Medicine and Health Sciences Commons^™

Genomic Analysis Of Chimeric Human Cytomegalovirus Vaccine Candidates Derived From Strains Towne And Toledo, Nicolás M. Suárez, Betty Lau, George M. Kemble, Ronzo Lee, Edward S. Mocarski, Gavin W. G. Wilkinson, Stuart P. Adler, Michael A. Mcvoy, Andrew J. Davison

Pediatrics Publications

Human cytomegalovirus (HCMV) is an important opportunistic pathogen in immunocompromised patients and a major cause of congenital birth defects when acquired in utero. In the 1990s, four chimeric viruses were constructed by replacing genome segments of the high passage Towne strain with segments of the low passage Toledo strain, with the goal of obtaining live attenuated vaccine candidates that remained safe but were more immunogenic than the overly attenuated Towne vaccine. The chimeras were found to be safe when administered to HCMV-seronegative human volunteers, but to differ significantly in their ability to induce seroconversion. This suggests that chimera-specific genetic differences …

Use Of Management Pathways Or Algorithms In Children With Chronic Cough Chest Guideline And Expert Panel Report, Anne B. Chang, John J. Oppenheimer, Miles M. Weinberger, Bruce K. Rubin, Kelly Weir, Cameron C. Grant, Richard S. Irwin, Chest Expert Cough Panel

Pediatrics Publications

BACKGROUND: Using management algorithms or pathways potentially improves clinical outcomes. We undertook systematic reviews to examine various aspects in the generic approach (use of cough algorithms and tests) to the management of chronic cough in children (aged ≤ 14 years) based on key questions (KQs) using the Population, Intervention, Comparison, Outcome format.

METHODS: We used the CHEST Expert Cough Panel's protocol for the systematic reviews and the American College of Chest Physicians (CHEST) methodological guidelines and Grading of Recommendations Assessment, Development and Evaluation framework. Data from the systematic reviews in conjunction with patients' values and preferences and the clinical context …

A Preliminary Longitudinal Study Of White Matter Alteration In Cocaine Use Disorder Subjects, Liangsuo Ma, Joel L. Steinberg, Qin Wang, Joy M. Schmitz, Edward L. Boone, Ponnada A. Narayana, F. Gerard Moeller

Radiology Publications

Background

Previous diffusion tensor imaging (DTI) studies have consistently shown that subjects with cocaine use disorder (CocUD) had altered white matter microstructure in the corpus callosum. It is believed that these alterations are due to preexisting factors, chronic cocaine use, or both. However, there is no published longitudinal DTI study on human cocaine users yet which could shed light on the relationship between cocaine use and DTI findings.

Methods

This study used a longitudinal design and DTI to test if the white matter microstructure shows quicker alteration in CocUD subjects than controls. DTI data were acquired from eleven CocUD subjects …

A Randomized Prospective Long-Term (> 1 Year) Clinical Trial Comparing The Efficacy And Safety Of Radiofrequency Ablation To 980nm Laser Ablation Of The Great Saphenous Vein, Malcolm Sydnor, John Mavropoulos, Natalia Slobodnik, Luke Wolfe, Brian Strife, Daniel Komorowski

Radiology Publications

Purpose

To compare the short- and long-term (>1 year) efficacy and safety of radiofrequency ablation (ClosureFAST™) versus endovenous laser ablation (980 nm diode laser) for the treatment of superficial venous insufficiency of the great saphenous vein.

Materials and methods

Two hundred patients with superficial venous insufficiency of the great saphenous vein were randomized to receive either radiofrequency ablation or endovenous laser ablation (and simultaneous adjunctive therapies for surface varicosities when appropriate). Post-treatment sonographic and clinical assessment was conducted at one week, six weeks, and six months for closure, complications, and patient satisfaction. Clinical assessment of each patient was conducted …

Dynamical System Modeling To Simulate Donor T Cell Response To Whole Exome Sequencing-Derived Recipient Peptides: Understanding Randomness In Alloreactivity Incidence Following Stem Cell Transplantation, Vishal Koparde, Badar Abdul Razzaq, Tara Suntum, Roy Sabo, Allison Scalora, Myrna Serrano, Max Jameson-Lee, Charles Hall, David Kobulnicky, Nihar Sheth, Juliana Feltz, Daniel Contaifer, Dayanjan Wijesinghe, Jason Reed, Catherine Roberts, Rehan Qayyum, Gregory Buck, Michael Neale, Amir Toor

