Digital Commons Network^™

The Long-Term Effectiveness Of The Anti-Obesity Medication Phentermine (Leap) Trial: Rationale, Design, And Baseline Characteristics, Caroline Blackwell Young, Emily Rives, Kimberly A Gudzune, Byron C Jaeger, Courtney G Simmons, Brian N White, Stephanie A Hooker, Deborah B Horn, Deborah R Young, Jennifer Vesely, Amanda Velazquez, Catherine Price, Shelly D Cook, Katy Martin-Fernandez, Galina Inzhakova, Nicholas M Pajewski, Jamy D Ard, Kristina H Lewis

Faculty, Staff and Student Publications

Background: Current clinical practice guidelines support the long-term use of pharmacotherapy for obesity treatment. Historically, phentermine has been one of the most prescribed obesity medications (OMs), however, its long-term efficacy and safety have never been evaluated in a randomized trial as its market approval predates such requirements. Here we describe the design, rationale, and baseline characteristics for a 24-month, double-blind, randomized controlled trial evaluating the efficacy, cardiovascular risk, and safety of phentermine in adults with overweight or obesity.

Methods: This multicenter trial will compare outcomes among participants randomized to phentermine 24 mg daily versus placebo for 24 months. All participants …

Contemporary Structures, Processes, And Outcomes Of Critical Care Nursing Education: An Integrative Review, Farida Saghafi, Carol Grech, Belinda Causby, Angelique Clarke, Jacqueline Jauncey-Cooke, Deb Massey, Kaye Rolls, Kylie Thompson, Melanie Greenwood

Research outputs 2022 to 2026

Objective: The critical care workforce requires nurses who are specialised, educated, and adaptable to manage complex situations, with the capability to make informed decisions for optimal patient care. The Australian College of Critical Care Nurses supports evidence-based practice through an education position statement, which is periodically updated to reflect evolving needs. In this review, our aim was to inform revisions to the position statement on critical care nurse education by examining the structure, processes, and outcomes of contemporary education programs designed to enhance the capability of registered nurses working in critical care environments internationally. Review method used: An integrative review …

Obstructive Sleep Apnea Prediction: A Comprehensive Review And Comparative Study, Thi Khanh Chi Huynh, Amonae Dabbs-Brown, Anna Jurek-Loughrey, James Mulhall, Tuan Dung Pham, Ngoc Phu Doan, Viet Hung Tran, Zichi Zhang, Xuan Hoang Nguyen, Yimeng An, Peixin Li, Phi Hung Nguyen, Thi Linh Hoang, Xinming Shi, Hans Vandierendonck, Sebastien Bailly, Jean-Louis Pépin, Thai Son Mai

Research Collection School Of Computing and Information Systems

Obstructive Sleep Apnea (OSA) is a highly prevalent sleep disorder linked to considerable public health burdens and comorbidities. However, its heterogeneous presentation and the limited accessibility of traditional diagnostic tools such as polysomnography (PSG) lead to widespread underdiagnosis. As a result, artificial intelligence (AI) approaches, including machine learning (ML) and deep learning (DL) models, have attracted attention as an alternative pathway to detection. This paper first provides a comprehensive review of AI-driven OSA diagnosis, covering different diagnosis problems, input-data types, data biases, pre-processing techniques, and model performance. We then leverage the largest clinical dataset used in OSA prediction to date, …

Bet Inhibitor-Based Combinations Targeting Novel Dependencies In Mecom-Rearranged (R) Aml, Christine E Birdwell, Warren Fiskus, Christopher P Mill, Tapan M Kadia, Naval Daver, Courtney D Dinardo, Koji Sasaki, John A Davis, Kaberi Das, Hanxi Hou, Antrix Jain, Anna Malovannaya, Lauren B Flores, Rasoul Pourebrahim, Selina Yuan, Xiaoping Su, Michele Ceribelli, Kapil N Bhalla

Faculty, Staff and Student Publications

MECOM rearrangement in AML involves either inv(3)(q21;q26.2) or t(3;3)(q21;q26.2), where the dislocated GATA2 enhancer drives overexpression of the transcriptional regulator EVI1, causes concomitant GATA2 repression, and promotes AML progression, aggressive phenotype and therapy refractoriness. Treatment with BET protein inhibitor (BETi) induces in vitro and in vivo efficacy in MECOM-r AML cells. Utilizing an unbiased, high-throughput drug screen, focused on mechanistically-annotated drugs, we identified BRD4, PIK3CA, mTOR, BCL-xL and XIAP as dependencies in the MECOM-r AML cells. Monotherapy with mivebresib (BETi), dactolisib (PI3K/mTORi) and LCL161 (IAPi) dose-dependently induced greater lethality in PD MECOM-r versus non-MECOM-r AML cells. RNA-Seq and/or mass spectrometry …

