Medical Specialties Commons^™

Mri-Based Synthetic Ct Images For Impt Treatment Planning Of Nasopharyngeal Carcinoma Patients, Shupeng Chen, Y Peng, Y Liu, C Zhao, X Deng, An Qin, Di Yan, Craig Stevens, Rohan Deraniyagala, Xuanfeng Ding

Conference Presentation Abstracts

Purpose or Objective To investigate the feasibility of using an MRI-based synthetic CT image (SCT) generated via a generative adversarial network (GAN) for intensity-modulated proton therapy (IMPT) treatment planning of nasopharyngeal carcinoma (NPC) patients. Materials and Methods T1-weighted MR images and paired CT (PCT) images were obtained from 158 NPC patients with radiotherapy immobilization. Deformable image registration was performed between each MR and PCT image for each patient to create an MR-CT pair. Thirteen pairs were randomly chosen as independent test sets and the remaining 145 pairs (10 for validation and 135 for training) were used to build a conditional …

Causes Of Early Hip Revision Vary By Age And Sex: Analysis Of Data From A Statewide Quality Registry, Jacob F. Markel, John A. Driscoll, Richard Hughes, Jamers Verner, Thomas Zheng, Brian Halstrom, David C. Markel

Conference Presentation Abstracts

INTRODUCTION: While THA is extremely successful, early failures do occur. The purpose of this study was to determine the cause of revision in specific patient demographic groups at three timepoints to improve quality. The data should guide treatment regimens and implant choice. METHODS: Data for cases performed between 2012 and 2018 from a statewide, quality improvement arthroplasty registry was used. The database included 79,205 THA cases and 1,433 revisions with identified etiology (1,584 total). All revisions performed at < 5 years from the primary THA were reviewed. Six groups: men/women, <65, 65-75, and >75 years, were compared at revision timepoints <6 mo, <1 year, and <5 years. RESULTS: There were obvious and significant differences between subgroups based on demographics and timepoints (p<.0001). The most common etiologies within 1 year (961 revisions) were: fracture (324, 33.7%), dislocation (235, 24.5%) and infection (164, 17.0%). 756 (78%) of the 1-year revisions occurred within 6 months, the vast majority within 6 weeks. At this early timepoint, the most common revision cause was fracture for all groups and ages (316, 42%) ranging from 27.6% in young men to 60% in older women. Joint instability became the leading cause for revision after 6 months in younger women whereas for younger men infection became the primary issue. The most striking finding was the incidence of fracture as the leading cause of revision at all time points for both men and women >75 years. CONCLUSION: This quality project demonstrated clinically significant differences in the reason for THA …

Augmented Immunomodulation Of Endogenous Marrow-Derived Stem Cells In The Setting Of Acl Rupture, Mackenzie Fleischer, Michael Newton, Samantha Hartner, John A. Driscoll, Anthony Arveschoug, Chritopher C. Vasileff, Kevin Baker

Conference Presentation Abstracts

PURPOSE: Augmentation of MSC immunomodulation is an unexplored, potentially useful therapeutic to combat PTOA following ACLR. Lower kynurenine-to-tryptophan ratios observed in synovial fluid of ACL rupture (ACLR) rats suggests decreased activity of tryptophan metabolizing enzyme, Ido, known to be secreted by MSCs to promote T-reg expansion and Th17 suppression. This study aims to characterize the immunomodulatory capacity of pharmacologically mobilized MSCs in conjunction with exogenously delivered Ido. METHODS: Rats (N = 48) underwent ACLR to evaluate the effects of mobilized MCSs on Ido1 and inflammatory cytokine expression profiles in the synovial fluid. Additionally, rats (N = 160) underwent ACLR to …

A Lesson Learned From Mounting A Motorcycle, Joseph Friedli, Tyler Drewry, Nobin Kottukapally, Carolyn Landsberg

Conference Presentation Abstracts

A 32-year-old male presented for evaluation of right knee pain.

