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Articles 3271 - 3300 of 8417

Full-Text Articles in Medical Specialties

Gut Permeability And Osteoarthritis, Towards A Mechanistic Understanding Of The Pathogenesis: A Systematic Review, Giorgio Guido, Guido Ausenda, Veronica Iascone, Emanuele Chisari Dec 2021

Gut Permeability And Osteoarthritis, Towards A Mechanistic Understanding Of The Pathogenesis: A Systematic Review, Giorgio Guido, Guido Ausenda, Veronica Iascone, Emanuele Chisari

Rothman Institute Papers

Osteoarthritis (OA) is the most common condition affecting human joints. Along with mechanical and genetic factors, low-grade inflammation is increasingly supported as a causal factor in the development of OA. Gut microbiota and intestinal permeability, via the disruption of tight junction competency, are proposed to explain a gut-joint axis through the interaction with the host immune system. Since previous studies and methods have underestimated the role of the gut-joint axis in OA and have only focussed on the characterisation of microbiota phenotypes, this systematic review aims to appraise the current evidence concerning the influence of gut permeability in the pathogenesis …


Commentary: Zoom Into The Coronary Anastomosis During Coronavirus Disease 2019 (Covid-19), Danial Ahmad, Vakhtang Tchantchaleishvili Dec 2021

Commentary: Zoom Into The Coronary Anastomosis During Coronavirus Disease 2019 (Covid-19), Danial Ahmad, Vakhtang Tchantchaleishvili

Division of Cardiology Faculty Papers

No abstract provided.


Vte And Anticoagulation In Menstruating Women, Ida Micaily, Bethany T. Samuelson Bannow Dec 2021

Vte And Anticoagulation In Menstruating Women, Ida Micaily, Bethany T. Samuelson Bannow

Department of Medicine Faculty Papers

Women of childbearing potential have a high prevalence of venous thromboembolism (VTE) due to high estrogen states, such as pregnancy and the use of estrogen-containing contraceptives. Abnormal uterine bleeding (AUB) affects up to two-thirds of menstruating women on anticoagulation (AC), and can severely impair a woman's quality of life. Rates of heavy menstrual bleeding (HMB) and other forms of AUB including inter-menstrual and postmenopausal bleeding are consistently underreported in the original clinical trials utilizing AC. VTE can occur at any time in a woman's life, and the aim of this review article is to discuss the current landscape of literature …


Assessment Of Temporal Variations In Adherence To Nrp Using Video Recording In The Delivery Room, Amy J Sloane, Kaitlin M Kenaley, Michael T Favara Dec 2021

Assessment Of Temporal Variations In Adherence To Nrp Using Video Recording In The Delivery Room, Amy J Sloane, Kaitlin M Kenaley, Michael T Favara

Department of Medicine Faculty Papers

INTRODUCTION: Video recording and video evaluation tools have been successfully used to evaluate neonatal resuscitation performance. The objective of our study was to evaluate differences in Neonatal Resuscitation Program (NRP) adherence at time of birth between three temporal resuscitative periods using scored video recordings.

METHODS: This is a retrospective review of in-situ resuscitation video recordings from a level 3 perinatal center between 2017 and 2018. The modified Neonatal Resuscitation Assessment (mNRA) scoring tool was used as a surrogate marker to assess NRP adherence during daytime, evening, and nighttime hours.

RESULTS: A total of 260 resuscitations, of which 258 were births …


Clinical Applications Of Magnetic Resonance Imaging Based Functional And Structural Connectivity, Chengyuan Wu, Francisca Ferreira, Michael Fox, Noam Harel, Jona Hattangadi-Gluth, Andreas Horn, Saad Jbabdi, Joshua Kahan, Ashwini Oswal, Sameer A Sheth, Yanmei Tie, Vejay Vakharia, Ludvic Zrinzo, Harith Akram Dec 2021

Clinical Applications Of Magnetic Resonance Imaging Based Functional And Structural Connectivity, Chengyuan Wu, Francisca Ferreira, Michael Fox, Noam Harel, Jona Hattangadi-Gluth, Andreas Horn, Saad Jbabdi, Joshua Kahan, Ashwini Oswal, Sameer A Sheth, Yanmei Tie, Vejay Vakharia, Ludvic Zrinzo, Harith Akram

Department of Neurosurgery Faculty Papers

Advances in computational neuroimaging techniques have expanded the armamentarium of imaging tools available for clinical applications in clinical neuroscience. Non-invasive, in vivo brain MRI structural and functional network mapping has been used to identify therapeutic targets, define eloquent brain regions to preserve, and gain insight into pathological processes and treatments as well as prognostic biomarkers. These tools have the real potential to inform patient-specific treatment strategies. Nevertheless, a realistic appraisal of clinical utility is needed that balances the growing excitement and interest in the field with important limitations associated with these techniques. Quality of the raw data, minutiae of the …


