Medicine and Health Sciences Commons^™

Global-Local Feature Fusion: A Robust Hybrid Deep Learning Model For Multiclass Brain Tumor Classification With Grad-Cam++ Interpretation, Kirti Pant, Pijush Kanti Dutta Pramanik, Shahid Mohammad Ganie, Anindita Saha, Zhongming Zhao

Faculty, Staff and Student Publications

Background: Accurate classification of brain tumors in MRI scans is critical for effective clinical decision making, yet manual assessment is labor-intensive and subject to variability. Although deep learning models, particularly CNNs and Transformers, have shown potential, each architecture alone has limitations: CNNs excel at local feature extraction but lack global context awareness, while Transformers capture global relationships but may overlook fine-grained details.

Objectives: To develop a hybrid Transfer Learning-Transformer model that integrates CNN-driven local feature modeling with Transformer-based global reasoning to enhance multi-class brain tumor classification.

Methods: The proposed workflow comprises three stages: (1) benchmarking standalone CNN (ResNet50, VGG19, ConvNeXtBase, …

Genetic Variants Associated With Sjögren’S Disease Subtypes Stratified By Clinical Feature, Nitesh Enduru, Chihiro Iwaya, Akiko Suzuki, Zhongming Zhao, Junichi Iwata

Faculty, Staff and Student Publications

Introduction: Sjögren's disease (SjD) is a chronic autoimmune disorder characterized by dry mouth (xerostomia) and dry eyes (xerophthalmia) due to inflammation in exocrine glands, particularly the salivary and lacrimal glands. The condition presents a wide variety of clinical features, suggesting that it may involve heterogeneous conditions without a clear boundary. Although genome-wide association studies (GWAS) have identified several genetic variants associated with SjD, their roles in SjD pathogenesis remain unclear.

Methods: In this study, we aimed to identify single-nucleotide polymorphisms (SNPs) associated with SjD by categorizing patients based on four diagnostic markers: anti-Ro/SSA and anti-La/SSB antibodies, IgG levels, and lymphocyte …

Negotiating Health: A Qualitative Analysis Of Home Smoking Rules Among Families With Medically Vulnerable Infants, Yolanda R Villarreal, Thomas F Northrup, Stephen M Fischer, Jackson S Norwood, Angela L Stotts

Faculty, Staff and Student Publications

Introduction: Approximately 5000 child deaths are attributed to secondhand smoke exposure (SHSe) annually, which is three times the number of childhood cancers combined. Infants, medically fragile infants, are highly vulnerable to the harmful effects of SHSe, including respiratory infections and sudden infant death syndrome. While having a home smoking ban may mitigate these risks, implementation remains a challenge for many families. Our primary aim was to explore the familial and sociocultural factors associated with smoking-ban initiation and maintenance in households with medically fragile infants.

Methods: Qualitative interviews were conducted with 20 mothers participating in a behavioral intervention from 2015 to …

Erratum: Assessment Of Skin Fibrosis In A Murine Model Of Systemic Sclerosis With Multifunctional Optical Coherence Tomography (Erratum), Harshdeep Singh Chawla, Yanping Chen, Minghua Wu, Pavel Nikitin, Jessica Gutierrez, Chandra Mohan, Manmohan Singh, Salavat R Aglyamov, Shervin Assassi, Kirill V Larin

Faculty, Staff and Student Publications

This corrects the article "Assessment of skin fibrosis in a murine model of systemic sclerosis with multifunctional optical coherence tomography" in volume 30(3), 036007.

Overcoming Stigma In Women's Hiv And Syphilis Care: The Role Of Faith In Healing, Irene A Stafford, Phillip C Johnson, Robin L Beach

Faculty, Staff and Student Publications

Point-of-care (POC) testing for syphilis and HIV is an effective way to provide same-day testing, results management, counseling, and treatment. Although commonly used in antenatal or sexual health clinics, our field study aimed to offer POC testing to women attending a standard care clinic in Guatemala. Nearly all women accepted testing, highlighting the patient-centered benefits and acceptability of screening in non-stigmatizing settings. Upon disclosure of results, especially positive diagnoses, patients drew comfort and resilience from their faith, an often-underprioritized resource not typically considered when addressing sexual health. These results underscore the value of integrating POC testing into routine care and …

Circulating Biomarkers In Subjects With Progressive Pulmonary Fibrosis: Data From The Inbuild Trial, Toby M Maher, R Gisli Jenkins, Francesco Bonella, Shervin Assassi, Claudia Diefenbach, Carina Ittrich, Klaus B Rohr, Martin Kolb

Faculty, Staff and Student Publications

Background: We investigated the prognostic potential of circulating biomarkers at baseline and the effects of nintedanib on changes in these biomarkers in subjects with progressive pulmonary fibrosis (PPF).

