Medicine and Health Sciences Commons^™

Pneumococcal Vaccine Guidance 2022, Bona Shin, Michael Do, Elaina Lioudis

Transformative Medicine (T-Med)

PCV15 and PCV20 received FDA approval in 2021. This article provides an overview of all pneumococcal vaccines - PPSV23, PCV13, PCV15, and PCV20 and their place in therapy. It provides a summary of pneumococcal disease burden in the U.S., vaccine spectrum of activity, indications, adult/pediatric dosing schedules, efficacy, and common adverse drug reactions.

Total Transfemoral Percutaneous Endovascular Aortic Arch Repair Using 3-Vessel Inner Branch Stent-Graft, Emanuel R Tenorio, Thanila A Macedo, Laura Ocasio, Marina Dias Neto, Guilherme B Barbosa Lima, Aidin Baghbani-Oskouei, Anthony L Estrera, Abhijeet Dhoble, Shao Feng Zhou, Gustavo S Oderich

Journal Articles

Endovascular repair has been introduced to decrease the morbidity and mortality associated with open surgical repair of aortic arch pathology. We illustrate total percutaneous transfemoral approach with a 3-vessel inner branch stent-graft to treat aortic arch aneurysm. (Level of Difficulty: Advanced.).

Total Transfemoral Percutaneous Endovascular Aortic Arch Repair Using 3-Vessel Inner Branch Stent-Graft, Emanuel R Tenorio, Thanila A Macedo, Laura Ocasio, Marina Dias Neto, Guilherme B Barbosa Lima, Aidin Baghbani-Oskouei, Anthony L Estrera, Abhijeet Dhoble, Shao Feng Zhou, Gustavo S Oderich

Journal Articles

Endovascular repair has been introduced to decrease the morbidity and mortality associated with open surgical repair of aortic arch pathology. We illustrate total percutaneous transfemoral approach with a 3-vessel inner branch stent-graft to treat aortic arch aneurysm. (Level of Difficulty: Advanced.).

Postoperative Atrial Fibrillation Prevention: A Quality Improvement Project, Emily O. Schneiderman

Doctors of Nursing Practice (DNP) Final Projects, 2020-current

Postoperative atrial fibrillation remains one of the most common complications after cardiac surgery despite surgical and medical advances in the field. While generally transient, postoperative atrial fibrillation increases long-term morbidity and mortality, hospital length of stay, and financial obligation. The postoperative heart's unique chemical and physical properties make tactics for preventing and treating postoperative atrial fibrillation differ from classic atrial fibrillation management. This quality improvement project utilizes a care bundle for non-pharmacologic measures and early beta-blockade administration to reduce the incidence of postoperative atrial fibrillation. Implementation of this care bundle establishes a standard of care, increases clinician knowledge and accountability, …

Noninvasive Quantification Of Tissue Sodium Concentration In The Kidney Disease Spectrum Using 23na Magnetic Resonance Imaging, Fabio R. Salerno

Electronic Thesis and Dissertation Repository

Chronic kidney disease (CKD), especially when requiring kidney replacement therapy (hemodialysis (HD) and peritoneal dialysis (PD)), is associated with extracellular water expansion with increased total body sodium. Sodium can also be accumulated in tissues independently of extracellular water. Sodium-23 magnetic resonance imaging (²³Na MRI) can quantify the concentration of sodium nuclei in tissues. Applied to the human leg, quantification of tissue sodium concentrations mainly at the skin and muscle level is possible. We hypothesized that increased tissue sodium concentrations exert toxic effects in CKD and dialysis. We aimed to (1) compare tissue sodium concentrations in adults, children and …

Partial Outpatient Oral Antibiotic Treatment Of Infective Endocarditis Is Non-Inferior To Inpatient Intravenous Antibiotic Therapy, Nicholas J. Murphy

Clinical Research in Practice: The Journal of Team Hippocrates

A clinical decision report using:

Iversen K, Ihlemann N, Gill SU, et al. Partial Oral versus Intravenous Antibiotic Treatment of Endocarditis. N Engl J Med. 2019; 380:415-424. https://doi.org/10.1056/NEJMoa1808312

for a patient with infective endocarditis and intravenous drug use with desire to leave the hospital.

