Medical Specialties Commons^™

Systemic Sclerosis-Associated Interstitial Lung Disease: Improved Understanding And Advances In Management, Amit Syal, Chris T. Derk

Student Papers, Posters & Projects

Interstitial lung disease (ILD), a common manifestation of systemic sclerosis (SSc), has the highest organ-specific morbidity and mortality, particularly in patients with diffuse cutaneous SSc (dcSSc). Recent advances in diagnostics-including artificial intelligence (AI)-enhanced high-resolution computed tomography (HRCT) and biomarkers such as Krebs van den Lungen (KL)-6-have enabled earlier detection and monitoring of disease progression. Therapeutically, the approval of antifibrotics like nintedanib (NINT) and immunomodulators such as tocilizumab (Toci) has significantly expanded treatment options. Updated international guidelines from the American College of Rheumatology (ACR), American College of Chest Physicians (CHEST), American Thoracic Society (ATS), and European league against Rheumatism (EULAR) now …

Surgical Treatment Of Post-Traumatic Elbow Stiffness In Pediatric Patients: A Systematic Review And Meta-Analysis, Roya Khorram, Areeb Ahmad, Reza Vafadar, Ronald Joseph Shamus, Surena Namdari, G. Russell Huffman, Amir R. Kachooei

Rothman Institute Papers

BACKGROUND: Post-traumatic elbow stiffness (PTES) has been reported in up to 21% of pediatric patients following elbow fractures and can profoundly compromise a child's function, and independence. The primary surgical approaches include open and arthroscopic arthrolysis, both of which have demonstrated improvements in range of motion (ROM) and functional scores. This systematic review and meta-analysis aims to compare the effectiveness, ROM, and complication rates between open and arthroscopic release in pediatric patients with PTES.

METHODS: The Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines were utilized to conduct a systematic review and meta-analysis on surgical treatment for PTES. Comprehensive …

Evaluating The Impact Of A Community-Based Prostate Cancer Screening Program, Amy Leader, Kristine Pham, Nicola Cianci, Hannah Knapp, Fatuma Doka, Suzanne Barron, Oleksandr Kolesnikov, Jordan Dehoratius, Katie Bradley, Le'ann Robles, Robert Giamboy, Olivia Dahlgren, Leonard G. Gomella

Kimmel Cancer Center Faculty Papers

BACKGROUND: One out of eight men in the U.S. will be diagnosed with prostate cancer during his lifetime. Black men are more likely to be diagnosed with and die from prostate cancer than other males, contributing to significant prostate cancer disparities. Early detection, often by routine screening, allows for more options for treatment and an increased chance of survival. Barriers to screening contribute to prostate cancer disparities, particularly among those who lack regular access to health care. Community based screening programs may overcome barriers to prostate cancer screening.

METHODS: An urban, NCI-designated cancer center collaborated with a national prostate cancer …

A Phase-Ii Randomized Controlled Pilot And Feasibility Study Of Nicotinamide Riboside Supplementation In Older Adults With Amnestic Mild Cognitive Impairment, Christopher R. Martens, Kevin P. Decker, Theodore M. Deconne, Faria Sanjana, Fiona Horvat, Nicholas A. Rizzi, Catherine Awad, Elizabeth Habash, Joshua C. Hobson, Michael L. Armstrong, Nichole Reisdorph, Ryan T. Pohlig, Alyssa M. Lanzi, Curtis L. Johnson, Matthew L. Cohen, James M. Ellison

Department of Psychiatry and Human Behavior Faculty Papers

Abstract

Background

The decline of nicotinamide adenine dinucleotide (NAD+) with aging may elevate risk of Alzheimer’s disease and related neurocognitive disorders (ADRD) by impairing cellular energy metabolism and reducing cerebral blood flow.

Method

We conducted a 12-week double-blind, randomized, placebo-controlled pilot study to evaluate the safety, tolerability, and preliminary efficacy of the NAD+ precursor, nicotinamide riboside (NR; 500 mg b.i.d.), for enhancing cognitive function and cerebral perfusion in older adults with mild cognitive impairment (MCI).

