Medical Specialties Commons^™

Clinical Characteristics And Survival Of Pulmonary Arterial Hypertension With Or Without Interstitial Lung Disease In Systemic Sclerosis, Jessica L Fairley, Dylan Hansen, Laura Ross, Susanna Proudman, Joanne Sahhar, Gene-Siew Ngian, Jennifer Walker, Lauren V Host, Kathleen Morrisroe, Diane Apostolopoulous, Nava Ferdowsi, Michelle Wilson, Maryam Tabesh, Wendy Stevens, Mandana Nikpour

Faculty, Staff and Student Publications

Objectives

To describe the clinical phenotype and prognosis of people in the Australian Scleroderma (SSc) Cohort Study with pulmonary arterial hypertension (PAH) with or without interstitial lung disease (ILD).

Methods

Participants meeting ACR/EULAR criteria for SSc were divided into four mutually exclusive groups: those meeting criteria for PAH (PAH-only), ILD (ILD-only), concurrent PAH and ILD (PAH-ILD) or neither PAH nor ILD (SSc-only). Logistic or linear regression analyses were used for associations between clinical features, health-related quality of life (HRQoL) and physical function. Survival analysis was performed using Kaplan–Meier estimates and Cox-regression modelling.

Results

Of 1561 participants, 7% fulfilled criteria for …

Videolaryngoscopy Versus Direct Laryngoscopy For Tracheal Intubation In Neonates, Krithika Lingappan, Nicole Neveln, Jennifer L Arnold, Caraciolo J Fernandes, Mohan Pammi

Faculty, Staff and Students Publications

BACKGROUND: Establishment of a secure airway is a critical part of neonatal resuscitation in the delivery room and the neonatal intensive care unit. Videolaryngoscopy has the potential to facilitate successful endotracheal intubation, and decrease adverse consequences of a delay in airway stabilization. Videolaryngoscopy may enhance visualization of the glottis and intubation success in neonates. This is an update of a review first published in 2015, and updated in 2018.

OBJECTIVES: To determine the effectiveness and safety of videolaryngoscopy compared to direct laryngoscopy in decreasing the time and attempts required for endotracheal intubation and increasing the success rate on first intubation …

Association Between Remote Monitoring And Interstage Morbidity And Mortality In Single Ventricle Patients Across Socioeconomic Groups, Bianca Cherestal

Research Days

Background: Despite improvements in outcomes over time, morbidity and mortality for infants with single ventricle (SV) heart disease remains high. Among other risk factors for mortality, infants of low socioeconomic status (SES) are known to be particularly vulnerable following stage 1 palliation.

Objectives/Goal: We sought to determine whether use of a novel remote monitoring program, CHAMP (Cardiac High Acuity Monitoring Program), mitigates differences in outcomes by SES for infants with SV during the interstage period.

Methods/Design: Using the CHAMP database, we identified 610 infants across 11 institutions enrolled in the program between 2014–2021. All enrolled patients’ families were provided with …

Functional Evaluation Of A Novel Rpl30 Mutation And Its Role In Diamond Blackfan Anemia (Dba), Alexandra Prosser, Alexandria Cockrell, Danny Miller, Chris Seidel, Tamara Potapova, John M. Perry, Midhat Farooqi, Erin M. Guest, Jennifer Gerton

Research Days

Background: Bone marrow failure is life-threatening and requires prompt, intensive treatment, which is dependent upon identification of genetic drivers. Although there has been investigation into associated genetic mutations, especially in Diamond Blackfan anemia (DBA), the relationship between genotype and phenotype remains unclear.DBA has been identified as a ribosomopathy, also known as a disease associated with defects in ribosome biogenesis. We identified a novel heterozygous variant (c.167+769C >T) in the noncoding region of RPL30 in a patient with clinical diagnosis of DBA. Clinical RNA sequencing (RNA-seq) suggests the variant generates a novel splice acceptor site resulting in truncated RPL30 transcripts. Elucidation …

