Medicine and Health Sciences Commons^™

Impact Of A Rapid High-Sensitivity Troponin Pathway On Patient Flow In An Urban Emergency Department, Edward Hyun Suh, Aleksandr M Tichter, Lauren S Ranard, Andrew Amaranto, Betty C Chang, Phong Anh Huynh, Alexander Kratz, Rebekah Jihae Lee, Leroy E Rabbani, Dana Sacco, Andrew J Einstein

Faculty, Staff and Students Publications

STUDY OBJECTIVE: To evaluate whether the introduction of a 1-hour high-sensitivity cardiac troponin-T (hs-TnT) pathway for patients who present to the emergency department (ED) with suspected acute coronary syndrome (ACS) improves ED patient flow without changing the rate of "missed" major adverse cardiac events (MACE), compared to use of conventional cardiac troponin with an associated 3-hour pathway.

METHODS: This was a prospective, uncontrolled observational study conducted before and after implementation of a 1-hour hs-TnT pathway at a high-volume urban ED. Patients undergoing evaluation for ACS in the ED were enrolled during their initial visit and clinical outcomes were assessed at …

Interventions For Prevention Of Non-Communicable Diseases Among Adolescents Living With Hiv: A Systematic Review, Eunice Ndirangu, Constance Shumba, Peter Gatiti, Bernard Mutwiri, Amina Abubakar

School of Nursing & Midwifery, East Africa

While the uptake of antiretroviral drugs has rapidly expanded among adolescents and adults living with HIV, research evidence suggests that people living with HIV have a higher risk of non-communicable diseases (NCDs). With more than 35% of the global burden of NCDs stemming from adolescence, there is a need to comprehend the existing evidence on early prevention, detection, and disease management, especially among the at-risk population. In line with the WHO Global Action Plan, 2013–2020 and “Best Buys”, recommendations on practical interventions for NCDs prevention, this systematic review seeks to synthesise evidence on the current interventions for preventing NCDs among …

Circadian Disruption Of Hippocampus In An Early Senescence Male Mouse Model, Jennifer A Davis, Jodi R Paul, Mugdha V Mokashi, Stefani A Yates, Daniel J Mount, Hira A Munir, Lacy K Goode, Martin E Young, David B Allison, Karen L Gamble

Children’s Nutrition Research Center Staff Publications

Age-related cognitive decline and disruptions in circadian rhythms are growing problems as the average human life span increases. Multiple strains of the senescence-accelerated mouse (SAM) show reduced life span, and the SAMP8 strain in particular has been well documented to show cognitive deficits in behavior as well as a bimodal pattern of circadian locomotor activity. However, little is known about circadian regulation within the hippocampus of these strains of mice. Here we test the hypothesis that in this early senescence model, disruption of the molecular circadian clock in SAMP8 animals drives disrupted behavior and physiology. We found normal rhythms in …

An Exercise-Inducible Metabolite That Suppresses Feeding And Obesity, Veronica L Li, Yang He, Kévin Contrepois, Hailan Liu, Joon T Kim, Amanda L Wiggenhorn, Julia T Tanzo, Alan Sheng-Hwa Tung, Xuchao Lyu, Peter-James H Zushin, Robert S Jansen, Basil Michael, Kang Yong Loh, Andrew C Yang, Christian S Carl, Christian T Voldstedlund, Wei Wei, Stephanie M Terrell, Benjamin C Moeller, Rick M Arthur, Gareth A Wallis, Koen Van De Wetering, Andreas Stahl, Bente Kiens, Erik A Richter, Steven M Banik, Michael P Snyder, Yong Xu, Jonathan Z Long

Children’s Nutrition Research Center Staff Publications

Exercise confers robust protection against obesity, type 2 diabetes, and other cardiometabolic diseases.1–5 However, the molecular and cellular mechanisms that mediate the metabolic benefits of physical activity remain unclear.6 Here we show that exercise stimulates production of Lac-Phe, a blood-borne signaling metabolite that suppresses feeding and obesity. Lac-Phe biosynthesis from lactate occurs in CNDP2+ cells including immune cells, epithelial cells, and mesenchymal stem cells localized to diverse organs. In diet-induced obese mice, pharmacological elevation of circulating Lac-Phe reduces food intake without affecting movement or energy expenditure. Chronic administration of Lac-Phe decreases adiposity and body weight and …

Diabetes-Related Outcomes Following Use Of Basal-Bolus Insulin Vs Premixed Insulin In A Va Population With Type 2 Diabetes: A Retrospective Chart Review., Ravisha Bai, Kavita Batra, Charmaine Yap, Kenneth Izuora

School of Medicine Faculty Presentations

No abstract provided.

