Medicine and Health Sciences Commons^™

Phase Ib Study Of Telisotuzumab Vedotin In Combination With Erlotinib In Patients With C-Met Protein-Expressing Non-Small-Cell Lung Cancer, D Ross Camidge, Daniel Morgensztern, Et Al.

2020-Current year OA Pubs

PURPOSE: Overexpression of c-Met protein and epidermal growth factor receptor (

PATIENTS AND METHODS: This study evaluated Teliso-V (2.7 mg/kg once every 21 days) plus erlotinib (150 mg once daily) in adult patients (age ≥ 18 years) with c-Met+ NSCLC. Later enrollment required presence of an

RESULTS: As of January 2020, 42 patients were enrolled (N = 36 efficacy-evaluable). Neuropathies were the most common any-grade adverse events reported, with 24 of 42 patients (57%) experiencing at least one event. The pharmacokinetic profile of Teliso-V plus erlotinib was similar to Teliso-V monotherapy. Median PFS for all efficacy-evaluable patients was 5.9 months …

Management Of Patients With Refractory Cardiogenic Shock And Cardiointestinal Syndrome With Impella 5.5 As Bridge To Decision: Case Series, Ismael A. Salas De Armas, Bindu Akkanti, Amanda Bergeron, Anju Bhardwaj, Kha Dinh, Ali Shirafkan, Jayeshkumar A. Patel, Manish K. Patel, Carlos R. Manrique Neira, Igor D. Gregoric, Biswajit Kar, Mehmet H. Akay

Journal of Shock and Hemodynamics

Patients with advanced heart failure require multi-system management as a majority succumb to end-organ dysfunction, including gastrointestinal sequelae. Temporizing measures, such as early mechanical circulatory support, can assist in the recovery of patients with acute cardiogenic shock. The temporary support can improve patient characteristics to enable future definitive heart failure therapies such as durable left ventricular assist devices and orthotopic heart transplantation. We present two cases of cardiogenic shock that were successfully bridged with an Impella 5.5 (Abiomed). The management enabled the patients to recover from reversible cardiointestinal syndrome and undergo successful definitive therapies.

Revascularization In Cardiogenic Shock: Residual Syntax Score And Chronic Total Occlusions, Venugopal Menon

Journal of Shock and Hemodynamics

The residual syntax score (rSS) is strongly associated with outcomes in patients with stable coronary artery disease. In patients with acute myocardial infarction-associated cardiogenic shock (AMI-CS), the correlation or association of the rSS, mortality risk, and revascularization strategy has not yet been elucidated and needs more investigation. The SHOCK trial demonstrated that patients with left main and severe triple-vessel disease, who underwent coronary artery bypass grafts, had improved outcomes and higher 1-year survival rates than those with initial medical stabilization. However, it is unclear which is the superior technique for achieving complete revascularization. In contrast to the SHOCK trial’s results, …

Covid-19 Induced Right Ventricular Failure And Right Ventricular Assist Device Support, Marvin Slepian M.D.

Journal of Shock and Hemodynamics

COVID-19, while primarily recognized for its pulmonary and systemic manifestations, afflicts the cardiovascular system through various abnormalities. Notably, right ventricular (RV) involvement leading to dysfunction and failure is a manifestation seen in up to 20% of severe COVID patients. RV severity correlates with overall COVID severity, serving as a prognostic marker. Data review reveals that RV failure was largely underdiagnosed, particularly early on in the pandemic. The therapy approach for RV failure in patients with COVID should focus on supporting overall RV perfusion pressure, maintaining sinus rhythm, optimizing RV loading conditions and contractility, and addressing anticoagulation and thrombus-related conditions. Beyond …

Right Ventricular Hemodynamics In Covid-19 Patients, Steven Hollenberg

Journal of Shock and Hemodynamics

The right ventricle is highly sensitive to afterload, and pulmonary compromise can increase pulmonary vascular resistance and lead to right ventricular dysfunction. Pulmonary hypertension can also be exacerbated by mechanical ventilation. Patients with COVID-19 pneumonia and respiratory failure, especially those ventilated with positive end-expiratory pressure, are prone to pulmonary hypertension. Understanding their right ventricular hemodynamics can have therapeutic and prognostic implications.

Medical School Watercooler Newsletter - February 9, 2023, Lindsey Lyle

Watercooler Newsletter

This is the February 9, 2023 edition of the Frederick P. Whiddon College of Medicine's newsletter - Watercooler.

