Medicine and Health Sciences Commons^™

Persistence Of Pet Scan Positivity After Chemoimmunotherapy For Dlbcl, James O. Armitage, Matthew A. Lunning, Julie M. Vose, Dan L. Longo

Journal Articles: Oncology and Hematology

Approximately 80% of patients with diffuse large B-cell lymphoma achieve a complete response after chemoimmunotherapy as defined by positron emission tomography (PET) scan. However, not all patients who fail to achieve a metabolic complete response are destined to relapse. In a number of these patients, the PET scan is falsely positive (ie, 20%-40% in several large series), particularly when the PET scan has a Deauville score of 4. Reflexively intervening with salvage systemic therapy or radiotherapy in these patients is potentially harmful. It seems that very sensitive measurements of circulating tumor DNA might be able to differentiate between patients who …

Efficacy And Safety Of Epcoritamab In Relapsed Or Refractory Large B-Cell Lymphoma: 3-Year Update From The Epcore Nhl-1 Trial, Yasmin H. Karimi, Chan Y. Cheah, Michael Roost Clausen, David Cunningham, Umar Farooq, Tatyana Feldman, Herve Ghesquieres, Wojciech Jurczak, Kim M. Linton, Tycel Phillips, Julie M. Vose, Won Seog Kim, Pegah Jafarinasabian, Barbara D'Angelo Månsson, David Soong, Andrew J. Steele, Zhu Li, Christian W. Eskelund, Martin Hutchings, Catherine Thieblemont

Journal Articles: Oncology and Hematology

Epcoritamab, a CD3xCD20 bispecific antibody, resulted in deep, durable responses with a manageable safety profile in patients with relapsed/refractory large B-cell lymphoma (LBCL) in EPCORE^® NHL-1 (NCT03625037). We report results from a 3-year follow-up. Adults with relapsed/refractory LBCL received epcoritamab until progressive disease or unacceptable toxicity. The primary endpoint was overall response rate (ORR). Median age was 64.0 years, 39% of patients received prior CAR T-cell treatment, and 75% were refractory to ≥ 2 consecutive lines of treatment. As of May 3, 2024 (median follow-up 37.1 months [range, 0.3-45.5]), ORR was 59% and complete response (CR) rate …

Behavioral And Psychological Financial Hardship Among Caregivers Of Pediatric Cancer Patients, Josiane Kabayundo, Cheng Zheng, Edward S. Peters, Don W. Coulter, Shinobu Watanabe-Galloway

Journal Articles: Epidemiology

BACKGROUND: Financial hardship encompasses material, behavioral, and psychological domains; however, most research among caregivers of pediatric cancer patients has focused on material hardship. This study examined factors associated with behavioral and psychological financial hardship among caregivers of pediatric cancer patients in Nebraska.

METHODS: We conducted a cross-sectional survey of caregivers of children diagnosed within the past 5 years and treated at two pediatric oncology specialty clinics. Behavioral hardship was defined as delaying medical or mental healthcare due to cost, while psychological hardship was measured by worry about ability to pay medical bills. Descriptive statistics and poisson regression with robust variance …

Application Of Current Enteral Nutrition Support Recommendations To Infants Born Less Than 750 Grams Or Less Than 25 Weeks' Gestation: A Critical Review, Mar Romero-Lopez, Mamta Naik, Teresa Hartman, Ann Anderson-Berry, Melissa Thoene

Journal Articles: Pediatrics

Clinicians face a paucity of evidence-based recommendations for provision of enteral nutrition in infants born < 750 g or < 25 weeks' gestation, termed "nano-preterm." Current enteral nutrition recommendations for extremely low birth weight infants may not be broadly applicable to nano-preterm infants due to physiological and developmental differences, while others may be appropriate. Key enteral nutrition-related considerations include: the unique anatomy and physiology of the gastrointestinal tract, altered metabolic capacity, availability of maternal milk and use of alternative substrates, detailed methods of initiation and advancement of enteral feeding, methods of human milk fortification, targeted requirements for macronutrient and micronutrients, and the safety and efficacy of enteral nutrition support management to optimize the growth and development of the nano-preterm infant. This comprehensive review focused on enteral nutrition provision in nano-preterm infants, thoroughly evaluating available literature and identifying knowledge gaps about the unique physiology and metabolism of the nano-preterm infant as it pertains to enteral nutrition. Ultimately, prospective multicenter research is needed to establish evidence-based guidelines to promote optimal growth and development while minimizing complications of extreme prematurity.

