Medical Specialties Commons^™

Patient Perceptions And Knowledge Of Corticosteroid Injections: A Cross-Sectional Survey Study, Juliet Chung, Sina Ramtin, Philip Koehler, Stephen Stache, Charles Langman, Bryan Hozack, Asif M. Ilyas

Rothman Institute Papers

INTRODUCTION: Although cortisone injections are commonly used, patient understanding of cortisone is variable and often affected by misconceptions. This study explores patient perspectives, identifies misconceptions, and emphasizes the importance of improved patient education to enhance patient-centered care.

METHODS: A cross-sectional survey study was conducted from April to August 2024 among patients aged 18 and older presenting to an orthopedic physicians' office. Patients completed a novel anonymous questionnaire designed to assess their knowledge and perceptions of cortisone injections. A total of 246 patients participated, with responses collected electronically via SurveyMonkey.

RESULTS: Among 246 respondents, individuals with history of prior cortisone infections …

Outcomes Of Lumbar Fusion Surgery In Isthmic Versus Degenerative Spondylolisthesis: A Systematic Review And Meta-Analysis, Pavlos Texakalidis, Stavros Matsoukas, Constantine L. Karras, Christopher S. Ahuja, Najib El Tecle, Tyler R. Koski, Nader S. Dahdaleh

Department of Neurosurgery Faculty Papers

Lumbar spondylolisthesis can cause a significant disability due to back and lower extremity pain. Degenerative spondylolisthesis (DS) and isthmic spondylolisthesis (IS) are the two most common types. DS results from arthritic changes and degenerative disc disease, whereas IS occurs secondary to a pars interarticularis defect. This study compared surgical outcomes between IS and DS. A systematic literature review and meta-analysis was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Twenty studies comprising 3136 patients were included (DS: 1944; IS: 1192). No differences were identified in terms of estimated blood loss (mean difference [MD]: 5.79, 95% …

Polθ Activity Modulates Sensitivity To Standard Therapies In Dnmt3a-Deficient Leukemia, Bac Viet Le, Umeshkumar Vekariya, Monika M. Toma, Margaret Nieborowska-Skorska, Marie-Christine Caron, Malgorzata Gozdecka, Zayd Haydar, Martin Walsh, Jayashri Ghosh, Elaine Vaughan-Williams, Paulina Podszywalow-Bartnicka, Anna-Mariya Kukuyan, Sylwia Ziolkowska, Jessica Atkins, Emir Hadzijusufovic, Gurushankar Chandramouly, Reza Nejati, Katarzyna Piwocka, Richard T. Pomerantz, George S. Vassiliou, Brian J.P. Huntly, Peter Valent, Mariusz Wasik, Alfonso Bellacosa, Jean-Yves Masson, Gaorav P. Gupta, Grant A. Challen, Tomasz Skorski

Department of Biochemistry and Molecular Biology Faculty Papers

Myeloid malignancies carrying somatic DNMT3A mutations (DNMT3Amut) are refractory to standard therapy. DNMT3Amut leukemia cells accumulate toxic DNA double-strand breaks (DSBs) and stalled replication forks, rendering them dependent on DNA damage response (DDR). We report here that DNA polymerase theta (Polθ), a key element in DSB repair by end-joining (Polθ-mediated end-joining [TMEJ]) and in fork restarting, promotes survival and proliferation of DNMT3Amut leukemia cells. Polθ is overexpressed in DNMT3Amut leukemia cells due to abrogation of PARP1 PARylation-dependent UBE2O E3 ligase-mediated ubiquitination and proteasomal degradation of Polθ. In addition, PARP1-mediated recruitment of the SMARCAD1-MSH2/MSH3 repressive complex to DSBs is diminished in …

Infectious Aortitis Secondary To Gastrointestinal Pathogens: A Case Series And Syndromic Review, Natasa Kostic, Ilana Goldberg, Devin Weber

Division of Internal Medicine Faculty Papers & Presentations

Aortitis is a rare but serious complication of infection that results in high morbidity and mortality. The most common location is in preexisting aneurysmal disease in a patient with multiple chronic comorbidities. The pathogens often reflect gastrointestinal bacteria, the classic example being Salmonella spp., but also include other enteric flora, Staphylococcus aureus, Streptococcus spp., and more. Herein, we describe 2 cases of aortitis caused by gastrointestinal bacteria and review management of this complex syndrome.

