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Full-Text Articles in Medicine and Health Sciences

Dyke-Davidoff-Masson Syndrome: A Rare Cause Of Drug Refractory Epilepsy In An Adult, Paresh Zanzmera, Vaidehi Chauhan, Tvisha Patel, Jaineel Patel, Ankit Dumaswala, Kinjal Shah Mar 2025

Dyke-Davidoff-Masson Syndrome: A Rare Cause Of Drug Refractory Epilepsy In An Adult, Paresh Zanzmera, Vaidehi Chauhan, Tvisha Patel, Jaineel Patel, Ankit Dumaswala, Kinjal Shah

Tower Health Research Day

No abstract provided.


Effectiveness Of Intrapartum Azithromycin To Prevent Infections In Planned Vaginal Births In Low-Income And Middle-Income Countries: A Post-Hoc Analysis Of Data From A Multicentre, Randomised, Double-Blind Placebo-Controlled Trial, Waldemar A. Carlo, Alan T.N. Tita, Janet L. Moore, Musaku Mwenechanya, Elwyn Chomba, Jennifer J. Hemingway-Foday, Avinash Kavi, Mrityunjay C. Metgud, Shivaprasad S. Goudar, Richard J. Derman, Adrien Lokangaka, Antoinette Tshefu, Melissa Bauserman, Jackie K. Patterson, Poonam Shivkumar, Manju Waikar, Archana Patel, Patricia L. Hibberd, Paul Nyongesa, Fabian Esamai, Osayame Austine Ekhaguere, Sherri Bucher, Saleem Jessani, Shiyam Sunder Tikmani, Sarah Saleem, Robert L. Goldenberg, Sk Masum Billah, Ruth Lennox, Rashidul Haque, William Petri, Manolo Mazariegos, Nancy F. Krebs, Denise C. Babineau, Elizabeth M. Mcclure, Marion Koso-Thomas, A-Plus Trial Group Mar 2025

Effectiveness Of Intrapartum Azithromycin To Prevent Infections In Planned Vaginal Births In Low-Income And Middle-Income Countries: A Post-Hoc Analysis Of Data From A Multicentre, Randomised, Double-Blind Placebo-Controlled Trial, Waldemar A. Carlo, Alan T.N. Tita, Janet L. Moore, Musaku Mwenechanya, Elwyn Chomba, Jennifer J. Hemingway-Foday, Avinash Kavi, Mrityunjay C. Metgud, Shivaprasad S. Goudar, Richard J. Derman, Adrien Lokangaka, Antoinette Tshefu, Melissa Bauserman, Jackie K. Patterson, Poonam Shivkumar, Manju Waikar, Archana Patel, Patricia L. Hibberd, Paul Nyongesa, Fabian Esamai, Osayame Austine Ekhaguere, Sherri Bucher, Saleem Jessani, Shiyam Sunder Tikmani, Sarah Saleem, Robert L. Goldenberg, Sk Masum Billah, Ruth Lennox, Rashidul Haque, William Petri, Manolo Mazariegos, Nancy F. Krebs, Denise C. Babineau, Elizabeth M. Mcclure, Marion Koso-Thomas, A-Plus Trial Group

Global Health Articles

Background

In 2023, the Azithromycin Prevention in Labor Use (A-PLUS) trial showed intrapartum azithromycin reduces maternal sepsis or death in women with planned vaginal delivery in low-resource settings, but whether it reduces maternal infection is unknown. We aimed to evaluate the effectiveness of intrapartum azithromycin in reducing maternal infection.

Methods

We performed a post-hoc analysis of the multicentre, facility-based, randomised, double-blind, placebo-controlled A-PLUS trial. This trial compared prophylactic intrapartum single oral dose of 2 g azithromycin versus placebo on maternal morbidity and mortality in low-resource settings in southeast Asia and Africa from Sept 9, 2020, to Aug 18, 2022. The …


Cost-Effectiveness Of Intrapartum Azithromycin To Prevent Maternal Infection, Sepsis, Or Death In Low-Income And Middle-Income Countries: A Modelling Analysis Of Data From A Randomised, Multicentre, Placebo-Controlled Trial, Jackie K. Patterson, Simon Neuwahl, Sydney Kirsch, Janet L. Moore, Alan T.N. Tita, Waldemar A. Carlo, Adrien Lokangaka, Antoinette Tshefu, Musaku Mwenechanya, Elwyn Chomba, Avinash Kavi, Mrityunjay C. Metgud, Shivaprasad S. Goudar, Richard J. Derman, Poonam Shivkumar, Manju Waikar, Archana Patel, Patricia L. Hibberd, Paul Nyongesa, Fabian Esamai, Osa A. Ekhaguere, Sherri Bucher, Saleem Jessani, Shiyam S. Tikmani, Sarah Saleem, Blair J. Wylie, Robert L. Goldenberg, Sk Masum Billah, Ruth Lennox, Rashidul Haque, William A. Petri, Manolo Mazariegos, Nancy F. Krebs, Jennifer J. Hemingway-Foday, Denise Babineau, Marion Koso-Thomas, Elizabeth M. Mcclure, Melissa Bauserman Mar 2025

