Medical Sciences Commons^™

Outcomes And Resource Utilization In Hyperkalemic Emergency Department Patients Treated With Patiromer Or Sodium Zirconium Cyclosilicate, William Frank Peacock, Zubaid Rafique, Julie Gayle, James Neuenschwander, Harold Brown, Jennifer Kammerer, Jeffrey Budden, Ning Rosenthal

Faculty, Staff and Students Publications

OBJECTIVES: Hyperkalemia (HK) is a life-threatening condition commonly treated in emergency department (ED). Real-world outcomes associated with ED administration of potassium binders are limited. This study assessed ED discharge disposition and resource utilization in hyperkalemic ED patients treated with patiromer or sodium zirconium cyclosilicate (SZC).

METHODS: We performed a retrospective cohort study using discharge data from 230 hospitals in the Premier PINC AI Healthcare Database. ED patients were included if they were ≥18 years old, had potassium ≥5 mEq/L, and received patiromer/SZC during January 1, 2019 to December 31, 2021. Descriptive statistics and multivariable logistic regression analysis were used to …

Community-Engaged Medical Student Elective To Improve Knowledge And Attitudes Toward Individuals With Intellectual And Developmental Disabilities, Kathryn J Kemere, Nital Appelbaum, Priya Chandan, Elisha Acosta

Faculty, Staff and Students Publications

Individuals with intellectual and developmental disabilities (IDD) face multiple barriers to inclusion throughout life. One barrier is the medical knowledge and biases of adult healthcare providers with diagnoses traditionally associated with childhood. Medical school curricula have limited content related to IDD, and students have limited opportunities to engage with community organizations during their clinical years. Methods: We created a one-month clinical elective to address medical students' attitudes and knowledge regarding individuals with IDD using experiential learning. Students saw adult patients in our primary care clinic with a variety of IDD diagnoses and spent 30% of their time at community sites …

A Simple, Interpretable Machine Learning Model Based On Clinical Factors Accurately Predicts Incident Dysplasia Or Malignancy In Barrett's Esophagus, Ashwin Rao, Jasmine Haydel, Samuel Ma, Aaron P Thrift, Theresa Nguyen-Wenker, Hashem B El-Serag

Faculty, Staff and Students Publications

Purpose: Identifying patients likely to develop dysplasia or malignancy is critical for effective surveillance in patients with Barrett's Esophagus (BE). However, current predictive models are limited. We evaluated the performance of machine learning (ML) models in predicting incident dysplasia or malignancy in a cohort of veteran patients with BE.

Methods: We analyzed data from 598 patients newly diagnosed with non-dysplastic BE (NDBE), BE indefinite for dysplasia (BE-IND), and BE with non-persistent low-grade dysplasia (LGD) at the Michael DeBakey Veterans Affairs Medical Center from November 1990 to January 2019 with follow-up through January 2024. Progressors were patients who developed persistent LGD, …

Congestion And Sinonasal Illness In Outer Space: A Study On The International Space Station, Faizaan Khan, Koyal Ansingkar, Roshan Dongre, Zain Mehdi, Aatin K Dhanda, Kayla Powell, Tariq Syed, Samuel E Razmi, Isuru Somawardana, Jeffrey T Vrabec, David Hilmers, Omar G Ahmed, Masayoshi Takashima

Faculty, Staff and Students Publications

Objectives: This study aims to characterize quantitative data pertaining to sinonasal symptoms and their related medication use aboard the International Space Station (ISS). A secondary focus involves correlating these findings with mission parameters such as extravehicular activity (EVA) participation and mission duration.

Methods: This retrospective cohort study was conducted utilizing data requested from the National Aeronautics and Space Administration (NASA) Lifetime Surveillance of Astronaut Health (LSAH) program.

