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Articles 1 - 30 of 8945
Full-Text Articles in Entire DC Network
Conjunctival Papilloma Across Eras: Comparison Of Historical And Modern Cohorts, Lily C. Farrell, Robert J. Medina, Justin C. Muste, Hemal P. Patel, Sara E. Lally, Ralph C. Eagle C. Eagle, Carol L. Shields, Tatyana Milman
Conjunctival Papilloma Across Eras: Comparison Of Historical And Modern Cohorts, Lily C. Farrell, Robert J. Medina, Justin C. Muste, Hemal P. Patel, Sara E. Lally, Ralph C. Eagle C. Eagle, Carol L. Shields, Tatyana Milman
Wills Eye Hospital Papers
Objective: To evaluate and compare epidemiology, clinical and histopathologic features, and outcomes of conjunctival papilloma in historical and modern cohorts. Design: Retrospective comparative cohort study. Participants: Patients with conjunctival papilloma at a tertiary referral center between 2015 and 2024. Methods: A retrospective review of Oncology and Pathology records was conducted to identify all patients with conjunctival papilloma over a 10-year period (2015–2024). Data collected included demographics, HPV vaccination status, clinical tumor characteristics, treatment modalities, outcomes, and histopathologic findings of excised lesions. Patients were stratified by age (≤20 vs.> 20 years). Findings were compared with a historical cohort managed at the …
Bemotrizinol And The Modernization Of Us Sunscreen Regulation, Umayr R. Shaikh, Christopher G. Richter, Leela K. Raj, Afrin Mirza, Harold William Higgins, Jane M. Grant-Kels
Bemotrizinol And The Modernization Of Us Sunscreen Regulation, Umayr R. Shaikh, Christopher G. Richter, Leela K. Raj, Afrin Mirza, Harold William Higgins, Jane M. Grant-Kels
SKMC Student Presentations and Publications
No abstract provided.
Early Prediction Of The Breast Cancer Response To Neoadjuvant Chemotherapy Based On Intratumoral Interstitial Fluid Pressure Using 3-D Subharmonic-Aided Pressure Estimation, Sung In Choi, Basak Dogan, Corinne E. Wessner, Jessica H. Porembka, Priscilla Machado, B. Bersu Ozcan, Nisha Unni, Maysa Abu-Khalaf, Kenneth Hoyt, Flemming Forsberg, Kibo Nam
Early Prediction Of The Breast Cancer Response To Neoadjuvant Chemotherapy Based On Intratumoral Interstitial Fluid Pressure Using 3-D Subharmonic-Aided Pressure Estimation, Sung In Choi, Basak Dogan, Corinne E. Wessner, Jessica H. Porembka, Priscilla Machado, B. Bersu Ozcan, Nisha Unni, Maysa Abu-Khalaf, Kenneth Hoyt, Flemming Forsberg, Kibo Nam
Department of Radiology Faculty Papers
Elevated intratumoral interstitial fluid pressure (IFP) may negatively impact the efficacy of neoadjuvant chemotherapy (NAC). This study aimed to predict the breast cancer response to NAC based on intratumoral IFP using 3D contrast-enhanced ultrasound (CEUS) with subharmonic-aided pressure estimation (SHAPE). This prospective study enrolled breast cancer patients undergoing NAC from two clinical sites. 3D CEUS was performed at 0%, 10%, and 30% of NAC completion using a GE Logiq E9 with Definity. The pressure gradients between the tumor and adjacent normal tissue were estimated by SHAPE, utilizing the inverse linear relationship between the ultrasound contrast agent’s subharmonic signal amplitude and …
Early Hands-On Surgical Exposure: Outcomes Of A Student-Led Surgical Externship Program For Preclinical Students, Meryem C. Guler, Elizabeth Spitz, Jennifer E. Geller, Talar Tatarian, Renee Tholey
Early Hands-On Surgical Exposure: Outcomes Of A Student-Led Surgical Externship Program For Preclinical Students, Meryem C. Guler, Elizabeth Spitz, Jennifer E. Geller, Talar Tatarian, Renee Tholey
Department of Surgery Faculty Papers
Objective: Early surgical exposure may potentially influence medical students' decision to pursue a surgical career. At our urban, academic medical school, senior medical students developed a Surgical Externship Program (SEP) to provide first-years with hands-on OR experience. This program is a structured 1- to 2-week immersive experience in which first-year students scrubbed into operations, participated in rounds, and engaged with surgical teams under resident and attending supervision. This study evaluates the SEP's impact on surgical interest, OR confidence, and clinical exposure.
Setting: Academic tertiary care hospital.
Participants: First-year medical students.
Design: First-year students participated in a 1- or 2-week SEP …
A Word From The Writing Team (October 2026), Pam Walter, Mfa, Laura Deloretta, Phd
A Word From The Writing Team (October 2026), Pam Walter, Mfa, Laura Deloretta, Phd
A Word From the Writing Team (Newsletter)
No abstract provided.