The Prospects Of Car T-Cell Therapies In Changing The Therapeutic Algorithm Of Neurologic Autoimmunities, Marinos C. Dalakas

Department of Neurosurgery Faculty Papers

T cells, genetically modified to express chimeric antigen receptors (CAR T), successfully used in hemato-oncologic malignancies, are showing promising and sustained benefits in refractory autoimmune neurological diseases, including Myasthenia Gravis, stiff-person syndrome, neuromyelitis optica, myositis, autoimmune neuropathies, and multiple sclerosis. Several reported patients with a steadily progressive disease and evolving disability unresponsive to available therapies, including rituximab and new biologics, after 2-3 months of treatment with CARs targeting CD19-positive, antibody-secreting, long-lived plasma cells, and plasmablasts exhibit impressive, long-lasting, and drug-free clinical improvements with the potential for immune reset shifting immunity to a healthy state without the need for continuing more …

Cannabis Stigma And Symptom Management Considerations In Cancer Survivors: A Mixed-Methods Exploration Of Patient Perspectives, Sera Levy, Salimah Meghani, Brooke Worster, Colleen Kilanowski, Danielle Smith, Amy A. Case, Rebecca L. Ashare

Department of Medical Oncology Faculty Papers

PURPOSE: This study aims to assess for indications of stigma and attitudes toward cannabis among cancer survivors (CS) who use or consider the use of cannabis.

METHODS: This study employed a convergent, parallel mixed methods design utilizing focus group and questionnaire data to assess the presence of stigma among a sample of CS (n = 23) who use (n = 10) and do not use (n = 13) cannabis to manage symptoms. CS were recruited from a multi-site observational study in the Northeast U.S. region that assesses cannabis use among oncology patients.

RESULTS: A total of 23 CS participated in …

Quality Of Robotic Segmentectomy Vs. Video-Assisted Thoracoscopic Segmentectomy In Non-Small Cell Lung Cancer: A Retrospective Cohort Study, Sneha S. Alaparthi, Anurag Ishwar, Isheeta Madeka, Annie Ho, Tyler Grenda, Nathaniel R. Evans Iii, Olugbenga T. Okusanya

Jefferson Hospital Staff Papers and Presentations

Background & Methods

• Lung cancer remains a leading cause of cancer death worldwide. Sub lobar resection (segmentectomy) has proved to be a safe and effective alternative to lobectomy in recent literature.
• Our objective is to compare quality of resection between robotic assisted (RVATS) and video assisted (VATS) thoracoscopic segmentectomy. Our hypothesis is that robotic segmentectomy will allow for an improved oncologic resection.
• Retrospective cohort study of National Cancer Database (NCDB). Patients >18 undergoing RVATS or VATS segmentectomy for clinical N0M0, ≤ 2 cm between 2010-2020.
• Quality of oncologic resection assessed with presence and number of nodes examined, margin positivity, upstaging, …

Publication Productivity Among International Medical Graduates And U.S. Medical Graduates In Neurosurgery: A Comparative Assessment Using The Arms Race Control Score, Joanna M. Roy, Omar M. M. Mansoor, Samit Sen, Aaron C. Segura, Rithvik Naga Ganti, Basel Musmar, Gilberto Perez Rodriguez Garcia, Brett Henshey, Saarang Patel, Sruthi Ranganathan, Victor Gabriel El-Hajj, Stavropoula I. Tjoumakaris, M. Reid Gooch, Robert H. Rosenwasswer, Christian Bowers, Pascal Jabbour

Department of Neurosurgery Faculty Papers

BACKGROUND AND OBJECTIVES: The Arms Race Control Score (ARCS) was developed to provide a quantitative assessment of publications among residency applicants. International medical graduates (IMGs) often have higher numbers of publications compared to U.S medical graduates (US MDs). However, there is limited knowledge of publication quality and effort among IMGs and US MDs. Our study analyzes publication productivity among IMGs and US MDs using the ARCS.