Meqtl Mapping In The Genoa Study Reveals Genetic Determinants Of Dna Methylation In African Americans, Lulu Shang, Wei Zhao, Yi Zhe Wang, Zheng Li, Jerome J Choi, Minjung Kho, Thomas H Mosley, Sharon L R Kardia, Jennifer A Smith, Xiang Zhou

Faculty, Staff and Student Publications

Identifying genetic variants that are associated with variation in DNA methylation, an analysis commonly referred to as methylation quantitative trait locus (meQTL) mapping, is an important first step towards understanding the genetic architecture underlying epigenetic variation. Most existing meQTL mapping studies have focused on individuals of European ancestry and are underrepresented in other populations, with a particular absence of large studies in populations with African ancestry. We fill this critical knowledge gap by performing a large-scale cis-meQTL mapping study in 961 African Americans from the Genetic Epidemiology Network of Arteriopathy (GENOA) study. We identify a total of 4,565,687 cis-acting meQTLs …

3-Phosphoinositide-Dependent Kinase 1 Drives Acquired Resistance To Osimertinib, Ismail M Meraz, Mourad Majidi, Bingliang Fang, Feng Meng, Lihui Gao, Ruping Shao, Renduo Song, Feng Li, Yonathan Lissanu, Huiqin Chen, Min Jin Ha, Qi Wang, Jing Wang, Elizabeth Shpall, Sung Yun Jung, Franziska Haderk, Philippe Gui, Jonathan Wesley Riess, Victor Olivas, Trever G Bivona, Jack A Roth

Faculty, Staff and Students Publications

Osimertinib sensitive and resistant NSCLC NCI-H1975 clones are used to model osimertinib acquired resistance in humanized and non-humanized mice and delineate potential resistance mechanisms. No new EGFR mutations or loss of the EGFR T790M mutation are found in resistant clones. Resistant tumors grown under continuous osimertinib pressure both in humanized and non-humanized mice show aggressive tumor regrowth which is significantly less sensitive to osimertinib as compared with parental tumors. 3-phosphoinositide-dependent kinase 1 (PDK1) is identified as a potential driver of osimertinib acquired resistance, and its selective inhibition by BX795 and CRISPR gene knock out, sensitizes resistant clones. In-vivo inhibition of …

Sepsis-Induced Acute Lung Injury (Ali) And The Development Of Bronchopulmonary Dysplasia (Bpd) In Premature Infants., Jacob S. Ward, Hung-Wen Yeh, Megan Tucker, Venkatesh Sampath

Research Days

Background: Bronchopulmonary dysplasia (BPD) is a significant cause of morbidity and mortality in premature infants with several known risk factors. Recent literature described the harmful effect of inflammation on the developing lung. Recently, we showed that late-onset sepsis (LOS) and necrotizing enterocolitis (NEC) causes acute lung injury (ALI) in preterm infants as measured by increases in pulmonary severity scores (PSS). The aim of this study was to investigate the association between LOS-induced ALI and BPD outcomes. We hypothesized that LOS would increase the likelihood of developing BPD, and the associated LOS-induced ALI will add to the ability to predict development …

Home Oxygen And Monitoring For Covid-19 Patients: A Multidisciplinary Team Approach, Mahta Salehi, Shehrose Chaudry, Rebecca B. Newman, Josette Hartnett, Suzanne J. Rose, Forugh Homayounrooz

Journal of Community Hospital Internal Medicine Perspectives

Introduction: During the initial COVID-19 pandemic peak, Stamford Hospital implemented a home oxygen program (HOP) to create a comprehensive, multi-disciplinary outpatient initiative without sacrificing a safe discharge. Primary care physicians monitored program participants, whose only indication for remaining admitted was an oxygen requirement. We retrospectively examined participant co-morbidities and outcomes, including death and readmission rates to evaluate HOP safety.

