Medicine and Health Sciences Commons^™

Contemporary Functional Coronary Angiography: An Update, Josiah Bennett, Sanjay Chandrasekhar, Edward Woods, Patrick Mclean, Noah Newman, Brett Montelaro, Hafeez Ul Hassan Virk, Mahboob Alam, Samin K Sharma, Hani Jned, Muzamil Khawaja, Chayakrit Krittanawong

Faculty, Staff and Students Publications

Functional coronary angiography (FCA) is a novel modality for assessing the physiology of coronary lesions, going beyond anatomical visualization by traditional coronary angiography. FCA incorporates indices like fractional flow reserve (FFR) and instantaneous wave-free ratio (IFR), which utilize pressure measurements across coronary stenoses to evaluate hemodynamic impacts and to guide revascularization strategies. In this review, we present traditional and evolving modalities and uses of FCA. We will also evaluate the existing evidence and discuss the applicability of FCA in various clinical scenarios. Finally, we provide insight into emerging evidence, current challenges, and future directions in FCA.

Sex-Specific Outcomes Of Lbbap Versus Biventricular Pacing: Results From I-Clas, Faiz A Subzposh, Parikshit S Sharma, Óscar Cano, Shunmuga Sundaram Ponnusamy, Bengt Herweg, Francesco Zanon, Marek Jastrzebski, Jiangang Zou, Mihail G Chelu, Kevin Vernooy, Zachary I Whinnett, Girish M Nair, Manuel Molina-Lerma, Karol Curila, Kenneth A Ellenbogen, Pugazhendhi Vijayaraman

Faculty, Staff and Students Publications

Background: Cardiac resynchronization therapy (CRT) using biventricular pacing (BVP) has been associated with greater clinical improvement in women than men. Recently, left bundle branch area pacing (LBBAP) has been shown to be an alternative form of CRT.

Objectives: The purpose of this study was to investigate sex-specific outcomes for death and heart failure events in a large, international, multicenter, cohort of patients undergoing CRT with BVP or LBBAP.

Methods: In this international study of 1,778 patients (575 female and 1203 male), sex-specific survival analysis was performed to compare the effect of LBBAP-CRT relative to BVP-CRT on the combined endpoint of …

Optical Coherence Elastography Measures The Biomechanical Properties Of The Ex Vivo Porcine Cornea After Lasik, Achuth Nair, Fernando Zvietcovich, Manmohan Singh, Mitchell P Weikert, Salavat R Aglyamov, Kirill V Larin

Faculty, Staff and Students Publications

SIGNIFICANCE: The biomechanical impact of refractive surgery has long been an area of investigation. Changes to the cornea structure cause alterations to its mechanical integrity, but few studies have examined its specific mechanical impact.

AIM To quantify how the biomechanical properties of the cornea are altered by laser assisted in situ keratomileusis (LASIK) using optical coherence elastography (OCE) in ex vivo porcine corneas.

APPROACH: Three OCE techniques, wave-based air-coupled ultrasound (ACUS) OCE, heartbeat (Hb) OCE, and compression OCE were used to measure the mechanical properties of paired porcine corneas, where one eye of the pair was left untreated, and the …

The Utility Of Software-Detected Non-Invasive Tear Break-Up In Comparison To Fluorescein Tear Break-Up Measurements, Stephen C Pflugfelder, Yasushi Kikukawa, Shin Tanaka, Takuya Kosugi

Faculty, Staff and Students Publications

PURPOSE: The purpose of this study is to characterize and discuss the difference between software-detected non-invasive tear break-up time (NIBUT) and the traditional clinical method of fluorescein break-up time (FBUT).

METHODS: Tear interferometry with the KOWA DR-1α (Kowa, Japan) and a standardized comprehensive ocular surface/tear evaluation were performed in 307 eyes. Software-detected NIBUT in the KOWA DR-1α images and the investigator-detected FBUT were compared.

RESULTS: Software-detected NIBUT was significantly shorter than investigator-measured FBUT. NIBUT was 3.1 ± 2.5 s (mean ± SD), whereas FBUT was 4.8 ± 3.0 s. This difference was due to three different patterns or conditions: a …

Trpv4 Affects Visual Signals In Photoreceptors And Rod Bipolar Cells, Ye Long, Maxim Kozhemyakin, Samuel M Wu, Ji-Jie Pang

Faculty, Staff and Students Publications

INTRODUCTION: Mechanical sensitive channels expressed in mammalian retinas are effectors of elevated pressure stresses, but it is unclear how their activation affects visual function in pressure-related retinal disorders.

METHODS: This study investigated the role of the transient potential channel vanilloid TRPV4 in photoreceptors and rod bipolar cells (RBCs) with immunohistochemistry, confocal microscopy, electroretinography (ERG), and patch-clamp techniques.