Contents include:

• Solidarity week set for Feb. 13-17
• Thakur leads largest study published to date on keyhole approach to skull base surgery
• Save the date: Gulf coast Trauma Symposium
• Meet a Med Student: Ashley Nguyen

How I Want Future Generations To Remember Covid-19, Anonymous

Community Reflections

For the future generations, I want them to know that COVID-19 wasn’t just “two weeks off from school”, I want them to know and realize that life was troublesome for many people and families still haven’t recovered years later.

Massive Loss Of Proprioceptive Ia Synapses In Rat Spinal Motoneurons After Nerve Crush Injuries In The Postnatal Period, Ariadna Arbat-Plana, Sara Bolívar, Xavier Navarro, Esther Udina, Francisco J. Alvarez

Neuroscience, Cell Biology & Physiology Faculty Publications

Peripheral nerve injuries (PNIs) induce the retraction from the ventral horn of the synaptic collaterals of Ia afferents injured in the nerve, effectively removing Ia synapses from α-motoneurons. The loss of Ia input impairs functional recovery and could explain, in part, better recovery after PNIs with better Ia synaptic preservation. Synaptic losses correlate with injury severity, speed, and efficiency of muscle reinnervation and requires ventral microglia activation. It is unknown whether this plasticity is age dependent. In neonates, axotomized motoneurons and sensory neurons undergo apoptosis, but after postnatal day 10 most survive. The goal of this study was to analyze …

Covid- 19, Anonymous

Community Reflections

Many aspects of our daily lives were thrown into disarray because of the COVID-19 pandemic. Even until January 2023, no one knew what true, long-term consequences it would have. It would introduce new customs that many of us had never experienced before, like wearing masks, keeping six feet apart, and not shaking each other's hands to introduce ourselves. We have not seen such an outbreak since the 1980s with HIV and AIDS in the U.S., where there was so much paranoia within our society that we were constantly sanitizing our hands and quarantining when someone was infected with COVID-19.

My Covid Lesson, Anonymous

Community Reflections

What was supposed to be a two-week break turned into months of quarantining and not seeing any of my close friends. Covid-19 was hard on many people. During this time, I found who I am on my own.

Covid Birthday, Anonymous

Community Reflections

Covid 19 was a shock to us all. No one knew what to expect. It was a new way of living for everyone.

My Brutal Covid Experience, Anonymous

Community Reflections

Within weeks, Covid 19 was present in the United States. It affected everyone in the world. Nobody knew what to do at the start of this, and nobody completely knew what was going on.

My Account Of Covid- 19, Ryan Anonymous

Community Reflections

It was March 13, 2020, when the first encounter happened. The Coronavirus was still new to many of us, so we really did not know the true severity that this virus had in store. One morning, during second period, the entire school was called down to the auditorium for an impromptu assembly. With the recent closings of neighboring schools, we were certain that we were the next to close; everyone was ecstatic.

Covid 19 And Other Pandemics, Anonymous

Community Reflections

The Coronavirus was a global pandemic that spread from China to the United States in March 2020. In March, it was announced to us that the United States had to go into lockdown for two weeks. Little did we know that this two-week lockdown was going to turn into almost a year. This news was found to be very surprising by everyone because it has been so many years since we had a pandemic that affected everyone.

Family Experience, Anonymous

Community Reflections

It started with whispers in the hallway. Hearing rumors from peers that we would have two weeks off from school and then return to share stories from those glorious 14 days. In hindsight, it was naïve to think that Covid-19 would have such little impact on my life, but it eventually struck my family as it did thousands of others.

Remembering Covid, Anonymous

Community Reflections

This is a short reflection on my experience as a firefighter during the COVID-19 pandemic.

Current And Emerging Therapies For Atherosclerotic Cardiovascular Disease Risk Reduction In Hypertriglyceridemia, Reed Mszar, Sarah Bart, Alexander Sakers, Daniel Soffer, Dean G. Karalis

Division of Cardiology Faculty Papers

Hypertriglyceridemia (HTG) is a prevalent medical condition in patients with cardiometabolic risk factors and is associated with an increased risk of atherosclerotic cardiovascular disease (ASCVD), if left undiagnosed and undertreated. Current guidelines identify HTG as a risk-enhancing factor and, as a result, recommend clinical evaluation and lifestyle-based interventions to address potential secondary causes of elevated triglyceride (TG) levels. For individuals with mild to moderate HTG at risk of ASCVD, statin therapy alone or in combination with other lipid-lowering medications known to decrease ASCVD risk are guideline-endorsed. In addition to lifestyle modifications, patients with severe HTG at risk of acute pancreatitis …

Impact Of An Addiction Medicine Consult Service On Patients Admitted To The Hospital With Injection Drug Use-Associated Infective Endocarditis, Savitha Racha, Lynn Manganiello, Mary K. Carney, Alvin Mercado, Kara Aplin, Madeline King, Ryan Schmidt, Brian Roberts, Matthew Scott Salzman

Cooper Rowan Medical Journal

Background: The addition of an addiction medicine consult service has been shown to improve mortality and decrease hospital costs but its impact on the proportion of patients discharged against medical advice (DAMA) and in-hospital initiation of medication for opioid use disorder (MOUD) has not been examined.