Narrative Review-Drug Delivery In Age-Related Macular Degeneration, Rachel Israilevich, Raziyeh Mahmoudzadeh, Mirataollah Salabati, David Xu Dec 2021

Narrative Review-Drug Delivery In Age-Related Macular Degeneration, Rachel Israilevich, Raziyeh Mahmoudzadeh, Mirataollah Salabati, David Xu

Wills Eye Hospital Papers

This narrative review highlights routes of ocular drug delivery for age-related macular degeneration (AMD). AMD is the leading cause of irreversible blindness in industrialized countries and accounts for 8.7% of blindness worldwide. Advanced AMD can be classified into two subtypes: late-stage dry AMD [known as geographic atrophy (GA)] and neovascular AMD (nAMD). GA is often bilateral and results from progressive and irreversible loss of photoreceptors and areas of the retinal pigment epithelium. Wet AMD is characterized by angiogenesis from the choroid to the normally avascular regions underneath the retinal pigment epithelium (RPE) or retina, a process known as choroidal neovascularization …


Predicting Risk Factors For Thromboembolic Complications In Patients With Sickle Cell Anaemia - Lessons Learned For Prophylaxis, Salam Alkindi, Anwaar R Al-Ghadani, Samah R Al-Zeheimi, Said Y Alkindi, Naglaa Fawaz, Samir K. Ballas, Anil V Pathare Dec 2021

Predicting Risk Factors For Thromboembolic Complications In Patients With Sickle Cell Anaemia - Lessons Learned For Prophylaxis, Salam Alkindi, Anwaar R Al-Ghadani, Samah R Al-Zeheimi, Said Y Alkindi, Naglaa Fawaz, Samir K. Ballas, Anil V Pathare

Cardeza Foundation for Hematologic Research

Objective: To assess the clinical and laboratory predictors of venous thromboembolism (VTE) in patients with sickle cell anaemia (SCA) and its relationship to morbidity and mortality.

Methods: This retrospective case-control study analysed data from patients with SCA that experienced VTE compared with matched control patients with SCA but no VTE (2:1 ratio).

Results: A total of 102 patients with SCA were enrolled (68 cases with VTE and 34 controls). Amongst the 68 cases (median age, 29.5 years), 26 (38.2%) presented with isolated pulmonary embolism (PE). A higher prevalence of splenectomy (73.5% versus 35.3%) was observed in the cases compared with …


Contrast-Enhanced Ultrasound Of Muscle Perfusion May Indicate Patient Response To Left Ventricular Assist Device Therapy., Lauren J. Delaney, Kathleen Fitzgerald, Maria Stanczak, Priscilla Machado, John W..C. Entwistle, Flemming Forsberg, Gordon R. Reeves Dec 2021

Contrast-Enhanced Ultrasound Of Muscle Perfusion May Indicate Patient Response To Left Ventricular Assist Device Therapy., Lauren J. Delaney, Kathleen Fitzgerald, Maria Stanczak, Priscilla Machado, John W..C. Entwistle, Flemming Forsberg, Gordon R. Reeves

Department of Radiology Faculty Papers

PURPOSE: Left ventricular assist device (LVAD) support is associated with peripheral vascular abnormalities beyond those associated with heart failure (HF). These abnormalities are associated with persistent functional impairments that adversely impact quality of life (QoL). Methods for measuring peripheral vascular function in this population are needed.

METHODS: This pilot study investigated the use of contrast-enhanced ultrasound (CEUS) using standardized protocols to estimate changes in peripheral (quadriceps) muscle perfusion among patients with HF (INTERMACS profile 3) undergoing LVAD implantation (n = 7). Patients were then stratified by those who did ("responders", n = 4) and did not ("nonresponders", n = 3) …


Ogr1-Dependent Regulation Of The Allergen-Induced Asthma Phenotype, Ajay P Nayak, Deepak A. Deshpande, Phd, Sushrut D. Shah, Dominic R Villalba, Roslyn Yi, Nadan Wang, Raymond B. Penn Dec 2021

Ogr1-Dependent Regulation Of The Allergen-Induced Asthma Phenotype, Ajay P Nayak, Deepak A. Deshpande, Phd, Sushrut D. Shah, Dominic R Villalba, Roslyn Yi, Nadan Wang, Raymond B. Penn

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

The proton-sensing receptor, ovarian cancer G protein-coupled receptor (OGR1), has been shown to be expressed in airway smooth muscle (ASM) cells and is capable of promoting ASM contraction in response to decreased extracellular pH. OGR1 knockout (OGR1KO) mice are reported to be resistant to the asthma features induced by inhaled allergen. We recently described certain benzodiazepines as OGR1 activators capable of mediating both procontractile and prorelaxant signaling in ASM cells. Here we assess the effect of treatment with the benzodiazepines lorazepam or sulazepam on the asthma phenotype in wild-type (WT) and OGR1KO mice subjected to inhaled house dust mite (HDM; …