Robust Lc–Ms/Ms Method For Quantification Of Ascorbic Acid In Infant Formula And Heat-Processed Donor Human Milk: A Stabilization And Matrix Effects Mitigation Approach, Omar M. Al Kilani, Lee C. Winchester, Melissa Thoene, Colman Freel, Christopher Lee Shaffer, Anthony T. Podany

Journal Articles: Pediatrics

Ascorbic acid is an essential antioxidant for infant health; however, its quantification in infant formula and human milk is challenging due to matrix complexity, analyte instability, and lack of blank matrix equivalents. This study presents a simple and robust LC-MS/MS method that bypasses the need for standard addition using only 20 µL sample. The method showed excellent linearity (R² > 0.99), precision (CV < 15%), accuracy (±10%), and sensitivity (LOD < 0.0375 µg/mL). Stock and working solutions remained stable for months at −20 and −80 °C, respectively, avoiding daily preparation. Optimized extraction substantially reduced matrix effects. The method was externally validated using certified infant formula reference material and successfully applied to commercial samples, with incurred sample reanalysis showing <  20% variation. This validated method offers a practical tool for the routine quantification of ascorbic acid in heat-processed donor human milk and infant formula, with the potential for application to other matrices.

Nutritional Management At 22-23 Weeks Gestational Age: Evidence And Knowledge Gaps, Mar Romero-Lopez, Mamta Naik, Melissa Thoene, Ann Anderson-Berry

Journal Articles: Pediatrics

With advancing medical capabilities, survival of infants born at 22-23 weeks' gestation is increasing. However, specific recommendations for nutrition support for these infants are lacking. This review examines the unique characteristics of infants born at 22-23 weeks' gestation that impact parenteral and enteral nutrition support, highlighting the lack of evidence and knowledge gaps for optimal practices. Current recommendations developed for extremely or very low birth weight infants may be unsuitable for infants born at 22-23 weeks' gestation due to important differences in anatomy, physiology, body composition, and metabolic capabilities. Key challenges include severely limited intraluminal digestion, profound immune and microbiome …

Efficacy And Safety Of Anticoagulation For Pediatric Cerebral Sinovenous Thrombosis: Systematic Review And Meta-Analysis, Muayad Azzam, Hassan Kawtharany, Marisol Betensky, Aseel Alkhader, Qais Hamarsha, Hadi Khaled Abou Zeid, Razan Mansour, Carine Tabak, Payal Patel, Sarah Lamat Baghdadi, Rachel S. Bercovitz, Rukhmi Bhat, Tina Bliss, Brian R. Branchford, Leonard R. Brandão, Anthony K. C. Chan, E. Vincent S. Faustino, Julie Jaffray, Sophie Jones, Bryce A. Kerlin, Nicole Kucine, Riten Kumar, Christoph Male, Marie-Claude Pelland-Marcotte, Leslie Raffini, Chittalsinh M. Raulji, Sarah E. Sartain, Clifford M. Takemoto, Cristina Tarango, C. Heleen Van Ommen, Maria C. Velez, Sara K. Vesely, John Wiernikowski, Suzan Williams, Hope P. Wilson, Gary Woods, Ayesha Zia, Paul Monagle, Reem A. Mustafa

Journal Articles: Pediatrics

We performed this systematic review and meta-analysis to assess the efficacy and safety of anticoagulation therapy versus no anticoagulation in pediatric patients with cerebral sinovenous thrombosis (CSVT). Eligible studies included pediatric patients with CSVT that compared anticoagulation to no anticoagulation and reported on at least one relevant outcome (mortality, neurological deficit, thrombus resolution, recurrence, and bleeding). Meta-analysis reported risk ratios (RR) or differences (RD) (95% CIs) and absolute effects per 1000 patients. Risk of bias was assessed using ROBINS-I, and the certainty of evidence was evaluated with GRADE. After removing duplicates, we screened 8925 records independently and in duplicate, from …

