Medical Specialties Commons^™

Comparison Of Bacterial Culture With Biofire® Filmarray® Multiplex Pcr Screening Of Archived Cerebrospinal Fluid Specimens From Children With Suspected Bacterial Meningitis In Nigeria, S Obaro, F Hassan-Hanga, N Medugu, Rasaq Olaosebikan, G Olanipekun, B Jibir, S Gambo, Theresa Ajose, Carissa Duru, B Ebruke, H D Davies

Department of Pharmacology and Experimental Therapeutics Faculty Papers

BACKGROUND: Diagnosis of bacterial meningitis remains a challenge in most developing countries due to low yield from bacterial culture, widespread use of non-prescription antibiotics, and weak microbiology laboratories. The objective of this study was to compare the yield from standard bacterial culture with the multiplex nested PCR platform, the BioFire® FilmArray® Meningitis/Encephalitis Panel (BioFire ME Panel), for cases with suspected acute bacterial meningitis.

METHODS: Following Gram stain and bacterial culture on cerebrospinal fluid (CSF) collected from children aged less than 5 years with a clinical suspicion of acute bacterial meningitis (ABM) as defined by the WHO guidelines, residual CSF specimens …

Multilevel Community Engagement To Inform A Randomized Clinical Trial, Kirby L. Wycoff, Jabina G. Coleman, Christine M. Santoro, Leah L. Zullig, Niesha Darden, Porsche M. Holland, Jane F. Cruice, Shukriyyah Mitchell, Michelle Smith, Saleemah J. Mcneil, Sharon J. Herring

Counseling and Behavioral Health Faculty Papers

OBJECTIVE: To explore how patients, community-based perinatal support professionals, and health system clinicians and staff perceived facilitators and barriers to implementation of a randomized clinical trial (RCT) designed to optimize Black maternal heart health.

METHODS: This article describes the formative work that we believed needed to occur before the start of the Change of H.E.A.R.T (Here for Equity, Advocacy, Reflection and Transformation) RCT. We used a qualitative, descriptive design and community-based, participatory approach, the latter of which allowed our team to intentionally focus on avoiding harm and equalizing power dynamics throughout the research process. Data were collected between November 2021 …

Should We Use Rifampicin In Periprosthetic Joint Infections Caused By Staphylococci When The Implant Has Been Exchanged? A Multicenter Observational Cohort Study, Tobias Siegfried Kramer, Alex Soriano, Sarah Tedeschi, Antonia F. Chen, Pierre Tattevin, Eric Senneville, Joan Gomez-Junyent, Victoria Birlutiu, Sabine Petersdorf, Vicens Diaz De Brito, Ignacio Sancho Gonzalez, Katherine A. Belden, Marjan Wouthuyzen-Bakker

Division of Infectious Diseases and Environmental Medicine Faculty Papers

BACKGROUND: Previous studies demonstrated the efficacy of a rifampicin-based regimen in the treatment of acute staphylococcal periprosthetic joint infections (PJIs) treated with surgical debridement. However, evidence is lacking to support the use of rifampicin in cases where the implant is exchanged during revision.

METHODS: We included all consecutive cases of staphylococcal PJIs treated from January 2013 to December 2018 with revision surgery in this international, retrospective, multicenter observational cohort study. PJI was defined according to the European Bone and Joint Infection Society diagnostic criteria. A relapse or reinfection during follow-up, the need for antibiotic suppressive therapy, the need for implant …

The Diagnostic Process Of Spinal Post-Traumatic Deformity: An Expert Survey Of 7 Cases, Consensus On Clinical Relevance Does Exist, Erin E.A. De Gendt, Lori M. Benneker, Andrei F. Joaquim, Mohammad El-Sharkawi, Gaurav R. Dhakal, Frank Kandziora, Jin Tee, Richard J. Bransford, Emiliano N. Vialle, Alexander R. Vaccaro, Eugen C. Popescu, Rishi M. Kanna, David W. Polly, Klaus J. Schnake, Pedro Berjano, Sergey Ryabykh, Marko Neva, Claudio Lamartina, Dominique A Rothenfluh, Stephan J. Lewis, Sander. P.J Muijs, F. Cumhur Oner

Rothman Institute Papers

STUDY DESIGN: Survey of cases.

