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Article ; Online: How I treat pain in hematologic malignancies safely with opioid therapy.

Geyer, Holly L / Gazelka, Halena / Mesa, Ruben

2020 Volume 135, Issue 26, Page(s) 2354–2364

Abstract: The field of malignant hematology has experienced extraordinary advancements with survival rates doubling for many disorders. As a result, many life-threatening conditions have since evolved into chronic medical ailments. Paralleling these advancements ... ...

Abstract	The field of malignant hematology has experienced extraordinary advancements with survival rates doubling for many disorders. As a result, many life-threatening conditions have since evolved into chronic medical ailments. Paralleling these advancements have been increasing rates of complex hematologic pain syndromes, present in up to 60% of patients with malignancy who are receiving active treatment and up to 33% of patients during survivorship. Opioids remain the practice cornerstone to managing malignancy-associated pain. Prevention and management of opioid-related complications have received significant national attention over the past decade, and emerging data suggest that patients with cancer are at equal if not higher risk of opioid-related complications when compared with patients without malignancy. Numerous tools and procedural practice guides are available to help facilitate safe prescribing. The recent development of cancer-specific resources directing algorithmic use of validated pain screening tools, prescription drug monitoring programs, urine drug screens, opioid use disorder risk screening instruments, and controlled substance agreements have further strengthened the framework for safe prescribing. This article, which integrates federal and organizational guidelines with known risk factors for cancer patients, offers a case-based discussion for reviewing safe opioid prescribing practices in the hematology setting.
MeSH term(s)	Abdominal Pain/drug therapy ; Abdominal Pain/etiology ; Adult ; Analgesics, Opioid/adverse effects ; Analgesics, Opioid/therapeutic use ; Anti-Inflammatory Agents, Non-Steroidal/therapeutic use ; Back Pain/etiology ; Back Pain/therapy ; Chronic Pain/drug therapy ; Chronic Pain/etiology ; Chronic Pain/physiopathology ; Chronic Pain/therapy ; Combined Modality Therapy ; Disease Susceptibility ; Drug Monitoring ; Hematologic Neoplasms/complications ; Hematologic Neoplasms/physiopathology ; Hostility ; Humans ; Leukemia, Myelogenous, Chronic, BCR-ABL Positive/complications ; Male ; Middle Aged ; Multiple Myeloma/complications ; Opioid-Related Disorders/prevention & control ; Oxycodone/adverse effects ; Oxycodone/therapeutic use ; Pain Management ; Patient Education as Topic ; Phantom Limb/etiology ; Phantom Limb/psychology ; Phantom Limb/therapy ; Physical Therapy Modalities ; Risk Assessment ; Stress Disorders, Post-Traumatic/complications ; Substance-Related Disorders/complications ; Thrombocythemia, Essential/complications ; Yoga
Chemical Substances	Analgesics, Opioid ; Anti-Inflammatory Agents, Non-Steroidal ; Oxycodone (CD35PMG570)
Language	English
Publishing date	2020-04-24
Publishing country	United States
Document type	Case Reports ; Journal Article
ZDB-ID	80069-7
ISSN	1528-0020 ; 0006-4971
ISSN (online)	1528-0020
ISSN	0006-4971
DOI	10.1182/blood.2019003116
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Article ; Online: How Hospital Stays Resemble Enhanced Interrogation.

Mishark, Kenneth J / Geyer, Holly / Ubel, Peter A

Annals of internal medicine

2020 Volume 173, Issue 7, Page(s) 572–573

MeSH term(s)	Hospitalization ; Humans ; Inpatients/psychology ; Torture/psychology
Language	English
Publishing date	2020-07-21
Publishing country	United States
Document type	Editorial
ZDB-ID	336-0
ISSN	1539-3704 ; 0003-4819
ISSN (online)	1539-3704
ISSN	0003-4819
DOI	10.7326/M19-3874
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Article: Global well-being, anxiety, social isolation, and emotional support among hospitalists during COVID-19 and Mpox outbreaks.

Dugani, Sagar B / Fischer, Karen M / Schroeder, Darrell R / Geyer, Holly L / Maniaci, Michael J / Paulson, Margaret / Croghan, Ivana T / Burton, M Caroline

Hospital practice (1995)

2023 Volume 51, Issue 4, Page(s) 211–218

Abstract: Objective: The Coronavirus Disease-19 (COVID-19) pandemic caused a decline in hospitalist wellness. The COVID-19 pandemic has evolved, and new outbreaks (i.e. Mpox) have challenged healthcare systems. The objective of the study was to assess changes in ... ...