The Β2Αb Loop Determines Nad(P) Cofactor Specificity And Kinetics In Trypanosomal D-3-Hydroxybutyrate Dehydrogenases, Hideharu Hashimoto, Ian H. Mawn, William Escobar-Arrillaga, Linh Nguyen, Laura A. Madigan, Gina Antuono, Tatiana Rossy, Jorna Sojati, Anna Mienko, Erik W. Debler, Jennifer B. Palenchar
The Β2Αb Loop Determines Nad(P) Cofactor Specificity And Kinetics In Trypanosomal D-3-Hydroxybutyrate Dehydrogenases, Hideharu Hashimoto, Ian H. Mawn, William Escobar-Arrillaga, Linh Nguyen, Laura A. Madigan, Gina Antuono, Tatiana Rossy, Jorna Sojati, Anna Mienko, Erik W. Debler, Jennifer B. Palenchar
Department of Biochemistry and Molecular Biology Faculty Papers
Bacterial d-3-hydroxybutyrate dehydrogenases (HBDHs) catalyze the conversion between d-3-hydroxybutyrate and acetoacetate with NAD as the cofactor but not with NAD 2'-phosphate (NADP). However, HBDHs of the early-branched eukaryotic genus Trypanosoma utilize both NAD and NADP (T. brucei) or exclusively NADP (T. cruzi). Here we reveal that NADP specificity of T. cruzi HBDH arises from stabilization of the flexible β2αB loop by the 2'-phosphate interaction. Stabilization of this loop by a nearby C64Y mutation enables T. cruzi HBDH to use NAD in addition to NADP; thus, the Cys/Tyr residue is critical for determining cofactor specificity in trypanosomal HBDHs, suggesting that most …
Palopegteriparatide For Adults With Chronic Hypoparathyroidism: Skeletal Dynamics Through 3 Years Of The Phase 2 Path Forward Trial, Mishaela Rubin, Bart Clarke, Lorenz Hofbauer, Aliya Khan, Peter Schwarz, Tamara Vokes, Intekhab Ahmed, Andrea Palermo, Filomena Cetani, Uberto Pagotto, Carol Zhao, Michael Ominsky, Bryant Lai, Jenny Ukena, Aimee Shu, Lars Rejnmark
Palopegteriparatide For Adults With Chronic Hypoparathyroidism: Skeletal Dynamics Through 3 Years Of The Phase 2 Path Forward Trial, Mishaela Rubin, Bart Clarke, Lorenz Hofbauer, Aliya Khan, Peter Schwarz, Tamara Vokes, Intekhab Ahmed, Andrea Palermo, Filomena Cetani, Uberto Pagotto, Carol Zhao, Michael Ominsky, Bryant Lai, Jenny Ukena, Aimee Shu, Lars Rejnmark
Division of Endocrinology, Diabetes and Metabolic Diseases Faculty Papers
Hypoparathyroidism is an endocrine disease caused by insufficient levels of PTH, which acts directly on bone and kidney and indirectly on the intestine to regulate calcium and phosphate balance. In clinical trials, palopegteriparatide (TransCon PTH) treatment enabled independence from conventional therapy (no active vitamin D, ≤600 mg/d calcium) and maintained serum biochemistries within normal ranges. The current analyses describe patterns of change in BMD, serum bone turnover markers, and serum and urine calcium in adults with chronic hypoparathyroidism treated with palopegteriparatide through 3 years of the PaTH Forward trial. Baseline BMD Z-scores for the LS, TH, FN, and 1/3 distal …
Using An Automated Evaluation System To Improve Medical Student Evaluation Response Rate And Reduce Administrative Burden, Chaiya Laoteppitaks, Alisha Agarwal, Jason Gonzalez, Nina Mingioni, Xiao C. Zhang
Using An Automated Evaluation System To Improve Medical Student Evaluation Response Rate And Reduce Administrative Burden, Chaiya Laoteppitaks, Alisha Agarwal, Jason Gonzalez, Nina Mingioni, Xiao C. Zhang
Department of Emergency Medicine Faculty Papers
BACKGROUND: Email reminders facilitate timely task completion but can create substantial administrative burdens for clerkship staff. In our emergency medicine (EM) clerkship, third-year medical students initiate digital evaluation requests after each clinical shift, requiring frequent manual reminders to maintain completion rates. The time-intensive nature of this process highlights the need for a more efficient and scalable approach.
METHODS: This multi-site, pre-post study evaluated clinical performance evaluation completion rates and time to completion during the required EM clerkship over 48 weeks before and after implementation of an automated reminder system in September 2024. The system integrated existing survey functionality with Microsoft …
Management Of Non-Survivable Head Trauma: Opportunities For Improvement, Sanjana R. Salwi, Mackenzie D. Castellanos, Therese Murphy, Pious D. Patel, Sonia Ajmera, Alex P. Vaz, Connor A. Wathen, Niels D. Martin, Monisha A. Kumar, James M. Schuster, Dmitriy Petrov
Management Of Non-Survivable Head Trauma: Opportunities For Improvement, Sanjana R. Salwi, Mackenzie D. Castellanos, Therese Murphy, Pious D. Patel, Sonia Ajmera, Alex P. Vaz, Connor A. Wathen, Niels D. Martin, Monisha A. Kumar, James M. Schuster, Dmitriy Petrov
Department of Neurosurgery Faculty Papers
BACKGROUND: Managing patients with non-survivable head trauma who do not meet brain death criteria presents significant ethical and clinical challenges. Decisions frequently fall to surrogates with limited guidance, particularly when organ donation status is unknown. This study assessed physician perspectives on communication, interventions, and institutional factors.
