Medicine and Health Sciences Commons^™

Deep Filtered Back Projection For Ct Reconstruction, X I Tan, Xuan Liu, Kai Xiang, Jing Wang, Shan Tan

Faculty, Staff and Student Publications

Filtered back projection (FBP) is a classic analytical algorithm for computed tomography (CT) reconstruction, with high computational efficiency. However, images reconstructed by FBP often suffer from excessive noise and artifacts. The original FBP algorithm uses a window function to smooth signals and a linear interpolation to estimate projection values at un-sampled locations. In this study, we propose a novel framework named DeepFBP in which an optimized filter and an optimized nonlinear interpolation operator are learned with neural networks. Specifically, the learned filter can be considered as the product of an optimized window function and the ramp filter, and the learned …

Rapid Response To Sirolimus In Patients With Pik3ca-Related Overgrowth Spectrum, Jessica R Nye, Jackson C Green, Michael Talanker, Jose Barrera, Kate Richardson, Neethu M Menon, Adelaide A Hebert, Matthew R Greives, Autumn A Atkinson

Faculty, Staff and Student Publications

PIK3CA-related overgrowth spectrum (PROS) is an umbrella term used to unify a heterogenous group of vascular overgrowth disorders by a shared genetic cause. Given that patients with PROS have a known, or likely, gene mutation in the PI3K/AKT/mTOR cascade, we hypothesize they experience a rapid response to inhibitors of this pathway, including sirolimus. In the following case series, we describe 3 patients with PROS and their response to sirolimus therapy. Despite their unique clinical presentations, insight into the genetic origin of their vascular overgrowth allowed for their successful treatment with the same medication.

Intranasal Sensitization Model Of Alopecia Areata Using Pertussis Toxin As Adjuvant, Yuying Liu, Jasmin Freeborn, Beanna Okeugo, Shabba A Armbrister, Zeina M Saleh, Ana Beatriz Fadhel Alvarez, Thomas K Hoang, Evelyn S Park, John William Lindsey, Ronald P Rapini, Steven Glazer, Keith Rubin, Jon Marc Rhoads

Faculty, Staff and Student Publications

Background: Nasopharyngeal Bordetella pertussis (BP) colonization is common, with about 5% of individuals having PCR evidence of subclinical BP infection on nasal swab, even in countries with high vaccination rates. BP secretes pertussis toxin (PTx). PTx is an adjuvant commonly used to induce autoimmunity in multiple animal models of human disease. Colocalization of PTx and myelin from myelinated nerves in the nasopharynx may lead to host sensitization to myelin with subsequent autoimmune pathology.

Methods: C57BL/6J female adult mice were given varied doses and schedules of intranasal PTx, MOG35-55 antigen, or controls to test whether intranasal administration of PTx and myelin …

Registration Of Hyperspectral Images And Mass Spectrometry Data For The Correlation Of Tissue Optical Spectra And Molecular Profiles, Angie T Fei, Douglas W Strand, Jing Wang

Faculty, Staff and Student Publications

Hyperspectral imaging (HSI) is a label-free imaging modality that is emerging for non-invasive detection of various diseases including cancers. HSI provides high-resolution spatial images where each pixel has a spectral curve with numerous wavelength bands from the visible to infrared ranges. The rich spatial and spectral information can be used to discriminate various types of tissues and pathophysiological conditions. However, it can be difficult to explain spectral data with respect to the underline cellular and molecular mechanism. In this study, we developed an approach that registers hyperspectral images and mass spectrometry (MS) data where MS provides tissue molecular profiles. Human …

Increased Risk For Alcohol- And Other Substance-Exposed Pregnancies Among Women Who Smoke Tobacco: A Secondary Analysis Of A Primary Care-Based Intervention, Thomas F Northrup, Angela L Stotts, Stephen M Fischer, Kirk L Von Sternberg, Mary M Velasquez

Faculty, Staff and Student Publications

Introduction: Among women at risk for alcohol-exposed pregnancies (AEP), smoking tobacco may be associated with increased severity of alcohol use, and risk for tobacco-exposed and other substance-exposed pregnancies (TEPs/SEPs). Our secondary data analysis of the 'CHOICES Plus' intervention trial explored AEP and SEP risk by smoking status.

