Medicine and Health Sciences Commons^™

Story Of An Unfortunate Fall: Cardiac Contusion Presenting With An Atrioventricular Block, Maryam Saleem, Fatima Ahmed, Kinjan Patel, Muhamad B. Munir, Mary Warden

Faculty & Staff Scholarship

Blunt cardiac injury (BCI), also referred to in the literature as a cardiac contusion, is a known cause of myocardial injury. It is often challenging to diagnose this condition in the absence of clear diagnostic criteria. Furthermore, its clinical presentation is highly variable depending on the severity, type, and duration of the trauma, as well as the timing from the initial insult. The clinical manifestation of BCI ranges from none to fatal arrhythmias to cardiac wall rupture seen on post-mortem examination. Cardiac biomarkers and electrocardiograms (EKG) are usually helpful in identifying cardiac trauma but are not necessarily abnormal in all …

Meniscal Repair In Pediatric Populations: A Systematic Review Of Outcomes, Daniel J. Liechti, David S. Constantinescu, Taylor J. Ridley, Jorge Chahla, Justin J. Mitchell, Alexander R. Vap

Faculty & Staff Scholarship

Background: Loss of meniscal tissue in the pediatric population can have long-term consequences on joint health, highlighting the importance of meniscal preservation in this group. Purpose: To systematically review reported knee outcome measures and complication rates after repair of meniscal tears in children and adolescents. Study Design: Systematic review; Level of evidence, 4. Methods: A review of the literature regarding the existing evidence for pediatric meniscal tear outcomes was performed through use of the Cochrane Database of Systematic Reviews, the Cochrane Central Register of Controlled Trials, PubMed (1980-present), and MEDLINE (1980-present). Included were articles in English that reported the outcomes …

Closed-Loop Cardiovascular Interactions And The Baroreflex Cardiac Arm: Modulations Over The 24 H And The Effect Of Hypertension, Gianfranco Parati, Paolo Castiglioni, Andrea Faini, Marco Di Rienzo, Giuseppe Mancia, Riccardo Barbieri, J. Philip Saul

Faculty & Staff Scholarship

Closed-loop models of the interactions between blood pressure (BP) and heart rate variations allow for estimation of baroreflex sensitivity (feedback effects of BP changes on heart rate) while also considering the feedforward effects of heart rate on BP. Our study is aimed at comparing modulations of feedback and feedforward couplings over 24 h in normotensive and hypertensive subjects, by assessing closed-loop baroreflex models in ambulatory conditions. Continuous intra-arterial BP recordings were performed for 24 h in eight normotensive and eight hypertensive subjects. Systolic BP (SBP) and pulse interval (PI) beat-by-beat series were analyzed by an autoregressive moving average model over …

Correction To: Determinant Roles Of Dendritic Cell-Expressed Notch Delta-Like And Jagged Ligands On Anti-Tumor T-Cell Immunity, Elena E. Tchekneva, Mounika U.L. Goruganthu, Roman V. Uzhachenko, Portia L. Thomas, Anneliese Antonucci, Irina Chekneva, Michael Koenig, Longzhu Piao, Anwari Akhter, Maria Teresa P. De Aquino, Paravathi Ranganathan, Nicholas Long, Thomas Magliery, Anna Valujskikh, Jason V. Evans, Rajeswara R. Arasada, Pierre P. Massion, David P. Carbone, Anil Shanker, Mikhail M. Dikov

Faculty & Staff Scholarship

Background: Notch intercellular communication instructs tissue-specific T-cell development and function. In this study, we explored the roles of dendritic cell (DC)-expressed Notch ligands in the regulation of T-cell effector function. Methods: We generated mice with CD11c lineage-specific deletion of Notch Delta-like ligand (Dll)1 and Jagged (Jag)2. Using these genetically-ablated mice and engineered pharmacological Notch ligand constructs, the roles of various Delta-like and Jagged ligands in the regulation of T-cell-mediated immunity were investigated. We assessed tumor growth, mouse survival, cytokine production, immunophenotyping of myeloid and lymphoid populations infiltrating the tumors, expression of checkpoint molecules and T-cell function in the experimental settings …

Assessment Of Volume Status During Prone Spine Surgery Via A Novel Point-Of-Care Ultrasound Technique, Jeremy Hensley, Hong Wang

