Medicine and Health Sciences Commons^™

Comparison Of Authentic Urine N-Ethylpentedrone Metabolites To Predicted In Silico And In Vitro Human Hepatocyte Metabolism, Gloria Daziani, Omayema Taoussi, Diletta Berardinelli, Giulia Bambagiotti, Marilyn A. Huestis, Francesco P. Busardò, Jeremy Carlier

Institute of Emerging Health Professions Faculty Papers

Synthetic cathinones are the second most common class of substances belonging to the category of new psychoactive substances (NPS). N-ethylpentedrone (NEPD) self-administration was reported, making it important to elucidate its metabolic pathway to improve its detection. NEPD is often taken together with other substances; confidently identifying its intake is important for accurate toxicological analysis and understanding its toxicity. NEPD metabolism was studied following incubation with human hepatocytes and analysis by liquid chromatography-high-resolution mass spectrometry paired with Compound Discoverer software (Thermo Fisher Scientific). Prediction of possible metabolites was performed with the online software GLORYx. In vivo NEPD metabolism was evaluated by …

Outcomes Of The Modified Cabrol Technique In Aortic Root Replacement: Early And Midterm Experience, Nayeem Nasher, Joshua R. Chen, Purab Kothari, Colin King, Jacqueline Mcgee, Vishal Shah, Saarah Khairi, Konstadinos A. Plestis

Department of Surgery Faculty Papers

OBJECTIVES: The modified Cabrol technique has been associated with excellent graft patency. However, prior studies were limited to patients largely on long-term anticoagulation. We sought to analyze outcomes in patients primarily managed without mechanical prostheses.

METHODS: We retrospectively analyzed all patients who underwent aortic root replacement by a single surgeon from 2014 to 2024. Patients who underwent reimplantation of one or both coronary ostia using the modified Cabrol technique with separate interposition grafts were identified. Baseline characteristics and postoperative outcomes were reported. Predictors of mortality were analyzed using Cox proportional hazards, and overall survival was reported using Kaplan-Meier analysis.

RESULTS: …

Rethinking Pain Relief After Surgery: What We Can Learn From Knee Replacements, Asim Trimzi

SKMC Student Presentations and Publications

This paper offers a clear, evidence-based look at how we can reduce opioid use after knee replacement surgery without sacrificing pain relief. This review focuses specifically on total knee arthroplasty (TKA)-one of the most commonly performed and most painful surgeries-and asks whether opioids are truly necessary. By analyzing results from 21 clinical trials, the paper shows that non-opioid medications like NSAIDs and gabapentinoids can provide similar pain control with fewer side effects, such as nausea, dizziness, constipation, and sedation. Lower risk of long-term use is an added benefit. A recent RCT found that after knee/shoulder arthroscopy, 72% of patients in …

Trajectory Of Iron And Red Cell Parameters In Moderately Anemic Iron-Deficient Pregnant Women Receiving Daily Iron-Folic Acid Supplementation: A Prospective Cohort Study, J. P. Akshaykirthan, Manjunath S. Somannavar, S. Yogeshkumar, M. S. Deepthy, Umesh Charantimath, Amaresh Patil, Mrutyunjaya B. Bellad, Richard Derman, Shivaprasad S. Goudar

Global Health Articles

Background/Objectives: The objective is to study the trajectories of hematologic and biochemical markers in moderately anemic pregnant women receiving oral iron supplementation throughout pregnancy. Methods: This prospective cohort study was conducted from August 2021 to September 2023 involving 315 pregnant women from rural areas of Belgaum, Karnataka, India, with hemoglobin levels between 7.0 and 9.9 g/dL and serum ferritin < 30 ng/mL and/or TSAT < 20%. Participants received iron-folic acid supplementation (IFAS) as per Anaemia Mukt Bharat guidelines. Blood samples were collected to measure various hematologic and iron markers and compared across each visits. Results: We report a complete adherence rate of 95.3% for iron and 97.8% for folic acid supplementation throughout pregnancy and also observed significant improvements in hemoglobin (9.36 (8.55, 9.74) to 12.03 (11.49, 12.72)) g/dL, hematocrit (29.93 ± 2.87 to …

