Baltimore City Hospitals Research Articles

A retrospective chart review of Hepatitis C prevalence and screening practices in pregnancy

Hepatitis C is a significant cause of morbidity and mortality. The CDC estimates that 2.7-3.9 million people in the US have chronic hepatitis C. Serious consequences of hepatitis C infection include cirrhosis, liver cancer and death. Hepatitis C is transmitted through intravenous drug use, sex, and through birth to an infant by an infected mother. Due to high rates of intravenous drug use, Baltimore has particularly high rates of hepatitis C infection. The Maryland Department of Health and Mental Hygiene estimates that in 2014, 26-40,000 individuals in Baltimore had Hepatitis C infection. However this is likely an underestimate due to the fact that many individuals carry asymptomatic infections and may not seek medical attention. A cure is available for hepatitis C, however individuals need to know they are infected in order to be treated. Pregnancy is a time when women have multiple regular encounters with healthcare providers. This unique period of access has been used with great success to screen and treat women for HIV infection, virtually eliminating perinatal transmission of HIV and connecting many women and their partners to treatment. A similar approach may prove useful for Hepatitis C. However, first it will be necessary to determine the frequency with which women are screened and tested under current guidelines. The purpose of this study is to determine the prevalence of known hepatitis C infection in the pregnant population of a major Baltimore City hospital and the frequency with which women are being tested for hepatitis C under current guidelines.

Community-Academic Partnership to Investigate Low Birth Weight Deliveries and Improve Maternal and Infant Outcomes at a Baltimore City Hospital.

Purpose Mercy Medical Center (MMC), a community hospital in Baltimore Maryland, has undertaken a community initiative to reduce low birth weight (LBW) deliveries by 10% in 3years. MMC partnered with a School of Public Health to evaluate characteristics associated with LBW deliveries and formulate collaborations with obstetricians and community services to improve birth outcomes. Description As part of the initiative, a case control study of LBW was undertaken of all newborns weighing <2500 grams during June 2010-June 2011 matched 2:1 with newborns ≥2500 grams (n=862). Assessment Logistic regression models including maternal characteristics prior to and during pregnancy showed an increased odds of LBW among women with a previous preterm birth (aOR 2.48; 95% CI: 1.49-4.13), chronic hypertension (aOR: 2.53; 95% CI: 1.25-5.10), hospitalization during pregnancy (aOR: 2.27; 95% CI:1.52-3.40), multiple gestation (aOR:12.33; 95% CI:5.49-27.73) and gestational hypertension (aOR: 2.81; 95% CI: 1.79-4.41). Given that both maternal pre-existing conditions and those occurring during pregnancy were found to be associated with LBW, one strategy to address pregnant women at risk of LBW infants is to improve the intake and referral system to better triage women to appropriate services in the community. Meetings were held with community organizations and feedback was operationalized into collaboration strategies which can be jointly implemented. Conclusion Education sessions with providers about the referral system are one ongoing strategy to improve birth outcomes in Baltimore City, as well as provision of timely home visits by nurses to high-risk women.

The Violence of Care: Rape Victims, Forensic Nurses, and Sexual Assault Intervention