METHODS: We conducted a national survey of academic neurosurgery, trauma surgery, and neurocritical care programs. Items examined communication barriers, interventions by donor status, institutional support, and a dissonance measure for interventions viewed as inappropriate.
RESULTS: A total of 133 physicians responded. Top communication barriers were medical literacy, unclear patient values, and intrafamily conflict. Physicians …
Evaluating Electronic Health Record Intervention Efficacy In Enhancing Inpatient Initiation Of Guideline-Directed Medical Therapy, Sheraz Qamar, Trisha Sindhu, Charlotte Pirquet, Benjamin Richter, Charlotte Sacksteder, Tatianna Branch, Jeffrey Riggio, Cara Martino, Patricia C. Henwood, Alan Kubey
Evaluating Electronic Health Record Intervention Efficacy In Enhancing Inpatient Initiation Of Guideline-Directed Medical Therapy, Sheraz Qamar, Trisha Sindhu, Charlotte Pirquet, Benjamin Richter, Charlotte Sacksteder, Tatianna Branch, Jeffrey Riggio, Cara Martino, Patricia C. Henwood, Alan Kubey
Department of Medicine Faculty Papers
BACKGROUND: Heart failure (HF) is a leading cause of hospitalization, morbidity, and mortality. Despite evidence supporting guideline-directed medical therapy (GDMT), prescribing remains suboptimal, particularly at hospital discharge.
PROJECT RATIONALE: Hospitalization provides an opportunity to initiate or optimize GDMT, but workflow barriers and practice variation limit implementation. To address this gap, our system implemented a system-wide HF quality improvement initiative featuring evidence-based order sets and an electronic health record smart phrase ("HFNOTE") to centralize and standardize documentation and encourage GDMT use.
PROJECT SUMMARY: We analyzed 2,859 HF hospitalizations across 10 hospitals between December 1, 2024 and June 30, 2025. Use of …
Ehr-Based Quality Interventions Associated With Differential Gdmt Prescribing In Community Versus Academic Hospitals, Trisha Sindhu, Charlotte Pirquet, Sheraz Qamar, Tanay-Veer Gandhi, Patricia C. Henwood, Cara Martino, Jeffrey Riggio, Jared Vanderzell, Charlotte Sacksteder, Alan Kubey
Ehr-Based Quality Interventions Associated With Differential Gdmt Prescribing In Community Versus Academic Hospitals, Trisha Sindhu, Charlotte Pirquet, Sheraz Qamar, Tanay-Veer Gandhi, Patricia C. Henwood, Cara Martino, Jeffrey Riggio, Jared Vanderzell, Charlotte Sacksteder, Alan Kubey
Department of Medicine Faculty Papers
BACKGROUND: Institutional barriers are associated with suboptimal guideline-directed medical therapy (GDMT) prescribing at heart failure discharge.
PROJECT RATIONALE: Practice variations between academic medical centers (defined as "teaching" hospitals with residents) and community hospitals are poorly understood. Evaluating how diverse settings respond to quality improvement strategies is vital.
PROJECT SUMMARY: A multicenter study across 10 electronic health record-unified hospitals evaluated 3,535 heart failure encounters. Phase 1 implemented educational work groups and financial incentives; phase 2 introduced clinical decision support systems. Community hospitals responded significantly to phase 1 education/incentives, with mean discharge of GDMT agents rising from 2.19 to 2.44 (P = …
Feasibility And Acceptability Of Perioperative Application Of Biofeedback-Based Virtual Reality Vs Control For Pain And Anxiety In Children And Adolescents Undergoing Surgery: Pilot Randomized Controlled Trial, Anna Lin, Brenna Rachwal, Lindsey Asti, Zandantsetseg Orgil, Isabela Santiago, Lili Ding, Susmita Kashikar-Zuck, Christopher King, Sara Williams, William Black, Peter Minneci, Vanessa Olbrecht
Feasibility And Acceptability Of Perioperative Application Of Biofeedback-Based Virtual Reality Vs Control For Pain And Anxiety In Children And Adolescents Undergoing Surgery: Pilot Randomized Controlled Trial, Anna Lin, Brenna Rachwal, Lindsey Asti, Zandantsetseg Orgil, Isabela Santiago, Lili Ding, Susmita Kashikar-Zuck, Christopher King, Sara Williams, William Black, Peter Minneci, Vanessa Olbrecht
Department of Anesthesiology Faculty Papers
BACKGROUND: The impact of biofeedback-based virtual reality (VR-BF) on pain and anxiety in pediatric surgical patients remains unexplored.
OBJECTIVE: The objective of this study was to evaluate the feasibility and acceptability of perioperative VR-BF use in children and adolescents.
