Medicine and Health Sciences Commons^™

Capsule Integrated Polypeptide Multilayer Films For Effective Ph-Responsive Multiple Drug Co-Delivery, Shichao Zhang, Malcolm Xing, Bingyun Li

Clinical and Translational Science Institute

Many applications using drug-carrying biomedical materials require on-demand, localized delivery of multiple therapeutic agents in precisely controlled and patient-specific time sequences, especially after assembly of the delivery vehicles; however, creating such materials has proven extremely challenging. Here, we report a novel strategy to create polypeptide multilayer films integrated with capsules as vehicles for co-delivery of multiple drugs using layer-bylayer self-assembly technology. Our approach allows the multilayered polypeptide nanofilms and preimpregnated capsules to assemble into innovative biomedical materials with high and controllable loading of multiple drugs at any time postpreparation and to achieve pH-responsive and sustained release. The resulting capsule-integrated polypeptide …

Pulmonary Toxicity And Lung Tumorigenic Potential Of Surrogate Metal Oxides In Gas Metal Arc Welding–Stainless Steel Fume: Iron As A Primary Mediator Versus Chromium And Nickel, Lauryn M. Falcone, Aaron Erdely, Rebecca Salmen, Michael Keane, Lori Battelli, Vamsi Kodali, Aleksandr B. Stefaniak, Michael L. Kashon, James M. Antonini, Patti C. Zeidler-Erdely

Faculty & Staff Scholarship

In 2017, the International Agency for Research on Cancer classified welding fumes as “car- cinogenic to humans” (Group 1). Both mild steel (MS) welding, where fumes lack carcino- genic chromium and nickel, and stainless steel (SS) increase lung cancer risk in welders; therefore, further research to better understand the toxicity of the individual metals is needed. The objectives were to (1) compare the pulmonary toxicity of chromium (as Cr(III) oxide [Cr2O3] and Cr (VI) calcium chromate [CaCrO4]), nickel [II] oxide (NiO), iron [III] oxide (Fe2O3), and gas metal arc welding-SS (GMAW-SS) fume; and (2) determine if these metal oxides can …

Hypoxic Preconditioning Attenuates Reoxygenation-Induced Skeletal Muscle Dysfunction In Aged Pulmonary Tnf-Α Overexpressing Mice, China-Chen Chuang, Tingyang Zhou, Mark Olfert, Li Zuo

Faculty & Staff Scholarship

No abstract provided.

Gait Rehabilitation Using Functional Electrical Stimulation Induces Changes In Ankle Muscle Coordination In Stroke Survivors: A Preliminary Study, Jessica L. Allen, Lena H. Ting, Trisha M. Kesar

Faculty & Staff Scholarship

No abstract provided.

Low Sucrose, Omega-3 Enriched Diet Has Region-Specific Effects On Neuroinflammation And Synaptic Function Markers In A Mouse Model Of Doxorubicin-Based Chemotherapy, Tonya S. Orchard, Monica M. Gaudier-Diaz, Panchita Phuwamongkolwiwat-Chu, Rebecca Andridge, Maryam B. Lustberg, Joshua Bomser, Rachel M. Cole, Martha A. Belury, A. Courtney Devries

Clinical and Translational Science Institute

Chemotherapeutic agents such as doxorubicin may negatively affect long-term brain functioning in cancer survivors; neuroinflammation may play a causal role. Dietary approaches that reduce inflammation, such as lowering sucrose and increasing eicosapentaenoic acid plus docosahexaenoic acid (EPA + DHA), may attenuate chemotherapy-induced neuroinflammation and synaptic damage, thereby improving quality of life. Ovariectomized, C57BL/6 mice were assigned to a chemotherapy (9 mg/kg doxorubicin + 90 mg/kg cyclophosphamide) or vehicle two-injection regimen, with injections two and four weeks after starting diets. In Study 1, mice received low sucrose diets with EPA + DHA or No EPA + DHA for four to six …

Gender Differences In Patient-Reported Outcomes Among Adults With Atherosclerotic Cardiovascular Disease, Victor Okunrintemi, Javier Valero-Elizondo, Benjamin Patrick, Joseph Salami, Martin Tibuakuu, Saba Ahmad, Oluseye Ogunmoroti, Shiwani Mahajan, Safi U. Khan, Martha Gulati, Khurram Nasir, Erin D. Michos