Faculty & Staff Scholarship

Background Operations performed with the patient in the prone position can pose a significant challenge to the anesthesiologist. Hypotension is a commonly encountered complication. Intravascular volume depletion and decreased cardiac output secondary to decreased preload are thought to be the most likely cause of hypotension in the prone position. Measurement of inferior vena cava (IVC) diameter via point-of-care ultrasound examination (POC_US) has been used to provide an estimate of intravascular volume status. However, this measurement is most often obtained with the patient in the supine position. Materials and methods In this study, we describe a technique for evaluating IVC diameter …

Trends In Suicide Among Youth Aged 10 To 19 Years In The United States, 1975 To 2016, Donna A. Ruch, Arielle H. Sheftall, Paige Schlagbaum, Joseph Rausch, John V. Campo, Jefferey A. Bridge

Faculty & Staff Scholarship

IMPORTANCE Suicide is a leading cause of death among youth aged 10 to 19 years in the United States, with rates traditionally higher in male than in female youth. Recent national mortality data suggest this gap may be narrowing, which warrants investigation. OBJECTIVE To investigate trends in suicide rates among US youth aged 10 to 19 years by age group, sex, race/ethnicity, and method of suicide. DESIGN, SETTING, AND PARTICIPANTS Cross-sectional study using period trend analysis of US suicide decedents aged 10 to 19 years from January 1, 1975, to December 31, 2016. Data were analyzed for periods defined by …

Patient Advocacy In Plastic Surgery: An Underutilized Tool, Cody L. Mullens, Shelby L. Nathan, Geoffrey M. Kozak, John P. Fischer, Gregory A. Greco, Cristiane M. Ueno

Faculty & Staff Scholarship

Summary: Healthcare advocacy is an important tool in the plastic surgeon’s arsenal that stands the potential to improve both patient care and the profession. However, many physicians underestimate the importance and influence that healthcare advocacy has on the profession and feel that they lack the leverage and knowledge to advocate on behalf of themselves, their practices, their patients, and their profession, all of which are untrue. Plastic surgeons are uniquely positioned to advocate based on their clinical acumen, personal experiences with patient care, and their position in the healthcare ecosystem value chain. This article aims to equip plastic surgeons with …

Bordetella Pertussis Can Be Motile And Express Flagellum-Like Structures, Cassandra L. Hoffman, Laura A. Gonyar, Federico Zacca, Federico Sisti, Julieta Fernandez, Ting Wong, F. Heath Damron, Erik L. Hewlett

Faculty & Staff Scholarship

ABSTRACT Bordetella bronchiseptica encodes and expresses a flagellar apparatus. In contrast, Bordetella pertussis, the causative agent of whooping cough, has historically been described as a nonmotile and nonflagellated organism. The previous statements that B. pertussis was a nonmotile organism were consistent with a stop codon located in the flagellar biosynthesis gene, flhA, discovered when the B. pertussis Tohama I genome was sequenced and analyzed by Parkhill et al. in 2003 (J. Parkhill, M. Sebaihia, A. Preston, L. D. Murphy, et al., Nat Genet, 35:32– 40, 2003, https://doi.org/10 .1038/ng1227). The stop codon has subsequently been found in all annotated genomes. Parkhill …

Synthesis Of The Literature: Variables Influencing Caregiver Use Or Nonuse Of Supportive Services, Kristina M. Childers

Faculty & Staff Scholarship

Two out of three caregivers (CGs) of persons with dementia (PWD) living in the community do not use supportive services or resources, and three out of four underutilize available support. These findings are troubling because CGs report many unmet needs in providing support to PWD. What predisposing, enabling, and need variables influence CGs to use or not use support services are poorly understood. This article reviews the literature on CG of PWD to find characteristic variables that are related to CG's decisions to use or not use support services. Instruments used in research studies were named to determine recommendations for …

Association Of Lowering Low‐Density Lipoprotein Cholesterol With Contemporary Lipid‐Lowering Therapies And Risk Of Diabetes Mellitus: A Systematic Review And Meta‐Analysis, Safi U. Khan, Hammad Rahman, Victor Okunrintemi, Haris Riaz, Muhammad Shahzeb Khan, Sudhakar Sattur, Edo Kaluski, A. Michael Lincoff, Seth S. Martin, Michael J. Blaha

Faculty & Staff Scholarship

Background

The relationship between lowering LDL (low‐density lipoprotein) cholesterol with contemporary lipid‐lowering therapies and incident diabetes mellitus (DM) remains uncertain.

