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Full-Text Articles in Medicine and Health Sciences

Unsupervised Machine Learning Using K-Means Identifies Radiomic Subgroups Of Pediatric Low-Grade Gliomas That Correlate With Key Molecular Markers, Debanjan Haldar, Anahita Fathi Kazerooni, Sherjeel Arif, Ariana Familiar, Rachel Madhogarhia, Nastaran Khalili, Sina Bagheri, Hannah Anderson, Ibraheem Salman Shaikh, Aria Mahtabfar, Meen Chul Kim, Wenxin Tu, Jefferey Ware, Arastoo Vossough, Christos Davatzikos, Phillip B Storm, Adam Resnick, Ali Nabavizadeh Dec 2022

Unsupervised Machine Learning Using K-Means Identifies Radiomic Subgroups Of Pediatric Low-Grade Gliomas That Correlate With Key Molecular Markers, Debanjan Haldar, Anahita Fathi Kazerooni, Sherjeel Arif, Ariana Familiar, Rachel Madhogarhia, Nastaran Khalili, Sina Bagheri, Hannah Anderson, Ibraheem Salman Shaikh, Aria Mahtabfar, Meen Chul Kim, Wenxin Tu, Jefferey Ware, Arastoo Vossough, Christos Davatzikos, Phillip B Storm, Adam Resnick, Ali Nabavizadeh

Department of Neurosurgery Faculty Papers

Introduction: Despite advancements in molecular and histopathologic characterization of pediatric low-grade gliomas (pLGGs), there remains significant phenotypic heterogeneity among tumors with similar categorizations. We hypothesized that an unsupervised machine learning approach based on radiomic features may reveal distinct pLGG imaging subtypes.

Methods: Multi-parametric MR images (T1 pre- and post-contrast, T2, and T2 FLAIR) from 157 patients with pLGGs were collected and 881 quantitative radiomic features were extracted from tumorous region. Clustering was performed using K-means after applying principal component analysis (PCA) for feature dimensionality reduction. Molecular and demographic data was obtained from the PedCBioportal and compared between imaging subtypes.

Results: …


Comparison Ultrasound-Guided Handheld Vacuum Assisted Breast Biopsy And Core Biopsy In Breast Cancer, Anak Agung Ngurah Bagus Satya Sueningrat, Mendy Mendy Dec 2022

Comparison Ultrasound-Guided Handheld Vacuum Assisted Breast Biopsy And Core Biopsy In Breast Cancer, Anak Agung Ngurah Bagus Satya Sueningrat, Mendy Mendy

The New Ropanasuri Journal of Surgery

Introduction. Needle biopsy, including core needle biopsy (CNB) and vacuum-assisted breast biopsy (VABB) with or without radiological support) is the initial investigative method of choice for the preoperative diagnosis of breast lesions. Ultrasound-guided VABB (US-VABB) has become widely accepted because of its high accuracy. In this review, the diagnostic performance indices of CNB were compared with US-VABBB techniques.

Method. A literature search proceeded in online databases compiling studies from the last 20 years in the PubMed, EBSCOhost, ScienceDirect, and ProQuest databases. Eighteen eligible studies compared US-VABB and CNB for diagnostic accuracy. All studies were cohort retrospective. This literature search proceeded …


The Correlation Between Premenopausal Estrogen And Estrogen Receptors In Breast Cancer, Ahmad Kurnia, Dedy Pratama, Muhammad Mirwan Dec 2022

The Correlation Between Premenopausal Estrogen And Estrogen Receptors In Breast Cancer, Ahmad Kurnia, Dedy Pratama, Muhammad Mirwan

The New Ropanasuri Journal of Surgery

Introduction. The correlation between the premenopausal estrogen hormone and estrogen receptors is unknown. The hormone estrogen has a risk factor for causing breast cancer. Meanwhile, the estrogen receptor plays a role in determining further treatment plans in breast cancer patients. Patients with high estrogen receptors have a better prognosis. If the premenopausal estrogen hormone can affect the estrogen-receptor, then the estrogen hormone can be modified to have a better prognosis.

Method. A cross-sectional study enrolled 32 subjects with complete data and was statistically analyzed to find the correlation between premenopausal estrogen hormone and estrogen-receptors.

Results. The estradiol ranged from 15.3 …


Prognostic Factors Of Myasthenia Gravis Remission After Thymectomy At National Referral Hospital In Indonesia, Suprayitno Wardoyo, Winda J. Layardi Dec 2022

Prognostic Factors Of Myasthenia Gravis Remission After Thymectomy At National Referral Hospital In Indonesia, Suprayitno Wardoyo, Winda J. Layardi

The New Ropanasuri Journal of Surgery

Introduction. Thymectomy is a recommended treatment for myasthenia gravis, enfacing the problem of a low remission rate. However, Indonesian-specific characteristics of myasthenia gravis are somehow different from those of well-developed countries. Thus, identifying prognostic factors influencing remission is required for patient selection to provide optimal preoperative issues.

