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Erik A. Wallace

Bio: Erik A. Wallace is an academic researcher from University of Colorado Denver. The author has contributed to research in topics: Poison control & Suicide prevention. The author has an hindex of 5, co-authored 18 publications receiving 115 citations. Previous affiliations of Erik A. Wallace include University of Oklahoma Health Sciences Center & University of Oklahoma.

Papers
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Journal ArticleDOI
TL;DR: Increased healthcare provider awareness of CHS as a cause of nausea, vomiting, and abdominal pain coupled with an attentiveness to focused history taking can lead to effective treatment through cannabis cessation.
Abstract: Cannabinoid hyperemesis syndrome (CHS) is characterized by cyclic vomiting and compulsive bathing behaviors in chronic cannabis users. Patients are typically diagnosed with CHS only after multiple and extensive medical evaluations, consequently without a clear etiology of their symptoms or treatment plan leading to symptomatic improvement. Increased healthcare provider awareness of CHS as a cause of nausea, vomiting, and abdominal pain coupled with an attentiveness to focused history taking-especially noting symptomatic improvement with prolonged exposure to hot showers or baths-can lead to effective treatment through cannabis cessation. We propose a diagnosis and treatment algorithm for physicians to follow when evaluating patients presenting with nausea, vomiting, and abdominal pain who are suspected to suffer from CHS.

81 citations

Journal ArticleDOI
TL;DR: This is the largest reported number of cases of methanol toxicity from the inhalation of carburetor cleaning fluid fumes and demonstrates a problem with recurrent abuse among some older Native American men.
Abstract: Background. The purpose of this report is to evaluate the presentation, treatment, and outcomes of adults with methanol toxicity from inhalation of carburetor cleaning fluid fumes. Methods. Retrosp...

12 citations

Journal ArticleDOI
TL;DR: A 2-day Resident Academy orientation improved knowledge and attitudes of new residents before the start of residency, and residents were satisfied with the experience.
Abstract: Background Future physicians may not be prepared for the challenges of caring for the growing population of poor patients in this country. Given the potential for a socioeconomic “gulf” between physicians and patients and the lack of curricula that address the specific needs of poor patients, resident knowledge about caring for this underserved population is low. Intervention We created a 2-day Resident Academy orientation, before the start of residency training, to improve community knowledge and address resident attitudes toward poor patients through team-based experiential activities. We collected demographic and satisfaction data through anonymous presurvey and postsurvey t tests, and descriptive analysis of the quantitative data were conducted. Qualitative comments from open-ended questions were reviewed, coded, and divided into themes. We also offer information on the cost and replicability of the Academy. Results Residents rated most components of the Academy as “very good” or “excellent.”...

8 citations

Journal ArticleDOI
TL;DR: This research presents a meta-answers to the question of whether conventional or innovative approaches to care selection should be considered when selecting patients for high-value, cost-conscious care.
Abstract: Recent publications have emphasized the importance of physicians taking a lead role in delivering patient-centered, high-value, cost-conscious care. However, the increasing availability of direct-t...

7 citations

Journal ArticleDOI
03 Sep 2014-JAMA
TL;DR: The debate over direct-to-consumer (DTC) screening companies intensi ed recently as Public Citizen, a consumer advocacy organization, sent letters to 20 hospitals urging their leadership to sever business relationships with HealthFair, a prominent DTC screening company.
Abstract: The debate over direct-to-consumer (DTC) screening companies intensi ed recently as Public Citizen, a consumer advocacy organization, sent letters to 20 hospitals on June 19, 2014, urging their leadership to sever business relationships with HealthFair, a prominent DTC screening company. Public Citizen states that HealthFair’s “heavily promoted, community-wide cardiovascular health screening programs are unethical and are much more likely to do harm than good,” and they cite peer-reviewed evidence in support of their claims. If such claims are true, should any hospital sponsor or co-brand with DTC screening companies that allegedly sell “potentially harmful and unethical services?” (For example, sponsorship arrangements include allowing the use of a hospital's name in DTC company print or online advertising, providing or sharing a physical location where screening is performed, or both; co-branding includes promotion of a DTC screening company on a hospital's website.) Hospitals exist to provide medical services to the general community. Todeliver on theirmissions, hospitals must have a su cient number of patients use services to fund their operations. In an increasingly competitive health care environment, one strategy to bring innew“customers” is tosponsoroutreachprogramsthat

