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Article ; Online: Immediate possible adverse event rates in infants treated with oral propranolol for infantile haemangiomas at an Australian urban tertiary hospital between 2016 and 2019.

Adams, Lucinda / Ryan, Emma

2022 Volume 63, Issue 4, Page(s) 473–478

Abstract: Background/objectives: Infantile haemangiomas (IH) are common benign tumours of childhood. The current guideline recommended treatment is oral propranolol, the use of which for IH is relatively recent and there are no safety audits in Australian ... ...

Abstract	Background/objectives: Infantile haemangiomas (IH) are common benign tumours of childhood. The current guideline recommended treatment is oral propranolol, the use of which for IH is relatively recent and there are no safety audits in Australian children published. As a result, it is a primarily inpatient initiated treatment. The aim of this study was to examine the short-term complication rates in infants treated with oral propranolol for IH. Methods: Retrospective case note review of IH patients initiated on oral propranolol admitted to the day-unit of tertiary metropolitan hospital in an Australia capital city, from January 2016 to December 2019. Results: Overall, 72 children were included in the study. Mean age at time of admission was 3.8 ± 2 months. Eight patients (11.1%) experienced complications during their initiation admission. Pulmonary complications (oxygen desaturation, wheeze, increased respiratory rate) was the most common type. No children required high-dependency or intensive care unit admission. The children who experienced complications had a mean age of 2.4 ± 1.2 months; t-test of equality of means found a relationship between propranolol-associated complication rate and age (p = 0.007). All other patient or admission characteristics were not associated with complication events (all p > 0.05). Conclusions: Propranolol is a safe, effective and well-tolerated treatment in Australian children with IH. This study demonstrates younger infants will most likely benefit from inpatient initiation. More research needs to be done to characterise the risk profile of propranolol initiation for IH.
MeSH term(s)	Infant ; Humans ; Propranolol/adverse effects ; Hemangioma/drug therapy ; Retrospective Studies ; Tertiary Care Centers ; Adrenergic beta-Antagonists ; Skin Neoplasms/drug therapy ; Australia ; Hemangioma, Capillary/complications ; Hospitals, Urban ; Treatment Outcome ; Administration, Oral
Chemical Substances	Propranolol (9Y8NXQ24VQ) ; Adrenergic beta-Antagonists
Language	English
Publishing date	2022-08-08
Publishing country	Australia
Document type	Journal Article
ZDB-ID	138052-7
ISSN	1440-0960 ; 0004-8380
ISSN (online)	1440-0960
ISSN	0004-8380
DOI	10.1111/ajd.13906
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Article ; Online: Transumbilical Silicone Breast Augmentation: A Practical Review of an Innovative Technique.

Ryan, Emma / Haiavy, Jacob / Patino, Gabriel

Annals of plastic surgery

2023 Volume 90, Issue 5, Page(s) 494–500

Abstract: Abstract: Transumbilical silicone breast augmentation (TUSBA) is a fairly new and rapidly growing technique of endoscopically assisted placement of silicone breast implants. In comparison, the well-known transumbilical breast augmentation (TUBA) with ... ...

