Digital Commons Network^™

A Prospective, Multicenter Analysis Of Recurrence-Free Survival After Sentinel Lymph Node Biopsy Decisions Influenced By The 31-Gep., J Michael Guenther, Andrew Ward, Brian J Martin, Mark Cripe, Timothy Beard, Oliver Wisco, Rohit Sharma, Stanley P Leong, Richard Essner, Joseph I Clark, John Hamner, Brenda Sickle-Santanello, Maki Yamamoto

Oncology Articles

BACKGROUND: Although most patients with cutaneous melanoma (CM) will have a negative sentinel lymph node biopsy (SLNB), up to 20%-30% of these patients will recur. The 31-gene expression profile (31-GEP) test has been prospectively validated to identify patients at low (Class 1A), intermediate (Class 1B/2A), and high (Class 2B) risk of SLN positivity and recurrence.

METHODS: DECIDE is a prospective, multicenter study to assess the effect of 31-GEP testing on SLNB performance rates in patients with T1-T2 tumors considering SLNB and to study long-term outcomes. Here, we assessed outcomes in patients with a Class 1A 31-GEP result (n = 130). …

Virtual Hospital Follow-Up: Effects On 30-Day Readmission And Patient Satisfaction, Lidia Wiersum, Karen Valiyev, Kristin Wisegarver, Lucas Hopkins

Articles, Abstracts, and Reports

No abstract provided.

De Novo Variants In Rybp Are Associated With A Severe Neurodevelopmental Disorder And Congenital Anomalies, Monika Weisz-Hubshman, Lindsay C Burrage, Sharayu V Jangam, Jill A Rosenfeld, Sandra Von Hardenberg, Anke Bergmann, Manuela Friederike Richter, Malgorzata Rydzanicz, Rafal Ploski, Agnieszka Stembalska, Wendy K Chung, Rebecca R Hernan, Foong Y Lim, Theresa Brunet, Steffen Syrbe, Boris Keren, Solveig Heide, David R Murdock, Hongzheng Dai, Fan Xia, Shamika Ketkar, Brian Dawson, Vinodh Narayanan, Hillary K Graves, Undiagnosed Diseases Network, Michael F Wangler, Carlos Bacino, Brendan Lee

Duncan NRI Faculty and Staff Publications

Purpose: Polycomb group proteins are key epigenetic transcriptional regulators. Multiple neurodevelopmental disorders are associated with pathogenic variants of the genes encoding Polycomb group proteins. RYBP is a core component of the noncanonical Polycomb Repressor Complex 1; however, its role in disease is unclear.

Methods: Functional consequences of RYBP variants were assessed using in vitro cellular and in vivo Drosophila melanogaster studies.

Results: We described 7 individuals with heterozygous de novo variants of RYBP and their clinical findings, including severe developmental delay, dysmorphisms, and multiple congenital anomalies. We showed that all single-nucleotide variants in RYBP localize to the N-terminal domain of …

Streamlining The Journey Of Research Into Clinical Practice: Making Your Patients And Practice Flourish Evaluation And Treatment Of Pyogenic Spondylodiscitis Of The Spine: Ao Spine Knowledge Forum Trauma And Infection, Sebastian F. Bigdon, Emiliano Vialle, Charlotte Dandurand, Julian Scherer, Gaston Camino-Willhuber, Andrei F. Joaquim, Harvinder S. Chhabra, Mohammad El-Sharkawi, Richard Bransford, Charles G. Fisher, Klaus J. Schnake, Gregory D. Schroeder

Rothman Institute Papers

Study DesignLiterature Review with clinical recommendations.ObjectiveTo highlight impactful studies on pyogenic spondylodiscitis (PS), identified by the AO Spine Knowledge Forum Trauma and Infection, with recommendations for their integration into clinical practice.MethodsFive influential studies on PS that have the potential to shape current practice in spinal infections were selected and reviewed. Each study was chosen for its contribution to a critical phase in PS management: diagnosis, imaging, surgical vs conservative treatment, and antibiotic duration. Recommendations were graded as strong or conditional following the GRADE methodology.ResultsFive studies were highlighted. Article 1: Pluemer et al introduced the Spinal Infection Treatment Evaluation (SITE) Score, …