Augmentation Of Pedicle Screws Using Bone Grafting In Patients With Spinal Osteoporosis, Andrey Evgenievich Bokov, Anatoliy Bulkin, I S. Bratsev, Svetlana Ya Kalinina, Sergey G. Mlyavykh, David G. Anderson Dec 2021

Augmentation Of Pedicle Screws Using Bone Grafting In Patients With Spinal Osteoporosis, Andrey Evgenievich Bokov, Anatoliy Bulkin, I S. Bratsev, Svetlana Ya Kalinina, Sergey G. Mlyavykh, David G. Anderson

Department of Neurosurgery Faculty Papers

The aim of the study was to develop a new method of vertebral augmentation based on autologous and allogeneic bone chips to be used in pedicle screw fixation and to compare this method with the technique based on polymethyl methacrylate (PMMA). Materials and Methods. This prospective non-randomized study included 164 patients with degenerative pathologies or traumatic injuries of the lumbar spine and transitional thoracolumbar segments; 153 of the operated patients were followed up for 18 months. In these patients, radiodensity of the cancellous bone tissue was below 110 HU by the Hounsfield scale. Patients with degenerative spinal disorders underwent pedicle …


Outcomes Of Mechanical Thrombectomy For Patients With Stroke Presenting With Low Alberta Stroke Program Early Computed Tomography Score In The Early And Extended Window, Eyad Almallouhi, Sami Al Kasab, Zachary Hubbard, Eric C Bass, Guilherme Porto, Ali Alawieh, Reda Chalhoub, Pascal Jabbour, Robert M Starke, Stacey Q Wolfe, Adam S Arthur, Edgar Samaniego, Ilko Maier, Brian M Howard, Ansaar Rai, Min S Park, Justin Mascitelli, Marios Psychogios, Reade De Leacy, Travis Dumont, Michael R Levitt, Adam Polifka, Joshua Osbun, Roberto Crosa, Joon-Tae Kim, Walter Casagrande, Shinichi Yoshimura, Charles Matouk, Peter T Kan, Richard W Williamson, Benjamin Gory, Maxim Mokin, Isabel Fragata, Osama Zaidat, Albert J Yoo, Alejandro M Spiotta Dec 2021

Outcomes Of Mechanical Thrombectomy For Patients With Stroke Presenting With Low Alberta Stroke Program Early Computed Tomography Score In The Early And Extended Window, Eyad Almallouhi, Sami Al Kasab, Zachary Hubbard, Eric C Bass, Guilherme Porto, Ali Alawieh, Reda Chalhoub, Pascal Jabbour, Robert M Starke, Stacey Q Wolfe, Adam S Arthur, Edgar Samaniego, Ilko Maier, Brian M Howard, Ansaar Rai, Min S Park, Justin Mascitelli, Marios Psychogios, Reade De Leacy, Travis Dumont, Michael R Levitt, Adam Polifka, Joshua Osbun, Roberto Crosa, Joon-Tae Kim, Walter Casagrande, Shinichi Yoshimura, Charles Matouk, Peter T Kan, Richard W Williamson, Benjamin Gory, Maxim Mokin, Isabel Fragata, Osama Zaidat, Albert J Yoo, Alejandro M Spiotta

Department of Neurosurgery Faculty Papers

Importance: Limited data are available about the outcomes of mechanical thrombectomy (MT) for real-world patients with stroke presenting with a large core infarct.

Objective: To investigate the safety and effectiveness of MT for patients with large vessel occlusion and an Alberta Stroke Program Early Computed Tomography Score (ASPECTS) of 2 to 5.

Design, setting, and participants: This retrospective cohort study used data from the Stroke Thrombectomy and Aneurysm Registry (STAR), which combines the prospectively maintained databases of 28 thrombectomy-capable stroke centers in the US, Europe, and Asia. The study included 2345 patients presenting with an occlusion in the internal carotid …


In Response: Neuraxial And Peripheral Misconnection Events Leading To Wrong-Route Medication Errors, Eugene R. Viscusi, Vincent Hugo, Klaus Hoerauf, Frederick S Southwick Dec 2021

In Response: Neuraxial And Peripheral Misconnection Events Leading To Wrong-Route Medication Errors, Eugene R. Viscusi, Vincent Hugo, Klaus Hoerauf, Frederick S Southwick

Department of Anesthesiology Faculty Papers

No abstract provided.


