Digital Commons Network^™

Impact Of Consensus Guidelines For Breast-Conserving Surgery In Patients With Ductal Carcinoma In Situ, Abigail Tremelling, Rebecca L Aft, Amy E Cyr, William E Gillanders, Katherine Glover-Collins, Virginia Herrmann, Julie A Margenthaler

2020-Current year OA Pubs

BACKGROUND: Consensus guidelines published in 2016 recommended a 2 mm free margin as the standard for negative margins in patients undergoing breast-conserving surgery (BCS) for ductal carcinoma in situ (DCIS). The goal of the guideline recommendation was standardization of re-excision practices.

AIMS: To evaluate the impact of this consensus guideline on our institutional practices.

METHODS: We identified all patients at our institution with pure DCIS who were initially treated with BCS from September 2014 to August 2018 using a prospectively-maintained institutional database. A retrospective chart review was performed to determine margin status and re-excision rates during the 2 years before …

Exploring Reasons For Md-Phd Trainees' Experiences Of Impostor Phenomenon, Devasmita Chakraverty, Jose E Cavazos, Donna B Jeffe

2020-Current year OA Pubs

BACKGROUND: Acceptance into U.S. MD-PhD dual-degree programs is highly competitive, and the lengthy training program requires transitioning between multiple phases (pre-clinical-, PhD-research-, and clinical-training phases), which can be stressful. Challenges faced during MD-PhD training could exacerbate self-doubt and anxiety. Impostor phenomenon is the experience of feeling like a fraud, with some high-achieving, competent individuals attributing their successes to luck or other factors rather than their own ability and hard work. To our knowledge, impostor phenomenon among MD-PhD trainees has not been described. This study examined impostor phenomenon experiences during MD-PhD training and reasons trainees attributed to these feelings.

METHODS: Individuals …

Analyzing Relationships Between Economic And Neighborhood-Related Social Determinants Of Health And Intensive Care Unit Length Of Stay For Critically Ill Children With Medical Complexity Presenting With Severe Sepsis, Hunter Hamilton, Alina N West, Nariman Ammar, Lokesh Chinthala, Fatma Gunturkun, Tamekia Jones, Arash Shaban-Nejad, Samir H Shah

Faculty, Staff and Student Publications

OBJECTIVES: Of the Social Determinants of Health (SDoH), we evaluated socioeconomic and neighborhood-related factors which may affect children with medical complexity (CMC) admitted to a Pediatric Intensive Care Unit (PICU) in Shelby County, Tennessee with severe sepsis and their association with PICU length of stay (LOS). We hypothesized that census tract-level socioeconomic and neighborhood factors were associated with prolonged PICU LOS in CMC admitted with severe sepsis in the underserved community.

METHODS: This single-center retrospective observational study included CMC living in Shelby County, Tennessee admitted to the ICU with severe sepsis over an 18-month period. Severe sepsis CMC patients were …

Cefuroxime-Induced Toxic Maculopathy: A Cataract Co-Management Conundrum, Leonid Skorin Jr., Do, Od, Ms

Optometric Clinical Practice

Background: Cefuroxime-induced toxic maculopathy can occur when an incorrect dilution is injected intracamerally after cataract surgery. This results in a guarded visual prognosis. Cefuroxime-induced toxic maculopathy can also occur sporadically even when the medication dilution is the standard correct dosage. These patients usually recover their vision by the first postoperative week.

Case Report: A 72-year-old Caucasian female developed cefuroxime-induced toxic maculopathy after uneventful cataract surgery. Investigation of the case confirmed that she had a sporadic response to the cefuroxime. It was verified that she received the standard correct dilution of cefuroxime intracamerally. The patient showed a significant improvement in her …

Markers Of Kidney Function, Genetic Variation Related To Cognitive Function, And Cognitive Performance In The Uk Biobank, Erin L Richard, Linda K Mcevoy, Ian J Deary, Gail Davies, Steven Y Cao, Eyal Oren, John E Alcaraz, Andrea Z Lacroix, Jan Bressler, Rany M Salem

Faculty, Staff and Student Publications

BACKGROUND: Chronic kidney disease has been linked to worse cognition. However, this association may be dependent on the marker of kidney function used, and studies assessing modification by genetics are lacking. This study examined associations between multiple measures of kidney function and assessed effect modification by a polygenic score for general cognitive function.

