Medical Specialties Commons^™

Patient And Physician Predictors Of Ffr/Ifr Utilization In Acs And Sihd, Payal Kohli, Peiqi Wang, Andrew Wang, Lucy Liu, Ali Weinstein, Jeptha P. Curtis, John A. Spertus, Jonathan P. Piccini, Marty Makary, Tyler J Gluckman

Articles, Abstracts, and Reports

Background

Despite guidelines supporting FFR/iFR to guide PCI, these modalities remain underutilized. We sought to characterize factors associated with FFR/iFR use in patients undergoing index PCI for an acute coronary syndrome (ACS) or stable ischemic heart disease (SIHD).

Methods

ICD-9/10 codes were used to identify patients undergoing PCI and receiving FFR/iFR for an ACS (n=1,042,896) or SIHD (n=255,213) in a Medicare claims database from Jan. 1, 2013-June 30, 2018. Patients with functional/anatomical testing were excluded (5d prior in ACS; 60d prior in SIHD). Individuals with FFR/iFR performed 1-60 days prior to PCI were also excluded to limit analysis to non-staged …

Clinical Characteristics Of Patients Classified As Very High Risk And Not Very High Risk Based On The 2018 Aha/Acc Multi-Society Cholesterol Guideline, Aparna Sajja, Amir Ali, Hsin-Fang Li, Kateri Spinelli, Salim S. Virani, Seth Shay Martin, Tyler J Gluckman

Articles, Abstracts, and Reports

Background

The 2018 AHA/ACC Cholesterol Guideline recommendation to classify ASCVD patients as very high-risk (VHR) vs not-VHR (NVHR) has important implications for ezetimibe and PCSK9 inhibitor eligibility. We aimed to define the clinical characteristics of these two groups within a large multi-state healthcare system in the Western U.S.

Methods

We performed a retrospective cohort analysis of patients defined as having ASCVD in 2018 using EHR ICD-10 codes. VHR was defined by ≥2 major ASCVD events (ACS ≤12 months, history of MI >12 months, ischemic stroke, or symptomatic PAD) or 1 major ASCVD event and ≥2 high-risk conditions (age ≥65, DM, …

Association Of Immunophenotype With Expression Of Topoisomerase Ii Α And Β In Adult Acute Myeloid Leukemia., Andrew P Michelson, Shannon Mcdonough, Cheryl L Willman, Eric R Koegle, John E Godwin, Stephen H Petersdorf, Alan F List, Megan Othus, Frederick R Appelbaum, Jerald P Radich, Mahrukh K Ganapathi, Anjali S Advani, Ram N Ganapathi

Articles, Abstracts, and Reports

Anthracyclines used in the treatment of acute myelogenous leukemia (AML) inhibit the activity of the mammalian topoisomerase II (topo II) isoforms, topo II α and topo IIβ. In 230 patients with non-M3 AML who received frontline ara-C/daunorubicin we determined expression of topo IIα and topo IIβ by RT-PCR and its relationship to immunophenotype (IP) and outcomes. Treatment outcomes were analyzed by logistic or Cox regression. In 211 patients, available for analysis, topo IIα expression was significantly lower than topo IIβ (P < 0.0001). In contrast to topo IIα, topo IIβ was significantly associated with blast percentage in marrow or blood (P = 0.0001), CD7 (P = 0.01), CD14 (P < 0.0001) and CD54 (P < 0.0001). Event free survival was worse for CD56-negative compared to CD56-high (HR = 1.9, 95% CI [1.0-3.5], p = 0.04), and overall survival was worse for CD-15 low as compared to CD15-high (HR = 2.2, 95% CI [1.1-4.2], p = 0.02). Ingenuity pathway analysis indicated topo IIβ and immunophenotype markers in a network associated with cell-to-cell signaling, hematological system development/function and inflammatory response. Topo IIβ expression reflects disease biology of highly proliferative disease and distinct IP but does not appear to be an independent variable influencing outcome in adult AML patients treated with anthracycline-based therapy.

