Medicine and Health Sciences Commons^™

Lessons Learned As Thomas Jefferson University's Rural Physician Shortage Area Program (Psap) Approaches The Half-Century Mark, Howard K. Rabinowitz, Robert J. Motley, Fred W. Markham Jr., Gillian A. Love

Department of Family & Community Medicine Faculty Papers

To help increase the supply and retention of rural family physicians, Thomas Jefferson University initiated the Physician Shortage Area Program (PSAP) in 1974. The program selectively admits medical school applicants who both grew up in a rural area and plan to practice in a rural area. During medical school, PSAP students have ongoing mentoring and rural clinical experiences.

As the program now approaches the half-century mark, this commentary summarizes several important lessons learned. First, outcomes research is critical, and program leaders have been able to publish 15 papers and a book about the PSAP and its outcomes. Second, these studies …

Open Repair Of Complete Proximal Hamstring Avulsions In Workers' Compensation Patients, Emma E Johnson, Joseph M Brutico, Lasya Rangavajjula, Yuwei Xia, Ryan W Paul, Peters Otlans, Justin W Arner, Sommer Hammoud, James P Bradley, Steven B Cohen

Rothman Institute Papers

Background: Several studies have reported excellent results after surgical repair of proximal hamstring avulsions. However, the effect on these patients of receiving workers' compensation has not yet been explored.

Hypothesis: Workers' compensation patients undergoing proximal hamstring repair of complete tears will have similar outcomes when compared with a matched control group of non-workers' compensation patients.

Study Design: Cohort study; Level of evidence, 3.

Methods: Workers' compensation patients who underwent complete proximal hamstring avulsion open repair between 2010 and 2019 were identified (WC group). A control group was matched by age (±3 years), sex, and body mass index (BMI; ±3). Demographics …

A Word From The Writing Team (September 2022), Pam Walter, Mfa, Liz Declan, Ma, Mfa

A Word From the Writing Team (Newsletter)

This issue includes:

• Upcoming Workshops
• Writing Opportunity

Genitourinary And Sexual Symptoms And Treatments In Transfeminine Individuals: A Qualitative Exploration Of Patients' Needs, Paul Chung, Vishal Swaminathan, Sabina Spigner, Joon Yau Leong, Jessica Bulafka, Rosemary Frasso

Department of Urology Faculty Papers

Introduction: Medical providers may not be familiar with the genitourinary and sexual symptoms of transgender and non-binary (TGNB) individuals. This lack of familiarity may hinder a provider's ability to address these issues as patients may hesitate to report symptoms due to fear of stigma, misgendering, and being treated disrespectfully.

Aim: To describe the array of genitourinary and sexual symptoms in transfeminine individuals.

Methods: Upon institutional review board approval, researchers used semi-structured interviews with 25 transfeminine individuals assigned male at birth to explore urinary and sexual symptoms on a sample of convenience. Participants were recruited and interviews were conducted until saturation …

Association Between Acute Kidney Injury And Long-Term Mortality In Patients With Aneurysmal Subarachnoid Hemorrhage: A Retrospective Study, Yangchun Xiao, Jun Wan, Yu Zhang, Xing Wang, Hanwen Zhou, Han Lai, Weelic Chong, Yang Hai, L Dade Lunsford, Chao You, Shui Yu, Fang Fang

Department of Medical Oncology Faculty Papers

Background: Though acute kidney injury (AKI) in the context of aneurysmal subarachnoid hemorrhage (aSAH) worsens short-term outcomes, its impact on long-term survival is unknown.

Aim: We aimed to evaluate the association between long-term mortality and AKI during hospitalization for aSAH.

Methods: This was a retrospective study of patients who survived >12 months after aSAH. All patients were evaluated at West China Hospital, Sichuan University, between December 2013 and June 2019. The minimum follow-up time was over 1 year. the maximum follow-up time was about 7.3 years. AKI was defined by the KDIGO (The Kidney Disease Improving Global Outcomes) guidelines, which …

Highlights From The 67th Annual Meeting Of The American Society For Artificial Internal Organs In Chicago, Il, Christopher D. Pritting, Alice L. Sweedo, Vakhtang Tchantchaleishvili, Dongfang Wang, Joseph B. Zwischenberger

Department of Surgery Faculty Papers

Dr. Willem J. Kolff founded the American Society for Artificial Internal Organs (ASAIO) in 1955. Each year experts in the fields of renal, pulmonary, pancreatic, cardiac, bioengineering, and orthopedic research congregate to discuss the latest developments in their respective fields. Throughout the conference's history, ASAIO has adapted to promote inquiry, ingenuity, and innovation. The congeniality partnered with the expertise of the conference's attendees has facilitated continuous progress since the conference's inception.

