Medicine and Health Sciences Commons^™

Clinically Adjudicated Deceased Donor Acute Kidney Injury And Graft Outcomes, Sherry G Mansour, Nadeen Khoury, Ravi Kodali, Sarthak Virmani, Peter P Reese, Isaac E Hall, Yaqi Jia, Yu Yamamoto, Heather R Thiessen-Philbrook, Wassim Obeid, Mona D Doshi, Enver Akalin, Jonathan S Bromberg, Meera N Harhay, Sumit Mohan, Thangamani Muthukumar, Pooja Singh, Francis L Weng, Dennis G Moledina, Jason H Greenberg, Francis P Wilson, Chirag R Parikh

Department of Medicine Faculty Papers

Background: Acute kidney injury (AKI) in deceased donors is not associated with graft failure (GF). We hypothesize that hemodynamic AKI (hAKI) comprises the majority of donor AKI and may explain this lack of association.

Methods: In this ancillary analysis of the Deceased Donor Study, 428 donors with available charts were selected to identify those with and without AKI. AKI cases were classified as hAKI, intrinsic (iAKI), or mixed (mAKI) based on majority adjudication by three nephrologists. We evaluated the associations between AKI phenotypes and delayed graft function (DGF), 1-year eGFR and GF. We also evaluated differences in urine biomarkers among …

Is Timing Of Steroid Exposure Prior To Immune Checkpoint Inhibitor Initiation Associated With Treatment Outcomes In Melanoma? A Population-Based Study, Nikita Nikita, Joshua Banks, Scott W. Keith, Andrew Song, Jennifer M. Johnson, Melissa Wilson, Swapnil Sharma, Grace Lu-Yao

Department of Medical Oncology Faculty Papers

Immune checkpoint inhibitors (ICIs) harness the immune system and are the therapy of choice for multiple cancers. Although immunosuppressive agents such as steroids are also used in many cancers, it is unknown how their timing affects treatment outcomes. Thus, we investigated the relationship between the timing of steroid exposure preceding ICI administration and subsequent treatment outcomes in melanoma. This population-based study utilized the SEER-Medicare-linked database to identify patients diagnosed with melanoma between 1991 and 2015 and receiving ICIs between 2010 and 2016, examining last steroid exposure in the 12 months preceding ICI. The main outcome was all-cause mortality (ACM) after …

Protective Benefit Of Minimally Invasive Liver Surgery For Hepatocellular Carcinoma Prior To Transplant, Simone Khouzam, Duilio Pagano, Marco Barbara, Vito Di Marco, Giada Pietrosi, Marco Maringhini, Marco Canzonieri, Sergio Calamia, Salvatore Gruttadauria

Department of Medicine Faculty Papers

Aim: The purpose of this study is to assess the benefit of laparoscopic liver resection (LLR) for hepatocellular carcinoma (HCC) given recurrence and future need for liver transplantation (LT). Methods: Data on liver resections were gathered from the Istituto di Ricovero e Cura a Carattere Scientifico-Istituto Mediterraneo per i Trapianti e Terapie ad alta specializzazione (IRCCS-ISMETT) from 2003-2021. A retrospective analysis of 1408 consecutive adult patients who had a liver resection was performed with categorization based on the underlying disease process. A sub-analysis studied the 291 patients who had an LLR with an intention to transplant approach after LLR. Results: …

Consistency Of Acetabular Height In Sequential Bilateral Total Hip Arthroplasty, Qingwu Kong, Walaa Abdelfadeel, Rock Hwang, Arjun Saxena, Andrew Star

Rothman Institute Papers

Background: Achieving appropriate leg length after surgery remains a concern for surgeons performing total hip arthroplasty (THA). The focus of surgeons trying to equalize leg length has been primarily on positioning of the femoral implant. This study evaluates the impact of acetabular height on leg length and its impact on femoral component choices during THA.

Methods: We reviewed standing pelvic radiographs of 100 patients who underwent staged bilateral THA by a single surgeon from 2016 to 2019. Leg length discrepancies and acetabular heights were determined from preoperative and postoperative radiographs. The difference between the first and second operative hips was …

Anterior Segment Optical Coherence Tomography Features Of Netarsudil-Associated Reticular Corneal Edema, Ashley Kahlilil, Reza Razeghinejad, Zeba Syed

Wills Eye Hospital Papers

No abstract provided.

Can Trainees Perform Ahmed Glaucoma Valve Surgery As Effectively As Attendings?, Melih Ustaoglu, Hugh Huynh, Sharmenie Esin, Aakriti Garg Shukla, Reza Razeghinejad

Wills Eye Hospital Papers

OBJECTIVE: To compare the surgical outcomes and early postoperative complications of Ahmed glaucoma valve (AGV) implantation performed by residents with those performed by attending physicians.