7 citations


Cited by
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Journal ArticleDOI
TL;DR: Cannabinoid hyperemesis syndrome is a cyclic vomiting syndrome, preceded by daily to weekly cannabis use, usually accompanied by symptom improvement with hot bathing, and resolution with cessation of cannabis, which appears to be the best treatment.
Abstract: Cannabinoid hyperemesis syndrome (CHS) is a syndrome of cyclic vomiting associated with cannabis use. Our objective is to summarize the available evidence on CHS diagnosis, pathophysiology, and treatment. We performed a systematic review using MEDLINE, Ovid MEDLINE, Embase, Web of Science, and the Cochrane Library from January 2000 through September 24, 2015. Articles eligible for inclusion were evaluated using the Grading and Recommendations Assessment, Development, and Evaluation (GRADE) criteria. Data were abstracted from the articles and case reports and were combined in a cumulative synthesis. The frequency of identified diagnostic characteristics was calculated from the cumulative synthesis and evidence for pathophysiologic hypothesis as well as treatment options were evaluated using the GRADE criteria. The systematic search returned 2178 articles. After duplicates were removed, 1253 abstracts were reviewed and 183 were included. Fourteen diagnostic characteristics were identified, and the frequency of major characteristics was as follows: history of regular cannabis for any duration of time (100%), cyclic nausea and vomiting (100%), resolution of symptoms after stopping cannabis (96.8%), compulsive hot baths with symptom relief (92.3%), male predominance (72.9%), abdominal pain (85.1%), and at least weekly cannabis use (97.4%). The pathophysiology of CHS remains unclear with a dearth of research dedicated to investigating its underlying mechanism. Supportive care with intravenous fluids, dopamine antagonists, topical capsaicin cream, and avoidance of narcotic medications has shown some benefit in the acute setting. Cannabis cessation appears to be the best treatment. CHS is a cyclic vomiting syndrome, preceded by daily to weekly cannabis use, usually accompanied by symptom improvement with hot bathing, and resolution with cessation of cannabis. The pathophysiology underlying CHS is unclear. Cannabis cessation appears to be the best treatment.

245 citations

Journal Article
01 Jan 2008-JAMA
TL;DR: This paper found that white students within the highest quintile for student body racial and ethnic diversity, measured by the proportion of underrepresented minority (URM) students, were more likely to rate themselves as highly prepared to care for minority populations than those in the lowest diversity quintile (61.1 % vs 53.9 %, respectively; P<.001).
Abstract: Context Many medical schools assert that a racially and ethnically diverse student body is an important element in educating physicians to meet the needs of a diverse society. However, there is limited evidence addressing the educational effects of student body racial diversity. Objective To determine whether student body racial and ethnic diversity is associated with diversity-related outcomes among US medical students. Design, Setting, and Participants A Web-based survey (Graduation Questionnaire) administered by the Association of American Medical Colleges of 20112 graduating medical students (64% of all graduating students in 2003 and 2004) from 118 allopathic medical schools in the United States. Historically black and Puerto Rican medical schools were excluded. Main Outcome Measures Students' self-rated preparedness to care for patients from other racial and ethnic backgrounds, attitudes about equity and access to care, and intent to practice in an underserved area. Results White students within the highest quintile for student body racial and ethnic diversity, measured by the proportion of underrepresented minority (URM) students, were more likely to rate themselves as highly prepared to care for minority populations than those in the lowest diversity quintile (61.1 % vs 53.9 %, respectively; P<.001; adjusted odds ratio [OR], 1.33; 95% confidence interval [Cl], 1.13-1.57). This association was strongest in schools in which students perceived a positive climate for interracial interaction. White students in the highest URM quintile were also more likely to have strong attitudes endorsing equitable access to care (54.8% vs 44.2%, respectively; P<.001; adjusted OR, 1.42; 95% Cl, 1.15-1.74). For nonwhite students, after adjustment there were no significant associations between student body URM proportions and diversity-related outcomes. Student body URM proportions were not associated with white or nonwhite students' plans to practice in underserved communities, although URM students were substantially more likely than white or nonwhite/ non-URM students to plan to serve the underserved (48.7% vs 18.8% vs 16.2%, respectively; P<.001). Conclusion Student body racial and ethnic diversity within US medical schools is associated with outcomes consistent with the goal of preparing students to meet the needs of a diverse population.

