Medicine and Health Sciences Commons^™

Patenting The Unexpected, Sean B. Seymore

Vanderbilt Law School Faculty Publications

Unexpected discoveries have transformed human existence. They’ve revolutionized science and spawned entire new fields of research. While unexpected discoveries seem inventive and worthy of patent protection, they don’t formally align with traditional patent theory. The bedrock principle that an invention begins with the conception of an idea in the inventor’s mind and ends with implementation doesn’t apply to unexpected discoveries. This misalignment is most acute for pharmaceuticals, where the discovery of new uses for old drugs has tremendous social and economic importance. Since a drug can inherently treat multiple conditions in a patient—even those unknown to the patient, doctor, or …

Beyond Parallel Programmes: A Roadmap For Operational Integration Of Family Planning And Nutrition In Low- And Middle-Income Countries, Marleen Temmerman, Samuel Ojong

Centre of Excellence in Women and Child Health

No abstract provided.

Daily Outdoor Pm2.5 Exposure Characterization And Road Edge Effect During A 2022 - 2023 Monitoring Campaign In Gambia, Kenya And Mozambique, Terence Mushore, Handsome Nyoni, Laura Munthali, Sibusisiwe Makhanya, Laurine Chikoko, Anotida Chapunza, Stanley Luchters, Matthew Chersich, Marleen Temmerman, Angela Koech

Centre of Excellence in Women and Child Health

Air pollution is a major contributor to mortality and adverse health outcomes, particularly in pregnant women and children, with vehicular emissions as a key source. This study aimed to characterize long-term exposure to fine particulate matter (PM2.5), evaluate potential health risks, and quantify the contribution of road transport and proximity to roads in The Gambia, Kenya, and Mozambique. Multi-temporal personal exposure data were interpolated into continuous spatial surfaces and aggregated into daily averages, which were then compared with World Health Organization (WHO) guidelines to assess potential health impacts. Multi-distance buffers at 10 m intervals up to 1000m from major roads …

When Birth Control Turns Biliary: A Rare Case Of Profound Hyperbilirubinemia From Oral Contraceptives, Taiwo Ajani, Aura Calderon, Jose J. Loayza Pintado, Nayiri Derian, Catherine Matos, Ivan Mogollon, Andres Suarez Parraga

School of Medicine Publications

Oral contraceptives (OCs) are extensively utilized and generally considered safe (reference); nonetheless, infrequent hepatobiliary complications such as cholestasis and hyperbilirubinemia have been documented, particularly among individuals with a genetic predisposition. We present a case involving a 19-year-old female who exhibited significant conjugated hyperbilirubinemia shortly after the commencement of OC therapy. Comprehensive investigations ruled out alternative causes, and the findings from liver biopsy, in conjunction with the clinical context, indicated an estrogen-induced cholestatic injury, likely revealing an underlying Dubin–Johnson syndrome. This case underscores the critical necessity of acknowledging hepatic adverse effects associated with estrogen as well as the influence of genetic …

A Market Of Care Skills: Profiting From Professional Education And Practice, Yasmin Y. Ortiga

Research Collection School of Social Sciences

Who profits from the commodification of care and how does such accumulation occur? Focusing on the case of the nursing care market, this paper shows how professional schools and local hospitals within source nations like the Philippines profit from nurses seeking the credentials to qualify for jobs overseas. While existing studies show how nursing skills are exploited and undervalued, this paper argues that it is the process of skilling itself that allows for the accumulation of profit, regardless of whether nurses leave their origin countries to work abroad. This study reveals how global care economies are tightly linked to local …

Building Qualitative Research Capacity In The Global Health Workforce And Developing A Community Of Practice In Parts Of Sub-Saharan Africa: A Case Study, Jack Lumsdon, Catherine Dotchin, Albert Akpalu, Benedict Calys-Tagoe, Dilraj Sokhi, Momodou Cham, Njideka Okubadejo, Richard Morton, Violet Naanyu, Richard Walker

Internal Medicine, East Africa

Background Qualitative research offers unique insights into the lived experience of individuals with chronic conditions which can tie directly into public health priorities and identifying the need for additional support. More participatory approaches and qualitative data surrounding chronic diseases are needed in sub-Saharan Africa (SSA). Valuable “insider” insights are often missing as the conceptualisation of research often overlooks the value of such interactions. For successful and meaningful global health research, it is imperative to involve in-country experts and strengthen the capacity of research teams with qualitative skills.

