Medical Specialties Commons^™

Advances In The Treatment Of Congenital Ptosis, Alon Kahana

Conference Presentation Abstracts

No abstract provided.

The Many Uses Of 5-Fluorouracil In Oculoplastic Surgery, Alon Kahana

Conference Presentation Abstracts

No abstract provided.

Orbital Vascular Anomalies: Classification And Treatment, Alon Kahana

Conference Presentation Abstracts

No abstract provided.

Advances In The Treatment Of Thyroid Eye Disease, Alon Kahana

Conference Presentation Abstracts

No abstract provided.

Immune Thrombocytopenia In Covid Pneumonia: A Case Report Of The Oldest Patient, Samiksha Pandey, Kamil Sardarli, Candace Franklin, Ashbina Pokharel, Sumesh Khanal, Bipin Ghimire, Feroze A. Momin

Conference Presentation Abstracts

Introduction: COVID infection has shown to cause thrombocytopenia with multiple different mechanisms including the destruction of platelets with immune system stimulation similar to ITP with little evidence for optimal management. Here, we present a COVID infected patient presented with idiopathic thrombocytopenia with a partial delayed response to the treatment. Case Presentation: A 92-year-old man with a past medical history of coronary artery disease status post remote coronary artery bypass graft, hypertension, diabetes mellitus presented with petechiae, epistaxis, and was found to be profoundly thrombocytopenic with a platelet count of 1x109/L. He also had an asymptomatic COVID 19 infection, a normal …

Mosaic Pattern Of Progenitor Cell Marker Cd133 Expression To Identify Podocyte Proliferation Supports Collapsing Variant Of Focal Segmental Glomerulosclerosis (Fsgs), A Xiao, H Kanaan, W Li, P Zhang

Conference Presentation Abstracts

Introduction: Previous studies using immunofluorescent methods indicate that both the cellular crescents in crescentic glomerulonephritis and the podocyte proliferation in collapsing FSGS may both originate from parietal epithelial cells, which serve as CD133 positive progenitor cells. We have previously confirmed positive CD133 staining in the cellular crescents of crescentic glomerulonephritis. However, the role of CD133 expression in highlighting the proliferative podocytes in collapsing FSGS has not been adapted to the renal pathology practice. Methods: We have identified 19 collapsing FSGS from our archive over past 10 years (out of 3942 renal biopsies, 0.5 %). The collapsing FSGS cases were either …

The Use Of Actigraphy And Its Impact On Perceived Sleep Quality And Activity Levels In Individuals With Traumatic Brain Injury In An Inpatient Rehabilitation Setting., Lina Shkokani, Amanda Reyes, Bachar Hazim, Jason Kisser, Philip T. Roskos

Conference Presentation Abstracts

No abstract provided.

Cerebral Perfusion Using The Resistive Index On Doppler Ultrasound In Extremely Premature Newborns With Ventriculomegaly, Rawad Obeid, Marni Jacobs, Taeun Chang, An N. Massaro, Dorothy Bulas, Anna Penn

Conference Presentation Abstracts

Background: In extremely premature newborns, the effect of ventriculomegaly, as seen on cranial ultrasound (CUS), on cerebral perfusion is not well studied. The resistive index (RI) (Figure-1) is a marker of change of the flow velocity on Doppler ultrasound that could be used to understand this effect.

Objective: To identify the following: 1- The normal RI values in premature infants without intraventricular hemorrhage (IVH), 2- The relation between the RI in the major intracerebral arteries and the ventricular size on CUS using the fronto-temporal horn ratio (FTHR) in newborns with and without IVH, and 3-The association with white matter injury …

Illumina Trusight Oncology 500 Sequencing Panel Validation At A Large Community Based Hospital, Sandeep Kumar, John Schwartz, Mitual Amin, Jennifer Kilbourn, Hlee Vue, Susan Daraiseh, Kausar Jabbar

