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Full-Text Articles in Medicine and Health Sciences

Opioid Prescribing Patterns And The Effect Of Chronic Kidney Disease In Pediatric Urology Population: A Retrospective Cohort Analysis., Kristen M. Meier, Darren Ha, Carter Sevick, Eliza D. Blanchette, Megan A. Brockel, Vijaya M. Vemulakonda, Kyle O. Rove Apr 2025

Opioid Prescribing Patterns And The Effect Of Chronic Kidney Disease In Pediatric Urology Population: A Retrospective Cohort Analysis., Kristen M. Meier, Darren Ha, Carter Sevick, Eliza D. Blanchette, Megan A. Brockel, Vijaya M. Vemulakonda, Kyle O. Rove

Manuscripts, Articles, Book Chapters and Other Papers

BACKGROUND: Significant efforts have been undertaken to decrease opioid prescribing, but there is little research into patient-specific factors presenting as barriers in the pediatric surgical population. Non-steroidal anti-inflammatory drugs (NSAIDs) have been shown to be a safe and effective alternative to opioids for pain control, however, concerns about their impact on renal function limit their use in patients with chronic kidney disease (CKD). Data is limited on the interplay of CKD on opioid prescribing.

OBJECTIVE: We hypothesized that opioid reduction efforts were successful, but patients with CKD would be more likely to receive an opioid prescription than those without CKD. …


Genetic Testing Utilization In The U.S. Registry For Childhood Interstitial And Diffuse Lung Diseases., Laura A. Voss, Rebekah J. Nevel, Jennifer A. Wambach, Lawrence M. Nogee, Robin R. Deterding, Alicia M. Casey, Michael G. O'Connor, Daniel I. Craven, Jane B. Taylor, Gail H. Deutsch, Jade B. Tam-Williams, Lea C. Steffes, Steven K. Brennan, Maria T. Santiago, Sara C. Sadreameli, Andrea F. Heras, Michael R. Powers, Antonia P. Popova, Manvi Bansal, Aaron Hamvas, William A. Gower, Fernando Urrego, Lisa R. Young, Child Registry Collaborative Apr 2025

Genetic Testing Utilization In The U.S. Registry For Childhood Interstitial And Diffuse Lung Diseases., Laura A. Voss, Rebekah J. Nevel, Jennifer A. Wambach, Lawrence M. Nogee, Robin R. Deterding, Alicia M. Casey, Michael G. O'Connor, Daniel I. Craven, Jane B. Taylor, Gail H. Deutsch, Jade B. Tam-Williams, Lea C. Steffes, Steven K. Brennan, Maria T. Santiago, Sara C. Sadreameli, Andrea F. Heras, Michael R. Powers, Antonia P. Popova, Manvi Bansal, Aaron Hamvas, William A. Gower, Fernando Urrego, Lisa R. Young, Child Registry Collaborative

Manuscripts, Articles, Book Chapters and Other Papers

INTRODUCTION: Childhood interstitial and diffuse lung diseases (chILD) comprise a diverse group of rare disorders. Identifying the underlying cause is crucial for treatment, prognosis, and estimating recurrence risk. The objective of this study was to assess the utilization of genetic testing for subjects enrolled in the United States National Registry for ChILD, a multicenter observational study.

METHODS: Genetic data from participating sites were reviewed and analyzed in relationship to clinical characteristics.

RESULTS: Of 609 children enrolled from 22 centers, genetic testing was performed for 55.5% (n = 338). Genetic testing results were positive (diagnostic) for 22.8% (n = 77), negative …


Factors Associated With Shock At Presentation In Kawasaki Disease Versus Multisystem Inflammatory Syndrome In Children Associated With Covid-19., Supriya S. Jain, Ashraf S. Harahsheh, Simon Lee, Geetha Raghuveer, Nagib Dahdah, Michael Khoury, Michael A. Portman, Melissa Wehrmann, Arash A. Sabati, Marianna Fabi, Deepika Thacker, Nilanjana Misra, Mark D. Hicar, Nadine F. Choueiter, Matthew D. Elias, Audrey Dionne, William B. Orr, Jacqueline R. Szmuszkovicz, Seda Selamet Tierney, Luis Martin Garrido-Garcia, Frederic Dallaire, Balasubramanian Sundaram, Deepa Prasad, Tyler H. Harris, Elizabeth Braunlin, Elisa Fernandez Cooke, Cedric Manlhiot, Pedrom Farid, Brian W. Mccrindle, International Kawasaki Disease Registry Apr 2025