Methods To address this, two hybrid qualitative research skills workshops were conducted in …

Renal Adverse Effects Of Antiangiogenic Agents In A Tertiary Hospital In Kenya, Joan Wambugu, Joyce Bwombengi, Jasmit Shah, Manel Haj Mansour

Internal Medicine, East Africa

Introduction Anti-angiogenic therapies, including vascular endothelial growth factor (VEGF) inhibitors and tyrosine kinase inhibitors (TKIs), have transformed cancer management by targeting tumor vasculature and suppressing metastasis. However, these agents can induce renal toxicities such as hypertension, proteinuria, and acute kidney injury (AKI), which may affect treatment continuity and outcomes. Data from sub-Saharan Africa on these adverse effects remains scarce.

Methods This was a retrospective cross-sectional study conducted at the Aga Khan University Hospital, Nairobi, oncology clinic. Medical records of adult patients receiving anti-angiogenic therapy between January 2020 and December 2024 were reviewed. Demographic data, comorbidities, treatment regimens, renal parameters, and …

Transfusion In Transit: A Decade Of Prehospital Blood Transfusion In Pediatric Trauma, Krysta M Sutyak, Eunise C Chen, Lea Mock, Rudolfo Cabrera, Jeannette M Joly, Kuojen Tsao, Bryan A Cotton, David E Meyer, Charles S Cox, Kevin P Lally, Natalie A Drucker

The Brown Foundation: Institute of Molecular Medicine

Background: Prehospital blood transfusion improves mortality in adults, with limited evidence in children. This study describes prehospital blood transfusion in pediatric trauma patients and the impact on shock index, pediatric adjusted (SIPA).

Methods: This study is a retrospective cohort study of trauma patients younger than 18 years who received blood transfusions during helicopter transport to a Level 1 pediatric trauma center from 2011 to 2023. Primary outcome was change in SIPA at time of emergency department (ED) arrival with prehospital transfusion. Secondary subgroup analysis was performed based on transport origin.

Results: Of 137 patients, 58% (80 of 137 patients) were …

Affinity-Optimized Trop2 Antibodies Support Potent Antitumor Activity In Antibody-Drug Conjugates, Aiko Yamaguchi, Junping Hong, Leike Li, Kiyotaka Kobayashi, Chisato M Yamazaki, Summer Y Y Ha, Yasuaki Anami, Wei Xiong, Junquan Liu, Zhiqiang An, Ningyan Zhang, Kyoji Tsuchikama

The Brown Foundation: Institute of Molecular Medicine

Background: Trophoblast cell surface antigen 2 (TROP2) is frequently overexpressed in epithelial tumors and is associated with poor prognosis, making it an attractive therapeutic target. Antibody-drug conjugates (ADCs) directed against TROP2 show clinical benefit, but expression in normal tissues such as skin raises concerns about on-target, off-tumor toxicity. Strategies that improve antitumor efficacy without increasing toxicity are needed.

Methods: Using an in-house phage library, we identified and characterized a novel fully human monoclonal antibody recognizing a unique conformational epitope of TROP2 with reduced binding affinity. This antibody was engineered into homogeneous ADCs carrying auristatin and/or duocarmycin payloads. Comparative studies with …

Telomerase Knockout In Myeloid Cells Predisposes Mice To Foam Cell Formation, Dyslipidemia, Lung Fibrosis, And Cardiac Dysfunction, Zhanguo Gao, Yongmei Yu, David Wiggins, Eva M Sevick-Muraca, Mikhail G Kolonin