Results: Of 71 de-identified ISS astronauts beginning with Expedition 1 in the year 2000 through 62 in 2019, there were 754 logged medical events; 60 astronauts reported any type of sinonasal medical event …

An Electronic Trigger To Detect Telemedicine-Related Diagnostic Errors, Daniel R Murphy, Himabindu Kadiyala, Li Wei, Hardeep Singh

Faculty, Staff and Students Publications

Introduction

Methods

Developing Culturally Centered Outreach Materials For Rural Native Veterans, Alexandra B Caloudas, Kelley Arredondo, Gail Beauchamp, Sharon Anastas, Kathy Marchant-Miros, Kristen Frosio, Giselle Day, Katherine Bay, Stephanie Day, Jan Lindsay, Jay Shore

Faculty, Staff and Students Publications

Native Americans serve in the U.S. military at the highest rate per capita of any ethnoracial group and have elevated rates of mental health (MH) difficulties compared to other ethnoracial groups, including posttraumatic stress disorder, alcohol use disorders, and suicide. Almost half of Native Veterans live in rural areas; rurality is associated with significant barriers to MH services. Engaging in outreach with Native Veterans is an important pathway for connecting them with MH care, but the outreach process and educational materials must be culturally aligned to be more effective. We collaborated with partners at a rural Department of Veterans Affairs …

Hemorrhagic Gastropathy From Paclitaxel-Carboplatin Combination Chemotherapy, Kristeen Onyirioha, Maya Balakrishnan

Faculty, Staff and Students Publications

A 58-year-old woman with endometrial cancer started on paclitaxel in combination with carboplatin chemotherapy, presented to the hospital with severe anemia and melena. An esophagogastroduodenoscopy with biopsies revealed diffuse gastric antrum hemorrhagic gastropathy without inflammatory changes. She had recurrent admissions with similar presentations during her chemotherapy. Her management included frequent blood transfusions, endoscopic Argon plasma coagulation to hemorrhagic lesions, and a prolonged course of proton pump inhibition to facilitate post-Argon plasma coagulation mucosal healing. Weeks after completing chemotherapy, her hemoglobin improved and recurrent upper gastrointestinal bleeding resolved. In this case, we identify a rare paclitaxel, in combination with carboplatin, associated …

Racial And Ethnic Disparity For Cancer Mortality In General And Single-Payer Healthcare Systems In The United States, Rock Bum Kim, Emily Zhou, Kaitlin N Swinnerton, Jennifer La, Shengling Ma, Mrinal Ranjan, Nhan V Do, Mary T Brophy, Nathanael R Fillmore, Ang Li

Faculty, Staff and Students Publications

Background: It remains unclear what factors significantly drive racial disparity in cancer survival in the United States (US). We compared adjusted mortality outcomes in cancer patients from different racial and ethnic groups on a population level in the US and a single-payer healthcare system.

Patients and methods: We selected adult patients with incident solid and hematologic malignancies from the Surveillance, Epidemiology, and End Results (SEER) 2011-2020 and Veteran Affairs national healthcare system (VA) 2011-2021. We classified the self-reported NIH race and ethnicity into non-Hispanic White (NHW), non-Hispanic Black (NHB), non-Hispanic Asian Pacific Islander (API), and Hispanic. Cox regression models for …

Incidence Of And Risk Factors For Hospital-Acquired Bleeding In People With Cancer: A Systematic Review, Mansour Gergi, Jinah Kim, Amalia Dolan, Laura Haines, Ang Li, Neil A Zakai

Faculty, Staff and Students Publications

Background: Hospital-acquired (HA) bleeding (bleeding occurring during hospitalization) in cancer patients is poorly characterized, potentially increasing morbidity and mortality due to under- or overprescription of low-dose anticoagulation for venous thromboembolism prevention.

Objectives: To perform a systematic review and meta-analysis (as appropriate) to identify the incidence of and risk factors for HA bleeding in people with cancer.

Methods: A systematic English-language search was conducted using Ovid MEDLINE, Ovid EMBASE, Google Scholar, and Cochrane Library. Keywords and controlled vocabulary related to bleeding risk in hospitalized cancer patients were iteratively refined. Studies assessing HA bleeding as a primary or coprimary endpoint were included, …

Plasminogen Mutation-Associated Thrombotic Microangiopathy And Role Of Anticoagulation: A Single Institution Case Series, Shreya Agarwal, Nicola Pozzi, Senthil Sukumar, Camila Masias, Anuja Java, Spero Cataland

Faculty, Staff and Students Publications

Background: Knowledge gaps exist regarding the role of coagulation pathway mutations such as those in the plasminogen (PLG) gene in the pathogenesis of thrombotic microangiopathy (TMA) and treatment outcomes.

Objectives: This study aims to describe the unique phenotypic features of patients with PLG mutations and perform structural mapping of the variants to enhance variant interpretation.