Glucocentric Drugs In Cardiovascular Disease Protection And Heart Failure, Khawaja M. Talha, Gregg C. Fonarow, Salim S. Virani, Javed Butler

Office of the Provost

Evidence for cardiovascular outcomes with older-generation antihyperglycemic drugs in the management of type 2 diabetes is based on aggregated data from prior randomized controlled trials and observational studies that were not focused on prespecified cardiovascular end points. Newer antihyperglycemic medications have undergone a rigorous evaluation of cardiovascular outcomes through randomized controlled trials since the US Food and Drug Administration imposed a mandatory requirement for all glucose-lowering drugs in 2008. The three classes of drugs that have been most extensively studied are dipeptidyl peptidase 4 inhibitors, glucagon-like peptide 1 receptor agonists, and sodium-glucose cotransporter-2 (SGLT2) inhibitors, the latter two reporting significant …

Unfavorable Social Determinants Of Health Are Associated With Higher Burden Of Financial Toxicity Among Patients With Atherosclerotic Cardiovascular Disease In The Us: Findings From The National Health Interview Survey, Javier Valero-Elizondo, Zulqarnain Javed, Rohan Khera, Mauricio E. Tano, Ramzi Dudum, Isaac Acquah, Adnan A. Hyder, Julia Andrieni, Garima Sharma, Salim S. Virani

Office of the Provost

Background: Atherosclerotic cardiovascular disease (ASCVD) is a major cause of financial toxicity, defined as excess financial strain from healthcare, in the US. Identifying factors that put patients at greatest risk can help inform more targeted and cost-effective interventions. Specific social determinants of health (SDOH) such as income are associated with a higher risk of experiencing financial toxicity from healthcare, however, the associations between more comprehensive measures of cumulative social disadvantage and financial toxicity from healthcare are poorly understood.
Methods: Using the National Health Interview Survey (2013-17), we assessed patients with self-reported ASCVD. We identified 34 discrete SDOH items, across 6 …

Patient Care Management Of Hypertension Through Improving Follow-Up And Reducing Missed Appointments In A Primary Care Clinic: A Qi Project, Victoria Idubor

Doctor of Nursing Practice

Background. Missed follow-up appointments constitute significant problems clinics and health centers face nationwide. A significant portion of primary care providers’ patients will require follow-up appointments to manage their chronic illnesses. About 20 to 40% of patients seen at this clinic have a history of hypertension. Uncontrolled hypertension has been shown to increase the risk of certain cardiovascular disease events and mortality. Follow-up appointments are crucial for patients with hypertension to monitor for more life-threatening signs and manage their overall care. Purpose. The purpose of this project is to improve the timely management of care for patients with hypertension …

Childhood And Adolescent Obesity: Related Comorbidities And Interventions, Jasmine Wong

Nursing | Senior Theses

Background

The prevalence of childhood and adolescent obesity in the United States has steadily risen over the years and has become a public health concern. Obesity is defined as a BMI at or above the 95th percentile for children and teens of the same age and sex. Obese children and adolescents are at risk for poor health and poor quality of life. Furthermore, there are numerous comorbidities associated with childhood and adolescent obesity. While some of the associated diseases are acute, others can become chronic and result in lifelong conditions.

Objective

The purpose of the present thesis is to explore …

A Study Of Heart Disease Diagnosis Using Machine Learning And Data Mining, Intisar Ahmed

Electronic Theses, Projects, and Dissertations

Heart disease is the leading cause of death for people around the world today. Diagnosis for various forms of heart disease can be detected with numerous medical tests, however, predicting heart disease without such tests is very difficult. Machine learning can help process medical big data and provide hidden knowledge which otherwise would not be possible with the naked eye. The aim of this project is to explore how machine learning algorithms can be used in predicting heart disease by building an optimized model. The research questions are; 1) What Machine learning algorithms are used in the diagnosis of heart …

Ankyrin Dependent Mitochondrial Function And Bioenergetics In The Heart, Janani Subramaniam, Janani Subramaniam

Dissertations & Theses (Open Access)

