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Babiarz J, Ryu H, Williams C, Ham Y, Rivera Sarti J, Levander XA. Slicing through silos: Development and evaluation of a hospital-based telehealth hepatitis C virus treatment program. Int J Drug Policy 2024; 127:104396. [PMID: 38593518 DOI: 10.1016/j.drugpo.2024.104396] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2023] [Revised: 03/12/2024] [Accepted: 03/14/2024] [Indexed: 04/11/2024]
Abstract
BACKGROUND There exist many barriers to hepatitis C virus (HCV) treatment for those with substance use disorder (SUD) or who lack access to routine medical care. A hospital-based telehealth program was developed to provide treatment opportunities for hospitalized patients living with HCV. METHODS This single site prospective cohort study conducted from July 2022 to March 2023 aimed to measure linkage to care with an HCV clinician and initiation of HCV treatment in hospitalized patients. Patients were assessed in-person by a social worker then seen via telehealth by a clinician who prescribed either glecaprevir/pibrentasvir or sofosbuvir/velpatasvir. Treatment was initiated with pharmacist assistance. The team conducted in-person and/or telephonic outreach during and after hospitalization. Cure was confirmed by sustained virologic response at 12 weeks (SVR12) post-treatment. RESULTS A total of 25 patients were enrolled and completed telehealth visits. All patients had a history of SUD and 18 (72 %) were unstably housed. Nineteen patients (76 %) initiated treatment, and 14 (56 %) successfully completed treatment. Twelve patients (48 %) completed post-treatment labs, including two who prematurely discontinued treatment. Eleven patients (44 %) achieved confirmed cure with SVR12. CONCLUSION A hospital-based, multidisciplinary telehealth program can be an innovative care model to successfully treat HCV in a difficult-to-treat patient populations.
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Affiliation(s)
- J Babiarz
- Department of Medicine, Division of Internal Medicine and Geriatrics, Oregon Health & Science University, 3181 SW Sam Jackson Park Rd., Portland, OR 97239 United States
| | - H Ryu
- Department of Pharmacy, Oregon Health & Science University, 3181 SW Sam Jackson Park Rd., Portland, OR 97239 United States
| | - C Williams
- Department of Care Management, Division of General Internal Medicine and Geriatrics, Oregon Health & Science University, 3181 SW Sam Jackson Park Rd., Portland, OR 97239 United States
| | - Y Ham
- Department of Pharmacy, Oregon Health & Science University, 3181 SW Sam Jackson Park Rd., Portland, OR 97239 United States
| | - J Rivera Sarti
- Department of Medicine, Division of Infectious Disease, Oregon Health & Science University, 3181 SW Sam Jackson Park Rd., Portland, OR 97239 United States
| | - X A Levander
- Department of Medicine, Division of General Internal Medicine and Geriatrics, Section of Addiction Medicine, Oregon Health & Science University, 3181 SW Sam Jackson Park Rd., Portland, OR 97239 United States
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Ham Y, Mehta H, Kang-Mieler J, Mieler WF, Chang A. Novel Drug Delivery Methods and Approaches for the Treatment of Retinal Diseases. Asia Pac J Ophthalmol (Phila) 2023; 12:402-413. [PMID: 37523432 DOI: 10.1097/apo.0000000000000623] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2023] [Accepted: 05/30/2023] [Indexed: 08/02/2023] Open
Abstract
This review discusses emerging approaches to ocular drug delivery for retinal diseases. Intravitreal injections have proven to be an effective, safe, and commonly used drug delivery method. However, the optimal management of chronic retinal diseases requires frequent intravitreal injections over extended periods of time. Although this can be achieved in a clinical trial environment, it is difficult to replicate in routine clinical practice. In addition, frequent treatment increases the risk of complications, incurs more costs, and increases the treatment burden for patients and caregivers. Given the aging global population and diabetes pandemic, there is an urgent need for drug delivery methods that support more durable retinal therapy while maintaining the efficacy and safety of currently available intravitreal therapies. Several innovative drug delivery methods are currently being investigated. These include sustained-release implants and depots using prodrugs, microparticles, and hydrogels, surgically implanted reservoirs, gene therapy via submacular injections or suprachoroidal injections, as well as topical and systemic therapies.