Cost-Effectiveness Of Intrapartum Azithromycin To Prevent Maternal Infection, Sepsis, Or Death In Low-Income And Middle-Income Countries: A Modelling Analysis Of Data From A Randomised, Multicentre, Placebo-Controlled Trial, Jackie K. Patterson, Simon Neuwahl, Sydney Kirsch, Janet L. Moore, Alan T.N. Tita, Waldemar A. Carlo, Adrien Lokangaka, Antoinette Tshefu, Musaku Mwenechanya, Elwyn Chomba, Avinash Kavi, Mrityunjay C. Metgud, Shivaprasad S. Goudar, Richard J. Derman, Poonam Shivkumar, Manju Waikar, Archana Patel, Patricia L. Hibberd, Paul Nyongesa, Fabian Esamai, Osa A. Ekhaguere, Sherri Bucher, Saleem Jessani, Shiyam S. Tikmani, Sarah Saleem, Blair J. Wylie, Robert L. Goldenberg, Sk Masum Billah, Ruth Lennox, Rashidul Haque, William A. Petri, Manolo Mazariegos, Nancy F. Krebs, Jennifer J. Hemingway-Foday, Denise Babineau, Marion Koso-Thomas, Elizabeth M. Mcclure, Melissa Bauserman

Global Health Articles

BACKGROUND: Sepsis is one of the leading causes of maternal mortality globally. In 2023, the Azithromycin Prevention in Labor Use (A-PLUS) trial showed intrapartum azithromycin for women planning a vaginal birth reduced the risk of maternal sepsis or death and infection. We aimed to evaluate the cost-effectiveness of intrapartum azithromycin for pregnant people planning a vaginal birth in low-income and middle-income countries (LMICs) using A-PLUS trial data.

METHODS: We compared the benefits and costs of intrapartum azithromycin versus standard care across 100 000 model simulations using data from the A-PLUS trial and a probabilistic decision tree model that included 24 …


Bh3 Mimetics Augment Cytotoxic T Cell Killing Of Acute Myeloid Leukemia Via Mitochondrial Apoptotic Mechanism, Kapil Saxena, Shao-Hsi Hung, Esther Ryu, Shailbala Singh, Qi Zhang Tatarata, Zhihong Zeng, Zhe Wang, Marina Y Konopleva, Cassian Yee Mar 2025

Bh3 Mimetics Augment Cytotoxic T Cell Killing Of Acute Myeloid Leukemia Via Mitochondrial Apoptotic Mechanism, Kapil Saxena, Shao-Hsi Hung, Esther Ryu, Shailbala Singh, Qi Zhang Tatarata, Zhihong Zeng, Zhe Wang, Marina Y Konopleva, Cassian Yee

Faculty, Staff and Student Publications

Adoptive cell therapy (ACT) can address an unmet clinical need for patients with relapsed/refractory acute myeloid leukemia (AML), but its effect is often modest in the setting of high tumor burden. In this study, we postulated that strategies to lower the AML apoptotic threshold will augment T cell killing of AML cells. BH3 mimetics, such as venetoclax, are a clinically approved class of compounds that predispose cells to intrinsic apoptosis by inhibiting anti-apoptotic mitochondrial proteins. We explored the anti-leukemic efficacy of BH3 mimetics combined with WT1-specific CD8+ T cells on AML cell lines and primary samples from patients with a …


Outcomes In Patients With Classic Hodgkin Lymphoma Refractory Or Intolerant To Brentuximab Vedotin And Anti-Pd-1 Therapy: A Real World Analysis From 15 U.S. Academic Centers, Timothy J. Voorhees, Eric M. Mclaughlin, Pallawi Torka, Jorge Florindez, Na Hyun Kim, Tamara K. Moyo, Heather Reves, Nuttavut Sumransub, Saarang Deshpande, Ashley Rose, Cassandra Duarte, Muhammad Salman Faisal, Showkat Hamid, Suki Subbiah, Sabarish Ayyappan, Lauren Shea, Matt Cortese, Krish Patel, Ajay Major, Hayder Saeed, Jakub Svoboda, Sanjal Desai, Praveen Ramakrishnan Geethakumari, Mehdi Hamadani, Natalie Grover, Narendranath Epperla Mar 2025

Outcomes In Patients With Classic Hodgkin Lymphoma Refractory Or Intolerant To Brentuximab Vedotin And Anti-Pd-1 Therapy: A Real World Analysis From 15 U.S. Academic Centers, Timothy J. Voorhees, Eric M. Mclaughlin, Pallawi Torka, Jorge Florindez, Na Hyun Kim, Tamara K. Moyo, Heather Reves, Nuttavut Sumransub, Saarang Deshpande, Ashley Rose, Cassandra Duarte, Muhammad Salman Faisal, Showkat Hamid, Suki Subbiah, Sabarish Ayyappan, Lauren Shea, Matt Cortese, Krish Patel, Ajay Major, Hayder Saeed, Jakub Svoboda, Sanjal Desai, Praveen Ramakrishnan Geethakumari, Mehdi Hamadani, Natalie Grover, Narendranath Epperla

