Digital Commons Network^™

Remimazolam And Its Place In The Current Landscape Of Procedural Sedation And General Anesthesia, Matthew Brohan, Janette Brohan, Basavana Goudra

Department of Anesthesiology Faculty Papers

Remimazolam was derived from its parent compound by adding an ester linkage into its structure so that the drug becomes a substrate for ester metabolism. As a result, it undergoes organ-independent ester hydrolysis, although the clinical benefits in terms of shorter recovery are not uniformly observed in clinical practice. Remimazolam is mainly tested in procedural sedation. In comparison to propofol, the current gold standard for procedural sedation, its proposed attractiveness is shorter wake-up times and a clear-headed recovery. Its clear advantages over propofol are better hemodynamic stability, lack of pain on injection and availability of a reversal agent in the …

Genome-Wide Methylation Patterns In Primary Uveal Melanoma: Development Of Methylsig-Um, An Epigenomic Prognostic Signature To Improve Patient Stratification, Emilie Lalonde, Dong Li, Kathryn Ewens, Carol L. Shields, Arupa Ganguly

Wills Eye Hospital Papers

Despite studies highlighting the prognostic utility of DNA methylation in primary uveal melanoma (pUM), it has not been translated into a clinically useful tool. We sought to define a methylation signature to identify newly diagnosed individuals at high risk for developing metastasis. Methylation profiling was performed on 41 patients with pUM with stage T2-T4 and at least three years of follow-up using the Illumina Infinium HumanMethylation450K BeadChip (N = 24) and the EPIC BeadChip (N = 17). Findings were validated in the TCGA cohort with known metastatic outcome (N = 69). Differentially methylated probes were identified in patients who developed …

Adult Zymosan Re-Exposure Exacerbates The Molecular Alterations In The Brainstem Rostral Ventromedial Medulla Of Rats With Early Life Zymosan-Induced Cystitis, Bhavana Talluri, Sankar Addya, Maia Terashvili, Bidyut K. Medda, Anjishnu Banerjee, Reza Shaker, Jyoti N. Sengupta, Banani Banerjee

Kimmel Cancer Center Papers, Presentations, and Grand Rounds

Recent evidence suggests that the descending modulatory pathways from the brainstem rostral ventromedial medulla (RVM) are important for bladder inflammatory pain. This study aimed to identify the long-term molecular changes in RVM neurons due to early life cystitis during neuronal development and the effect of reexposure later in adulthood. RVM tissues from two treatment protocols were used: (1) neonatal zymosan exposures with acute adult rechallenge (RC) and (2) only neonatal zymosan exposures (NRC). RNAseq analysis showed upregulation of several genes associated with synaptic plasticity (Grin1, Grip2, Notch1, Arc, and Scn2b) in the cystitis groups compared to controls in both protocols. …

From Deleuze And Guattari’S Interregnum To Our Own, Or How To Navigate The Coming Post-Neoliberal Age, Samuel Weeks, Evan Lyons

College of Humanities and Sciences Faculty Papers

No abstract provided.

Assessing Pharmacy Budget Impact Of Tirzepatide For Weight Loss: A U.S. Commercial Payer Perspective, Christopher J. Bigness, Pharmd, Bcps

Master of Science in Applied Health Economics and Outcomes Research Capstone Presentations

Obesity has emerged as a significant health concern, with increasing prevalence rates impacting morbidity and mortality. In recent years, the FDA has approved several medications for weight management, including phentermine/topiramate, bupropion/naltrexone, liraglutide, and semaglutide. Despite the availability of various prescription weight loss medications, their real-world effectiveness remains uncertain. In November 2023, a new promising injectable medication, tirzepatide, received FDA approval to treat obesity. This study investigates the potential pharmacy budget impact of tirzepatide into a U.S. commercial pharmacy benefit plan for an employer group with 10,000 adult members over a 5-year time horizon. The model encompasses all injectable weight loss …

