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Article ; Online: Detailed analysis of enteric pathogen incidence associated with COVID-19 mitigation behaviors informs upcoming clinical and policy decision making.

Lennon, Robert P

The Lancet regional health. Western Pacific

2021 Volume 16, Page(s) 100285

Language	English
Publishing date	2021-09-20
Publishing country	England
Document type	Journal Article
ISSN	2666-6065
ISSN (online)	2666-6065
DOI	10.1016/j.lanwpc.2021.100285
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article ; Online: Direct Care Is an Important Component of Military Global Health Engagement.

Lennon, Robert P

Military medicine

2021 Volume 186, Issue 11-12, Page(s) 321–322

MeSH term(s)	Global Health ; Humans ; Military Medicine ; Military Personnel
Language	English
Publishing date	2021-04-21
Publishing country	England
Document type	Letter
ZDB-ID	391061-1
ISSN	1930-613X ; 0026-4075
ISSN (online)	1930-613X
ISSN	0026-4075
DOI	10.1093/milmed/usab152
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Article ; Online: Distinguishing Ethical From Moral Duties in Medical Practice.

Lennon, Robert P

Family medicine

2019 Volume 51, Issue 1, Page(s) 61–62

MeSH term(s)	Ethics, Medical ; Family Practice ; Moral Obligations ; Morals
Language	English
Publishing date	2019-01-11
Publishing country	United States
Document type	Letter ; Comment
ZDB-ID	639374-3
ISSN	1938-3800 ; 0742-3225
ISSN (online)	1938-3800
ISSN	0742-3225
DOI	10.22454/FamMed.2019.637014
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Article ; Online: Meningitis in the Guise of Dementia: Lyme-Induced Normal Pressure Hydrocephalus.

Liu, Ryan / Polly, Matheus / Lennon, Robert P / Reedy-Cooper, Alexis

Clinical medicine & research

2024 Volume 21, Issue 4, Page(s) 226–229

Abstract: While the cause of altered mentation in the elderly may be multifactorial, infectious etiologies may be missed. This case report aims to detail an account of a patient with dementia, found to have Lyme meningitis in the setting of a normal pressure ... ...

Abstract	While the cause of altered mentation in the elderly may be multifactorial, infectious etiologies may be missed. This case report aims to detail an account of a patient with dementia, found to have Lyme meningitis in the setting of a normal pressure hydrocephalus (NPH). The patient smelled of urine and presented with ambulatory dysfunction, fitting the "wet, wacky, and wobbly" triad of NPH while also having subjective chills and leukocytosis. Non-contrast brain CT scan showed dilated ventricles. Cerebrospinal fluid (CSF) studies suggested aseptic meningitis. Serum studies using a modified two-tiered algorithm confirmed the diagnosis of Lyme disease. Treatment of the underlying condition with a prolonged course of doxycycline improved symptoms and clinical course. Review of the literature on the association between Lyme meningitis and NPH reveals that few cases of Lyme-related NPH have been reported worldwide and further research into the pathophysiology, diagnostic approach, treatment modalities, and management of NPH secondary to Lyme meningitis may be warranted.
MeSH term(s)	Humans ; Aged ; Hydrocephalus, Normal Pressure/diagnosis ; Hydrocephalus, Normal Pressure/diagnostic imaging ; Brain ; Lyme Disease/complications ; Lyme Disease/diagnosis ; Meningitis/complications ; Meningitis/diagnosis ; Dementia/complications ; Dementia/diagnosis
Language	English
Publishing date	2024-01-31
Publishing country	United States
Document type	Review ; Case Reports ; Journal Article
ZDB-ID	2303793-3
ISSN	1554-6179 ; 1539-4182
ISSN (online)	1554-6179
ISSN	1539-4182
DOI	10.3121/cmr.2023.1829
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Article ; Online: Detailed analysis of enteric pathogen incidence associated with COVID-19 mitigation behaviors informs upcoming clinical and policy decision making

Robert P. Lennon

The Lancet Regional Health. Western Pacific, Vol 16, Iss , Pp 100285- (2021)

2021

Keywords	Public aspects of medicine ; RA1-1270
Language	English
Publishing date	2021-11-01T00:00:00Z
Publisher	Elsevier
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Assessing the risk of COVID-19 reinfection and severe outcomes among individuals with substance use disorders: a retrospective study using real-world electronic health records.

