Medicine and Health Sciences Commons^™

Towards Global Consensus On Core Outcomes For Hidradenitis Suppurativa Research: An Update From The Historic Consensus Meetings I And Ii, Linnea Thorlacius, Amit Garg, John R. Ingram, Bente Villumsen, P. Theut Riis, Alice B. Gottlieb, Joseph F. Merola, Robert Dellavalle, Gregor B.E Jemec

NYMC Faculty Publications

BACKGROUND: A core outcomes set (COS) is an agreed minimum set of outcomes that should be measured and reported in all clinical trials for a specific condition. Hidradenitis suppurativa (HS) has no agreed-upon COS. A central aspect in the COS development process is to identify a set of candidate outcome domains from a long list of items. Our long list had been developed from patient interviews, a systematic review of the literature and a healthcare professional survey, and initial votes had been cast in two e-Delphi surveys. In this manuscript, we describe two in-person consensus meetings of Delphi participants designed …

Type Ii Brugada Syndrome Syncopal Seizure: A Diagnostic Dilemma, Syed Rafay Ali Sabzwari, Nghia Hoang

Department of Medicine

Background: Type II Brugada syndrome is a rare entity that can present as syncope, sudden cardiac death, palpitations and nocturnal agonal respiration as a manifestation of ventricular tachyarrythmia. Although patients can experience a syncopal seizure, the dilemma between epileptic seizure and syncopal seizure due to type II Brugada syndrome is rarely encountered and reported in literature.

Case: 45 years old caucasian male with history of bicuspid aortic valve and no family history of sudden cardiac death or arrhythmia presented with generalized body shaking, unresponsiveness, mouth frothing and rolling of eyes for 4 minutes during sleep followed by 30 minutes of …

Obesity Is Not Associated With A Differential Outcome Following Coronary Artery Bypass Surgery, Lohit Garg Md, Sahil Agrawal Md, Amitoj Singh, Raman Dusaj, Jamshid Shirani

Department of Medicine

Background: Conflicting data exists regarding the impact of obesity on mortality and morbidity following coronary artery bypass graft (CABG) surgery with some suggesting a paradoxical reduction in adverse outcomes. We aimed to compare the in-hospital outcomes of CABG in obese and non-obese subjects.

Methods: The Nationwide Inpatient Sample for years 2003- 2014 was used to identify adults (age ≥18 years) who underwent isolated CABG.

Results: A total of 2,297,932 patients underwent CABG of which 554,857 (28.2%) surgeries were for acute coronary syndrome (ACS) and 1,743075 (74.2%) were elective. Obese patients in either group were younger, were more likely to be …

Cardiac Amyloidosis Masquerading As Hypertrophic Obstructive Cardiomyopathy, Lohit Garg Md, Naveen Sablani, Amy Ahnert, Bruce Feldman Do

Department of Medicine

Background: Cardiac amyloidosis (CA) remains a diagnostic challenge and is associated with significant morbidity and mortality.

Case: A 67-year old male was referred for septal myomectomy for hypertrophic obstructive cardiomyopathy (HOCM) due to worsening symptoms despite medical therapy. His medical history included chronic diastolic heart failure, and atrial fibrillation post pulmonary vein isolation. His examination revealed mid peaking crescendo-decrescendo systolic murmur, worse on Valsalva. An electrocardiogram revealed normal sinus rhythm and normal voltage. Transthoracic and transesophageal echocardiogram revealed asymmetric septal hypertrophy, chordal systolic anterior motion (SAM), and left ventricular (LV) obstruction with a peak gradient of 40 mmHg at rest. …

Temporal Trends In Incidence, Sepsis-Related Mortality, And Hospital-Based Acute Care After Sepsis., Nathaniel Meyer, Michael O. Harhay, Dylan S. Small, Hallie C. Prescott, Kathryn H. Bowles, David F. Gaieski, Mark E Mikkelsen

Department of Emergency Medicine Faculty Papers

OBJECTIVES: A growing number of patients survive sepsis hospitalizations each year and are at high risk for readmission. However, little is known about temporal trends in hospital-based acute care (emergency department treat-and-release visits and hospital readmission) after sepsis. Our primary objective was to measure temporal trends in sepsis survivorship and hospital-based acute care use in sepsis survivors. In addition, because readmissions after pneumonia are subject to penalty under the national readmission reduction program, we examined whether readmission rates declined after sepsis hospitalizations related to pneumonia.