Factors Associated With Shock At Presentation In Kawasaki Disease Versus Multisystem Inflammatory Syndrome In Children Associated With Covid-19., Supriya S. Jain, Ashraf S. Harahsheh, Simon Lee, Geetha Raghuveer, Nagib Dahdah, Michael Khoury, Michael A. Portman, Melissa Wehrmann, Arash A. Sabati, Marianna Fabi, Deepika Thacker, Nilanjana Misra, Mark D. Hicar, Nadine F. Choueiter, Matthew D. Elias, Audrey Dionne, William B. Orr, Jacqueline R. Szmuszkovicz, Seda Selamet Tierney, Luis Martin Garrido-Garcia, Frederic Dallaire, Balasubramanian Sundaram, Deepa Prasad, Tyler H. Harris, Elizabeth Braunlin, Elisa Fernandez Cooke, Cedric Manlhiot, Pedrom Farid, Brian W. Mccrindle, International Kawasaki Disease Registry

Manuscripts, Articles, Book Chapters and Other Papers

BACKGROUND: While clinical overlap between Kawasaki disease (KD) and multisystem inflammatory syndrome in children (MIS-C) has been evident, information regarding those presenting with shock has been limited. We sought to determine associations with shock within and between diagnosis groups.

METHODS: The International KD Registry enrolled contemporaneous patients with either KD or MIS-C from 39 sites in 7 countries from January 1, 2020, to January 1, 2023. Demographics, clinical features and presentation, management, laboratory values, and outcomes were compared between the diagnosis and shock groups.

RESULTS: Shock at presentation was noted for 19 of 672 KD patients (2.8%) and 653 of …


Association Between Use Of Services To Address Adverse Social Determinants Of Health And Documented Suicide Attempt Among Patients In The Veterans Health Administration, John R. Blosnich, Aerin Derussy, Joshua S. Richman, Melissa E. Dichter, Gala True, Ann Elizabeth Montgomery Apr 2025

Association Between Use Of Services To Address Adverse Social Determinants Of Health And Documented Suicide Attempt Among Patients In The Veterans Health Administration, John R. Blosnich, Aerin Derussy, Joshua S. Richman, Melissa E. Dichter, Gala True, Ann Elizabeth Montgomery

School of Medicine Faculty Publications

Suicide prevention is a top priority for the US Department of Veterans Affairs (VA), and suicide is often associated with adverse social factors (e.g., financial, legal, and housing problems). The VA provides social services integrated with healthcare services, which may increase the opportunities to detect and document suicide attempt in EHR records. Using VA administrative data, we examined three cohorts of all patients from 2014 to 2018 who had housing instability (n = 659,987), justice involvement (n = 200,487), and unemployment (n = 346,556). Administrative records were used to determine ordinal indicators of receipt of VA social services (no services, …


The Epidemiology Of Sports And Recreation Related Toe Fractures In The United States, Dogerno Norceide, Gabriel I. Onor, Oluwatomi Akingbola, William Justice, Nana F. Amponsah, Abimbola Okulaja, Ifeanyichukwu Onor, Michael Okoronkwo, Chibuikem Nwizu, David Pedowitz Apr 2025

The Epidemiology Of Sports And Recreation Related Toe Fractures In The United States, Dogerno Norceide, Gabriel I. Onor, Oluwatomi Akingbola, William Justice, Nana F. Amponsah, Abimbola Okulaja, Ifeanyichukwu Onor, Michael Okoronkwo, Chibuikem Nwizu, David Pedowitz

School of Medicine Faculty Publications

BACKGROUND: Fractures of the toes are among the most frequently diagnosed lower extremity fractures. In sports, toe fractures may present after diverse mechanisms of injury, varying severity, and varying implications for management. This study aimed to discern trends in toe fractures presenting to US emergency departments (EDs) particularly in association with sports and recreational activities. An additional aim of the study was to identify if rates of toe fracture presentation significantly decreased during the year 2020 at the height of the COVID-19 pandemic. METHODS: We queried the National Electronic Injury Surveillance System (NEISS) database to identify toe fractures presented to …


Uterus Didelphys Bicollis Bicolpos —A Case Report, Felix Oindi, Felix Nyagaka Apr 2025