Methods. A retrospective cohort proceeded in our tertiary hospital, enrolling those diagnosed with myasthenia gravis who underwent thymectomy for four years. Disease period modified Osserman classification, age, sex, preoperative plasmapheresis, preoperative steroid therapy, type of surgery, and thymic pathology were the variables of interest for three-year follow-up. In addition, these variables …


Potential Of Tumor Cell Seeding And Clinical Impact On Percutaneous Breast Biopsy Tracks: A Literature Review, I G.N. Gunawan Wibisana, Muhammad Mirwan Dec 2022

Potential Of Tumor Cell Seeding And Clinical Impact On Percutaneous Breast Biopsy Tracks: A Literature Review, I G.N. Gunawan Wibisana, Muhammad Mirwan

The New Ropanasuri Journal of Surgery

Introduction. Based on its effectiveness, a percutaneous breast biopsy was chosen because it has minimum side effects and fewer complications, does not distort the breast tissue architecture, and can be performed on an outpatient basis. However, the biopsy can damage the integrity of tumor cells, creating seeding at the site of the track made. Therefore, core biopsy is the method of choice for breast lesion sampling using a 14G needle that provides greater sensitivity. This study aims to explain whether the percutaneous biopsy track has the potential for the formation of tumor cell seeding and its clinical impact.

Methods …


Transplantation In Pediatrics Liver Failure Associated With Acute Hepatitis Of Unknown Etiology, Afid B. Putra, Agi S. Putranto, Muftah Risyaldi, Luthfian A. Nurachman Dec 2022

Transplantation In Pediatrics Liver Failure Associated With Acute Hepatitis Of Unknown Etiology, Afid B. Putra, Agi S. Putranto, Muftah Risyaldi, Luthfian A. Nurachman

The New Ropanasuri Journal of Surgery

Introduction. On 5th April 2022, some cases of severe acute hepatitis of unknown etiology in children were reported in the United Kingdom. Since then, the number has increased rapidly, with 650 probable cases identified worldwide. This review focuses on available information about managing acute liver failure (ALF) in pediatrics with acute hepatitis of unknown etiology through the perspective of hepatobiliary surgery.

Method. A literature review proceeded on some databases, namely PubMed and Google Scholar. Epidemiological data and technical policy were obtained from World Health Organization and some government institutions.

Results. Severe acute hepatitis can progressively develop into acute liver …


The Potential Of Liquid For Breast Cancer: A Review, Sonar Soni Panigoro, Clarissa Kezia Yuella - Dec 2022

The Potential Of Liquid For Breast Cancer: A Review, Sonar Soni Panigoro, Clarissa Kezia Yuella -

The New Ropanasuri Journal of Surgery

Introduction. Tissue biopsy is the current gold standard for cancer diagnosis, targeted treatment, and prognosis. However, biopsy is an invasive procedure that could result in postoperative bleeding, pain, and infection. Such limitations may now be resolved by the clinical technique known as liquid biopsy, which enables a better representation of disease status.

Method. This literature review was conducted through online databases (PubMed, Ascopubs, EuroPMC) using the following keywords: "liquid biopsy", "ctDNA", "CTC", "breast cancer", "pathogenesis of breast cancer", "tumor microenvironment”, “ctdna detection technologies”, "early diagnosis", "targeted therapy" ,"monitoring disease progression”, and "prognosis”. The literature search was conducted using the PRISMA …


Quality Of Life And Its Associated Factors In Patients After Esophagectomy At A Single National Referral Center, Dogma H. Sirirui, Agi S. Putranto Dec 2022

Quality Of Life And Its Associated Factors In Patients After Esophagectomy At A Single National Referral Center, Dogma H. Sirirui, Agi S. Putranto

The New Ropanasuri Journal of Surgery

Introduction. Esophagectomy is the standard surgical treatment for resectable esophageal cancer patients. However, the success rate for this procedure was about 25–35% and was associated with a severe risk of postoperative complications. In addition, patients after esophagectomy have decreased their quality of life (QOL), but no research has been done in Indonesia. Therefore, this study was conducted to determine the quality of life after esophagectomy in Indonesia based on the patient population at Dr. Cipto Mangunkusumo General Hospital (CMGH).

