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Full-Text Articles in Medical Specialties

Clinical Factors Implicated In Antibiotic Resistance In Helicobacter Pylori Patients, Brian White, Maria Winte, Joshua Desipio, Sangita Phadtare Jan 2022

Clinical Factors Implicated In Antibiotic Resistance In Helicobacter Pylori Patients, Brian White, Maria Winte, Joshua Desipio, Sangita Phadtare

Division of Internal Medicine Faculty Papers & Presentations

Helicobacter pylori is a common gastric pathogen associated with multiple clinical syndromes, including cancer. Eradication rates of H. pylori remain suboptimal despite the progress made in the past few decades in improving treatment strategies. The low eradication rates are mainly driven by antibiotic resistance of H. pylori. Non-invasive molecular testing to identify patients with antibiotic-resistant H. py-lori represents a promising therapeutic avenue, however this technology currently remains limited by availability, costs, and lack of robust validation. Moreover, there is insufficient evidence to demonstrate that resistance-testing-based treatment approaches are superior to appropriately designed empiric strat-egies. Consensus guidelines recommend use of proven …


Radiation Of Meningioma Dural Tail May Not Improve Tumor Control Rates., Keenan Piper, Siyuan Yu, Mohammad Taghvaei, Christian Fernandez, Nikolaos Mouchtouris, Rupert D Smit, Clifford Yudkoff, Sarah Collopy, Maikerly Reyes, Pascal Lavergne, Michael Karsy, Giyarpuram Prashant, Wenyin Shi, James J. Evans Jan 2022

Radiation Of Meningioma Dural Tail May Not Improve Tumor Control Rates., Keenan Piper, Siyuan Yu, Mohammad Taghvaei, Christian Fernandez, Nikolaos Mouchtouris, Rupert D Smit, Clifford Yudkoff, Sarah Collopy, Maikerly Reyes, Pascal Lavergne, Michael Karsy, Giyarpuram Prashant, Wenyin Shi, James J. Evans

Student Papers, Posters & Projects

Introduction: Dural tails are thickened contrast-enhancing portions of dura associated with some meningiomas. Prior studies have demonstrated the presence of tumor cells within the dural tail, however their inclusion in radiation treatment fields remains controversial. We evaluated the role of including the dural tail when treating a meningioma with stereotactic radiation and the impact on tumor recurrence.

Methods: This is a retrospective, single-institution, cohort study of patients with intracranial World Health Organization (WHO) grade 1 meningioma and identified dural tail who were treated with stereotactic radiosurgery (SRS) or fractionated stereotactic radiotherapy (FSRT) from January 2012 to December 2018. SRS and …


Resting-State Functional Mri Metrics In Patients With Chronic Mild Traumatic Brain Injury And Their Association With Clinical Cognitive Performance., Faezeh Vedaei, Andrew B. Newberg, Md, Mahdi Alizadeh, Jennifer Muller, Shiva Shahrampour, Devon Middleton, Ms, George Zabrecky, Nancy Wintering, Anthony J. Bazzan Md, Daniel A. Monti, Md, Feroze Mohamed, Phd Dec 2021

Resting-State Functional Mri Metrics In Patients With Chronic Mild Traumatic Brain Injury And Their Association With Clinical Cognitive Performance., Faezeh Vedaei, Andrew B. Newberg, Md, Mahdi Alizadeh, Jennifer Muller, Shiva Shahrampour, Devon Middleton, Ms, George Zabrecky, Nancy Wintering, Anthony J. Bazzan Md, Daniel A. Monti, Md, Feroze Mohamed, Phd

Department of Radiology Faculty Papers

Mild traumatic brain injury (mTBI) accounts for more than 80% of people experiencing brain injuries. Symptoms of mTBI include short-term and long-term adverse clinical outcomes. In this study, resting-state functional magnetic resonance imaging (rs-fMRI) was conducted to measure voxel-based indices including fractional amplitude of low-frequency fluctuation (fALFF), regional homogeneity (ReHo), and functional connectivity (FC) in patients suffering from chronic mTBI; 64 patients with chronic mTBI at least 3 months post injury and 40 healthy controls underwent rs-fMRI scanning. Partial correlation analysis controlling for age and gender was performed within mTBI cohort to explore the association between rs-fMRI metrics and neuropsychological …


Intraoperative Acoustics: Auditory Cues In Hip Reconstructive Surgery, Jeffrey M. Henstenburg, Walaa Abdelfadeel, Anthony J. Boniello, Joseph Schmitz, Jeffrey J. Vakil, Andrew M. Star Dec 2021

Intraoperative Acoustics: Auditory Cues In Hip Reconstructive Surgery, Jeffrey M. Henstenburg, Walaa Abdelfadeel, Anthony J. Boniello, Joseph Schmitz, Jeffrey J. Vakil, Andrew M. Star

Rothman Institute Papers

Background: Orthopaedic surgeons rely on visual and tactile cues to guide performance in the operating room (OR). However, there is very little data on how sound changes during orthopaedic procedures and how surgeons incorporate audio feedback to guide performance. This study attempts to define meaningful
changes in sound during vital aspects of total hip arthroplasty (THA) within the spectrum of human hearing.