METHODS: In this cross-sectional study of up to 341,208 European ancestry participants from the UK Biobank study, we examined associations between albuminuria and estimated glomerular filtration rate based on creatinine (eGFRcre) or cystatin C (eGFRcys) with cognitive performance on tests of verbal-numeric reasoning, reaction time and visual …

High Rates Of Undiagnosed And Uncontrolled Hypertension Upon A Screening Campaign In Rural Rwanda: A Cross-Sectional Study, Evariste Ntaganda, Victor G Davila-Roman, Kenneth Schechtman, Angela L Brown, Lisa De Las Fuentes, Dominic Reeds, Et Al.

2020-Current year OA Pubs

BACKGROUND: Hypertension remains the major risk factor for cardiovascular diseases (CVDs) worldwide with a prevalence and mortality in low- and middle-income countries (LMICs) among the highest. The early detection of hypertension risk factors is a crucial pillar for CVD prevention.

DESIGN AND METHOD: This cross-sectional study included 4284 subjects, mean age 46 ± 16SD, 56.4% females and mean BMI 26.6 ± 3.7 SD. Data were collected through a screening campaign in rural area of Kirehe District, Eastern of Rwanda, with the objective to characterize and examine the prevalence of elevated blood pressure (BP) and other CVD risk factors. An adapted …

Cisplatin Resistance Can Be Curtailed By Blunting Bnip3-Mediated Mitochondrial Autophagy, Caterina Vianello, Gerald W Dorn 2nd, Et Al

Open Access Publications

Cisplatin (CDDP) is commonly used to treat a multitude of tumors including sarcomas, ovarian and cervical cancers. Despite recent investigations allowed to improve chemotherapy effectiveness, the molecular mechanisms underlying the development of CDDP resistance remain a major goal in cancer research. Here, we show that mitochondrial morphology and autophagy are altered in different CDDP resistant cancer cell lines. In CDDP resistant osteosarcoma and ovarian carcinoma, mitochondria are fragmented and closely juxtaposed to the endoplasmic reticulum; rates of mitophagy are also increased. Specifically, levels of the mitophagy receptor BNIP3 are higher both in resistant cells and in ovarian cancer patient samples …

Intimate Partner Violence Education For Pregnant And Postpartum Adolescents And Young Adults, Tatiana Filajdic

Dissertations

Abstract

Problem The commencement of intimate partner violence (IPV) often begins with relationships during adolescence and young adulthood; hence, young age is a risk factor. Young adult females, pregnant and post-partum adolescents are at high risk of experiencing intimate partner violence (IPV).

Methods A prospective, descriptive design evaluating the impact of three IPV education sessions offered over a three-month period at a non-profit shelter specific for young adult, pregnant and post-partum adolescents.

Results Twelve participants attended the sessions (N=12), and seven (n=7, 61.5%) of shelter residents attended at least one IPV education session. A two-proportion z …

Longitudinal Gut Virome Analysis Identifies Specific Viral Signatures That Precede Necrotizing Enterocolitis Onset In Preterm Infants, Emily A Kaelin, Cynthia Rodriguez, Carla Hall-Moore, Julie A Hoffmann, Laura A Linneman, I Malick Ndao, Barbara B Warner, Phillip I Tarr, Lori R Holtz, Efrem S Lim

Open Access Publications

Necrotizing enterocolitis (NEC) is a serious consequence of preterm birth and is often associated with gut bacterial microbiome alterations. However, little is known about the development of the gut virome in preterm infants, or its role in NEC. Here, using metagenomic sequencing, we characterized the DNA gut virome of 9 preterm infants who developed NEC and 14 gestational age-matched preterm infants who did not. Infants were sampled longitudinally before NEC onset over the first 11 weeks of life. We observed substantial interindividual variation in the gut virome between unrelated preterm infants, while intraindividual variation over time was significantly less. We …

Calgb 40603 (Alliance): Long-Term Outcomes And Genomic Correlates Of Response And Survival After Neoadjuvant Chemotherapy With Or Without Carboplatin And Bevacizumab In Triple-Negative Breast Cancer, Jonathan H Shepherd, Cynthia Ma, Et Al.