OBJECTIVE: To evaluate the opinion of experts in the diagnostic process of clinically relevant Spinal Post-traumatic Deformity (SPTD).

SUMMARY OF BACKGROUND DATA: SPTD is a potential complication of spine trauma that can cause decreased function and quality of life impairment. The question of when SPTD becomes clinically relevant is yet to be resolved.

METHODS: The survey of 7 cases was sent to 31 experts. The case presentation was medical history, diagnostic assessment, evaluation of diagnostic assessment, diagnosis, and treatment options. Means, ranges, percentages of participants, and descriptive statistics were calculated.

RESULTS: Seventeen spinal surgeons reviewed …

Prevalence Of Age-Related Macular Degeneration And Associated Factors In Indian Cohort In A Tertiary Care Setting, Jacqueline Hamati, Sai Prashanthi, Raja Narayanan, Niroj Sahoo, Anthony Vipin Das, Padmaja Kumari Rani, Umesh Chandra Behera, Rohit Khanna, Gudlavalleti V.S. Murthy

Student Papers, Posters & Projects

PURPOSE: To report a big data analysis of risk and protective factors in patients with AMD, as well as report on the age-adjusted prevalence in a geriatric Indian cohort in a hospital setting.

METHODS: This retrospective, observational study of all patients older than 60 years of age. Multiple logistic regression was performed for the binary outcome and the presence of AMD. Variables analyzed include age, gender, socioeconomic status, occupation, urban-rural-metropolitan distribution, self-reported history of diabetes mellitus (DM), hypertension (HTN), or coronary artery disease (CAD), ocular comorbidities, history of cataract surgery, and presenting VA. Odds ratios (OR) and 99% confidence intervals …

Distinguishing Dystrophic Calcification From Calciphylaxis, Elizabeth Jones, Alexander Valiga, Miriam Solowey

Department of Dermatology and Cutaneous Biology Faculty Papers

Introduction

Calcinosis cutis, a disorder in which calcium salts deposit in skin and subcutis, is categorized into five subtypes: dystrophic calcification, metastatic calcification, idiopathic calcification, iatrogenic calcification, and calciphylaxis.

Dystrophic calcification, the most common subtype, typically results from local tissue damage1,2 and is proposed to be caused by the release of phosphate binding proteins by necrotic cells in response to tissue damage, inflammation, or hypoxia.2 The condition often presents with nontender nodules of the skin or subcutis and normal serum calcium.

Calciphylaxis is believed to be caused by impaired inhibition of calcification in the microvasculature.3 …

An Unusual Presentation Of Pigmented Purpuric Lichenoid Dermatitis, Christine De Antonis, Jordan T. Hyde, Jason B. Lee, Sylvia Hsu

Department of Dermatology and Cutaneous Biology Faculty Papers

Pigmented purpuric lichenoid dermatitis (PPLD) is a rare subtype of pigmented purpuric dermatosis, which classically presents with a mixture of lichenoid papules and patches on the bilateral lower extremities. Herein, we describe an unusual case of a 47-year-old man with PPLD who presented with 1-3mm discrete papules without the presence of larger patches. The diagnosis of PPLD should be considered for patients presenting with bilateral symmetric discrete papules on the legs.

Perforated Pre-Pyloric Ulcer In The Gastric Remnant Over A Decade After Roux-En-Y Gastric Bypass: A Case Report, Bianca Marquez, Emmanuel Luciano, Ryan Cohen, Christina Maser, Matthew Hubbard

Einstein Health Papers

INTRODUCTION AND IMPORTANCE: Roux-en-Y gastric bypass (RYGB) is one of the two most common weight loss surgeries. Surgical emergencies after gastric bypass can be complicated by devastating events that are often difficult to diagnose and manage. Perforated ulcers are a very rare complication after a RYGB.

