Medicine and Health Sciences Commons^™

Modified Electroconvulsive Therapy As Maintenance Treatment, Jatin Kumar, Kishor M, Murali M R

Digital Journal of Clinical Medicine

Depression is the most common psychiatric condition that significantly affects the quality of life of individual affected with it and it can present with various signs and symptoms. It usually presents with persistent and pervasive sadness of mood, anhedonia, sleep disturbance, reduced appetite, reduced concentration, multiple somatic symptoms, and suicidal thoughts. In this case report a 61-year-old gentleman presented with sadness of mood, loss of interest, sleep disturbance, multiple body aches, and abdominal pain which varied from 2 to 6 weeks. He had failed to respond to multiple classes of antidepressants, mood stabilizers, and antipsychotics. However, he would respond well …

Cerebral Venous Thrombosis In Pregnancy : A Case Report, Dr Sumuk M S Sr, Dr Anupama Marnal B A Sr, Dr Mamatha S Professor And Head Of The Department, Poornima M Associate Professor

Digital Journal of Clinical Medicine

Cerebral venous thrombosis (CVT) is a rare complication encountered in pregnancy. Symptoms of CVT include headache, limb paresis, seizures , disturbed consciousness , visual disturbances. We present our 25 years old pregnant patient who presented with unsteadiness of gait , weakness and numbness of all four limbs, vomiting headache , giddiness due to which it was difficult for her to perform her daily activities. After the differential diagnostic examinations, we recognised cerebral venous thrombosis. After anti-coagulant treatment , the symptoms resolved. We would like to convey that such symptoms in pregnant women we should always think of CVT.

Relationship Between Femoral Artery Intima-Media Thickness And Atherosclerosis In Patients With Chronic Kidney Disease- A One Year Hospital-Based Cross-Sectional Study, Dr. Somashekhar Sogi, Dr. Ravi Sarvi, Dr. Pradeep Goudar, Dr. Mallikarjun Karishetti, Dr.V.V Hattiholi, Dr.Meenakshi Sarvi

Digital Journal of Clinical Medicine

Introduction: Chronic kidney disease (CKD) is one of the leading causes of morbidity and mortality worldwide. CKD and Peripheral arterial disease both independently increase the risk for cardiovascular disease (CVD) events and contribute significantly to morbidity and mortality. There is limited data about the co-relation between ultrasound measures of the femoral artery in peripheral vascular disease (PVD) & renal functional status. This research hence will help us in the establishment of a relationship between femoral intima-media thickness (fIMT) with CKD. Also, IMT assessment might help in earlier detection of atherosclerotic plaques & hence PVD.

Materials and methods: A cross sectional …

Hyperdiploid Chromosomes In Patients With B Cell Acute Lymphoblastic Leukemia, Anjali Shastry

Digital Journal of Clinical Medicine

Introduction: Hyperdiploidy (more than 50 chromosomes) is an important cytogenetic abnormality found in B cell acute lymphoblastic leukemia (B cell ALL). The presence of hyperdiploidy > 50 is considered to be a good prognostic marker since it has increased sensitivity to standard chemotherapy. Patients with hyperdiploidy have the longest disease-free survival compared with any other cytogenetic group.

Aim of study:

To estimate prevalence of hyperdiploid chromosomes in patients with B cell ALL through conventional karyotyping and Fluorescent in situ hybridization (FISH).

Materials and methods:

Retrospective study was done on 200 bone marrow samples diagnosed with B cell Acute lymphoblastic leukemia …

Dengue Fever With Normal Platelet Count In A Patient With Β-Thalassemia Trait: A Case Report, Pankaj Kumar Jain, Manoj Seval, Vikas Meena, Rajesh Yadav