METHODS: We performed a single-blind, 2-arm, randomized pilot trial. Children aged 12 to 18 years undergoing surgery with expected moderate-to-severe postoperative pain and more than 1 overnight admission were randomized (1:1) to the intervention or control group. Participants in the intervention group received VR-BF using ForeVR (functional outcome response to engaging virtual reality [VR]), a novel, gamified digital intervention that integrates …
Successful Treatment Of Recurrent Epithelioid Trophoblastic Tumor (Ett) With Pembrolizumab After Pembrolizumab: A Case Report And Review Of Literature In Treatment Of Ett, Sarah Mokma, Sarah Alnaif, Nicholas Cardillo
Successful Treatment Of Recurrent Epithelioid Trophoblastic Tumor (Ett) With Pembrolizumab After Pembrolizumab: A Case Report And Review Of Literature In Treatment Of Ett, Sarah Mokma, Sarah Alnaif, Nicholas Cardillo
Abington Jefferson Health Papers
BACKGROUND: Epithelioid Trophoblastic Tumors (ETT) are rare, which makes an optimal treatment regimen difficult to determine. Since PD-L1 is expressed in placental tissue and in gestational trophoblastic neoplasia (GTN), immunotherapies such as pembrolizumab have been proposed as possible treatments.
CASE PRESENTATION: The case presented is a 50-year-old postmenopausal female who presented with postmenopausal bleeding and a large, fungating cervical mass. Cervical biopsies confirmed ETT. The patient underwent primary debulking surgery with radical abdominal hysterectomy, bilateral salpingo-oophorectomy, and sigmoid colon resection. The patient was diagnosed with a FIGO Stage IV ETT due to tumor extension to sigmoid colon with a high-risk …
Understanding The Lived Experiences Of Individuals With Post-Acute Sequelae Of Sars-Cov-2 Infection (Pasc) In Rwanda: A Phenomenological Qualitative Study, Iliza Grace Ndatinya, Simal Thind, Fernand Rwamwejo
Understanding The Lived Experiences Of Individuals With Post-Acute Sequelae Of Sars-Cov-2 Infection (Pasc) In Rwanda: A Phenomenological Qualitative Study, Iliza Grace Ndatinya, Simal Thind, Fernand Rwamwejo
Global Health Articles
OBJECTIVES: To qualitatively explore the lived experiences of individuals with post-acute sequelae of SARS-CoV-2 infection (PASC) in Rwanda, with the aim of informing context-appropriate interventions to improve patients' quality of life.
DESIGN: Qualitative, phenomenological study using in-depth interviews and thematic analysis.
SETTING: All provinces of Rwanda, including the City of Kigali.
PARTICIPANTS: Adults who tested positive for PASC during a nationwide prevalence study were purposively sampled across all study sites. A total of 30 people were interviewed before saturation was reached.
RESULTS: Participants' lived experiences with PASC were characterised by numerous themes. Despite describing significant life changes since their COVID-19 …
Exploring Which Ehr Interventions Improve Heart Failure Hospitalization Outcomes Across 10 Hospitals, Sheraz Qamar, Andres Alvarado, Thomas Buckwalter, Patricia C. Henwood, Dana Jordan, Cara Martino, Jeffrey Riggio, Charlotte Sacksteder, Jared Vanderzell, Alan Kubey
Exploring Which Ehr Interventions Improve Heart Failure Hospitalization Outcomes Across 10 Hospitals, Sheraz Qamar, Andres Alvarado, Thomas Buckwalter, Patricia C. Henwood, Dana Jordan, Cara Martino, Jeffrey Riggio, Charlotte Sacksteder, Jared Vanderzell, Alan Kubey
Department of Medicine Faculty Papers
BACKGROUND: Heart failure (HF) remains a major cause of mortality and hospitalization despite advances in guideline-directed medical therapy (GDMT). Electronic health record (EHR)-based clinical decision support tools may improve care delivery, but their impact on outcomes remains ill-defined.
PROJECT RATIONALE: As part of a system-wide HF quality improvement initiative, we evaluated 2 EHR interventions: an evidence-based HF admission order set promoting early diuresis and GDMT optimization, and a templated HF documentation tool (HFNOTE) designed to capture clinical complexity.