Uterus Didelphys Bicollis Bicolpos —A Case Report, Felix Oindi, Felix Nyagaka

Obstetrics and Gynaecology, East Africa

Uterus didelphys refers to a congenital uterine anomaly that occurs due to failed fusion of the paired Müllerian ducts. It is characterized by two separate noncommunicating uterine horns each with its cervix and fallopian tube. Duplication may be limited to the uterus, cervix or also involve the vagina. Here, we present a case of a 27-year-old primigravida incidentally diagnosed during pregnancy, followed up with cervical cerclage at 13 weeks due to a short cervix and had preterm delivery via cesarean section at 35 weeks. She had a successful pregnancy outcome and an uneventful postnatal course. Uterus didelphys is associated with …


"Health Gatekeepers": The Influence Of Women On Health Practices In Rural, Central Appalachia, Reese Lycan Apr 2025

"Health Gatekeepers": The Influence Of Women On Health Practices In Rural, Central Appalachia, Reese Lycan

Senior Theses

Women have historically assumed leadership roles in familial and community health promotion, intervention, and facilitation. While the role of women in family health is globally understood and the historical importance of female leadership has been documented, there remains a gap in knowledge regarding the role of women as “health gatekeepers”. Furthermore, when considering the Appalachian region, there are limited studies regarding women’s place in leadership as far as health is concerned. Therefore, this study employs a hermeneutic phenomenological framework to explore the lived experiences of women in relation to their family and community’s health in rural, Central Appalachia- a region …


Aht Diagnoses: The Influences Of Clinical Presentation And Evidence Of Impact, Ruairi Smith-Dewey, Angela Bachim, Colleen Bressler, Kristine Campbell, Lori Frasier, Christopher Greeley, Danielle Horton, Nicole Johnson, Jan Leonard, Megan Letson, Caitlin Mcnamara, Ashley K. Sherman, Shalon Nienow, Joanne Wood, James Anderst Apr 2025

Aht Diagnoses: The Influences Of Clinical Presentation And Evidence Of Impact, Ruairi Smith-Dewey, Angela Bachim, Colleen Bressler, Kristine Campbell, Lori Frasier, Christopher Greeley, Danielle Horton, Nicole Johnson, Jan Leonard, Megan Letson, Caitlin Mcnamara, Ashley K. Sherman, Shalon Nienow, Joanne Wood, James Anderst

Posters

In cases where Child Abuse Pediatricians (CAPs) diagnose abusive head trauma (AHT) in young children, some factors surrounding the diagnosis have been challenged including causative shaking, necessity of external signs of impact, or concomitant suspicious injuries. Evaluation of CAP diagnoses in children with subdural hemorrhage (SDH) can give insight into factors related to the frequency of abusive head trauma (AHT) diagnoses. Additionally, characterization of those with SDH+CSI without evidence of impact may inform controversies around AHT diagnoses. Objective We aim to compare CAP diagnoses in subjects with SDH across clinical presentations and in the context of evidence of head impact. …


Decreasing Time To Narcotic Pain Medication In Patients With Sickle Cell Disease Presenting With Acute Pain Crises In A Pediatric Emergency Department: A Quality Improvement Initiative, Allison Adam, Lina Patel, Christopher Kaberline, Ibad Siddiqi, Leslie Hueschen Apr 2025

Decreasing Time To Narcotic Pain Medication In Patients With Sickle Cell Disease Presenting With Acute Pain Crises In A Pediatric Emergency Department: A Quality Improvement Initiative, Allison Adam, Lina Patel, Christopher Kaberline, Ibad Siddiqi, Leslie Hueschen

Posters

No abstract provided.


A Risk Score To Predict Recurrent High Intensity Inpatient Resource Utilization For Children With Medical Complexity., Charles Maloy, Matt Hall, Jessica L. Bettenhausen, Yr Chan, Leah Jones, Kathryn Kyler, Laura Plencner, Jessica Markham, Jacqueline Walker, Smit Shah, Sian Best, Jonathan Ermer, Shelby Chesbro, Maria Newmaster, Hank Puls Apr 2025

A Risk Score To Predict Recurrent High Intensity Inpatient Resource Utilization For Children With Medical Complexity., Charles Maloy, Matt Hall, Jessica L. Bettenhausen, Yr Chan, Leah Jones, Kathryn Kyler, Laura Plencner, Jessica Markham, Jacqueline Walker, Smit Shah, Sian Best, Jonathan Ermer, Shelby Chesbro, Maria Newmaster, Hank Puls

Posters

Background

Children with medical complexity (CMC) use a greater amount of inpatient resources and stand to benefit from unique care models and coordination. However, hospital resources can be limited, and a better understanding of which CMC are high resource users could improve hospital and staff planning.

Objective:

To develop a risk score predictive of recurrent high intensity inpatient utilization among CMC.