Methods: This was a single-center retrospective study of patients with TMA in whom genetic testing was performed between 2011 and 2023. Data were collected regarding demographics, clinical features at their first presentation, renal outcomes, genetic mutations, and recurrence for those who were found …

Stool-Based Molecular Tuberculosis Treatment Monitoring: A Faster Means For Detecting Persistent Mycobacteria Compared To Phenotypic Culture, Clement Gascua Adu Gyamfi, Abigail Seeger, Durbbin Mulengwa, Anca Vasiliu, Lucia Carratala-Castro, Bariki Mtafya, Nontobeko Maphalala, Shilzia Munguambe, Belen Saavedra, Tara Ness, Gugu Maphalala, Sozinho Acacio, Edson Mambuque, Joanna Ehrlich, Rojelio Mejia, Mangaliso Ziyane, H Lester Kirchner, Christoph Lange, Alexander Kay, Alberto L Garcia-Basteiro, Anna Mandalakas, Andrew R Dinardo

Faculty, Staff and Students Publications

Background: Tuberculosis (TB) treatment monitoring is hindered by the lack of a rapidly measured biomarker that accurately predicts clinically relevant outcomes. Symptom screening poorly correlates with bacillary burden. Although culture is a direct measure of viable bacillary burden, the long turnaround time makes it clinically irrelevant.

Methods: The TB treatment monitoring potential of stool-based, quantitative polymerase chain reaction (qPCR) was prospectively assessed among 231 participants of all ages from Eswatini, Tanzania, and Mozambique with microbiologically confirmed TB. Stool qPCR results were compared to sputum culture, persistent symptoms, drug resistance, and World Health Organization TB outcomes.

Results: Quantitative bacillary burden measured …

The Resilience Of The Human Lungs: Evolution, Smoke, And Disease, Joan B Soriano, Francesca Polverino

Faculty, Staff and Students Publications

No abstract provided.

Low-Dose Metformin Requires Brain Rap1 For Its Antidiabetic Action, Hsiao-Yun Lin, Weisheng Lu, Yanlin He, Yukiko Fu, Kentaro Kaneko, Peimeng Huang, Ana B De La Puente-Gomez, Chunmei Wang, Yongjie Yang, Feng Li, Yong Xu, Makoto Fukuda

Faculty, Staff and Students Publications

Metformin is the most commonly prescribed antidiabetes drug, yet its precise mechanism of action remains controversial. Previous studies have suggested that metformin acts peripherally by reducing hepatic glucose output and altering gut functions. Here, we report a neural mechanism via the small guanosine triphosphatase Ras-related protein 1 (Rap1). Mice with forebrain-specific Rap1 knockout exhibited resistance to the antidiabetic effects of low-dose metformin while remaining sensitive to other antidiabetic agents. Centrally administered metformin inhibited brain Rap1 and reduced hyperglycemia. Conversely, forced activation of brain Rap1 increased glycemia and abolished the glycemic effect of metformin. Metformin activated a specific subset of neurons …

The Glycosyltransferase Poglut1 Regulates Muscle Stem Cell Development And Maintenance In Mice, Soomin Cho, Emilia Servián-Morilla, Victoria Navarro, Beatriz Rodriguez-Gonzalez, Youxi Yuan, Raquel Cano, Arjun A Rambhiya, Radbod Darabi, Robert S Haltiwanger, Carmen Paradas, Hamed Jafar-Nejad

Faculty, Staff and Students Publications

Mutations in protein O-glucosyltransferase 1 (POGLUT1) cause a recessive limb-girdle muscular dystrophy (LGMDR21) with reduced satellite cell number and NOTCH1 signaling in adult patient muscles and impaired myogenic capacity of patient-derived muscle progenitors. However, the in vivo roles of POGLUT1 in the development, function, and maintenance of satellite cells are not well understood. Here, we show that conditional deletion of mouse Poglut1 in myogenic progenitors leads to early lethality, postnatal muscle growth defects, reduced Pax7 expression, abnormality in muscle extracellular matrix, and impaired muscle repair. Poglut1-deficient muscle progenitors exhibit reduced proliferation, enhanced differentiation, and accelerated fusion into myofibers. Inducible loss …

Mx1-Labeled Pulp Progenitor Cells Are The Main Contributors Of Odontoblast And Dentin Regeneration In Murine Molars, Dongwook Yang, Youngjae Jeong, Laura Ortinau, Jea Giezl Solidum, Dongsu Park