METHODS: This is a retrospective, case-control study. Data were gathered from chart reviews of consecutive cases of AGV model FP7 implantation between January 2014 and July 2017. Postoperative 1-year results of patients who had at least 3 months follow-up were evaluated.

RESULTS: One hundred and forty-four eyes of 144 patients were included in this study: 72 patients in the resident group, and 72 age- and sex-matched patients in the attending group. Hyphema and shallow anterior …

Fulminant Giant Cell Myocarditis Requiring Bridge With Mechanical Circulatory Support To Heart Transplantation, Yevgeniy Brailovsky Do, Msc, Amirali Masoumi Md, Rachel Bijou Md, Estefania Oliveros Md, Ms, Gabriel Sayer Md, Koji Takeda Md, Phd, Nir Uriel Md, Msc

Division of Cardiology Faculty Papers

Giant cell myocarditis is a rare cause of cardiogenic shock requiring a high index of suspicion, rapid immunosuppressive therapy, and mechanical circulatory support. We present the case of a patient with giant cell myocarditis who underwent a successful bridge with four different types of mechanical circulatory support devices to heart transplantation. (Level of Difficulty: Advanced.)

Prognostic Value Of H2fpef Score In Covid-19, Priya Patel, Max Ruge, Joanne Michelle D. Gomez, Jeanne Du Fay De Lavallaz, Anupama Rao, Kim A. Williams, Annabelle Santos Volgman, Maria Rosa R. Costanzo, Tisha Suboc, Karolina Marinescu

Division of Internal Medicine Faculty Papers & Presentations

Study objective: This study sought to assess the predictive value of H2FPEF score in patients with COVID-19.

Design: Retrospective study.

Setting: Rush University Medical Center.

Participants: A total of 1682 patients had an echocardiogram in the year preceding their COVID-19 admission with a preserved ejection fraction (≥50%). A total of 156 patients met inclusion criteria. Interventions: Patients were divided into H2FPEF into low (0–2), intermediate (3–5), and high (6–9) score H2FPEF groups and outcomes were compared.

Main outcome measures: Adjusted multivariable logistic regression models evaluated the association between H2FPEF score group and a composite outcome for severe COVID-19 infection consisting …

Ramifications Of The Hla-I Allelic Reactivity Of Anti-Hla-E*01:01 And Anti-Hla-E*01:03 Heavy Chain Monoclonal Antibodies In Comparison With Anti-Hla-I Igg Reactivity In Non-Alloimmunized Males, Melanoma-Vaccine Recipients, And End-Stage Renal Disease Patients, Mepur H Ravindranath, Narendranath M Ravindranath, Fatiha El Hilali, Senthamil R Selvan, Edward J Filippone

Department of Medicine Faculty Papers

Serum anti-HLA-I IgG are present in non-alloimmunized males, cancer patients, and transplant recipients. Anti-HLA-I antibodies are also present in intravenous immunoglobulin (IVIg), prepared from the plasma of thousands of healthy donors. However, the HLA-Ia reactivity of IVIg diminishes markedly after passing through HLA-E HC-affinity columns, suggesting that the HLA-I reactivity is due to antibodies formed against HLA-E. Hence, we examined whether anti-HLA-E antibodies can react to HLA-I alleles. Monoclonal IgG antibodies (mAbs) against HCs of two HLA-E alleles were generated in Balb/C mice. The antibodies were analyzed using multiplex bead assays on a Luminex platform for HLA-I reactivity. Beads coated …

Predictors Of Anticoagulation Adherence In Patients With Acute Pulmonary Embolism, Karim Merchan, Parth V. Desai, Stephen Morris, Sovik De Sirkar, Dalila Masic, Parth Shah, Nicolas Krepostman, Matthew Collins, Kevin Walsh, Nathalie Antonios, Lucas Chan, Sorcha Allen, Ahmad Manshad, Shannon Kuhrau, Alexandru Marginea, Ahmed Elkaryoni, Jawed Fareed, Yevgeniy Brailovsky, Amir Darki

Division of Cardiology Faculty Papers

Background: Anticoagulation (AC) adherence after acute pulmonary embolism (PE) is vital to prevent mortality and future recurrence of venous thromboembolism (VTE). We aimed to analyze factors affecting AC adherence after acute PE. Methods: Consecutive adult patients with CT angiography or V/Q scan confirmed acute PE were included in a single-center retrospective study from April 2016 to May 2020. Adherence data, including AC refill dates, were collected from pharmacies, and adherence measures including Continuous Measure of Medication Acquisition (CMA), Proportion of Days Covered (PDC), and Optimal Medication Adherence (OMA) were calculated per standardized formulas. Univariable and multivariable linear and logistic regression …

