Medicine and Health Sciences Commons^™

Quantitative Tumor Depth Determination Using Dual Wavelength Excitation Fluorescence, Christine M. O'Brien, Kevin W. Bishop, Haini Zhang, Xiao Xu, Leo Shmuylovich, Elizabeth Conley, Karen Nwosu, Kathleen Duncan, Suman B. Mondal, Gail Sudlow

2020-Current year OA Pubs

No abstract provided.

Brain Volume In Chronic Ketamine Users - Relationship To Sub-Threshold Psychotic Symptoms And Relevance To Schizophrenia, Robert A Chesters, Fiona Pepper, Celia Morgan, Jonathan D Cooper, Oliver D Howes, Anthony C Vernon, James M Stone

2020-Current year OA Pubs

RATIONALE: Ketamine may model aspects of schizophrenia arising through NMDA receptor activity deficits. Although acute ketamine can induce effects resembling both positive and negative psychotic symptoms, chronic use may be a closer model of idiopathic psychosis.

OBJECTIVES: We tested the hypotheses that ketamine users had lower brain volumes, as measured using MRI, and greater sub-threshold psychotic symptoms relative to a poly-drug user control group.

METHODS: Ketamine users (n = 17) and poly-drug using controls (n = 19) were included in the study. All underwent volumetric MRI imaging and measurement of sub-threshold psychotic symptoms using the Comprehensive Assessment of At-Risk Mental …

Distinct Stimulus-Dependent Neutrophil Dynamics Revealed By Real-Time Imaging Of Intestinal Mucosa After Acute Injury, Veronica Azcutia, Matthias Kelm, Seonyoung Kim, Anny-Claude Luissint, Sven Flemming, Lisa Abernathy-Close, Vincent B Young, Asma Nusrat, Mark J Miller, Charles A Parkos

2020-Current year OA Pubs

Clinical symptoms in many inflammatory diseases of the intestine are directly related to neutrophil (PMN) migration across colonic mucosa and into the intestinal lumen, yet in-vivo studies detailing this process are lacking. Using real-time intravital microscopy and a new distal colon loop model, we report distinct PMN migratory dynamics in response to several models of acute colonic injury. PMNs exhibited rapid swarming responses after mechanically induced intestinal wounds. Similar numbers of PMNs infiltrated colonic mucosa after wounding in germ-free mice, suggesting microbiota-independent mechanisms. By contrast, acute mucosal injury secondary to either a treatment of mice with dextran sodium sulfate or …

Implementation Of Telemedicine Infectious Diseases Consultation In A Rural Hospital Using The Active Implementation Framework, Jason P Burnham, Stephanie A Fritz, Graham A Colditz

2020-Current year OA Pubs

In this pilot study, guided by the Active Implementation Framework, telemedicine infectious diseases consultation was provided to hospitalized inpatients at a rural Missouri hospital. Measured outcomes included the implementation outcomes of feasibility, acceptability, appropriateness, and fidelity, as well as clinical outcomes of readmissions and death.

A Randomized Phase Ii Study Of Sm-88 Plus Methoxsalen, Phenytoin, And Sirolimus In Patients With Metastatic Pancreatic Cancer Treated In The Second Line And Beyond, Marcus S Noel, Semmie Kim, Marion L Hartley, Steve Wong, Vincent J Picozzi, Harry Staszewski, Dae Won Kim, Jan M Van Tornout, Philip Agop Philip, Vincent Chung, Allyson J Ocean, Andrea Wang-Gillam

2020-Current year OA Pubs

BACKGROUND: This trial explores SM-88 used with methoxsalen, phenytoin, and sirolimus (MPS) in pretreated metastatic pancreatic ductal adenocarcinoma (mPDAC) METHODS: Forty-nine patients were randomized to daily 460 or 920 mg oral SM-88 with MPS (SM-88 Regimen). The primary endpoint was objective response rate (RECIST 1.1).