Massey Comprehensive Cancer Center Data

Quantitative relationship between the magnitude of variation in minor histocompatibility antigens (mHA) and graft versus host disease (GVHD) pathophysiology in stem cell transplant (SCT) donor-recipient pairs (DRP) is not established. In order to elucidate this relationship, whole exome sequencing (WES) was performed on 27 HLA matched related (MRD), & 50 unrelated donors (URD), to identify nonsynonymous single nucleotide polymorphisms (SNPs). An average 2,463 SNPs were identified in MRD, and 4,287 in URD DRP (p

Glypican-3 And Cd81 Promote Development Of Hepatocellular Carcinoma And Hepatoblastoma Through Negative Selection., Yuhua Xue, Wendy Mars, William Bowen, Aatur D. Singhi, Sarangarajan Ranganathan, George K. Michalopoulos

Hepatobiliary Cancers: Pathobiology and Translational Advances

No abstract provided.

Role Of Epigenetic Modification And Immunomodulation In A Murine Prostate Cancer Model, Jay E. Sulek, Samuel P. Robinson, Albert A. Petrossian, Shaoqing Zhou, Ekaterine Goliadze, Masoud H. Manjili, Amir Toor, Georgi Guruli

Surgery Publications

INTRODUCTION. Decreased expression of highly immunogenic cancer-testis antigens (CTA) might help tumor to achieve low immunogenicity, escape immune surveillance and grow unimpeded. Our aim was to evaluate CTA expression in tumor and normal tissues and to investigate possible means of improving the immune response in a murine prostate cancer (CaP) model by using the combination of epigenetic modifier 5-azacitidine (5-AzaC) and immunomodulator lenalidomide. No study to date has examined the effect of this combination on the prostate cancer or its impact on antigen-presenting cells (APC).

MATERIALS AND METHODS. Gene microarrays were performed to compare expression of several CTA in murine …

Management Of Children With Chronic Wet Cough And Protracted Bacterial Bronchitis Chest Guideline And Expert Panel Report, Anne B. Chang, John J. Oppenheimer, Miles M. Weinberger, Bruce K. Rubin, Cameron C. Grant, Kelly Weir, Richard S. Irwin, Chest Expert Cough Panel

Pediatrics Publications

BACKGROUND: Wet or productive cough is common in children with chronic cough. We formulated recommendations based on systematic reviews related to the management of chronic wet cough in children (aged
METHODS: We used the CHEST expert cough panel's protocol for systematic reviews and the American College of Chest Physicians (CHEST) methodologic guidelines and GRADE framework (the Grading of Recommendations Assessment, Development and Evaluation). Data from the systematic reviews in conjunction with patients' values and preferences and the clinical context were used to form recommendations. Delphi methodology was used to obtain consensus for the recommendations/suggestions made.

RESULTS: Combining data from the …

History Of The Innovation Of Damage Control For Management Of Trauma Patients: 1902-2016, Derek J. Roberts, Chad G. Ball, David V. Feliciano, Ernest E. Moore, Rao R. Ivatury, Charles E. Lucas, Timothy C. Fabian, David A. Zygun, Andrew W. Kirkpatrick, Henry T. Stelfox

Surgery Publications

Objective: To review the history of the innovation of damage control (DC) for management of trauma patients.

Background: DC is an important development in trauma care that provides a valuable case study in surgical innovation.

Methods: We searched bibliographic databases (1950-2015), conference abstracts (2009-2013), Web sites, textbooks, and bibliographies for articles relating to trauma DC. The innovation of DC was then classified according to the Innovation, Development, Exploration, Assessment, and Long-term study model of surgical innovation.

Results: The "innovation'' of DC originated from the use of therapeutic liver packing, a practice that had previously been abandoned after World War II …

A Pilot Study To Measure Dynamic Elasticity Of The Bladder During Urodynamics, Andrew F. Colhoun, Adam P. Klausner, Anna S. Nagle, Ashley W. Carroll, Robert W. Barbee, Paul H. Ratz, John E. Speich

Surgery Publications

AIMS: Previous studies using isolated strips of human detrusor muscle identified adjustable preload tension, a novel mechanism that acutely regulates detrusor wall tension. The purpose of this investigation was to develop a method to identify a correlate measure of adjustable preload tension during urodynamics.

