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Article ; Online: Identifying barriers to emergency department-initiated buprenorphine: A spatial analysis of treatment facility access in Michigan.

Dora-Laskey, Aaron / King, Andrew / Sadler, Richard

The American journal of emergency medicine

2021 Volume 51, Page(s) 393–396

Abstract: Study objectives: Emergency department (ED)-initiated buprenorphine/naloxone has been shown to improve treatment retention and reduce illicit opioid use; however, its potential may be limited by a lack of accessible community-based facilities. This ... ...

Abstract	Study objectives: Emergency department (ED)-initiated buprenorphine/naloxone has been shown to improve treatment retention and reduce illicit opioid use; however, its potential may be limited by a lack of accessible community-based facilities. This study compared one state's geographic distribution of EDs to outpatient treatment facilities that provide buprenorphine treatment and identified ED and geographic factors associated with treatment access. Methods: Treatment facility data were obtained from the SAMHSA 2018 National Directory of Drug and Alcohol Abuse Treatment Facilities, and ED data were obtained from the Michigan College of Emergency Physician's 2018 ED directory. Geospatial analysis compared EDs to buprenorphine treatment facilities using 5-, 10-, and 20-mile network buffers. Results: Among 131 non-exclusively pediatric EDs in Michigan, 57 (43.5%) had a buprenorphine treatment facility within 5 miles, and 66 (50.4%) had a facility within 10 miles. EDs within 10 miles of a Medicaid-accepting, outpatient buprenorphine treatment facility had higher average numbers of beds (41 vs. 15; p < 0.0001) and annual patient volumes (58,616 vs. 17,484; p < 0.0001) compared to those without. Among Michigan counties with EDs, those with at least one buprenorphine facility had larger average populations (286,957 vs. 44,757; p = 0.005) and higher annual rates of opioid overdose deaths (mean 18.3 vs. 13.0 per 100,000; p = 0.02) but were similar in terms of opioid-related hospitalizations and socioeconomic distress. Conclusion: Only half of Michigan EDs are within 10 miles of a buprenorphine treatment facility. Given these limitations, expanding access to ED-initiated buprenorphine in states similar to Michigan may require developing alternative models of care.
MeSH term(s)	Architectural Accessibility/statistics & numerical data ; Buprenorphine/therapeutic use ; Emergency Service, Hospital/statistics & numerical data ; Health Services Accessibility/statistics & numerical data ; Hospital Bed Capacity/statistics & numerical data ; Hospitalization/statistics & numerical data ; Humans ; Medicaid ; Michigan ; Narcotic Antagonists/therapeutic use ; Opiate Overdose/epidemiology ; Opioid-Related Disorders/drug therapy ; Socioeconomic Factors ; Spatial Analysis ; United States
Chemical Substances	Narcotic Antagonists ; Buprenorphine (40D3SCR4GZ)
Language	English
Publishing date	2021-11-11
Publishing country	United States
Document type	Journal Article
ZDB-ID	605890-5
ISSN	1532-8171 ; 0735-6757
ISSN (online)	1532-8171
ISSN	0735-6757
DOI	10.1016/j.ajem.2021.11.014
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Article ; Online: Single Lung Transplant for Secondary Pulmonary Hypertension

Brian Housman / Daniel Laskey / Gbalekan Dawodu / Scott Scheinin

Journal of Clinical Medicine, Vol 12, Iss 21, p

The Right Option for the Right Patient

2023 Volume 6789

Abstract: Introduction : The optimal treatment for Secondary Pulmonary Hypertension from End-Stage Lung Disease remains controversial. Double Lung Transplantation is widely regarded as the treatment of choice as it eliminates all diseased parenchyma and introduces ...