Hospital And Temporal Variations In Limitations Of Care Among Hospitalized Patients With Covid-19: A Virus Registry Retrospective Cohort Study, Nathan Mesfin, Nitesh Kumar Jain, Anwar Khedr, Hisham Mushtaq, Abbas B. Jama, Noura Attallah, Esraa Hassan, Benjamin Langworthy, Nicholas Ingraham, Juan Pablo Domecq Garces, Thoyaja Koritala, Donna Lee Armaignac, Nicholas Eugene Perkins, Katherine Belden, Vishakha Kumar, Karen Boman, Devang K. Sanghavi, Vikas Bansal, Rahul Kashyap, Rodrigo Cartin-Ceba, Abigail La Nou, Allan J. Walkey, R. Adams Dudley, Syed Anjum Khan

Division of Infectious Diseases and Environmental Medicine Faculty Papers

INTRODUCTION: Life-support limits (i.e., code status), the first step in the continuum of palliation and end-of-life (EoL) care, stem from decisions made by patients and their providers to align care near the EoL with patients' wishes. The pandemic created health care strain that may have influenced life-support limitation practices among patients with serious COVID-19. In this study, we examine variations in life-support limitations (do-not-resuscitate, DNR; do-not-intubate, DNI) depending on the hospital and period of hospitalization.

METHODS: We included all adults admitted to a hospital in the United States with COVID-19 from January 2020 to December 2021 using the VIRUS registry. …

Er Stress Tolerance Is Regulated By Copper-Dependent Perk Kinase Activity., Sarah E. Bond Newton, Xinglong Shi, Noah R. Beratan, Julia Perhacs, Jitendra K. Arya, Margaret K. Bond, Tali Gidalevitz, Cagla Akay-Espinoza, Donita C. Brady, Kelly L. Jordan-Sciutto

Farber Institute for Neuroscience Faculty Papers

Pancreatic/PKR-like endoplasmic reticulum (ER) kinase (PERK) is a kinase that, in response to ER stress, mediates dual homeostatic and pro-apoptotic signaling. Thus, intricate regulation is required for physiological function. Attempts to modulate PERK activity have shown that the determinants of adaptive vs. maladaptive signaling remain ambiguous. Here, with purified protein, we provide evidence that PERK binds copper, identifies residues required for interaction, and demonstrates that copper is necessary for kinase activity. Furthermore, cellular PERK activity can be modulated via copper availability, and this regulatory relationship can be manipulated to dictate ER stress tolerance. Critically, these phenomena translate to phenotypes in …

Non-Invasive Detection Of Choroidal Melanoma Via Tear-Derived Protein Corona On Gold Nanoparticles: A Machine Learning Approach, Hakimeh Rakhshandeh, Ahmad Nasiraei, Hamid Riazi-Esfahani, Babak Masoomian, Fariba Ghassemi, Mojtaba Arjmand, Saeed Heidari Keshel, Fatemeh Atyabi, Rassoul Dinarvand

Wills Eye Hospital Papers

This study investigates the feasibility of using tear sample analysis, based on protein corona formation on gold nanoparticles combined with electrospray ionization mass spectrometry (ESI-MS) and machine learning techniques, as a non-invasive approach for the detection of choroidal melanoma. The aim is to assess whether protein-nanoparticle interactions can support early and reliable identification of this ocular condition. Tear samples were collected using Schirmer strips from six healthy individuals and six patients diagnosed with choroidal melanoma, with subsequent augmentation to 18 samples per group. Gold nanoparticles (AuNPs, ~ 20 nm) were synthesized via citrate reduction and incubated with tear samples to …

The Impact Of Myopia On Regional Visual Field Loss And Progression In Glaucoma, Anagha Lokhande, Luo Song, Yueyin Pang, Yan Luo, Louis R. Pasquale, Sarah R. Wellik, Carlos G. De Moraes, Jonathan S. Myers, Mohammad Eslami, Tobias Elze, Lucy Q. Shen, Nazlee Zebardast, David S. Friedman, Michael V. Boland, Mengyu Wang

Wills Eye Hospital Papers

PURPOSE: The purpose of this study was to investigate the impact of myopia on regional visual field (VF) loss and progression in glaucoma.

METHODS: We included 112,633 24-2 VFs; longitudinal analyses comprised patients with at least 5 reliable VFs over 4 years. The degree of myopia was measured by spherical equivalent (SE) extracted from VF testing. Linear and Cox regressions determined the impact of myopia on regional VF loss and progression, respectively. We calculated three VF progression outcomes: (1) mean deviation (MD) progression: MD slope < 0; (2) total deviation (TD) pointwise progression: at least 3 TD locations with TD slope ≤-1 decibels (dB)/year; (3) MD fast progression: MD slope ≤-1 dB/year (P value < 0.05). Longitudinal analyses were conducted for all subjects and with exclusion of patients with high myopia (SE ≤-6.00 diopters [D]).