A Word From The Writing Center (March 2022), Pam Walter, Mfa, Liz Declan, Ma, Mfa

A Word From the Writing Team (Newsletter)

This issue includes:

• Quick Tip: Inclusivity and Awareness in Writing
• Upcoming Workshop Reminders
• News from the Academic Commons

Tadalafil Enhances Immune Signatures In Response To Neoadjuvant Nivolumab In Resectable Head And Neck Squamous Cell Carcinoma, Adam J. Luginbuhl, Jennifer Johnson, Larry Harshyne,, Alban J Linnenbach, Sanket Kumar Shukla, Angela Alnemri, Gaurav Kumar, David Cognetti, Joseph Curry, Nikita Kotlov, Zoya Antysheva, Sandrine Degryse, Kyle Mannion, Michael K Gibson, James Netterville, Brandee Brown, Rita S. Axelrod, Ralph G. Zinner, Madalina Tuluc, Stacey Gargano, Benjamin E Leiby, Ayako Shimada, M G Mahoney, Ubaldo E. Martinez-Outshoorn, Ulrich Rodeck, Young J Kim, Andrew P. South, Athanassios Argiris

Department of Otolaryngology - Head and Neck Surgery Faculty Papers

Purpose: We hypothesize that the addition of the phosphodiesterase-5 inhibitor tadalafil to the PD-1 inhibitor nivolumab, is safe and will augment immune-mediated antitumor responses in previously untreated squamous cell carcinoma of the head and neck (HNSCC).

Patients and methods: We conducted a two-arm multi-institutional neoadjuvant randomized trial in any-stage resectable HNSCC (NCT03238365). Patients were stratified at randomization by human papillomavirus (HPV) status. Patients in both arms received nivolumab 240 mg intravenously on days 1 and 15 followed by surgery on day 28. Those in the combination therapy arm also received tadalafil 10 mg orally once daily for 4 weeks. Imaging, …

Is Shunt Location A Risk Factor For The Development Of De Novo Post-Shunt Seizures?, Hanieh Bazrafshan, Mohamad Sadegh Masoudi, Mehdi Bazrafshan, Ali Akbar Asadi-Pooya

Department of Neurology Faculty Papers

Background: While ventriculo-extracranial shunting procedures have been the standard treatment option for hydrocephalus for a long time, their long-term morbidity, including the development of post-shunt de Novo seizures, should be taken into account. This study aimed to investigate the rate and risk factors of the occurrence of de Novo post-shunt seizures in patients with hydrocephalus.

Methods: In this retrospective longitudinal study, all patients with hydrocephalus who had ventriculo-peritoneal shunt insertion from 2014 to 2017 at Namazi Hospital, (Shiraz, Iran) were studied. Phone calls were made to all patients to obtain their postoperative seizure outcome and other data (e.g., sex, age …

Gender Parity In Authorship Of Published Randomized Clinical Trials In Stroke Neurology From 2000 To 2021., Noor F Shaik, Ali A Saherwala, Diana L Tzeng

Department of Neurology Faculty Papers

Gender parity is a crucial goal in clinical medicine so that women have equal access and representation. Although approximately half (46%) of US neurology residents and fellows are female, proportions of female assistant, associate, and full professors are 49%, 41%, and 23%, respectively. This has far-reaching effects, from clinical publications to invited speakerships.Although a study noted increasing trends in female authorship in high-impact neurology journals the current literature lacks evidence on a more informative benchmark—first and last authorship in randomized clinical trials (RCTs), which is typically considered for career advancement. This study assessed annual proportions and trends of female first …

Degenerative Cervical Myelopathy, Ratko Yurac, José Manuel Matamala, Juan José Zamorano, James S Harrop, Benjamin M Davies, Aria Nouri, Michael G Fehlings

Department of Neurology Faculty Papers

Degenerative cervical myelopathy (DCM) is the most common cause of spinal cord dysfunction in adults. Its prevalence is increasing as a result of population aging. The diagnosis of DCM is often delayed or overlooked, resulting in secondary neurologic morbidity. The natural course of DCM typically presents as a gradual neurological deterioration, with symptoms ranging from muscle weakness to complete paralysis, with variable degrees of sensory deficits and sphincter dysfunction. Magnetic resonance imaging (MRI) and electrophysiological studies allow the assessment of spinal cord function and its structural damage to determine treatment and clinical outcomes. All patients with signs and symptoms consistent …