Conference Presentation Abstracts

Background: With growing efficacy of targeted therapy, it is critical to have comprehensive tumor profiling. TruSight Oncology 500 (TSO500) is a hybrid capture based next generation sequencing (NGS) assay that enables comprehensive genomic profiling of tumor samples. TSO500 includes 523 cancer-related genes which provides identification of pertinent single nucleotide variants (SNV), insertions and deletions (Indels), splice variants, fusions, copy number variants (CNV), tumor mutational burden (TMB) and microsatellite instability (MSI), from genomic DNA and RNA. Design: We evaluated the performance of TSO500 using a combination of 102 formalin fixed paraffin embedded (FFPE) tumor types, 41 hematologic samples and 27 reference …

Diagnosing Total Joint Arthroplasty-Associated Periprosthetic Joint Infections In Immunocompromised Patient Populations, Erin A. Baker, Philip Zakko, Christian Huber, Corinn Gehrke, Michael Flierl

Conference Presentation Abstracts

No abstract provided.

Intraoperative Purulence As A Criteria In Diagnosing Periprosthetic Joint Infection In Total Joint Arthroplasty, Corinn Gehrke, Brett Friedman, Christian Huber, Philip Zakko, Matthew Sims, Michael Flierl

Conference Presentation Abstracts

No abstract provided.

Two-Year Outcomes Of The Artisan-Snm Study For The Treatment Of Urinary Urgency Incontinence With The Axonics Rechargeable Sacral Neuromodulation System, Andrea Pezzella, Rebecca Mccrery, Felicia Lane, Kevin Benson, Chris Taylor, Kenneth M. Peters

Conference Presentation Abstracts

Introduction: Sacral neuromodulation is a guideline-recommended therapy for treatment of urinary urgency incontinence (UUI) patients [1]. The Axonics® System is the first FDA-approved rechargeable SNM system that is qualified to delivery therapy for at least 15 years. The ARTISAN-SNM study is a prospective, pivotal study, designed to evaluate the safety and effectiveness of the Axonics System for UUI treatment. Clinical outcomes at 2 years are presented. Methods: 129 UUI participants across 19 centers in the US and Europe were implanted with the Axonics System in a single, non-staged procedure. Clinical outcomes were reported from 3-day bladder diaries, a validated quality …

Concordance Between Antibiotic Resistance Genes By Multiplex Polymerase Chain Reaction And Antibiotic Susceptibility By Pooled Antibiotic Sensitivity Testing In Symptomatic Patients With Urinary Tract Infection, Annah Vollstedt, Dakun Wang, Natalie Luke, David Baunoch, Kirk J. Wojno, Kevin Cline, Natalie Gaines, Howard Korman, S Mohammad Jafri, David Wenzler, Frank Burks, Larry Sirls

Conference Presentation Abstracts

Introduction: Studies have shown many genes influence antibiotic resistance, and the relationship between genotypic and phenotypic antibiotic resistance is unclear. We sought to analyze the concordance between the presence of antibiotic resistance (ABR) genes and antibiotic susceptibility results in urine samples collected from symptomatic UTI patients. Methods: Urine samples were collected from patients presenting with possible UTI to 37 geographically disparate Urology clinics from July 2018 to February 2019. Multiplex polymerase chain reaction (M-PCR) was used to test for 33 different ABR genes. Samples in which at least one organism was identified at a quantity of ≥104 cells per mL, …

Changes In Patient Reported Outcome Measures After Treatment Of Female Urethral Stricture, Alyssa Gracely, Giulia I. Lane, Pansy Uberoi, Una Lee, Ariana Smith, Priya Padmanabhan

Conference Presentation Abstracts

Introduction: There is a paucity of patient reported outcome measures (PROM) data for women with urethral strictures. Prior literature focuses on anatomic success, with almost no data describing patient centered outcomes. To fill this critical gap, we aim to evaluate change in PROM among women who underwent surgery for stricture. Methods: Data were collected as part of a multiinstitutional retrospective cohort study of women treated for urethral stricture between 2010-19. Median change between baseline and postoperative follow-up on the American Urological Association Symptom Index (AUA-SI) and Urinary Distress Inventory (UDI-6) were assessed using paired Wilcoxon signed-rank tests. Results: Of the …