Methods: A retrospective analysis of program participants discharged between April 2020-Janurary 2021 was performed. Variables included demographics, oxygen requirement, days enrolled in the HOP, and major comorbidities such as cardiovascular disease (CVD), diabetes (DM), hypertension (HTN), obesity, chronic kidney disease, malignancies …

Social Determinants Of Health Among Family Caregiver Centered Outcomes In Lung Cancer: A Systematic Review, Dede K. Teteh, Madeleine Love, Marissa Ericson, Marissa Chan, Tanyanika Phillips, Aroona Toor, Betty Ferrell, Loretta Erhunmwunsee, Susanne B. Montgomery, Virginia Sun, Jae Y. Kim

Health Sciences and Kinesiology Faculty Articles

Background: Lung cancer is the leading cause of cancer death globally. Both lung cancer patients and family caregivers (FCGs) have unmet quality of life (QOL) needs. An understudied topic in lung cancer research is the role of social determinants of health (SDOH) on QOL outcomes for this population. The purpose of this review was to explore the state of research on SDOH FCGs centered outcomes in lung cancer.

Methods: The databases PubMed/MEDLINE, Cochrane Library, Cumulative Index to Nursing and Allied Health Literature, and American Psychological Association (APA) PsycInfo were searched for peer-reviewed manuscripts evaluating defined SDOH domains on …

Preclinical Investigations Of The Efficacy Of The Glutaminase Inhibitor Cb-839 Alone And In Combinations In Chronic Lymphocytic Leukemia, Natalia Timofeeva, Mary L Ayres, Natalia Baran, Janice M Santiago-O'Farrill, Gamze Bildik, Zhen Lu, Marina Konopleva, Varsha Gandhi

Faculty, Staff and Student Publications

INTRODUCTION: Chronic lymphocytic leukemia (CLL) cells are metabolically flexible and adapt to modern anticancer treatments. Bruton tyrosine kinase (BTK) and B-cell lymphoma-2 (BCL-2) inhibitors have been widely used to treat CLL, but CLL cells become resistant to these treatments over time. CB-839 is a small-molecule glutaminase-1 (GLS-1) inhibitor that impairs glutamine use, disrupts downstream energy metabolism, and impedes the elimination of reactive oxygen species.

METHODS: To investigate the

RESULTS: We found that CB-839 caused dose-dependent decreases in GLS-1 activity and glutathione synthesis. CB-839-treated cells also showed increased mitochondrial superoxide metabolism and impaired energy metabolism, which were reflected in decreases in …

Elucidating The Impact Of Sos-Response Timing In On Escherichia Coli Survival Following Treatment With Fluoroquinolone Topoisomerase Inhibitors, Stephanie Schofield

Honors Scholar Theses

Antibiotic treatment failure is a public health crisis, with a 2019 report stating that roughly 35,000 deaths occur in the United States yearly due to bacterial infections that are unresponsive to antibiotics (1). One complication in the treatment of bacterial infection is antibiotic persistence which further compromises our battle to effectively treat infection. Bacterial persisters can exist in clonal bacterial cultures and can tolerate antibiotic treatment by undergoing reversible phenotypic changes. They can survive drug concentrations that their genetically identical kin cannot. Some persisters remain in a slow growing state and are difficult to target with current antibiotics. A specific …

Oxidative Damage Together With Post-Occlusive Re-Oxygenation Kinetics, In Calf Muscle, Implicate Microvessels In The Myopathy Of Peripheral Artery Disease, Molly Schieber

Theses & Dissertations

Background:Peripheral Artery Disease (PAD) is characterized by calf muscle fibrosis and myofiber oxidative damage (OxD). Our laboratory has demonstrated architectural changes of calf-muscle microvessels (

Methods:Gastrocnemius biopsies were collected from controls, patients with Stage II PAD, and Stage IV patients with limb-threatening ischemia. Carbonyl adducts (CA; oxidative damage), and Heme Oxygenase-1 (HO-1; anti-OxD in microvessels) were quantified in microvessels (