METHODS: Applicants were selected from ACGME-accredited training programs that enrolled both IMG and US MD residents over the 2018-2024 match cycle. Programs without IMG residents in a given year were excluded from the analysis. …

Social Determinants Of Health And Quality Of Life Among Korean Americans With Chronic Hepatitis B, Cindy Xin Fang, Yoonjin Nam, Ann C. Klassen, Hee-Soon Juon

Department of Medical Oncology Faculty Papers

BACKGROUND: Hepatitis B virus (HBV) infection disproportionately affects Korean Americans, who often experience persistent social and structural challenges that may influence quality of life. Recent community studies showed most Korean Americans with chronic hepatitis B (CHB) were disengaged from clinical care, emphasizing the need to better understand factors affecting their well-being. This study examined associations between social determinants of health (SDOH) and physical and mental health related quality of life (HRQoL) among Korean Americans with CHB.

METHODS: A total of 365 CHB patients completed the enrollment survey. SF-12 was used to measure quality of life, calculating physical and mental components …

Defining A Multi-Omic, Ai-Enabled Stool Screening Paradigm For Colorectal Cancer: A Consensus Framework For Clinical Translation, Arturo Loaiza-Bonilla, Yan Leyfman, Viviana Cortiana, Rhys Crawford, Shivani Modi

Einstein Health Papers

Colorectal cancer (CRC) develops through both conventional adenoma-carcinoma and serrated neoplasia pathways, yet noninvasive screening still under-detects the advanced precursor lesions that enable true cancer prevention. Stool-based screening reduces CRC mortality, but its preventive impact remains constrained by limited detection of advanced precancerous lesions (APLs), including advanced adenomas and sessile serrated lesions. Next-generation multitarget stool DNA assays (mt-sDNA; e.g., Cologuard Plus) have established high sensitivity for CRC and specificity approaching 94%, leaving improved APL detection as the principal opportunity for innovation. This review presents a consensus framework for a multi-omic stool screening paradigm that integrates host epigenetic markers (DNA methylation) …

Virtual Reality For The Management Of Postoperative Pain And Anxiety In Children And Adolescents Undergoing Nuss Repair Of Pectus Excavatum: Randomized Controlled Trial, Charlotte M. Walter, Dillon Froass, Nora Bell, Lauren Haack, Chloe Boehmer, Claudia Bruguera Torres, Rachel Spivak, Max Chou, Kristie Geisler, Keith O'Conor, Sara E. Williams, Lili Ding, Christopher D. King, Vanessa A. Olbrecht

Department of Medicine Faculty Papers

BACKGROUND: Virtual reality (VR) is a novel technology with implications for pain and sensory processing. VR may serve as a novel, scalable method to deliver clinically validated therapy for pain management as an alternative or adjunct to opioids for acute pain. Given that psychological factors and pain perception are both components of postoperative pain, it may also be beneficial to incorporate modalities that decrease anxiety, such as active relaxation and guided meditation with VR. Unfortunately, these therapies are not widely available due to multiple barriers. VR has the potential to deliver pain-reducing, psychologically based therapy to children, thereby enhancing multimodal …

The Association Of P27 With Prostate Cancer Outcomes: A Secondary Analysis Of Nrg/Rtog 8610 And 9202, Krishnan Patel, Stephanie Pugh, Jeffry Simko, Anthony Zietman, Michelangelo Fiorentino, David Paul D'Souza, Seth Rosenthal, Adam Currey, Adam Dicker, Bradley Stish, Eric Horwitz, Tyler Robin, Michael Dominello, Christopher Peters, Kwang Choi, Jason Efstathiou, Samir Narayan, George Daniel Grass, Zaker Rana, Phuoc Tran, Massimo Loda, Paul Nguyen

Kimmel Cancer Center Faculty Papers

PURPOSE: The cyclin-dependent kinase inhibitor p27 is a well-profiled modulator of cell cycle progression. Low nuclear p27 levels have been demonstrated to have a negative prognostic impact on outcomes in patients undergoing prostatectomy. The prognostic value of p27 after radiation therapy (RT) for prostate cancer is unknown.