PROJECT SUMMARY: We analyzed 4,865 HF hospitalizations across 10 hospitals between December 2024 and June 2025. Overall risk-adjusted mortality index was 0.83 …
Validation Of Next‑Generation Sequencing‑Derived Circulating Mrna Variants As Potential Diagnostic Tools In Hepatocellular Carcinoma And Cholangiocarcinoma, Daniel Zezulinski, Maarouf A. Hoteit, David E. Kaplan, Tingting Zhan, Cataldo Doria, Timothy M. Block, Aejaz Sayeed
Validation Of Next‑Generation Sequencing‑Derived Circulating Mrna Variants As Potential Diagnostic Tools In Hepatocellular Carcinoma And Cholangiocarcinoma, Daniel Zezulinski, Maarouf A. Hoteit, David E. Kaplan, Tingting Zhan, Cataldo Doria, Timothy M. Block, Aejaz Sayeed
Department of Pharmacology, Physiology, and Cancer Biology Faculty Papers
Liquid biopsy can transform oncology practice through early detection and real‑time monitoring of cancer progression and response to treatment. Circulating cell‑free tumor RNA offers promise as a novel and emerging alternative to circulating cell‑free tumor DNA for detecting the presence and understanding the biology of liver tumors. Both circulating DNA and RNA, which predominantly reside in extracellular vesicles, carry evidence of vital germline and somatic mutations. High impact single nucleotide changes, insertions and deletions in circulating RNA (ctRNA) serve a key role in cancer development and progression. Tumor cells exploit the RNA splicing machinery to induce structural and functional changes …
Strengthening Health System-Community Partnerships To Address Pediatric Social Needs: A Qualitative Study, Joy Friedman, Melissa A. Alderfer, Kelsey Higgins, Aaron Carpenter, Jennifer Sciolla, Sarah E. Wawrzynski
Strengthening Health System-Community Partnerships To Address Pediatric Social Needs: A Qualitative Study, Joy Friedman, Melissa A. Alderfer, Kelsey Higgins, Aaron Carpenter, Jennifer Sciolla, Sarah E. Wawrzynski
Department of Pediatrics Faculty Papers
IntroductionStructural and social conditions influence pediatric health outcomes. Successful implementation of social needs screening and referral programs depends on community-based organizations (CBOs) to provide resources that address health-related social needs (HRSN). We explored current practices and perspectives of health care workers and CBO representatives on improving health system-CBO partnerships.MethodsParticipants were purposively recruited from a variety of health care settings involved in HRSN screening and CBOs delivering resources in the community. Participants completed semi-structured interviews. Qualitative thematic analysis was used to summarize data.ResultsTen key informants participated (six health care workers and four CBO representatives). Four themes were identified: 1) mismatches in …
Impact Of The Hidden Curriculum And Unprofessionalism On Medical Student Specialty Choice, Melissa George, Kristie White, Balaram Puligandla, Hailey Gosnell, Amanda Lofgreen, Kristen Johnson, Stephanie Barak, Mary Berg, Satyapal Chahar, John Childs, Barbara Knollmann-Ritschel, Julie Karp, Md, Cindy Mccloskey, Bronwyn Bryant
Impact Of The Hidden Curriculum And Unprofessionalism On Medical Student Specialty Choice, Melissa George, Kristie White, Balaram Puligandla, Hailey Gosnell, Amanda Lofgreen, Kristen Johnson, Stephanie Barak, Mary Berg, Satyapal Chahar, John Childs, Barbara Knollmann-Ritschel, Julie Karp, Md, Cindy Mccloskey, Bronwyn Bryant
Department of Pathology, Anatomy, and Cell Biology Faculty Papers
The hidden curriculum in medical education refers to implicit lessons not formally taught, including specialty hierarchies, stereotypes, and misconceptions. Pathology, in particular, is often subject to derogatory comments and the perception that communication skills and patient care are wasted in this specialty. This study explored pathology residents' experiences with the hidden curriculum and its impact on medical student education. A survey was administered to pathology trainees to assess demographic trends and specialties associated with positive or negative perceptions of pathology and included free-text responses. Most respondents reported encountering negative remarks about pathology, spanning all levels of training and practice. Reactions …
Editorial: Invisible Hazards, Lasting Impact: Airborne Toxicants And Systemic Disease From Environmental And Occupational Exposures, Tammy Butterick, Julie Tomáška, Pamala Ginex, Janeen Trembley, Paul Barach
Editorial: Invisible Hazards, Lasting Impact: Airborne Toxicants And Systemic Disease From Environmental And Occupational Exposures, Tammy Butterick, Julie Tomáška, Pamala Ginex, Janeen Trembley, Paul Barach
College of Population Health Faculty Papers
No abstract provided.
Intravascular Immune Cell Labeling As A Critical Methodological Tool For Characterizing Cd4+ T Cells In The Lung In Eae, Gholamreza Azizi, Mohamad Rostami
Intravascular Immune Cell Labeling As A Critical Methodological Tool For Characterizing Cd4+ T Cells In The Lung In Eae, Gholamreza Azizi, Mohamad Rostami
Department of Neurology Faculty Papers
INTRODUCTION: Growing evidence highlights the lung -brain axis as a key contributor to CNS autoimmunity. However, accurate characterization of lung immune cells remains technically challenging because standard transcardial perfusion does not eliminate the lung's extensive marginated intravascular leukocyte pool, allowing circulating cells to contaminate analyses of the lung parenchyma.