Methods: 84 audio recordings were obtained during primary elective THA procedures during sawing of the femoral neck, reaming of the acetabulum, acetabular cup impaction, polyethylene liner impaction, femoral broaching, planning of the femoral calcar and press-fit of a …


Personalized Nutrition As A Key Contributor To Improving Radiation Response In Breast Cancer, Anuradha A. Shastri, Joseph Lombardo, Samantha C Okere, Stephanie Higgins, Brittany C Smith, Tiziana Deangelis, Ajay Palagani, Kamryn Hines, Daniel A. Monti, Stella Volpe, Edith P. Mitchell, Nicole L Simone Dec 2021

Personalized Nutrition As A Key Contributor To Improving Radiation Response In Breast Cancer, Anuradha A. Shastri, Joseph Lombardo, Samantha C Okere, Stephanie Higgins, Brittany C Smith, Tiziana Deangelis, Ajay Palagani, Kamryn Hines, Daniel A. Monti, Stella Volpe, Edith P. Mitchell, Nicole L Simone

Department of Radiation Oncology Faculty Papers

Understanding metabolic and immune regulation inherent to patient populations is key to improving the radiation response for our patients. To date, radiation therapy regimens are prescribed based on tumor type and stage. Patient populations who are noted to have a poor response to radiation such as those of African American descent, those who have obesity or metabolic syndrome, or senior adult oncology patients, should be considered for concurrent therapies with radiation that will improve response. Here, we explore these populations of breast cancer patients, who frequently display radiation resistance and increased mortality rates, and identify the molecular underpinnings that are, …


Platelet Micrornas Inhibit Primary Tumor Growth Via Broad Modulation Of Tumor Cell Mrna Expression In Ectopic Pancreatic Cancer In Mice, Jeremy G.T. Wurtzel, Sophia Lazar, Sonali Sikder, Kathy Q Cai, Igor Astsaturov, Andrew S Weyrich, Jesse W Rowley, Lawrence E. Goldfinger Dec 2021

Platelet Micrornas Inhibit Primary Tumor Growth Via Broad Modulation Of Tumor Cell Mrna Expression In Ectopic Pancreatic Cancer In Mice, Jeremy G.T. Wurtzel, Sophia Lazar, Sonali Sikder, Kathy Q Cai, Igor Astsaturov, Andrew S Weyrich, Jesse W Rowley, Lawrence E. Goldfinger

Department of Medicine Faculty Papers

We investigated the contributions of platelet microRNAs (miRNAs) to the rate of growth and regulation of gene expression in primary ectopic tumors using mouse models. We previously identified an inhibitory role for platelets in solid tumor growth, mediated by tumor infiltration of platelet microvesicles (microparticles) which are enriched in platelet-derived miRNAs. To investigate the specific roles of platelet miRNAs in tumor growth models, we implanted pancreatic ductal adenocarcinoma cells as a bolus into mice with megakaryocyte-/platelet-specific depletion of mature miRNAs. We observed an ~50% increase in the rate of growth of ectopic primary tumors in these mice compared to controls …


Eliminating Contamination In Umbilical Cord Blood Culture Sampling For Early-Onset Neonatal Sepsis., Vilmaris Quinones Cardona, Vanessa Lowery, David Cooperberg, Endla K Anday, Alison J Carey Dec 2021

Eliminating Contamination In Umbilical Cord Blood Culture Sampling For Early-Onset Neonatal Sepsis., Vilmaris Quinones Cardona, Vanessa Lowery, David Cooperberg, Endla K Anday, Alison J Carey

Department of Pediatrics Faculty Papers

Introduction: Despite the advantages of umbilical cord blood culture (UCBC) use for diagnosis of early onset sepsis (EOS), contamination rates have deterred neonatologists from its widespread use. We aimed to implement UCBC collection in a level III neonatal intensive care unit (NICU) and apply quality improvement (QI) methods to reduce contamination in the diagnosis of early onset sepsis. Methods: Single-center implementation study utilizing quality improvement methodology to achieve 0% contamination rate in UCBC samples using the Plan-Do-Study-Act (PDSA) model for improvement. UCBC was obtained in conjunction with peripheral blood cultures (PBC) in neonates admitted to the NICU due to maternal …


The Effects Of Physical Activity On Cancer Patients Undergoing Treatment With Immune Checkpoint Inhibitors: A Scoping Review., Amy L Shaver, Swapnil Sharma, Nikita Nikita, Daniel S Lefler, Atrayee Basu-Mallick, Jennifer M Johnson, Meghan Butryn, Grace Lu-Yao Dec 2021