Abstract	Objective: The Coronavirus Disease-19 (COVID-19) pandemic caused a decline in hospitalist wellness. The COVID-19 pandemic has evolved, and new outbreaks (i.e. Mpox) have challenged healthcare systems. The objective of the study was to assess changes in hospitalist wellness and guide interventions. Methods: We surveyed hospitalists (physicians and advanced practice providers [APPs]), in May 2021 and September 2022, at a healthcare system's 16 hospitals in four US states using PROMIS® measures for global well-being, anxiety, social isolation, and emotional support. We compared wellness score between survey periods; in the September 2022 survey, we compared wellness scores between APPs and physicians and evaluated the associations of demographic and hospital characteristics with wellness using logistic (global well-being) and linear (anxiety, social isolation, emotional support) regression models. Results: In May 2021 vs. September 2022, respondents showed no statistical difference in top global well-being for mental health (68.4% vs. 57.4%) and social activities and relationships (43.8% vs. 44.3%), anxiety (mean difference: +0.8), social isolation (mean difference: +0.5), and emotional support (mean difference: -1.0) (all, Conclusion: In hospitalists, concern about contracting COVID-19 at work was associated with higher anxiety and social isolation. The unchanged wellness scores between survey periods identified opportunities for intervention. Mpox had apparently minor impact on wellness.
MeSH term(s)	Humans ; Hospitalists ; COVID-19/epidemiology ; Pandemics ; Mpox (monkeypox) ; Anxiety/epidemiology ; Anxiety/psychology ; Disease Outbreaks ; Social Isolation
Language	English
Publishing date	2023-08-01
Publishing country	England
Document type	Journal Article
ZDB-ID	2570453-9
ISSN	2377-1003 ; 2154-8331 ; 8750-2836
ISSN (online)	2377-1003
ISSN	2154-8331 ; 8750-2836
DOI	10.1080/21548331.2023.2241342
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Article: Amiodarone-induced pulmonary toxicity.

Colby, Rebecca / Geyer, Holly

JAAPA : official journal of the American Academy of Physician Assistants

2017 Volume 30, Issue 11, Page(s) 23–26

Abstract: Amiodarone is widely used to prevent ventricular and supraventricular dysrhythmias but has a number of toxicities. One of the most devastating adverse reactions to this drug is pulmonary toxicity, which can present in a myriad of different ways. Toxicity ...

Abstract	Amiodarone is widely used to prevent ventricular and supraventricular dysrhythmias but has a number of toxicities. One of the most devastating adverse reactions to this drug is pulmonary toxicity, which can present in a myriad of different ways. Toxicity is difficult to diagnose because many of its features also are seen in nontoxic patients. This article reviews the pathophysiology, presentation, diagnosis, and treatment of amiodarone-induced pulmonary toxicity.
MeSH term(s)	Aged, 80 and over ; Amiodarone/adverse effects ; Anti-Arrhythmia Agents/adverse effects ; Atrial Fibrillation/drug therapy ; Humans ; Lung Diseases/chemically induced ; Male
Chemical Substances	Anti-Arrhythmia Agents ; Amiodarone (N3RQ532IUT)
Language	English
Publishing date	2017-11
Publishing country	United States
Document type	Case Reports ; Journal Article
ZDB-ID	2415226-2
ISSN	0893-7400 ; 1547-1896
ISSN (online)	0893-7400
ISSN	1547-1896
DOI	10.1097/01.JAA.0000524713.17719.c8
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Article: Perception of barriers to research among internal medicine physician hospitalists by career stage.

Dugani, Sagar B / Geyer, Holly L / Maniaci, Michael J / Burton, M Caroline

Hospital practice (1995)

2020 Volume 48, Issue 4, Page(s) 206–212

Abstract: Background: Physician hospitalists may participate in research and generate knowledge for evidence-based hospital practice. Despite this, physician hospitalists are primarily involved in patient care, and there is sparse information on barriers for ... ...

