Medical Specialties Commons^™

Coronary Vasospasm: Not Gone But Often Forgotten, Michael Savage, Tabitha Moe

Division of Cardiology Faculty Papers

No abstract provided.

Symptomatic Presentation Of Acute Myocardial Infarction In Heart Transplantation Patients, Shashank Jain, Dexter Jacob, Mahek Shah, David L. Fischman

Division of Cardiology Faculty Papers

Patients with acute myocardial infarction with a history of an orthotopic heart transplantation rarely present with classic anginal symptoms, secondary to cardiac denervation. We present 2 cases, the first of a patient with a ST-segment elevation myocardial infarction and the second who presented with a non-ST-segment elevation myocardial infarction. Both patients presented with typical symptoms and were treated with percutaneous coronary intervention.

High-Dose-Rate Brachytherapy For The Treatment Of Basal And Squamous Cell Carcinomas On Sensitive Areas Of The Face: A Report Of Clinical Outcomes And Acute And Subacute Toxicities, James M. Taylor, Bahar Dasgeb, Spencer Liem, Ayesha Ali, Amy Harrison, Mitchell Finkelstein, Jisun Cha, Rani Anne, Steven Greenbaum, William Sherwin, Wenyin Shi

Department of Radiation Oncology Faculty Papers

Purpose Basal cell and cutaneous squamous cell carcinoma are common malignancies (keratinocyte carcinomas [KCs]). Surgical resection is the standard of care. Radiation using high-dose rate brachytherapy (HDR-BT) may serve as a superior alternative where surgical scars may be of cosmetic concern or in elderly patients with significant comorbidity. We aim to describe the clinical and cosmetic outcomes as well as posttreatment radiation toxicities associated with HDR-BT in patients who were treated for KCs of the face.

Methods and Materials Patients with KCs treated with HDR-BT from 2015 to 2018 were included in the study. Patient medical records and clinical photos …

Safety And Efficacy Of Catheter Directed Thrombolysis (Cdt) In Elderly With Pulmonary Embolism (Pe)., Eneida Harrison, Jin Sun Kim, Vladimir Lakhter, Ka U Lio, Rami Alashram, Huaqing Zhao, Rohit Gupta, Maulin Patel, James Harrison, Joseph Panaro, Kerry Mohrien, Riyaz Bashir, Gary Cohen, Gerard Criner, Parth Rali

Department of Psychiatry and Human Behavior Faculty Papers

INTRODUCTION: Acute pulmonary embolism (PE) remains a common cause for morbidity and mortality in patients over 65 years. Given the increased risk of bleeding in the elderly population with the use of systemic thrombolysis, catheter-directed therapy (CDT) is being increasingly used for the treatment of submassive PE. Nevertheless, the safety of CDT in the elderly population is not well studied. We, therefore, aimed to evaluate the safety of CDT in our elderly patients.

METHODS: We conducted a retrospective observational study of consecutive patients aged >65 years with a diagnosis of PE from our Pulmonary Embolism Response Team database. We compared …

Preliminary Data On The Potential For Unintentional Antidoping Rule Violations By Permitted Cannabidiol (Cbd) Use., Ute Mareck, Gregor Fusshöller, Hans Geyer, Marilyn A. Huestis, Anja B Scheiff, Mario Thevis

Institute of Emerging Health Professions Faculty Papers

According to the World Anti-Doping Agency (WADA) regulations, cannabinoids use is prohibited in competition except for cannabidiol (CBD) use. For an adverse analytical finding (AAF) in doping control, cannabinoid misuse is based on identification of the pharmacologically inactive metabolite 11-nor-delta-9-carboxy-tetrahydrocannabinol-9-carboxylic acid (carboxy-THC) in urine at a concentration greater than 180 ng/ml. All other (minor) cannabinoids are reported as AAF when identified, except for CBD that has been explicitly excluded from the class of cannabinoids on WADA's Prohibited List since 2018. However, due to the fact that CBD isolated from cannabis plants may contain additional minor cannabinoids, the permissible use of …

Point-Of-Care Lung Ultrasound For Covid-19: Findings And Prognostic Implications From 105 Consecutive Patients, Kosuke Yasukawa, Taro Minami, David R Boulware, Ayako Shimada, Ernest A Fischer

Department of Pharmacology and Experimental Therapeutics Faculty Papers

Background: The prognostic value of point-of-care lung ultrasound has not been evaluated in a large cohort of patients with COVID-19 admitted to general medicine ward in the United States. The aim of this study was to describe lung ultrasound findings and their prognostic value in patients with COVID-19 admitted to internal medicine ward.