Methods: In the INBUILD trial, subjects with PPF received nintedanib (n=332) or placebo (n=331). Associations between biomarker levels at baseline and the rate of forced vital capacity (FVC) decline (mL·year-1) over 52 weeks, time to interstitial lung disease (ILD) progression (absolute decline in FVC % predicted ≥10%) or death over 52 weeks, time to first acute exacerbation or death over the whole trial, and time to death over the whole trial were …

Isolated Immune-Mediated Enteritis In Patients Treated With Immune Checkpoint Inhibitor Therapy, Sharada Wali, Rohan Srinivas Patel, Maria Julia Moura Nascimento Santos, Anirudha Chatterjee, Sophia Chenyu Fan, Sean Ngo, Tanvi Gupta, Kian Abdul Baki, Lucie Heinzerling, Bryan J Schneider, Kathryn Bollin, Jessica Philpott, Anusha Thomas, Yinghong Wang

Faculty, Staff and Student Publications

Background: Immune checkpoint inhibitors (ICIs) commonly cause colitis, but isolated immune-mediated enteritis (IMEN) is poorly characterized. This study describes the clinical features, diagnostic findings, and outcomes of IMEN.

Method: We retrospectively identified adults with cancer who developed IMEN within one year of ICI initiation, confirmed as duodenitis, ileitis, or both.

Results: Among 20,991 ICI-treated patients, 30 (0.143%) developed isolated IMEN. Median age was 69.5 years; 73.3% were male, and 80% white. The most common malignancies were gastrointestinal/hepatobiliary (26.7%) and melanoma (23.3%). Presenting symptoms included nausea (66.7%), diarrhea (53.3%), and vomiting (46.7%); 62.5% of patients with diarrhea had grade ≥2 severity. …

Conduction Abnormalities After Tavi And Their Role In Patient Management: A Systematic Review, Ionuț Tudorancea, Irene Paula Popa, Mihai Ștefan Cristian Haba, Ștefan Popa, Viviana Onofrei, Dragomir Nicolae Șerban, Ionela Lăcrămioara Șerban, Irina Iuliana Costache-Enache, Radu Iliescu, Cătălin Loghin

Faculty, Staff and Student Publications

Objective: Transcatheter aortic valve implantation (TAVI) is associated with a relatively high incidence of permanent pacemaker implantation (PPM-I). We aimed to evaluate the existing literature on electrocardiographic (ECG) changes before and after TAVI, identify predictors for PPM-I, and suggest a standardized post-TAVI ECG monitoring protocol.

Methods: A systematic literature review was conducted across multiple databases, including PubMed, Web of Science, and JSTOR, to identify studies published between 2001 and 2024.

Results: From an initial pool of 24,170 records, 17 studies met the inclusion criteria. Pre-existing right bundle branch block and significant prolongation of ECG intervals were identified as strong predictors …

Mitochondrial Dysfunction In Alzheimer’S Disease And Related Sex Differences, Afzal Misrani, Conelius Ngwa, Fudong Liu

Faculty, Staff and Student Publications

Alzheimer's disease (AD), the most common form of dementia, accounts for 70% of cases and remains a major healthcare challenge due to its rising prevalence and lack of disease-modifying treatments. Clinically, AD is a sexually dimorphic disease. Women exhibit more rapid cognitive decline and accelerated brain atrophy during mild cognitive impairment and early dementia, whereas men more frequently present cardiovascular comorbidities, earlier mitochondrial dysfunction, and greater neuropsychiatric symptoms. AD is marked by amyloid-β (Aβ) plaques, neurofibrillary tangles, neuroinflammation, and neuronal loss, with mitochondrial dysfunction emerging as a key early contributor that exhibits sex specific phenotypes. Mitochondria are vital for neuronal …