CASE PRESENTATION: In this report, the diagnosis and surgical management of a 59-year-old immunosuppressed male patient who presented with late perforation of a pre-pyloric ulcer in the gastric remnant after RYGB is presented. The perforation was repaired transversely in a running horizontal mattress fashion and patched with a piece of well-vascularized omentum.

CLINICAL DISCUSSION: …

Heart Failure Readmissions After Cardiac Surgeries: Navigating The High-Risk Terrain, Waqas Ullah, Indranee Rajapreyar, Yevgeniy Brailovsky

Division of Cardiology Faculty Papers

No abstract provided.

Outcomes And Discriminatory Accuracy Of The Cha2ds2vasc Score In Atrial Fibrillation And Cancer, Waqas Ullah, Mathew Dimeglio, Daniel Frisch, Rodrigo Bagur, Louise Sun, David Fischman, Andrija Matetic, Bonnie Ky, Mamas Mamas

Division of Cardiology Faculty Papers

Background: Atrial fibrillation (AF) is highly prevalent among cancer patients. The role of traditional risk stratification scores in the context of different cancer types in these patients remains unknown. Objectives: The purpose of this study was to determine the discriminative accuracy of the CHA₂DS₂VASc score for ischemic stroke using receiver operating characteristic and area under the curve. Methods: The National Readmission Database (2015-2019) was used to identify all AF patients stratified by the cancer diagnosis, type, and CHA₂DS₂VASc category (low; moderate; high risk). Outcomes at 30-day readmission were compared between cancer and …

Role Of Preoperative Nerve Conduction Studies For Penetrating Hand Injuries Involving The Median Palmar Cutaneous Nerve, Saral Patel, David Hutchinson, Sebastian D. Arango, Andrew J. Miller, Rowena Mcbeath

Department of Orthopaedic Surgery Faculty Papers

Penetrating lacerations to the hand are a common cause of nerve injury and can lead to debilitating pain and numbness in the distribution of the nerve affected. Owing to an overlap in the cutaneous innervation from different sensory nerves, clinically identifying the injured nerve can be difficult. We present a novel case of isolated injury to the palmar cutaneous nerve from a penetrating knife injury which was detected using 'comparison waveform' nerve conduction studies. Using this technique, we can isolate injuries to the palmar cutaneous branch of the median nerve (PCBmdn) from the median nerve, dorsal radial sensory nerve, and …

Neurologic Outcomes For Adult Spinal Cord Ependymomas Stratified By Tumor Location: A Retrospective Cohort Study And 2-Year Outlook, Keanu Chee, Grégoire P Chatain, Michael W Kortz, Stephanie Serva, Keshari Shrestha, Timothy H Ung, Jens-Peter Witt, Michael Finn

Department of Neurosurgery Faculty Papers

Determine whether craniocaudal spinal cord tumor location affects long-term neurologic outcomes in adults diagnosed with spinal ependymomas (SE). A retrospective cohort analysis of patients aged ≥ 18 years who underwent surgical resection for SE over a ten-year period was conducted. Tumor location was classified as cervical, thoracic, or lumbar/conus. Primary endpoints were post-operative McCormick Neurologic Scale (MNS) scores at < 3 days, 6 weeks, 1 year, and 2 years. One-way ANOVA was performed to detect significant differences in MNS scores between tumor locations. Twenty-eight patients were identified. The average age was 44.2 ± 15.4 years. Sixteen were male, and 13 were female. There were 10 cervical-predominant SEs, 13 thoracic-predominant SEs, and 5 lumbar/conus-predominant SEs. No significant differences were observed in pre-operative MNS scores between tumor locations (p = 0.73). One-way ANOVA testing demonstrated statistically significant differences in post-operative MNS scores between tumor locations at < 3 days (p = 0.03), 6 weeks (p = 0.009), and 1 year (p = 0.003); however, no significant difference was observed between post-operative MNS scores at 2 years (p = 0.13). The mean MNS score for patients with thoracic SEs were higher at all follow-up time points. Tumors arising in the thoracic SE are associated with worse post-operative neurologic outcomes in comparison to SEs arising in other spinal regions. This is likely multifactorial in etiology, owing to both anatomical differences including spinal cord volume as well as variations in tumor characteristics. No significant differences in 2-year MNS scores were observed, suggesting that patients ultimately recover from neurological insult sustained at the time of surgery.