METHODS: Experimental autoimmune encephalomyelitis (EAE) was induced in mice by immunization with MOG35-55 peptide in complete Freund's adjuvant, followed by pertussis toxin administration. Lung mononuclear cells were isolated after intravascular (IV) CD45 labeling, transcardial perfusion, and enzymatic digestion. Immune cell populations and intracellular cytokine production were analyzed by multicolor flow cytometry …
Medetomidine As A Fentanyl Adulterant: Pharmacology, Detection, Clinical Presentation, And Management, Kory S. London, Phil Durney, Brendan Hart, Ashish Thakrar, Dennis Goodstein, Alex J. Krotulski, Daniel Teixeira Da Silva, Joseph D’Orazio, Lara Weinstein, Jeanmarie Perrone, Michael J. Lynch
Medetomidine As A Fentanyl Adulterant: Pharmacology, Detection, Clinical Presentation, And Management, Kory S. London, Phil Durney, Brendan Hart, Ashish Thakrar, Dennis Goodstein, Alex J. Krotulski, Daniel Teixeira Da Silva, Joseph D’Orazio, Lara Weinstein, Jeanmarie Perrone, Michael J. Lynch
Division of Internal Medicine Faculty Papers & Presentations
Purpose of Review Medetomidine is a veterinary α2-adrenergic agonist that has been an adulterant of illicitly manufactured opioids since 2022. We review its pharmacology, detection, intoxication, withdrawal, and management, and assess why severe withdrawal has emerged in some regions but not others. Recent Findings Medetomidine has spread through North American drug markets yet evades most toxicology testing. Roughly two hundred times more potent than xylazine, with greater α2 selectivity and imidazoline-1 activity, it causes intoxication resembling other α2 agonists: sedation and bradycardia. The dominant clinical problem is withdrawal: autonomic dysregulation, intractable vomiting, and encephalopathy frequently requiring intensive care. Treatment requires …
Blinatumomab Care Delivery For Pediatric B-Cell Acute Lymphoblastic Leukemia, Daniel Zheng, Katelyn Oranges, Subhash Ramakrishnan, Lingyun Ji, Melissa Beauchemin, Sarah Alexander, Allison Leahy, Kira Bona, Emi Caywood, Sharon Castellino, Sumit Gupta, Douglas Hawkins, Olga Militano, Kathleen Montgomery, Haley Newman, Rachel Rau, Susan Rheingold, Joanna Robles, Michael Roth, David Teachey, Sarah Vargas, Sue Zupanec, Susan Parsons
Blinatumomab Care Delivery For Pediatric B-Cell Acute Lymphoblastic Leukemia, Daniel Zheng, Katelyn Oranges, Subhash Ramakrishnan, Lingyun Ji, Melissa Beauchemin, Sarah Alexander, Allison Leahy, Kira Bona, Emi Caywood, Sharon Castellino, Sumit Gupta, Douglas Hawkins, Olga Militano, Kathleen Montgomery, Haley Newman, Rachel Rau, Susan Rheingold, Joanna Robles, Michael Roth, David Teachey, Sarah Vargas, Sue Zupanec, Susan Parsons
Department of Pediatrics Faculty Papers
IMPORTANCE: Blinatumomab, a novel immunotherapy administered as a 28-day continuous infusion, has fundamentally shifted the treatment paradigm for pediatric B-cell acute lymphoblastic leukemia (B-ALL) and is now considered a component of standard therapy for the most common childhood cancer. However, the care delivery challenges in transitioning from an experimental agent on a clinical trial to widespread clinical implementation are unknown.
OBJECTIVE: To characterize the clinical landscape of pediatric blinatumomab care-delivery practice and challenges in the US from the perspective of treating centers.
DESIGN, SETTING, AND PARTICIPANTS: This survey study was conducted from February to March 2025 among US member institutions …
Diversity Among Academic Orthopaedic Surgery Sports Medicine Faculty Across Us Residency Programs, Terence L. Thomas, Alexander Zavitsanos, Claude Regis, John Czarnicki, Harrison S. Fellheimer, Gabriel I. Onor, William Justice, Jalen Broome, Damon V. Briggs, Edward S. Chang, Meghan Bishop, Christopher C. Dodson
Diversity Among Academic Orthopaedic Surgery Sports Medicine Faculty Across Us Residency Programs, Terence L. Thomas, Alexander Zavitsanos, Claude Regis, John Czarnicki, Harrison S. Fellheimer, Gabriel I. Onor, William Justice, Jalen Broome, Damon V. Briggs, Edward S. Chang, Meghan Bishop, Christopher C. Dodson
Rothman Institute Papers
BACKGROUND: Despite growing attention to workforce diversity in orthopaedic surgery, limited data exist describing the demographic composition of academic sports medicine faculty. This study examines the diversity of sports medicine fellowship-trained orthopaedic surgery faculty across US orthopaedic surgery residency training programs.
METHODS: A cross-sectional analysis of all ACGME-accredited orthopaedic surgery sports medicine faculty was conducted. Faculty data included sex, race, level of professorship, residency attended, year of residency graduation, and h-index. Underrepresented in Orthopaedics (URiO) was defined as non-White and non-Asian by race and all women. Descriptive statistics were performed.
RESULTS: A total of 812 sports medicine-fellowship trained faculty were …
Universal Screening For Measles Immunity During Pregnancy: A Cost-Effectiveness Analysis, Anuradha Devabhaktuni, Sarah Boudova, Elias Kassir, Sohum Shah, Neil S. Silverman, Christina S. Han
Universal Screening For Measles Immunity During Pregnancy: A Cost-Effectiveness Analysis, Anuradha Devabhaktuni, Sarah Boudova, Elias Kassir, Sohum Shah, Neil S. Silverman, Christina S. Han
Department of Obstetrics and Gynecology Faculty Papers
BACKGROUND: Measles is a highly contagious illness capable of causing significant morbidity and mortality, including adverse pregnancy outcomes. Routine screening for measles immunity is not currently recommended during pregnancy. Given the increasing frequency of measles outbreaks nationally and globally, awareness of measles immunity status can influence management of pregnant individuals who incur measles exposures and offer an opportunity for postpartum or preconception vaccination.