Survivorship, Complications, And Outcomes Following Distal Femoral Arthroplasty For Non-Neoplastic Indications., Keenan Rhys Sobol, Brianna R Fram, John T Strony, Scot A Brown

Department of Orthopaedic Surgery Faculty Papers

AIMS: Endoprosthetic reconstruction with a distal femoral arthroplasty (DFA) can be used to treat distal femoral bone loss from oncological and non-oncological causes. This study reports the short-term implant survivorship, complications, and risk factors for patients who underwent DFA for non-neoplastic indications.

METHODS: We performed a retrospective review of 75 patients from a single institution who underwent DFA for non-neoplastic indications, including aseptic loosening or mechanical failure of a previous prosthesis (n = 25), periprosthetic joint infection (PJI) (n = 23), and native or periprosthetic distal femur fracture or nonunion (n = 27). Patients with less than 24 months' follow-up …

Pkcε Activation Restores Loss Of Pkcε, Manganese Superoxide Dismutase, Vascular Endothelial Growth Factor, And Microvessels In Aged And Alzheimer's Disease Hippocampus, Guetchyn Millien, Huaixing Wang, Zongxiu Zhang, Dan L Alkon, Jarin Hongpaisan

Center for Translational Medicine Faculty Papers

Vascular endothelial dysfunction and capillary loss are currently considered to be a primary phenotype of normal human aging and Alzheimer's disease (AD). Activation of protein kinase C (PKCε) improves several molecular, cellular, physiological, and behavioral endpoints, yet it is not known whether a loss of PKCε activity occurs in the microvascular endothelium in aged and AD hippocampi, whether this loss contributes to microvascular change, or whether activation of PKCε protects against microvascular damage, an early change that induces age-associated memory defect and AD. We investigated the effect of the PKCε activation on microvascular loss in the hippocampus, important for memory …

Immortal Plain Gut Sutures: A Case Report, Hannah J. Anderson, Kathryn Lynn, Raziyeh Mahmoudzadeh, Tatyana Milman, Manish Jain, Sunir J Garg

Wills Eye Hospital Papers

Purpose: We report the case of a 79-year-old male who presented with irritation and foreign body sensation due to the subconjunctival plain gut sutures that did not dissolve three years after undergoing pars plana vitrectomy (PPV) for macular hole repair.

Observation: A 79-year-old male presented with foreign body sensation and irritation in his left eye. On slit lamp examination, the source of the foreign body sensation was two apparently intact plain gut sutures were visible under the conjunctiva, nasal and temporal to the cornea. These plain gut sutures were placed at the conclusion of PPV surgery three years prior to …

A Sacral Filum Terminale Arteriovenous Fistula Fed By A Left T9 Artery Of Adamkiewicz, Kareem El Naamani, Rawad Abbas, Georgios S. Sioutas, Abdelaziz Amllay, Alfredo Munoz, Nabeel Herial, Stavropoula Tjoumakaris, Michael Reid Gooch, James Harrop, Robert H. Rosenwasswer, Pascal Jabbour

Department of Neurosurgery Faculty Papers

This is a case of 62-year-old patient presenting with tingling and numbness extending from the buttocks area towards the lower extremities and gait instability. Contrast Magnetic Resonance Imaging (MRI) and time-resolved imaging of contrast kinetics Magnetic Resonance Imaging (TRICKS MRI) raised suspicion for a possible dural arteriovenous fistula. Diagnostic Digital Subtraction Angiography (DSA) showed a filum terminale arterio venous fistula (AVF) fed by the left T9 from the anterior spinal artery of Adamkiewicz all the way down to the fistulous point at L5-S1. The patient underwent successful laminectomy of L5-S1 and clipping of the filum terminale arteriovenous fistula.