A Quantitative Dose Pertubation Comparison Study Between Gold And Platinum Visicoil Fiducial Markers In Proton Beam Therapy, Xuanfeng Ding, Gang Liu, Weili Zheng, Jessica Vadas, Xiaoqiang Li, Lewei Zhao, An Qin, Daniel Krauss, Di Yan

Conference Presentation Abstracts

Purpose: To quantitatively investigate the dose perturbations difference between gold and platinum VISICOILTM fiducial markers in proton beam therapy Method: Gold and platinum VISICOILTM fiducial markers with two different dimensions were tested, including 0.35 & 0.5mm in diameter and 5mm in length. Total four kinds of markers. Gafchromic EBT2 was used to measure dose perturbations along the beam path in a ‘‘sandwich’’ setup (Figure 1). Dose perturbation was reported in each depth (0.3mm, 1.65mm, 3.00mm, 5.40mm, 7.80mm, 10.20mm, 12.60mm, 18.15mm). Relative proton stopping power relative to water were calculated through National Institute of Standards and Technology database and SRIM (version …

Assessing The Interplay Effect Based On A Precise Machine-Specific Delivery Sequence And Time For Cyclotron Accelerator Proton Therapy System., Lewei Zhao, Gang Liu, Jiajian Sher, Andrew Lee, Di Yan, Rohan Deraniyagala, Craig Stevens, Xiaoqiang Li, Shikui Tang, Xuanfeng Ding

Conference Presentation Abstracts

Purpose: We proposed an experimental approach to build a precise machine-specific model for standard, volumetric, and layer repainting delivery based on a cyclotron accelerator system. Then, we assessed the interplay effect using a 4D mobile lung target phantom compared to a generic delivery sequence model from West German Proton Therapy Essen (WPE). Methods: The machine delivery log files, from an IBA ProteusPLUSt system, were retrospectively analyzed to quantitatively model energy layer switching time, spot switching time, and spot drill time for standard and volumetric repainting delivery. To quantitatively evaluate the interplay effect, a series of digital thoracic 4DCT image sets …

Contralateral Control Rate With Unilateral Proton Beam Radiotherapy For Oropharyngeal Scc: A Multi-Institutional Prospective Study From The Proton Collaborative Group, Aleksander Vayntraub, Thomas Quinn, John Chang, Noah Kalman, Sanford Katz, James Urbanic, Arpi Thukral, Jason Molitoris, Craig Stevens, Rohan Deraniyagala

Conference Presentation Abstracts

Introduction: Select patients with oropharyngeal SCC are candidates for unilateral radiation therapy. We sought to investigate if ipsilateral targeting leads to increased contralateral recurrences. Methods: We queried the PCG database for patients treated with unilateral proton RT for head and neck SCC from 2015 – 2020 at 12 institutions. DICOMs were evaluated to ensure dose delivered matched a unilateral proton treatment plan. Demographic, clinical and pathological, toxicity and dosimetry information were compiled. Results: We found 43 cases treated with unilateral proton RT. 94% (n¼16) of recurrent cases received prior radiation. Oropharyngeal sites included tonsillar fossa (n¼32), and base of tongue …

The First Modeling Of The Spot-Scanning Proton Arc(Sparc) Delivery Sequence And Investigating Its Efficiency Improvement, Xuanfeng Ding, Gang Liu, Lewei Zhao, Rohan Deraniyagala, Craig Stevens, Di Yan, Xiaoqiang Li

Conference Presentation Abstracts

Purpose: Introduce an experimental approach to model a precise prototype arc system and quantitatively assess its efficiency improvement in the routine proton clinical operation. Methods: The SPArc delivery sequence model(DSMSPArc) includes two kinds of parameters:(1) mechanical parameters. (2) irradiation parameters. Log files and an independent gantry inclinometer were used to derive the irradiation parameters through a series of test plans. The in-house DSMSPArc was established by fitting both mechanical and irradiation parameters. Eight SPArc plans from different disease sites were used to validate the model’s accuracy. To assess the treatment efficiency improvement, the DSMSPArc was used to simulate the SPArc …