Retrospective Longitudinal Analysis Of Blood Microrna-7-5p As A Possible Progression Biomarker In People With Parkinson’S Disease, Shayan Abdollah Zadegan, Corrine Hutchinson, Chiamaka Onuigbo, Juan D Martinez-Lemus, Laura Talbot, E Jeffrey Metter, Marie-Francoise Doursout, Emily Tharp, Jessika Suescun, Mohammad Shahnawaz, Timothy M Ellmore, Mya Schiess, Christopher Adams

Faculty, Staff and Student Publications

Background: MicroRNA-7-5p (miR-7-5p) may play a neuroprotective role in people with Parkinson's disease (PwP), as it has been found to regulate α-synuclein (α-syn) and the NLRP3 inflammasome in animal models of Parkinson's disease (PD).

Objective: The study aimed to investigate the use of miR-7-5p as a potential biomarker for disease progression in PwP by correlating it with time, clinical measures, and neurofilament light chain (NfL).

Methods: We performed a longitudinal retrospective analysis of blood miR-7-5p levels in 303 de novo PwP and 159 healthy controls (HCs) from the Parkinson's Progression Markers Initiative (PPMI) cohort. In PwP, a linear mixed-effects …

Defining Large Core Infarction: Comparing The Accuracy Of Non-Contrast Ct Aspects Versus Ct Perfusion Core Volume, Ngoc Mai Le, Joseph Samaha, Ananya S Iyyangar, Javier Gomez-Farias, Bruna Kfoury, Ritesh Bajaj, Connor Nguyen, Syed Shams, Camille Neal-Harris, Emmanuel Ebirim, Hussain Azeem, Anjan N Ballekere, Saagar Dhanjani, Eunyoung Lee, Luca Giancardo, Sunil A Sheth

Faculty, Staff and Student Publications

Background and purpose: We evaluated agreement and performance of non-contrast head-computerized tomography (NCHCT) and CT-perfusion (CTP) in identifying large core infarct in acute ischemic stroke (AIS) due to large vessel occlusion (LVO) undergoing endovascular therapy (EVT), using MRI as reference.

Methods: From our prospective multicenter registry, we identified patients with LVO-AIS due to internal carotid artery or middle cerebral artery M1occlusions who underwent EVT between 2017 and 2024. Final infarct volume (FIV) was defined using 24-48 h post-EVT diffusion-weighted imaging magnetic resonance imaging (MRI-FIV). To limit infarct growth bias, only patients with CTP-to-EVT start time < 3 h were included. Large core infarct was defined at FIV thresholds: 50, 70, and 100 mL. The primary outcome was agreement between NCHCT and CTP in identifying large core infarct using kappa-statistics. Large core was considered if NCHCT-ASPECTS< 6 or rCBF< 30% volume>70 mL on CTP (RAPID/Viz.AI). …

The Effects Of Measurement Errors On Minimum Ablative Margins After Thermal Ablation Of Liver Tumors: A Simulation Study, Iwan Paolucci, Jessica Albuquerque, Noreen S Siddiqi, A Kyle Jones, Kristy K Brock, Bruno C Odisio

Faculty, Staff and Student Publications

Purpose: To develop a mathematical framework to estimate the in silico A0 threshold based on the technical specifications of a specific ablation confirmation software package for thermal ablation of liver tumors that can then be used to identify the impact of different sources of error.

Methods: To estimate in silico A0 thresholds, we developed a simulation framework incorporating technical parameters and biological effects. Technical parameters were segmentation error, registration error, and slice thickness, and biological effects were tissue shrinkage and microscopic satellite lesions; these parameters and effects were all modeled using statistical distributions. For each permutation of parameters, a logistic …

Dosimetric Effect Of Abdominal Compression In Online Adaptive Planning For Abdominal Cancers Treated With A 15 Tesla Magnetic Resonance-Guided Linear Accelerator, Moghadaseh Khaleghibizaki, Angela Sobremonte, Luis Perles, Surendra Prajapati, Ergys Subashi, Yao Ding, Kristy Brock, Roya Barati, Eugene Koay, Chad Tang, Jinzhong Yang

Faculty, Staff and Student Publications

Compression belts (CBs) are sometimes used to reduce respiratory motion during stereotactic body radiotherapy of abdominal cancers with magnetic resonance (MR)-guided online adaptive planning. This study evaluated the dosimetric effects of overriding the relative electron density (ED) value of CBs in creating synthetic computed tomography (CT) scans for MR-guided adaptive planning. We evaluated plans for 12 patients with abdominal cancer and identified that ED values between 0.2 and 0.3 achieved the best approximation of CB ED in dose calculation. Our study presented an approach to estimate appropriate ED overrides for CBs in MR-guided online adaptive planning.

