Medicine and Health Sciences Commons^™

Human Hepatocyte 4-Acetoxy- N, N-Diisopropyltryptamine Metabolite Profiling By Reversed-Phase Liquid Chromatography Coupled With High-Resolution Tandem Mass Spectrometry, Sara Malaca, Marilyn A Huestis, Leonardo Lattanzio, Luigi T Marsella, Adriano Tagliabracci, Jeremy Carlier, Francesco P Busardò

College of Health Professions Faculty Papers

Tryptamine intoxications and fatalities are increasing, although these novel psychoactive substances (NPS) are not controlled in most countries. There are few data on the metabolic pathways and enzymes involved in tryptamine biotransformation. 4-acetoxy-N,N-diisopropyltryptamine (4-AcO-DiPT) is a synthetic tryptamine related to 4-hydroxy-N,N-diisopropyltryptamine (4-OH-DiPT), 4-acetyloxy-N,N-dipropyltryptamine (4-AcO-DPT), and 4-acetoxy-N,N-dimethyltryptamine (4-AcO-DMT). The aim of this study was to determine the best 4-AcO-DiPT metabolites to identify 4-AcO-DiPT consumption through human hepatocyte metabolism and high-resolution mass spectrometry. 4-AcO-DiPT metabolites were predicted in silico with GLORYx freeware to assist in metabolite identification. 4-AcO-DiPT was incubated with 10-donor-pooled human hepatocytes and sample analysis was performed with reversed-phase liquid …

Bias In Measurement Of Autism Symptoms By Spoken Language Level And Non-Verbal Mental Age In Minimally Verbal Children With Neurodevelopmental Disorders, Shuting Zheng, Aaron Kaat, Cristan Farmer, Audrey Thurm, Catherine A. Burrows, Stephen Kanne, Stelios Georgiades, Amy Esler, Catherine Lord, Nicole Takashashi, Kerri P. Nowell, Elizabeth A. Will Ph.D., Jane E. Roberts, Somer L. Bishop

Faculty Publications

Increasing numbers of children with known genetic conditions and/or intellectual disability are referred for evaluation of autism spectrum disorder (ASD), highlighting the need to refine autism symptom measures to facilitate differential diagnoses in children with cognitive and language impairments. Previous studies have reported decreased specificity of ASD screening and diagnostic measures in children with intellectual disability. However, little is known about how cognitive and language abilities impact the measurement of specific ASD symptoms in this group. We aggregated a large sample of young children (N = 1196; aged 31-119 months) to examine measurement invariance of ASD symptoms among minimally verbal …

Malignant Hyperthermia, Luther Nyirenda

Nursing Student Class Projects (Formerly MSN)

Malignant hyperthermia (MH) is a rare, life-threatening, and rapidly progressing disorder of the skeletal muscle tissue. It can be induced with the use of neuromuscular blocking agents and inhaled anesthetics which are frequently used by anesthesia providers. The pathophysiology of MH involves an uncontrolled release of free calcium from the ryanodine receptor that is found in the sarcoplasmic reticulum leading to a hypermetabolic state. MH has hereditary significance due to mutation of the ryanodine receptor, thus genetic testing and MH contracture biopsy should be performed to assess susceptibility. Signs and symptoms present as tachycardia. labile blood pressure, hyperthermia, elevated carbon …

Association Of Body Mass Index And Plant-Based Diet With Cognitive Impairment Among Older Chinese Adults: A Prospective, Nationwide Cohort Study, Fang Liang, Jialin Fu, Gabrielle Turner-Mcgrievy Ph.D., Rd, Yechuang Wang, Nan Qiu, Kai Ding, Jing Zeng, Justin B. Moore, Rui Li

Faculty Publications

To examine the association of body mass index (BMI) and a plant-based diet (PBD) with cognitive impairment in older adults, this cohort study used data from the Chinese Longitudinal Healthy Longevity Survey (CLHLS), a national, community-based, longitudinal, prospective study in China. Cognitive function was evaluated via the Mini-Mental State Examination (MMSE). Diet was assessed using a simplified food frequency questionnaire (FFQ), and PBD patterns were estimated using the overall plant-based diet index (PDI), the healthful plant-based diet index (hPDI), and the unhealthful plant-based diet index (uPDI). BMI was measured objectively during the physical examination. Cox proportional hazard models and restricted …