Methods:

We conducted a retrospective cohort study of children < 18 years old with ≥3 complex chronic conditions (CCC) discharged from one of 48 children’s hospitals in the Pediatric Health Information System during 2021 and 2022. To reflect CMC typically cared for by a general medical service, children with cardiac procedures, dialysis, oncology, or transplant CCCs, and index hospitalization mortality were excluded. We used multivariable logistic regression to determine factors present on the index hospitalization associated with ≥5 hospitalizations or ≥3 hospitalizations with one lasting ≥25 days within any 365-day period (high inpatient utilization) in 2021-2023. We developed risk scoring system using model coefficients and defined the optimal risk score cutoff to maximize sensitivity and specificity. We then applied the risk score cutoff to children discharged to determine (a) ratio of predicted:actual CMC with recurrent high resource use and (b) the total predicted daily volume on 50th, 75th, and 90th percentile days for each hospital.

Results:

Of 44,432 included children , 9,596 (21.6%) had high inpatient utilization (Table). Children under 1 year of age had the highest odds of high inpatient utilization (OR 2.26 [95% …


Metaplastic Breast Cancer: A Retrospective Chart Review Of Clinical Features, Nidhi Navaratna, Mariam Aoun, Nitya Batra, Mohammad M. Chisti Apr 2025

Metaplastic Breast Cancer: A Retrospective Chart Review Of Clinical Features, Nidhi Navaratna, Mariam Aoun, Nitya Batra, Mohammad M. Chisti

Conference Presentation Abstracts

No abstract provided.


The Effect Of A M-Health Application Compared To Standard Of Care On Adherence To Preoperative Fasting Instructions Among Adult Patients Undergoing Elective Surgery: A Randomized Controlled Study, Ivy Njeri Wanyoike Apr 2025

The Effect Of A M-Health Application Compared To Standard Of Care On Adherence To Preoperative Fasting Instructions Among Adult Patients Undergoing Elective Surgery: A Randomized Controlled Study, Ivy Njeri Wanyoike

Master of Medicine in Anaesthesiology

Background: Preoperative fasting has been a pillar of the practice of anaesthesiology with the main aim of enhancing patient safety by reducing the risk of aspiration. Current clinical guidelines on preoperative fasting guidelines encourage shorter durations of fasting in keeping with current evidence that shows better patient outcomes while maintaining patient safety. Despite this, adherence to preoperative fasting instructions remains universally poor, with patients enduring long fasting periods. Advances in mobile technology, improving internet access and the widespread availability of smartphones have made mobile health a useful tool in patient care. mHealth applications are being increasingly used in perioperative …


Academic Productivity At Orthopaedic Surgery Sports Medicine Fellowship Programs In The United States Has A Weak Positive Correlation With Nonresearch Lifetime Industry Earnings, Benjamin Miltenberg, William Johns, Anthony Baumann, Faheem Pottayil, Bradley Richey, Albert Anastasio, Kempland Walley, Christopher Dodson, Sommer Hammoud Apr 2025

Academic Productivity At Orthopaedic Surgery Sports Medicine Fellowship Programs In The United States Has A Weak Positive Correlation With Nonresearch Lifetime Industry Earnings, Benjamin Miltenberg, William Johns, Anthony Baumann, Faheem Pottayil, Bradley Richey, Albert Anastasio, Kempland Walley, Christopher Dodson, Sommer Hammoud

Rothman Institute Papers

PURPOSE: To characterize the relationship between academic productivity, as defined by the h-index, and industry payments for fellowship-trained sports medicine surgeons in faculty positions at sports medicine fellowships.

METHODS: The American Orthopaedic Society for Sports Medicine fellowship directory was used to create a comprehensive list of all fellowship programs nationwide. Fellowship websites were then reviewed to generate a list of the teaching faculty associated with each program. Total nonresearch lifetime earnings were obtained from the Centers for Medicare & Medicaid Services website. Academic productivity of each fellowship faculty was assessed via the h-index. Frequency counts and other descriptive statistic measures …


2025 Research Day Program, Lincoln Memorial University Apr 2025

2025 Research Day Program, Lincoln Memorial University

Research Day

This program contains poster presentation summaries from LMU's 2025 Annual Research Day conference.