RESULTS: Thirty-seven patients completed ≥ one cycle of SM-88 Regimen (response evaluable population). Disease control rate (DCR), overall survival (OS), and progression-free survival (PFS) did not differ significantly between dose levels. Stable disease was achieved in 9/37 patients (DCR, 24.3%); there were no complete or partial responses. Quality-of-life (QOL) was maintained and trended in favor …

Mitochondrial Dysfunction And Pharmacodynamics Of Mitofusin Activation In Murine Charcot-Marie-Tooth Disease Type 2a, Antonietta Franco, Xiawei Dang, Lihong Zhang, Perry B Molinoff, Gerald W Dorn 2nd

2020-Current year OA Pubs

Mitofusin (MFN) 1 and MFN2 are dynamin GTPase family mitochondrial proteins that mediate mitochondrial fusion requiring MFN conformational shifts, formation of macromolecular complexes on and between mitochondria, and GTP hydrolysis. Damaging MFN2 mutations cause an untreatable, largely pediatric progressive peripheral neuropathy, Charcot-Marie-Tooth (CMT) disease type 2A. We used small molecule allosteric mitofusin activators that promote MFN conformations favoring fusion to interrogate the effects of MFN2 conformation and GTPase activity on MFN2-mediated mitochondrial fusion and motility in vitro. We translated these findings in vivo by defining dose-dependent pharmacodynamic and disease-modifying effects of mitofusin activators in murine CMT2A. MFN2 catalytic GTPase activity …

Importance Of First Pass Reperfusion In Endovascular Stroke Care - Insights From Thrombectomy And Aneurysm Registry (Star), Ilko L Maier, Joshua Osbun, Et Al.

2020-Current year OA Pubs

BACKGROUND: Mechanical thrombectomy has become the first-line treatment strategy for patients with large-vessel occlusion strokes. Often >1 thrombectomy maneuver is necessary to achieve reperfusion. A first-pass (FP) effect with improved functional outcomes after mechanical thrombectomy has been described. Aim of the present study is to investigate the FP effect in a large, international, multicenter stroke database.

METHODS: Patients who underwent mechanical thrombectomy for large-vessel occlusion stroke in the anterior cerebral circulation between January 2014 and January 2021 and achieved complete reperfusion were identified from the STAR (Stroke Thrombectomy and Aneurysm Registry). We compared functional outcomes of patients with FP (defined …

Age-Dependent Rebound In Asthma Exacerbations After Covid-19 Lockdown, Guy Hazan, Carolyn Fox, Huram Mok, Jeffrey Haspel

2020-Current year OA Pubs

BACKGROUND: Virus mitigation measures enacted early in the coronavirus infectious disease 2019 (COVID-19) pandemic suppressed common respiratory viruses and reduced the number of obstructive lung disease exacerbations. However, many localities began to ease these precautions in the year 2021, leading to a resurgence of non-COVID viruses. How asthma and chronic obstructive pulmonary disease (COPD) activity responded to this upswing in viral abundance is unclear.

OBJECTIVE: Our aim was to examine how viral resurgence during the relaxation of COVID-19 restrictions affected asthma and COPD exacerbations.

METHODS: We analyzed electronic medical records for emergency department (ED) respiratory virus positivity, asthma visits, and …

A Preclinical And Phase Ib Study Of Palbociclib Plus Nab-Paclitaxel In Patients With Metastatic Adenocarcinoma Of The Pancreas, Manuel Hidalgo, Kian-Huat Lim, Et Al.

2020-Current year OA Pubs

PURPOSE: To assess the preclinical efficacy, clinical safety and efficacy, and MTD of palbociclib plus nab-paclitaxel in patients with advanced pancreatic ductal adenocarcinoma (PDAC).

EXPERIMENTAL DESIGN: Preclinical activity was tested in patient-derived xenograft (PDX) models of PDAC. In the open-label, phase I clinical study, the dose-escalation cohort received oral palbociclib initially at 75 mg/day (range, 50‒125 mg/day; modified 3+3 design; 3/1 schedule); intravenous nab-paclitaxel was administered weekly for 3 weeks/28-day cycle at 100‒125 mg/m

RESULTS: Palbociclib plus nab-paclitaxel was more effective than gemcitabine plus nab-paclitaxel in three of four PDX models tested; the combination was not inferior to paclitaxel plus …

Implementation Of An Electronic, Secure, Web-Based Application To Support Routine Hand Hygiene Observation With Immediate Direct Feedback And Anonymized Benchmarking, Simon Simonet, Jonas Marschall, Rolf Kuhn, Matthias Schlegel, Christian R Kahlert

2020-Current year OA Pubs

A secure web-based electronic tool was developed and implemented to record adherence to hand hygiene during routine care and to provide direct feedback including anonymized benchmarking. It was found suitable for documenting hand hygiene improvements in a local campaign and following rollout to other institutions in 2013, the tool is currently used in >100 hospitals in Switzerland and will play a major part in upcoming national hand hygiene campaigns.