Clinical and Translational Science Institute

Background Atherosclerotic cardiovascular disease (ASCVD) accounts for approximately one third of deaths in women. Although there is an established relationship between positive patient experiences, health‐related quality of life, and improved health outcomes, little is known about gender differences in patient‐reported outcomes among ASCVD patients. We therefore compared gender differences in patient‐centered outcomes among individuals with ASCVD. Methods and Results Data from the 2006 to 2015 Medical Expenditure Panel Survey, a nationally representative US sample, were used for this study. Adults ≥18 years with a diagnosis of ASCVD, ascertained by International Classification of Diseases, Ninth Revision (ICD‐9) codes and/or self‐reported data, …

Human Breast Cancer Xenograft Model Implicates Peroxisome Proliferator-Activated Receptor Signaling As Driver Of Cancer-Induced Muscle Fatigue, Hannah E. Wilson, Kacey K. Rhodes, Daniel Rodriguez, Ikttesh Chahal, David A. Stanton, Joseph Bohlen, Mary Davis, Aniello M. Infante, Hannah Hazard-Jenkins, David J. Klinke, Elena N. Pugacheva, Emidio E. Pistilli

Clinical and Translational Science Institute

Purpose: This study tested the hypothesis that a patient-derived orthotopic xenograft (PDOX) model would recapitulate the common clinical phenomenon of breast cancer–induced skeletal muscle (SkM) fatigue in the absence of muscle wasting. This study additionally sought to identify drivers of this condition to facilitate the development of therapeutic agents for patients with breast cancer experiencing muscle fatigue. Experimental Design: Eight female BC-PDOX–bearing mice were produced via transplantation of tumor tissue from 8 female patients with breast cancer. Individual hind limb muscles from BC-PDOX mice were isolated at euthanasia for RNA-sequencing, gene and protein analyses, and an ex vivo muscle contraction …

Future Implications Of Using Registered Dietitians In Multidisciplinary Polycystic Ovary Syndrome Treatment, Wendy M. Wolf, Rachel A. Wattick, Pamela J. Murray, Melanie Clemmer, Melissa D. Olfert

Clinical and Translational Science Institute

Polycystic ovary syndrome (PCOS) is the most common reproductive endocrine disorder in females with insulin resistance playing a key role in pathogenesis. The objective of this study was to investigate current trends and future implications of multidisciplinary PCOS clinics with inclusion of dietitians. A two-phase, formative investigation on practitioners was conducted through an anonymous survey followed by focus groups. Survey respondents included 261 health care providers from around the world; the majority (59%) representing multidisciplinary teams. Focus group participants included four dietitians, three physicians, a health psychologist and a licensed nutritionist. Primary barriers for future multidisciplinary clinics included: money/resources, insurance …

Permeability Changes And Effect Of Chemotherapy In Brain Adjacent To Tumor In An Experimental Model Of Metastatic Brain Tumor From Breast Cancer, Afroz S. Mohammad, Chris E. Adkins, Neal Shah, Rawaa Aljammal, Jessica I. G. Griffith, Rachel M. Tallman, Katherine L. Jarrell, Paul R. Lockman

Clinical and Translational Science Institute

Background: Brain tumor vasculature can be significantly compromised and leakier than that of normal brain blood vessels. Little is known if there are vascular permeability alterations in the brain adjacent to tumor (BAT). Changes in BAT permeability may also lead to increased drug permeation in the BAT, which may exert toxicity on cells of the central nervous system. Herein, we studied permeation changes in BAT using quantitative fluorescent microscopy and autoradiography, while the effect of chemotherapy within the BAT region was determined by staining for activated astrocytes. Methods: Human metastatic breast cancer cells (MDA-MB-231Br) were injected into left ventricle of …

Opioid Use And The Presence Of Alzheimer's Disease And Related Dementias Among Elderly Medicare Beneficiaries Diagnosed With Chronic Pain Conditions, Chan Shen, Xiaohui Zhao, Nilanjana Dwibedi, R. Constance Wiener, Patricia A. Findley, Usha Sambamoorthi

Clinical and Translational Science Institute

Introduction: There is scant literature on the use of opioids among community-dwelling elderly with Alzheimer’s disease and related dementias (ADRD). Methods: We adopted a retrospective, cross-sectional study design using Medicare Current Beneficiary Survey data from 2006 to 2013. The study sample included elderly community-dwelling Medicare beneficiaries who were diagnosed with chronic pain conditions and had Medicare fee-for-service plans for the entire year. We conducted bivariate c2 test and multivariate logistic regression to examine the relationship between opioid use and ADRD status. Results: The study sample included 19,347 Medicare beneficiaries; 7.7% of them had ADRD. We found no statistically significant difference …

