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Articles 3481 - 3510 of 8417

Full-Text Articles in Medical Specialties

A Phase 1b/2a Study Of Soticlestat As Adjunctive Therapy In Participants With Developmental And/Or Epileptic Encephalopathies., Jonathan J. Halford, Michael R. Sperling, Dimitrios Arkilo, Mahnaz Asgharnejad, Celia Zinger, Rengyi Xu, Matthew During, Jacqueline A. French Aug 2021

A Phase 1b/2a Study Of Soticlestat As Adjunctive Therapy In Participants With Developmental And/Or Epileptic Encephalopathies., Jonathan J. Halford, Michael R. Sperling, Dimitrios Arkilo, Mahnaz Asgharnejad, Celia Zinger, Rengyi Xu, Matthew During, Jacqueline A. French

Department of Neurology Faculty Papers

OBJECTIVE: To evaluate the safety, tolerability, and pharmacokinetics of soticlestat, a first-in-class cholesterol 24-hydroxylase inhibitor, in adults with developmental and/or epileptic encephalopathies (DEE).

METHODS: The study comprised a 30-day, randomized, double-blind, placebo-controlled phase (Part A), followed by a 55-day open-label phase (Part B) (ClinicalTrials.gov ID: NCT03166215) . In Part A, patients with DEE and at least one bilateral motor seizure during the 4-week prospective baseline period were randomized 4:1 to receive soticlestat or placebo, in addition to their usual antiseizure medication. In Part B, all patients received open-label soticlestat. Soticlestat doses were titrated according to tolerability to a maximum of …


Outcomes Of Intravenous Chemotherapy (Chemoreduction) For Retinoblastoma Based On Patient Age In 964 Eyes Of 554 Patients., Zeynep Bas, Lauren A. Dalvin, Sameeksha Tadepalli, Raksha Rao, Amish Shah, Ann M. Leahey, Carol L. Shields Aug 2021

Outcomes Of Intravenous Chemotherapy (Chemoreduction) For Retinoblastoma Based On Patient Age In 964 Eyes Of 554 Patients., Zeynep Bas, Lauren A. Dalvin, Sameeksha Tadepalli, Raksha Rao, Amish Shah, Ann M. Leahey, Carol L. Shields

Wills Eye Hospital Papers

PURPOSE: To evaluate retinoblastoma control after intravenous chemotherapy (chemoreduction) by patient age at presentation.

DESIGN: Retrospective case series.

METHODS: This study included 964 eyes of 554 patients treated with chemoreduction at Ocular Oncology Service at Wills Eye Hospital. Patients received 6 monthly cycles of standard chemoreduction. Additional therapies for tumor control were performed as needed.

RESULTS: Of 964 eyes, a comparison by age group (24 months) revealed more advanced age group with higher frequency of group E tumor (15% vs. 25% vs. 32% vs. 39%, P < 0.001). By treatment outcomes, complete tumor control was achieved with chemoreduction alone more often in less advanced age group (46% vs. 30% vs. 17% vs. 8%, P < 0.001). Additional treatment after chemoreduction was needed more often in more advanced age group with external beam radiotherapy (EBRT; 9% vs. 16% vs. 20% vs. 15%, P = 0.006) or enucleation (12% vs. 18% vs. 26% vs. 37%, P < 0.001). Over time (1994-1998 vs. 1999-2003 vs. 2004-2008 vs. 2009-2013 vs. 2014-2019), the paradigm for additional required treatment after chemoreduction shifted toward less EBRT (27% vs. 24% vs. 14% vs. 7% vs. 2%, P < 0.001) and more intra-arterial (0% vs. 0% vs. 1% vs. 25% vs. 48%, P < 0.001) and intravitreal (0% vs. 0% vs. 3% vs. 10% vs. 20%, P < 0.001) chemotherapy.

CONCLUSIONS: Chemoreduction is a safe and effective treatment method for patients with retinoblastoma, demonstrating …


Perceptions And Challenges Experienced By African Physicians When Prescribing Methotrexate For Rheumatic Disease: An Exploratory Study, Carol A Hitchon, Girsh M Mody, Candace H Feldman, Yan Lau, Steven Shi, Michele Meltzer, Rosie Scuccimarri, Michael E Weinblatt, Ines Colmegna Aug 2021

Perceptions And Challenges Experienced By African Physicians When Prescribing Methotrexate For Rheumatic Disease: An Exploratory Study, Carol A Hitchon, Girsh M Mody, Candace H Feldman, Yan Lau, Steven Shi, Michele Meltzer, Rosie Scuccimarri, Michael E Weinblatt, Ines Colmegna

Department of Medicine Faculty Papers

Objective: Guidelines for methotrexate (MTX) use in rheumatic disease may not be feasible for physicians practicing in the least developed countries. We aimed to understand the experiences of MTX prescribers relating to MTX use for rheumatic disease in African countries to inform the development of culturally and geographically appropriate recommendations.

Methods: African physicians who self-identified as MTX prescribers from countries classified as having a low versus a medium or high Human Development Index (L-HDI versus MH-HDI) participated in semistructured interviews between August 2016 and September 2017. Interviews were transcribed verbatim, coded thematically, and stratified by HDI.