Results: Post-occlusive re-oxygenation of calf muscle was slowed in Stage II patients versus controls. Kinetic parameters correlated poorly with Ankle-Brachial Index. Microvessel CA was increased in pre- and post-exercise Stage II patients and in Stage IV patients versus …

Center Based Cardiac Rehabilitation Outcomes Associated With Covid-19 Pandemic: A Retrospective Comparative Cohort Study, Haley Williams, Kayla Woodworth

Doctor of Nursing Practice Projects: College of Nursing

Background: Traditional cardiac rehabilitation (CR) is a multidisciplinary, multifaceted program for cardiac patients. Throughout the Covid-19 pandemic, health care, including center-based CR (CBCR) programs, were closed to in-person sessions. Even with the return to CBCR participation, patient outcomes may have been affected by this disruption in care. The goal of this study was to determine if CR participation outcomes differed before and after CBCR program closure due to Covid-19.

Methods: A retrospective comparative cohort design was used to examine CR participant outcome data before and after the Covid-19 pandemic. Convenience sampling of CR participants at a large, urban …

Impact Of The Covid-19 Pandemic On The Management Of Risk Factors In Patients With Stable Atherosclerotic Vascular Disease, Dean Karalis, Patrick Moeller, Albert Crawford, Maria Janelli, Scott Hessen

Division of Cardiology Faculty Papers

Background

Effective control of risk factors in patients with ASCVD is important to reduce recurrent cardiovascular events. However, many ASCVD patients do not have their risk factors controlled, and this may have worsened during the COVID-19 pandemic.

Methods

We retrospectively evaluated risk factor control among 24,760 ASCVD patients who had at least 1 outpatient encounter both pre-pandemic and during the first year of the pandemic. Risk factors were uncontrolled if the blood pressure (BP) ≥ 130/80 mm Hg, LDL-C ≥ 70 mg/dL, HgbA1c ≥ 7 for diabetic patients, and patients were current smokers.

Results

During the pandemic, many patients had …

Higher Dose Corticosteroids In Patients Admitted To Hospital With Covid-19 Who Are Hypoxic But Not Requiring Ventilatory Support (Recovery): A Randomised, Controlled, Open-Label, Platform Trial, Recovery Collaborative Group

Faculty, Staff and Student Publications

BACKGROUND: Low-dose corticosteroids have been shown to reduce mortality for patients with COVID-19 requiring oxygen or ventilatory support (non-invasive mechanical ventilation, invasive mechanical ventilation, or extracorporeal membrane oxygenation). We evaluated the use of a higher dose of corticosteroids in this patient group.

METHODS: This randomised, controlled, open-label platform trial (Randomised Evaluation of COVID-19 Therapy [RECOVERY]) is assessing multiple possible treatments in patients hospitalised for COVID-19. Eligible and consenting adult patients with clinical evidence of hypoxia (ie, receiving oxygen or with oxygen saturation

FINDINGS: Between May 25, 2021, and May 13, 2022, 1272 patients with COVID-19 and hypoxia receiving no oxygen …

Home-Based Tdcs For Apathy In Alzheimer’S Disease: A Protocol For A Randomized Double-Blinded Controlled Pilot Study, Antonio L Teixeira, Laís Bhering Martins, Thiago Macedo E Cordeiro, Lijin Jose, Robert Suchting, Holly M Holmes, Ron Acierno, Hyochol Ahn

Faculty, Staff and Student Publications

BACKGROUND: Apathy is among the most common behavioral symptoms in dementia and is consistently associated with negative outcomes in Alzheimer's disease (AD). Despite its prevalence and clinical relevance, available pharmacological and non-pharmacological strategies to treat apathy in AD have been marked, respectively, by potentially severe side effects and/or limited efficacy. Transcranial direct current stimulation (tDCS) is a relatively novel non-pharmacological method of neuromodulation with promising results. Compared to previous tDCS formats, recent technological advances have increased the portability of tDCS, which creates the potential for caregiver-administered, home use. Our study aims to evaluate the feasibility, safety, and efficacy of home-based …