DESIGN AND SETTING: Retrospective, observational cohort study conducted within an academic healthcare system from 2010 …

A Word From The Writing Center (March 2018), Jennifer Wilson, Ms, Els

A Word From the Writing Team (Newsletter)

This issue includes:

• Writing Center News
• Resources for Writing and Publishing
• Writing Café

Calculation Of Resistive Loads For Elastic Resistive Exercises, Kelsey J. Picha, Timothy L. Uhl

Physical Therapy Faculty Publications

Context:

What is the correct resistive load to start resistive training with elastic resistance to gain strength? This question is typically answered by the clinician's best estimate and patient's level of discomfort without objective evidence.

Objective:

To determine the average level of resistance to initiate a strengthening routine with elastic resistance following isometric strength testing.

Design:

Cohort.

Setting:

Clinical.

Participants:

Thirty-four subjects (31±13yrs, 73±17kg, 170±12cm).

Interventions:

The force produced was measured in Newtons (N) with an isometric dynamometer. The force distance was the distance from center of joint to location of force applied was measured in meters to calculate torque …

A Retrospective Cohort Study Of Quickdash Scores For Three Hand Therapy Acute Upper Limb Conditions, Enrique V. Smith-Forbes, Dana M. Howell, Jason Willoughby, Donald G. Pitts, Timothy L. Uhl

Physical Therapy Faculty Publications

Introduction: The QuickDASH is a valid and reliable outcome measure widely used to assess the function and pain in arm, shoulder, and hand disabilities. A recent study introduced a QuickDASH 80% cut point test to gauge patients at risk of poor outcomes. However, the utility of this test has not been validated.

Purpose: To determine typical QuickDASH scores for three upper limb conditions and to test the sensitivity and specificity of the QuickDASH 80% cut point test in predicting patients at risk of poor outcomes.

Methods: This is a retrospective study with a total of 406 patient records for whom …

National Athletic Trainers' Association Position Statement: Evaluation, Management, And Outcomes Of And Return-To-Play Criteria For Overhead Athletes With Superior Labral Anterior-Posterior Injuries, Lori A. Michener, Jeffrey S. Abrams, Kellie C. Huxel Bliven, Sue Falsone, Kevin G. Laudner, Edward G. Mcfarland, James E. Tibone, Charles A. Thigpen, Timothy L. Uhl

Physical Therapy Faculty Publications

Objective: To present recommendations for the diagnosis, management, outcomes, and return to play of athletes with superior labral anterior-posterior (SLAP) injuries.

Background: In overhead athletes, SLAP tears are common as either acute or chronic injuries. The clinical guidelines presented here were developed based on a systematic review of the current evidence and the consensus of the writing panel. Clinicians can use these guidelines to inform decision making regarding the diagnosis, acute and long-term conservative and surgical treatment, and expected outcomes of and return-to-play guidelines for athletes with SLAP injuries.

Recommendations: Physical examination tests may aid diagnosis; 6 tests are recommended …

Capacity Building In Sub-Saharan Africa: Models Of Care, Patrick J. Loehrer, Barry Rosen, Elkanah Omenge, Julie R. Gralow

Obstetrics and Gynaecology, East Africa

No abstract provided.

Streptococcus Equi Infections In Horses: Guidelines For Treatment, Control, And Prevention Of Strangles—Revised Consensus Statement, A. G. Boyle, John F. Timoney, J. R. Newton, M. T. Hines, A. S. Waller, B. R. Buchanan

Maxwell H. Gluck Equine Research Center Faculty Publications

This consensus statement update reflects our current published knowledge and opinion about clinical signs, pathogenesis, epidemiology, treatment, complications, and control of strangles. This updated statement emphasizes varying presentations in the context of existing underlying immunity and carrier states of strangles in the transmission of disease. The statement redefines the “gold standard” for detection of possible infection and reviews the new technologies available in polymerase chain reaction diagnosis and serology and their use in outbreak control and prevention. We reiterate the importance of judicious use of antibiotics in horses with strangles. This updated consensus statement reviews current vaccine technology and the …