Methods: A retrospective before-after cohort study was performed at an urban, academic medical center between January 1, 2015 and November 1, 2019. We included adult patients with infective endocarditis and injection drug use determined by admitting diagnosis ICD-9 or ICD-10 codes or documentation within the history section of electronic health recordEHR. Our …

Racial And Ethnic Disparities In Speech-Language Pathology (Slp) Services, Hope A. Lemmons

Student Theses and Dissertations

The purpose of the study was to examine the experiences with and perceptions of racially and socioeconomically diverse people in accessing early intervention day treatment (EIDT) facilities. Participants completed a questionnaire which included questions regarding the parents’ age, ethnicity, socioeconomic status (SES), gender, education level, income level, along with other questions. Participants were recruited from the KidSPOT facility, an EIDT center in Jonesboro, Arkansas. Participants had to have a child enrolled in speech therapy and enrolled in EIDT services at KidSPOT. A total of 10 participants completed the questionnaire: six females and four males. When asked the participants’ race, only …

Comentarios Críticos Escritos Por Estudiantes De Medicina Sobre La Evaluación Del Paciente, David Sánchez-Jiménez

Publications and Research

La presente investigación analiza los comentarios críticos producidos por estudiantes chilenos de 3º y 4º de Medicina en la sección Comentario/Reflexión final de la Ficha Clínica con el objetivo de conocer su opinión sobre la experiencia de su estancia hospitalaria y la práctica médica en general, así como de entender los elementos retórico-discursivos que utilizan para posicionar su voz en el texto al evaluar dicha experiencia. Para investigar este fenómeno se realizó un análisis textual computarizado de las categorías gramaticales y los contenidos semántico-funcionales valorativos desde un enfoque cualitativo inductivo-deductivo. Los resultados del estudio mostraron un predominio de los comentarios …

Tobacco Exposure In Adults And Children With Proteinuric Glomerulopathies: A Neptune Cohort Study., Linda Wang, Bayle Smith-Salzberg, Kevin Ec Meyers, Dorey A. Glenn, Katherine R. Tuttle, Vimal K. Derebail, Tammy M. Brady, Keisha Gibson, Abigail R. Smith, Michelle M. O'Shaughnessy, Tarak Srivastava, Gentzon Hall, Jarcy Zee, Markus Bitzer, Christine B. Sethna

Manuscripts, Articles, Book Chapters and Other Papers

BACKGROUND: Tobacco exposure has been recognized as a risk factor for cardiovascular disease (CVD) and progression of kidney disease. Patients with proteinuric glomerulopathies are at increased risk for cardiovascular morbidity and mortality. Multiple studies have linked tobacco exposure to CVD and chronic kidney disease, but the relationships between smoking and proteinuric glomerulopathies in adults and children have not been previously explored.

METHODS: Data from the Nephrotic Syndrome Study Network (NEPTUNE), a multi-center prospective observational study of participants with proteinuric glomerulopathies, was analyzed. 371 adults and 192 children enrolled in NEPTUNE were included in the analysis. Self-reported tobacco exposure was classified …

Opioid Prescriptions In A Veteran Population Undergoing Lumbar Spine Surgery: What Are The Current Knowledge Gaps?, Mark J. Lambrechts, Hernan Roca, Brian A. Karamian

Department of Orthopaedic Surgery Faculty Papers

No abstract provided.

Early Restrictive Or Liberal Fluid Management For Sepsis-Induced Hypotension, Nathan I Shapiro, Ivor S Douglas, Roy G Brower, Samuel M Brown, Matthew C Exline, Adit A Ginde, Michelle N Gong, Colin K Grissom, Douglas Hayden, Catherine L Hough, Weixing Huang, Theodore J Iwashyna, Alan E Jones, Akram Khan, Poying Lai, Kathleen D Liu, Chadwick D Miller, Katherine Oldmixon, Pauline K Park, Todd W Rice, Nancy Ringwood, Matthew W Semler, Jay S Steingrub, Daniel Talmor, B Taylor Thompson, Donald M Yealy, Wesley H Self

Faculty, Staff and Student Publications

BACKGROUND: Intravenous fluids and vasopressor agents are commonly used in early resuscitation of patients with sepsis, but comparative data for prioritizing their delivery are limited.