Methods: Eligible women (N=261) were recruited from 12 primary care clinics in a public healthcare system, not pregnant, aged 18-44 years, drinking >3 drinks/day or >7 drinks/week, sexually active, and not using effective contraception. We compared women who did and did not smoke tobacco on alcohol and drug severity, and psychological distress (e.g. …

Refinement Of An Emergency Department-Based, Advance Care Planning Intervention For Patients With Cognitive Impairment And Their Caregivers, Kei Ouchi, Christopher Joshi, Jenson Kaithamattam, Seth A Gale, Gad A Marshall, Alison Pietras, Wei Wang, Edward W Boyer, James A Tulsky, Susan D Block, Dorene Rentz, Mara A Schonberg

Faculty, Staff and Student Publications

Background and objectives: Advance care planning (ACP) conversations are important to provide goal-concordant care (i.e., the care that matches the patient's previously stated goals) near end of life. While 31% of older adults presenting to the emergency department (ED) have dementia, only 39% have previously had ACP conversations. We refined and piloted an ED-based, motivational interview designed to stimulate ACP conversations (ED GOAL) for patients living with cognitive impairment and their caregivers.

Research design and methods: We systematically refined ED GOAL and then conducted an acceptability study in an urban, academic medical center. We prospectively enrolled adults aged 50+ with …

Editorial: Immunological Aspects Of Emerging And Re-Emerging Zoonoses, Wei Wang, Jingxin Li, Yuejin Liang, Wenping Gong

Faculty, Staff and Student Publications

No abstract provided.

Unicentric Castleman Disease: Illustration Of Its Morphologic Spectrum And Review Of The Differential Diagnosis, Siba El Hussein, Andrew G Evans, Hong Fang, Wei Wang, L Jeffrey Medeiros

Faculty, Staff and Student Publications

Context: Unicentric Castleman disease (UCD) is a dynamic entity with a wide spectrum of morphologic findings. UCD can be further subdivided into hyaline-vascular and mixed/plasmacytic variants. Hyaline-vascular UCD has both follicular and interfollicular (stromal) changes, and occasionally these lesions show a skewed representation of either the follicular or stromal compartments. Plasmacytosis is usually minimal in the hyaline-vascular variant. The mixed/plasmacytic variant of UCD is composed of sheets of plasma cells often associated with a variable number of follicles with regressive changes.

Objective: To illustrate the differential diagnosis of UCD, as it is quite broad and includes lymphomas, plasma cell neoplasms, …

Absolute Concentration Estimation Of Covid-19 Convalescent And Post-Vaccination Igg Antibodies, Melvin E Klegerman, Tao Peng, Ira Seferovich, Mohammad H Rahbar, Manouchehr Hessabi, Amirali Tahanan, Audrey Wanger, Carolyn Z Grimes, Luis Z Ostrosky-Zeichner, Kent Koster, Jeffrey D Cirillo, Dinuka Abeydeera, Steve De Lira, David D Mcpherson

Faculty, Staff and Student Publications

Soon after commencement of the SARS-CoV-2 disease outbreak of 2019 (COVID-19), it became evident that the receptor-binding domain of the viral spike protein is the target of neutralizing antibodies that comprise a critical element of protective immunity to the virus. This study addresses the relative lack of information regarding actual antibody concentrations and binding affinities in convalescent plasma (CP) samples from COVID-19 patients and extends these analyses to post-vaccination (PV) samples to estimate protective IgG antibody (Ab) levels. A direct enzyme-linked immunosorbent assay (ELISA) was used to measure IgG anti-spike protein (SP) antibodies (Abs) relative to human chimeric spike S1 …