Comparing Standard Versus Enhanced Implementation Of An Evidence-Based Hiv Prevention Program Among Bahamian Sixth Grade Students: Findings From Nationwide Implementation Trials, Bo Wang, Lynette Deveaux, Carly Herbert, Xiaoming Li Ph.D., Lesley Cottrell, Richard Adderley, Maxwell Poitier, Arvis Mortimer, Glenda Rolle, Sharon Marshall, Nikkiah Forbes, Bonita Stanton

Faculty Publications

Background Effective implementation strategies are needed to address the challenges encountered by teachers in implementation of evidence-based HV prevention programs in schools. The current study: 1) compares implementation fidelity of Focus on Youth in the Caribbean (FOYC) plus Caribbean Informed Parents and Children Together (CImPACT)intervention using enhanced implementation strategies (including biweekly monitoring/feedback and site-based mentoring) to those using more traditional approach (teacher training only); and 2) evaluates the impact of school coordinators’ and mentors’ performance on teachers’ implementation fidelity and student outcomes.

Methods

Data from an enhanced implementation trial in 2019–2020, involving 24 government primary schools, 79 teachers, and …

Mevalonate Pathway Inhibitors Potentiate The Efficacy Of Chemotherapeutic Drugs To Limit Breast Cancer Cell Growth, Cole Moore

Theses and Dissertations

Breast cancer is currently the most prevalent form of cancer in women worldwide and the second most prevalent in the United States. Chemotherapy is a major treatment modality for breast cancer, however, chemotherapy causes severe side effects that significantly lowers the patient’s quality of life. Mevalonate pathway inhibitors have historically been implicated in the treatment of cardiovascular disease but have more recently garnered interest as potential anticancer agents with minimal side effects. Here, we report for the first time to our knowledge that mevalonate pathway inhibitors and chemotherapeutic drugs synergistically attenuate human breast cancer cell (MCF-7) proliferation in culture. We …

Development Of A Decellularized Hydrogel Composite And Its Application In A Novel Model Of Disc-Associated Low Back Pain In Female Sprague Dawley Rats, David Lillyman

Department of Agricultural and Biological Systems Engineering: Dissertations, Theses, and Student Research

Chronic low back pain is a global socioeconomic crisis compounded by an absence of reliable, curative treatments. The predominant pathology associated with chronic low back pain is degeneration of intervertebral discs in the lumbar spine. During degeneration, nerves can sprout into the intervertebral disc tissue and be chronically subjected to inflammatory and mechanical stimuli, resulting in pain. Pain arising from the intervertebral disc, or disc-associated pain, is a complex, multi-faceted disorder which necessitates valid animal models to screen therapeutics and study pathomechanisms of pain.

While many research teams have created animal models of disc degeneration, the translation of these platforms …

Evolution Of The Ao Spine Sacral And Pelvic Classification System: A Systematic Review, Barry Ting Sheen Kweh, Jin W. Tee, F. Cumhur Oner, Klaus J. Schnake, Emiliano N. Vialle, Frank Kanziora, Shanmuganathan Rajasekaran, Marcel Dvorak, Jens R. Chapman, Lorin M. Benneker, Gregory Schroeder, Alexander R. Vaccaro

Rothman Institute Papers

OBJECTIVE: The purpose of this study was to describe the genesis of the AO Spine Sacral and Pelvic Classification System in the context of historical sacral and pelvic grading systems.

METHODS: A systematic search of MEDLINE, EMBASE, Google Scholar, and Cochrane databases was performed consistent with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines to identify all existing sacral and pelvic fracture classification systems.

RESULTS: A total of 49 articles were included in this review, comprising 23 pelvic classification systems and 17 sacral grading schemes. The AO Spine Sacral and Pelvic Classification System represents both the evolutionary …

Lower Sars-Cov-2 Seroprevalence Among Cancer Patients In Sub-Saharan Africa, For Yue Tso, Salum J. Lidenge, John R. Ngowi, Phoebe B. Peña, Ashley A. Clegg, Owen Ngalamika, Chacha J. Mwita, Julius Mwaiselage, Charles Wood

School of Medicine Faculty Publications

Background: Despite the high COVID-19 morbidity and mortality rates across the world, the reported rates in sub-Saharan Africa (SSA), which has a higher burden of other infectious diseases and overwhelmed healthcare systems, remain relatively low. This study aims to better understand the potential factors that contribute to this phenomenon, especially among cancer patients who are considered as a high-risk group for developing severe COVID-19. Methods: Plasma samples collected during the COVID-19 pandemic from SARS-CoV-2 unvaccinated cancer and potential blood donor populations were analyzed for SARS-CoV-2 (spike and nucleocapsid proteins) antibodies by an immunofluorescence assay. The relationships between SARS-CoV-2 seroprevalences and …