Social Health Programming During Adolescence Is Associated With Increased Serum Levels Of Carotenoids, Vitamin A, And Vitamin E In Young Women: An Observational Cohort Study, Rebecca Drakowski, Matthew Vanormer, Laura Ebers, Katie Mayhan, Anum Akbar, Colman Freel, Taija Hahka, Rebekah Rapoza, Corrine K. Hanson, Keyonna King, Aaryn Mustoe, Melissa K. Thoene, Ann Anderson-Berry

Journal Articles: Pediatrics

Over 85% of young women in the United States do not meet fruit and vegetable intake recommendations, placing them at risk for low antioxidant nutrient intake. Social health programming (SHP) can improve dietary intake of fruits and vegetables, but it is not known how SHP impacts serum levels of specific antioxidant nutrients. This observational cohort study assessed the effect of participation in SHP through Girls Inc., Omaha, on serum carotenoid, retinol, and tocopherol levels for 12–29-year-old women. Serum nutrient levels were measured using high-performance liquid chromatography and nutrient intake from diet was measured using three 24 h dietary recalls (ASA24 …

An Anti-Adhesive Compound Modulating The Production Of Staphylococcus Aureus Cell Wall-Anchored Proteins, Allison C. Leonard, Ruina Bao, Cindy Menjivar, Megan J. Myers, Telmo O. Paiva, Zhiyong Zheng, Kirsten A. Berry, Kenneth W. Bayles, Ronald S. Flannagan, Yves F. Dufrêne, Jeffrey L. Bose, David E. Heinrichs, Georgina Cox

Journal Articles: Pathology and Microbiology

As one of the leading global causes of death associated with antimicrobial resistance, Staphylococcus aureus frequently colonizes the human nasal cavity and adheres to keratinized skin, establishing reservoirs that drive subsequent infections and emphasize the need for new decolonization strategies. Using a high-throughput, whole-cell screening platform, here we identify geranylgeranoic acid (GGA), a naturally occurring polyunsaturated, branched-chain fatty acid, as having dual activity against methicillin-resistant S. aureus (MRSA). At elevated concentrations, GGA exhibits microbicidal effects, whereas at sub‑microbicidal doses, it effectively inhibits MRSA adhesion to keratin, fibronectin, fibrinogen, and immunoglobulins. GGA possesses anti-adhesive activity against a panel of multidrug-resistant S. …

Real-Time Electronic Drug Monitoring: Experiences From A Multinational Phase 3 Clinical Trial To Prevent Multidrug-Resistant Tb, T. Jimah, J.E. Haberer, K.R. Amico, J. Tinkamanyire, M.A. Kendall, S. Moonsamy, R.T. Khan, K.B.F. Fetalvero, N. Suryavanshi, A. Gupta, A.C. Hesseling, Susan Swindells, G. Churchyard

Journal Articles: Infectious Diseases

OBJECTIVE: We describe the experience of implementing real-time electronic drug monitoring (EDM) within a clinical trial to prevent multidrug-resistant TB (MDR-TB) among high-risk household contacts.

METHODS: The Protecting Households On Exposure to Newly Diagnosed Index Multidrug-Resistant Tuberculosis Patients (PHOENIx) trial is a phase 3, open-label, cluster-randomised clinical trial conducted in 31 sites in Africa, Asia, and Latin America. Household contacts of adults with MDR-TB were enrolled from June 2019 to January 2025, each receiving an EDM device to monitor adherence to TB preventive therapy. Here, we review selection of the adherence monitoring approach and key procedures implemented to support EDM …