Navigating P2y12 Inhibition In The Labyrinth Of Cardio-Oncology Care: Cangrelor Bridging In Patients With Cancer, Abdelrahman Ali, Poonam Jewani, Max Bourdillon, Efstratios Koutroumpakis, Shaden Khalaf, Konstantinos Charitakis, Kara Thompson, Konstantinos Marmagkiolis, Anita Deswal, Cezar Iliescu

Faculty, Staff and Student Publications

Cangrelor, a potent intravenous P2Y12 platelet inhibitor, has demonstrated effectiveness in reducing ischemic events without a corresponding increase in severe bleeding during percutaneous coronary intervention, as evidenced by the CHAMPION-PHOENIX trial. Its off-label role as a bridging antiplatelet agent for patients facing high thrombotic risks who must temporarily stop oral P2Y12 inhibitor therapy further underscores its clinical utility. This is the first case series to shed light on the application of cangrelor in cancer patients needing to pause dual antiplatelet therapy for a range of medical interventions, marking it as a pioneering effort in this domain. The inclusion of patients …

Highly Variable Timing Renders Immunotherapy Efficacy And Toxicity Impractical Biomarkers Of One Another In Clinical Practice, Mitchell S Von Itzstein, Yuqiu Yang, Yiqing Wang, David Hsiehchen, Thomas Y Sheffield, Farjana Fattah, Vinita Popat, Murtaza Ahmed, Jade Homsi, Jonathan E Dowell, Sawsan Rashdan, Jay Lohrey, Hans J Hammers, Randall S Hughes, Tao Wang, Yang Xie, David E Gerber

Faculty, Staff and Student Publications

Background: A useful clinical biomarker requires not only association but also a consistent temporal relationship. For instance, chemotherapy-induced neutropenia and epidermal growth-factor inhibitor-related acneiform rash both occur within weeks of treatment initiation, thereby providing information prior to efficacy assessment. Although immune checkpoint inhibitor (ICI)-associated immune-related adverse events (irAE) have been associated with therapeutic benefit, irAE may have delayed and highly variable onset. To determine whether ICI efficacy and irAE could serve as clinically useful biomarkers for predicting each other, we determined the temporal relationship between initial efficacy assessment and irAE onset in a diverse population treated with ICI.

Methods: Using …

Optimizing Delirium Care In The Era Of Age-Friendly Health System, Min Ji Kwak, Sharon K Inouye, Donna M Fick, Alice Bonner, Terry Fulmer, Emily Carter, Victor Tabbush, Kerri Maya, Nicholas Reed, Christine Waszynski, Esther S Oh

Faculty, Staff and Student Publications

Delirium is a significant geriatric condition associated with adverse clinical and economic outcomes. The cause of delirium is usually multifactorial, and person-centered multicomponent approaches for proper delirium management are required. In 2017, the John A. Hartford Foundation and the Institute for Healthcare Improvement (IHI) launched a national initiative, Age-Friendly Health System (AFHS), promoting the use of a framework called 4Ms (what matters, medication, mentation, and mobility). The 4Ms framework's primary goal is to provide comprehensive and practical person-centered care for older adults and it aligns with the core concepts of optimal delirium management. In this special article, we demonstrate how …

Foxp1 And Klf2 Reciprocally Regulate Checkpoints Of Stem-Like To Effector Transition In Car T Cells, Ziang Zhu, Guohua Lou, Xiao-Lu Teng, Haixia Wang, Ying Luo, Wangke Shi, Kiddist Yihunie, Shumeng Hao, Kole Degolier, Chengheng Liao, Huocong Huang, Qing Zhang, Terry Fry, Tao Wang, Chen Yao, Tuoqi Wu

Faculty, Staff and Student Publications

During cancers and infections, self-renewing stem-like CD8+ T cells mediate the response of immunotherapies and replenish terminally exhausted T cells and effector-like T cells. However, the programs governing the lineage choice in chimeric antigen receptor (CAR) T cells are unclear. Here, by simultaneously profiling single-cell chromatin accessibility and transcriptome in the same CAR T cells, we identified heterogeneous chromatin states within CD8+ T cell subsets that foreshadowed transcriptional changes and were primed for regulation by distinct transcription factors. Transcription factors that controlled each CD8+ T cell subset were regulated by high numbers of enhancers and positioned as hubs of gene …

Editorial: Advances And Methods In Mesenchymal Stem Cells, Pamela L Wenzel

Faculty, Staff and Student Publications

No abstract provided.