Results: Physicians (23 rheumatologists; …


Gender Disparity In Host Responses To Hepatitis B-Related Hepatocellular Carcinoma: A Case Series, Rukaiya Bashir-Hamidu, Divya Chalikonda, Hie-Won Hann Aug 2021

Gender Disparity In Host Responses To Hepatitis B-Related Hepatocellular Carcinoma: A Case Series, Rukaiya Bashir-Hamidu, Divya Chalikonda, Hie-Won Hann

Division of Gastroenterology and Hepatology Faculty Papers

Chronic hepatitis B virus (HBV) infection is one of the most common causes of hepato-cellular carcinoma (HCC), a malignant tumor with high mortality worldwide. One remarkable clinical feature of HBV-related HCC is that the risk of development is higher in males and post-menopausal females compared to other females. Increasing evidence also indicates that the prognosis of HBV-associated HCC may involve gender disparity, with females having more favorable out-comes. The proposed mechanism of this gender disparity is thought to be complex and multifactorial. Attributions have been made to gender differences in behavioral risk factors, host stress, immune response, psychology, metabolic risk …


Returning To Sport: Female Athletes Living With And Beyond Cancer., Anna L. Schwartz, Christopher Terry Aug 2021

Returning To Sport: Female Athletes Living With And Beyond Cancer., Anna L. Schwartz, Christopher Terry

Kimmel Cancer Center Faculty Papers

Many athletes living with and beyond cancer can continue to train and, in some cases, compete during treatment. Following cancer treatment, athletes can return to competitive sport but need to learn to adapt their physical strength and training to the lingering effects of cancer. It is critical for oncology healthcare providers to use the principles of assess, refer and advise to exercise oncology programs that are appropriate for the individual. Managing side effects of treatment is key to being able to train during and immediately following cancer treatment. Keen attention to fatigue is important at any point in the cancer …


Gemcitabine-Loaded Microbubble System For Ultrasound Imaging And Therapy., Lauren J. Delaney, John R. Eisenbrey, David Brown, Jonathan R Brody, Masaya Jimbo, Brian E Oeffinger, Maria Stanczak, Flemming Forsberg, Ji-Bin Liu, Margaret A Wheatley Aug 2021

Gemcitabine-Loaded Microbubble System For Ultrasound Imaging And Therapy., Lauren J. Delaney, John R. Eisenbrey, David Brown, Jonathan R Brody, Masaya Jimbo, Brian E Oeffinger, Maria Stanczak, Flemming Forsberg, Ji-Bin Liu, Margaret A Wheatley

Department of Radiology Faculty Papers

Ultrasound imaging presents many positive attributes, including safety, real-time imaging, universal accessibility, and cost. However, inherent difficulties in discrimination between soft tissues and tumors prompted development of stabilized microbubble contrast agents. This presents the opportunity to develop agents in which drug is entrapped in the microbubble shell. We describe preparation and characterization of theranostic poly(lactide) (PLA) and pegylated PLA (PEG-PLA) shelled microbubbles that entrap gemcitabine, a commonly used drug for pancreatic cancer (PDAC). Entrapping 6 wt% gemcitabine did not significantly affect drug activity, microbubble morphology, or ultrasound contrast activity compared with unmodified microbubbles. In vitro microbubble concentrations yielding ≥ 500nM …


Scleral Buckling For Primary Retinal Detachment: Outcomes Of Scleral Tunnels Versus Scleral Sutures., Matthew R. Starr, Edwin H. Ryan, Anthony Obeid, Claire Ryan, Xinxiao Gao, Malika L. Madhava, Sean M. Maloney, Adam Z. Adika, Krishi V. Peddada, Kareem Sioufi, Luv G. Patel, Michael J. Ammar, Nora J. Forbes, Antonio Capone, Geoffrey G. Emerson, Daniel P. Joseph, Dean Eliott, Carl Regillo, Jason Hsu, Omesh P. Gupta, Yoshihiro Yonekawa, For The Primary Retinal Detachment Outcomes Pro Study Group Jul 2021

Scleral Buckling For Primary Retinal Detachment: Outcomes Of Scleral Tunnels Versus Scleral Sutures., Matthew R. Starr, Edwin H. Ryan, Anthony Obeid, Claire Ryan, Xinxiao Gao, Malika L. Madhava, Sean M. Maloney, Adam Z. Adika, Krishi V. Peddada, Kareem Sioufi, Luv G. Patel, Michael J. Ammar, Nora J. Forbes, Antonio Capone, Geoffrey G. Emerson, Daniel P. Joseph, Dean Eliott, Carl Regillo, Jason Hsu, Omesh P. Gupta, Yoshihiro Yonekawa, For The Primary Retinal Detachment Outcomes Pro Study Group

Wills Eye Hospital Papers

Purpose: There are primarily two techniques for affixing the scleral buckle (SB) to the sclera in the repair of rhegmatogenous retinal detachment (RRD): scleral tunnels or scleral sutures.

Methods: This retrospective study examined all patients with primary RRD who were treated with primary SB or SB combined with vitrectomy from January 1, 2015 through December 31, 2015 across six sites. Two cohorts were examined: SB affixed using scleral sutures versus scleral tunnels. Pre- and postoperative variables were evaluated including visual acuity, anatomic success, and postoperative strabismus.