Abstract	Abstract: Transumbilical silicone breast augmentation (TUSBA) is a fairly new and rapidly growing technique of endoscopically assisted placement of silicone breast implants. In comparison, the well-known transumbilical breast augmentation (TUBA) with saline has been described in the literature since 1993 (Planas J. Introduction of breast implants through the abdominal route. Plast Reconstr Surg. 1976;57:431-437). The TUBA procedure has proven to be safe, efficient, and cosmetically sound over the last 29 years (Shiffman MA, Caleel RT, Shumway R, et al. Survey of transumbilical breast augmentation (TUBA). Am J Cosmet Surg. 2011;28:5-11). Augmentation with silicone through the umbilicus is becoming more popular due to several factors: first, because the acceptance of TUBA with saline has been good with positive outcomes and, second, because patients prefer the discrete location and small size of the umbilical scar left behind. Endoscopic guidance is a critical tool for learning and visualization and for reducing complications such as hematoma or misplacement of the implant.Breast augmentation continues to grow in popularity and acceptance, alongside cosmetic procedures in general. This author expects that, as the TUSBA technique becomes more widespread in use, surgeons will benefit from having a practical clinical publication from which to modify their own technique. This publication will present the authors' TUSBA technique and chart review of practice data from May 2021 through November 2022, wherein the TUSBA procedure was performed.Forty women aged 21 to 61 years (mean, 35.13 years) underwent endoscopically assisted TUSBA. All patients had the implants placed in the submuscular pocket. Patient surveys and postoperative visit data were used in the generation of follow-up information. Upon inspection of the chart data at 3, 6, 9, and 12 months, there were no reports of capsular contracture. Transumbilical silicone breast augmentation is a safe and efficient method for silicone implant placement in select patients.
MeSH term(s)	Female ; Humans ; Mammaplasty/methods ; Breast Implants/adverse effects ; Silicone Gels ; Endoscopy ; Saline Solution ; Breast Implantation/methods
Chemical Substances	Silicone Gels ; Saline Solution
Language	English
Publishing date	2023-03-08
Publishing country	United States
Document type	Journal Article
ZDB-ID	423835-7
ISSN	1536-3708 ; 0148-7043
ISSN (online)	1536-3708
ISSN	0148-7043
DOI	10.1097/SAP.0000000000003511
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Article ; Online: Reply by Authors.

Ní Néill, Emma / Richards, Helen L / Hennessey, Derek / Ryan, Emma M / Fortune, Dónal G

The Journal of urology

2023 Volume 209, Issue 1, Page(s) 70

Language	English
Publishing date	2023-01-01
Publishing country	United States
Document type	Journal Article ; Comment
ZDB-ID	3176-8
ISSN	1527-3792 ; 0022-5347
ISSN (online)	1527-3792
ISSN	0022-5347
DOI	10.1097/JU.0000000000003032.02
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Article ; Online: Medical, nursing, and physician assistant student knowledge and attitudes toward climate change, pollution, and resource conservation in health care.

Ryan, Emma C / Dubrow, Robert / Sherman, Jodi D

BMC medical education

2020 Volume 20, Issue 1, Page(s) 200

Abstract: Background: Climate change and pollution generated by the health care sector impose significant public health burdens. This study aimed to assess medical, nursing and physician assistant student knowledge and attitudes regarding climate change, ... ...

Abstract	Background: Climate change and pollution generated by the health care sector impose significant public health burdens. This study aimed to assess medical, nursing and physician assistant student knowledge and attitudes regarding climate change, pollution from the health care sector, and responsibility for resource conservation within professional practice. Methods: In February-March, 2018, medical, nursing, and physician assistant students at Yale University (1011 potential respondents) were sent a 17-question online Qualtrics survey. Data analysis included descriptive statistics, as well as Fisher's exact test and logistic regression to assess associations between variables of interest and the personal characteristics of gender, age, geographic place of origin, school, and year in school (among medical students). Results: The response rate was 28% (280 respondents). 90% felt that physicians, nurses, and physician assistants have a responsibility to conserve resources and prevent pollution within their professional practice. 63% agreed or strongly agreed that the relationship between pollution, climate change, and health should be covered in the classroom and should be reinforced in the clinical setting. 57% preferred or strongly preferred reusable devices. 91% felt lack of time and production pressure, and 85% believed that lack of education on disease burden stemming from health care pollution, were barriers to taking responsibility for resource conservation and pollution prevention. Women and physician assistant students exhibited a greater commitment than men and medical students, respectively, to address pollution, climate change, and resource conservation in patient care and professional practice. Conclusion: We found that health professional students are engaged with the concept of environmental stewardship in clinical practice and would like to see pollution, climate change, and health covered in their curriculum. In order for this education to be most impactful, more research and industry transparency regarding the environmental footprint of health care materials and specific clinician resource consumption patterns will be required.
MeSH term(s)	Adult ; Attitude ; Climate Change ; Conservation of Natural Resources ; Cross-Sectional Studies ; Delivery of Health Care ; Environmental Pollution ; Female ; Humans ; Knowledge ; Male ; Middle Aged ; Physician Assistants/psychology ; Students, Medical/psychology ; Students, Nursing/psychology ; Surveys and Questionnaires ; Young Adult
Language	English
Publishing date	2020-06-23
Publishing country	England
Document type	Journal Article
ZDB-ID	2044473-4
ISSN	1472-6920 ; 1472-6920
ISSN (online)	1472-6920
ISSN	1472-6920
DOI	10.1186/s12909-020-02099-0
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Article ; Online: Cost-Effectiveness of Venous Thromboembolism Prophylaxis During Neoadjuvant Chemotherapy for Ovarian Cancer.