Crizotinib In Patients With Tumors Harboring Alk Or Ros1 Rearrangements In The Nci-Match Trial., A S Mansfield, Z Wei, R Mehra, A T Shaw, C H Lieu, P M Forde, A E Drilon, Edith P. Mitchell, J J Wright, N Takebe, E Sharon, D Hovelson, S Tomlins, J Zeng, K Poorman, N Malik, R J Gray, S Li, L M Mcshane, L V Rubinstein, D Patton, P M Williams, S R Hamilton, B A Conley, C L Arteaga, L N Harris, P J O'Dwyer, A P Chen, K T Flaherty

Department of Medical Oncology Faculty Papers

The NCI-MATCH was designed to characterize the efficacy of targeted therapies in histology-agnostic driver mutation-positive malignancies. Sub-protocols F and G were developed to evaluate the role of crizotinib in rare tumors that harbored either ALK or ROS1 rearrangements. Patients with malignancies that progressed following at least one prior systemic therapy were accrued to the NCI-MATCH for molecular profiling, and those with actionable ALK or ROS1 rearrangements were offered participation in sub-protocols F or G, respectively. There were five patients who enrolled on Arm F (ALK) and four patients on Arm G (ROS1). Few grade 3 or 4 toxicities were noted, …

Leveraging Similar Interests And Diverse Perspectives Through Interprofessional Team Science: A Reflection, Angela Gerolamo, Phd

Collaborative Healthcare: Interprofessional Practice, Education and Evaluation (JCIPE)

The ultimate goal of our work is to inform the development of patient-centered interventions that improve teh care experience and patient health outcomes.

Meet An Ipe Faculty Champion From Tju

Collaborative Healthcare: Interprofessional Practice, Education and Evaluation (JCIPE)

Louis N. Hunter, PT, DPT / Associate Professor, Department of Physical Therapy, Director of Global Strategic Initiatives, Jefferson College of Rehabilitation Science

Interviews With Health Mentor John More And Nursing Student/Hmp Participant David Kaplan

Collaborative Healthcare: Interprofessional Practice, Education and Evaluation (JCIPE)

Interview with John More (Health Mentor) and David Kaplan, Class of 2022

Addressing Ceiling Effects In Ipe Assessments, Richard W. Hass, Phd, Jasmine Tenpa, Mbbs, Mph

Collaborative Healthcare: Interprofessional Practice, Education and Evaluation (JCIPE)

To aid proper development of interprofessional competencies, assessment systems much provide reliable and valid feedback to students and professionals.

Meet An Ipe Student Champion At Tju

Collaborative Healthcare: Interprofessional Practice, Education and Evaluation (JCIPE)

Ashton Guidebeck, MS in Couple and Family Therapy, Class of 2022

Impact Of An Interprofessional Alzheimer's 3-D Virtual Training On Student Knowlege Confidence, Jeannette Kates, Phd, Susan Toth-Cohen, Phd, Richard W. Hass, Phd

Collaborative Healthcare: Interprofessional Practice, Education and Evaluation (JCIPE)

Three dimensional virtual worlds (3-DVW) provide meaningful opportunities for students to practice communication with patients and other providers in a safe, low stakes environment.

Jcipe Updates

Collaborative Healthcare: Interprofessional Practice, Education and Evaluation (JCIPE)

JCIPE Update

From The Editors

Collaborative Healthcare: Interprofessional Practice, Education and Evaluation (JCIPE)

Welcome to the winter 2022 edition of our newsletter.

Collaborative Healthcare: Interprofessional Practice, Education And Evaluation (Jcipe), Volume 12, Number 2, Fall 2021/Winter 2022

Collaborative Healthcare: Interprofessional Practice, Education and Evaluation (JCIPE)

In this Issue:

• Letter from the Editor
• JCIPE Update
• Impact of an Interprofessional Alzheimer's 3-D Virtual Training on Student Knowlege Confidence
• Meet an IPE Student Champion from TJU
• Addressing Ceiling Effects in IPE Assessments
• Interviews with Health Mentor John Moore and Nursing Student David Kaplan
• Meet an IEP Faculty Champion from TJU
• Leveraging Similar Interests in Diverse Perspectives Through Interprofessional Team Science: A Reflection

Targeting Angiogenesis In Squamous Cell Carcinoma Of The Head And Neck: Opportunities In The Immunotherapy Era, Nabil Saba, Pooja Vijayvargiya, Jan Vermorken, Juan Rodrigo, Stefan Willems, Nina Zidar, Remco De Bree, Antti Mäkitie, Greg Wolf, Athanassios Argiris, Yong Teng, Alfio Ferlito

Department of Medical Oncology Faculty Papers

Despite the lack of approved anti-angiogenic therapies in squamous cell carcinoma of the head and neck (SCCHN), preclinical and more recent clinical evidence support the role of targeting the vascular endothelial growth factor (VEGF) in this disease. Targeting VEGF has gained even greater interest following the recent evidence supporting the role of immunotherapy in the management of advanced SCCHN. Preclinical evidence strongly suggests that VEGF plays a role in promoting the growth and progression of SCCHN, and clinical evidence exists as to the value of combining this strategy with immunotherapeutic agents. Close to 90% of SCCHNs express VEGF, which has …