Tuan, Wen-Jan / Kindt, Hailey M / Lennon, Robert P

BMJ open

2023 Volume 13, Issue 12, Page(s) e074993

Abstract: Objective: Despite advancement in vaccines and treatments for COVID-19 over the past 2 years, many concerns remain about reinfection and waning immunity against COVID-19 and its variants, especially among people with substance use disorder (SUD). The ... ...

Abstract	Objective: Despite advancement in vaccines and treatments for COVID-19 over the past 2 years, many concerns remain about reinfection and waning immunity against COVID-19 and its variants, especially among people with substance use disorder (SUD). The study assessed the risk of COVID-19 reinfection and severe illness among adults with SUD and their vaccination status to inform management in this vulnerable population as the pandemic continues. Design: Retrospective cohort study. Setting: Nationwide electronic health records (TriNetX database) in the USA among adults with COVID-19 infection from January 2020 to June 2022. Participants: Adults (age ≥18 years) who were infected by COVID-19, excluding those who had cancer or lived in nursing homes or palliative care facilities. Outcome measures: COVID-19 reinfection was defined as a new diagnosis after 45 days of the initial infection. Logistic regression was applied to assess the OR of COVID-19 reinfection and severe outcomes within 30 day of reinfection for adults with alcohol (AUD), opioid (OUD), cocaine (CUD), stimulant (STUD), cannabis (CAUD) and other use disorders, controlled for demographic and comorbid conditions. Results: The SUD cohort was 13%-29% more likely to be reinfected by COVID-19 and had significantly higher 30-day mortality. Adults with AUD, STUD and OUD were at greater risks (adjusted ORs, AORs=1.69-1.86) of emergency department, hospital and intensive care admissions after 30 days of reinfection. Individuals with SUD and multiple vaccines doses were associated with decreased risks of worse COVID-19 outcomes. Lower COVID-19 reinfection rates (AORs=0.67-0.84) were only found among individuals with AUD, CUD or CAUD who had COVID-19 vaccination. Conclusions: Individuals with SUD had greater risks of COVID-19 reinfection and poor outcomes, especially those with OUD, STUD and AUD. Multiple vaccinations are recommended to reduce severe illness after COVID-19 reinfection in the SUD population.
MeSH term(s)	Adult ; Humans ; Adolescent ; Retrospective Studies ; COVID-19/epidemiology ; COVID-19 Vaccines ; Electronic Health Records ; Reinfection ; Substance-Related Disorders/epidemiology
Chemical Substances	COVID-19 Vaccines
Language	English
Publishing date	2023-12-10
Publishing country	England
Document type	Journal Article
ZDB-ID	2599832-8
ISSN	2044-6055 ; 2044-6055
ISSN (online)	2044-6055
ISSN	2044-6055
DOI	10.1136/bmjopen-2023-074993
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Article ; Online: Preferred Information Source Correlates to COVID-19 Risk Misperception.

Ezrina, Emilia V / Dong, Huamei / Block, Ray / Lennon, Robert P

Health literacy research and practice

2023 Volume 7, Issue 2, Page(s) e105–e110

Abstract: Inaccurate perceptions of COVID-19 (coronavirus disease 2019) risk may decrease compliance with public health mitigation practices, in turn increasing disease burden. The extent to which public perceptions of COVID-19 risk are inaccurate is not well ... ...

