolyn Buckley, Svetlana Gorbatov, James Gosnell, Talora Steen, Avery Vafai, Jose Zeballos, Louis Cardenas, Ashley Berry, John Getchell, Nicholas Quercetti, Daniel I. Sessler, Sabry Ayad, Manal Hassan, Assad Ali, Gauasan Bajracharya, Damien Billow, Michael Bloomfield, Kavita Elliott, Robert Hampton, Linda He, Hooman Honar, Dilara Khoshknabi, Daniel Kim, Paul Minko, Adam Morris, Azfar Niazi, Tara Nutcharoen, Jeffrey Roberts, Partha Saha, Ahmed Salih, Alexis Skolaris, Taylor Stang, Victor Strimbu, Jesse Templeton, Andrew Volio, Jiayi Wang, Kelly Bolkus, Matthew DeAngelis, Gregory Dodson, Jeffrey Gerritsen, Brian McEniry, Ludmil Mitrev, Kwesi Kwofie, Flynn Bonazza, Vera Lloyd, Izabela Panek, Jared Dabiri, Chris Chavez, Jason Craig, Todd Davidson, Chad Dietrichs, Cheryl Fleetwood, Mike Foley, Chris Getto, Susie Hailes, Sarah Hermes, Andy Hooper, Greg Koener, Kate Kohls, Leslie Law, Adam Lipp, Allison Losey, William Nelson, Mario Nieto, Pam Rogers, Steve Rutman, Garrett Scales, Barbara Sebastian, Tom Stanciu, Gregg Lobel, Michelle Giampiccolo, Dara Herman, Margit Kaufman, Bryan Murphy, Clara Pau, Thomas Puzio, Marlene Veselsky, Trevor Stone, Kelly Apostle, Dory Boyer, Brenda Chen Fan, Susan Lee, Mike Lemke, Richard Merchant, Farhad Moola, Kyrsten Payne, Bertrand Perey, Darius Viskontas, Mark Poler, Patricia D'Antonio, Richard Sheppard, Amer Abdullah, Jamie Fish-Fuhrmann, Mark Giska, Christina Fidkowski, Trent Guthrie, William Hakeos, Lillian Hayes, Joseph Hoegler, Katherine Nowak, Robert Hymes, Jeffery Beck, Jaslynn Cuff, Greg Gaski, Sharon Haaser, Michael Holzman, A. Stephen Malekzadeh, Jeff Schulman, Cary Schwartzbach, Frederick Sieber, Tangwan Azefor, Charles Brown, Arman Davani, Mahmood Jaberi, Courtney Masear, Balram Sharma, Syed Basit Haider, Carolyn Chungu, Ali Ebrahimi, Karim Fikry, Kerri Gannon, Andrew Marcantonio, Meredith Pace, David Sanders, Collin Clarke, Abdel Lawendy, Gary Schwartz, Mohit Garg, Joseph Kim, Mitchell Marshall, Juan Caurci, Ekow Commeh, Randy Cuevas, Germaine Cuff, Lola Franco, David Furguiele, Matthew Giuca, Melissa Allman, Omid Barzideh, James Cossaro, Armando D'Arduini, Anita Farhi, Jason Gould, John Kafel, Anuj Patel, Abraham Peller, Hadas Reshef, Mohammed Safur, Fiore Toscano, Tiffany Tedore, Michael Akerman, Eric Brumberger, Sunday Clark, Rachel Friedlander, Anita Jegarl, Joseph Lane, John P. Lyden, Nili Mehta, Matthew T. Murrell, Nathan Painter, William Ricci, Kaitlyn Sbrollini, Rahul Sharma, Peter A.D. Steel, Michele Steinkamp, Roniel Weinberg, David Stephenson Wellman, Antoun Nader, Paul Fitzgerald, Michaela Ritz, Steven Papp, Greg Bryson, Alexandra Craig, Cassandra Farhat, Braden Gammon, Wade Gofton, Nicole Harris, Karl Lalonde, Allan Liew, Bradley Meulenkamp, Kendra Sonnenburg, Eugene Wai, Geoffrey Wilkin, Derek Donegan, Cassandra