Medical Specialties Commons^™

Evaluating Of Hpv-Dna Ish As An Adjunct To P16 Testing In Oropharyngeal Cancer, J. Chi, I. R. Preeshagul, S. Sheikh-Fayyaz, S. Teckie, N. Kohn, Y. Ziemba, A. Laser, D. Frank, M. Ghaly, D. Kamdar, D. Kraus, D. Paul, N. Seetharamu

Journal Articles

© 2020 Jeffrey Chi. Aim: Current guidelines recommend p16 immunohistochemistry (IHC) for testing human papillomavirus (HPV) in oropharyngeal carcinoma (OPSCC). We evaluated the value of adding DNA in situ hybridization (ISH) to p16 IHC. Methods: Fifty patients with OPSCC were analyzed. Concordance between HPV-DNA ISH and p16 IHC was measured by Gwet's agreement coefficient. Results: p16 IHC was positive in 35/48 (72.9%), negative in 8/48 (16.7%) patients. Wide spectrum DNA-ISH was positive in 9/23 (39%) and negative in 14/23 (60.9%) patients. High-risk 16/18 (HR) HPV DNA-ISH was positive in 11/23 (47.8%) and negative in 12 (52.2%) patients. The agreement between …

Thrombotic Microangiopathy And Acute Kidney Injury Induced After Intravitreal Injection Of Vascular Endothelial Growth Factor Inhibitors Vegf Blockade-Related Tma After Intravitreal Use, R. M. Hanna, N. Tran, S. S. Patel, J. Hou, K. D. Jhaveri, R. Parikh, U. Selamet, L. Ghobry, V. Bijol, I. B. Kurtz, +6 Additional Authors

Journal Articles

No abstract provided.

Continuous Positive Airway Pressure (Cpap) In Nonapneic Asthma: A Clinical Review Of Current Evidence, H. M. Karim, A. M. Esquinas, S. Ziatabar, G. Insalaco, S. Skoczyński, I. Šarc, L. Ferini-Strambi, L. P. Özyiğit, T. Hernández-Gilsoul, B. A. Mina, +17 Additional Authors

Journal Articles

© 2020 by Turkish Thoracic Society-. The use of continuous positive airway pressure (CPAP) in asthma has been a point of debate over the past several years. Various studies, including those on animals and humans have attempted to understand the role and pathophysiology of CPAP in patients with either well controlled or poorly controlled asthma. The aim of this manuscript is to review the currently available literature on the physiologic and clinical effects of CPAP in animal models of asthma and on humans with stable asthma.

Comparison Of A Continuous Noninvasive Temperature To Monitor Core Temperature Measures During Targeted Temperature Management, M. Wagner, K. Lim-Hing, M. A. Bautista, B. Blaber, T. Ryder, J. Haymore, N. Badjatia

Journal Articles

No abstract provided.

Deep Brain Stimulation For Refractory Obsessive-Compulsive Disorder (Ocd): Emerging Or Established Therapy?, H. Wu, M. Hariz, V. Visser-Vandewalle, L. Zrinzo, V. A. Coenen, S. A. Sheth, C. Bervoets, M. Naesstrom, M. Schulder, B. Nuttin, +45 Additional Authors

Journal Articles

No abstract provided.

Author Correction: Noninvasive Sub-Organ Ultrasound Stimulation For Targeted Neuromodulation (Nature Communications, (2019), 10, 1, (952), 10.1038/S41467-019-08750-9), V. Cotero, Y. Fan, T. Tsaava, A. M. Kressel, I. Hancu, T. R. Coleman, S. Zanos, K. J. Tracey, S. S. Chavan, C. Puleo, +10 Additional Authors

Journal Articles

© 2020, The Author(s). This article contained an error in the ordinate axis in Fig. 2d, where the units were reported as nmol/L. The unit should have been reported as pg/ml. This has now been corrected in both the PDF and HTML versions of the Article.