Abstract	Inaccurate perceptions of COVID-19 (coronavirus disease 2019) risk may decrease compliance with public health mitigation practices, in turn increasing disease burden. The extent to which public perceptions of COVID-19 risk are inaccurate is not well studied. This study investigates the relationship between preferred information sources and inaccurate COVID-19 risk perception. A cross-sectional online survey of adults in the United States using online snowball techniques was administered between April 9, 2020 and July 12, 2020. Raking techniques were used to generate a representative U.S. sample from 10,650 respondents. Respondents who did not provide an answer to key questions were excluded. The remaining sample included 1,785 health care workers (HCW) and 4,843 non-HCW. Subjective risk was measured as the product of perceived likelihood of COVID-19 infection and perceived harm from infection. Objective risk was measured as a function of the presence of known COVID-19 risk factors. Discrepancies between subjective and objective risk were compared between respondents with different preferred information sources. Chi Square contingency tables and pair-wise correlation were used to evaluate differences to 95% confidence. For HCW and non-HCW, the greatest overestimation of personal COVID-19 risk assessment (
MeSH term(s)	Adult ; Humans ; Information Sources ; COVID-19 ; Cross-Sectional Studies ; Cost of Illness ; Risk Factors
Language	English
Publishing date	2023-06-01
Publishing country	United States
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ISSN	2474-8307
ISSN (online)	2474-8307
DOI	10.3928/24748307-20230523-01
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Article ; Online: Assessing the risk of COVID-19 reinfection and severe outcomes among individuals with substance use disorders

Robert P Lennon / Wen-Jan Tuan / Hailey M Kindt

BMJ Open, Vol 13, Iss

a retrospective study using real-world electronic health records

2023 Volume 12

Abstract: Objective Despite advancement in vaccines and treatments for COVID-19 over the past 2 years, many concerns remain about reinfection and waning immunity against COVID-19 and its variants, especially among people with substance use disorder (SUD). The ... ...

Abstract	Objective Despite advancement in vaccines and treatments for COVID-19 over the past 2 years, many concerns remain about reinfection and waning immunity against COVID-19 and its variants, especially among people with substance use disorder (SUD). The study assessed the risk of COVID-19 reinfection and severe illness among adults with SUD and their vaccination status to inform management in this vulnerable population as the pandemic continues.Design Retrospective cohort study.Setting Nationwide electronic health records (TriNetX database) in the USA among adults with COVID-19 infection from January 2020 to June 2022.Participants Adults (age ≥18 years) who were infected by COVID-19, excluding those who had cancer or lived in nursing homes or palliative care facilities.Outcome measures COVID-19 reinfection was defined as a new diagnosis after 45 days of the initial infection. Logistic regression was applied to assess the OR of COVID-19 reinfection and severe outcomes within 30 day of reinfection for adults with alcohol (AUD), opioid (OUD), cocaine (CUD), stimulant (STUD), cannabis (CAUD) and other use disorders, controlled for demographic and comorbid conditions.Results The SUD cohort was 13%–29% more likely to be reinfected by COVID-19 and had significantly higher 30-day mortality. Adults with AUD, STUD and OUD were at greater risks (adjusted ORs, AORs=1.69–1.86) of emergency department, hospital and intensive care admissions after 30 days of reinfection. Individuals with SUD and multiple vaccines doses were associated with decreased risks of worse COVID-19 outcomes. Lower COVID-19 reinfection rates (AORs=0.67–0.84) were only found among individuals with AUD, CUD or CAUD who had COVID-19 vaccination.Conclusions Individuals with SUD had greater risks of COVID-19 reinfection and poor outcomes, especially those with OUD, STUD and AUD. Multiple vaccinations are recommended to reduce severe illness after COVID-19 reinfection in the SUD population.
Keywords	Medicine ; R
Subject code	360
Language	English
Publishing date	2023-12-01T00:00:00Z
Publisher	BMJ Publishing Group
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article: Opioid dose risk, clinician and patient characteristics, and adherence to opioid prescribing recommendations in chronic non-cancer pain.

Coleman, Christa / Lennon, Robert P / Robinson, James M / Tuan, Wen-Jan / Sehgal, Nalini / Zgierska, Aleksandra E

Journal of opioid management

2023 Volume 19, Issue 5, Page(s) 413–422

Abstract: ... respectively). Higher MEDD correlated (p < 0.001) with Medicare insurance, current cigarette smoking, higher ... clinicians more frequently prescribed (p < 0.001) and male patients were more likely to be prescribed (p < 0 ... coprescribed benzodiazepines (p = 0.015), lower depression screening (p = 0.048), urine drug testing (p = 0.003 ...