Allogeneic Autophagosome-Enriched Composition For The Treatment Of Disease, Traci Hilton, Sandra Aung, Rieneke Van De Ven, Christopher Paustian, Tarsem Moudgil, Christopher Dubay, Christopher Twitty, Hong-Ming Hu, Bernard A Fox

Technology Transfer - Patents

A method is presented for screening cells that produce allogeneic autophagosome enriched compositions able to induce expression of a selective marker on a subpopulation of peripheral blood mononuclear cells, the method comprising contacting a cell with a proteasome inhibitor, contacting the cell with a lysosome inhibitor, harvesting the resulting autophagosomes, determining a molecular signature of the harvested autophagosomes, and selecting cells that divert one or more Toll-like receptor agonist and/or one or more molecular chaperones to the harvested autophagosomes. By screening for cells that divert one or more Toll-like receptor agonist and/or one or more molecular chaperones to the harvested …

Allogeneic Autophagosome-Enriched Composition For The Treatment Of Disease, Traci Hilton, Sandra Aung, Rieneke Van De Ven, Christopher Paustian, Tarsem Moudgil, Christopher Dubay, Christopher Twitty, Hong-Ming Hu, Bernard A Fox

Technology Transfer - Patents

A method is presented for screening cells that produce allogeneic autophagosome enriched compositions able to induce expression of a selective marker on a subpopulation of peripheral blood mononuclear cells, the method comprising contacting a cell with a proteasome inhibitor, contacting the cell with a lysosome inhibitor, harvesting the resulting autophagosomes, determining a molecular signature of the harvested autophagosomes, and selecting cells that divert one or more Toll-like receptor agonist and/or one or more molecular chaperones to the harvested autophagosomes. By screening for cells that divert one or more Toll-like receptor agonist and/or one or more molecular chaperones to the harvested …

Comparison Of Echocardiographic Outcomes Following Transcatheter Aortic Valve Replacement With Edwards S3 23 Mm Versus Medtronic Evolut 26 Mm Valves, Michael Ring, Ruyun Jin, Rollie Parrish, Brydan Curtis, Matthew Forrester, Branden Reynolds, Sameer Gafoor

Articles, Abstracts, and Reports

Background

Patients with small aortic valve annulus (SAVA) undergoing TAVR are prone to higher post TAVR trans-valve gradients. In many such patients, the choice of TAVR valve commonly involves choosing between the Edwards S3 23 mm (ES23) versus the Medtronic Evolut 26 mm (ME26). The supraannular design of the Evolut has been touted as providing superior hemodynamics in SAVA. We sought to compare performance of these two valves in SAVA, particularly in regard to occurrence of elevated trans-valve gradients.

Methods

We queried the Providence St Joseph Health STS/ACC TVT Registry database for patients undergoing TAVR for SAVA with either the …

Covid-19 Clinical Guidance For The Cardiovascular Care Team, Thomas M. Maddox, Eric C. Stecker, Biykem Bozkurt, Nathalie Demichelis, John U. Doherty, Andrew Freeman, Tyler J Gluckman, Dipti Itchhaporia, Andrew P. Miller, Andrea L. Price, Lonny Reisman, Prem Soman, Mohammad Madjid, Scott D. Solomon, Orly Vardeny

Articles, Abstracts, and Reports

COVID-19 is a quickly evolving public health emergency. The guidance provided in this document is based on the best available published information and expert evaluation. This document is intended to supplement, not supersede, relevant guidance from the Centers for Disease Control and Prevention, state and local health authorities, and your institution’s infectious disease containment, mitigation, and response plan.