RESULTS: More negative SE values were associated with worse TD values in the paracentral VF …

Refractory Cutaneous Symptoms In Systemic Mastocytosis, Laura Gleason, Safiyyah Bhatti, Molly Wallace, Jason B. Lee, Onder Alpdogan, Neda Nikbakht

Department of Dermatology and Cutaneous Biology Faculty Papers

No abstract provided.

Global, Regional, And National Burden Of Cardiovascular Diseases And Risk Factors In 204 Countries And Territories, 1990-2023, Global Burden Of Cardiovascular Diseases And Risks 2023 Collaborators, Mohammadreza Abbasian

Department of Orthopaedic Surgery Faculty Papers

BACKGROUND: Cardiovascular diseases (CVDs) are the leading cause of mortality and are among the foremost causes of disability globally. CVD burden has continued to increase in most countries since 1990, with trends driven by changing exposures to harmful risk factors, population growth, and population aging.

OBJECTIVES: We report estimates of global, national, and subnational CVD burden, including 18 subdiseases and 12 associated modifiable risk factors. We analyzed change in CVD burden from 1990 to 2023 and identified drivers of change including population growth, population aging, and risk factor exposure.

METHODS: The Global Burden of Disease (GBD) 2023 study, a multinational …

Purulent Pericarditis: Treating A Medically-Complex Patient With Intrapericardial Antibiotics, Meryem Guler, Sudheshna Vemula, Matthew Hart, Josh Wiener, Darius Farzad, Mark Decaro, Gregary D. Marhefka, Devin Weber, John W.C. Entwistle, Jacqueline Urtecho

Division of Cardiology Faculty Papers

OBJECTIVE: Purulent pericarditis is a rare, lethal complication of a bacterial pericardial infection. This case report outlines the protocol for instilling intrapericardial antibiotics for methicillin-sensitive Staphylococcus aureus (MSSA) pericarditis without fibrinolytics in a 51-year-old man.

KEY STEPS: An appropriately sized percutaneous pericardial drain was placed. Then, a 3-day course of intrapericardial infusions of 50 mL vancomycin was begun. Drainage of all accessible fluid was performed before each infusion. The daily infusions each had an 8-hour dwell time. The prior drainage protocol continued after each infusion.

POTENTIAL PITFALLS: Strict dosage and infusion length management are required to prevent direct toxicity. Potential …

Monitoring The Hematologic Markers In Patients Undergoing Single-Stage Exchange Arthroplasty For Periprosthetic Joint Infection, Wenbo Mu, Juan D. Lizcano, Boyong Xu, Wentao Guo, Abudousaimi Aimaiti, Xiaogang Zhang, Javad Parvizi, Li Cao

Rothman Institute Papers

BACKGROUND: Periprosthetic joint infection (PJI) is a serious complication that necessitates a complex treatment strategy. Single-stage exchange arthroplasty, combined with intravenous and intra-articular antibiotic infusions, has shown high efficacy in treating complex PJIs. However, the impact of this approach on hematologic parameters remains underexplored. This study aims to evaluate the postoperative trends in blood platelet count, white blood cell (WBC) count, and neutrophil count in patients undergoing single-stage exchange arthroplasty.

METHODS: A retrospective analysis was conducted on 313 patients who underwent single-stage revision for PJI between June 2010 and October 2022. Hematologic parameters were monitored for the first seven postoperative …