2020-Current year OA Pubs

PURPOSE: CALGB 40603 (NCT00861705), a 2 × 2 randomized phase II trial, demonstrated that adding carboplatin or bevacizumab to weekly paclitaxel (wP) followed by doxorubicin and cyclophosphamide significantly increased the pathologic complete response (pCR) rate in stage II-III triple-negative breast cancer. We now report long-term outcomes (LTOs) and correlative science end points.

PATIENTS AND METHODS: The Kaplan-Meier method was used to estimate LTOs in 443 patients who initiated study treatment. Log-rank tests and Cox proportional hazards models evaluated the impact of clinical characteristics, pathologic response, calculated residual cancer burden (RCB) in patients with residual disease (RD), treatment assignment, and dose …

Racing To Equality: A Critique Of Female Exclusion In Motorsports, Luke Colegrove

Line by Line: A Journal of Beginning Student Writing

I wrote this article as an assignment for my ENG 198 class. We were originally assigned to establish a research-supported argument on the subject of gender, choosing the direction we wanted to take. As a fan of all types of motorsports, I noticed a lack of competition among males and females on the professional level. There are numerous examples of talented women in the sport, and I believed their voices needed to be heard. This inspired me to develop this piece of writing. After multiple drafts, peer reviews, and personal critiques by my professor, I was able to create an …

Relationship Between Age At Menopause, Obesity, And Incident Heart Failure: The Atherosclerosis Risk In Communities Study, Imo A Ebong, Machelle D Wilson, Duke Appiah, Erin D Michos, Susan B Racette, Amparo Villablanca, Khadijah Breathett, Pamela L Lutsey, Melissa Wellons, Karol E Watson, Patricia Chang, Alain G Bertoni

2020-Current year OA Pubs

Background The mechanisms linking menopausal age and heart failure (HF) incidence are controversial. We investigated for heterogeneity by obesity on the relationship between menopausal age and HF incidence. Methods and Results Using postmenopausal women who attended the Atherosclerosis Risk in Communities Study Visit 4, we estimated hazard ratios of incident HF associated with menopausal age using Cox proportional hazards models, testing for effect modification by obesity and adjusting for HF risk factors. Women were categorized by menopausal age: <45 years, 45 to 49 years, 50 to 54 years, and ≥55 years. Among 4441 postmenopausal women, aged 63.5±5.5 years, there were 903 incident HF events over a mean follow-up of 16.5 years. The attributable risk of generalized and central obesity for HF incidence was greatest among women who experienced menopause at age ≥55 years: 11.09/1000 person-years and 7.38/1000 person-years, respectively. There were significant interactions of menopausal age with body mass index and waist circumference for HF incidence,

Hyperactivation Is Sufficient To Release Porcine Sperm From Immobilized Oviduct Glycans, Momal Sharif, Vincent Hickl, Gabriel Juarez, Xingjian Di, Karl Kerns, Peter Sutovsky, Nicolai Bovin, David J Miller

Faculty, Staff and Students Publications

Fertilizing sperm are retained by adhesion to specific glycans on the epithelium of the oviduct forming a reservoir before sperm are released from the reservoir so fertilization can ensue. Capacitated sperm lose affinity for the oviduct epithelium but the components of capacitation that are important for sperm release are uncertain. One important correlate of capacitation is the development of hyperactivated motility. Hyperactivation is characterized by asymmetrical flagellar beating with high beat amplitude. We tested whether the development of full-type asymmetrical motility was sufficient to release sperm from immobilized oviduct glycans. Sperm hyperactivation was induced by four different compounds, a cell-permeable …

Need For Better And Broader Training In Cardio-Obstetrics: A National Survey Of Cardiologists, Cardiovascular Team Members, And Cardiology Fellows In Training, Natalie A Bello, Akanksha Agrawal, Melinda B Davis, Colleen M Harrington, Kathryn J Lindley, Margo B Minissian, Garima Sharma, Mary Norine Walsh, Ki Park