Faculty, Staff and Students Publications

Regeneration of dentin and odontoblasts from dental pulp progenitor cells is essential for the maintenance of permanent tooth. However, the in vivo identity of endogenous pulp progenitor cells and how they contribute to reparative dentinogenesis remain elusive. Here we show that comparative single-cell analysis of pulp cells before and after molar eruption reveal that endogenous pulp progenitor cells are enriched in coronal papilla-like cells with Mx1-Cre and Cxcl12–GFP expression. Further, lineage tracing and fluorescence-activated cell sorting analysis indicated that Mx1-labeled (Mx1+) pulp cells include long-term repopulating progenitor cells with higher expression of stem cell markers. Notably, …

First Assembly Of A Draft Genome Of The Critically Endangered Northern Muriqui ( Brachyteles Hypoxanthus , Primates, Atelidae) Including Non‐Invasive Genotyping Strategies For The Species, Amanda Alves De Melo-Ximenes, Romina Batista, Leonardo Carlos Jeronimo Corvalán, Tomas Marques-Bonet, Lukas Kuderna, Kyle Farh, Jeffrey Rogers, Mariane Da Cruz Kaizer, Jean Philippe Boubli, Fabiano Rodrigues De Melo, Rhewter Nunes, Mariana Pires De Campos Telles

Faculty, Staff and Students Publications

Genomic resources, such as draft genomes, are vital for biodiversity monitoring and conservation. For endangered species, they enable the development of tools like organellar genomes and molecular markers, which are crucial for population genetics. Advances in sequencing technologies now allow high‐throughput genotyping with detailed amplicon sequences, enhancing genetic variation studies. The northern muriqui ( Brachyteles hypoxanthus ), a critically endangered primate endemic to Brazil's Atlantic Forest, currently lacks both nuclear and mitochondrial genome data and species‐specific microsatellite markers for population genetic studies. We assembled a 2.52 Gb draft genome for B. hypoxanthus with 202,243 contigs (N50 = 29,134 bp), and …

Comparative Efficacy Of Current Topical Treatments For Dry Eye Disease: A Review Of Pivotal Clinical Trials Evaluating Corneal Staining Outcomes, Ahmad Fahmy, Masih Ahmed, Stephen Pflugfelder, Anara Serikbaeva, Fang-Wei Tsao

Faculty, Staff and Students Publications

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Plain Language Summary About Glp-1 Treatments In People With Metabolic Dysfunction-Associated Steatotic Liver Disease, Layla A Abushamat, Pir Ahmad Shah, Robert H Eckel, Stephen A Harrison, Diana Barb

Faculty, Staff and Students Publications

No abstract provided.

Crispr-Cas9 Engineering Of Human T Regulatory Cells – Design And Optimization Of A Manufacturing Process, Ortal Shimon, Adam M Dean, Shoshana Cohen, Aiden L Moser, Clifford C Dacso, Yosi Gilad, David M Lonard, Bert W O'Malley

Faculty, Staff and Students Publications

Regulatory T cells (Tregs) are a subset of CD4 + T cells that comprise 5-10 % of the total CD4 + T cell population. Tregs, which are critically important for the maintenance of immune tolerance and immune homeostasis, are distinguished from other subtypes of CD4 + T cells by the expression of the transcription factor FOXP3. Because of the centrality to immunoregulation, Tregs have gained increasing attention as promising targets for clinical applications in autoimmune diseases, transplant rejection and graft-versus-host disease (GvHD). However, the essential role of Tregs in the complex network of the immune system implies their targeting as …

Construct And Predictive Validity Of The Kansas City Cardiomyopathy Questionnaire In Adult Congenital Heart Disease, Ryan D Byrne, Ajith P Nair, Stephen J Dolgner, Swati Choudhry, Edward J Hickey, Alexis C Wood, Savitri Fedson, Biykem Bozkurt, Christopher R Broda

Faculty, Staff and Students Publications

Background: The Kansas City Cardiomyopathy Questionnaire (KCCQ) is an Food and Drug Administration-approved health status measure for patients with heart failure (HF) but has not been directly assessed in adult congenital heart disease (ACHD).

Objectives: This study evaluates construct and predictive validity of the KCCQ in ambulatory ACHD patients.

