Digital Commons Network^™

Oral Low-Dose Naltrexone In The Treatment Of Grontal Fibrosing Alopecia And Lichen Planopilaris: An Uncontrolled Open-Label Prospective Study, Remi K. Hamel, Ling Chen, Cailin O'Connell, Caroline Mann

2020-Current year OA Pubs

Background Frontal fibrosing alopecia (FFA) and lichen planopilaris (LPP) is scarring alopecias with limited evidence supporting their treatment options. We investigated the use of low-dose naltrexone (3 mg oral daily) as adjunctive therapy in the treatment of FFA and LPP. Methods A single-center, uncontrolled open-label prospective study was performed, with 26 patients who took low-dose naltrexone for one year included in the per-protocol analysis. Both patient-reported (pruritus and burning/pain) and physician-assessed (erythema, scale, and scalp involvement) outcomes were analyzed. Results There were decreases in erythema and scale for the overall longitudinal outcomes using linear mixed effects model analysis. However, only …

Online Health Information For Penile Prosthesis Implants Lacks Quality And Is Unreadable To The Average Us Patient, Benjamin Plambeck, Jinfeng Jiang, Jesus Perez, Brittany E. Wordekemper, David Fu, Alexandra Colvin, Christopher M. Deibert

2020-Current year OA Pubs

BACKGROUND: Online health information (OHI) has become widely accessible and affects patient decisions regarding their healthcare. The purpose of this study was to assess the readability, quality, and accuracy of information available to patients online about penile prosthesis implants (PPIs).

METHODS: We performed a Google search using the keywords "penile implant" and "penile prosthesis." The first 30 search results for both terms were analyzed, and advertisements, news articles, duplicates, and videos were excluded. Websites were categorized as institutional, commercial, and personal/patient support. Readability of each website was determined using the Flesch-Kincaid grade level (FKGL) readability formula within the readable tool. …

Sex-Related Differences In Premature Cardiovascular Disease In Familial Hypercholesterolemia, Anandita Agarwala, Elena Deych, Laney K Jones, Amy C Sturm, Karen Aspry, Zahid Ahmad, Christie M Ballantyne, Anne C Goldberg

2020-Current year OA Pubs

BACKGROUND: Familial hypercholesterolemia (FH) is associated with an increased prevalence of premature atherosclerotic cardiovascular disease (ASCVD), however, little is known about sex-specific differences in premature ASCVD and its risk factors.

OBJECTIVE: The present study seeks to assess the burden and risk factors for premature ASCVD among men and women with FH.

METHODS: In this study we retrospectively examined sex-specific differences in ASCVD prevalence, risk factor burdens, and lipid treatment outcomes in 782 individuals with clinically or genetically confirmed FH treated in 5 U.S. lipid and genetics clinics. A generalized linear model using Binomial distribution with random study site effect and …

An Analysis Of Major Target Deviations In Craniospinal Irradiation Treatment Plans For Patients With Intermediate-Risk Medulloblastoma Within A Phase 3 Clinical Trial (Children's Oncology Group Study Acns0331), Joshua P Schiff, Yimei Lee, Yu Wang, Stephanie M Perkins, Sandy K Kessel, Thomas J Fitzgerald, Nicole A Larrier, Jeff M Michalski

2020-Current year OA Pubs

PURPOSE: Craniospinal irradiation remains an essential and yet difficult part of the treatment of patients with medulloblastoma. Whereas technological advances offer promise of increased conformity, realiance on advanced technology is not without risk, and it remains critical to carefully delineate targets. We describe examples of target deviations (TDs) in craniospinal irradiation treatment plans for postoperative patients with medulloblastoma in a phase 3 clinical trial (ACNS 0331).

METHODS AND MATERIALS: The principal investigator independently performed a review of the treatment plans and portal films of enrolled patients and evaluated the plans for TDs. TDs of dose, dose uniformity, and volume were …

The Neurotoxin Dsp-4 Dysregulates The Locus Coeruleus-Norepinephrine System And Recapitulates Molecular And Behavioral Aspects Of Prodromal Neurodegenerative Disease, Alexa F. Iannitelli, Michael A. Kelberman, Daniel J. Lustberg, Anu Korukonda, Katharine E. Mccann, Bernard Mulvey, Arielle Segal, L Cameron Liles, Steven A. Sloan, Joseph D. Dougherty, David Weinshenker

2020-Current year OA Pubs

The noradrenergic locus coeruleus (LC) is among the earliest sites of tau and α-synuclein pathology in Alzheimer's disease (AD) and Parkinson's disease (PD), respectively. The onset of these pathologies coincides with loss of noradrenergic fibers in LC target regions and the emergence of prodromal symptoms including sleep disturbances and anxiety. Paradoxically, these prodromal symptoms are indicative of a noradrenergic hyperactivity phenotype, rather than the predicted loss of norepinephrine (NE) transmission following LC damage, suggesting the engagement of complex compensatory mechanisms. Because current therapeutic efforts are targeting early disease, interest in the LC has grown, and it is critical to identify …

Simulation-Free Radiation Therapy: An Emerging Form Of Treatment Planning To Expedite Plan Generation For Patients Receiving Palliative Radiation Therapy, Joshua P Schiff, Tianyu Zhao, Yi Huang, Baozhou Sun, Geoffrey D Hugo, Matthew B Spraker, Christopher D Abraham

2020-Current year OA Pubs

PURPOSE: Herein we report the clinical and dosimetric experience for patients with metastases treated with palliative simulation-free radiation therapy (SFRT) at a single institution.