Meet An Ipe/Cp Alumna Champion, Oreoluwa James, Mph

Collaborative Healthcare: Interprofessional Practice, Education and Evaluation (JCIPE)

This past academic year I had the opportunity to participate in the Jefferson Student Interprofessional Complex Care Collaborative (J-SICCC). I worked with a team of four other Jefferson students from different academic programs to be a student advocate for a patient. Our team worked with her on managing some of her health concerns and goals such as a regimen for her diabetic medication and resources regarding medication disposal, social support, and mental health services. I also participated as a student moderator for Community Voices with Pastor Shawn Edmonds and facilitated his panel on the very important topic of mental health …

Meet An Ipe/Cp Faculty Champion, Maureen Kane, Edd, Msn, Rn

Collaborative Healthcare: Interprofessional Practice, Education and Evaluation (JCIPE)

I was introduced to JCIPE in 2013 and began facilitating Health Mentors Program small group sessions in the spring semester of 2014. I continued facilitating Health Mentors orientation and small group sessions, then also became a faculty facilitator for TeamSAFE simulations in 2017. In 2021, I learned about the Hotspotting Program (now the Jefferson Student Interprofessional Complex Care Collaborative, or J-SICCC). I was glad to be onboarded with the faculty advisor team and advised student teams in fall 2021 and 2022. Before the fall 2023 semester, I was asked to become part of the J-SICCC leadership team as the Jefferson …

Jcipe Awards And Recognition - 2024 Award Recipients

Collaborative Healthcare: Interprofessional Practice, Education and Evaluation (JCIPE)

Jefferson Center for Interprofessional Practice & Education (JCIPE) congratulates this year’s interprofessional education (IPE) and collaborative practice (CP) award winners and thanks them for all of their efforts to support and advance this work on campus and beyond. Their contributions are immeasurable!

Interview Of Health Mentor: Pat Noto, Jessica O'Keeffe

Collaborative Healthcare: Interprofessional Practice, Education and Evaluation (JCIPE)

Jefferson’s Health Mentors Program offers an opportunity for interprofessional teams of students to learn firsthand about what matters to people living with chronic health conditions. Small teams of students from 12 different health professions work together with a health mentor, or community volunteer, to learn about their experiences with healthcare and wellness within the context of the Social- Ecological Model (Bronfenbrenner, 1979).

Pat Noto’s experience guiding college students inspired her to become a health mentor, and her experience as both patient and caregiver shaped her mentoring approach, as she always emphasizes the importance of compassion and empathy when working in …

Expanding Awareness And Engagement In Interprofessional Education And Collaborative Practice Through Linkedin®, Tina Patel Gunaldo, Phd, Dpt, Mhs, Reena Depaolo, Ms

Collaborative Healthcare: Interprofessional Practice, Education and Evaluation (JCIPE)

Social media platforms have transformed the way we learn and connect with others across the globe. These platforms provide virtual synchronous and asynchronous opportunities for professionals from diverse backgrounds to share insights, discuss best practices, and collaborate. Interprofessional work involves collaboration of health and social care professionals both across the healthcare system and with individuals in related fields, such as law or environmental services. As a professional networking platform, LinkedIn® provides an opportunity to connect with professionals in other fields outside of traditional conferences and institutional settings.

Team Reflection On The J-Siccc Experience

Collaborative Healthcare: Interprofessional Practice, Education and Evaluation (JCIPE)

Over the past year, we – a group of pre/ health professional students – had the immense privilege to participate in the Jefferson Student Interprofessional Complex Care Collaborative (J-SICCC). Our team, composed of five students from diverse backgrounds and areas of study in prehealth and health professions programs, met and began working together in July 2023. With the help of advisors from similarly heterogenous fields, we embarked on a year-long journey with a simple, but not easy, goal: work alongside a single patient with complex care needs to navigate the tumultuous world of health and healthcare.