METHODS: Patients reporting urgency most or all of the time based on ICIq-OAB survey scores were prospectively enrolled in an extended repeat fill-and-empty urodynamics study designed to identify a correlate of adjustable preload tension which we now call dynamic elasticity. Cystometric capacity was determined during initial fill. Repeat fills to defined percentages of capacity with passive …

Safety And Effectiveness Of Propranolol In Severely Burned Patients: Systematic Review And Meta-Analysis, Ramiro Manzano-Nunez, Herney Andrés García-Perdomo, Paula Ferrada, Carlos Alberto Ordoñez Delgado, Diego Andrés Gomez, Jorge Esteban Foianini

Surgery Publications

Background

The objective of this systematic review was to determine the effectiveness and safety of propranolol compared to placebo or usual care for improving clinical relevant outcomes in severely burned patients (TBSA >20%).

Methods

Relevant articles from randomized controlled trials were identified by a literature search in MEDLINE, EMBASE, and CENTRAL. We included trials involving patients with a severe burn (>20% of total body surface area affected). Trials were eligible if they evaluated propranolol and compared to usual care or placebo. Two investigators independently assessed articles for inclusion and exclusion criteria and selected studies for the final analysis. We …

Characterization Of Lower Urinary Tract Symptoms In Patients With Idiopathic Normal Pressure Hydrocephalus, Sarah C. Krzastek, William M. Bruch, Samuel P. Robinson, Harold F. Young, Adam P. Klausner

Surgery Publications

AIMS: The purpose of this study was to evaluate lower urinary tract symptoms (LUTS) in idiopathic normal pressure hydrocephalus (iNPH).

METHODS: Patients with new-onset iNPH were prospectively evaluated for LUTS via detailed history and physical, and administration of questionnaires from the International Consultation on Incontinence to assess incontinence (ICIq-UI), overactive bladder (ICIq-OAB), and quality of life (ICIq-LUTqol), as well as the American Urological Association Symptom Score bother scale. All patients with moderate-to-severe LUTS were offered urodynamic testing. Sub-analysis was performed based on gender, medical comorbidities, and age.

RESULTS: Fifty-five consecutive patients with iNPH completed the initial evaluation and surveys. Total …

Pelvic Trauma: Wses Classification And Guidelines, Federico Coccolini, Philip F. Stahel, Giulia Montori, Walter Biffl, Tal M. Horer, Fausto Catena, Yoram Kluger, Ernest E. Moore, Andrew B. Peitzman, Rao Ivatury, Raul Coimbra, Gustavo Pereira Fraga, Bruno Pereira, Sandro Rizoli, Andrew Kirkpatrick, Ari Leppaniemi, Roberto Manfredi, Stefano Magnone, Osvaldo Chiara, Leonardo Solaini, Marco Ceresoli, Niccolò Allievi, Catherine Arvieux, George Velmahos, Zsolt Balogh, Noel Naidoo, Dieter Weber, Fikri Abu-Zidan, Massimo Sartelli, Luca Ansaloni

Surgery Publications

Complex pelvic injuries are among the most dangerous and deadly trauma related lesions. Different classification systems exist, some are based on the mechanism of injury, some on anatomic patterns and some are focusing on the resulting instability requiring operative fixation. The optimal treatment strategy, however, should keep into consideration the hemodynamic status, the anatomic impairment of pelvic ring function and the associated injuries. The management of pelvic trauma patients aims definitively to restore the homeostasis and the normal physiopathology associated to the mechanical stability of the pelvic ring. Thus the management of pelvic trauma must be multidisciplinary and should be …

Scedosporium Prolificans Septic Arthritis, Collier S. Pace, Jessica A. Frankenhoff, Jonathan E. Isaacs

Surgery Publications

Scedosporium prolificans is an emerging fungal pathogen that can cause significant morbidity, and even mortality, in both immunocompromised and immunocompetent patients. Approximately 10% of patients affected by this rare fungal pathogen present with septic osteomyelitis or arthritis. Overall, the rate of mortality is close to 50%, and several patients with orthopedic infections have required amputations.1 Our patient is a 59-year-old woman, with a history of rheumatoid arthritis requiring immunosuppressants, who presented with a 5-month history of right wrist pain and swelling. She described an oscillating course of swelling, erythema, and pain involving the dorsal aspect of her wrist that did …

Operative And Nonoperative Management Of Blunt Liver Injuries, Jill Peysha, Paula Ferrada

Surgery Publications

Purpose of Review

The purpose of this review is to discuss the indications for operative and nonoperative management in patients with blunt liver injuries.