Aging-Related Hearing Decline And Resting State Networks, Cassidy S. T. Ellsworth

College of Education and Human Sciences: Dissertations, Theses, and Student Research

This study investigated the effects of age-related hearing decline on functional networks using resting-state functional magnetic resonance imaging (rs-fMRI). The main objective of the present study was to examine resting-state functional connectivity (rsFC) and graph theory-based network efficiency metrics in forty-nine adults categorized by age and hearing thresholds to identify the neural mechanisms of age-related hearing decline. RsFC within key brain networks and auditory-related brain regions, including the default mode network, salience network, dorsal attention network, and primary auditory cortices, was assessed using region-of-interest (ROI)-based and graph theory approaches. Functional metrics, such as rsFC strength and global and local efficiency, …

Music And Word Learning In Children Diagnosed With Developmental Language Disorder, Rebekah G. Sweeney

College of Education and Human Sciences: Dissertations, Theses, and Student Research

Purpose: This study investigates whether incorporating music into vocabulary interventions improves rate of learning and retention of words in children with developmental language disorder (DLD). Emerging literature continues to show the plentiful benefits of music as a tool for intervention in many settings, including the world of speech pathology (Levitin, 2024). However, it is also evident that there is a connection between struggling with language, and struggling with musical elements, such as rhythm and pitch perception, particularly in children with DLD (Boorom et al., 2022; Kreidler et al., 2023). This study seeks to tease out if music is an effective …

Uterus Didelphys Bicollis Bicolpos —A Case Report, Felix Oindi, Felix Nyagaka

Obstetrics and Gynaecology, East Africa

Uterus didelphys refers to a congenital uterine anomaly that occurs due to failed fusion of the paired Müllerian ducts. It is characterized by two separate noncommunicating uterine horns each with its cervix and fallopian tube. Duplication may be limited to the uterus, cervix or also involve the vagina. Here, we present a case of a 27-year-old primigravida incidentally diagnosed during pregnancy, followed up with cervical cerclage at 13 weeks due to a short cervix and had preterm delivery via cesarean section at 35 weeks. She had a successful pregnancy outcome and an uneventful postnatal course. Uterus didelphys is associated with …

The Effect Of A M-Health Application Compared To Standard Of Care On Adherence To Preoperative Fasting Instructions Among Adult Patients Undergoing Elective Surgery: A Randomized Controlled Study, Ivy Njeri Wanyoike

Master of Medicine in Anaesthesiology

Background: Preoperative fasting has been a pillar of the practice of anaesthesiology with the main aim of enhancing patient safety by reducing the risk of aspiration. Current clinical guidelines on preoperative fasting guidelines encourage shorter durations of fasting in keeping with current evidence that shows better patient outcomes while maintaining patient safety. Despite this, adherence to preoperative fasting instructions remains universally poor, with patients enduring long fasting periods. Advances in mobile technology, improving internet access and the widespread availability of smartphones have made mobile health a useful tool in patient care. mHealth applications are being increasingly used in perioperative …

Demographic Clinical Trial Diversity Assessment Methods: Use Of Real-World Data, Hua Chen, Nnadozie Emechebe, Sudeep Karve, Leon Raskin, Jailene Leal, Ning Cheng, Wendy Sebby, Kim Ribeiro, Samuel Crawford

Children’s Nutrition Research Center Staff Publications

Diversity in clinical trials is defined by the inclusion of clinical trial participants from various demographic groups that are representative of the broader population impacted by a disease state. Diversity in clinical trials is critical in identifying potential differences in safety and efficacy of treatments across races, ethnicities, ages, sexes, or other variables. In the United States, clinical trial diversity is often benchmarked against US Census data, which may limit the representativeness of patient demographics in clinical trials. Disease-specific, demographic estimates from real-world data (RWD) can facilitate benchmarking of clinical trials, support trial enrollment and the development of trial diversity …

