Optimization of methylation capture sequencing workflow in formalin fixed tissue from oral squamous cell carcinoma patients

Oral Oncology · 2025-07-01 · 1 citations

Total laryngectomy

Operative Techniques in Otolaryngology-Head and Neck Surgery · 2024-04-17

Health screenings with a medical interpreter in a required Ambulatory Care Introductory Pharmacy Practice Experience

Currents in Pharmacy Teaching and Learning · 2024-05-11 · 2 citations

Fourth-year Student Pharmacists’ Perceptions of a Required Student-run Free Clinic Experience

American Journal of Pharmaceutical Education · 2024-11-12

OBJECTIVE: The University of Michigan Student-Run Free Clinic (UMSRFC) provides quality preventive, acute, and chronic care free of charge to uninsured and underinsured community members. We sought to assess fourth-year student pharmacists' (P4) attitudes toward providing care as part of a required experience at the UMSRFC during their Ambulatory Care Advanced Pharmacy Practice Experience. METHODS: All P4s in the 2023-2024 academic year completed an 8-hour experience at the UMSRFC. Preclinic and postclinic surveys were electronically administered, and items related to social determinants of health, patient-centered care, interprofessional teams, and interest in future opportunities were included. Data were analyzed using descriptive statistics and paired t tests. RESULTS: A total of 78 of 83 students (94.0%) participated in the research study. After the experience, students reported higher comfort with providing efficient, cost-effective pharmacy services, assessing patients' health care status and needs, and advocating for and assisting patients in obtaining the resources and care they need. Students also reported a higher level of comfort collaborating as part of an interprofessional team after the experience. Most students (92.3%) recommended that the experience continue for future P4s. CONCLUSION: A clinical experience at a student-run free clinic can allow P4s to practice multiple skills that align with the Curricular Outcomes and Entrustable Professional Activities. After this experience, P4s felt more comfortable working with underserved populations and collaborating on interprofessional teams and reported being more likely to volunteer at a free medical clinic. We encourage pharmacy programs affiliated with a student-run free clinic to consider implementing a required clinical experience for P4 students.

Patient Satisfaction with Nonopioid Postoperative Analgesia in Head and Neck Surgery: A Prospective Randomized Trial

Otolaryngology · 2024-06-29 · 1 citations

OBJECTIVE: To evaluate patients' satisfaction with opioid versus opioid-sparing postoperative analgesia in patients undergoing outpatient head and neck surgery. STUDY DESIGN: Prospective randomized trial. SETTING: Tertiary care academic hospital. METHODS: Adult patients undergoing outpatient head and neck surgery were randomly assigned to 1 of 3 analgesic regimens. First- and second-line medications were the following by group (1) Hydrocodone-acetaminophen with ibuprofen, (2) ibuprofen with hydrocodone-acetaminophen, and (3) ibuprofen with acetaminophen. Preoperative counseling was provided to patients regarding expected pain and proper medication use. Postoperative questionnaires were administered to assess satisfaction. RESULTS: One hundred three patients were enrolled in the study (mean age, 56.5 years; women, 75 [73%]). The mean satisfaction score with the pain regimen assigned was similar between the 3 groups (scale 0-10, [7.7, 8.3, 8.5, P = .46]). A similar percentage of patients in each group reported that surgery was more painful than anticipated (25%, 32%, 26%, P = .978), and a similar percentage of patients reported willingness to utilize the same analgesic regimen following future surgeries (75%, 83%, 76%, P = .682). Additional questions evaluating the side effect profile, maximum and minimum pain scores, and difficulty of recovery were not statistically different between the 3 groups. CONCLUSION: In the postoperative population for outpatient head and neck surgeries, there was no significant difference in patient satisfaction and pain control between the opioid and nonopioid arms. Providers should discuss opioid-sparing regimens preoperatively with patients and describe them as effective in providing adequate pain control without a significant impact on patient's perception of care.

Unsuspected Malignant Mimicry From Topical Vitamin E and Micro Spike Roller

Head & Neck · 2024-11-22 · 1 citations

BACKGROUND: Topical vitamin E is commonly used for its antioxidant properties in a rapidly expanding anti-aging market. Cutaneous reaction to vitamin E is rare and can present a difficult diagnosis. METHODS: We report a unique case of a 46-year-old female who developed a severe cutaneous inflammatory chin lesion after topical use of vitamin E oil with a micro-spike roller. Clinical examination found a friable and fungating mass which prompted biopsy due to suspected malignancy. Pathology ruled out malignancy and revealed chronic inflammation with xanthogranulomatous-like features. RESULTS: The lesion was significantly improved with Kenalog injection treatment over 18 months. A scar excision procedure further enhanced the lesion cosmetically. CONCLUSIONS: This case highlights the rarity and clinical diversity of vitamin E skin reactions, and their potential to mimic malignancies.