Results: The mean preoperative logMAR VA for the belt loop cohort was 1.05 ±" …


Qualitative Research Methods, Erin Kelly, Md Jul 2021

Qualitative Research Methods, Erin Kelly, Md

Department of Family & Community Medicine Presentations and Grand Rounds

No abstract provided.


A Literature Review And Best Practice Advice For Second And Third Trimester Risk Stratification, Monitoring, And Management Of Pre-Eclampsia: Compiled By The Pregnancy And Non-Communicable Diseases Committee Of Figo (The International Federation Of Gynecology And Obstetrics)., Liona C. Poon, Laura A. Magee, Stefan Verlohren, Andrew Shennan, Peter Von Dadelszen, Eyal Sheiner, Eran Hadar, Gerard Visser, Fabricio Da Silva Costa, Anil Kapur, Fionnuala Mcauliffe, Amala Nazareth, Muna Tahlak, Anne B. Kihara, Hema Divakar, H. David Mcintyre, Vincenzo Berghella, Huixia Yang, Roberto Romero, Kypros H H. Nicolaides, Nir Melamed, Moshe Hod Jul 2021

A Literature Review And Best Practice Advice For Second And Third Trimester Risk Stratification, Monitoring, And Management Of Pre-Eclampsia: Compiled By The Pregnancy And Non-Communicable Diseases Committee Of Figo (The International Federation Of Gynecology And Obstetrics)., Liona C. Poon, Laura A. Magee, Stefan Verlohren, Andrew Shennan, Peter Von Dadelszen, Eyal Sheiner, Eran Hadar, Gerard Visser, Fabricio Da Silva Costa, Anil Kapur, Fionnuala Mcauliffe, Amala Nazareth, Muna Tahlak, Anne B. Kihara, Hema Divakar, H. David Mcintyre, Vincenzo Berghella, Huixia Yang, Roberto Romero, Kypros H H. Nicolaides, Nir Melamed, Moshe Hod

Department of Obstetrics and Gynecology Faculty Papers

No abstract provided.


Rehabilitation And Return-To-Play Criteria After Fresh Osteochondral Allograft Transplantation: A Systematic Review., Michael Stark, Somnath Rao, Brendan Gleason, Robert A. Jack, Bradford Tucker, Sommer Hammoud, Kevin B. Freedman Jul 2021

Rehabilitation And Return-To-Play Criteria After Fresh Osteochondral Allograft Transplantation: A Systematic Review., Michael Stark, Somnath Rao, Brendan Gleason, Robert A. Jack, Bradford Tucker, Sommer Hammoud, Kevin B. Freedman

Rothman Institute Papers

Background: Fresh osteochondral allograft (OCA) is a treatment option that allows for the transfer of size-matched allograft cartilage and subchondral bone into articular defects of the knee. Although long-term studies show good functional improvement with OCA, there continues to be wide variability and a lack of consensus in terms of postoperative rehabilitation protocols and return to sport.

Purpose: To systematically review the literature and evaluate the reported rehabilitation protocols after OCA of the knee, including weightbearing and range of motion (ROM) restrictions as well as return-to-play criteria.

Study Design: Systematic review; Level of evidence, 4.

Methods: PubMed, EMBASE, Cumulative Index …


Severe Acute Generalized Exanthematous Pustulosis With Toxic Epidermal Necrolysis-Like Desquamation: A Case Series Of 8 Patients, Simo Huang, Amara Ahmed, Sylvia Hsu, Jason B. Lee, Kiran Motaparthi Jul 2021

Severe Acute Generalized Exanthematous Pustulosis With Toxic Epidermal Necrolysis-Like Desquamation: A Case Series Of 8 Patients, Simo Huang, Amara Ahmed, Sylvia Hsu, Jason B. Lee, Kiran Motaparthi

Department of Dermatology and Cutaneous Biology Faculty Papers

No abstract provided.


Longitudinal Evaluation Of Azithromycin And Cytokine Concentrations In Amniotic Fluid Following One-Time Oral Dosing In Pregnancy., Rupsa C. Boelig, Edwin Lam, Ankit Rochani, Gagan Kaushal, Amanda Roman, Walter K. Kraft Jul 2021

Longitudinal Evaluation Of Azithromycin And Cytokine Concentrations In Amniotic Fluid Following One-Time Oral Dosing In Pregnancy., Rupsa C. Boelig, Edwin Lam, Ankit Rochani, Gagan Kaushal, Amanda Roman, Walter K. Kraft

Department of Pharmacology and Experimental Therapeutics Faculty Papers

To utilize noninvasive collection of amniotic fluid in the setting of preterm premature rupture of membranes (PPROMs) to report the time concentration profile of azithromycin in amniotic fluid over 7 days from a single dose, and evaluate the correlation between azithromycin concentration and inflammatory markers in amniotic fluid. Prospective cohort study of five pregnant patients admitted with PPROMs and treated with a single 1 g oral azithromycin dose. Amniotic fluid was collected from pads and used to quantify azithromycin concentration as well as TNFa, IL-1a, IL-1b, IL-6, IL-8, and IL-10 concentrations. Primary outcome was time/concentration profile of azithromycin in amniotic …