School of Medicine Faculty Publications

Anti-PD-1 based therapies and brentuximab vedotin (BV) have significantly improved survival in patients with classic Hodgkin lymphoma (cHL) and have been incorporated into earlier lines of therapy. However, there is insufficient data regarding the clinical outcomes in patients who develop refractory disease or who become intolerant of BV and anti-PD-1 therapies (double refractory/intolerant; DR/INT). Here, we evaluated outcomes in patients with DR/INT cHL from 15 US academic medical centers. A total of 173 patients were identified as DR/INT. The median overall survival from the time of cHL diagnosis (OS-1) was 14.8 years (95% CI: 10.9–20.9 years) and the 10-year OS-1 …


Differences In Covid-19 Deaths Amongst Cancer Patients And Possible Mediators For This Relationship, Leah Vaidya, Nubaira Rizvi, Xiao Cheng Wu, Lauren S. Maniscalco, Yong Yi, Augusto Ochoa, Qingzhao Yu Mar 2025

Differences In Covid-19 Deaths Amongst Cancer Patients And Possible Mediators For This Relationship, Leah Vaidya, Nubaira Rizvi, Xiao Cheng Wu, Lauren S. Maniscalco, Yong Yi, Augusto Ochoa, Qingzhao Yu

School of Public Health Faculty Publications

Previous research demonstrated Non-Hispanic Black populations experience higher COVID-19 mortality rates than Non-Hispanic White individuals. Additionally, cancer status is a known risk factor for COVID-19 death. While prior studies investigated comorbidities as exploratory variables in differences in COVID-19 hospitalization, none have explored their role in COVID-19-related deaths. This study aimed to evaluate whether Charlson Comorbidity Index (CCI) and subsequently, individual diseases are potential explanatory variables for this relationship. The analysis focused on Non-Hispanic Black and Non-Hispanic White cancer patients aged 20 or older, diagnosed between 2011 and 2019, who tested positive for COVID-19 from the start of pandemic through June …


Β-Catenin Drives The Foxc2-Mediated Epithelial-Mesenchymal Transition And Acquisition Of Stem Cell Properties, Maria Castaneda, Petra Den Hollander, Steve Werden, Esmeralda Ramirez-Peña, Suhas V Vasaikar, Nick A Kuburich, Claire Gould, Rama Soundararajan, Sendurai A Mani Mar 2025

Β-Catenin Drives The Foxc2-Mediated Epithelial-Mesenchymal Transition And Acquisition Of Stem Cell Properties, Maria Castaneda, Petra Den Hollander, Steve Werden, Esmeralda Ramirez-Peña, Suhas V Vasaikar, Nick A Kuburich, Claire Gould, Rama Soundararajan, Sendurai A Mani

Faculty, Staff and Student Publications

Background: Aggressive forms of breast cancer, such as triple-negative breast cancer (TNBC), are associated with an increase in cancer cells that exhibit stem cell properties. The activation of the epithelial-mesenchymal transition (EMT) program, mediated by the transcription factor FOXC2, generates these stem-like cells. FOXC2 is linked to poor prognoses across various cancer types and is notably upregulated in TNBC, where it establishes and sustains these stem-like cells within the tumor population.

Methods: Here, we decode the pathways regulating FOXC2 activation using EMT-enriched cell line models. Stemness was assessed using mammosphere assays and mesenchymal markers by western blot. Expression …


Combined Targeting Of Glioblastoma Stem Cells Of Different Cellular States Disrupts Malignant Progression, Chenfei Lu, Tao Kang, Junxia Zhang, Kailin Yang, Yang Liu, Kefan Song, Qiankun Lin, Deobrat Dixit, Ryan C Gimple, Qian Zhang, Zhumei Shi, Xiao Fan, Qiulian Wu, Daqi Li, Danyang Shan, Jiancheng Gao, Danling Gu, Hao You, Yangqing Li, Junlei Yang, Linjie Zhao, Zhixin Qiu, Hui Yang, Ningwei Zhao, Wei Gao, Weiwei Tao, Yingmei Lu, Yun Chen, Jing Ji, Zhe Zhu, Chunsheng Kang, Jianghong Man, Sameer Agnihotri, Qianghu Wang, Fan Lin, Xu Qian, Stephen C Mack, Zhibin Hu, Chaojun Li, Michael D Taylor, Ning Liu, Nu Zhang, Ming Lu, Yongping You, Jeremy N Rich, Wei Zhang, Xiuxing Wang Mar 2025