Long-Term Safety Of Dexamethasone Sodium Phosphate Encapsulated In Autologous Erythrocytes In Pediatric Patients With Ataxia Telangiectasia, Mary Kay Koenig, Vincenzo Leuzzi, Riadh Gouider, Eppie M Yiu, Barbara Pietrucha, Asbjørg Stray-Pedersen, Susan L Perlman, Steve Wu, Trudy Burgers, Rupam Borgohain, Rukmini Mridula Kandadai, Isabelle Meyts, Giorgia Bucciol, Anaita Udwadia-Hegde, Ravi Yadav, Donna Roberts, Aaron Dane, Maureen Roden, Dirk Thye, Biljana Horn, Howard M Lederman, William P Whitehouse

Faculty, Staff and Student Publications

Background: Dexamethasone sodium phosphate (DSP) encapsulated in autologous erythrocytes (EryDex) was developed as an alternative to standard glucocorticoids in an effort to eliminate chronic steroid toxicity while preserving efficacy. The primary objective of this report is to describe the safety of long-term use of EryDex in treatment of pediatric patients with ataxia telangiectasia.

Methods: This is a post-hoc analysis of patients treated with EryDex for a minimum of 24 months in two prospective clinical trials. Outcomes include adverse events, growth, hemoglobin and serum iron, glucose levels, HbA1c, CD4+ lymphocytes, and bone mineral density.

Results: Sixty-eight patients completed a minimum of …

A Systematic Review Of Infant Mental Health Prevention And Treatment Programs, Megan M Hare, Taylor D Landis, Melissa L Hernandez, Paulo A Graziano

Faculty, Staff and Student Publications

Although many prevention and treatment programs exist for children and families, there have been no reviews specifically examining their impact on infant mental health at the program level. Therefore, the purpose of the current review was to a) systematically examine prevention and treatment programs targeting infant mental health outcomes (i.e., internalizing problems, externalizing problems, social-emotional development, trauma) or the parent-infant relationship/ attachment in children from pregnancy to 2 years; b) classify each program by level of empirical support; and c) highlight strengths and identify gaps in the existing literature to inform future mental health intervention science. From over 121,341 publications …

Impact Of Covid-19 On Nationwide Pediatric Complicated Sinusitis Trends Throughout 2018–2022, Gianna Rosamilia, Kyung Hyun Lee, Soham Roy, Catherine Hart, Zhen Huang

Faculty, Staff and Student Publications

Objectives: To describe and analyze the trends of pediatric sinusitis cases from 2018 to 2022 across the country utilizing the Pediatric Hospital Information System (PHIS) database focusing on volumes, socioeconomics, and severity of cases.

Study design: Retrospective Cohort Study.

Methods: A retrospective cohort study using the Pediatric Health Information System (PHIS) database, which consists of 50 children's hospitals was performed. Regions were defined according to PHIS guidelines. We evaluated percentage of sinusitis cases demographic and socioeconomic information and subgrouped by region throughout 2018-2022.

Results: In all regions there were a greater number of sinusitis cases post-COVID compared to pre-COVID, with …

Individualized Risk Assessment For Use Of Hormone Therapy In People With Sickle Cell Disease, Maureen K Baldwin, Bethany Samuelson Bannow, Rachel P Rosovsky, Nancy Sokkary, Lakshmi V Srivaths

Faculty, Staff and Student Publications

No abstract provided.