Inhibition Of Radiographic Progression Across Levels Of Composite Index-Defined Disease Activity In Patients With Active Psoriatic Arthritis Treated With Intravenous Golimumab: Results From A Phase-3, Double-Blind, Placebo-Controlled Trial., Philip Mease, M Elaine Husni, Shelly Kafka, Soumya D Chakravarty, Diane D Harrison, Kim Hung Lo, Stephen Xu, Elizabeth C Hsia, Arthur Kavanaugh

Articles, Abstracts, and Reports

BACKGROUND: In the GO-VIBRANT trial of intravenous golimumab in psoriatic arthritis (PsA), golimumab significantly inhibited radiographic progression. In post hoc analyses, we evaluated changes in total PsA-modified Sharp/van der Heijde scores (SHS) across levels of composite index-defined disease activity following treatment.

METHODS: In this phase-3, double-blind, placebo-controlled trial, 480 bio-naïve patients with active PsA randomly received intravenous golimumab 2 mg/kg (N = 241; week 0, week 4, every 8 weeks [q8w]) or placebo (N = 239; week 0, week 4, week 12, week 20) followed by golimumab (week 24, week 28, q8w) through week 52. Week 24 and week 52 …

Primary Sclerosing Cholangitis: Epidemiology, Genetics, Diagnosis, And Current Management., Eric Gochanour, Channa Jayasekera, Kris V Kowdley

Articles, Abstracts, and Reports

http://aasldpubs.onlinelibrary.wiley.com/hub/journal/10.1002/(ISSN)2046-2484/video/15-3-reading-gochanour a video presentation of this article http://aasldpubs.onlinelibrary.wiley.com/hub/journal/10.1002/(ISSN)2046-2484/video/15-3-interview-kowdley an interview with the author.

Enthesitis In Psoriatic Arthritis (Part 3): Clinical Assessment And Management., Philip Mease

Articles, Abstracts, and Reports

Enthesitis is a common clinical feature of PsA, which is characterized by inflammation at the site of insertion of tendons, ligaments and joint capsule fibres into bone. Enthesitis is relatively unique to the spondyloarthritides, setting this group of diseases apart from other rheumatological conditions. The pathophysiological underpinnings of this clinical domain, and the imaging assessment of it, are described in accompanying articles in this supplement. The focus of this article is on the assessment of enthesitis by physical examination, the impact of enthesitis on function and quality of life, the impact of concomitant FM on clinical assessment, and the evidence …

A First-In-Human Phase 1 Dose Escalation Study Of Spartalizumab (Pdr001), An Anti-Pd-1 Antibody, In Patients With Advanced Solid Tumors., Aung Naing, Justin F Gainor, Hans Gelderblom, Patrick M Forde, Marcus O Butler, Chia-Chi Lin, Sunil Sharma, Maria Ochoa De Olza, Andrea Varga, Matthew H Taylor, Jan H M Schellens, Hongqian Wu, Haiying Sun, Antonio P Silva, Jason Faris, Jennifer Mataraza, Scott Cameron, Todd M Bauer

Articles, Abstracts, and Reports

BACKGROUND: Spartalizumab is a humanized IgG4κ monoclonal antibody that binds programmed death-1 (PD-1) and blocks its interaction with PD-L1 and PD-L2. This phase 1/2 study was designed to assess the safety, pharmacokinetics, and preliminary efficacy of spartalizumab in patients with advanced or metastatic solid tumors.

METHODS: In the phase 1 part of the study, 58 patients received spartalizumab, intravenously, at doses of 1, 3, or 10 mg/kg, administered every 2 weeks (Q2W), or 3 or 5 mg/kg every 4 weeks (Q4W).

RESULTS: Patients had a wide range of tumor types, most commonly sarcoma (28%) and metastatic renal cell carcinoma (10%); …

Comparison Of Outcomes Following Minimally Invasive And Open Posterior Cervical Foraminotomy: Description Of Minimally Invasive Technique And Review Of Literature., Andrew Platt, Carter S Gerard, John E O'Toole

Articles, Abstracts, and Reports

Although minimally invasive posterior cervical foraminotomy (MIS-PCF) is frequently employed in the treatment of cervical radiculopathy, there are very few studies directly comparing outcomes between MIS-PCF and open posterior cervical foraminotomy and between MIS-PCF and percutaneous endoscopic (full-endoscopic) posterior cervical foraminotomy (FE-PCF). This study includes a description of technique and systematic review of literature and analysis of clinical studies comparing outcomes between MIS-PCF and open posterior cervical foraminotomy and between MIS-PCF and FE-PCF. Six comparative studies, including one randomized controlled trial were included in analysis. Average operative time ranged from 60.5 to 171 minutes in the open group and 77.65 …

Preface To The Psoriatic Arthritis Supplement., Philip Mease

Articles, Abstracts, and Reports

No abstract provided.