The Relationship Between Vitamin C Or Thiamine Levels And Outcomes For Severe Sepsis Patients Admitted To The Icu., Nandan Prasad, Anne V. Grossestreuer, Nuala J. Meyer, Sarah M. Perman, Mark E. Mikkelsen, Judd Hollander, David F. Gaieski Jul 2021

The Relationship Between Vitamin C Or Thiamine Levels And Outcomes For Severe Sepsis Patients Admitted To The Icu., Nandan Prasad, Anne V. Grossestreuer, Nuala J. Meyer, Sarah M. Perman, Mark E. Mikkelsen, Judd Hollander, David F. Gaieski

Department of Emergency Medicine Faculty Papers

Preliminary data have produced conflicting results regarding whether initial vitamin C levels in patients with severe sepsis correlate with mortality outcomes. We hypothesized that low plasma ascorbic acid or thiamine levels in severe sepsis patients admitted from the Emergency Department (ED) to the Intensive Care Unit (ICU) would be associated with increased mortality and an increased incidence of shock. Retrospective analysis of a prospective database of severe sepsis patients admitted to the ICU at an urban, academic medical center. Ascorbic acid and thiamine levels were analyzed in relation to survivors vs. non-survivors and shock vs. non-shock patients. 235 patients were …


Genomic Variability In The Survival Motor Neuron Genes (Smn1 And Smn2): Implications For Spinal Muscular Atrophy Phenotype And Therapeutics Development, Matthew E R Butchbach Jul 2021

Genomic Variability In The Survival Motor Neuron Genes (Smn1 And Smn2): Implications For Spinal Muscular Atrophy Phenotype And Therapeutics Development, Matthew E R Butchbach

Department of Pediatrics Faculty Papers

Spinal muscular atrophy (SMA) is a leading genetic cause of infant death worldwide that is characterized by loss of spinal motor neurons leading to muscle weakness and atrophy. SMA results from the loss of survival motor neuron 1 (SMN1) gene but retention of its paralog SMN2. The copy numbers of SMN1 and SMN2 are variable within the human population with SMN2 copy number inversely correlating with SMA severity. Current therapeutic options for SMA focus on increasing SMN2 expression and alternative splicing so as to increase the amount of SMN protein. Recent work has demonstrated that not all …


Standardizing Definitions Of Hematopoietic Recovery, Graft Rejection, Graft Failure, Poor Graft Function, And Donor Chimerism In Allogeneic Hematopoietic Cell Transplantation: A Report On Behalf Of The American Society For Transplantation And Cellular Therapy., Mohamed A. Kharfan-Dabaja, Ambuj Kumar, Ernesto Ayala, Mahmoud Aljurf, Taiga Nishihori, Rebecca Marsh, Lauri M. Burroughs, Navneet Majhail, A. Samer Al-Homsi, Zaid S. Al-Kadhimi, Merav Bar, Alice Bertaina, Jaap J. Boelens, Richard Champlin, Sonali Chaudhury, Zachariah Defilipp, Bhagirathbhai Dholaria, Areej El-Jawahri, Suzanne Fanning, Ellen Fraint, Usama Gergis, Sergio Giralt, Betty K. Hamilton, Shahrukh K. Hashmi, Biljana Horn, Yoshihiro Inamoto, David A. Jacobsohn, Tania Jain, Laura Johnston, Abraham S. Kanate, Ankit Kansagra, Adetola Kassim, Leslie S. Kean, Carrie L. Kitko, Jessica Knight-Perry, Joanne Kurtzberg, Hien Liu, Margaret L. Macmillan, Zahra Mahmoudjafari, Marco Mielcarek, Mohamad Mohty, Arnon Nagler, Eneida Nemecek, Timothy S. Olson, Betul Oran, Miguel-Angel Perales, Susan E. Prockop, Michael A. Pulsipher, Iskra Pusic, Marcie L. Riches, Cesar Rodriguez, Rizwan Romee, Gabriela Rondon, Ayman Saad, Nina Shah, Peter J. Shaw, Shalini Shenoy, Jorge Sierra, Julie Talano, Michael R. Verneris, Paul Veys, John E. Wagner, Bipin N. Savani, Mehdi Hamadani, Paul A. Carpenter Jul 2021