Ryan, Emma S / Havrilesky, Laura J / Salinaro, Julia R / Davidson, Brittany A

JCO oncology practice

2021 Volume 17, Issue 8, Page(s) e1075–e1084

Abstract: Purpose: Two recent clinical trials have demonstrated that direct oral anticoagulants (DOACs) are effective as venous thromboembolism (VTE) prophylaxis in patients with moderate-to-high risk ambulatory cancer initiating chemotherapy. Patients with ... ...

Abstract	Purpose: Two recent clinical trials have demonstrated that direct oral anticoagulants (DOACs) are effective as venous thromboembolism (VTE) prophylaxis in patients with moderate-to-high risk ambulatory cancer initiating chemotherapy. Patients with advanced ovarian cancer receiving neoadjuvant chemotherapy are at particularly increased risk of VTE. We performed a cost-effectiveness analysis from a health system perspective to determine if DOACs are a feasible prophylactic strategy in this population. Methods: A simple decision tree was created from a health system perspective, comparing two strategies: prophylactic DOAC taken for 18 weeks during chemotherapy versus no VTE prophylaxis. Rates of VTE (7.3% DOAC Results: In the base case model, DOAC prophylaxis is more costly and more effective than no therapy (incremental cost-effectiveness ratio = $256,218 in US dollars/quality-adjusted life year). In one-way sensitivity analyses, reducing the DOAC cost by 32% or raising the baseline VTE rate above 18% renders this strategy potentially cost-effective with an incremental cost-effectiveness ratio below $150,000 in US dollars/quality-adjusted life year. Conclusion: Further confirmation of the true baseline VTE rate among women initiating neoadjuvant chemotherapy for ovarian cancer will determine whether prophylactic dose DOAC is a value-based strategy. Less costly VTE prophylaxis options such as generic DOACs (once available) and aspirin also warrant investigation.
MeSH term(s)	Aged ; Anticoagulants/adverse effects ; Cost-Benefit Analysis ; Female ; Humans ; Medicare ; Neoadjuvant Therapy/adverse effects ; Ovarian Neoplasms/drug therapy ; United States ; Venous Thromboembolism/drug therapy ; Venous Thromboembolism/prevention & control
Chemical Substances	Anticoagulants
Language	English
Publishing date	2021-04-29
Publishing country	United States
Document type	Journal Article
ZDB-ID	3028198-2
ISSN	2688-1535 ; 2688-1527
ISSN (online)	2688-1535
ISSN	2688-1527
DOI	10.1200/OP.20.00783
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Article ; Online: Intrapartum and Postpartum Management of Intra-amniotic Infection.

Ryan, Emma S / Varvoutis, Megan / Kuller, Jeffrey A / Dotters-Katz, Sarah

Obstetrical & gynecological survey

2021 Volume 76, Issue 2, Page(s) 114–121

Abstract: Importance: Intra-amniotic infection (IAI) is a common condition with potentially devastating maternal and neonatal complications. However, there are incomplete data regarding the most effective antimicrobial treatment regimen for this condition.: ... ...