Giant Abdominal Aortic Aneurysms, Joshua I Ng, Tuong Nguyen, Anand Tarpara, Dawn Salvatore, Paul J Dimuzio, Babak Abai Dec 2021

Giant Abdominal Aortic Aneurysms, Joshua I Ng, Tuong Nguyen, Anand Tarpara, Dawn Salvatore, Paul J Dimuzio, Babak Abai

Department of Surgery Faculty Papers

Giant abdominal aortic aneurysms (AAAs) are defined as AAAs >10 to 13 cm in the maximum transverse diameter. We have described a case of a patient who had presented for open repair of an 18-cm AAA and a review of reported cases of giant AAAs >10 cm in the maximum transverse diameter. Forty cases were compiled. The average maximum AAA diameter was 14.5 ± 4.1 cm. The AAA was ruptured on presentation in 12 patients (30%). Of the 40 cases, 34 (85%) were repaired with open surgery. The reported mortality was 15%. Despite the case complexity, five endovascular repairs were …


Disparities In Delaware Caregiver Beliefs About The Covid-19 Vaccine For Their Children, Thao-Ly Phan, Paul T Enlow, Michael K. Wong, Amanda M. Lewis, Anne E Kazak, Jonathan M. Miller Dec 2021

Disparities In Delaware Caregiver Beliefs About The Covid-19 Vaccine For Their Children, Thao-Ly Phan, Paul T Enlow, Michael K. Wong, Amanda M. Lewis, Anne E Kazak, Jonathan M. Miller

Department of Pediatrics Faculty Papers

Objective: To describe sociodemographic disparities in caregiver beliefs about the COVID-19 vaccine for their children. Methods: This was a cross-sectional study, linking caregiver-reported data to geocoded sociodemographic data from child EHRs. Caregivers of children receiving care in a Delaware pediatric healthcare system were invited to complete a survey about COVID-19 vaccine beliefs from March 19 to April 16, 2021. Results: 1499 caregivers participated (18% Black, 11% Hispanic, 32% public insurance, 12% rural). 54% of caregivers intended to vaccinate their children, while 34% were unsure and 12% would not. Caregivers of younger children (aOR 3.70, CI 2.36-5.79), Black children (aOR 2.11, …


Reactive Granulomatous Dermatitis Associated With Ovarian Cancer And A Review Of Its Role As A Harbinger For Malignancy, Alexander Sherban, Jisun Cha, Elizabeth Jones Dec 2021

Reactive Granulomatous Dermatitis Associated With Ovarian Cancer And A Review Of Its Role As A Harbinger For Malignancy, Alexander Sherban, Jisun Cha, Elizabeth Jones

Department of Dermatology and Cutaneous Biology Faculty Papers

Reactive granulomatous dermatitis (RGD) is a rare dermatosis with a variety of cutaneous manifestations unified by a dermal granulomatous infiltrate on histology. Rheumatoid arthritis and autoimmune disease are classic associations, but an increasing number of cases have been attributed to covert malignancy. Only 41 cases of paraneoplastic RGD have been documented to our knowledge and we present an additional case that manifested eight months prior to the diagnosis of ovarian cancer and clinically mimicked morphea. Histopathologic examination identifying palisaded CD68+ cells and collagen degeneration are helpful in diagnosing this entity which may mimic a host of other cutaneous processes, including …


Utility Of Blood Cellular Indices In The Risk Stratification Of Patients Presenting With Acute Pulmonary Embolism., Brett Slajus, Yevgeniy Brailovsky, Iman Darwish, Jawed Fareed, Amir Darki Nov 2021

Utility Of Blood Cellular Indices In The Risk Stratification Of Patients Presenting With Acute Pulmonary Embolism., Brett Slajus, Yevgeniy Brailovsky, Iman Darwish, Jawed Fareed, Amir Darki

Division of Cardiology Faculty Papers

Pulmonary embolism (PE) clinical manifestations vary widely, and that scope is not fully captured by current all-cause mortality risk models. PE is associated with inflammatory, coagulation, and hemostatic imbalances so blood cellular indices may be prognostically useful. Complete blood count (CBC) data may improve current risk models like the simplified pulmonary embolism severity index (sPESI) for all-cause mortality, offering greater accuracy and analytic ability. Acute PE patients (n = 228) with confirmatory diagnostic imaging were followed for all-cause mortality. Blood cellular indices were assessed for association to all-cause mortality and were supplemented into sPESI using multivariate logistic regression. Multiple blood …


The Role Of Decorin And Biglycan Signaling In Tumorigenesis, Valentina Diehl, Lisa Sophie Huber, Jonel Trebicka, Malgorzata Wygrecka, Renato V. Iozzo, Liliana Schaefer Nov 2021

The Role Of Decorin And Biglycan Signaling In Tumorigenesis, Valentina Diehl, Lisa Sophie Huber, Jonel Trebicka, Malgorzata Wygrecka, Renato V. Iozzo, Liliana Schaefer