Application Of Multimodal Neuromonitoring In Posterior Inferior Cerebellar Artery Aneurysm Clippings: Review Of Two Cases., J. W. Silverstein, A. Rosenthal, K. Kwan, K. Wagner, J. A. Ellis

Journal Articles

Neurophysiological monitoring is advocated for the prevention of neurological sequelae secondary to the clipping of an aneurysm involved in posterior circulation. Unfortunately, there is a paucity in the literature regarding what neurophysiological monitoring techniques are best employed. The authors here present two cases where multimodal neuromonitoring techniques were used during the clippings of two posterior inferior cerebellar artery (PICA) aneurysms. There is increased neurologic morbidity associated with PICA aneurysm clippings, as a number of eloquent structures live in close proximity to the PICA. The application of a multimodal neuromonitoring paradigm may reduce a poor neurological outcome.

N-Butyl Cyanoacrylate Transvenous Arteriovenous Malformation Embolization With Arterial Balloon Assistance: Defining Parameters For A Transvenous Approach As A Potential Upfront Treatment Option In Managing Cerebral Arteriovenous Malformations., C. Higbie, D. Khatri, B. Ligas, R. Ortiz, D. Langer

Journal Articles

Complete obliteration of arteriovenous malformations (AVMs) using a transvenous approach as the primary and stand-alone treatment modality has been increasingly considered as a useful endovascular approach in the treatment of AVMs. AVMs are typically treated with microsurgery, stereotactic radiosurgery, endovascular embolization, or some combination of the three methods. Preservation of the draining vein is a key requisite common to all treatment modalities. Transvenous embolization (TVE) is conventionally not recommended as a stand-alone treatment for the vast majority of AVMs and has been thought to be best indicated when traditional approaches are considered less safe and when specific evaluation criteria are …

Secondary Encephalocele In An Adult Leading To Subdural Empyema, T. Wang, A. Uddin, N. Mobarakai, R. Gilad, M. Raden, S. Motivala

Journal Articles

© 2020 The Author(s) Brain abscesses are an uncommon but potentially fatal infection. They can spread directly from an adjacent source or hematogenously from a distant source. Encephaloceles represent a rare form of neural tube defects that can potentially be complicated by the development of meningitis or brain abscess. We report a case of a 63-year-old female who presented with bilateral lower extremity weakness and was ultimately found to have a Streptococcus pneumoniae subdural empyema and an associated frontal lobe encephalocele extending through the left frontal sinus. She was treated with surgical drainage, intravenous antimicrobials, and ultimately surgical repair of …

Fusiform Superior Cerebellar Artery Aneurysm Treated With Flow Diversion: A Case Report, Y. Serulle, D. Khatri, J. Fletcher, A. Pappas, A. Heidbreder, D. Langer, R. A. Ortiz

Journal Articles

© 2020 Published by Scientific Scholar on behalf of Surgical Neurology International. Background: Fusiform aneurysms of the distal superior cerebellar artery are rare and challenging to treat. Due to the rarity of these lesions, there is little consensus regarding their management. Treatment options have traditionally included parent artery sacrifice with either an endovascular approach or microsurgical clipping. Given the small diameter of the superior cerebellar artery, flow diversion has not been typically considered as a viable treatment option for these aneurysms. Case Description: A 67-year-old female presented complaining of severe sudden onset headache. Noncontrast head CT demonstrated no intracranial hemorrhage. …

Evaluation Of Concordance Between Original Death Certifications And An Expert Panel Process In The Determination Of Sudden Unexplained Death In Childhood, L. G. Crandall, J. H. Lee, D. Friedman, K. Lear, K. Maloney, J. K. Pinckard, P. Lin, T. Andrew, A. K. Williamson, O. Devinsky, +8 Additional Authors

Journal Articles

Importance: The true incidence of sudden unexplained death in childhood (SUDC), already the fifth leading category of death among toddlers by current US Centers for Disease Control and Prevention estimates, is potentially veiled by the varied certification processes by medicolegal investigative offices across the United States. Objective: To evaluate the frequency of SUDC incidence, understand its epidemiology, and assess the consistency of death certification among medical examiner and coroner offices in the US death investigation system. Design, Setting, and Participants: In this case series, 2 of 13 forensic pathologists (FPs) conducted masked reviews of 100 cases enrolled in the SUDC …

Escape The Trauma Room, M. Podlog, A. Husain, J. Greenstein, S. Sanghvi

Journal Articles

© 2019 by the Society for Academic Emergency Medicine Traditional conference didactics may not be effectively meeting the learning needs of today's emergency medicine (EM) residents, and educators are employing various interactive approaches to engage learners. Escape Room is a popular adventure game in which participants must work together to solve a series of puzzles to escape a locked room. Our aim was to adapt this game design to teach core EM content and procedural aptitude. Upon entering the “locked” room residents were faced with a series of puzzles involving concepts such as toxicology antidotes, ventilator management, echocardiogram interpretations, airway …

Intention To Leave Emergency Medicine: Mid-Career Women Are At Increased Risk, M. D. Lall, S. M. Perman, N. Garg, N. Kohn, K. Whyte, A. Gips, T. Madsen, J. M. Baren, J. Linden

Journal Articles

No abstract provided.