Standardizing Definitions Of Hematopoietic Recovery, Graft Rejection, Graft Failure, Poor Graft Function, And Donor Chimerism In Allogeneic Hematopoietic Cell Transplantation: A Report On Behalf Of The American Society For Transplantation And Cellular Therapy., Mohamed A. Kharfan-Dabaja, Ambuj Kumar, Ernesto Ayala, Mahmoud Aljurf, Taiga Nishihori, Rebecca Marsh, Lauri M. Burroughs, Navneet Majhail, A. Samer Al-Homsi, Zaid S. Al-Kadhimi, Merav Bar, Alice Bertaina, Jaap J. Boelens, Richard Champlin, Sonali Chaudhury, Zachariah Defilipp, Bhagirathbhai Dholaria, Areej El-Jawahri, Suzanne Fanning, Ellen Fraint, Usama Gergis, Sergio Giralt, Betty K. Hamilton, Shahrukh K. Hashmi, Biljana Horn, Yoshihiro Inamoto, David A. Jacobsohn, Tania Jain, Laura Johnston, Abraham S. Kanate, Ankit Kansagra, Adetola Kassim, Leslie S. Kean, Carrie L. Kitko, Jessica Knight-Perry, Joanne Kurtzberg, Hien Liu, Margaret L. Macmillan, Zahra Mahmoudjafari, Marco Mielcarek, Mohamad Mohty, Arnon Nagler, Eneida Nemecek, Timothy S. Olson, Betul Oran, Miguel-Angel Perales, Susan E. Prockop, Michael A. Pulsipher, Iskra Pusic, Marcie L. Riches, Cesar Rodriguez, Rizwan Romee, Gabriela Rondon, Ayman Saad, Nina Shah, Peter J. Shaw, Shalini Shenoy, Jorge Sierra, Julie Talano, Michael R. Verneris, Paul Veys, John E. Wagner, Bipin N. Savani, Mehdi Hamadani, Paul A. Carpenter

Department of Medical Oncology Faculty Papers

Allogeneic hematopoietic cell transplantation (allo-HCT) is potentially curative for certain hematologic malignancies and nonmalignant diseases. The field of allo-HCT has witnessed significant advances, including broadening indications for transplantation, availability of alternative donor sources, less toxic preparative regimens, new cell manipulation techniques, and novel GVHD prevention methods, all of which have expanded the applicability of the procedure. These advances have led to clinical practice conundrums when applying traditional definitions of hematopoietic recovery, graft rejection, graft failure, poor graft function, and donor chimerism, because these may vary based on donor type, cell source, cell dose, primary disease, graft-versus-host disease (GVHD) prophylaxis, and …


A Single Dose Of Replication-Competent Vsv-Vectored Vaccine Expressing Sars-Cov-2 S1 Protects Against Virus Replication In A Hamster Model Of Severe Covid-19., Delphine C. Malherbe, Drishya Kurup, Christoph Wirblich, Adam J. Ronk, Chad Mire, Natalia Kuzmina, Noor Shaik, Sivakumar Periasamy, Matthew A. Hyde, Julie M. Williams, Pei-Yong Shi, Matthias J. Schnell, Alexander Bukreyev Jul 2021

A Single Dose Of Replication-Competent Vsv-Vectored Vaccine Expressing Sars-Cov-2 S1 Protects Against Virus Replication In A Hamster Model Of Severe Covid-19., Delphine C. Malherbe, Drishya Kurup, Christoph Wirblich, Adam J. Ronk, Chad Mire, Natalia Kuzmina, Noor Shaik, Sivakumar Periasamy, Matthew A. Hyde, Julie M. Williams, Pei-Yong Shi, Matthias J. Schnell, Alexander Bukreyev

Department of Microbiology and Immunology Faculty Papers

The development of effective countermeasures against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the agent responsible for the COVID-19 pandemic, is a priority. We designed and produced ConVac, a replication-competent vesicular stomatitis virus (VSV) vaccine vector that expresses the S1 subunit of SARS-CoV-2 spike protein. We used golden Syrian hamsters as animal models of severe COVID-19 to test the efficacy of the ConVac vaccine. A single vaccine dose elicited high levels of SARS-CoV-2 specific binding and neutralizing antibodies; following intranasal challenge with SARS-CoV-2, animals were protected from weight loss and viral replication in the lungs. No enhanced pathology was observed …


Global Initiative For Asthma (Gina): What’S New In Gina 2021?, Christopher Chambers, Md Jul 2021

Global Initiative For Asthma (Gina): What’S New In Gina 2021?, Christopher Chambers, Md

Department of Family & Community Medicine Presentations and Grand Rounds

No abstract provided.


Pre-Operative Fluid Resuscitation In The Emergency General Surgery Septic Patient: Does It Really Matter?, Benjamin Moran, Erin Major, Joseph A Kufera, Samuel A Tisherman, Jose Diaz Jul 2021

Pre-Operative Fluid Resuscitation In The Emergency General Surgery Septic Patient: Does It Really Matter?, Benjamin Moran, Erin Major, Joseph A Kufera, Samuel A Tisherman, Jose Diaz

Department of Emergency Medicine Faculty Papers

OBJECTIVE: Emergency general surgery (EGS) patients presenting with sepsis remain a challenge. The Surviving Sepsis Campaign recommends a 30 mL/kg fluid bolus in these patients, but recent studies suggest an association between large volume crystalloid resuscitation and increased mortality. The optimal amount of pre-operative fluid resuscitation prior to source control in patients with intra-abdominal sepsis is unknown. This study aims to determine if increasing volume of resuscitation prior to surgical source control is associated with worsening outcomes.

