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1,568 results on '"Rothberg, Michael B."'

14. A Novel Magnetic Resonance Imaging/Ultrasound Fusion Prostate Biopsy Technique Using Transperineal Ultrasound: An Initial Experience

Author

Enders, Jacob J., Pinto, Peter A., Xu, Sheng, Gomella, Patrick, Rothberg, Michael B., Noun, Jibriel, Blake, Zoe, Daneshvar, Michael, Seifabadi, Reza, Nemirovsky, Daniel, Hazen, Lindsey, Garcia, Charisse, Li, Ming, Gurram, Sandeep, Choyke, Peter L., Merino, Maria J., Toubaji, Antoun, Turkbey, Baris, Varble, Nicole, and Wood, Bradford J.

Published
2023
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31. Renoprotective Effects of Metabolic Surgery Versus GLP1 Receptor Agonists on Progression of Kidney Impairment in Patients with Established Kidney Disease.

Author

Aminian, Ali, Gasoyan, Hamlet, Zajichek, Alexander, Alavi, Mohammad Hesam, Casacchia, Nicholas J., Wilson, Rickesha, Xiaoxi Feng, Corcelles, Ricard, Brethauer, Stacy A., Schauer, Philip R., Kroh, Matthew, Rosenthal, Raul J., Taliercio, Jonathan J., Poggio, Emilio D., Nissen, Steven E., and Rothberg, Michael B.

Abstract

Objective: To examine the renoprotective effects of metabolic surgery in patients with established chronic kidney disease (CKD). Background: The impact of metabolic surgery compared with glucagon-like peptide-1 receptor agonists (GLP-1RA) in patients with established CKD has not been fully characterized. Methods: Patients with obesity (body mass index =30 kg/m²), type 2 diabetes, and baseline estimated glomerular filtration rate (eGFR) 20-60 mL/min/1.73 m² who underwent metabolic bariatric surgery at a large US health system (2010-2017) were compared with nonsurgical patients who continuously received GLP-1RA. The primary end point was CKD progression, defined as a decline of eGFR by =50% or to <15 mL/min/1.73 m2, initiation of dialysis, or kidney transplant. The secondary end point was the incident kidney failure (eGFR <15 mL/min/1.73 m2, dialysis, or kidney transplant) or all-cause mortality. Results: 425 patients, including 183 patients in the metabolic surgery group and 242 patients in the GLP-1RA group, with a median follow-up of 5.8 years (IQR, 4.4-7.6), were analyzed. The cumulative incidence of the primary end point at 8 years was 21.7% (95% CI: 12.2-30.6) in the surgical group and 45.1% (95% CI: 27.7 to 58.4) in the nonsurgical group, with an adjusted hazard ratio of 0.40 (95% CI: 0.21 to 0.76), P=0.006. The cumulative incidence of the secondary composite end point at 8 years was 24.0% (95% CI: 14.1 to 33.2) in the surgical group and 43.8% (95% CI: 28.1 to 56.1) in the nonsurgical group, with an adjusted HR of 0.56 (95% CI: 0.31 to 0.99), P= 0.048. Conclusions: Among patients with type 2 diabetes, obesity, and established CKD, metabolic surgery, compared with GLP-1RA, was significantly associated with a 60% lower risk of progression of kidney impairment and a 44% lower risk of kidney failure or death. Metabolic surgery should be considered as a therapeutic option for patients with CKD and obesity. [ABSTRACT FROM AUTHOR]

Published
2024
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41. Shared Medical Appointments and Prediabetes: The Power of the Group

Author

Papadakis, Aphrodite, Pfoh, Elizabeth R., Hu, Bo, Liu, Xiaobo, Rothberg, Michael B., and Misra-Hebert, Anita D.