2020-Current year OA Pubs

Background Team-based models of cardio-obstetrics care have been developed to address the increasing rate of maternal mortality from cardiovascular diseases. Cardiovascular clinician and trainee knowledge and comfort with this topic, and the extent of implementation of an interdisciplinary approach to cardio-obstetrics, are unknown. Methods and Results We aimed to assess the current state of cardio-obstetrics knowledge, practices, and services provided by US cardiovascular clinicians and trainees. A survey developed in conjunction with the American College of Cardiology was circulated to a representative sample of cardiologists (N=311), cardiovascular team members (N=51), and fellows in training (N=139) from June 18, 2020, to …

Emergency Department Antimicrobial Use In A Low-Resource Setting: Results From A Retrospective Observational Study At A Referral Hospital In Liberia, Sojung Yi, Anu Ramachandran, Lane Epps, Alex Mayah, Taylor W Burkholder, Michael Senyu Jaung, Ahson Haider, Paul Whesseh, John Shakpeh, Kayla Enriquez, Corey Bills

Faculty, Staff and Students Publications

OBJECTIVE: Data on antimicrobial use in low-income and middle-income countries (LMICs) remain limited. In Liberia, the absence of local data impedes surveillance and may lead to suboptimal treatment, injudicious use and resistance against antimicrobials. This study aims to examine antimicrobial prescribing patterns for patients in the emergency department (ED) of a large Liberian public hospital. Secondarily, this prescribing was compared with WHO prescribing indicators.

DESIGN: Retrospective observational study.

SETTING: An adult ED of a large public hospital in Monrovia, Liberia.

PARTICIPANTS: A total of 1082 adult patients (>18 years of age) were recorded in the ED, from 1 January …

Navigating Covid-19: Female Ph.D. Students Coping With Family, Academic, And Job Duties, Aizhan Shomotova, Tatiana Karabchuk

Journal of International Women's Studies

In response to the COVID-19 outbreak, many governments introduced lockdown measures in which people were expected to work and study from their homes. Schools, daycares, and extracurricular programs were temporarily closed. All students from primary to the post-graduate level were transferred to online learning. This shift added a tremendous burden and additional workload for parents who were supposed to combine their own work and supervision of the online studies of their children from home. Recent research confirmed that women took more responsibilities for household chores and care of children during the pandemic. We conducted a study on female doctoral students …

Evaluation Of An Adapted Version Of The Diabetes Prevention Program For Low- And Middle-Income Countries: A Cluster Randomized Trial To Evaluate "Lifestyle Africa" In South Africa., Delwyn Catley, Thandi Puoane, Lungiswa Tsolekile, Ken Resnicow, Kandace K. Fleming, Emily A. Hurley, Joshua M. Smyth, Frank T. Materia, Estelle V. Lambert, Mara Z. Vitolins, Naomi S. Levitt, Kathy Goggin

Manuscripts, Articles, Book Chapters and Other Papers

BACKGROUND: Low- and middle-income countries (LMICs) are experiencing major increases in diabetes and cardiovascular conditions linked to overweight and obesity. Lifestyle interventions such as the United States National Diabetes Prevention Program (DPP) developed in high-income countries require adaptation and cultural tailoring for LMICs. The objective of this study was to evaluate the efficacy of "Lifestyle Africa," an adapted version of the DPP tailored for an underresourced community in South Africa compared to usual care.

METHODS AND FINDINGS: Participants were residents of a predominantly Xhosa-speaking urban township of Cape Town, South Africa characterized by high rates of poverty. Participants with body …

Associations Of Steps Per Day And Step Intensity With The Risk Of Diabetes: The Hispanic Community Health Study / Study Of Latinos (Hchs/Sol)., Carmen C. Cuthbertson, Christopher C. Moore, Daniela Sotres-Alvarez, Gerardo Heiss, Carmen R. Isasi, Yasmin Mossavar-Rahmani, Jordan A. Carlson, Linda C. Gallo, Maria M. Llabre, Olga L. Garcia-Bedoya, David Goldsztajn Farelo, Kelly R. Evenson

Manuscripts, Articles, Book Chapters and Other Papers

BACKGROUND: Higher levels of moderate-to-vigorous physical activity have been associated with a lower risk of diabetes, but less is known about how daily step counts (steps/day) are associated with diabetes risk. Therefore, we examined the association of steps/day and step intensity with incident diabetes.