70 Reviews documentation. I found one oblique refer- ence to hospitalization (p. 101), but it is not clear from the context whether this refers to a hypothetical or an actual case. However, Atkinson’s last chapter is the strongest in the book. Based on research he conducted with his colleague Michael Kehler, he explores boys’ P.E. classes as an arena of somatic dominance and humiliation, but also of resistance and resilience. While the other five empirical chapters are plagued by too much theoretical throat-clearing (both of the authors exhibit an encyclopedic knowl- edge of social theory that too often over- whelms the data), here there is a better bal- ance between theory and data. This chapter also provides the most vivid evidence of embodiment, as the boys speak with surpris- ing candor about their bodies and the strate- gies they use to deflect ridicule and body shaming from their bullying peers. This is the sort of thing I was hoping to find more of throughout the collection. While several passages earlier in the book acknowledge the still-problematic legacy of Cartesian dualism for embodiment scholars, the analy- sis from both authors often stays too much in the head. Only rarely, as in this last chapter, do they deliver evidence of the body’s pecu- liar eloquence. As a general observation, I found this ten- dency toward abstraction also encouraged some stylistic habits that may tax readers. Especially in the introduction and first chap- ter I felt overwhelmed by a continuous bar- rage of parenthetical inserts, italicized text, overuse of the slash, and a surfeit of scare quotes. I also longed for a concluding chapter, wherein the authors could bring the sociological insights gleaned from their many collective years as masculinities scholars to bear on these specific empirical cases. What did they learn from their collabo- ration? What does challenging these various myths suggest about the future of masculin- ities and gendered embodiment? Informed readers are likely to draw a variety of conclu- sions from these stimulating cases; it would be nice to have the authors weigh in as well. This book is appropriate for graduate-level courses in gender studies, masculinities, and embodiment studies. At this writing it is available in hardback and electronic form. The Violence of Care: Rape Victims, Forensic Nurses, and Sexual Assault Intervention, by Sameena Mulla. New York: New York University Press, 2014. 277 pp. $26.00 paper. ISBN: 9781479867219. S IMON A. C OLE University of California, Irvine scole@uci.edu The way sexual assault victims are treated in hospitals in the United States changed beginning in the 1970s. In response to a vari- ety of social forces, a specialized expertise known as ‘‘forensic nursing’’ has arisen, and forensic nurses now very often have ‘‘jurisdiction’’—in the sociological sense— over the medical examination of sexual assault victims. This development seems at first glance to be a positive one. It arose through a conflu- ence of good intentions. Feminists demanded that sexual assault victims be treated with greater care and dignity and that sexual assaults be prosecuted with greater vigor. Law enforcement agencies saw valuable evi- dence being lost or discarded. And nursing, a feminized, caring profession, seemed the right fit for the job. ‘‘Having witnessed sexual assault interventions in their role as chaper- ones’’ when gynecologists were in charge of sexual assault examinations, anthropologist Semeena Mulla notes, ‘‘nurses were among the loudest critics of the haphazard response and treatment rape victims received in the health care system’’ (p. 12). However, recently a number of scholars, while by no means condemning the rise of forensic nursing, have begun exploring some of the unintended consequences of the institutionalization of forensic nursing. The Violence of Care is a contribution to this body of work. Sameena Mulla obtained training as a rape crisis counselor in 2002, and she performed participant observation at the Baltimore city hospital designated to conduct forensic sexual assault examination. She observed more than 40 sexual assault examinations through 2006. Her observational eye, howev- er, was trained not on her fellow rape crisis counselors—about whom we hear relatively Contemporary Sociology 45, 1 Downloaded from csx.sagepub.com at UNIV CALIFORNIA IRVINE on January 4, 2016

Women's Health Research in the Last Four Decades

Gerson Weiss speaks to Natasha Leeson, Assistant Commissioning Editor Gerson Weiss obtained his MD degree from New York University (NY, USA). After an internship in internal medicine at Baltimore City Hospital (MD, USA), he completed residency in obstetrics and gynecology at New York University. Further training in reproductive endocrinology was obtained as a postdoctoral research fellow in physiology at the University of Pittsburgh (PA, USA), in the laboratory of Dr Ernst Knobil. Following this fellowship, Dr Weiss returned to New York University where he ultimately became Professor of Obstetrics and Gynecology, Professor of Pharmacology and Director of the Division of Reproductive Endocrinology and Infertility. In 1986, he became Professor and Chair of the Department of Obstetrics and Gynecology at New Jersey Medical School (NJ, USA). Dr Weiss is the author of more than 274 scientific articles. His research has been continuously funded since 1975 by grants from the NIH, the United Cerebral Palsy Foundation and the Andrew W Mellon Foundation. He has served as a member of the Division of Reproductive Endocrinology of the American Board of Obstetrics and Gynecology, a member of the Reproductive Biology Study Section of the NIH, a member of the Residency Review Committee for Obstetrics and Gynecology of the Accreditation Council for Graduate Medical Education. He has served as the President of the New York Obstetrical Society, the New York Gynecologic Society, the Council of University Chairs of Obstetrics and Gynecology, and the American Board of Obstetrics and Gynecology. He was the Chairman of the Committee on Gynecologic Practices for the American College of Obstetricians and Gynecologists and Chairman of American Board of Obstetrics and Gynecology. He was a member of the Executive Committee of the American Board of Medical Specialties. Dr Weiss is a past President of the Society for Gynecologic Investigation. He currently serves on the NIH's Advisory Committee on Research on Women's Health. Dr Weiss conducts an active clinical practice both in gynecology and reproductive endocrinology and infertility at his institution.