External Validation Of A Model Determining Risk Of Neoplastic Progression Of Barrett’S Esophagus In A Cohort Of Us Veterans, Theresa H Nguyen, Aaron P Thrift, Gyanprakash A Ketwaroo, Xianglin L Du, Luis Leon Novelo, Rollin George, Daniel G Rosen, Hashem B El-Serag

Faculty, Staff and Student Publications

BACKGROUND AND AIMS: Risk of esophageal adenocarcinoma (EAC) in those with Barrett's esophagus (BE) is 11-fold greater than the general population. It remains unclear which BE patients are at highest risk of progression to EAC. We aimed to validate a predictive model risk-stratifying BE patients.

METHODS: We conducted a retrospective cohort study at the Houston Veteran Affairs Medical Center of consecutive patients with a new diagnosis of BE from November 1990 to January 2019. Study follow-up was through February 2020. Patients were excluded if they had no follow-up EGD with esophageal biopsy sampling after the initial BE-diagnosing EGD or evidence …

Leveraging Single Cell Technologies For The Characterization And Treatment Of Refractory Pancreatic Cancer, Maria Monberg

Dissertations and Theses (Open Access)

Heterogeneity is a hallmark of cancer, and the advent of multimodal single-cell technologies has helped uncover heterogeneity in a high-throughput manner in different cancers across varied contexts at an unprecedented resolution. In an effort to improve precision medicine approaches in pancreatic ductal adenocarcinoma (PDAC), a highly lethal malignancy with a mere 11% 5-year survival rate, this dissertation focuses on first questioning the assumptions of the most basic models used to study PDAC via multimodal single-cell characterization methods at multiple levels of biological organization (scCNVseq and snATACseq for DNA assays, scRNAseq for transcriptomics, and paired protein assays such as multiplexed immunofluorescence …

Hiv Response Interventions That Integrate Hiv Molecular Cluster And Social Network Analysis: A Systematic Review, Daniel J Gore, Kellie Schueler, Santhoshini Ramani, Arno Uvin, Gregory Phillips, Moira Mcnulty, Kayo Fujimoto, John Schneider

Faculty, Staff and Student Publications

Due to improved efficiency and reduced cost of viral sequencing, molecular cluster analysis can be feasibly utilized alongside existing human immunodeficiency virus (HIV) prevention strategies. The goal of this paper is to elucidate how HIV molecular cluster and social network analyses are being integrated to implement HIV response interventions. We searched PubMed, Scopus, PsycINFO, and Cochrane Library databases for studies incorporating both HIV molecular cluster and social network data. We identified 32 articles that combined analyses of HIV molecular sequences and social or sexual networks. All studies were descriptive. Six studies described network interventions informed by molecular and social data …

Knowledge-Based Planning For The Radiation Therapy Treatment Plan Quality Assurance For Patients With Head And Neck Cancer, Wenhua Cao, Mary Gronberg, Adenike Olanrewaju, Thomas Whitaker, Karen Hoffman, Carlos Cardenas, Adam Garden, Heath Skinner, Beth Beadle, Laurence Court

Faculty, Staff and Student Publications

This study aimed to investigate the feasibility of using a knowledge-based planning technique to detect poor quality VMAT plans for patients with head and neck cancer. We created two dose-volume histogram (DVH) prediction models using a commercial knowledge-based planning system (RapidPlan, Varian Medical Systems, Palo Alto, CA) from plans generated by manual planning (MP) and automated planning (AP) approaches. DVHs were predicted for evaluation cohort 1 (EC1) of 25 patients and compared with achieved DVHs of MP and AP plans to evaluate prediction accuracy. Additionally, we predicted DVHs for evaluation cohort 2 (EC2) of 25 patients for which we intentionally …