Method: This prospective observational study consecutively enrolled 105 hospitalized participants with COVID-19 at 2 tertiary care centers. Ultrasound was performed in 12 lung zones within 24 hours of admission. Findings were assessed relative to 4 outcomes: intensive care unit (ICU) need, need for intensive respiratory support, length …

Umbilical Amnion And Amniotic Membrane Transplantation For Infectious Scleritis And Scleral Melt: A Case Series., Zeba Syed, Christopher J Rapuano

Wills Eye Hospital Papers

Purpose: To report the outcomes of two cases of infectious scleritis with severe scleral thinning managed using combined mechanical debridement, cryopreserved umbilical amnion (UA) and amniotic membrane (AM) grafts, and antimicrobial therapy.

Observations: Two patients presented with severe infectious scleritis with progressive scleral melts secondary to Pseudomonas aeruginosa subsequent to pterygium surgery and intravitreal injection, respectively. Surgical debridement was followed by UA grafting, AM transplantation, and antimicrobial therapy. Epithelialization and vascularization were seen within 1–4 weeks post-operatively. At last follow up of 5–6 months, the structural integrity of the sclera remained preserved with no infection recurrence, graft necrosis, or wound …

Biomechanics Of Circumferential Cervical Fixation Using Posterior Facet Cages: A Cadaveric Study., Bernardo De Andrada Pereira, Joshua Pelta-Heller, Jennifer N Lehrman, Anna G U Sawa, Brian P Kelly

Department of Neurosurgery Faculty Papers

OBJECTIVE: Anterior cervical discectomy and fusion (ACDF) is a common procedure for the treatment of cervical disease. Circumferential procedures are options for multilevel pathology. Potential complications of multilevel anterior procedures are dysphagia and pseudarthrosis, whereas potential complications of posterior surgery include development of cervical kyphosis and postoperative chronic neck pain. The addition of posterior cervical cages (PCCs) to multilevel ACDF is a minimally invasive option to perform circumferential fusion. This study evaluated the biomechanical performance of 3-level circumferential fusion with PCCs as supplemental fixation to anteriorly placed allografts, with and without anterior plate fixation.

METHODS: Nondestructive flexibility tests (1.5 Nm) …

C1q Complement/Tumor Necrosis Factor-Associated Proteins In Cardiovascular Disease And Covid-19, Yaoli Xie, Zhijun Meng, Jia Gao, Caihong Liu, Jing Wang, Rui Guo, Jianli Zhao, Bernard Lopez, Theodore Christopher, Daniel Lee, Xin-Liang Ma, Yajing Wang

Department of Emergency Medicine Faculty Papers

With continually improving treatment strategies and patient care, the overall mortality of cardiovascular disease (CVD) has been significantly reduced. However, this success is a double-edged sword, as many patients who survive cardiovascular complications will progress towards a chronic disorder over time. A family of adiponectin paralogs designated as C1q complement/tumor necrosis factor (TNF)-associated proteins (CTRPs) has been found to play a role in the development of CVD. CTRPs, which are comprised of 15 members, CTRP1 to CTRP15, are secreted from different organs/tissues and exhibit diverse functions, have attracted increasing attention because of their roles in maintaining inner homeostasis by regulating …

Atg16l1 As A Novel Biomarker And Autophagy Gene For Diabetic Retinopathy., Xinxiao Gao, Yunhui Du, Wayne Bond Lau, Yu Li, Siquan Zhu, Xin-Liang Ma

Department of Emergency Medicine Faculty Papers

Objective: Accumulating evidence suggests the critical role of autophagy in the pathogenesis of diabetic retinopathy (DR). In the current study, we aim to identify autophagy genes involved in DR via microarray analyses.