Method. A retrospective study was conducted using quality–of–life instruments issued by the European Organization for Research and Treatment of Cancer (EORTC). …


Prognostic Factors For Mortality Of Pediatric Burn Injury In A National Tertiary Referral Center, Heru Angkoso, Aria Kekalih Dec 2022

Prognostic Factors For Mortality Of Pediatric Burn Injury In A National Tertiary Referral Center, Heru Angkoso, Aria Kekalih

The New Ropanasuri Journal of Surgery

Introduction. In Indonesia, burn injuries cause about 195,000 deaths annually. Data from the Ministry of the Health Republic of Indonesia showed the incidence of burns predominated at 1-4 years old. The mortality of pediatric burn patients in a tertiary hospital was 37.26%. This study aimed to find an association between known and unknown prognostic factors of mortality in Indonesian-specific characteristics.

Method. A retrospective analytical study included all pediatric burns admitted to Dr. Cipto Mangunkusumo General Hospital (CMGH) from 1998 to 2010. Variables within a period of the first 72 hours of admission were the focus of interest and were extracted …


Surgical Intervention For Endobronchial Tuberculosis With Total Bronchial Occlusion: A Case Report, Muhammad A. Putra, Matthew Billy, Radhyaksa Ardaya, Rut Hp Ekasiwi, Sari Rahmawati, Karel Hs Sumarsudi Dec 2022

Surgical Intervention For Endobronchial Tuberculosis With Total Bronchial Occlusion: A Case Report, Muhammad A. Putra, Matthew Billy, Radhyaksa Ardaya, Rut Hp Ekasiwi, Sari Rahmawati, Karel Hs Sumarsudi

The New Ropanasuri Journal of Surgery

Introduction. Endobronchial Tuberculosis (EBTB) is a specific TB form affecting the tracheobronchial tree with microbial and histopathological evidence. Early diagnosis is essential to provide timely treatment and prevent complications but also proves difficult due to the low positive rate of acid–fast bacilli (AFB) staining of sputum smears and non–specific clinical and radiological findings.

Case Illustration. We reported a 19–year–old man with a productive cough suspected of pulmonary tuberculosis, with a positive GeneXpert test and negative AFB smear. He received anti–tuberculosis drugs for six months. Although the symptoms initially seemed to improve, the patient complained of dyspnea during moderate activities in …


Development Of An On-Call Assessment Tool For Competency-Based Surgical Training, Eric C. Mitchell Dec 2022

Development Of An On-Call Assessment Tool For Competency-Based Surgical Training, Eric C. Mitchell

Electronic Thesis and Dissertation Repository

Introduction: A central tenet of competency-based medical education is formative assessment of trainees. There are no assessments examining resident competence on-call, despite this being a significant component of resident training and characterized by less supervision compared to daytime.

Methods: A national survey was conducted to evaluate the state of assessment in Canadian Plastic and Reconstructive Surgery programs. An on-call assessment tool was developed based on a consensus group and was piloted over six months. Validity of the tool was examined through qualitative and quantitative methods.

Results: There were 63 tools completed across ten residents and seven staff physicians. Tool reliability …


Pyrvinium Pamoate: Past, Present, And Future As An Anti-Cancer Drug, Christopher W Schultz, Avinoam Nevler Dec 2022

Pyrvinium Pamoate: Past, Present, And Future As An Anti-Cancer Drug, Christopher W Schultz, Avinoam Nevler

Department of Surgery Faculty Papers

Pyrvinium, a lipophilic cation belonging to the cyanine dye family, has been used in the clinic as a safe and effective anthelminthic for over 70 years. Its structure, similar to some polyaminopyrimidines and mitochondrial-targeting peptoids, has been linked with mitochondrial localization and targeting. Over the past two decades, increasing evidence has emerged showing pyrvinium to be a strong anti-cancer molecule in various human cancers in vitro and in vivo. This efficacy against cancers has been attributed to diverse mechanisms of action, with the weight of evidence supporting the inhibition of mitochondrial function, the WNT pathway, and cancer stem cell renewal. …


Thoracic Aortic Aneurysm Patients’ Diagnosis, Treatments, And Outcomes: The New York Experience, Ashutosh Yaligar, Annet Kuruvilla, Joshua Helali, Junying Wang, Mohammad Noubani, Sohaib Agha, Daniel Wolbrom, Jie Yang, Jonathan Price, Thomas Bilfinger, Henry Tannous, Annie-Laurie Shroyer, Allison Mclarty Dec 2022

Thoracic Aortic Aneurysm Patients’ Diagnosis, Treatments, And Outcomes: The New York Experience, Ashutosh Yaligar, Annet Kuruvilla, Joshua Helali, Junying Wang, Mohammad Noubani, Sohaib Agha, Daniel Wolbrom, Jie Yang, Jonathan Price, Thomas Bilfinger, Henry Tannous, Annie-Laurie Shroyer, Allison Mclarty

Department of Surgery Faculty Publications

IMPORTANCE: Traditionally, thoracic aortic aneurysms (TAA) were diagnosed upon complications arising or post-mortem examination. Following 2014, asymptomatic new TAA diagnoses noticeably rose at increasing rates. In parallel, reductions in the rates of urgent/emergent TAA-related treatments and adverse risk-adjusted short-term outcomes were observed.