February 2026, Swosu Rural Health Center

RURAL ROCKS

• Current Indications for Sodium-Glucose Cotransporter 2 (SGLT2) Inhibitors
• CMS unveils LEAD, its new 10-year accountable care model
• UnitedHealthcare pauses effort to cut RPM coverage after stating the tech has 'no evidence'
• Walgreens unveils PharmStart to strengthen tech-to-pharmacist pipeline
• Rural Health Transformation Program awards announced—Here's who's getting the most in FY2026
• FDA Grants Two National Priority Vouchers
• 2026 Outlook: Hybrid care companies poised for growth driven by economic, policy tailwinds
• Brain Drain: Retail pharmacy struggles to retain pharmacists, pharmacy technicians
• The 5 biggest challenges facing retail pharmacy
• Retail pharmacy must mine the gaps
• CMS Establishes Office of Rural Health Transformation Nationwide …

Three-Dimensional Displacement Of Upper Cervical Vertebrae In Severe Mandibular Deviation Caused By Condylar Hyperplasia: A Tomographic Segmentation Study, Claudia Milena Ramírez, Rodrigo Cárdenas-Perilla, Luis Eduardo Almeida, Diego Fernando López

School of Dentistry Faculty Research and Publications

Objective: To evaluate the three-dimensional (3D) angular displacement (Roll, Yaw, and Pitch) of the upper cervical vertebrae (C1, C2, and C3) in patients with severe mandibular deviation (MD) due to condylar hyperplasia (CH), utilizing a computed tomography (CT)-based segmentation approach. Methods: This retrospective cross-sectional study included 50 patients with MD ≥ 6 mm caused by hemimandibular elongation (HE) or a hybrid form (HF) of CH. The skull, mandible, and cervical vertebrae (C1–C3) were segmented using 3D Slicer software. Angular deviations (Pitch, Yaw, Roll) were measured relative to the Frankfurt plane. Patients were categorized by the side of CH (right or …

Mastering The First Year Of Ownership, Amrita Patel Dds

The Journal of the Michigan Dental Association

This column provides a reflective look at the first year of dental practice ownership, describing it as a mix of exhilaration and pressure. It highlights the importance of transitioning from a clinical mindset to one focused on financial clarity, cash flow variability, and team dynamics. The author discusses the necessity of developing efficient systems to resolve bottlenecks and understanding the patient base on a deeper level. The piece emphasizes that leadership confidence grows through action and adjustment.

How Do I Avoid Burning Out My Staff?, Jodi Schafer Sphr, Shrm-Scp

The Journal of the Michigan Dental Association

This column details the financial advantages of utilizing MDA-endorsed vendors to improve practice profitability. It explains the vetting process performed by volunteers to ensure vendors offer meaningful discounts and vetted solutions. The source highlights specific services, such as PPO fee negotiation, dental marketing, and insurance verifications, which can save a practice over $58,000 annually. By leveraging collective bargaining, members gain access to revenue-boosting solutions without exhaustive trial-and-error searching.

Quantitative Echocardiography Markers To Denote Severity Of Tricuspid Regurgitation Compared To Cardiac Mri In Single Right Ventricle Variants, Tony Zunica, Daniel Forsha, Janelle Noel-Macdonnell, Anmol Goyal

Posters

Background: Single right ventricle and Hypoplastic Left Heart Syndrome (HLHS) are congenital heart diseases that require multiple palliative surgeries to create a single right ventricular system. 25-30% of these patients develop significant tricuspid regurgitation (TR), which is associated with worse outcomes among all stages of palliation. Echocardiography remains the cornerstone imaging modality for serial evaluation in these patients. However, estimating tricuspid regurgitation is highly subjective in the pediatric population, necessitating need for reliable and reproducible quantitative echocardiography markers. Currently, cardiac magnetic resonance (CMR) is considered the gold standard for quantification of tricuspid regurgitation with good accuracy and reproducibility. Objectives/Goal: Our …

Adapt Vr In Dental Education: Boosting Preclinical Skill And Self-Confidence, Shehabeldin Mohamed Saber Prof.Dr.