Recent Findings

Over the past several years, research has begun to show that nonoperative management in blunt liver injuries is feasible and has favorable outcomes over immediate operations in patients who are hemodynamically stable. This includes high-grade injuries who were previously taken to the operating room, in the absence of peritoneal signs or instability, for washout and packing. This trend in management is likely multifactorial and includes improved quality of critical care medicine, advances in imaging …

Panamerican Trauma Society: The First Three Decades, Rao R. Ivatury, Michel Aboutanos

Surgery Publications

Panamerican Trauma Society was born 30 years ago with the mission of improving trauma care in the Americas by exchange of ideas and concepts and expanding knowledge of trauma and acute illness. The authors, immediate-past leaders of the organization, review the evolution of this assembly of diverse cultures and nationalities.

The Global Alliance For Infections In Surgery: Defining A Model For Antimicrobial Stewardship—Results From An International Cross-Sectional Survey, Massimo Sartelli, Francesco M. Labricciosa, Pamela Barbadoro, Leonardo Pagani, Luca Ansaloni, Adrian J. Brink, Jean Carlet, Ashish Khanna, Alain Chichom-Mefire, Federico Coccolini, Salomone Di Saverio, Addison K. May, Pierluigi Viale, Richard R. Watkins, Luigia Scudeller, Lilian M. Abbo, Fikri M. Abu-Zidan, Abdulrashid K. Adesunkanmi, Sara Al-Dahir, Majdi N. Al-Hasan, Halil Alis, Carlos Alves, André R. Araujo Da Silva, Goran Augustin, Miklosh Bala, Philip S. Barie, Marcelo A. Beltrán, Aneel Bhangu, Belefquih Bouchra, Stephen M. Brecher, Miguel A. Caínzos, Adrian Camacho-Ortiz, Marco Catani, Sujith J. Chandy, Asri Che Jusoh, Jill R. Cherry-Bukowiec, Osvaldo Chiara, Elif Colak, Oliver A. Cornely, Yunfeng Cui, Zaza Demetrashvili, Belinda De Simone, Jan J. De Waele, Sameer Dhingra, Francesco Di Marzo, Agron Dogjani, Gereltuya Dorj, Laurent Dortet, Therese M. Duane, Mutasim M. Elmangory, Mushira A. Enani, Paula Ferrada, J. Esteban Foianini, Mahir Gachabayov, Chinmay Gandhi, Wagih Mommtaz Ghnnam, Helen Giamarellou, Georgios Gkiokas, Harumi Gomi, Tatjana Goranovic, Ewen A. Griffiths, Rosio I. Guerra Gronerth, Julio C. Haidamus Monteiro, Timothy C. Hardcastle, Andreas Hecker, Adrien M. Hodonou, Orestis Ioannidis, Arda Isik, Katia A. Iskandar, Hossein S. Kafil, Souha S. Kanj, Lewis J. Kaplan, Garima Kapoor, Aleksandar R. Karamarkovic, Jakub Kenig, Ivan Kerschaever, Faryal Khamis, Vladimir Khokha, Ronald Kiguba, Hong B. Kim, Wen-Chien Ko, Kaoru Koike, Iryna Kozlovska, Anand Kumar, Leonel Lagunes, Rifat Latifi, Jae G. Lee, Young R. Lee, Ari Leppäniemi, Yousheng Li, Stephen Y. Liang, Warren Lowman, Gustavo M. Machain, Marc Maegele, Piotr Major, Sydney Malama, Ramiro Manzano-Nunez, Athanasios Marinis, Isidro Martinez Casas, Sanjay Marwah, Emilio Maseda, Michael E. Mcfarlane, Ziad Memish, Dominik Mertz, Cristian Mesina, Shyam K. Mishra, Ernest E. Moore, Akutu Munyika, Eleftherios Mylonakis, Lena Napolitano, Ionut Negoi, Milica D. Nestorovic, David P. Nicolau, Abdelkarim H. Omari, Carlos A. Ordonez, José-Artur Paiva, Narayan D. Pant, Jose G. Parreira, Michal Pędziwiatr, Bruno M. Pereira, Alfredo Ponce-De-Leon, Garyphallia Poulakou, Jacobus Preller, Céline Pulcini, Guntars Pupelis, Martha Quiodettis, Timothy M. Rawson, Tarcisio Reis, Miran Rems, Sandro Rizoli, Jason Roberts, Nuno Rocha Pereira, Jesús Rodríguez-Baño, Boris Sakakushev, James Sanders, Natalia Santos, Norio Sato, Robert G. Sawyer, Sandro Scarpelini, Loredana Scoccia, Nusrat Shafiq, Vishalkumar Shelat, Costi D. Sifri, Boonying Siribumrungwong, Kjetil Søreide, Rodolfo Soto, Hamilton P. De Souza, Peep Talving, Ngo Tat Trung, Jeffrey M. Tessier, Mario Tumbarello, Jan Ulrych, Selman Uranues, Harry Van Goor, Andras Vereczkei, Florian Wagenlehner, Yonghong Xiao, Kuo-Ching Yuan, Agnes Wechsler-Fördös, Jean-Ralph Zahar, Tanya L. Zakrison, Brian Zuckerbraun, Wietse P. Zuidema, Fausto Catena