Memote For Standardized Genome-Scale Metabolic Model Testing., Christian Lieven, Moritz E Beber, Brett G Olivier, Frank T Bergmann, Meric Ataman, Parizad Babaei, Jennifer A Bartell, Lars M Blank, Siddharth Chauhan, Kevin Correia, Christian Diener, Andreas Dräger, Birgitta E Ebert, Janaka N Edirisinghe, José P Faria, Adam M Feist, Georgios Fengos, Ronan M T Fleming, Beatriz García-Jiménez, Vassily Hatzimanikatis, Wout Van Helvoirt, Christopher S Henry, Henning Hermjakob, Markus J Herrgård, Ali Kaafarani, Hyun Uk Kim, Zachary King, Steffen Klamt, Edda Klipp, Jasper J Koehorst, Matthias König, Meiyappan Lakshmanan, Dong-Yup Lee, Sang Yup Lee, Sunjae Lee, Nathan E Lewis, Filipe Liu, Hongwu Ma, Daniel Machado, Radhakrishnan Mahadevan, Paulo Maia, Adil Mardinoglu, Gregory L Medlock, Jonathan M Monk, Jens Nielsen, Lars Keld Nielsen, Juan Nogales, Intawat Nookaew, Bernhard O Palsson, Jason A Papin, Kiran R Patil, Mark Poolman, Nathan D Price, Osbaldo Resendis-Antonio, Anne Richelle, Isabel Rocha, Benjamín J Sánchez, Peter J Schaap, Rahuman S Malik Sheriff, Saeed Shoaie, Nikolaus Sonnenschein, Bas Teusink, Paulo Vilaça, Jon Olav Vik, Judith A H Wodke, Joana C Xavier, Qianqian Yuan, Maksim Zakhartsev, Cheng Zhang

Articles, Abstracts, and Reports

No abstract provided.

Blood Test Shows High Accuracy In Detecting Stage I Non-Small Cell Lung Cancer., Cherylle Goebel, Christopher L Louden, Robert Mckenna, Osita Onugha, Andrew Wachtel, Thomas Long

Articles, Abstracts, and Reports

BACKGROUND: In a previous study (Goebel et. al, Cancer Genomics Proteomics 16:229-244, 2019), we identified 33 biomarkers for an early stage (I-II) Non-Small Cell Lung Cancer (NSCLC) test with 90% accuracy, 80.3% sensitivity, and 95.4% specificity. For the current study, we used a narrowed ensemble of 21 biomarkers while retaining similar accuracy in detecting early stage lung cancer.

METHODS: A multiplex platform, 486 human plasma samples, and 21 biomarkers were used to develop and validate our algorithm which detects early stage NSCLC. The training set consisted of 258 human plasma with 79 Stage I-II NSCLC samples. The 21 biomarkers with …

Biomass Fuel Use And Cardiac Function In Nepali Women., Jasleen Tiwana, Catherine Benziger, Laura Hooper, Karl Pope, Vijay Alurkar, Ramchandra Kafle, Tula R Sijali, John R Balmes, Joel D Kaufman, Michael N Bates

Articles, Abstracts, and Reports

Background: Exposure to household air pollution (HAP) from cooking with biomass fuel affects billions of people. We hypothesized that HAP from woodsmoke, compared to other household fuels, was associated with adverse cardiovascular outcomes, of which there have been few studies.