Jcipe Updates

Collaborative Healthcare: Interprofessional Practice, Education and Evaluation (JCIPE)

JCIPE Updates

From The Editors

Collaborative Healthcare: Interprofessional Practice, Education and Evaluation (JCIPE)

Spring is a time to celebrate the outcomes of dedicated efforts throughout the academic year. We at Jefferson Center for Interprofessional Practice & Education (JCIPE) encourage you to celebrate together with those in other professions. Not only is it important to come together in our work, but it is just as important to come together to recognize each other’s achievements—to desilo our celebrations! At JCIPE, we are taking steps to celebrate more collaboratively too. Each spring, JCIPE bestows the James B. Erdmann Awards for Excellence in Interprofessional Education & Collaborative Practice to members of the Jefferson community for outstanding contributions …

Collaborative Healthcare: Interprofessional Practice, Education And Evaluation (Jcipe), Volume 14, Number 2, Spring/Summer 2024

Collaborative Healthcare: Interprofessional Practice, Education and Evaluation (JCIPE)

In this Issue:

• Letter from the Editors
• JCIPE Updates
• Team Reflection on the J-SICCC Experience
• Expanding Awareness and Engagement in Interprofessional Education and Collaborative Practice Through LinkedIn®
• Interview of Health Mentor: Pat Noto
• JCIPE Awards and Recognition - 2024 Award Recipients
• Meet an IPE Staff Champion
• Meet an IPE Alumna Champion

Glucose-6-Phosphate Dehydrogenase Deficiency As A Cause For Nonimmune Hydrops Fetalis And Severe Fetal Anemia: A Systematic Review, Neel S. Iyer, Matthew H. Mossayebi, Tracy J. Gao, Lylach Haizler-Cohen, Daniele Di Mascio, Rodney A. Mclaren, Huda B. Al-Kouatly

Department of Obstetrics and Gynecology Faculty Papers

BACKGROUND: Glucose-6-phosphate dehydrogenase (G6PD) deficiency is an X-linked recessive disorder that predisposes individuals to hemolysis due to an inborn error of metabolism. We performed a systematic literature review to evaluate G6PD deficiency as a possible etiology of nonimmune hydrops fetalis (NIHF) and severe fetal anemia.

METHODS: PubMed, OVID Medline, Scopus, and clinicaltrials.gov were queried from inception until 31 April 2023 for all published cases of NIHF and severe fetal anemia caused by G6PD deficiency. Keywords included "fetal edema," "hydrops fetalis," "glucose 6 phosphate dehydrogenase deficiency," and "fetal anemia." Cases with workup presuming G6PD deficiency as an etiology for NIHF and …

Dna Fork Remodeling Proteins, Zranb3 And Smarcal1, Are Uniquely Essential For Aging Hematopoiesis, Saul Kushinsky, Matthew V. Puccetti, Clare M. Adams, Irina Shkundina, Nikkole James, Brittany M. Mahon, Peter Michener, Christine M. Eischen

Department of Pharmacology, Physiology, and Cancer Biology Faculty Papers

Over a lifetime, hematopoietic stem and progenitor cells (HSPCs) are forced to repeatedly proliferate to maintain hematopoiesis, increasing their susceptibility to DNA damaging replication stress. However, the proteins that mitigate this stress, protect HSPC replication, and prevent aging-driven dysregulation are unknown. We report two evolutionarily conserved, ubiquitously expressed chromatin remodeling enzymes with similar DNA replication fork reversal biochemical functions, Zranb3 and Smarcal1, have surprisingly specialized roles in distinct HSPC populations. While both proteins actively mitigate replication stress and prevent DNA damage and breaks during lifelong hematopoiesis, the loss of either resulted in distinct biochemical and biological consequences. Notably, defective long-term …

Leukemia Cutis And Anterior Uveitis Associated With Chronic Myelomonocytic Leukemia, Kamran K. Harper, Vanessa Mutch, Jordan Philip Safran, Daisy Wu, Nidhi Aggarwal, Ekta Maheshwari, Allison K. Weinstock, Kevin F. Gibson, Marie-Helene Errera, Jing-Zhou Hou, Arivarasan D. Karunamurthy, Yuri L. Bunimovich