METHODS AND MATERIALS: Levels of p27 were evaluated in pre-RT prostate biopsy samples from 2 randomized, phase 3 trials, NRG/RTOG 8610 and 9202, which treated patients with RT with or without androgen deprivation therapy (ADT). Nuclear p27 was analyzed using immunohistochemistry and quantified using automated imaging analysis. The association of p27 as both …

Endometriosis Knowledge Among Emergency Medicine Providers: Diagnostic Skills And Symptom Recognition, Caidon Iwuagwu, Laurel X. Chen, Ellen Slattery, Pranjal Srivastava, Hamsitha Karra, Sheyenne Tung, Adrienne Burton, Camila Bomtempo, Jamie Aranda

Department of Surgery Faculty Papers

Objective: Endometriosis is associated with significant diagnostic delays, averaging 6.7 years, largely due to nonspecific symptoms and inadequate diagnostic approaches. Over 15,000 emergency department (ED) visits in the United States annually involve patients with endometriosis, highlighting the need for knowledge of endometriosis. This study surveys emergency medicine (EM) attendings, residents, nurse practitioners, physician assistants, and fellows to assess knowledge and practice in managing endometriosis-related ED complaints. Methods: A questionnaire from a prior endometriosis survey was modified for EM providers and administered anonymously via email (Qualtrics, Provo, UT) in monthly newsletters to providers at an academic and six associated community EDs. …

Real-World Precision Medicine Data In Metastatic Prostate Cancer - A Retrospective Cohort Study, Awais Paracha, Derek Tran, Margot Noyelle, Jonathan Kapilian, Zohair Siddiqui, Adrian Choppa, Anthony Corsi, Jacob Stone, Xin-Hua Zhu

Department of Medicine Faculty Papers

Background: Prostate cancer (PC) is the most common cancer in men in the United States with a 5-year relative survival rate for people with distant metastases of 36%. We conducted a single institution, retrospective cohort study of patients with metastatic PC to investigate whether certain gene mutations can be used as predictive biomarkers.

Methods: 200 patients with metastatic hormone sensitive (mHSPC) and castration resistant (mCRPC) prostate cancer who had a FoundationOne report and were treated from June 2007 to October 2024 were included in the study. Disease progression was evaluated according to RECIST criteria, PCWG3 criteria, and PSA values. Assessed …

Ergonomic Trends In Endoscopic Skull-Base Surgeons: A Survey To The North American Skull Base Society, Shreya Mandloi, Alexander Duffy, Praneet Kaki, Elina Toskala, Marc Rosen, Christopher Farrell, James Evans, Gurston G. Nyquist, Mindy Rabinowitz, Md

Department of Otolaryngology - Head and Neck Surgery Faculty Papers

OBJECTIVE: Lack of ergonomic practices in the operating room results in significant musculoskeletal strain. This study obtains a current assessment of self-reported musculoskeletal strain associated with endoscopic endonasal and open skull base surgery as reported by members of the North American Skull Base Society (NASBS).

STUDY DESIGN: Online Survey.

SETTING: Online.

METHODS: A survey assessing current symptoms in endoscopic skull base surgery was distributed to members of the NASBS.