METHODS AND MATERIALS: SFRT was performed at a single institution. Multiple fractionation regimens were used. Diagnostic imaging was used for treatment planning. Patient characteristics as well as planning and treatment time points were collected. A matched cohort of patients with conventional computed tomography simulation radiation therapy (CTRT) was acquired to evaluate for differences in planning and treatment time. SFRT dosimetry was evaluated to determine the fidelity of SFRT. Descriptive statistics were calculated on all variables and …

Patterns Of Utilization And Clinical Adoption Of 0.35 Tesla Mr-Guided Radiation Therapy In The United States - Understanding The Transition To Adaptive, Ultra-Hypofractionated Treatments, Michael D Chuong, Lauren E Henke, Et Al.

2020-Current year OA Pubs

PURPOSE/OBJECTIVE: Magnetic resonance-guided radiation therapy (MRgRT) utilization is rapidly expanding worldwide, driven by advanced capabilities including continuous intrafraction visualization, automatic triggered beam delivery, and on-table adaptive replanning (oART). Our objective was to describe patterns of 0.35Tesla(T)-MRgRT (MRIdian) utilization in the United States (US) among early adopters of this novel technology.

MATERIALS/METHODS: Anonymized administrative data from all US MRIdian treatment systems were extracted for patients completing treatment from 2014 to 2020. Detailed treatment information was available for all MRIdian linear accelerator (linac) systems and some cobalt systems.

RESULTS: Seventeen systems at 16 centers delivered 5736 courses and 36,389 fractions (fraction details …

Substance Use Treatment Utilization Among Women With And Without Human Immunodeficiency Virus, Ayako W Fujita, Aditi Ramakrishnan, Et Al.

2020-Current year OA Pubs

BACKGROUND: Substance use (SU) contributes to poor health outcomes, yet limited data exist to inform strategies to optimize SU treatment among persons with human immunodeficiency virus (HIV). We describe SU and SU treatment utilization among women with and without HIV in the Women's Interagency HIV Study (WIHS).

METHODS: We included data from women enrolled in WIHS from 2013 to 2020. Current SU was self-reported, nonmedical use of drugs in the past year, excluding use of only marijuana. SU treatment utilization was self-reported use of a drug treatment program in the past year. Multivariable regression models were used to investigate associations …

Nonalcoholic Fatty Liver Disease Is A Risk Factor For Thiopurine Hepatotoxicity In Crohn's Disease, Alvin T George, Matthew Glover, Quazim Alayo, Maria Zulfiqar, Daniel R Ludwig, Matthew A Ciorba, Scott Mchenry, Parakkal Deepak

2020-Current year OA Pubs

BACKGROUND: Patients with Crohn's disease (CD) are predisposed to nonalcoholic fatty liver disease (NAFLD). CD management often includes thiopurines which can promote hepatotoxicity. We aimed to identify the role of NAFLD on the risk of developing liver injury from thiopurines in CD.

METHODS: In this prospective cohort analysis, CD patients at a single center were recruited 6/2017-5/2018. Patients with alternative liver diseases were excluded. The primary outcome was time to elevation of liver enzymes. Patients underwent MRI with assessment of proton density fat fraction (PDFF) on enrollment, where NAFLD was defined as PDFF >5.5%. Statistical analysis was performed using a …

Prevalence Of Bourbon And Heartland Viruses In Field Collected Ticks At An Environmental Field Station In St. Louis County, Missouri, Usa, Ishmael D. Aziati, Derek Mcfarland Jr., Avan Antia, Astha Joshi, Anahi Aviles-Gamboa, Preston Lee, Houda Harastani, David Wang, Solny A. Adalsteinsson, Adrianus C M Boon

2020-Current year OA Pubs

Heartland and Bourbon viruses are pathogenic tick-borne viruses putatively transmitted by Amblyomma americanum, an abundant tick species in Missouri. To assess the prevalence of these viruses in ticks, we collected 2778 ticks from eight sampling sites at Tyson Research Center, an environmental field station within St. Louis County and close to the City of St. Louis, from May - July in 2019 and 2021. Ticks were pooled according to life stage and sex, grouped by year and sampling site to create 355 pools and screened by RT-qPCR for Bourbon and Heartland viruses. Overall, 14 (3.9%) and 27 (7.6%) of the …

Circulatory Arrest For Traumatic Brachiocephalic Artery Pseudoaneurysm Repair, Conor F Hynes, Kunal D Kotkar

2020-Current year OA Pubs

Blunt traumatic injuries to the brachiocephalic artery require surgical management. The operative technique used depends on the location of the injury, the patient's hemodynamic stability, and the surgeon's experience. Perfusion strategy can facilitate vascular control of the aortic arch and branch vessels. This report presents an urgent repair of a proximal posterior blunt traumatic brachiocephalic artery injury under circulatory arrest, with an excellent outcome.