Gold 2023 Update: Implications For Clinical Practice, Diana R. Tamondong-Lachica, Neil Skolnik, John R. Hurst, Nathaniel Marchetti, Adrian Paul J. Rabe, Maria Montes De Oca, Bartolome R. Celli

Abington Jefferson Health Papers

In 2022, over 3 million people died of chronic obstructive pulmonary disease (COPD) and the global burden of the disease is expected to increase over the coming decades. Recommendations for the treatment and management of patients with COPD are published by the Global Initiative for Chronic Obstructive Lung Disease, and updated annually with scientific evidence-based recommendations. The 2023 updates, published in November 2022, contain key changes to recommendations for diagnosis and treatment of COPD that are anticipated to have a significant impact on clinical practice for patients with COPD. Updates to how COPD is defined and diagnosed, including the expansion …

Diagnosing Hypertrophic Cardiomyopathy In Athletes, Chalisa Srisukajorn, Tamonwan Megan Jirakulaporn, Helen C Huang, Erik Fung, Polakit Teekakirikul

Journal of the Hong Kong College of Cardiology

Sudden cardiac death (SCD) in a young asymptomatic individual is a devastating, unpredictable event, with a widespread impact on the public health system. Hypertrophic cardiomyopathy (HCM) is the most common form of genetic heart disease, and considered one of the leading causes of SCD affecting young and frequently asymptomatic patients. A diagnosis of HCM is challenging particularly in young athletes due to overlapping clinical phenotypesbetween pathological left ventricular hypertrophy (LVH) and exercise-induced physiological LVH. Severalinvestigational tools have been used to differentiate these two distinct entities. This review article focuses upon the diagnosis of HCM in young athletes, SCD risk assessment, …

Procedural And Clinical Outcomes Of Dedicated Venous Stents In Acute And Chronic Venous Obstruction: A Retrospective Single Center Study, Guangming Tan, Madeleine G Yan, Bryan Py Yan

Journal of the Hong Kong College of Cardiology

Background Endovenous angioplasty with stenting is an accepted treatment for patient with venous obstruction. Dedicated venous stents have been developed to improve the efficacy and safety of the venoplasty procedure. We report the procedural as well as clinical outcomes of these new generation stents in the treatment of acute and chronic venous obstruction. Method This is a single centre retrospective cohort study of patients who received venous stenting for either acute or chronic venous obstruction. Baseline demographics, procedural details, clinical outcomes including 30 day all-cause mortality, 90 day primary patency rate, and change in Villalta score were reported. Result 41 …

The Effects Of Prenatal Buprenorphine Exposure On The Neurobehavioral Development Of The Child, Zaineb Zubair, Maryam Zubair, Juan Alonso, Abdullah Zubair

Rowan-Virtua Research Day

Background: Current guidelines for pregnant women with substance use disorder advise prenatal maintenance of opioid agonist therapy with either buprenorphine or methadone. Despite this rise in prenatal opioid agonist therapy, little is known about the effect of prenatal buprenorphine on the neurobehavioral development of the child. This poses the question: does buprenorphine have a long-lasting effect on the central and peripheral nervous system development and behavior of children who were exposed prenatally?

