Digital Commons Network^™

Nerve Transfers For Median Nerve Injury, Corinne Wee

Faculty Scholarship

Due to its role in hand function, median nerve injuries can have a significant impact on patients’ lives. Nerve transfers can be performed alone or in conjunction with tendon transfers to restore critical functions supplied by the median nerve, with a particular emphasis on restoring grasp, pinch, and sensation. Continued study into possible nerve transfers for median nerve injury has led to multiple options that can be tailored to the patient's demands, deficits, and injury pattern.

Dissemination And Implementation Approach To Increasing Access To Local Pre-Exposure Prophylaxis (Prep) Resources With Black Cisgender Women: Intervention Study With Vlogs Shared On Social Media, Mandy J Hill, Laurenia Mangum, Sandra J Coker, Tristen Sutton, Diane M Santa Maria

Faculty, Staff and Student Publications

Background: Black cisgender women account for only 2% of pre-exposure prophylaxis (PrEP)-eligible people in the United States who use PrEP to prevent HIV. Owing to the low PrEP use, Black cisgender women continue to contract HIV more frequently than women from every other racial group. Intervention efforts that can bridge the link between knowing that PrEP prevents HIV and support with access to PrEP are necessary for Black cisgender women.

Objective: The purposes of the vlogs through the campaign were to share information about ways to prevent HIV using PrEP and fact-based education and provide access to PrEP resources with …

Real-World Impact Of Latanoprostene Bunod Ophthalmic Solution 0.024% In Glaucoma Therapy: A Narrative Review, W. Daniel Stamer, Thomas Chiu, Da-Wen Lu, Tsing Hong Wang, Prin Rojanapongpun, Ngamkae Ruangvaravate, Youn Hye Jo, Marlene R. Moster, Murray Fingeret, Nora Lee Cothran, Jessica Steen, Ian B. Gaddie, Ömür Uçakhan-Gündüz, Wesam S. Shalaby, Cindy M. L. Hutnik

Wills Eye Hospital Papers

Latanoprostene bunod ophthalmic solution (LBN) 0.024% is a topical nitric oxide (NO)-donating prostaglandin F2α (PGF2α) analog first approved in November 2017 for reduction of intraocular pressure (IOP) in patients with ocular hypertension (OHT) or open-angle glaucoma (OAG). This narrative review describes the unique mechanism of action of LBN and summarizes available real-world data. Upon instillation, LBN is metabolized into latanoprost acid and butanediol mononitrate, which is further reduced to NO and an inactive metabolite. Latanoprost acid increases aqueous humor outflow primarily through the uveoscleral (unconventional) pathway, whereas NO increases outflow through the trabecular (conventional) pathway. Eight studies were identified: 2 …

Assessing Cancer Therapeutic Efficacy In Vivo Using [2h7]Glucose Deuterium Metabolic Imaging, Mario C Chang, Vinay R Malut, Rohit Mahar, Anna Rushin, Marc A Mcleod, Geraldine L Pierre, Indu R Malut, Stephen J Staklinski, Max E Glanz, Mukundan Ragavan, Gaurav Sharma, Manoj Madheswaran, Arshee Badar, Aparna D Rao, Brian K Law, Michael S Kilberg, James H P Collins, Vikram D Kodibagkar, James A Bankson, Ralph J Deberardinis, Matthew E Merritt

Faculty, Staff and Student Publications

Metabolic imaging produces powerful visual assessments of organ function in vivo. Current techniques can be improved by safely increasing metabolic contrast. The gold standard, 2-[18F]fluorodeoxyglucose-positron emission tomography (FDG-PET) imaging, is limited by radioactive exposure and sparse assessment of metabolism beyond glucose uptake and retention. Deuterium magnetic resonance imaging (DMRI) with [6,6-2H2]glucose is nonradioactive, achieves tumor metabolic contrast, but can be improved by enriched contrast from deuterated water (HDO) based imaging. Here, we developed a DMRI protocol employing [2H7]glucose. Imaging 2H-signal and measuring HDO production in tumor-bearing mice detected differential glucose utilization across baseline tumors, tumors treated with vehicle control or …

Evaluating A Large Language Model’S Accuracy In Chest X-Ray Interpretation For Acute Thoracic Conditions, Adam M. Ostrovsky

SKMC Student Presentations and Publications

BACKGROUND: The rapid advancement of artificial intelligence (AI) has great ability to impact healthcare. Chest X-rays are essential for diagnosing acute thoracic conditions in the emergency department (ED), but interpretation delays due to radiologist availability can impact clinical decision-making. AI models, including deep learning algorithms, have been explored for diagnostic support, but the potential of large language models (LLMs) in emergency radiology remains largely unexamined.