Penile And Scrotal Strangulation Due To Metal Rings: Case Reports And A Review Of The Literature, Neel Patel, Jonathan B. Bloom, Nikil Uppaluri, Michael Iorga, Suraj Parikh, John L. Phillips, Muhammad Choudhury

NYMC Faculty Publications

Penile and scrotal entrapment from a metal ring placed at the base of the penis is a rare, but important clinical dilemma encountered in urology. Emergent presentation to the urologist, after ring placement far longer than safely practiced, risks ischemic and permanent injury to penile, scrotal, and intrascrotal structures. Treating urologists should be aware of the prevalence of metal ring use, their potential complications, and the surgical approach to their safe removal. We present two patients who were identified at our institution with strangulating injuries of retained penile rings. The first patient was a healthy, 43-year-old male with a metal …

Prospective Assessment Of Patients With Stroke In Tikur Anbessa Specialised Hospital, Addis Ababa, Ethiopia, Ayalew Zewdie, Finot Debebe, Sofia Kebede, Aklilu Azazh, Adam Laytin, Golnar Pashmforoosh, Getaw W. Hassen

NYMC Faculty Publications

Introduction: The burden of stroke is increasing in many low- and middle-income countries. In Ethiopia, stroke has become a major cause of morbidity, long-term disability, and mortality. Time from stroke onset to hospital presentation is a critical factor in acute stroke care. This study aimed to describe risk factors for stroke and clinical presentation of patients presenting to the emergency centre with stroke. Methods: We conducted a cross sectional study conducted from August 2015 to January 2016 in an urban tertiary care centre in Addis Ababa, Ethiopia. Descriptive statistics and multivariable logistic regression models were used to evaluate associations between …

Outcome Of Patients With Small Vessel Vasculitis After Renal Transplantation: National Database Analysis, Amr El-Husseini, Sherif Saleh, Omer Hamad, Xiaonan Mei, Ana L. Castellanos, Daniel L. Davenport, Roberto Gedaly, B. Peter Sawaya

Internal Medicine Faculty Publications

Background. Small vessel vasculitis commonly affects the kidney and can progress to end-stage renal disease. The goal of this study is to compare outcomes of patients who received a renal transplant as a result of small vessel vasculitis (group A) with those who received kidney transplants because of other causes (group B). Methods. This is a retrospective analysis of United Network for Organ Sharing registry data for adult primary kidney transplants from January 2000 to December 2014. Group A patients (N = 2196) were compared with a group B (N = 6588); groups were case matched for age, race, sex, …

Central Nervous System Histoplasmosis: Multicenter Retrospective Study On Clinical Features, Diagnostic Approach And Outcome Of Treatment, Joseph Wheat, Thein Myint, Ying Guo, Phebe Kemmer, Chadi A. Hage, Colin Terry, Marwan M. Azar, James Riddell, Peter Ender, Sharon Chen, Kareem Shehab, Kerry Cleveland, Eden Esguerra, James Johnson, Patty Wright, Vanja Douglas, Pascalis Vergidis, Winnie Ooi, John Baddley, David Bamberger, Raed N. Khairy, Holenarasipur R. Vikram, Elizabeth Jenny-Avital, Geetha Sivasubramanian, Karen Bowlware, Barbara Pahud, Juan Sarria, Townson Tsai, Maha Assi, Satish Mocherla

Internal Medicine Faculty Publications

Central nervous system (CNS) involvement occurs in 5 to 10% of individuals with disseminated histoplasmosis. Most experience has been derived from small single center case series, or case report literature reviews. Therefore, a larger study of central nervous system (CNS) histoplasmosis is needed in order to guide the approach to diagnosis, and treatment.

A convenience sample of 77 patients with histoplasmosis infection of the CNS was evaluated. Data was collected that focused on recognition of infection, diagnostic techniques, and outcomes of treatment.