Advances In Diagnosis And Management Of Atypical Spinal Infections: A Comprehensive Review, Glenn A. Gonzalez, Guilherme Porto, Eric Tecce, Yazan Shamli Oghli, J. Miao, Matthew O'Leary, Daniela Perez Chadid, Michael Vo, James Harrop

Department of Neurosurgery Faculty Papers

Atypical spinal infections (ASIs) of the spine are a challenging pathology to management with potentially devastating morbidity and mortality. To identify patients with atypical spinal infections, it is important to recognize the often insidious clinical and radiographic presentations, in the setting of indolent and smoldering organism growth. Trending of inflammatory markers, and culturing of organisms, is essential. Once identified, the spinal infection should be treated with antibiotics and possibly various surgical interventions including decompression and possible fusion depending on spine structural integrity and stability. Early diagnosis of ASIs and immediate treatment of debilitating conditions, such as epidural abscess, correlate with …

Supradiaphragmatic Origin Of The Celiac Trunk Leading To Median Arcuate Ligament Syndrome With Superior Mesenteric Artery Involvement, Martina Rama, Wissam Nasser, Prashanth Palvannan, Sara Belko, Paul Dimuzio, Francesco Palazzo

Department of Surgery Faculty Papers

Median arcuate ligament (MAL) syndrome (MALS) is a rare condition caused by compression of the celiac artery by the MAL. Symptoms include abdominal pain, nausea, and weight loss. Rarely, the MAL can compress both the celiac artery and the superior mesenteric artery (SMA). We describe the case of a young man with MALS involving the celiac artery and SMA. Laparoscopic release of the MAL was performed, and the patient had resolution of his symptoms at 6 months of follow-up. A review of the literature identified only six cases of MALS involving the SMA and celiac artery, making this a rare …

Pericardial Effusions And Cardiac Tamponade In Hospitalized Systemic Sclerosis Patients: Analysis Of The National Inpatient Sample, Bikash Basyal, Waqas Ullah, Chris T. Derk

Abington Jefferson Health Papers

Introduction

Clinically significant pericardial effusions and cardiac tamponade in systemic sclerosis (SSc) patients is uncommon and the factors that contribute to progression of pericardial involvement in SSc patients have not been well established.

Methods

A review of the national inpatient sample database was performed looking SSc related hospitalizations between 2002 and 2019. Data was collected on patients with pericardial effusions and cardiac tamponade and analyzed to identify and describe patient characteristics and comorbidities.

Results

Out of a total of 523,410 SSc hospitalizations, with an overall inpatient mortality rate of 4.7% (24,764 patients), pericardial effusion was identified in 3.1% of all …

Circulating Endocannabinoids And N-Acylethanolamines In Individuals With Cannabis Use Disorder-Preliminary Findings, Nadia Boachie, Erin Gaudette, Richard P. Bazinet, Lin Lin, Rachel F. Tyndale, Esmaeil Mansouri, Marilyn A. Huestis, Junchao Tong, Bernard Le Foll, Stephen J. Kish, Tony P. George, Isabelle Boileau

Institute of Emerging Health Professions Faculty Papers

BACKGROUND: Endocannabinoids and related N-acylethanolamines (NAEs) are bioactive lipids with important physiological functions and putative roles in mental health and addictions. Although chronic cannabis use is associated with endocannabinoid system changes, the status of circulating endocannabinoids and related NAEs in people with cannabis use disorder (CUD) is uncertain.