RESULTS: Sixty-six responses were completed and analyzed. 95% of respondents indicated they had musculoskeletal strain at the neck and C-spine. There was no significant difference in average operating time per week …

Ergonomic Trends In Endoscopic Skull-Base Surgeons: A Survey To The North American Skull Base Society, Shreya Mandloi, Alexander Duffy, Praneet C. Kaki, Elina Toskala, Marc Rosen, Christopher Farrell, James J. Evans, Gurston G. Nyquist, Mindy R. Rabinowitz

Department of Otolaryngology - Head and Neck Surgery Faculty Papers

OBJECTIVE: Lack of ergonomic practices in the operating room results in significant musculoskeletal strain. This study obtains a current assessment of self-reported musculoskeletal strain associated with endoscopic endonasal and open skull base surgery as reported by members of the North American Skull Base Society (NASBS).

STUDY DESIGN: Online Survey.

SETTING: Online.

METHODS: A survey assessing current symptoms in endoscopic skull base surgery was distributed to members of the NASBS.

RESULTS: Sixty‐six responses were completed and analyzed. 95% of respondents indicated they had musculoskeletal strain at the neck and C‐spine. There was no significant difference in average operating time per week …

A Novel Laparoscopic Renal Denervation System In A Preclinical Swine Model, Linwei Zhao, Wei Yang, Binbin Zhu, Yahui Liu, Peng Tian, Xinyu Guo, Yang Dong, Zhiqiang Fan, Huiping Li, Yu Feng, Lijie Zhu, Minfu Bai, Qiuping Zhao, Xingkun Zhang, Chenchen Si, Qianqian Cheng, Gan-Xin Yan, Chuanyu Gao

Department of Medicine Faculty Papers

Laparoscopic renal denervation (RDN) represents a specialized approach for hypertension, particularly when conventional methods face limitations. While catheter-based RDN has demonstrated significant efficacy in recent large-scale clinical trials and has been integrated into international guidelines, its effectiveness can be constrained by complex renal anatomy or incomplete ablation. We developed a novel laparoscopic RDN system, comprising an integrated radiofrequency (RF) clamp, RF generator, and cooling pump, to achieve more controlled adventitial ablation. This study aims to evaluate the safety, feasibility, and optimal parameters of this new system in a preclinical swine model. Sixteen pigs were divided into an immediate group ( …

Operative Confidence In Open And Endovascular Procedures Among Vascular Surgery Graduates Reflects Procedural Exposure During Training, Jin Park, Nicola Habash, Dawn Salvatore, Michael Nooromid, Paul J. Dimuzio, Babak Abai

Department of Surgery Faculty Papers

Objective: The shift toward minimally invasive techniques has transformed vascular surgery practice and training. As endovascular procedures replace many traditional open operations, concerns have emerged about whether current training adequately prepares graduates for independent practice, particularly in complex open procedures.

Methods: A web-based survey was distributed to recent graduates of Accreditation Council for Graduate Medical Education-accredited vascular surgery training programs from 2022 and 2024. The survey assessed demographics, program characteristics, estimated case volumes, and confidence in 22 core vascular operations using a five-point Likert scale. Mann-Whitney U and Kruskal-Wallis tests, as well as multivariable logistic regression, identified factors associated with …

Determining The Optimal Management Of Geriatric Type Ii Odontoid Fractures: A Comparative Network Meta-Analysis, Shaan Patel, Shiva A. Nischal, Kush M. Kale, Stavros Matsoukas, Joshua Heller, Jack Jallo, James S. Harrop, Srinivas K. Prasad

Department of Neurosurgery Faculty Papers

UNLABELLED: Type II odontoid fractures are the most common cervical injury in geriatric populations, yet optimal management remains debated. This study compared the safety and effectiveness of non-surgical management (NSM), anterior dens screw (ADS) fixation, and posterior arthrodesis (PA) in these patients. A systematic review and frequentist network meta-analysis was conducted according to PRISMA-NMA guidelines. PubMed/MEDLINE, Embase, and CENTRAL were searched from inception to October 2025. Comparative studies including patients ≥ 60 years with Anderson-D’Alonzo type II fractures and reporting at least one primary outcome (mortality, union, stable non-union, unstable non-union) were eligible. Random-effects network models generated pooled odds ratios …

Infectious Retinitis Associated With Jak Inhibitors: The Ongoing Duality Of Jak Inhibitors, Jose S. Pulido, Fukutaro Mano, Marcello Casella, Susumu Ishida

Wills Eye Hospital Papers

PURPOSE: To discuss the recent evidence that Janus kinase (JAK) inhibitors can cause viral retinitis.