Dinh, Nabil Elkassabany, Annamarie Horan, Samir Mehta, Karen Troxell, Mary Ellen Alderfer, Jason Brannen, Christopher Cupitt, Stacy Gerhart, Renee McLin, Julie Sheidy, Katherine Yurick, Jeffrey Carson, Fei Chen, Karen Dragert, Geza Kiss, Halina Malveaux, Deborah McCloskey, Scott Mellender, Sagar S. Mungekar, Helaine Noveck, Carlos Sagebien, Barry Perlman, Luat Biby, Gail McKelvy, Anna Richards, Syed Azim, Ramon Abola, Brittney Ayala, Darcy Halper, Ana Mavarez, Stephen Choi, Imad Awad, Brendan Flynn, Patrick Henry, Richard Jenkinson, Lilia Kaustov, Elizabeth Lappin, Paul McHardy, Amara Singh, Ellen Hauck, Joanne Donnelly, Meera Gonzalez, Christopher Haydel, Jon Livelsberger, Theresa Pazionis, Bridget Slattery, Maritza Vazquez-Trejo, Eric Schwenk, Jaime Baratta, Brittany Deiling, Laura Deschamps, Michael Glick, Daniel Katz, James Krieg, Jennifer Lessin, Marc Torjman, Ki Jinn Chin, Rongyu Jin, Mary Jane Salpeter, Mark Powell, Jeffrey Simmons, Prentiss Lawson, Promil Kukreja, Shanna Graves, Adam Sturdivant, Ayesha Bryant, Sandra Joyce Crump, Derek Dillane, Michael Taylor, Michelle Verrier, Richard Applegate, Ana Arias, Natasha Pineiro, Jeffrey Uppington, Phillip Wolinsky, Joshua Sappenfield, Amy Gunnett, Jennifer Hagen, Sara Harris, Kevin Hollen, Brian Holloway, Mary Beth Horodyski, Trevor Pogue, Ramachandran Ramani, Cameron Smith, Anna Woods, Matthew Warrick, Kelly Flynn, Paul Mongan, Yatish Ranganath, Sean Fernholz, Esperanza Ingersoll-Weng, Anil Marian, Melinda Seering, Zita Sibenaller, Lori Stout, Allison Wagner, Alicia Walter, Cynthia Wong, Jay Magaziner, Denise Orwig, Trina Brown, Jim Dattilo, Susan Ellenberg, Rui Feng, Lee Fleisher, Lakisha Gaskins, Maithri Goud, Chris Helker, Lydia Mezenghie, Brittany Montgomery, Peter Preston, Alisa Stephens, J. Sanford Schwartz, Ann Tierney, Ramona Weber, Jacques Chelly, Shiv Goel, Wende Goncz, Touichi Kawabe, Sharad Khetarpal, Kevin King, Frank Kunkel, Charles Luke, Amy Monroe, Vladislav Shick, Anthony Silipo, Caroline Stehle, Katherine Szabo, Sudhakar Yennam, Mark Hoeft, Max Breidenstein, Timothy Dominick, Alexander Friend, Donald Mathews, Richard Lennertz, Helen Akere, Tyler Balweg, Amber Bo, Christopher Doro, David Goodspeed, Gerald Lang, Maggie Parker, Amy Rettammel, Mary Roth, Robert Sanders, Marissa White, Paul Whiting, Brian Allen, Tracie Baker, Debra Craven, Matt McEvoy, Teresa Turnbo, Stephen Kates, Melanie Morgan, Teresa Willoughby, Wade Weigel, David Auyong, Ellie Fox, Tina Welsh, Bruce Cusson, Sean Dobson, Christopher Edwards, Lynette Harris, Daryl Henshaw, Kathleen Johnson, Glen McKinney, Scott Miller, Jon Reynolds, Jimmy Turner, David VanEenenaam, Robert Weller, Shamsuddin Akhtar, Marcelle Blessing, Chanel Johnson, Michael Kampp, Kimberly Kunze, Jinlei Li, Mary O'Connor, and Miriam Treggiari