A Direct Machine-Specific Parameters Incorporated Spot-Scanning Proton Arc (Sparc) Algorithm, Gang Liu, Lewei Zhao, Di Yan, Xiaoqiang Li, Xuanfeng Ding

Conference Presentation Abstracts

Purpose: To address the challenges of generating a deliverable and efficient spot-scanning proton arc (SPArc) plan for a proton therapy system. We developed a novel SPArc optimization algorithm (SPArcDMSP) by directly incorporating machinespecific parameters such as mechanical constraints and delivery sequence. Method and Material: A SPArc delivery sequence model (DSMarc) was built based on the machine-specific parameters of the prototype arc delivery system IBA ProteusONEt. The SPArcDMSP resamples and adjusts each control point’s delivery speed based on the DSMarc calculation through the iterative approach (Fig1). Users could set the expected delivery time and gantry max acceleration as a mechanical constraint …

Hiv-Associated Nephropathy Presenting As The First Manifestation Of Hiv-2 Infection, Kamil Sardarli, Rania Daboul, Sumesh Khanal, Sami Zarouk

Conference Presentation Abstracts

HIV-2 is distinguished from HIV-1 with low virulence, longer asymptomatic period, slower decline in CD4 count, low viral load, and low mortality from AIDS. While the kidney pathology associated with HIV-1 is well established, due to its low prevalence, kidney pathology in HIV-2 is not well documented. We report a case of HIV associated nephropathy (HIVAN) as the first presentation in a patient with HIV-2. A 65 year old man from Ghana presented within a few days of arrival to the United States with nausea, loss of appetite, shortness of breath, and bilateral lower extremity edema. He has a past …

You’Re Testing My Patients: Clinicians’ Preferences For Structured Reporting And Measurement Data, Davit Meliksetyan, Allan Brazier, Adela Pouzar, Sayf Al-Katib

Conference Presentation Abstracts

No abstract provided.

Impact Of The Mental Skills Curriculum On Stress Response Of Surgical Residents Performing A Simulated Task, Andrew Angus, Kathryn K. Howard, Harkirat Jawanda, Kathryn M. Ziegler, Victoria Roach

Conference Presentation Abstracts

No abstract provided.

Proteinuria In Thrombotic Microangiopathy (Tma) Can Be Associated With Adaptive Partial Podocytopathy With Focal Podocyte Hyperplasia, Megan Moore, Olabisi Afolayan-Oloye, Wei Li, Hassan Kanaan, Ping Zhang

Conference Presentation Abstracts

Background: TMA associated renal failure is easy to understand, but it has been difficult to explain the significant proteinuria in some cases of TMA. We recently confirmed that 100% of hyperplastic podocytes in collapsing glomerulopathy stained positively for CD133 (a stem cell/progenitor marker) as previously reported. The goal of this study was to determine if there was significant fusion of foot processes (FFP) and CD133-positive hyperplastic podocytes in TMA to correlate with the proteinuria. Design: The study included 12 negative controls (renal parenchyma away from renal cell carcinoma) and 25 TMA cases, either induced by drugs or due to other …

Untargeted Metabolomic Identification Of Diagnostic Biomarkers In Ectopic Pregnancy, Onur Turkoglu, Robert Quinn, Stewart F. Graham, Ray Bahado-Singh

Conference Presentation Abstracts

Introduction: Ectopic pregnancy (EP) is a potentially life-threatening condition and early diagnosis still remains a challenge, causing a delay in management leading to tubal rupture. Targeted metabolomics has been shown to identify novel biomarkers for the detection of ectopic pregnancy. Using untargeted metabolomics approach, we sought to identify putative plasma biomarkers for the detection of tubal EP compared to intrauterine pregnancies. Methods: This case-control study included prospective recruitment of 50 tubal EP cases and 50 early intrauterine pregnancy controls. Plasma samples were biochemically profiled using tandem liquid chromatographymass (MS/MS) spectrometry with untargeted metabolomics approach. To avoid over-fitting, datasets were randomly …

Proteinuria In Thrombotic Microangiopathy (Tma) Can Be Associated With Adaptive Partial Podocytopathy With Focal Podocyte Hyperplasia, Megan Moore, Olabisi Afaolayan-Oloye, Wei Li, Hassan Kanaan, Ping Zhang