Ash/Isth 2026 Guidelines For Anticoagulant Prophylaxis In Pediatric Patients At Risk Of Venous Thromboembolism, Marisol Betensky, Muayad Azzam, Rachel Bercovitz, Rukhmi V. Bhat, Tina Biss, Brian Branchford, Leonardo R. Brandão, Anthony K.C. Chan, E. Vincent S. Faustino, Qais Hamarsha, Julie Jaffray, Sophie Jones, Hassan Kawtharany, Bryce A. Kerlin, Jana Khawandi, Grace Krider, Nicole Kucine, Riten Kumar, Christoph Male, Paul Monagle, Marie-Claude Pelland-Marcotte, Leslie Raffini, Chittalsinh M. Raulji, Sarah E. Sartain, Clifford M. Takemoto, Cristina Tarango, C. Heleen Van Ommen, Maria C. Velez, Sarak Vesely, John Wiernikowski, Suzan Williams, Hope P. Wilson, Gary Woods, Reem A. Mustafa

Journal Articles: Pediatrics

High-quality data on anticoagulant prophylaxis for pediatric VTE prevention are scarce. Key research priorities include the development and validation of subgroups-specific VTE risk assessment models, and evaluation of the safety and efficacy of risk-stratified anticoagulant prophylaxis strategies across different pediatric subgroups.

BACKGROUND: Venous thromboembolism (VTE) is a significant cause of morbidity in children, particularly among hospitalized patients and those with chronic medical conditions. There is a lack of consensus on anticoagulant prophylaxis strategies.

OBJECTIVE: These evidence-based guidelines from the American Society of Hematology (ASH) and the International Society on Thrombosis and Haemostasis (ISTH) are intended to support patients and health …

A Zinc Chelate Of Lysine/Glutamic Acid Reduces Alcohol-Induced Ciliary Dysfunction, Emily Do, Daren L. Knoell, Christopher Bauer, Deanna Mosley, Deandra R. Smith, Derrick R. Samuelson, Todd A. Wyatt

Journal Articles: Environmental, Agricultural & Occupational Health

Alcohol misuse is a known risk factor for pneumonia, and up to 50% of individuals who misuse alcohol are zinc deficient. Chronic alcohol misuse can lead to alcohol-induced ciliary dysfunction (AICD), preventing effective mucociliary clearance and protection against lung infection. Because zinc salts fail to alter AICD, we hypothesized a form of zinc (Zinpro Zinc LG) with enhanced cell uptake would protect against AICD. Human and mouse airway epithelial cells were treated with 50 mM ethanol for 1-24 h followed by the ciliostimulatory agents. Cilia beat frequency (CBF) and cAMP-dependent protein kinase (PKA) activity were assayed. Cyclic AMP or beta …

Intersections Of Art And Medicine, Lina Adwer

EMET Projects

No abstract provided.

The Underexplored Complexity Of Pancreatic Cancer: Early Dissemination And Quiescence, Nivedeta Krishna Kumar, Annant Bir Kaur, Surinder K. Batra, Moorthy P. Ponnusamy

Journal Articles: Biochemistry & Molecular Biology

Pancreatic cancer has been renowned for its aggressive nature and occasionally manifests periods of dormancy, presenting a perplexing challenge in studying disease progression. Despite surgery, many patients relapse due to dormancy and chemoresistance, resulting in recurrence and death within a few years. Studies also suggest that pancreatic cancer disseminates early on, spreading to secondary organs with no evidence of disease. The lingering question is: how, where, and when does pancreatic cancer recur and spread? Herein, we explore evidence for clinically dormant pancreatic cancer cells, examining the roles of quiescence and stemness populations and their interactions with the tumor microenvironment. Understanding …

Pancreatic Cancer Detection Consortium Biomarker Bakeoff: A Phase Ii Blinded Biomarker Validation And Panel Discovery Study, Ann L. Oberg, William R. Bamlet, Grant Izmirlian, Seetharaman Balasenthil, Surinder K. Batra, Masataka Hayashi, Daniel S. Herman, Michael A. Hollingsworth, Maneesh Jain, Ann M. Killary, Brianna M. Krusen, Suyu Liu, Shounak Majumder, Gopalakrishnan Natarajan, Subrata Sen, Lynette M. Smith, Sudhir Srivastava, Brian M. Wolpin, Kenneth S. Zaret, Michael G. Goggins

Journal Articles: Biochemistry & Molecular Biology

PURPOSE: The Pancreatic Cancer Detection Consortium (PCDC) performed a blinded Early Detection Research Network-defined phase II biomarker bakeoff study of blood-based biomarker panels. The aims were to evaluate panel performance, to compare the panels' performance with that of cancer antigen 19-9 (CA19-9) alone, and to evaluate the performance of new combinations of the individual biomarkers.