Department of Pathology, Anatomy, and Cell Biology Faculty Papers

The complex and adaptive nature of malignant neoplasm constitute a major challenge for the development of effective anti-oncogenic therapies. Emerging evidence has uncovered the pivotal functions exerted by the small leucine-rich proteoglycans, decorin and biglycan, in affecting tumor growth and progression. In their soluble forms, decorin and biglycan act as powerful signaling molecules. By receptor-mediated signal transduction, both proteoglycans modulate key processes vital for tumor initiation and progression, such as autophagy, inflammation, cell-cycle, apoptosis, and angiogenesis. Despite of their structural homology, these two proteoglycans interact with distinct cell surface receptors and thus modulate distinct signaling pathways that ultimately affect cancer …


Igg4-Mediated Neurologic Autoimmunities: Understanding The Pathogenicity Of Igg4, Ineffectiveness Of Ivig, And Long-Lasting Benefits Of Anti-B Cell Therapies, Marinos Dalakas Nov 2021

Igg4-Mediated Neurologic Autoimmunities: Understanding The Pathogenicity Of Igg4, Ineffectiveness Of Ivig, And Long-Lasting Benefits Of Anti-B Cell Therapies, Marinos Dalakas

Department of Neurology Faculty Papers

Background and objectives: Describe the unique functions of immunoglobulin G4 (IgG4) in IgG4-neurologic disorders (IgG4-ND) and explain why, in contrast to their IgG1-counterparts, they respond poorly to intravenous immune globulin (IVIg) but effectively to anti-B cell therapies.

Methods: The IgG4 structure and isotype switch, B cells and plasmablasts relevant to IgG4 production, and IgG4-induced disruption of the targeted antigens are reviewed and compared with IgG1-mediated autoimmune ND, where IVIg inhibits IgG1-triggered inflammatory effects.

Results: The main IgG4-ND include muscle-specific kinase myasthenia; nodal/paranodal chronic inflammatory demyelinating polyradiculoneuropathy with antibodies to neurofascin-155, contactin-1/caspr-1, or pan-neurofascins; antileucine-rich, glioma-inactivated-1 and contactin-associated protein-like 2 associated-limbic …


A Systematic Review Of Health State Utility Values In The Plastic Surgery Literature, Adrienne Christopher, Martin P Morris, Viren Patel, Kevin Klifto, John P Fischer Nov 2021

A Systematic Review Of Health State Utility Values In The Plastic Surgery Literature, Adrienne Christopher, Martin P Morris, Viren Patel, Kevin Klifto, John P Fischer

Department of Surgery Faculty Papers

Cost-utility analyses assess health gains acquired by interventions by incorporating weighted health state utility values (HSUVs). HSUVs are important in plastic and reconstructive surgery (PRS) because they include qualitative metrics when comparing operative techniques or interventions. We systematically reviewed the literature to identify the extent and quality of existing original utilities research within PRS.

Methods: A systematic review of articles with original PRS utility data was conducted in accordance with the Preferred Reporting Items for a Systematic Review and Meta-Analysis guidelines. Subspecialty, survey sample size, and respondent characteristics were extracted. For each HSUV, the utility measure [direct (standard gamble, time …


Multi-Institutional Study Validates Safety Of Intraoperative Cesium-131 Brachytherapy For Treatment Of Recurrent Head And Neck Cancer, Adam J. Luginbuhl, Alyssa Calder, David Kutler, Chad Zender, Trisha Wise-Draper, Jena Patel, Michael Cheng, Vidhya Karivedu, Tingting Zhan, Bhupesh Parashar, Shuchi Gulati, Min Yao, Pierre Lavertu, Vinita Takiar, Alice Tang, Jennifer Johnson, William M. Keane, Joseph Curry, David Cognetti, Voichita Bar-Ad Nov 2021

Multi-Institutional Study Validates Safety Of Intraoperative Cesium-131 Brachytherapy For Treatment Of Recurrent Head And Neck Cancer, Adam J. Luginbuhl, Alyssa Calder, David Kutler, Chad Zender, Trisha Wise-Draper, Jena Patel, Michael Cheng, Vidhya Karivedu, Tingting Zhan, Bhupesh Parashar, Shuchi Gulati, Min Yao, Pierre Lavertu, Vinita Takiar, Alice Tang, Jennifer Johnson, William M. Keane, Joseph Curry, David Cognetti, Voichita Bar-Ad

Department of Otolaryngology - Head and Neck Surgery Faculty Papers

Introduction: Surgery is the primary treatment for resectable, non-metastatic recurrent head and neck squamous cell carcinoma (HNSCC). We explore the safety and oncologic benefit of intraoperative Cesium-131 (Cs-131) brachytherapy combined with salvage local and/or regional surgical resection.