Subjects
medicine.medical_specialty, Canada, Research Subjects, Patient engagement, Hip fracture surgery, Patient Advocacy, Anesthesia, General, Patient advocacy, Anesthesia, Spinal, 03 medical and health sciences, 0302 clinical medicine, Nursing, 030202 anesthesiology, Fracture Fixation, Medicine, Humans, General anaesthesia, Cooperative Behavior, Geriatrics, Hip fracture, business.industry, Hip Fractures, Lived experience, Age Factors, Research process, medicine.disease, United States, Anesthesiology and Pain Medicine, Research Design, Patient Participation, business, Decision Making, Shared
Abstract

Summary Engaging patients—defined broadly as individuals with lived experience of a given condition, family members, caregivers, and the organisations that represent them—as partners in research is a priority for policymakers, funders, and the public. Nonetheless, formal efforts to engage patients are absent from most studies, and models to support meaningful patient engagement in clinical anaesthesia research have not been previously described. Here, we review our experience in developing and implementing a multifaceted patient engagement strategy within the Regional Versus General Anesthesia for Promoting Independence After Hip Fracture (REGAIN) surgery trial, an ongoing randomised trial comparing spinal vs general anaesthesia for hip fracture surgery in 1600 older adults across 45 hospitals in the USA and Canada. This strategy engaged patients and their representatives at both the level of overall trial oversight and at the level of individual recruiting sites. Activities spanned a continuum ranging from events designed to elicit patients' input on key decisions to longitudinal collaborations that empowered patients to actively participate in decision-making related to trial design and management. Engagement activities were highly acceptable to participants and led to concrete changes in the design and conduct of the REGAIN trial. The REGAIN experience offers a model for future efforts to engage patients as partners in clinical anaesthesia research, and highlights potential opportunities for investigators to increase the relevance of anaesthesia studies by incorporating patient voices and perspectives into the research process.

Published
2020

22. Polygonaceae (buckwheat family) of New York State /

Author

Mitchell, Richard Sheppard, 1938, Dean, J. Kenneth, New York Botanical Garden, LuEsther T. Mertz Library, Mitchell, Richard Sheppard, 1938, and Dean, J. Kenneth

Subjects
New York (State), Polygonaceae
Published
1978

23. A checklist of New York State plants /

Author

Mitchell, Richard Sheppard, 1938, New York Botanical Garden, LuEsther T. Mertz Library, and Mitchell, Richard Sheppard, 1938

Subjects
New York (State), Nomenclature, Plants
Published
1986

24. Magnoliaceae through Ceratophyllaceae of New York State /

Author

Mitchell, Richard Sheppard, 1938, Beal, Ernest O., 1924, New York Botanical Garden, LuEsther T. Mertz Library, Mitchell, Richard Sheppard, 1938, and Beal, Ernest O., 1924

Subjects
Botany, Dicotyledons, Geographical distribution, Identification, Identification guides, New York, New York (State), Phytogeography, Vegetation
Published
1979

25. Platanaceae through Myricaceae of New York State /

Author

Mitchell, Richard Sheppard, 1938, New York Botanical Garden, LuEsther T. Mertz Library, and Mitchell, Richard Sheppard, 1938

Subjects
Botany, Dicotyledons, Identification, Identification guides, New York (State)
Published
1988

26. Berberidaceae through Fumariaceae of New York State /

Author

Mitchell, Richard Sheppard, 1938, New York Botanical Garden, LuEsther T. Mertz Library, and Mitchell, Richard Sheppard, 1938

Subjects
Botany, Dicotyledons, Identification, Identification guides, New York, New York (State), Staat, Zweikeimblättrige
Published
1983

27. Atlas of New York State ferns /

Author

Mitchell, Richard Sheppard, 1938, New York Botanical Garden, LuEsther T. Mertz Library, and Mitchell, Richard Sheppard, 1938

Subjects
Atlas, Farnpflanzen, Ferns, Fougères - New York (État) - Atlas, Geographical distribution, Maps, New York (Staat), New York (State), Staat New York
Published
1984