Combined Targeting Of Glioblastoma Stem Cells Of Different Cellular States Disrupts Malignant Progression, Chenfei Lu, Tao Kang, Junxia Zhang, Kailin Yang, Yang Liu, Kefan Song, Qiankun Lin, Deobrat Dixit, Ryan C Gimple, Qian Zhang, Zhumei Shi, Xiao Fan, Qiulian Wu, Daqi Li, Danyang Shan, Jiancheng Gao, Danling Gu, Hao You, Yangqing Li, Junlei Yang, Linjie Zhao, Zhixin Qiu, Hui Yang, Ningwei Zhao, Wei Gao, Weiwei Tao, Yingmei Lu, Yun Chen, Jing Ji, Zhe Zhu, Chunsheng Kang, Jianghong Man, Sameer Agnihotri, Qianghu Wang, Fan Lin, Xu Qian, Stephen C Mack, Zhibin Hu, Chaojun Li, Michael D Taylor, Ning Liu, Nu Zhang, Ming Lu, Yongping You, Jeremy N Rich, Wei Zhang, Xiuxing Wang

Faculty, Staff and Students Publications

Glioblastoma (GBM) is the most lethal primary brain tumor with intra-tumoral hierarchy of glioblastoma stem cells (GSCs). The heterogeneity of GSCs within GBM inevitably leads to treatment resistance and tumor recurrence. Molecular mechanisms of different cellular state GSCs remain unclear. Here, we find that classical (CL) and mesenchymal (MES) GSCs are enriched in reactive immune region and high CL-MES signature informs poor prognosis in GBM. Through integrated analyses of GSCs RNA sequencing and single-cell RNA sequencing datasets, we identify specific GSCs targets, including MEOX2 for the CL GSCs and SRGN for the MES GSCs. MEOX2-NOTCH and SRGN-NFκB axes play important …


Evaluating The Role Of Traditional And Nontraditional Educational Resources In Point-Of-Care Ultrasound Training: A Cross-Sectional Survey Of Educator Preferences And Practices, Arthur Broadstock, Annahieta Kalantari, Almaz S. Dessie, Al'ai Alvarez, Resa E. Lewiss, Josie Acuna, Anthony Weekes, Kaylah Maloney, Uwe Stolz, Lori Stolz, Aalap Shah Mar 2025

Evaluating The Role Of Traditional And Nontraditional Educational Resources In Point-Of-Care Ultrasound Training: A Cross-Sectional Survey Of Educator Preferences And Practices, Arthur Broadstock, Annahieta Kalantari, Almaz S. Dessie, Al'ai Alvarez, Resa E. Lewiss, Josie Acuna, Anthony Weekes, Kaylah Maloney, Uwe Stolz, Lori Stolz, Aalap Shah

Department of Emergency Medicine Faculty Papers

BACKGROUND: Recently, nontraditional educational resources like podcasts, blogs, and online media have gained prominence in medical education and are abundant within the field of point-of-care ultrasound (POCUS). However, the extent to which POCUS educators utilize online resources compared to traditional resources, like textbooks, journal articles, and in-person workshops, is unknown. We aim to define which types of educational resources are used and preferred by POCUS educators to teach trainees.

METHODS: An expert working group developed a survey aimed to characterize the types of materials used by POCUS educators and their perceived importance on a 6-point forced ranking scale. We administered …


Distinct Patterns Of Pv And Sst Gabaergic Neuronal Activity In The Basal Forebrain During Olfactory-Guided Behavior In Mice, Elizabeth H Moss, Evelyne K Tantry, Elaine Le, Pey-Shyuan Chin, Priscilla Ambrosi, Katie L Brandel-Ankrapp, Benjamin R Arenkiel Mar 2025

Distinct Patterns Of Pv And Sst Gabaergic Neuronal Activity In The Basal Forebrain During Olfactory-Guided Behavior In Mice, Elizabeth H Moss, Evelyne K Tantry, Elaine Le, Pey-Shyuan Chin, Priscilla Ambrosi, Katie L Brandel-Ankrapp, Benjamin R Arenkiel

Duncan NRI Faculty and Staff Publications

Sensory perception relies on the flexible detection and interpretation of stimuli across variable contexts, conditions, and behavioral states. The basal forebrain (BF) is a hub for behavioral state regulation, supplying dense cholinergic and GABAergic projections to various brain regions involved in sensory processing. Of GABAergic neurons in the BF, parvalbumin (PV) and somatostatin (SST) subtypes serve opposing roles toward regulating behavioral states. To elucidate the role of BF circuits in sensory-guided behavior, we investigated GABAergic signaling dynamics during odor-guided decision-making in male and female mice. We used fiber photometry to record cell type-specific BF activity during an odor discrimination task …


Connecting Disciplines: Dermatologists Discuss Skin Cancer Screening In Physical Therapy, Michael T. Robinson, Lindsay Gietzen Mar 2025

Connecting Disciplines: Dermatologists Discuss Skin Cancer Screening In Physical Therapy, Michael T. Robinson, Lindsay Gietzen

Pacific Journal of Health

Background: This study aims to explore dermatologists’ perspectives on the integration of skin cancer screening within physical therapy practice. The hypothesis is that insights from dermatologists can enhance the efficacy and accuracy of skin cancer screening by physical therapists (PTs), thereby improving early detection rates and patient outcomes. Methods: A total of five dermatologists participated in this study, each with between 5 and 18 years of experience and a diverse range of expert opinions and insights. This qualitative study utilized semi-structured interviews with participating dermatologists. The interview questions focused on their knowledge of skin cancer screening, perceptions of its implementation …


Health Literacy: Impact And Interventions, Elizabeth Simpson Mar 2025

Health Literacy: Impact And Interventions, Elizabeth Simpson

Lynchburg Journal of Medical Science

The objectives of this paper are to examine the connection between health literacy level and patient outcome, identify contributing factors of low health literacy, and identify ways in which providers and health literacy programs can promote health literacy on an individual and community level. I conducted a literature search using PubMed and Google Scholar in order to lend evidence to these objectives.