The Effects Of Physical Activity On Cancer Patients Undergoing Treatment With Immune Checkpoint Inhibitors: A Scoping Review., Amy L Shaver, Swapnil Sharma, Nikita Nikita, Daniel S Lefler, Atrayee Basu-Mallick, Jennifer M Johnson, Meghan Butryn, Grace Lu-Yao

Department of Medical Oncology Faculty Papers

BACKGROUND: Cancer therapies are associated with multiple adverse effects, including (but not limited to) cancer-related fatigue (CRF). Fatigue is one of the most common side effects of immune checkpoint inhibitors (ICIs), occurring in up to 25% of patients. Physical activity has been shown to help reduce CRF through modulating the immune system, and may synergistically aid in the anti-tumor effects of ICIs. This review describes the nature and scope of evidence for the effects associated with concurrent physical activity while undergoing ICI therapy.

METHOD: Scoping review methodology was utilized to identify studies, extract data, and collate and summarize results.

RESULTS: …


Endovascular Approach In The Management Of Idiopathic Myointimal Hyperplasia Of The Inferior Mesenteric Vein, Yash B Shah, Derek Lee, Tamim S Khaddash Dec 2021

Endovascular Approach In The Management Of Idiopathic Myointimal Hyperplasia Of The Inferior Mesenteric Vein, Yash B Shah, Derek Lee, Tamim S Khaddash

Department of Medicine Faculty Papers

Background: Idiopathic myointimal hyperplasia of the mesenteric vein (IMHMV) is a rare, often undiagnosed pathology affecting the colon. Patients typically present with severe abdominal pain and inflammation caused by smooth muscle proliferation of the veins, leading to arterialization, stenosis, and potential occlusion. The etiology remains unclear, but it has been hypothesized that an arteriovenous connection may be associated with the pathology. This is the first reported case indicating such an association. This case additionally highlights the potential utility of endovascular treatment, as endovascular embolization is generally a less invasive alternative to surgical resection in the treatment of such vascular disorders. …


The Effects Of Physical Activity On Cancer Patients Undergoing Treatment With Immune Checkpoint Inhibitors: A Scoping Review, Amy L Shaver, Swapnil Sharma, Nikita Nikita, Daniel S Lefler, Atrayee Basu Mallick, Jennifer Johnson, Meghan Butryn, Grace Lu-Yao Dec 2021

The Effects Of Physical Activity On Cancer Patients Undergoing Treatment With Immune Checkpoint Inhibitors: A Scoping Review, Amy L Shaver, Swapnil Sharma, Nikita Nikita, Daniel S Lefler, Atrayee Basu Mallick, Jennifer Johnson, Meghan Butryn, Grace Lu-Yao

Department of Medical Oncology Faculty Papers

Background: Cancer therapies are associated with multiple adverse effects, including (but not limited to) cancer-related fatigue (CRF). Fatigue is one of the most common side effects of immune checkpoint inhibitors (ICIs), occurring in up to 25% of patients. Physical activity has been shown to help reduce CRF through modulating the immune system, and may synergistically aid in the anti-tumor effects of ICIs. This review describes the nature and scope of evidence for the effects associated with concurrent physical activity while undergoing ICI therapy.

Method: Scoping review methodology was utilized to identify studies, extract data, and collate and summarize results.

Results: …


The Relationship Between Discoid Meniscus And Articular Cartilage Thickness: A Quantitative Observational Study With Mri, Joseph Brutico, Margaret Wright, Sarah Kamel, Adam C Zoga, Kirsten Poehling-Monaghan, Sommer Hammoud Dec 2021

The Relationship Between Discoid Meniscus And Articular Cartilage Thickness: A Quantitative Observational Study With Mri, Joseph Brutico, Margaret Wright, Sarah Kamel, Adam C Zoga, Kirsten Poehling-Monaghan, Sommer Hammoud

Rothman Institute Papers

Background: Several cadaveric imaging studies have demonstrated that the articular cartilage thickness on the tibial plateau varies depending on coverage by native meniscal tissue. These differences are thought to partially contribute to the rates of cartilage degeneration and development of osteoarthritis after meniscectomy. Because there is greater tibial plateau coverage with meniscal tissue in the setting of a discoid meniscus, these findings may also have implications for the long-term health of the knee after saucerization of a torn discoid meniscus.