Methods: Gene microarrays were performed to identify differentially expressed lncRNAs/mRNAs between normal and DR retinas. Gene Ontology and Kyoto Encyclopedia of Genes and Genomes analyses of lncRNA-coexpressed mRNAs were used to determine the related pathological pathways and biological modules. Real-time polymerase chain reactions (PCR) were conducted to validate the microarray analyses.

Results: A total of 2474 significantly dysregulated lncRNAs and 959 differentially expressed mRNAs were identified in the …

Initial Experience In Monitoring Qt Intervals Using A Six-Lead Contactless Mobile Electrocardiogram In An Inpatient Setting., Daniel Frisch, Eitan Frankel, Darius Farzad, Md, Sang H Woo, Alan Kubey

Division of Cardiology Faculty Papers

Mobile electrocardiograms (ECGs) (mECGs) using smartphone applications are an emerging technology. In the coronavirus disease 2019 (COVID-19) era, minimizing patient contact has gained increasing importance. Additionally, increased QT/corrected QT (QTc) monitoring has concurrently been required. The KardiaMobile 6L ECG device, cleared by the United States Food and Drug Administration (FDA) for recording ECGs, along with the KardiaStation tablet application is a platform (AliveCor, Mountain View, CA, USA) that addresses these two issues. A team of residents, fellows, hospitalists, and cardiologists identified inpatients in need of QT/QTc interval monitoring to pilot the adoption of a system composed of a KardiaMobile 6L …

Phenotype Expression Variability In Children With Gabrb3 Heterozygous Mutations., Abdulhafeez M. Khair, Alana E. Salvucci

Department of Pediatrics Faculty Papers

GABRB3 gene is a recently identified gene located in 15q12 chromosome and encodes for gamma-aminobutyric acid (GABA) receptor subunit beta-3 protein, which is linked to the GABAA receptor. The gene is believed to share a role in inhibitory GABAergic synapses, GABA iron-gated channel function, and possible cellular response to histamine. The β3 subunit is expressed in cerebral grey matter, thalami, hippocampi, and cerebellum, among other structures. Faulty GABRB3 function is linked to several neurological disorders and clinical syndromes. However, the spectrum of such disorders is not yet well known. We present three case reports highlighting the potentially expanding clinical phenotype …

Figo (International Federation Of Gynecology And Obstetrics) Initiative On Fetal Growth: Best Practice Advice For Screening, Diagnosis, And Management Of Fetal Growth Restriction, Nir Melamed, Ahmet Baschat, Yoav Yinon, Apostolos Athanasiadis, Federico Mecacci, Francesc Figueras, Vincenzo Berghella, Amala Nazareth, Muna Tahlak, H David Mcintyre, Fabrício Da Silva Costa, Anne B Kihara, Eran Hadar, Fionnuala Mcauliffe, Mark Hanson, Ronald C Ma, Rachel Gooden, Eyal Sheiner, Anil Kapur, Hema Divakar, Diogo Ayres-De-Campos, Liran Hiersch, Liona C Poon, John Kingdom, Roberto Romero, Moshe Hod

Department of Obstetrics and Gynecology Faculty Papers

No abstract provided.

Can Early Treatment Of Twitcher Mice With High Dose Aavrh10-Galc Eliminate The Need For Bmt?, Mohammad Rafi, Paola Luzi, David A Wenger

Department of Neurology Faculty Papers

Introduction: Krabbe disease (KD) is an autosomal recessive disorder caused by mutations in the galactocerebrosidase (GALC) gene resulting in neuro-inflammation and defective myelination in the central and peripheral nervous systems. Most infantile patients present with clinical features before six months of age and die before two years of age. The only treatment available for pre-symptomatic or mildly affected individuals is hematopoietic stem cell transplantation (HSCT). In the animal models, combining bone marrow transplantation (BMT) with gene therapy has shown the best results in disease outcome. In this study, we examine the outcome of gene therapy alone.