OBJECTIVES: For New York State adult residents, the trends from 2005 to 2018 in new thoracic aortic aneurysm (TAA) diagnoses, surgical treatments, percutaneous treatments, and risk-adjusted outcomes were examined.

DESIGN: This retrospective cohort study documented the quality of TAA care provided to New York adult residents.

SETTING: Using the 2005 to 2018 New York Statewide Planning and …


Epigenetic Basis Of Diabetic Vasculopathy, Theja Bhamidipati, Manishekhar Kumar, Sumit S. Verma, Sedat Kacar, Diamond Reese, Michelle M. Martinez, Malgorzata M. Kamocka, Kenneth W. Dunn, Chandan K. Sen, Kanhaiya Singh Dec 2022

Epigenetic Basis Of Diabetic Vasculopathy, Theja Bhamidipati, Manishekhar Kumar, Sumit S. Verma, Sedat Kacar, Diamond Reese, Michelle M. Martinez, Malgorzata M. Kamocka, Kenneth W. Dunn, Chandan K. Sen, Kanhaiya Singh

Einstein Health Papers

Type 2 diabetes mellitus (T2DM) causes peripheral vascular disease because of which several blood-borne factors, including vital nutrients fail to reach the affected tissue. Tissue epigenome is sensitive to chronic hyperglycemia and is known to cause pathogenesis of micro- and macrovascular complications. These vascular complications of T2DM may perpetuate the onset of organ dysfunction. The burden of diabetes is primarily because of a wide range of complications of which nonhealing diabetic ulcers represent a major component. Thus, it is imperative that current research help recognize more effective methods for the diagnosis and management of early vascular injuries. This review addresses …


Sagittal Alignment Differences On The Operating Room Table Compared To Preoperative And Postoperative Imaging In Anterior Cervical Discectomy And Fusion, Mark J. Lambrechts, Gregory R. Toci, Brian A. Karamian, Zachary Kozick, John Prodoeh, David Reiter, Rahul Muchintala, Eric Tecce, Alexander Vaccaro Jr., Patrick O’Connor, Amit Syal, Dominic Lambo, Jose A. Canseco, I. David Kay, Barrett I. Woods, Alan S. Hilibrand, Christopher K. Kepler, Alexander R. Vaccaro, Gregory D. Schroeder Dec 2022

Sagittal Alignment Differences On The Operating Room Table Compared To Preoperative And Postoperative Imaging In Anterior Cervical Discectomy And Fusion, Mark J. Lambrechts, Gregory R. Toci, Brian A. Karamian, Zachary Kozick, John Prodoeh, David Reiter, Rahul Muchintala, Eric Tecce, Alexander Vaccaro Jr., Patrick O’Connor, Amit Syal, Dominic Lambo, Jose A. Canseco, I. David Kay, Barrett I. Woods, Alan S. Hilibrand, Christopher K. Kepler, Alexander R. Vaccaro, Gregory D. Schroeder

Rothman Institute Faculty Papers

Study Design: The study design used was a retrospective cohort. Objective: The objective of this study is to determine if intraoperative improvements in sagittal alignment on the operating table persisted on postoperative standing radiographs. Summary of Background Data: Cervical sagittal alignment may be correlated to postoperative outcomes. Since anterior cervical discectomy and fusions (ACDFs) can restore some cervical lordosis through intervertebral grafts/cages, it is important to understand if intraoperative radiographic measurements correlate with persistent postoperative radiographic changes. Materials and Methods: Patients undergoing elective primary ACDF were screened for the presence of lateral cervical radiographs preoperatively, intraoperatively, and postoperatively. Patients were …


The Importance Of Stigma Theory For Clinical Decisions Related To Diabetic Foot Amputations, Rachael Garcia, Callie Bartkowiak, Alison Nesbitt Do Dec 2022

The Importance Of Stigma Theory For Clinical Decisions Related To Diabetic Foot Amputations, Rachael Garcia, Callie Bartkowiak, Alison Nesbitt Do

Clinical Research in Practice: The Journal of Team Hippocrates

The authors examine the unconsidered impact of social stigma theory on the shared clinical decision-making process for a patient with foot osteomyelitis and MRSA bacteremia facing the prospect of an amputation.