Axl/Mertk Inhibitor Ono-7475 Potently Synergizes With Venetoclax And Overcomes Venetoclax Resistance To Kill F Lt 3-Itd Acute Myeloid Leukemia, Sean M Post, Huaxian Ma, Prerna Malaney, Xiaorui Zhang, Marisa J L Aitken, Po Yee Mak, Vivian R Ruvolo, Tomoko Yasuhiro, Ryohei Kozaki, Lauren E Chan, Lauren B Ostermann, Marina Konopleva, Bing Z Carter, Courtney Dinardo, Michael D Andreeff, Joseph D Khoury, Peter P Ruvolo

Faculty, Staff and Student Publications

FMS-like Tyrosine Kinase 3 (FLT3) mutation is associated with poor survival in acute myeloid leukemia (AML). The specific Anexelekto/MER Tyrosine Kinase (AXL) inhibitor, ONO-7475, kills FLT3-mutant AML cells with targets including Extracellular- signal Regulated Kinase (ERK) and Myeloid Cell Leukemia 1 (MCL1). ERK and MCL1 are known resistance factors for Venetoclax (ABT-199), a popular drug for AML therapy, prompting the investigation of the efficacy of ONO-7475 in combination with ABT-199 in vitro and in vivo. ONO-7475 synergizes with ABT-199 to potently kill FLT3-mutant acute myeloid leukemia cell lines and primary cells. ONO-7475 is effective against ABT-199-resistant cells including cells that …

Peripheral Blood Gene Expression Profiling Shows Predictive Significance For Response To Mycophenolate In Systemic Sclerosis-Related Interstitial Lung Disease, Shervin Assassi, Elizabeth R Volkmann, W Jim Zheng, Xuan Wang, Holly Wilhalme, Marka A Lyons, Michael D Roth, Donald P Tashkin

Faculty, Staff and Student Publications

OBJECTIVES: To characterise the peripheral blood cell (PBC) gene expression changes ensuing from mycophenolate mofetil (MMF) or cyclophosphamide (CYC) treatment and to determine the predictive significance of baseline PBC transcript scores for response to immunosuppression in systemic sclerosis (SSc)-related interstitial lung disease (ILD).

METHODS: PBC RNA samples from baseline and 12-month visits, corresponding to the active treatment period of both arms in Scleroderma Lung Study II, were investigated by global RNA sequencing. Joint models were created to examine the predictive significance of

RESULTS: 134 patients with SSc-ILD (CYC=69 and MMF=65) were investigated. CYC led to an upregulation of erythropoiesis, inflammation …

Using Artificial Neural Networks To Predict Intra-Abdominal Abscess Risk Post-Appendectomy, Morouge M Alramadhan, Hassan S Al Khatib, James R Murphy, Kuojen Tsao, Michael L Chang

Faculty, Staff and Student Publications

OBJECTIVE: To determine if artificial neural networks (ANN) could predict the risk of intra-abdominal abscess (IAA) development post-appendectomy.

BACKGROUND: IAA formation occurs in 13.6% to 14.6% of appendicitis cases with "complicated" appendicitis as the most common cause of IAA. There remains inconsistency in describing the severity of appendicitis with variation in treatment with respect to perforated appendicitis.

METHODS: Two "reproducible" ANN with different architectures were developed on demographic, clinical, and surgical information from a retrospective surgical dataset of 1574 patients less than 19 years old classified as either negative (n = 1,328) or positive (n = 246) for IAA post-appendectomy …

Impact Of Post-Arrest Care Variation On Hospital Performance After Out-Of-Hospital Cardiac Arrest, Ryan Huebinger, Jordan Thomas, Benjamin S Abella, John Waller-Delarosa, Rabab Al-Araji, Richard Witkov, Normandy Villa, Peter Nikonowicz, Taylor Renbarger, Micah Panczyk, Bentley Bobrow

Faculty, Staff and Student Publications

BACKGROUND: Large variation exists for out-of-hospital-cardiac-arrest (OHCA) prehospital care, but less is known about variations in post-arrest care. We sought to evaluate variation in post-arrest care in Texas as well as factors associated with higher performing hospitals.