METHODS: A commentary on the case report in this issue and a review of cases in the literature.

RESULTS: A total of 6 cases have now been reported of cytomegalovirus retinitis associated with Jak inhibitors. Additionally, there was a case of bilateral toxoplasma retinitis and a case of herpetic scleritis.

DISCUSSION: It is important to be aware of the potential blinding complications associated with JAK inhibitors and if the patient complains of acute vision loss and/or floaters, the patient should be emergently referred to a …

Repair Of Uterine Rupture With Placenta Accreta At 22 Weeks, Followed By Cesarean Hysterectomy Delivery Of Healthy Neonate At 32 Weeks, Molly Dickinson, Thomas Jefferson University, Marco Goldberg, Mae Florendo, Andrew Chau, Corrado Minimo, Kate Stampler, Jay Goldberg

Einstein Health Papers

Introduction: Uterine rupture at previable gestational ages is almost always treated with evacuation of the pregnancy, followed by uterine repair or hysterectomy. Case Presentation: A 40-year-old woman with one prior cesarean section presented at 22 weeks of gestation with an acute abdomen. Imaging noted hemoperitoneum with areas of bulging in the anterior uterine wall. Laparoscopy converted to a laparotomy through a midline incision, noted an actively bleeding 2 cm area of uterine rupture with protruding placental tissue. The uterine rupture was surgically closed with sutures. The patient was kept in the hospital for the remainder of her pregnancy. At 32 …

Multi-Stakeholder Perspectives On Barriers To Mental Health Support For Informal Caregivers, Maria Lizette Rangel, Donaji Stelzig, Cassandra Martinez Enriquez, Hoda Badr

Department of Medical Oncology Faculty Papers

BACKGROUND: Informal caregivers experience elevated psychological distress but face substantial challenges in accessing mental health support. Prior research has focused primarily on individual or interpersonal determinants, with less attention to how organizational, community, and policy contexts shape access and contribute to inequities in service availability.

METHODS: Fifty-one stakeholders, including 17 informal caregivers, 23 community health workers (CHWs), and 11 mental health professionals, completed a demographic survey and 60-90-min semi-structured interviews in English or Spanish. Data were analyzed using thematic analysis, combining deductive coding guided by the Socioecological Model with inductive identification of emergent themes.

RESULTS: Participants identified both barriers and …

Patterns Of Recurrent Preterm Birth: An Individual Patient Data Meta-Analysis, Charlotte E. Van Dijk, Annemijn A. De Ruigh, Benjamin Y. Gravesteijn, Brenda M. Kazemier, Vincenzo Berghella, John Owen, Roberto Eduardo Bittar, Rashmi Bagga, Joan M. G. Crane, Andrew H. Shennan, Birgit Arabin, Ben Willem Mol, Eva Pajkrt, C. Emily Kleinrouweler

Department of Obstetrics and Gynecology Faculty Papers

OBJECTIVE: Pregnant patients with a previous spontaneous preterm birth are at high risk for recurrent (spontaneous) preterm birth. We investigated whether the number of previous spontaneous preterm births, gestational age of the previous birth and cervical length could stratify patients into different risk groups for recurrence to investigate whether there is a risk group that does not require additional interventions.

DATA SOURCES: A systematic search of MEDLINE and EMBASE was conducted from 1995 until April 2025.