ANK2 mutations in patients are associated with numerous arrhythmias, cardiomyopathies, and other heart defects. In the heart, AnkB, the protein encoded by ANK2, clusters relevant ion channels and cell adhesion molecules in several important domains; however, its role at Mitochondria Associated ER/SR Membranes (MAMs) has yet to be investigated. MAMs are crucial to mitochondrial function and metabolism and are signaling hubs implicated in various cardiac pathologies. Among several functions, these sites mediate the direct transfer of calcium from the ER/SR to the mitochondria to modulate ATP synthesis. Given that mitochondrial function and energy production are paramount to cardiovascular heath, …

Weekly Telehealth Weigh-In For Bmi Reduction, Kelly Ahmad

Student Scholarly Projects

Practice Problem: The citizens of the United States are known for being overweight or obese. The Centers for Disease Control and Prevention (CDC, 2021) reported that approximately 74% of adults are either overweight or obese. PICOT: The PICOT question that guided this project was In overweight adults (P), does telemonitoring weekly for counseling and weigh-in (I) compared to current practice (C) decrease BMI over an 8-week period of time (T)? Evidence: The citizens of the United States are known for being overweight or obese. The Centers for Disease Control and Prevention (CDC, 2021) reported that approximately 74% of …

The Impact Of Volatile Organic Compound Exposure On Subclinical Biomarkers Of Cardiovascular Injury., Breandon Taylor

Electronic Theses and Dissertations

Pollution has been identified as the leading environmental cause of non-communicable disease and premature deaths globally. Volatile organic compounds (VOCs) are gaseous chemical constituents of pollution derived from a variety of sources, including industrial solvents and byproducts, automobile exhaust, tobacco smoke, cleaning supplies, and personal care products. VOCs are also abundant at various Superfund and Hazardous Waste Sites. Emerging data suggest that VOC exposure is associated with several adverse health outcomes, including cardiovascular disease (CVD). VOCs and their metabolites can potentially damage the endothelial lining of blood vessels, resulting in perturbed vascular function and vascular inflammation. We hypothesize that VOC …

Rapid Cooling Is A Safe Technique In Patients Undergoing Circulatory Arrest For Aortic Repair, Holly N Smith, Akiko Tanaka, Max Chehadi, Harleen K Sandhu, Charles C Miller, Hazim J Safi, Anthony L Estrera

Journal Articles

OBJECTIVE: To evaluate our institutional experience with rapid cooling for hypothermic circulatory arrest in proximal aortic repair.

METHODS: We retrospectively reviewed data from 2171 patients who underwent proximal aortic surgery requiring hypothermic circulatory arrest between 1991 and 2020. Cooling times were divided into quartiles and clinical outcome event rates were compared across quartiles using contingency table methods. Incremental effect of cooling time was assessed in the context of other perfusion time variables using multiple logistic regression analysis.

RESULTS: Median age was 61 years (interquartile range, 49-70 years) and 34.1% of patients were women. The procedure was emergent in 33.5% of …

Spontaneous Celiac Artery Dissection Treated By Balloon Angioplasty, Regina Husman, Akiko Tanaka, S Keisin Wang, Kourosh Keyhani, Arash Keyhani

Journal Articles

Spontaneous isolated celiac artery dissection (SICAD) is a rare condition, defined as dissection of the celiac artery without aortic involvement. Because of its low prevalence, most studies have been limited to case reports and case series. We have described the case of a 44-year-old woman who had presented with symptomatic SICAD that had resulted in compromised flow to the hepatic arteries and was successfully treated with balloon angioplasty. Angioplasty alone might be effective for cases of extensive false lumen thrombosis in SICAD for immediate flow restoration to the true lumen, expediting positive remodeling.

Association Of Apremilast With Vascular Inflammation And Cardiometabolic Function In Patients With Psoriasis: The Vip-A Phase 4, Open-Label, Nonrandomized Clinical Trial., Joel M Gelfand, Daniel B Shin, April W Armstrong, Stephen K Tyring, Andrew Blauvelt, Scott Gottlieb, Benjamin N Lockshin, Robert E Kalb, Robert Fitzsimmons, Justin Rodante, Philip Parel, Grigory A Manyak, Laurel Mendelsohn, Megan H Noe, Maryte Papadopoulos, Maha N Syed, Thomas J Werner, Joy Wan, Martin P Playford, Abass Alavi, Nehal N Mehta

Journal Articles

IMPORTANCE: Psoriasis is an inflammatory condition associated with metabolic and cardiovascular disease. Apremilast, a phosphodiesterase 4 inhibitor, is commonly used for psoriasis and can cause weight loss.