METHODS: We analyzed data in Texas Cardiac Arrest Registry to Enhance Survival (TX-CARES), including all adult, non-traumatic OHCAs from 1/1/2014 through 12/31/ 2020 that survived to hospital admission. We first evaluated variability in provisions of post-arrest care and outcomes. We then stratified hospitals into quartiles based on their rate of survival and evaluated the association between improving quartiles and care. Lastly, we evaluated …

Noninvasive Testing And Surrogate Markers In Invasive Fungal Diseases, George R Thompson, David R Boulware, Nathan C Bahr, Cornelius J Clancy, Thomas S Harrison, Carol A Kauffman, Thuy Le, Marisa H Miceli, Eleftherios Mylonakis, M Hong Nguyen, Luis Ostrosky-Zeichner, Thomas F Patterson, John R Perfect, Andrej Spec, Dimitrios P Kontoyiannis, Peter G Pappas

Faculty, Staff and Student Publications

Invasive fungal infections continue to increase as at-risk populations expand. The high associated morbidity and mortality with fungal diseases mandate the continued investigation of novel antifungal agents and diagnostic strategies that include surrogate biomarkers. Biologic markers of disease are useful prognostic indicators during clinical care, and their use in place of traditional survival end points may allow for more rapid conduct of clinical trials requiring fewer participants, decreased trial expense, and limited need for long-term follow-up. A number of fungal biomarkers have been developed and extensively evaluated in prospective clinical trials and small series. We examine the evidence for these …

A Phase 1 Trial Of 8-Chloro-Adenosine In Relapsed/Refractory Acute Myeloid Leukemia: An Evaluation Of Safety And Pharmacokinetics, Rong Chen, Yuling Chen, Ping Xiong, Daniella Zheleva, David Blake, Michael J Keating, William G Wierda, William Plunkett

Faculty, Staff and Student Publications

Fadraciclib (CYC065) is a second-generation aminopurine CDK2/9 inhibitor with increased potency and selectivity toward CDK2 and CDK9 compared to seliciclib (R-roscovitine). In chronic lymphocytic leukemia (CLL), a disease that depends on the over-expression of anti-apoptotic proteins for its survival, inhibition of CDK9 by fadraciclib reduced phosphorylation of the C-terminal domain of RNA polymerase II and blocked transcription in vitro; these actions depleted the intrinsically short-lived anti-apoptotic protein Mcl-1 and induced apoptosis. While the simulated bone marrow and lymph node microenvironments induced Mcl-1 expression and protected CLL cells from apoptosis, these conditions did not prolong the turnover rate of Mcl-1, and …

Pityriasis Rosea-Like Rash After Messenger Rna Covid-19 Vaccination: A Case Report And Review Of The Literature, Jordan E Buckley, Laura N Landis, Ronald P Rapini

Faculty, Staff and Student Publications

A spectrum of cutaneous reactions to SARs-CoV-2 (COVID-19) vaccines have been reported in the literature. We present a case of a pityriasis rosea-like rash occurring after Pfizer COVID-19 vaccination and review cases of pityriasis rosea (PR)/PR-like eruption (PR-LE) after mRNA COVID-19 vaccine published in the medical literature. Of the 30 cases found, none experienced severe adverse effects and the rash resolved in an average of 5.6 weeks. It is important for physicians to be aware of this self-limited reaction so they can reassure and appropriately counsel patients that it is safe to receive subsequent vaccine doses despite the cutaneous eruption. …

Utility Of The Motivation To Change Lifestyle And Health Behaviors For Dementia Risk Reduction Scale (Mclhb-Drr) Based On A North American Sample, Angelina E. Witbeck

Dissertations

As the population ages, the prevalence rates of dementia continue to increase. Without a cure or promising treatment for dementia, the best course of lowering the prevalence rates of dementia is through preventative measures. Through an electronic survey, the study utilized the MCLHB-DRR scale to determine whether (1) gender, age, educational background, and socioeconomic status will impact the motivational factors to change lifestyle and health behaviors to reduce the risk of developing dementia and (2) direct experiences with individuals that have a dementia diagnosis are likely to impact one's motivational factors to change lifestyle and health behaviors to reduce the …