Larotrectinib Compared With Real-World Non-Tropomyosin Receptor Kinase Inhibitor Therapies In Patients With Tropomyosin Receptor Kinase Fusion Cancer, Marcia S. Brose, C. Benedikt Westphalen, Xiaoyun Pan, Vadim Bernard-Gauthier, Milena Kurtinecz, Helen Guo, Virginie Aris, Neil R. Brett, Abdelali Majdi, Vivek Subbiah, Nathan A. Pennell, Kenneth L. Kehl, Alexander Drilon

Kimmel Cancer Center Faculty Papers

PURPOSE: Neurotrophic tyrosine receptor kinase gene fusions are oncogenic drivers of various solid tumors. Larotrectinib is a highly selective tropomyosin receptor kinase (TRK) inhibitor approved for patients with TRK fusion cancer on the basis of single-arm trials. This study was a matched comparative effectiveness study of larotrectinib in clinical trials versus standard of care (SOC) in the real-world (RW) setting.

METHODS: Adult patients with advanced/metastatic TRK fusion non-small cell lung cancer, colorectal cancer, soft tissue sarcoma, thyroid cancer, or salivary gland carcinoma were included. Deduplicated data from RW patients were from US and ex-US data sources. Patients in the larotrectinib …

Experiences And Attitudes Of Caregivers During Mealtimes In Children With Autism Spectrum Disorder At A Tertiary Facility In Kenya., Lynnette Muthoni Mwangi

Master of Medicine in Paediatrics and Child Health

Introduction: - ASD is a neurodevelopmental disorder characterized by deficits in social interactions and communication along with restrictive and repetitive behaviours affecting 1 in 100 children globally, with a higher prevalence in males. Despite the rising global statistics, there is limited information regarding the prevalence of ASD in Sub-Saharan Africa. Children with ASD often experience feeding challenges, which have been broadly categorized as food selectivity, food refusal, and disruptive mealtime behaviour, which poses challenges for caregivers during mealtime. While medical management of ASD receives considerable attention, less focus has been placed on the impact of ASD on caregivers and …

The Lived Experience Of Acute Stroke Advanced Practice Registered Nurses (Aprn) Working In Expanded Roles: A Mixed Methods Study, Terri-Ellen Kiernan

Theses and Dissertations (ETD)

Introduction. Nurse practitioners have made credible gains through the six decades since inception to cover the growing need for outpatient family care. Nurse practitioners are now working in all aspects of medicine by continuing to fill gaps with healthcare needs that persist due to physician shortages. Stroke neurology is a medical specialty plagued by a shortage of physician specialists in hospital acute care which can limit acute stroke diagnosis and treatment capabilities. Stroke nurse practitioners (SNP) are vascular neurology trained specialists who fill relatively new hospital roles to assume traditionally physician-based responsibilities in an expanded role. This study aims to …

Hbv Transmission Knowledge Among Korean-American Chronic Hepatitis B Patients In The United States, Giyoung Lee, Hee-Soon Juon, Eunji Kim, Katherine C Smith, Hie-Won Hann, Mimi Chang, Ann C. Klassen

Division of Gastroenterology and Hepatology Faculty Papers

Chronic hepatitis B (CHB) is a condition that disproportionately affects Asian Americans in the United States. Knowledge of transmission is crucial for CHB patients to practice prevention methods to limit the spread of the hepatitis B virus (HBV), but also live their lives free from unwarranted fears or restrictions. Among Asian CHB patients, several misperceptions about HBV transmission have been identified. This analysis aims to assess the current state of HBV knowledge among a cohort of Korean-American CHB patients. This mixed-methods study includes 363 respondents who completed a survey in either Korean (N = 298) or English (N = 65) …

Mental Health Diagnoses Amongst Children With Complex Chronic Medical Conditions, Maria Newmaster, Matt Hall, Adrienne Deporre, Molly Krager, Cy Nadler, Laura Plencner, Henry T. Puls

Presentations

Background: Mental health (MH) diagnoses are known to complicate outcomes of underlying medical conditions in pediatrics, but the prevalence of MH diagnoses across the array of medically complex and/or chronic conditions are not well known. Objective: To compare prevalence of MH diagnoses across levels of medical complexity and chronicity, and identify factors associated with MH diagnoses among children with complex chronic conditions (CCC). Methods: This retrospective cross-sectional study included children ages 5-17 years with at least 11 months of continuous Medicaid enrollment in 2022 from the Merative Marketscan Medicaid Database which collects data from all children with Medicaid in the …

Behavioral Escalation In The Ed, Children's Mercy Kansas City

Clinical Pathways

No abstract provided.