Abstract	Background: Physician hospitalists may participate in research and generate knowledge for evidence-based hospital practice. Despite this, physician hospitalists are primarily involved in patient care, and there is sparse information on barriers for their participation in research and if these barriers differ by career stage. Methods: We conducted a survey of physician hospitalists at Mayo Clinic sites based in four states (Arizona, Florida, Minnesota, and Wisconsin). We surveyed physician hospitalists on demographics, academic rank, current research skills, barriers for participation in research, and research skills they aspire to acquire. Responses were summarized using descriptive statistics and categorized by early-career (<10 years), mid-career (10-20 years), and later-career (≥20 years) stages at Mayo Clinic. The survey was conducted from March to April 2019. Results: Of 188 physician hospitalists, there was a 52% response rate with 71% in early career, 21% mid-career, and 7% late career, with 39% female. Physician hospitalists at early-career (90%), mid-career (76%), and later-career (71%) stages were interested in participating in research. Among physician hospitalists with ≤3 peer-reviewed publications, barriers for participation in research included lack of mentorship, time, research skills, and funding. Among physician hospitalists with ≥4 peer-reviewed publications, factors for research success included mentorship (89% early-career, 38% mid-career, 75% later-career; p = 0.002) and membership in a research team. Compared to mid- and later-career physician hospitalists, a higher proportion of early-career hospitalists was interested in acquiring skills to both critically review the literature (70% early-career, 43% mid-career, 0% later-career; p = 0.006) and write manuscripts (86% early-career, 57% mid-career, 50% later-career; p = 0.02); there was generally similar interest across career stages to acquire skills to conduct literature searches and write grants. Conclusion: The generally similar responses from physician hospitalists across career stages highlight system-level opportunities to increase research mentorship, promote the acquisition of research skills, and reduce barriers for participation in research.
MeSH term(s)	Academic Success ; Adult ; Age Factors ; Aged ; Female ; Hospitalists/psychology ; Humans ; Male ; Mentors/psychology ; Middle Aged ; Research/organization & administration ; Research Support as Topic/organization & administration ; Socioeconomic Factors ; Time Factors
Language	English
Publishing date	2020-06-30
Publishing country	England
Document type	Journal Article
ZDB-ID	2570453-9
ISSN	2377-1003 ; 2154-8331 ; 8750-2836
ISSN (online)	2377-1003
ISSN	2154-8331 ; 8750-2836
DOI	10.1080/21548331.2020.1779537
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Article ; Online: Management of symptoms in polycythemia vera and essential thrombocythemia patients.

Radia, Deepti / Geyer, Holly L

Hematology. American Society of Hematology. Education Program

2015 Volume 2015, Page(s) 340–348

Abstract: The BCR-ABL-negative myeloproliferative neoplasms (MPNs) are clonal stem cell derived malignancies, which include polycythemia vera (PV), essential thrombocythemia (ET), and myelofibrosis (MF). The MPNs are characterized by dysregulated JAK-STAT ... ...

Abstract	The BCR-ABL-negative myeloproliferative neoplasms (MPNs) are clonal stem cell derived malignancies, which include polycythemia vera (PV), essential thrombocythemia (ET), and myelofibrosis (MF). The MPNs are characterized by dysregulated JAK-STAT signaling pathways. PV and ET are associated with an increased risk of thrombo-hemorrhagic complications, risk of progression to MF and leukemia. Presentation of patients with PV and ET is variable and usually as a result of abnormal full blood count indices (raised hemoglobin and hematocrit, leukocytosis, and thrombocytosis). Presentation with thrombosis or splenomegaly occurs in ~30% of patients. Historically thought of as indolent compared with MF, patients with PV and ET have significant disease symptom burden which does not directly correlate to the current clinical prognostic classifications. The mainstay of therapy is reserved for patients with high-risk disease and thus excludes a population of patients with significant symptom related morbidity impacting their quality-of-life and survival. Recent treatment strategies have aimed to incorporate disease burden assessment into the selection of therapeutic interventions such as JAK2 inhibitors and HDAC inhibitors. We will review the advances in the field of MPN symptom assessment and symptom burden experienced by ET and PV patients. We will also discuss the risk-stratified management of ET and PV patients alongside symptom assessment and the impact of potential novel therapies, for patients who fail to respond to conventional treatment.
MeSH term(s)	Blood Cell Count ; Clinical Trials as Topic ; Cytokines/metabolism ; Disease Progression ; Female ; Hemoglobins/analysis ; Humans ; Janus Kinase 2/metabolism ; Male ; Polycythemia Vera/therapy ; Prevalence ; Primary Myelofibrosis/therapy ; Prognosis ; Quality of Life ; Risk ; Signal Transduction ; Thrombocythemia, Essential/therapy ; Thrombosis/pathology ; Treatment Outcome
Chemical Substances	Cytokines ; Hemoglobins ; JAK2 protein, human (EC 2.7.10.2) ; Janus Kinase 2 (EC 2.7.10.2)
Language	English
Publishing date	2015
Publishing country	United States
Document type	Journal Article ; Review
ISSN	1520-4383
ISSN (online)	1520-4383
DOI	10.1182/asheducation-2015.1.340
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Article ; Online: Two masks can be worse than one: N95 respirator failure caused by an overlying face mask.