Efficacy Of Laser Interstitial Thermal Therapy For Biopsy-Proven Radiation Necrosis In Radiographically Recurrent Brain Metastases, Michael Chan, Albert H Kim, Eric Leuthardt, Et Al.

2020-Current year OA Pubs

BACKGROUND: Laser interstitial thermal therapy (LITT) in the setting of post-SRS radiation necrosis (RN) for patients with brain metastases has growing evidence for efficacy. However, questions remain regarding hospitalization, local control, symptom control, and concurrent use of therapies.

METHODS: Demographics, intraprocedural data, safety, Karnofsky performance status (KPS), and survival data were prospectively collected and then analyzed on patients who consented between 2016-2020 and who were undergoing LITT for biopsy-proven RN at one of 14 US centers. Data were monitored for accuracy. Statistical analysis included individual variable summaries, multivariable Fine and Gray analysis, and Kaplan-Meier estimated survival.

RESULTS: Ninety patients met …

Health Utilities And Quality-Adjusted Life Years For Patients With Amyotrophic Lateral Sclerosis Receiving Reldesemtiv Or Placebo In Fortitude-Als, Paulos Gebrehiwet, Lisa Meng, Stacy A Rudnicki, Phil Sarocco, Jenny Wei, Andrew A Wolff, Michael Butzner, Adriano Chiò, Jinsy A Andrews, Angela Genge, Dyfrig A Hughes, Carlayne E Jackson, Noah Lechtzin, Timothy M Miller, Jeremy M Shefner

2020-Current year OA Pubs

AIMS: To estimate the health utilities and quality-adjusted life years (QALYs) in patients with amyotrophic lateral sclerosis (ALS) receiving

MATERIALS AND METHODS: We performed a post hoc analysis of clinical trial data from FORTITUDE-ALS (NCT03160898). This Phase IIb, double-blind, randomized, dose-ranging, placebo-controlled, parallel-group, 12-week trial evaluated

RESULTS: The full analysis set consisted of 456 patients (

CONCLUSIONS: This post hoc analysis of FORTITUDE-ALS suggests that

CLINICALTRIALS.GOV IDENTIFIER: NCT03160898.

Differential Expression Of Programmed Death 1 (Pd-1) On Various Immune Cells And Its Role In Human Leprosy, Mohammad Tarique, Huma Naz, Mohd Suhail, Ali Turan, Chaman Saini, Naoshad Muhammad, Hari Shankar, Torki A Zughaibi, Tabish H Khan, Neena Khanna, Alpana Sharma

2020-Current year OA Pubs

Leprosy is a chronic bacterial disease caused by

Molecular Techniques Drive Cutting Edge Advancements In Management Of Cutaneous T Cell Lymphoma, Mitchell N Lefebvre, Nicholas Borcherding, Ryan J Reis, Eric Mou, Vincent Liu, Ali Jabbari

2020-Current year OA Pubs

Cutaneous 5T cell lymphoma (CTCL), characterized by malignant T cells infiltrating the skin with potential for dissemination, remains a challenging disease to diagnose and treat due to disease heterogeneity, treatment resistance, and lack of effective and standardized diagnostic and prognostic clinical tools. Currently, diagnosis of CTCL practically relies on clinical presentation, histopathology, and immunohistochemistry. These methods are collectively fraught with limitations in sensitivity and specificity. Fortunately, recent advances in flow cytometry, polymerase chain reaction, high throughput sequencing, and other molecular techniques have shown promise in improving diagnosis and treatment of CTCL. Examples of these advances include T cell receptor clonotyping …

Jeremiah’S Portrayal Of War As Worship: Hollow Form Of Holiness, Oliver Glanz

Andrews University Seminary Studies (AUSS)

From an anthropological perspective, the acts of war and worship share similarities. Both are mission-driven, exercise rituals and liturgies, use songs, and have calls to duty. As such, the ultimate legitimization of war uses elements of sacred language usually found in the context of worship. The study of Jeremiah’s language usage provides a critical perspective on this typical anthropological phenomenon: the legitimization of war employing sacred language. When tracing Jeremiah’s vocabulary with the help of valence analysis, it can be argued that the prophet purposefully unmasks human war as a potential form of idol worship. Human war can, therefore, be …