Hiv Virologic Response Better With Single-Tablet Once Daily Regimens Compared To Multiple-Tablet Daily Regimens, Shashi N. Kapadia, Robert R. Grant, Susan B. German, Baljinder Singh, Amy L. Davidow, Shobha Swaminathan, Sally Hodder

Clinical and Translational Science Institute

Background: Single-tablet regimens are preferred prescription choices for HIV treatment, but there are limited outcomes data comparing single-tablet regimens to multiple-tablet regimens. Methods: We retrospectively assessed treatment-naïve patients at a single urban HIV clinic in the United States for viral load suppression at 6 and 12months after initiating either single-tablet or multiple-tablet regimens. Multivariate regression was performed to obtain relative risks and adjust for potential confounders. Results: Of 218 patients, 47% were on single-tablet regimens and 53% on multiple-tablet regimens; 77% of single-tablet regimen patients had undetectable viral load at 6months compared to 61% of multiple-tablet regimen patients (p=0.012). At …

The Use Of Theory-Based Formative Research To Design Suicide Prevention Messaging For U.S. Veterans In Midlife., Elizabeth Karras, Cara M. Stokes, Sara C. Warfield, Heather Elder, Brady Stephens, Robert M. Bossarte

Clinical and Translational Science Institute

Background. Communication campaigns offer a viable mechanism to promote suicide prevention and reinforce mental health for U.S. veterans in midlife, a group with a high suicide burden. However, little empirical investigation of this type of messaging has been conducted, with formative campaign research conspicuously missing from the limited literature. Aims. Using the theory of planned behavior as a guide, formative research was conducted to inform the design of suicide prevention messaging by (a) describing and measuring several theoretical constructs among our audience and (b) modeling associations between constructs and intentions to seek help for suicidal behaviors and mental health more …

Predictors Of Major Bleeding Among Working-Age Adults With Atrial Fibrillation: Evaluating The Effects Of Potential Drug-Drug Interactions And Switching From Warfarin To Non-Vitamin K Oral Anticoagulants, Xue Feng, Usha Sambamoorthi, Kim Innes, Gregory Castelli, Traci Lemasters, Lianjie Xiong, Michael U. Williams, Xi Tan

Clinical and Translational Science Institute

Purpose This study aims to evaluate the associations between switching from warfarin to non-vitamin K oral anticoagulants (NOACs), exposure to potential drug-drug interactions (DDIs), and major bleeding events in working-age adults with atrial fibrillation (AF). Methods We conducted a retrospective cohort study using the claims database of commercially insured working-age adults with AF from 2010 to 2015. Switchers were defined as patients who switched from warfarin to NOAC; non-switchers were defined as those who remained on warfarin. We developed novel methods to calculate the number and proportion of days with potential DDIs with NOAC/warfarin. Multivariate logistic regressions were utilized to …

Healthcare Utilization And Expenditures In Working-Age Adults With Atrial Fibrillation: The Effect Of Switching From Warfarin To Non-Vitamin K Oral Anticoagulants, Xue Feng, Usha Sambamoorthi, Kim Innes, Traci Lemasters, Gregory Castelli, Nilanjana Dwibedi, Xi Tan

Clinical and Translational Science Institute

Objective Our objective was to evaluate the association between switching from warfarin to non-vitamin K oral anticoagulants (NOACs) and potential drug–drug interactions (DDIs), healthcare utilization, and expenditures in working-age adults with atrial fbrillation (AF). Methods We conducted a retrospective cohort study using data from 2010 to 2015 for patients who switched from warfarin to NOACs (switchers) and those who continued to receive warfarin (non-switchers). We identifed medications known or suspected to have clinically signifcant interactions with NOACs or warfarin. We used multivariate logistic regression, negative binomial, and generalized linear models to evaluate the infuence of switching to NOACs and of …

Aerobic Exercise And Fatigue In Rheumatoid Arthritis Participants: A Meta-Analysis Using The Minimal Important Difference Approach, George A. Kelley, Kristi S. Kelley, Leigh F. Callahan

Clinical and Translational Science Institute

Objective To use the minimal important difference (MID) versus the standardized mean difference (SMD) approach in order to provide more robust and clinically relevant information regarding the association between land‐based aerobic exercise and changes in self‐reported fatigue among adults with rheumatoid arthritis (RA). Methods Data from a previous meta‐analysis of 5 randomized controlled trials that represented up to 298 participants per study were utilized to calculate 9 effect sizes, using the MID approach. Data used to obtain the MID were derived from previously reported anchor‐based values specific to each fatigue instrument in adults with RA. Results were pooled using a …