Practice Patterns In Management Of Low- To Intermediate-Grade Salivary Gland Carcinoma: A Multi-Institutional Study, Mirabelle Sajisevi, Kenny Nguyen, Peter Callas, Andrew Holcomb, Emre Vural, Kyle Davis, Carissa Thomas, John Stein, Ameya Asarkar, Ricardo Aulet, Rebecca Bell, Michael Blasco, Vanessa Bowmaster, Clayton Burruss, Jeffson Chung, Kimberly Chan, Brent Chang, Charles Coffey, David Cognetti, Dylan Cooper, Joehassin Cordero, John Donovan, Yue Jennifer Du, Yusuf Dundar, Rogerio Dedivitis, Heather Edwards, Boban Erovic, Antoine Eskander, Philip Feinberg, Emily Garvey, David Goldstein, Joseph Goodman, Rafael Goulart, Neerav Goyal, Stefan Grasl, Jonathan Giurintano, Nikita Gupta, Andy Habib, Trevor Hackman, Jared Hara, Christina Henson, Michael Hinni, Nadia Hua, Stephanie Johnson-Obaseki, Aditya Juloori, Noah Kalman, Alexandra Kejner, Sobia Khaja, Jamie Ku, Arnaud Lambert, Bao Luu, Kelly Magliocca, Luiz Medina Dos Santos, Cara Michael, Brett Miles, Giulianno De Melo, Michael Moore, Gregoire Morand, Kauê Moura, Hesameddin Noroozi, Rusha Patel, Joseph Paydarfar, Karolina Plonowska-Hirschfeld, Nader Sadeghi, Fabrice Savaria, Nicole Schmitt, Justin Shapiro, Timothy Shaver, Sandro Stoeckli, William Stokes, Anita Sulibhavi, Jason Tasoulas, Varun Vendra, Daniel Vinh, Celina Virgen, Neil Woody, Geoffrey Young, Kiran Kakarala, Danny Enepekides, Michael Hier, Louise Davies, William Ryan

Department of Otolaryngology - Head and Neck Surgery Faculty Papers

OBJECTIVES: To characterize practice patterns and outcomes in the management of low- and intermediate-grade salivary gland carcinoma prior to the existence of treatment guidelines.

METHODS: Analysis of a registry of patients who underwent parotid and submandibular gland resections for low-and intermediate-grade carcinomas between 2010 and 2019.

RESULTS: Of all 786 patients included in the study, 726 (92%) had preoperative imaging and 653 (83%) had preoperative biopsy. Of the 729 patients with parotid gland cancer, the majority underwent superficial (n = 384, 53%) or total (n = 254, 35%) parotidectomy. In patients with facial nerve preservation, total parotidectomy was …

Understanding Cancer Survivorship Care Needs Using Amazon Reviews: Content Analysis, Algorithm Development, And Validation Study, Liwei Wang, Qiuhao Lu, Rui Li, Taylor B. Harrison, Heling Jia, Ming Huang, Heidi Dowst, Rui Zhang, Hoda Badr, Jungwei W. Fan, Hongfang Liu

Department of Medical Oncology Faculty Papers

BACKGROUND: Complementary therapies are being increasingly used by cancer survivors. As a channel for customers to share their feelings, outcomes, and perceived knowledge about the products purchased from e-commerce platforms, Amazon consumer reviews are a valuable real-world data source for understanding cancer survivorship care needs.

OBJECTIVE: In this study, we aimed to highlight the potential of using Amazon consumer reviews as a novel source for identifying cancer survivorship care needs, particularly related to symptom self-management. Specifically, we present a publicly available, manually annotated corpus derived from Amazon reviews of health-related products and develop baseline natural language processing models using deep …

Clinical Outcomes Of Neoadjuvant Chemoimmunotherapy Vs. Chemoradiotherapy In Operable Non-Small Cell Lung Cancer, Tal Sherman, Nikta Nair, Marli Meller, Raleigh Anderson, Guillermo Jimenez, Elizaveta Flevora, Charalambos Solomides, Rita Axelrod, Sarah Gordon, Ida Micaily, Maria Werner-Wasik, Sung Whang, Tyler Grenda, Olugbenga Okusanya, Nathaniel R. Evans, Iii, Nilanjan Haldar, Erik Blomain

Department of Radiation Oncology Posters

Introduction

• Non-small cell lung cancer (NSCLC) accounts for ~85% of lung cancers and remains the leading cause of cancer death.
• Surgery is curative for early-stage disease, but recurrence rates remain high.
• CheckMate-816 trial established neoadjuvant chemo-immunotherapy (chemo-IO) as a new standard for resectable NSCLC, demonstrating improved pathologic response and event-free survival.
• PACIFIC trial showed the survival benefit of consolidative immunotherapy after chemoradiotherapy (chemo-RT) in unresectable stage III NSCLC, highlighting the synergy between radiation and immune checkpoint blockade.
• Despite these advances, there is little comparative data on the role of chemo-IO versus chemo-RT in the neoadjuvant, operable setting.
• Objective: To compare …

Anatomically Accurate, Low-Cost 3d-Printed Nasopharynx Simulator For Nasolaryngoscopy Training, Tal Sherman, Robert Walker, Voichita Bar-Ad, Firas Mourtada

Department of Radiation Oncology Posters

Introduction

- Flexible nasopharyngolaryngoscopy (NPL) is a core diagnostic and procedural skill in otolaryngology, radiation oncology, and related specialties. Early mastery is essential for safe patient care, but traditional training is limited by:

• Reliance on patient encounters, which may cause discomfort and restrict practice opportunities.
• High cost of commercial simulators(often $3,000–$5,000), restricting access across many programs.
• Lack of anatomical accuracyin available models, limiting their educational value.