Result

52 participants (33 females, 19 males) were randomized and 42 completed the trial (NR = 22, placebo = 20). Adherence was similar between groups …

The Role Of Reproductive Aging And Surgeries For Alzheimer’S Disease And Related Dementias (Adrd) Diagnoses In The Cardiovascular Health Study, Alexis Reeves, Oscar L. Lopez, Michelle D. Shardell, Hoda S. Abdel Magid, C. Elizabeth Shaaban, Michelle C. Odden

Department of Neurology Faculty Papers

Abstract

Background

Most US individuals with ADRD are women. Menopause typically occurs in midlife, accompanied by declines in potentially neuroprotective and cardioprotective hormones. Earlier menopause leads to earlier exposure to decreased sex hormones, potentially increasing ADRD risk. Surgical menopause via reproductive surgeries may cause a sudden loss of hormones and may represent be a modifiable risk factor for ADRD. We aimed to determine if menopausal type and age are associated with physician adjudicated-ADRD diagnoses.

Methods

Data were from 3371 women prospectively followed from age 65+ years. Participants self-reported age of menopause and/or surgeries, hormone-therapy, education, and race (Black/White). For this …

Synergistic Effects Of Gfap With Tnfr1 And Tnfr2 On Conversion To Ad Dementia And Overall Survival Across The Alzheimer’S Disease Spectrum, Laura Alejandra Ramirez Tirado, Ann D. Cohen, C. Elizabeth Shaaban, Cristy Matan, Brian J. Lopresti, Milos D. Ikonomovic, Thomas K. Karikari, Victor L. Villemagne, Oscar L. Lopez

Department of Neurology Faculty Papers

Background: We recently reported synergistic effects of TNFR1 and TNFR2 with
astrogliosis resulting in greater vascular burden and neurodegeneration, particularly in
Aβ+ participants. Here, we aimed to assess the interactions of peripheral inflammation
and astrogliosis on incidence of AD dementia and mortality. We hypothesized
synergistic effects with astrogliosis resulting in increased incidence of dementia, and
mortality, particularly in Aβ+ participants.
Methods: Participants of the Gingko evaluation of memory (GEM) study underwent
PiB-PET scans between 2009-2018. GFAP and peripheral inflammatory markers were
measured in 2009 by immunoassay. We evaluated the relationship of peripheral
markers of inflammation (TNFR1,TNFR2) and astrogliosis (GFAPdementia incidence …

A Tissue Renewal-Based Mechanism Drives Colon Tumorigenesis, Ryan M. Boman, Gilberto Schleiniger, Christopher Raymond, Juan P. Palazzo, Anne Shehab, Bruce M. Boman

Department of Pathology, Anatomy, and Cell Biology Faculty Papers

Our Goal is to identify how colorectal cancer (CRC) arises in the single-layered cell epithelium (simple columnar epithelium) that lines the luminal surface of the large intestine. Background: We recently reported that the dynamic organization of cells in colonic epithelium is encoded by five biological rules and conjectured that colon tumorigenesis involves an autocatalytic tissue renewal reaction. Introduction Our objective was to define how altered crypt turnover explains tissue disorganization that leads to adenoma morphogenesis and CRC. Hypothesis: Changes in rate of tissue renewal-based cell polymerization leads to epithelial expansion and tissue disorganization during adenoma histogenesis. Methods: Accordingly, we created …

Epidemiology And Screening Of Traumatic Vertebral Artery Injuries At A Large Scandinavian Level 1 Trauma Center, Paulina Cewe, Victor E. Staartjes, Victor Gabriel El-Hajj, Ihab Ahmad Al-Rikabi, Basel Musmar, Joana M. Roy, Dennis Troung, Mats Beckman, Marcus Ohlsson, Pascal Jabbour, Adrian Elmi-Terander, Erik Edström

Jefferson Hospital Staff Papers and Presentations

OBJECTIVE: Traumatic vertebral artery injuries (tVAIs) are uncommon but potentially devastating if missed. While computed tomography angiography (CTA) is routinely used for diagnosis, data on the number needed to image (NNI) remain limited. We hence analyzed tVAI epidemiology and imaging practices at a major Scandinavian level 1 trauma center.

METHODS: A retrospective study (2013-2020) was performed based on a single-center trauma registry. Patients were grouped based on CTA imaging protocol used; selective screening (2013-2017) and universal screening (2018-2020). Imaging protocols, treatment strategies, and outcomes were analyzed.