Gradual Common Carotid Artery Occlusion As A Novel Model For Cerebrovascular Hypoperfusion, Dominic D. Quintana, Xuefang Ren, Heng Hu, Elizabeth B. Engler-Chiurazzi, Stephanie L. Rellick, Sara E. Lewis, Jessica M. Povroznik, James W. Simpkins, Mohammad Alvi

Clinical and Translational Science Institute

Chronic cerebrovascular hypoperfusion results in vascular dementia and increases predisposition to lacunar infarcts. However, there are no suitable animal models. In this study, we developed a novel model for chronic irreversible cerebral hypoperfusion in mice. Briefly, an ameroid constrictor was placed on the right carotid artery to gradually occlude the vessel, while a microcoil was placed on the left carotid artery to prevent compensation of the blood flow. This procedure resulted in a gradual hypoperfusion developing over a period of 34 days with no cerebral blood flow recovery. Histological analysis of the brain revealed neuronal and axonal degeneration as well …

Oxygen-Induced Leakage Of Spin Polarization In Overhauser- Enhanced Magnetic Resonance Imaging: Application For Oximetry In Tumors, Artem A. Gorodetskii, Timothy D. Eubank, Benoit Driesschaert, Martin Poncelet, Emily Ellis, Valery V. Khramtsov, Andrey A. Bobko

Clinical and Translational Science Institute

Overhauser-enhanced Magnetic Resonance Imaging (OMRI) is a double resonance technique applied for oxygen imaging in aqueous samples and biological tissues. In this report, we present an improved OMRI approach of oxygen measurement using the single line “Finland” trityl spin probe. Compared to a traditional approach, we introduced an additional mechanism of leakage of spin polarization due to an interaction of a spin system with oxygen. The experimental comparison of the new approach with an oxygen-dependent leakage factor to a traditional approach performed in phantom samples in vitro, and mouse tumor model in vivo, shows improved accuracy of determination of oxygen …

Waking Up Every Day In A Body That Is Not Yours: A Qualitative Research Inquiry Into The Intersection Between Eating Disorders And Pregnancy, Elizabeth A. Claydon, Danielle M. Davidov, Keith J. Zullig, Christa L. Lilly, Lesley Cottrell, Stephanie C. Zerwas

Clinical and Translational Science Institute

Background

Women with eating disorders are more likely to negatively react to finding out they are pregnant, although this difference in attitudes between women with eating disorders and controls disappears at 18-weeks’ gestation. Those with anorexia also are twice as likely to have an unplanned pregnancy and those with bulimia have a 30-fold increased chance compared with healthy controls. Therefore, due to these considerations, pregnancy and the transition to motherhood can be an extremely challenging time for these women both psychologically and physically. The purpose of this qualitative descriptive study was to understand the intersection between eating disorders and pregnancy …

Conditional Knockout Of Shp2 In Erbb2 Transgenic Mice Or Inhibition In Her2-Amplified Breast Cancer Cell Lines Blocks Oncogene Expression And Tumorigenesis, Hua Zhao, Elisha Martin, Fatimah Matalkah, Neal Shah, Alexey Ivanov, J. Michael Ruppert, Paul R. Lockman, Yehenew M. Agazie

Clinical and Translational Science Institute

Overexpression of the human epidermal growth factor receptor 2 (HER2) is the cause of HER2- positive breast cancer (BC). Although HER2-inactivating therapies have benefited BC patients, development of resistance and disease recurrence have been the major clinical problems, pointing to a need for alternative therapeutic strategies. For that to happen, proteins that play critical roles in the biology of HER2-induced tumorigenesis have to be identified and characterized. Here, we show that the Src homology phosphotyrosyl phosphatase 2 (Shp2) encoded by the Ptpn11 gene is a requisite for ErbB2-induced tumorigenesis. We report that conditional knockout of Shp2 alleles in the ErbB2 …

Human Ancestry Indentification Under Resource Constraints -- What Can One Chromosome Tell Us About Human Biogeographical Ancestry?, Tanjin T. Toma, Jeremy M. Dawson, Donald A. Adjeroh

Clinical and Translational Science Institute

Background: While continental level ancestry is relatively simple using genomic information, distinguishing between individuals from closely associated sub-populations (e.g., from the same continent) is still a difficult challenge. Methods: We study the problem of predicting human biogeographical ancestry from genomic data under resource constraints. In particular, we focus on the case where the analysis is constrained to using single nucleotide polymorphisms (SNPs) from just one chromosome. We propose methods to construct such ancestry informative SNP panels using correlation-based and outlier-based methods. Results: We accessed the performance of the proposed SNP panels derived from just one chromosome, using data from the …