RESULTS: TRPV4 immunoreactivity (IR) was found in the outer segments of photoreceptors, dendrites and somas of PKCα-positive RBCs and other BCs, plexiform layers, and retinal ganglion cells (RGCs) in wild-type mice. TRPV4-IR was largely diminished in the retinas of homozygous TRPV4 transgenic mice. …

Evaluating One-Week Post-Casting Alignment Checks And Surgical Intervention Rates In Pediatric Type Iia Supracondylar Humeral Fractures, Jason Z Amaral, Rebecca J Schultz, Benjamin M Martin, Jacob P Scioscia, Basel Touban, Barkha N Chhabra, Kelly Cline, Scott D Mckay

Faculty, Staff and Students Publications

BACKGROUND: This study aims to determine the rate of surgical intervention in children with type IIA supracondylar humerus fractures (SCHF) following routine post-casting radiographic assessment. We hypothesized that no cases would convert to operative management following one-week post-casting alignment assessments.

METHODS: This single-center retrospective study focused on pediatric patients diagnosed with type IIA SCHF from 2019 to 2022. Patients were treated with initial long arm cast immobilization, followed by a one-week post-casting radiographic alignment check in cast. Fractures were graded in consensus using the Wilkins-Modified Gartland classification system by three fellowship-trained pediatric orthopaedic surgeons. Demographics, casting details, follow-up dates, and …

Patient Questions Surrounding Posterior Nasal Nerve Ablation For Chronic Rhinitis, Daniel Gorelik, Samuel E Razmi, Robert Kenneth Sims, Aatin K Dhanda, Masayoshi Takashima, Ella S Brissett, Nicholas R Rowan, Michael T Yim, Najm Khan, Meha G Fox, Omar G Ahmed

Faculty, Staff and Students Publications

OBJECTIVE: In-office ablation of the posterior nasal nerve (PNN) has emerged as an effective treatment option for chronic rhinitis patients. This study explored questions patients commonly search online regarding this therapy and the quality of content available.

STUDY DESIGN: A retrospective analysis of online search criteria and sources was performed with subsequent analysis of results.

SETTING: Search and data acquisition was in September of 2023.

METHODS: Most common search terms related to cryotherapy and radiofrequency neurolysis of the PNN were identified with associated People Also Ask (PAA) questions. Questions were categorized and organized into subtopics and sources evaluated using readability …

Relationship Between Clinical Measures Of Hearing And Clinical Measures Of Vestibular Function, Helen S Cohen, Haleh Sangi-Haghpeykar, J Connor Sullivan, Nathan Silver, Liam D Ferreira, Jen Li Dong, Alex D Sweeney, Angela S Peng

Faculty, Staff and Students Publications

PURPOSE: Patients often have basic audiometry (BA) but not objective diagnostic tests of the vestibular system (VNG) when complaining of symptoms of a vestibular disorder. The relationship of BA results to VNG results is unknown. This study sought to determine if BA scores are related to impaired VNG scores.

MATERIALS AND METHODS: We reviewed electronic medical records at a tertiary care center, for patients seen between 2015 and 2021 who had had both a BA and a VNG (n = 651). BA subtests were pure tone averages, word recognition, and tympanogram. VNG subtests were cervical vestibular evoked myogenic potentials, Dix-Hallpike …

Uterine Rupture In The First Trimester: A Case Report And Review Of The Literature., Steve Mutiso, Felix Oindi, Debbie Mundia

Obstetrics and Gynaecology, East Africa

Background: Uterine rupture is a rare complication that can occur in the frst trimester of pregnancy. It can lead to serious maternal morbidity or mortality, which is mostly due to catastrophic bleeding. First trimester uterine rupture is rare; hence, diagnosis can be challenging as it may be confused with other causes of early pregnancy bleeding such as an ectopic pregnancy. We present a case of frst trimester scar dehiscence and conduct a literature review of this rare condition.

Case presentation: A 39-year-old African patient with four previous hysterotomy scars presented with severe lower abdominal pain at 11 weeks of gestation. …

Effects Of The Covid-19 Crisis On Seafarers And Shipping, Raphael Baumler, María Carrera-Arce, Johan Hollander, Magnus Broström, Karolina Stark

Reports

The report is a testament to the remarkable resilience of the ships and port interface, and the adaptability of port workers and seafarers during the COVID-19 crisis. It also brings to light the vulnerabilities and trends within the sector. The ability of these workers to manage the shockwave ensured that trade flow continued, sustaining the world. However, this period had severe impacts on their livelihoods, starkly highlighting the industry’s inadequate consideration of its human element and the rapid pace of digitalization. The research employed a unique combination of quantitative and qualitative approaches to explore and cross-validate information. This included an …