Purpose: To evaluate the relationship between lateral compartment articular cartilage thickness and the presence or absence of a discoid meniscus. …


Utility Of S100a12 As An Early Biomarker In Patients With St-Segment Elevation Myocardial Infarction, Xiaolin Zhang, Minghui Cheng, Naijing Gao, Yi Li, Chenghui Yan, Xiaoxiang Tian, Dan Liu, Miaohan Qiu, Xiaozeng Wang, Bo Luan, Jie Deng, Shouli Wang, Hongyan Tian, Geng Wang, Xin-Liang Ma, Gregg W Stone, Yaling Han Dec 2021

Utility Of S100a12 As An Early Biomarker In Patients With St-Segment Elevation Myocardial Infarction, Xiaolin Zhang, Minghui Cheng, Naijing Gao, Yi Li, Chenghui Yan, Xiaoxiang Tian, Dan Liu, Miaohan Qiu, Xiaozeng Wang, Bo Luan, Jie Deng, Shouli Wang, Hongyan Tian, Geng Wang, Xin-Liang Ma, Gregg W Stone, Yaling Han

Department of Emergency Medicine Faculty Papers

Importance: S100A12 is a calcium binding protein which is involved in inflammation and progression of atherosclerosis.

Objective: We sought to investigate the utility of S100A12 as a biomarker for the early diagnosis and prognostication of patients presenting with ST-segment elevation myocardial infarction (STEMI).

Design, Setting, and Participants: S100A12 was measured in 1023 patients presenting to the emergency department with acute chest pain between June 2012 and November 2015. An independent cohort of 398 patients enrolled at 3 different hospitals served as a validation cohort.

Main Outcomes and Measures: The primary clinical endpoint of interest was major adverse cardiac and cerebral …


Risk Factors For Poor Outcomes Among Patients With Extensively Drug-Resistant Tuberculosis (Xdr-Tb): A Scoping Review, Karan Varshney, Beverly Anaele, Matthew Molaei, Rosemary Frasso, Vittorio Maio Dec 2021

Risk Factors For Poor Outcomes Among Patients With Extensively Drug-Resistant Tuberculosis (Xdr-Tb): A Scoping Review, Karan Varshney, Beverly Anaele, Matthew Molaei, Rosemary Frasso, Vittorio Maio

College of Population Health Faculty Papers

In recent years, there has been an upsurge in cases of drug-resistant TB, and strains of TB resistant to all forms of treatment have begun to emerge; the highest level of resistance is classified as extensively drug-resistant tuberculosis (XDR-TB). There is an urgent need to prevent poor outcomes (death/default/failed treatment) of XDR-TB, and knowing the risk factors can inform such efforts. The objective of this scoping review was to therefore identify risk factors for poor outcomes among XDR-TB patients. We searched three scientific databases, PubMed, Scopus, and ProQuest, and identified 25 articles that examined relevant risk factors. Across the included …


Abdominal Paraganglioma In A Patient With Fever Of Unknown Origin, Samantha Sokoloff, Barbara Simon Dec 2021

Abdominal Paraganglioma In A Patient With Fever Of Unknown Origin, Samantha Sokoloff, Barbara Simon

Department of Medicine Faculty Papers

Reaxys Chemistry database information SciVal Topics Funding details

Abstract

Introduction: Paragangliomas have a wide range of clinical presentations. A significant portion of these tumors are discovered as abdominal masses on imaging or palpation in patients without typical symptoms of catecholamine excess [1]. This case reports a 28-year-old female who presented with fever of unknown origin and was found to have an abdominal mass on CT imaging. This mass was biopsied prior to a complete evaluation and confirmed to be a paraganglioma. Case report: We discuss the case of a 28 year-old-female who presented to the Endocrinology office after she was …


Inhibition Of Nadph Oxidase Blocks Netosis And Reduces Thrombosis In Heparin-Induced Thrombocytopenia, Halina H L Leung, Jose Perdomo, Zohra Ahmadi, Feng Yan, Steven E. Mckenzie, Beng H Chong Dec 2021

Inhibition Of Nadph Oxidase Blocks Netosis And Reduces Thrombosis In Heparin-Induced Thrombocytopenia, Halina H L Leung, Jose Perdomo, Zohra Ahmadi, Feng Yan, Steven E. Mckenzie, Beng H Chong

Department of Medicine Faculty Papers

Heparin-induced thrombocytopenia (HIT) is associated with severe and potentially lethal thrombotic complications. NETosis was recently shown to be an important driver of thrombosis in HIT. We investigated the role of reactive oxygen species (ROS) and nicotinamide adenine dinucleotide phosphate (NADPH) oxidase 2 (NOX2) and their contributions to thrombus development in HIT. We showed that neutrophil activation by HIT immune complexes induced ROS-dependent NETosis. Analysis of thrombi formed in a microfluidics system showed ROS production in both platelets and neutrophils, and abundant neutrophil extracellular traps (NETs) and ROS distributed throughout the clot. Neutrophil-targeted ROS inhibition was sufficient to block HIT-induced NETosis …


Beyond The Raskin Protocol: Ketamine, Lidocaine, And Other Therapies For Refractory Chronic Migraine., Jeffrey J. Mojica, Eric S. Schwenk, Clinton Lauritsen, Stephanie J. Nahas Dec 2021

Beyond The Raskin Protocol: Ketamine, Lidocaine, And Other Therapies For Refractory Chronic Migraine., Jeffrey J. Mojica, Eric S. Schwenk, Clinton Lauritsen, Stephanie J. Nahas

Department of Anesthesiology Faculty Papers

PURPOSE OF REVIEW: The purpose of this review is to discuss the available evidence and therapeutic considerations for intravenous drug therapy for refractory chronic migraine.