Methods: A cross-sectional study was completed in 299 females aged 40-70 years in Kaski District, Nepal, during 2017-18. All participants underwent a standard 12-lead ECG, ankle and brachial systolic blood pressure measurement, and 2D color and Doppler echocardiography. Current stove type was confirmed by inspection. Blood pressure, height, and weight were measured using a standardized protocol. Hypertension was defined as …

Mild: Magnetic Intestinal Lengthening Device, Walaa Abdelmoaty

Technology Transfer - Patents

No abstract provided.

Assessing Structural Damage Progression In Psoriatic Arthritis And Its Role As An Outcome In Research., Désirée Van Der Heijde, Dafna D Gladman, Arthur Kavanaugh, Philip Mease

Articles, Abstracts, and Reports

Psoriatic arthritis (PsA) is an immune-mediated, clinically heterogeneous disease characterized by arthritis, enthesitis, dactylitis, spondylitis, and psoriasis of the skin and nails. Persistent articular inflammation in patients with PsA can lead to structural damage, which can result in reduced physical function and quality of life. Structural damage can occur rapidly, and irreversible joint damage may be observed if patients are not treated promptly and appropriately. Therefore, evaluating therapeutic agents for their ability to inhibit structural progression has become increasingly important, with radiographic progression becoming a key efficacy outcome in clinical trials in PsA. Here, we review how structural damage and …

Tumor Slice Culture As A Biologic Surrogate Of Human Cancer., Heidi L Kenerson, Kevin M Sullivan, Yongwoo D Seo, Kathryn M Stadeli, Cigdem Ussakli, Xiaowei Yan, Christopher G Lausted, Venu G Pillarisetty, James O Park, Kimberly J Riehle, Matthew Yeh, Qiang Tian, Raymond S Yeung

Articles, Abstracts, and Reports

Background: The tumor microenvironment (TME) is critical to every aspect of cancer biology. Organotypic tumor slice cultures (TSCs) preserve the original TME and have demonstrated utility in predicting drug sensitivity, but the association between clinicopathologic parameters and

Methods: One hundred and eight fresh tumor specimens from liver resections at a tertiary academic center were procured and precisely cut with a Vibratome to create 250 μm × 6 mm slices. These fixed-dimension TSCs were grown on polytetrafluoroethylene inserts, and their metabolic activities were determined by a colorimetric assay. Correlation between baseline activities and clinicopathologic parameters was assessed. Tissue CEA mRNA expression …

Methylation Signatures In Peripheral Blood Are Associated With Marked Age Acceleration And Disease Progression In Patients With Primary Sclerosing Cholangitis., Michael Trauner, Yevgeniy Gindin, Zhaoshi Jiang, Chuhan Chung, G Mani Subramanian, Robert P Myers, Aliya Gulamhusein, Kris V Kowdley, Cynthia Levy, Zachary Goodman, Michael P Manns, Andrew J Muir, Christopher L Bowlus

Articles, Abstracts, and Reports

Background & Aims: A DNA methylation (DNAm) signature derived from 353 CpG sites (the Horvath clock) has been proposed as an epigenetic measure of chronological and biological age. This epigenetic signature is accelerated in diverse tissue types in various disorders, including non-alcoholic steatohepatitis, and is associated with mortality. Here, we assayed whole blood DNAm to explore age acceleration in patients with primary sclerosing cholangitis (PSC).

Methods: Using the MethylationEPIC BeadChip (850K) array, DNAm signatures in whole blood were analyzed in 36 patients with PSC enrolled in a 96-week trial of simtuzumab (Ishak F0-1, n = 13; F5-6, n = 23). …

Implementation Of A Cardiogenic Shock Protocol And Data Review Process Is Associated With Improved In-Hospital Survival, Adrienne Jones, Renee Swanson, Kateri Spinelli, Joshua Remick, Daniel Westerdahl, Jill M Gelow, David Hotchkin, Jason Wells, Tim Lewis, Robert Kim, Jeff Robinson, Roxanna Barr, Sarah Ramelli, Jacob Abraham

Articles, Abstracts, and Reports

Background: Despite increasing use of mechanical circulatory support devices (MCS), cardiogenic shock (CS) mortality is persistently high, with worsening outcomes in later stages of CS. Delays in diagnosis and practice variation may contribute to in-hospital mortality.