Collaborating across multiple health care institutions in an urban colorectal cancer screening program

Maryland, excluding Baltimore City, began public health screening for colorectal cancer in 2000. Initiating colorectal cancer screening in Baltimore City was an objective in the Maryland Comprehensive Cancer Control Plan. The Centers for Disease Control and Prevention's (CDC's) funding announcement for the "Colorectal Cancer Screening Demonstration Program" (CRCSDP) was seen as a potential opportunity for Maryland to begin screening in Baltimore City. The Maryland Department of Health and Mental Hygiene (DHMH), the American Cancer Society, and five Baltimore City Hospitals collaborated to develop the funding application and model for the Baltimore City CRCSDP. After receipt of funding, between 2005 and September 2009, screening sites collaborated with the DHMH to implement the multi-site colorectal cancer screening program in Baltimore City. Close collaboration across organizational boundaries enabled the funding, formation, and implementation of the CRCSDP in Baltimore City. The Baltimore City CRCSDP illustrates the complexity of establishing a functional public health screening program. The program overcame expected and unexpected fiscal, programmatic, and clinical challenges to successfully perform 709 colonoscopies screening cycles among 696 people and detect three cancers during the 38 months of screening. Partnerships among the state and local health department, the American Cancer Society, and hospitals in Baltimore City enabled the implementation of this successful program. Lessons learned from the collaborative planning process and the program implementation may facilitate similar collaborations in other geographic areas.

Biological Aging and Social Characteristics: Gerontology, the Baltimore City Hospitals, and the National Institutes of Health

The intramural gerontological research program in the National Institutes of Health underwent a substantial growth after its creation within the precincts of the Baltimore City Hospitals in 1940. This paper analyzes its development and the associated problems of its early years. Gerontologists aimed at improving the social and economic life of the elderly through scientific research. With this aim in mind, they conducted various investigations using the indigent aged patients of the Baltimore City Hospitals. Yet the scientists of aging, who hoped to eliminate negative social factors that might bias their research and heighten the confusion between pathology and aging per se, eventually stopped using these patients in the hospital as human subjects. Instead they sought educated affluent subjects in order to eliminate the impact of poverty. By doing so, however, they introduced a new source of social bias to their work, especially within the novel project begun in 1958, the Baltimore Longitudinal Study of Aging. This article thus examines the context of the development of gerontologists' research by analyzing their agenda, institutional environment, and research subjects in the 1940s and the 1950s.

Barry Wayne Uhr, MD: A Conversation with the Editor

Barry Uhr (Figure ​(Figure11) was born on March 29, 1939, in New Braunfels, Texas, and that is where he grew up. He graduated from the University of Texas at Austin in 1961 and from the University of Texas Southwestern Medical School at Dallas in 1965. His internship in internal medicine was at the Baltimore City Hospitals in Baltimore, Maryland, from 1965 to 1966. He then entered the US Air Force as a general medical officer, where he also served as the base's psychiatrist until 1968, when he moved to Philadelphia as a resident in ophthalmology at the University of Pennsylvania. He returned to Dallas in 1971 to enter private practice. Since 1973, his practice has been on the campus of Baylor University Medical Center (BUMC), and he has been a very important member of the BUMC medical staff. He has been president of the Texas Ophthalmological Association, the Dallas Academy of Ophthalmology, and the Dallas County Medical Society. He and his lovely wife, Karen, are the proud parents of three successful offspring. Both of them have been active in various community activities. Both are wonderful people, lifelong learners, and fun to be around.