RESULTS: Among 2,843 patients admitted with level 1 trauma and receiving CTA imaging, 62 …

Efficacy Of Intravenous Immunoglobulin In Patients With Chronic Inflammatory Demyelinating Polyneuropathy With Or Without Diabetes: Insights From A Multicenter Prospective Comparative Study., Samir P. Macwan, Shalini Mahajan, Peter Novak, Khosro Farhad, Ericka Wong, Thomas H. Brannagan, Sohail Masood, Fawad Piracha, Marinos C. Dalakas

Department of Neurology Faculty Papers

BACKGROUND: Chronic inflammatory demyelinating polyradiculoneuropathy (CIDP) is the most frequently observed autoimmune neuropathy in patients with diabetes mellitus (DM). While intravenous immune globulin (IVIG) is a well-established treatment for CIDP, its efficacy in diabetic patients remains uncertain due to their exclusion from prior randomized trials, largely because of concerns about confounding diabetic axonal neuropathy.

OBJECTIVES: To evaluate the effectiveness of IVIG therapy in CIDP patients with diabetes mellitus (CIDP-DM) compared to those without diabetes (CIDP).

DESIGN: Multi-center, prospective, observational study after at least 3 monthly infusions of IVIG therapy.

METHODS: Thirty-six patients meeting diagnostic criteria for CIDP were enrolled and …

Protocol For Nucleo-Cytoplasmic Fractionation Of Mammalian Cells To Study Protein Translocation Via Immunoblotting, Adhikarimayum Lakhikumar Sharma, Eddy Zhu, Rithika Padyala, Kavya Parikh, Mudit Tyagi

Center for Translational Medicine Faculty Papers

Studying protein translocation is essential for understanding protein function and regulatory mechanisms, including the activity of transcription factors. Here, we present a protocol for isolating high-quality cytoplasmic and nuclear protein fractions from mammalian cells. We describe steps for separating cytoplasmic proteins, washing nuclei, and extracting nuclear proteins. We then detail procedures for quantifying proteins and analyzing their distribution by immunoblotting within a single immunoblot. This protocol is applicable to both suspension and adherent cell types. For complete details on the use and execution of this protocol, please refer to Sharma et al.

The Effect Of Glp-1 Receptor Agonists On Reoperation Following Anterior Cervical Discectomy And Fusion, Nicholas C. Bank, Daniel Whittingslow, Sam Duggan, Joshua L. Morningstar, Douglas S. Weinberg

Student Papers, Posters & Projects

BACKGROUND: Pseudarthrosis remains a significant complication of ACDF, contributing to patient morbidity and increased healthcare costs. Glucagon-like peptide-1 receptor agonists (GLP-1RA), widely prescribed for diabetes and obesity, have been shown to reduced odds of pseudoarthrosis after ACDF. However, it remains unclear whether these reductions meaningfully translate to reduced odds of subsequent cervical surgery.

METHODS: The TriNetX United States Collaborative Network was queried for patients who underwent single- or multi-level ACDF between 2013-2023. Patients with perioperative GLP-1RA use and propensity-score-matched controls without GLP-1RA use were compared for subsequent rates of pseudoarthrosis and cervical reoperation at 6-, 12-, and 24-month intervals. Odds …

P-15 Peptide Enhanced Bone Graft Improves Time To Fusion In Transforaminal Lumbar Interbody Fusion: A Randomized, Controlled, Investigational Device Exemption Study, James S. Harrop, Michael P. Steinmetz, John E. O'Toole, Christopher D Chaput, Rick C. Sasso, K. Brandon Strenge, Greg Maislin, Jeffrey P. Mullin, Thomas B. Freeman, Anthony Guanciale, Howard Lantner, Michael E. Janssen, David G. Schwartz, John M. Small, Wellington K. Hsu, Paul M. Arnold

Department of Neurosurgery Faculty Papers

STUDY DESIGN: Prospective, multicenter, single-blind, randomized, and controlled pivotal study.

OBJECTIVE: Compare time-to-fusion in patients treated with P-15L (PearlMatrix TM P-15 peptide enhanced bone graft) versus local autograft over 24 months and evaluate changes in pain and quality of life at 24 months relative to baseline.

SUMMARY OF BACKGROUND DATA: P-15L, an FDA-designated breakthrough device, is a composite bone graft with P-15, a 15-amino acid polypeptide that promotes cellular adhesion, proliferation, and differentiation to support bone formation.