METHODS: We included 6634 adults from the population-based prospective cohort Hispanic Community Health Study/Study of Latinos (HCHS/SOL) (2008-2017). Cox proportional hazard models that accounted for complex survey design and sampling weights were used to estimate the association of baseline accelerometer-assessed steps/day and step intensity with 6-year risk of incident diabetes as hazard ratios (HR) and 95% …

From The Battlefield To The Classroom: An Exploration Of Post-9/11 Female Combat Veterans Who Completed Graduate School After Military Service, Arthur Littler Iii

Dissertations

Since 2011, approximately 200,000 service members transitioned from military service to the civilian sector each year (U.S. Department of Veterans Affairs, 2016). , 2014). According to the U.S. Bureau of Labor Statistics’ 2018 Employment Situation of Veterans Summary report, 8.9% of veterans were disadvantaged as they have little to no higher education. Without a financial support system to fall back on, transitioning veterans face the inevitable issue of homelessness. Research by Tsai, Hoff, and Harpaz- Rotem (2017) found the rate of homelessness among veterans has increased over the past decade with female veterans more likely than their male counterparts to …

Hormone And Receptor Activator Of Nf-Κb (Rank) Pathway Gene Expression In Plasma And Mammographic Breast Density In Postmenopausal Women, Rachel Mintz, Mei Wang, Shuai Xu, Graham A Colditz, Chris Markovic, Adetunji T Toriola

2020-Current year OA Pubs

BACKGROUND: Hormones impact breast tissue proliferation. Studies investigating the associations of circulating hormone levels with mammographic breast density have reported conflicting results. Due to the limited number of studies, we investigated the associations of hormone gene expression as well as their downstream mediators within the plasma with mammographic breast density in postmenopausal women.

METHODS: We recruited postmenopausal women at their annual screening mammogram at Washington University School of Medicine, St. Louis. We used the NanoString nCounter platform to quantify gene expression of hormones (prolactin, progesterone receptor (PGR), estrogen receptor 1 (ESR1), signal transducer and activator of transcription (STAT1 and STAT5), …

Vulvovaginal Candidiasis: A Review Of The Evidence For The 2021 Centers For Disease Control And Prevention Of Sexually Transmitted Infections Treatment Guidelines., Paul Nyirjesy, Carolyn Brookhart, Gweneth Lazenby, Jane Schwebke, Jack D Sobel

Department of Obstetrics and Gynecology Faculty Papers

BACKGROUND: Vulvovaginal candidiasis (VVC) is a common cause of vulvovaginal itching and discharge. This article discusses the latest CDC STI Treatment Guidelines for VVC.

METHODS: A literature search of relevant topics was performed, and a team of experts was convened to discuss (1) diagnosis/testing modalities; treatment of (2) uncomplicated VVC , (3) complicated VVC, and (4) VVC caused by non-albicans yeast; (5) alternative treatment regimens; (6) susceptibility testing of yeast; Special Populations: (7) pregnancy and (8) HIV and VVC.

RESULTS: Yeast culture remains the gold standard for diagnoses. Newer molecular assays have been developed for the diagnosis of VVC and …

Identification Of Small Regions Of Overlap From Copy Number Variable Regions In Patients With Hypospadias, Carter H Scott, Ina E Amarillo

Open Access Publications

Hypospadias is a common form of congenital atypical sex development that is often associated with other congenital comorbidities. Many genes have been associated with the condition, most commonly single sequence variations. Further investigations of recurrent and overlapping copy number variations (CNVs) have resulted in the identification of genes and chromosome regions associated with various conditions, including differences of sex development (DSD). In this retrospective study, we investigated the DECIPHER database, as well as an internal institutional database, to identify small recurrent CNVs among individuals with isolated and syndromic hypospadias. We further investigated these overlapping recurrent CNVs to identify 75 smallest …

From Self-Efficacy To Imposter Syndrome: The Intrapersonal Traits Of Surgeons, Alexandra Medline, Helyn Grissom, Ndéye F Guissé, Victoria Kravets, Sandra Hobson, Julie Balch Samora, Mara Schenker

Open Access Publications

BACKGROUND: Demographic differences among surgical trainees regarding intrapersonal traits, such as imposter syndrome and assertiveness, have become widely acknowledged. However, many of these characteristics have not been examined in tandem, nor among both trainees and surgeons in practice. This study aimed to address these knowledge gaps.