METHODS: This study assessed ChatGPT's feasibility in interpreting chest X-rays for acute thoracic conditions commonly encountered in the ED. A subset of 1400 images from the NIH Chest X-ray dataset was analyzed, representing seven pathology …

An Assessment Of The Performance Of Different Chatbots On Shoulder And Elbow Questions, Mohamad Y. Fares, Tarishi Parmar, Peter Boufadel, Mohammad Daher, Jonathan Berg, Austin Witt, Brian W. Hill, John G. Horneff, Adam Z. Khan, Joseph A. Abboud

Rothman Institute Papers

Background/Objectives: The utility of artificial intelligence (AI) in medical education has recently garnered significant interest, with several studies exploring its applications across various educational domains; however, its role in orthopedic education, particularly in shoulder and elbow surgery, remains scarcely studied. This study aims to evaluate the performance of multiple AI models in answering shoulder- and elbow-related questions from the AAOS ResStudy question bank.

Methods: A total of 50 shoulder- and elbow-related questions from the AAOS ResStudy question bank were selected for the study. Questions were categorized according to anatomical location, topic, concept, and difficulty. Each question, along with the …

Wound Dehiscence Rate Between Chevron Osteotomy Procedure Vs. Lapidus For Correction Of Hallux Valgus Deformity, Isabella V. Strash, Abelardo Osuna, Madelaine Adkins

School of Podiatric Medicine - Student Research

Format: Scientific

Length of follow-up: n/a

Level of Evidence: Cross-Sectional Study (Level III)

Classification: Surgery

Purpose: Distal metatarsal osteotomies, like the chevron procedure, were once preferred for their stability and faster recovery in hallux valgus correction. However, recent advancements have increased the use of proximal procedures, such as the lapidus. This study aims to compare complications between distal and proximal hallux valgus surgeries.

Methodology & Procedure: Data was downloaded from the TriNetX Research Network on February 2, 2023 using CPT codes 28296 (chevron) and 28297 (lapidus). Inclusion criteria consisted of patients between 18 and 60 years of age and required …

Left Ventricular And Aortic Pressures Measured With Fluid-Filled And Solid-State Pressure Catheters: Similarities And Differences, Priscilla Machado, Ira Cohen, Brian Osler, Maureen E. Mcdonald, Cara Esposito, Marguerite Davis, David Fischman, Michael P. Savage, Praveen Mehrotra, Flemming Forsberg, Jaydev K. Dave

Division of Cardiology Faculty Papers

Objective: To compare left ventricular (LV) and aortic (AO) pressures obtained using fluid-filled and high-fidelity solid-state pressure catheters in subjects undergoing left heart catheterization.

Materials and Methods: Twenty subjects scheduled for a left heart catheterization were enrolled and 18 subjects completed this IRB-approved study. LV and AO pressures were obtained using fluid-filled pressure catheter (standard-of-care) and high-fidelity solid-state pressure catheter synchronously. Pressure tracings were analyzed to measure LV systolic (LVSP), LV minimum-diastolic (LVMDP), LV end-diastolic (LVEDP), AO systolic (AOSP), and AO diastolic (AODP) pressures. Isovolumic contraction and relaxation rates (peak ± dp/dt) were derived from the pressure waveforms. Repeated measures …

Distinct Patterns Of Pv And Sst Gabaergic Neuronal Activity In The Basal Forebrain During Olfactory-Guided Behavior In Mice, Elizabeth H Moss, Evelyne K Tantry, Elaine Le, Pey-Shyuan Chin, Priscilla Ambrosi, Katie L Brandel-Ankrapp, Benjamin R Arenkiel