Fractional Carbon Dioxide Vaginal Laser For The Treatment Of Urinary Symptoms: Preliminary Short-Term Results, Annah Vollstedt, Lauren Tennyson, Michael Rezaee, Ly Hoang Roberts, Larry Sirls, Priya Padmanabhan, Kenneth M. Peters

Conference Presentation Abstracts

Introduction: Previous studies have shown that the fractional carbon dioxide (fCO2) vaginal laser improves genitourinary symptoms of menopause. It has been proposed that fCO2 vaginal laser can also treat stress urinary incontinence (SUI) by increasing collagen production. The aim of our study was to evaluate the effect of vaginal fCO2 laser therapy in patient complaining of SUI. Methods: Women over 18 years old with complaints of urogenital symptoms who had been off vaginal estrogen for at least three months were enrolled in this open-label prospective trial. Participants received 3 laser treatments approximately 6 weeks apart. Stress test was performed on …

Are Consortia Polymicrobial Urinary Tract Infections More Symptomatic Than Monomicrobial? Results From A Multi-Institutional Study, Annah Vollstedt, Dakun Wang, Natalie Luke, David Baunoch, Kirk J. Wojno, Kevin Cline, Natalie Gaines, Howard Korman, S Mohammad Jafri, David Wenzler, Frank Burks, Larry Sirls

Conference Presentation Abstracts

Introduction: Polymerase chain reaction (PCR) has been shown to be more sensitive in the detection of polymicrobial infections in patients with urinary tract infection (UTI). Bacterial consortia are non-random communities of microbes that may act synergistically to provide growth and survival advantages. We aim to investigate the relationship between bacteria detected by PCR, and the presence of consortia, with clinical findings in patients with symptomatic UTI. Methods: We performed a retrospective analysis of 2493 UTI-symptomatic patients over the age of 60 from 37 geographically disparate urology clinics in the U.S. from July 2018 to February 2019. Clinical findings, including UA …

Defining And Detecting Bacterial Consortia Within Urine Samples Of Patients With Symptomatic Urinary Tract Infection, Annah Vollstedt, Dakun Wang, Natalie Luke, David Baunoch, Kirk J. Wojno, Kevin Cline, Natalie Gaines, Howard Korman, S Mohammad Jafri, David Wenzler, Frank Burks, Larry Sirls

Conference Presentation Abstracts

Introduction: Bacterial consortia are non-random patterns of bacterial communities that work synergistically to provide growth and survival advantages over planktonic, free-floating, microbes. In this study, we aim to characterize bacterial consortia identified by multiplex polymerase chain reaction (M-PCR) in symptomatic patients with polymicrobial urinary tract infections (UTI). Methods: We performed a retrospective analysis of 2493 UTI-symptomatic patients over the age of 60 from 37 geographically disparate urology clinics from July 2018 to February 2019. M-PCR was performed to detect 24 different bacterial species. A cutoff of 10 detections was used to distinguish a bacterial consortium from a random association of …

Fractional Carbon Dioxide Vaginal Laser For The Treatment Of Urinary Symptoms: Preliminary Short-Term Results, Annah Vollstedt, Lauren Tennyson, Michael Rezaee, Ly Hoang Roberts, Larry Sirls, Priya Padmanabhan, Kenneth M. Peters

Conference Presentation Abstracts

Introduction: It has been proposed that fractional carbon dioxide (fCO2) vaginal laser can also treat stress urinary incontinence (SUI) by increasing collagen production. The aim of our study was to evaluate the effect of vaginal fCO2 laser therapy in patients complaining of SUI. Methods: This is a prospective, open-label study of women over 18 years old with complaints of urogenital symptoms. Women with a history of vaginal estrogen use within the last 3 months were excluded. Participants received 3 laser treatments 6 weeks apart. Cough stress test (CST) was performed at each visit. Incontinence-Quality of Life (I-QOL), Questionnaire for Urinary …

Stimwave For Pudendal Neuralgia, Ly Hoang Roberts, Joshua Volin, Teresa Mccartney, Annah Vollstedt, Kenneth M. Peters