Dentistry

Introduction: Preclinical dental training requires extensive feedback and repetition, which traditional manikin exercises often lack. Adapt VR is a cost-effective, immersive system that delivers interactive, adaptive training with real-time feedback. Methods: This comparative study aimed to evaluate the effectiveness of the Adapt VR system in preclinical training. A total of 126 third-year dental students were randomly assigned to an Adapt VR Group 1 (n = 63), acquiring VR learning experience before practicing on laboratory simulators, or a control group (n = 63) who started their training on simulators directly. After practising Class I and II cavity preparations, laboratory performance was …

Transcriptomics And Metabolomics Analysis Reveal Cell Subpopulations Of Trophoblast Cells Associated With Preeclampsia, Xiaojun Zhu, Ying Jiang, Lilin Wang, Peiyue Jiang, Zixing Zhong, Hetong Li, Caihong Zheng, Lujiao Chen, Juan Wei, Xishi Lin, Peng Ding, Zehua Dong, Xiaosheng Wang, Qiong Luo

Faculty, Staff and Student Publications

Placental abnormalities are central to preeclampsia (PE), yet the cellular and molecular mechanisms underlying this dysfunction remain unclear. We applied a multi-layered, integrative approach to investigate placental tissue from patients with PE and matched controls. Single-cell RNA sequencing (scRNA-seq; GSE173193) and bulk RNA sequencing (bulk RNA-seq; GSE203507) datasets were obtained from the Gene Expression Omnibus. The scRNA-seq dataset included two PE and two control samples, whereas the bulk RNA-seq dataset focused on eight early-onset PE and five uncomplicated term births. Trophoblast subpopulations were identified via scRNA-seq, and pseudotime analysis was used to trace differentiation trajectories. Differential expression and pathway enrichment …

Intraoperative Care And Complications Of Symptomatic Adolescent And Young Adult Patients Undergoing Laparoscopy To Diagnose And/Or To Treat Endometrioses: A Multi-Institutional Review., Jacquelyn R. Evans, Katherine Bergus, Lindsey Asti, Lesley L. Breech, Ruiqi Cen, Yuan Yuan Gong, S Paige Hertweck, Holly R. Hoefgen, Anne H. Horne, Ashli A. Lawson, Seema Menon, Kathleen E. O'Brien, Shashwati Pradhan, Brenna Rachwal, Yolanda R. Smith, Priya Suvarna, Sarah Van Son, Geri Hewitt

Manuscripts, Articles, Book Chapters and Other Papers

STUDY OBJECTIVE: This multi-institutional, retrospective study explores the risks of laparoscopy for diagnosis and treatment of endometriosis to facilitate shared medical decision-making in patients age < 22 years old with chronic pain considering surgery.

METHODS: A retrospective review of patients less than 22 years old who had surgically proven endometriosis at eight pediatric hospitals was completed. Patient demographics, operative interventions, concurrent procedures, and complications were evaluated.

RESULTS: There were 284 patients with pathologically confirmed endometriosis with a median age of 16.86 years (15.51, 18.06). During the index procedure, diagnostic biopsy alone was performed (35.92%), followed by ablation (29.93%), excision (20.07%), excision and ablation (12.68%), and cryoablation (1.41%). Most common …

A Word From The Writing Team (February 2026), Pam Walter, Mfa, Laura Deloretta, Phd

A Word From the Writing Team (Newsletter)

No abstract provided.

Prevalence And Risk Factors For Laparoscopic Managed Ectopic Pregnancies At A Tertiary Referral Hospital - A 10-Year Synopsis: A Cross Sectional Study, Steve Mutiso, Eric Mugambi

Obstetrics and Gynaecology, East Africa

Background Ectopic pregnancies (EP) are a common pregnancy associated complication. They are associated with significant morbidity, and rarely mortality, if not managed properly. EP have a myriad of predisposing factors that help identify patients at risk and facilitate early diagnosis and intervention. We set out to conduct an audit of EP managed surgically at our hospital for a 10-year period and discern the incidence, prevalence and risk factors of their occurrence.