Conference Presentation Abstracts

Background: TMA associated renal failure is easy to understand, but it has been difficult to explain the significant proteinuria in some cases of TMA. We recently confirmed that 100% of hyperplastic podocytes in collapsing glomerulopathy stained positively for CD133 (a stem cell/progenitor marker) as previously reported. The goal of this study was to determine if there was significant fusion of foot processes (FFP) and CD133-positive hyperplastic podocytes in TMA to correlate with the proteinuria. Design: The study included 12 negative controls (renal parenchyma away from renal cell carcinoma) and 25 TMA cases, either induced by drugs or due to other …

A Soft Tissue Tumor With Eml4-Alk Fusion, Granular Cell Changes, Metastasis, And Response To Kinase Inhibitor Therapy In A Young Girl, Zhenhong Qu, Chris Hysell, Ping Zhang, Mark Micale

Conference Presentation Abstracts

Background: An increasing number of soft tissue neoplasms with fusion of well-defined driver genes are being discovered. We report such a case in a 3-year-old girl with a 2-year follow-up. Design: The patient first presented at age of 3.5 years with a painless right axillary/chest wall mass without constitutional symptoms. MRI demonstrated a 4.5 x 3.5 x 3.5 cm T2 hyper- and T1 hypointense mass. The mass was excised and showed a well-demarcated solid lesion with a homogeneous pale-white fleshy cut surface. No necrosis, myxoid or cystic change, hemorrhage, or calcification was noted. Microscopically, it was a variably hypercellular lesion …

A Soft Tissue Tumor With Eml4-Alk Fusion, Granular Cell Changes, Metastasis, And Response To Kinase Inhibitor Therapy In A Young Girl, Zhenhong Qu, Chris Hysell, Ping Zhang, Mark Micale

Conference Presentation Abstracts

Background: An increasing number of soft tissue neoplasms with fusion of well-defined driver genes are being discovered. We report such a case in a 3-year-old girl with a 2-year follow-up. Design: The patient first presented at age of 3.5 years with a painless right axillary/chest wall mass without constitutional symptoms. MRI demonstrated a 4.5 x 3.5 x 3.5 cm T2 hyper- and T1 hypointense mass. The mass was excised and showed a well-demarcated solid lesion with a homogeneous pale-white fleshy cut surface. No necrosis, myxoid or cystic change, hemorrhage, or calcification was noted. Microscopically, it was a variably hypercellular lesion …

Final Counts Of Monoclonal Gammopathy Of Renal Significance (Mgrs) After Bone Marrow Biopsies (Bmb) And Follow-Up, Brandon Metcalf, James Zhiyan Huang, Wei Li, Hassan Kanaan, Ping Zhang

Conference Presentation Abstracts

Background: MGRS is a relatively new concept for patients with renal paraprotein deposition (RPD) (except monoclonal cast nephropathy) with no bone marrow confirmed diagnosis of malignancy or premalignancy (< 10% monoclonal plasma cells). This concept has been used as a reason for a nephrology consult for a bone marrow biopsy (BMB), therefore it is important to evaluate the outcome of MGRS tentatively diagnosed via renal biopsy and confirmed by BMB. This study’s purpose was to identify what percentage of various subtypes of MGRS tentatively diagnosed via renal biopsy can be confirmed as MGRS by BMB and followup. Design: In total, 124 renal biopsies with variants of RPD were identified at our center out of 3811 renal biopsies (3.3% of overall cases) over past 10 years. Biopsy cases with known Myeloma, B Cell Lymphoma or Monoclonal Cast Nephropathy were separated as a heavy burden group. The remaining biopsies with RPD were considered as tentative MGRS diagnoses. Their BMB and clinical indices were followed up to determine the percent that resulted in a confirmed MGRS diagnosis. Results: Among the 124 renal paraprotein deposition cases, 43 cases (34.7%) were categorized to the heavy burden group (Figure). The remaining 81 cases with other variants of RPD were further divided into four categories based on the follow-up. Myeloma or Lymphoma were found in 34 cases (27.4%). Twelve outside consultation cases (10%) did not show follow-up biopsies as we were unable to obtain record access. BMB’s diagnosed as nonmalignant (6 cases, 4.8%) or premalignant (29 cases, 23.4%) were confirmed to be MGRS for a total of 35 cases (28.2%). Among the different categories of tentative MGRS, Monoclonal Light/Heavy Chain Deposition Diseases (L/HCDD) had the highest positivity rate for myeloma on the subsequent BMB. Proliferative Glomerulonephritis with Monoclonal Immunoglobulin Deposition (PGNMID) had a high rate of nonmalignant or premalignant diagnosis by BMB. Monoclonal Amyloidosis had some nonmalignant and pre-malignant diagnoses after BMB although myeloma was associated with this renal entity. Conclusions: The data indicate that BMB is crucial for confirming a diagnosis of MGRS. The study also provides pathologists and clinicians with general expectations regarding the possible BMB outcome for the many variants of MGRS identified tentatively via renal biopsy.

