Browsing by Author "Lapin, Brittany"

Now showing 1 - 2 of 2
  • Thumbnail Image
    ItemOpen Access
    Frequency of Physical Therapist Intervention Is Associated With Mobility Status and Disposition at Hospital Discharge for Patients With COVID-19.
    (Physical therapy, 2021-01) Johnson, Joshua K; Lapin, Brittany; Green, Karen; Stilphen, Mary

    Objective

    For patients diagnosed with the novel coronavirus, COVID-19, evidence is needed to understand the effect of treatment by physical therapists in the acute hospital on patient outcomes. The primary aims of this study were to examine the relationship of physical therapy visit frequency and duration in the hospital with patients' mobility status at discharge and probability of discharging home.

    Methods

    This retrospective study included patients with COVID-19 admitted to any of 11 hospitals in 1 health system. The primary outcome was mobility status at discharge, measured using the Activity Measure for Post-Acute Care 6-Clicks basic mobility (6-Clicks mobility) and the Johns Hopkins Highest Level of Mobility scales. Discharge to home versus to a facility was a secondary outcome. Associations between these outcomes and physical therapy visit frequency or mean duration were tested using multiple linear or modified Poisson regression. Potential moderation of these relationships by particular patient characteristics was examined using interaction terms in subsequent regression models.

    Results

    For the 312 patients included, increased physical therapy visit frequency was associated with higher 6-Clicks mobility (b = 3.63; 95% CI, 1.54-5.71) and Johns Hopkins Highest Level of Mobility scores (b = 1.15; 95% CI, 0.37-1.93) at hospital discharge and with increased probability of discharging home (adjusted relative risk = 1.82; 95% CI, 1.25-2.63). Longer mean visit duration was also associated with improved mobility at discharge and the probability of discharging home, though the effects were less pronounced. Few moderation effects were observed.

    Conclusion

    Patients with COVID-19 demonstrated improved mobility at hospital discharge and higher probability of discharging home with increased frequency and longer mean duration of physical therapy visits. These associations were not generally moderated by patient characteristics.

    Impact

    Physical therapy should be an integral component of care for patients hospitalized due to COVID-19. Providing sufficient physical therapist interventions to improve outcomes must be balanced against protection from viral spread.

    Lay summary

    Patients with COVID-19 can benefit from more frequent and longer physical therapy visits in the hospital.
  • Thumbnail Image
    ItemOpen Access
    TNF is a potential therapeutic target to suppress prostatic inflammation and hyperplasia in autoimmune disease.
    (Nature communications, 2022-04) Vickman, Renee E; Aaron-Brooks, LaTayia; Zhang, Renyuan; Lanman, Nadia A; Lapin, Brittany; Gil, Victoria; Greenberg, Max; Sasaki, Takeshi; Cresswell, Gregory M; Broman, Meaghan M; Paez, J Sebastian; Petkewicz, Jacqueline; Talaty, Pooja; Helfand, Brian T; Glaser, Alexander P; Wang, Chi-Hsiung; Franco, Omar E; Ratliff, Timothy L; Nastiuk, Kent L; Crawford, Susan E; Hayward, Simon W
    Autoimmune (AI) diseases can affect many organs; however, the prostate has not been considered to be a primary target of these systemic inflammatory processes. Here, we utilize medical record data, patient samples, and in vivo models to evaluate the impact of inflammation, as seen in AI diseases, on prostate tissue. Human and mouse tissues are used to examine whether systemic targeting of inflammation limits prostatic inflammation and hyperplasia. Evaluation of 112,152 medical records indicates that benign prostatic hyperplasia (BPH) prevalence is significantly higher among patients with AI diseases. Furthermore, treating these patients with tumor necrosis factor (TNF)-antagonists significantly decreases BPH incidence. Single-cell RNA-seq and in vitro assays suggest that macrophage-derived TNF stimulates BPH-derived fibroblast proliferation. TNF blockade significantly reduces epithelial hyperplasia, NFκB activation, and macrophage-mediated inflammation within prostate tissues. Together, these studies show that patients with AI diseases have a heightened susceptibility to BPH and that reducing inflammation with a therapeutic agent can suppress BPH.