Abstract	Introduction : The optimal treatment for Secondary Pulmonary Hypertension from End-Stage Lung Disease remains controversial. Double Lung Transplantation is widely regarded as the treatment of choice as it eliminates all diseased parenchyma and introduces a large volume of physiologically normal allograft. By comparison, the role of single lung transplantation for pulmonary hypertension (PAH) is less clear. The remaining diseased lung will limit clinical improvements and permit downstream sequelae; including residual cough, recurrent infection, and continued pulmonary hypertension. But not every patient can undergo DLT. Advanced age, frailty, co-morbid conditions, and limited availability of organs will all affect surgical candidacy and can offset the benefits of double lung procedures. Studies that compare SLT and DLT do not commonly explore the utility of single lung procedures even though multiple theoretical advantages exist; including reduced waiting times, less waitlist mortality, fewer surgical complications, and lower operative mortality. Worse, multiple forms of publication and selection bias may favor DLT in registry-based studies. In this review, we present the prevailing literature on single and double lung transplants in patients with secondary pulmonary hypertension and clarify the potential utility of these procedures. Materials and Methods: A PubMed search for English-language articles exploring single and double lung transplants in the setting of secondary pulmonary hypertension was conducted from 1990 to 2023. Key words included “single lung transplant”, “double lung transplant”, “pulmonary hypertension”, “rejection”, “complications”, “extracorporeal membranous oxygenation”, “death”, and all appropriate Boolean operators. We prioritized research from retrospective studies that evaluated clinical outcomes from single centers. Conclusions: The question is not whether DLT is better at resolving lung disease; instead, we must ask if SLT is an acceptable form of therapy in a select group of high-risk ...
Keywords	single lung transplant ; double lung transplant ; pulmonary hypertension ; rejection ; complications ; extracorporeal membranous oxygenation ; Medicine ; R
Subject code	610
Language	English
Publishing date	2023-10-01T00:00:00Z
Publisher	MDPI AG
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Intraoperative Extracorporeal Support during Lung Transplantation

Daniel Laskey / Brian Housman / Gbalekan Dawodu / Scott Scheinin

Journal of Clinical Medicine, Vol 13, Iss 1, p

Not Just for the High-Risk Patient

2023 Volume 192

Abstract: The use of intraoperative mechanical support during lung transplantation has traditionally been a controversial topic. Trends for intraoperative mechanical support strategies swing like a pendulum. Historically, cardiopulmonary bypass (CPB) was the ... ...

Abstract	The use of intraoperative mechanical support during lung transplantation has traditionally been a controversial topic. Trends for intraoperative mechanical support strategies swing like a pendulum. Historically, cardiopulmonary bypass (CPB) was the modality of choice during transplantation. It provides full hemodynamic support including oxygenation and decarboxylation. Surgical exposure is improved by permitting the drainage of the heart and provides more permissive retraction. CPBs contain drainage reservoirs with hand-held pump suction catheters promoting blood conservation through collection and re-circulation. But CPB has its disadvantages. It is known to cause systemic inflammation and coagulopathy. CPB requires high doses of heparinization, which increases bleeding risks. As transplantation progressed, off-pump transplantation began to trend as a preferable option. ECMO, however, has many of the benefits of CPB with less of the risk. Outcomes were improved with ECMO compared to CPB. CPB has a higher blood transfusion requirement, a higher need for post-operative ECMO support, a higher re-intubation rate, high rates of kidney injury and need for hemodialysis, longer ICU stays, higher incidences of PGD grade 3, as well as overall in-hospital mortality when compared with ECMO use. The focus now shifts to using intraoperative mechanical support to protect the graft, helping to reduce ischemia-reperfusion injury and allowing for lung protective ventilator settings. Studies show that the routine use of ECMO during transplantation decreases the rate of primary graft dysfunction and many adverse outcomes including ventilator time, need for tracheostomy, renal failure, post-operative ECMO requirements, and others. As intraoperative planned ECMO is considered a safe and effective approach, with improved survival and better overall outcomes compared to both unplanned ECMO implementation and off-pump transplantation, its routine use should be taken into consideration as standard protocol.
Keywords	single-lung transplant ; double-lung transplant ; pulmonary hypertension ; rejection ; complications ; extracorporeal membranous oxygenation ; Medicine ; R
Subject code	610
Language	English
Publishing date	2023-12-01T00:00:00Z
Publisher	MDPI AG
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Measuring the margin distance in pulmonary wedge resection.

Wolf, Andrea / Laskey, Daniel / Yip, Rowena / Beasley, Mary B / Yankelevitz, David F / Henschke, Claudia I

Journal of surgical oncology

2022 Volume 126, Issue 7, Page(s) 1350–1358

Abstract: Background: Margin distance contributes to survival and recurrence during wedge resections for early-stage non-small cell lung cancer. The Initiative for Early Lung Cancer Research on Treatment sought to standardize a surgeon-measured margin ... ...