RECENT FINDINGS: In carefully monitored settings, the inpatient administration of intravenous lidocaine and ketamine can be successful in treating refractory chronic migraine. Many patients with refractory chronic migraine have experienced treatment failure with the Raskin protocol. The use of aggressive inpatient infusion therapy consisting of intravenous lidocaine or ketamine, along with other adjunctive medications, has become increasingly common for these patients when all other treatments have failed. There is a clear need for prospective studies …


Evaluation Of Pediatric Rheumatology Telehealth Satisfaction During The Covid-19 Pandemic, Lindsay N Waqar-Cowles, John Chuo, Pamela F Weiss, Sabrina Gmuca, Marianna Lanoue, Jon M Burnham Dec 2021

Evaluation Of Pediatric Rheumatology Telehealth Satisfaction During The Covid-19 Pandemic, Lindsay N Waqar-Cowles, John Chuo, Pamela F Weiss, Sabrina Gmuca, Marianna Lanoue, Jon M Burnham

College of Population Health Faculty Papers

Background: During the Coronavirus disease 2019 pandemic, ambulatory pediatric rheumatology healthcare rapidly transformed to a mainly telehealth model. However, pediatric patient and caregiver satisfaction with broadly deployed telehealth programs remains largely unknown. This study aimed to evaluate patient/caregiver satisfaction with telehealth and identify the factors associated with satisfaction in a generalizable sample of pediatric rheumatology patients.

Methods: Patients with an initial telehealth video visit with a rheumatology provider between April and June 2020 were eligible. All patients/caregivers were sent a post-visit survey to assess a modified version of the Telehealth Usability Questionnaire (TUQ) and demographic and clinical characteristics. TUQ total …


Coping In Pediatric Burn Survivors And Its Relation To Social Functioning And Self-Concept, Mira D H Snider, Sarah Young, Paul T Enlow, Corrine Ahrabi-Nejad, Ariel M Aballay, Christina L Duncan Dec 2021

Coping In Pediatric Burn Survivors And Its Relation To Social Functioning And Self-Concept, Mira D H Snider, Sarah Young, Paul T Enlow, Corrine Ahrabi-Nejad, Ariel M Aballay, Christina L Duncan

Department of Pediatrics Faculty Papers

Pediatric burn survivors experience increased risk for bullying, stigmatization, body image concerns, and problematic social functioning. Although coping behaviors are associated with engagement in social supports and positive self-concept in multiple pediatric illness populations, their relation has not been examined in pediatric burns. This study examined coping in relation to social functioning and self-concept in 51 pediatric burn survivors aged 7–17years (M=12.54; SD=2.65). Survivors and their caregivers completed the Child Coping Strategies Checklist (CCSC; youth report); the Burn Injury Social Questionnaire (BISQ; parent and youth report); and the Piers-Harris Children’s Self-Concept Scale-2 (PH-2; youth report). Associations between coping, social functioning, …


Sox10 Requirement For Melanoma Tumor Growth Is Due, In Part, To Immune-Mediated Effects, Sheera Rosenbaum, Manoela Tiago, Signe Caksa, Claudia Capparelli, Timothy J. Purwin, Gaurav Kumar, Mckenna Glasheen, Danielle Pomante, Daniel Kotas, I Chervoneva, A E Aplin Dec 2021

Sox10 Requirement For Melanoma Tumor Growth Is Due, In Part, To Immune-Mediated Effects, Sheera Rosenbaum, Manoela Tiago, Signe Caksa, Claudia Capparelli, Timothy J. Purwin, Gaurav Kumar, Mckenna Glasheen, Danielle Pomante, Daniel Kotas, I Chervoneva, A E Aplin

Department of Cancer Biology Faculty Papers

Developmental factors may regulate the expression of immune modulatory proteins in cancer, linking embryonic development and cancer cell immune evasion. This is particularly relevant in melanoma because immune checkpoint inhibitors are commonly used in the clinic. SRY-box transcription factor 10 (SOX10) mediates neural crest development and is required for melanoma cell growth. In this study, we investigate immune-related targets of SOX10 and observe positive regulation of herpesvirus entry mediator (HVEM) and carcinoembryonic-antigen cell-adhesion molecule 1 (CEACAM1). Sox10 knockout reduces tumor growth in vivo, and this effect is exacerbated in immune-competent models. Modulation of CEACAM1 expression but not HVEM elicits modest …


