Leveraging Biomarkers for Personalized Treatment of Alcohol Use Disorder Comorbid With PTSD
The proposed study is a double-blind, 2-group randomized controlled trial designed to contrast acute and persisting effects of topiramate to those of placebo treatment in a sample of 150 participants with moderate to severe AUD comorbid with PTSD/subthreshold PTSD, and to evaluate the moderating effect of rs2832407 genotype on medication effects. Participants will be randomized in a 2:1 ratio to topiramate vs. placebo. Drug will be titrated to a maximum dose of 200 mg over 8 weeks, continued for 4 more weeks for a total of 12 weeks of treatment, and tapered over a 2-week period. We propose an integrative translational focus on alterations in excitatory and inhibitory signaling, focusing on GABA and glutamate and related circuitry, to model the neurobiology of AUD comorbid with PTSD/subthreshold PTSD and the mitigating effects of topiramate. We will study the behavioral, genetic, and plasma biomarker effects of topiramate vs. placebo in 150 participants with co-occurring AUD and PTSD/subthreshold and ascertain multi-modal imaging markers including structural MRI, task-based fMRI, and TMS evoked potentials in EEG. Imaging markers will be used to characterize excitatory and inhibitory circuits in the clinical trial participants with AUD+PTSD/subthreshold to determine predictors and mechanisms of topiramate vs. placebo treatment outcomes. Clinical interviews will be audio- taped to ensure clinical adherence and conduct interrater reliability. De-identified audio recordings of participants who consent to participate in the voicemarkers analysis will be encrypted and sent via secure sites for analysis. This project will advance our knowledge of personalized medicine for AUD comorbid with PTSD/subthreshold, with particular emphasis on understanding the mechanisms that account for the high variability in treatment outcomes for this comorbidity, how treatments like TPM are effective for certain individuals, and how best to identify those most likely to respond to TPM.
Leveraging the EHR to Promote Pharmacy Adoption of Dosing Best Practices and Reduce Parent Errors in Administering Pediatric Liquid Medications: A Health Literacy-Informed Approach
This is a pre-/post-implementation study that will be performed with English- and Spanish-speaking parents of children prescribed oral liquid medications (dose 10mL or less) in the pediatric emergency room, outpatient general pediatric clinic, and pediatric subspecialty clinics of 2 New York city hospital systems (NYU Langone Health – Brooklyn and NYC Health+Hospitals - Bellevue Hospital). A total of 500 subjects will be recruited across the 2 hospital systems, 250 pre-implementation and 250 post-implementation. Our intervention is an EHR-based intervention that leverages electronic prescriptions (e-Rx’s) to support optimal pharmacy dispensing practices (maintenance of dosing instructions in mL-only on prescription bottle labels and provision of optimal dosing tools) and reduce parent dosing errors. This intervention will be built directly into the Epic electronic health record (EHR). Prior to implementation, e-Rx’s will be generated by the EHR in the usual fashion; after implementation, e-Rx’s will be generated by the EHR with instructions to the dispensing pharmacy to: 1) keep the dosing instructions in mL-only, and 2) dispense a specific dosing tool based on the amount prescribed. Additionally, we will conduct post-trial investigations assessing pharmacy staff perceptions of the intervention. Interviews with a convenience sample of pharmacy staff (n=30) will be performed for feedback on e-Rx requests, including assessment of acceptability and barriers to following recommended guidance.
LGBTQ+ Cancer Care & Research Program | NYU Langone Health
NYU Langone’s LGBTQ+ Cancer Care and Research Program, part of Perlmutter Cancer Center, aims to improve cancer care and advance research.
Lifestyle Changes for Achalasia | NYU Langone Health
NYU Langone gastroenterologists may recommend lifestyle changes, such as dietary adjustments, to help reduce the discomfort of achalasia.
Lifestyle Changes for Angina with No Blockage | NYU Langone Health
NYU Langone cardiologists may recommend lifestyle changes to treat angina (chest discomfort) with no blockage, also known as ischemia with no obstructive coronary arteries (INOCA). Learn More.
Lifestyle Changes for Aortoiliac Occlusive Disease | NYU Langone Health
Doctors at NYU Langone often recommend lowering blood pressure, eating healthfully, and exercising to manage aortoiliac occlusive disease.
Lifestyle Changes for Atrial Fibrillation & Atrial Flutter | NYU Langone Health
NYU Langone cardiologists recommend lifestyle modifications to avoid triggering atrial fibrillation and atrial flutter.
Lifestyle Changes for Autonomic Disorders | NYU Langone Health
NYU Langone doctors recommend lifestyle changes to help people with orthostatic and postprandial hypotension, types of autonomic disorders.
Lifestyle Changes for Barrett’s Esophagus | NYU Langone Health
NYU Langone doctors recommend lifestyle changes to reduce acid reflux and help prevent Barrett’s esophagus from worsening.
Lifestyle Changes for Bradycardia | NYU Langone Health
NYU Langone doctors recommend heart-healthy lifestyle modifications to avoid triggering symptoms of bradycardia.