Abstract	Background: Margin distance contributes to survival and recurrence during wedge resections for early-stage non-small cell lung cancer. The Initiative for Early Lung Cancer Research on Treatment sought to standardize a surgeon-measured margin intraoperatively. Methods: Lung cancer patients who underwent wedge resection were reviewed. Margins were measured by the surgeon twice as per a standardized protocol. Intraobserver variability as well as surgeon-pathologist variability were compared. Results: Forty-five patients underwent wedge resection. Same-surgeon measurement analysis indicated good reliability with a small mean difference and narrow limit of agreement for the two measures. The median surgeon-measured margin was 18.0 mm, median pathologist-measured margin was 16.0 mm and the median difference between the surgeon-pathologist margin was -1.0 mm, ranging from -18.0 to 12.0 mm. Bland-Altman analysis for margin measurements demonstrated a mean difference of 0.65 mm. The limit of agreement for the two approaches were wide, with the difference lying between -16.25 and 14.96 mm. Conclusions: A novel protocol of surgeon-measured margin was evaluated and compared with pathologist-measured margin. High intraobserver agreement for repeat surgeon measurements yet low-to-moderate correlation or directionality between surgeon and pathologic measurements were found. Discussion: A standardized protocol may reduce variability in pathologic assessment. These findings have critical implications considering the impact of margin distance on outcomes.
MeSH term(s)	Humans ; Carcinoma, Non-Small-Cell Lung/pathology ; Lung Neoplasms/pathology ; Pneumonectomy/methods ; Reproducibility of Results ; Margins of Excision ; Retrospective Studies ; Neoplasm Recurrence, Local/surgery
Language	English
Publishing date	2022-08-17
Publishing country	United States
Document type	Journal Article
ZDB-ID	82063-5
ISSN	1096-9098 ; 0022-4790
ISSN (online)	1096-9098
ISSN	0022-4790
DOI	10.1002/jso.27053
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Article ; Online: Worth a Double Take? An In-Depth Review of Lung Retransplantation

Gbalekan Dawodu / Shubham Gulati / Helena Bugacov / Daniel Laskey / Brian Housman / Harish Seethamraju / Scott Scheinin

Journal of Clinical Medicine, Vol 12, Iss 23, p

2023 Volume 7418

Abstract: Provided advancements in Lung Transplantation (LT) survival, the efficacy of Lung Retransplantation (LRT) has often been debated. Decades of retrospective analyses on thousands of LRT cases provide insight enabling predictive patient criteria for ... ...

Abstract	Provided advancements in Lung Transplantation (LT) survival, the efficacy of Lung Retransplantation (LRT) has often been debated. Decades of retrospective analyses on thousands of LRT cases provide insight enabling predictive patient criteria for retransplantation. This review used the Preferred Reporting Items for Systematic Reviews and Meta Analyses (PRISMA) guidelines. The PubMed search engine was utilized for articles relating to LRT published through August 2023, and a systematic review was performed using Covidence software version 2.0 (Veritas Health Innovation, Australia). Careful patient selection is vital for successful LRT, and the benefit leans in favor of those in optimal health following their initial transplant. However, the lack of a standardized approach remains apparent. Through an in-depth review, we will address considerations such as chronic lung allograft dysfunction, timing to LRT, surgical and perioperative complexity, and critical ethical concerns that guide the current practice as it relates to this subset of patients for whom LRT is the only therapeutic option available.
Keywords	lung transplantation ; lung retransplantation ; cardiothoracic surgery ; extracorporeal oxygenation ; respiratory failure ; primary graft dysfunction ; Medicine ; R
Subject code	610
Language	English
Publishing date	2023-11-01T00:00:00Z
Publisher	MDPI AG
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: The Evaluation and Management of Coronary Artery Disease in the Lung Transplant Patient

Gregory Serrao / Manish Vinayak / Johny Nicolas / Varsha Subramaniam / Ashton C. Lai / Daniel Laskey / Annapoorna Kini / Harish Seethamraju / Scott Scheinin

Journal of Clinical Medicine, Vol 12, Iss 24, p

2023 Volume 7644

Abstract: Lung transplantation can greatly improve quality of life and extend survival in those with end-stage lung disease. In order to derive the maximal benefit from such a procedure, patients must be carefully selected and be otherwise healthy enough to ... ...