Duncan NRI Faculty and Staff Publications

Sensory perception relies on the flexible detection and interpretation of stimuli across variable contexts, conditions, and behavioral states. The basal forebrain (BF) is a hub for behavioral state regulation, supplying dense cholinergic and GABAergic projections to various brain regions involved in sensory processing. Of GABAergic neurons in the BF, parvalbumin (PV) and somatostatin (SST) subtypes serve opposing roles toward regulating behavioral states. To elucidate the role of BF circuits in sensory-guided behavior, we investigated GABAergic signaling dynamics during odor-guided decision-making in male and female mice. We used fiber photometry to record cell type-specific BF activity during an odor discrimination task …

Evaluating The Role Of Traditional And Nontraditional Educational Resources In Point-Of-Care Ultrasound Training: A Cross-Sectional Survey Of Educator Preferences And Practices, Arthur Broadstock, Annahieta Kalantari, Almaz S. Dessie, Al'ai Alvarez, Resa E. Lewiss, Josie Acuna, Anthony Weekes, Kaylah Maloney, Uwe Stolz, Lori Stolz, Aalap Shah

Department of Emergency Medicine Faculty Papers

BACKGROUND: Recently, nontraditional educational resources like podcasts, blogs, and online media have gained prominence in medical education and are abundant within the field of point-of-care ultrasound (POCUS). However, the extent to which POCUS educators utilize online resources compared to traditional resources, like textbooks, journal articles, and in-person workshops, is unknown. We aim to define which types of educational resources are used and preferred by POCUS educators to teach trainees.

METHODS: An expert working group developed a survey aimed to characterize the types of materials used by POCUS educators and their perceived importance on a 6-point forced ranking scale. We administered …

Management Of Electrolyte Abnormalities In The Emergency Department, Todd W. Jones

Lynchburg Journal of Medical Science

The objective of this article review is to discuss standard treatment options and review emerging therapies for the more common electrolyte abnormalities. The number of emergency departments (ED) in the United States has declined over the past 15 years, which has created overcrowding. This makes it more difficult to prioritize patients based on severity. The importance of this topic is to assist providers in taking quick action on patients presenting with critical electrolyte levels in busy EDs. A literature search using PubMed from 2019 to 2024 identified numerous articles that supported the purpose. This review will discuss the various electrolyte …

A Clinical Overview Of Endometriosis, Adriane Strawn

Lynchburg Journal of Medical Science

Endometriosis, the finding of endometrial tissue in areas of the body other than the interior of the uterus, affects about 10% of menstruating women worldwide and is a common reason for dysmenorrhea and infertility. The underlying pathophysiology is not fully known but thought to be mostly due to retrograde menstruation through the oviducts into the abdominopelvic cavity. Other major pathogenic theories include vascular and lymphatic spread and coelomic metaplasia. Patient symptoms may include dysmenorrhea, dyschezia, dyspareunia, pelvic pain, infertility, and fatigue, but patients can also be asymptomatic. Endometriosis is difficult to diagnose, and although it is possible to visualize certain …

Testosterone Replacement Therapy In The Middle-Aged Male, Gina N. Demilt

Lynchburg Journal of Medical Science

The purpose of this review was to investigate the use of testosterone supplementation in the middle-aged male with a focus on the pathophysiology of testosterone throughout the lifespan, current supplementation options and their adverse effects, and the overall benefit of supplementing to enhance quality of life. A comprehensive search of electronic databases was conducted identifying studies that assessed clinical outcomes, pathophysiology, supplementation options, adverse effects and benefits of treatments. The findings suggested that testosterone levels naturally decline with age with most men developing symptoms of hypogonadism around age 60. Testosterone supplementation outside of current guidelines is not recommended, however men …

A Life Course Approach To Understanding Preserved Cognition In Late Life, Cassidy E. Doyle