Digital Journal of Clinical Medicine

Dengue fever is an arboviral infection typically characterized by thrombocytopenia and hemoconcentration. However, hematological manifestations may differ in patients with underlying hemoglobinopathies. We report a case of 18-year-old female diagnosed with dengue fever (IgM ELISA positive), presented with persistent fever, vomiting, and myalgia. Laboratory evaluation revealed moderate microcytic anemia (Hb 9.7 g/dL, MCV 54.7 fL) with a low Mentzer index (8.7). High-performance liquid chromatography confirmed β-thalassemia trait (HbA2 4.6%). Contrary to the typical presentation of dengue, the patient had elevated platelet counts at admission (584,000/µL), which remained within normal to high range during hospitalization. This case highlights that dengue infection …

Characterization And Investigation Of Cold Atmospheric Plasma And Its Effects On Cancer Cell Biology, Thomas M. Ritrosky

Theses and Dissertations

Modern cancer treatment uses radiation therapy in over 50% of patient cases. It is an e↵ective way of treating tumors because the mechanisms of cell killing are well known through the damage that ionizing radiation does to DNA. The amount of radiation can be tracked through measuring the dose of the clinical photon or electron beam used. However, there are limitations in the usage of radiation therapy, for example, a tumor can create hypoxic areas that become radioresistant leading to complete ine↵ectiveness of further radiation treatment. This project looks into the application of cold atmospheric plasma as an adjuvant therapy …

Vulnerability And Adaptation Of Neocortical Neuron Subtypes In Models Of Concussive Traumatic Brain Injury And Multiple Sclerosis, Alan C. Harris Jr.

Theses and Dissertations

The pathognomonic sequela of traumatic brain injury is traumatic axonal injury, the

burden of which correlates with less favorable outcomes. Elucidation of

the intrinsic variables that endow delineated neuronal subgroups and microanatomical domains with outsized vulnerability to injury represents a critical domain of inquiry toward the successful translation of disease-modifying therapeutics. To this end, we studied mild traumatic brain injury (mTBI) within the central fluid percussion model to examine the consequences of mTBI on the morphology and functional integrity of the axon initial segment (AIS) and the relative contributions to network homeostasis mediated by distinct populations of inhibitory interneurons. One …

Development Of A Chemical Biology Approach To Uncover The Influence Of Sequence Variations On Ces1 Activity In Live Cells, Samuel James Knebel

Masters Theses

Drug metabolism is the biochemical process of modifying drugs to detoxify and remove them through enzymatic transformations. These biotransformation’s occur primarily in the liver and are critical to understanding how pharmaceutical compounds are chemically altered inside the human body. Human carboxylesterases (CESs) catalyze the hydrolysis of esters, amides, thioesters, and carbamates. CES-mediated hydrolysis plays an important role in the metabolism of many drugs including the first FDA approved antiviral treatment for COVID-19, remdesivir (Veklury), the seizure control medication rufinamide (Banzel), and the flu antiviral drug oseltamivir (Tamiflu). CES activity is known to be influenced by a variety of factors including …

Dermatological Concerns For Women And Girls With Turner Syndrome, David Rodriguez-Buritica, Meaghan Mones, Siddharth K Prakash, Michelle Rivera, Melissa Aldrich, Megan Rogge, Kate Richardson

Faculty, Staff and Student Publications

Introduction: Turner syndrome (TS) is associated with distinct manifestations in women and girls including short stature, cardiac abnormalities, premature ovarian failure as well as dermatological features, including lymphedema, keloids, onychodystrophy, and acne. Although many dermatological concerns present during the first few decades of life, the overwhelming majority of respondents are not provided with dermatology referrals at diagnosis.

Methods: This cross-sectional study utilized an author designed survey to assess self-reported dermatological manifestations, dermatology referral experience, common therapies for select dermatological conditions, as well as a validated 10-question Dermatology Life Quality Index (DLQI) to assess quality-of-life impact in women and girls with …

Subendocardial And Transmural Myocardial Ischemia: Clinical Characteristics, Prevalence, And Outcomes With And Without Revascularization, K Lance Gould, Tung Nguyen, Richard Kirkeeide, Amanda E Roby, Linh Bui, Danai Kitkungvan, Monica B Patel, Mohammad Madjid, Mary Haynie, Dejian Lai, Ruosha Li, Jagat Narula, Nils P Johnson

Faculty, Staff and Student Publications

BACKGROUND: Subendocardial ischemia is commonly diagnosed but not quantified by imaging.