Twenty nine percent of patients were not immunosuppressed. Histoplasma antigen, or anti-Histoplasma antibodies were detected in the …

Delayed Sternal Closure Does Not Reduce Complications Associated With Coagulopathy And Right Ventricular Failure After Left Ventricular Assist Device Implantation, Roh Yanagida, Navin Rajagopalan, Daniel L. Davenport, Thomas A. Tribble, Mark A. Bradley, Charles W. Hoopes

Internal Medicine Faculty Publications

Delayed sternal closure (DSC) is occasionally adopted after implantation of left ventricular assist device (LVAD). Recent studies suggest that DSC be used for high risk group of patients with coagulopathy, hemodynamic instability or right ventricular failure. However, whether DSC is efficacious for bleeding complication or right ventricular failure is not known. This study is single center analysis of 52 patients, who underwent LVAD implantation. Of those 52 patients, 40 consecutive patients underwent DSC routinely. The sternum was left open with vacuum assist device after implantation of LVAD. Perioperative outcome of the patients who underwent routine DSC were compared with 12 …

Wellness And Multiple Sclerosis: The National Ms Society Establishes A Wellness Research Working Group And Research Priorities, Robert W. Motl, Ellen M. Mowry, Dawn M. Ehde, Nicholas G. Larocca, Kathy E. Smith, Kathleen Costello, Lynne Shinto, Alexander V. Ng, Amy B. Sullivan, Barbara Giesser, Kevin K. Mccully, Bo Fernhall, Malachy Bishop, Matthew Plow, Patrizia Casaccia, Nancy D. Chiaravalloti

Early Childhood, Special Education, and Counselor Education Faculty Publications

Background: People with multiple sclerosis (MS) have identified “wellness” and associated behaviors as a high priority based on “social media listening” undertaken by the National MS Society (i.e. the Society).

Objective: The Society recently convened a group that consisted of researchers with experience in MS and wellness-related research, Society staff members, and an individual with MS for developing recommendations regarding a wellness research agenda.

Method: The members of the group engaged in focal reviews and discussions involving the state of science within three approaches for promoting wellness in MS, namely diet, exercise, and emotional wellness.

Results: That process informed a …

Evaluation Of Root Morphology And Canal Configuration Of Maxillary Premolars In A Sample Of Pakistani Population By Using Cone Beam Computed Tomography, Muhammad Rizwan Nazeer, Farhan Raza Khan, Rabia Ghafoor

Section of Dental-Oral Maxillofacial Surgery

Objectives: To evaluate the root canal morphology of maxillary premolars.

Method: This retrospective study was conducted from November 2016 to January 2017 at Aga Khan University Hospital, Karachi, and reviewed Cone Beam Computed Tomography images of maxillary first and second premolars done from November 2014 to October 2016. Frequency distribution of Vertucci's classification was determined. Chi square test was applied to determine any association between Vertucci's type and gender. SPSS 19 was used for data analysis.

Results: Of the 114 first premolars, 74(68.6%) were bi-rooted and 36(31.5%) were single-rooted. The mean lengths of buccal and palatal roots were …

Curcumin Potentiates The Function Of Human Α 7 -Nicotinic Acetylcholine Receptors Expressed In Sh-Ep1 Cells, Eslam El Nebrisi, Lina T. Al Kury, Keun Hang Susan Yang, Petrilla Jayaprakash, Frank C. Howarth, Nadine Kabbani, Murat Oz

All Works

© 2018 Elsevier Ltd Effects of curcumin, a biologically active ingredient of turmeric, were tested on the Ca 2+ transients induced by the activation of α 7 subunit of the human nicotinic acetylcholine (α 7 nACh) receptor expressed in SH-EP1 cells. Curcumin caused a significant potentiation of choline (1 mM)-induced Ca 2+ transients with an EC 50 value of 133 nM. The potentiating effect of curcumin was not observed in Ca 2+ transients induced by high K + (60 mM) containing solutions or activation of α 4 β 2 nACh receptors and the extent of curcumin potentiation was not altered …

It's Time To Reverse Our Thinking: The Reverse Translation Research Paradigm, Valentina Shakhnovich

Manuscripts, Articles, Book Chapters and Other Papers

No abstract provided.