Artificial intelligence-based epigenomic, transcriptomic and histologic signatures of tobacco use in oral squamous cell carcinoma

npj Precision Oncology · 2024-06-08 · 12 citations

Oral squamous cell carcinoma (OSCC) biomarker studies rarely employ multi-omic biomarker strategies and pertinent clinicopathologic characteristics to predict mortality. In this study we determine for the first time a combined epigenetic, gene expression, and histology signature that differentiates between patients with different tobacco use history (heavy tobacco use with ≥10 pack years vs. no tobacco use). Using The Cancer Genome Atlas (TCGA) cohort (n = 257) and an internal cohort (n = 40), we identify 3 epigenetic markers (GPR15, GNG12, GDNF) and 13 expression markers (IGHA2, SCG5, RPL3L, NTRK1, CD96, BMP6, TFPI2, EFEMP2, RYR3, DMTN, GPD2, BAALC, and FMO3), which are dysregulated in OSCC patients who were never smokers vs. those who have a ≥ 10 pack year history. While mortality risk prediction based on smoking status and clinicopathologic covariates alone is inaccurate (c-statistic = 0.57), the combined epigenetic/expression and histologic signature has a c-statistic = 0.9409 in predicting 5-year mortality in OSCC patients.

Spiritual practices and beliefs as a social determinant of health: When will the profession of pharmacy address the whole body-mind-spirit triad?

American Journal of Health-System Pharmacy · 2023-04-15 · 1 citations

In the foreword to Cultural and Religious Sensitivity: A Pocket Guide for Health Care Professionals, Michael S. Woods, MD, writes “It’s undeniable that understanding a patient’s cultural practices and spiritual beliefs influences not only the delivery of health care in our global society, but also the individual’s outcome and satisfaction. . . . If a patient, because of a cultural or spiritual ‘disconnect,’ can’t appreciate what is being prescribed or why it’s necessary, or if the information is delivered in a way that inadvertently frightens, offends, or confuses the patient, how can we fulfill our mission as health care providers?”1 The value of spiritual care in wellness has been studied for decades.2 Most studies evaluating the effects of religious activities on healthcare outcomes have found that patients experience better mental health, adapt more successfully to stress, and are physically healthier, which decreases the number of health services utilized.3 The World Health Organization defines social determinants of health (SDOH) as the nonmedical factors that influence health outcomes and include the conditions in which people are born, grow, work, live, and age and the wider set of forces and systems shaping the conditions of daily life.4 Recent research on SDOH has concentrated on socioeconomic status; spiritual practices and beliefs are additional nonmedical factors that can influence health outcomes. As patients age, they encounter more health challenges and may begin to confront their mortality.5 This confrontation with mortality seems to be associated with a focus on religiosity (the extent to which an individual believes, follows, and practices a religion), which may be an extension of spirituality (the personal quest for answers to ultimate questions about life, about meaning, and about the relationship to the sacred or transcendent).6 One study revealed that the individual factors that people identified as providing meaning to their life changed with age. While younger persons mentioned “friends,” “partnership,” or “work” as decisive factors, “spirituality/religion” and “nature experiences/animals” were most important to patients aged 70 or older.7 When respondents in the US were asked whether they consider themselves to be a religious person on the World Values Survey (2010-2014), significantly more people 60 years of age and older (77.6%) gave affirmative responses compared to people under 60 years of age (64.7%).8

Joint address from the President and the Chief Executive Officer: Be Bold, Be More: Leading Through Innovation, Collaboration, and Advocacy

American Journal of Health-System Pharmacy · 2023-09-04

Journal Article Corrected proof Joint address from the President and the Chief Executive Officer: Be Bold, Be More: Leading Through Innovation, Collaboration, and Advocacy Get access Paul C Walker, PharmD, FASHP, Paul C Walker, PharmD, FASHP University of Michigan College of Pharmacy, Ann Arbor, MI, USA Search for other works by this author on: Oxford Academic Google Scholar Paul W Abramowitz, PharmD, ScD (Hon), FASHP Paul W Abramowitz, PharmD, ScD (Hon), FASHP ASHP, Bethesda, MD, USA Address correspondence to Dr. Abramowitz (ceo@ashp.org). Search for other works by this author on: Oxford Academic Google Scholar American Journal of Health-System Pharmacy, zxad173, https://doi.org/10.1093/ajhp/zxad173 Published: 04 September 2023 Article history Corrected and typeset: 04 September 2023 Published: 04 September 2023

Neurotrophin Pathway Receptors NGFR and TrkA Control Perineural Invasion, Metastasis, and Pain in Oral Cancer

Advanced Biology · 2022-08-04 · 23 citations

Oral squamous cell carcinoma (OSCC) patients suffer from poor survival due to metastasis or locoregional recurrence, processes that are both facilitated by perineural invasion (PNI). OSCC has higher rates of PNI than other cancer subtypes, with PNI present in 80% of tumors. Despite the impact of PNI on oral cancer prognosis and pain, little is known about the genes that drive PNI, which in turn drive pain, invasion, and metastasis. In this study, clinical data, preclinical, and in vitro models are leveraged to elucidate the role of neurotrophins in OSCC metastasis, PNI, and pain. The expression data in OSCC patients with metastasis, PNI, or pain demonstrate dysregulation of neurotrophin genes. TrkA and nerve growth factor receptor (NGFR) are focused, two receptors that are activated by NGF, a neurotrophin expressed at high levels in OSCC. It is demonstrated that targeted knockdown of these two receptors inhibits proliferation and invasion in an in vitro and preclinical model of OSCC, and metastasis, PNI, and pain. It is further determined that TrkA knockdown alone inhibits thermal hyperalgesia, whereas NGFR knockdown alone inhibits mechanical allodynia. Collectively the results highlight the ability of OSCC to co-opt different components of the neurotrophin pathway in metastasis, PNI, and pain.