Digital Commons Network^™

Molecular Classification Of Endometrial Cancers (Ec) And Association With Relapse-Free Survival (Rfs) And Overall Survival (Os) Outcomes: Ancillary Analysis Of Gog-0258, Aine Clements, Danielle Enserro, Kyle C Strickland, Rebecca Previs, Daniela Matei, David Mutch, Matthew Powell, Ann Klopp, David Scott Miller, William Small, Paul Disilvestro, Nick Spirtos, Casey Cosgrove, Greg Sfakianos, J Rebecca Liu, Roberto Vargas, Mark Shahin, Bradley Corr, Kimberly Dessources, Frederick Ueland, David Warshal, Jessica Gillen, Angeles Alvarez Secord

Faculty, Staff and Student Publications

Purpose: Determine if molecular classification using mismatch repair (MMR) and p53 protein expression predicts recurrence-free survival (RFS) and overall survival (OS) in endometrial cancer (EC) patients treated with chemotherapy and radiation (CRT) versus chemotherapy (CT).

Methods: GOG-0258, a phase III randomized trial (NCT00942357), compared CRT to CT. Immunohistochemistry assessed MMR and p53 status. Kaplan-Meier curves and adjusted Cox models analyzed survival outcomes by molecular subtype.

Results: ECs classified as deficient MMR (dMMR) (27 %), p53 abnormal (p53abn) (24 %), and p53 wild type (p53wt) (49 %). p53abn were more frequent in patients that were older, Black, and had …

Undervaluing Nondrug Rewards Or Overvaluing Cocaine? Cocaine Demand Relates To Cocaine Use Severity More Strongly Than Anhedonia In Individuals With Cocaine Use Disorder, Cecilia Nunez, Jin H Yoon, Constanza De Dios, Vincent Dang, Scott D Lane, Jessica N Vincent, Joy M Schmitz, Margaret C Wardle

Faculty, Staff and Student Publications

Cocaine use disorder (CUD) is a major public health issue, and greater cocaine use severity has been associated with worse treatment retention and outcomes. Therefore, greater understanding of processes that influence cocaine use is needed. Both anhedonia (i.e., undervaluation of non-drug rewards) and cocaine demand (i.e., cocaine valuation) are related to cocaine use severity and thematically related to each other at face value, but no studies have directly compared these outcomes to our knowledge. The current study represents a secondary analysis from a two-phase sequential, multiple assignment, randomized trial (SMART) aimed at developing adaptive interventions for CUD. We examined the …

Advancing Diagnostic Accuracy And Quality Of Patient Care Through The Implementation Of A Flow Cytometry Quality Assurance Program, Dylan Wang, Hong Fang, Chi Young Ok, Jeffrey L Jorgensen, L Jeffrey Medeiros, Wei Wang, Sa A Wang

Faculty, Staff and Student Publications

Context.—: Flow cytometry immunophenotypic analysis plays an important role in the diagnosis, classification, and disease monitoring of hematologic neoplasms. The interpretation of flow cytometry testing can be challenging.

Objective.—: To explore ways to improve diagnostic accuracy and in turn enhance the quality of patient care.

Design.—: A flow cytometry quality assurance (QA) program was developed. Cases from various complex flow cytometry panels were randomly selected and cross-reviewed. The outcomes of the QA review were categorized into 3 groups: complete agreement, minor discrepancy, and major discrepancy. Each discrepancy underwent a process of documentation, discussion, and resolution. Here we summarize our 3 …

Safety And Efficacy Of Toripalimab In Patients With Cholangiocarcinoma: An Open-Label, Phase 1 Study, Aung Naing, Amit Mahipal, Milind Javle, Judy Wang, Todd M Bauer, David L Bajor, Anthony D Elias, Anthony Shields, Elizabeth Davis, Sant Chawla, Howard Safran, John D Powderly, Gina D'Amato, Christian F Meyer, Xiongwen Tang, Sheng Yao, Patricia Keegan

Faculty, Staff and Student Publications

Introduction: This was the first phase 1 study conducted in the United States. It consisted of dose-escalation (part A) and multiple indication-specific cohort expansion (part B), investigating the safety and preliminary efficacy of toripalimab (anti-programmed cell death-1 inhibitor) in patients with advanced malignancies.