Conference Presentation Abstracts

Introduction: Pudendal neuralgia is a chronic and debilitating condition with 10- 25% of patients refractory to traditional therapies including sacral neuromodulation. Prior studies have shown chronic pudendal nerve stimulation with Interstim® (Medtronic, Inc., Minneapolis, MN) is effective for this patient population. This study reports on a wireless system to power an implanted lead at the pudendal nerve, StimWave®, to treat pudendal neuralgia. Methods: Retrospective chart review identified patients with pudendal neuralgia who had a lead placed at the pudendal nerve and powered wirelessly according to patient need. Clinical outcomes were assessed at post-operative visits as well as phone calls. Non-validated …

Parental Leave Satisfaction In Physicians Compared To Non-Physicians, Aryana Sharrak, Ly Hoang Roberts, Annah Vollstedt, Melissa Fischer, Esther Han

Conference Presentation Abstracts

Introduction: United States is one of the last two countries without a national parental leave mandate. Professional women of child-bearing age are uniquely impacted by the lack of a robust standardized policy. The purpose of this study is to investigate parental leave satisfaction amongst physicians versus non-physicians. Methods: After IRB approval, a 34-question electronic survey was developed through Qualtrics®, to ascertain satisfaction across professions. This was distributed via Facebook to Physician Moms Group, Beaumont Parenting Group, and Nurse Moms Group. Descriptive characteristics are reported. Statistical analysis included t- test and chi-square test. Results: Out of 816 respondents, 96% (n= 782) …

Concordance Between Antibiotic Resistance Genes By Multiplex Polymerase Chain Reaction And Antibiotic Susceptibility By Pooled Antibiotic Sensitivity Testing In Symptomatic Patients With Urinary Tract Infection, Annah Vollstedt, Dakun Wang, Natalie Luke, David Baunoch, Kirk J Wojno, Kevin Cline, Natalie Gaines, Howard Korman, S Mohammad Jafri, David Wenzler, Frank Burks, Larry Sirls

Conference Presentation Abstracts

Introduction: Studies have shown many genes influence antibiotic resistance, and the relationship between genotypic and phenotypic antibiotic resistance is unclear. We sought to analyze the concordance between the presence of antibiotic resistance (ABR) genes and antibiotic susceptibility results in urine samples collected from symptomatic UTI patients. Methods: Urine samples were collected from patients presenting with possible UTI to 37 geographically disparate Urology clinics from July 2018 to February 2019. Multiplex polymerase chain reaction (M-PCR) was used to test for 33 different ABR genes. Samples in which at least one organism was identified at a quantity of ≥104 cells per mL, …

Incomplete Bladder Emptying And Urinary Tract Infections After Onabotulinumtoxina Injection For Overactive Bladder In Men And Women: Multi-Institutional Collaboration From The Sufu Research Network, William Stuart Reynolds, Anne M. Suskind, Jennifer T. Anger, Benjamin M. Brucker, Anne Pelletier Cameron, Priya Padmanabhan

Conference Presentation Abstracts

Introduction: OnabotulinumtoxinA (BTX) is an effective third-line therapy for overactive bladder (OAB), however the potential for adverse events may prevent patients from initiating therapy. The objective of this study is to report rates of incomplete emptying and urinary tract infection (UTI) in men and women undergoing BTX for OAB and to identify potential risk factors for these adverse events. Methods: Eleven clinical sites performed an IRBapproved retrospective study of adult women and men undergoing first-time BTX injection (100 units) for non-neurogenic OAB in 2016. Exclusions included: post void residual (PVR) >150ml, prior BTX, pelvic radiation, or catheterization. Clinical data was …

Are Surgeons Still Doing Sentinel Node Biopsies In Older Women, Eric A. Brown

Conference Presentation Abstracts

INTRODUCTION: SSO published guidelines suggesting that surgeons should not routinely perform sentinel lymph node (SLN) biopsies for patients (pts) * 70 years of age (yo) with hormone receptor positive, her2 negative (HR+her2-) early stage invasive breast cancer (IBC). METHODS: We evaluated HR+her2- early stage IBC patients (pts) who were accrued to a multicenter trial between 2016-2018. Lymph node (LN) evaluation was left to the discretion of the treating surgeon. We sought to determine whether those * 70 yo were treated differently in terms of LN staging than their younger counterparts, the results of the SLN biopsy, and its impact on …

510 Contemporary Trends In Cesarean Delivery Rates And Indications, Sara Jaber, Christina Blanchard, Michelle Y. Lu

Conference Presentation Abstracts

Objective

The American College of Obstetrics and Gynecology (ACOG) introduced updated guidelines for labor management (2014) and fetal heart rate interpretation in an attempt to reduce cesarean delivery (CD) rates – especially the primary CD. We sought to describe CD rates and indications at a single center in order to assess the impact of these guidelines on trends in clinical practice.