STUDY ELIGIBILITY CRITERIA: Studies that were included were prospective studies with original individual patient data available that reported on asymptomatic pregnant individuals with ≥1 …

Identification Of De Novo Variants From Parent-Proband Duos Via Long-Read Sequencing, Leandros Boukas, Emmanuèle C. Délot, Georgia Pitsava, Christine Lambert, Cairbre Fanslow, Primo Baybayan, Sami Belhadj, Bojan Losic, John Harting, Krista Bluske, Jonathan Lotempio, Huda B. Al-Kouatly, Rachid Karam, William J. Rowell, Changrui Xiao, Eric Vilain, Seth I. Berger

Department of Obstetrics and Gynecology Faculty Papers

While de novo variants cause many Mendelian disorders, their detection currently requires sequencing of the proband and both biological parents. This is not feasible when only one parent is available, a limitation for millions of families. Here, we develop duoNovo, which identifies de novo variants from parent-proband duos using long-read sequencing followed by haplotype reconstruction and detection of identical-by-descent haplotype blocks. We sequenced 104 trios with PacBio HiFi sequencing and applied duoNovo to each of the 208 duos constructed by masking one parent, classifying over 55 million variants according to their de novo status. We evaluated duoNovo's performance against classifications …

Epigenetic Activation Of Ebv Bglf4 Determines Antiviral-Based Regimen Response In Ebv+Cns Lymphoproliferative Disease, Christoph Weigel, Haley Klimaszewski, Fode Tounkara, Selamawit Addissie, Sarah Schlotter, Betsy Pray, James Dugan, Bradley Haverkos, Lynda Villagomez, Mark Lustberg, Pierluigi Porcu, Timothy Voorhees, Richard Ambinder, Shannon Kenney, Joyce Fingeroth, Henri-Jacques Delecluse, Michael Caligiuri, Lapo Alinari, Ginny Bumgardner, Christopher Oakes, Robert Baiocchi

Kimmel Cancer Center Faculty Papers

Epstein-Barr virus (EBV)–associated primary central nervous system lymphoproliferative diseases (EBV+PCNSL) are aggressive conditions with poor prognoses. We previously reported durable responses in patients with PCNSL who were treated with the antivirals ganciclovir and azidothymidine, plus rituximab and dexamethasone (GARD). Responses were associated with the detection of the lytic viral protein kinases, BGLF4 and BXLF1. These antiviral activating kinases are associated with lytic EBV, however, the mechanism for expression in latently infected EBV+CNSL is unknown. Expanding on previous work, we provide long-term clinical outcome data (N = 24) and show that RNA expression analysis in CNSL tissue biopsies (n = 12) …

Sickle Cell Visualization In Vivo In Humans: Microvascular Occlusion Formation And Hemorheological Indices, Marisa M Morakis, Luojie Huang, Gregory N. Mckay, Sophie Lanzkron, Lydia H. Pecker, Nicholas J. Durr

Cardeza Foundation for Hematologic Research

Vaso-occlusion is a signature pathology of sickle cell disease (SCD). However, the lack of in vivo methods to observe individual blood cell dynamics in humans limits our understanding of occlusion formation mechanisms. We present a novel in vivo, noninvasive, label-free, and high-resolution imaging technique to study blood flow and sickled cell behavior in affected individuals. We used oblique back-illumination microscopy (OBM) to capture videos of 91.0 ± 42.3 sublingual capillaries in each of 10 participants with SCD before and after red cell transfusions and compared the measurements to 10 unaffected controls. With direct observation of blood cell activity, we identified …

Process Perspectives On Lung Cancer Screening In Primary Care: A Qualitative Study Of Providers And Staff In An Urban U.S. Healthcare System, Tina Duong Nguyen, Elochukwu Ezenwankwo, Lem Phan, Melissa Dicarlo, Amanda Indictor, Ronald Myers, Jan M Eberth

Department of Medical Oncology Faculty Papers

BACKGROUND: The limited integration of important aspects of lung cancer screening (LCS) into routine primary care practice has contributed to suboptimal LCS rates nationwide. We aimed to shed light on the pathways that facilitate LCS referral/order and completion in primary care patients, focusing on the screening workflows and processes.