Methods This study was designed as a Retrospective Clinical Audit based at the Aga Khan University Hospital (AKUH). Study population was all women admitted to AKUH with a diagnosis …

Prediction Of First And Multiple Antiretroviral Therapy Interruptions In People Living With Hiv: Comparative Survival Analysis Using Cox And Explainable Machine Learning Models, Donald Salami, Emily Koech, Janet Turan, Kristen Stafford, Lilly Nyagah, Stephen Ohakanu, Anthony Ngugi, Manhattan Charurat

Institute for Human Development, East Africa

Background: The Cox proportional hazards (CPH) model is a common choice for analyzing time-to-treatment interruptions in patients on antiretroviral therapy (ART), valued for its straightforward interpretability and flexibility in handling time-dependent covariates. Machine learning (ML) models have increasingly been adapted for handling temporal data, with added advantages of handling complex, nonlinear relationships and large datasets, and providing clear practical interpretations.

Objective: This study aims to compare the predictive performance of the traditional CPH model and ML models in predicting treatment interruptions among patients on ART, while also providing both global and individual-level explanations to support personalized, data-driven interventions …

Wellness Connection Newsletter February 2026, Roger Williams University School Of Law

Life of the Law School (1993- )

No abstract provided.

Himmelfarb Liaison Letter - February 2026, The George Washington University, Himmelfarb Health Sciences Library

Himmelfarb Library Liaison Letters

No abstract provided.

Analysis Of Pediatric Cervical Spine Injury Evaluation Workflow In The Emergency Department, Annie J Truelove, Megan E Gregory, Fahd A Ahmad, Sean P Pajak, Nicole C Hammer, Daniel Corwin, Leah Tzimenatos, Scott O King, Matthew Szadkowski, Martin J Herman, Julie C Leonard

2020-Current year OA Pubs

OBJECTIVES: The decision to image children for cervical spine injuries (CSI), an uncommon injury with high associated morbidity and mortality, is complex. X-rays and computed tomography are often used to screen for CSI; however, radiation exposure increases lifetime cancer risk. We recently developed a CSI prediction rule to inform pediatric imaging decisions. To guide implementation, we conducted a workflow analysis of CSI screening in children after blunt trauma.

METHODS: We interviewed emergency departments (ED) and trauma clinicians at 21 hospitals following the applied cognitive task analysis task diagram, knowledge audit, and simulation interview approaches. Interviews were coded using a combined …

Management Of Mechanical Ventilation In Emergency Medicine: A Scoping Review, Robert J Klemisch, Mitchell S Hymowitz, Ryan J Alcantara, Brendan F Mullan, Margaret L Davis, Rachel Blume, Nicholas J Johnson, Brian M Fuller

2020-Current year OA Pubs

OBJECTIVES: Invasive mechanical ventilation is used for approximately 250,000 emergency medicine (EM) patients annually and continues to increase. Despite rising volumes, EM clinicians receive limited training in ventilation management. Much of the existing evidence is derived from other environments, which may not fully apply to the unique conditions of EM. This scoping review broadly categorizes literature on invasive ventilation specific to EM patients and clinicians and identifies knowledge gaps to direct future research.

METHODS: Following Preferred Reporting Items for Systematic Review and Meta-Analysis extension for Scoping Reviews Checklist guidelines, this review comprehensively mapped the literature on optimizing invasive mechanical ventilation …

Lightweight Open-Source Large Language Models Versus Ctakes For Information Extraction From Discharge Summaries: Tobacco Smoking Status Test Case, David M Dávila-García, Matthew J Schuelke, Adam B Wilcox

2020-Current year OA Pubs

OBJECTIVES: To compare lightweight open-source large language models (LLMs) with cTAKES, a state-of-the-art natural language processing (NLP) system, in an information extraction task from hospitalization discharge summaries.

MATERIALS AND METHODS: Two readers annotated 250 randomly sampled adult discharge summaries (BJC HealthCare, 2018-2023) for tobacco smoking status as "Smoker," "Never smoker," "Unknown." Six LLMs (Llama-3 [1B-70B], gpt-oss-20B, MedGemma-27B) and cTAKES extracted smoking status from summaries. Performance was benchmarked against consensus annotations using weighted F1-score, macro F1-score, and per-class F1-scores and a noninferiority test.

RESULTS: Inter-reader agreement was excellent (κ = 0.91). LLM size (2.3-47.3 GB) and inference time (2.5-14.5 s/note) varied. …

Catatonia And Elevated Mortality: A Population-Wide Cohort Study With Healthy, Sibling, And Schizophrenia Spectrum Controls, Chih-Wei Hsu, Yang-Chieh Brian Chen, Marco Solmi, Chih-Sung Liang, Mu-Hong Chen, Yao-Hsu Yang, Liang-Jen Wang, Edward Chia-Cheng Lai

Children’s Nutrition Research Center Staff Publications

Aim: To determine whether catatonia is associated with increased long-term all-cause and cause-specific mortality.