METHODS: Patients (22-80 y) with degenerative disc disease were randomized to the investigational (P-15L) or control (local autograft) group during single-level transforaminal lumbar …

Status Of Training In The Use Of Lumen-Apposing Metal Stents For Therapeutic Endoscopic Ultrasound During Advanced Endoscopy Fellowship: A Survey Questionnaire, Yasi Xiao, Maham Hayat, Abdul S. Mohammed, Abdullah Abbasi, Sagar Pathak, Saurabh Chandan, Daryl Ramai, Deepanshu Jain, Muhammad K. Hasan, Mustafa A. Arain, Kambiz K. Kadkhodayan, Natalie Cosgrove, Dennis Yang

Division of Gastroenterology and Hepatology Faculty Papers

Background and Aims The lumen-apposing metal stent (LAMS) has revolutionized endoscopic ultrasound (EUS). However, there is a paucity of data on the optimal approaches to training on the use of LAMSs. This survey study aimed to evaluate the status of training in LAMSs among advanced endoscopy fellowship (AEF) trainees. Methods AEF (academic year 2023-2024) trainees were invited to complete a 15-question survey on LAMS training. The questions included the following domains: demographics, exposure to LAMSs before AEF, number of observed and hands-on participation using LAMSs for EUS-guided pancreatic fluid collection drainage (EUS-PFCD), choledochoduodenostomy (EUS-CD), gallbladder drainage (EUS-GBD), and gastrojejunostomy (EUS-GJ) …

Postoperative Anaemia: The Unseen Challenge In Cardiac Surgery, Matthew A. Warner, Jacob Raphael

Department of Anesthesiology Faculty Papers

Postoperative anaemia is an overlooked complication of cardiac surgery that is associated with adverse clinical outcomes. Although small clinical trials suggest that postoperative treatment with i.v. iron improves haemoglobin recovery and reduces transfusion utilisation, appropriately powered randomised controlled trials are necessary to definitively evaluate the efficacy of treatment on clinical outcomes of importance to patients, clinicians, and healthcare systems. A comprehensive approach to perioperative anaemia management demands a renewed focus on both prevention and treatment to improve patient outcomes.

Surgical Revision In The Presence Of An S. Aureus Infection Increases Virulence Factor Expression And Activates A Multi-Tissue Inflammatory Response, Carly J. Smith, Arianna J. Moniodes, Amanda R. Watkins, Autumn G. Melvage, Thomas P. Thompson, Eirene Choi, Abigail A. Lucas, Brendan F. Gilmore, Thomas P. Schaer, Noreen J. Hickok, Theresa A. Freeman

Department of Orthopaedic Surgery Faculty Papers

Replacing implanted medical hardware due to infection often requires one or more revision surgeries. Each surgery triggers a tissue injury response and disrupts the established bacterial biofilm. However, the complex tissue response to reinjury and biofilm disturbance is not well understood. Our results show that with an existing infection, immunological niches such as the bone marrow, lymph nodes, and circulating blood further upregulate pro-inflammatory programs in response to revision. Rather than reducing bacterial burden, this heightened inflammation provokes virulence factor expression and tissue damage, including bone osteolysis and muscle fibrosis. While muscle fibrosis appears transient and begins resolving by 14 …

Urinothorax And Empyema: Presentation Of An Unusual Complication Of A Rare Condition, Nolan Fox, Nicholas Fox, Shourjo Chakravorty, Neeraj Sinha

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

A 68-year-old male with a history of metastatic bladder cancer and urinary obstruction presented with intractable hiccups and chest pain is presented in this case. He was found to have a unilateral pleural effusion in addition to ipsilateral renal metastasis abutting the diaphragm. Imaging revealed empyema. Thoracentesis revealed positive cultures and a lack of malignant cells on cytology. Comorbid urinary obstruction and urinary tract infection suggested the rare diagnosis of an infected urinothorax. Thoracentesis also revealed pleural fluid creatinine greater than serum creatinine, meeting the most specific diagnostic criteria for urinothorax and establishing the diagnosis. Treatment aimed at evacuating the …