Association Between Three-Dimensional Margin Assessment And Local Tumor Control In Percutaneous Lung Cryoablation Of Colorectal Metastases, Frank Mohn, Koustav Pal, Caleb O'Connor, Iwan Paolucci, Austin Castelo, Kamran Ahrar, Steven Yevich, Joshua D Kuban, Bruno C Odisio, Alda Lui Tam, Rahul A Sheth, Kristy K Brock

Faculty, Staff and Student Publications

Purpose

To evaluate the association of two minimum ablation margin (MAM) estimation methods: manual three-dimensional segmentation and biomechanical deformable image registration (DIR) with local tumor progression-free survival (LTPFS) after percutaneous lung cryoablation of colorectal pulmonary metastases.

Materials and Methods

This retrospective single-institution study included patients who underwent percutaneous lung cryoablation between May 2012 and March 2023 (median follow-up, 3.6 years; range, 0.8–9.6 years). Manual three-dimensional MAM was calculated for all tumors, and DIR-based MAM was estimated in a subset with intraprocedural full-thorax imaging. Cox proportional hazards regression assessed associations between MAM and LTPFS. The primary outcome was 2-year LTPFS, with …

Ai-Powered Immune Cell Knowledge Graph (Ickg) With Granular Immune Contexts Enables Immune Program Interpretation, Shan He, Yukun Tan, Qing Ye, Matthew M Gubin, Merve Dede, Hind Rafei, Weiyi Peng, Katayoun Rezvani, Vakul Mohanty, Ken Chen

Faculty, Staff and Student Publications

The widespread application of single-cell and spatial omics to models and patient samples has transformed immune cell profiling across physiological conditions. However, knowledge of immune cell states, functions, and gene regulation remains fragmented across publications, limiting our ability to synthesize insights and derive mechanistic understanding from the literature. To address this gap and facilitate literature integration, we constructed Immune Cell Knowledge Graphs (ICKGs)-four cell type-specific graphs derived from over 24,000 cancer immunotherapy-focused PubMed abstracts using large language models (LLMs) with "human verifiable" validation. Unlike conventional databases, which provide context-agnostic pathways, ICKGs capture directed, literature-supported relationships among genes, pathways and immune …

Outcomes Of Patients With Melanoma Brain Metastases Treated With Ipilimumab And Nivolumab With Or Without Upfront Comprehensive Stereotactic Radiosurgery, Troy J Kleber, Denái R Milton, Subhiksha Srinivasan, Bikash Panthi, Warren Floyd, Eric A Goethe, Michael A Davies, Hussein A Tawbi, Isabella C Glitza Oliva, Diana Kaya, Jing Li, Todd A Swanson, Subha Perni, Martin C Tom, Chenyang Wang, Sujit Prabhu, Jeffrey S Weinberg, Ian E Mccutcheon, Caroline Chung, Sherise D Ferguson, Thomas H Beckham

Faculty, Staff and Student Publications

Background: The efficacy of ipilimumab and nivolumab (ipi/nivo) for melanoma brain metastases (MBMs) has been previously reported, leading to uncertainty regarding the optimal role of comprehensive stereotactic radiosurgery (cSRS). We therefore conducted a single-institution retrospective study to compare outcomes of upfront versus deferred cSRS for MBM treated with ipi/nivo.

Methods: We identified patients who started ipi/nivo for newly diagnosed MBMs between 2018 and 2023, with or without upfront cSRS. Patients with >15 MBMs, leptomeningeal disease, or whole-brain radiotherapy at baseline were excluded. Outcomes were compared using multivariable regression and reported as adjusted hazard ratios (aHRs) with 95% CIs.

Results: Of …

Reply To: Late Nonrelapse Mortality: A Hidden Risk In Triplet Therapy For Idh-Mutated Aml?, Jennifer Marvin-Peek, Courtney D Dinardo

Faculty, Staff and Student Publications

No abstract provided.