OBJECTIVE: To determine the association between apremilast and aortic vascular inflammation as assessed by 18F-fluorodeoxyglucose positron emission tomography/computed tomography (FDG-PET/CT), cardiometabolic markers (primary outcomes at week 16), and abdominal fat composition.

DESIGN, SETTING, AND PARTICIPANTS: A single-arm, open-label, interventional, nonrandomized clinical trial in which the imaging and laboratory outcomes were measured by an investigator who was blinded to time was conducted between April 11, 2017, and August 17, 2021, at 7 dermatology sites …

Endovascular Repair Of Aortic Arch Graft Pseudoaneurysm Using A Duct Occluder Device With Onlay Fusion Guidance, Guilherme B Barbosa Lima, Laura Ocasio, Emanuel R Tenorio, Marina Dias-Neto, Thanila A Macedo, Gustavo S Oderich

Journal Articles

Aortic arch pseudoaneurysms can be caused by previous surgery, infection, or trauma. In select patients with small tears and no evidence of infection, local repair can be performed using an open or endovascular technique.1 Open surgical repeat surgery has increased risks and endovascular repair has been especially appealing for the elderly, higher risk patients, and patients with multiple prior procedures.2 We have reported the use of a ductal occluder device in a patient with a large aortic arch pseudoaneurysm.3 Our patient has provided written informed consent for the report of his case details and imaging studies.

Registry Of Aortic Diseases To Model Adverse Events And Progression (Roadmap) In Uncomplicated Type B Aortic Dissection: Study Design And Rationale, Domenico Mastrodicasa, Martin J Willemink, Valery L Turner, Virginia Hinostroza, Marina Codari, Kate Hanneman, Maral Ouzounian, Daniel Ocazionez Trujillo, Rana O Afifi, Sandeep Hedgire, Nicholas S Burris, Bo Yang, Joan M Lacomis, Thomas G Gleason, Davide Pacini, Gianluca Folesani, Luigi Lovato, Ricarda Hinzpeter, Hatem Alkadhi, Arthur E Stillman, Edward P Chen, Sander M J Van Kuijk, Geert W H Schurink, Anna M Sailer, Kathrin Bäumler, D Craig Miller, Michael P Fischbein, Dominik Fleischmann

Journal Articles

PURPOSE: To describe the design and methodological approach of a multicenter, retrospective study to externally validate a clinical and imaging-based model for predicting the risk of late adverse events in patients with initially uncomplicated type B aortic dissection (uTBAD).

MATERIALS AND METHODS: The Registry of Aortic Diseases to Model Adverse Events and Progression (ROADMAP) is a collaboration between 10 academic aortic centers in North America and Europe. Two centers have previously developed and internally validated a recently developed risk prediction model. Clinical and imaging data from eight ROADMAP centers will be used for external validation. Patients with uTBAD who survived …

The Impact Of High-Intensity Interval Training On Vascular Function In Adults: A Systematic Review And Meta-Analysis, Mousa Khalafi, Mohammad Hossein Sakhaei, Fatemeh Kazeminasab, Michael E. Symonds, Sara K. Rosenkranz

Kinesiology and Nutrition Sciences Faculty Publications

Aim: We performed a systematic review and meta-analysis to investigate the effects of high-intensity interval training (HIIT) compared with moderateintensity continuous training (MICT) or with no exercise (CON) on vascular function in adults who were free of cardiometabolic diseases and those with cardiometabolic diseases.