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Affiliation(s)
- Yeji Ham
- Sydney Retina Clinic, Sydney, Australia
| | - Hemal Mehta
- Sydney Retina Clinic, Sydney, Australia
- Save Sight Registries, The University of Sydney, Sydney, Australia
- Strathfield Retina Clinic, Sydney, Australia
| | - Jennifer Kang-Mieler
- Department of Biomedical Engineering, Stevens Institute of Technology, Hoboken, NJ
| | | | - Andrew Chang
- Sydney Retina Clinic, Sydney Eye Hospital, The University of Sydney, Sydney, Australia
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Horie S, Corradetti G, Esmaeilkhanian H, Sadda SR, Cheung CMG, Ham Y, Chang A, Takahashi T, Ohno-Matsui K. Microperimetry in Retinal Diseases. Asia Pac J Ophthalmol (Phila) 2023; 12:211-227. [PMID: 36971707 DOI: 10.1097/apo.0000000000000597] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2022] [Accepted: 12/06/2022] [Indexed: 03/29/2023] Open
Abstract
Retinal microperimetry (MP) is a procedure that assesses the retinal sensitivity while the fundus is directly observed, and an eye tracker system is active to compensate for involuntary eye movements during testing. With this system, the sensitivity of a small locus can be accurately determined, and it has become an established ophthalmic test for retinal specialists. Macular diseases are characterized by chorioretinal changes; therefore, the condition of the retina and choroid requires careful and detailed evaluations to perform effective therapy. Age-related macular degeneration is a representative retinal disease in which the macular function has been evaluated by the visual acuity throughout the course of the disease process. However, the visual acuity represents the physiological function of only the central fovea, and the function of the surrounding macular area has not been sufficiently evaluated throughout the different stages of the macula disease process. The new technique of MP can compensate for such limitations by being able to test the same sites of the macular area repeatedly. This is especially useful in the recent management of age-related macular degeneration or diabetic macular edema during anti-vascular endothelial growth factor treatments because MP can assess the effectiveness of the treatment. MP examinations are also valuable in diagnosing Stargardt disease as they can detect visual impairments before any abnormalities are found in the retinal images. The visual function needs to be carefully assessed along with morphologic observations by optical coherence tomography. In addition, the assessment of retinal sensitivity is useful in the presurgical or postsurgical evaluations.
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Affiliation(s)
- Shintaro Horie
- Department of Advanced Ophthalmic Imaging, Tokyo Medical and Dental University, Tokyo, Japan
- Department of Ophthalmology and Visual Science, Tokyo Medical and Dental University, Tokyo, Japan
| | - Giulia Corradetti
- Doheny Eye Institute, Pasadena, CA, US
- Department of Ophthalmology, David Geffen School of Medicine at UCLA, Los Angeles, CA, US
| | - Houri Esmaeilkhanian
- Doheny Eye Institute, Pasadena, CA, US
- Department of Ophthalmology, David Geffen School of Medicine at UCLA, Los Angeles, CA, US
| | - SriniVas R Sadda
- Doheny Eye Institute, Pasadena, CA, US
- Department of Ophthalmology, David Geffen School of Medicine at UCLA, Los Angeles, CA, US
| | | | - Yeji Ham
- Sydney Retina Clinic and Day Surgery, Sydney, Australia
| | - Andrew Chang
- Sydney Eye Hospital, The University of Sydney, Sydney Retina Clinic and Day Surgery, Sydney, Australia
| | - Tomonari Takahashi
- Department of Advanced Ophthalmic Imaging, Tokyo Medical and Dental University, Tokyo, Japan
| | - Kyoko Ohno-Matsui
- Department of Advanced Ophthalmic Imaging, Tokyo Medical and Dental University, Tokyo, Japan
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Buntting CS, Ham Y, Teng KX, Dimou J, Gauden AJ, Nair G. Scalpel sign: Dorsal thoracic arachnoid web, thoracic arachnoid cyst and ventral cord herniation. Radiol Case Rep 2022; 17:3564-3569. [PMID: 35923346 PMCID: PMC9340144 DOI: 10.1016/j.radcr.2022.06.100] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2022] [Revised: 06/26/2022] [Accepted: 06/29/2022] [Indexed: 12/01/2022] Open
Abstract
The “Scalpel sign” is a radiological sign which can be identified on magnetic resonance imaging and indicates dorsal compression of the spinal cord [1]. Prior descriptions of a “Scalpel sign” have been reported in the literature and the awareness and identification of this pathognomonic sign may aid in the rapid diagnosis and treatment of patients with dorsal arachnoid web, dorsal arachnoid cyst or ventral cord herniation. We describe 3 cases which highlight these rare conditions for which this sign is pathognomonic and summarize the pertinent literature related to these disorders [1,2].