Methods: Patients with advanced malignancies that progressed after treatment with at least one prior line of standard systemic therapy, including the patients with advanced/recurrent cholangiocarcinoma (CCA), received toripalimab 240 mg every 3 weeks in part B. The primary endpoint was safety assessment. Efficacy endpoints included objective response rate (ORR), disease control rate (DCR), duration of response (DoR), …

Mayo Genetic Risk Models For Newly Diagnosed Acute Myeloid Leukemia Treated With Venetoclax + Hypomethylating Agent, Naseema Gangat, Azeem Elbeih, Nour Ghosoun, Kristen Mccullough, Fnu Aperna, Isla M Johnson, Maymona Abdelmagid, Aref Al-Kali, Hassan B Alkhateeb, Kebede H Begna, Michelle Elliott, Abhishek Mangaonkar, Aasiya Matin, Antoine N Saliba, Mehrdad Hefazi Torghabeh, Mark R Litzow, William Hogan, Mithun Shah, Mrinal M Patnaik, Animesh Pardanani, Talha Badar, Hemant Murthy, James Foran, Jeanne Palmer, Lisa Sproat, Nandita Khera, Cecilia Arana Yi, Samuel Yates, Abigail Sneider, Emily Dworkin, Anand A Patel, Alexandre Bazinet, Jayastu Senapati, Alex Bataller, Courtney Dinardo, Tapan Kadia, Ayalew Tefferi

Faculty, Staff and Student Publications

Patients with newly diagnosed acute myeloid leukemia (ND-AML) derive variable survival benefit from venetoclax + hypomethylating agent (Ven-HMA) therapy. The primary objective in the current study was to develop genetic risk models that are predictive of survival and are applicable at the time of diagnosis and after establishing treatment response. Among 400 ND-AML patients treated with Ven-HMA at the Mayo Clinic, 247 (62%) achieved complete remission with (CR) or without (CRi) count recovery. Multivariable analysis-derived hazard ratios (HR), including 1.8 for European LeukemiaNet (ELN) adverse karyotype, 4.7 for KMT2Ar, 1.7 for TP53

A Multicenter Open-Label Randomized Phase Ii Study Of Osimertinib With And Without Ramucirumab In Tyrosine Kinase Inhibitor–Naïve Egfr-Mutant Metastatic Non–Small Cell Lung Cancer (Ramose Trial), Xiuning Le, Jyoti D Patel, Elaine Shum, Christina Baik, Rachel E Sanborn, Catherine A Shu, Chul Kim, Mary Jo Fidler, Richard Hall, Yasir Y Elamin, Janet Tu, George Blumenschein, Jianjun Zhang, Don Gibbons, Carl Gay, Nisha A Mohindra, Young Chae, Yanis Boumber, Joshua Sabari, Rafael Santana-Davila, Shane Rogosin, Benjamin Herzberg, Ben Creelan, Bruna Pellini, Tawee Tanvetyanon, Simon Heeke, Mike Hernandez, Jhanelle E Gray, Andreas Saltos, John V Heymach

Faculty, Staff and Student Publications

Purpose: Preclinical studies demonstrated that dual inhibition of epidermal growth factor receptor (EGFR) and vascular endothelial growth factor (VEGF) pathways delay the emergence of resistance to EGFR tyrosine kinase inhibitors (TKIs), and in trials with first-generation EGFR TKIs, the combination of EGFR VEGF pathway inhibitors prolonged progression-free survival (PFS).