The 2022 ASAIO Annual Conference was held in Chicago, IL in an entirely in-person format, the first since the 65th conference in 2019. This year there were exhibits by …

Robotic Versus Conventional Sternotomy Mitral Valve Surgery: A Systematic Review And Meta-Analysis, Michael L. Williams, Bridget Hwang, Linna Huang, Ashley Wilson-Smith, John Brookes, Aditya Eranki, Tristan D. Yan, T. Sloane Guy, Johannes Bonatti

Department of Surgery Faculty Papers

Background: Robotic-assisted mitral valve surgery (RMVS) is becoming an increasingly performed procedure in cardiac surgery, however, its true safety and efficacy compared to the gold standard conventional sternotomy approach [conventional sternotomy mitral valve surgery (CSMVS)] remains debated. The aim of this meta-analysis was to provide a comprehensive analysis of all available literature comparing RMVS to CSMVS.

Methods: An electronic search of five databases was performed to identify all relevant studies comparing RMVS to CSMVS. Pre-defined primary outcomes of interest included all-cause mortality, cerebrovascular accidents (CVA) and re-operation for bleeding. Secondary outcomes of interest included cross clamp time, cardiopulmonary bypass (CPB) …

Future Opportunities For Research In Rescue Treatments, James W. Wheless, Daniel Friedman, Gregory L. Krauss, Vikram R. Rao, Michael R Sperling, Enrique Carrazana, Adrian L. Rabinowicz

Department of Neurology Faculty Papers

Clinical studies of rescue medications for seizure clusters are limited and are designed to satisfy regulatory requirements, which may not fully consider the needs of the diverse patient population that experiences seizure clusters or utilize rescue medication. The purpose of this narrative review is to examine the factors that contribute to, or may influence the quality of, seizure cluster research with a goal of improving clinical practice. We address five areas of unmet needs and provide advice for how they could enhance future trials of seizure cluster treatments. The topics addressed in this article are: (1) unaddressed end points to …

Is Strongyloides Stercoralis Hyperinfection Induced By Gglucocorticoids A Result Of Both Suppressed Host Immunity And Altered Parasite Genetics?, De'broski R Herbert, Jonathan D C Stoltzfus, Heather L Rossi, David Abraham

Department of Microbiology and Immunology Faculty Papers

The gastrointestinal (GI) nematode Strongyloides stercoralis (S.s.) causes human strongyloidiasis, a potentially life-threatening disease that currently affects over 600 million people globally. The uniquely pernicious aspect of S.s. infection, as compared to all other GI nematodes, is its autoinfective larval stage (L3a) that maintains a low-grade chronic infection, allowing undetectable persistence for decades. Infected individuals who are administered glucocorticoid therapy can develop a rapid and often lethal hyperinfection syndrome within days. Hyperinfection patients often present with dramatic increases in first- and second-stage larvae and L3a in their GI tract, with L3a widely disseminating throughout host organs leading to sepsis. How …

Tnf-Α And Nf-Κb Signaling Play A Critical Role In Cigarette Smoke-Induced Epithelial-Mesenchymal Transition Of Retinal Pigment Epithelial Cells In Proliferative Vitreoretinopathy, Victor Wang, Alison Heffer, Elisa Roztocil, Steven E Feldon, Richard T Libby, Collynn F Woeller, Ajay E Kuriyan

Wills Eye Hospital Papers

Proliferative vitreoretinopathy (PVR) is characterized by the growth and contraction of cellular membranes within the vitreous cavity and on both surfaces of the retina, resulting in recurrent retinal detachments and poor visual outcomes. Proinflammatory cytokines like tumor necrosis factor alpha (TNFα) have been associated with PVR and the epithelial-mesenchymal transition (EMT) of retinal pigment epithelial (RPE) cells. Cigarette smoke is the only known modifiable risk factor for PVR, but the mechanisms are unclear. The purpose of this study was to examine the impact of cigarette smoke on the proinflammatory TNFα/NF-κB/Snail pathway in RPE cells to better understand the mechanisms through …

Cyberknife Robotic-Assisted Stereotactic Radiosurgery For Advanced Stages Of Ciliochoroidal Uveal Melanoma. Preliminary Results In Mexico, Gustavo Ortiz-Morales, Irving Dominguez-Varela, Daniela E. Gomez-Elizondo, Erik Perez-Ramos, Sara González-Godínez, Dione Aguilar Y Méndez, Christian Estrada-Hernández, Ramiro Corral, Octavio Zamorano-Gómez, Carol L. Shields, Lauren A. Dalvin, Efren Gonzalez-Monroy, David Ancona-Lezama

Wills Eye Hospital Papers

Objective: The objective of this study was to report the early results of CyberKnife^® (CK^®) stereotactic radiosurgery in advanced stages of ciliochoroidal (CBCh) melanoma in Mexican patients.