USF Tampa Graduate Theses and Dissertations

Some level of cognitive decline is generally expected with advanced age. However, a subgroup of individuals – commonly labeled as ‘SuperAgers’ – maintain youthful memory abilities into their 80s and beyond. Relatively little is known about factors across the life course related to this phenotype. This dissertation used population-based data from the Health and Retirement Study (HRS) to investigate lifestyle factors related to the most youthful cognitive trajectory in the United States and assess how their cognition fares over time. Three research questions were addressed: (1) Can samples of youthful cognitive agers be identified longitudinally in a population-based dataset? (2) …

Rising Incidence Of Acute Hepatitis A Among Adults And Clinical Characteristics In A Tertiary Care Center Of Pakistan, Yumna Shahid, Amna Subhan Butt, Iqra Jamali, Faisal Wasim Ismail

Section of Gastroenterology

Background: For decades, hepatitis A virus (HAV) has been a leading cause of acute hepatitis among children and was less prevalent among adults. However, recently a paradigm shift has been observed in the epidemiology of HAV, as evident by cases of acute hepatitis due to HAV among adults.
Aim: To estimate frequency of HAV in acute viral hepatitis and compare characteristics in HAV and hepatitis E virus (HEV) infection.
Methods: This was a trend analysis conducted at Aga Khan University Hospital Karachi (Sindh, Pakistan) from February 2024 to May 2024. Individuals aged 18 years and older diagnosed with acute viral …

All Quality Metrics Are Wrong; Some Quality Metrics Could Become Useful., Michael E Johansen, Andrew S Detty, Jonathan Doo Young Yun

Ambulatory and Primary Care Articles

No abstract provided.

Ovarian-Specific Cyp17a1 Overexpression In Female Mice: A Novel Model Of Endogenous Testosterone Excess, Serene Joseph, Vaibhave Ubba, Zhiqiang Wang, Mingxiao Feng, Milan K Dsilva, Sofia Suero, Danielle Waheed, Nathaniel W Snyder, Xiaofeng Yang, Hong Wang, Joanne S Richards, Chemyong J Ko, Sheng Wu

Faculty, Staff and Students Publications

Excessive androgen levels can severely affect female health. However, most existing models of androgen excess rely on exogenous androgen administration, which does not fully capture the effect of elevated local ovarian testosterone on reproductive and metabolic functions. Here, we report the development of a novel hyperandrogenic mouse model, Cyp17TM-625, generated by combining CRISPR-Cas9 and a Tet-On doxycycline system to induce Cyp17A1 overexpression in ovarian theca-interstitial cells. As a result, Cyp17TM-625 mice exhibited significantly elevated Cyp17A1 messenger RNA and protein levels, accompanied by increased testosterone concentrations without alterations in basal levels of estradiol, progesterone, luteinizing hormone, or follicle-stimulating hormone. These mice …

A Workflow Enabling The Automated Synthesis, Chain-End Degradation, And Rapid Mass Spectrometry Analysis For Molecular Information Storage In Sequence-Defined Oligourethanes, Julia R Shuluk, Christopher D Wight, James R Howard, Mary E King, Sarah R Moor, Rachel J Dehoog, Samuel D Dahlhauser, Livia S Eberlin, Eric V Anslyn

Faculty, Staff and Students Publications

The field of molecular information storage has recently expanded to include abiotic sequence-defined polymers. While robust methods have been developed, there is a current bottleneck in the throughput of this work as information density is increased. Herein, we introduce an automated workflow in which a commercial peptide synthesizer composed of a single XYZ liquid-handling robot was adapted to both synthesize and sequence sequence-defined oligourethanes. Our sequencing method was improved to cut down the number of samples required for each oligomer from 13 to one. Additionally, we introduce the use of desorption electrospray ionization mass spectrometry as our analysis method for …

Sexual Health In The Era Of Artificial Intelligence: A Scoping Review Of The Literature, Elia Abou Chawareb, Brian H. Im, Sherry Lu, Muhammed A.M. Hammad, Tiffany R. Huang, Henry Chen, Faysal A. Yafi

Student Papers, Posters & Projects

INTRODUCTION: Artificial Intelligence (AI) has witnessed significant growth in the field of medicine, leveraging machine learning, artificial neuron networks, and large language models. These technologies are effective in disease diagnosis, education, and prevention, while raising ethical concerns and potential challenges. However, their utility in sexual medicine remains relatively unexplored.