EXPERIMENTAL DESIGN: Ten biomarkers representing eight biomarker panels and CA19-9 were evaluated using plasma, serum, and germline DNA from 140 stage I to IV pancreatic ductal adenocarcinoma (PDAC) cases and 140 controls from three tertiary care institutions, with controls frequency matched to cases on age …

Rac1 Gtpase Regulates The Scfβtrcp-Mediated Degradation Of Claspin And The Cellular Response Of Pancreatic Cancer Cells To Gamma Rays, Neha Chaudhary, Tabbatha N. Somers, Surinder K. Batra, Ying Yan, Michel M. Ouellette

Journal Articles: Biochemistry & Molecular Biology

BACKGROUND/OBJECTIVES: Pancreatic ductal adenocarcinomas (PDACs) are lethal tumors exhibiting resistance to most cancer therapeutics, particularly DNA-damaging agents. The

METHODS: Western blot analyses were used to assess the impacts of Rac1 inhibition on the components of the ATR/Chk1 cascade.

RESULTS: Here, we show that Rac1 inhibition disrupts ATR/Chk1 signaling by promoting degradation of Claspin, a key component of the fork protection complex needed for the Ser345-phosphorylation of Chk1 by ATR. In PDACs and normal pancreatic ductal cells, Rac1 inhibition (via inhibitors or siRNA) decreased Claspin protein levels without affecting its mRNA, reflecting a >3-fold reduction in Claspin's half-life. Claspin contains a …

Overcoming Radiation Resistance: Ferroptosis Induction To Sensitize Solid Tumors To Radiation Therapy, Joseph Carmicheal, Caden M. Fritson, Alexandra Seas, Heidi M. Vieira, Surinder K. Batra

Journal Articles: Biochemistry & Molecular Biology

Radiation therapy (RT) is a mainstay of treatment for a myriad of cancers, often utilized for tumors that are unable to be resected, as well as an adjunct to surgery and chemotherapy. Unfortunately, many cancers are resistant to RT-induced damage and subsequent cell death. This has spurred the pursuit of novel radiation sensitizers that could potentiate the effects of this widely used and important treatment modality. Since its discovery as a regulated cell death mechanism in 2012, ferroptosis has been studied for its connection to cancer and other known oxidative pathways. With this, the interplay between RT and ferroptosis in …

Distinct Glycosyltransferase Expression Governs Organ-Specific Survival In Pancreatic Cancer Metastasis, Venkatesh Varadharaj, Frank Leon, Nivedeta Krishna Kumar, Palanisamy Nallasamy, Pratima Raut, Annant Bir Kaur, Kirtana Arikath, Wyatt Petersen, Sanchita Rauth, Neelanjana Gayen, Zahraa Wajih Alsafwani, Poompozhil Mathivanan, Saravanakumar Marimuthu, Kavita Mallya, Madhu Bommideni, Jesse L. Cox, G. Talmon, Paul M. Grandgenett, Michael A. Hollingsworth, Dominick J. Dimaio, Jean L. Grem, Surinder K. Batra, Moorthy P. Ponnusamy

Journal Articles: Biochemistry & Molecular Biology

Pancreatic ductal adenocarcinoma (PDAC) is among the most lethal cancers, with over 83% of patients presenting metastases to vital organs such as the liver, lungs, and peritoneum. Although glycosylation has been established as a critical factor in PDAC development, little is known about the molecular underpinnings of organ-specific metastasis. In this study, we investigated the role of glycosyltransferases (GTs) in mediating PDAC metastatic organotropism. Through an unbiased transcriptomic screen, we identified distinct GT expression patterns in liver- and lung-tropic PDAC cells. Notably, GCNT3 and B3GNT3 were selectively upregulated in liver and lung-tropic cells, respectively. These mutually exclusive expression patterns were …