Methods: A comprehensive literature review identified articles relating to prenatal buprenorphine and neurobehavioral outcomes. Article searches were conducted on PubMed and Dynamed. Publications from 2002 through November 2021 …

Biopsychosocial Impacts Of Social Distancing Due To Covid-19 In People Over 65: A Literature Review, Nicole Lacap

Rowan-Virtua Research Day

Background: Since the beginning of the Covid-19 pandemic in January 2020, elderly populations aged 65+ have been deemed at-risk for severe symptoms and poor prognosis. Because it is important to protect this vulnerable population, policies such as social distancing and shelter-in-place orders have been implemented in the United States in order to prevent the spread of Covid-19. However, many older citizens may live alone or may not have access to technology, and therefore may be limited in their ability to maintain important relationships and social interactions throughout shelter-in-place orders and social distancing. Therefore, it is important to understand the cost …

Outcomes Of Arthroscopic Vs. Open Biceps Tenodesis For Treatment Of Slap Lesion In Female Patients, Adeeb Hanna, Matthew Wallingford, William Johns, John Sonner, Emma Johnson, Sommer Hammoud, Brandon Erickson, Steven Cohen, Michael Ciccotti, Meghan Bishop

Rowan-Virtua Research Day

Background: Biceps tenodesis (BT) is one alternative treatment to repair of superior labrum anterior to posterior (SLAP) tears. It can be performed as an arthroscopy or open procedure. While there have been studies comparing the outcomes of SLAP repair procedures with BT for the treatment of SLAP tears, literature comparing arthroscopic and open BT for the treatment of SLAP tears is limited. Additionally, no previous study has specifically examined the outcomes of these procedures in female patients.

Hypothesis/Purpose: The purpose of this study was to compare outcomes following Arthroscopic BT and Open BT for SLAP tears in females. The authors …

Inflammatory Marker Levels Among Patients Diagnosed With Autism Spectrum Disorder And Congenital Heart Defects, Patrick Pearce, Venkateswar Venkataraman, Andrea Iannuzzelli, Jennifer Lecomte

Rowan-Virtua Research Day

Autism Spectrum Disorder (ASD) and congenital heart defects (CHD) are conditions that both confer an immense increase in standard of care, and utilization of medical resources addressing comorbidities. One shared symptom that has been consistently cited is inflammation. This review sought to explore the levels of Tumor Necrosis Factor-�� (TNF-��) and Interleukin-6 (IL-6) between patients diagnosed as having either ASD or CHD. By compiling published data containing the mean values of these two inflammatory markers within these populations, it was shown that while both have significantly elevated levels compared to a phenotypically normal demographic, there is no significant difference between …

Is There An Association Between Preeclampsia/Eclampsia And Congenital Heart Disease Among The Neurodivergent Population?, Jasmine Emanuel, Venkateswar Venkataraman, Jennifer Lecomte, Andrea Iannuzzelli

Rowan-Virtua Research Day

Preeclampsia and eclampsia are very common gestational conditions among pregnant individuals worldwide. These individuals are diagnosed with high blood pressure (after 20 weeks of gestation), proteinuria/end-stage organ disease, and may include seizures. These conditions can put the mother and fetus at risk. A review of literature has shown that there is an association between cardiovascular defects among the neurodivergent population, where these individuals have a higher risk of developing atrial septal defects and ventricular septal defects. The Rowan-Virtua Integrated Special Needs (RISN) Center patient population will be used to investigate whether preeclampsia/eclampsia in mothers is indicative of higher congenital heart …

Case Report: Proximal Large Bowel Obstruction Due To Constipation Requiring Subtotal Colectomy And Ileostomy, Brian Lim, Russell Mordecai, James Espinosa, Alan Lucerna

Rowan-Virtua Research Day

Large bowel obstructions are an abdominal emergency with morbidity and mortality dependent on early diagnosis . This case is of a 58-year-old male who presented with large bowel obstruction due to constipation. Differential diagnosis of large bowel obstruction ranges from benign to emergent should include conditions such as Ogilvie’s syndrome, paralytic ileus, small bowel obstruction to toxic megacolon. This male with only a risk factor of opioid use after spinal surgery. Attempts at medical management were made but the patient ultimately needed definitive management through exploratory laparostomy.