28. Ranunculaceae (Crowfoot family) of New York State /

Author

Mitchell, Richard Sheppard, 1938, Dean, J. Kenneth, New York Botanical Garden, LuEsther T. Mertz Library, Mitchell, Richard Sheppard, 1938, and Dean, J. Kenneth

Subjects
Bestimmungsbuch, Botany, Geographical distribution, Hahnenfußgewächse, Identification, Identification guides, New York, New York (State), Phytogeography, Ranunculaceae, Staat
Published
1982

29. Rare plants of New York State /

Author

Mitchell, Richard Sheppard, 1938, Sheviak, Charles J., New York Botanical Garden, LuEsther T. Mertz Library, Mitchell, Richard Sheppard, 1938, and Sheviak, Charles J.

Subjects
New York (State), Rare plants
Published
1981

30. Unusual Case of Colonized Pacemaker Lead Presenting with Endocarditis, Hemoptysis and Tricuspid Valve Stenosis

Author

Jean-Francois Morin, Richard Sheppard, and Patrick Chamoun

Subjects
Diseases of the respiratory system, RC705-779
Abstract

The present report is the first to describe a case of hemoptysis caused by an endocardial pacemaker lead. In addition, the patient presented with endocarditis and tricuspid valve stenosis. Aggressive treatment consisted of surgical extraction of two pacemaker leads and one pacemaker battery, replacement of the tricuspid valve and implantation of a DDD-R epicardial pacemaker.

Published
2011
Full Text
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32. BILATERAL INGUINAL LYMPHADENOPATHY AS THE EXTRAPULMONARY PRESENTATION OF PULMONARY SARCOIDOSIS: A RARE CLINICAL PRESENTATION

Author

Richard Sheppard, Janet Joseph, Raji Ayinla, and Sai S. Achi

Subjects
Pulmonary and Respiratory Medicine, medicine.medical_specialty, Pulmonary sarcoidosis, business.industry, Medicine, Inguinal lymphadenopathy, Presentation (obstetrics), medicine.symptom, Cardiology and Cardiovascular Medicine, Critical Care and Intensive Care Medicine, business, Dermatology
Published
2021

33. Potential barriers to lung cancer screening in a minority population: Assessing attitudes, beliefs, and values towards screening with low-dose computed tomography amongst a high-risk minority population

Author

Meena Ahluwalia, Janet Joseph, Richard Sheppard, Stefani Beale, Raji Ayinla, Sai S. Achi, and Abosede Showunmi

Subjects
Oncology, Cancer Research, medicine.medical_specialty, education.field_of_study, medicine.diagnostic_test, Task force, business.industry, Low dose, Population, Computed tomography, medicine.disease, Attitudes beliefs, Internal medicine, medicine, National Lung Screening Trial, Lung cancer, education, business, Lung cancer screening
Abstract

17 Background: While the National Lung Screening Trial (NLST) has shown a relative reduction in mortality from lung cancer with the application of the United States Preventative Services Task Force (USPSTF) guidelines for the use of Low-Dose Computed Tomography (LDCT) in a select high risk population, many studies have shown that the rate of screening has been below the national average in minority population. Furthermore, lung cancer mortality still appears to be disproportionately higher amongst minority populations. With this study, we aim to evaluate the attitudes, beliefs and values towards lung cancer screening with LDCT in a predominantly Black and Hispanic population in our outpatient clinic. Methods: A survey was conducted over a 3-month period in our outpatient department at an urban inner-city safety net hospital. We included high risk smokers, aged 50 to 80 years who reported no evidence of symptoms. The survey consisted of 20 questions; these included utilizing the Health Belief Model to assess beliefs on perceived susceptibility, severity, benefits and barriers to screening, questions exploring fears of cancer screening and questions assessing overall willingness to undergo lung cancer screening with LDCT. We also included a question on the willingness of participants to engage in educational sessions with regards to lung cancer screening and risk reduction. Results were collected and analyzed via univariate logistic regression model to compare patient populations. Results: 67 patients participated in our survey. 62% were Black, 34% were Hispanic and 4% were Asian/Pacific Islanders. The mean age of our population was 64.5 years and they had an average of 27.2 pack-years of smoking. Issues related to insurance coverage and co-pay were identified as the most significant concern with regards to the unwillingness to undergo screening (p < 0.05). Other concerns identified were the fear of a positive screening result, fear of radiation exposure and lack of understanding of the association with smoking history and lung cancer (p = 0.12). All participants responded yes to being open to be educated on reducing their risk of lung cancer (p < 0.05). Conclusions: While many factors still exist with regards to lung cancer screening in minority populations, the cost of medical care, fear of radiation exposure and anxiety were identified as potential barriers to willingness to screen. Structured educational programs were identified as a possible measure that can be implemented to address these factors, with the potential to increase the willingness to undergo screening in a high risk minority population.

