Browsing by Author "Perry, Matthew T."

Now showing 1 - 2 of 2
  • Thumbnail Image
    Item
    Computer adaptive testing to assess impairing behavioral health problems in emergency department patients with somatic complaints
    (Wiley, 2022-09-22) O’Reilly, Lauren M.; Dalal, Azhar I.; Maag, Serena; Perry, Matthew T.; Card, Alex; Bohrer, Max B.; Hamersly, Jackson; Nader, Setarah Mohammad; Peterson, Kelli; Beiser, David G.; Gibbons, Robert D.; D’Onofrio, Brian M.; Musey, Paul I.; Emergency Medicine, School of Medicine
    Objectives: To assess: (1) the prevalence of mental health and substance use in patients presenting to the emergency department (ED) through use of a computer adaptive test (CAT-MH), (2) the correlation among CAT-MH scores and self- and clinician-reported assessments, and (3) the association between CAT-MH scores and ED utilization in the year prior and 30 days after enrollment. Methods: This was a single-center observational study of adult patients presenting to the ED for somatic complaints (97%) from May 2019 to March 2020. The main outcomes were computer-adaptive-assessed domains of suicidality, depression, anxiety, post-traumatic stress disorder (PTSD), and substance use. We conducted Pearson correlations and logistic regression for objectives 2 and 3, respectively. Results: From a sample of 794 patients, the proportion of those at moderate/severe risk was: 24.1% (suicidality), 8.3% (depression), 16.5% (anxiety), 12.3% (PTSD), and 20.4% (substance use). CAT-MH domains were highly correlated with self-report assessments (r = 0.49-0.79). Individuals who had 2 or more ED visits in the prior year had 62% increased odds of being in the intermediate-high suicide risk category (odds ratio [OR], 1.62; 95% confidence interval [CI], 1.07-2.44) compared to those with zero prior ED visits. Individuals who scored in the intermediate-high-suicide risk group had 63% greater odds of an ED visit within 30 days after enrollment compared to those who scored as low risk (OR, 1.63; 95% CI, 1.09, 2.44). Conclusion: The CAT-MH documented that a considerable proportion of ED patients presenting for somatic problems had mental health conditions, even if mild. Mental health problems were also associated with ED utilization.
  • Thumbnail Image
    Item
    Pediatric Prostatic Alveolar Rhabdomyosarcoma Presenting with Metastatic Spinal Cord Compression in the Thoracic Spine: A Case Report and Review of the Literature
    (Springer Nature, 2024-03-20) Perry, Matthew T.; Witten, Andrew J.; Marwan, Majeed; Vortmeyer, Alexander; Tailor, Jignesh; Neurological Surgery, School of Medicine
    Rhabdomyosarcoma (RMS) is a pediatric malignancy with a variable prognosis depending on tumor stage and genotype. There has been a significant improvement in survival rates over the past decades. However, aggressive variants can metastasize to locations that are difficult to treat. We report a case of prostatic alveolar rhabdomyosarcoma with metastases to the bone marrow and thoracic spine in a child. The patient was treated with a multimodal approach that included surgical resection of the epidural mass; the administration of vincristine, dactinomycin, and cyclophosphamide; and radiotherapy. Unfortunately, after six months, the patient showed disease progression and was started on secondary-line treatment. This case illustrates the difficulties in managing end-stage metastatic rhabdomyosarcoma and is the first report of prostatic rhabdomyosarcoma presenting with spinal cord compression in a child.