Changes Overtime In Perinatal Management And Outcomes Of Extremely Preterm Infants In One Tertiary Care Romanian Center, Diana Ungureanu, Nansi Boghossian, Laura Mihaela Suciu

Faculty Publications

Background and Objectives: Extremely preterm infants were at increased risk of mortality and morbidity. The purpose of this study was to: (1) examine changes over time in perinatal management, mortality, and major neonatal morbidities among infants born at 25⁰–28⁶ weeks’ gestational age and cared for at one Romanian tertiary care unit and (2) compare the differences with available international data. Material and Methods: This study consisted of infants born at 25⁰–28⁶ weeks in one tertiary neonatal academic center in Romania during two 4-year periods (2007–2010 and 2015–2018). Major morbidities were defined as any of …

Successful Aging Through Aging In Place : The Perspectives Of The Elderly And Adult Children In Shenzhen, Feng Huang

Lingnan Theses (Doctoral degree)

Aging in place (AIP) has been adopted to cope with the aging population worldwide. The present research invoked the concept of successful aging as a theoretical perspective on AIP with Shenzhen, China as the backdrop. This study adopted the successful aging model of Rowe and Kahn (1987, 1997, 1998) and employed a mixed methods with qualitative and quantitative research. It examined the AIP policies in China and Shenzhen and how the “users” (the elderly and adult children) perceive AIP and successful aging. It also explored which factors would affect successful aging through AIP. Findings showed that financial security and intergenerational …

Chronic Constant Light Exposure Aggravates High Fat Diet-Induced Renal Injury In Rats, Lin Xing, Shanyu Wu, Ying Shi, Fangzhi Yue, Lin Wei, Ryan D. Russell, Dongmei Zhang

Health & Human Performance Faculty Publications

Obesity-related kidney disease is now recognized as a global health issue, with a substantial number of patients developing progressive renal failure and end-stage renal disease. Interestingly, recent studies indicate light pollution is a novel environmental risk factor for chronic kidney disease. However, the impact of light pollution on obesity-related kidney disease remains largely unknown, with its underlying mechanism insufficiently explained. Renal hypoxia induced factor 1α (HIF1α) is critical in the development of glomerulosclerosis and renal fibrosis. The present study explored effects of constant light exposure on high fat diet (HFD) -induced renal injury and its association with HIF1α signal pathway. …

Clinical Outcomes Of Patients With Recurrent Microsatellite-Stable Endometrial Cancer In Early-Phase Immunotherapy Clinical Trials, Jeffrey A How, Amir A Jazaeri, Siqing Fu, Jordi Rodon Ahnert, Jing Gong, Bettzy Stephen, Hanna Ferreira Dalla Pria, Priya Bhosale, Amber Johnson, Ying Yuan, Funda Meric-Bernstam, Aung Naing

Faculty, Staff and Student Publications

Recurrent microsatellite stable (MSS) endometrial cancer has poor response to conventional therapy and limited efficacy with immune checkpoint monotherapy. We conducted a retrospective study of recurrent MSS endometrial cancer patients enrolled in immunotherapy-based clinical trials at MD Anderson Cancer Center between 1 January 2010 and 31 December 2019. Patients were evaluated for radiologic response using RECIST 1.1 criteria, progression-free survival (PFS), and overall survival (OS). Thirty-five patients were treated with immune checkpoint inhibitors: 8 with monotherapy, 17 with immunotherapy (IO) in combination with another IO-only, and 10 with IO in combination with non-IO therapy. Among those treated with combination IO …

Ppp1r7 Is A Novel Translocation Partner Of Cbfb Via T(2; 16)(Q37; Q22) In Acute Myeloid Leukemia, Lulu Wang, Wei Wang, Hannah C Beird, Xueqian Cheng, Hong Fang, Guilin Tang, Gokce A Toruner, C Cameron Yin, M James You, Ghayas C Issa, Gautam Borthakur, Guang Peng, Joseph D Khoury, L Jeffrey Medeiros, Zhenya Tang