Ivermectin Induces Apoptosis Of Esophageal Squamous Cell Carcinoma Via Mitochondrial Pathway, Nana Xu, Mengmeng Lu, Jiaxin Wang, Yujia Li, Xiaotian Yang, Xiajie Wei, Jiaoyang Si, Jingru Han, Xiaojuan Yao, Juanmei Zhang, Junqi Liu, Yanming Li, Hushan Yang, Dengke Bao Dec 2021

Ivermectin Induces Apoptosis Of Esophageal Squamous Cell Carcinoma Via Mitochondrial Pathway, Nana Xu, Mengmeng Lu, Jiaxin Wang, Yujia Li, Xiaotian Yang, Xiajie Wei, Jiaoyang Si, Jingru Han, Xiaojuan Yao, Juanmei Zhang, Junqi Liu, Yanming Li, Hushan Yang, Dengke Bao

Department of Medical Oncology Faculty Papers

Background: Esophageal squamous cell carcinoma (ESCC) is the most predominant primary malignant tumor among worldwide, especially in China. To date, the successful treatment remains a mainly clinical challenge, it is imperative to develop successful therapeutic agents.

Methods: The anti-proliferative effect of ivermectin on ESCC is investigated in cell model and in nude mice model. Cell apoptosis was assessed using flow cytometry, TUNEL assay and western blotting. Mitochondrial dysfunction was determined by reactive oxygen species accumulation, mitochondrial membrane potential and ATP levels.

Results: Our results determined that ivermectin significantly inhibited the proliferation of ESCC cells in vitro and in vivo. Furthermore, …


Dual-Mobility Implants And Constrained Liners In Revision Total Hip Arthroplasty, Emanuele Chisari, Blair Ashley, Ryan Sutton, Garrett Largoza, Marco Dispagna, Nitin Goyal, P. Maxwell Courtney, Javad Parvizi Dec 2021

Dual-Mobility Implants And Constrained Liners In Revision Total Hip Arthroplasty, Emanuele Chisari, Blair Ashley, Ryan Sutton, Garrett Largoza, Marco Dispagna, Nitin Goyal, P. Maxwell Courtney, Javad Parvizi

Rothman Institute Papers

Background

Instability remains the most common complication after revision total hip arthroplasty (THA). The purpose of this study was to determine whether there was a difference in aseptic revision rates and survivorship between dual-mobility (DM) and constrained liners (CL) in revision THA.

Methods

We reviewed a consecutive series of 2432 revision THA patients from 2008 to 2019 at our institution and identified all patients who received either a CL or DM bearing. We compared demographics, comorbidities, indications, dislocations, and aseptic failure rates between the two groups. Bivariate and multivariate regression analyses were used to determine risk factors for failure, and …


Metabolic Pathways And Targets In Chondrosarcoma, Ida Micaily, Megan E Roche, Mohammad Y Ibrahim, Ubaldo E. Martinez-Outshoorn, Atrayee Basu Mallick Dec 2021

Metabolic Pathways And Targets In Chondrosarcoma, Ida Micaily, Megan E Roche, Mohammad Y Ibrahim, Ubaldo E. Martinez-Outshoorn, Atrayee Basu Mallick

Department of Medical Oncology Faculty Papers

Chondrosarcomas are the second most common primary bone malignancy. Chondrosarcomas are characterized by the production of cartilaginous matrix and are generally resistant to radiation and chemotherapy and the outcomes are overall poor. Hence, there is strong interest in determining mechanisms of cancer aggressiveness and therapeutic resistance in chondrosarcomas. There are metabolic alterations in chondrosarcoma that are linked to the epigenetic state and tumor microenvironment that drive treatment resistance. This review focuses on metabolic changes in chondrosarcoma, and the relationship between signaling via isocitrate dehydrogenase 1 and 2 (IDH1 and IDH2), hedgehog, PI3K-mTOR-AKT, and SRC, as well as histone acetylation and …


Mistrust, Neighborhood Deprivation, And Telehealth Use In African Americans With Diabetes., Barry W. Rovner, Robin J. Casten, Anna Marie Chang, Judd E. Hollander, Kristin Rising Dec 2021

Mistrust, Neighborhood Deprivation, And Telehealth Use In African Americans With Diabetes., Barry W. Rovner, Robin J. Casten, Anna Marie Chang, Judd E. Hollander, Kristin Rising

Department of Emergency Medicine Faculty Papers

This study explored the relationship between trust in physicians and telehealth use during the COVID pandemic in 162 African Americans with diabetes. More than 90% of patients had internet-capable devices and internet service but only 61 patients (39%) had a telehealth visit. Compared to the latter, participants with no telehealth visits had less trust in physicians' ability to diagnose COVID, less trust in physicians' ability to treat via telehealth, and resided in more deprived neighborhoods. There were no differences in age, sex, education, nor literacy. For African Americans with diabetes, health disparities may increase unless fundamental issues such as trust …


The Transition To Peer Learning, C. G. Roth, H. V. Naringrekar, A. E. Flanders Dec 2021