Tdp-43 Is Elevated In Plasma Neuronal-Derived Exosomes Of Patients With Alzheimer’S Disease, N. Zhang, D. Gu, M. Meng, M. L. Gordon

Journal Articles

© Copyright © 2020 Zhang, Gu, Meng and Gordon. Background: Recently, TDP-43 has been recognized as a common proteinopathy in the “oldest old” and a neuropathological comorbidity in patients with Alzheimer’s disease (AD). However, since it has a low concentration in cerebrospinal fluid, the presence of TDP-43 in AD is rarely investigated in vivo. Methods: Twenty-four patients with amyloid PET confirmed AD and 15 healthy controls (HCs) were included in this study. TDP-43 level in plasma neuronal-derived exosomes (NDEs) was measured by enzyme-linked immunosorbent assay. Results: TDP-43 level was elevated in patients with AD compared with HCs (median 1.08 ng/ml, …

Mucocutaneous Disease And Related Clinical Characteristics In Hospitalized Children And Adolescents With Covid-19 And Multisystem Inflammatory Syndrome In Children., S. Rekhtman, R. Tannenbaum, A. Strunk, M. Birabaharan, S. Wright, A. Garg

Journal Articles

Background

Little is known about mucocutaneous disease in acutely ill children and adolescents with COVID-19 and multisystem inflammatory syndrome in children (MIS-C).

Objective

To characterize mucocutaneous disease and its relation to clinical course among hospitalized patients with COVID-19 and MIS-C.

Methods

Descriptive cohort study of prospectively and consecutively hospitalized eligible patients between May 11, 2020 and June 5, 2020.

Results

In COVID-19 patients, 4 of 12 (33%) had rash and/or mucositis, including erythema, morbilliform pattern, and lip mucositis. In MIS-C patients, 9 of 19 (47%) had rash and/or mucositis, including erythema, morbilliform, retiform purpura, targetoid and urticarial patterns, along with …

Association Of Anticoagulation Dose And Survival In Hospitalized Covid-19 Patients: A Retrospective Propensity Score-Weighted Analysis, F. Ionescu, I. Jaiyesimi, I. Petrescu, P. R. Lawler, E. Castillo, Y. Munoz-Maldonado, Z. Imam, M. Narasimhan, A. E. Abbas, G. B. Nair, +1 Additional Author

Journal Articles

© 2020 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd Background: Hypercoagulability may contribute to COVID-19 pathogenicity. The role of anticoagulation (AC) at therapeutic (tAC) or prophylactic doses (pAC) is unclear. Objectives: We evaluated the impact on survival of different AC doses in COVID-19 patients. Methods: Retrospective, multi-center cohort study of consecutive COVID-19 patients hospitalized between March 13 and May 5, 2020. Results: A total of 3480 patients were included (mean age, 64.5 years [17.0]; 51.5% female; 52.1% black and 40.6% white). 18.5% (n = 642) required intensive care unit (ICU) stay. 60.9% received pAC (n …

Pathophysiology And Pathology Of Acute Kidney Injury In Patients With Covid-19, J. H. Ng, V. Bijol, M. A. Sparks, M. E. Sise, H. Izzedine, K. D. Jhaveri

Journal Articles

© 2020 National Kidney Foundation, Inc. Acute kidney injury (AKI) is common among hospitalized patients with Coronavirus Infectious Disease 2019 (COVID-19), with the occurrence of AKI ranging from 0.5% to 80%. The variability in the occurrence of AKI has been attributed to the difference in geographic locations, race/ethnicity, and severity of illness. AKI among hospitalized patients is associated with increased length of stay and in-hospital deaths. Even patients with AKI who survive to hospital discharge are at risk of developing chronic kidney disease or end-stage kidney disease. An improved knowledge of the pathophysiology of AKI in COVID-19 is crucial to …