Published
2021

34. RESPIRATORY SYNCYTIAL VIRUS AND SARS-COV-2 CO-INFECTIONS DURING THE COVID-19 PANDEMIC: A CASE SERIES OF COEXISTING RESPIRATORY INFECTIONS IN A NEW YORK CITY PUBLIC HEALTH CARE SYSTEM

Author

Janet Joseph, Raji Ayinla, Richard Sheppard, and Sai S. Achi

Subjects
Pulmonary and Respiratory Medicine, medicine.medical_specialty, Coronavirus disease 2019 (COVID-19), business.industry, Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), Chest Infections, Critical Care and Intensive Care Medicine, Virus, Public health care, Pandemic, Emergency medicine, medicine, Respiratory system, Cardiology and Cardiovascular Medicine, business, Co infection
Published
2021

39. Myocardial Recovery in Patients With Systolic Heart Failure and Autoantibodies Against β 1 -Adrenergic Receptors

Author

Yuji Nagatomo, Dennis M. McNamara, Jeffrey D. Alexis, Leslie T. Cooper, G. William Dec, Daniel F. Pauly, Richard Sheppard, Randall C. Starling, W.H. Wilson Tang, Karen Janosko, Charles McTiernan, Barry London, Karen Hanley-Yanez, John Gorcsan, Hidekazu Tanaka, Mathew Suffoletto, Cynthia Oblak, Annette McNallan, LuAnne Koenig, Paul Mather, Natalie Pierson, Sharon Rubin, Yanique Bell, Alicia Ervin, John Boehmer, Patricia Frey, Jeffrey Alexis, Janice Schrack, Pam LaDuke, Guillermo Torre-Amione, Jeannie Arredondo, Pamela C. Smith, Stephanie Fuoco, Ilan S. Wittstein, Elayne Breton, Vinay Thohan, Deborah Wesley, Diane Cocca-Spofford, David W. Markham, Lynn Fernandez, Colleen Debes, Mark J. Zucker, Laura Adams, Peter Liu, Judith Renton, Jagat Narula, Byron Allen, and Elizabeth Westberg

Subjects
0301 basic medicine, medicine.medical_specialty, Ejection fraction, business.industry, Incidence (epidemiology), Cardiomyopathy, 030204 cardiovascular system & hematology, medicine.disease, Transplantation, 03 medical and health sciences, 030104 developmental biology, 0302 clinical medicine, Internal medicine, Heart failure, Heart rate, Cardiology, Medicine, Cardiology and Cardiovascular Medicine, Immunoadsorption, business, Prospective cohort study
Abstract