Perspective: Radiotherapy And Body Composition: Unmet Needs In Low- And Middle-Income Countries, Alexia J Murphy-Alford, Aaron J Grossberg, Vickie E Baracos, Maha Barbar, Judy Bauer, Jonathan P Bennett, Elena Fidarova, Clifton D Fuller, Anastassia Löser, Amy C Moreno, Anurima Patra, Deepa Puttaswamy, David I Rosenthal, Judy Schoeman, Yavuz Anacak

Faculty, Staff and Student Publications

Radiotherapy plays a vital role in cancer treatment, yet its effects on patients' nutritional status can precipitate muscle loss, with significant implications for treatment tolerance and outcomes. Evidence from high-income countries increasingly links radiation-induced muscle loss to adverse clinical outcomes. In contrast, low- and middle-income countries face a stark evidence gap, despite the heightened vulnerability of cancer patients in these settings due to delayed diagnosis, limited access to care, and high rates of co-morbidities. This paper highlights the critical gaps in nutritional care for radiotherapy patients in low- and middle-income countries.

Metastasis-Directed Radiotherapy For Oligometastatic Urothelial Carcinoma Of The Bladder And Upper Tract, Patrick Carriere, Omar Alhalabi, Jianjun Gao, Amishi Shah, Sangeeta Goswami, Matthew Campbell, Ruitao Lin, Lauren Mayo, Osama Mohamad, Karen Hoffman, Henry Mok, Charmaigne Lozano, Ashish Kamat, Neema Navai, Kelly Bree, Byron Lee, Charles Guo, Michael Rooney, Chad Tang, Seungtaek Choi, Comron Hassanzadeh

Faculty, Staff and Student Publications

Background: Metastasis-directed therapy (MDT) for oligometastatic cancer is utilized for genitourinary malignancies including prostate and kidney cancers. Clinical research on MDT for urothelial carcinoma (UC) remains sparse, especially as systemic therapy advances have improved outcomes.

Objective: We investigated the role of MDT, specifically radiotherapy, for patients with oligometastatic bladder or upper-tract UC.

Methods: Data were collated on patients with metastatic UC with 5 or fewer metastatic sites undergoing MDT with ablative radiotherapy with or without preceding systemic therapy during January 2016 to July 2024. Endpoints were progression-free survival (PFS), and overall survival (OS). Cox proportional hazards analysis was conducted to …

Cesarean Section Rates In Lucas Do Rio Verde, Brazil: Assessing The Impact Of Socioeconomic Status And Maternal And Neonatal Outcomes, Ramya Vemulapalli, Roni Arienti, Linder Wendt, Jay Brooks Jackson, Mary B Rysavy, Kimberly A Kenne

Faculty, Staff and Student Publications

Background

Brazil is globally known for its high rate of cesarean section despite endorsing the WHO’s current recommendation of 15%.

Objectives

Determine if socioeconomic status correlated with the rate of cesarean section (CS) at a mixed private and public hospital in the west-central region of Brazil. Describe the maternal and neonatal outcomes by mode of delivery (MOD) in the same population.

Design

Cohort study

Methods

Data from all delivering patients at São Lucas Hospital were collected during an 18-month period and analyzed. Demographics, baseline maternal health status, pregnancy and delivery information, maternal outcomes, and neonatal outcomes were entered into a …

Congenital Syphilis: From Near-Elimination To Crisis, Chad J Abresch, Irene A Stafford, Regan M Johnson, Kayode Olabanji, Ashleigh M Sutphen, Helen E Cejtin, Ashley Hoover

Faculty, Staff and Student Publications

This analytic essay examines the transformation of congenital syphilis (CS) in the United States from near-elimination to crisis. Drawing from the January 2025 Congenital Syphilis Summit in Atlanta, Georgia-convening public health leaders, Tribal health departments, the National Coalition of STD Directors, and Centers for Disease Control and Prevention experts-we contrast prevention systems during near-elimination (1998-2005) with the current crisis (2018-2025). Evidence revealed how dismantling public health infrastructure produced dramatically different outcomes, with CS cases increasing 937% over the past decade and racial/ethnic disparities worsening. American Indian/Alaska Native communities face rates up to 100 times higher than White populations in some …

Sickle Cell Crisis-Induced Painless Bilateral Orbital Bone Infarction: A Case Report, Luke Farson, Marina Shenouda, Agni Kakouri, Ashkan Kashanchi, Clark Sitton, Timothy Mcculley, Ying Chen

Faculty, Staff and Student Publications

Introduction: Sickle cell disease is associated with painful vaso-occlusive crises, bone infarction, avascular necrosis, and osteomyelitis. Sickle cell orbitopathy is a rare manifestation with signs similar to periorbital cellulitis and has subtle radiologic features.