Surgery Publications

Background

Antimicrobial Stewardship Programs (ASPs) have been promoted to optimize antimicrobial usage and patient outcomes, and to reduce the emergence of antimicrobial-resistant organisms. However, the best strategies for an ASP are not definitively established and are likely to vary based on local culture, policy, and routine clinical practice, and probably limited resources in middle-income countries. The aim of this study is to evaluate structures and resources of antimicrobial stewardship teams (ASTs) in surgical departments from different regions of the world.

Methods

A cross-sectional web-based survey was conducted in 2016 on 173 physicians who participated in the AGORA (Antimicrobials: A Global …

The Role Of Open Abdomen In Non-Trauma Patient: Wses Consensus Paper, Federico Coccolini, Giulia Montori, Marco Ceresoli, Fausto Catena, Ernest E. Moore, Rao Ivatury, Walter Biffl, Andrew Peitzman, Raul Coimbra, Sandro Rizoli, Yoram Kluger, Fikri M. Abu-Zidan, Massimo Sartelli, Marc De Moya, George Velmahos, Gustavo Pereira Fraga, Bruno M. Pereira, Ari Leppaniemi, Marja A. Boermeester, Andrew W. Kirkpatrick, Ron Maier, Miklosh Bala, Boris Sakakushev, Vladimir Khokha, Manu Malbrain, Vanni Agnoletti, Ignacio Martin-Loeches, Michael Sugrue, Salomone Di Saverio, Ewen Griffiths, Kjetil Soreide, John E. Mazuski, Addison K. May, Philippe Montravers, Rita Maria Melotti, Michele Pisano, Francesco Salvetti, Gianmariano Marchesi, Tino M. Valetti, Thomas Scalea, Osvaldo Chiara, Jeffry L. Kashuk, Luca Ansaloni

Surgery Publications

The open abdomen (OA) is defined as intentional decision to leave the fascial edges of the abdomen un-approximated after laparotomy (laparostomy). The abdominal contents are potentially exposed and therefore must be protected with a temporary coverage, which is referred to as temporal abdominal closure (TAC). OA use remains widely debated with many specific details deserving detailed assessment and clarification. To date, in patients with intra-abdominal emergencies, the OA has not been formally endorsed for routine utilization; although, utilization is seemingly increasing. Therefore, the World Society of Emergency Surgery (WSES), Abdominal Compartment Society (WSACS) and the Donegal Research Academy united a …

The Management Of Intra-Abdominal Infections From A Global Perspective: 2017 Wses Guidelines For Management Of Intra-Abdominal Infections, Massimo Sartelli, Alain Chichom-Mefire, Francesco M. Labricciosa, Timothy Hardcastle, Fikri M. Abu-Zidan, Abdulrashid K. Adesunkanmi, Luca Ansaloni, Miklosh Bala, Zsolt J. Balogh, Marcelo A. Beltrán, Offir Ben-Ishay, Walter L. Biffl, Arianna Birindelli, Miguel A. Cainzos, Gianbattista Catalini, Marco Ceresoli, Asri Che Jusoh, Osvaldo Chiara, Federico Coccolini, Raul Coimbra, Francesco Cortese, Zaza Demetrashvili, Salomone Di Saverio, Jose J. Diaz, Valery N. Egiev, Paula Ferrada, Gustavo P. Fraga, Wagih M. Ghnnam, Jae Gil Lee, Carlos A. Gomes, Andreas Hecker, Torsten Herzog, Jae Il Kim, Kenji Inaba, Arda Isik, Aleksandar Karamarkovic, Jeffry Kashuk, Vladimir Khokha, Andrew W. Kirkpatrick, Yoram Kluger, Kaoru Koike, Victor Y. Kong, Ari Leppaniemi, Gustavo M. Machain, Ronald V. Maier, Sanjay Marwah, Michael E. Mcfarlane, Giulia Montori, Ernest E. Moore, Ionut Negoi, Iyiade Olaoye, Abdelkarim H. Omari, Carlos A. Ordonez, Bruno M. Pereira, Gerson A. Pereira Júnior, Guntars Pupelis, Tarcisio Reis, Boris Sakakushev, Norio Sato, Helmut Ovia Lohse A. Segovia Lohse, Vishal G. Shelat, Kjetil Søreide, Waldemar Uhl, Jan Ulrych, Harry Van Goor, George C. Velmahos, Kuo-Ching Yuan, Imtiaz Wani, Dieter G. Weber, Sanoop K. Zachariah, Fausto Catena

Surgery Publications

Intra-abdominal infections (IAIs) are common surgical emergencies and have been reported as major contributors to non-trauma deaths in the emergency departments worldwide.