METHODS: In an unblinded superiority trial conducted at 60 U.S. centers, we randomly assigned patients to either a restrictive fluid strategy (prioritizing vasopressors and lower intravenous fluid volumes) or a liberal fluid strategy (prioritizing higher volumes of intravenous fluids before vasopressor use) for a 24-hour period. Randomization occurred within 4 hours after a patient met the criteria for sepsis-induced hypotension refractory to initial treatment with 1 to 3 liters of intravenous fluid. We hypothesized that …

Increasing Student Engagement: Case-Based Teaching And Learning, Necole Leland, Lisa Nicholas

UNLV Best Teaching Practices Expo

Case-based learning (CBL) is an active learning approach using hypothetical or real life problems that help learners develop clinical judgment and problem-solving skills (Bastable, 2023). CBL can be used in multiple settings, including the classroom, the clinical environment, and simulation. CBL can be used in most disciplines to bring real life scenarios to life for learners. Learners identify the problem in the case, develop multiple approaches to solving problems, discuss different viewpoints or assumptions, propose alternate decisions, and weigh consequences (Young & Paterson, 2007). CBL helps make connections that transfer theoretical knowledge to practical application (Billings & Halstead, 2020). CBL …

Subtypes Of Dual Users Of Combustible And Electronic Cigarettes: Longitudinal Changes In Product Use And Dependence Symptomatology, Anne Buu, Zhaoxue Tong, Zhanrui Cai, Runze Li, James J Yang, Douglas E Jorenby, Megan E Piper

Faculty, Staff and Student Publications

Introduction: Cross-sectional surveys found behavioral heterogeneity among dual users of combustible and electronic cigarettes. Yet, prior classification did not reflect dynamic interactions between cigarette and e-cigarette consumption, which may reveal changes in product-specific dependence. The contexts of dual use that could inform intervention were also understudied.

Methods: This study conducted secondary analysis on 13 waves of data from 227 dual users who participated in a 2-year observational study. The k-means method for joint trajectories of cigarette and e-cigarette consumption was adopted to identify the subtypes of dual users. The time-varying effect model was used to characterize the subtype-specific trajectories of …

The Clinical And Genetic Spectrum Of Autosomal-Recessive Tor1a-Related Disorders, Afshin Saffari, Tracy Lau, Homa Tajsharghi, Ehsan Ghayoor Karimiani, Ariana Kariminejad, Stephanie Efthymiou, Giovanni Zifarelli, Tipu Sultan, Mehran Beiraghi Toosi, Shahnaz Ibrahim

Department of Paediatrics and Child Health

In the field of rare diseases, progress in molecular diagnostics led to the recognition that variants linked to autosomal-dominant neurodegenerative diseases of later onset can, in the context of biallelic inheritance, cause devastating neurodevelopmental disorders and infantile or childhood-onset neurodegeneration. TOR1A-associated arthrogryposis multiplex congenita 5 (AMC5) is a rare neurodevelopmental disorder arising from biallelic variants in TOR1A, a gene that in the heterozygous state is associated to torsion dystonia-1 (DYT1 or DYT-TOR1A), an early-onset dystonia with reduced penetrance. While 15 individuals with TOR1A-AMC5 have been reported (less than 10 in detail), a systematic investigation of the full disease-associated spectrum has …

North American Blastic Plasmacytoid Dendritic Cell Neoplasm Consortium: Position On Standards Of Care And Areas Of Need, Naveen Pemmaraju, Hagop Kantarjian, Kendra Sweet, Eunice Wang, Jayastu Senapati, Nathaniel R Wilson, Marina Konopleva, Arthur E Frankel, Vikas Gupta, Ruben Mesa, Matthew Ulrickson, Edward Gorak, Sumeet Bhatia, Tulin Budak-Alpdogan, James Mason, Maria Teresa Garcia-Romero, Norma Lopez-Santiago, Gabriela Cesarman-Maus, Pankit Vachhani, Sangmin Lee, Vijaya Raj Bhatt, William Blum, Roland B Walter, Dale Bixby, Ivana Gojo, Madeleine Duvic, Raajit K Rampal, Marcos De Lima, James Foran, Amir T Fathi, Aric Cameron Hall, Meagan A Jacoby, Jeffrey Lancet, Gabriel Mannis, Anthony S Stein, Alice Mims, David Rizzieri, Rebecca Olin, Alexander Perl, Gary Schiller, Paul Shami, Richard M Stone, Stephen Strickland, Matthew J Wieduwilt, Naval Daver, Farhad Ravandi, Sumithira Vasu, Monica Guzman, Gail J Roboz, Joseph Khoury, Muzaffar Qazilbash, Phyu P Aung, Branko Cuglievan, Yazan Madanat, Mohamed A Kharfan-Dabaja, Anna Pawlowska, Justin Taylor, Martin Tallman, Prajwal Dhakal, Andrew A Lane