A National Multi-Institutional Analysis Of Predictors Of Surgical Site Complications And Unplanned Reoperation After Paramedian Forehead Flap Reconstruction, Garrett Ni, Rohan Brebion, Pablo A. Baltodano, Michael C. Coronado, Nicholas Elmer, Theresa K. Webster, Huaqing Zhao, Xiaoning Lu, Sthefano Araya, Sameer Patel Dec 2022

A National Multi-Institutional Analysis Of Predictors Of Surgical Site Complications And Unplanned Reoperation After Paramedian Forehead Flap Reconstruction, Garrett Ni, Rohan Brebion, Pablo A. Baltodano, Michael C. Coronado, Nicholas Elmer, Theresa K. Webster, Huaqing Zhao, Xiaoning Lu, Sthefano Araya, Sameer Patel

Student Papers & Posters

Background: Although postoperative complications of paramedian forehead flap (PMFF) are generally low, surgical site complications and unplanned reoperation can still occur. Recent literature suggests infection to be the most common complication following PMFF reconstruction. This study sought to determine the patient and preoperative factors associated with surgical site complications and unplanned reoperations at a national level.

Methods: Patients who underwent PMFF reconstruction from the ACS-NSQIP 2007 - 2019 database were analyzed to determine composite surgical site morbidity and unplanned return to the operating room. Patient and operative factors were also analyzed to assess independent risk factors for surgical site morbidity …


Improving The Perioperative Experience Of Patients And Families In A Pediatric Setting, Anjanette Pong Dec 2022

Improving The Perioperative Experience Of Patients And Families In A Pediatric Setting, Anjanette Pong

Student Scholarly Projects

Practice Problem: The experience of surgery for pediatric patients and their families can be dependent on multiple factors including adequate preparation, English language proficiency and realistic expectations. Anxiety can contribute to a negative experience that may result in poor outcomes and a damaging reflection of the healthcare team and organization.

PICOT: The PICOT question that guided this project was: In preoperative pediatric patients and their families, how do therapeutic communication style and the provision of information about the perioperative experience affect their healthcare experience over eight weeks?

Evidence: A multi-modal approach to providing tailored preoperative education for the child and …


Biomarkers In The Development Of Individualized Treatment Regimens For Colorectal Cancer, Madison Crutcher, Scott A Waldman Nov 2022

Biomarkers In The Development Of Individualized Treatment Regimens For Colorectal Cancer, Madison Crutcher, Scott A Waldman

Department of Surgery Faculty Papers

Introduction: Colorectal cancer (CRC) is the third most common and second most deadly malignancy in the world with an estimated 1. 9 million cases and 0.9 million deaths in 2020. The 5-year overall survival for stage I disease is 92% compared to a dismal 11% in stage IV disease. At initial presentation, up to 35% of patients have metastatic colorectal cancer (mCRC), and 20-50% of stage II and III patients eventually progress to mCRC. These statistics imply both that there is a proportion of early stage patients who are not receiving adequate treatment and that we are not adequately treating …


A Long-Term Follow-Up Of The Stability Study: Multicenter Rct Comparing Anterior Cruciate Ligament Reconstruction With And Without Lateral Extra-Articular Tenodesis In Individuals At High Risk Of Graft Failure, Katelyn M. Inch Nov 2022

A Long-Term Follow-Up Of The Stability Study: Multicenter Rct Comparing Anterior Cruciate Ligament Reconstruction With And Without Lateral Extra-Articular Tenodesis In Individuals At High Risk Of Graft Failure, Katelyn M. Inch

Electronic Thesis and Dissertation Repository

One hundred and ninety-six patients at the Fowler Kennedy Sport Medicine Clinic (FKSMC) undergoing anterior cruciate ligament (ACL) reconstruction (ACLR) were randomized as part of the multi-center STABILITY study to receive either an isolated ACLR or ACLR with a lateral extra-articular tenodesis (LET). The STABILITY study followed these patients up to two years postoperative, and a long-term follow-up protocol was initiated afterwards. Eighty-two patients from this center were seen at three, five and seven years postoperative as part of a long-term follow-up. Our primary outcome was a composite outcome of instability and graft failure. Secondary outcomes included patient-reported outcome measures …


Predicting Left Ventricular Assist Device Outcomes Utilizing The Stanford Integrated Psychosocial Assessment For Transplant Measure, Nicholas Chesher, Kristina L. Greenwood, Candace Fanale, Cody Gustaveson, Brian Jaski, Hirsch S. Mehta, Peter Hoagland, Kristine Ortiz, Marc Verlasky, Robert Adamson, Walter Dembitsky Nov 2022

Predicting Left Ventricular Assist Device Outcomes Utilizing The Stanford Integrated Psychosocial Assessment For Transplant Measure, Nicholas Chesher, Kristina L. Greenwood, Candace Fanale, Cody Gustaveson, Brian Jaski, Hirsch S. Mehta, Peter Hoagland, Kristine Ortiz, Marc Verlasky, Robert Adamson, Walter Dembitsky