Methods: The RAMOSE trial (ClinicalTrials.gov identifier: NCT03909334, HCRN LUN-18-335) is a randomized, open-label multicenter phase II study comparing osimertinib with ramucirumab (arm A) to osimertinib (arm B) for initial treatment of metastatic EGFR-mutant non-small cell lung cancer (NSCLC) with 2:1 random assignment. The primary end point is PFS for …

Decoding Cancer Etiology With Cellular Reprogramming, Mo-Fan Huang, Megan E Fisher, Trinh T T Phan, Ruiying Zhao, Dung-Fang Lee

Faculty, Staff and Student Publications

Cancer research remains clinically unmet in many areas due to limited access to patient samples and the lack of reliable model systems that truly reflect human cancer biology. The emergence of patient-derived induced pluripotent stem cells and engineered human pluripotent stem cells (hPSCs) has helped overcome these challenges, offering a versatile alternative platform for advancing cancer research. These hPSCs are already proving to be valuable models for studying specific cancer driver mutations, offering insights into cancer origins, pathogenesis, tumor heterogeneity, clonal evolution, and facilitating drug discovery and testing. This article reviews recent progress in utilizing hPSCs for clinically relevant cancer …

Imaging Lung Tumor Motion Using Integrated-Mode Proton Radiography-A Phantom Study Towards Tumor Tracking In Proton Radiotherapy, Ryan Fullarton, Mikaël Simard, Lennart Volz, Allison Toltz, Savanna Chung, Christoph Schuy, Daniel G Robertson, Gary Royle, Sam Beddar, Colin Baker, Christian Graeff, Charles-Antoine Collins-Fekete

Faculty, Staff and Student Publications

BACKGROUND: Motion of lung tumors during radiotherapy leads to decreased accuracy of the delivered dose distribution. This is especially true for proton radiotherapy due to the finite range of the proton beam. Methods for mitigating motion rely on knowing the position of the tumor during treatment.

PURPOSE: Proton radiography uses the treatment beam, at an energy high enough to traverse the patient, to produce a radiograph. This work shows the first results of using an integrated-mode proton radiography system to track the position of moving objects in an experimental phantom study; demonstrating the potential of using this method for measuring …

Rapidbrachyivbt: A Dosimetry Software For Patient-Specific Intravascular Brachytherapy Dose Calculations On Optical Coherence Tomography Images, Maryam Rahbaran, Jonathan Kalinowski, Joseph M Decunha, Kevin J Croce, Brian A Bergmark, James M G Tsui, Phillip M Devlin, Shirin A Enger

Faculty, Staff and Student Publications

Background: Coronary artery disease is the most common form of cardiovascular disease. It is caused by excess plaque along the arterial wall, blocking blood flow to the heart (stenosis). A percutaneous coronary intervention widens the arterial wall with the inflation of a balloon inside the lesion area and leaves behind a metal stent to prevent re-narrowing of the artery (restenosis). However, in-stent restenosis may occur due to damage to the arterial wall tissue, triggering neointimal hyperplasia, producing fibrotic and calcified plaques and narrowing the artery again. Drug-eluting stents, which slowly release medication to inhibit neointimal hyperplasia, are used to prevent …

Open-Chest Cardiac Ultrasound-Mediated Imaging With A Vacuum Coupler, Nilesh Mathuria, Krithik Vishwanath, Giorgio Brero, Blake C Fallon, Antonio Martino, Richard C Willson, Carly S Filgueira, Richard R Bouchard

Faculty, Staff and Student Publications

BACKGROUND: A fundamental obstacle for the preclinical development of ultrasound-(US) mediated cardiac imaging remains cardiac motion, which limits interframe correlation during extended acquisition periods.

PURPOSE: To address this need, we present the design and implementation of a 3D-printed vacuum coupler that stabilizes a US transducer on the epicardial surface of the heart for feasibility assessment and development of advanced, cardiac, US-mediated imaging approaches.