Estimating The Predictive Value Of Negative Sars-Cov-2 Results: A Prospective Study, D. Hirschwerk, M. Foley, M. Lesser, B. Farber, J. M. Crawford, K. W. Davidson, G. J. Berry, E. Smith, C. Kast, T. Mcginn, +1 Additional Author

Journal Articles

© 2020 by The Society for Healthcare Epidemiology of America. All rights reserved. We performed a prospective study of 501 patients, regardless of symptoms, admitted to the hospital, to estimate the predictive value of a negative Nasopharyngeal swab for SARS-CoV-2. At a positivity rate of 10.2%, the estimated Negative Predictive Value (NPV) was 97.2% and NPV rose as prevalence decreased during the study.

Characteristics And Risk Factors Associated With Critical Illness In Pediatric Covid-19, G. Fisler, S. M. Izard, S. Shah, D. Lewis, M. K. Kainth, S. H. F. Hagmann, J. A. Belfer, L. M. Feld, F. Mastroianni, C. L. Kvasnovsky, C. A. Capone, J. Schneider, T. Sweberg, C. Schleien, M. D. Taylor

Journal Articles

© 2020, The Author(s). Background: While much has been reported regarding the clinical course of COVID-19 in children, little is known regarding factors associated with organ dysfunction in pediatric COVID-19. We describe critical illness in pediatric patients with active COVID-19 and identify factors associated with PICU admission and organ dysfunction. This is a retrospective chart review of 77 pediatric patients age 1 day to 21 years admitted to two New York City pediatric hospitals within the Northwell Health system between February 1 and April 24, 2020 with PCR + SARS-CoV-2. Descriptive statistics were used to describe the hospital course and …

Patient Attitudes Toward Telepsychiatry During The Covid-19 Pandemic: A Nationwide, Multisite Survey., D. Guinart, P. Marcy, M. Hauser, M. Dwyer, J. M. Kane

Journal Articles

Background

The COVID-19 pandemic and its associated movement restrictions forced a rapid and massive transition to telepsychiatry to successfully maintain care continuity.

Objective

The aim of this study is to examine a large number of patients' experiences of, use of, and attitudes toward telepsychiatry.

Methods

An anonymous 11-question survey was delivered electronically to 14,000 patients receiving telepsychiatry care at 18 participating centers across 11 US states between the months of April and June 2020, including questions about their age and length of service use, as well as experience and satisfaction with telepsychiatry on a 5-point Likert scale. Descriptive statistics were …

Alterations In Plasma Membrane Ion Channel Structures Stimulate Nlrp3 Inflammasome Activation In Apol1 Risk Milieu, A. Jha, V. Kumar, S. Haque, K. Ayasolla, S. Saha, X. Lan, A. Malhotra, M. A. Saleem, K. Skorecki, P. C. Singhal

Journal Articles

© 2019 Federation of European Biochemical Societies We evaluated alterations in the structural configurations of channels and activation of nucleotide-binding domain, leucine-rich-containing family, pyrin domain-containing-3 (NLRP3) inflammasome formation in apolipoprotein L1 (APOL1) risk and nonrisk milieus. APOL1G1- and APOL1G2-expressing podocytes (PD) displayed enhanced K+ efflux, induction of pyroptosis, and escalated transcription of interleukin (IL)-1β and IL-18. APOL1G1- and APOL1G2-expressing PD promoted the transcription as well as translation of proteins involved in the formation of inflammasomes. Since glyburide (a specific inhibitor of K+ efflux channels) inhibited the transcription of NLRP3, IL-1β, and IL-18, the role of K+ efflux in the activation …

The Relationship Between Medication Discrepancies And Hospitalization Risk Among Patients With Advanced Ckd, V. Sakhiya, J. James, K. D. Jhaveri, M. Zhang, J. H. Ng, C. Halinski Np, J. Tomanguillo-Chumbe, S. Fishbane

Journal Articles

No abstract provided.

'Whatsapp (R)' Ening In Nephrology Training, K. D. Jhaveri, B. Pascarelli, A. Hasan, A. Kozikowski, S. Fishbane, R. Pekmezaris

Journal Articles

No abstract provided.