Methods: A retrospective review of charts was performed to analyze the outcomes of patients who underwent CK^® (Accuray Inc, Sunnyvale, CA, United States).

Results: Four patients with CBCh melanoma were treated under this protocol. The mean age was 53.2 ± 5.3 years (range, 47-60). Median of follow-up was 9.5 ± 3.1 months (range, 5-12). Mean tumor diameter was 13.49 mm, mean thickness, 11.74 mm, and mean gross tumor volume …

Long-Term Effectiveness Of Ivig Maintenance Therapy In 36 Patients With Gad Antibody-Positive Stiff-Person Syndrome., Jessica Yi, Marinos Dalakas

Department of Neurology Faculty Papers

BACKGROUND AND OBJECTIVES: IVIg has been the preferred immunotherapy in stiff-person syndrome (SPS) based on a 3-month controlled trial, but whether it is also effective in inducing long-term benefits or arresting disease progression is unknown. The information is needed because SPS is a progressively disabling disease and IVIg is liberally used as chronic therapy without efficacy data. The present study explores the long-term effects of IVIg in the largest cohort of well-characterized patients with SPS followed by the same clinicians over 10 years.

METHODS: Data of 36 patients (32 glutamic acid decarboxylase [GAD] positive), diagnosed and treated with monthly maintenance …

Patient-Specific Genome-Scale Metabolic Models For Individualized Predictions Of Liver Disease, Alexandra Manchel, Jan B. Hoek, Ramon Bataller, Radhakrishnan Mahadevan, Rajanikanth Vadigepalli

Department of Pathology, Anatomy, and Cell Biology Faculty Papers

The prevalence of liver disease is steadily increasing, coupled with the limited availability of therapeutic treatments. Recent literature points to metabolic reprogramming as a key feature of liver failure. Hence, we sought to uncover the metabolic pathways and mechanisms associated with liver disease and acute liver failure. We generated patient-specific genome scale metabolic models by integrating RNA-seq data from patient liver samples with a generalized human metabolic model. Flux balance analysis simulations showed a distinct separation of non-alcohol associated and alcohol-associated disease states. Our analysis suggests that the alcohol associated liver has an increased flux through nucleotide and glycerophospholipid metabolic …

The Impact Of Intraoperative Image-Guidance Modalities And Neurophysiologic Monitoring In The Safety Of Sacroiliac Fusions., Thiago Montenegro, Christian Hoelscher, Md, Kevin Hines, Md, Sara Thalheimer, Caio Matias, Bryan Wilent, James Harrop, Joshua E. Heller

Department of Neurosurgery Faculty Papers

STUDY DESIGN: Retrospective observational cohort.

OBJECTIVE: A review of efficiency and safety of fluoroscopy and stereotactic navigation system for minimally invasive (MIS) Sacroiliac (SI) fusion through a lateral technique.

METHODS: Retrospective analysis of an observational cohort of 96 patients greater than 18 years old, that underwent MIS SI fusion guided by fluoroscopy or navigation between January 2013 and April 2020 with a minimum of 3 months follow-up. Intraoperative neuromonitoring (IONM) with a variable combination of electromyography (EMG), somatosensory evoked potentials (SSEPs) and motor evoked potentials (MEPs) was also utilized.

RESULTS: The overall complication rate in the study was 9.4%, and …

Bronchial Artery Revascularization In Lung Transplantation: A Systematic Review And Meta-Analysis., Danial Ahmad, Thomas J O'Malley, Andrew M Jordan, Elizabeth J Maynes, Abhiraj Saxena, Kyle W Prochno, Taufiek K Rajab, Howard T Massey, Richard C Daly, Vakhtang Tchantchaleishvili

Department of Surgery Faculty Papers

Background: Bronchial artery revascularization (BAR) during lung transplantation has been hypothesized to improve early tracheal healing and delay the onset of bronchiolitis obliterans syndrome (BOS). We aimed to assess the outcomes of BAR after lung transplantation.