The Brown Foundation: Institute of Molecular Medicine

Aging-associated changes in myeloid cells are incompletely understood. One of the culprits of aging is the downregulation of the Tert gene coding for the catalytic subunit of telomerase. Studies of mouse models with Tert knockout (KO) in specific cells have revealed the importance of the telomere-independent noncanonical function of TERT in supporting mitochondrial metabolism and protection from cell senescence. To investigate the role of TERT in myeloid cells (MCs), we analyzed mice with Tert KO in the LysM+ lineage, indelibly labeled with membrane green fluorescent protein (mG). Macrophage numbers and properties in various organs were compared. Changes in the vasculature, …

Availability Of Cancer Screening Across Hiv Treatment Sites In The Iedea Consortium, Rachael Pellegrino, Bryan Shepherd, Sanjay Pujari, Valeria Fink, Gad Murenzi, Miriam Nakalembe, Sally Coburn, Eliane Rohner, Antoine Jaquet, Elkanah Orang'o

Obstetrics and Gynaecology, East Africa

Cancer remains a leading cause of morbidity and mortality in people with HIV, and the importance of cancer screening increasesas this population ages. In 2017, 2020, and 2023, cross-sectional surveys were conducted at HIV care sites across 5 continentswithin the International epidemiology Databases to Evaluate AIDS (IeDEA) consortium. We described cancer screening avail-ability in 2023 and over time for cervical and anal cancer screening using generalized estimating equations with a logit linkfunction to account for site clustering, rurality, and country income. Of the 220 sites in the 2023 survey, 61% (134/220) reportedcervical cancer screening by cytology or human papillomavirus (HPV) …

Availability Of Cancer Screening Across Hiv Treatment Sites In The Iedea Consortium, Rachael Pellegrino, Bryan Shepherd, Sanjay Pujari, Valeria Fink, Gad Murenzi, Miriam Nakalembe, Sally Coburn, Eliane Rohner, Antoine Jaquet, Elkanah Orang'o

Obstetrics and Gynaecology, East Africa

Cancer remains a leading cause of morbidity and mortality in people with HIV, and the importance of cancer screening increasesas this population ages. In 2017, 2020, and 2023, cross-sectional surveys were conducted at HIV care sites across 5 continentswithin the International epidemiology Databases to Evaluate AIDS (IeDEA) consortium. We described cancer screening avail-ability in 2023 and over time for cervical and anal cancer screening using generalized estimating equations with a logit linkfunction to account for site clustering, rurality, and country income. Of the 220 sites in the 2023 survey, 61% (134/220) reportedcervical cancer screening by cytology or human papillomavirus (HPV) …

Natural Language Generation In Healthcare: A Review Of Methods And Applications, Mengxian Lyu, Xiaohan Li, Ziyi Chen, Jinqian Pan, Cheng Peng, Sankalp Talankar, Yonghui Wu

Faculty, Staff and Student Publications

Objective: This study presents a systematic review of natural language generation (NLG) methods and applications in the medical domain, providing quantitative and qualitative analyses to answer four key research questions regarding methods, evaluation, applications, and challenges of NLG in healthcare.

Methods: We searched PubMed, ACM Digital Library, Web of Science, Science Direct, Scopus, Embase, and ACL Anthology for NLG-related studies in healthcare from 2018 to 2024. Out of 3,988 research articles, 113 met the inclusion criteria and were analyzed across data modality, model architecture, evaluation metrics, and application domain.

Results and conclusion: NLG in healthcare has grown substantially, with annual …

Traumatic Brain Injury And Risk Of Early-Onset Dementia: A Population-Based Cohort Study, Aishwarya Saravanan, Katherine Giorgio, Natalia Lakomski, Andrea L C Schneider, Barbara A Olson-Bullis, Behnam Sabayan, James S Pankow, Paul S De Vries, Kristine Yaffe, Alexa Beiser, Abbas Dehghan, Elizabeth A Peterson, Rachel Zmora, John J Stephen, Denise Scholtens, Maxwell Mansolf, Lenore J Launer, Richard F Maclehose, Pamela L Lutsey, Norrina B Allen, Sanaz Sedaghat

Faculty, Staff and Student Publications

Introduction: We investigated the association between traumatic brain injury (TBI) and incidence of early-onset dementia (EOD) versus late-onset dementia (LOD).