Suspected Abusive Head Trauma, Children's Mercy Kansas City

Clinical Pathways

No abstract provided.

Alert Design In The Real World: A Cross-Sectional Analysis Of Interruptive Alerting At 9 Academic Pediatric Health Systems, Swaminathan Kandaswamy, Julia K W Yarahuan, Elizabeth A Dobler, Matthew J Molloy, Lindsey A Knake, Sean M Hernandez, Anne A Fallon, Lauren M Hess, Allison B Mccoy, Regine M Fortunov, Eric S Kirkendall, Naveen Muthu, Evan W Orenstein, Adam C Dziorny, Juan D Chaparro

Faculty, Staff and Students Publications

Objective: To assess the prevalence of recommended design elements in implemented electronic health record (EHR) interruptive alerts across pediatric care settings.

Materials and methods: We conducted a 3-phase mixed-methods cross-sectional study. Phase 1 involved developing a codebook for alert content classification. Phase 2 identified the most frequently interruptive alerts at participating sites. Phase 3 applied the codebook to classify alerts. Inter-rater reliability (IRR) for the codebook and descriptive statistics for alert design contents were reported.

Results: We classified alert content on design elements such as the rationale for the alert's appearance, the hazard of ignoring it, directive versus informational content, …

Development And Evaluation Of An Automated Multimodal Mobile Detection Of Oral Cancer Imaging System To Aid In Risk-Based Management Of Oral Mucosal Lesions, Ruchika Mitbander, David Brenes, Jackson B Coole, Alex Kortum, Imran S Vohra, Jennifer Carns, Richard A Schwarz, Ida Varghese, Safia Durab, Sean Anderson, Nancy E Bass, Ashlee D Clayton, Hawraa Badaoui, Loganayaki Anandasivam, Rachel A Giese, Ann M Gillenwater, Nadarajah Vigneswaran, Rebecca Richards-Kortum

Faculty, Staff and Student Publications

Oral cancer is a major global health problem. It is commonly diagnosed at an advanced stage, although often preceded by clinically visible oral mucosal lesions, termed oral potentially malignant disorders, which are associated with an increased risk of oral cancer development. There is an unmet clinical need for effective screening tools to assist front-line healthcare providers to determine which patients should be referred to an oral cancer specialist for evaluation. This study reports the development and evaluation of the mobile detection of oral cancer (mDOC) imaging system and an automated algorithm that generates a referral recommendation from mDOC images. mDOC …

Ccr7 Regulated Mechanisms That Limit The Adaptive Immune Response, Jaisel Amilcar Cervantes

Open Access Theses & Dissertations

C-C chemokine receptor 7 (CCR7) is critical in guiding T cell migration within the thymus and peripheral lymphoid tissues, shaping the adaptive immune response by promoting central tolerance and regulating immune homeostasis. Although its role in lymphocyte trafficking is well established, the molecular mechanisms by which CCR7 influences thymocyte development and T cell receptor (TCR) repertoire formation remain less understood. This study examines how CCR7 deficiency impacts thymic selection, TCR diversity, and the signaling events that shape repertoire restriction. Using a homozygously deleted CCR7 murine model, we found that the absence of CCR7 results in a less restricted TCR repertoire …

Estimation Of Therapeutic Threshold For Tuberculosis Using Adapted Nominal Group Technique And Clinical Vignettes In Clinical And Community Settings In Southern Africa, Alfred Kipyegon Keter, Alastair Van Heerden, Tom Decroo, Tom Boyles, Shannon Bosman, Thandanani Madonsela, Lindani Innocent Msimango, Lenika Naiken, Carlos Kiyan, Mashaete Kamele

Population Health, East Africa

Background: When confronted with diagnostic uncertainty and a decision on whether to start treatment or not, clinicians consider the potential harm and benefit of offering versus withholding treatment. Treatment can be offered if the probability of tuberculosis (TB) in the patient is above the “therapeutic threshold” (ThT): the probability of disease at which the expected utility of treating and not treating is the same. We estimated ThT for TB in clinical and community settings in Southern Africa using two methods: an adapted nominal group technique (aNGT), and decisions made based on clinical vignettes (CVs).