Student Papers, Posters & Projects

Chronic myelomonocytic leukemia (CMML) is an uncommon myeloid neoplasm with myeloproliferative and myelodysplastic features characterized by peripheral monocytosis and cytopenia. CMML may have cutaneous manifestations known as leukemia cutis (LC). LC in the setting of CMML may portend malignant transformation to acute myeloid leukemia (AML). The distribution and morphologic features of LC in CMML are highly variable and often nonspecific. CMML may coexist with numerous secondary autoimmune and inflammatory processes; this phenomenon presents a clinical challenge which can delay correct diagnosis and appropriate therapeutic management. Thus, careful consideration of extramedullary manifestations of CMML and associated autoimmune conditions in the skin …

Molecular Mechanism Of Bitter Taste Receptor Agonist-Mediated Relaxation Of Airway Smooth Muscle, Stanley Conaway, Weiliang Huang, Miguel A. Hernandez-Lara, Maureen A. Kane, Raymond B. Penn, Deepak A. Deshpande

Center for Translational Medicine Faculty Papers

G-protein-coupled receptors (GPCRs) belonging to the type 2 taste receptors (TAS2Rs) family are predominantly present in taste cells to allow the perception of bitter-tasting compounds. TAS2Rs have also been shown to be expressed in human airway smooth muscle (ASM), and TAS2R agonists relax ASM cells and bronchodilate airways despite elevating intracellular calcium. This calcium “paradox” (calcium mediates contraction by pro-contractile Gq-coupled GPCRs) and the mechanisms by which TAS2R agonists relax ASM remain poorly understood. To gain insight into pro-relaxant mechanisms effected by TAS2Rs, we employed an unbiased phosphoproteomic approach involving dual-mass spectrometry to determine differences in the phosphorylation of contractile-related …

Motif-Vi Loop Acts As A Nucleotide Valve In The West Nile Virus Ns3 Helicase, Priti Roy, Zachary Walter, Lauren Berish, Holly Ramage, Martin Mccullagh

Department of Microbiology and Immunology Faculty Papers

The Orthoflavivirus NS3 helicase (NS3h) is crucial in virus replication, representing a potential drug target for pathogenesis. NS3h utilizes nucleotide triphosphate (ATP) for hydrolysis energy to translocate on single-stranded nucleic acids, which is an important step in the unwinding of double-stranded nucleic acids. Intermediate states along the ATP hydrolysis cycle and conformational changes between these states, represent important yet difficult-to-identify targets for potential inhibitors. Extensive molecular dynamics simulations of West Nile virus NS3h+ssRNA in the apo, ATP, ADP+Pi and ADP bound states were used to model the conformational ensembles along this cycle. Energetic and structural clustering analyses depict a clear …

Refining The Optimal Caf Cluster Marker For Predicting Tme-Dependent Survival Expectancy And Treatment Benefits In Nsclc Patients, Kai Li, Rui Wang, Guo-Wei Liu, Zi-Yang Peng, Ji-Chang Wang, Guo-Dong Xiao, Shou-Ching Tang, Ning Du, Jia Zhang, Jing Zhang, Hong Ren, Xin Sun, Yi-Ping Yang, Da-Peng Liu

Department of Pathology, Anatomy, and Cell Biology Faculty Papers

The tumor microenvironment (TME) plays a pivotal role in the onset, progression, and treatment response of cancer. Among the various components of the TME, cancer-associated fibroblasts (CAFs) are key regulators of both immune and non-immune cellular functions. Leveraging single-cell RNA sequencing (scRNA) data, we have uncovered previously hidden and promising roles within this specific CAF subgroup, paving the way for its clinical application. However, several critical questions persist, primarily stemming from the heterogeneous nature of CAFs and the use of different fibroblast markers in various sample analyses, causing confusion and hindrance in their clinical implementation. In this groundbreaking study, we …

Predicting Choroidal Nevus Transformation To Melanoma Using Machine Learning, Prashant D. Tailor, Piotr K. Kopinski, Haley S. D'Souza, David A. Leske, Timothy W. Olsen, Carol L. Shields, Jerry A. Shields, Lauren A. Dalvin

Wills Eye Hospital Papers

PURPOSE: To develop and validate machine learning (ML) models to predict choroidal nevus transformation to melanoma based on multimodal imaging at initial presentation.