Faculty, Staff and Student Publications

In a subset of acute myeloid leukemia (AML) cases, the core binding factor beta subunit gene (CBFB) was rearranged via inv(16)(p13.1q22) or t(16;16)(p13.1;q22), in which the smooth muscle myosin heavy chain 11 gene (MYH11) was the partner (CBFB::MYH11). Rare variants of CBFB rearrangement occurring via non-classic chromosomal aberrations have been reported, such as t(1;16), t(2;16), t(3;16), t(5;16), and t(16;19), but the partners of CBFB have not been characterized. We report a case of AML with a complex karyotype, including t(2;16)(q37;q22), in which the protein phosphatase 1 regulatory subunit 7 gene (PPP1R7) at …

Effect Of A Glp-1 Mimetic On The Insulin Response To Oral Sugar Testing In Horses, Darko Stefanovski, Mary A Robinson, Andrew Van Eps

Faculty, Staff and Student Publications

BACKGROUND: Insulin dysregulation (ID) is the most important risk factor for the development of laminitis in horses and therapies to control it are needed.

HYPOTHESIS/OBJECTIVES: To assess the effects of a single dose of the synthetic GLP-1 analog exenatide on postprandial insulin dynamics. We hypothesized that exenatide would improve insulin sensitivity and lower postprandial blood insulin concentrations.

STUDY DESIGN: Randomized, crossover, experimental study.

ANIMALS: Six horses (3 mares, 3 geldings; 2 with normal insulin regulation [NIR] and 4 with mild ID).

METHODS: Horses completed both study arms: subcutaneous administration of exenatide (or no treatment) 30 min before an oral sugar …

A Multitask Deep Learning Approach For Pulmonary Embolism Detection And Identification, Xiaotian Ma, Emma C Ferguson, Xiaoqian Jiang, Sean I Savitz, Shayan Shams

Faculty, Staff and Student Publications

Pulmonary embolism (PE) is a blood clot traveling to the lungs and is associated with substantial morbidity and mortality. Therefore, rapid diagnoses and treatments are essential. Chest computed tomographic pulmonary angiogram (CTPA) is the gold standard for PE diagnoses. Deep learning can enhance the radiologists'workflow by identifying PE using CTPA, which helps to prioritize important cases and hasten the diagnoses for at-risk patients. In this study, we propose a two-phase multitask learning method that can recognize the presence of PE and its properties such as the position, whether acute or chronic, and the corresponding right-to-left ventricle diameter (RV/LV) ratio, thereby …

Predicting Which Genes Will Respond To Transcription Factor Perturbations, Yiming Kang, Wooseok J Jung, Michael R Brent

2020-Current year OA Pubs

The ability to predict which genes will respond to the perturbation of a transcription factor serves as a benchmark for our systems-level understanding of transcriptional regulatory networks. In previous work, machine learning models have been trained to predict static gene expression levels in a biological sample by using data from the same or similar samples, including data on their transcription factor binding locations, histone marks, or DNA sequence. We report on a different challenge-training machine learning models to predict which genes will respond to the perturbation of a transcription factor without using any data from the perturbed cells. We find …

[ 18 F]-Labeled Parp-1 Pet Imaging Of Psma Targeted Alpha Particle Radiotherapy Response, Hanwen Zhang, Diane Abou, Peng Lu, Abbie Meghan Hasson, Alexandria Villmer, Nadia Benabdallah, Wen Jiang, David Ulmert, Sean Carlin, Buck E Rogers, Norman F Turtle, Michael R Mcdevitt, Brian Baumann, Brian W Simons, Farrokh Dehdashti, Dong Zhou, Daniel L J Thorek

2020-Current year OA Pubs

The growing interest and clinical translation of alpha particle (α) therapies brings with it new challenges to assess target cell engagement and to monitor therapeutic effect. Noninvasive imaging has great potential to guide α-treatment and to harness the potential of these agents in the complex environment of disseminated disease. Poly(ADP) ribose polymerase 1 (PARP-1) is among the most abundantly expressed DNA repair enzymes with key roles in multiple repair pathways-such as those induced by irradiation. Here, we used a third-generation PARP1-specific radiotracer, [

Orbitofrontal Cortex Contributes To The Comparison Of Values Underlying Economic Choices, Sébastien Ballesta, Weikang Shi, Camillo Padoa-Schioppa