Adjudicated Cardiovascular Events In Patients With Covid-19: Association With Vaccination Status And Changes Over Time, Behnood Bikdeli, Darsiya Krishnathasan, Antoine Bejjani, Candrika D. Khairani, Nada Hamade, Umberto Campia, Julia Davies, Nicole Porio, Ali Assi, Andre Armero, Anthony Tristani, Marcos D. Ortiz-Rios, Victor Nauffal, Zaid I. Almarzooq, Eric Q. Wei, Bridget Mcgonagle, Mariana Pfeferman, Sina Rashedi, Alyssa Sato, Giovanni Scimeca, Valeria Zuluaga-Sánchez, Mehrdad Zarghami, Aditya Achanta, Sirus Jesudasen, Bruce C. Tiu, Geno J. Merli, Orly Leiva, John Fanikos, Aditya M. Sharma, Samantha M. Rizzo, Ruth B. Morrison, Alec Vishnevsky, Shiavax J. Rao, Sivan Naveh, Abdelghani El Rafei, James Welker, Marc P. Bonaca, Brett J. Carroll, Samuel Z. Goldhaber, Zhou Lan, Gregory Piazza, The Corona-Vte Network Investigators

Jefferson Hospital Staff Papers and Presentations

BACKGROUND: Patients with COVID-19 are at risk of thrombotic and cardiovascular complications. Existing risk estimates derive from early COVID-19 experiences. More recent event rates, temporal trends, and the association between vaccination status and cardiovascular outcomes remain unclear.

METHODS: The CORONA-VTE Network (COVID-19 Registry to Assess Frequency, Risk Factors, Management, and Outcomes of Arterial and Venous Thromboembolic Complications) multicenter registry included patients with COVID-19 from March 2020 to February 2024. A composite of venous and arterial thrombotic events and a composite of adjudicated cardiovascular events were assessed at 90 days after COVID-19 diagnosis. Time-to-first-event analyses were stratified by inpatients and outpatients …

Radiogenomic Profiling Of Prostate Tumors Prior To External Beam Radiotherapy Converges On A Transcriptomic Signature Of Tgf-Β Activity Driving Tumor Recurrence, Anson T. Ku, Uma Shankavaram, Shana Y. Trostel, Hong Zhang, Sumeyra Kartal, Houssein A. Sater, Stephanie A. Harmon, Nicole V. Carrabba, Yang Liu, Hyunnam Ryu, James A. Proudfoot, Boon Hao Hong, Bradford J. Wood, Peter A. Pinto, Peter L. Choyke, Mack Roach, Howard M. Sandler, Stephanie L. Pugh, Kenneth L. Zeitzer, Lucas C. Mendez, Nirav S. Kapadia, William A. Hall, Anand B. Desai, Radka S. Stoyanova, Alan Pollack, Elai Davicioni, Melvin L. K. Chua, Baris Turkbey, Adam G. Sowalsky, Deborah E. Citrin

Einstein Health Papers

PURPOSE: Clinical risk grouping based on PSA, tumor grade, and disease extent guides treatment intensity for localized prostate cancer. However, many patients with intermediate- or high-risk disease treated with external beam radiotherapy (EBRT) and androgen deprivation therapy (ADT) still develop biochemical recurrence (BCR). Early identification of patients at high risk for BCR could enable personalized treatment strategies.

EXPERIMENTAL DESIGN: We prospectively enrolled 29 patients with intermediate- or high-risk prostate cancer undergoing EBRT and ADT. Pretreatment biopsies (n = 60) underwent whole-transcriptome microarray and whole-exome sequencing. Patients received multiparametric MRI at baseline and 6 months after treatment, with a median follow-up …

Vasoactive Drug Use In Children With Community Acquired Septic Shock In Australia And New Zealand, Elliot Long, Stephen Hearps, Amanda Williams, Ben Gelbart, Warwick Butt, Thomas Rozen, Sarah Mcnab, Meredith Borland, Simon Erickson, Shefali Jani, Marino Festa, Eunicia Tan, Natalie Phillips, Sainath Raman, Amit Kochar, Subodh Ganu, Simon Craig, Anna Lithgow, Arjun Rao, Emma Whyte, Stuart Dalziel, Shane George, Fran Balamuth, Scott Weiss, Nathan Kuppermann, Franz Babl

Department of Medicine Faculty Papers

BACKGROUND: Vasoactive agents are a critical supportive therapy for children with sepsis. We describe the choice and use patterns of vasoactive agents in children with sepsis.

METHODS: Prospective observational study conducted in 11 hospitals in Australia and New Zealand through the Paediatric Research in Emergency Departments International Collaborative (PREDICT) Network from April 2021 to December 2023. Children aged 0-< 18 years with suspected sepsis were included. Children admitted to hospital and treated with parenteral antibiotics and either 1) a provisional diagnosis of sepsis, and/or 2) treatment for suspected sepsis (fluid bolus to treat poor perfusion). The frequency and sequence of use of vasoactive agents, and contributors to the choice of initial vasoactive were collected.