OBJECTIVE: We aim to provide a comprehensive summary of the status of AI in the field of sexual medicine.

METHODS: A comprehensive search was conducted using MeSH keywords, including "artificial intelligence," "sexual medicine," "sexual health," and "machine learning." Two investigators screened articles for eligibility within the PubMed and MEDLINE databases, with …

Stingers—A Review Of Current Understanding And Management, Teleale Gebeyehu, James Harrop, Stavros Matsoukas, Alexander Vaccaro

Department of Neurosurgery Faculty Papers

Abstract: A stinger is the transient sensory and motor loss of one upper extremity caused by a stretch or compression injury to the brachial plexus or the exiting cervical nerve roots. Athletes from contact sports like American football, rugby, wrestling, and horseback riding are most affected. Given today’s competitive athletic culture and recent advancements in sports medicine, understanding the clinical, diagnostic, and therapeutic aspects of stingers is crucial. Thus, this narrative review highlights current knowledge of pathology, clinical features, diagnostic modalities, radiologic measurements, management, rehabilitation, and return-to-play protocols. Recent and prominent English publications on adult athletes revealed that the brachial …

"The Role Of Venous Excess Ultrasound Score In Optimizing Acute Heart Failure Diagnosis And Prognosis, Saoussen Antit, Sarra Romdhane, Imen Mtiri, Lilia Zakhama

Journal of the Saudi Heart Association

Acute heart failure (AHF) is a critical condition with significant morbidity and mortality, necessitating timely and accurate diagnosis for effective management.

The Venous Excess Ultrasound (VExUS) score has emerged as a non-invasive diagnostic tool, aimed at evaluating venous congestion through ultrasound. This scoring system integrates assessments of the inferior vena cava, hepatic veins, portal veins, and renal venous flow to quantify congestion severity. By providing a real-time assessment of venous pressure, the VExUS score has shown potential in optimizing early diagnosis of AHF and predicting outcomes and overall prognosis.

Recent studies suggest that incorporating the VExUS score into clinical practice …

Spasticity And Pain And The Improvement Of Muscle Strength In Athletes With Partial Spinal Cord Injury, Dariusz Tadeusz Skalski, Kinga Łosińska, Magdalena Prończuk, Alicja Markiel, Jarosław Markowski, Jan Pilch, Joanna Motowidło, Petr Stastny, Adam Maszczyk

Baltic Journal of Health and Physical Activity

Spasticity and chronic pain are common secondary complications following spinal cord injury (SCI), significantly impacting functional recovery and quality of life. Robot-assisted gait training (RAGT) using the Lokomat has been proposed as an effective rehabilitation method to improve motor function and reduce these symptoms. However, the impact of training frequency on rehabilitation outcomes remains unclear, particularly in athletes and physically active individuals. This study aimed to evaluate the effects of Lokomat training on spasticity reduction, pain alleviation, and improvements in gait function and lower limb muscle strength in athletes and physically active individuals with partial SCI. A total of 45 …

Gene Expression Profiling Of Pancreatic Ductal Adenocarcinoma Cells In Hypercapnia Identifies Siah3 As A Novel Prognostic Biomarker, Nitzan Zohar, Ryan Maguire, Saed Khalilieh, Aditi Jain, Dmitriy Bosykh, Wilbur B. Bowne, Harish Lavu, Charles J. Yeo, Avinoam Nevler

Department of Surgery Faculty Papers

Hypercapnia is a key feature of the respiratory microenvironment in many pathologic conditions. It occurs both as a regional and as a systemic process, and it is associated with multiple metabolic changes such as mitochondrial dysfunction, decreased ATP production, and metabolic shift from glycolytic energy production to fatty acid metabolism. In the cancer tumor microenvironment, hypercapnia has been linked at times to enhanced cell migration, invasion, and chemoresistance. Our previous work has shown that hypercapnia-associated gene signatures can be used as prognostic biomarkers. However, unlike the hypoxia-inducible factor pathway, there are no validated targets to quantify hypercapnia. In this study, …