Abstract	Lung transplantation can greatly improve quality of life and extend survival in those with end-stage lung disease. In order to derive the maximal benefit from such a procedure, patients must be carefully selected and be otherwise healthy enough to survive a high-risk surgery and sometimes prolonged immunosuppressive therapy following surgery. Patients therefore must be critically assessed prior to being listed for transplantation with close attention paid towards assessment of cardiovascular health and operative risk. One of the biggest dictators of this is coronary artery disease. In this review article, we discuss the assessment and management of coronary artery disease in the potential lung transplant candidate.
Keywords	coronary artery disease ; percutaneous coronary intervention ; coronary artery bypass surgery ; lung transplant evaluation ; Medicine ; R
Language	English
Publishing date	2023-12-01T00:00:00Z
Publisher	MDPI AG
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Involving Patients and Clinicians in the Design of Wireframes for Cancer Medicines Electronic Patient Reported Outcome Measures in Clinical Care

Emma Dunlop / Aimee Ferguson / Tanja Mueller / Kelly Baillie / Jennifer Laskey / Julie Clarke / Amanj Kurdi / Ann Wales / Thomas Connolly / Marion Bennie

JMIR Formative Research, Vol 7, p e

Mixed Methods Study

2023 Volume 48296

Abstract: BackgroundCancer treatment is a key component of health care systems, and the increasing number of cancer medicines is expanding the treatment landscape. However, evidence of the impact on patients has been focused more on chemotherapy toxicity and ... ...

Abstract	BackgroundCancer treatment is a key component of health care systems, and the increasing number of cancer medicines is expanding the treatment landscape. However, evidence of the impact on patients has been focused more on chemotherapy toxicity and symptom control and less on the effect of cancer medicines more broadly on patients’ lives. Evolving electronic patient-reported outcome measures (ePROMs) presents the opportunity to secure early engagement of patients and clinicians in shaping the collection of quality-of-life metrics and presenting these data to better support the patient-clinician decision-making process. ObjectiveThe aim of this study was to obtain initial feedback from patients and clinicians on the wireframes of a digital solution (patient app and clinician dashboard) for the collection and use of cancer medicines ePROMs. MethodsWe adopted a 2-stage, mixed methods approach. Stage 1 (March to June 2019) consisted of interviews and focus groups with cancer clinicians and patients with cancer to explore the face validity of the wireframes, informed by the technology acceptance model constructs (perceived ease of use, perceived usefulness, and behavioral intention to use). In stage 2 (October 2019 to February 2020), the revised wireframes were assessed through web-based, adapted technology acceptance model questionnaires. Qualitative data (stage 1) underwent a framework analysis, and descriptive statistics were performed on quantitative data (stage 2). Clinicians and patients with cancer were recruited from NHS Greater Glasgow & Clyde, the largest health board in Scotland. ResultsA total of 14 clinicians and 19 patients participated in a combination of stage 1 interviews and focus groups. Clinicians and patients indicated that the wireframes of a patient app and clinician dashboard for the collection of cancer medicines ePROMs would be easy to use and could focus discussions, and they would be receptive to using such tools in the future. In stage 1, clinicians raised the potential impact on ...
Keywords	Medicine ; R
Subject code	616 ; 170
Language	English
Publishing date	2023-12-01T00:00:00Z
Publisher	JMIR Publications
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Obesity-related endometrial cancer: an update on survivorship approaches to reducing cardiovascular death.

Laskey, R A / McCarroll, M L / von Gruenigen, V E

BJOG : an international journal of obstetrics and gynaecology

2016 Volume 123, Issue 2, Page(s) 293–298

Abstract: As the rate of obesity increases worldwide, so will the number of women diagnosed with obesity-related malignancy. The strongest correlation between obesity and cancer is endometrial cancer (EC). Obesity is the most significant modifiable risk factor for ...

Abstract	As the rate of obesity increases worldwide, so will the number of women diagnosed with obesity-related malignancy. The strongest correlation between obesity and cancer is endometrial cancer (EC). Obesity is the most significant modifiable risk factor for development of EC and also contributes to the most common cause of death in EC survivors-cardiovascular disease (CVD). Most cancer survivors after diagnosis do not implement lifestyle changes aimed at weight-loss and CVD risk reduction. This selective review highlights recent novel and unique approaches for managing CVD co-morbidities in EC survivorship.
MeSH term(s)	Body Mass Index ; Cardiovascular Diseases/etiology ; Cardiovascular Diseases/mortality ; Cardiovascular Diseases/prevention & control ; Comorbidity ; Endometrial Neoplasms/etiology ; Endometrial Neoplasms/mortality ; Female ; Humans ; Obesity/complications ; Obesity/mortality ; Risk Factors ; Risk Reduction Behavior ; Survivors/psychology
Language	English
Publishing date	2016-01
Publishing country	England
Document type	Journal Article ; Review
ZDB-ID	2000931-8
ISSN	1471-0528 ; 0306-5456 ; 1470-0328
ISSN (online)	1471-0528
ISSN	0306-5456 ; 1470-0328
DOI	10.1111/1471-0528.13684
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Article ; Online: Evaluating the Antimicrobial Properties of Commercial Hand Sanitizers.