Methods and Results

Thirty‐three randomized controlled trials (21 of statins, 12 of PCSK9 [proprotein convertase subtilisin/kexin type 9] inhibitors, and 0 of ezetimibe) were selected using Medline, Embase, and the Cochrane Central Register of Controlled Trials (inception through November 15, 2018). A total of 163 688 nondiabetic patients were randomly assigned to more intensive (83 123 patients) or less intensive (80 565 patients) lipid‐lowering therapy. More intensive lipid‐lowering therapy was defined as the more potent pharmacological strategy (PCSK9 inhibitors, higher …

Long-Term Effectiveness Of Balloon Catheter Sinuplasty In Pediatric Chronic Maxillary Sinusitis, Habib G. Zalxal, Chadi A. Makary, Hassan Ramadan

Faculty & Staff Scholarship

The objective of our study was to assess the long-term effectiveness of balloon catheter sinuplasty in the treatment of pediatric chronic maxillary sinusitis following failed first-line medical and surgical management with adenoidectomy. Pediatric patients younger than 12 years were reviewed for having failed previous adenoidectomy and undergone a balloon catheter sinuplasty between August 2006 and March 2011 for chronic rhinosinusitis. Demographic data and clinical characteristics were recorded in patients who met inclusion criteria. Outcomes were assessed by need for functional endoscopic sinus surgery and persistence of chronic infection within at least 5 years of follow-up. Failure was defined by any …

Esophageal Crohn's Disease Unresponsive To Glucocorticoids, Tanureet Kochar, Matthew Krafft, Swapna Gayam

Faculty & Staff Scholarship

No abstract provided.

Early Class Iii Treatment Decision-Making, Peter Ngan, David Musich

Faculty & Staff Scholarship

Clinicians make decisions for their patients everyday. Ryan Hamilton, in his course guidebook, How You Decide: The Science of Human Decision Making, summarized the current research on the 4 R's of decision-making that matter: reference points, reasons, resources, and replacement. The authors will apply this principle in the decision- making necessary for the growing Class III patients. First, the decision on whether to treat or not to treat Class III patients in the mixed dentition rely on a thorough diagnosis and objectives for early treatment. For example, elimination of a functional shift of the mandible may be a good …

Diagnosis And Long-Term Management Of Uromodulin Kidney Disease, Emily Wheeler, Suresh Thomas

Faculty & Staff Scholarship

Uromodulin kidney disease (UKD) is a subtype of autosomal dominant tubulointerstitial kidney disease (ADTKD), and is a rare cause of renal failure and gout in young people. Although it is inherited in an autosomal dominant fashion, the gene mutation exhibits variable expressivity so the phenotype varies dramatically among affected individuals. While it is rare, it is important for physicians in the primary care setting to be able to recognize the disorder, initiate proper workup, and refer patients to nephrology teams that are equipped to manage the long-term needs of these patients. Eventually, most will progress to renal failure with necessary …

Micrornas And The Genetic Nexus Of Brain Aging, Neuroinflammation, Neurodegeneration, And Brain Trauma, Saumyendra N. Sarkar, Ashley E. Russell, Russell Elizabeth B. Engler-Chiurazzi, Keyana N. Porter, James W. Simpkins

Faculty & Staff Scholarship

ABSTRACT: Aging is a complex and integrated gradual deterioration of cellular activities in specific organs of the body, which is associated with increased mortality. This deterioration is the primary risk factor for major human pathologies, including cancer, diabetes, cardiovascular disorders, neurovascular disorders, and neurodegenerative diseases. There are nine tentative hallmarks of aging. In addition, several of these hallmarks are increasingly being associated with acute brain injury conditions. In this review, we consider the genes and their functional pathways involved in brain aging as a means of developing new strategies for therapies targeted to the neuropathological processes themselves, but also as …

Contextual Factors Associated With County-Level Suicide Rates In The United States, 1999 To 2016, Danielle L. Steelsmith, Cynthia A. Fontanella, John V. Campo, Jefferey A. Bridge, Keith L. Warren, Elisabeth D. Root

Faculty & Staff Scholarship

Importance Understanding geographic and community-level factors associated with suicide can inform targeted suicide prevention efforts.

Objectives To estimate suicide rates and trajectories, assess associated county-level contextual factors, and explore variation across the rural-urban continuum.