METHODS: Eleven individuals with CUD and 54 healthy non-cannabis using control participants (HC) provided plasma for measurement by high-performance liquid chromatography-mass spectrometry of endocannabinoids (2-arachidonoylglycerol (2-AG) and N-arachidonoylethanolamine (AEA)) and related NAE fatty acids (N-docosahexaenoylethanolamine (DHEA) and N-oleoylethanolamine (OEA)). Participants were genotyped for the functional gene variant of FAAH (rs324420, C385A) which …

Pet Imaging Of Microglia Using Pbr28suv Determines Therapeutic Efficacy Of Autologous Bone Marrow Mononuclear Cells Therapy In Traumatic Brain Injury, Supinder S Bedi, Michael C Scott, Max A Skibber, Akshita Kumar, Henry W Caplan, Hasen Xue, David Sequeira, Alison L Speer, Fanni Cardenas, Franciska Gudenkauf, Karen Uray, Amit K. Srivastava, Alan R Prossin, Charles S Cox

Cardeza Foundation for Hematologic Research

Traumatic brain injury (TBI) results in activated microglia. Activated microglia can be measured in vivo by using positron emission topography (PET) ligand peripheral benzodiazepine receptor standardized uptake values (PBR28suv). Cell based therapies have utilized autologous bone marrow mononuclear cells (BMMNCs) to attenuate activated microglia after TBI. This study aims to utilize in vivo PBR28suv to assess the efficacy of BMMNCs therapy after TBI. Seventy-two hours after CCI injury, BMMNCs were harvested from the tibia and injected via tail-vein at 74 h after injury at a concentration of 2 million cells per kilogram of body weight. There were three groups of …

Prevalence Of Post-Liver Transplant Complications And Nash-Related Cirrhosis In Postmenopausal Women, Natalia Salinas Parra, Michelle Schafer, Heather M. Ross, John Bruckbauer, Brian Yan, Sarah L. Chen, Adnan Khan Do, Danielle M. Tholey, Dina Halegoua-De Marzio

Student Papers, Posters & Projects

INTRODUCTION AND OBJECTIVES: Compared to premenopausal women, postmenopausal women are at greater risk of developing NAFLD and NASH, two common indications for liver transplantation (LT). We aim to determine the prevalence of NASH-related cirrhosis in postmenopausal women from a cohort of LT patients and investigate their post-LT complications.

MATERIALS AND METHODS: Chart review of 1200 LT patients from 2002-2020 was performed. Postmenopausal women were defined as women over 51 and compared to a control group of men over 51. Prevalence of LT indications was determined. Subgroup analysis assessed cardiovascular disease risk. BMI and ASCVD risk scores were calculated at the …

Global Outcomes For Microsurgical Clipping Of Unruptured Intracranial Aneurysms: A Benchmark Analysis Of 2245 Cases, Richard Drexler, Thomas Sauvigny, Tobias F. Pantel, Franz L. Ricklefs, Joshua S. Catapano, John E. Wanebo, Michael T. Lawton, Aminaa Sanchin, Nils Hecht, Peter Vajkoczy, Kunal Raygor, Daniel Tonetti, Adib Abla, Kareem El Naamani, Stavropoula I. Tjoumakaris, Pascal Jabbour, Brian T. Jankowitz, Mohamed M. Salem, Jan-Karl Burkhardt, Arthur Wagner, Maria Wostrack, Jens Gempt, Bernhard Meyer, Michael Gaub, Justin R. Mascitelli, Philippe Dodier, Gerhard Bavinzski, Karl Roessler, Nico Stroh, Matthias Gmeiner, Andreas Gruber, Eberval G. Figueiredo, Antonio Carlos Samaia Da Silva Coelho, Anatoliy V. Bervitskiy, Egor D. Anisimov, Jamil A. Rzaev, Harald Krenzlin, Naureen Keric, Florian Ringel, Dougho Park, Mun-Chul Kim, Eleonora Marcati, Marco Cenzato, Manfred Westphal, Lasse Dührsen

Department of Neurosurgery Faculty Papers

BACKGROUND AND OBJECTIVES: Benchmarks represent the best possible outcome and help to improve outcomes for surgical procedures. However, global thresholds mirroring an optimal and reachable outcome for microsurgical clipping of unruptured intracranial aneurysms (UIA) are not available. This study aimed to define standardized outcome benchmarks in patients who underwent clipping of UIA.