Methods: Using Taiwan's National Health Insurance Database (2000-2022), we assembled a population-based cohort of all adults (≥18 years) with catatonia and matched each to four controls without catatonia on sex and birthdate. Mortality was compared between (1) individuals with catatonia and their unaffected siblings and (2) individuals with schizophrenia spectrum disorders with catatonia and those with schizophrenia spectrum disorders without catatonia. The primary outcome was all-cause mortality; secondary outcomes were natural- and unnatural-cause deaths. Adjusted hazard ratios (HRs) with 95% confidence intervals (CIs) were estimated with …

Uncovering Predictors Of Bipolar Ii Conversion To Bipolar I: A Machine Learning Analysis Of National Health Records In Taiwan, Chih-Wei Hsu, Yang-Chieh Brian Chen, Liang-Jen Wang, Kuo-Chuan Hung, Mu-Hong Chen, Eduard Vieta, Chien-Yuan Chen, Chih-Sung Liang, Andre F Carvalho

Children’s Nutrition Research Center Staff Publications

Background: Bipolar II disorder (BD-II) can progress to bipolar I disorder (BD-I), carrying profound psychosocial consequences. However, limited research has investigated the transition from BD-II to BD-I. Our study uses machine learning to predict the conversion using real-world data.

Methods: We conducted a retrospective cohort study using the Taiwan National Health Insurance Research Database (2000-2013) to identify adults diagnosed with BD-II. A predictive model for BD-I conversion was developed using extreme gradient boosting (XGBoost), incorporating demographic factors, healthcare utilization, comorbidities, and psychotropic medication use. The dataset was randomly divided into development (80 %) and test (20 %) sets. Model performance …

Silent Messengers In The Nano-World: Harnessing Extracellular Vesicles As Theranostic Tools For Neonatal Surgical Conditions, Augusto Zani

2020-Current year OA Pubs

Extracellular vesicles (EVs) are lipid bilayer-enclosed nanoparticles secreted by all cells that mediate intercellular communication by transferring proteins, lipids, and nucleic acids. Among their cargo, microRNAs are key post-transcriptional regulators of organogenesis. In fetal lung development, EV-mediated signaling is essential for the coordination of epithelial, mesenchymal, endothelial, and immune cells. In congenital diaphragmatic hernia (CDH), disruption of these interactions leads to pulmonary hypoplasia and pulmonary hypertension, the primary causes of morbidity and mortality. Amniotic fluid stem cell-derived EVs (AFSC-EVs) have emerged as a promising cell-free therapy to restore this impaired communication. In rodent, rabbit, and human models of pulmonary hypoplasia, …

Computational Single-Neuron Mechanisms Of Visual Object Coding In The Human Temporal Lobe, Runnan Cao, Jie Zhang, Jie Zheng, Yue Wang, Peter Brunner, Jon T Willie, Shuo Wang

2020-Current year OA Pubs

Understanding how the human brain encodes visual objects involves deciphering the neural computations and circuits in the temporal lobe. Here, we recorded intracranial EEG from the human ventral temporal cortex (VTC) and medial temporal lobe (MTL), as well as single-neuron activity in the MTL, to investigate the computational mechanisms of neural object coding. The VTC exhibited axis-based feature coding, and a neural feature space could be constructed using VTC neural axes, within which visual objects clustered according to high-level categorical relationships. Importantly, MTL neurons encoded receptive fields within this VTC neural feature space, exhibiting selective responses to objects that shared …

Skida1 Sustains Mll::Enl-Expressing Hematopoietic Progenitors During Neonatal Stages And Promotes B-Lineage Priming, Jonny Mendoza-Castrejon, Wei Yang, Elisabeth Denby, Rohini Muthukumar, Emily B Casey, Riddhi M Patel, Sarah K Tasian, Jeffrey A Magee

2020-Current year OA Pubs

Infant leukemias arise as B-cell acute lymphoblastic or acute myeloid leukemia. Most are driven by chromosomal rearrangements of the

Phase 1 Study Of Inbrx-105, A Tnfrsf9 (4-1bb) And Pd-L1 Bispecific Antibody, In Patients With Select Solid Tumors, Jong Chul Park, Doug R Adkins, Et Al.