The VAD Journal

Objective: Durable mechanical circulatory support is a proven therapy to extend survival for patients with end-stage heart failure (HF). The International Society for Heart and Lung Transplantation guidelines recommend a detailed psychosocial assessment when selecting candidates for durable mechanical circulatory support. Currently, there are no formally validated psychosocial evaluation tools for left ventricular assist device (LVAD) candidacy. The Stanford Integrated Psychosocial Assessment for Transplantation (SIPAT) uses a multidisciplinary algorithm to evaluate the impact of pre-transplant risk factors on post-transplant outcomes. Emerging literature suggests that the SIPAT might be useful for assessing psychosocial risk factors for LVAD outcomes.

Methods: A total …


Left Atrial Veno-Arterial Extracorporeal Membrane Oxygenation (Lava-Ecmo): Percutaneous Bi-Atrial Drainage To Avoid Pulmonary Edema In A Patient With Left Ventricular Systolic Dysfunction, Kenneth R. Dulnuan, Joseph B. Zwischenberger, John G. Gurley, Maya Guglin Nov 2022

Left Atrial Veno-Arterial Extracorporeal Membrane Oxygenation (Lava-Ecmo): Percutaneous Bi-Atrial Drainage To Avoid Pulmonary Edema In A Patient With Left Ventricular Systolic Dysfunction, Kenneth R. Dulnuan, Joseph B. Zwischenberger, John G. Gurley, Maya Guglin

The VAD Journal

Veno-arterial extracorporeal membrane oxygenation (V-A ECMO) is used in patients with severe cardiogenic shock refractory to medical therapy. During V-A ECMO, retrograde flow in the aorta towards the left ventricle (LV) causes increased left-sided filling pressures, which may lead to pulmonary edema. Different strategies have been proposed to decompress the left heart, including placement of an intraaortic balloon pump (IABP), Impella® (Abiomed), or TandemHeart® (Cardiac Assist). Percutaneous decompression of the left atrium via placement of a transseptal cannula incorporated into the existing venous limb had also been previously done. We describe the novel use of the VFEM venous femoral cannula …


Cladophialophora Bantiana Brain Abscess And Concurrent Pulmonary Cryptococcus Neoformans Infection In A Patient Twenty Years After Renal Transplantation, Daniel Tsang, Sara Haddad, Ziver Sahin, Chairut Vareechon, Mitchell Sternlieb, Tricia. Royer Nov 2022

Cladophialophora Bantiana Brain Abscess And Concurrent Pulmonary Cryptococcus Neoformans Infection In A Patient Twenty Years After Renal Transplantation, Daniel Tsang, Sara Haddad, Ziver Sahin, Chairut Vareechon, Mitchell Sternlieb, Tricia. Royer

Department of Medicine Faculty Papers

Recipients of solid organ transplants are at risk for a variety of infections due to their immunocompromised status. The types of infections are often correlated to the timing from their transplant. After about six to twelve months, transplant recipients remain at risk for typical community acquired pathogens, late viral infections, and fungal infections including atypical molds such as Cladophialophora bantiana. C. bantiana is a dematiaceous fungus that has a predilection for infecting the brain and is the most common cause of cerebral phaeohyphomycosis - a term used to describe infections caused by molds that produce dark cell walls. Patients with …


Injury To The Posterior Horn Of The Lateral Meniscus From A Misplaced Tibial Tunnel For Anterior Cruciate Ligament Reconstruction: A Case Report, Amar S Vadhera, Jonathan S Lee, Harsh Singh, Safa Gursoy, Kyle N Kunze, Nikhil N Verma, Jorge Chahla Nov 2022

Injury To The Posterior Horn Of The Lateral Meniscus From A Misplaced Tibial Tunnel For Anterior Cruciate Ligament Reconstruction: A Case Report, Amar S Vadhera, Jonathan S Lee, Harsh Singh, Safa Gursoy, Kyle N Kunze, Nikhil N Verma, Jorge Chahla

Department of Orthopaedic Surgery Faculty Papers

BACKGROUND Posterior meniscal root avulsions can cause meniscal extrusion, joint space narrowing, and progressive knee arthritis. Iatrogenic posterior meniscal root avulsions after malpositioning of the transtibial tunnels during anterior cruciate ligament (ACL) reconstruction can account for poor long-term outcomes seen in some patients following ACL reconstruction. Therefore, correct transtibial tunnel placement during ACL reconstruction is essential to avoid iatrogenic meniscal damage. CASE REPORT A 32-year-old man presented with 1 year of right knee pain and instability following a non-contact twisting injury sustained while playing soccer. An ACL tear with no meniscal involvement was diagnosed at an outside institution. A double-bundle …