Methods: Electronic search in Ovid Medline, Cumulative Index of Nursing and Allied Health Literature (CINAHL), Scopus, and Cochrane Controlled Trials Register (CCTR) databases was performed to identify all relevant studies published about lung transplantation with BAR. Studies discussing lung transplantation utilizing BAR were included while those without outcome data such as BOS and survival were excluded. Cohort-level data were extracted and pooled for analysis. …

Unreliable Automated Complete Blood Count Results: Causes, Recognition, And Resolution, Gene Gulati, Guldeep Uppal, Jerald Z. Gong

Department of Pathology, Anatomy, and Cell Biology Faculty Papers

Automated hematology analyzers generate accurate complete blood counts (CBC) results on nearly all specimens. However, every laboratory encounters, at times, some specimens that yield no or inaccurate result(s) for one or more CBC parameters even when the analyzer is functioning properly and the manufacturer's instructions are followed to the letter. Inaccurate results, which may adversely affect patient care, are clinically unreliable and require the attention of laboratory professionals. Laboratory professionals must recognize unreliable results, determine the possible cause(s), and be acquainted with the ways to obtain reliable results on such specimens. We present a concise overview of the known causes …

Coronavirus Disease-19 Infection And Angioedema In African Americans: A Case Series, Jose Manuel Martinez Manzano, Otoniel Ysea-Hill, Brenda Chiang, Simone A Jarrett, Kevin Bryan Lo, Zurab Azmaiparashvili

Department of Medicine Faculty Papers

Rationale: Few case series have described the simultaneous development of angioedema in patients with coronavirus 19 disease (COVID-19). Most of these reports were described in at-risk patients for developing bradykinin angioedema. Therefore, we aim to describe 5 African American patients who developed simultaneous COVID-19 and angioedema.

Methods: This was a case series of hospitalized patients with simultaneous angioedema and COVID-19 infection in a single center from May 2020 to February 2022. We used descriptive statistics. The study was approved by the institutional review board.

Results: Their median age was 55 years (range 28-66); all patients were African American, and 3/5 …

Accrual-Monitoring Practices For Various Disease Trials Among Aaci Member Cancer Centers, Zachary T Elliott, Zachary N. Goldberg, Ramez Philips, Jennifer Johnson, Margaret Kasner, William Kevin Kelly, Sarah Osipowicz, Rachael Dampman, Joseph Curry

Department of Otolaryngology - Head and Neck Surgery Faculty Papers

Progress in the management of rare diseases, including rare cancers, is dependent upon clinical trials; however, as many as 32% of rare-disease trials go uncompleted or unpublished due to insufficient accrual. Monitoring practices may differ between institutions. We sought to survey the regulatory standards for various trial types among major U.S. cancer centers. A 10-question survey was designed using Qualtrics assessment software. The survey was sent via email to an internal server of member institutions of the Association of American Cancer Institutes (AACI). Of 103 AACI centers, 31% completed the survey (n = 32). Respondents differed in their definitions …

Editorial: Promising Strategies For Vaccine Messages: The Message And The Source, Bridget J. Kelly, Amy E. Leader, Nora B. Henrikson

Department of Medical Oncology Faculty Papers

No abstract provided.

A Scoping Review Protocol To Elucidate Outcomes Following Abiraterone Versus Enzalutamide For Prostate Cancer, Yash B Shah, Amy L Shaver, William Kevin Kelly, Grace Lu-Yao

Department of Medical Oncology Faculty Papers

INTRODUCTION: Abiraterone acetate and enzalutamide are commonly employed in prostate cancer therapy in an interchangeable manner. These drugs are highly efficacious in androgen antagonism to improve patient outcomes, but they also carry noteworthy risk of adverse effects. Common toxicities vary amongst the two drugs and may have differential interactions with patient co-morbidities, but these patterns are unclear as co-morbidities typically serve as exclusion criteria in clinical trials. Hence, there is no existing guidance on how clinicians may tailor treatment based on patient-specific factors. Analysis of differential patient outcomes between these two drugs can inform future systematic reviews, new clinical studies, …

Comorbidity Of Novel Crhr2 Gene Variants In Type 2 Diabetes And Depression, Mutaz Amin, Jurg Ott, Derek Gordon, Rongling Wu, Teodor T Postolache, Michael Vergare, Claudia Gragnoli