The Transition To Peer Learning, C. G. Roth, H. V. Naringrekar, A. E. Flanders

Department of Radiology Posters

Problem Description: Historically, peer review has been compelled by regulatory and legislative mandates, such as the Joint Commission Ongoing Professional Practice Evaluation (OPPE) requirement and the Health Care Quality Improvement Act (HCQIA) enacted by Congress in 1986. [1] However, these external mandates were focused on quality assurance, generally carrying punitive connotations and practically translated into rote compliance without the benefit of learning and improvement. In fact, the lack of quality improvement focus prompted the Institute of Medicine (IOM) to release its 2015 report, “Improving Diagnosis in Health Care,” stating that a “critical type of error in health care—diagnostic error—has received …


Association Between Sex And Immune Checkpoint Inhibitor Outcomes For Patients With Melanoma., Se Ryeong Jang, Nikita Nikita, Joshua Banks, Scott W. Keith, Jennifer M. Johnson, Melissa Wilson, Grace Lu-Yao Dec 2021

Association Between Sex And Immune Checkpoint Inhibitor Outcomes For Patients With Melanoma., Se Ryeong Jang, Nikita Nikita, Joshua Banks, Scott W. Keith, Jennifer M. Johnson, Melissa Wilson, Grace Lu-Yao

Kimmel Cancer Center Faculty Papers

Importance: Immune checkpoint inhibitors (ICIs) have revolutionized melanoma treatment and are now standard of care. Although sex is associated with immune function and immune-related diseases, the interaction between sex and ICIs is understudied.

Objective: To examine whether cancer immunotherapy effectiveness varies between female and male patients with advanced melanoma treated with either nivolumab plus ipilimumab combination therapy or anti-programmed cell death protein 1 (PD-1) therapy (namely, pembrolizumab or nivolumab).

Design, Setting, and Participants: The study population consisted of 1369 older adults (aged ≥65 years) with a record of melanoma diagnosis from January 1, 1991, to December 31, 2015, in the …


Reduced Risk Of Reoperations With Modern Deep Brain Stimulator Systems: Big Data Analysis From A United States Claims Database, Chengyuan Wu, Sean J Nagel, Rahul Agarwal, Monika Pötter-Nerger, Wolfgang Hamel, Ashwini Sharan, Allison T Connolly, Binith Cheeran, Paul S Larson Dec 2021

Reduced Risk Of Reoperations With Modern Deep Brain Stimulator Systems: Big Data Analysis From A United States Claims Database, Chengyuan Wu, Sean J Nagel, Rahul Agarwal, Monika Pötter-Nerger, Wolfgang Hamel, Ashwini Sharan, Allison T Connolly, Binith Cheeran, Paul S Larson

Department of Neurosurgery Faculty Papers

Objective: There have been significant improvements in the design and manufacturing of deep brain stimulation (DBS) systems, but no study has considered the impact of modern systems on complications. We sought to compare the relative occurrence of reoperations after de novo implantation of modern and traditional DBS systems in patients with Parkinson's disease (PD) or essential tremor (ET) in the United States.

Design: Retrospective, contemporaneous cohort study.

Setting: Multicenter data from the United States Centers for Medicare and Medicaid Services administrative claims database between 2016 and 2018.

Participants: This population-based sample consisted of 5,998 patients implanted with a DBS system, …


Durable Response To Brentuximab Vedotin Plus Cyclophosphamide, Doxorubicin, And Prednisone (Bv-Chp) In A Patient With Cd30-Positive Ptcl Arising As A Post-Transplant Lymphoproliferative Disorder (Ptld), Jennifer Hong, William T Johnson, Saritha Kartan, Anitha S Gonsalves, Jonathan M. Fenkel, Jerald Z. Gong, Pierluigi Porcu Dec 2021

Durable Response To Brentuximab Vedotin Plus Cyclophosphamide, Doxorubicin, And Prednisone (Bv-Chp) In A Patient With Cd30-Positive Ptcl Arising As A Post-Transplant Lymphoproliferative Disorder (Ptld), Jennifer Hong, William T Johnson, Saritha Kartan, Anitha S Gonsalves, Jonathan M. Fenkel, Jerald Z. Gong, Pierluigi Porcu

Department of Medical Oncology Faculty Papers

T-cell PTLDs are lymphoid proliferations that develop in recipients of SOT or allogeneic HSCT. They carry an extremely poor prognosis with a reported median survival of only 6 months. The infrequency with which they are encountered makes treatment a challenge due to the lack of prospective trials to guide management. The significantly higher risk of morbidity and mortality in T-cell PTLD, compared to B-cell PTLD, underscores the challenge of treating these patients and the need for new therapeutic options. Brentuximab vedotin, an ADC targeting CD30, is FDA-approved in combination with CHP as front-line treatment for patients with CD30 expressing PTCL. …