Subjects
Medical appointments and schedules -- Methods, Peer groups -- Health aspects, Diabetes therapy -- Social aspects -- Management, Medical consultation -- Methods, Prediabetic state -- Care and treatment -- Social aspects, Company business management, Health, Science and technology
Abstract

Shared medical appointments, which allow greater access to care and provide peer support, may be an effective treatment modality for prediabetes. We used a retrospective propensity-matched cohort analysis to compare patients attending a prediabetes shared medical appointment to usual care. Primary outcome was patient's weight change over 24 months. Secondary outcomes included change in hemoglobin [A.sub.1c], low density lipoprotein, and systolic blood pressure. The shared medical appointments group lost more weight (2.88 kg vs 1.29 kg, P = .003), and achieved greater reduction in hemoglobin [A.sub.1c] (-0.87% vs + 0.87%, P = .001) and systolic blood pressure (-4.35 mmHg vs +0.52 mmHg, P = .044). The shared medical appointment model can be effective in treating prediabetes. Key words: insulin resistance; metabolic syndrome; prediabetic state; shared medical appointments, INTRODUCTION More than 1 in 3 adults have prediabetes, and nearly three-quarters of these will progress to diabetes. (1,2) Diabetic complications such as microvascular dysfunction may already be present in [...]

Published
2021
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47. Role of Patient Characteristics and Insurance Type in Newly Diagnosed Multiple Myeloma Care Disparities.

Author

Gasoyan, Hamlet, Anwer, Faiz, Casacchia, Nicholas J., Kovach, Jeffrey D., Valent, Jason, Ming Wang, Halpern, Michael T., and Rothberg, Michael B.

Subjects
STEM cell transplantation, MULTIPLE myeloma treatment, MULTIPLE myeloma diagnosis, COMBINATION drug therapy, PEARSON correlation (Statistics), SOCIAL determinants of health, RESEARCH funding, HEALTH insurance, QUESTIONNAIRES, LOGISTIC regression analysis, FISHER exact test, KRUSKAL-Wallis Test, MEDICARE, CANCER patients, RETROSPECTIVE studies, DESCRIPTIVE statistics, MULTIVARIATE analysis, CHI-squared test, MANN Whitney U Test, LONGITUDINAL method, CARBOCYCLIC acids, ANTHROPOMETRY, DATA analysis software, EVALUATION
Abstract

PURPOSE Little is known about the role of social determinants of health (SDOH) in the utilization of novel treatments among patients with newly diagnosed multiple myeloma (NDMM). METHODS This retrospective cohort study used Taussig Cancer Center's Myeloma Patient Registry to identify adults with NDMM between January 1, 2017, and December 31, 2021. Electronic health records data captured treatment with (1) triplet or quadruplet regimen and (2) lenalidomide during the first year after NDMM, and (3) stem-cell transplant (SCT) through December 31, 2022. Multivariable logistic regression models examined associations of demographic/clinical characteristics and SDOH with care patterns. RESULTS We identified 569 patients with median age at diagnosis of 66 years (IQR, 59-73); 55% were male, 76% White, 23% Black, 1.1% other races, insured by Medicare (51%), private payer (38%), Medicaid (8.3%), and self-pay/other (1.8%). In the multivariable models, self-pay/other payers (adjusted odds ratio [AOR], 0.15 [95% CI, 0.03 to 0.54]) was associated with lower odds of triplet or quadruplet regimen, compared with Medicare. Private insurance (AOR, 0.48 [95% CI, 0.27 to 0.86]) and self-pay/other payers (AOR, 0.16 [95% CI, 0.04 to 0.74]) had lower odds of lenalidomide. Black patients (v White; AOR, 0.47 [95% CI, 0.26 to 0.85]) and patients treated at regional hospitals (v Taussig Cancer Center; AOR, 0.27 [95% CI, 0.12 to 0.57]) had lower odds of SCT. The odds of receiving triplet or quadruplet regimen, lenalidomide, and SCT also varied by the year of NDMM. CONCLUSION Care for NDMM varied based on race, insurance type, year of diagnosis, and treatment facility. It may be useful to examine the impact of insurance-related characteristics and recent policy initiatives on care disparities. [ABSTRACT FROM AUTHOR]

Published
2024
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