Department of Psychiatry and Human Behavior Faculty Papers

The corticotropin-releasing hormone receptor 2 (CRHR2) gene encodes CRHR2, contributing to the hypothalamic-pituitary-adrenal stress response and to hyperglycemia and insulin resistance. CRHR2-/- mice are hypersensitive to stress, and the CRHR2 locus has been linked to type 2 diabetes and depression. While CRHR2 variants confer risk for mood disorders, MDD, and type 2 diabetes, they have not been investigated in familial T2D and MDD. In 212 Italian families with type 2 diabetes and depression, we tested 17 CRHR2 single nucleotide polymorphisms (SNPs), using two-point parametric-linkage and linkage-disequilibrium (i.e., association) analysis (models: dominant-complete-penetrance-D1, dominant-incomplete-penetrance-D2, recessive-complete-penetrance-R1, recessive-incomplete-penetrance-R2). We detected novel linkage/linkage-disequilibrium/association …

Characteristics, Emotional Experience, And Impact Of Unplanned Out-Of-Hospital Births In The City Of Beit Shemesh, Israel, Allison Rosenbaum, Dm, Cnm, Mss

Midwifery Thinks! Symposium

Allison Rosenbaum, CNM, MSS, DM has been living and practicing midwifery in Israel since 2002. She obtained a master’s degree in social work from the Bryn Mawr Graduate School of Social Work and Social Research in 1994, then went on to study nursing and midwifery at MGH School of Health Professionals and Philadelphia University’s Institute of Midwifery and Women’s Health (now Thomas Jefferson University), earning her Master of Science in 2018 and her Doctorate in Midwifery in 2022. Currently, she works at Assuta Medical Center in Ashdod, Israel, and is the director of their waterbirth program. She is also involved …

Disease Burden In Patients With Acute Hepatic Porphyria: Experience From The Phase 3 Envision Study, Bruce Wang, Paolo Ventura, Kei-Ichiro Takase, Manish Thapar, David Cassiman, Ilja Kubisch, Shangbin Liu, Marianne T Sweetser, Manisha Balwani

Division of Gastroenterology and Hepatology Faculty Papers

BACKGROUND: Acute hepatic porphyria (AHP) is a family of four rare genetic diseases, each involving deficiency in a hepatic heme biosynthetic enzyme. Resultant overproduction of the neurotoxic intermediates δ-aminolevulinic acid (ALA) and porphobilinogen (PBG) leads to disabling acute neurovisceral attacks and progressive neuropathy. We evaluated the AHP disease burden in patients aged ≥ 12 years in a post hoc analysis of the Phase 3, randomized, double-blind, placebo-controlled ENVISION trial of givosiran (NCT03338816), an RNA interference (RNAi) therapeutic that targets the enzyme ALAS1 to decrease ALA and PBG production. We analyzed baseline AHP severity via chronic symptoms between attacks, comorbidities, concomitant …

Continuous Glucose Monitoring Metrics For Earlier Identification Of Pre-Diabetes: Protocol For A Systematic Review And Meta-Analysis, Sara Gottfried, Laura Pontiggia, Andrew B. Newberg, Gregory Laynor, Daniel A. Monti

Institute of Emerging Health Professions Faculty Papers

Introduction: Glycaemic variability and other metrics are not well characterised in subjects without diabetes. More comprehensive sampling as obtained with continuous glucose monitoring (CGM) may improve diagnostic accuracy of the transition from health to pre-diabetes. Our goal is to investigate the glycaemic system as it shifts from health to pre-disease in adult patients without diabetes using CGM metrics. New insights may offer therapeutic promise for reversing dysglycaemia more successfully with dietary, nutritional and lifestyle change before progression occurs to pre-diabetes and diabetes.

Methods and analysis: This systematic review will include comprehensive searches of the PubMed, Scopus, Cochrane Library and ClinicalTrials.gov …

Editorial: Progress In Understanding The Immunogenetic Basis Of Disease Susceptibility And Outcomes, Tina Bharani, Divyansh Agarwal

Department of Surgery Faculty Papers

No abstract provided.

Creating And Implementing A Principal Investigator Tool Kit For Enhancing Accrual To Late Phase Clinical Trials: Development And Usability Study., Kristin A Higgins, Alexandra Thomas, Nancy Soto, Rebecca Paulus, Thomas J George, Thomas B Julian, Sharon Hartson Stine, Merry Jennifer Markham, Maria Werner-Wasik

Kimmel Cancer Center Faculty Papers

BACKGROUND: Accrual to oncology clinical trials remains a challenge, particularly during the COVID-19 pandemic. For late phase clinical trials funded by the National Cancer Institute, the development of these research protocols is a resource-intensive process; however, mechanisms to optimize patient accrual after trial activation are underdeveloped across the National Clinical Trial Network (NCTN). Low patient accrual can lead to the premature closure of clinical trials and can ultimately delay the availability of new, potentially life-saving therapies in oncology.