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Affiliation(s)
| | - Yeji Ham
- Royal Melbourne Hospital, 300 Grattan Street, Parkville, 3050, Victoria, Australia
| | - Ken X Teng
- Royal Melbourne Hospital, 300 Grattan Street, Parkville, 3050, Victoria, Australia
| | - James Dimou
- Royal Melbourne Hospital, 300 Grattan Street, Parkville, 3050, Victoria, Australia
| | - Andrew J Gauden
- Royal Melbourne Hospital, 300 Grattan Street, Parkville, 3050, Victoria, Australia
| | - Girish Nair
- Royal Melbourne Hospital, 300 Grattan Street, Parkville, 3050, Victoria, Australia
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Ham Y, Mack H, Colville D, Harraka P, Savige J. Gitelman syndrome and ectopic calcification in the retina and joints. Clin Kidney J 2021; 14:2023-2028. [PMID: 34476088 PMCID: PMC8406063 DOI: 10.1093/ckj/sfab034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2020] [Indexed: 11/23/2022] Open
Abstract
Gitelman syndrome is a rare inherited renal tubular disorder with features that resemble thiazide use, including a hypokalemic metabolic alkalosis, hypomagnesemia, hypocalciuria and a low or normal blood pressure, hyperreninemia and hyperaldosteronism. Treatment is primarily correction of the potassium and magnesium levels. The diagnosis is confirmed with genetic testing but Gitelman syndrome is often not suspected. However, the association with ectopic calcification in the retina, blood vessels and chondrocalcinosis in the joints is a useful pointer to this diagnosis. Bilateral symmetrical whitish deposits of calcium pyrophosphate are visible superotemporally on ophthalmoscopy and retinal photography but are actually located beneath the retina in the sclerochoroid. Optical coherence tomography is even more sensitive for their detection. These deposits increase in size with time, but the rate of progression slows with long-term correction of the hypomagnesemia. Calcification may be complicated by atrophy of the overlying retina and visual loss. The deposits often correlate with ectopic calcification in the aorta and coronary and cerebral vessels. Chondrocalcinosis occurs in the large joints such as the knees. Ectopic calcification in Gitelman syndrome indicates the need for more aggressive management of Mg levels. Calcification is much less common in Bartter syndrome, which itself is rarer and associated less often with hypomagnesemia.
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Affiliation(s)
- Yeji Ham
- Department of Medicine, University of Melbourne, Melbourne Health and Northern Health, Royal Melbourne Hospital, Parkville, VIC, Australia
| | - Heather Mack
- Department of Ophthalmology, University of Melbourne, Royal Victorian Eye and Ear Hospital, East Melbourne, VIC, Australia
| | - Deb Colville
- Department of Medicine, University of Melbourne, Melbourne Health and Northern Health, Royal Melbourne Hospital, Parkville, VIC, Australia
| | - Philip Harraka
- Department of Medicine, University of Melbourne, Melbourne Health and Northern Health, Royal Melbourne Hospital, Parkville, VIC, Australia
| | - Judy Savige
- Department of Medicine, University of Melbourne, Melbourne Health and Northern Health, Royal Melbourne Hospital, Parkville, VIC, Australia
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Choi D, Lee K, Na K, Chang Y, Ham Y, Jeon J, Kim H. SUN-022 SERUM GDF15 AS A PROGNOSTIC MARKER OF MEMBRANOUS GLOMERULONEPHRITIS. Kidney Int Rep 2019. [DOI: 10.1016/j.ekir.2019.05.417] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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Choi D, Lee K, Na K, Chang Y, Ham Y, Jeon J, Kim H, Jeong J. MON-211 KELCH LIKE FAMILY MEMBER 3 KNOCK-OUT AMELIORATES RENAL FIBROSIS IN UNILATERAL URETERAL OBSTRUCTION MICE. Kidney Int Rep 2019. [DOI: 10.1016/j.ekir.2019.05.1010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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Ham Y, Minegishi T, Hisatomi T, Domen K. A SrTiO3 photoanode prepared by the particle transfer method for oxygen evolution from water with high quantum efficiencies. Chem Commun (Camb) 2016; 52:5011-4. [DOI: 10.1039/c6cc00497k] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
A photoanode prepared from flux-synthesized Al-doped SrTiO3 by the particle transfer method with a Ta contact layer exhibited a high IPCE of 69% at 320 nm.
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Affiliation(s)
- Y. Ham
- Department of Chemical System Engineering
- School of Engineering
- The University of Tokyo
- Bunkyo-ku
- Japan
| | - T. Minegishi
- Department of Chemical System Engineering
- School of Engineering
- The University of Tokyo
- Bunkyo-ku
- Japan
| | - T. Hisatomi
- Department of Chemical System Engineering
- School of Engineering
- The University of Tokyo
- Bunkyo-ku
- Japan
| | - K. Domen
- Department of Chemical System Engineering
- School of Engineering
- The University of Tokyo
- Bunkyo-ku
- Japan
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