The results demonstrated a clear correlation between low health literacy levels and poor patient outcomes. Low health literacy is also correlated with reduced medication adherence, improper use of medication, more emergency department visits, and unhealthy habits during pregnancy …


Polycystic Ovarian Syndrome: A Clinical Review, Amanda Nettles Mar 2025

Polycystic Ovarian Syndrome: A Clinical Review, Amanda Nettles

Lynchburg Journal of Medical Science

Polycystic ovarian syndrome (PCOS) is a pervasive condition that affects women all over the world. It presents with a wide variety of symptoms like menstrual irregularity, hyperandrogenism, and polycystic ovarian morphology. Although generally considered to be solely a reproductive disorder, PCOS impacts metabolic, psychological, and cardiovascular health, and increases the risk for those diagnosed for other complications. Although PCOS is relatively common, it remains greatly misunderstood, which makes diagnosing the condition even more complex. Risk factors taken into consideration include genetics, environment, and lifestyle. The pathophysiology of PCOS focuses on dysfunction of the hypothalamic-pituitary-ovarian axis, insulin resistance, and inflammation. There …


Evolution Of Btk Inhibitors, Dena Mathew Mar 2025

Evolution Of Btk Inhibitors, Dena Mathew

Lynchburg Journal of Medical Science

The purpose of this clinical review evaluates the evolution of bruton’s tyrosine kinase (BTK) inhibitors in becoming the standard of care in treating chronic lymphocytic leukemia (CLL). The first-generation BTK inhibitor ibrutinib has demonstrated superior efficacy over traditional chemotherapy in several randomized clinical trials in terms of progression free survival (PFS). However, due to cardiovascular toxicities of atrial fibrillation (afib), hypertension (HTN), and bleeding, have led to drug discontinuation. Second-generation BTK inhibitors, acalabrutinib and zanubrutinib have demonstrated reduced rates in cardiovascular toxicities due to improved BTK receptor selectivity, as seen in three head-to-head ibrutinib clinical trials. The emergence of BTK …


Management Of Electrolyte Abnormalities In The Emergency Department, Todd W. Jones Mar 2025

Management Of Electrolyte Abnormalities In The Emergency Department, Todd W. Jones

Lynchburg Journal of Medical Science

The objective of this article review is to discuss standard treatment options and review emerging therapies for the more common electrolyte abnormalities. The number of emergency departments (ED) in the United States has declined over the past 15 years, which has created overcrowding. This makes it more difficult to prioritize patients based on severity. The importance of this topic is to assist providers in taking quick action on patients presenting with critical electrolyte levels in busy EDs. A literature search using PubMed from 2019 to 2024 identified numerous articles that supported the purpose. This review will discuss the various electrolyte …


Common Misconceptions In Hormone Therapy (Ht) Treatment In Menopause, Miranda Zuhlke Mar 2025

Common Misconceptions In Hormone Therapy (Ht) Treatment In Menopause, Miranda Zuhlke

Lynchburg Journal of Medical Science

ABSTRACT
The purpose of this review is to address the misconceptions surrounding Hormone Therapy (HT) in menopause largely surrounding the findings from Women’s Health Initiative (WHI). The review explores the history of HT, the risks and benefits, along with current guidelines for HT and non-hormonal options. A comprehensive search was conducted using electronic databases focusing on the effect of HT on breast cancer, cardiovascular health, bone health, and quality of life. Studies that analyzed the implications from the WHI were included as well as the North American Menopause Society (NAMS) current recommendations and guidelines for treatment options in menopause. Findings …


Stop The Bleed! Acute Epistaxis Management, Christopher R. Cannell Mar 2025

Stop The Bleed! Acute Epistaxis Management, Christopher R. Cannell

Lynchburg Journal of Medical Science

Epistaxis, the most common Otolaryngology-related emergency, is responsible for one in 200 emergency department (ED) visits in the United States (US) and one-third of otolaryngology visits.1,11 Up to 60% of the population will experience epistaxis during their lifetime, and 6% -10 % will require medical intervention.2,3 Epistaxis occurs in children and adults and has a seasonal variation. Although 85% of nosebleeds are idiopathic, they are more frequent in those on supplemental oxygen, anticoagulation, antiplatelet therapy, and in those with other conditions that may predispose them to bleeding. Most clinicians will encounter patients with acute epistaxis; therefore, it is …