METHODS: The vacuum coupler was 3D printed with biocompatible resins and secured with a standard intraoperative suction aspirator. US-mediated imaging (i.e., B-mode and photoacoustic [PA] imaging) was performed in an open-chest porcine model with and without the …

Incidence Of Heterotopic Ossification Without Additional Long-Term Nsaid Prophylaxis After Periacetabular Osteotomy And Concomitant Hip Arthroscopy, J Matthew Helm, Omar Stocks, Brian Crowley, Alexis Aboulafia, Jacob Siahaan, Alfred A Mansour

Faculty, Staff and Student Publications

Background: Periacetabular osteotomy (PAO) is an established treatment for hip dysplasia and has been increasingly combined with concomitant hip arthroscopy to address additional intra-articular hip pathology. Heterotopic ossification (HO) is a complication of arthroscopic and open hip procedures. Nonsteroidal anti-inflammatory drugs (NSAIDs) have become an established form of HO prophylaxis, but their use may delay bone healing.

Purpose: To examine the incidence of HO without NSAID prophylaxis in patients after PAO with concomitant hip arthroscopy and to evaluate the impact of other variables on the development of HO in these patients.

Study design: Case series; Level of evidence, 4.

Methods: …

A Randomized, Double-Blind, Placebo-Controlled Trial Of Daxibotulinumtoxina For Injection For The Treatment Of Upper Limb Spasticity In Adults After Stroke Or Traumatic Brain Injury, Atul T Patel, Michael C Munin, Ziyad Ayyoub, Gerard E Francisco, Rashid Kazerooni, Todd M Gross

Faculty, Staff and Student Publications

Background: Intramuscular injection of botulinum toxin type A is a first-line pharmacotherapy for adults with upper limb spasticity (ULS). However, reemergence of symptoms within 12 weeks of treatment is common and longer-lasting treatments are needed.

Objective: To evaluate the efficacy and safety of three doses of DaxibotulinumtoxinA for Injection (DAXI) for treatment of ULS in adults with stroke or traumatic brain injury.

Intervention: Intramuscular injections of placebo (N = 24), DAXI 250 U (N = 22), DAXI 375 U (N = 19), or DAXI 500 U (N = 18) to the suprahypertonic muscle (SMG) and other muscle groups.

Design: Randomized, …

American Society For Gastrointestinal Endoscopy Guideline On The Diagnosis And Management Of Gerd: Methodology And Review Of Evidence, Asge Standards Of Practice Committee, Madhav Desai, Wenly Ruan, Nirav C Thosani, Manuel Amaris, J Stephen Scott, Ahmed Saeed, Barham Abu Dayyeh, Marcia Irene Canto, Wasif Abidi, Omeed Alipour, Stuart K Amateau, Natalie Cosgrove, Sherif E Elhanafi, Nauzer Forbes, Divyanshoo R Kohli, Richard S Kwon, Larissa L Fujii-Lau, Jorge D Machicado, Neil B Marya, Saowanee Ngamruengphong, Swati Pawa, Sunil G Sheth, Nikhil R Thiruvengadam, Bashar J Qumseya

Faculty, Staff and Student Publications

This clinical practice guideline from the American Society for Gastrointestinal Endoscopy (ASGE) provides an evidence-based approach for strategies to diagnose and manage GERD. This document was developed using the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) framework and serves as an update to the prior ASGE guideline on the role of endoscopy in the management of GERD (2014). The updated guideline addresses the indications for endoscopy in patients with GERD, including patients who have undergone sleeve gastrectomy (SG) and peroral endoscopic myotomy (POEM). It also discusses endoscopic evaluation of gastroesophageal junctional integrity comprehensively and uniformly. Important, this guideline discusses …

Developing A High-Performing Network Computation Of Big Bipartite Network Data Toward Alcohol Use Disorder Treatment Referrals, Muhammad Tuan Amith, Sharon Andrews, Angela Heads, Bruno Kluwe-Schiavon, Atchyutha Choday, Ramya Poonam, Sai Venkat Ballem, Cui Tao, Jane Hamilton

Faculty, Staff and Student Publications

Electronic health care records offer big data to mine and analyze towards improving public health outcomes. The information extracted, specifically social network data, could help us understand the primary care referrals for patients experiencing alcohol use disorder and wield that knowledge to better inform the engagement of this patient population. Network exposure and affiliation exposure models are two metrics that can be utilized to analyze the influence of social networks. We developed a core software library that address the scalability issue of our previous work. Our library computed high volume, randomly generated network graphs that range from 500–10,000 nodes (~126,000–40 …