Methods: Twitcher (twi) mice …

Covid-19 In Solid Organ Transplantation: Disease Severity And Clinical Update., Akanksha Arya, Michael Li, Nana Aburjania, Pooja Singh, Tricia. Royer, Sean Moss, Katherine A. Belden

Department of Medicine Faculty Papers

BACKGROUND: Solid organ transplant (SOT) recipients are a complex, immunocompromised population in whom greater coronavirus disease 2019 (COVID-19) mortality has been reported compared with the general population.

METHODS: We examined a retrospective cohort of 58 SOT recipients with first-wave COVID-19, comparing patients with severe and nonsevere illness. Additionally, SOT recipients are compared with general patients with first-wave COVID-19.

RESULTS: Organs transplanted included 38 kidneys, 8 livers, 5 hearts, and 3 pancreases. Average SOT recipient age was 57.4 years; 62% were male; 46.6% were African American 36.2% were white. Comorbidities included hypertension (86%), chronic kidney disease (86%), diabetes mellitus (50%), coronary …

Glioma Stem Cells As Immunotherapeutic Targets: Advancements And Challenges, Keenan Piper, Lisa Depledge, Michael Karsy, Charles Cobbs

Department of Neurosurgery Faculty Papers

Glioblastoma is the most common and lethal primary brain malignancy. Despite major investments in research into glioblastoma biology and drug development, treatment remains limited and survival has not substantially improved beyond 1–2 years. Cancer stem cells (CSC) or glioma stem cells (GSC) refer to a population of tumor originating cells capable of self-renewal and differentiation. While controversial and challenging to study, evidence suggests that GCSs may result in glioblastoma tumor recurrence and resistance to treatment. Multiple treatment strategies have been suggested at targeting GCSs, including immunotherapy, posttranscriptional regulation, modulation of the tumor microenvironment, and epigenetic modulation. In this review, we …

Considerations Of Expanded Carrier Screening: Lessons Learned From Combined Malonic And Methylmalonic Aciduria., Marie Cosette Gabriel, Stephanie M. Rice, Jennifer L. Sloan, Matthew H. Mossayebi, Charles P. Venditti, Huda B. Al-Kouatly

Department of Obstetrics and Gynecology Faculty Papers

BACKGROUND: Expanded carrier screening (ECS) utilizes high-throughput next-generation sequencing to evaluate an individual's carrier status for multiple conditions. Combined malonic and methylmalonic aciduria (CMAMMA) due to ACSF3 deficiency is a rare inherited disease included in such screening panels. Some cases have been reported with metabolic symptoms in childhood yet other cases describe a benign clinical course, suggesting the clinical phenotype is not well defined.

METHODS/CASE REPORT: Clinical and laboratory findings during the prenatal period were obtained retrospectively from medical records.

RESULTS: A 37-year-old nulliparous woman and her partner were each identified as carriers of ACSF3 variants and presented at 9 …

Determinants Of The Outcome Of The Transition Of Children With Sickle Cell Disease To Adult Programs., Samir K. Ballas, Gaye Riddick-Burden, Elisabeth Congdon-Martin

Cardeza Foundation for Hematologic Research

Transition of adolescents with sickle cell disease to adult programs is associated with increased morbidity and mortality. The reasons for this poor outcome are not well known. This report describes the various factors that affect the outcome of the transition process. These include four inter-personal factors: country of residence, region within the country of residence, the health care system and intra-personal factors. Each factor is described in some detail. Understanding these factors and the establishment of guidelines or recommendations could improve the outcome of this critical transition in the life of patients with sickle cell disease.

Psychological Experience And Coping Strategies Of Patients In The Northeast Us Delaying Care For Infertility During The Covid-19 Pandemic., David B Seifer, William D Petok, Alisha Agrawal, Tanya L Glenn, Arielle H Bayer, Barry R Witt, Blair D Burgin, Harry J Lieman

Department of Obstetrics and Gynecology Faculty Papers

BACKGROUND: On March 17, 2020 an expert ASRM task force recommended the temporary suspension of new, non-urgent fertility treatments during an ongoing world-wide pandemic of Covid-19. We surveyed at the time of resumption of fertility care the psychological experience and coping strategies of patients pausing their care due to Covid-19 and examined which factors were associated and predictive of resilience, anxiety, stress and hopefulness.