Methods: We enrolled health …

Comparison Of Six Handheld Ultrasound Devices By Pediatric Point Of Care Ultrasound (Pocus) Experts, Stephanie K Leung, Ria Dancel, Riya N Soni, Ariadna Perez-Sanchez, Michael J Mader, Haitham Al-Wahab, Thomas W Conlon, Maria V Fraga, Javier J Lasa, Andrea Matho, Hannah Smith, Nilam J Soni

Faculty, Staff and Student Publications

BACKGROUND: Point of care ultrasound (POCUS) use is increasing among pediatric clinicians, but lack of access to ultrasound devices is a major barrier. The availability of pocket-sized handheld ultrasound devices ("handhelds") has improved access. However, no head-to-head comparative studies of handhelds in children have been performed to guide purchasing decisions.

METHODS: This cross-sectional study compared six handhelds: Butterfly iQ+™ (Butterfly Network Inc.), Clarius® (Clarius Mobile Health™), Kosmos™(EchoNous), TE Air™ (Mindray®), Vscan Air™ SL (General Electric), and Lumify™ (Philips Healthcare). Eight pediatric POCUS experts acquired views showing the abdominal right upper quadrant (RUQ), cardiac apical 4-chamber, and superficial neck and lung …

The Placenta Regulates Intrauterine Fetal Growth Via Exosomal Pparγ, Xiaofang Luo, Biao Huang, Ping Xu, Hao Wang, Baozhen Zhang, Li Lin, Jiujiang Liao, Mingyu Hu, Xiyao Liu, Jiayu Huang, Yong Fu, Mark D Kilby, Rodney E Kellems, Xiujun Fan, Yang Xia, Philip N Baker, Hongbo Qi, Chao Tong

Faculty, Staff and Student Publications

Abnormal adipogenesis is a major contributor to fetal growth restriction (FGR) and its associated complications. However, the underlying etiology remains unclear. Here, it is reported that the placentas of women with pregnancies complicated with FGR exhibit peroxisome proliferator-activated receptor γ (PPARγ) inactivation. In mice, trophoblast-specific ablation of murine PPARγ reproduces the phenotype of human fetuses with FGR and defective adipogenesis. Coculture of trophoblasts with preadipocytes significantly improves preadipocyte commitment and differentiation and increases the transcription of a series of adipogenic genes via intercellular transfer of exosomal PPARγ proteins. Moreover, nanoparticle-mediated placenta-specific delivery of rosiglitazone (RGZ) significantly rescues adipogenesis defects in …

Cell-Free Dna Results Indicating Mosaic Monosomy X Of Likely Maternal Origin: Impact On Genetic Counseling Practices And Patient Experiences, Audrey Mcbride, Ashley Cannon, Siddharth Prakash, Aaron W Roberts, Angela Seasely, Anna C E Hurst, Laura Hendon

Faculty, Staff and Student Publications

Objective: To investigate the current genetic counseling practices involving a cfDNA result indicating mosaic monosomy X of likely maternal origin, and to better understand the perspectives of patients who have received this result.

Method: A total of 60 prenatal genetic counselors completed surveys about their experiences with this result, cfDNA consenting practices, and management practices. In addition, qualitative interviews were conducted with 5 patients to gain insight into their experiences with result disclosure and follow-up care.

Results: 95% of genetic counselors reported feeling prepared to counsel on these results. However, responses to current practices varied. Of the genetic counselors surveyed, …

Cerebral Air Embolism: Process Change With Unintended Consequences., J J Baumann, Michelle Hill, Amy Swank, Ricky Medel

Neuroscience Articles

INTRODUCTION: During a cerebrovascular procedure, diligent care is made to ensure no air is present in lines and connectors. Should air enter the cerebral vasculature, cerebral air emboli can cause worsening neurological outcome or death. This communication outlines how a process change of refrigerating mixed heparin for storage lead to the presence of unintentional air, or off-gassing of the fluid.