Anti-Sars-Cov-2 Nucleoprotein Iga Is Associated With Worse Disease Severity In Critically Ill Covid-19 Pneumonia Patients, David Brett-Major, Dylan S. George, Eric D. Morrell, Carmen Mikacenic, Julie Carstens, Laura E. Evans, Mark M. Wurfel, Pavan K. Bhatraju, M. Jana Broadhurst

Journal Articles: Epidemiology

While humoral responses to vaccination and infection have largely focused on IgG, there is an evolving literature on ways in which IgA may drive neutrophil activity in lung injury secondary to viral infections, including COVID-19. We evaluated 238 immune-naïve, critically ill patients in the first year of the COVID-19 pandemic. Employing a laboratory-developed, multiplexed antibody testing, clinical history, medical record, and machine learning, we pursued relationships between systemic IgA and disease severity. Individuals with elevated anti-N IgA had 4-fold odds of more severe disease. This work emphasizes the importance of continued work to understand how different elements of the immune …

Creative Works By Ed Fehringer, M.D., Ed Fehringer

The Art of Medicine

• Ode to a Skeleton
• Progress

Creative Works By Zoe Keese, Zoe Keese

The Art of Medicine

• A Family History of Obstetrics and Gynecology

Creative Works By Elizabeth Kettler, Elizabeth Kettler

The Art of Medicine

• Towards the Sun

Intratracheal Interleukin-10 Administration Reduces Acute Lung Injury Induced By Sulfur Dioxide Exposure In Mice, Amy J. Nelson, Todd A. Wyatt, Bradley W. Richmond, Belinda Diaz, Angela Gleason, Michael J. Duryee, Geoffrey M. Thiele, Ted R. Mikuls, Jill A. Poole

Journal Articles: Environmental, Agricultural & Occupational Health

Therapies capable of reducing acute high-consequence airborne chemical exposure-induced lung disease are lacking. This study seeks to determine the therapeutic potential of interleukin (IL)-10 administered following acute sulfur dioxide (SO₂) exposure in mice. C57BL/6 male and female mice were exposed to SO₂ gas at 125 ppm for 4 h and subsequently treated 2-3 h later with IL-10 (1 μg) or vehicle control by intratracheal instillation for a total of 3 doses over 2 days with comparisons to sham-treated mice (N = 20 mice/group). IL-10 treatment reduced SO₂-induced weight loss with corresponding reductions in SO_{2 …}

Standardizing Embolization Terminology In Non-Variceal Upper Gi Bleeding: Therapeutic, Preventive, And Empiric Approaches, Nurlan Aliyev, Lei Yu, Fedja A. Rochling, Ishfaq Bhat

Graduate Medical Education Research Journal

N/A

Assessing Access To Orthopaedic Care For Patients With Osteogenesis Imperfecta, Annemarie K. Leonard, Kara Ayers, Lauren Faokunla, Kaeli Samson, Erika Carter, Tracy Hart, Maegen Wallace

Graduate Medical Education Research Journal

Background. Osteogenesis Imperfecta (OI) is a rare disorder caused by variations in collagen. Clinical manifestations include multiple fractures, short stature, scoliosis, blue sclera, hearing loss, and opalescent teeth. Patients often need many different medical providers frequently, which may place financial burdens on families. This study sought to identify and understand barriers to care for children with OI.

Methods. We utilized an Institutional Review Board (IRB)-approved survey for primary caregivers of children with OI. Questions included demographic data, type of health insurance, history of and reasons for insurance denials, access to multidisciplinary OI care, and travel to receive OI care. The …

Factors Associated With Tooth Loss In Periodontal Maintenance Patients: A Retrospective Study, Nicholas D. Stolze, Randin A. Rawlings, W. Edward Hardy, Kaeli K. Samson, Laura E. Ruiz, Bobbie J. Fowler, Kavya Shankar Muttanahally, Jeffrey B. Payne

Graduate Medical Education Research Journal

Background. Tooth retention is related to overall health and quality of life. Thus, it is important to understand factors associated with tooth loss. The objective of this cross-sectional study was to evaluate associations between systemic and oral factors with tooth loss in a retrospective study of periodontal maintenance patients.