The cornerstones of effective treatment of IAIs are early recognition, adequate source control, and appropriate antimicrobial therapy. Prompt resuscitation of patients with ongoing sepsis is of utmost important.

In hospitals worldwide, non-acceptance of, or lack of access to, accessible evidence-based practices and guidelines result in overall poorer outcome of patients suffering IAIs.

The aim of this paper is to promote global standards of care in IAIs and update the 2013 WSES guidelines for management of intra-abdominal infections.

Splenic Trauma: Wses Classification And Guidelines For Adult And Pediatric Patients, Federico Coccolini, Giulia Montori, Fausto Catena, Yoram Kluger, Walter Biffl, Ernest E. Moore, Viktor Reva, Camilla Bing, Miklosh Bala, Paola Fugazzola, Hany Bahouth, Ingo Marzi, George Velmahos, Rao Ivatury, Kjetil Soreide, Tal Horer, Richard Ten Broek, Bruno M. Pereira, Gustavo P. Fraga, Kenji Inaba, Joseph Kashuk, Neil Parry, Peter T. Masiakos, Konstantinos S. Mylonas, Andrew Kirkpatrick, Fikri Abu-Zidan, Carlos Augusto Gomes, Simone Vasilij Benatti, Noel Naidoo, Francesco Salvetti, Stefano Maccatrozzo, Vanni Agnoletti, Emiliano Gamberini, Leonardo Solaini, Antonio Costanzo, Andrea Celotti, Matteo Tomasoni, Vladimir Khokha, Catherine Arvieux, Lena Napolitano, Lauri Handolin, Michele Pisano Pisano, Stefano Magnone, David A. Spain, Marc De Moya, Kimberly A. Davis, Nicola De Angelis, Ari Leppaniemi, Paula Ferrada, Rifat Latifi, David Costa Navarro, Yashuiro Otomo, Raul Coimbra, Ronald V. Maier, Frederick Moore, Sandro Rizoli, Boris Sakakushev, Joseph M. Galante, Osvaldo Chiara, Stefania Cimbanassi, Alain Chichom Mefire, Dieter Weber, Marco Ceresoli, Andrew B. Peitzman, Liban Wehlie, Massimo Sartelli, Salomone Di Saverio, Luca Ansaloni

Surgery Publications

Spleen injuries are among the most frequent trauma-related injuries. At present, they are classified according to the anatomy of the injury. The optimal treatment strategy, however, should keep into consideration the hemodynamic status, the anatomic derangement, and the associated injuries. The management of splenic trauma patients aims to restore the homeostasis and the normal physiopathology especially considering the modern tools for bleeding management. Thus, the management of splenic trauma should be ultimately multidisciplinary and based on the physiology of the patient, the anatomy of the injury, and the associated lesions. Lastly, as the management of adults and children must be …

A Meta-Analysis Of Resuscitative Endovascular Balloon Occlusion Of The Aorta (Reboa) Or Open Aortic Cross-Clamping By Resuscitative Thoracotomy In Non-Compressible Torso Hemorrhage Patients, Ramiro Manzano Nunez, Maria Paula Naranjo, Esteban Foianini, Paula Ferrada, Erika Rincon, Herney Andrés García-Perdomo, Paola Burbano, Juan Pablo Herrera, Alberto F. García, Carlos A. Ordoñez

Surgery Publications

Background

The objective of this systematic review and meta-analysis was to determine the effect of REBOA, compared to resuscitative thoracotomy, on mortality and among non-compressible torso hemorrhage trauma patients.

Methods

Relevant articles were identified by a literature search in MEDLINE and EMBASE. We included studies involving trauma patients suffering non-compressible torso hemorrhage. Studies were eligible if they evaluated REBOA and compared it to resuscitative thoracotomy. Two investigators independently assessed articles for inclusion and exclusion criteria and selected studies for final analysis. We conducted meta-analysis using random effect models.