OBJECTIVES: This study sought to define size and severity of subendocardial and transmural stress perfusion deficits, clinical associations, and outcomes.

METHODS: Regional rest-stress perfusion in mL/min/g, coronary flow reserve, coronary flow capacity (CFC), relative stress flow, subendocardial stress-to-rest ratio and stress subendocardial-to-subepicardial ratio as percentage of left ventricle were measured by positron emission tomography (PET) with rubidium Rb 82 and dipyridamole stress in serial 6,331 diagnostic PETs with prospective 10-year follow-up for major adverse cardiac events with and without revascularization.

RESULTS: Of 6,331 diagnostic PETs, 1,316 (20.7%) had severely …

Precision Medicine Approach To Alzheimer’S Disease: Rationale And Implications, Dale E. Bredesen, Kat Toups, Ann Hathaway, Deborha Gordon, Henrianna Chung, Cyrus Raji, Alan Boyd, Benjamin D. Hill, Sharon Hausman-Cohen, Mouna Attarha, Won Jong Chwa, Alexei Kurakin, Michael Jarrett

University Faculty and Staff Publications

The neurodegenerative disease field has enjoyed extremely limited success in the development of effective therapeutics. One potential reason is the lack of disease models that yield accurate predictions and optimal therapeutic targets. Standard clinical trials have pre-determined a single treatment modality, which may be unrelated to the primary drivers of neurodegeneration. Recent proof-of-concept clinical trials using a precision medicine approach suggest a new model of Alzheimer’s disease (AD) as a chronic innate encephalitis that creates a network insufficiency. Identifying and addressing the multiple potential contributors to cognitive decline for each patient may represent a more effective strategy. Here we review …

Adaptive Leadership In Local Responses To Covi D-19: Cases Of The Cities Of Santa Rosa And Valenzuela, Philippines, Miriam Caryl Carada, Therese Pardo, Aileen Lapitan

Journal of Public Affairs and Development

The Coronavirus Disease (COVID-19) created a disruption to the global landscape that called for the quick response of key governance actors, specifically an adaptive approach by the local leaders. In this study, we analyze strategies of two local chief executives to draw insights about how adaptive leadership practiced in the context of two cities in the Philippines deemed to excel in managing the pandemic at the height of its onslaught. Owing to COVID restrictions at the time of the study, secondary data from various social media accounts, local government portals, and news websites were utilized together with the accounts from …

Understanding Cancer Patients' Desire To Quit Tobacco Without Assistance: A Mixed-Methods, Longitudinal Study, Tia Borger

Theses and Dissertations--Psychology

Introduction: Unassisted attempts to quit tobacco are a well-established reason for quit failure. Nonetheless, many cancer patients prefer to make a quit attempt without using evidence-based tobacco treatment. This study aimed to understand the rationale that underlies cancer patients’ desire to quit tobacco without assistance and to track longitudinally the smoking cessation outcomes of patients with this preference. Method: In a mixed-methods, longitudinal study, 35 cancer patients who were current tobacco users and declined tobacco treatment because of the desire to quit on their own provided data via three questionnaires and 1-2 semi-structured interviews across 60 days. Participants were recruited …

Effect Of Relaxation Intervention On Stress Levels And Cognitive Skills In Professional Students, Sandhra Sabu, Ravikiran Kisan, . Swapnali

Digital Journal of Clinical Medicine

Background: Medical Professional training is likely to encounter a variety of hassles and stress in relation to the developmental tasks associated with transition from school life to professional college life. The vast syllabus, peer competition for academic performance, continuous evaluation, and long duration of the training makes medical education stressful. Many students feel a need to relieve stress and it is a necessity to equip students with proven techniques to reduce stress and cope up with the situation. Proper cognitive functioning has been found to be an important factor for academic performance.