Methods: In June 2018, we devised and implemented a CS protocol at two hospitals from one health system in Portland, OR. The CS protocol was designed to promote early CS recognition, rapid notification of a multi-disciplinary specialty team lead by a heart failure cardiologist, invasive hemodynamic evaluation, and institution of MCS as appropriate. CS was defined by widely accepted clinical and hemodynamic criteria. Patient …

Ridges And Pouches: A Case Series Of Anomalous Atrial Septal Fusion., David Zisa, Francesco F Faletra, Benjamin S Wessler, Neil J Halin, Pranitha Reddy, Ayan R Patel, Natesa G Pandian

Articles, Abstracts, and Reports

No abstract provided.

Solving The Sepsis Puzzle: Every Minute Counts, Jamie Roney, Amber Cline

Articles, Abstracts, and Reports

SPEMS Pre-Conference Course Sepsis Class

A Case Of Blunt Trauma-Induced St-Elevation Myocardial Infarction Sustained During A Prison Brawl., Zachary T Clark, Natalie Thiel, John Perry, Michael R Minckler

Articles, Abstracts, and Reports

Myocardial infarction (MI) is a serious and time-sensitive condition. MIs are typically seen in patients with coronary artery disease (CAD) and are caused by the rupture of an atherosclerotic plaque due to factors contributing to plaque instability. However, this case illustrates that plaque rupture can also be caused by blunt trauma to the chest. Considering MI as a possible result of chest trauma may decrease time from presentation to diagnosis and treatment and, therefore, improve outcomes in similar cases, particularly when patients presents unusually or with very few risk factors for MI.

Micom: Metagenome-Scale Modeling To Infer Metabolic Interactions In The Gut Microbiota., Christian Diener, Sean M Gibbons, Osbaldo Resendis-Antonio

Articles, Abstracts, and Reports

Compositional changes in the gut microbiota have been associated with a variety of medical conditions such as obesity, Crohn's disease, and diabetes. However, connecting microbial community composition to ecosystem function remains a challenge. Here, we introduce MICOM, a customizable metabolic model of the human gut microbiome. By using a heuristic optimization approach based on L2 regularization, we were able to obtain a unique set of realistic growth rates that corresponded well with observed replication rates. We integrated adjustable dietary and taxon abundance constraints to generate personalized metabolic models for individual metagenomic samples. We applied MICOM to a balanced cohort of …

Epigenetic Reprogramming At Estrogen-Receptor Binding Sites Alters 3d Chromatin Landscape In Endocrine-Resistant Breast Cancer., Joanna Achinger-Kawecka, Fatima Valdes-Mora, Phuc-Loi Luu, Katherine A Giles, C Elizabeth Caldon, Wenjia Qu, Shalima Nair, Sebastian Soto, Warwick J Locke, Nicole S Yeo-Teh, Cathryn M Gould, Qian Du, Grady C Smith, Irene R Ramos, Kristine F Fernandez, Dave S B Hoon, Julia M W Gee, Clare Stirzaker, Susan J Clark

Articles, Abstracts, and Reports

Endocrine therapy resistance frequently develops in estrogen receptor positive (ER+) breast cancer, but the underlying molecular mechanisms are largely unknown. Here, we show that 3-dimensional (3D) chromatin interactions both within and between topologically associating domains (TADs) frequently change in ER+ endocrine-resistant breast cancer cells and that the differential interactions are enriched for resistance-associated genetic variants at CTCF-bound anchors. Ectopic chromatin interactions are preferentially enriched at active enhancers and promoters and ER binding sites, and are associated with altered expression of ER-regulated genes, consistent with dynamic remodelling of ER pathways accompanying the development of endocrine resistance. We observe that loss of …