Results

We included three studies in our systematic review. These studies included …

State Of Harmonization Of 24 Serum Albumin Measurement Procedures And Implications For Medical Decisions, Lorin M. Bachmann, Min Yu, James C. Boyd, David E. Bruns, W. Greg Miller

Pathology Publications

BACKGROUND: Measurements of serum and plasma albumin are widely used in medicine, including as indicators of quality of patient care in renal dialysis centers.

METHODS: Pools were prepared from residual patient serum (n = 50) and heparin plasma (n = 48) from patients without renal disease, and serum from patients with kidney failure before hemodialysis (n = 53). Albumin was measured in all samples and in ERM-DA470k/IFCC reference material (RM) by 3 immunochemical, 9 bromcresol green (BCG), and 12 bromcresol purple (BCP) methods.

RESULTS: Two of 3 immunochemical procedures, 5 of 9 BCG, and 10 of 12 BCP methods recovered …

Quality Of Life In Chronic Pancreatitis Is Determined By Constant Pain, Disability/Unemployment, Current Smoking, And Associated Co-Morbidities, Jorge D. Machicado, Stephen T. Amann, Michelle A. Anderson, Judah Abberbock, Stuart Sherman, Darwin L. Conwell, Gregory A. Cote, Vikesh K. Singh, Michele D. Lewis, Samer Alkaade, Bimaljit S. Sandhu, Nalini M. Guda, Thiruvengadam Muniraj, Gong Tang, John Baillie, Randall E. Brand, Timothy B. Gardner, Andres Gelrud, Christopher E. Forsmark, Peter A. Banks, Adam Slivka, C. Mel Wilcox, David C. Whitcomb, Dhiraj Yadav

Pathology Publications

OBJECTIVES: Chronic pancreatitis (CP) has a profound independent effect on quality of life (QOL). Our aim was to identify factors that impact the QOL in CP patients.

METHODS: We used data on 1,024 CP patients enrolled in the three NAPS2 studies. Information on demographics, risk factors, co-morbidities, disease phenotype, and treatments was obtained from responses to structured questionnaires. Physical and mental component summary (PCS and MCS, respectively) scores generated using responses to the Short Form-12 (SF-12) survey were used to assess QOL at enrollment. Multivariable linear regression models determined independent predictors of QOL.

RESULTS: Mean PCS and MCS scores were …

Development And Validation Of Clinical Whole-Exome And Whole-Genome Sequencing For Detection Of Germline Variants In Inherited Disease, Madhuri Hegde, Avni Santani, Rong Mao, Andrea Ferreira-Gonzalez, Karen E. Weck, Karl V. Voelkerding

Pathology Publications

Context.-With the decrease in the cost of sequencing, the clinical testing paradigm has shifted from single gene to gene panel and now whole-exome and whole-genome sequencing. Clinical laboratories are rapidly implementing next-generation sequencing-based whole-exome and whole-genome sequencing. Because a large number of targets are covered by whole-exome and whole-genome sequencing, it is critical that a laboratory perform appropriate validation studies, develop a quality assurance and quality control program, and participate in proficiency testing.

Objective.-To provide recommendations for wholeexome and whole-genome sequencing assay design, validation, and implementation for the detection of germline variants associated in inherited disorders.

Data Sources.-An example of …

Development And Validation Of Targeted Next-Generation Sequencing Panels For Detection Of Germline Variants In Inherited Diseases., Avni Santani, Jill Murrell, Birgit Funke, Zhenming Yu, Madhuri Hegde, Rong Mao, Andrea Ferreira-Gonzalez, Karl V. Voelkerding, Karen E. Weck

Pathology Publications

Context.-The number of targeted next-generation sequencing (NGS) panels for genetic diseases offered by clinical laboratories is rapidly increasing. Before an NGS-based test is implemented in a clinical laboratory, appropriate validation studies are needed to determine the performance characteristics of the test.

Objective.-To provide examples of assay design and validation of targeted NGS gene panels for the detection of germline variants associated with inherited disorders.

Data Sources.-The approaches used by 2 clinical laboratories for the development and validation of targeted NGS gene panels are described. Important design and validation considerations are examined.

Conclusions.-Clinical laboratories must validate performance specifications of each test …

Hiv Induces Expression Of Complement Component C3 In Astrocytes By Nf-Κb-Dependent Activation Of Interleukin-6 Synthesis, Jadwiga Nitkiewicz, Alejandra Borjabad, Susan Morgello, Jacinta Murray, Wei Chao, Luni Emdad, Paul B. Fisher, Mary Jane Potash, David J. Volsky

Pathology Publications

Background

Abnormal activation of the complement system contributes to some central nervous system diseases but the role of complement in HIV-associated neurocognitive disorder (HAND) is unclear.