Faculty, Staff and Student Publications

Blastic plasmacytoid dendritic cell neoplasm (BPDCN) is a rare hematologic malignancy with historically poor outcomes and no worldwide consensus treatment approach. Unique among most hematologic malignancies for its frequent cutaneous involvement, BPDCN can also invade other extramedullary compartments, including the central nervous system. Generally affecting older adults, many patients are unfit to receive intensive chemotherapy, and although hematopoietic stem cell transplantation is preferred for younger, fit individuals, not all are eligible. One recent therapeutic breakthrough is that all BPDCNs express CD123 (IL3Rα) and that this accessible surface marker can be pharmacologically targeted. The first-in-class agent for BPDCN, tagraxofusp, which targets …

The Landscape Of Immunotherapy For Retroperitoneal Sarcoma, Alicia A Gingrich, Elise F Nassif, Christina L Roland, Emily Z Keung

Faculty, Staff and Student Publications

Significant multidisciplinary scientific effort has been undertaken to understand the heterogeneous family of neoplasms that comprise soft tissue sarcomas. Within this family of neoplasms, outcomes for retroperitoneal sarcomas (RPS) are currently limited given a lack of effective therapies. In this review, we focus on immunotherapy and its relationship with the common RPS histologic subtypes. Although initial outcomes for RPS patients with immune checkpoint inhibition alone have been somewhat disappointing, subsequent analyses on histologies, the tumor microenvironment, sarcoma immune class, tumor infiltrating lymphocytes and genetic analysis for tumor mutational burden have yielded insight into the interplay between sarcomas and immunotherapy. Such …

Sphenopalatine Artery Pseudoaneurysm Formation Following Facial Trauma: A Case Report And Literature Review, Kareem El Naamani, Stephen Capone, Ching-Jen Chen, Lisa Tartaglino, Marc Rosen, Rawad Abbas, Georgios S. Sioutas, Abdelaziz Amllay, Adam Hunt, Michael Reid Gooch, Nabeel Herial, Pascal Jabbour, Robert H. Rosenwasswer, Stavropoula Tjoumakaris

Department of Neurosurgery Faculty Papers

Facial fractures, specifically orbitozygomatic and zygomaticomaxillary complex fractures, are well-documented and common injuries. Pseudoaneurysm formation following cerebrovascular blunt trauma is a rarely experienced complication with an incidence rate of less than 1% with only a few cases reported in the literature. Traumatic pseudoaneurysm formation of the sphenopalatine artery (SPA), the deepest branch of the maxillary artery, is extremely rare due to the deep location of the SPA and its protection from bony landmarks. In craniofacial trauma, pseudoaneurysm formation is not apparent on physical examination due to its deep location and usually presents as persistent nasal bleeding. SPA pseudoaneurysms can present …

Retinoid X Receptor Promotes Hematopoietic Stem Cell Fitness And Quiescence And Preserves Hematopoietic Homeostasis, María Piedad Menéndez-Gutiérrez, Jesús Porcuna, Ramesh Nayak, Ana Paredes, Haixia Niu, Vanessa Núñez, Aditi Paranjpe, Manuel J Gómez, Anukana Bhattacharjee, Daniel J Schnell, Fátima Sánchez-Cabo, John S Welch, Nathan Salomonis, Jose A Cancelas, Mercedes Ricote

2020-Current year OA Pubs

Hematopoietic stem cells (HSCs) balance self-renewal and differentiation to maintain hematopoietic fitness throughout life. In steady-state conditions, HSC exhaustion is prevented by the maintenance of most HSCs in a quiescent state, with cells entering the cell cycle only occasionally. HSC quiescence is regulated by retinoid and fatty-acid ligands of transcriptional factors of the nuclear retinoid X receptor (RXR) family. Herein, we show that dual deficiency for hematopoietic RXRα and RXRβ induces HSC exhaustion, myeloid cell/megakaryocyte differentiation, and myeloproliferative-like disease. RXRα and RXRβ maintain HSC quiescence, survival, and chromatin compaction; moreover, transcriptome changes in RXRα;RXRβ-deficient HSCs include premature acquisition of an …