Survey Of Vitamin D Supplementation Practices In Extremely Preterm Infants, Mar Romero-Lopez, Mamta Naik, Lindsay F Holzapfel, Ariel A Salas, Kaashif A Ahmad, Matthew A Rysavy, Waldemar A Carlo, Yuxin Zhang, Covi Tibe, Jon E Tyson

Faculty, Staff and Student Publications

Background: Most extremely preterm (EP) infants are vitamin D deficient (serum 25-hydroxyvitamin D levels below 20 ng/mL), and optimal supplementation practices for EP infants remain unknown. Our objective is to assess current vitamin D supplementation practices in U.S. neonatal intensive care units (NICU) for EP infants to provide baseline information for the design of future clinical trials.

Methods: We conducted an online survey to study vitamin D intake and supplementation practices in U.S. NICUs caring for EP infants. Descriptive statistics compared responses by affiliation and level of care.

Results: We analyzed responses from 253 NICUs, representing the majority of academic …

Immigration Status Checks, Emergency Medicaid Utilization, And Health Care Access For Uninsured Individuals With Kidney Disease, Katherine Rizzolo, Ryan Murray, Jade Teakell, Eric Kerns, Prakrati Acharya, Priti Patel, Prachi Sharma, Lilia Cervantes

Faculty, Staff and Student Publications

No abstract provided.

Bringing Team Science To The Ambulatory Diagnostic Process: How Do Patients And Clinicians Develop Shared Mental Models?, Aubrey Samost-Williams, Eric J Thomas, Olivia Lounsbury, Scott I Tannenbaum, Eduardo Salas, Sigall K Bell

Faculty, Staff and Student Publications

The ambulatory diagnostic process is potentially complex, resulting in faulty communication, lost information, and a lack of team coordination. Patients and families have a unique position in the ambulatory diagnostic team, holding privileged information about their clinical conditions and serving as the connecting thread across multiple healthcare encounters. While experts advocate for engaging patients as diagnostic team members, operationalizing patient engagement has been challenging. The team science literature links improved team performance with shared mental models, a concept reflecting the team's commonly held knowledge about the tasks to be done and the expertise of each team member. Despite their proven …

Melanoma Risk In Turner Syndrome: A Case-Control Study In Surveillance, Epidemiology, And End Results-Medicare, Gabriella V Alvarez, Kai-Ping Liao, Mackenzie R Wehner, Megan N Rogge

Faculty, Staff and Student Publications

No abstract provided.

Patient Outcomes Following Parasagittal Interlaminar Epidural Steroid Injections For Bilateral Lumbar Radicular Symptoms: Correlation Of Contrast Spread With Symptom Relief, Jamal Hasoon, Omar Viswanath, Alan D Kaye, Alberto Pasqualucci, Giustino Varrassi

Faculty, Staff and Student Publications

Introduction Bilateral lumbar radicular symptoms are commonly treated with interlaminar epidural steroid injections (ILESIs). The parasagittal approach often results in unilateral contrast spread, which may influence the degree of bilateral symptom relief. This study evaluates whether unilateral contrast spread correlates with symptom improvement in both ipsilateral and contralateral symptoms. Methods A retrospective review of six patients with bilateral lumbar radiculopathy secondary to lumbar degenerative disc disease, spondylosis, or disc herniation was conducted. All patients underwent ILESIs using a parasagittal approach. The injectate consisted of bupivacaine, preservative-free normal saline, and triamcinolone. Contrast spread was assessed fluoroscopically, and symptom relief was evaluated …

Psychiatric Manifestations Of Encephalitis, Paris Bean, Ashley Heck, Ralph Habis, Swathi Sowmitran, Zoe Cartaina, Rajesh Gupta, John Probasco, Rodrigo Hasbun, Arun Venkatesan

Faculty, Staff and Student Publications

Objective: Encephalitis is a serious and potentially life-threatening condition of infectious or autoimmune cause. We aim to characterize the frequency and clinical spectrum of presenting psychiatric symptoms in encephalitis in order to inform earlier recognition and initiation of treatment.