Methods and materials: Findings were reported from a single arm multi-institutional prospective phase 1/2 trial involving surgery plus Cs-131 (surgery + Cs-131) treatment. The results of two retrospective cohorts-surgery alone and surgery plus intensity modulated radiation therapy (surgery + ReIMRT)-were also described. Included patients had recurrent HNSCC and radiation history. Safety, tumor re-occurrence, and survival were evaluated.

Results: Forty-nine patients were enrolled in …


Spinal Anesthesia Or General Anesthesia For Hip Surgery In Older Adults, Mark D. Neuman, Rui Feng, Jeffrey L. Carson, Lakisha J. Gaskins, Derek Dillane, Daniel I. Sessler, Frederick Sieber, Jay Magaziner, Edward R. Marcantonio, Samir Mehta, Diane Menio, Sabry Ayad, Trevor Stone, Steven Papp, Eric S. Schwenk, Nabil Elkassabany, Mitchell Marshall, J. Douglas Jaffe, Charles Luke, Balram Sharma, Syed Azim, Robert A. Hymes, Ki-Jinn Chin, Richard Sheppard, Barry Perlman, Joshua Sappenfield, Ellen Hauck, Mark A. Hoeft, Mark Giska, Yatish Ranganath, Tiffany Tedore, Stephen Choi, Jinlei Li, M. Kwesi Kwofie, Antoun Nader, Robert D. Sanders, Brian F. S. Allen, Kamen Vlassakov, Stephen Kates, Lee A. Fleisher, James Dattilo, Ann Tierney, Alisa J. Stephens-Shields, Susan S. Ellenberg Nov 2021

Spinal Anesthesia Or General Anesthesia For Hip Surgery In Older Adults, Mark D. Neuman, Rui Feng, Jeffrey L. Carson, Lakisha J. Gaskins, Derek Dillane, Daniel I. Sessler, Frederick Sieber, Jay Magaziner, Edward R. Marcantonio, Samir Mehta, Diane Menio, Sabry Ayad, Trevor Stone, Steven Papp, Eric S. Schwenk, Nabil Elkassabany, Mitchell Marshall, J. Douglas Jaffe, Charles Luke, Balram Sharma, Syed Azim, Robert A. Hymes, Ki-Jinn Chin, Richard Sheppard, Barry Perlman, Joshua Sappenfield, Ellen Hauck, Mark A. Hoeft, Mark Giska, Yatish Ranganath, Tiffany Tedore, Stephen Choi, Jinlei Li, M. Kwesi Kwofie, Antoun Nader, Robert D. Sanders, Brian F. S. Allen, Kamen Vlassakov, Stephen Kates, Lee A. Fleisher, James Dattilo, Ann Tierney, Alisa J. Stephens-Shields, Susan S. Ellenberg

Department of Anesthesiology Faculty Papers

Background: The effects of spinal anesthesia as compared with general anesthesia on the ability to walk in older adults undergoing surgery for hip fracture have not been well studied.

Methods: We conducted a pragmatic, randomized superiority trial to evaluate spinal anesthesia as compared with general anesthesia in previously ambulatory patients 50 years of age or older who were undergoing surgery for hip fracture at 46 U.S. and Canadian hospitals. Patients were randomly assigned in a 1:1 ratio to receive spinal or general anesthesia. The primary outcome was a composite of death or an inability to walk approximately 10 ft (3 …


Spect Functional Neuroimaging Distinguishes Adult Attention Deficit Hyperactivity Disorder From Healthy Controls In Big Data Imaging Cohorts, Daniel G Amen, Theodore A Henderson, Andrew Newberg Nov 2021

Spect Functional Neuroimaging Distinguishes Adult Attention Deficit Hyperactivity Disorder From Healthy Controls In Big Data Imaging Cohorts, Daniel G Amen, Theodore A Henderson, Andrew Newberg

Marcus Institute of Integrative Health Faculty Papers

Background: The diagnosis of attention deficit hyperactivity disorder (ADHD) relies on history and observation, as no reliable biomarkers have been identified. In this study, we compared a large single diagnosis group of patients with ADHD (combined, inattentive, and hyperactive) to healthy controls using brain perfusion single-photon emission computed tomography (SPECT) imaging to determine specific brain regions which could serve as potential biomarkers to reliably distinguish ADHD. Methods: In a retrospective analysis, subjects (n = 1,135) were obtained from a large multisite psychiatric database, where resting state (baseline) and on-task SPECT scans were obtained. Only baseline scans were analyzed in …


Is Living In A Region With High Groundwater Arsenic Contamination Associated With Adverse Reproductive Health Outcomes? An Analysis Using Nationally Representative Data From India, Jessie Pinchoff, Brent Monseur, Sapna Desai, Katelyn Koons, Ruben Alvero, Michelle J Hindin Nov 2021

Is Living In A Region With High Groundwater Arsenic Contamination Associated With Adverse Reproductive Health Outcomes? An Analysis Using Nationally Representative Data From India, Jessie Pinchoff, Brent Monseur, Sapna Desai, Katelyn Koons, Ruben Alvero, Michelle J Hindin

Department of Medicine Faculty Papers

Background: Exposure to groundwater arsenic via drinking water is common in certain geographies, such as parts of India, and causes a range of negative health effects, potentially including adverse reproductive health outcomes.