FINDINGS: 6232 children with suspected sepsis were included; median age of 2.1 years (IQR 0.3-7.1 years), in-hospital mortality of 60 (1.0%), in whom a subset of 306 (4.9%) met Phoenix sepsis criteria. Vasoactive agents were used in 179 (2.9%) children overall …

Extracellular Matrix-Mycaf Signatures Correlate With Resistance To Neoadjuvant Apd-L1 Immune Checkpoint Inhibition With Durvalumab + Metformin In Hpv+ Hnscc, Pablo Llerena, Hani Samarah, Kathryn Nunes, Zhao Lin, Kelly Bridgham, Sruti Tekumalla, Amiti Jain, Larry A. Harshyne, Sanket Kumar Shukla, Ioannis Vathiotis, Madalina Tuluc, Stacey Gargano, John R. Eisenbrey, Scott W Keith, David Cognetti, Voichita Bar-Ad, Adam J. Luginbuhl, Rita S. Axelrod, Rajanikanth Vadigepalli, Hushan Yang, Diana Whitaker-Menezes, Megan Roche, My G. Mahoney, Athanassios Argiris, Charalambos C. Solomides, Jennifer Johnson, Md, Mouadh Barbirou, Amanda Miller, Andrew P. South, Ramkrishna Mitra, Alban J Linnenbach, Ubaldo E. Martinez-Outshoorn, Joseph Curry

Department of Otolaryngology - Head and Neck Surgery Faculty Papers

PURPOSE: Immune checkpoint inhibitors (ICI) have demonstrated clinical benefit in head and neck squamous cell carcinoma (HNSCC); however, single-agent efficacy is limited, leaving significant unmet needs. Metformin may synergize with ICIs, offering promise to improve response rates. We leveraged multiomic data from a randomized, presurgical neoadjuvant trial (NCT03618654) evaluating a single infusion of the anti-PD-L1 ICI durvalumab with or without daily, standard dose metformin in previously untreated, nondiabetic patients with HNSCC to understand predictors of response and the effect of combination therapy.

PATIENTS AND METHODS: Clinical, pathologic, and correlative data were analyzed to investigate response and resistance mechanisms. We present …

Diagnosis Of Platelet Dysfunction In Children: Clinical Predictors And Test Methods, Bhavya S. Doshi, Eric N. Thompson, Walter Faig, Abigail Wax, Amrom E. Obstfeld, Michele P. Lambert

Student Papers, Posters & Projects

Evaluation for platelet function disorders (PFD) in children is complicated by their limited exposure to hemostatic challenges, large volumes needed for light transmission aggregometry (LTA) testing, and limited data on the performance characteristics of whole-blood methods such as whole-blood impedance lumiaggregometry (WBILA). The objective of this study was to determine the clinical variables associated with the diagnosis of a PFD. A single-center, retrospective, cohort study of children evaluated for PFD was conducted. Medical charts were abstracted for demographics, medications, testing indications, bleeding sites and severity, and laboratory results. Univariate odds ratios (OR) and multivariable modeling were conducted for association of …

Impact Of Postoperative Intraocular Pressure Spikes On Outcomes Following Goniotomy: A Comparative Study Of Surgical Techniques, Wesam S. Shalaby, Steven L. Chang, Julia Yu, Teresa Horan, Sagar Shah, Shahin Hallaj, Marlene Moster, Reza Razeghinejad, Daniel Lee, Michael Pro, Aakriti Shukla, Ping Huang, Jonathan S. Myers, Tina Xia, Dilru Amarasekera

Wills Eye Hospital Papers

AIM AND BACKGROUND:To compare postoperative intraocular pressure (IOP) spikes and 1-year surgical success among goniotomy procedures: Kahook Dual Blade (KDB), OMNI, bent ab interno needle goniotomy (BANG), and gonioscopy-assisted transluminal trabeculotomy (GATT).

MATERIALS AND METHODS: This single-center, retrospective chart review included glaucoma patients ≥18 years, who underwent goniotomy from January 2021 to December 2022 with ≥3 months of follow-up. Primary outcomes were IOP spikes (≥10 mm Hg increase within 3 months) and 12-month surgical success (≥20% IOP and/or ≥1 medication reduction without further surgery). Secondary outcomes included IOP and medication changes.