Abstract	Objective: This study aims to assess associations between morphine-equivalent daily dose (MEDD) of opioids, clinician and patient characteristics, and prescriber adherence to guidelines for long-term opioid therapy (LTOT) in chronic noncancer pain (CNCP) and to elucidate potential relationships associated with increased-risk opioid prescribing. Design: Retrospective cross-sectional study. Setting: Academic health system's 33 primary care clinics. Patients: Adults (≥18 years old) prescribed LTOT (10 + outpatient prescriptions in the past year) for CNCP. Main outcome measure(s): Electronic health record data on prescribed opioids (for MEDD), clinician/patient characteristics, and adherence rates to LTOT guideline-concordant recommendations. Results: A total of 2,738 patients were eligible, 61.6 percent Lower, 15.7 percent Moderate, and 22.7 percent Higher Risk MEDD (<50, 50-89, and ≥90 mg/day, respectively). Higher MEDD correlated (p < 0.001) with Medicare insurance, current cigarette smoking, higher pain intensity and interference scores, and the presence of opioid use disorder diagnoses. Male clinicians more frequently prescribed (p < 0.001) and male patients were more likely to be prescribed (p < 0.001) higher MEDD compared to their female counterparts. Higher Risk MEDD was associated with higher coprescribed benzodiazepines (p = 0.015), lower depression screening (p = 0.048), urine drug testing (p = 0.003), comparable active treatment agreement (p = 0.189), opioid misuse risk screening (p = 0.619), and prescription drug monitoring checks (p = 0.203). Conclusions: This study documented that higher MEDD was associated with risks of worse health outcomes without improved adherence to opioid prescribing guideline recommendations. Enhanced clinician awareness of factors associated with MEDD has the potential to mitigate LTOT risks and improve overall patient care.
MeSH term(s)	Adult ; Humans ; Male ; Female ; Aged ; United States ; Adolescent ; Analgesics, Opioid/adverse effects ; Retrospective Studies ; Cross-Sectional Studies ; Chronic Pain/diagnosis ; Chronic Pain/drug therapy ; Practice Patterns, Physicians' ; Medicare ; Morphine ; Opioid-Related Disorders/diagnosis ; Opioid-Related Disorders/epidemiology ; Opioid-Related Disorders/prevention & control
Chemical Substances	Analgesics, Opioid ; Morphine (76I7G6D29C)
Language	English
Publishing date	2023-11-08
Publishing country	United States
Document type	Journal Article
ZDB-ID	2397614-7
ISSN	1551-7489
ISSN	1551-7489
DOI	10.5055/jom.0815
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Article ; Online: Race, employment, and the pandemic: An exploration of covariate explanations of COVID-19 case fatality rate variance.

Griffin, Christopher / Block, Ray / Silverman, Justin D / Croad, Jason / Lennon, Robert P

PloS one

2023 Volume 18, Issue 2, Page(s) e0274470

Abstract: We derive a simple asymptotic approximation for the long-run case fatality rate of COVID-19 (alpha and delta variants) and show that these estimations are highly correlated to the interaction between US State median age and projected US unemployment rate ...

Abstract	We derive a simple asymptotic approximation for the long-run case fatality rate of COVID-19 (alpha and delta variants) and show that these estimations are highly correlated to the interaction between US State median age and projected US unemployment rate (Adj. r2 = 60%). We contrast this to the high level of correlation between point (instantaneous) estimates of per state case fatality rates and the interaction of median age, population density and current unemployment rates (Adj. r2 = 50.2%). To determine whether this is caused by a "race effect," we then analyze unemployment, race, median age and population density across US states and show that adding the interaction of African American population and unemployment explains 53.5% of the variance in COVID case fatality rates for the alpha and delta variants when considering instantaneous case fatality rate. Interestingly, when the asymptotic case fatality rate is used, the dependence on the African American population disappears, which is consistent with the fact that in the long-run COVID does not discriminate on race, but may discriminate on access to medical care which is highly correlated to employment in the US. The results provide further evidence of the impact inequality can have on case fatality rates in COVID-19 and the impact complex social, health and economic factors can have on patient survival.
MeSH term(s)	Humans ; COVID-19/epidemiology ; SARS-CoV-2 ; Pandemics ; Employment
Language	English
Publishing date	2023-02-02
Publishing country	United States
Document type	Journal Article
ZDB-ID	2267670-3
ISSN	1932-6203 ; 1932-6203
ISSN (online)	1932-6203
ISSN	1932-6203
DOI	10.1371/journal.pone.0274470
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