Larotrectinib Compared With Real-World Non-Tropomyosin Receptor Kinase Inhibitor Therapies In Patients With Tropomyosin Receptor Kinase Fusion Cancer, Marcia S. Brose, C. Benedikt Westphalen, Xiaoyun Pan, Vadim Bernard-Gauthier, Milena Kurtinecz, Helen Guo, Virginie Aris, Neil R. Brett, Abdelali Majdi, Vivek Subbiah, Nathan A. Pennell, Kenneth L. Kehl, Alexander Drilon Apr 2025

Larotrectinib Compared With Real-World Non-Tropomyosin Receptor Kinase Inhibitor Therapies In Patients With Tropomyosin Receptor Kinase Fusion Cancer, Marcia S. Brose, C. Benedikt Westphalen, Xiaoyun Pan, Vadim Bernard-Gauthier, Milena Kurtinecz, Helen Guo, Virginie Aris, Neil R. Brett, Abdelali Majdi, Vivek Subbiah, Nathan A. Pennell, Kenneth L. Kehl, Alexander Drilon

Kimmel Cancer Center Faculty Papers

PURPOSE: Neurotrophic tyrosine receptor kinase gene fusions are oncogenic drivers of various solid tumors. Larotrectinib is a highly selective tropomyosin receptor kinase (TRK) inhibitor approved for patients with TRK fusion cancer on the basis of single-arm trials. This study was a matched comparative effectiveness study of larotrectinib in clinical trials versus standard of care (SOC) in the real-world (RW) setting.

METHODS: Adult patients with advanced/metastatic TRK fusion non-small cell lung cancer, colorectal cancer, soft tissue sarcoma, thyroid cancer, or salivary gland carcinoma were included. Deduplicated data from RW patients were from US and ex-US data sources. Patients in the larotrectinib …


Vpac Receptor Positivity In Comparison With Mp-Mri In The Diagnosis Of Prostate Cancer: A Preliminary Study, Nishant Setya, Shridhar Ghagane, Rajendra Nerli, Ashwin Bokare, Mathew Thakur, Leonard Gomella Apr 2025

Vpac Receptor Positivity In Comparison With Mp-Mri In The Diagnosis Of Prostate Cancer: A Preliminary Study, Nishant Setya, Shridhar Ghagane, Rajendra Nerli, Ashwin Bokare, Mathew Thakur, Leonard Gomella

Kimmel Cancer Center Faculty Papers

Objective: The study aimed to prospectively evaluate the feasibility of diagnosing PCa using voided urine samples and by targeting the genomic VPAC (vasoactive intestinal peptide and pituitary adenylate cyclase-activating peptide) receptors in comparison with multiparametric magnetic resonance imaging (mp-MRI) in male patients (≥40 years of age) with lower urinary tract symptoms and having a serum PSA of >4 but < 15 ng/ml.

Patients and methods: Male patients attending urological services ≥40 years old, with lower urinary tract symptoms and serum PSA levels of >4 but < 15 ng/ml formed the study group. Voided urine samples were collected to target VPAC receptors on malignant cells. All patients underwent mp-MRI. A 12-core transrectal ultrasound-guided prostate biopsy was performed in all, and the results were compared for the diagnosis of PCa.

Results: A total of 61 patients with a median age of 65.33 ± 8.11 years and with a …


Experiences And Attitudes Of Caregivers During Mealtimes In Children With Autism Spectrum Disorder At A Tertiary Facility In Kenya., Lynnette Muthoni Mwangi Apr 2025

Experiences And Attitudes Of Caregivers During Mealtimes In Children With Autism Spectrum Disorder At A Tertiary Facility In Kenya., Lynnette Muthoni Mwangi

Master of Medicine in Paediatrics and Child Health

Introduction: - ASD is a neurodevelopmental disorder characterized by deficits in social interactions and communication along with restrictive and repetitive behaviours affecting 1 in 100 children globally, with a higher prevalence in males. Despite the rising global statistics, there is limited information regarding the prevalence of ASD in Sub-Saharan Africa. Children with ASD often experience feeding challenges, which have been broadly categorized as food selectivity, food refusal, and disruptive mealtime behaviour, which poses challenges for caregivers during mealtime. While medical management of ASD receives considerable attention, less focus has been placed on the impact of ASD on caregivers and …


Ibuprofen, Flurbiprofen Or Naproxen Sodium Minimally Influences Musculoskeletal Adaptations To Treadmill Exercise In Rats, Brandon Roberts, Alyssa Geddis, Alexandra Ciuciu, Marinaliz Reynoso, Nikhil Mehta, Alyssa Varanoske, Alyssa Kelley, Maximus Leiss, Alexander Kolb, Julie Hughes, Marshall Naimo, Ryan Tomlinson, Jeffery Staab Apr 2025