Design, Setting, and Participants This cross-sectional study included all individuals aged 25 to 64 years who died by suicide from January 1, 1999, to December 31, 2016, in the United States. Spatial analysis was used to map excess risk of suicide, and longitudinal random-effects models using negative binomial regression tested associations of contextual variables with suicide rates as well as interactions among county-level contextual variables. Data …

Pro-Con Debate: Nitrous Oxide For Labor Analgesia, Manuel C. Vallejo, Mark I. Zakowski

Faculty & Staff Scholarship

This Pro-Con debate will provide the practitioner with an evidence-based knowledge approach to assist the clinician in determining whether to employ (Pro) or not to employ (Con) this technique in the obstetrical suite for labor analgesia. Nitrous oxide has been used safely in dentistry and medicine for many centuries. However, accumulating preclinical and clinical evidence increasingly suggests previously unrecognized adverse maternal and fetal effects of nitrous oxide, which warrants reconsideration of its use in pregnant women and a more detailed informed consent. Nitrous oxide is associated with metabolic, oxidative, genotoxic, and transgenerational epigenetic effects in animals and humans that may …

Global Climate Change And Invariable Photoperiods: A Mismatch That Jeopardizes Animal Fitness, William H. Walker Ii, Olga Hecmarie Meléndez‐Fernández, Randy J. Nelson, Russel J. Reiter

Faculty & Staff Scholarship

The Earth's surface temperature is rising, and precipitation patterns throughout the Earth are changing; the source of these shifts is likely anthropogenic in nature. Alterations in temperature and precipitation have obvious direct and indirect ef‐ fects on both plants and animals. Notably, changes in temperature and precipita‐ tion alone can have both advantageous and detrimental consequences depending on the species. Typically, production of offspring is timed to coincide with optimal food availability; thus, individuals of many species display annual rhythms of reproductive function. Because it requires substantial time to establish or re‐establish reproduc‐ tive function, individuals cannot depend on the …

Factors Related To Intra-Tendinous Morphology Of Achilles Tendon In Runners, Kai-Yu Ho, Ari Baquet, Yu-Jen Chang, Luang-Chang Chien, Michelle Harty, Gregory Bashford, Kornelia Kulig

Faculty & Staff Scholarship

The purpose of this study was to determine and explore factors (age, sex, anthropometry, running and injury/pain history, tendon gross morphology, neovascularization, ankle range of motion, and ankle plantarflexor muscle endurance) related to intra-tendinous morphological alterations of the Achilles tendon in runners. An intra-tendinous morphological change was defined as collagen fiber disorganization detected by a low peak spatial frequency radius (PSFR) obtained from spatial frequency analysis (SFA) techniques in sonography. Ninety-one runners (53 males and 38 females; 37.9 ± 11.6 years) with 8.8 ± 7.3 years of running experience participated. Height, weight, and waist and hip circumferences were recorded. Participants …

Development Of Multifunctional Overhauser-Enhanced Magnetic Rresonance Imaging For Concurrent In Vivo Mapping Of Tumor Interstitial Oxygenation, Acidosis And Inorganic Phosphate Concentration, Artem A. Gorodetskii, Timothy D. Eubank, Benoit Driesschaert, Martin Poncelet, Emily Ellis, Valery V. Khramtsov, Andrey A. Bobko

Faculty & Staff Scholarship

Tumor oxygenation (pO2), acidosis (pH) and interstitial inorganic phosphate concentration (Pi) are important parameters of the malignant behavior of cancer. A noninvasive procedure that enables visualization of these parameters may provide unique information about mechanisms of tumor pathophysiology and provide clues to new treatment targets. In this research, we present a multiparametric imaging method allowing for concurrent mapping of pH, spin probe concentration, pO2, and Pi using a single contrast agent and Overhauser-enhanced magnetic resonance imaging technique. The developed approach was applied to concurrent multifunctional imaging in phantom samples and in vivo in a mouse model of …

Maternal Characteristics Associated With Injury-Related Infant Death In West Virginia, 2010-2014, Wilson A. Koech, Toni M. Rudisill, Ian R. H. Rockett

Faculty & Staff Scholarship

Although injury-related deaths have been documented among children and adult populations, insufficient attention has been directed towards injury-related infant deaths. The objective of this retrospective study was to investigate maternal and infant characteristics associated with injury-related infant deaths in West Virginia. Birth and infant mortality data for 2010–2014 were sourced from the West Virginia Bureau for Public Health, Charleston. Relative risk was calculated using log-binomial regression utilizing generalized estimating equations. Maternal characteristics associated with injury-related infant mortality in West Virginia were race/ethnicity ( = 7.48, p = .03), and smoking during pregnancy (, p < .00). Risk of a Black Non-Hispanic infant suffering an injury-related death was 4.0 (95% CL 1.7, 9.3) times that of infants of other races/ethnicities. Risk of an infant dying from an injury-related cause, if the mother smoked during pregnancy, was 2.9 (95% CL 1.6, 5.0) times the risk of such a death if maternal smoking status during pregnancy is unknown or no smoking, controlling for race/ethnicity. This study provides important information to public health stakeholders at both the state and local levels in designing interventions for partial reduction or prevention of injury-related infant mortality in West Virginia.