OBJECTIVE: We sought to evaluate the cost-effectiveness of universal screening for measles immunity during pregnancy in the United States.
STUDY DESIGN: A decision-analytic model was constructed to evaluate the cost-effectiveness of universal screening for measles immunity during …
Prepregnancy Obesity Versus Excessive Gestational Weight Gain: A Comparative Evaluation Of Adverse Outcomes, Samuel Schultz, David Krantz, Matthew Blitz, Ashley Battarbee, Moti Gulersen
Prepregnancy Obesity Versus Excessive Gestational Weight Gain: A Comparative Evaluation Of Adverse Outcomes, Samuel Schultz, David Krantz, Matthew Blitz, Ashley Battarbee, Moti Gulersen
Department of Obstetrics and Gynecology Faculty Papers
Background/Objectives: Obesity and excessive gestational weight gain (EGWG) are known risk factors for adverse outcomes in pregnancy, but the comparative risk is less well defined and increasingly relevant in an era of increasing use of weight loss medications. We aimed to determine whether EGWG was associated with adverse maternal and neonatal outcomes, compared with prepregnancy obesity. Methods: Multicenter retrospective cohort study of pregnant patients who delivered a singleton within a single university health system from 2019–2024. Patients with missing prepregnancy body mass index (BMI) data, BMI < 18.5 kg/m2, or pregestational diabetes were excluded. Logistic regression with propensity score weights and g-computation were used to evaluate if the incidence of several adverse maternal and neonatal outcomes were impacted by prepregnancy obesity and gestational weight gain (GWG). p values were adjusted for multiple comparisons. Results: Among the 129,615 pregnancies included, 28,516 (22.0%) had prepregnancy obesity, 36,943 (28.5%) were overweight prior to pregnancy, and 64,156 (49.5%) had a normal BMI prior to pregnancy. When compared to patients with obesity, patients with normal prepregnancy BMI and EGWG had a lower risk of adverse maternal and neonatal outcomes, including gestational diabetes, gestational hypertension, preeclampsia, eclampsia, cesarean delivery, and postpartum hemorrhage, as well as large and small for gestational age birthweight, stillbirth, neonatal intensive care unit admission, neonatal mechanical ventilation, respiratory distress syndrome, intraventricular hemorrhage, necrotizing enterocolitis, and sepsis. Beneficial effects were attenuated for patients with overweight prepregnancy BMI or for larger EGWG. Conclusions: Lower prepregnancy BMI, even with the potential unintended consequence of EGWG, may be more favorable than untreated prepregnancy obesity with regard to perinatal outcomes.
Intrawound Vancomycin For Prevention Of Surgical Site Infection: Meta-Analysis Of Randomized Clinical Trials, Shaan Patel, Shiva Nischal, Kush Kale, Angelette Mendonca, Nelson Sofoluke, Srinivas Prasad, James Harrop, Daniel Refai
Intrawound Vancomycin For Prevention Of Surgical Site Infection: Meta-Analysis Of Randomized Clinical Trials, Shaan Patel, Shiva Nischal, Kush Kale, Angelette Mendonca, Nelson Sofoluke, Srinivas Prasad, James Harrop, Daniel Refai
Department of Neurosurgery Faculty Papers
BACKGROUND: Surgical site infection remains a major cause of postoperative morbidity. Intrawound vancomycin has been proposed as an adjunct to standard prophylaxis, but its effectiveness across surgical settings remains uncertain. This systematic review and meta-analysis of randomized clinical trials aimed to evaluate the association between intraoperative intrawound vancomycin and surgical site infection in adults undergoing surgery.
METHODS: MEDLINE, Embase, and CENTRAL were searched from database inception to March 2026 for randomized clinical trials comparing intrawound vancomycin with standard care in adults undergoing operative procedures. Two reviewers independently performed screening, data extraction, and risk-of-bias assessment using the Cochrane Risk of Bias …
Discovering Repurposable Drugs For Alzheimer's Disease And Related Dementias: Target Trial Emulation Using Decentralised Real-World Data, Qiong Wu, Lu Li, Yuqing Lei, Ting Zhou, Huilin Tang, Bingyu Zhang, Yiwen Lu, Maxwell Salvatore, Dazheng Zhang, Jiayi Tong, Tingyin Wang, Siqi Chen, Haoyang Li, Zhenxing Xu, Yu Huang, Yu Hu, Na Hong, Yujia Zhou, Fongci Lin, Kyra O'Brien, Yong Chen, Ruowang Li, Hua Xu, Fei Wang, Jiang Bian, David Wolk, Yong Chen
Discovering Repurposable Drugs For Alzheimer's Disease And Related Dementias: Target Trial Emulation Using Decentralised Real-World Data, Qiong Wu, Lu Li, Yuqing Lei, Ting Zhou, Huilin Tang, Bingyu Zhang, Yiwen Lu, Maxwell Salvatore, Dazheng Zhang, Jiayi Tong, Tingyin Wang, Siqi Chen, Haoyang Li, Zhenxing Xu, Yu Huang, Yu Hu, Na Hong, Yujia Zhou, Fongci Lin, Kyra O'Brien, Yong Chen, Ruowang Li, Hua Xu, Fei Wang, Jiang Bian, David Wolk, Yong Chen
College of Population Health Faculty Papers
BACKGROUND: Alzheimer's disease and related dementias (ADRD) affect nearly 6.9 million Americans, with the number expected to triple by 2050, while disease-modifying therapies remain unavailable. Drug repurposing, which identifies new indications for already approved medications, offers a more efficient and cost-effective pathway to accelerate development of effective therapies for ADRD. The aim of this study is to identify potential drug repurposing signals by systematically screening routinely prescribed drugs for associations with progression from mild cognitive impairment (MCI) to ADRD.