METHODS: We conducted semi-structured interviews with 10 providers and staff members at Jefferson Health, an urban U.S. health system that employs a hybrid approach to LCS. Data were analyzed using thematic analysis.

RESULTS: We identified eight themes related to care coordination and systemic challenges in LCS processes in primary care. While …

Differences In Graft Rupture And Subsequent Meniscal Tears Following Adolescent Acl Reconstruction Using Quadriceps Tendon Versus Hamstrings Autograft: A Retrospective Study With Minimum 2-Year Follow-Up., Morgan E. Swanson, Christopher Defrancesco, Kevin M. Landrum, David Kell, Richa Gandhi, Sulagna Sarkar, Theodore J. Ganley, Kathleen J. Maguire

Department of Medicine Faculty Papers

BACKGROUND: Anterior cruciate ligament (ACL) reconstruction (ACLR) using quadriceps tendon (QT) autograft is associated with lower rates of graft rupture and favorable functional outcomes compared with hamstring (HS) autograft in adolescents. The ACL-deficient knee is at increased risk of injury to secondary stabilizers of the knee, including the menisci, although studies have not reported differences in rates of subsequent meniscal tear between HS and QT groups.

PURPOSE: The goal of this study was to compare rates of graft rupture and subsequent meniscal tear after adolescent ACLR using HS or QT autograft.

STUDY DESIGN: Cohort study; Level of evidence, 3.

METHODS: …

Association Between Functional Status And Cardiac Function In Chronic Heart Failure: Insights From The C-Mic Ii Trial., Marat Fudim, Tamara Kovacevic-Preradovic, Marija Zdravkovic, Sasko Jovev, Nermir Granov, Tanja Popov, Igor Rudez, Petar Vukovic, Velibor Ristic, Annette Holtdirk, Muhammad Shahzeb Khan, Faouzi Kallel, Miodrag Peric, Javed Butler, Stefan D. Anker, Dragana Kosevic, J. Eduardo Rame

Department of Medicine Faculty Papers

INTRODUCTION: Relationship between changes in cardiac function, functional capacity, and patient-reported health status in heart failure (HF) remains incompletely defined, which may help inform endpoint selection and clarify how distinct clinical domains reflect treatment response.

METHODS: This post hoc analysis of the randomized cardiac microcurrent (C-MIC) II trial, which evaluated the efficacy and safety of C-MIC therapy in patients with chronic HF with reduced ejection fraction on optimal guideline-directed medical therapy, included 65 ambulatory patients with non-ischaemic dilated cardiomyopathy, New York Heart Association (NYHA) Class III-IV symptoms, and baseline left ventricular ejection fraction (LVEF) 25-35%. Correlations between changes in Kansas …

Vlx-1005, But Not Argatroban, Prevents Itam-Mediated Platelet Activation And Heparin-Induced Thrombocytopenia, Adriana Yamaguchi, Victoria Putzbach, Reheman Adili, Sophia Lazar, Livia Stanger, Devin Gilmore, David J. Maloney, Steven E. Mckenzie, James V. Michael, Michael Holinstat

Cardeza Foundation for Hematologic Research

Heparin-induced thrombocytopenia (HIT) is an immune prothrombotic disorder characterized by the binding of platelet-activating immunoglobulin G antibodies to platelet factor 4/heparin. In platelets, this leads to cross-linking of the immunoreceptor tyrosine-based activation motif (ITAM)-bearing receptor FcγRIIa, platelet activation, and thrombocytopenia, which in combination with extensive thrombin generation significantly increases the risk of thrombosis. Our laboratory has previously demonstrated that 12-lipoxygenase (12-LOX), an oxygenase primarily expressed in platelets, plays a critical role in platelet activation through FcγRIIa. In this study, we aimed to determine the effectiveness of VLX-1005, a potent and selective inhibitor of 12-LOX, alone or in combination with argatroban, …