METHODS: Cross sectional cohort patient survey using an anonymous, self-reported, single time, web-based, HIPPA compliant platform (REDCap). Survey sampled two Northeast academic fertility practices (Yale Medicine Fertility Center in CT and Montefiore's Institute for Reproductive Medicine …

Mir-21 Plays A Dual Role In Tumor Formation And Cytotoxic Response In Breast Tumors, Tu Dan, Anuradha A. Shastri, Ajay Palagani, Simone Buraschi, Thomas Neill, Jason E Savage, Aastha Kapoor, Tiziana Deangelis, Sankar Addya, Kevin Camphausen, Renato V. Iozzo, Nicole L Simone

Department of Radiation Oncology Faculty Papers

Breast cancer (BrCa) relies on specific microRNAs to drive disease progression. Oncogenic miR-21 is upregulated in many cancers, including BrCa, and is associated with poor survival and treatment resistance. We sought to determine the role of miR-21 in BrCa tumor initiation, progression and treatment response. In a triple-negative BrCa model, radiation exposure increased miR-21 in both primary tumor and metastases. In vitro, miR-21 knockdown decreased survival in all BrCa subtypes in the presence of radiation. The role of miR-21 in BrCa initiation was evaluated by implanting wild-type miR-21 BrCa cells into genetically engineered mouse models where miR-21 was intact, heterozygous …

Allocation Of Anchors During Labral Repair: A Multicenter Cohort Analysis Of Labral Treatment In Hip Arthroscopy., Ryan P Mcgovern, John J Christoforetti, Benjamin R Kivlan, Shane J Nho, Andrew B Wolff, John P Salvo, Dean Matsuda, Thomas J Ellis, Allston J Stubbs, Dominic S Carreira

Rothman Institute Papers

Background: While previous studies have established several techniques for suture anchor repair of the acetabular labrum to bone during arthroscopic surgery, the current literature lacks evidence defining the appropriate number of suture anchors required to effectively restore the function of the labral tissue.

Purpose/Hypothesis: To define the location and size of labral tears identified during hip arthroscopy for acetabular labral treatment in a large multicenter cohort. The secondary purpose was to differentiate the number of anchors used during arthroscopic labral repair. The hypothesis was that the location and size of the labral tear as well as the number of anchors …

Epidemiology, Biostatistics, And Population Health Concepts, Allison R. Casola, Phd, Mph, Mches

Department of Family & Community Medicine Presentations and Grand Rounds

Overview

Study Designs

• Overview

Epidemiology and Biostatistics

• Vocabulary Review
• Reliability, Variability, and Bias
• Diagnostic Testing and Measures of Association

Population Health

• Evidence Based Medicine
• Interpreting and Evaluating Literature
• Clinical Decision Making

Perinatal Maternal Mood Disorders, Sarah Elizabeth Hirsh Cokenakes, Md

Department of Family & Community Medicine Presentations and Grand Rounds

Learning Objectives

1. To identify the spectrum of peripartum mood disorders, their features, diagnostic criteria, and treatments.
2. To review FDA pregnancy safety categories and lactation categories for commonly prescribed mood medications.
3. To identify the role of family physicians in identifying and treating peripartum mood disorders.