Dependence Of Mitochondrial Calcium Signalling And Dynamics On The Disaggregase, Clpb, Donato D'Angelo, Víctor H. Sánchez-Vázquez, Benjamín Cartes-Saavedra, Denis Vecellio Reane, Ryan R. Cupo, Hilda Delgado De La Herran, Giorgia Ghirardo, James Shorter, Ron A. Wevers, Saskia B. Wortmann, Fabiana Perocchi, Rosario Rizzuto, Anna Raffaello, György Hajnóczky

Department of Pathology, Anatomy, and Cell Biology Faculty Papers

Cells utilize protein disaggregases to avoid abnormal protein aggregation that causes many diseases. Among these, caseinolytic peptidase B protein homolog (CLPB) is localized in the mitochondrial intermembrane space and linked to human disease. Upon CLPB loss, MICU1 and MICU2, regulators of the mitochondrial calcium uniporter complex (mtCU), and OPA1, a main mediator of mitochondrial fusion, become insoluble but the functional outcome remains unclear. In this work we demonstrate that CLPB is required to maintain mitochondrial calcium signalling and fusion dynamics. CLPB loss results in altered mtCU composition, interfering with mitochondrial calcium uptake independently of cytosolic calcium and mitochondrial membrane potential. …

Rare Damaging Ccr2 Variants Are Associated With Lower Lifetime Cardiovascular Risk, Marios K Georgakis, Rainer Malik, Omar El Bounkari, Natalie R Hasbani, Jiang Li, Jennifer E Huffman, Gabrielle Shakt, Reinier W P Tack, Tamara N Kimball, Yaw Asare, Alanna C Morrison, Noah L Tsao, Renae Judy, Braxton D Mitchell, Huichun Xu, May E Montasser, Ron Do, Eimear E Kenny, Ruth J F Loos, James G Terry, John Jeffrey Carr, Joshua C Bis, Bruce M Psaty, W T Longstreth, Kendra A Young, Sharon M Lutz, Michael H Cho, Jai Broome, Alyna T Khan, Fei Fei Wang, Nancy Heard-Costa, Sudha Seshadri, Ramachandran S Vasan, Nicholette D Palmer, Barry I Freedman, Donald W Bowden, Lisa R Yanek, Brian G Kral, Lewis C Becker, Patricia A Peyser, Lawrence F Bielak, Farah Ammous, April P Carson, Michael E Hall, Laura M Raffield, Stephen S Rich, Wendy S Post, Russel P Tracy, Kent D Taylor, Xiuqing Guo, Michael C Mahaney, Joanne E Curran, John Blangero, Shoa L Clarke, Jeffrey W Haessler, Yao Hu, Themistocles L Assimes, Charles Kooperberg, Jürgen Bernhagen, Christopher D Anderson, Scott M Damrauer, Ramin Zand, Jerome I Rotter, Paul S De Vries, Martin Dichgans

Faculty, Staff and Student Publications

BACKGROUND: Previous work has shown a role of CCL2, a key chemokine governing monocyte trafficking, in atherosclerosis. However, it remains unknown whether targeting CCR2, the cognate receptor of CCL2, provides protection against human atherosclerotic cardiovascular disease.

METHODS: Computationally predicted damaging or loss-of-function (REVEL > 0.5) variants within CCR2 were detected in whole-exome-sequencing data from 454,775 UK Biobank participants and tested for association with cardiovascular endpoints in gene-burden tests. Given the key role of CCR2 in monocyte mobilization, variants associated with lower monocyte count were prioritized for experimental validation. The response to CCL2 of human cells transfected with these variants was tested …

Erratum: Hematopoietic Stem And Progenitor Cells Confer Cross-Protective Trained Immunity In Mouse Models, Bailee N Kain, Brandon T Tran, Pamela N Luna, Ruoqiong Cao, Duy T Le, Marcus A Florez, Laure Maneix, Jack D Toups, Daniel E Morales-Mantilla, Scott Koh, Hyojeong Han, Roman Jaksik, Yun Huang, Andre Catic, Chad A Shaw, Katherine Y King

Faculty, Staff and Students Publications

[This corrects the article DOI: 10.1016/j.isci.2023.107596.].