Amplitude Synchronization Of Spontaneous Activity Of Medial And Lateral Temporal Gyri Reveals Altered Thalamic Connectivity In Patients With Temporal Lobe Epilepsy, Anish V. Sathe, Michael Kogan, Kichang Kang, Jingya Miao, Mashaal Syed, Isaiah Ailes, Caio M. Matias, Devon Middleton, Feroze B. Mohamed, Scott Faro, Joseph Tracy, Ashwini Sharan, Mahdi Alizadeh Nov 2022

Amplitude Synchronization Of Spontaneous Activity Of Medial And Lateral Temporal Gyri Reveals Altered Thalamic Connectivity In Patients With Temporal Lobe Epilepsy, Anish V. Sathe, Michael Kogan, Kichang Kang, Jingya Miao, Mashaal Syed, Isaiah Ailes, Caio M. Matias, Devon Middleton, Feroze B. Mohamed, Scott Faro, Joseph Tracy, Ashwini Sharan, Mahdi Alizadeh

Department of Neurosurgery Faculty Papers

In this study, we examined whether amplitude synchronization of medial (MTL) and lateral (LTL) temporal lobes can detect unique alterations in patients with MTL epilepsy (mTLE) with mesial temporal sclerosis (MTS). This was a retrospective study of preoperative resting-state fMRI (rsfMRI) data from 31 patients with mTLE with MTS (age 23-69) and 16 controls (age 21-35). fMRI data were preprocessed based on a multistep preprocessing pipeline and registered to a standard space. Using each subject's T1-weighted scan, the MTL and LTL were automatically segmented, manually revised and then fit to a standard space using a symmetric normalization registration algorithm. Dual …


Systematic Review And Meta-Analysis Of Mid-Term Survival, Reoperation, And Recurrent Mitral Regurgitation For Robotic-Assisted Mitral Valve Repair, Michael L. Williams, Aditya Eranki, Andrew Mamo, Ashley Wilson-Smith, Bridget Hwang, Ramanen Sugunesegran, Tristan Yan, Emiliano Navarra, T. Sloane Guy, Johannes Bonatti Nov 2022

Systematic Review And Meta-Analysis Of Mid-Term Survival, Reoperation, And Recurrent Mitral Regurgitation For Robotic-Assisted Mitral Valve Repair, Michael L. Williams, Aditya Eranki, Andrew Mamo, Ashley Wilson-Smith, Bridget Hwang, Ramanen Sugunesegran, Tristan Yan, Emiliano Navarra, T. Sloane Guy, Johannes Bonatti

Department of Surgery Faculty Papers

Background: Over the past two decades surgical approaches for mitral valve (MV) disease have evolved with the advent of minimally invasive techniques. Robotic mitral valve repair (RMVr) safety and efficacy has been well documented, however, mid- to long-term data are limited. The aim of this review was to provide a comprehensive analysis of the available mid- to long-term data for RMVr.

Methods: Electronic searches of five databases were performed to identify all relevant studies reporting minimum five-year data on RMVr. Pre-defined primary outcomes of interest were overall survival, freedom from MV reoperation and from moderate or worse mitral regurgitation (MR) …


Association Of Noncontrast Computed Tomography And Perfusion Modalities With Outcomes In Patients Undergoing Late-Window Stroke Thrombectomy, Guilherme B F Porto, Ching-Jen Chen, Sami Al Kasab, Muhammed Amir Essibayi, Eyad Almallouhi, Zachary Hubbard, Reda Chalhoub, Ali Alawieh, Ilko Maier, Marios-Nikos Psychogios, Stacey Q Wolfe, Pascal Jabbour, Ansaar Rai, Robert M Starke, Amir Shaban, Adam Arthur, Joon-Tae Kim, Shinichi Yoshimura, Jonathan Grossberg, Peter Kan, Isabel Fragata, Adam Polifka, Joshua Osbun, Justin Mascitelli, Michael R Levitt, Richard Williamson, Daniele G Romano, Roberto Crosa, Benjamin Gory, Maxim Mokin, Kaustubh S Limaye, Walter Casagrande, Mark Moss, Ramesh Grandhi, Albert Yoo, Alejandro M Spiotta, Min S Park Nov 2022