Methods: We included 501,710 UK Biobank participants (average age 56.5). Over a median 13.6 years of follow-up, 836 developed EOD (before 65) and 8947 developed LOD (after 65). We estimated hazard ratios (HRs) for TBI's association with EOD and LOD using Cox proportional hazard models with TBI as a time-varying exposure and coefficient.

Results: TBI was associated with higher risk of both EOD (HR: 4.06 [95% confidence interval: 3.13, 5.26]) and LOD (HR: 2.51 [2.31, 2.72]. Among participants included in …

Double-Crispr Knockout Simulation (Dkosim): A Monte-Carlo Randomization System To Model Cell Growth Behavior And Infer The Optimal Library Design For Growth-Based Double Knockout Screens, Yue Gu, Traver Hart, Luis Leon-Novelo, John Paul Shen

Faculty, Staff and Student Publications

Advances in functional genomic technology, notably CRISPR using Cas9 or Cas12, now allow for large-scale double perturbation screens in which pairs of genes are inactivated, allowing for the experimental detection of genetic interactions (GIs). However, as it is not possible to validate GIs in high-throughput, there is no gold standard dataset where true interactions are known. Hence, we constructed a Double-CRISPR Knockout Simulation (DKOsim), which allows users to reproducibly generate synthetic simulation data where the single gene fitness effect of each gene and the interaction of each gene pair can be specified by the investigator. We adapted Monte-Carlo randomization methods …

Continuous Versus Bolus Norepinephrine Administration To Treat Hypotension After Induction Of General Anaesthesia In Low-To-Moderate Risk Noncardiac Surgery Patients: A Randomised Trial, Kristen K Thomsen, Finn Külls, Christina Vokuhl, Linda Krause, Dominik Müller, Max Bossemeyer, Mirja Wegge, Alina Kröker, Alina Bergholz, Christian Zöllner, Daniel I Sessler, Bernd Saugel

Faculty, Staff and Student Publications

Background: Hypotension after induction of general anaesthesia (postinduction hypotension) is common in patients undergoing noncardiac surgery and frequently requires treatment with vasopressors such as norepinephrine. We tested the hypothesis that giving norepinephrine continuously using a syringe infusion pump, compared with giving it as repeated manual boluses, reduces postinduction hypotension within 15 min after starting induction of general anaesthesia in low-to-moderate risk noncardiac surgery patients.

Methods: Patients undergoing elective noncardiac surgery were randomised to either continuous norepinephrine infusion or manual bolus norepinephrine administration intravenously during induction of general anaesthesia. In both groups, norepinephrine was administered through a peripheral venous catheter. Blood …

Fatigue Survival And Biomechanical Behavior Of Two-Piece Titanium And Zirconia Dental Implants, Jefferson David Melo De Matos, Guilherme Da Rocha Scalzer Lopes, Nathália De Carvalho Ramos, Mário Alexandre Coelho Sinhoreti, Alexandre Luiz Souto Borges, Daher Antonio Queiroz, Marco Antonio Bottino

Faculty, Staff and Student Publications

Background: Titanium implants are considered the gold standard for oral rehabilitation; however, zirconia implants have emerged as a metal-free alternative with promising esthetic and biological properties. Despite these advantages, limited evidence is available regarding their long-term fatigue behavior and fracture resistance.

Material and methods: In this in vitro experimental study conducted at São Paulo State University (UNESP), Brazil, forty implants were divided into two groups (n = 20): zirconia implants (ZZ) and titanium implants (TZ) (4.1 × 10 mm). Implants were embedded in polyurethane blocks according to ISO 14801:2016 specifications. Monolithic zirconia crowns were fabricated using CAD/CAM technology and cemented …

Exploring Single Celled Rna Biomarkers Using Deconvolution Analysis For Severe Retinopathy Of Prematurity In Extremely Premature Newborns, Vighnesh Ghatpande, Saachi A. Bodas, Nitin Chouthai

Conference Presentation Abstracts

Background: Timely, precise diagnosis of Retinopathy of Prematurity (ROP) is key to implementing appropriate treatment, as distinctions between mild-ROP and severe-ROP are the primary factors in its characterization. Deconvolution analysis of bulk RNA sequencing is an indirect method to identify static and dynamic molecular and physiological associations.