Methods: We conducted an ecological analysis of self-reported rates of stillbirth, recurrent pregnancy loss, and infertility in relation to groundwater arsenic levels in India. We used a gridded, modeled dataset of the probability of groundwater arsenic exceeding 10 μg/L (World Health Organization drinking water limit) to calculate mean probabilities at the district level (n = 599 districts). A spatial integration approach was used to merge these estimates with …


Efficacy And Safety Of Fremanezumab In Clinical Trial Participants Aged ≥60 Years With Episodic Or Chronic Migraine: Pooled Results From 3 Randomized, Double-Blind, Placebo-Controlled Phase 3 Studies, Stephanie J. Nahas, Steffen Naegel, Joshua M Cohen, Xiaoping Ning, Lindsay Janka, Verena Ramirez Campos, Lynda J Krasenbaum, Dagny Holle-Lee, David Kudrow, Christian Lampl Nov 2021

Efficacy And Safety Of Fremanezumab In Clinical Trial Participants Aged ≥60 Years With Episodic Or Chronic Migraine: Pooled Results From 3 Randomized, Double-Blind, Placebo-Controlled Phase 3 Studies, Stephanie J. Nahas, Steffen Naegel, Joshua M Cohen, Xiaoping Ning, Lindsay Janka, Verena Ramirez Campos, Lynda J Krasenbaum, Dagny Holle-Lee, David Kudrow, Christian Lampl

Department of Neurology Faculty Papers

Background: Although migraine is less common in older people, preventive treatment of migraine in these individuals may be more challenging due to the presence of multiple comorbidities and polypharmacy. Additionally, evidence for migraine treatment efficacy, safety, and tolerability is limited in this population. We evaluated efficacy, safety, and tolerability of fremanezumab, a fully humanized monoclonal antibody (IgG2Δa) that selectively targets calcitonin gene-related peptide (CGRP), in clinical trial participants aged ≥60 years with episodic migraine (EM) or chronic migraine (CM).

Methods: This analysis included data from 3 randomized, double-blind, placebo-controlled phase 3 studies: the HALO EM study, HALO CM study, and …


Promoter Considerations In The Design Of Lentiviral Vectors For Use In Treating Lysosomal Storage Diseases, Estera Rintz, Takashi Higuchi, Hiroshi Kobayashi, Deni S Galileo, Grzegorz Wegrzyn, Shunji Tomatsu Nov 2021

Promoter Considerations In The Design Of Lentiviral Vectors For Use In Treating Lysosomal Storage Diseases, Estera Rintz, Takashi Higuchi, Hiroshi Kobayashi, Deni S Galileo, Grzegorz Wegrzyn, Shunji Tomatsu

Department of Pediatrics Faculty Papers

More than 50 lysosomal storage diseases (LSDs) are associated with lysosomal dysfunctions with the frequency of 1:5,000 live births. As a result of missing enzyme activity, the lysosome dysfunction accumulates undegraded or partially degraded molecules, affecting the entire body. Most of them are life-threatening diseases where patients could die within the first or second decade of life. Approximately 20 LSDs have the approved treatments, which do not provide the cure for the disorder. Therefore, the delivery of missing genes through gene therapy is a promising approach for LSDs. Over the years, ex vivo lentiviral-mediated gene therapy for LSDs has been …


Fever In A Returning Traveler: A Case And Literature Review Of Melioidosis, Akanksha Arya, Hamadullah Shaikh, Devin Weber, Matthew Pettengill, Sean Moss Nov 2021

Fever In A Returning Traveler: A Case And Literature Review Of Melioidosis, Akanksha Arya, Hamadullah Shaikh, Devin Weber, Matthew Pettengill, Sean Moss

Division of Infectious Diseases and Environmental Medicine Faculty Papers

Burkholderia pseudomallei is an aerobic, motile, non-spore-forming gram-negative bacillus found in tropical endemic environments that causes the disease melioidosis. Melioidosis displays a diversity of clinical presentations ranging from septic shock to chronic latent infection, often with characteristic abscesses in multiple organs. Melioidosis is an opportunistic infection, with risk factors, including diabetes, alcohol use, chronic lung disease, and chronic renal disease, and these risk factors increase the severity of disease (Wiersinga et al., 2006) [1]. In this case report, we illustrate a case of a 32 year old man with several risk factors and recent travel to an endemic region presenting …


