Publications by authors named "Yaowaree Leavell"

4 Publications

  • Page 1 of 1

Paraproteinemias and Peripheral Nerve Disease.

Clin Geriatr Med 2021 May;37(2):301-312

Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, NY, USA. Electronic address:

This article provides an overview of the clinical features, diagnosis, and treatment of the major paraprotein-related peripheral neuropathies, including monoclonal gammopathy of undetermined significance, Waldenström macroglobulinemia, POEMS syndrome, multiple myeloma, transthyretin amyloidosis, and light chain amyloidosis. For each paraprotein neuropathy, the epidemiology, demographics, systemic findings, and electrophysiologic features are presented. Pharmacologic treatment of transthyretin amyloid polyneuropathy also is reviewed.
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http://dx.doi.org/10.1016/j.cger.2021.01.004DOI Listing
May 2021

Toward safer opioid prescribing: effects of the TOWER intervention on HIV care providers.

AIDS Care 2021 Mar 9:1-6. Epub 2021 Mar 9.

Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, NY, USA.

Rates of opioid use disorder and associated deaths remain alarmingly high. Measures to address the epidemic have included reductions in opioid prescribing, in part guided by the Centers for Disease Control Opioid Prescribing Guideline (CDCG). While reductions in over-prescribing have occurred, these measures have also resulted in decreased access and adverse outcomes for some stable opioid-treated chronic pain patients. The TOWard SafER Opioid Prescribing (TOWER) intervention was designed to support HIV primary care providers in use of the CDCG and in decision-making and patient-provider communication regarding safe opioid prescribing. Eleven HIV primary care providers and 40 of their patients were randomized into intervention and control groups. Transcripts from 21 patient visits were analyzed, focusing on opioid and pain-related communications. Findings from this research indicate greater alignment with the CDCG among visits carried out with providers in the TOWER intervention group. However, control group visits were notably consistent with guideline recommendations in several key areas. Differences observed between the intervention and control group visits demonstrate intervention strengths, as well as areas where additional work needs to be done to ensure prescribing and communication consistent with the CDCG.
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http://dx.doi.org/10.1080/09540121.2021.1887444DOI Listing
March 2021

Baseline Characteristics and Readmissions after Cerebral Venous Sinus Thrombosis in a Nationally Representative Database.

Cerebrovasc Dis 2018 2;46(5-6):249-256. Epub 2019 Jan 2.

Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, New York, USA,

Background: There are limited epidemiologic data on cerebral venous sinus thrombosis (CVST). We aim to summarize baseline characteristics and outcomes using a large nationally representative administrative database.

Methods: Using the 2013 Nationwide Readmissions Database, we used validated International Classification of Disease, Ninth Revision codes to identify baseline characteristics of patients admitted with CVST. We calculated readmission rates (per 100,000 index hospitalizations) for neurological complications. Multivariable Poisson regression yielded rate ratios (RR) of associations between index admission variables and all-cause readmission up to 1 year.

Results: Among 2,105 patients with index admission for CVST, mean age was 46.8 (SD 18.4); 65.2% were female, and 6.1% were pregnant. Hemorrhagic stroke (15.6%) was more common than ischemic stroke (10.7%), seizure occurred in 16.3, and 3.7% of patients died during index hospitalization. The 90-day readmission rate (per 100,000 index CVST hospitalizations) was the highest for CVST (1,447) and ischemic stroke (755). Diabetes (RR 1.10, 95% CI 1.002-1.22), cancer (1.23, 1.09-1.39), insurance status (0.92, 0.83-0.97 for Medicare/private insurance vs. others), and discharge home (RR 0.89, 95% CI 0.85-0.99) were associated with increased readmission rate.

Conclusions: We provide baseline characteristics and readmission rates after CVST over a 1-year period. In-hospital mortality rate and association with pregnancy were lower than previously observed.
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http://dx.doi.org/10.1159/000495420DOI Listing
July 2019

Assessment of Chicken-Egg Membrane as a Dressing for Wound Healing.

Adv Skin Wound Care 2016 Mar;29(3):131-4

Fernando Guarderas, MD, is an Emergency Medicine Resident, University of North Carolina, Chapel Hill, North Carolina. Yaowaree Leavell, MD, is an Internal Medicine Resident, Orlando Regional Medical Center, Internal Medicine Department, Orlando, Florida. Trisha Sengupta, BBA, is a Medical Student, Florida State University College of Medicine, Tallahassee, Florida. Mariya Zhukova, BS, is a Medical Student, Florida State University College of Medicine, Tallahassee, Florida. Timothy L. Megraw, PhD, is Associate Professor, Florida State University College of Medicine, Biomedical Sciences, Tallahassee, Florida.

Objectives: To examine the efficacy of the folk remedy of chicken-egg membrane dressing on wound healing.

Design: Full-thickness excisional wounds were created on 14 male Sprague-Dawley rats in 2 separate trials. Each animal received 2 wounds on the upper back. One wound was untreated, and the other was dressed with chicken-egg membrane to assess its impact on wound healing. Half of the rats received egg membrane treatment on the inferior wound, whereas the other half received egg membrane treatment on the superior wound. Membrane replacement, wound debridement, and imaging were done on days 5, 8, and 10 and then imaging continued on days 12, 14, 16, 18, and 20 of the experiment. Healing rate was measured based on the wound area over the 20 days of the experiment.

Results: The wounds dressed with chicken-egg membrane had a significantly (P < .01) faster rate of healing compared with the control at the early stages of healing between days 0 and 5. This group healed 21% faster during this early phase, compared with the control group. Overall, however, wound healing rates were indistinguishable from days 5 to 20.

Conclusion: Chicken-egg membrane dressing significantly improves healing of cutaneous wounds in the early stages of wound healing.
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http://dx.doi.org/10.1097/01.ASW.0000480359.58866.e9DOI Listing
March 2016