Objective: The objective of this this study was to evaluate if deconvolution analysis can be used to identify cellular biomarkers of ROP.

Design/Methods: This is a prospective study (IRB#086113MP2E) with a convenience sample size of 8 neonates with no ROP, 6 neonates with mild to moderate ROP (M-ROP), and 7 neonates with severe …

Maternal Infection At Delivery And Risk Of Stillbirth And Early Neonatal Death: Nested Case-Control Studies In East African Pregnancy Cohorts, Anna Seale, Meron Kebede, Rosanna Glazik, Mussie Brhane, Mulu Berihun, Zelalem Teklemariam, Dadi Marami, Joseph Oundo, Tadesse Gure, Angela Koech

Centre of Excellence in Women and Child Health

Background Stillbirths and early neonatal deaths remain common in low- and middle-income countries. Maternal infections are likely contributors, but data are extremely limited. We aimed to describe maternal infections at delivery and their association with perinatal death.

Methods We investigated maternal infections at delivery in two hospitals in East Africa: in Kilifi County Hospital (2011–2017), Kenya, and Hiwot Fana Comprehensive Specialised Hospital (2019–2020), Ethiopia. We compared 642 mothers delivering stillbirths/newborns dying in the first 24 h after birth (cases) and 855 mothers with newborns surviving ≥ 24 h (controls) from pregnancy cohorts. We tested maternal blood with molecular diagnostic panels …

Deep Learning In Fetal, Infant, And Toddler Neuroimaging Research, Jenna H Chin, Madeleine K Wyburd, Vladislav Ayzenberg, Laurie Bayet, Berkin Bilgic, Emily M Chen, Yuting Chen, Áine Dineen, Shohei Fujita, Janelle Liu, Yohan Jun, M Catalina Camacho, Lilla Zöllei

2020-Current year OA Pubs

Artificial intelligence (AI) is increasingly being integrated into everyday tasks and work environments. However, its adoption in medical image analysis has progressed more slowly due to high clinical stakes, limited availability of labeled data, and substantial variability in imaging protocols and population. These challenges are further pronounced in the field of fetal, infant, and toddler (FIT) neuroimaging, where datasets are especially scarce and subject to large amounts of anatomical variability. However, deep learning (DL), a specific method within machine learning, which is itself a subfield of AI, has emerged as a powerful framework to adapt to the challenges of medical …

Performance Of Multiple Multi-Cancer Detection Tests Using A Large Independent Reference Set (Alliance A212102), Marie E Wood, Mark Watson, Et Al.

2020-Current year OA Pubs

BACKGROUND: Reference sets are needed to evaluate performance of multi-cancer detection (MCD) assays. The National Cancer Institute funded the Alliance reference set study to assess MCDs for use in future trials.

METHODS: Individuals with cancer and controls were recruited; blood specimens were collected prior to cancer treatment. A performance evaluation study was designed utilizing reference set samples. Companies (n = 6) were selected to participate based on review of performance data and ability to utilize the blood collection tube. Companies received samples from cancer types their assay was designed to detect ("targeted"), plus additional "non-targeted" and control samples. Companies reported …

Technology-Assisted Total Hip Arthroplasty: A Contemporary Analysis Of Regional Trends, National Trends, And 90-Day Outcomes In A Nationwide Cohort, Amy Y Zhao, Alex Gu, Gireesh Reddy, Bryant M Song, Ilya Bendich, Andrew M Schneider

2020-Current year OA Pubs

BACKGROUND: Technology-assisted total hip arthroplasty (THA)-including computer-navigated and robotic-assisted techniques-has emerged as a strategy to enhance component alignment and potentially improve postoperative outcomes. Although prior studies have described increasing utilization, contemporary trends and associated complication rates remain underexplored.