220 citations

Journal ArticleDOI
01 Jan 2019-JAMA
TL;DR: The marketing of prescription drugs, disease awareness campaigns, health services, and laboratory tests and the related consequences and regulation in the United States over a 20-year period (1997-2016) is reviewed.
Abstract: Importance Manufacturers, companies, and health care professionals and organizations use an array of promotional activities to sell and increase market share of their products and services. These activities seek to shape public and clinician beliefs about laboratory testing, the benefits and harms of prescription drugs, and some disease definitions. Objective To review the marketing of prescription drugs, disease awareness campaigns, health services, and laboratory tests and the related consequences and regulation in the United States over a 20-year period (1997-2016). Evidence Analysis (1997-2016) of consumer advertising (Kantar Media data for spending and number of ads); professional marketing (IQVIA Institute for Human Data Science, Open Payments Data [Centers for Medicare & Medicaid Services]); regulations and legal actions of the US Food and Drug Administration (FDA), Federal Trade Commission (FTC), state attorneys general, and US Department of Justice; and searches (1975-2018) of peer-reviewed medical literature (PubMed), business journals (Business Source Ultimate), and news media (Lexis Nexis) for articles about expenditures, content, and consequences and regulation of consumer and professional medical marketing. Spending is reported in 2016 dollars. Findings From 1997 through 2016, spending on medical marketing of drugs, disease awareness campaigns, health services, and laboratory testing increased from $17.7 to $29.9 billion. The most rapid increase was in direct-to-consumer (DTC) advertising, which increased from $2.1 billion (11.9%) of total spending in 1997 to $9.6 billion (32.0%) of total spending in 2016. DTC prescription drug advertising increased from $1.3 billion (79 000 ads) to $6 billion (4.6 million ads [including 663 000 TV commercials]), with a shift toward advertising high-cost biologics and cancer immunotherapies. Pharmaceutical companies increased DTC marketing about diseases treated by their drugs with increases in disease awareness campaigns from 44 to 401 and in spending from $177 million to $430 million. DTC advertising for health services increased from $542 million to $2.9 billion, with the largest spending increases by hospitals, dental centers, cancer centers, mental health and addiction clinics, and medical services (eg, home health). DTC spending on advertising for laboratory tests (such as genetic testing) increased from $75.4 million to $82.6 million, although the number of ads increased more substantially (from 14 100 to 255 300), reflecting an increase in less expensive electronic media advertising. Marketing to health care professionals by pharmaceutical companies accounted for most promotional spending and increased from $15.6 billion to $20.3 billion, including $5.6 billion for prescriber detailing, $13.5 billion for free samples, $979 million for direct physician payments (eg, speaking fees, meals) related to specific drugs, and $59 million for disease education. Manufacturers of FDA-approved laboratory tests paid $12.9 million to professionals in 2016. From 1997 through 2016, the number of consumer and professional drug promotional materials that companies submitted for FDA review increased from 34 182 to 97 252, while FDA violation letters for misleading drug marketing decreased from 156 to 11. Since 1997, 103 financial settlements between drug companies and federal and state governments resulted in more than $11 billion in fines for off-label or deceptive marketing practices. The FTC has acted against misleading marketing by a single for-profit cancer center. Conclusions and Relevance Medical marketing increased substantially from 1997 through 2016, especially DTC advertising for prescription drugs and health services. Pharmaceutical marketing to health professionals accounted for most spending and remains high even with new policies to limit industry influence. Despite the increase in marketing over 20 years, regulatory oversight remains limited.

213 citations

Journal ArticleDOI
TL;DR: It has become apparent that the cardinal feature of achalasia, impaired lower esophageal sphincter relaxation, can occur in several disease phenotypes; however, without a disease-specific biomarker, no manometric pattern is absolutely specific.

193 citations

Journal ArticleDOI
TL;DR: The mechanisms by which the ECS links stress and visceral pain are reviewed, including how transcription of CNR1 is modified through epigenetic processes under conditions of chronic stress and how these processes might link stress with abdominal pain.

146 citations