Durable Melanoma Control Following Disseminated Talimogene Laherparepvec Herpetic Infection, Leonid Shmuylovich, Aubriana M Mcevoy, Ryan C Fields, Leonel Hernandez-Aya, George Ansstas, David Y Chen

2020-Current year OA Pubs

No abstract provided.

Acute-Onset, Painful, Acral Granuloma Annulare In A 52-Year-Old Female, Faisal S Ahmad, Michael R Vittori, William H Mccoy Iv

2020-Current year OA Pubs

No abstract provided.

Associations Between Transcranial Doppler Vasospasm And Clinical Outcomes After Aneurysmal Subarachnoid Hemorrhage: A Retrospective Observational Study, Abhijit V. Lele, Rafael Wabl, Sarah Wahlster, Jade Keen, Andrew M. Walters, Christine T. Fong, Vasu B. Dhulipala, Umeshkumar Athiraman, Anne Moore, Monica S. Vavilala, Louis J. Kim, Michael R. Levitt

2020-Current year OA Pubs

OBJECTIVE: The objective is to examine the relationship between transcranial Doppler cerebral vasospasm (TCD-vasospasm), and clinical outcomes in aneurysmal subarachnoid hemorrhage (aSAH).

METHODS: In a retrospective cohort study, using univariate and multivariate analysis, we examined the association between TCD-vasospasm (defined as Lindegaard ratio >3) and patient's ability to ambulate without assistance, the need for tracheostomy and gastrostomy tube placement, and the likelihood of being discharged home from the hospital.

RESULTS: We studied 346 patients with aSAH; median age 55 years (Interquartile range IQR 46,64), median Hunt and Hess 3 [IQR 1-5]. Overall, 68.6% (n=238) had TCD-vasospasm, and 28% (n=97) had …

Upper Limb Nerve Transfer Surgery In Patients With Tetraplegia, Saad Javeed, Christopher F Dibble, Jacob K Greenberg, Justin K Zhang, Jawad M Khalifeh, Yikyung Park, Thomas J Wilson, Eric L Zager, Amir H Faraji, Mark A Mahan, Lynda J Yang, Rajiv Midha, Neringa Juknis, Wilson Z Ray

2020-Current year OA Pubs

IMPORTANCE: Cervical spinal cord injury (SCI) causes devastating loss of upper extremity function and independence. Nerve transfers are a promising approach to reanimate upper limbs; however, there remains a paucity of high-quality evidence supporting a clinical benefit for patients with tetraplegia.

OBJECTIVE: To evaluate the clinical utility of nerve transfers for reanimation of upper limb function in tetraplegia.

DESIGN, SETTING, AND PARTICIPANTS: In this prospective case series, adults with cervical SCI and upper extremity paralysis whose recovery plateaued were enrolled between September 1, 2015, and January 31, 2019. Data analysis was performed from August 2021 to February 2022.

INTERVENTIONS: Nerve …

Self-Care Management Of Bothersome Symptoms As Recommended By Clinicians For Patients With A Chronic Condition: A Delphi Study, Heleen Westland, Shayleigh Dickson Page, Michelle Van Rijn, Subhash Aryal, Kenneth E Freedland, Christopher Lee, Anna Strömberg, Ercole Vellone, Douglas J Wiebe, Tiny Jaarsma, Barbara Riegel

2020-Current year OA Pubs

BACKGROUND: Chronically medically ill patients often need clinical assistance with symptom management, as well as self-care interventions that can help to reduce the impact of bothersome symptoms. Experienced clinicians can help to guide the development of more effective self-care interventions.

OBJECTIVE: To create a consensus-based list of common bothersome symptoms of chronic conditions and of self-care management behaviors recommended to patients by clinicians to reduce the impact of these symptoms.