Intussusception in infants and children. By Mark M. Ravitch, M.D., Associate Professor of Surgery, The Johns Hopkins University School of Medicine, Surgeon-in-Chief, The Baltimore City Hospital, Baltimore, Maryland. 11 × 8½ in. Pp. 121, with 43 illustrations. 1960. Illinois: Charles C. Thomas. (Oxford: Blackwell Scientific Publications Ltd.) 76s

Intussusception in infants and children. By Mark M. Ravitch, M.D., Associate Professor of Surgery, The Johns Hopkins University School of Medicine, Surgeon-in-Chief, The Baltimore City Hospital, Baltimore, Maryland. 11 × 8½ in. Pp. 121, with 43 illustrations. 1960. Illinois: Charles C. Thomas. (Oxford: Blackwell Scientific Publications Ltd.) 76s

Obituary

George Wesley Santos, MD, 1928–2001 On January 21, 2001, the transplantation community lost one of its visionaries, Dr. George Wesley Santos. Among his many friends and colleagues around the world, he will be remembered not only for accomplishments that moved the field of bone marrow transplantation (BMT) from its infancy to where it is today but also for his generosity and his friendship. George developed his interest in BMT while serving in the Naval Reserves at the U.S. Naval Radiologic Defense Laboratory in San Francisco from 1956 through 1958. He and his colleagues were asked to study the effects of high-dose radiation on animals and to determine whether BMT could rescue lethally irradiated animals. George was one of the first to realize that the “wasting” or “secondary” disease after allogeneic BMT in animals represented, in fact, a graft-host reaction. Although the military's concern was focused on the aftermath of a nuclear disaster, George saw the additional potential of this approach as a treatment for cancer and life-threatening hematologic disorders. It was during this time that George also cultivated his commitment to integrating basic laboratory research with the clinic, what George liked to call “engineering” (no doubt a tribute to his undergraduate alma mater, Massachusetts Institute of Technology, where he also earned a masters in biophysics) but now better known as translational research. Following his military service, George returned to Johns Hopkins, his medical school, for residency training. In 1960, he became Albert Owens's first fellow in what would be called more than a decade later the subspecialty of oncology. George and Al soon began their ground-breaking studies into the effects of high-dose cyclophosphamide on the immune system and transplantation tolerance in animals. These studies rapidly led to the first clinical trials of high-dose cyclophosphamide as pretransplant conditioning. The site of these studies was the Johns Hopkins Oncology Unit, initially housed at the old Baltimore City Hospital. There George founded the Hopkins BMT Program in 1968, the same year he transplanted his first patient. With his colleagues in the early days, George engineered much of what is now standard of care in BMT. Examples include high-dose cyclophosphamide and later busulfan (as an alternative to total body irradiation) for pretransplant conditioning, cyclosporine for graft vs-host disease, 4-hydroperoxycyclophosphamide (4HC) for autograft purging, acyclovir as prophylaxis for herpes infections, and counterflow centrifugal elutriation for T-cell depletion of allografts. George's contributions go well beyond science. He was a tremendous role model for those who were fortunate enough to work with him, and he was a compassionate and caring physician. Although George received many prestigious awards, it was rare to hear George talk about his accomplishments. Rather, it was common for him to brag about the achievements of his patients by name, and his office contained a wall of photographs of the patients he had treated. He loved to recount the wedding of one of his patients who was transplanted 15 years earlier. He always credited the nursing and support staff, who were integral to the success of his program. He was hard-working and focused (some would say driven), yet he was one of the most forthrightly honest individuals I have known. He could be demanding and his probing questions are legend (few ever forget giving a lecture when George was in the audience). George loved a healthy discussion (argument) for the purposes of provoking thought and stimulating new ideas. Despite strong and passionate convictions, he could always be persuaded by strong data. A whole generation of Hopkins-trained translational scientists look to George as their intellectual and spiritual mentor. The world of biomedical science has recently embraced the concept of translational research, or engineering, to use George's term. George, however, was showing the Hopkins medical community how to engineer decades before it was in vogue. Moreover, his animal studies into transplantation biology continue to guide many of our current “new” therapeutic approaches, including non-myeloablative transplants and the use of high-dose cyclophosphamide for autoimmunity. We miss you, George. All of your patients, colleagues, students, and friends thank you for your accomplishments, vision, and support.

Tribute to Dr. Austin Lamont.