Abstract	Importance: Intra-amniotic infection (IAI) is a common condition with potentially devastating maternal and neonatal complications. However, there are incomplete data regarding the most effective antimicrobial treatment regimen for this condition. Objective: This article aims to review the current evidence and recommendations for intrapartum and postpartum management of IAI. Evidence acquisition: Original research articles, review articles, and guidelines on IAI were reviewed. Results: Numerous known risk factors for IAI exist, some of which are modifiable. Serious neonatal complications can result from exposure to IAI including increased risk of preterm birth and neonatal death. Possible maternal complications include increased risk of cesarean delivery, postpartum hemorrhage, and postpartum endometritis. Antibiotics are the mainstay of treatment for IAI for both mothers and neonates, although there is no consensus on which antimicrobial agents are best and the appropriate duration of therapy. Conclusions and relevance: Monitoring patients for signs of IAI, proper treatment, and communication of the diagnosis with the pediatric team are essential for preventing maternal and neonatal complications of IAI. More research is needed to determine the proper treatment regimens for both mothers diagnosed with IAI and their neonates.
MeSH term(s)	Anti-Bacterial Agents/standards ; Anti-Bacterial Agents/therapeutic use ; Chorioamnionitis/therapy ; Female ; Humans ; Infant, Newborn ; Perinatal Care/methods ; Perinatal Care/standards ; Practice Guidelines as Topic ; Pregnancy ; Pregnancy Complications, Infectious/therapy ; Premature Birth/microbiology ; Premature Birth/prevention & control ; Prenatal Care/methods ; Prenatal Care/standards
Chemical Substances	Anti-Bacterial Agents
Language	English
Publishing date	2021-02-24
Publishing country	United States
Document type	Journal Article ; Review
ZDB-ID	391345-4
ISSN	1533-9866 ; 0029-7828
ISSN (online)	1533-9866
ISSN	0029-7828
DOI	10.1097/OGX.0000000000000867
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Article ; Online: Psychological Distress in Patients With Urolithiasis: A Systematic Review and Meta-analysis.

Ní Néill, Emma / Richards, Helen L / Hennessey, Derek / Ryan, Emma M / Fortune, Dónal G

The Journal of urology

2022 Volume 209, Issue 1, Page(s) 58–70

Abstract: Purpose: Urolithiasis can be a painful condition associated with significant individual and health care burdens. Several studies have shown that anxiety and depression, termed psychological distress, may be associated with urolithiasis. However, there ... ...

Abstract	Purpose: Urolithiasis can be a painful condition associated with significant individual and health care burdens. Several studies have shown that anxiety and depression, termed psychological distress, may be associated with urolithiasis. However, there is little consensus on this relationship. We performed a systematic review and meta-analysis on the relationship between urolithiasis and psychological distress and examined rates of psychological distress in this population. Materials and methods: We searched online databases including MEDLINE (via PubMed), Embase (via Ovid), Web of Science, and the Cochrane Library with predefined search criteria up to March 2022 utilizing the Preferred Reporting Items for Systematic Review and Meta-analyses. Forty-nine peer-reviewed publications were included in this review. We performed a narrative synthesis on included studies, and a random-effects meta-analysis to obtain a single summary estimate for the relationship between urolithiasis and anxiety. Results: Narrative synthesis found evidence for a relationship between urolithiasis and psychological distress, both anxiety and depression. Meta-analysis of 7 studies found a moderate pooled association between urolithiasis and state anxiety. Additionally, higher proportions of urolithiasis patients experienced psychological distress compared to nonurolithiasis samples across studies. Our findings are limited by the observed heterogeneity in assessment protocols within the data set. Conclusions: Our findings suggest a moderate but significant association between anxiety and urolithiasis, as well as a greater than expected number of urolithiasis patients experiencing psychological distress. More high-quality research studies are required to better understand factors that may influence the relationship between urolithiasis and psychological distress.
MeSH term(s)	Humans ; Peer Review ; Psychological Distress
Language	English
Publishing date	2022-10-17
Publishing country	United States
Document type	Meta-Analysis ; Systematic Review ; Journal Article ; Review
ZDB-ID	3176-8
ISSN	1527-3792 ; 0022-5347
ISSN (online)	1527-3792
ISSN	0022-5347
DOI	10.1097/JU.0000000000003032
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Article ; Online: Anxiety following myocardial infarction: A systematic review of psychological interventions.

Ryan, Emma M / Creaven, Ann-Marie / Ní Néill, Emma / O'Súilleabháin, Páraic S

Health psychology : official journal of the Division of Health Psychology, American Psychological Association

2022 Volume 41, Issue 9, Page(s) 599–610

Abstract: Objective: Anxiety is highly prevalent following myocardial infarction (MI) and is linked with adverse effects on a person's recovery, quality of life, physical health, and life expectancy. The primary objective of this systematic review was to assess ... ...