Increased Rate Of Multidrug-Resistant Gram-Negative Bacterial Infections In Hospitalized Immunocompromised Pediatric Patients, Sarah Khafaja, Yara Salameh, Celina F Boutros, Cherine Awad, Kawthar Faour, Nadim Tfaily, Sarah Merhi, Zeinab El Zein, Samer Bou Karroum, Dana Oweini, Danielle Fayad, George F Araj, Ramia Zakhour, Ghassan S Dbaibo

Faculty, Staff and Student Publications

Introduction: Multidrug resistant Gram-negative bacterial infections are considered a major public health threat. Immunocompromised pediatric patients are at a great risk of severe or overwhelming infections. The aim of this study was to describe the frequency of infections with multidrug resistant (MDR) Gram-negative bacteria (GNB) in immunocompromised pediatric patients and to determine the risk factors. In addition, we aimed to identify the antimicrobial resistance patterns of these isolates.

Materials and methods: This was a retrospective observational study conducted at the American University of Beirut Medical Center (AUBMC) from 2009 to 2017. The study included immunocompromised patients 18 years of age …

Defining The Disparity: A Multi-Institutional Analysis Of Factors Associated With Decreased Resident Operative Experience, Adam D Price, Darci C Foote, Matthew R Woeste, Leah K Winer, Kelsey B Montgomery, Motaz Al Yafi, Jeffry T Nahmias, Lauren M Postlewait, Jeffrey M Sutton, R Cutler Quillin, Alexander R Cortez

Faculty, Staff and Student Publications

Introduction: Technical learning in surgical training is multifaceted and existing literature suggests a positive relationship between case volume and proficiency. Little is known about factors associated with a decreased volume of operative experience. This study aimed to identify resident and program factors associated with general surgery residents (GSR) in the bottom quartile of logged case volume upon program completion.

Methods: A post hoc analysis of a multicenter study was used to examine case logs for categorical GSR. Participants included graduates between 2010 and 2020 from 20 programs. Residents below and above the 25th percentile for total operative volume were compared. …

The Positive Role Of Physical Therapy And Appropriate Technology In The Reduction Of Bone Mineral Density Loss Associated With Complete Spinal Cord Injury: A Case Report, Marcie Kern, Shuo-Hsiu Chang

Faculty, Staff and Student Publications

While no single method effectively prevents bone loss after spinal cord injury (SCI), consistent participation in activity-based therapies can help reduce it in individuals with chronic complete SCI. This case report presents the results of multiple dual-energy X-ray absorptiometry scans conducted over 14 years, highlighting changes in bone mineral density (BMD). The individual studied maintained a healthy lifestyle, preventing secondary complications associated with SCI. The focus is on the participant's engagement in various therapies, including functional electrical stimulation, lower-extremity cycling, and walking with a robotic exoskeleton. Remarkably, the findings indicate that, rather than losing BMD, this individual not only maintained …

Botulinum Toxin Treatment May Improve Myoelectric Pattern Recognition In Robot-Assisted Stroke Rehabilitation, Zhiyuan Lu, Yingchun Zhang, Sheng Li, Ping Zhou

Faculty, Staff and Student Publications

No abstract provided.

Effect Of Pioglitazone On Inflammatory Response And Clinical Outcome In T2dm Patients With Covid-19: A Randomized Multicenter Double-Blind Clinical Trial, Khaled Baagar, Thamer Alessa, Mohamed Abu-Farha, Jehad Abubaker, Heba Alhumaidi, Jose Antonio Franco Ceruto, Mohammad Khair Hamad, Ali Omrani, Salma Abdelrahman, Muhammad Zaka-Ul Haq, Abdul Wajid Safi, Bassem Alhariri, Manish Barman, Alaaeldin Abdelmajid, Humberto Vidal Denis Cancio, Eman Elmekaty, Irina Al-Khairi, Preethi Cherian, Lina Jayyousi, Mohammed Ahmed, Mohammed Qaddoumi, Sulaiman Hajji, Ahmad Esmaeel, Ali Al-Andaleeb, Arshad Channanath, Sriraman Devarajan, Hamad Ali, Thangavel Alphonse Thanaraj, Salman Al-Sabah, Fahd Al-Mulla, Muhammad Abdul-Ghani, Amin Jayyousi