METHODS: We conducted an 8-year retrospective chart review of EGS patients undergoing surgery for abdominal sepsis within 24 h of admission. Patients in …


Exploiting The Power Of Information In Medical Education., William B. Cutrer, W. Anderson Spickard, Marc M. Triola, Bradley L. Allen, Nathan Spell, Steven K. Herrine, John L. Dalrymple, Paul N. Gorman, Kimberly D. Lomis Jul 2021

Exploiting The Power Of Information In Medical Education., William B. Cutrer, W. Anderson Spickard, Marc M. Triola, Bradley L. Allen, Nathan Spell, Steven K. Herrine, John L. Dalrymple, Paul N. Gorman, Kimberly D. Lomis

Division of Gastroenterology and Hepatology Faculty Papers

The explosion of medical information demands a thorough reconsideration of medical education, including what we teach and assess, how we educate, and whom we educate. Physicians of the future will need to be self-aware, self-directed, resource-effective team players who can synthesize and apply summarized information and communicate clearly. Training in metacognition, data science, informatics, and artificial intelligence is needed. Education programs must shift focus from content delivery to providing students explicit scaffolding for future learning, such as the Master Adaptive Learner model. Additionally, educators should leverage informatics to improve the process of education and foster individualized, precision education. Finally, attributes …


Developing Standardized Patient-Based Cases For Communication Training: Lessons Learned From Training Residents To Communicate Diagnostic Uncertainty., Dimitrios Papanagnou, Matthew R Klein, Xiao Chi Zhang, Kenzie A Cameron, Amanda Doty, Danielle M Mccarthy, Kristin L. Rising, David H Salzman Jul 2021

Developing Standardized Patient-Based Cases For Communication Training: Lessons Learned From Training Residents To Communicate Diagnostic Uncertainty., Dimitrios Papanagnou, Matthew R Klein, Xiao Chi Zhang, Kenzie A Cameron, Amanda Doty, Danielle M Mccarthy, Kristin L. Rising, David H Salzman

Department of Emergency Medicine Faculty Papers

Health professions education has benefitted from standardized patient (SP) programs to develop and refine communication and interpersonal skills in trainees. Effective case design is essential to ensure an SP encounter successfully meets learning objectives that are focused on communication skills. Creative, well-designed case scenarios offer learners the opportunity to engage in complex patient encounters, while challenging them to address the personal and emotional contexts in which their patients are situated. Therefore, prior to considering the practical execution of the patient encounter, educators will first need a clear and structured strategy for writing, organizing, and developing cases. The authors reflect on …


Lncrna Nonhsat069381 And Nonhsat140844 Increase In Aging Human Blood, Regulating Cardiomyocyte Apoptosis., Jinyang Zhao, Xiaolong Lin, Haoxuan Sun, Donghui Zhao, Qin Ma, Wayne Bond Lau, Zichao Cheng, Fanqi Li, Jinghua Liu, Qian Fan Jul 2021

Lncrna Nonhsat069381 And Nonhsat140844 Increase In Aging Human Blood, Regulating Cardiomyocyte Apoptosis., Jinyang Zhao, Xiaolong Lin, Haoxuan Sun, Donghui Zhao, Qin Ma, Wayne Bond Lau, Zichao Cheng, Fanqi Li, Jinghua Liu, Qian Fan

Department of Emergency Medicine Faculty Papers

Aging augments postischemic apoptosis via incomplete mechanisms. Our previous animal study suggests that in addition to proapoptotic effects, lncRNAs also exert antiapoptotic effects in cardiomyocytes. However, whether this unexpected phenomenon exists in humans is unknown. In the present study, we investigated the relationship between aging and apoptosis regulation in human blood samples and confirmed their role by utilizing the cardiomyocyte lines (AC16 cells). Human blood samples were collected from 20 pairs of older adult and young volunteers. Age-different apoptotic regulatory lncRNAs and miRNAs were identified by microarray and bioinformatics analysis. The results indicated that lncRNA (NONHSAT069381 and NONHSAT140844) and miRNA …


Distinct Cortical Systems Reinstate The Content And Context Of Episodic Memories., James E. Kragel, Youssef Ezzyat, Bradley C. Lega, Michael R. Sperling, Gregory A. Worrell, Robert E. Gross, Barbara C. Jobst, Sameer A. Sheth, Kareem A. Zaghloul, Joel M. Stein, Michael J. Kahana Jul 2021

Distinct Cortical Systems Reinstate The Content And Context Of Episodic Memories., James E. Kragel, Youssef Ezzyat, Bradley C. Lega, Michael R. Sperling, Gregory A. Worrell, Robert E. Gross, Barbara C. Jobst, Sameer A. Sheth, Kareem A. Zaghloul, Joel M. Stein, Michael J. Kahana

Department of Neurology Faculty Papers

Episodic recall depends upon the reinstatement of cortical activity present during the formation of a memory. Evidence from functional neuroimaging and invasive recordings in humans suggest that reinstatement organizes our memories by time or content, yet the neural systems involved in reinstating these unique types of information remain unclear. Here, combining computational modeling and intracranial recordings from 69 epilepsy patients, we show that two cortical systems uniquely reinstate the semantic content and temporal context of previously studied items during free recall. Examining either the posterior medial or anterior temporal networks, we find that forward encoding models trained on the brain's …


Patient Resilience Has Moderate Correlation With Functional Outcomes, But Not Satisfaction, After Primary Unilateral Total Knee Arthroplasty., Amer Haffar, Sean Bryan, Marc Harwood, Jess H. Lonner Jul 2021

Patient Resilience Has Moderate Correlation With Functional Outcomes, But Not Satisfaction, After Primary Unilateral Total Knee Arthroplasty., Amer Haffar, Sean Bryan, Marc Harwood, Jess H. Lonner

Rothman Institute Papers

Background: As many as 20% of patients who undergo total knee arthroplasty (TKA) are dissatisfied. Psychological factors have been shown to play a role in outcomes after TKA. The purpose of this study was to investigate the impact of patient resilience on functional outcomes and satisfaction after primary unilateral TKA.