METHODS: A total of 2245 microsurgically treated UIA from 15 centers were analyzed. Patients were categorized into low- ("benchmark") and high-risk ("nonbenchmark") patients based on known factors affecting outcome. The benchmark was defined as the 75th percentile of all centers' median scores for a given outcome. Benchmark outcomes …

Can The Date Of Last Menstrual Period Be Trusted In The First Trimester? Comparisons Of Gestational Age Measures From A Prospective Cohort Study In Six Low-Income To Middle-Income Countries, Archana Patel, Carla M. Bann, Vanessa R. Thorsten, Sowmya R. Rao, Adrien Lokangaka, Antoinette Tshefu Kitoto, Melissa Bauserman, Lester Figueroa, Nancy F. Krebs, Fabian Esamai, Sherri Bucher, Sarah Saleem, Robert L. Goldenberg, Elwyn Chomba, Waldemar A. Carlo, Shivaprasad Goudar, Richard Derman, Marion Koso-Thomas, Elizabeth Mcclure, Patricia L. Hibberd

Global Health Articles

OBJECTIVES: We examined gestational age (GA) estimates for live and still births, and prematurity rates based on last menstrual period (LMP) compared with ultrasonography (USG) among pregnant women at seven sites in six low-resource countries.

DESIGN: Prospective cohort study SETTING AND PARTICIPANTS: This study included data from the Global Network's population-based Maternal and Newborn Health Registry which follows pregnant women in six low-income and middle-income countries (Democratic Republic of the Congo, Guatemala, India, Kenya, Pakistan and Zambia). Participants in this analysis were 42 803 women, including their 43 230 babies, who registered for the study in their first trimester based …

The Use Of Iodophor-Impregnated Drapes In Patients With Iodine-Related Allergies: A Case Series And Review Of The Literature, Andrew Fraval, Nicolina Zappley, William J. Hozack

Rothman Institute Papers

Background

Methods

Does Physical Therapy Impact Clinical Outcomes After Lumbar Decompression Surgery?, Jeremy C. Heard, Nicholas D. D'Antonio, Mark J. Lambrechts, Payton Boere, Tariq Z. Issa, Yunsoo A. Lee, Jose A. Canseco, Ian David Kaye, Barrett R. Woods, Alan S. Hilibrand, Alexander R. Vaccaro, Christopher K. Kepler, Gregory D. Schroeder

Rothman Institute Papers

OBJECTIVES: The objectives of our study were to (1) determine if physical therapy (PT) impacts patient-reported outcomes (PROMs) after lumbar decompression surgery and (2) determine if PT impacts postsurgical readmissions or reoperations after lumbar decompression surgery.

METHODS: Patients >18 years of age who underwent primary one‑ or two‑level lumbar decompression at our institution were identified. Patient demographics, surgical characteristics, surgical outcomes (all‑cause 90 days readmissions and 90 days surgical readmissions), and patient‑reported outcomes (PROMs) were compared between the groups. Multivariate linear regression was utilized to determine the individual predictors of 90 days readmissions and PROMs at the 1‑year postoperative point. …

Neighborhood Disadvantage And Neural Correlates Of Threat And Reward Processing In Survivors Of Recent Trauma, E. Kate Webb, Timothy D. Ely, Grace E. Rowland, Lauren A.M. Lebois, Sanne J.H. Van Rooij, Steven E. Bruce, Tanja Jovanovic, Stacey L. House, Francesca L. Beaudoin, Xinming An, Thomas C. Neylan, Gari D. Clifford, Sarah D. Linnstaedt, Laura T. Germine, Kenneth A. Bollen, Scott L. Rauch, John P. Haran, Alan B. Storrow, Christopher Lewandowski, Paul I. Musey, Phyllis L. Hendry, Sophia Sheikh, Christopher W. Jones, Brittany E. Punches, Robert A. Swor, Jose L. Pascual, Mark J. Seamon, Elizabeth M. Datner, Claire Pearson, David A. Peak, Roland C. Merchant, Robert M. Domeier, Niels K. Rathlev, Paulina Sergot, Leon D. Sanchez, Ronald C. Kessler, Karestan C. Koenen, Samuel A. Mclean, Jennifer S. Stevens, Kerry J. Ressler, Nathaniel G. Harnett