Faculty, Staff and Student Publications

Background: Coronavirus disease 2019 (COVID-19) caused by the coronavirus SARS-CoV-2, has emerged as a rapidly spreading contagious disease across the globe. Recent studies showed that people with diabetes mellitus, severe obesity, and cardiovascular disease are at higher risk of mortality from COVID-19. It has been suggested that the increased risk is due to the chronic inflammatory state associated with type 2 diabetes. This study aimed to evaluate the efficacy of pioglitazone, a strong insulin sensitizer with anti-inflammatory properties, in improving the clinical outcomes of patients with type 2 diabetes admitted with moderate-severe COVID-19.

Method: We enrolled 350 patients with type …

Brain-Wide Functional Connectome Analysis Of 40,000 Individuals Reveals Brain Networks That Show Aging Effects In Older Adults, Yezhi Pan, Chuan Bi, Peter Kochunov, Michelle Shardell, J Carson Smith, Rozalina G Mccoy, Zhenyao Ye, Jiaao Yu, Tong Lu, Yifan Yang, Hwiyoung Lee, Song Liu, Si Gao, Yizhou Ma, Yiran Li, Chixiang Chen, Tianzhou Ma, Ze Wang, Thomas Nichols, L Elliot Hong, Shuo Chen

Faculty, Staff and Student Publications

The functional connectome changes with aging. We systematically evaluated aging-related alterations in the functional connectome using a whole-brain connectome network analysis in 39,675 participants in UK Biobank project. We used adaptive dense network discovery tools to identify networks directly associated with aging from resting-state functional magnetic resonance imaging (fMRI) data. We replicated our findings in 499 participants from the Lifespan Human Connectome Project in Aging study. The results consistently revealed two motor-related subnetworks (both with permutation test p-values < 0.001) that showed a decline in resting-state functional connectivity (rsFC) with increasing age. The first network primarily comprises sensorimotor and dorsal/ventral attention regions from precentral gyrus, postcentral gyrus, superior temporal gyrus, and insular gyrus, while the second network is exclusively composed of basal ganglia regions, namely the caudate, putamen, and globus pallidus. Path analysis indicates that white matter fractional anisotropy mediates 19.6% (p < 0.001, 95% CI [7.6% 36.0%]) and 11.5% (p < 0.001, 95% CI [6.3% 17.0%]) of the age-related decrease in both networks, respectively. The total volume of white matter hyperintensity mediates 32.1% (p < 0.001, 95% CI [16.8% 53.0%]) of the aging-related effect on rsFC in the first subnetwork.

Brazilian Psychiatric Association Treatment Guidelines For Generalized Anxiety Disorder: Perspectives On Pharmacological And Psychotherapeutic Approaches, Leonardo Baldaçara, Ana Beatriz Paschoal, Aldo Felipe Pinto, Fabiano Franca Loureiro, Luiz Antonio Vesco Gaiotto Antonio, Diogo De Lacerda Veiga, Thales Marcon Almeida, Diogo Cesar Dos Santos, Leandro Fernandes Malloy-Diniz, Marcelo Feijó De Mello, Andrea Feijó De Mello, Marsal Sanches, Lucas Marques Gandarela, Márcio Antonini Bernik, Antonio E Nardi, Antônio Geraldo Da Silva, Ricardo R Uchida

Faculty, Staff and Student Publications

Generalized anxiety disorder is a highly prevalent mental disorder. Previous data indicate that more than 18 million Brazilians suffer from this condition. Traditionally, generalized anxiety disorder has been considered a mild mental health disorder, despite its links to lower life expectancy, cardiovascular disease, and suicide. The aim of this article is to combine elements of systematic and critical reviews to produce a synthesis of the best evidence about generalized anxiety disorder treatment. Systematic reviews, meta-analyses, and randomized controlled trials were included. The descriptor used in the search was "generalized anxiety disorder," which resulted in 4,860 articles and seven other studies, …