The Life Story Analysis Of Those Suffering From Autoimmune Thyroiditis, Azalea Di Nardi

Dissertations

The purpose of this study was to understand the pervasive impacts of autoimmune thyroiditis, specifically Hashimoto’s and Graves’ disease. To accomplish this, the life story methodology was utilized to gather individual experiences from 11 participants diagnosed with Hashimoto’s or Graves’ disease. The participants completed a background and general health questionnaire and 45- to-100-minute virtual interview disclosing their journey from the onset of symptoms, through diagnosis, to their most recent state. Themes were compiled from the interviews, which allowed identification of the largest areas of impact, needs, and future implications for practitioners and providers. Major themes identified were decreased quality of …

Prognosticators Of Visual Acuity After Indirect Traumatic Optic Neuropathy, Alex J Wright, Joanna H Queen, Emilio P Supsupin, Alice Z Chuang, John J Chen, Rod Foroozan, Ore-Ofe O Adesina

Faculty, Staff and Student Publications

BACKGROUND: The purpose of this study is to determine whether there are radiographic and systemic clinical characteristics that can predict final visual outcomes in patients with indirect traumatic optic neuropathy (iTON).

METHODS: This study is a retrospective, multicenter case series of adult patients with iTON treated initially at large, urban, and/or academic trauma centers with follow-up at an affiliated ophthalmology clinic. In addition to detailed cranial computed tomography characteristics, demographics, systemic comorbidities, coinjuries, blood products administered, and intracranial pressure, along with other factors, were gathered. LogMAR visual acuity (VA) at the initial presentation to the hospital and up to 12 …

Aberrant Fibrin Clot Structure Visualized Ex Vivo In Critically Ill Patients With Severe Acute Respiratory Syndrome Coronavirus 2 Infection, Lisa S Brubaker, Arun Saini, Trung C Nguyen, Marina Martinez-Vargas, Fong W Lam, Qizhi Yao, Michele M Loor, Todd K Rosengart, Miguel A Cruz

Faculty, Staff and Students Publications

OBJECTIVES: Disseminated fibrin-rich microthrombi have been reported in patients who died from COVID-19. Our objective is to determine whether the fibrin clot structure and function differ between critically ill patients with or without COVID-19 and to correlate the structure with clinical coagulation biomarkers.

DESIGN: A cross-sectional observational study. Platelet poor plasma was used to analyze fibrin clot structure; the functional implications were determined by quantifying clot turbidity and porosity.

SETTING: ICU at an academic medical center and an academic laboratory.

PATIENTS: Patients admitted from July 1 to August 1, 2020, to the ICU with severe acute respiratory syndrome coronavirus 2 …

Midlife Determinants Of Healthy Cardiovascular Aging: The Atherosclerosis Risk In Communities (Aric) Study, Xiaoming Jia, Caroline Sun, Vijay Nambi, Salim S Virani, George Taffet, Eric Boerwinkle, Jan Bressler, Chiadi Ndumele, B Gwen Windham, James A De Lemos, Kunihiro Matsushita, John William Mcevoy, Ron C Hoogeveen, Elizabeth Selvin, Christie M Ballantyne

Faculty, Staff and Students Publications

BACKGROUND AND AIMS: Risk factor cutoffs are derived from associations with clinical cardiovascular disease (CVD), but how these risk factors associate with preserved cardiovascular health into old age is not well studied. We investigated midlife determinants of healthy versus nonhealthy cardiovascular aging in the Atherosclerosis Risk in Communities (ARIC) study.