DESIGN: Retrospective multicenter study.

PARTICIPANTS: Patients diagnosed with choroidal nevus on the Ocular Oncology Service at Wills Eye Hospital (2007-2017) or Mayo Clinic Rochester (2015-2023).

METHODS: Multimodal imaging was obtained, including fundus photography, fundus autofluorescence, spectral domain OCT, and B-scan ultrasonography. Machine learning models were created (XGBoost, LGBM, Random Forest, Extra Tree) and optimized for area under receiver operating characteristic curve (AUROC). The Wills Eye Hospital cohort was used for training and testing (80% training-20% testing) with …

Association Of High Fibrinogen To Albumin Ratio With Long-Term Mortality In Patients With Spontaneous Intracerebral Hemorrhage, Shiping Chen, Yu Zhang, Yangchun Xiao, Xin Cheng, Liyuan Peng, Yixin Tian, Tiangui Li, Jialing He, Pengfei Hao, Weelic Chong, Yang Hai, Chao You, Fang Fang

Department of Medical Oncology Faculty Papers

BACKGROUND: The association between fibrinogen-to-albumin ratio (FAR) and in-hospital mortality in patients with spontaneous intracerebral hemorrhage (ICH) has been established. However, the association with long-term mortality in spontaneous ICH remains unclear. This study aims to investigate the association between FAR and long-term mortality in these patients.

METHODS: Our retrospective study involved 3,538 patients who were diagnosed with ICH at West China Hospital, Sichuan University. All serum fibrinogen and serum albumin samples were collected within 24 h of admission and participants were divided into two groups according to the FAR. We conducted a Cox proportional hazard analysis to evaluate the association …

National Estimates For The Percentage Of All Readmissions With Demographic Features, Morbidity, Overall And Gender-Specific Mortality Of Transcutaneous Versus Open Surgical Tricuspid Valve Replacement/Repair, Muhammad Shayan Khan, Abdul Baqi, Ayesha Tahir, Ghulam Mujtaba Ghumman, Waqas Ullah, Jay Shah, Yasar Sattar, Tanveer Mir, Zain Sheikh, Fnu Salman, Moaaz Baghal, Kritika Luthra, Vinod Khatri, Zainulabedin Waqar, Malik Waleed Zeb Khan, Mohammed Taleb, Syed Sohail Ali

Abington Jefferson Health Papers

BACKGROUND: The aim of the study was to determine national estimates for the percentage of all readmissions with demographic features, length of stay (LOS), cost analysis, comorbidities, complications, overall and gender-specific mortality and complications of transcutaneous tricuspid valve replacement/repair (TTVR) vs. open surgical tricuspid valve replacement/repair (open TVR).

METHODS: Data were extrapolated from the Nationwide Readmissions Database (NRD) 2015-19. Of the 75,266,750 (unweighted) cases recorded in the 2015 - 2019 dataset, 429 had one or more of the percutaneous approach codes as per the ICD-10 dataset, and 10,077 had one or more of the open approach codes.

RESULTS: Overall, the …

Effect Of Transcranial Direct Current Stimulation And Narrow-Band Auditory Stimulation On The Intraoperative Electroencephalogram: An Exploratoratory Feasibility Study, Oliver G. Isik, Tuan Z. Cassim, Meah T. Ahmed, Matthias Kreuzer, Alice M. Daramola, Paul S. Garcia

SKMC Student Presentations and Publications

INTRODUCTION: During general anesthesia, frontal electroencephalogram (EEG) activity in the alpha frequency band (8-12 Hz) correlates with the adequacy of analgesia. Transcranial direct current stimulation (tDCS) and auditory stimulation, two noninvasive neuromodulation techniques, can entrain alpha activity in awake or sleeping patients. This study evaluates their effects on alpha oscillations in patients under general anesthesia.