A Clinical Overview Of Endometriosis, Adriane Strawn Mar 2025

A Clinical Overview Of Endometriosis, Adriane Strawn

Lynchburg Journal of Medical Science

Endometriosis, the finding of endometrial tissue in areas of the body other than the interior of the uterus, affects about 10% of menstruating women worldwide and is a common reason for dysmenorrhea and infertility. The underlying pathophysiology is not fully known but thought to be mostly due to retrograde menstruation through the oviducts into the abdominopelvic cavity. Other major pathogenic theories include vascular and lymphatic spread and coelomic metaplasia. Patient symptoms may include dysmenorrhea, dyschezia, dyspareunia, pelvic pain, infertility, and fatigue, but patients can also be asymptomatic. Endometriosis is difficult to diagnose, and although it is possible to visualize certain …


Testosterone Replacement Therapy In The Middle-Aged Male, Gina N. Demilt Mar 2025

Testosterone Replacement Therapy In The Middle-Aged Male, Gina N. Demilt

Lynchburg Journal of Medical Science

The purpose of this review was to investigate the use of testosterone supplementation in the middle-aged male with a focus on the pathophysiology of testosterone throughout the lifespan, current supplementation options and their adverse effects, and the overall benefit of supplementing to enhance quality of life. A comprehensive search of electronic databases was conducted identifying studies that assessed clinical outcomes, pathophysiology, supplementation options, adverse effects and benefits of treatments. The findings suggested that testosterone levels naturally decline with age with most men developing symptoms of hypogonadism around age 60. Testosterone supplementation outside of current guidelines is not recommended, however men …


Optimizing Interventions For Major Depressive Disorder And Provider Burnout: Self-Speak Exercise Dosing (Sed), Laureen Maloney-Gepfert Mar 2025

Optimizing Interventions For Major Depressive Disorder And Provider Burnout: Self-Speak Exercise Dosing (Sed), Laureen Maloney-Gepfert

Lynchburg Journal of Medical Science

ABSTRACT

Major Depressive Disorder (MDD) is ranked highest among mental illnesses in the United States (US) and significantly contributes to the mental health care crisis. Patients experience resistance to pharmacologic interventions, side effects, co-morbidities, and mental health provider shortages. Subsequently, 33 % of Serious Mental Illnesses (SMIs) are being redirected to Primary Care Providers (PCPs). Concurrently, prescriber mental health is in crisis. Growing workloads for physicians and Advanced Practice Providers (APPs) have increased provider burnout syndrome (BOS). Major Depressive Disorder and BOS are positively affected by exercise, Cognitive Restructuring (CR), and Behavioral Activation (BA). Sports medicine and psychology research shows …


Image Quality Analysis Of Head Cts Obtained On A New Portable Scanner Compared To Stationary Ct, Mara M. Kunst, Juan E. Small, Sebastian E. Flacke, Joseph D. Burns, Maximilian Smith, Christoph D. Wald Mar 2025

Image Quality Analysis Of Head Cts Obtained On A New Portable Scanner Compared To Stationary Ct, Mara M. Kunst, Juan E. Small, Sebastian E. Flacke, Joseph D. Burns, Maximilian Smith, Christoph D. Wald

The Lahey Journal

Background/Purpose: The use of mobile head CT scanning in the ICU setting has both clinical and economic advantages, particularly if able to provide image quality close or equal to fixed CT scanners.

The purpose of the study is to evaluate the image quality of a new portable CT scanner, compared to a fixed CT platform.

Materials/Methods: Inpatients (n=11), age> 60 requiring head CT evaluation were enrolled and consented to obtain an additional head CT on the portable CT, following their fixed exam.

Nine patients were able to complete the study; seven patients received duplicate exams with matched imaging technique, and …


Comparing Testosterone Suppression In Intramuscular And Subcutaneous Leuprolide Acetate Formulations, Annalise Mcdonald, Kali Sullivan, Cara Cloghessy, Benjamin Sweigart, Brendan J. Connell Mar 2025

Comparing Testosterone Suppression In Intramuscular And Subcutaneous Leuprolide Acetate Formulations, Annalise Mcdonald, Kali Sullivan, Cara Cloghessy, Benjamin Sweigart, Brendan J. Connell

The Lahey Journal

Introduction

Androgen deprivation therapy (ADT) is commonly used to treat prostate cancer. Leuprolide acetate (LA) is a common ADT, manufactured as an intramuscular injection, Lupron® (LA-IM), and a subcutaneous injection, Eligard® (LA-SC) with the goal of testosterone < 50 ng/dL. We investigated for differences in testosterone suppression between the two formulations in patients with prostate cancer.

Methods

Clinical data was abstracted from our medical records system for patients with prostate cancer who started leuprolide acetate between January 2016 through March 2022 with a subsequent testosterone value checked. Primary endpoint was the proportion of subjects with testosterone levels < 50mg/dL, with secondary endpoints including the proportion of subject achieving testosterone levels < 20ng/dL and median testosterone levels.