Methods: This was a retrospective study of adult patients who met the 2013 International Encephalitis Consortium (IEC) and/or 2016 Graus criteria between February 2005 and February 2023. The study included two hospital systems in Houston, Texas, and Baltimore, Maryland and included a total of 642 patients. Psychiatric manifestations were grouped into five high-level categories: behavior, psychosis, mood, sleep disturbances, and catatonia. …

From Stable Teamwork To Dynamic Teaming In The Ambulatory Care Diagnostic Process, Scott I Tannenbaum, Eric J Thomas, Sigall K Bell, Eduardo Salas

Faculty, Staff and Student Publications

Dynamic teaming is required whenever people must coordinate with one another in a fluid context, particularly when the fundamental structures of a team, such as membership, priorities, tasks, modes of communication, and location are in near-constant flux. This is certainly the case in the contemporary ambulatory care diagnostic process, where circumstances and conditions require a shifting cast of individuals to coordinate dynamically to ensure patient safety. This article offers an updated perspective on dynamic teaming commonly required during the ambulatory diagnostic process. Drawing upon team science, it clarifies the characteristics of dynamic diagnostic teams, identifies common risk points in the …

Protein Arginine Methyltransferases As Regulators Of Cellular Stress, Julia Zaccarelli-Magalhães, Cristiane Teresinha Citadin, Julia Langman, Drew James Smith, Luiz Henrique Matuguma, Hung Wen Lin, Mariana Sayuri Berto Udo

Faculty, Staff and Student Publications

Arginine modification can be a "switch" to regulate DNA transcription and a post-translational modification via methylation of a variety of cellular targets involved in signal transduction, gene transcription, DNA repair, and mRNA alterations. This consequently can turn downstream biological effectors "on" and "off". Arginine methylation is catalyzed by protein arginine methyltransferases (PRMTs 1-9) in both the nucleus and cytoplasm, and is thought to be involved in many disease processes. However, PRMTs have not been well-documented in the brain and their function as it relates to metabolism, circulation, functional learning and memory are understudied. In this review, we provide a comprehensive …

Deformity Considerations In Cervical Laminoplasty: A Narrative Review, Joseph P Drain, Paul Alvarez, William Ryan Spiker, Elizabeth Yu

Faculty, Staff and Student Publications

Objectives: We discuss the incidence of postoperative kyphosis following laminoplasty and its impact on outcomes, as well as critical radiographic parameters, intraoperative technical factors, and postoperative protocols that can be used to improve results.

Summary of background data: When appropriately selected, cervical laminoplasty is a motion-sparing treatment option for cervical myelopathy and is a valid alternative to laminectomy and fusion procedures. However, like other posterior-based cervical decompression techniques, laminoplasty can cause postoperative kyphosis.

Methods: A PubMed search was performed to gather articles that focus on cervical deformity in the context of cervical laminoplasty.

Results: The reported conversion rates of lordotic …

Non-Invasive Prenatal Screening: Testing Motivations And Decision Making In The Low-Risk Population, Jenna K Lea, Blair K Stevens, Shannon Mulligan, Syed S Hashmi, Rebecca Lunstroth, Meagan G Choates

Faculty, Staff and Student Publications

Non-invasive prenatal screening provides a risk assessment for aneuploidies by utilizing cell-free DNA (cfDNA). It is recommended that cell-free DNA screening (cfDNA screening) be offered to all pregnant people regardless of a priori risk for aneuploidy. In the absence of an increased risk, alternative motives for electing cfDNA screening and different levels of informed decision making may arise. Therefore, our study aimed to characterize low-risk patients' motivations for cfDNA screening election, determine how often informed decisions are being made, and compare motivations between informed and uninformed decision makers. A survey that included a modified, validated measure of informed choice (MMIC) …