Return-To-Play Rates And Clinical Outcomes Of Baseball Players After Concomitant Ulnar Collateral Ligament Reconstruction And Selective Ulnar Nerve Transposition., Somnath Rao, Taylor D'Amore, Donald P. Willier, Richard J. Gawel, Robert A Jack, Steven B. Cohen, Michael G. Ciccotti Nov 2021

Return-To-Play Rates And Clinical Outcomes Of Baseball Players After Concomitant Ulnar Collateral Ligament Reconstruction And Selective Ulnar Nerve Transposition., Somnath Rao, Taylor D'Amore, Donald P. Willier, Richard J. Gawel, Robert A Jack, Steven B. Cohen, Michael G. Ciccotti

Rothman Institute Papers

Background: Injury to the ulnar collateral ligament (UCL) leading to medial elbow instability and possible ulnar neuritis is common in overhead-throwing athletes. Treatment may require UCL reconstruction (UCLR) and concomitant ulnar nerve transposition (UNT) for those with preoperative ulnar neuritis.

Purpose: To evaluate the return-to-play (RTP) rates, clinical outcomes, and rates of persistent ulnar neuritis after concomitant UCLR and UNT in a cohort of baseball players with confirmed preoperative ulnar neuritis.

Study Design: Case series; Level of evidence, 4.

Methods: Eligible patients were those who underwent concomitant UCLR and UNT at a single institution between January 2008 and June 2018 …


Attitudes Toward Osteopathic Medicine Scale: Development And Psychometrics, Mohammadreza Hojat Professor, Jennifer Desantis, Robert A Cain, Mark R Speicher, Lynn Bragan, Leonard H Calabrese Nov 2021

Attitudes Toward Osteopathic Medicine Scale: Development And Psychometrics, Mohammadreza Hojat Professor, Jennifer Desantis, Robert A Cain, Mark R Speicher, Lynn Bragan, Leonard H Calabrese

Department of Medicine Faculty Papers

Objective: To develop a valid and reliable instrument for measuring attitudes toward osteopathic medicine.

Methods: Participants included 5,669 first-year students from 33 U.S. colleges of osteopathic medicine, who completed an online survey at the beginning of the 2019-2020 academic year. Using data from the nationwide Project in Osteopathic Medical Education and Empathy, we developed a 13-item instrument: Attitudes Toward Osteopathic Medicine Scale (ATOMS) and demonstrated the validity and reliability of its scores. The social desirability response bias was controlled in statistical analyses.

Results: The corrected item-total score correlations were all positive and statistically significant, and the effect sizes of item …


Metabolic Adaptation To The Chronic Loss Of Ca 2+ Signaling Induced By Ko Of Ip 3 Receptors Or The Mitochondrial Ca 2+ Uniporter, Michael P. Young, Zachary T Schug, David M. Booth, David I Yule, Katsuhiko Mikoshiba, György Hajnóczky, Suresh K Joseph Nov 2021

Metabolic Adaptation To The Chronic Loss Of Ca 2+ Signaling Induced By Ko Of Ip 3 Receptors Or The Mitochondrial Ca 2+ Uniporter, Michael P. Young, Zachary T Schug, David M. Booth, David I Yule, Katsuhiko Mikoshiba, György Hajnóczky, Suresh K Joseph

Department of Pathology, Anatomy, and Cell Biology Faculty Papers

Calcium signaling is essential for regulating many biological processes. Endoplasmic reticulum inositol trisphosphate receptors (IP3Rs) and the mitochondrial Ca2+ uniporter (MCU) are key proteins that regulate intracellular Ca2+ concentration. Mitochondrial Ca2+ accumulation activates Ca2+-sensitive dehydrogenases of the tricarboxylic acid (TCA) cycle that maintain the biosynthetic and bioenergetic needs of both normal and cancer cells. However, the interplay between calcium signaling and metabolism is not well understood. In this study, we used human cancer cell lines (HEK293 and HeLa) with stable KOs of all three IP3R isoforms (triple KO [TKO]) or MCU to examine metabolic and bioenergetic responses to the chronic …


Native Valve Endocarditis Complicated By Abscess Formation Caused By Rothia Mucilaginosa, S Haddad, Y Saade, B Ramlawi, B Kreidieh, B Gilbert, S Rao Nov 2021

Native Valve Endocarditis Complicated By Abscess Formation Caused By Rothia Mucilaginosa, S Haddad, Y Saade, B Ramlawi, B Kreidieh, B Gilbert, S Rao

Division of Infectious Diseases and Environmental Medicine Faculty Papers

Rothia mucilaginosa is increasingly recognized as an emerging pathogen associated with endocarditis. It has mostly been reported a causative agent for prosthetic valve endocarditis. The previously reported cases of native valve endocarditis caused by this organism only required medical treatment with no surgical intervention. We report a case of R. mucilaginosa native valve endocarditis complicated by abscess formation requiring surgical intervention and review the literature of native valve endocarditis caused by this organism.