2020-Current year OA Pubs

Economic choices between goods entail the computation and comparison of subjective values. Previous studies examined neuronal activity in the orbitofrontal cortex (OFC) of monkeys choosing between different types of juices. Three groups of neurons were identified: offer value cells encoding the value of individual offers, chosen juice cells encoding the identity of the chosen juice, and chosen value cells encoding the value of the chosen offer. The encoded variables capture both the input (offer value) and the output (chosen juice, chosen value) of the decision process, suggesting that values are compared within OFC. Recent work demonstrates that choices are causally …

The University Of Pennsylvania Glioblastoma (Upenn-Gbm) Cohort: Advanced Mri, Clinical, Genomics, & Radiomics, Spyridon Bakas, Aristeidis Sotiras, Sung Min Ha, Et Al

2020-Current year OA Pubs

Glioblastoma is the most common aggressive adult brain tumor. Numerous studies have reported results from either private institutional data or publicly available datasets. However, current public datasets are limited in terms of: a) number of subjects, b) lack of consistent acquisition protocol, c) data quality, or d) accompanying clinical, demographic, and molecular information. Toward alleviating these limitations, we contribute the "University of Pennsylvania Glioblastoma Imaging, Genomics, and Radiomics" (UPenn-GBM) dataset, which describes the currently largest publicly available comprehensive collection of 630 patients diagnosed with de novo glioblastoma. The UPenn-GBM dataset includes (a) advanced multi-parametric magnetic resonance imaging scans acquired during …

Perceived Stress, Resilience, And Wellbeing In Seasoned Isha Yoga Practitioners Compared To Matched Controls During The Covid-19 Pandemic, Preeti Upadhyay, Shilpa Narayanan, Tanvi Khera, Lauren Kelly, Pooja A. Mathur, Akshay Shanker, Lena Novack, Ruth Pérez-Robles, Kim A. Hoffman, Multiple Additional Authors

OHSU-PSU School of Public Health Faculty Publications and Presentations

Background: Yoga practices, including breathing, meditation, and posture protocols (asanas), have been shown to facilitate physical and mental wellbeing.

Methods: Seasoned yoga practitioners were recruited from the Isha Foundation. Recruitment of the comparison group was achieved using snowball sampling and were not yoga practitioners. Participants in the non-yoga group were randomized to a 3-min Isha practice or a comparator group asked to perform 15-min of daily reading. Participants completed a series of web-based surveys (REDCap) at baseline, 6, and 12 weeks. These surveys include validated scales and objective questions on COVID-19 infection and medical history. The validated questionnaires assess for: …

Sex Differences In The Genetic Architecture Of Cognitive Resilience To Alzheimer's Disease, Jaclyn M Eissman, Carlos Cruchaga, Et Al.

2020-Current year OA Pubs

Approximately 30% of elderly adults are cognitively unimpaired at time of death despite the presence of Alzheimer's disease neuropathology at autopsy. Studying individuals who are resilient to the cognitive consequences of Alzheimer's disease neuropathology may uncover novel therapeutic targets to treat Alzheimer's disease. It is well established that there are sex differences in response to Alzheimer's disease pathology, and growing evidence suggests that genetic factors may contribute to these differences. Taken together, we sought to elucidate sex-specific genetic drivers of resilience. We extended our recent large scale genomic analysis of resilience in which we harmonized cognitive data across four cohorts …

Stem Cell Transplantation For Systemic Sclerosis, Sebastian Bruera, Harish Sidanmat, Donald A Molony, Maureen D Mayes, Maria E Suarez-Almazor, Kate Krause, Maria Angeles Lopez-Olivo

Faculty, Staff and Students Publications

BACKGROUND: Systemic sclerosis (SSc) is a chronic autoimmune disease characterized by systemic inflammation, fibrosis, vascular injury, reduced quality of life, and limited treatment options. Autologous hematopoietic stem cell transplantation (HSCT) has emerged as a potential intervention for severe SSc refractory to conventional treatment.

OBJECTIVES: To assess the benefits and harms of autologous hematopoietic stem cell transplantation for the treatment of systemic sclerosis (specifically, non-selective myeloablative HSCT versus cyclophosphamide; selective myeloablative HSCT versus cyclophosphamide; non-selective non-myeloablative HSCT versus cyclophosphamide).