METHODS: A two-round Delphi study was performed among an international panel of 47 clinicians using online surveys to identify common and bothersome symptoms and related self-care management behaviors recommended to …

Guidance For The Diagnosis And Treatment Of Hypolipidemia Disorders, Cindy Bredefeld, Nicholas O Davidson, Et Al.

2020-Current year OA Pubs

The Abetalipoproteinemia and Related Disorders Foundation was established in 2019 to provide guidance and support for the life-long management of inherited hypocholesterolemia disorders. Our mission is "to improve the lives of individuals and families affected by abetalipoproteinemia and related disorders". This review explains the molecular mechanisms behind the monogenic hypobetalipoproteinemia disorders and details their specific pathophysiology, clinical presentation and management throughout the lifespan. In this review, we focus on abetalipoproteinemia, homozygous hypobetalipoproteinemia and chylomicron retention disease; rare genetic conditions that manifest early in life and cause severe complications without appropriate treatment. Absent to low plasma lipid levels, in particular cholesterol …

To Calibrate Or Not To Calibrate? A Methodological Dilemma In Experimental Pain Research, Waclaw M Adamczyk, Tibor M Szikszay, Hadas Nahman-Averbuch, Jacek Skalski, Jakub Nastaj, Philip Gouverneur, Kerstin Luedtke

2020-Current year OA Pubs

To calibrate or not to calibrate? This question is raised by almost everyone designing an experimental pain study with supra-threshold stimulation. The dilemma is whether to individualize stimulus intensity to the pain threshold / supra-threshold pain level of each participant or whether to provide the noxious stimulus at a fixed intensity so that everyone receives the identical input. Each approach has unique pros and cons which need to be considered to i) accurately design an experiment, ii) enhance statistical inference in the given data and, iii) reduce bias and the influence of confounding factors in the individual study e.g., body …

Local Failure Events In Prostate Cancer Treated With Radiotherapy: A Pooled Analysis Of 18 Randomized Trials From The Meta-Analysis Of Randomized Trials In Cancer Of The Prostate Consortium (Leviathan), Ting Martin Ma, Jeff M Michalski, Et Al.

2020-Current year OA Pubs

CONTEXT: The prognostic importance of local failure after definitive radiotherapy (RT) in National Comprehensive Cancer Network intermediate- and high-risk prostate cancer (PCa) patients remains unclear.

OBJECTIVE: To evaluate the prognostic impact of local failure and the kinetics of distant metastasis following RT.

EVIDENCE ACQUISITION: A pooled analysis was performed on individual patient data of 12 533 PCa (6288 high-risk and 6245 intermediate-risk) patients enrolled in 18 randomized trials (conducted between 1985 and 2015) within the Meta-analysis of Randomized Trials in Cancer of the Prostate Consortium. Multivariable Cox proportional hazard (PH) models were developed to evaluate the relationship between overall survival …

International Consensus Guidelines For Adjuvant Radiation Therapy For Bladder Cancer After Radical Cystectomy: Update From An Ibis Workgroup, Flor Verghote, Paul Sargos, John P Christodouleas, Vedang Murthy, Brian C Baumann, Piet Dirix, Charlien Berghen, Leen Paelinck, Tom Vercauteren, Valérie Fonteyne

2020-Current year OA Pubs

PURPOSE: In 2016, international consensus clinical target volume (CTV) guidelines for adjuvant radiation treatment after radical cystectomy in patients with muscle-invasive bladder cancer with high risk for locoregional failure (LRF) were published. A subsequent external validation study recommended several CTV optimizations (CTV-OPT). This study aimed to update international consensus guidelines based on new clinical experiences.

METHODS AND MATERIALS: Phase 1 (delineation interobserver variability): Four observers delineated the CTV of 9 patients post radical cystectomy, as in clinical practice. Interobserver agreement in contouring was evaluated using volume- and κ-statistics. Phase 2 (pattern of failure analysis): Among a prospective cohort of 72 …

A Report Of 2 Cases Of The Use Of The Inari Flowtriever System In The Treatment Of Pulmonary Embolism, Richard Pham, Alexander Sasha Ushinsky, Naganathan Mani, Pavan K Kavali

2020-Current year OA Pubs

The FlowTriever System (Inari Medical, Irvine, California) is the first FDA-approved mechanical thrombectomy device used for treatment of pulmonary embolism. This device enables nonsurgical removal of pulmonary blood clots without the use of thrombolytic medication and its associated risks. We report 2 cases of successful application of the Inari FlowTriever in treatment of pulmonary embolism and right atrial thrombus.

