A5102021569- Musculoskeletal pain and rehabilitation
- Opioid Use Disorder Treatment
- Anesthesia and Pain Management
- Fibromyalgia and Chronic Fatigue Syndrome Research
- Pain Management and Opioid Use
- Cardiac, Anesthesia and Surgical Outcomes
- Pain Management and Placebo Effect
- Pain Mechanisms and Treatments
- Colorectal Cancer Screening and Detection
- Cutaneous Melanoma Detection and Management
- Cancer Genomics and Diagnostics
- Pain Management and Treatment
- Healthcare cost, quality, practices
- Cancer Diagnosis and Treatment
- Uterine Myomas and Treatments
- Molecular Biology Techniques and Applications
- Occupational Health and Performance
- Endometriosis Research and Treatment
- Genomic variations and chromosomal abnormalities
- Sepsis Diagnosis and Treatment
- Health Systems, Economic Evaluations, Quality of Life
- Nonmelanoma Skin Cancer Studies
- Genetic Associations and Epidemiology
- BRCA gene mutations in cancer
- Soft tissue tumor case studies
University of Michigan
2015-2022
Michigan United
2018-2019
Michigan Medicine
2015-2018
VA Center for Clinical Management Research
2016
Vanderbilt University Medical Center
2016
Quality and Reliability (Greece)
2016
October 6 University
2016
Mayo Clinic in Arizona
2015
University Health System
2015
Vanderbilt University
2015
<h3>Importance</h3> Despite increased focus on reducing opioid prescribing for long-term pain, little is known regarding the incidence and risk factors persistent use after surgery. <h3>Objective</h3> To determine of new minor major surgical procedures. <h3>Design, Setting, Participants</h3> Using a nationwide insurance claims data set from 2013 to 2014, we identified US adults aged 18 64 years without in year prior surgery (ie, no prescription fulfillments 12 months 1 month procedure). For...
Few studies have assessed postoperative trends in opioid cessation and predictors of persistent use after total knee arthroplasty (TKA) hip (THA). Preoperatively, 574 TKA THA patients completed validated, self-report measures pain, functioning, mood were longitudinally for 6 months surgery. Among who naive the day surgery, 8.2% 4.3% using opioids at months. In comparison, 53.3% 34.7% reported surgery continued to Patients taking >60 mg oral morphine equivalents preoperatively had an 80%...
Patterns of preoperative opioid use are not well characterized across different surgical services, and studies in this patient population have lacked important self-reported data pain affect.To assess the prevalence characteristics these patients a broadly representative cohort.Cross-sectional, observational study undergoing surgery at tertiary care academic medical center. Data were collected as part large prospective institutional research registries from March 1, 2010, through April 30,...
Objective: To explore the clinical and financial implications of preoperative opioid use in major abdominal surgery. Background: Opioids are increasingly used to manage chronic pain, users challenging care for perioperatively. Given epidemic opioid-related morbidity mortality, it is critical understand how impacts surgical outcomes. Methods: This was an analysis nonemergent, abdominopelvic surgeries from 2008 2014 a single center within Michigan Surgical Quality Collaborative registry...
We developed the Michigan Body Map (MBM) as a self-report measure to assess body areas where chronic pain is experienced and specifically quantify degree of widespread when assessing for centralized features (eg, fibromyalgia-like presentation). A total 402 patients completed in 5 distinct studies support validation original revised version MBM. Administration rapid 39 44 seconds, errors MBM were detected only 7.2% possible areas. Most underestimated number painful or represented confusion...
The current study was designed to test the hypothesis that fibromyalgia survey criteria would be directly associated with increased opioid consumption after hysterectomy even when accounting for other factors previously described as being predictive acute postoperative pain.Two hundred eight adult patients undergoing between October 2011 and December 2013 were phenotyped preoperatively use of validated self-reported questionnaires including criteria, measures pain severity descriptors,...
Objective: The aim of this study was to determine preoperative patient characteristics associated with postoperative outpatient opioid use and assess the frequency overprescribing. Summary Background Data: Although inpatient have been described, data regarding factors after discharge are lacking. This hampers development individualized approaches prescribing. Methods: We included opioid-naïve patients undergoing hysterectomy, thoracic surgery, total knee hip arthroplasty in a single-center...