SEARCH METHODS: We searched for randomized controlled trials (RCTs) in CENTRAL, MEDLINE, Embase, and trial registries from database insertion to 4 February …

Reporting Of Mycetoma Cases From Skin And Soft Tissue Biopsies Over A Period Of Ten Years: A Single Center Report And Literature Review From Pakistan, Mohammad Zeeshan, Saira Fatima, Joveria Farooqi, Kauser Jabeen, Arsalan Ahmed, Afreen Haq, Muhammad Omer Arif, Afia Zafar

Department of Pathology and Laboratory Medicine

Background: Mycetoma is an important neglected tropical disease associated with debilitation, disfigurement and death if not diagnosed and treated adequately. In Pakistan, mycetoma cases have frequently been diagnosed in histopathology and microbiology laboratories. However, there is scarcity of published data from this country. Therefore, the objectives of this study were to evaluate the frequency and type of mycetoma reported in skin and soft tissue biopsies from a single center over 10 years and review of published literature from Pakistan.
Method: This descriptive observational retrospective study was conducted at the Aga Khan University Hospital laboratory, Karachi, Pakistan. Laboratory data from 2009-2018 …

Icsm 3rd Annual Scientific Meeting Plenary Lectures

Journal of the Hong Kong College of Cardiology

No abstract provided.

Complications And Hospital Admissions Among Pregnant Women With Substance Abuse, Melissa A. Nehls, Jamila Iqbal Ranavaya, Sydney Smith-Graham, Micah Ray, Aryana Misaghi, Jennie Yoost, Kelly Cummings

Marshall Journal of Medicine

Introduction

In recent times, there has been an increase in drug abuse in the general population and in women of reproductive age. Our objectives were to identify, classify, and describe the spectrum of complications, the average number of admissions, and the length of hospital stay among pregnant women with substance abuse. The aim was to understand complication prevalence better to improve management in this ever-growing population.

Methods

A retrospective chart review was conducted of pregnant women ages 18-45 with a history of substance abuse from 2013-2018 in the tri-state area of West Virginia, Ohio, and Kentucky. We collected the following …

A Case Of Metastatic Melanoma Presenting As A Small Bowel Obstruction, Danielle Harris, Micah Ray, Andrew J Weaver, Stephen Wilson

Marshall Journal of Medicine

Small bowel obstructions are most commonly caused by adhesion. Less common causes arise from malignant pathology. Here we present a relatively rare case of a small bowel obstruction due to malignant melanoma. Melanoma involving the gastrointestinal tract is relatively rare with most cases occurring as metastatic spread from a cutaneous primary. The treatment typically requires a surgical resection or palliative bypass. When a patient presents with a small bowel obstruction but without prior abdominal surgeries or hernias a malignant obstruction must be on the differential.

Syphilis And Proteinuria In Pregnancy, Jay Jensen, Jesse Cottrell

Marshall Journal of Medicine

Syphilis has the potential to result in serious irreversible morbidity and mortality during pregnancy and has been increasing in incidence across the United States. While syphilis is a common disease and a known but rare cause of membranous nephropathy, it can complicate the clinical picture and obscure accurate diagnosis of women presenting with proteinuria during pregnancy. We report a case of proteinuria with syphilis in the second trimester of pregnancy as an educational review.

Treatment Of Tardive Dyskinesia With High Dose Vitamin B6 Associated With Depression, Marjorie Mccoy, Adam Schindzielorz, Suzanne Holroyd

Marshall Journal of Medicine

Tardive dyskinesia (TD) is a movement disorder associated with dopamine receptor blocking medications. Recommended treatments for TD include discontinuing the causative agent, adding vesicular monoamine transporter 2 (VMAT2) inhibitors, or adding vitamin B6. We present a 66-year-old Caucasian male with bipolar I disorder who developed TD while on lithium and quetiapine having been euthymic on this regimen for three years. He was initially treated with 1200 mg B6 daily. This failed to improve his TD and was associated with a depressive episode. He switched to valbenazine 40 mg daily which improved his TD and concurrently his mood, but months later …

Surgical Fixation Of Complex Rib Fractures To Sternum For Flail Chest: A Case Report, Andrew J Weaver, Wai Hau Bs, Mark H. Cooper Md, Phd

Marshall Journal of Medicine

Rib fractures are among the most common injuries found in a patient presenting from blunt trauma. They are associated with significant morbidity and mortality, largely due to pulmonary complications. Open reduction and internal fixation (ORIF) has been the mainstay treatment for patients with multiple rib fractures. In this report, we present a case of a patient that sustained blunt thoracic trauma with multiple anterolateral rib fractures, including a flail segment. This fail segment involved the costal cartilage and required fixation of ribs to the sternum in order to restore chest wall stabilization and integrity. This was achieved using the Zimmer …