METHODS: ARIC participants were categorized by cardiovascular status in older age (mean age 75.8 ± 5.3 years, range 66-90): healthy, subclinical disease (assessed by biomarkers and left ventricular function), clinical CVD (coronary heart disease, stroke, or heart failure), or prior death. We examined associations of midlife (mean age 52.1 ± …

Covid-19 Public Transportation Air Circulation And Virus Mitigation Study, Aly Tawfik, Deify Law, Juris Grasis, Joseph Oldham, Moe Salem

Mineta Transportation Institute

COVID-19 may have forever changed our world. Given the limited space and air circulation, potential infections on public transportation could be concerningly high. Accordingly, this study has two objectives: (1) to understand air circulation patterns inside the cabins of buses; and (2) to test the impact of different technologies in mitigating viruses from the air and on surfaces inside bus cabins. For the first objective, different devices, metrics and experiments (including colored smoke; videotaping; anemometers; pressure differentials; particle counts; and 3D numerical simulation models) were utilized and implemented to understand and quantify air circulation inside different buses, with different characteristics, …

Unique Case Of Spontaneous Basilar Artery Stroke In An Operated Child With Craniopharyngioma, Krishna Shah, Shrey Jain, Ajit K Sinha

Faculty, Staff and Students Publications

Craniopharyngiomas are the most commonly presented nonglial tumors in child patients. They cause significant morbidity and mortality, both before and after surgery. The most common immediate postsurgery complications are attributable to pituitary insufficiency. Neurovascular complications account for only 2.7 to 2.9% surgical cases, and usually involve the vessels of the Circle of Willis. Thrombosis or vasospasm of the vessels of posterior circulation is unheard of. Here, we are reporting a unique case of a child with craniopharyngioma who developed acute spontaneous basilar artery thrombosis and posterior circulation stroke 6 days after surgery.

Prune1 C933g>A Synonymous Variant Induces Exon 7 Skipping, Disrupts The Dhha2 Domain, And Leads To An Atypical Nmihba Syndrome Presentation: Case Report And Review Of The Literature, Christina L Magyar, David R Murdock, Lindsay C Burrage, Hongzheng Dai, Seema R Lalani, Richard A Lewis, Yuezhen Lin, Marcela F Astudillo, Jill A Rosenfeld, Alyssa A Tran, James B Gibson, Undiagnosed Diseases Network, Carlos A Bacino, Brendan H Lee, Hsiao-Tuan Chao

Faculty, Staff and Students Publications

Prune exopolyphosphatase-1 (PRUNE1) encodes a member of the aspartic acid-histidine-histidine (DHH) phosphodiesterase superfamily that regulates cell migration and proliferation during brain development. In 2015, biallelic PRUNE1 loss-of-function variants were identified to cause the neurodevelopmental disorder with microcephaly, hypotonia, and variable brain abnormalities (NMIHBA, OMIM#617481). NMIHBA is characterized by the namesake features and structural brain anomalies including thinning of the corpus callosum, cerebral and cerebellar atrophy, and delayed myelination. To date, 47 individuals have been reported in the literature, but the phenotypic spectrum of PRUNE1-related disorders and their causative variants remains to be characterized fully. Here, we report a novel homozygous …

Impact Of The Covid-19 Pandemic On Visual Outcomes Of Diabetic Macular Edema Patients At A Tertiary Care Veterans Affairs Center, Philip Zhou, Jie Gao, Xiaofan Huang, Kristen A Staggers, Kristin Biggerstaff, Silvia Orengo-Nania, Roomasa Channa

Faculty, Staff and Students Publications

PURPOSE: There are limited studies on factors that impacted retina clinic patient outcomes during the COVID-19 pandemic. We aimed to evaluate visual and anatomic outcomes in patients with diabetic macular edema (DME) requiring anti-VEGF injections at the veterans' affairs tertiary care eye clinic in Houston, TX.

METHODS: Patient volume from April 2020 was compared to that of April 2019 to determine attendance changes. To evaluate outcomes, we reviewed patients with DME who had scheduled appointments during April 2020. We tracked changes in central foveal thickness (CFT) and Snellen visual acuity (VA) measurements. Patient outcomes were classified as poor (defined as …

Medicinal Plant Use For Type-2 Diabetes Treatment In The Traditional Vietnamese Medicine System Of Southern Vietnam, Lan Truong

Dissertations, Theses, and Capstone Projects

This ethnobotanical study examines the traditional health care system of the Mekong River Delta in Vietnam. The basic inquiry focuses on how the healers in the traditional Vietnamese medicine (TVM) system are treating a disease relatively new in Vietnam, type-2 diabetes (T2D). The study includes a description of the system in which the healers work. The research design compares two locations, one on the mainland (Rạch Giá City) and the other on a nearby island (Phú Quốc Island).