OBJECTIVE: The purpose of this study is to formally create an easily implemented tool kit of resources for investigators of oncology clinical …

G Protein-Coupled Receptor Kinase 6 (Grk6) Regulates Insulin Processing And Secretion Via Effects On Proinsulin Conversion To Insulin, Matthew J Varney, Wouter Steyaert, Paul J Coucke, Joris R Delanghe, David E Uehling, Babu Joseph, Richard Marcellus, Rima Al-Awar, Jeffrey L Benovic

Department of Biochemistry and Molecular Biology Faculty Papers

Recent studies identified a missense mutation in the gene coding for G protein-coupled receptor kinase 6 (GRK6) that segregates with type 2 diabetes (T2D). To better understand how GRK6 might be involved in T2D, we used pharmacological inhibition and genetic knockdown in the mouse β-cell line, MIN6, to determine whether GRK6 regulates insulin dynamics. We show inhibition of GRK5 and GRK6 increased insulin secretion but reduced insulin processing while GRK6 knockdown revealed these same processing defects with reduced levels of cellular insulin. GRK6 knockdown cells also had attenuated insulin secretion but enhanced proinsulin secretion consistent with decreased processing. In support …

The Pro-Fibrotic Response To Lens Injury Is Signaled In A Pi3k Isoform-Specific Manner, A. Sue Menko, Janice L. Walker

Department of Pathology, Anatomy, and Cell Biology Faculty Papers

The signaling inputs that function to integrate biochemical and mechanical cues from the extracellular environment to alter the wound-repair outcome to a fibrotic response remain poorly understood. Here, using a clinically relevant post-cataract surgery wound healing/fibrosis model, we investigated the role of Phosphoinositide-3-kinase (PI3K) class I isoforms as potential signaling integrators to promote the proliferation, emergence and persistence of collagen I-producing alpha smooth muscle actin (αSMA+) myofibroblasts that cause organ fibrosis. Using PI3K isoform specific small molecule inhibitors, our studies revealed a requisite role for PI3K p110α in signaling the CD44+ mesenchymal leader cell population that we previously identified as …

Refinement & Preliminary Examination Of A Fidelity Assessment For The Spinal Cord Injury -- Movement Index (Sci-Mi), Nicole Gerhardt, Otd(C), Otr/L

Department of Occupational Therapy Posters and Presentations

Introduction: Assessment fidelity refers to the adherence to intended procedures and guidelines when administering an assessment (Mowbray et al., 2003; Walton et al., 2020). Clinical outcome assessments (COAs) play a crucial role in the assessment of treatment effects in clinical trials. However, there is a scarcity of fidelity assessments for COAs, which has the potential to impact the accurate evaluation of treatment effects (Richardson et al., 2016). The Spinal Cord Injury Movement Index (SCI-MI) is a performance-based COA being developed with the intent to be used in spinal cord injury (SCI) clinical trials. As the stakes in SCI clinical trials …

Cardiovascular Outcomes Of Transradial Versus Transfemoral Percutaneous Coronary Intervention In End-Stage Renal Disease: A Regression-Based Comparison, Yasar Sattar, Mohammed Faisaluddin, Talal Almas, Noora Alhajri, Rajendra Shah, Mohamed Zghouzi, Fnu Zafrullah, Prasana M Sengodon, Muhammad Zia Khan, Waqas Ullah, Mahboob Alam, Sudharshan Balla, Nasser Lakkis, Akram Kawsara, Ramesh Daggubati, M Chadi Alraies

Division of Cardiology Faculty Papers

Background: Limited data is available on the comparison of outcomes of transradial (TR) and transfemoral (TF) access for percutaneous coronary intervention (PCI) in patients with end-stage stage renal disease (ESRD).

Methods: Online databases were queried to compare cardiovascular outcomes among TR. and TF in ESRD patients. The outcomes assessed included differences in mortality, cerebrovascular accidents (CVA), periprocedural myocardial infarction (MI), bleeding, transfusion, and periprocedural cardiogenic shock (CS). Unadjusted odds ratios (OR) were calculated using a random-effect effect model.

Results: A total of 6 studies including 7,607 patients (TR-PCI = 1,288; TF-PCI = 6,319) were included. The overall mean age was …