Macrophage Inflammatory Factors Promote Epithelial-Mesenchymal Transition In Breast Cancer, Robert Bednarczyk, Neha Tuli, Elyse Hanly, Ghada Ben Rahoma, Abraham Mittelman, Jan Geliebter, Raj K. Tiwari

NYMC Faculty Publications

The majority of breast cancers (90-95%) arise due to mediators distinct from inherited genetic mutations. One major mediator of breast cancer involves chronic inflammation. M1 macrophages are an integral component of chronic inflammation and the breast cancer tumor microenvironment (TME). Previous studies have demonstrated that up to 50% of the breast tumor comprise of tumor-associated macrophages (TAMs) and increased TAM infiltration has been associated with poor patient prognosis. Furthermore, breast cancer associated deaths are predominantly attributed to invasive cancers and metastasis with epithelial-mesenchymal transition (EMT) being implicated. In this study, we investigated the effects of cellular crosstalk between TAMs and …

The Pharmacogene Variation (Pharmvar) Consortium: Incorporation Of The Human Cytochrome P450 (Cyp) Allele Nomenclature Database, Andrea Gaedigk, Magnus Ingelman-Sundberg, Neil A. Miller, J Steven Leeder, Michelle Whirl-Carrillo, Teri E. Klein

Manuscripts, Articles, Book Chapters and Other Papers

The Human Cytochrome P450 (CYP) Allele Nomenclature Database, a critical resource to the pharmacogenetics and genomics communities, will be transitioning to the Pharmacogene Variation (PharmVar) Consortium. In this report we provide a summary of the current database, provide an overview of the PharmVar consortium and highlight the PharmVar database which will serve as the new home for pharmacogene nomenclature.

Echocardiographic Detection Of Increased Ventricular Diastolic Stiffness In Pediatric Heart Transplant Recipients: A Pilot Study., Shahryar M. Chowdhury, Ryan J. Butts, Anthony M. Hlavacek, Carolyn L. Taylor, Karen S. Chessa, Varsha M. Bandisode, Girish S. Shirali, Arni Nutting, G Hamilton Baker

Manuscripts, Articles, Book Chapters and Other Papers

Background: Pediatric heart transplant recipients are at risk for increased left ventricular (LV) diastolic stiffness. However, the noninvasive evaluation of LV stiffness has remained elusive in this population. The objective of this study was to compare novel echocardiographic measures of LV diastolic stiffness versus gold-standard measures derived from pressure-volume loop (PVL) analysis in pediatric heart transplant recipients.

Methods: Patients undergoing left heart catheterization were prospectively enrolled. PVLs were obtained via conductance. The end-diastolic pressure-volume relationship was obtained via balloon occlusion. The stiffness constant, β, was calculated. Echocardiographic measures of diastolic function were derived from spectral and tissue Doppler and two-dimensional …

Percutaneous And Endoscopic Management Of Nephrolithiasis In A Patient With Five Native Ureters (Trifid Right And Bifid Left Collecting System), Neel Patel, Mark J. Ferretti, Jonathan B. Bloom, Suraj Parikh, David Schwalb, Majid Eshghi, Andrew Fishman

NYMC Faculty Publications

Triplication of the ureter is a rare urologic finding that has been well described in the literature. Patients can present with urinary tract infections, incontinence, and calculi. We present the case of a patient with extensive stone burden with right trifid and left bifid collecting systems. Stone management was performed with a multimodal approach using a combination of endoscopic and percutaneous approaches. Our systematic and staged approach highlights a method for efficacious stone treatment in a complex endourologic case.

Is It Time To Reconsider Pressure Injuries As A Nurse-Sensitive Indicator?, Christine A. Schindler

College of Nursing Faculty Research and Publications

No abstract provided.

First Report Of Nrg Oncology/Radiation Therapy Oncology Group 0622: A Phase 2 Trial Of Samarium-153 Followed By Salvage Prostatic Fossa Irradiation In High-Risk Clinically Nonmetastatic Prostate Cancer After Radical Prostatectomy., Richard K. Valicenti, Stephanie L. Pugh, Edouard J. Trabulsi, Oliver Sartor, Eric C. Ko, Michael R. Girvigian, Seth A. Rosenthal, Mark E. Shaves, Jean Hoffman-Censits, John Schallenkamp, Howard M. Sandler

Department of Urology Faculty Papers

PURPOSE: To investigate the utility of ¹⁵³Sm lexidronam (Quadramet) in the setting of men with prostate cancer status post radical prostatectomy who develop biochemical failure with no clinical evidence of osseous metastases.