Methods: We performed cross-sectional and prospective cohort studies of ACHD patients who completed the KCCQ to assess construct and predictive validity, respectively. KCCQ scores were compared across ACHD complexity categories, disease characteristics and physiologic failure, and within 2 primary composite outcomes: death or all-cause hospitalization (DH) and death or interventional cardiac …

Are There Rural-Urban Disparities In Cardiovascular Disease Hospitalization And Other Outcomes In People With Gout? A Nationwide Us Study, Jasvinder A Singh, Sumanth R Chandrupatla

Faculty, Staff and Students Publications

Objective: The objective of this study was to assess whether rural vs urban patient residence is associated with the risk of myocardial infarction (MI) hospitalization and other outcomes in people with gout.

Methods: We used the 2016-2019 U.S. National Inpatient Sample (NIS) database to assess whether rural patient residence is associated with a higher risk of MI hospitalizations in gout, while adjusting for demographics (age, sex, race), comorbidity, median household income, insurance payer, and hospital characteristics (location and teaching status, bed size, hospital control, and hospital region). We calculated adjusted odds ratios (aORs) and 95% CIs (CIs).

Results: We found …

Potential Intermediate-Term Survival Differences Among Heart Transplant Recipients From Circulatory Death Vs Brain Death Donors, Anh Nguyen, Abbas Rana, Alexis Shafii, Gabriel Loor, Andrew Civitello, Jose Euberto Mendez Reyes, O Howard Frazier, Todd Rosengart, Kenneth Liao

Faculty, Staff and Students Publications

Background: This study builds upon previous analyses by examining heart transplant survival from donation after circulatory death (DCD) vs donation after brain death (DBD) using the United Network for Organ Sharing (UNOS) database, with follow-up extended to 3 years post-transplant.

Methods: We conducted a retrospective cohort study of 1,453 DCD and 16,561 DBD adult heart transplants from January 2019 to June 2024 using the UNOS database. Propensity scores were generated based on clinically relevant covariates, and 1-to-1 propensity-score matching was performed. Survival analysis was conducted using Cox proportional hazards regression and Kaplan-Meier curves, with the log-rank test comparing overall survival …

Rest-Activity Rhythm Phenotypes In Adults With Epilepsy And Intellectual Disability, Nandani Adhyapak, Grace E Cardenas, Mark A Abboud, Vaishnav Krishnan

Faculty, Staff and Students Publications

Objective: Rest-activity rhythms (RARs) are perturbed in many forms of neuropsychiatric illness. In this study, we applied wrist actigraphy to describe RAR perturbations in intellectually disabled adults with epilepsy ("E + ID"), using a cross-sectional case-control design. We examined whether RAR phenotypes correlated with epilepsy severity, deficits in adaptive function, and/or comorbid psychopathology.

Methods: Caregivers of E + ID subjects provided informed consent during routine ambulatory clinic visits and were asked to complete standardized surveys of overall epilepsy severity (GASE, Global Assessment of Severity of Epilepsy), adaptive function (ABAS-3, Adaptive Behavior Assessment System-3) and psychopathology (ABCL, Adult Behavior Checklist). Caregivers …

Genetic Diversity And Expanded Phenotypes In Dystonia: Insights From Large-Scale Exome Sequencing, Mirja Thomsen, Fabian Ott, Sebastian Loens, Gamze Kilic-Berkmen, Ai Huey Tan, Shen-Yang Lim, Ebba Lohmann, Kaja M Schröder, Lea Ipsen, Lena A Nothacker, Linn Welzel, Alexandra S Rudnik, Frauke Hinrichs, Thorsten Odorfer, Kirsten E Zeuner, Friederike Schumann, Andrea A Kühn, Simone Zittel, Marius Moeller, Robert Pfister, Christoph Kamm, Anthony E Lang, Yi Wen Tay, Ana Luísa De Almeida Marcelino, Marie Vidailhet, Emmanuel Roze, Joel S Perlmutter, Jeanne S Feuerstein, Victor S C Fung, Florence Chang, Richard L Barbano, Steven Bellows, Aparna A Wagle Shukla, Alberto J Espay, Mark S Ledoux, Brian D Berman, Stephen Reich, Andres Deik, Andre Franke, Michael Wittig, Sören Franzenburg, Jens Volkmann, Norbert Brüggemann, H A Jinnah, Tobias Bäumer, Christine Klein, Hauke Busch, Katja Lohmann

Faculty, Staff and Students Publications

Objective: Dystonia is one of the most prevalent movement disorders, characterized by significant clinical and etiological heterogeneity. Despite considerable heritability (~25%), the etiology in most patients remains elusive. Moreover, understanding correlations between clinical manifestations and genetic variants has become increasingly complex.