- Gap: There is currently no accessible, anatomically faithful, and affordable tool for widespread trainee use.

- Objective: To design, fabricate, and validate a low-cost, anatomically accurate 3D-printed simulator for training in flexible NPL

Retracted: Idea Density And Grammatical Complexity As Neurocognitive Markers, Diego Iacono, Gloria Feltis

Department of Neurology Faculty Papers

Language, a uniquely human cognitive faculty, is fundamentally characterized by its capacity for complex thoughts and structured expressions. This review examines two critical measures of linguistic performance: idea density (ID) and grammatical complexity (GC). ID quantifies the richness of information conveyed per unit of language, reflecting semantic efficiency and conceptual processing. GC, conversely, measures the structural sophistication of syntax, indicative of hierarchical organization and rule-based operations. We explore the neurobiological underpinnings of these measures, identifying key brain regions and white matter pathways involved in their generation and comprehension. This includes linking ID to a distributed network of semantic hubs, like …

Neurofilament Light (Nfl) Chain Levels Predict Clinical Decline In Alzheimer’S Disease: A Systematic Review And Meta-Analysis, Kim Thomas, Paul Spin, Nikita Sir, Kevin Hou, Nicholas J. Ashton, Henrik Zetterberg, Sonya Miller, Carol Pringle, Richard G. Stefanacci, Claude M. Wischik, Serge Gauthier

College of Population Health Faculty Papers

BACKGROUND: Regulatory approval of new investigational Alzheimer's disease (AD) therapies could be accelerated if reasonably likely surrogate endpoints could be used. Neurofilament light chain (NfL) has potential utility as a prognostic biomarker of neurodegeneration in AD.

OBJECTIVE: To synthesize available evidence on the relationship between baseline NfL levels and longitudinal clinical decline.

METHODS: A systematic literature review identified 19 eligible studies, contributing 37 longitudinal statistical models evaluating the association between baseline NfL (plasma or cerebrospinal fluid [CSF]) with subsequent clinical decline based on validated clinical scales including Mini-Mental State Examination (MMSE), Alzheimer's Disease Assessment Scale-Cognitive Subscale, and Clinical Dementia Rating. …

Immunotherapy For Precision Medicine In Colorectal Cancer, Miao Cao, Michael Xu, Zinah Bairmani, Babar Bashir, Scott A. Waldman, Adam E. Snook

Department of Pharmacology, Physiology, and Cancer Biology Faculty Papers

INTRODUCTION: Colorectal cancer (CRC) is the fourth most common cancer and second leading cause of cancer-related death in the United States. The implementation of CRC screening has decreased CRC incidence in adults older than 65 years. However, among young adults who experience more aggressive disease progression, CRC incidence has been increasing for decades. Immunotherapy represents a collection of innovative and promising approaches with greater efficacy and safety. In this review, we discuss modalities and selected targets of immunotherapies for CRCs that are guided by precision medicine.

AREAS COVERED: The following review focuses on immunological approaches for CRCs, including therapeutic monoclonal …

Prevalence Of Helmet Use In Skateboarders: A Systematic Review And Narrative Synthesis, Katherine Hunzinger, Ricker Adkins, Stevie Chen, Thomas Li, Lujie Chen

Department of Exercise Science Faculty Papers

Introduction: Helmet adoption remains low among skateboarders, but the specific prevalence remains unclear. The purpose of this study was to summarize available evidence on helmet-use prevalence among skateboarders. Methods: A systematic search of PubMed and Web of Science was conducted using the search terms: skateboard, skateboarding, protective gear, protective equipment, pads, or helmet. Articles were included if they were in English with specific data on helmet use among skateboarders. Articles excluded were those representing reviews or conference abstracts/presentations; or if helmet use prevalence for skateboarders could not be ascertained. Data extraction and quality assessment were performed independently by two reviewers, …