METHODS: We conducted a multi-site target trial emulation using electronic health record (EHR) data from four decentralised databases: INSIGHT Clinical Research …
Artificial Intelligence Models For Automated And Semiautomated Analysis And Interpretation Of Clinical Electroencephalography, Sándor Beniczky, Birgit Frauscher, Fábio Nascimento, Shobi Sivathamboo, Catalina Rojas, Michael Sperling, Samden Lhatoo, Philippe Ryvlin, Levin Kuhlmann
Artificial Intelligence Models For Automated And Semiautomated Analysis And Interpretation Of Clinical Electroencephalography, Sándor Beniczky, Birgit Frauscher, Fábio Nascimento, Shobi Sivathamboo, Catalina Rojas, Michael Sperling, Samden Lhatoo, Philippe Ryvlin, Levin Kuhlmann
Department of Neurology Faculty Papers
Electroencephalography is the most commonly used diagnostic tool for epilepsy. However, interpreting electroencephalograms (EEGs) requires expertise that is not widely available. Advances in digital technology and wearables have enabled large-scale EEG recording, generating vast amounts of data that cannot be managed through traditional visual interpretation by experts. Artificial intelligence (AI) has the potential to augment human expertise and reduce workloads. The application of artificial neural networks in analysing clinical EEG recordings has led to major breakthroughs, bringing AI-based EEG interpretation closer to clinical implementation. In this Review, we summarise the most important research and development results in this field from …
Measuring Quality Of Life In Advanced Chronic Liver Disease With Fact-Hep: Findings From The Pal Liver Trial, Manisha Verma, Binu John, Don Rockey, Sid Barritt, Victor Navarro, Linda Shaw, Andrzej Kosinski, Elliot Tapper, Archita Desai
Measuring Quality Of Life In Advanced Chronic Liver Disease With Fact-Hep: Findings From The Pal Liver Trial, Manisha Verma, Binu John, Don Rockey, Sid Barritt, Victor Navarro, Linda Shaw, Andrzej Kosinski, Elliot Tapper, Archita Desai
Einstein Health Papers
BACKGROUND: Patient-reported outcome measures (PROMs) are increasingly incorporated into hepatology research, yet few have been rigorously evaluated, particularly among patients with decompensated cirrhosis. The Functional Assessment of Cancer Therapy-Hepatobiliary (FACT-Hep) captures multidimensional liver disease-specific burden, while the disease-agnostic PROMIS-29 assesses physical and mental health broadly. We evaluated the performance of FACT-Hep and its relationship to PROMIS-29 among participants with cirrhosis or hepatocellular carcinoma (HCC) enrolled in a prospective multicenter clinical trial.
METHODS: Baseline data were analyzed from 935 participants enrolled in the PAL LIVER trial. This study enrolled patients with Child-Turcotte-Pugh (CTP) B/C cirrhosis and/or with HCC. Health-related quality of …
Postoperative Complications In Patients With Sickle Cell Disease After Total Shoulder Arthroplasty, Katie Zehner, Gwyneth C. Maloy, John Slevin, Wesley Day, Mitchell K. Ng, Xuan Luo, Jonathan N. Grauer, Arya G. Varthi
Postoperative Complications In Patients With Sickle Cell Disease After Total Shoulder Arthroplasty, Katie Zehner, Gwyneth C. Maloy, John Slevin, Wesley Day, Mitchell K. Ng, Xuan Luo, Jonathan N. Grauer, Arya G. Varthi
Rothman Institute Papers
BACKGROUND: Sickle cell disease (SCD) encompasses a spectrum of genetic hematologic disorders characterized by erythrocyte sickling. Patients may experience musculoskeletal manifestations, such as osteonecrosis, which may warrant consideration for total shoulder arthroplasty (TSA). While prior literature suggests patients with SCD more frequently suffer complications after orthopaedic procedures, this is not well characterized for TSA.
METHODS: Adult TSA patients (older than 18 years) were identified in the 2010 to 2023 PearlDiver M170 database. Patients with SCD were matched 1:4 to patients without SCD based on age, sex, and Elixhauser Comorbidity Index (ECI). Ninety-day postoperative complications, emergency department (ED) visits, and readmissions …