Results

525 subjects were included. The LA-IM and LA-SC groups were balanced for age and race but the doses of leuprolide differed …


Cross-Sectional Analysis Of International Rotations Among Ophthalmology Residency Programs, Malcolm M Kates, Riley Ct Duke, Krupa H. Patel, Russell W Read Mar 2025

Cross-Sectional Analysis Of International Rotations Among Ophthalmology Residency Programs, Malcolm M Kates, Riley Ct Duke, Krupa H. Patel, Russell W Read

Journal of Academic Ophthalmology

Background: Applicants to ophthalmology residency programs have increasingly expressed interest in international surgical rotations. As such, ophthalmology residency program directors (PDs) have expanded international offerings to meet this desire but the true number of residency programs with international offerings is unknown. Methods: In February 2023, the official residency websites of all 125 accredited US-based ophthalmology residency programs were analyzed for any mention of international rotations. Websites were identified using a Google™ search by entering the program name and “ophthalmology residency.” All websites were surveyed for information regarding international rotations including the presence/absence of an international rotation and any additional information …


A Life Course Approach To Understanding Preserved Cognition In Late Life, Cassidy E. Doyle Mar 2025

A Life Course Approach To Understanding Preserved Cognition In Late Life, Cassidy E. Doyle

USF Tampa Graduate Theses and Dissertations

Some level of cognitive decline is generally expected with advanced age. However, a subgroup of individuals – commonly labeled as ‘SuperAgers’ – maintain youthful memory abilities into their 80s and beyond. Relatively little is known about factors across the life course related to this phenotype. This dissertation used population-based data from the Health and Retirement Study (HRS) to investigate lifestyle factors related to the most youthful cognitive trajectory in the United States and assess how their cognition fares over time. Three research questions were addressed: (1) Can samples of youthful cognitive agers be identified longitudinally in a population-based dataset? (2) …


Pediatric Relapsed/Refractory Alk-Positive Anaplastic Large Cell Lymphoma Treatment And Outcomes In The Targeted-Drug Era., Lianna J. Marks, Victor Ritter, Jennifer E. Agrusa, Kala Y. Kamdar, Julie Rivers, Rebecca Gardner, Matthew J. Ehrhardt, Kaitlin J. Devine, Charles A. Phillips, Anne Reilly, Keith August, Joanna Weinstein, Prakash Satwani, Christopher J. Forlenza, Christine Moore Smith, Chelsee Greer, Zeinab Afify, Carol H. Lin, Jennifer A. Belsky, Hilda Ding, David Hoogstra, Keri Toner, Michael P. Link, Liora M. Schultz, Eric J. Lowe, Catherine Aftandilian Mar 2025

Pediatric Relapsed/Refractory Alk-Positive Anaplastic Large Cell Lymphoma Treatment And Outcomes In The Targeted-Drug Era., Lianna J. Marks, Victor Ritter, Jennifer E. Agrusa, Kala Y. Kamdar, Julie Rivers, Rebecca Gardner, Matthew J. Ehrhardt, Kaitlin J. Devine, Charles A. Phillips, Anne Reilly, Keith August, Joanna Weinstein, Prakash Satwani, Christopher J. Forlenza, Christine Moore Smith, Chelsee Greer, Zeinab Afify, Carol H. Lin, Jennifer A. Belsky, Hilda Ding, David Hoogstra, Keri Toner, Michael P. Link, Liora M. Schultz, Eric J. Lowe, Catherine Aftandilian

Manuscripts, Articles, Book Chapters and Other Papers

Treatment options for patients with relapsed or refractory (R/R) anaplastic large cell lymphoma (ALCL) have increased in the era of targeted therapies such as brentuximab vedotin (BV) and anaplastic lymphoma kinase (ALK) inhibitors. However, there is no standard treatment and published data evaluating their use are limited. The goal of this retrospective study was to describe current real-world treatment and outcomes of pediatric, adolescent, and young adult patients with R/R ALK-positive ALCL. We conducted a retrospective, multi-institutional study identifying 81 patients with R/R ALK-positive ALCL aged ≤21 years at initial diagnosis treated between 2011 and 2022 across 18 institutions. Median …


Aerosolized Transmissible Diseases Guidance Document, J. David Miller, John P. (Jack) Springston Jr., Cheryl L. Marcham, J. David Krause, Ling-Ling Hung, Wane A. Baker Mar 2025

Aerosolized Transmissible Diseases Guidance Document, J. David Miller, John P. (Jack) Springston Jr., Cheryl L. Marcham, J. David Krause, Ling-Ling Hung, Wane A. Baker

Publications

Prior to COVID-19, pandemic influenza viruses have emerged four times in the previous one hundred years. This includes “Spanish” influenza (H1N1) in 1918, “Asian” influenza (H2N2) in 1957, “Hong Kong” influenza (H3N2) in 1968, and H1N1 “swine” influenza in 2009 (Saunders-Hastings & Krewski, 2016; Taubenberger, 2005). In early May 2024, the first reported human case of avian flu (H5N1) that had also infected cows in the US appeared in the literature (Uyeki et al., 2024). In late August 2024, OSHA released a hazard alert providing information for dairy workers on avian influenza in dairy cattle, together with personal protective equipment …


The Incidence Between Carpal Tunnel Syndrome (Cts) And De Quervain’S Tenosynovitis (Dqt) Using Electrophysiological And Ultrasonography Study., Shaimaa M. Abd El Aziz, Lamis Safwat Mar 2025