Chojnacki, M / Dobrotka, C / Osborn, R / Johnson, W / Young, M / Meyer, B / Laskey, E / Wozniak, R A F / Dewhurst, S / Dunman, P M

mSphere

2021 Volume 6, Issue 2

Abstract: Hand sanitizers have been developed as a convenient means to decontaminate an individual's hands of bacterial pathogens in situations in which soap and water are not available. Yet to our knowledge, no study has compared the antibacterial efficacy of a ... ...

Abstract	Hand sanitizers have been developed as a convenient means to decontaminate an individual's hands of bacterial pathogens in situations in which soap and water are not available. Yet to our knowledge, no study has compared the antibacterial efficacy of a large collection of hand sanitizers. Using zone of growth inhibition and kill curve assays, we assessed the performance of 46 commercially available hand sanitizers that were obtained from national chain big-box stores, gasoline stations, pharmacies, and boutiques for antibacterial activity toward prototypical Gram-positive (
MeSH term(s)	Animals ; COVID-19/prevention & control ; COVID-19/transmission ; Cell Line ; Chlorocebus aethiops ; Escherichia coli/drug effects ; Escherichia coli Infections/prevention & control ; Escherichia coli Infections/transmission ; Hand Disinfection/methods ; Hand Sanitizers/pharmacology ; Humans ; Microbial Sensitivity Tests ; SARS-CoV-2/drug effects ; Staphylococcal Infections/prevention & control ; Staphylococcal Infections/transmission ; Staphylococcus aureus/drug effects ; Vero Cells
Chemical Substances	Hand Sanitizers
Language	English
Publishing date	2021-03-03
Publishing country	United States
Document type	Evaluation Study ; Journal Article ; Research Support, N.I.H., Extramural ; Research Support, Non-U.S. Gov't
ISSN	2379-5042
ISSN (online)	2379-5042
DOI	10.1128/mSphere.00062-21
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Article ; Online: Opportunities and challenges when using record linkage of routinely collected electronic health care data to evaluate outcomes of systemic anti-cancer treatment in clinical practice.

Mueller, Tanja / Laskey, Jennifer / Baillie, Kelly / Clarke, Julie / Crearie, Christine / Kavanagh, Kimberley / Graham, Janet / Graham, Kathryn / Waterson, Ashita / Jones, Robert / Kurdi, Amanj / Morrison, David / Bennie, Marion

Health informatics journal

2022 Volume 28, Issue 1, Page(s) 14604582221077055

Abstract: The efficacy and safety of cancer medicines as reported from randomised clinical trials do not always translate into similar benefits in routine clinical practice; hence, post-marketing studies are a useful addition to the evidence base. With recent ... ...

Abstract	The efficacy and safety of cancer medicines as reported from randomised clinical trials do not always translate into similar benefits in routine clinical practice; hence, post-marketing studies are a useful addition to the evidence base. With recent advances in digital infrastructure and the advent of electronically available health records, linkage of routinely collected data has emerged as a promising evaluation method for these studies. This paper discusses the opportunities and challenges when applying an electronic record linkage methodology with respect to systemic anti-cancer therapy by showcasing exemplar studies conducted over a three-year period in Scotland, and highlights some of the potential pitfalls spanning the entire breadth and depth of the research process. Our experiences as an interdisciplinary team indicate that there is scope to conduct large cohort studies to generate results from routine clinical practice within a reasonable time frame; however, close collaboration between researchers, data controllers and clinicians is required in order to obtain valid and meaningful results.
MeSH term(s)	Delivery of Health Care ; Electronics ; Humans ; Neoplasms/drug therapy ; Scotland
Language	English
Publishing date	2022-02-23
Publishing country	England
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	2213115-2
ISSN	1741-2811 ; 1460-4582
ISSN (online)	1741-2811
ISSN	1460-4582
DOI	10.1177/14604582221077055
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