Browsing by Author "Patel, Riya T."

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    Low availability, long wait times, and high geographic disparity of psychiatric outpatient care in the US
    Sun, Ching-Fang; Correll, Christoph U.; Trestman, Robert L.; Lin, Yezhe; Xie, Hui; Hankey, Maria Stack; Uymatiao, Raymond Paglinawan; Patel, Riya T.; Metsutnan, Vemmy L.; McDaid, Erin Corinne; Saha, Atreyi; Kuo, Chin; Lewis, Paula; Bhatt, Shyam H.; Lipphard, Lauren Elizabeth; Kablinger, Anita S. (Elsevier, 2023-09-01)
    Objective: To identify potential barriers to care, this study examined the general psychiatry outpatient new appointment availability in the US, including in-person and telepsychiatry appointments, comparing results between insurance types (Medicaid vs. private insurance), states, and urbanization levels. Method: This mystery shopper study investigated 5 US states selected according to Mental Health America Adult Ranking and geography to represent the US mental health care system. Clinics across five selected states were stratified sampled by county urbanization levels. Calls were made during 05/2022–07/2022. Collected data included contact information accuracy, appointment availability, wait time (days), and related information. Results: Altogether, 948 psychiatrists were sampled in New York, California, North Dakota, Virginia, and Wyoming. Overall contact information accuracy averaged 85.3%. Altogether, 18.5% of psychiatrists were available to see new patients with a significantly longer wait time for in-person than telepsychiatry appointments (median = 67.0 days vs median = 43.0 days, p < 0.01). The most frequent reason for unavailability was provider not taking new patients (53.9%). Mental health resources were unevenly distributed, favoring urban areas. Conclusion: Psychiatric care has been severely restricted in the US with low accessibility and long wait times. Transitioning to telepsychiatry represents a potential solution for rural disparities in access.
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    Neurofibroma with glomus-like bodies: A novel association-Thoughts about origin
    Patel, Riya T.; Rizzo, Marissa T.; Guerra, Karla C.; Grider, Douglas J. (Wiley, 2024-05-03)
    A neurofibroma with focal glomus-like body differentiation is an unusual phenomenon recently encountered in an excision specimen from the right lateral distal forearm of a 26-year-old man. Glomus cells are modified smooth muscle cells normally present in glomus-like bodies but can also be found in glomus tumors (GT) or lesions considered in the spectrum of GT, including myopericytoma, myofibroma, and angiolipoma. Neurofibromas are peripheral nerve sheath tumors derived from the neural crest cells. While both GT and its variants and neurofibroma are thought to be derived from different cell types, there is growing evidence that glomus cells have a neural crest origin. This is based on multiple theories, with some overlapping pathways, including neural crest cell differentiation, Schwann cell reprogramming, VEGF expression, and NF1 gene biallelic inactivation. This report adds to the growing evidence of possible neural crest origin for glomus cells and would help explain finding glomus-like bodies scattered through a neurofibroma.