METHODS: A retrospective cohort study was conducted using a large national database to identify patients who underwent primary elective THA between 2010 and 2023. Patients were stratified into conventional vs technology-assisted THA groups, with the latter defined by the use of computer navigation or robotic assistance. Annual utilization trends were evaluated using linear regression, and 90-day postoperative complications were compared using multivariate …

Automating Evaluation Of Llm-Generated Responses To Patient Questions About Rare Diseases, Min Zhao, Inez Y Oh, Aditi Gupta, Sally Cohen-Cutler, Kathryn M Harmoney, Albert M Lai, Bryan A Sisk

2020-Current year OA Pubs

OBJECTIVES: Patients with rare diseases often struggle to find accurate medical information, and large language model (LLM)-based chatbots may help meet this need. However, evaluating LLM-generated free-text answers typically requires physician review, which is time-consuming and difficult to scale. This study compared traditional natural language processing (NLP) metrics to emerging LLM-based evaluation approaches for assessing answer quality in the context of Complex Lymphatic Anomalies (CLAs).

MATERIALS AND METHODS: We compiled 25 common patients' questions about CLAs and generated 175 responses to these questions from seven LLMs. Three expert physicians scored these responses for accuracy. We compared these physician-assigned scores with …

Ten Tips On How To Prevent And Manage Post-Transplant Lymphoproliferative Disease In Kidney Transplant Recipients, Rose Mary Attieh, Armin Ghobadi, Naoka Murakami

2020-Current year OA Pubs

Post-transplant lymphoproliferative disease (PTLD) remains a challenging and high-impact complication of kidney transplantation, requiring thoughtful prevention, timely recognition, and multidisciplinary management. Key strategies include careful selection of immunosuppressive regimens, particularly avoiding belatacept in Epstein-Barr virus (EBV)-seronegative recipients and exercising caution with lymphodepleting induction in EBV-mismatched pairs, along with targeted EBV surveillance in high-risk patients. Once PTLD is suspected or confirmed, accurate staging and a stepwise treatment approach beginning with reduction of immunosuppression and escalating to rituximab, chemotherapy, or advanced cellular therapies are essential, with EBV-CTLs and chimeric antigen receptor T-cell therapy offering promising options in refractory disease. Close monitoring for …

Metabolically Reprogrammed Eosinophils Impair T Cell Immunity And Cause Chronic Skin Infection, David Barinberg, Heidi Sebald, Tobias Gold, Baplu Rai, Daniel Radtke, Dominik Lerm, David Voehringer, Jonathan Jantsch, Stefan Wirtz, Alina Ulezko Antonova, Marco Colonna, Christian Bogdan, Ulrike Schleicher

2020-Current year OA Pubs

Eosinophils exhibit antimicrobial, cytotoxic and immunoregulatory effects, but our knowledge of their transcriptional and functional heterogeneity is still limited, especially in non-intestinal tissues. Here, we used a mouse model of chronic cutaneous inflammation elicited by the protozoan pathogen Leishmania mexicana to investigate the function and transcriptional dynamics of skin eosinophils. Infection of C57BL/6 mice triggered local and systemic eosinophilia that was driven by type 2 innate lymphoid cells and interleukin-5. Genetic and pharmacological eosinophil depletion led to an enhanced Th1 response, polarization towards M1-like macrophages and resolution of clinical disease, despite an unexpected simultaneous upregulation of IL-4. Single-cell transcriptomics revealed …

Sialidosis Type I: How To Alleviate Disabling Myoclonic Seizures? - A Multicenter Analysis Of Eight Cases And Review Of The Literature, Janina Gburek-Augustat, Shao Ching Tu, Marwan Shinawi, Isabel Alfradique-Dunham, Manouela Valtcheva, Et Al.

2020-Current year OA Pubs

OBJECTIVE: Sialidosis type I (ST-1) is an autosomal-recessive, very rare, progressive lysosomal storage disorder caused by pathogenic variants in NEU1. It is clinically characterized by progressive ataxia, myoclonic seizures (MS), bilateral tonic-clonic seizures (BTCS), and distinctive ophthalmological findings. Given the lack of curative options, in this study, we investigated symptomatic treatment strategies, with a particular focus on the efficacy of antiseizure medications (ASMs).