Racial Disparities In The Utilization And Outcomes Of Structural Heart Disease Interventions In The United States, Mohamad Alkhouli, Fahad Alqahtani, David R. Holmes, Chalak Berzingi

Faculty & Staff Scholarship

Background-—Data on race- and ethnicity-based disparities in the utilization and outcomes of structural heart disease interventions in the United States are scarce. Methods and Results-—We used the National Inpatient Sample (2011-2016) to examine racial and ethnic differences in the utilization, in-hospital outcomes, and cost of structural heart disease interventions among patients ≥65 years of age. A total of 106 119 weighted hospitalizations for transcatheter aortic valve replacement, transcatheter mitral valve repair, and left atrial appendage occlusion were included. The utilization rates (defined as the number of procedures performed per 100 000 US people >65 years of age) were higher in …

A Role For Regulator Of G Protein Signaling-12 (Rgs12) In The Balance Between Myoblast Proliferation And Differentiation, Adam B. Schroer, Junaith S. Mohamed, Melinda D. Wilard, Vincent Setola, Emily Oesteich, David P. Siderovski

Faculty & Staff Scholarship

• Regulators of G Protein Signaling (RGS proteins) inhibit G protein-coupled receptor (GPCR) signaling by accelerating the GTP hydrolysis rate of activated Gα subunits. Some RGS proteins exert additional signal modulatory functions, and RGS12 is one such protein, with five additional, functional domains: a PDZ domain, a phosphotyrosine-binding domain, two Ras-binding domains, and a Gα·GDP-binding GoLoco motif. RGS12 expression is temporospatially regulated in developing mouse embryos, with notable expression in somites and developing skeletal muscle. We therefore examined whether RGS12 is involved in the skeletal muscle myogenic program. In the adult mouse, RGS12 is expressed in the tibialis anterior (TA) muscle, …

Modeling Human Cancer-Induced Cachexia, Erin E. Talbert, Maria C. Cuitin˜ O, Katherine J. Ladner, Priyani V. Rajasekerea, Melissa Siebert, Reena Shakya, Gustavo W. Leone, Michael C. Ostrowski, Brain Paleo, Noah Weisleder, Peter J. Reiser, Amy Webb, Cynthia D. Timmers, Daniel S. Eiferman, David C. Evans, Mary E. Dilhoff, Carl R. Schmidt

Faculty & Staff Scholarship

Talbert et al. developed an inducible mouse model of cachexia caused by pancreatic cancer. This model exhibits features of the human condition, including the progressive depletion of muscle and adipose tissue associated with tumor progression.

H2o2‐Induced Microvessel Barrier Dysfunction: The Interplay Between Reactive Oxygen Species, Nitric Oxide, And Peroxynitrite, Xueping Zhou, Yan Qian, Dong Yuan, Qilong Feng, Pingnian He

Faculty & Staff Scholarship

Elevated H2O2 is implicated in many cardiovascular diseases. We previously demonstrated that H2O2-induced endothelial nitric oxide synthase (eNOS) activation and excessive NO production contribute to vascular cell injury and increases in microvessel permeability. However, the mechanisms of excessive NO-mediated vascular injury and hyperpermeability remain unknown. This study aims to examine the functional role of NO-derived peroxynitrite (ONOO) in H2O2-induced vascular barrier dysfunction by elucidating the interrelationships between H2O2-induced NO, superoxide, ONOO, and changes in endothelial [Ca2+ ]i and microvessel permeability. Experiments were conducted on intact rat mesenteric venules. Microvessel permeability was determined by measuring hydraulic conductivity (Lp). Endothelial [Ca2+ ]i, …

The Role Of Sirt1 In Skeletal Muscle Function And Repair Of Older Mice, Mathew J. Myers, Danielle L. Sheperd, Andrya J. Durr, David S. Stanton, Junaith S. Mohamed, John M. Hollander, Stephen E. Alway