Validation Of The Jefferson Health-Related Social Needs Screener, Sara Beachy, Kristin L. Rising, Richard W. Hass, Terry Hyslop, Isabella Muti, Mackenzie Kemp, Rhea E. Powell, Cara Martino, Baligh R. Yehia, Joseph G. Cacchione, Patricia C. Henwood

Jefferson Hospital Staff Papers and Presentations

INTRODUCTION: Screening for health-related social needs (HRSN) is a growing national health priority. While multiple HRSN screening tools currently exist, none to our knowledge have been evaluated using robust statistical analyses. The goal of this work is to provide results from a validation study of the Jefferson HRSN screener conducted across inpatient and outpatient settings.

METHODS: This retrospective cross-sectional psychometric study included HRSN assessments conducted across inpatient and outpatient settings with adult patients from March 2023 to May 2024. The study was conducted across a 17-hospital academic health system serving a diverse community in a 9-county area crossing two states …

Music For Self-Care, A Nurse Well-Being Strategy, Kristen Gilmore Msn, Rn, Cen, Tcrn, Ne-Bc, Nc-Bc, Allison Mccrea Mmt, Mt-Bc, Stephen Didonato Phd, Lcp

Jefferson Hospital Staff Papers and Presentations

Background

• Evidence suggests that individuals with trauma exposure, such as the impact of crisis such as COVID-19, may benefit from music therapy.
• In 2021, the Hospital and Healthsystem Association of Pennsylvania (HAP) recognized the importance of ensuring well-being of the nursing workforce identifying the vital role that nursing plays upholding the highest standards of patient care.
• HAP, in partnership with the Pennsylvania Council on the Arts, created a three year, first of its kind program, to support the provision of music therapy program services for healthcare workers.
• Through this grant-funded program, Jefferson Health- Pennsylvania hospitals, were awarded $162,000. This grant …

Medical Guidelines For Fibrodysplasia Ossificans Progressiva, Frederick S. Kaplan, Mona Al Mukaddam, Genevieve Baujat, Alberto Hidalgo Bravo, Matthew Brown, Amanda Cali, Tae-Joon Cho, Corrie Crowe, Carmen L. De Cunto, Patricia L. R. Delai, Robert J. Diecidue, Elisabeth Marelise W Eekhoff, Lisa Friedlander, Clive S. Friedman, Zvi Grunwald, Nobuhiko Haga, Edward C. Hsiao, Richard Keen, Joseph A. Kitterman, Charles Levy, Vrisha Madhuri, Rolf Morhart, J. Coen Netelenbos, Christiaan Scott, Eileen M. Shore, Michael Zasloff, Keqin Zhang, Robert J. Pignolo

Department of Oral and Maxillofacial Surgery Faculty Papers

Fibrodysplasia ossificans progressiva (FOP) is an ultra-rare genetic condition characterized by congenital malformations of the great toes and progressive heterotopic ossification (HO) in specific anatomic patterns. Present management summarized here is focused on early diagnosis, assiduous avoidance of injury and iatrogenic harm, symptomatic amelioration of painful flare-ups, and optimization of residual function. Twenty-one members of the International Clinical Council on FOP (ICC) and seven consultants from 15 countries, chosen for their clinical expertise in FOP, developed this summary statement. Further advances in therapeutics will be based on rigorous clinical trials to assess novel and emerging treatment and prevention strategies. A …

Chronic Poppers Maculopathy: Case Report And Literature Comparison Of Chronic And Acute Use, Francesco Cappellani, Caterina Gagliano, Jose S. Pulido

Wills Eye Hospital Papers

RATIONALE: Alkyl nitrites ("poppers") are recreational substances known for their vasodilatory and euphoric effects. Increasing evidence links them to a vision-threatening condition termed poppers maculopathy, characterized by foveal yellow spots and outer retinal changes on optical coherence tomography. While most reports describe acute exposure, little is known about long-term consequences. This case describes one of the longest documented durations of chronic poppers use, combined with a literature review to contextualize the clinical spectrum.