Morphea (Localized Scleroderma) Presenting With Recurrent Skin And Soft Tissue Infections: A Diagnostic Dilemma., A. M. Khatri, M. Mclemore, P. Malhotra

Journal Articles

Morphea or localized scleroderma is reported to be triggered through diverse stimuli. We present a case of morphea that presented as a non-healing wound with superimposed methicillin-sensitive Staphylococcus aureus (MSSA) infection. In our case, morphea was thought to have been potentially triggered by a post-surgical infection. We discuss the potential infectious triggers and common infections that may confound the diagnosis.

Management Of Barrett's Esophagus With Dysplasia Refractory To Radiofrequency Ablation, K. L. Raphael, A. J. Trindade

Journal Articles

No abstract provided.

Bevacizumab-Induced Pneumonitis In A Patient With Metastatic Colon Cancer: A Case Report, S. Pervaiz, S. Homsy, N. Narula, S. Ngu, D. Elsayegh

Journal Articles

© The Author(s) 2020. Bevacizumab is a vascular endothelial growth factor–directed humanized monoclonal antibody used to treat many types of cancer and some eye diseases. Due to inhibition of angiogenesis, many adverse reactions such as bowel necrosis, nasal septal perforation, and renal thrombotic microangiopathy have been described. However, its association with interstitial pneumonitis is scarcely reported in the literature. We report a case of a 79-year-old woman with metastatic colon cancer who presented with cough and dyspnea on exertion the day after initiation of bevacizumab. She was found to have bilateral airspace opacities on imaging. Infectious and cardiogenic etiologies of …

Do Not Fall To The Vape Trap!, S. Acharya, S. I. Ali, S. Anwar, A. Glaser

Journal Articles

© 2020 The Author(s) Introduction: Whilst the use of combustible tobacco products continues to decline in the United States, the use of e-cigarettes has seen an explosive rise in recent years. In 2019 an outbreak on EVALI was seen across the country, highlighting the fact that e-cigarettes may not be as harmless as previously perceived. Case description: A 22-year-old male came to the emergency department complaining of vomiting and shortness of breath. Patient reported using a “pod” a day of a “JUUL” e-cigarette. Patient's oxygen requirement continued to increase and was eventually shifted to the intensive care unit and mechanically …

Isolated Pulmonary Valve Endocarditis., S. Acharya, S. Anwar, M. Iannuzzi, V. Anugu, F. Ghavami

Journal Articles

Infective endocarditis involving the right side of the heart is typically associated with IV drug abuse and chronic indwelling catheters which commonly involve the tricuspid valve. Isolated pulmonary valve endocarditis (PVE) is a rare clinical entity. We report a rare case of a young woman with a history of end-stage renal disease (ESRD) on hemodialysis through tunneled catheter presenting with persistent coagulase-negative staphylococcus (CoNS) epidermidis bacteremia despite being on appropriate treatment with IV vancomycin for two weeks. Because of the persistent bacteremia, a transesophageal echocardiogram was performed and it revealed a thickened pulmonary valve with 1.8 cm vegetation in the …

A Rare But Reversible Cause Of Lithium-Induced Bradycardia., B. Ataallah, R. Al-Zakhari, A. Sharma, M. Tofano, G. Haggerty

Journal Articles

Lithium is a well-known medication that has been used for many years to treat mood disorders. One of its side effects is cardiotoxicity, which usually occurs at serum lithium levels > 1.5 mEq/L but rarely occurs when therapeutic levels of lithium are used. Other causes of bradycardia should be eliminated by performing a detailed workup that includes calcium level, thyroid function, and cardiac workup, with consideration of any medication interactions. Lithium-induced bradycardia is reversible upon discontinuation of lithium, but irreversible sinus node can occur and may warrant permanent insertion of a pacemaker to maintain sinus rhythm when long-term lithium therapy is …

“Palliative Pandemic Plan,” Triage And Symptoms Algorithm As A Strategy To Decrease Providers’ Exposure, While Trying To Increase Teams Availability And Guidance For Goals Of Care (Goc) And Symptoms Control, S. Lopez, G. Decastro, K. M. Van Ogtrop, S. Weiss-Domis, S. R. Anandan, C. J. Magalee, R. Roofeh, T. A. Liberman

Journal Articles

No abstract provided.