Methods: Exome sequencing was conducted on 1924 genetically unsolved, mainly late-onset isolated dystonia patients, recruited primarily from two dystonia registries (DysTract and the Dystonia Coalition). Rare variants in genes previously linked to dystonia (n = 406) were examined, confirmed via Sanger sequencing, and analyzed for segregation when possible.

Results: We identified 137 distinct likely pathogenic/pathogenic variants (according to ACMG …

The Synaptic Architecture Of Layer 5 Thick Tufted Excitatory Neurons In Mouse Visual Cortex, Agnes L Bodor, Casey M Schneider-Mizell, Chi Zhang, Leila Elabbady, Alex Mallen, Andi Bergeson, Derrick Brittain, Joann Buchanan, Daniel J Bumbarger, Rachel Dalley, Clare Gamlin, Emily Joyce, Daniel Kapner, Sam Kinn, Gayathri Mahalingam, Sharmishtaa Seshamani, Shelby Suckow, Marc Takeno, Russel Torres, Wenjing Yin, J Alexander Bae, Manuel A Castro, Sven Dorkenwald, Akhilesh Halageri, Zhen Jia, Chris Jordan, Nico Kemnitz, Kisuk Lee, Kai Li, Ran Lu, Thomas Macrina, Eric Mitchell, Shanka Subhra Mondal, Shang Mu, Barak Nehoran, Sergiy Popovych, William Silversmith, Nicholas L Turner, Szi-Chieh Yu, William Wong, Jingpeng Wu, Brendan Celii, Luke Campagnola, Stephanie C Seeman, Tim Jarsky, Naixin Ren, Anton Arkhipov, Jacob Reimer, H Sebastian Seung, R Clay Reid, Forrest Collman, Nuno Maçarico Da Costa

Faculty, Staff and Students Publications

Despite significant progress in characterizing neocortical cell types, a complete understanding of the synaptic connections of individual excitatory cells remains elusive. This study investigates the connectivity of mouse visual cortex thick tufted layer 5 pyramidal cells, also known as extratelencephalic neurons (L5-ETns), using a 1 mm3 publicly available electron microscopy dataset. The analysis reveals that, in their immediate vicinity, L5-ETns primarily establish connections with a group of inhibitory cell types, which, in turn, specifically target the L5-ETns back. The most common excitatory targets of L5-ETns are layer 5 intertelencephalic neurons (L5-ITns) and layer 6 (L6) pyramidal cells, whereas synapses with …

Ruptured Arteriovenous Malformation Mortality: Incidence, Risk Factors, And Inpatient Outcome Score, Eric Feldstein, Allison Zhong, Kevin Clare, Bridget Nolan, Smit Patel, Nir Lavi-Romer, Zehavya Stadlan, Alis Dicpinigaitis, Jose Dominguez, Haris Kamal, Steven D Shapiro, Arundhati Biswas, Omar Tanweer, Ketan Bulsara, Carrie Muh, Jared Pisapia, Simon Hanft, Stephan Mayer, Chirag D Gandhi, Fawaz Al-Mufti

Faculty, Staff and Students Publications

Background

Limited literature exists on the morbidity and mortality of AVM associated intracerebral hemorrhage (ICH) compared with non-AVM ICH.

Objective

We examine morbidity and mortality in cAVM in a large nationwide inpatient sample to create a prognostic inpatient ruptured AVM mortality score.