2020-Current year OA Pubs

PURPOSE: INBRX-105, a tetravalent, PD-L1-targeted TNFRSF9 (4-1BB) agonist, demonstrated preclinical antitumor activity. This first-in-human study evaluated INBRX-105 in solid tumors.

PATIENTS AND METHODS: This open-label, 4-part, phase 1 study evaluated INBRX-105 alone or with pembrolizumab in adults with locally advanced/metastatic, unresectable solid tumors (NCT03809624). INBRX-105 was administered intravenously once every 2 weeks or 4 weeks in parts 1 (single-agent dose escalation; 0.001-3 mg/kg) and 2 (single-agent expansion) or once every 3 weeks in parts 3 (combination dose escalation; INBRX-105 0.03-1.0 mg/kg) and 4 (combination expansion). Part 2 enrolled patients with checkpoint inhibitor-relapsed/refractory (CPI-R/R) tumors. Part 4 enrolled patients with CPI-R/R …

Quality Improvement Project: Improving Transitional Care Management (Tcm) Follow-Up Through Medical Assistant Education, Oben Assick

Doctor of Nursing Practice Projects

The underutilization of Transitional Care Management (TCM) services in primary care significantly contributes to preventable hospital readmissions and revenue loss. Despite established Centers for Medicare & Medicaid Services (CMS) guidelines, execution often fails due to knowledge gaps among frontline staff. This quality improvement project addressed low TCM task completion rates by implementing a structured educational intervention for medical assistants (MAs). The purpose was to evaluate whether targeted training improves timely patient follow-up, visit scheduling, and billing accuracy. The project utilized Kotter’s 8-Step Change Model to guide organizational change and the Health Belief Model to address behavioral barriers. A quantitative, quasi-experimental …

Age And Sex Impact The Role Of Thrombospondin-2 And Thrombospondin-5 In Response To Hindlimb Ischemia, Irene Helenowski, Ashley Peters, Melissa Rangel, Corinne Bunn Md, Xuerong Wang, Kristopher Maier, Vivian Gahtan

Biostatistics Collaborative Core: Faculty Publications and Other Works

Peripheral arterial disease progression to critical limb ischemia remains a significant burden in the aged, necessitating revascularization. Therapies to enhance neovascularization, such as angiogenesis or arteriogenesis, may provide an option for patients not suitable for surgery. The thrombospondins (TSPs) are secreted matricellular glycoproteins, with TSP-1, TSP-2, and TSP-5 implicated in neovascularization. Currently, there is little data regarding the effects of TSP-2, TSP-5, sex, and aging on angiogenesis and arteriogenesis. In vitro, the effect of TSP-2 or TSP-5 on early or late passage endothelial cell (EC) tubule formation or disruption was assessed. In vivo, angiogenesis, and arteriogenesis in male and female, …

Flare Guns And Trauma: Patterns, Severity, And Clinical Implications From Case And National Surveillance Data, Ramsay Hafer, Andrew Huff, Lara Phillips

Department of Emergency Medicine Faculty Papers

Flare guns are pyrotechnic devices capable of causing serious injury due to high-temperature combustion and projectile discharge. Though intended for signaling in maritime or wilderness settings, improper use can result in trauma patterns distinct from those seen with typical burns or fireworks. Despite their severity, flare gun injuries remain underreported and poorly characterized. We conducted a scoping review of PubMed, Scopus, and Ovid to identify 12 case reports involving 13 patients, and reviewed US National Electronic Injury Surveillance System records from 2015 to 2024, identifying 18 flare gun-specific injuries for a combined total of 31 injuries. Demographic, injury mechanism, body …

Recurrent Miller Fisher Syndrome: A Case Report, Larry Vernier, Griffin B. Gilmore, Kelsey Van Housen, Xiao C. Zhang

Department of Emergency Medicine Faculty Papers

INTRODUCTION: Guillain-Barré syndrome can manifest with progressive paralysis, requiring careful monitoring and treatment with steroids or intravenous (IV) immunoglobin. While this disease can be devastating and require intensive care unit level of care, there are few incidences of relapses.

CASE REPORT: A 67-year-old man with a past medical history of Miller Fisher syndrome variant of Guillain-Barré syndrome, with complete recovery, presented to the emergency department (ED) with ataxia, ophthalmoplegia, dysphonia, and ambulatory dysfunction. The patient noticed his neurologic symptoms after waking up, and he presented to the ED with physical examination positive for difficulty with upward gaze, mild right lower …