Methods: The present study is a cross …

Improved Outcomes With “7+3” Induction Chemotherapy For Acute Myeloid Leukemia Over The Past Four Decades: Analysis Of Swog Trial Data, Megan Othus, Guillermo Garcia-Manero, John E Godwin, James K Weick, Frederick R Appelbaum, Harry P Erba, Elihu H Estey

Faculty, Staff and Student Publications

We have previously shown that complete response (CR) rates and overall survival of patients with acute myeloid leukemia have improved since the 1980s. However, we have not previously evaluated how the length of first CR (CR1) has changed over this time period. To address this, we analyzed 1,247 patients aged 65 or younger randomized to "7+3" arms from five SWOG studies: S8600 (n=530), S9031 (n=98), S9333 (n=57), S0106 (n=301), and S1203 (n=261). We evaluated length of CR1 and survival after relapse from CR1 over the four decades that these studies represent. Both length of CR1 and survival after relapse from …

Flecainide For Conversion And Maintenance Of Sinus Rhythm After Mitral Valve Replacement In Rheumatic Atrial Fibrillation, Umesh Tripathi, Aditya Kapoor, Surendra Kumar Agarwal, Prabhat Tewari, Shantanu Pande, Bipin Chandra, Ankit Sahu, Roopali Khanna, Sudeep Kumar, Naveen Garg, Satyendra Tewari

Faculty, Staff and Student Publications

BACKGROUND: Despite successful mitral valve replacement (MVR), many patients remain in AF. Flecainide can be useful in these patients but has not been used because of underlying structural heart disease.

METHODS: We assessed oral flecainide for conversion and maintenance of SR in 25 patients of chronic rheumatic AF following MVR (age 34.4 yrs, mean AF duration: 3.6 yrs). Non-converters underwent DC cardioversion at 24 h and 4 weeks. Patients received flecainide and bb/diltiazem at discharge.

RESULTS: Single oral dose of Flecainide achieved SR in 6/25 (24%) while 19/25 achieved SR after DCC; at24 h 21/25 (84%) were in SR. With …

Cardiovascular Disease Risk Factors Among Middle-Aged And Older Adult Vietnamese American Members Of A Northern California Health Plan, Donna B Haysbert, Joan C Lo, Nirmala D Ramalingam, Nancy P Gordon

Faculty, Staff and Student Publications

OBJECTIVE: There is increasing recognition that cardiovascular disease (CVD) risk factors vary by Asian subgroups. We examined CVD risk factor prevalence among Vietnamese adults in a northern California health plan.

METHODS: We used electronic health record data to examine smoking, overweight/obesity (body mass index ≥23.0 kg/m

RESULTS: Current smoking prevalence was 20.3% for middle-aged men, 7.0% for older men, and

CONCLUSIONS: Study results suggest that more research on health conditions, lifestyle, and social factors among Vietnamese American adults is needed to develop culturally competent interventions to reduce CVD risk in this growing ethnic group.

Combining Mek And Src Inhibitors For Treatment Of Colorectal Cancer Demonstrate Increased Efficacy In Vitro But Not In Vivo, Fan Fan, Susmita Ghosh, Reid Powell, Jason Roszik, Yongsun Park, Mary Sobieski, Alexey Sorokin, Clifford Stephan, Scott Kopetz, Lee M Ellis, Rajat Bhattacharya

Faculty, Staff and Student Publications

Metastatic colorectal cancer (mCRC) is the second leading cause of cancer deaths in the United States. More than 50% of patients with mCRC harbor mutations of the oncogenic driver RAS (KRAS or NRAS). Because directly targeting most mutations of RAS is technically challenging, researchers have concentrated on targeting MEK, a downstream mediator of RAS. However, targeting MEK as single-agent therapy is ineffective in patients with mCRC. We hypothesize that combining a MEK inhibitor with other agents can enhance the efficacy of MEK targeting in mCRC. Unbiased high-throughput screening (HTS) was performed to identify drugs that enhance the efficacy of MEK …