Faculty & Staff Scholarship

Background Sirtuin 1 (SIRT1) is a NAD+ sensitive deacetylase that has been linked to longevity and has been suggested to confer beneficial effects that counter aging-associated deterioration. Muscle repair is dependent upon satellite cell function, which is reported to be reduced with aging; however, it is not known if this is linked to an aging-suppression of SIRT1. This study tested the hypothesis that Sirtuin 1 (SIRT1) overexpression would increase the extent of muscle repair and muscle function in older mice. Methods We examined satellite cell dependent repair in tibialis anterior, gastrocnemius, and soleus muscles of 13 young wild-type mice (20–30 …

Emerging Risk Profile Of Lung Cancer Therapy: Diffuse Alveolar Hemorrhage From Osimertinib, Michael J. Forte, Rahul G. Sangani

Faculty & Staff Scholarship

Osimertinib is an oral epithelial growth factor receptor tyrosine kinase inhibitor (EGFR-TKI) used primarily in the treatment of metastatic non-small cell lung cancer. It is usually well tolerated with less than 5% of patients developing significant pulmonary toxicity from the medication, typically within the first few months after initiation. Previously reported pulmonary adverse reactions include pneumonitis (nonspecific interstitial pneumonia or other forms of acute interstitial process), fleeting asymptomatic infiltrates on imaging, and eosinophilic pneumonia. We present an interesting case of a 65-year-old female with recurrent metastatic adenocarcinoma of the lung, treated with Osimertinib for 4 months, who developed a previously …

Metabolic Deregulation Of The Blood-Outer Retinal Barrier In Retinitis Pigmentosa, Wei Wang, Ashwini Kini, Yekai Wang, Tingting Liu, Yao Chen, Eric Vukmanic, Douglas Emery, Yongqing Liu, Xiaoqin Lu, Lei Jin, San Joon Lee, Patrick Scott, Xiao Liu, Kevin Dean, Qingxian Lu, Enzo Fortuny, Robert James, Henry J. Kaplan, Jianhai Du, Douglas C. Dean

Faculty & Staff Scholarship

Retinitis pigmentosa (RP) initiates with diminished rod photoreceptor function, causing peripheral and nighttime vision loss. However, subsequent loss of cone function and high-resolution daylight and color vision is most debilitating. Visual pigment-rich photoreceptor outer segments (OS) undergo phagocytosis by the retinal pigment epithelium (RPE), and the RPE also acts as a blood-outer retinal barrier transporting nutrients, including glucose, to photoreceptors. We provide evidence that contact between externalized phosphatidylserine (PS) on OS tips and apical RPE receptors activates Akt, linking phagocytosis with glucose transport to photoreceptors for new OS synthesis. As abundant mutant rod OS tips shorten in RP, Akt activation …

Target® Intracranial Aneurysm Coiling Prospective Multicenter Registry: Final Analysis Of Peri-Procedural And Long-Term Safety And Efficacy Results, Osama O. Zaidat, Alicia C. Castonguay, Ansaar T. Rai, Aamir Badruddin, William J. Mack, Amer K. Alshekhlee, Qaisar A. Shah, Syed I. Hussain, Mouhammed R. Kabbani, Ketan R. Bulsara, Asif M. Taqi, Vallabh Janardhan, Mary S. Patterson, Britany L. Nordhaus, Lucas Elijovich, Ajit S. Puri

Faculty & Staff Scholarship

Background and Purpose: To describe the final results of the TARGET Registry, a multicenter, real-world study of patients with intracranial aneurysms treated with new generation TARGET Coils.

Methods: The TARGET Registry is a prospective, single-arm study with independent medical event monitoring and core-lab adjudication. Patients with de novo intracranial aneurysms were embolized with either TARGET-360° or helical coils in 12 US centers. The primary outcome was aneurysm packing density (PD), which was assessed immediately post-procedure. The secondary outcomes were immediate and long-term aneurysm occlusion rate using the Raymond Scale, and independent functional outcome using the modified Rankin Scale (mRS). A …

An Entire Coronary System Arising From Right Coronary Cusp: A Rare Anomaly, Muhammad Shabbir Rawala, Syed Imran Rizvi, Syed Bilal Rizvi

Faculty & Staff Scholarship

The prevalence of coronary artery anomalies is approximately 0.6% in individuals undergoing angiography. Most of the anomalies are benign, but some can lead to myocardial infarction, cardiomyopathy, and sudden cardiac death. It is very rare to have an entire coronary circulation that arises from the right coronary cusp. We present a case of a 57-year-old male who presented with complaints of chest pain and dyspnea on exertion. An invasive angiogram revealed all the three coronary arteries originating from the right coronary cusp. It is crucial to define coronary anatomy as anomalies dictate which cardiac intervention should be attempted in cases …