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Medical Rounds

Opioid Use Disorder: Treatment Where It’s Needed

When addiction specialist Megan Buresh isn’t seeing patients at Johns Hopkins Bayview Medical Center, you can find her in an unassuming mobile van outside the Baltimore City Detention Center.

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Technology: Neurocritical Care Meets Precision Medicine

Jose Suarez and colleagues in the Neurosciences Critical Care Division are harnessing data captured in the neurocritical care unit to improve patient outcomes through early detection of crises precursors.

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Pediatrics: Preventing Neonatal Dysbiosis

Rather than attacking microbial imbalances in infants after the fact—in already colonized newborns, by disinfecting neonatal ICUs or administering antibiotics—the fight needs to begin much sooner.

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Psychiatry: Filling Gaps in Reproductive Psychiatry

Lauren Osborne and some 40 colleagues across the country have created a national curriculum on reproductive psychiatry that covers 15 topics, including perinatal depression and bipolar disorders, infertility and perinatal loss.

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Cardiac Surgery: When the Ceiling Has Eyes

A Johns Hopkins team is using sensors in the ceiling of the hospital to monitor patient mobility to predict who is at risk for readmission, who is ready to be discharged to acute rehab, and how long patients will need to stay on the progressive care unit.

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“Physicians are overwhelmed with clerical data entry, and we need informatics tools and resources in the electronic health record to harvest that information to unburden physicians from entering it in a structured way.”

—Professor of Medicine Christopher Chute, Bloomberg Distinguished Professor of Health Informatics, writing in the New England Journal of Medicine (Oct. 12). Noting the unprecedented rate at which electronic health data are accumulating, Chute advocates for health organizations to consider using ontologies (a means of naming and organizing the information into categories for easier retrieval) to best make use of available information for precision medicine purposes. Although electronic health records document many types of data, Chute says, it may not be easy to extract information needed to put patients into subgroups to deliver more tailored care.

“Our results should add to evidence and reassure the general public and the transplant community that acutely injured deceased-donor kidneys appear to have the same success rates as noninjured kidneys from otherwise similar donors.”

Chirag Parikh, director of the Division of Nephrology at Johns Hopkins and senior author of a study published in Kidney International in November that suggests that patients in need of kidney transplant could have access to more kidneys—potentially shortening organ waiting list times. “Even transplanted kidneys with the highest severity of acute kidney injury did not have worse outcomes, so we should bring these kidneys into the donor pool with confidence,” Parikh notes.

5,000

The number of eyeglasses distributed to Baltimore City public schoolchildren (as of Dec. 10) since the launch of the Vision for Baltimore program in 2006. Through strategic partnerships with Johns Hopkins, the nonprofit Vision to Learn and eyewear retailer Warby Parker, the program aims to conduct vison screenings for every student between pre-K and eighth grade in Baltimore City Public Schools—that’s roughly 60,000 kids—and to provide free eyeglasses to students who need them. To date, 43,000 students have been screened.

A research team, led by the Wilmer Eye Institute’s Megan Collins and school of education professor Robert Slavin, will compare students’ standardized test scores before and after receiving glasses to understand the impact of school-based eye care on academic performance. The team is also working to develop strategies to reduce the rate of lost or broken eyeglasses and is conducting a cost analysis of the economic impact of expanded programs for vision screening and school-based care.

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