MATERIAL & METHOD: The off-gassing phenomenon was noted during procedure. Various hypotheses were considered, including fluid preparation and manufacturing defects of lines and tubes. Further investigation identified a new process in mixing of heparin bags that were then refrigerated. The …

Fostering Cognitive Complexity In Behavioral Health Providers: Perspectives From Supervisors In Integrated Primary Care, Katherina Nako

Counseling & Human Services Theses & Dissertations

The integration of behavioral health into primary care settings, known as Integrated Primary Care (IPC), offers a holistic approach to addressing both physical and mental health needs (Ramanuj et al., 2019). Efforts to expand access to mental healthcare have contributed to the growing presence of IPC settings (Martin 2017), with mental health providers, such as mental health counselors, joining these teams as Behavioral Health Providers (BHPs; Blount, 2017). However, the unique complexities of IPC often leave BHPs feeling underprepared, largely due to the traditional training frameworks emphasized in many graduate counseling programs. The need for BHPs to adapt to the …

Defining A 'Cells To Society' Research Framework For Appendiceal Tumours, Andreana N Holowatyj, Michael J Overman, Konstantinos I Votanopoulos, Andrew M Lowy, Patrick Wagner, Mary K Washington, Cathy Eng, Wai Chin Foo, Richard M Goldberg, Mojgan Hosseini, Kamran Idrees, Douglas B Johnson, Ardaman Shergill, Erin Ward, Nicholas C Zachos, Deborah Shelton

Faculty, Staff and Student Publications

Tumours of the appendix — a vestigial digestive organ attached to the colon — are rare. Although we estimate that around 3,000 new appendiceal cancer cases are diagnosed annually in the USA, the challenges of accurately diagnosing and identifying this tumour type suggest that this number may underestimate true population incidence. In the current absence of disease-specific screening and diagnostic imaging modalities, or well-established risk factors, the incidental discovery of appendix tumours is often prompted by acute presentations mimicking appendicitis or when the tumour has already spread into the abdominal cavity — wherein the potential misclassification of appendiceal tumours as …

Symptom Documentation In Unstructured Palliative Care Notes Of Children And Adolescents With Cancer., Katherine Bernier Carney, Jacob Wilkes, Tumilara Aderibigbe, Kristin Stegenga, Holly Spraker-Perlman, Lauri A. Linder

Manuscripts, Articles, Book Chapters and Other Papers

CONTEXT: Children and adolescents with cancer experiencing complex symptoms can benefit from subspeciality palliative care. However, standardized methods of symptom documentation by pediatric palliative care teams are lacking. Understanding current approaches to symptom documentation will inform next steps to optimize symptom support.

OBJECTIVE: To explore the documentation of symptom prevalence and characteristics in unstructured clinical notes by pediatric palliative care clinicians caring for children and adolescents with cancer.

METHODS: We reviewed unstructured clinical notes documented by the pediatric palliative care team for 115 children and adolescents with cancer. Symptom-related data were abstracted and evaluated using content analysis based on the …

Words Matter: Destigmatizing The Language Of Medicine Through Research, Training, And Future Directions For Emergency Medicine, Natalie Strokes, Richard Sapp, Meta Carroll, Elizabeth Maxwell Hovis, Mary Mclean, Shannon Markus, Aaryn Hammond, Rosemarie Diaz, Ryan E Tsuchida, Marcia Perry, Edgardo Ordonez

Faculty, Staff and Students Publications

Background: In emergency medicine (EM), language choice significantly impacts patient care and can potentially cause harm, dehumanize patients, and introduce bias. Stigmatizing language in medical settings can affect patient dignity, trust, and outcomes. Despite its importance, there is limited education on avoiding stigmatizing language in EM. This concept paper addresses the need to raise awareness and develop strategies for use of inclusive language in the emergency department (ED).