METHODS: 30 patients receiving general anesthesia for surgery were enrolled in this two-by-two randomized clinical trial. Each participant received active or sham tDCS followed by auditory stimulation or silence according to assigned group (TDCS/AUD, TDCS/SIL, SHAM/AUD, SHAM/SIL). Frontal EEG was recorded before and after neuromodulation. …

Early Bolus Epinephrine Administration During Pediatric Cardiopulmonary Resuscitation For Bradycardia With Poor Perfusion: An Icu-Resuscitation Study, Amanda O'Halloran, Ron Reeder, Robert Berg, Tageldin Ahmed, Michael Bell, Robert Bishop, Matthew Bochkoris, Candice Burns, Joseph Carcillo, Todd Carpenter, J. Michael Dean, J. Wesley Diddle, Myke Federman, Richard Fernandez, Ericka Fink, Deborah Franzon, Aisha Frazier, Stuart Friess, Kathryn Graham, Mark Hall, David Hehir, Christopher M Horvat, Leanna Huard, Martha Kienzle, Todd Kilbaugh, Tensing Maa, Arushi Manga, Patrick Mcquillen, Kathleen Meert, Peter Mourani, Vinay Nadkarni, Maryam Naim, Daniel Notterman, Murray Pollack, Anil Sapru, Carleen Schneiter, Matthew Sharron, Neeraj Srivastava, Bradley Tilford, Alexis Topjian, Shirley Viteri, David Wessel, Heather Wolfe, Andrew Yates, Athena Zuppa, Robert Sutton, Ryan Morgan

Department of Pediatrics Faculty Papers

BACKGROUND: Half of pediatric in-hospital cardiopulmonary resuscitation (CPR) events have an initial rhythm of non-pulseless bradycardia with poor perfusion. Our study objectives were to leverage granular data from the ICU-RESUScitation (ICU-RESUS) trial to: (1) determine the association of early epinephrine administration with survival outcomes in children receiving CPR for bradycardia with poor perfusion; and (2) describe the incidence and time course of the development of pulselessness.

METHODS: Prespecified secondary analysis of ICU-RESUS, a multicenter cluster randomized trial of children (< 19 years) receiving CPR in 18 intensive care units in the United States. Index events (October 2016-March 2021) lasting ≥ 2 min with a documented initial rhythm of bradycardia with poor perfusion were included. Associations between early epinephrine (first 2 min of CPR) and outcomes were evaluated with Poisson multivariable regression controlling for a priori pre-arrest characteristics. Among patients with arterial lines, intra-arrest blood pressure waveforms were reviewed to determine presence of a pulse during CPR interruptions. The temporal nature of progression to pulselessness was described and outcomes were compared between patients according to subsequent pulselessness status.

RESULTS: Of 452 eligible subjects, 322 (71%) received early epinephrine. The early epinephrine group had higher pre-arrest severity of illness …

Mutant Androgen Receptor Induces Neurite Loss And Senescence Independently Of Are Binding In A Neuronal Model Of Sbma, Jordyn Karliner, Y Liu, Diane Merry

Department of Biochemistry and Molecular Biology Faculty Papers

Spinal and bulbar muscular atrophy (SBMA) is a slowly progressing neuromuscular disease caused by a polyglutamine (polyQ)-encoding CAG trinucleotide repeat expansion in the androgen receptor (AR) gene, leading to AR aggregation, lower motor neuron death, and muscle atrophy. AR is a ligand-activated transcription factor that regulates neuronal architecture and promotes axon regeneration; however, whether AR transcriptional functions contribute to disease pathogenesis is not fully understood. Using a differentiated PC12 cell model of SBMA, we identified dysfunction of polyQ-expanded AR in its regulation of neurite growth and maintenance. Specifically, we found that in the presence of androgens, polyQ-expanded AR inhibited neurite …