Ibuprofen, Flurbiprofen Or Naproxen Sodium Minimally Influences Musculoskeletal Adaptations To Treadmill Exercise In Rats, Brandon Roberts, Alyssa Geddis, Alexandra Ciuciu, Marinaliz Reynoso, Nikhil Mehta, Alyssa Varanoske, Alyssa Kelley, Maximus Leiss, Alexander Kolb, Julie Hughes, Marshall Naimo, Ryan Tomlinson, Jeffery Staab

Department of Orthopaedic Surgery Faculty Papers

BACKGROUND: Non-steroidal anti-inflammatory drugs (NSAIDs) may influence musculoskeletal health. The purpose of this study was to compare the effects of three different NSAIDS: naproxen sodium, ibuprofen, flurbiprofen or a placebo on musculoskeletal adaptations in rodents with or without 6 weeks of aerobic exercise.

METHODS: Nine-week-old male Wistar rats (n = 80) were randomized to either exercise (EX) or no-exercise control (CON) conditions and treated with naproxen, ibuprofen (IBU), flurbiprofen (FLU) or placebo (PLA). For exercise, rats ran 5 days per week for 6 weeks at a 5% incline on a motorized treadmill for 30 min. Three-point bending (3 PB) and …


The Multiple Roles Of 5-Lo In Tissue Regeneration – Insights From Translational Animal Models Utilizing Pharmacological And Genetic Approaches, Roel Navarro, Nidhin John, Claudia Biguetti Apr 2025

The Multiple Roles Of 5-Lo In Tissue Regeneration – Insights From Translational Animal Models Utilizing Pharmacological And Genetic Approaches, Roel Navarro, Nidhin John, Claudia Biguetti

School of Podiatric Medicine - Student Research

Inflammation following tissue injury is a natural physiological response, where its course, duration, and intensity help determine whether it promotes beneficial or detrimental outcomes in tissue healing. Arachidonic acid (AA) serves as a substrate for5-lipoxygenase (5-LO) pathway, which synthesizes metabolites such as leukotrienes that influence both acute and chronic inflammatory response.  AA and its product's inhibitors are currently used to treat hypersensitivity reactions. However, literature suggests potential therapeutic efficacy in tissue healing.


Increased Rates Of Dysphagia, Longer Length Of Stay, Nonroutine Discharge, And Higher Hospital Costs In Patients Over 65 Undergoing Single-Level Cervical Disc Arthroplasty: A Propensity Score-Matched Analysis, Paul G. Mastrokostas, Leonidas E. Mastrokostas, Ahmed K. Emara, Ian J. Wellington, Elizabeth Ginalis, Jonathan Dalton, Amrit S. Khalsa, Jad Bou Monsef, Afshin E. Razi, Mitchell K. Ng Apr 2025

Increased Rates Of Dysphagia, Longer Length Of Stay, Nonroutine Discharge, And Higher Hospital Costs In Patients Over 65 Undergoing Single-Level Cervical Disc Arthroplasty: A Propensity Score-Matched Analysis, Paul G. Mastrokostas, Leonidas E. Mastrokostas, Ahmed K. Emara, Ian J. Wellington, Elizabeth Ginalis, Jonathan Dalton, Amrit S. Khalsa, Jad Bou Monsef, Afshin E. Razi, Mitchell K. Ng

Rothman Institute Papers

CONTEXT: Cervical disc arthroplasty (CDA) is a safe and effective treatment for cervical spine conditions, with increasing utilization. As the population over 65 grows, understanding the suitability of CDA in older patients is critical.

AIMS: This study evaluates differences in postoperative complications, hospital course, and costs between patients aged 18 and 65 and those over 65 undergoing CDA.

SETTINGS AND DESIGN: This was a retrospective cohort study using the National Inpatient Sample, a nationally representative database of U.S. hospital discharges.

SUBJECTS AND METHODS: Patients undergoing single-level CDA from 2016 to 2020 were identified. The cohort was divided into two groups: …


Trying To Ace Her Headache Away, Brittany Weaver, Jason Meredith, Ross Mathiasen Apr 2025

Trying To Ace Her Headache Away, Brittany Weaver, Jason Meredith, Ross Mathiasen

Posters and Presentations: Family Medicine

No abstract provided.


An Unhandy Presentation, Jackson Bagby, Ross Mathiasen, Jason Meredith Apr 2025

An Unhandy Presentation, Jackson Bagby, Ross Mathiasen, Jason Meredith

Posters and Presentations: Family Medicine

No abstract provided.