A Novel Method For Training Mice In Visuo-Tactile 3-D Object Discrimination And Recognition, Xian Hu, Ogaga Urhie, Kevin Chang, Rachel Hostetler, Ariel Agmon

Clinical and Translational Science Institute

Perceiving, recognizing and remembering 3-dimensional (3-D) objects encountered in the environment has a very high survival value; unsurprisingly, this ability is shared among many animal species, including humans. The psychological, psychophysical and neural basis for object perception, discrimination, recognition and memory has been extensively studied in humans, monkeys, pigeons and rodents, but is still far from understood. Nearly all 3-D object recognition studies in the rodent used the “novel object recognition” paradigm, which relies on innate rather than learned behavior; however, this procedure has several important limitations. Recently, investigators have begun to recognize the power of behavioral tasks learned through …

In Vivo Extracellular Ph Mapping Of Tumors Using Electron Paramagnetic Resonance, Denis A. Komarov, Yuki Ichikawa, Kumiko Yamamoto, Neil J. Stewart, Shingo Matsumoto, Hironobu Yasui, Igor A. Kirilyuk, Valery V. Khramtsov, Osamu Inanami, Hiroshi Hirata

Clinical and Translational Science Institute

An electron paramagnetic resonance (EPR)- based method for noninvasive three-dimensional extracellular pH mapping was developed using a pH-sensitive nitroxyl radical as an exogenous paramagnetic probe. Fast projection scanning with a constant magnetic field sweep enabled the acquisition of four-dimensional (3D spatial +1D spectral) EPR images within 7.5 min. Three-dimensional maps of pH were reconstructed by processing the pH-dependent spectral information on the images. To demonstrate the proposed method of pH mapping, the progress of extracellular acidosis in tumor-bearing mouse legs was studied. Furthermore, extracellular pH mapping was used to visualize the spatial distribution of acidification in different tumor xenograft mouse …

An Unusual Amnestic Syndrome Associated With Combined Fentanyl And Cocaine Use, Todd Davies

Clinical and Translational Science Institute

No abstract provided.

Mortality And Associated Morbidities Following Traumatic Brain Injury In Older Medicare Statin Users, Bilal Khokhar, Linda Simoni-Wastila, Julia F. Slejko, Eleanor Perfetto, Min Zhan, Gordon S. Smith

Clinical and Translational Science Institute

Objective: To assess the relationship between posttraumatic brain injury statin use and (1) mortality and (2) the incidence of associated morbidities, including stroke, depression, and Alzheimer’s disease and related dementias following injury. Setting and Participants: Nested cohort of all Medicare beneficiaries 65 years of age and older who survived a traumatic brain injury (TBI) hospitalization during 2006 through 2010. The final sample comprised 100 515 beneficiaries. Design: Retrospective cohort study of older Medicare beneficiaries. Relative risks (RR) and 95% confidence interval (CI) were obtained using discrete time analysis and generalized estimating equations. Measures: The exposure of interest included monthly atorvastatin, …

A Group Randomized Trial To Reduce Obesity Among Appalachian Church Members: The Walk By Faith Study, Electra D. Paskett, Ryan D. Baltic, Greg S. Young, Mira L. Katz, Samuel M. Lesko, Kelly H. Webber, Karen A. Roberto, Eugene J. Lengerich, Nancy E. Schoenberg, Stephenie K. Kennedy, Scherezade Mama, Courtney C. Midkiff, Mark B. Dignan

Clinical and Translational Science Institute

Background: Appalachia is a rural, socioeconomically disadvantaged region with high rates of cancer and obesity. Using community-based participatory research principles, the Appalachia Community Cancer Network tested an initiative to reduce weight among overweight and obese participants by partnering with churches, an important community-based institution in Appalachia. Methods: A group randomized trial was conducted with counties or groups of counties in five Appalachian states. These groups were randomly assigned to receive either monthly diet and exercise education sessions (“Walk by Faith”; WbF) or an educational program focused on cancer screening and education (“Ribbons of Faith”; RoF) to examine effects on weight …

Feasibility Of Dose Escalation Using Intraoperative Radiotherapy Following Resection Of Large Brain Metastases Compared To Post-Operative Stereotactic Radiosurgery, John A. Vargo, Kristie M. Sparks, Rahul Singh, Geraldine M. Jacobson, Joshua D. Hack, Christopher P. Cifarelli