Association Of Noncontrast Computed Tomography And Perfusion Modalities With Outcomes In Patients Undergoing Late-Window Stroke Thrombectomy, Guilherme B F Porto, Ching-Jen Chen, Sami Al Kasab, Muhammed Amir Essibayi, Eyad Almallouhi, Zachary Hubbard, Reda Chalhoub, Ali Alawieh, Ilko Maier, Marios-Nikos Psychogios, Stacey Q Wolfe, Pascal Jabbour, Ansaar Rai, Robert M Starke, Amir Shaban, Adam Arthur, Joon-Tae Kim, Shinichi Yoshimura, Jonathan Grossberg, Peter Kan, Isabel Fragata, Adam Polifka, Joshua Osbun, Justin Mascitelli, Michael R Levitt, Richard Williamson, Daniele G Romano, Roberto Crosa, Benjamin Gory, Maxim Mokin, Kaustubh S Limaye, Walter Casagrande, Mark Moss, Ramesh Grandhi, Albert Yoo, Alejandro M Spiotta, Min S Park

Department of Neurosurgery Faculty Papers

Importance: There is substantial controversy with regards to the adequacy and use of noncontrast head computed tomography (NCCT) for late-window acute ischemic stroke in selecting candidates for mechanical thrombectomy.

Objective: To assess clinical outcomes of patients with acute ischemic stroke presenting in the late window who underwent mechanical thrombectomy stratified by NCCT admission in comparison with selection by CT perfusion (CTP) and diffusion-weighted imaging (DWI).

Design, setting, and participants: In this multicenter retrospective cohort study, prospectively maintained Stroke Thrombectomy and Aneurysm (STAR) database was used by selecting patients within the late window of acute ischemic stroke and emergent large vessel …


How I Perform Totally Endoscopic Robotic Mitral Valve Repair., Colin C Yost, Jake L Rosen, Meagan Wu, Caroline M Komlo, Jordan E Goldhammer, T Sloane Guy Nov 2022

How I Perform Totally Endoscopic Robotic Mitral Valve Repair., Colin C Yost, Jake L Rosen, Meagan Wu, Caroline M Komlo, Jordan E Goldhammer, T Sloane Guy

Department of Medicine Faculty Papers

A sixty-two-year-old male presented with significant symptoms related to severe mitral regurgitation with posterior leaflet flail and prolapse on transesophageal echocardiogram (TEE). Preoperative computed tomography (CT) angiography showed normal caliber thoracoabdominal aorta and patent access vessels. The patient underwent totally endoscopic robotic mitral valve repair (rMVr) with left atrial CryoMAZE procedure.


Spontaneous Pneumothorax: A Rare Complication Of Neurofibromatosis Type 1 Associated Diffuse Lung Disease, Emma I. Sherfinski, Mark H. Cooper Md, Phd Oct 2022

Spontaneous Pneumothorax: A Rare Complication Of Neurofibromatosis Type 1 Associated Diffuse Lung Disease, Emma I. Sherfinski, Mark H. Cooper Md, Phd

Marshall Journal of Medicine

The visually striking neurocutaneous findings of neurofibromatosis type 1 (NF1) are well recognized and have been well documented throughout scientific literature. While not uncommon, the pulmonary manifestations of NF1 are unknown to many physicians. Complications of NF1 associated diffuse lung disease (NF-DLD) include pulmonary hypertension, pulmonary artery stenosis, subpleural cysts, and spontaneous pneumothorax. We present a case of a 34-year-old male with NF-DLD found incidentally in adolescence with previous apical bleb repair, presenting nearly twenty years later with spontaneous pneumothorax. In NF1 patients with pulmonary complaints, NF-DLD should be assessed with computed tomography (CT) and physicians should be familiar with …


Chronic Cavitary Pulmonary Aspergillosis: An Unusual Cause Of Chronic Cough, Pleuritic Chest Pain, And Hemoptysis In A 24-Year-Old Coal Mine Worker, Emma I. Sherfinski, Emily J. Vore, Mark H. Cooper Md, Phd, Peimei He Md Oct 2022

Chronic Cavitary Pulmonary Aspergillosis: An Unusual Cause Of Chronic Cough, Pleuritic Chest Pain, And Hemoptysis In A 24-Year-Old Coal Mine Worker, Emma I. Sherfinski, Emily J. Vore, Mark H. Cooper Md, Phd, Peimei He Md

Marshall Journal of Medicine

Pulmonary Aspergillus infections are caused by the ubiquitous fungus mold when spores found in compost, dust, and plant material are inhaled. Manifestation of the disease is represented by a delicate balance between host and pathogen interactions, making Aspergillus infection more commonly observed in immunocompromised individuals. Chronic cavitary pulmonary aspergillosis (CCPA) is a subtype of pulmonary Aspergillosis associated with history of chronic or prior lung disease. Here we present the case of a non-immunocompromised 24-year-old male with a history of intermittent asthma with chronic pulmonary symptoms and finding of a lung mass on imaging. We describe the diagnostic challenge and surgical …