RESULTS: Among 247 eyes (107 KDB, 63 OMNI, 77 …

Dose Adjustment Of The Anti-Seizure Medications Levetiracetam And Lamotrigine During The Postpartum Period. Schedule Plan, Safety And Efficacy, Nadejda Khmelev, Firas Fahoum, Lilach Goldstein

Department of Neurology Faculty Papers

INTRODUCTION: Lamotrigine (LTG) and Levetiracetam (LEV) are anti-seizure medications (ASMs) widely used for treatment of women with epilepsy (WWE) of childbearing age due to low teratogenic potential. Physiological changes during gestation results in enhanced clearance. Drug level monitoring and frequent dose adjustments are required to avoid decline in serum levels and compromised seizure control. Postpartum, physiological changes reverse and ASM clearance trends back to pre-pregnancy rate. Rapid metabolic changes make drug level monitoring and dose adjustments challenging. A delay in dose decrement could result in toxicity. The optimal postpartum dose reduction rate hasn't been established.

METHODS: We retrospectively examined medical …

Correction: Amino Acid Transporter Lat1 (Slc7a5) Promotes Metabolic Rewiring In Tnbc Progression Through The L-Trp/Qprt/Nad+ Pathway, Margot Y. Fedoroff, Lei Zhao, Shaomin Wang, Leili Saeednejad Zanjani, Alok Bhushan, Haifeng Yang, Karen M. Bussard, Stephen C Peiper, Jun He

Department of Pathology, Anatomy, and Cell Biology Faculty Papers

Correction: J Exp Clin Cancer Res 44, 190 (2025) Following publication of the original article [1], the authors found that Dr. Leila Saeednejad Zanjani was not included in the final author list despite her contributions. The details are provided below: Current authors: Margot Y. Fedoroff1†, Lei Zhao1†, Shaomin Wang1, Alok Bhushan2, Haifeng Yang1, Karen M. Bussard3, Stephen C. Peiper1 and Jun He1*. Updated author list: Margot Y. Fedoroff1†, Lei Zhao1†, Shaomin Wang1, Leili Saeednejad Zanjani1, Alok Bhushan2, Haifeng Yang1, Karen M Bussard3, Stephen C Peiper1, Jun He1*. The correction does not compromise the validity of the conclusions and the overall …

Sex-Specific Angiogenic Responses In Endothelial Cells-Role Of The Pluripotency Factor Oct4, Junchul Shin, Junyoung Hong, Iuliia Molokotina, Irene Krukovets, Ellin Kim, Svyatoslav Tkachenko, Eugene Podrez, Tatiana V Byzova, Olga A Cherepanova

Department of Pathology, Anatomy, and Cell Biology Faculty Papers

The study investigates the sex-specific effects of the pluripotency factor OCT4 deficiency in endothelial cells (ECs) on angiogenesis. OCT4 is known for its role in embryonic stem cells, but we recently found that it plays a protective role in ECs during atherosclerosis. Herein, we utilized cultured mouse aortic ECs (MAECs) and several in vivo models, including skin wounding, melanoma tumor implantation, and hindlimb ischemia, to explore the role of OCT4 in angiogenesis in both male and female mice. Our findings revealed significant sexual dimorphism in wild type mice, along with sex differences in responses to OCT4 deficiency across all three …

Incomplete (A3) Versus Complete (A4) Thoracolumbar Burst Fractures: Results From A Prospective International Multicenter Cohort Study, Jin W. Tee, Barry T. S. Kweh, Alex R. Vaccaro, Klaus J. Schnake, Mohammad El-Sharkawi, Eugen C. Popescu, Shanmuganathan Rajasekaran, Lorin M. Benneker, Sebastian F. Bigdon, John France, Jerome Paquet, R. Todd Allen, William F. Lavelle, Miguel Hirschfeld, Spyridon Pneumaticos, Richard J. Bransford, Andrei F. Joaquim, Harvinder S. Chhabra, Ulrich Spiegl, Hauri Dimitri, F. Cumhur Oner, Marcel Dvorak, Gregory D. Schroeder, Charlotte Dandurand

Department of Orthopaedic Surgery Faculty Papers

OBJECTIVE: The objective was to compare incomplete (A3) versus complete (A4) thoracolumbar burst fractures managed nonoperatively or operatively with respect to reaching minimal clinically important difference (MCID) in Oswestry Disability Index (ODI) score.