Background Among various cardiac autoantibodies (AAbs), those recognizing the β 1 -adrenergic receptor (β 1 AR) demonstrate agonist-like effects and induce myocardial damage that can be reversed by β-blockers and immunoglobulin G3 (IgG3) immunoadsorption. Objectives The goal of this study was to investigate the role of β 1 AR-AAbs belonging to the IgG3 subclass in patients with recent-onset cardiomyopathy. Methods Peripheral blood samples were drawn at enrollment in patients with recent-onset cardiomyopathy (left ventricular ejection fraction [LVEF] ≤0.40; 1 AR-AAb was determined, and echocardiograms were assessed, at baseline and 6 months. Patients were followed up for ≤48 months. Results Among the 353 patients who had blood samples adequate for the analysis, 62 (18%) were positive for IgG3-β 1 AR-AAbs (IgG3 group), 58 (16%) were positive for IgG but not IgG3 (non-IgG3 group), and the remaining were negative. There were no significant differences in baseline systolic blood pressure, heart rate, or LVEF among the groups at baseline. Left ventricular end-diastolic and end-systolic diameters were significantly larger in the non-IgG3 group compared with the other groups (left ventricular end-diastolic diameter, p 1 AR-AAb was an independent predictor of LVEF at 6 months and change in LVEF over 6 months, even after multivariable adjustment (LVEF at 6 months, β = 0.20, p = 0.01; change in LVEF, β = 0.20, p = 0.008). In patients with high New York Heart Association functional class (III or IV) at baseline, the IgG3 group had a lower incidence of the composite endpoint of all-cause death, cardiac transplantation, and hospitalization due to heart failure, whereas the non-IgG3 group had the highest incidence of the composite endpoint. Conclusions IgG3-β 1 AR-AAbs were associated with more favorable myocardial recovery in patients with recent-onset cardiomyopathy.

Published
2017

46. Contributions to a flora of New York State /

Author

Mitchell, Richard Sheppard, 1938, University of the State of New York, and New York Botanical Garden, LuEsther T. Mertz Library

Subjects
Botany, New York (State)
Published
1978

47. 967. The Association between PrEP Awareness and Behavioral, Demographic, and Socioeconomic Factors in NYC

Author

Marwa Fagir, Kamara Aminata, Idayat Brimah, Sharon B. Mannheimer, S. Tijani, Stefani Beale, Gerald Fletcher, Richard Sheppard, and Adewumi N. Adekunle

Subjects
Infectious Diseases, AcademicSubjects/MED00290, Oncology, business.industry, Environmental health, Poster Abstracts, Medicine, business, Association (psychology), Socioeconomic status
Abstract

Background Despite significant gains in the treatment of Human Immunodeficiency Virus (HIV), there are still over 38,000 newly diagnosed with the illness annually in the United States. One strategy to reduce HIV infections is Pre-Exposure Prophylaxis (PrEP) for HIV infection. PrEP involves daily oral emtricitabine/tenofovir disoproxil fumarate (FTC/TDF or Truvada®) to reduce infections in those with exposure(s) to HIV or high-risk groups. Studies have shown reduction in HIV transmission with PrEP treatment. The objective of the study is to investigate how behavioral, demographic, and socioeconomic status (SES) influences the awareness of PrEP treatment in NYC. Methods Data on economic, behavioral, PrEP awareness at the UHF neighborhood level was collected by the Community Health Survey (CHS) from the New York City Department of Health and Mental Hygiene and the American Community Survey from the U.S. Census. The population is a cross-sectional telephone survey of NYC residents with landlines and mobile phones for 2016 and 2017. Household income and neighborhood poverty level were used as proxies for SES. Sex-stratified, multivariate logistic regression model was constructed to estimate adjusted associations and determine differences in awareness of PrEP. The model controlled for age group, race, education level, men sex with men status (MSM), and having had an HIV test in the preceding 12 months. Results The final study sample was 5,515 and 5,761 in 2016 and 2017, respectively. In 2016 crude PrEP awareness rate was 24.3% and in 2017 it was 35.4%. In the multivariate analysis for both 2016 and 2017, PrEP awareness was independently associated with age group, education level, male MSM, and having had an HIV test in the preceding 12 months (p < 0.01). The strongest predictors of PrEP awareness were participants with a preceding HIV test in the past 12 months and males who are MSM. PrEP awareness was associated with race for males in 2016 and 2017. PrEP awareness was associated with race for women in 2016, but not 2017. Figure 1: (left) Median household income in NYC (right) HIV diagnoses and PrEP awareness for 2016 and 2017 Conclusion Understanding the relationship of neighborhood socioeconomic status and PrEP awareness is essential for HIV epidemiology. By monitoring PrEP awareness, HIV diagnoses, and risk factors associated with the two, public health officials better target interventions and health policy. Disclosures All Authors: No reported disclosures

Published
2020

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