Ascertainment Of Vaccination Status By Self-Report Versus Source Documentation: Impact On Measuring Covid-19 Vaccine Effectiveness, Meagan Stephenson, Jennie H Kwon, Et Al

2020-Current year OA Pubs

BACKGROUND: During the COVID-19 pandemic, self-reported COVID-19 vaccination might facilitate rapid evaluations of vaccine effectiveness (VE) when source documentation (e.g., immunization information systems [IIS]) is not readily available. We evaluated the concordance of COVID-19 vaccination status ascertained by self-report versus source documentation and its impact on VE estimates.

METHODS: Hospitalized adults (≥18 years) admitted to 18 U.S. medical centers March-June 2021 were enrolled, including COVID-19 cases and SARS-CoV-2 negative controls. Patients were interviewed about COVID-19 vaccination. Abstractors simultaneously searched IIS, medical records, and other sources for vaccination information. To compare vaccination status by self-report and documentation, we estimated percent agreement …

Better Operating Room Ventilation As Determined By A Novel Ventilation Index Is Associated With Lower Rates Of Surgical Site Infections, Bernard Surial, Andrew Atkinson, Rüdiger Külpmann, Arnold Brunner, Kurt Hildebrand, Benoît Sicre, Nicolas Troillet, Andreas Widmer, Eveline Rolli, Judith Maag, Jonas Marschall

2020-Current year OA Pubs

OBJECTIVE: The aim was to assess the impact of operating room (OR) ventilation quality on surgical site infections (SSIs) using a novel ventilation index.

BACKGROUND: Previous studies compared laminar air flow with conventional ventilation, thereby ignoring many parameters that influence air flow properties.

METHODS: In this cohort study, we surveyed hospitals participating in the Swiss SSI surveillance and calculated a ventilation index for their ORs, with higher values reflecting less turbulent air displacement. For procedures captured between January 2017 and December 2019, we studied the association between ventilation index and SSI rates using linear regression (hospital-level analysis) and with the …

American Cochlear Implant Alliance Task Force Guidelines For Clinical Assessment And Management Of Adult Cochlear Implantation For Single-Sided Deafness, Margaret T. Dillon, Armine Kocharyan, Ghazal S. Daher, Matthew L. Carlson, William H. Shapiro, Hillary A. Snapp, Jill B. Firszt

2020-Current year OA Pubs

The indications for cochlear implantation have expanded to include individuals with profound sensorineural hearing loss in the impaired ear and normal hearing (NH) in the contralateral ear, known as single-sided deafness (SSD). There are additional considerations for the clinical assessment and management of adult cochlear implant candidates and recipients with SSD as compared to conventional cochlear implant candidates with bilateral moderate to profound sensorineural hearing loss. The present report reviews the current evidence relevant to the assessment and management of adults with SSD. A systematic review was also conducted on published studies that investigated outcomes of cochlear implant use on …

An Assessment Of Pediatric Residency Applicant Perceptions Of "Fit" During The Virtual Interview Era, Jason D. Vadhan, Jorge G. Zarate Rodriguez, Michael Wallendorf, Michael M. Awad, Andrew J. White

2020-Current year OA Pubs

PURPOSE: Residency recruitment events and interviews are widely considered an integral component of the residency match experience. Due to the COVID-19 pandemic, residency recruitment and interviewing throughout the 2020-2021 academic year were performed virtually, which created challenges for applicants' ability to discern "fit" to a program. Given this change, it is reasonable to suspect that applicants would be less able to discern program fit. Therefore, this study evaluated how virtual interviews impacted pediatric residency applicants' ability to assess factors contributing to fit and subsequently how applicants assessed their self-perceived fit to their top-ranked programs.