Imaging And Treatment Of Posttraumatic Ankle And Hindfoot Osteoarthritis, Tetyana Gorbachova, Yulia V. Melenevsky, L. Daniel Latt, Jennifer S. Weaver, Mihra S. Taljanovic Dec 2021

Imaging And Treatment Of Posttraumatic Ankle And Hindfoot Osteoarthritis, Tetyana Gorbachova, Yulia V. Melenevsky, L. Daniel Latt, Jennifer S. Weaver, Mihra S. Taljanovic

Department of Radiology Faculty Papers

Posttraumatic osteoarthritis of the ankle and hindfoot is a common and frequently debil-itating disorder. 70% to 90% of ankle osteoarthritis is related to prior trauma that encompasses a spectrum of disorders including fractures and ligamentous injuries that either disrupt the articular surface or result in instability of the joint. In addition to clinical evaluation, imaging plays a sub-stantial role in the treatment planning of posttraumatic ankle and hindfoot osteoarthritis. Imaging evaluation must be tailored to specific clinical scenarios and includes weight bearing radiography that utilizes standard and specialty views, computed tomography which can be performed with a standard or a …


Metabolic Syndrome And Acute Respiratory Distress Syndrome In Hospitalized Patients With Covid-19, Joshua L Denson, Aaron S Gillet, Yuanhao Zu, Margo Brown, Thaidan Pham, Yilin Yoshida, Franck Mauvais-Jarvis, Ivor S Douglas, Mathew Moore, Kevin Tea, Andrew Wetherbie, Rachael Stevens, John Lefante, Jeffrey G Shaffer, Donna Lee Armaignac, Katherine Belden, Margit Kaufman, Smith F Heavner, Valerie C Danesh, Sreekanth R Cheruku, Catherine A St Hill, Karen Boman, Neha Deo, Vikas Bansal, Vishakha K Kumar, Allan J Walkey, Rahul Kashyap, Society Of Critical Care Medicine Discovery Viral Infection And Respiratory Illness Universal Study (Virus): Covid-19 Registry Investigator Group Dec 2021

Metabolic Syndrome And Acute Respiratory Distress Syndrome In Hospitalized Patients With Covid-19, Joshua L Denson, Aaron S Gillet, Yuanhao Zu, Margo Brown, Thaidan Pham, Yilin Yoshida, Franck Mauvais-Jarvis, Ivor S Douglas, Mathew Moore, Kevin Tea, Andrew Wetherbie, Rachael Stevens, John Lefante, Jeffrey G Shaffer, Donna Lee Armaignac, Katherine Belden, Margit Kaufman, Smith F Heavner, Valerie C Danesh, Sreekanth R Cheruku, Catherine A St Hill, Karen Boman, Neha Deo, Vikas Bansal, Vishakha K Kumar, Allan J Walkey, Rahul Kashyap, Society Of Critical Care Medicine Discovery Viral Infection And Respiratory Illness Universal Study (Virus): Covid-19 Registry Investigator Group

Division of Infectious Diseases and Environmental Medicine Faculty Papers

Importance: Obesity, diabetes, and hypertension are common comorbidities in patients with severe COVID-19, yet little is known about the risk of acute respiratory distress syndrome (ARDS) or death in patients with COVID-19 and metabolic syndrome.

Objective: To determine whether metabolic syndrome is associated with an increased risk of ARDS and death from COVID-19.

Design, setting, and participants: This multicenter cohort study used data from the Society of Critical Care Medicine Discovery Viral Respiratory Illness Universal Study collected from 181 hospitals across 26 countries from February 15, 2020, to February 18, 2021. Outcomes were compared between patients with metabolic syndrome (defined …


Prevalence Of Chronic Disease In Older Adults In Multitier Eye-Care Facilities In South India: Electronic Medical Records-Driven Big Data Analytics Report, Umesh Chandra Behera, Brooke Salzman, Anthony Vipin Das, Gumpili Sai Prashanthi, Parth Lalakia, Richard Derman, Bharat Panigrahy Dec 2021

Prevalence Of Chronic Disease In Older Adults In Multitier Eye-Care Facilities In South India: Electronic Medical Records-Driven Big Data Analytics Report, Umesh Chandra Behera, Brooke Salzman, Anthony Vipin Das, Gumpili Sai Prashanthi, Parth Lalakia, Richard Derman, Bharat Panigrahy

Department of Family & Community Medicine Faculty Papers

Purpose: To study the prevalence of systemic conditions in older adults, either self-reported or discovered during routine eye examinations, at multitier eye-care facilities over the past decade, and to explore their association with vision and common ocular disorders, including cataract, glaucoma, and retinopathy.

Methods: Retrospective review of a large data set compiled from the electronic medical records of patients older than 60 years who presented to an eye facility of a multitier ophthalmology network located in 200 different geographical locations that included urban and rural eye-care centers spread across four states in India over a 10-year period.

Results: 618,096 subjects …