Correspondence Between Perceived Pubertal Development And Hormone Levels In 9-10 Year-Olds From The Adolescent Brain Cognitive Development Study., Megan M Herting, Kristina A Uban, Marybel Robledo Gonzalez, Fiona C Baker, Eric C Kan, Wesley K Thompson, Douglas A Granger, Matthew D Albaugh, Andrey P Anokhin, Kara S Bagot, Marie T Banich, Deanna M Barch, Arielle Baskin-Sommers, Florence J Breslin, B J Casey, Bader Chaarani, Linda Chang, Duncan B Clark, Christine C Cloak, R Todd Constable, Linda B Cottler, Rada K Dagher, Mirella Dapretto, Anthony S Dick, Nico Dosenbach, Gayathri J Dowling, Julie A Dumas, Sarah Edwards, Thomas Ernst, Damien A Fair, Sarah W Feldstein-Ewing, Edward G Freedman, Bernard F Fuemmeler, Hugh Garavan, Dylan G Gee, Jay N Giedd, Paul E A Glaser, Aimee Goldstone, Kevin M Gray, Samuel W Hawes, Andrew C Heath, Mary M Heitzeg, John K Hewitt, Charles J Heyser, Elizabeth A Hoffman, Rebekah S Huber, Marilyn A. Huestis, Luke W Hyde, M Alejandra Infante, Masha Y Ivanova, Joanna Jacobus, Terry L Jernigan, Nicole R Karcher, Angela R Laird, Kimberly H Leblanc, Krista Lisdahl, Monica Luciana, Beatriz Luna, Hermine H Maes, Andrew T Marshall, Michael J Mason, Erin C Mcglade, Amanda S Morris, Bonnie J Nagel, Gretchen N Neigh, Clare E Palmer, Martin P Paulus, Alexandra S Potter, Leon I Puttler, Nishadi Rajapakse, Kristina Rapuano, Gloria Reeves, Perry F Renshaw, Claudiu Schirda, Kenneth J Sher, Chandni Sheth, Paul D Shilling, Lindsay M Squeglia, Matthew T Sutherland, Susan F Tapert, Rachel L Tomko, Deborah Yurgelun-Todd, Natasha E Wade, Susan R B Weiss, Robert A Zucker, Elizabeth R Sowell

Institute of Emerging Health Professions Faculty Papers

Aim: To examine individual variability between perceived physical features and hormones of pubertal maturation in 9-10-year-old children as a function of sociodemographic characteristics.

Methods: Cross-sectional metrics of puberty were utilized from the baseline assessment of the Adolescent Brain Cognitive Development (ABCD) Study—a multi-site sample of 9–10 year-olds (n = 11,875)—and included perceived physical features via the pubertal development scale (PDS) and child salivary hormone levels (dehydroepiandrosterone and testosterone in all, and estradiol in females). Multi-level models examined the relationships among sociodemographic measures, physical features, and hormone levels. A group factor analysis (GFA) was implemented to extract latent variables of pubertal …

Global Point-Of-Care Ultrasound Education And Training In The Age Of Covid-19., Onyinyechi F Eke, Patricia C. Henwood, Grace W Wanjiku, Abiola Fasina, Sigmund J Kharasch, Hamid Shokoohi

Department of Emergency Medicine Faculty Papers

The COVID-19 pandemic has disrupted traditional global point-of-care ultrasound (POCUS) education and training, as a result of travel restrictions. It has also provided an opportunity for innovation using a virtual platform. Tele-ultrasound and video-conferencing are alternative and supportive tools to augment global POCUS education and training. There is a need to support learners and experts to ensure that maximum benefit is gained from the use of these innovative modalities.

Anti-Sars-Cov-2 Antibodies Within Ivig Preparations: Cross-Reactivities With Seasonal Coronaviruses, Natural Autoimmunity, And Therapeutic Implications, Marinos Dalakas, Kleopatra Bitzogli, Harry Alexopoulos

Department of Neurology Faculty Papers

Introduction: Cross-reactivity to SARS-CoV-2 antigenic peptides has been detected on T-cells from pre-pandemic donors due to recognition of conserved protein fragments within members of the coronavirus's family. Further, preexisting antibodies recognizing SARS-CoV-2 with conserved epitopes in the spike region have been now seen in uninfected individuals. High-dose Intravenous Immunoglobulin (IVIg), derived from thousands of healthy donors, contains natural IgG antibodies against various antigens which can be detected both within the IVIg preparations and in the serum of IVIg-receiving patients. Whether IVIg preparations from pre-pandemic donors also contain antibodies against pre-pandemic coronaviruses or autoreactive antibodies that cross-react with SARS-CoV-2 antigenic epitopes, …