Applications Of Metabolomics And Lipidomics In The Neonatal Intensive Care Unit, Jonathan D Reiss, Samson J Mataraso, Lindsay F Holzapfel, Ivana Marić, Maya M Kasowski, Camilia R Martin, Jonathan Z Long, David K Stevenson, Gary M Shaw

Faculty, Staff and Student Publications

The metabolome and lipidome comprise the thousands of molecular compounds in an organism. Molecular compounds consist of the upstream metabolic components of intracellular reactions or the byproducts of cellular pathways. Molecular and biochemical perturbations are associated with disorders in newborns and infants. The diagnosis of inborn errors of metabolism has relied on targeted metabolomics for several decades. Newer approaches offer the potential to identify novel biomarkers for common diseases of the newborn and infant. They may also elucidate novel predictive or diagnostic measures for a variety of health trajectories. Here, we review the relevance of the metabolome and lipidome for …

Hemodynamic Response Of The Aortic Valve During Dobutamine Onset Then Progressive Aortic Banding, Rob Eerdekens, Philipos K Gebremedhin, Daniel T Johnson, Richard L Kirkeeide, Gretchen L Howe, Richard W Smalling, K Lance Gould, Pim A L Tonino, Nils P Johnson

Faculty, Staff and Student Publications

An increasing number of procedures over the past two decades for aortic stenosis (AS) reflects the combination of an aging population and less invasive transcatheter options. As a result, the hemodynamics of the aortic valve (AV) have gained renewed interest to understand its behavior and to optimize patient selection. We studied the hemodynamic relationship between pressure loss (ΔP) and transvalvular flow (Q) of the normal AV as well as the impact of a variable supravalvular stenosis. Our mechanistic study included 11 healthy swine monitored during dobutamine stress and followed by acute aortic banding to simulate AS. Hemodynamics were continuously recorded, …

Acquired Hepatocerebral Degeneration In A Septic Patient: Hospital Course And Mri Findings, Ethan L Porter, Alexandria R Koney, Alexia R Jauregui, Emelie N Mcquitty, Courtney T Huynh, Rita B Khouri, Alisha Kashyap, Matthew T Wong

Faculty, Staff and Student Publications

Acquired hepatocerebral degeneration (AHD) is a rare neuropsychiatric disorder affecting cirrhotic patients, often presenting with neuropsychiatric symptoms triggered by a precipitating factor. Magnetic resonance imaging (MRI) showing T1 hyperintensities in the globus pallidus is diagnostic. In this case report, a 40-year-old female patient with alcoholic cirrhosis presented with generalized swelling, jaundice, fever, and signs of septic shock. After stabilization, changes in cognition while this patient was hospitalized prompted the management of several different factors, including the underlying infection, hypernatremia, vitamin deficiency, alcohol withdrawal, and hyperammonemia. Infectious disease consultation helped determine the antibiotic selection and dosage for bacteremia and later concerns …

Pharmacologic Management Of Heart Failure With Preserved Ejection Fraction (Hfpef) In Older Adults, Ashkan Hashemi, Min Ji Kwak, Parag Goyal

Faculty, Staff and Student Publications

There are several pharmacologic agents that have been touted as guideline-directed medical therapy for heart failure with preserved ejection fraction (HFpEF). However, it is important to recognize that older adults with HFpEF also contend with an increased risk for adverse effects from medications due to age-related changes in pharmacokinetics and pharmacodynamics of medications, as well as the concurrence of geriatric conditions such as polypharmacy and frailty. With this review, we discuss the underlying evidence for the benefits of various treatments in HFpEF and incorporate key considerations for older adults, a subpopulation that may be at higher risk for adverse drug …

Exploring Unintended Consequences From The Prospective Payment System Transitional Drug Add-On Payment Adjustment To Refine Program Enhancement Strategies, Donald Andrew Molony, Dia Rose Waguespack

Faculty, Staff and Student Publications

No abstract provided.

Harnessing N-Of-1 Trials For Personalised Paediatric Care In The Era Of Information Overload, Joyce P Samuel

Faculty, Staff and Student Publications

No abstract provided.