Quality And Clinical Care Development In Spine Surgery-Connecting The Dots: An Expanded Clinical Narrative., Sarah Hopkins, Polly Brune, Jens R Chapman, Marc Horton, Rod J Oskouian, Akshal Patel, Marc D Moisi

Articles, Abstracts, and Reports

Our health care system is an evidenced-based quality-centric environment. Pursuit of quality is a process that encompasses knowledge development and care advancements through collaboration and expertise. Depicted here is the foundational knowledge, process, and contributions that hallmark successful clinical quality programs. Beginning with methodology, followed by process and form, we create the foundational knowledge and exemplars demonstrating framework and continuum of process in pursuit and attainment of successful clinical quality and care development for patients. Although our protocol has been devised for complex spine care, this could be implemented across all health care specialties to provide individualized and high-quality care …

Advances In Targeted Therapy For Acute Myeloid Leukemia., Jifeng Yu, Peter Y Z Jiang, Hao Sun, Xia Zhang, Zhongxing Jiang, Yingmei Li, Yongping Song

Articles, Abstracts, and Reports

Acute myeloid leukemia (AML) is a clonal malignancy characterized by genetic heterogeneity due to recurrent gene mutations. Treatment with cytotoxic chemotherapy has been the standard of care for more than half of a century. Although much progress has been made toward improving treatment related mortality rate in the past few decades, long term overall survival has stagnated. Exciting developments of gene mutation-targeted therapeutic agents are now changing the landscape in AML treatment. New agents offer more clinical options for patients and also confer a more promising outcome. Since Midostaurin, a FLT3 inhibitor, was first approved by US FDA in 2017 …

First Pass Effect In Patients Treated With The Trevo Stent-Retriever: A Track Registry Study Analysis., Maxim Mokin, Christopher T Primiani, Alicia C Castonguay, Raul G Nogueira, Diogo C Haussen, Joey D English, Sudhakar R Satti, Jennifer Chen, Hamed Farid, Candace Borders, Erol Veznedaroglu, Mandy J Binning, Ajit Puri, Nirav A Vora, Ron F Budzik, Guilherme Dabus, Italo Linfante, Vallabh Janardhan, Amer Alshekhlee, Michael G Abraham, Randall Edgell, Muhammad Asif Taqi, Ramy El Khoury, Aniel Q Majjhoo, Mouhammed R Kabbani, Michael T Froehler, Ira Finch, Sameer A Ansari, Roberta Novakovic, Thanh N Nguyen, Osama O Zaidat

Articles, Abstracts, and Reports

Background and Objective: The first pass effect (FPE; achieving complete recanalization with a single thrombectomy device pass) has been shown to be associated with higher rates of good clinical outcomes in patients with acute ischemic stroke. Here, we investigate clinical and radiographic factors associated with FPE in a large U.S. post-marketing registry (TRACK, Trevo Stent-Retriever Acute Stroke). Methods: We analyzed the TRACK database (multicenter registry of 634 patients from 23 centers from March 2013 through August 2015), which 609 patients were included in the final analysis. FPE was defined as a single pass/use of device, TICI 2c/3 recanalization, and no …

Investigating The Effects Of Brainstem Neuronal Adaptation On Cardiovascular Homeostasis., James H Park, Jonathan Gorky, Babatunde Ogunnaike, Rajanikanth Vadigepalli, James S Schwaber

Articles, Abstracts, and Reports

Central coordination of cardiovascular function is accomplished, in part, by the baroreceptor reflex, a multi-input multi-output physiological control system that regulates the activity of the parasympathetic and sympathetic nervous systems via interactions among multiple brainstem nuclei. Recent single-cell analyses within the brain revealed that individual neurons within and across brain nuclei exhibit distinct transcriptional states contributing to neuronal function. Such transcriptional heterogeneity complicates the task of understanding how neurons within and across brain nuclei organize and function to process multiple inputs and coordinate cardiovascular functions within the larger context of the baroreceptor reflex. However, prior analysis of brainstem neurons revealed …