Mueller, Jeffrey T / Geyer, Holly D / Karimi, Soroor / Poterack, Karl A / Seville, Maria Teresa A / Buckner Petty, Skye / Tipton, Steven M

Infection control and hospital epidemiology

2022 Volume 44, Issue 9, Page(s) 1529–1531

Abstract: We have demonstrated the effect of covering an N95 filtering facepiece respirator (FFR) with an overlying face mask. In total, 100 participants successfully completed quantitative fit testing wearing a 3M 1870+ FFR. Among them, 13 (13%; 95% CI, 7%-22%) ... ...

Abstract	We have demonstrated the effect of covering an N95 filtering facepiece respirator (FFR) with an overlying face mask. In total, 100 participants successfully completed quantitative fit testing wearing a 3M 1870+ FFR. Among them, 13 (13%; 95% CI, 7%-22%) failed subsequent fit testing when simultaneously wearing a Halyard 47117 procedural mask over the FFR.
MeSH term(s)	Humans ; N95 Respirators ; Masks ; Respiratory Protective Devices ; Occupational Exposure
Language	English
Publishing date	2022-12-20
Publishing country	United States
Document type	Journal Article
ZDB-ID	639378-0
ISSN	1559-6834 ; 0195-9417 ; 0899-823X
ISSN (online)	1559-6834
ISSN	0195-9417 ; 0899-823X
DOI	10.1017/ice.2022.277
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Article ; Online: Work Absence Following COVID-19 Vaccination in a Cohort of Healthcare Personnel.

Breeher, Laura E / Wolf, Michael E / Geyer, Holly / Brinker, Todd / Tommaso, Christopher / Kohlnhofer, Stacy / Hainy, Caitlin / Swift, Melanie

Journal of occupational and environmental medicine

2022 Volume 64, Issue 1, Page(s) 6–9

Abstract: Objective: To identify rates of work absence following receipt of COVID-19 vaccine in a cohort of healthcare personnel (HCP).: Methods: Short-term disability (STD) usage by HCP attributed to side effects of the COVID-19 vaccine was calculated for ... ...

Abstract	Objective: To identify rates of work absence following receipt of COVID-19 vaccine in a cohort of healthcare personnel (HCP). Methods: Short-term disability (STD) usage by HCP attributed to side effects of the COVID-19 vaccine was calculated for each vaccine manufacturer, job category, age group, and work region. Analysis was performed for the cohort of HCP during the initial vaccination campaign. Results: 4.1% of COVID-19 vaccinations generated a STD claim for lost work due to side effects, with increased STD rates after dose 2 than dose 1 (7.4% and 0.9%, respectively). Rates were higher for younger HCP and allied health staff. Conclusions: While side effects from mRNA vaccine dose 2 resulted in more work absence, statistically significant geographic differences in STD suggest cultural and staffing factors may impact HCP to utilize STD following vaccination.
MeSH term(s)	COVID-19 ; COVID-19 Vaccines ; Delivery of Health Care ; Health Personnel ; Humans ; SARS-CoV-2 ; Vaccination ; Vaccines, Synthetic ; mRNA Vaccines
Chemical Substances	COVID-19 Vaccines ; Vaccines, Synthetic ; mRNA Vaccines
Language	English
Publishing date	2022-01-04
Publishing country	United States
Document type	Journal Article
ZDB-ID	1223932-x
ISSN	1536-5948 ; 1076-2752
ISSN (online)	1536-5948
ISSN	1076-2752
DOI	10.1097/JOM.0000000000002376
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Article ; Online: Emerging drugs for the treatment of myelofibrosis.

Geyer, Holly L / Mesa, Ruben A

Expert opinion on emerging drugs

2015 Volume 20, Issue 4, Page(s) 663–678

Abstract: Introduction: Myelofibrosis (MF) is a myeloproliferative neoplasm associated with significant disease burden composed of splenomegaly, constitutional symptoms and a reduced life expectancy. The advent of targeted treatments has provided new means by ... ...