Abstract	Objective: Anxiety is highly prevalent following myocardial infarction (MI) and is linked with adverse effects on a person's recovery, quality of life, physical health, and life expectancy. The primary objective of this systematic review was to assess the effectiveness of psychological interventions for anxiety following MI. Method: CINAHL, Medline, PsycINFO, PsycARTICLES, Cochrane Library, EMBASE, and Web of Science were systematically searched for studies that provided information on anxiety pre and post psychological intervention following MI. Results: Eighteen studies were included (15 randomized controlled trials [RCTs] and three non-RCTs). Within these studies, psychological interventions comprised cognitive behavioral therapy, eye movement desensitization reprocessing, counseling, psychotherapy, psychological/psychosocial cardiac rehabilitation, illness perception interventions, relaxation training, mindfulness, stress management, and other psychological-based programmes. Ten studies reported a significant decrease in anxiety following a psychological intervention, when compared with usual care. Three studies noted mixed results, and five studies reported no significant difference in anxiety following a psychological intervention. The interventions varied in length, setting, facilitation, and format. Poor reporting of information increased the risk of bias within studies. Conclusion: Psychological interventions may be beneficial to individuals who experience anxiety following a MI. No particular type of psychological intervention appears to be superior to others within the existing literature. Further rigorous research is needed to identify the needs of this population and the specific form of psychological intervention that is most effective in alleviating anxiety following MI. Clinical implications and recommendations for future research are provided. (PsycInfo Database Record (c) 2022 APA, all rights reserved).
MeSH term(s)	Anxiety/therapy ; Anxiety Disorders ; Humans ; Myocardial Infarction/therapy ; Psychosocial Intervention ; Psychotherapy/methods
Language	English
Publishing date	2022-08-25
Publishing country	United States
Document type	Journal Article ; Systematic Review
ZDB-ID	226369-5
ISSN	1930-7810 ; 0278-6133
ISSN (online)	1930-7810
ISSN	0278-6133
DOI	10.1037/hea0001216
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Article ; Online: Adults with unilateral lower-limb amputation: greater spatial extent of pain is associated with worse adjustment, greater activity restrictions, and less prosthesis satisfaction.

Sions, Jaclyn Megan / Beisheim-Ryan, Emma Haldane / Pohlig, Ryan Todd / Seth, Mayank

Scandinavian journal of pain

2022 Volume 22, Issue 3, Page(s) 578–586

Abstract: Objectives: This study's primary purpose was to determine if the extent of bodily pain, as evaluated with pain body diagrams, is associated with prosthetic-related activity restrictions, adjustment, and satisfaction among adults with a major unilateral ... ...

Abstract	Objectives: This study's primary purpose was to determine if the extent of bodily pain, as evaluated with pain body diagrams, is associated with prosthetic-related activity restrictions, adjustment, and satisfaction among adults with a major unilateral lower-limb amputation. A secondary objective was to evaluate between-days, test-retest reliability for pain body diagrams among adults with lower-limb amputation. Methods: Adults with a lower-limb amputation that occurred ≥1 year prior participated in an online, cross-sectional research study. Outcome measures included pain body diagrams and the Trinity Amputation and Prosthesis Experience Scales-Revised, which evaluates post-amputation activity restrictions, psychosocial adjustment, and prosthesis satisfaction. Linear regression modeling was used to evaluate associations between the number of painful body regions and prosthetic outcomes, after considering covariates (alpha ≤ 0.010). A subset of participants recompleted pain body diagrams to evaluate between-days, test-retest reliability. Results: Data from 74 participants (n = 32 female; n = 42 transtibial-level; n = 27 traumatic etiology) were available. Beyond covariates (i.e., age, sex, amputation level), the total number of painful body regions was significantly associated with all Trinity Amputation and Prosthesis Experience Scales-Revised subscales (p < 0.001-0.006), with the exception of Social Adjustment (p = 0.764). The total number of painful body regions explained 14.5, 11.8, 11.6, and 7.4% of the variance in Functional Satisfaction with the Prosthesis, Adjustment to Limitation, General Adjustment, and Activity Restriction, respectively. In a subset (n = 54), test-retest reliability for total number of painful body regions per body diagrams was good [intraclass correlation coefficient (ICC) Conclusions: A greater number of painful body regions is associated with greater activity restriction, worse adjustment, and lower prosthesis satisfaction, supporting the need to enhance post-amputation pain management and both amputated- and secondary-site pain prevention. Ethical committee number: IRB #1611862.
MeSH term(s)	Adult ; Amputation, Surgical ; Artificial Limbs/psychology ; Cross-Sectional Studies ; Female ; Humans ; Pain ; Personal Satisfaction ; Reproducibility of Results
Language	English
Publishing date	2022-02-01
Publishing country	Germany
Document type	Journal Article ; Research Support, N.I.H., Extramural ; Research Support, Non-U.S. Gov't
ZDB-ID	2515451-5
ISSN	1877-8879 ; 1877-8860
ISSN (online)	1877-8879
ISSN	1877-8860
DOI	10.1515/sjpain-2021-0132
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Article ; Online: An Alcohol Symptom Checklist identifies high rates of alcohol use disorder in primary care patients who screen positive for depression and high-risk drinking.