Department of Emergency Medicine Faculty Papers

IMPORTANCE: Differences in neighborhood socioeconomic characteristics are important considerations in understanding differences in risk vs resilience in mental health. Neighborhood disadvantage is associated with alterations in the function and structure of threat neurocircuitry.

OBJECTIVE: To investigate associations of neighborhood disadvantage with white and gray matter and neural reactivity to positive and negative stimuli in the context of trauma exposure.

DESIGN, SETTING, AND PARTICIPANTS: In this cross-sectional study, survivors of trauma who completed sociodemographic and posttraumatic symptom assessments and neuroimaging were recruited as part of the Advancing Understanding of Recovery After Trauma (AURORA) study between September 2017 and June 2021. Data …

Multilevel Ossification Of The Posterior Longitudinal Ligament Causing Cervical Myelopathy: An Observational Series Of North American Patients, Jonathan A. Ledesma, Tariq Z. Issa, Mark J. Lambrechts, Cannon Greco Hiranaka, Khoa Tran, Patrick O'Connor, Jose A. Canseco, Alan S. Hilibrand, Christopher K. Kepler, Todd J. Albert, Alex R. Vaccaro, Gregory D. Schroeder, David Greg Anderson

Department of Orthopaedic Surgery Faculty Papers

BACKGROUND: Few studies regarding ossification of the posterior longitudinal ligament (OPLL) outside of Asia currently exist in the literature. A set of patients with multilevel cervical OPLL causing symptomatic myelopathy or radiculopathy from a North American sample is analyzed.

OBJECTIVE: The objective of this study was to describe the demographics, radiographic findings, and surgical outcomes of a cohort of North American patients with degenerative spondylosis presenting for operative management of multilevel (>3 segments) cervical OPLL.

MATERIALS AND METHODS: Forty-three patients diagnosed with multilevel cervical OPLL and degenerative spondylosis presenting with symptomatic cervical myelopathy or radiculopathy were surgically treated over …

Lateral Approach To The Lumbar Spine: The Utility Of An Access Surgeon, Matthew Meade, Yunsoo Lee, Parker Brush, Mark Lambrechts, Eleanor Jenkins, Cristian Desimone, Michael Mccurdy, John Mangan, Jose Canseco, Mark Kurd, Alan Hilibrand, Alexander Vaccaro, Christopher Kepler, Gregory Schroeder

Department of Orthopaedic Surgery Faculty Papers

BACKGROUND: Lateral lumbar interbody fusions (LLIFs) utilize a retroperitoneal approach that avoids the intraperitoneal organs and manipulation of the anterior vasculature encountered in anterior approaches to the lumbar spine. The approach was championed by spinal surgeons; however, general/vasculature surgeons may be more comfortable with the approach.

OBJECTIVE: The objective of this study was to compare short-term outcomes following LLIF procedures based on whether a spine surgeon or access surgeon performed the approach.

MATERIALS AND METHODS: We retrospectively identified all one- to two-level LLIFs at a tertiary care center from 2011 to 2021 for degenerative spine disease. Patients were divided into …

Bilateral Severe Iatrogenic Pigmentary Glaucoma Following Laser Treatment For Cosmetic Iris Color Change, Jiaru Liu, Salim Korban, Marlene R. Moster, Marc-André Rhéaume, Qianqian Wang

Wills Eye Hospital Papers

PURPOSE: We report a case of bilateral severe pigmentary glaucoma and paracentral acute middle maculopathy (PAMM) following laser treatment for iris color change.