Methods: Eighty-six patients who underwent primary unilateral TKA by a single surgeon were studied. Primary outcomes were the Brief Resilience Scale (BRS), mental health component of the Veterans Rand 12-Item Health Survey (VR-12 MCS), Knee Injury and Osteoarthritis Outcome Score for Joint Replacement, and New Knee Society Score. Correlations between …


Caregiver Health-Related Quality Of Life, Burden, And Patient Outcomes In Ambulatory Advanced Heart Failure: A Report From Revival., Nisha A. Gilotra, Salpy V. Pamboukian, Maria Mountis, Shawn W. Robinson, Michelle Kittleson, Keyur B. Shah, Rhondalyn C. Forde-Mclean, Donald C. Haas, Douglas A. Horstmanshof, Ulrich P. Jorde, Stuart D. Russell, Wendy C. Taddei-Peters, Neal Jeffries, Shokoufeh Khalatbari, Catherine A. Spino, Blair Richards, Matheos Yosef, Douglas L. Mann, Garrick C. Stewart, Keith D. Aaronson, Kathleen L. Grady Jul 2021

Caregiver Health-Related Quality Of Life, Burden, And Patient Outcomes In Ambulatory Advanced Heart Failure: A Report From Revival., Nisha A. Gilotra, Salpy V. Pamboukian, Maria Mountis, Shawn W. Robinson, Michelle Kittleson, Keyur B. Shah, Rhondalyn C. Forde-Mclean, Donald C. Haas, Douglas A. Horstmanshof, Ulrich P. Jorde, Stuart D. Russell, Wendy C. Taddei-Peters, Neal Jeffries, Shokoufeh Khalatbari, Catherine A. Spino, Blair Richards, Matheos Yosef, Douglas L. Mann, Garrick C. Stewart, Keith D. Aaronson, Kathleen L. Grady

Abington Jefferson Health Papers

Background

Heart failure (HF) imposes significant burden on patients and caregivers. Longitudinal data on caregiver health‐related quality of life (HRQOL) and burden in ambulatory advanced HF are limited.

Methods and Results

Ambulatory patients with advanced HF (n=400) and their participating caregivers (n=95) enrolled in REVIVAL (Registry Evaluation of Vital Information for VADs [Ventricular Assist Devices] in Ambulatory Life) were followed up for 24 months, or until patient death, left ventricular assist device implantation, heart transplantation, or loss to follow‐up. Caregiver HRQOL (EuroQol Visual Analog Scale) and burden (Oberst Caregiving Burden Scale) did not change significantly from baseline to follow‐up. At …


Here Comes The Sun … For Retinoblastoma, Carol L Shields, Jerry A Shields Jul 2021

Here Comes The Sun … For Retinoblastoma, Carol L Shields, Jerry A Shields

Wills Eye Hospital Papers

No abstract provided.


Ketamine In The Past, Present, And Future: Mechanisms, Metabolites, And Toxicity., Eric S. Schwenk, Basant Pradhan, Rohit Nalamasu, Lucas Stolle, Irving W. Wainer, Michael Cirullo, Alexander Olsen, Joseph V. Pergolizzi, Marc C. Torjman, Eugene R. Viscusi Jul 2021

Ketamine In The Past, Present, And Future: Mechanisms, Metabolites, And Toxicity., Eric S. Schwenk, Basant Pradhan, Rohit Nalamasu, Lucas Stolle, Irving W. Wainer, Michael Cirullo, Alexander Olsen, Joseph V. Pergolizzi, Marc C. Torjman, Eugene R. Viscusi

Department of Anesthesiology Faculty Papers

PURPOSE OF REVIEW: While ketamine's analgesia has mostly been attributed to antagonism of N-methyl-D-aspartate receptors, evidence suggests multiple other pathways are involved in its antidepressant and possibly analgesic activity. These mechanisms and ketamine's role in the nociplastic pain paradigm are discussed. Animal studies demonstrating ketamine's neurotoxicity have unclear human translatability and findings from key rodent and human studies are presented.