Methods: A didactic session titled "Words Matter: Destigmatizing the Language of Medicine" was developed and presented at the 2024 Society for Academic Emergency Medicine (SAEM) Annual Meeting. The session involved a collaborative …

Comparison Between Dynamic Models For Predicting Response To Corticosteroids In Alcohol-Associated Hepatitis: A Global Cohort Study, Francisco Idalsoaga, Luis Antonio Díaz, Leonardo Guizzetti, Winston Dunn, Heer Mehta, Jorge Arnold, Gustavo Ayares, Rokhsana Mortuza, Gurpreet Mahli, Alvi H Islam, Shiv K Sarin, Rakhi Maiwall, Wei Zhang, Steve Qian, Douglas Simonetto, Ashwani K Singal, Mohamed A Elfeki, Carolina Ramirez-Cadiz, Joaquín Cabezas, Victor Echavarría, Meritxell Ventura Cots, María Fátima Higuera-De La Tijera, Juan G Abraldes, Mustafa Al-Karaghouli, Prasun K Jalal, Mohamad Ali Ibrahim, Guadalupe García-Tsao, Daniela Goyes, Lubomir Skladaný, Daniel J Havaj, Karolina Sulejova, Svetlana Adamcova Selcanova, Diego Rincón, Vijay H Shah, Patrick S Kamath, Marco Arrese, Ramon Bataller, Juan Pablo Arab

Faculty, Staff and Students Publications

Several dynamic models predict mortality and corticosteroid response in alcohol-associated hepatitis (AH), yet no consensus exists on the most effective model. This study aimed to assess predictive models for corticosteroid response and short-term mortality in severe AH within a global cohort. We conducted a multi-national study of patients with severe AH treated with corticosteroids for at least 7 days, enrolled between 2009 and 2019. Dynamic models-Lille-4, Lille-7, trajectory of serum bilirubin (TSB), and neutrophil-to-lymphocyte ratio (NLR)-were used to estimate 30- and 90-day mortality. Lille-7 demonstrated the highest accuracy for both 30- and 90-day mortality.

Moderate Alcohol-Associated Hepatitis: A Real-World Multicenter Study, Francisco Idalsoaga, Luis Antonio Díaz, Winston Dunn, Heer Mehta, Karen Muñoz, Vicente Caldentey, Jorge Arnold, Gustavo Ayares, Rokhsana Mortuza, Shiv K Sarin, Rakhi Maiwall, Wei Zhang, Steve Qian, Douglas Simonetto, Ashwani K Singal, Mohamed A Elfeki, Carolina Ramirez-Cadiz, Gurpreet Malhi, Adan Ahmed, Hoomam Homsi, Zinia Abid, Joaquín Cabezas, Victor Echavarría, Maria Poca, German Soriano, Berta Cuyas, Meritxell Ventura Cots, María Fátima Higuera-De La Tijera, Maria Ayala-Valverde, Diego Perez, Jaime Gomez, Juan G Abraldes, Mustafa Al-Karaghouli, Prasun K Jalal, Mohamad Ali Ibrahim, Guadalupe García-Tsao, Daniela Goyes, Lubomir Skladaný, Daniel J Havaj, Karolina Sulejova, Svetlana Adamcova Selcanova, Diego Rincón, Kristina R Chacko, Juan C Restrepo, Pamela Yaquich, Luis G Toro, Vijay Shah, Marco Arrese, Patrick S Kamath, Ramon Bataller, Juan Pablo Arab

Faculty, Staff and Students Publications

Background: Severe alcohol-associated hepatitis (sAH) is a well-characterized disease with high short-term mortality. However, there is limited research on those with a "less severe condition" (moderate AH). This study aims to characterize in-depth patients with moderate AH (mAH), including the performance of mortality scoring systems, key prognostic factors, and survival over time.

Methods: A multicenter retrospective cohort study (2009-2019) included patients with mAH (MELD score ≤20 at admission). Cox regression and receiver operating characteristic curves with AUC were used for analysis.

Results: We included 1845 patients with AH (20 centers, 8 countries) between 2009 and 2019. mAH was defined as …