A Geospatial Analysis Of The Lung Cancer Burden In Philadelphia, Using Pennsylvania Cancer Registry Data From 2008-2017, Russell K. Mcintire, Katherine Senter, Christine S. Shusted, Rickisa Yearwood, Julie Barta, Scott W. Keith, Charnita Zeigler-Johnson

Division of Pulmonary, Allergy, and Critical Care Medicine Faculty Papers

(1) Background: Lung cancer is the deadliest and second most prevalent cancer in Pennsylvania (PA), and African American patients are disproportionately affected. Lung cancer morbidity and mortality in Philadelphia County are among the highest in PA. Geographic information systems (GIS) are useful to explore geospatial variations in the cancer burden and risk factors. Therefore, we used GIS to analyze the lung cancer burden in Philadelphia to assess which areas of the city have the highest morbidity and mortality, identify potential clusters, and determine which census tract-level characteristics were associated with higher tract-level cancer burden. (2) Methods: Using secondary data from …

Two-Dimensional Speckle Tracking Of The Ascending Aorta: A Novel Approach To Evaluate Arterial Stiffness In Pediatric Patients With Repaired Conotruncal Anomalies Using Echocardiography., Anmol Goyal, Anitha Parthiban, David A. White, Daniel Forsha, Doaa Aly

Manuscripts, Articles, Book Chapters and Other Papers

BACKGROUND: Children with repaired conotruncal abnormalities (CTA) are at risk of progressive aortic dilation and deteriorating aortic elasticity even after surgical correction. Strain imaging, using a 2-dimensional speckle tracking echocardiography (2D-STE), has been used for arterial stiffness assessment, but pediatric data are still lacking. We investigated the feasibility, reproducibility, and clinical value of 2D-STE derived ascending aorta (AAo) stiffness in children with repaired CTA.

METHODS: 22 pediatric patients with repaired CTA were included along with 25 age- and sex- matched healthy controls (mean age 10.2 ± 4.5 years). Conventional 2D echocardiographic and 2D-STE assessment of AAo mechanics was performed. M-mode …

Asymmetrical Glymphatic Dysfunction In Patients With Long Covid Associated Neurocognitive Impairment- Correlation With Bbb Disruption, Joga Chaganti, Tanush Talekar, Bruce J. Brew

Department of Radiology Faculty Papers

BACKGROUND AND PURPOSE: The glymphatic system, a waste clearance pathway, has been implicated in several neurological conditions associated with neuroinflammation. COVID-19 associated neurocognitive impairment, part of the post-acute sequelae of SARS-CoV-2 infection (PASC), is strongly associated with neuroinflammation and disrupted blood-brain barrier (BBB). Several studies have implicated a synergistic interaction between the glymphatic system dysfunction and BBB disruption. In this proof-of-concept study, we investigated the role of the MRI metric diffusion along the perivascular spaces DTI (DTI-ALPS) in patients with PASC and correlated this with the BBB capillary permeability metric- K trans derived from Dynamic contrast enhanced (DCE) perfusion.

MATERIALS …

Novel Valve-In-Valve Transcatheter Systemic Tricuspid Valve Replacement In Congenitally Corrected Transposition Of The Great Arteries, Aamer Naofal, Riyad Yazan Kherallah, Wilson W Lam, Dhaval R Parekh

Faculty, Staff and Students Publications

A 41-year-old woman with history of situs inversus totalis, dextrocardia, congenitally corrected transposition of the great arteries, and systemic tricuspid valve replacement presented with worsening of her baseline orthopnea and exertional dyspnea caused by stenosis of the tricuspid valve. Given her high risk for surgery, valve-in-valve transcatheter tricuspid valve replacement was pursued and performed successfully, leading to resolution of her symptoms. Previous valve-in-valve tricuspid interventions are rare. This case is notable as the first systemic atrioventricular valve-in-valve replacement in a patient with dextrocardia through a septal approach.