OBSERVATIONS: A 32-year-old female presented to our emergency clinic after having undergone 4 sessions of bilateral cosmetic iris laser treatment in Turkey to lighten the color of her dark brown irides. Visual acuity was 20/150 in the right eye (OD) and counting fingers in the left eye (OS) at presentation. Intraocular pressures (IOP) were 50 mmHg in the right eye and 42 mmHg in the left eye, with 4+ free-floating pigmented cells in the anterior chamber. The …

Association Between Number Of Vasopressors And Mortality In Covid-19 Patients, Michael Sunnaa, Mina Kerolos, Max Ruge, Ahmad Gill, Jeanne M. Du-Fay-De-Lavallaz, Perry Robin, Joanne Michelle Dumlao Gomez, Kim Williams, Anupama Rao, Annabelle Santos Volgman, Karolina Marinescu, Tisha Marie Suboc

COVID-19 Papers, Posters, and Presentations

Study objective

Study the clinical outcomes associated with the number of concomitant vasopressors used in critically ill COVID-19 patients.

Design

A single-center retrospective cohort study was conducted on patients admitted with COVID-19 to the intensive care unit (ICU) between March and October 2020.

Setting

Rush University Medical Center, United States.

Participants

Adult patients at least 18 years old with COVID-19 with continuous infusion of any vasopressors were included.

Main outcome measures

60-day mortality in COVID-19 patients by the number of concurrent vasopressors received.

Results

A total of 637 patients met our inclusion criteria, of whom 338 (53.1 %) required the …

The Philadelphia Lung Cancer Learning Community: A Multi-Health-System, Citywide Approach To Lung Cancer Screening, Julie A. Barta, Cherie P. Erkmen, Christine S. Shusted, Ronald E. Myers, Chelsea Saia, Sarah Cohen, Jocelyn Wainwright, Charnita Zeigler-Johnson, Farouk Dako, Richard Wender, Gregory C. Kane, Anil Vachani, Katharine A. Rendle

Division of Pulmonary, Allergy, and Critical Care Medicine Faculty Papers

Background

Lung cancer screening uptake for individuals at high risk is generally low across the United States, and reporting of lung cancer screening practices and outcomes is often limited to single hospitals or institutions. We describe a citywide, multicenter analysis of individuals receiving lung cancer screening integrated with geospatial analyses of neighborhood-level lung cancer risk factors. Methods

The Philadelphia Lung Cancer Learning Community consists of lung cancer screening clinicians and researchers at the 3 largest health systems in the city. This multidisciplinary, multi-institutional team identified a Philadelphia Lung Cancer Learning Community study cohort that included 11 222 Philadelphia residents who …

Ciliochoroidal Melanoma Masquerading As A Conjunctival Nevus, Samantha Pastore, Konica Singla, Carol L. Shields

Wills Eye Hospital Papers

No abstract provided.

Identification Of Sentinel Lymph Nodes In Esophageal Cancer Patients Using Contrast-Enhanced Eus With Peritumoral Injections, Ji-Bin Liu, Priscilla Machado, John R. Eisenbrey, Sriharsha Gummadi, Flemming Forsberg, Corinne E. Wessner, Anand Raman Kumar, Austin Chiang, Anthony Infantolino, Alexander Schlachterman, Thomas Kowalski, Robert Coben, David Loren

Department of Medicine Faculty Papers

OBJECTIVES: The objective of this pilot study was to compare the performance of contrast-enhanced EUS (CE-EUS)-guided fine-needle aspiration (FNA) with EUS-FNA for lymph node (LN) staging in esophageal cancer.

METHODS: Thirty-seven subjects with esophageal cancer undergoing EUS staging were enrolled, and 30 completed this institutional review board-approved study. A Prosound F75 US system (Hitachi Medical Systems, Tokyo, Japan) with harmonic contrast imaging software and GF-UCT180 curvilinear endoscope (Olympus, Tokyo, Japan) was utilized. All LNs identified by standard EUS were first noted. Sonazoid (dose: 1 mL; GE Healthcare, Oslo, Norway) was administered peritumorally, and all enhanced LNs were recorded. Fine-needle aspiration …