Development And Validation Of Early Death Risk Score Model For Emergency Status Prediction In Very Severe Aplastic Anemia, Xu Liu, Wenrui Yang, Li Zhang, Liping Jing, Lei Ye, Kang Zhou, Yuan Li, Jianping Li, Huihui Fan, Yang Yang, Youzhen Xiong, Xin Zhao, Fengkui Zhang

Faculty, Staff and Student Publications

This study developed and validated the Early Death Risk Score Model for early identification of emergency patients with very severe aplastic anemia (VSAA). All 377 patients with VSAA receiving first-line immunosuppressive therapy (IST) were categorized into training (n=252) and validation (n=125) cohorts. In the training cohort, age >24 years, absolute neutrophil count ≤0.015×109/L, serum ferritin >900ng/mL and times of fever before IST >1 time were significantly associated with early death. Covariates were assigned scores and categorized as: low (score 0-4), medium (score 5-7) and high (score ≥8) risk. Early death rate was significantly different between risk groups and the validation …

Osteoblast-Specific Overexpression Of Nucleolar Protein No66/Riox1 In Mouse Embryos Leads To Osteoporosis In Adult Mice, Qin Chen, Krishna M Sinha, Benoit De Crombrugghe, Ralf Krahe

Faculty, Staff and Student Publications

In previous study, we showed that nucleolar protein 66 (NO66) is a chromatin modifier and negatively regulates Osterix activity as well as mesenchymal progenitor differentiation. Genetic ablation of the NO66 (RIOX1) gene in cells of the Prx1-expressing mesenchymal lineage leads to acceleration of osteochondrogenic differentiation and a larger skeleton in adult mice, whereas mesenchyme-specific overexpression of NO66 inhibits osteochondrogenesis resulting in dwarfism and osteopenia. However, the impact of NO66 overexpression in cells of the osteoblast lineage in vivo remains largely undefined. Here, we generated osteoblast-specific transgenic mice overexpressing a FLAG-tagged NO66 transgene driven by the …

Role Of Sentinel Lymph Node Biopsy For Oral Squamous Cell Carcinoma: Current Evidence And Future Challenges, Sophie S Jang, Morgan E Davis, David R Vera, Stephen Y Lai, Theresa W Guo

Faculty, Staff and Student Publications

Sentinel lymph node biopsy (SLNB) has been used across oncological specialties for prognostication, staging, and identification of occult nodal metastasis. Recent studies demonstrated the potential clinical utility of SLNB in oral cavity squamous cell carcinoma (OCSCC). Elective neck dissection is the current standard of care in early management of OCSCC with depth of invasion greater than 2-4 mm; however, majority of patients ultimately do not have nodal disease on final pathology. SLNB is an alternative procedure widely adopted in early cancer management in many oncological subspecialities. Several considerations such as depth of invasion, nodal mapping, histopathology methods, operator variability, postoperative …

Multi-Organ Spatial Stratification Of 3-D Dose Distributions Improves Risk Prediction Of Long-Term Self-Reported Severe Symptoms In Oropharyngeal Cancer Patients Receiving Radiotherapy: Development Of A Pre-Treatment Decision Support Tool, Andrew Wentzel, Abdallah S R Mohamed, Mohamed A Naser, Lisanne V Van Dijk, Katherine Hutcheson, Amy M Moreno, Clifton D Fuller, Guadalupe Canahuate, G Elisabeta Marai

Faculty, Staff and Student Publications

Purpose: Identify Oropharyngeal cancer (OPC) patients at high-risk of developing long-term severe radiation-associated symptoms using dose volume histograms for organs-at-risk, via unsupervised clustering.