The Impact Of Hyperglycemia On Post-Reperfusion Outcomes In Patients With Hyperacute Ischemic Stroke, Nicole Schumacher Apr 2025

The Impact Of Hyperglycemia On Post-Reperfusion Outcomes In Patients With Hyperacute Ischemic Stroke, Nicole Schumacher

Theses and Dissertations (ETD)

Stroke is a major contributor to disability in the United States, with ischemic stroke accounting for approximately 87% of all cases. The use of approved reperfusion therapies, including intravenous thrombolysis with tissue plasminogen activator (tPA) and mechanical thrombectomy, has significantly improved functional outcomes for ischemic stroke patients. However, hyperglycemia at the time of hospital arrival is associated with worse outcomes, including increased infarct growth, higher rates of disability, and elevated mortality. Despite this, current stroke guidelines neither exclude hyperglycemic patients from receiving reperfusion therapy nor recommend glucose management during the hyperacute phase of care. While recent studies suggest that mild …


The Lived Experience Of Acute Stroke Advanced Practice Registered Nurses (Aprn) Working In Expanded Roles: A Mixed Methods Study, Terri-Ellen Kiernan Apr 2025

The Lived Experience Of Acute Stroke Advanced Practice Registered Nurses (Aprn) Working In Expanded Roles: A Mixed Methods Study, Terri-Ellen Kiernan

Theses and Dissertations (ETD)

Introduction. Nurse practitioners have made credible gains through the six decades since inception to cover the growing need for outpatient family care. Nurse practitioners are now working in all aspects of medicine by continuing to fill gaps with healthcare needs that persist due to physician shortages. Stroke neurology is a medical specialty plagued by a shortage of physician specialists in hospital acute care which can limit acute stroke diagnosis and treatment capabilities. Stroke nurse practitioners (SNP) are vascular neurology trained specialists who fill relatively new hospital roles to assume traditionally physician-based responsibilities in an expanded role. This study aims to …


Hbv Transmission Knowledge Among Korean-American Chronic Hepatitis B Patients In The United States, Giyoung Lee, Hee-Soon Juon, Eunji Kim, Katherine C Smith, Hie-Won Hann, Mimi Chang, Ann C. Klassen Apr 2025

Hbv Transmission Knowledge Among Korean-American Chronic Hepatitis B Patients In The United States, Giyoung Lee, Hee-Soon Juon, Eunji Kim, Katherine C Smith, Hie-Won Hann, Mimi Chang, Ann C. Klassen

Division of Gastroenterology and Hepatology Faculty Papers

Chronic hepatitis B (CHB) is a condition that disproportionately affects Asian Americans in the United States. Knowledge of transmission is crucial for CHB patients to practice prevention methods to limit the spread of the hepatitis B virus (HBV), but also live their lives free from unwarranted fears or restrictions. Among Asian CHB patients, several misperceptions about HBV transmission have been identified. This analysis aims to assess the current state of HBV knowledge among a cohort of Korean-American CHB patients. This mixed-methods study includes 363 respondents who completed a survey in either Korean (N = 298) or English (N = 65) …


Protective Factors Against Child Maltreatment Among Postpartum Mothers, Maggie Mann, Elizabeth Grady, Matthew Hall, Cristy Toburen, Ann Mattison, Jennifer Anderson, Katie J. Hocker, Francesca Donohue, Heather Williams, Jessica Sprague-Jones, James Anderst, Henry T. Puls Apr 2025

Protective Factors Against Child Maltreatment Among Postpartum Mothers, Maggie Mann, Elizabeth Grady, Matthew Hall, Cristy Toburen, Ann Mattison, Jennifer Anderson, Katie J. Hocker, Francesca Donohue, Heather Williams, Jessica Sprague-Jones, James Anderst, Henry T. Puls

Presentations

No abstract provided.


Aht Diagnoses: The Influences Of Clinical Presentation And Evidence Of Impact, Ruairi Smith-Dewey, Angela Bachim, Colleen Bressler, Kristine A. Campbell, Lori Frasier, Chris Greenley, Danielle Horton, Nicole R. Johnson, Jan Leonard, Megan M. Letson, Dan M. Lindberg, Caitlin R. Mcnamara, Shalon M. Nienow, Ashley K. Sherman, Joanne N. Wood, James Anderst Md, Msci Apr 2025

Aht Diagnoses: The Influences Of Clinical Presentation And Evidence Of Impact, Ruairi Smith-Dewey, Angela Bachim, Colleen Bressler, Kristine A. Campbell, Lori Frasier, Chris Greenley, Danielle Horton, Nicole R. Johnson, Jan Leonard, Megan M. Letson, Dan M. Lindberg, Caitlin R. Mcnamara, Shalon M. Nienow, Ashley K. Sherman, Joanne N. Wood, James Anderst Md, Msci