METHODS: A prospective observational international multicenter cohort study was conducted. After stratification using the AO Spine Thoracolumbar Injury Classification System, A3 and A4 outcomes were analyzed separately within nonoperative and operative management groups. Outcomes included absolute and relative improvement in ODI scores between discharge and 12-month follow-up. Kaplan-Meier curves were generated and compared with the log-rank test. Multivariable Cox regression models were constructed. The Cox regression models …

Delayed Delivery Of Antibiotics By Ultrasound-Mediated Rupture Of Polylactic Acid Pockets: In Vitro And In Vivo Studies, Selin Isguven Billmyer, Priscilla Machado, Ryan Tomlinson, Lauren J. Delaney, Ji-Bin Liu, Alexander H Harris, Eric Mclaughlin, Noreen J. Hickok, Flemming Forsberg

Department of Radiology Faculty Papers

Surgical site infections are a devastating complication of instrumented orthopaedic surgery, particularly in the spine. Bacterial biofilms, once formed on the implant surfaces, exhibit antibiotic tolerance and immune escape, which lead to treatment challenges. Up to 9% of instrumented spine surgeries result in infection, despite the use of systemic antibiotics and local, powdered antibiotics for prophylaxis. The bacteria that survive the initial prophylaxis may be susceptible to a second, high dose of antibiotic prophylaxis prior to establishing at the site. Hence, we designed a local drug delivery system consisting of polylactic acid (PLA) film pockets that can be noninvasively triggered …

A Nationwide Registry Study Of Surgical And Patient-Reported Outcomes Following Anterior Cervical Discectomy And Fusion: Part 2 - Cage With Versus Without Local Bone Graft, Daniel De Wilde, Victor Gabriel El-Hajj, Patrick Vigren, Victor E. Staartjes, Elias Atallah, Erik Edström, Adrian Elmi-Terander

Department of Neurosurgery Faculty Papers

BACKGROUND: Local bone grafts are commonly used as filling material in cages during anterior cervical discectomy and fusion (ACDF). Alternatively, cages without filling materials can be used. The literature comparing these approaches is limited, and their respective effects on patient-reported outcomes (PROM) have been scarcely studied. This study was conducted to compare surgical outcomes and PROMs between local bone graft-packed cages and empty cages in ACDF surgery.

METHODS: This observational study utilized data from the Swedish nationwide registry, Swespine. All adults who underwent ACDF between 2006 and 2020 were considered for inclusion. Exclusion criteria included missing baseline or outcome data. …

Patient Preferences When Selecting Their Total Joint Arthroplasty Surgeon: A Multicenter Survey Study, Jake Laverdiere, Danielle Lonati, Swaroopa Vaidya, Gregory Panza, Antonia Chen, Mary Morcos, Yale Fillingham, Jessica Leipman, Molly Hartzler, Jenna Bernstein

Rothman Institute Papers

BACKGROUND: Surgeon selection can influence patient satisfaction, outcomes, and access in total joint arthroplasty (TJA). Awareness of patient preferences enables practices to enhance trust, optimize communication, and improve adherence. While referrals and word-of-mouth recommendations often outweigh online marketing, prospective multicenter research exploring how patients choose their TJA surgeon is limited. The aim of this study was to identify key decision-making factors and how they vary by demographics.

METHODS: This prospective, multicenter cross-sectional survey study included patients undergoing elective total joint arthroplasty at 4 high-volume institutions from January 2024 to 2025. Participants completed a survey on surgeon selection, including how they …

The Breakdown Of Neurovascular Barriers: Molecular Mechanisms Of Tight Junction Dysfunction, Sowmya Shree Gopal, Mandeep Kaur, Sophie Lanzkron, Amit K. Srivastava

Department of Medicine Faculty Papers

The central nervous system (CNS) relies on tightly regulated barriers to maintain homeostasis and protect neural tissue from blood-borne toxins, pathogens, and inflammatory mediators. Tight junctions (TJs) are critical components of the blood-brain barrier (BBB) and blood-spinal cord barrier (BSCB), forming selective paracellular seals that regulate molecular trafficking. These structures comprise transmembrane proteins and cytoplasmic scaffolding proteins, which anchor TJs to the actin cytoskeleton. The spatial organization and function of TJs are dynamically regulated by calcium-dependent signaling, phosphorylation events, and G-protein-mediated pathways, which govern their assembly, disassembly, and response to physiological and pathological stimuli. The integrity of TJ complexes is …