Final Counts Of Monoclonal Gammopathy Of Renal Significance (Mgrs) After Bone Marrow Biopsies (Bmb) And Follow-Up, Brandon Metcalf, James Zhiyan Huang, Wei Li, Hassan Kanaan, Ping Zhang

Conference Presentation Abstracts

Background: MGRS is a relatively new concept for patients with renal paraprotein deposition (RPD) (except monoclonal cast nephropathy) with no bone marrow confirmed diagnosis of malignancy or premalignancy (< 10% monoclonal plasma cells). This concept has been used as a reason for a nephrology consult for a bone marrow biopsy (BMB), therefore it is important to evaluate the outcome of MGRS tentatively diagnosed via renal biopsy and confirmed by BMB. This study’s purpose was to identify what percentage of various subtypes of MGRS tentatively diagnosed via renal biopsy can be confirmed as MGRS by BMB and followup. Design: In total, 124 renal biopsies with variants of RPD were identified at our center out of 3811 renal biopsies (3.3% of overall cases) over past 10 years. Biopsy cases with known Myeloma, B Cell Lymphoma or Monoclonal Cast Nephropathy were separated as a heavy burden group. The remaining biopsies with RPD were considered as tentative MGRS diagnoses. Their BMB and clinical indices were followed up to determine the percent that resulted in a confirmed MGRS diagnosis. Results: Among the 124 renal paraprotein deposition cases, 43 cases (34.7%) were categorized to the heavy burden group (Figure). The remaining 81 cases with other variants of RPD were further divided into four categories based on the follow-up. Myeloma or Lymphoma were found in 34 cases (27.4%). Twelve outside consultation cases (10%) did not show follow-up biopsies as we were unable to obtain record access. BMB’s diagnosed as nonmalignant (6 cases, 4.8%) or premalignant (29 cases, 23.4%) were confirmed to be MGRS for a total of 35 cases (28.2%). Among the different categories of tentative MGRS, Monoclonal Light/Heavy Chain Deposition Diseases (L/HCDD) had the highest positivity rate for myeloma on the subsequent BMB. Proliferative Glomerulonephritis with Monoclonal Immunoglobulin Deposition (PGNMID) had a high rate of nonmalignant or premalignant diagnosis by BMB. Monoclonal Amyloidosis had some nonmalignant and pre-malignant diagnoses after BMB although myeloma was associated with this renal entity. Conclusions: The data indicate that BMB is crucial for confirming a diagnosis of MGRS. The study also provides pathologists and clinicians with general expectations regarding the possible BMB outcome for the many variants of MGRS identified tentatively via renal biopsy.