METHODS: We describe the clinical course of a patient followed from diagnosis to 18 years of age, and review seven additional cases from our cohort. In parallel, we conducted a narrative review of the literature (PubMed, January …

Preoperative Imaging For Cochlear Implantation: A Global Consensus, Farid Alzhrani, Craig Buchman, Et Al.

2020-Current year OA Pubs

OBJECTIVE: Preoperative imaging is vital for cochlear implant surgeries, aiding diagnosis, and surgical planning. This study evaluated global practices and the value of preoperative imaging through an international survey.

METHODS: A cross-sectional survey was conducted among international cochlear implantation experts using a 112-item questionnaire. The study explored imaging modalities, anatomical targets, evaluated parameters, and different imaging approaches' perceived value and risks. Participants were recruited from a global consortium of otolaryngology, otology, neurotology, and cochlear implant surgery professionals.

RESULTS: Thirty-nine practitioners from 36 centers in 16 countries completed the survey (95.1% response rate). All used computed tomography (CT) and magnetic resonance …

Predictors Of Delayed Recovery In Ambulatory Advanced Endoscopic Procedures, Zoilo K Suarez, Alexandria Lenyo, Philip M Frasse, Derek J Platt, Thomas Hollander, Talwinder Nagi, Michael Dedonno, Vladimir Kushnir, Juan Reyes Genere

2020-Current year OA Pubs

BACKGROUND: There is a scarcity of data evaluating patient-related outcomes of advanced or complex endoscopy (ACE) through the post-anesthesia recovery course. Yet, gastrointestinal distress following ACE can occur commonly, and this may impact recovery length of stay and the approach to post-anesthesia care. This study aimed to describe post-procedural symptoms in patients undergoing ACE and identify factors that influence recovery time and course.

METHODS: We retrospectively reviewed a prospectively collected database of patients who underwent ambulatory ACE. Procedural-related symptoms, recovery time, dismissal rate, and adverse events (AE) were recorded. Factors associated with extended recovery time were analyzed using multiple regression …

Predictors Of Opioid Misuse And Abuse Among Pregnant Women In The Us, Henry Ofori Duah, Diane Von Ah, Ethan Morgan

College of Nursing Faculty Research and Publications

Introduction

Opioid misuse and abuse during pregnancy can adversely affect maternal and infant outcomes. Factors that drive the burden of opioid misuse and abuse are multifaceted and understudied. This study sought to explore predictors of opioid misuse and abuse among pregnant women in the United States.

Methods

Secondary data analysis of the National Survey on Drug Use and Health (NSDUH) data from 2015-2019 was performed. The primary outcomes were past-year opioid misuse, past-month misuse, and past-year opioid abuse. Data analysis included weight-adjusted univariate, bivariate, and multivariable logistic regression.

Results

The pooled weighted sample comprised 2,258,599 pregnant women. The prevalence of …

Same Day Discharge Can Be Performed Safely After Atrial Fibrillation Catheter Ablation Using A Wide-Footprint Lattice-Tip Dual-Energy System., Tyler L Taigen, Devi G Nair, Dinesh Sharma, Erich L Kiehl, Jose Osorio, Petr Neuzil, Josef Kautzner, Stavros E Mountantonakis, Andrea Natale, John D Hummel, Shephal K Doshi, Anish K Amin, Usman R Siddiqui, Kelly A Van Bragt, Jeffrey Cerkvenik, Khaldoun G Tarakji, Vivek Y Reddy, Moussa Mansour, Elad Anter

Heart and Vascular Articles

BACKGROUND: Same-day discharge (SDD) after atrial fibrillation (AF) ablation is generally considered safe, since most complications are identified during (or immediately) after the procedure.

OBJECTIVE: This study aimed to evaluate SDD in the SPHERE Persistent-Atrial Fibrillation trial.

METHODS: Patients with persistent AF were randomized to the dual-energy lattice-tip mapping and ablation catheter (investigational) vs a conventional contact-force radiofrequency ablation system (control). SDD and timing of 30-day procedure- or device-related serious adverse events (SAEs) were assessed in the full cohort. In a subset of centers that performed SDD in the trial, predictors of SDD, 30-day readmissions, and mortality rates were assessed. …