Material and methods: All patients were treated using radiation therapy for OPC. Dose-volume histograms of organs-at-risk were extracted from patients' treatment plans. Symptom ratings were collected via the MD Anderson Symptom Inventory (MDASI) given weekly during, and 6 months post-treatment. Drymouth, trouble swallowing, mucus, and vocal dysfunction were selected for analysis in this study. Patient stratifications were obtained by applying Bayesian Mixture Models with three components to patient's dose histograms for relevant organs. The clusters with the …

The Contemporary Management Of Cancers Of The Sinonasal Tract In Adults, Rajat Thawani, Myung Sun Kim, Asad Arastu, Zizhen Feng, Malinda T West, Nicholas F Taflin, Kyaw Zin Thein, Ryan Li, Mathew Geltzeiler, Nancy Lee, Clifton David Fuller, Jennifer R Grandis, Charalampos S Floudas, Michael C Heinrich, Ehab Hanna, Ravi A Chandra

Faculty, Staff and Student Publications

Sinonasal malignancies make up <5% of all head and neck neoplasms, with an incidence of 0.5-1.0 per 100,000. The outcome of these rare malignancies has been poor, whereas significant progress has been made in the management of other cancers. The objective of the current review was to describe the incidence, causes, presentation, diagnosis, treatment, and recent developments of malignancies of the sinonasal tract. The diagnoses covered in this review included sinonasal undifferentiated carcinoma, sinonasal adenocarcinoma, sinonasal squamous cell carcinoma, and esthesioneuroblastoma, which are exclusive to the sinonasal tract. In addition, the authors covered malignances that are likely to be encountered in the sinonasal tract-primary mucosal melanoma, NUT (nuclear protein of the testis) carcinoma, and extranodal natural killer cell/T-cell lymphoma. For the purpose of keeping this review as concise and focused as possible, sarcomas and malignancies that can be classified as salivary gland neoplasms were excluded.

Targeted Exome-Based Predictors Of Patterns Of Progression Of Colorectal Liver Metastasis After Percutaneous Thermal Ablation, Iwan Paolucci, Yuan-Mao Lin, Yoshikuni Kawaguchi, Harufumi Maki, A Kyle Jones, Marco Calandri, Scott Kopetz, Timothy E Newhook, Kristy K Brock, Jean-Nicolas Vauthey, Bruno C Odisio

Faculty, Staff and Student Publications

BACKGROUND: Percutaneous thermal ablation is a curative-intent locoregional therapy (LRT) for selected patients with unresectable colorectal liver metastasis (CLM). Several factors have been identified that contribute to local tumour control after ablation. However, factors contributing to disease progression outside the ablation zone after ablation are poorly understood.

METHODS: In this retrospective study, using next-generation sequencing, we identified genetic biomarkers associated with different patterns of progression following thermal ablation of CLM.

RESULTS: A total of 191 ablation naïve patients between January 2011 and March 2020 were included in the analysis, and 101 had genomic profiling available. Alterations in the TGFβ pathway …

Stephen Massey: A Career In Visual Neuroscience, Stephen L Mills, David W Marshak

Faculty, Staff and Student Publications

This review is a memoir by Dr. Stephen C. Massey's longtime collaborator, Dr. Stephen L. Mills, and written, for the most part, in the first person. It also serves as an introduction to the virtual festschrift to celebrate Dr. Massey's retirement. and. The references cited here are only a few of the highlights of Dr. Massey's distinguished career. A complete list is found here: https://pubmed.ncbi.nlm.nih.gov/?term=massey+sc+%28retina+or+photoreceptors%29&sort=date.

Protective Role Of Colitis In Inflammatory Arthritis Via Propionate-Producing Bacteroides In The Gut, Hoh-Jeong Shon, Yu-Mi Kim, Kyeong Seog Kim, Jin-Ouk Choi, Sang-Hyun Cho, Sujin An, Se-Hyeon Park, Yong-Joon Cho, Joo-Hong Park, Sang-Uk Seo, Joo-Youn Cho, Wan-Uk Kim, Donghyun Kim

Faculty, Staff and Student Publications

OBJECTIVES: To investigate whether and how inflammatory disease in the intestine influences the development of arthritis, considering that organ-to-organ communication is associated with many physiological and pathological events.