Myeloperoxidase (Mpo) Immunostaining Can Identify Endothelial Injury Of Peritubular Capillaries And Glomeruli In Renal Antibody Mediated Rejection, Olabisi Afolayan-Oloye, Megan Moore, Wei Li, Hassan Kanaan, Ping Zhang

Conference Presentation Abstracts

Background: C4d positive staining in peritubular capillaries (PTC) of renal grafts has been used as a marker to support antibody mediated rejection (AMR), if there are morphologic changes of AMR and the renal recipient has positive donor specific antibody. But it is not clear if the C4d staining is related to any peritubular and glomerular injury during AMR. As injured endothelial cells can uptake the MPO into the endothelial cells, we used MPO immunostaining to highlight glomerular endothelial injury in crescentic glomerulonephritis previously. The goal of this study was to determine if there was an endothelial injury of PTC and …

Covid-19 Associated Myelin Oligodendrocyte Glycoprotein Antibody-Associated Disease (Mogad), Evan Palamara, Ay-Ming Wang, Samir E. Noujaim, Kathleen A. Barry, Suleiman Kojan, M Mazen Al-Hakim, Richard Silbergleit

Conference Presentation Abstracts

No abstract provided.

Dear Radiologist: Cure My Disc Bulge, But Please Don’T Miss My Spinal Tumor!, A Dearden, J Ghannam, A M Wang

Conference Presentation Abstracts

No abstract provided.

P118. Colonic Stent Presenting With Stent Impaction And Erosion Through The Colonic Wall, Benjamin Randall Hart, Jon Hain

Conference Presentation Abstracts

Background: Colonic stenting has been shown to be effective as a palliative measure in colorectal cancer when

patients present with obstructing symptoms. However, its efficacy when used for complications of colonic anastomoses are less well-studied. We present a case report of an elderly gentleman with a colonic stent placed for anastomotic stricture, which led to stent migration stent impaction with erosion in the sigmoid colon.

A 92-year-old gentleman presented to the ED with several days worth of nausea and vomiting. He had recently undergone a partial colectomy with an ileocolonic anastomosis approximately one year prior and then had a covered …

Reducing Post-Operative Emergency Department Visits And Readmissions After Nephrectomy: An Initial Evaluation Of The Music-Kidney Registry, M Butaney, A Johnson, A Bulusu, D Gandham, J Qi, M Jamil, A Patel, S Noyes, J Anema, Michael Levin, Bradley Rosenberg

Conference Presentation Abstracts

Introduction & Objectives: Emergency department (ED) visits and readmissions are often used metrics of quality care provided to surgical patients and important contributors to healthcare costs and utilization. We evaluate post-operative ED visits and readmissions after partial (PN) and radical (RN) nephrectomy in the MUSIC-KIDNEY registry to identify potentially preventable events and develop prevention strategies. Materials & Methods: Data abstractors recorded clinical, radiographic, pathologic, and follow-up data for patients with newly diagnosed clinical T1 renal masses (cT1RM) at 16 MUSIC practices with >90 physicians. All charts associated with 30-day ED visits and readmissions since the inception of MUSIC-KIDNEY (6/2017) were …

Variability And Outcomes Of Medical And Lifestyle Management Of Peripheral Arterial Disease At The Time Of Lower Extremity Bypass, Ryan Howard, Jeremy Albright, Matthew Corriere, Nicholas Osborne, Eugene Laveroni, Peter Henke

Conference Presentation Abstracts

Background: First-line treatment of peripheral arterial disease (PAD) involves medical therapy and lifestyle modification. Specifically, the 2016 American Heart Association/American College of Cardiology guidelines for the management of PAD make Class I recommendations for antiplatelet therapy, statin therapy, antihypertensive therapy, and cilostazol therapy, as well as exercise therapy and smoking cessation. Although evidence supports medical and lifestyle management of PAD before surgical intervention, it is currently unclear whether clinical practice reflects this. Moreover, it is also unknown whether variability in medical and lifestyle optimization before revascularization affects short- and long-term outcomes. This study was conducted to determine the proportion of …

Detection Of Progression Or Regression Of Gynecologic Cancers By Circulating Tumor Dna (Ctdna), Bipin Ghimire, Ujjwal Karki, Emma Herrman, Mohammad Muhsin Chisti

Conference Presentation Abstracts

Objectives The use of post-operative circulating tumor DNA (ctDNA) to detect cancer recurrence has been reported in various studies but the literature describing variable changes in ctDNA is limited. The objective of this study is to describe the utility of single and serial ctDNA values in detecting the progression or regression of gynecological cancers.