Case presentation: We report a case of a five-year-old girl with sickle cell who presented with bilateral orbital infarctions and subperiosteal hematomas, notably without periorbital pain, and was treated with antibiotics and steroids.

Conclusion: Physicians should be aware of this rare manifestation, especially in the pediatric population, as it can affect subsequent management.

Glaucoma Risk With Metformin And Sulfonylurea Therapies In Type 2 Diabetes: A Retrospective Cohort Study., Jared Lim, Jingru Zhou, Hulin Wu, Ziqi Liu, David A Lee

Faculty, Staff and Student Publications

Background: Research on metformin, sulfonylureas, and open-angle glaucoma risk in type 2 diabetes mellitus (T2DM) has yielded inconsistent findings. This study examined associations between hypoglycemic treatments and glaucoma diagnosis rates.

Methods: This retrospective cohort study analyzed electronic health records of newly diagnosed T2DM patients from the Merative™ Explorys® Therapeutic Dataset (2010-2022), comparing three groups: metformin monotherapy, sulfonylureas plus metformin combination, and untreated controls. Propensity score matching balanced demographics, glycemic control, body mass index, blood pressure, lipid levels, and comorbidities. Cox proportional hazards models calculated adjusted hazard ratios for incident glaucoma.

Results: After 1:1 propensity score matching, metformin monotherapy (N=100,387) showed …

Fostering Connection And Shame Resilience Through Self-Compassion: An Innovative Elective For Health Professions Learners, Gioconda Mojica, Peggy Hsieh, Andrew J Revell, Rex Marco

Faculty, Staff and Student Publications

Background: Shame is an emotional experience in health professions education, often contributing to burnout, isolation, and threats to professional identity. Self-compassion has been identified as a protective factor against shame. This study describes the development and evaluation of an elective designed to foster shame resilience and cultivate self-compassion among health professions students.

Methods: A 6-h elective, Fostering Connection and Shame Resilience Through Self-Compassion, was offered over 3 monthly 2-h sessions. Each session included a shared meal, abbreviated large-group conceptual learning, reflective writing, guided self-compassion practices, and small-group discussions. Participants completed the Self-Compassion Scale-Short Form (SCS-SF) at the beginning and …

Biomechanical And Computational Modeling Of Metastatic Acetabular Defects: Influence Of Tumor Location On The Risk Of Fracture, Jacob Doddridge, Hongjia He, Rui Yang, E U Conrad, Nicholas Dunbar

Faculty, Staff and Student Publications

Background: Metastatic bone disease can lead to pathologic fracture of the pelvis which affects quality of life. There are limited validated approaches for biomechanical modeling, classification, or surgical treatment of metastatic acetabular defects.

Methods: An artificial hemipelvis bone was used to calibrate a computed tomography-based computational model of the pelvis with varying locations and sizes of acetabular defects. Metastatic defects affecting the anterior and posterior column, medial wall, and their combinations were created. Mechanical testing was performed on each defect, and images of the lateral surface of the acetabulum were analyzed by digital image correlation to measure peak surface strains. …

Open Capsulorrhaphy With Capsular Shift And Open Coracohumeral Ligament Reconstruction For Chronic Recurrent Multidirectional Shoulder Instability, Anna E Sumpter, Christopher S Frey, Matthew T Provencher, Lance E Leclere

Faculty, Staff and Student Publications

Background: This case features the surgical reconstruction of the coracohumeral ligament (CHL) in conjunction with open capsulorrhaphy and capsular shift for the management of chronic, recurrent, multidirectional shoulder instability (MDI). While there is a paucity of existing literature examining the clinical outcomes of this technique, biomechanical studies have implied its potential to restore stability. This procedure may be of particular benefit to patients who have failed previous conservative management and/or attempts at surgical stabilization, as well as those with severe joint hyperlaxity or connective tissue disorders.