Methods

This retrospective cohort study from 2008 to 2014 compares outcomes in cAVM related hemorrhages and ICH utilizing the National Inpatient Sample database. Diagnostic codes for ICH and AVM underlying ICH were identified. We compared case fatality according to medical complications. Multivariate analysis was used to derive hazard ratios and 95% confidence intervals to assess odds of mortality. …

Diagnostic Value Of Cell-Free Dna Fetal Fraction In Patients With Prenatally Suspected Placenta Accreta Spectrum Disorder, Danielle Chirumbole, Christian M Parobek, Alex Tai, Haleh Sangi-Haghpeykar, Yamely H Mendez, Spoorthi Kamepalli, Christina C Reed, Arthur Ladron De Guevara, Keneshia Lane, Claire Hoppenot, Amir A Shamshirsaz, Michael A Belfort, Jessian L Munoz, Hendrik A Lombaard

Faculty, Staff and Students Publications

Objective: The purpose of this study was to investigate the relationship between fetal fraction (FF) and placenta accreta spectrum (PAS) pathology in patients with prenatally suspected PAS.

Methods: This was a case-control study utilizing a database of pregnancies with suspected or proven PAS delivered between 6/2012 and 7/2024 at a single institution. Pregnancies were excluded if FF was not reported. The primary outcome was mean FF in pregnancies with a final clinical diagnosis of low FIGO grade (no PAS or FIGO1-2) versus high FIGO grade (FIGO3) placenta accreta. Results were reported as mean FF ± standard error of the mean. …

Effect Of Social Drivers Of Health On Screening For Type 2 Diabetes In Individuals With Gestational Diabetes During Delivery Hospitalization And 4-12 Weeks Postpartum, Ingmar N Bastian, Manisha Gandhi, Mark A Turrentine

Faculty, Staff and Students Publications

Objective: To prospectively evaluate postpartum diabetes screening rates among individuals with gestational diabetes mellitus (GDM) offered testing during the delivery hospitalization or at 4-12 weeks postpartum compared with historic outpatient-only screening and to assess the role of social and structural drivers of health.

Methods: This retrospective study compared patients with GDM who delivered between January 1 and December 31, 2023 (retrospective cohort), and underwent outpatient screening at 4-12 weeks postpartum with a 75-g 2-hour oral glucose tolerance test (OGTT) with a prospective cohort (June 24-November 5, 2024) of the first 100 patients who underwent screening in the immediate postpartum delivery …

Outcomes Of Fenestrated-Branched Endovascular Aortic Repair Of Thoracoabdominal Aortic Aneurysms In Patients With Heritable Thoracic Aortic Diseases, Lucas Ribé, Lucas Ruiter Kanamori, Bruno P Schmid, Thanila A Macedo, Bernardo C Mendes, Steven Maximus, Ying Huang, Felipe Nasser, Gustavo S Oderich

Faculty, Staff and Students Publications

Objective: Open surgical repair is the first-line treatment for patients with complex aortic aneurysms and heritable thoracic aortic diseases (HTADs). Fenestrated-branched endovascular aortic repair (FB-EVAR) has been used selectively in higher-risk patients. This study assessed early- and midterm outcomes of FB-EVAR for complex aortic aneurysms in patients with HTADs.

Methods: We reviewed clinical data, imaging, and outcomes of consecutive patients treated by FB-EVAR for complex abdominal and thoracoabdominal aneurysms from April 2007 to June 2024. Patients with confirmed Marfan syndrome, Loeys-Dietz syndrome, vascular Ehlers-Danlos syndrome, or ACTA2 mutation were included. End points included 30-day mortality and major adverse events, cumulative …

Global Cardiac Anesthesia Workforce Assessment: A Cross-Sectional Observational Survey Study, Alexander J C Mittnacht, Carolina S Romero Garcia, Joshua B Cadwell, Jiapeng Huang, Iwan Sofjan, Mohamed R Eltahan, Hong Liu, Chirojit Mukherjee, Fabio Guarracino, Andrew Shaw, Pablo Motta, International Academy Of Cardiac Anaesthesiologists (Iaca) Global Survey Team

Faculty, Staff and Students Publications

Objective: The primary aim of this survey was to assess the demographics, training background, practice setting, and work environment of cardiac anesthesiologists globally.

Design: Cross-sectional study of the global cardiac anesthesia workforce. A multilingual web-based survey was conducted between June 1 and December 31, 2023.

Setting: The survey was distributed via cardiac anesthesia societies, special interest groups, and social media using a non-probabilistic sample and with snowballing techniques.

Participants: Anesthesiologists actively practicing cardiac anesthesia.

Interventions: None.

Measurements and main results: In total, 3,430 participants from 99 countries responded. Results were summarized as descriptive data comparing geographical regions, and noticeable differences …