Development And Validation Of A Prediction Model For Stroke, Cardiac, And Mortality Risk After Non-Cardiac Surgery., Sang H Woo, Gregary D. Marhefka, Scott W. Cowan, Md, Lily Ackermann, Md

Department of Medicine Faculty Papers

Background: Commonly used cardiovascular risk calculators do not provide risk estimation of stroke, a major postoperative complication with high morbidity and mortality. We developed and validated an accurate cardiovascular risk prediction tool for stroke, major cardiac complications (myocardial infarction or cardiac arrest), and mortality after non-cardiac surgery.

Methods and Results: This retrospective cohort study included 1 165 750 surgical patients over a 4-year period (2007-2010) from the American College of Surgeons National Surgical Quality Improvement Program Database. A predictive model was developed with the following preoperative conditions: age, history of coronary artery disease, history of stroke, emergency surgery, preoperative serum …

Skin Manifestations In Covid-19 Patients: Are They Indicators For Disease Severity? A Systematic Review, Parnian Jamshidi, Bahareh Hajikhani, Mehdi Mirsaeidi, Hassan Vahidnezhad, Masoud Dadashi, Mohammad Javad Nasiri

Department of Dermatology and Cutaneous Biology Faculty Papers

Introduction: Until now, there are several reports on cutaneous manifestations in COVID-19 patients. However, the link between skin manifestations and the severity of the disease remains debatable. We conducted a systematic review to evaluate the temporal relationship between different types of skin lesions and the severity of COVID-19. Methods: A systematic search was conducted for relevant studies published between January and July 2020 using Pubmed/Medline, Embase, and Web of knowledge. The following keywords were used: "SARS-CoV-2" or "COVID-19" or "new coronavirus" or "Wuhan Coronavirus" or "coronavirus disease 2019" and "skin disease" or "skin manifestation" or "cutaneous manifestation." Results: Out of …

Avoidance Of Maxillary Swing For Nasopharyngectomy Via Combined Open Lateral And Endoscopic Approach, S. Hamad Sagheer, Bs, Brian Swendseid, Md, Joseph M. Curry, Md, Mindy Rabinowitz, Md, Gurston Nyquist, Md, Marc R. Rosen, Md, James Evans, Md, Adam J. Luginbuhl

Department of Otolaryngology - Head and Neck Surgery Posters

Objectives: Nasopharyngectomy performed via a solely endoscopic approach has limitations in access and feasibility, particularly regarding management of the carotid artery. To address these limitations, we report three cases with one cadaver dissection where nasopharyngectomy was performed via a combined open lateral an endoscopic approach. We highlight the benefits and technical considerations for this operative technique.

Study Design: Case Series

Methods: Patients diagnosed with recurrent nasopharyngeal carcinoma (NPC) that underwent combined open lateral and endoscopic nasopharyngectomy from 2016-2020 were analyzed. A cadaver dissection was also performed.

Results: We present the details of the approach and follow-up in three patients with …

Free Tissue Transfer For Central Skull Base Defect Reconstruction: Case Series And Surgical Technique, S. Hamad Sagheer, Brian Swendseid, James Evans, Mindy Rabinowitz, Gurston Nyquist, Marc R. Rosen, Elina Toskala, Ryan Heffelfinger, Adam J. Luginbuhl, Joseph M. Curry

Department of Otolaryngology - Head and Neck Surgery Faculty Papers

Objectives: Local reconstruction of central skull base defects may be inadequate for large defects or reoperative cases; free tissue transfer may be necessary. Inset of the flap and management of the pedicle can be challenging. We report our experience and approach.

Methods: Retrospective review identifying seven patients with central skull base defects who underwent free flap reconstruction from 2016-2020.

Results: Four patients with recurrent nasopharyngeal carcinoma, one with recurrent craniopharyngioma, one with clival-cervical chordoma, and one with meningioma of the middle cranial fossa were analyzed. Six defects were closed with an anterolateral thigh free flap and one with a radial …