Abstract	Introduction: Myelofibrosis (MF) is a myeloproliferative neoplasm associated with significant disease burden composed of splenomegaly, constitutional symptoms and a reduced life expectancy. The advent of targeted treatments has provided new means by which to improve MF associated splenomegaly, symptoms, health-related quality of life and even mortality. Areas covered: We discuss the spectrum of targeted treatments currently under investigation for MF. We furthermore compare their effects on improving anemia, reducing fibrosis and splenomegaly and enhancing symptom control. Expert opinion: MF is a complex disorder, partly attributable to its heterogeneity. Although the severity of patient symptoms correlates with risk category, high symptom burden may also be observed in low-risk patients. Serial use of PRO tools allows clinicians to objectively evaluate the MF symptom burden, compare efficacy of therapies and adjust medications to improve symptom control. Novel targeted agents have proven superior to historic treatment regimens for symptom management. Promising treatment categories include JAK2 inhibitors, histone deacetylase inhibitors, hypomethylating agents, heat shock protein-90 inhibitors, hedgehog inhibitors, PI3-AKT-mTOR inhibitors, antifibrosing agents and telomerase inhibitors. The majority of therapies remain under investigation, either alone or in combination with other treatments. It is anticipated that these agents will be increasingly integrated into standard treatment algorithms for MF symptom management.
MeSH term(s)	Algorithms ; Animals ; Drug Design ; Humans ; Life Expectancy ; Molecular Targeted Therapy ; Primary Myelofibrosis/drug therapy ; Primary Myelofibrosis/physiopathology ; Quality of Life ; Severity of Illness Index ; Splenomegaly/etiology
Language	English
Publishing date	2015
Publishing country	England
Document type	Journal Article ; Review
ZDB-ID	2061369-6
ISSN	1744-7623 ; 1472-8214
ISSN (online)	1744-7623
ISSN	1472-8214
DOI	10.1517/14728214.2015.1061502
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Article: Psychologic wellness of PA, NP, and physician hospitalists during the COVID-19 pandemic.

Dugani, Sagar B / Fischer, Karen M / Geyer, Holly L / Maniaci, Michael J / Croghan, Ivana T / Burton, M Caroline

JAAPA : official journal of the American Academy of Physician Assistants

2022 Volume 35, Issue 5, Page(s) 45–53

Abstract: Objectives: Hospitalists, comprising PAs, NPs, and physicians, manage patients hospitalized with COVID-19. To guide the development of support programs, this study compared the psychologic wellness of hospitalist PAs, NPs, and physicians during the ... ...

Abstract	Objectives: Hospitalists, comprising PAs, NPs, and physicians, manage patients hospitalized with COVID-19. To guide the development of support programs, this study compared the psychologic wellness of hospitalist PAs, NPs, and physicians during the COVID-19 pandemic. Methods: We surveyed hospitalists in 16 hospitals at Mayo Clinic, from May 4 to 25, 2020. We used PROMIS surveys for self-reported global well-being (two single-item measures), anxiety, social isolation, and emotional support, before and during the pandemic. Linear and logistic regression models were adjusted for personal and professional factors. Results: The response rate was 52.2% (N = 154/295). In adjusted linear regression models, the change in scores (before minus during pandemic) for anxiety, social isolation, and emotional support was similar for PAs and NPs compared with physicians. In adjusted logistic regression models, physicians, compared with PAs and NPs, had a higher odds of top global well-being for mental health (adjusted odds ratio [95% confidence interval]: 2.82 [1.12, 7.13]; P = .03) and top global well-being for social activities and relationships (adjusted odds ratio 4.08 [1.38, 12.08]; P = .01). Conclusions: During the COVID-19 pandemic, global well-being was lower for PAs and NPs compared with physician hospitalists. These results can guide support programs for hospitalists.
MeSH term(s)	COVID-19/epidemiology ; Hospitalists/psychology ; Hospitalization ; Humans ; Mental Health ; Pandemics
Language	English
Publishing date	2022-04-13
Publishing country	United States
Document type	Journal Article
ZDB-ID	2415226-2
ISSN	0893-7400 ; 1547-1896
ISSN (online)	0893-7400
ISSN	1547-1896
DOI	10.1097/01.JAA.0000824964.37126.d8
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