METHODS: This was an anonymous, voluntary survey study comprised of validated measures of (1) self-efficacy, (2) imposter syndrome, (3) assertiveness, (4) perfectionism, and (5) self-rated likeability. A multimodal recruitment strategy was used and surgeons across all subspecialties were eligible for inclusion.

RESULTS: A total of 296 participants were included, with 54% identifying as female …

Ndrg1 In Aggressive Breast Cancer Progression And Brain Metastasis, Emilly S Villodre, Xiaoding Hu, Bedrich L Eckhardt, Richard Larson, Lei Huo, Ester C Yoon, Yun Gong, Juhee Song, Shuying Liu, Naoto T Ueno, Savitri Krishnamurthy, Stefan Pusch, Debu Tripathy, Wendy A Woodward, Bisrat G Debeb

Faculty, Staff and Student Publications

BACKGROUND: N-Myc downstream regulated gene 1 (NDRG1) suppresses metastasis in many human malignancies, including breast cancer, yet has been associated with worse survival in patients with inflammatory breast cancer. The role of NDRG1 in the pathobiology of aggressive breast cancers remains elusive.

METHODS: To study the role of NDRG1 in tumor growth and brain metastasis in vivo, we transplanted cells into cleared mammary fat pads or injected them in tail veins of SCID/Beige mice (n = 7-10 per group). NDRG1 protein expression in patient breast tumors (n = 216) was assessed by immunohistochemical staining. Kaplan-Meier method with 2-sided log-rank test …

The Efficacy Of Low-Dose Aspirin In Pregnancy Among Women In Malaria-Endemic Countries, Melissa Bauserman, Sequoia I Leuba, Jennifer Hemingway-Foday, Tracy L Nolen, Janet Moore, Elizabeth M Mcclure, Adrien Lokangaka, Antoinette Tsehfu, Jackie Patterson, Edward A Liechty, Fabian Esamai, Waldemar A Carlo, Elwyn Chomba, Robert L Goldenberg, Sarah Saleem, Saleem Jessani, Marion Koso-Thomas, Matthew Hoffman, Richard Derman, Steven R Meshnick, Carl L Bose

Department of Medicine Faculty Papers

Background: Low dose aspirin (LDA) is an effective strategy to reduce preterm birth. However, LDA might have differential effects globally, based on the etiology of preterm birth. In some regions, malaria in pregnancy could be an important modifier of LDA on birth outcomes and anemia.

Methods: This is a sub-study of the ASPIRIN trial, a multi-national, randomized, placebo controlled trial evaluating LDA effect on preterm birth. We enrolled a convenience sample of women in the ASPIRIN trial from the Democratic Republic of Congo (DRC), Kenya and Zambia. We used quantitative polymerase chain reaction to detect malaria. We calculated crude prevalence …

"Most Of The Cases Are Very Similar.": Documenting And Corroborating Conflict-Related Sexual Violence Affecting Rohingya Refugees, Lindsey Green, Thomas Mchale, Ranit Mishori, Linda M. Kaljee, Shahanoor Akter Chowdhury

Global Health Initiative Articles

BACKGROUND: In August 2017, a large population of Rohingya from northern Rakhine state in Myanmar fled to Bangladesh due to "clearance operations" by the Myanmar security forces characterized by widespread and systematic violence, including extensive conflict-related sexual violence (CRSV). This study sought to document the patterns of injuries and conditions experienced by the Rohingya, with a specific focus on sexual violence.

METHODS: Qualitative interviews were conducted with 26 health care professionals who cared for Rohingya refugees after their arrival in Bangladesh between November 2019 and August 2020.