Indications: This patient failed extensive physical therapy, as well as previous arthroscopic labral repair …

Are Skip Laminectomy And Oblique Corpectomy Effective Options To Treat Degenerative Cervical Myelopathy While Preserving Motion? Results Of A Scoping Review, Justin L Lomax, Ankit Mehta, Aditya Vedantam, Rory Goodwin, Nathan Evaniew, Mario Ganau, Chris J Neal, Rex A W Marco, Ryan Quisling, Jonathan Palmer, Adam T Archie, Keith L Jackson, John G Devine, Jefferson R Wilson, Uzondu F Agochukwu

Faculty, Staff and Student Publications

Study Design

Scoping Literature Review.

Objective

The aim of this literature review is to examine the results of both skip laminectomy and oblique corpectomy in the setting of degenerative cervical myelopathy (DCM).

Methods

A scoping review of the relevant literature examining the efficacy of cervical skip laminectomy and oblique corpectomy in patients with DCM was conducted using the Medline database. Our review strategy aimed at answering two research questions. #1: Do clinical outcomes differ between patients undergoing cervical laminoplasty vs skip laminectomy in the setting of myelopathy. #2: Which outcomes can oblique corpectomy provide, and how its related complication profile …

Thrombelastography As A Predictive Tool For Thromboembolic Events After Extremity Trauma: A Secondary Analysis Of Prevent-Clot, Cory K Mayfield, Nathan N O'Hara, Prism S Schneider, Renan C Castillo, Robert V O'Toole, Katherine P Frey, William Obremskey, Deborah M Stein, Reza Firoozabadi, Stephen J Warner, Madhav A Karunakar, Joshua L Gary

Faculty, Staff and Student Publications

Background: Venous thromboembolism (VTE) poses significant risk of morbidity and mortality in orthopaedic trauma patients. Thromboelastography (TEG) analysis has been demonstrated to provide value in demonstrating hypercoagulability and predicting the risk of post-injury VTE. The primary aim was to investigate if TEG analysis at the time of admission following severe extremity trauma predicts thromboembolic events. We hypothesized that previously described elevations in maximal amplitude (MA) on initial TEG would correlate with an increased risk of VTE.

Methods: This was a secondary study of PREVENT CLOT, a multicenter, randomized trial that enrolled adult patients with an extremity fracture (from hip to …

Personalized Management Of Chronic Rhinosinusitis In The Context Of Immune Deficiency, Christopher M Bell, Amber U Luong, Chadi A Makary

Faculty, Staff and Student Publications

Primary and secondary immunodeficiency as a cause of recalcitrant or difficult to treat chronic rhinosinusitis (CRS) and recurrent acute rhinosinusitis (RARS) are under-appreciated etiologies. Patients with persistent symptoms, frequent exacerbations despite appropriate medical therapy, or other sinopulmonary conditions known to be related to an immunodeficient state warrant further testing for immunodeficiency, as up to 20% of this cohort of patients may have underlying immunodeficiency. Testing for immunodeficiency includes CBC with differential, immunoglobulin levels, and pneumococcal vaccine titres before and after administration. Regarding secondary immunodeficiency, these patients may present with atypical symptoms, harbor atypical bacteria, or even present with severe complications …

Rituximab For The Treatment Of Immune Checkpoint Inhibitor-Induced Glomerulonephritis, Yazen Alasadi, Juan Cintron Garcia, Naszrin Arani, Valda Page, Yimin Geng, Clark R Andersen, Amanda Tchakarov, Abhijat Kitchlu, Omar Mamlouk, Ala Abudayyeh

Faculty, Staff and Student Publications

Background: Among patients receiving immune checkpoint inhibitor (ICI) therapy, the most common renal immune-related adverse event is interstitial nephritis, which is caused by severe T-cell infiltration and is typically responsive to steroids; although rarer, autoimmune induction in the kidney has also been reported. There is a paucity of data regarding ICI-induced autoimmune disease in the kidney and the challenges associated with continuing ICI therapy. Here, we present a single center case series of ICI-induced glomerulonephritis with data on treatment rechallenge.

Methods: We retrospectively reviewed 241 patients who underwent kidney biopsies at our institution between 2015 and 2024 and identified those …