Clinical and Translational Science Institute

Background and purpose Post-operative SRS (stereotactic radiosurgery) for large brain metastases is challenged by risks of radiation necrosis that limit SRS dose. Intraoperative radiotherapy (IORT) is a potential alternative, however standard dose recommendations are lacking. Methods and materials Twenty consecutive brain metastases treated with post-operative SRS were retrospectively compared to IORT plans generated for 10–30 Gy in 1 fraction to 0–5 mm by estimating the applicator size and distance from critical organs using pre-operative and post-operative MRI. Additionally, 7 consecutive patients treated with IORT 30 Gy to surface were compared to retrospectively generated SRS plans using the post-operative MRI to …

Mesenchymal Cox2-Pg Secretome Engages Nr4a-Wnt Signalling Axis In Haematopoietic Progenitors To Suppress Anti-Leukaemia Immunity, Limei Wu, Surya Amarachintha, Jian Xu, Frank Oley Jr., Wei Du

Clinical and Translational Science Institute

The bone marrow (BM) microenvironment (niche) plays important roles in supporting normal/abnormal haematopoiesis. We investigated the interaction between leukaemic mesenchymal niche and haematopoietic stem and progenitor cells (HSPCs) using the model of Fanconi anaemia (FA), a genetic disorder characterized by BM failure and leukaemia. Healthy donor HSPCs co‐cultured on mesenchymal stromal cells (MSCs) derived from FA patients with acute myeloid leukaemia (AML) exhibited higher human engraftment and myeloid expansion in Non‐obese diabetic severe combined immunodeficiency IL‐2γ−/−/SGM3 recipients. Untargeted metabolomics analysis revealed the progressively elevated prostaglandins (PGs) in the MSCs of FA patients with myelodysplastic syndromes (MDS) and AML. Reduced secretion …

Out Of The Basement And Into The Classroom: Pathways For Expanding The Role Of Radiation Oncologists In Medical Student Education, Malcolm D. Mattes, William Small Jr., Neha Vapiwala

Clinical and Translational Science Institute

Purpose To characterize radiation oncologist involvement in undergraduate medical education at US academic medical centers and to incorporate these findings into practical pathways for greater and broader integration of radiation oncology (RO) into medical curricula. Methods Chairpersons and residency program directors at RO departments directly affiliated with a medical school were asked to describe all the ways in which radiation oncologists in their department are involved in medical student education, excluding their elective clerkship. Results Of 75 eligible departments, 49 responded (response rate 65.3%). Twenty departments (40.8%) reported that at least one faculty member participates in a curricular educational session …

Repeat Lactate Level Predicts Mortality Better Than Rate Of Clearance, Zachary D. W. Dezman, Angela C. Comer, Gordon S. Smith, Peter F. Hu, Colin F. Mackenzie, Thomas M. Scalea, Jon Mark Hirshon

Clinical and Translational Science Institute

Background Lactate clearance has been developed into a marker of resuscitation in trauma, but no study has compared the predictive power of the various clearance calculations. Our objective was to determine which method of calculating lactate clearance best predicted 24-hour and in-hospital mortality after injury. Study design Retrospective chart review of patients admitted to a Level-1 trauma center directly from the scene of injury from 2010 to 2013 who survived >15 min, had an elevated lactate at admission (≥3 mmol/L), followed by another measurement within 24 h of admission. Lactate clearance was calculated using five models: actual value of the …

Comparative Study Of Clinical Outcome Of Endovascular Aortic Aneurysms Repair In Large Diameter Aortic Necks (>31 Mm) Versus Smaller Necks, Ali F. Aburahma, Trevor Derderian, Zachary T. Aburahma, Stephen M. Hass, Michael Yacoub, L. Scott Dean, Shadi Abu-Halimah, Albeir Y. Mousa

Clinical and Translational Science Institute

Background This study compares short-term (30 days) and intermediate term (3 years) clinical outcomes in patients with large (≥31 mm) versus small aortic neck diameters (≤28 and ≤31 mm). Methods Prospectively collected data from 741 patients who underwent endovascular aortic aneurysm repair were analyzed. Some surgeons have reported the threshold for a large aortic neck for endovascular aortic aneurysm repair to be 28 mm, whereas for others it is 31 mm. Therefore, we classified aortic neck diameter into less than or equal to 28 versus greater than 28 mm; and less than or equal to 31 versus greater than 31 …