<h3>Background</h3> Depression and anxiety are common comorbidities in chronic pain including osteoarthritis patients undergoing total joint arthroplasty (TJA). What is not clear whether psychiatric comorbidity precedes the manifestation of painful states or represents a reaction to living with associated functional impairment. The objective this research was explore decreases depressive symptoms after lower-extremity TJA could be due postsurgical reductions pain. <h3>Methods</h3> We...
Objective: Sepsis represents an acute life-threatening disorder resulting from a dysregulated host response. For patients who survive sepsis, there remains long-term consequences, including impaired inflammation, as result of profound immunosuppression. The mechanisms involved in this long-lasting deficient immune response are poorly defined. Approach and Results: was induced using the murine model cecal ligation puncture. Following full recovery period sepsis physiology, mice were subjected...
To examine whether the age based quality measure for screening colorectal cancer is associated with overuse of in patients aged 70-75 poor health and underuse those over 75 good health.Retrospective cohort study utilizing electronic data from Veterans Affairs (VA) Health Care System, largest integrated healthcare system United States.VA System.Veterans ≥ 50 due repeat average risk at a primary care visit fiscal year 2010.Completion colonoscopy, sigmoidoscopy, or fecal occult blood testing...
ObjectiveAs smoking impacts physiological pathways in the central nervous system, it is important to consider association between and fibromyalgia, a pain condition caused predominantly by system dysfunction. The objectives were assess prevalence of current among treatment-seeking chronic patients with (FM+) without (FM−) fibromyalgia-like phenotype; test individual combined influence fibromyalgia on severity interference; examine depression as mediator these processes.
The present study evaluated the relationship between 2011 American College of Rheumatology fibromyalgia (FM) survey criteria and quantitative sensory testing (QST).Patients with knee osteoarthritis scheduled to undergo arthroplasty completed FM self-report measures assessing clinical symptoms. Patients also underwent a battery QST procedures at surgical remote body sites, including pressure algometry, conditioned pain modulation, temporal summation. All assessments were before surgery. used...
Polygenic risk scores (PRS) are designed to serve as single summary measures that easy construct, condensing information from a large number of genetic variants associated with disease. They have been used for stratification and prediction disease risk. The primary focus this paper is demonstrate how we can combine PRS electronic health records data better understand the shared unique architecture etiology subtypes may be both related heterogeneous. construction strategies often depend on...
Many studies suggest a strong familial component to fibromyalgia (FM). However, those have nearly all been confined individuals with primary FM, i.e., FM without any other accompanying disorder. The current 2011 and 2016 criteria for diagnosing construct score using combination of the number painful body sites severity somatic symptoms (FM score). This study was undertaken estimate genetic heritability across sex age groups identify subgroups greater heritability, which may help in design...
Background The variable presentations and different phenotypes of sepsis suggest that risk comes from many genes each having a small effect. cumulative effect can be used to create individual profile. purpose this study was polygenic score determine the genetic variants associated with sepsis. Methods We sequenced ~14 million single nucleotide polymorphisms minimac imputation quality R2>0.3 minor allele frequency >10 −6 in patients Sepsis-2 or Sepsis-3. Genome-wide association...
<h3>Background and Objectives</h3> This study was designed to test whether a brief quantitative sensory testing assessment could be used detect hyperalgesia in patients with suspected opioid-induced (OIH). <h3>Methods</h3> Twenty on long-term opioid therapy OIH were recruited along 20 healthy controls. Pressure pain threshold, Pain50, measure of intermediate suprathreshold pressure sensitivity, tolerance levels evaluated. As secondary outcome, changes sensitivity after intravenous...
There is little empirical evidence supporting the long-term use of opioid therapy for chronic pain, suggesting need to reevaluate role opioids in pain management. Few studies have considered and cessation from perspective patient. This prospective structured interview study included 150 new patients seeking treatment at an outpatient tertiary care clinic. Of patients, 56% (N = 84) reported current use. Opioids users higher severity (t(137) -3.75, P < 0.001), worse physical functioning...
Metastatic mesothelioma to the oral cavity arises from pleura or peritoneum and distant hematogenous metastases are seen in more than half of cases but only a few reported cavity. A 75 year old male suffering metastatic presents an hyperplasia attached gingiva. Malignant is rare tumour arising pleura, pericardium peritoneum. This article highlights importance biopsy histopathological diagnosis lesions especially case malignant history.