PATIENTS AND METHODS: Trial NRG Oncology RTOG 0622 is a single-arm phase 2 trial that enrolled men with pT2-T4, N0-1, M0 prostate cancer status post radical prostatectomy, who meet at least 1 of these biochemical failure criteria: (1) prostate-specific antigen (PSA) > 1.0 ng/mL; (2) PSA > 0.2 ng/mL if Gleason score 9 to 10; or (3) PSA > 0.2 ng/mL if N1. Patients received ¹⁵³Sm (2.0 mCi/kg intravenously …

Cough, Hemoptysis And Hair Expectoration: An Intrapulmonary Teratoma, Shanila Ahmed, Habib Kibzai, Talha Shahzad, Saulat Fatimi, Madiha Bilal L Qureshi

Section of Haematology/Oncology

Teratomas can be found in different organs of the body and may involve gonads, saccrococcygeal region, mediastinum and other sites. Intrathoracic teratomas always occur in mediastinum and less often arise within the lung. As teratomas mostly involve sex organs (gonads), they rarely occur as extra-gonadal tumors accounting for only 3% of all the cases and very small percentage of such tumors occur in mediastinum.We reported an interesting case of middle aged male who presented to us with symptoms of cough, hemoptysis and trichoptysis (hair expectoration).We found that patient had intrapulmonary teratoma that was initially being treated as case of pulmonary …

Erythrocyte Long-Chain Omega-3 Fatty Acid Levels Are Inversely Associated With Mortality And With Incident Cardiovascular Disease: The Framingham Heart Study, William S. Harris, Nathan L. Tintle, Mark R. Etherton, Ramachandran S. Vasan

Faculty Work Comprehensive List

Background: The extent to which omega-3 fatty acid status is related to risk for death from any cause and for incident cardiovascular disease (CVD) remains controversial. Objective: To examine these associations in the Framingham Heart Study. Design: Prospective and observational. Setting: Framingham Heart Study Offspring cohort. Measurements: The exposure marker was red blood cell levels of eicosapentaenoic and docosahexaenoic acids (the Omega-3 Index) measured at baseline. Outcomes included mortality (total, CVD, cancer, and other) and total CVD events in participants free of CVD at baseline. Follow-up was for a median of 7.3 years. Cox proportional hazards models were adjusted for …

The Development Of A Patient-Reported Outcome Measure For Assessment Of Genital Psoriasis Symptoms: The Genital Psoriasis Symptoms Scale (Gpss), Alice B. Gottlieb, Brian Kirby, Caitriona Ryan, April N. Naegeli, Russel Burge, Alison Potts Bleakman, Gil Yosipovitch

NYMC Faculty Publications

INTRODUCTION: Patient-reported outcome measures (PROs) specific for genital psoriasis (GenPs) have not been described. METHODS: In this cross-sectional, qualitative study in patients with moderate-to-severe GenPs, we sought to develop a PRO useful for GenPs symptom assessment. A literature review was performed to identify relevant psoriasis or GenPs symptoms and existing PROs that may be useful in the evaluation of symptom severity in GenPs patients. The literature review findings were discussed with clinicians, and then patients with GenPs. RESULTS: Relevant psoriasis or GenPs symptoms from the literature review included itch, pain, scaling, redness/erythema, and stinging/burning. The validity of these symptoms for …

4-Year Results From The Rapid-Psa Phase 3 Randomised Placebo-Controlled Trial Of Certolizumab Pegol In Psoriatic Arthritis, Desiree Van Der Heijde, Atul Deodhar, Oliver Fitzgerald, Roy Fleischmann, Dafna Gladman, Alice B. Gottlieb, Phillip J. Mease

NYMC Faculty Publications

Objective: To report the efficacy, patient-reported, radiographic and safety outcomes of 4 years' certolizumab pegol (CZP) treatment in patients with psoriatic arthritis (PsA). Methods: RAPID-PsA (NCT01087788) was double-blind and placebo-controlled to Week 24, dose-blind to Week 48 and open-label (OL) to Week 216. Patients were randomised 1:1:1 to either placebo or CZP 200 mg every 2 weeks (Q2W) or 400 mg every 4 weeks (Q4W) (following 400 mg at Weeks 0/2/4). Patients randomised to CZP continued their assigned dose in the OL period. Patients randomised to placebo were re-randomised to CZP 200 mg Q2W or 400 mg Q4W (post-loading dose) …