Methods

We used real-time PCR and immunohistochemistry to detect complement expression in postmortem brain tissue from HAND patients and controls. To further investigate the basis for viral induction of gene expression in the brain, we studied the effect of HIV on C3 expression by astrocytes, innate immune effector cells, and targets of HIV. Human fetal astrocytes (HFA) were infected with HIV in culture and cellular pathways and factors involved in signaling to C3 expression …

Evaluation Of The Angiotensin Ii Receptor Blocker Azilsartan Medoxomil In African-American Patients With Hypertension, Wallace Johnson, William B. White, Domenic Sica, George L. Bakris, Michael A. Weber, Alison Handley, Alfonso Perez, Charlie Cao, Stuart Kupfer, Elijah B. Saunders

Pathology Publications

The efficacy and safety of azilsartan medoxomil (AZL-M) were evaluated in African-American patients with hypertension in a 6-week, double-blind, randomized, placebo-controlled trial, for which the primary end point was change from baseline in 24-hour mean systolic blood pressure (BP). There were 413 patients, with a mean age of 52years, 57% women, and baseline 24-hour BP of 146/91mmHg. Treatment differences in 24-hour systolic BP between AZL-M 40mg and placebo (-5.0mmHg; 95% confidence interval, -8.0 to -2.0) and AZL-M 80mg and placebo (-7.8mmHg; 95% confidence interval, -10.7 to -4.9) were significant (P.001 vs placebo for both comparisons). Changes in the clinic BPs …

Donor Ifnl4 Genotype Is Associated With Early Post-Transplant Fibrosis In Recipients With Hepatitis C, Taylor Aiken, Ari Garber, Dawn Thomas, Nicole Hamon, Rocio Lopez, Rajesh Konjeti, Arthur Mccullough, Nizar Zein, John Fung, Medhat Askar, Binu V. John

Pathology Publications

Background and Aims

Early post-transplant hepatic fibrosis is associated with poor outcomes and may be influenced by donor/recipient genetic factors. The rs368234815 IFNL4 polymorphism is related to the previously described IL28B polymorphism, which predicts etiology-independent hepatic fibrosis. The aim of this study was to identify the impact of donor and/or recipient IFNL4 genotype on early fibrosis among patients transplanted for hepatitis C (HCV).

Methods

Clinical data were collected for 302 consecutive patients transplanted for HCV. 116 patients who had available liver biopsies and donor/recipient DNA were included. 28% of these patients with stage 2 fibrosis or greater were compared to …

Simultaneous Papillary Carcinoma In Thyroglossal Duct Cyst And Thyroid, Gustavo Cancela E Penna, Henrique Gomes Mendes, Adele O. Kraft, Cynthia Koeppel Berenstein, Bernardo Fonseca, Wagner José Martorina, Andreise Laurian N. R. De Souza, Gustavo Meyer De Moraes, Kamilla Maria Araújo Brandão Rajão, Bárbara Érika Caldeira Araújo Sousa

Pathology Publications

Thyroglossal duct cyst (TDC) is a cystic expansion of a remnant of the thyroglossal duct tract. Carcinomas in the TDC are extremely rare and are usually an incidental finding after the Sistrunk procedure. In this report, an unusual case of a 36-year-old woman with concurrent papillary thyroid carcinoma arising in the TDC and on the thyroid gland is presented, followed by a discussion of the controversies surrounding the possible origins of a papillary carcinoma in the TDC, as well as the current management options.

Association Of Intraocular Pressure With Human Immunodeficiency Virus, Matthew T. Young, Rakhi T. Melvani, Faraaz A. Khan, Puneet S. Braich, Surbhi Bansal

Ophthalmology Publications

PURPOSE: Prior studies have shown an association between human immunodeficiency virus (HIV) and reduced intraocular pressures (IOP). The purpose of this study was to determine if patients with HIV on highly active antiretroviral therapy (HAART) had any difference in their IOP compared with patients without HIV or with HIV who are not on HAART.

DESIGN: Retrospective cross-sectional study.

METHODS: We included 400 patients from our academic eye center between 2000 and 2016. Group 1 (G1) consisted of patients with HIV on HAART (n = 176), Group 2 (G2) consisted of patients with HIV who were not on HAART (n = …