Presentations

In cases where Child Abuse Pediatricians (CAPs) diagnose abusive head trauma (AHT) in young children, some factors surrounding the diagnosis have been challenged including causative shaking, necessity of external signs of impact, or concomitant suspicious injuries. Evaluation of CAP diagnoses in children with subdural hemorrhage (SDH) can give insight into factors related to the frequency of abusive head trauma (AHT) diagnoses. Additionally, characterization of those with SDH+CSI without evidence of impact may inform controversies around AHT diagnoses. Objective We aim to compare CAP diagnoses in subjects with SDH across clinical presentations and in the context of evidence of head impact. …


Mental Health Diagnoses Amongst Children With Complex Chronic Medical Conditions, Maria Newmaster, Matt Hall, Adrienne Deporre, Molly Krager, Cy Nadler, Laura Plencner, Henry T. Puls Apr 2025

Mental Health Diagnoses Amongst Children With Complex Chronic Medical Conditions, Maria Newmaster, Matt Hall, Adrienne Deporre, Molly Krager, Cy Nadler, Laura Plencner, Henry T. Puls

Presentations

Background: Mental health (MH) diagnoses are known to complicate outcomes of underlying medical conditions in pediatrics, but the prevalence of MH diagnoses across the array of medically complex and/or chronic conditions are not well known. Objective: To compare prevalence of MH diagnoses across levels of medical complexity and chronicity, and identify factors associated with MH diagnoses among children with complex chronic conditions (CCC). Methods: This retrospective cross-sectional study included children ages 5-17 years with at least 11 months of continuous Medicaid enrollment in 2022 from the Merative Marketscan Medicaid Database which collects data from all children with Medicaid in the …


Variation In Blood Culture Testing For Three Common Infections, Smit Shah, Jennifer Goldman, Matt Hall, Jillian Cotter, Samantha A. House, Matthew J. Molloy, Michelle Polich, Michael J. Steiner, John R. Stephens, Michael J. Tchou, Ronald J. Teufel Ii, Irma Ugalde, Andrew Yu, Jessica L. Markham Apr 2025

Variation In Blood Culture Testing For Three Common Infections, Smit Shah, Jennifer Goldman, Matt Hall, Jillian Cotter, Samantha A. House, Matthew J. Molloy, Michelle Polich, Michael J. Steiner, John R. Stephens, Michael J. Tchou, Ronald J. Teufel Ii, Irma Ugalde, Andrew Yu, Jessica L. Markham

Presentations

Background: Routine blood culture (BC) testing in uncomplicated community-acquired pneumonia (CAP), skin and soft tissue infections (SSTI), and urinary tract infections (UTI) has demonstrated low clinical utility. Objectives: To evaluate hospital-level BC testing trends and their association with clinical outcome differences for children hospitalized with CAP, SSTI, and UTI. Methods: This retrospective cohort study used the Pediatric Health Information System database to identify hospitalizations of children aged 3 months-18 years admitted with CAP, SSTI, or UTI from 2016-2023. We excluded patients with complicated infections, medical complexity, ICU admission, or length of stay (LOS) >7 days. Hospital-level BC testing rates were …


Steroid Receptors And Coregulators: Dissemination Of Sex Differences And Emerging Technologies, Sally Pauss, Evelyn A. Bates, Genesee J. Martinez, Zane T. Bates, Zachary A. Kipp, Cassandra D. Gipson, Terry D. Hinds Jr. Apr 2025

Steroid Receptors And Coregulators: Dissemination Of Sex Differences And Emerging Technologies, Sally Pauss, Evelyn A. Bates, Genesee J. Martinez, Zane T. Bates, Zachary A. Kipp, Cassandra D. Gipson, Terry D. Hinds Jr.

Markey Cancer Center Faculty Publications

Steroid receptors are ligand-induced transcription factors that have broad functions among all living animal species, ranging from control of sex differences, body weight, stress responses, and many others. Their binding to coregulator proteins is regulated by corepressors and coactivators that interchange upon stimulation with a ligand. Coregulator proteins are an imperative and understudied aspect of steroid receptor signaling. Here, we discuss steroid receptor basics from protein domain structures that allow them to interact with coregulators and other proteins, their essential functions as transcription factors, and other elemental protein–protein interactions. We deliberate about the mechanisms that coregulators control in steroid receptor …