Safar Center for Resuscitation Research, University of Pittsburgh, 3434 Fifth Avenue, Pittsburgh, Pennsylvania 15260.To the Editor:-The beautiful article about Dr. Austin Lamont by Stanley Muravchick and Henry Rosenberg (Anesthesiology 1996; 84:436–41), is one of several highly deserved tributes to this pioneer in academic anesthesiology. Having been an anesthesiology resident with him at the University of Pennsylvania in 1950–52, I would like to add some personal memories.Because of an oversubscribed immigration quota for Austrians, my wife Eva and I went to Lima, Peru where in 1953 I initiated Peru's first academic department of anesthesiology. Without Lamont's and Dripps's interventions, we may not have obtained the then necessary special preference immigration visa (for needed specialists) to return to the US and become US citizens. Without Lamont's advice, I might not have gone to the Johns Hopkins Hospital (1954–55) and from there to Baltimore City Hospital as the first full-time chief of the department of anesthesiology (1955–61). Without these experiences, I would not have been prepared for the first chairmanship of the Department of Anesthesiology and Critical Care Medicine at the University of Pittsburgh Medical Center.After all anesthesiologists of the Johns Hopkins Hospital division of anesthesiology resigned in the summer of 1955 because of the impossibility to develop an academic anesthesiology department and residency there, Lamont shared with me his experiences at the Johns Hopkins Hospital. Later, after an invitation by Johns Hopkins historian, Magee Harvey, Professor Emeritus of Medicine, I submitted my biased reflections on four historic attempts to establish a strong academic anesthesiology department at the Johns Hopkins Hospital-under Lamont and Harmel in the 1940s; Proctor, Safar, and Bachman in the 1950s; Benson in the 1960s; and Nagel in the 1970s. In the 1980s, Rogers et al., finally succeeded.Austin was modest. In 1957, I showed him the Guedel airway I had modified with a mouthpiece for mouth-to-tube ventilation. He suggested replacing the straight mouthpiece with a turned around pediatric airway so it could also be used for children by turning it around. He asked for no credit.Austin was compassionate. For our severely asthmatic daughter, he arranged for a consultation on the then not popular aerosol treatments. When she died in 1966, Lamont said:“When suffering becomes unbearable, nature (God) often lifts the burden.” This applied to him at the end, when he died in 1969.Austin was an academician with principles. He quietly influenced me and other residents to consider research careers by making Claude Bernard's book An Introduction to the Study of Experimental Medicine his farewell gift.Austin was the best representative of American aristocracy. We miss him.Peter Safar, M.D.Safar Center for Resuscitation Research; University of Pittsburgh; 3434 Fifth Avenue; Pittsburgh, Pennsylvania 15260(Accepted for publication April 25, 1997.)

Reminiscences of Poliomyelitis Past

The article by Markel in the new Historical Perspectives of Pediatrics section of the ARCHIVES brings back a flood of memories, as I belong to the generation of pediatricians who actually used tank respirators in treating patients with poliomyelitis. In 1949, the city of Baltimore, Md, closed its contagious disease hospital (Sydenham), which served all of Maryland, and transferred its function to the Baltimore City Hospitals. The reasoning, in addition to a very low occupancy rate at Sydenham, was that the only contagious disease then likely ever to occur in epidemic form was poliomyelitis.

Harold E. Harrison

Harold E. Harrison died October 2, 1989, at the age of 81 years, after a brief, rapidly progressing illness. His passing ends a career virtually synonymous with the best of pediatrics in the 20th century. He brought excellence and rich contributions to every major type of endeavor in pediatrics from his formative years until the last months of his life. Together with his wife Helen, he advanced science through the application of chemistry to problems of calcium, phosphorus, and vitamin D. These studies helped to illuminate this field with contributions over more than a 50-year period, including some now to appear posthumously. These achievements have been noted by the academic community by several awards, most notably the Howland Award to Harold and Helen jointly. As a teacher, Harrison also trained two generations of pediatric residents both at his home institution, the Baltimore City Hospitals, and at The Johns Hopkins Hospital