Methods: A search across three electronic databases including Scopus, PubMed, and Web of Science was conducted through February 2022 to identify the randomized trials evaluating HIIT vs. MICT and/or CON on vascular function as measured using brachial artery flow-mediated dilation (FMD) in adults. Separate analyses were conducted for HIIT vs. MICT and/or CON to calculate weighted …

A Quantification And Impact Of Incomplete Revascularization Using Residual Syntax Score In Nstemi Patients After Percutaneous Coronary Intervention, Syed Waqar Ahmed, Nasir Rahman

Section of Cardiology

Objectives: The aim of this study was to assess the prognostic significance of rSS after PCI for NSTEMI in terms of all-cause mortality and MACE (Major adverse cardiac event) at 3 years of follow-up.
Methodology: A retrospective analysis of 115 consecutive NSTEMI patients who underwent PCI at the Aga Khan University Hospital Karachi between January 2016 and December 2016 was performed. 7 patients were excluded from the final analysis due to missing data (n=108). The SYNTAX scores before (baseline syntax=bSS) and after PCI (rSS) were calculated. Patients were stratified as CR if rSS =0, RICR if rSS >0 and ≤8 …

Hypertrophic And Fibrotic Human Pkd Hearts Are Associated With Macrophage Infiltration And Abnormal Tgf-Β1 Signaling, Farideh Amirrad, Gregory A. Fishbein, Robert A. Edwards, Surya M. Nauli

Pharmacy Faculty Articles and Research

Autosomal dominant polycystic kidney disease (PKD) is a hereditary kidney disorder which can affect cardiovascular system. Cardiac hypertrophy and cardiomyopathy in PKD have been reported by echocardiography analyses, but histopathology analyses of human PKD hearts have never been examined. The current studies evaluated human heart tissues from five subjects without PKD (non-PKD) and five subjects with PKD. Our histopathology data of human PKD hearts showed an increased extracellular matrix associated with cardiac hypertrophy and fibrosis. Hypertrophy- and fibrosis-associated pathways involving abnormal cardiac structure were next analyzed. We found that human PKD myocardium was infiltrated by inflammatory macrophage M1 and M2; …

Exploration Of The Pathophysiological Mechanisms Underlying Hemodialysis Associated Cardiac Ischemic Injury, Lisa Yun Jeong Hur

Electronic Thesis and Dissertation Repository

Hemodialysis (HD) provides life-saving treatment in individuals with kidney failure. However, HD is associated with poor quality of life and extremely high mortality rates mainly caused by cardiovascular disease due to heart failure and sudden cardiac death. Standard pharmacological treatment developed within the non-kidney disease community are largely ineffective in HD patients because of the difference in pathophysiology of cardiovascular mortality. HD treatment causes hypotension and recurrent ischemic injury to multiple vascular beds including the heart, leading to heart failure. These injuries can be abrogated by improving the patient’s tolerability of the treatment. To apply interventions that may improve hemodynamic …

30th Annual Scientific Congress Of Hong Kong College Of Cardiology Abstracts

Journal of the Hong Kong College of Cardiology

No abstract provided.

29th Annual Scientific Congress Of Hong Kong College Of Cardiology Proceedings

Journal of the Hong Kong College of Cardiology

No abstract provided.

24th Asc Of Icsm Proceedings

Journal of the Hong Kong College of Cardiology

No abstract provided.

29th Annual Scientific Congress Of Hong Kong College Of Cardiology Abstracts

Journal of the Hong Kong College of Cardiology

No abstract provided.

24th Asc Of Icsm Abstracts

Journal of the Hong Kong College of Cardiology

No abstract provided.

The Role Of Telehealth In Reducing Hospital Readmissions For Heart Failure Patients, Tommy Lee Bratcher

Graduate Theses, Dissertations, and Capstones

Heart failure affects over six million people annually, and is expected to increase to over eight million by 2030. Over 60 million people live in the rural United States. Telehealth is a tool to improve access to care, provide early intervention, and follow up with patients within 48 hours of a hospital discharge. Utilizing Telehealth to conduct a medication reconciliation within 48 hours of discharge to address any medication errors or admission, and reinforce adherence is a way to improve access to care to those living in rural areas.

The Enigma Of Primary Hypertension In Childhood, Bonita Falkner

Department of Medicine Faculty Papers

Beginning in the 1970s, hypertension in children and adolescents has been defined as systolic and/or diastolic blood pressure (BP) that is equal to or greater than the 95th percentile of the normal BP distribution in healthy children. The definition of hypertension in adults is based on longitudinal data that links a BP level with an increased risk for subsequent adverse outcomes related to hypertension including heart failure, kidney failure, stroke, or death. The statistical definition of hypertension continues to be used in childhood because there have been no data that link a BP level in childhood with a heightened risk …