There are six chapters. The first chapter establishes foundational information about the region, population, and the traditional medical system. The results of …

Peripheral Extracorporeal Membrane Oxygenation Support Expands The Application Of Robot-Assisted Coronary Artery Bypass, Vivek Patel, Zachary Gray, Mahboob Alam, Guilherme Vianna Silva, Leo Simpson, Kenneth Liao

Faculty, Staff and Students Publications

OBJECTIVE: Robot-assisted coronary artery bypass (RCAB) is typically not offered to higher risk patients with reduced cardiopulmonary function, critical coronary artery disease, and challenging chest wall anatomy. In this study, we report the novel use of nonemergency intraoperative peripheral extracorporeal membrane oxygenation as partial cardiopulmonary support during RCAB for patients who were considered high-risk candidates for conventional CAB and at the same time not eligible for RCAB without cardiopulmonary support.

METHODS: Forty-five high risk patients (mean age, 68 years; Society of Thoracic Surgeons score, 6.27%; ejection fraction, 45%) underwent RCAB with nonemergency peripheral extracorporeal membrane oxygenation support for the following …

Influence Of The Human Lipidome On Epicardial Fat Volume In Mexican American Individuals, Ana C. Leandro, Laura F. Michael, Marcio Almeida, Mikko Kuokkanen, Kevin Huynh, Corey Giles, Thy Duong, Vincent P. Diego, Ravindranath Duggirala, Geoffrey D. Clarke, John Blangero, Joanne E. Curran

School of Medicine Publications

Introduction: Cardiovascular disease (CVD) is the leading cause of mortality worldwide and is the leading cause of death in the US. Lipid dysregulation is a well-known precursor to metabolic diseases, including CVD. There is a growing body of literature that suggests MRI-derived epicardial fat volume, or epicardial adipose tissue (EAT) volume, is linked to the development of coronary artery disease. Interestingly, epicardial fat is also actively involved in lipid and energy homeostasis, with epicardial adipose tissue having a greater capacity for release and uptake of free fatty acids. However, there is a scarcity of knowledge on the influence of plasma …

Postoperative Major Adverse Cardiac Events In Patients With Systemic Lupus Erythematosus, Sebastian Bruera, Xiudong Lei, Brandon Blau, Hui Zhao, Anita Deswal, Jinoos Yazdany, Sharon H Giordano, Maria E Suarez-Almazor

Faculty, Staff and Students Publications

OBJECTIVES: Patients with systemic lupus erythematosus (SLE) have a high risk of cardiovascular disease that could potentially increase postoperative major adverse cardiac events (MACE). We determined the rate of MACE in patients with SLE undergoing noncardiac surgery using national claims-based data.

METHODS: This was a retrospective cohort study using Optum Clinformatics Data Mart from 2007 to 2020. We identified a cohort of patients with SLE who had undergone noncardiac surgeries using Current Procedural Terminology codes. We also identified two control cohorts without SLE, one with diabetes mellitus (DM) and one without DM. After matching cases and controls by age and …

A Novel Automated Junctional Ectopic Tachycardia Detection Tool For Children With Congenital Heart Disease, Jamie L S Waugh, Raajen Patel, Yilong Ju, Ankit B Patel, Craig G Rusin, Parag N Jain

Faculty, Staff and Students Publications

BACKGROUND: Junctional ectopic tachycardia (JET) is a prevalent life-threatening arrhythmia in children with congenital heart disease (CHD), with marked resemblance to normal sinus rhythm (NSR) often leading to delay in diagnosis.

OBJECTIVE: To develop a novel automated arrhythmia detection tool to identify JET.

METHODS: A single-center retrospective cohort study of children with CHD was performed. Electrocardiographic (ECG) data produced by bedside monitors is captured automatically by the Sickbay platform. Based on the detection of R and P wave peaks, 2 interpretable ECG features are calculated: P prominence median and PR interval interquartile range (IQR). These features are used as input …