RESULTS: Health care workers universally reported hearing accounts and seeing evidence of sexual …

Quality Of Life Impact And Recovery After Ureteroscopy And Stent Insertion: Insights From Daily Surveys In Stents, Jonathan D Harper, Alana C Desai, Jodi A Antonelli, Gregory E Tasian, Justin B Ziemba, Hussein R Al-Khalidi, H Henry Lai, Naim M Maalouf, Peter P Reese, Hunter B Wessells, Ziya Kirkali, Charles D Scales, Niddk Urinary Stone Disease Research Network (Usdrn)

2020-Current year OA Pubs

BACKGROUND: Our objective was to describe day-to-day evolution and variations in patient-reported stent-associated symptoms (SAS) in the STudy to Enhance uNderstanding of sTent-associated Symptoms (STENTS), a prospective multicenter observational cohort study, using multiple instruments with conceptual overlap in various domains.

METHODS: In a nested cohort of the STENTS study, the initial 40 participants having unilateral ureteroscopy (URS) and stent placement underwent daily assessment of self-reported measures using the Brief Pain Inventory short form, Patient-Reported Outcome Measurement Information System measures for pain severity and pain interference, the Urinary Score of the Ureteral Stent Symptom Questionnaire, and Symptoms of Lower Urinary Tract …

Perceptions Of Weight Status And Energy Balance Behaviors Among Patients With Non-Alcoholic Fatty Liver Disease, Natalia I Heredia, Ruchi Gaba, Yan Liu, Shilpa Jain, Manasi Rungta, Manav Rungta, Hashem B El-Serag, Fasiha Kanwal, Aaron P Thrift, Maya Balakrishnan

Faculty, Staff and Students Publications

Weight loss through behavioral modification is central to treating non-alcoholic fatty liver disease (NAFLD). To achieve this, patients need to accurately self-perceive their health behaviors. We aimed to identify predictors of concordance between self-perception and objective measures of body weight, physical activity (PA) and dietary behaviors. We used data from the Harris County NAFLD Cohort, an ongoing prospective study in a regional safety-net healthcare system. Patients completed self-administered baseline questionnaires on demographics, diet, PA, and self-perceptions. We assessed concordance between actual and self-perceived body weight and energy-balance behaviors. Multivariable logistic regression identified predictors of concordance. Patients (n = 458; average …

Demographic And Regional Trends Of Mortality In Patients With Aortic Dissection In The United States, 1999 To 2019, Salik Nazir, Robert W Ariss, Abdul Mannan Khan Minhas, Rochell Issa, Erin D Michos, Yochai Birnbaum, George V Moukarbel, P Kasi Ramanathan, Hani Jneid

Faculty, Staff and Students Publications

Background Aortic dissection (AoD) is associated with high morbidity and mortality. However, the burden of AoD mortality is not well characterized, and contemporary data and mortality trends in different demographic and geographic subgroups have not been described. Methods and Results Trends in AoD mortality were assessed using a cross-sectional analysis of the Centers for Disease Control and Prevention Wide-Ranging Online Data for Epidemiologic Research database. Crude and age-adjusted mortality rates (AAMR) per 1 million people with associated annual percent changes were determined. Joinpoint regression was used to assess trends in the overall sample and different demographic (sex, race and ethnicity, …

Left Ventricular Hypertrophy And Biomarkers Of Cardiac Damage And Stress In Aortic Stenosis, Elliot J Stein, Nishath Quader, Alan Zajarias, Anna Vatterott, Et Al

2020-Current year OA Pubs

Background Left ventricular hypertrophy (LVH) is associated with increased mortality risk and rehospitalization after transcatheter aortic valve replacement among those with severe aortic stenosis. Whether cardiac troponin (cTnT) and NT-proBNP (N-terminal pro-B-type natriuretic peptide) risk stratify patients with aortic stenosis and without LVH is unknown. Methods and Results In a multicenter prospective registry of 923 patients with severe aortic stenosis undergoing transcatheter aortic valve replacement, we included 674 with core-laboratory-measured LV mass index, cTnT, and NT-proBNP. LVH was defined by sex-specific guideline cut-offs and elevated biomarker levels were based on age and sex cut-offs. Adjusted Cox proportional hazards models evaluated …