Methods This is a retrospective observational study including nineteen patients, aged >=18 years who had the ctDNA test completed at hematology/oncology clinic of William Beaumont – Royal Oak and Troy Hospitals, Michigan, USA.

Results Among the nineteen patients, fifteen had breast, three had ovarian, and one …

A Study To Compare Baseline Functional Residual Capacity And Forced Vital Capacity As A Predictor Of Mortality And Hospitalization In A Cohort Of Mild To Moderate Interstitial Lung Disease, O R. Gomez Rojas, E Naeem, F Ionescu, E Castillo, G B. Nair

Conference Presentation Abstracts

Background Forced Vital Capacity (FVC) is a common parameter used to assess disease progression in patients with Interstitial lung disease (ILD) and acts as a surrogate for mortality. Previous studies suggest Functional Residual Capacity (FRC) may be an earlier predictor of disease progression in ILD. In this study, we compared ability of baseline FRC to FVC to predict one-year-mortality and respiratory related hospitalization in patients with mild to moderate ILD. Methods We retrospectively analyzed a prospective cohort of ILD patients attending a multidisciplinary ILD program from Jan 2017 to Oct 2021 at a large Health care system. Patients who had …

Impact Of Difelikefalin On 5d-Itch Domains In Patients With Ckd-Associated Pruritus, Anjay Rastogi, Joel M. Topf, Thilo Schaufler, Isabelle Morin, Frederique Menzaghi, Warren Wen, Kieran Mccafferty

Conference Presentation Abstracts

Background: Chronic kidney disease-associated pruritus (CKD-aP) is common in hemodialysis (HD) patients, impacting quality of life (QoL). In the Phase 3 KALM studies, difelikefalin (DFK), a selective kappa opioid receptor agonist approved in the United States and Europe for the treatment of moderate–severe pruritus in adults undergoing HD, improved itch intensity and QoL. The impact of DFK treatment on the subdomains of the 5D-itch scale (a multidimensional questionnaire validated in patients with chronic pruritus) were explored.

Methods: In this pooled KALM-1 and KALM-2 analysis (n=712), HD patients with moderate–severe CKD-aP were randomized 1:1 to receive intravenous DFK 0.5 µg/kg or …

#Askrenal: Use Of An Automated Twitter Account To Crowdsource Nephrology Queries, Jade M. Teakell, Alicja Rosolowska, Swapnil Hiremath, Matthew A. Sparks, Edgar V. Lerma, Joel M. Topf, Nikhil A. Shah

Conference Presentation Abstracts

Background: Social media platforms are used in contemporary crowdsourcing, and Twitter is apt for reaching a large number of people with a common interest. Users, especially those with a small follower count may find it challenging to reach a large audience. #AskRenal was developed as a Twitter crowdsourcing tool to help users get answers to nephrology questions. We hypothesized that the #AskRenal hashtag could be used by anyone to receive helpful and timely responses to simple or complex nephrology questions posed on the social media platform. Methods: A Twitter account @AskRenal, and an online Twitter bot that automatically retweeted any …

Dual Paraneoplastic Syndrome In Small Lung Cancer, Kamil Sardarli, Austin M. Morris, Jamal Abukhaled

Conference Presentation Abstracts

Introduction: Small cell lung cancer (SCLC) is an aggressive neuroendocrine lung cancer associated with paraneoplastic syndromes – syndrome of inappropriate ADH (SIADH) in 7-16% of cases and Ectopic ACTH Syndrome (EAS) in 3.5-4.3% of cases. Both syndromes are associated with a poor prognosis in patients with SCLC. We describe a patient who presented with SIADH, leading to a diagnosis of SCLC who subsequently developed EAS. Case Description: A 71-year-old female with a past medical history of hypertension, depression, and tobacco use presented with lethargy. She noted headache, but otherwise was unable to provide history due to altered mentation. Per her …