Formative Research About Shared Decision Making In The Treatment Of Opioid Use Disorder In Pregnant Women, Ruth Jeminiwa, Phd, Fadel Dadabaev, Pharmd, Heeyoung Kim, Pharmd, Caroline Popielaski, Pharmd, Sohyeon Park, Pharmd, Meghan Gannon, Phd Msph, Diane Abatemarco, Phd, Msw, Ronald Myers, Phd, Dsw

College of Pharmacy Posters

Background

• Shared Decision Making (SDM) is an evidence-based practice that involves a discussion between a health care professional and patient to reach a mutual agreed upon treatment plan.(1)
• A recent nationally-representative study indicates that only 39% of physicians use SDM for 50% or fewer Pregnant Women with Opioid Use Disorders (PWOUD).(2)
• Little is known about factors that affect SDM among PWOUD. This research project aimed to address this knowledge gap.

Bronchoalveolar Lavage Neutrophils And Matrix Metalloproteinase-9 In Sarcoidosis Clinical Phenotypes: Implications For Tissue Remodeling Leading To Pulmonary Fibrosis, Rafael L. Perez, Md, Jeff Ritzenthaler, E. Torres-Gonzalez, Prarthna Chandar, Md, Daniel Kramer, Md, Jesse Roman, Md

Division of Pulmonary, Allergy, and Critical Care Medicine Posters

Introduction

Pulmonary sarcoidosis may resolve or progress to advanced stages. Increased lung neutrophils obtained by bronchoalveolar lavage are found in advanced pulmonary sarcoidosis. Persistence of a neutrophilic alveolitis has been postulated to result in tissue injury and remodeling that leads to fibrosis and clinical features of advanced disease. Since neutrophils are a source of matrix-degrading proteins like matrix metalloproteinases (MMPs), we hypothesized that PMNs promote disease progression through the release of MMPs. This work explores the relationship between lung neutrophils and MMP9 levels and activity and how they are associated with sarcoidosis clinical phenotypes.

The Potential Anti-Arrhythmic Effect Of Sglt2 Inhibitors, Hong-Yi Duan, Hector Barajas-Martinez, Charles Antzelevitch, Dan Hu

Department of Medicine Faculty Papers

Sodium-glucose cotransporter type 2 inhibitors (SGLT2i) were initially recommended as oral anti-diabetic drugs to treat type 2 diabetes (T2D), by inhibiting SGLT2 in proximal tubule and reduce renal reabsorption of sodium and glucose. While many clinical trials demonstrated the tremendous potential of SGLT2i for cardiovascular diseases. 2022 AHA/ACC/HFSA guideline first emphasized that SGLT2i were the only drug class that can cover the entire management of heart failure (HF) from prevention to treatment. Subsequently, the antiarrhythmic properties of SGLT2i have also attracted attention. Although there are currently no prospective studies specifically on the anti-arrhythmic effects of SGLT2i. We provide clues from …

Apomorphine Titration With And Without Anti-Emetic Pretreatment In Patients With Parkinson’S Disease Experiencing Off Episodes: A Modified Delphi Panel, Stuart H. Isaacson, Richard Dewey, Robert A. Hauser, Daniel Kremens, Rajeev Kumar, Mark Lew, William Ondo, Fernando Pagan, Kelly E. Lyons, Rajesh Pahwa

Department of Neurology Faculty Papers

INTRODUCTION: In the United States (US), prophylactic treatment with the antiemetic trimethobenzamide has been used before initiating apomorphine therapy. However, US trimethobenzamide stores have been depleted, leaving uncertainty regarding whether antiemetic pretreatment is needed.

METHODS: This modified Delphi panel aimed to inform circumstances when apomorphine is initiated without antiemetic pretreatment. During Round 1, a panel of 9 US movement disorder specialists rated the appropriateness of prescribing apomorphine therapy with and without antiemetic pretreatment across 192 patient scenarios and were able to review their scores in relation to other scores. During the Round 2, consensus was defined for each scenario as …