METHODS: First, mice were given drinking water containing dextran sodium sulfate (DSS) and then subjected to inflammatory arthritis. We compared the phenotypic symptoms between the cohoused and separately-housed mice. Next, donor mice were divided into DSS-treated and untreated groups and then cohoused with recipient mice. Arthritis was then induced in the recipients. The fecal microbiome was analyzed by 16S rRNA amplicon sequencing. We obtained type strains of the candidate bacteria and generated …

Retinal Alpha-Synuclein Accumulation Correlates With Retinal Dysfunction And Structural Thinning In The A53t Mouse Model Of Parkinson’S Disease, Katie K N Tran, Vickie H Y Wong, Anh Hoang, David I Finkelstein, Bang V Bui, Christine T O Nguyen

Faculty, Staff and Student Publications

Abnormal alpha-synuclein (α-SYN) protein deposition has long been recognized as one of the pathological hallmarks of Parkinson's disease's (PD). This study considers the potential utility of PD retinal biomarkers by investigating retinal changes in a well characterized PD model of α-SYN overexpression and how these correspond to the presence of retinal α-SYN. Transgenic A53T homozygous (HOM) mice overexpressing human α-SYN and wildtype (WT) control littermates were assessed at 4, 6, and 14  months of age (male and female,

Adrenal Venous Sampling In Primary Aldosteronism: Single-Centre Experience From Western India, Krantikumar Rathod, Saba S Memon, Punit Mahajan, Anurag Lila, Dhaval Thakkar, Hemant Deshmukh, Tushar Bandgar

Faculty, Staff and Student Publications

INTRODUCTION: The protocols and criteria used for adrenal venous sampling (AVS) differ across centres. There are no studies from the Indian subcontinent describing AVS-based outcomes in primary aldosteronism (PA). We aim to describe our experience from a single centre.

METHODS: Retrospective records from 2018 to 2020 of patients with confirmed PA who underwent AVS were reviewed. Clinical, imaging, AVS data and outcomes (as per PASO criteria) were recorded. AVS was performed by sequential sampling with cosyntropin stimulation with intraprocedural cortisol and cut-off of selectivity >5 and lateralization >4 by a single radiologist.

RESULTS: Fifteen patients with median age of 50 …

Ifabp Levels Predict Visceral Malperfusion In The First Hours After Open Thoracoabdominal Aortic Repair, Panagiotis Doukas, Cathryn Bassett, Hanif Krabbe, Jelle Frankort, Michael J Jacobs, Moustafa Elfeky, Alexander Gombert

Faculty, Staff and Student Publications

INTRODUCTION: Intestinal ischemia after open thoracoabdominal aortic repairs, is a rare but devastating complication, associated with high mortality. Notoriously challenging to diagnose, visceral malperfusion necessitates immediate surgical attention. Intestinal fatty acid-binding protein (IFABP) has been proposed as a biomarker for the diagnosis of intestinal wall damage. In this prospectively conducted, observational study we evaluated the diagnostic capacity of IFABP levels in patients' serum and their correlation with visceral malperfusion.

METHODS: 23 patients undergoing open thoracoabdominal aortic repairs were included in this study and 8 of them were diagnosed postoperatively with visceral malperfusion-defined as a partial or complete thrombotic occlusion of …

Health-Related Quality Of Life And Disease Severity Among Patients With Idiopathic Pulmonary Fibrosis, Rowida Mohamed

Graduate Theses, Dissertations, and Problem Reports (ETD)

Background: Predicting the survival of patients with Idiopathic pulmonary fibrosis (IPF) remains challenging due to the remarkable heterogeneity of the disease prognosis. Therefore, developing reliable prognostic tools is of utmost importance in IPF management. Nomograms currently represent the most accurate and discriminatory tools for predicting outcomes, with superior performance compared to the commonly used integer score approach. Therefore, developing a valid local nomogram to predict mortality among patients with IPF is warranted. Additionally, IPF is characterized by a high symptom burden significantly impacting Health-related quality of life (HRQoL). Accurately measuring HRQoL in IPF is crucial as it guides treatment decisions …