The Possible Relationship Of Adiponectin And Gestational Weight Gain During Different Stages Of Pregnancy Amongst Different Ethnic Groups, Jayshree Chauhan, Xinhua Chen

Rowan-Virtua Research Day

Introduction: Gestational Weight Gain (GWG) is defined as weight gain between conception and birth. Adiponectin, a fat derived hormone, has an inverse relationship with weight gain. We investigated the relationship of maternal adiponectin concentration and GWG during different pregnancy stages among ethnic groups. Method: Serum adiponectin levels were measured at entry (week 16) and trimester three (week 28) in pregnant women (n = 1634, age 22.0±5.3, pre-pregnancy BMI 25.7±6.3) which included Hispanic (47%), African American (37%) and Caucasian (16%) women. GWG was measured at week 24, 28, 32, and delivery and was divided into inadequate, adequate, and excessive according to …

Mixed Beri’S: High Output Heart Failure From Severe Anemia And Thiamine Deficiency, Rohan Umrani, Hiral Amin, Ashley Pinckney, Charles Yang, Daniel Tran

Rowan-Virtua Research Day

Background: Severe anemia and thiamine deficiency can independently result in high output heart failure (HOHF) through different mechanisms. Data on the threshold and timeframe at which these etiologies may precipitate HOHF is unclear.

Case: A 63-year-old male with alcohol use disorder consuming 18 drinks/week presented with progressive shortness of breath and lower extremity edema for a few months. Physical exam revealed tachycardia, anasarca, jugular venous distension, Lancisi’s sign, and a midsystolic murmur. Echocardiogram demonstrated EF of 30-35%, dilated left ventricle, and cardiac index of 4.2L/min/m2.

Decision-Making: Heart failure can independently precipitate anemia while severe alcoholism can induce myelosuppression and promote …

Occurrence And Trends Of Musculoskeletal Pain Among Ski Instructors, Denis Causevic, Erol Kovacevic, Semir Masic, Seth Spicer, Ahmed Gawash

Rowan-Virtua Research Day

Musculoskeletal disorders (MSD) are incredibly common and are often related to work load. For any occupational or public health intervention, injury prevention is preferred to injury treatment. Occupational health and injury prevention research has the potential to help mitigate MSD in the workplace. The aim of this study was to determine how the work demands of ski instructors may affect the health of their musculoskeletal system.

Material and Methods

A cross-sectional study involved the participation of 87 ski instructors (age = 34.61 ±10.67) in Bosnia and Herzegovina (ATUS in Bosnia and Herzegovina). Observed variables were the prevalence of MSD measured …

Management And Considerations In The Usage Of Txa In Hemorrhagic Trauma Patients, Matthew Petterson, James Espinosa, Alan Lucerna

Rowan-Virtua Research Day

Tranexamic acid is a synthetic reversible competitive inhibitor that exerts its action on plasminogen, preventing plasmin formation and deterring fibrinolysis.1 Current FDA-approved indications of TXA include heavy menstrual bleeding and short-term blood loss prevention in patients with hemophilia following tooth extraction.1 TXA has more recently been utilized in the management of massive hemorrhagic trauma patients despite this being an off-label use. While TXA has shown promise as a hemostatic agent for this patient population, considerations in the pre-hospital and hospital settings must be examined for its integration into massive hemorrhage protocols.

A Rare Case Of Left Main Vasospasm Resulting In Sudden Cardiac Death, Trinava Roy, Anjeli Patel, Tania Maheshwari, Vasu Palli

Rowan-Virtua Research Day

Background: Coronary artery vasospasm (CAV) is transient spasm of a coronary artery that can lead to cardiac ischemia. We present a case with left main (LM) CAV identified on electrocardiogram (ECG) and cardiac catheterization resulting in appropriate therapy.

Case: A 52 year old female with months of spontaneously resolving episodic neck pain, flushing, and diaphoresis presented to the emergency department after a resuscitated cardiac arrest. Initial ECG was without evidence of ischemia, however high-sensitivity troponin (522) was elevated. Telemetry monitoring and ECG showed transient ST elevations in V1 and diffuse ST depressions with left bundle branch block. LV Function was …