Methods. Periodontal maintenance patients seen in both 2013 and 2019 at the University of Nebraska Medical Center College of Dentistry were included. Demographic data, smoking status, diabetes status, periodontitis stage and extent, medication use, alveolar bone height, probing depths, and tooth mobility were recorded from the electronic dental record. Adjusted odds …

Research Productivity Variation In Applicants Who Matched Into Home Orthopaedic Surgery Programs, Frances Akwuole, Cole Christenson, Freddy Jacome, James Macleod, Omar Shaikh, Michael W. Pullen, Avani Chopra, Owen Lema, Justin Lee, Sia Cho, Annemarie K. Leonard, Alfonso Mejia

Graduate Medical Education Research Journal

Background. Research output among orthopaedic surgery applicants remains an important factor in the orthopaedic surgery residency selection process. However, there is limited literature comparing objective measures such as research productivity across different types of orthopaedic surgery applicants. We aim to determine if students who match at their home programs have significantly different research productivity and, secondarily, Alpha Omega Alpha (AOA) membership rates, compared to those who match at external programs.

Methods. This study was conducted in April 2024. A list of orthopaedic surgery residents was acquired from publicly available websites using a Python script. Programs were stratified into four geographic …

Analgesic Safety And Efficacy Of Intrathecal Morphine In Elective Posterior Lumbar Fusion: A Systematic Review With Meta-Analyses, Luke J. Weisbrod, Jordan M. Rasmussen, Cindy Schmidt, Daniel L. Surdell

Graduate Medical Education Research Journal

Background. We evaluated perioperative intrathecal morphine (ITM) compared with placebo or standard postoperative pain strategies in adults undergoing elective posterior lumbar fusion.

Methods. A systematic search of EMBASE, MEDLINE, the Cochrane Library, and Google Scholar (December 12, 2023) identified studies involving ITM in posterior lumbar fusion. Eligible patients were ≥18 years. Two reviewers extracted outcomes and assessed non-randomized studies with the Newcastle- Ottawa scale. Odds ratios (OR) and mean differences (MD) with 95% confidence intervals (CI) were calculated using fixed- and random-effects models.

Results. Eleven studies met the inclusion criteria. ITM significantly lowered opioid requirements within 24 hours (MD -0.72, …

Salt Vs. Scalpel: A Surprisingly Simple Solution To Pyogenic Granulomas, Richard M. Regester, Kimberly Eisenstein

Graduate Medical Education Research Journal

Background. Pyogenic granulomas (PGs) are benign vascular lesions commonly encountered in primary care settings. They are often linked to trauma, hormonal changes, infections, or medications. While traditional treatments such as excision, curettage, and silver nitrate application are the treatment of choice, recurrence is possible, and they may result in discomfort, anxiety, or scarring. This case highlights the successful use of salt packing, a low-cost, minimally invasive alternative, for a PG resistant to conventional therapy.

Case. A 57-year-old female presented with a 10 mm PG on the right ventral thumb, which bled intermittently and increased in size over three months. An …

Peripheral Blood Biomarkers For Rheumatoid Arthritis-Associated Interstitial Lung Disease, Brent A. Luedders

Theses & Dissertations

Rheumatoid arthritis-associated interstitial lung disease (RA-ILD) is a common extra-articular complication of rheumatoid arthritis (RA). Measuring peripheral blood biomarkers represents an appealing strategy to inform the screening and prediction of RA-ILD. In these studies, I aimed to further characterize the associations of peripheral blood biomarkers with prevalent and incident RA-ILD. First, I evaluated the associations of matrix metalloproteinases (MMPs) with RA-ILD among a multicenter cohort of RA U.S. Veteran patients (n = 2,312). Higher concentrations of MMP-7 and MMP-9 were independently associated with both prevalent and incident RA-ILD, including a nearly four-fold increased odds of prevalent RA-ILD (adjusted odds ratio …