The Development of Aging Molecular Basis of Aging A. K. Roy B. Chatterjee

Journal Article The Development of Aging Get access Molecular Basis of Aging. Roy A. K. Chatterjee B., eds. Academic Press, Orlando, FL, 1984. 400 pp., illus. $29.50 (cloth). Nathan W. Shock Nathan W. Shock National Institute on Aging, Baltimore City Hospital, Baltimore, MD 21224 Search for other works by this author on: Oxford Academic Google Scholar BioScience, Volume 36, Issue 6, June 1986, Page 391, https://doi.org/10.2307/1310263 Published: 01 June 1986

Aging process yields secrets to long-term study at unique research center

In 1940, a one-year grant from the Josiah Macy Foundation provided salary for Edward J. Stieglitz, MD, and one technician to investigate the physiology of aging under National Institutes of Health auspices. Stieglitz had no way of knowing that the modest laboratory, established in the Baltimore City Hospitals (now Francis Scott Key Medical Center), would be the forerunner of a modern, glass and brick, four-story Gerontology Research Center erected on hospital grounds in 1968. When the Macy grant expired in 1941, the National Institutes of Health assumed support of the unit and recruited Nathan W. Shock, PhD, from the University of California, Berkeley, to spearhead the research effort. Under Shock's leadership, the Gerontology Research Unit—now part of the National Institute on Aging—has grown to employ 155 full-time staff and manage an annual budget of some $19 million; it is now the largest institution in the Western Hemisphere devoted entirely to

Research on aging burgeons as more Americans grow older

"A "Aging cannot be equated with a disease or a disorder, nor can there be a 'magic bullet' to stop it," observes Reubin Andres, MD, clinical director, National Institute on Aging facilities at Baltimore City Hospitals. Andres was a participant in a recent symposium on "Aging in the 21st Century," held in conjunction with a program on "Aging and the Dementias" as part of a centennial series sponsored by Montefiore Medical Center, Bronx, NY. The meetings featured presentations by experts on mental, physical, economic, and philosophic aspects of the so-called graying of America. According to symposium participant Elias E. Manuelidis, MD, professor of neuropathology and neurology, Yale University School of Medicine, New Haven, Conn, life expectancy in this country will extend well into the tenth decade of life by the middle of the 21st century. The fastest growing segment of the population now comprises persons 85 years of age and

Neuroendocrinology of Aging

Gerontology Research Center National Institute on Aging Baltimore City Hospitals Baltimore, Maryland

Biomedical Institutions, Biomedical Funding, and Public Policy

This is one of those books where a prospective editor, having persuaded a publisher that an audience awaits, invites or reprints a selection of articles around a general topic. The 11 chapters of this volume, some reprinted from major medical journals, appear without editorial comment. They cover a wide range—from a speculative essay comparing creativity in research and art, to the details of how Baltimore City Hospital pays its medical faculty. A technical article on prenatal diagnosis of the genetic disorders of hemoglobin is followed by a Genex Corporation report on the commercial potentials of recombinant DNA and by an account of how private foundations work, and how one of them, The Robert Wood Johnson Foundation, has decided its priorities (which, incidentally, do not include biomedical research). Additional chapters explain the research interests of the World Health Organization, how the pharmaceutical industry's approach to research differs from that of the

Medical professional needs for geriatric care

Medical professional needs for geriatric care

Marihuana: Effects of acute doses on human social conversation: Stephen Higgins, Maxine L. Stitzer and David K. O'Leary. The Johns Hopkins University School of Medicine, MD and Baltimore City Hospitals, MD

Marihuana: Effects of acute doses on human social conversation: Stephen Higgins, Maxine L. Stitzer and David K. O'Leary. The Johns Hopkins University School of Medicine, MD and Baltimore City Hospitals, MD

Aging Biological Markers of Aging Mitchell E. Roff Edward L. Schneider

Journal Article Aging Get access Biological Markers of Aging, by Roff Mitchell E. Schneider Edward L.. National Institutes of Health, U.S. Department of Health and Human Services, Bethesda, MD, 1982, 252 p., illus. (82–2221). N. W. Shock N. W. Shock National Institutes of Health, National Institute on Aging, Gerontology Research Center, Baltimore City Hospitals, Baltimore, MD 21224 Search for other works by this author on: Oxford Academic Google Scholar BioScience, Volume 34, Issue 3, March 1984, Page 188, https://doi.org/10.2307/1309760 Published: 01 March 1984