Ryan, Emma D / Chang, Yanni M / Oliver, Malia / Bradley, Katharine A / Hallgren, Kevin A

BMC health services research

2022 Volume 22, Issue 1, Page(s) 1123

Abstract: Background: Although alcohol use disorder can complicate depression management, there is no standard process for assessing AUD symptoms (i.e., AUD diagnostic criteria) in primary care for patients who screen positive for depression. This study ... ...

Abstract	Background: Although alcohol use disorder can complicate depression management, there is no standard process for assessing AUD symptoms (i.e., AUD diagnostic criteria) in primary care for patients who screen positive for depression. This study characterizes the association between depressive symptoms and high-risk drinking reported by primary care patients on screening measures in routine care. Then, using data from a novel clinical program, this study characterizes the association between depressive symptoms and AUD symptoms reported by primary care patients with high-risk drinking via an Alcohol Symptom Checklist. Methods: In this cross-sectional study, electronic health record data were obtained from patients who visited 33 Kaiser Permanente Washington primary care clinics between 03/2018 and 02/2020 and completed depression (PHQ-2) and alcohol consumption (AUDIT-C) screening measures as part of routine care (N = 369,943). Patients who reported high-risk drinking (AUDIT-C scores 7-12) also completed an Alcohol Symptom Checklist where they reported the presence or absence of 11 AUD criteria as defined by the DSM-5 (N = 8,184). Generalized linear models estimated and compared the prevalence of high-risk drinking (AUDIT-C scores 7-12) and probable AUD (2-11 AUD symptoms on Alcohol Symptom Checklists) for patients with and without positive depression screens. Results: Patients who screened positive for depression had a 131% higher prevalence of high-risk drinking than those who screened negative (5.2% vs. 2.2%; p < 0.001). Among patients with high-risk drinking, positive depression screens were associated with a significantly higher prevalence of probable AUD (69.8% vs. 48.0%; p < 0.001), with large differences in the prevalence of probable AUD observed with increasing PHQ-2 scores (e.g., probable AUD prevalence of 37.6%, 55.3% and 65.2%, for PHQ-2 scores of 0, 1, and 2, respectively). Although the overall prevalence of high-risk drinking was higher for male patients, similar patterns of association between depression screens, high-risk drinking, and AUD symptoms were observed for male and female patients. Conclusions: Patients with positive depression screens are more likely to have high-risk drinking. Large percentages of patients with positive depression screens and high-risk drinking report symptoms consistent with AUD to healthcare providers when given the opportunity to do so using an Alcohol Symptom Checklist.
MeSH term(s)	Alcohol Drinking/epidemiology ; Alcoholism/diagnosis ; Alcoholism/epidemiology ; Checklist ; Cross-Sectional Studies ; Depression/diagnosis ; Depression/epidemiology ; Female ; Humans ; Male ; Primary Health Care
Language	English
Publishing date	2022-09-05
Publishing country	England
Document type	Journal Article
ZDB-ID	2050434-2
ISSN	1472-6963 ; 1472-6963
ISSN (online)	1472-6963
ISSN	1472-6963
DOI	10.1186/s12913-022-08408-1
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