METHODS: An online, anonymous survey was …

Real-World Utilization And Outcomes Of Systemic Therapy Among Patients With Advanced Or Recurrent Endometrial Cancer In The United States, Jinan Liu, Bruno Emond, Eric M Maiese, Marie-Hélène Lafeuille, Patrick Lefebvre, Isabelle Ghelerter, Caterina Wu, Jean A Hurteau, Premal H Thaker

2020-Current year OA Pubs

OBJECTIVE: Evaluate systemic therapy utilization patterns and outcomes by line of therapy among patients with advanced/recurrent endometrial cancer (EC) treated in the United States.

METHODS: This retrospective observational study used the Optum Clinformatics Extended Data Mart Date of Death database (1 January 2004-31 December 2019) and included de-identified data from adult patients with advanced/recurrent EC who were treated with first-line (1L) platinum-based chemotherapy and initiated second-line (2L) anti-neoplastic therapy. The index date was the date of 1L therapy initiation. The number and sequence of treatments received and the proportion of patients who received each type of treatment for each line …

The Serotonin Receptor 3e Variant Is A Risk Factor For Female Ibs-D, Nikola Fritz, Gregory Sayuk, Et Al.

2020-Current year OA Pubs

Irritable bowel syndrome (IBS) is a gut-brain disorder of multifactorial origin. Evidence of disturbed serotonergic function in IBS accumulated for the 5-HT

Dose-Dependent Seizure Control With Mek Inhibitor Therapy For Progressive Glioma In A Child With Neurofibromatosis Type 1, Evan Cantor, Ashley Meyer, Stephanie M Morris, Judith L Z Weisenberg, Nicole M Brossier

2020-Current year OA Pubs

BACKGROUND: Low-grade gliomas (LGGs) occurring in children can result in many different neurologic complications, including seizures. MEK inhibitors are increasingly being used to treat LGG, but their effect on associated neurologic symptoms has not been established.

RESULTS: Here, we report a patient with neurofibromatosis type 1 (NF1), medically refractory epilepsy (MRE), and an extensive optic pathway glioma (OPG) who developed dose-dependent seizure control while being treated with selumetinib. Seizure frequency rebounded after dose reduction for cardiac toxicity, then improved, and finally ceased after restarting full dosing, allowing confidence in the cause of improvement.

CONCLUSION: Selumetinib may have promise in epilepsy …

Loneliness, Social Isolation, And Social Support In Older Adults With Active Cancer During The Covid-19 Pandemic, Katherine Clifton, Feng Gao, Joann Jabbari, Mary Van Aman, Patricia Dulle, Janice Hanson, Tanya M Wildes

2020-Current year OA Pubs

INTRODUCTION: The COVID-19 pandemic has had a considerable impact on mental health. The social distancing and stay-at-home orders have likely also impacted loneliness, social isolation, and social support. Older adults, particularly those with comorbidities such as cancer, have a greater potential to be impacted. Here we assessed loneliness, social isolation, and social support in older adults undergoing active cancer treatment during the pandemic.

MATERIALS AND METHODS: A mixed methods study in which quantitative data and qualitative response items were collected in parallel was conducted in 100 older adults with cancer. Participants completed a survey by telephone with a series of …

A Comparison Of Methods To Harmonize Cortical Thickness Measurements Across Scanners And Sites, Delin Sun, Evan Gordon, Et Al.

2020-Current year OA Pubs

Results of neuroimaging datasets aggregated from multiple sites may be biased by site-specific profiles in participants' demographic and clinical characteristics, as well as MRI acquisition protocols and scanning platforms. We compared the impact of four different harmonization methods on results obtained from analyses of cortical thickness data: (1) linear mixed-effects model (LME) that models site-specific random intercepts (LME

Clinical Characteristics Of Children With Cerebral Injury Preceding Treatment Of Diabetic Ketoacidosis, Nicole S Glaser, Kimberly S Quayle, Et Al.

2020-Current year OA Pubs

Previous studies have identified more severe acidosis and higher blood urea nitrogen (BUN) as risk factors for cerebral injury during treatment of diabetic ketoacidosis (DKA) in children; however, cerebral injury also can occur before DKA treatment. We found that lower pH and higher BUN levels also were associated with cerebral injury at presentation.