Evolution Of Whole Blood Trauma Resuscitation In Childbearing Age Females: Practice Patterns And Trends, Alexandra Mp Brito, Mark H Yazer, Jason L Sperry, James F Luther, Stephen R Wisniewski, Frances Guyette, Ernest E Moore, Bryan A Cotton, Laura Vincent, Erin Fox, Jeremy W Cannon, Nicholas Namias, Joseph P Minei, Lee Anne Ammons, Skye Clayton, Martin Schreiber

Faculty, Staff and Student Publications

Background: The use of low titer group O whole blood (LTOWB) for resuscitation of patients with traumatic hemorrhage is becoming increasingly common. Practices regarding the administration of RhD-positive LTOWB to childbearing age females (CBAFs) vary between institutions due to concerns about RhD alloimmunization. This study examined practices related to LTOWB transfusion as they pertain to age and sex.

Methods: This was a secondary analysis of the Shock, Whole blood, and Assessment of TBI (traumatic brain injury) trial, a prospective, multicenter observational cohort study where outcomes following LTOWB transfusion were analyzed at seven level 1 trauma centers between 2018 and 2021, …

Endoscopic Innovations In Diagnosis And Management Of Pancreatic Cancer: A Narrative Review And Future Directions, Prateek Suresh Harne, Vaishali Harne, Curtis Wray, Nirav Thosani

Faculty, Staff and Student Publications

Background: Noncompressible torso hemorrhage is a leading cause of preventable death. Resuscitative endovascular balloon occlusion of the aorta (REBOA) is used to control hemorrhage but full aortic occlusion is limited by distal ischemia. Partial REBOA (pREBOA) allows some distal perfusion to prolong occlusion, but precise balloon titration is difficult with standard devices. The COBRA-OS 4 French (Fr) aortic occlusion catheter was evaluated in vitro and in vivo for partial REBOA.

Methods: Bench-top (in vitro) and porcine (in vivo) models were used. The titration window of the device was evaluated in a non-hemorrhage porcine model and in a pulsatile aortic model. …

Victory Out Of Tragedy: Organ Donation, Ali Salim, Bryan A Cotton

Faculty, Staff and Student Publications

Major improvements in trauma care during the last decade have improved survival rates in the severely injured. The unintended consequence is the presentation of patients with non-survivable injuries in a time frame in which intervention is considered and often employed due to prognostic uncertainty. In light of this, discerning survivability in these patients remains increasingly problematic. Evidence-based cut-points of futility can guide early decisions for discontinuing aggressive treatment and use of precious resources in severely injured patients arriving in extremis.

Facing Futility In Hemorrhagic Shock: When To Say ‘When’ In Children And Adults, Bryan A Cotton

Faculty, Staff and Student Publications

No abstract provided.

Postsurgical Pyoderma Gangrenosum After Penile Inversion Vaginoplasty: Case With Review Of Diagnostic And Management Strategies, Michael M Talanker, Jessica R Nye, David T Mitchell, Daniel J Freet

Faculty, Staff and Student Publications

BACKGROUND: Postsurgical pyoderma gangrenosum (PSPG) is a highly uncommon and unpredictable wound healing complication. Rapid progression of ulcers at incisions can cause unfettered dehiscence. Most commonly, PSPG involves breast procedures; however, in this work, we detail a case of a patient who developed PSPG 10 days postoperatively after penile inversion vaginoplasty.

METHODS: The patient in this case underwent a penile inversion vaginoplasty with orchiectomy in the standard fashion. She had no risk factors for PSPG. Following an uncomplicated hospital stay, the patient developed difficulty with pain control and increasing serous drainage on the 10th postoperative day. On readmission, the patient …