RECENT FINDINGS: Ketamine's metabolites, and (2R,6R)-hydroxynorketamine in particular, may play a greater role in its clinical activity than previously believed. The activation of α-amino-3-hydroxy-5-methyl-4-isoxazolepropionic acid (AMPA) and the mammalian target of rapamycin by ketamine are mechanisms that are still being …


N-Acetyl Cysteine Administration Affects Cerebral Blood Flow As Measured By Arterial Spin Labeling Mri In Patients With Multiple Sclerosis., Shiva Shahrampour, Justin Heholt, Andrew Wang, Faezeh Vedaei, Feroze B. Mohamed, Mahdi Alizadeh, Ze Wang, George Zabrecky, Nancy Wintering, Anthony J. Bazzan, Thomas P. Leist, Daniel A. Monti, Andrew B. Newberg Jul 2021

N-Acetyl Cysteine Administration Affects Cerebral Blood Flow As Measured By Arterial Spin Labeling Mri In Patients With Multiple Sclerosis., Shiva Shahrampour, Justin Heholt, Andrew Wang, Faezeh Vedaei, Feroze B. Mohamed, Mahdi Alizadeh, Ze Wang, George Zabrecky, Nancy Wintering, Anthony J. Bazzan, Thomas P. Leist, Daniel A. Monti, Andrew B. Newberg

Department of Radiology Faculty Papers

Background: The purpose of this study was to explore if administration of N-acetyl-cysteine (NAC) in patients with multiple sclerosis (MS) resulted in altered cerebral blood flow (CBF) based on Arterial Spin Labeling (ASL) magnetic resonance imaging (MRI).

Methods: Twenty-three patients with mild to moderate MS, (17 relapsing remitting and 6 primary progressive) were randomized to either NAC plus standard of care (N = 11), or standard of care only (N = 12). The experimental group received NAC intravenously (50 mg/kg) once per week and orally (500mg 2x/day) the other six days. Patients in both groups were evaluated initially and after …


Medical Nutrition Therapy For Diabetes, Cheryl Marco, Rd, Cde Jul 2021

Medical Nutrition Therapy For Diabetes, Cheryl Marco, Rd, Cde

Department of Family & Community Medicine Presentations and Grand Rounds

No abstract provided.


Discovery Of A New Cdk4/6 And Pi3k/Akt Multiple Kinase Inhibitor Aminoquinol For The Treatment Of Hepatocellular Carcinoma., Zhong-Kun Xia, Wei Wang, Jian-Ge Qiu, Xi-Nan Shi, Hong-Jian Li, Rong Chen, Kun-Bin Ke, Chao Dong, Ying Zhu, Shi-Guo Wu, Rong-Ping Zhang, Zhuo-Ran Meng, Hui Zhao, Peng Gu, Kwong-Sak Leung, Man-Hon Wong, Xiao-Dong Liu, Feng-Mei Zhou, Jian-Ying Zhang, Ya-Ting Yao, Si-Jia Wang, Chun-Yang Zhang, Yan-Ru Qin, Marie Chia-Mi Lin, Bing-Hua Jiang Jul 2021

Discovery Of A New Cdk4/6 And Pi3k/Akt Multiple Kinase Inhibitor Aminoquinol For The Treatment Of Hepatocellular Carcinoma., Zhong-Kun Xia, Wei Wang, Jian-Ge Qiu, Xi-Nan Shi, Hong-Jian Li, Rong Chen, Kun-Bin Ke, Chao Dong, Ying Zhu, Shi-Guo Wu, Rong-Ping Zhang, Zhuo-Ran Meng, Hui Zhao, Peng Gu, Kwong-Sak Leung, Man-Hon Wong, Xiao-Dong Liu, Feng-Mei Zhou, Jian-Ying Zhang, Ya-Ting Yao, Si-Jia Wang, Chun-Yang Zhang, Yan-Ru Qin, Marie Chia-Mi Lin, Bing-Hua Jiang

Department of Pathology, Anatomy, and Cell Biology Faculty Papers

Background: Hepatocellular carcinoma (HCC) is a lethal malignancy lacking effective treatment. The Cyclin-dependent kinases 4/6 (CDK4/6) and PI3K/AKT signal pathways play pivotal roles in carcinogenesis and are promising therapeutic targets for HCC. Here we identified a new CDK4/6 and PI3K/AKT multi-kinase inhibitor for the treatment of HCC.

Methods: Using a repurposing and ensemble docking methodology, we screened a library of worldwide approved drugs to identify candidate CDK4/6 inhibitors. By MTT, apoptosis, and flow cytometry analysis, we investigated the effects of candidate drug in reducing cell-viability,inducing apoptosis, and causing cell-cycle arrest. The drug combination and thermal proteomic profiling (TPP) method were …


Robotic Assistance In Unicompartmental Knee Arthroplasty Results In Superior Early Functional Recovery And Is More Likely To Meet Patient Expectations., Meredith P. Crizer, Amer Haffar, Andrew Battenberg, Mikayla Mcgrath, Ryan Sutton, Jess H Lonner Jul 2021

Robotic Assistance In Unicompartmental Knee Arthroplasty Results In Superior Early Functional Recovery And Is More Likely To Meet Patient Expectations., Meredith P. Crizer, Amer Haffar, Andrew Battenberg, Mikayla Mcgrath, Ryan Sutton, Jess H Lonner

Rothman Institute Papers

Robotic technology has reduced the errors of implant alignment in unicompartmental knee arthroplasty (UKA), but its impact on functional recovery after UKA is poorly defined. The purpose of this study was to compare early functional recovery, pain levels, and satisfaction in UKA performed with either robotic assistance or conventional methods. A retrospective analysis was performed on 89 matched consecutive patients who underwent outpatient UKA by a single physician using either conventional instruments (n = 39) or robotic methods (n = 50), with otherwise identical perioperative protocols. Outcomes studied included Lower Extremity Functional Score (LEFS), new Knee Society Score …