PATIENT CONCERNS: A 68-year-old man with human immunodeficiency virus, type 2 diabetes, hypertension, and depression presented with progressive central vision loss in both eyes persisting for at …

Trends And Disparities In Acute Coronary Syndrome-Related Mortality In The United States: Implications For Healthcare, Muhammad Khuzzaim Khan, Ibrahim Ahmed Khan, Abdul Moiz Javed, Arslan Wazir, Hira Saleem, Muhammad Zohaib, Faisal Rasheed, Priyanka Mohan Lal, Syeda Laiba Sherazi, Amiaz Karim, Nikhil Duseja, Hussam Al Hennawi

Abington Jefferson Health Papers

Acute coronary syndrome (ACS) is a major cause of morbidity and mortality in the United States (US). However, the trends and disparities in ACS mortality are not well understood. This study aimed to analyze the ACS mortality in the US from 1999 to 2020 using the Centers for Disease Control and Prevention Wide-Ranging Online Data for Epidemiologic Research database. The age-adjusted mortality rates (AAMR) due to ACS were calculated for each year from 1999 to 2020, stratified by sex, race, urbanization, and state. The trends and disparities in AAMR were examined using descriptive statistics and graphical methods. The AAMR due …

Retinopathy Of Prematurity: History, Diagnosis, And Treatment, Henry Nguyen, Bs, Ayra Khan, Bs, Flavius Beca, Md, Yoshihiro Yonekawa, Md

inSIGHT

Abstract
Retinopathy of prematurity (ROP) is a vasoproliferative disorder that remains a leading cause of preventable childhood blindness worldwide. This review examines the current understanding of ROP's pathophysiology, prevention, diagnosis, and treatment. ROP develops in two distinct phases: an initial hyperoxic phase, denoted by decreased levels of vascular endothelial growth factor (VEGF), followed by a hypoxic phase, where increasing levels of VEGF trigger pathological neovascularization. Currently, the most effective therapeutics for management are laser photocoagulation and anti-VEGF therapies. The current paradigm in ROP management is shifting toward earlier identification, better risk stratification, and integration of digital screening technologies and standardizing …

Genetic Counseling In Ophthalmology: An Interview, Emmanuel Worede-Kal, Bs

inSIGHT

Ms. Procopio has been practicing as a genetic counselor for seven years, and in the Department of Ocular Genetics at Wills Eye Hospital for the past four years. She provides patients with information necessary to understand the role of genetic testing and the impact of results on their care as well as potential implications for family members. Given the rapidly changing field of ophthalmic genetics, Ms. Procopio is an important member of the multidisciplinary care team of patients with rare genetic conditions.

Comparing Approaches To Refractive Laser Eye Surgery, Tejal Patel, Ba

inSIGHT

Laser eye surgery is one of the most common outpatient ophthalmic procedures performed in the United States. Most patients choose laser eye surgery because they want to decrease the need for daily glasses or contact lens wear. In the past 10 years, over 700,00 eyes have been treated with some type of laser surgery (1).¹ While colloquially known as “LASIK,” there are three major types of laser eye surgeries: Photorefractive Keratectomy (PRK), Laser in Situ Keratomileusis (LASIK), and Small Incision Lenticule Extraction (SMILE). These surgeries all fundamentally rely on the same concept of using a laser to reshape the …

A Day In The Life Of An Orbital And Oculoplastic Surgeon, Alexis Duffy, Ba

inSIGHT

Have you ever heard of an oculoplastic surgeon before? And if so, ever wonder what they do or how they differ from plastic surgeons? Treating the periocular region requires an in-depth understanding not only of the eye, but also its complex interplay with adjacent orbital, sinus, and craniofacial anatomy; there is much more than meets the eye! The most common pathway to become an oculoplastic surgeon includes completion of a four-year ophthalmology residency, followed by one to two years of subspecialized oculoplastic fellowship. Oculoplastic fellowships provide surgical and medical experience managing pathology of the eyelid and orbit, and different programs …

Idiopathic Intracranial Hypertension: A Comprehensive Review Of Diagnosis And Management, Sriya Sadhu, Bs

inSIGHT

Idiopathic intracranial hypertension (IIH) is a critical vision-threatening disease that has been on the rise over the past 10 years.¹ IIH is a condition involving an increase in intracranial pressure due to an unknown (idiopathic), nonspecific cause. The previous alternative name of IIH, "pseudotumor cerebri" (false brain tumor), was given because IIH can present with symptoms similar to those that are seen in several brain tumors - severe headaches, seizures, nausea, and vision deterioration. IIH has a primarily female predominance and a strong association with obesity. As the rates of obesity increase, the prevalence of IIH is similarly expected …