The Incidence Between Carpal Tunnel Syndrome (Cts) And De Quervain’S Tenosynovitis (Dqt) Using Electrophysiological And Ultrasonography Study., Shaimaa M. Abd El Aziz, Lamis Safwat

Journal of Medicine in Scientific Research

One of the most common entrapment neuropathies affecting the upper limbs is carpal tunnel syndrome (CTS). de Quervain tenosynovitis (DQT) is a condition that affects the wrist's first dorsal compartment and is characterized by tendon entrapment and thickening of sheaths around the abductor pollicis longus and extensor pollicis brevis. The association of idiopathic CTS and idiopathic DQT has been studied in a few researches. In this study, we would like to summarize the most recent knowledge about the occurrence of CTS and DQT on the same hand using electrophysiological and ultrasonography studies.


Does Coronary Artery Bypass Grafting Surgery Affect The Right Ventricular Function Postoperatively?, Ahmed A Faragalla, Ahmed M Elshiemy, Sherif A Elhindawy, Ahmed A Abdelhamid Mar 2025

Does Coronary Artery Bypass Grafting Surgery Affect The Right Ventricular Function Postoperatively?, Ahmed A Faragalla, Ahmed M Elshiemy, Sherif A Elhindawy, Ahmed A Abdelhamid

Journal of Medicine in Scientific Research

Background A well-established benefit of coronary artery surgery (CABG) is to improve the left ventricular (LV) performance meanwhile, its impact on the right ventricular (RV) chamber is obscure and an issue of continuous investigations. Aim This study explores the influence of CABG on the RV performance. Methods This study employed a prospective longitudinal, observational design to evaluate function in 30 patients undergoing isolated CABG. Echocardiography with a transthoracic approach was accomplished preoperatively, one week and one-month post-surgery. The myocardial performance index (Tei index), tricuspid annular plane systolic excursion (TAPSE), and peak systolic (Sm) and early diastolic (Em) myocardial velocities at …


Chemoid-Guided Therapy Improves Objective Response Rate In Recurrent Platinum-Resistant Ovarian Cancer Randomized Clinical Trial, Thomas J. Herzog, Thomas C. Krivak, Stephen Bush Ii, John P. Diaz, Scott Lentz, Navya Nair, Nadim Bou Zgheib, Camille Gunderson-Jackson, Abhijit Barve, Krista L. Denning, Seth T. Lirette, Candace M. Howard, Jagan Valluri, Pier Paolo Claudio Mar 2025

Chemoid-Guided Therapy Improves Objective Response Rate In Recurrent Platinum-Resistant Ovarian Cancer Randomized Clinical Trial, Thomas J. Herzog, Thomas C. Krivak, Stephen Bush Ii, John P. Diaz, Scott Lentz, Navya Nair, Nadim Bou Zgheib, Camille Gunderson-Jackson, Abhijit Barve, Krista L. Denning, Seth T. Lirette, Candace M. Howard, Jagan Valluri, Pier Paolo Claudio

School of Medicine Faculty Publications

Patients with recurrent platinum-resistant ovarian cancer (PROC) have poor clinical outcomes, owing mainly to the presence of therapy-resistant cancer stem cells (CSCs). The NCT03949283 randomized clinical trial enrolled patients with recurrent PROC to receive ChemoID-guided chemotherapy or the best physician-choice regimen selected from the same list of thirteen mono or combination chemotherapies. The primary outcome was objective response rate (ORR) assessed on CT scans using the RECIST 1.1 criteria at 6 months follow-up. Subjects treated with the ChemoID assay had an ORR of 55% (CI(95) 39% - 73%), compared to 5% (CI(95) 0% - 11%) for those treated with physician’s …


Clinical Use Of Measurable Residual Disease In Adult All: Recommendations From A Panel Of Us Experts, Nicholas J Short, Ibrahim Aldoss, Daniel J Deangelo, Marina Konopleva, Jessica Leonard, Aaron C Logan, Jae Park, Bijal Shah, Wendy Stock, Elias Jabbour Mar 2025

Clinical Use Of Measurable Residual Disease In Adult All: Recommendations From A Panel Of Us Experts, Nicholas J Short, Ibrahim Aldoss, Daniel J Deangelo, Marina Konopleva, Jessica Leonard, Aaron C Logan, Jae Park, Bijal Shah, Wendy Stock, Elias Jabbour

Faculty, Staff and Student Publications

Measurable residual disease (MRD) is a powerful predictor of clinical outcomes in acute lymphoblastic leukemia (ALL). In addition to its clear prognostic importance, MRD information is increasingly used in clinical decision algorithms to guide therapeutic interventions. Although it is well established that achievement of MRD-negative remission is an important end point of ALL therapy, the prognostic and therapeutic implications of MRD in an individual patient are influenced by both disease-related factors (eg, cytomolecular risk) and assay-related factors (eg, sensitivity, specimen source, and timing of assessment), which add complexity to MRD-guided treatment decisions. In this review, we discuss the data supporting …