Study Design

Retrospective cohort study of women ≥ 23 weeks gestation delivering at a single tertiary care referral center from 2013 - 2018. Demographic characteristics, mode of delivery, and main CD indication were ascertained by individual chart review. Main …

Innovative Workflow To Collect Home Urine Samples From Symptomatic Patients Sheltered In Place During Covid-19, Andrew Korman, Siddharth Ramanathan, Jonathan Korman, Sadhna Ramanathan, Savitha Balaraman, Natalie Luke, Rajan Dewar, Kirk J. Wojno, Larry Sirls, Howard Korman

Conference Presentation Abstracts

Introduction: The two main challenges during the COVID 19 pandemic were to keep essential employees safe and to provide timely care to patients. We devised a novel urine specimen home pickup strategy for our patients with hematuria, irritative voiding symptoms as well as bladder cancer to address these issues. Methods: An employee dropped off necessary equipment for the urine sample to symptomatic patients’ houses. A clean catch specimen was collected and the sample left at the front door. The driver wearing PPE picked up the sample within 30 minutes and delivered it to the lab. Dipstick analysis was performed. Patients …

Diagnosis Of Early Delayed Graft Function (Dgf) Using Timp-2*Igfpb-7 Product In Transplant Recipients: Preliminary Results, Russell Leong, Cassandra Rodd, Kellyann M. Gomes, Solomiia Savedchuk, Paul S. Kellerman

Conference Presentation Abstracts

Background: DGF is acute kidney injury (AKI) defined as need for dialysis within one week of renal transplant. AKI is defined by a change in serum creatinine (SCr), however early recognition is limited by delay in creatinine rise. Accurate early biomarkers may lead to prevention or treatment of established AKI. The product of two novel biomarkers of cell cycle arrest, tissue Inhibitor of metalloproteinase-2 (TIMP-2) and insulin-like growth factor binding protein (IGFBP-7) have shown promise in predicting AKI. In prior studies, TIMP-2*IGFPB-7 ≤0.3 had high negative predictive value, and ≥2 high positive predictive value for AKI. Aims - 1) Investigate …

A Patient With Combined Metformin-Induced Lactic Acidosis And Euglycemic Diabetic Ketoacidosis, Kamil Sardarli, Russell Leong, Inayat Gill, Sami S. Zarouk

Conference Presentation Abstracts

Introduction: Metformin is a small, non-protein-bound molecule that can cause lactic acidosis in 6 out of 100,000 patients with a mortality rate of 30-50%. Concurrent euglycemic diabetic ketoacidosis (DKA) from sodium-glucose co-transporter-2 (SGLT2) inhibitor has been reported in one case. We report a unique case of a patient with acute kidney injury (AKI) in the setting of metformin-induced lactic acidosis and osmotic diuresis due to euglycemic DKA complicated by celecoxib use. Case Description: A 66-year-old female with a past medical history of type 2 diabetes mellitus for 21 years on metformin 1000 mg twice daily and empagliflozin 25 mg daily …

Does Breast Cancer Subtype Impact Margin Status In Patients Undergoing Partial Mastectomy?, Andrew Fenton, Elisabeth Dupont, Theodore Tsangaris, Carlos Garcia-Cantu, Marissa Howard-Mcnatt, Akiko Chiba, Adam Berger, Edward Levine, Jennifer Gass, Kristalyn Gallagher, Sharon Lum, Ricardo Martinez, Alliric Willis, Sonali Pandya, Eric A. Brown, Amanda Mendiola, Naveenraj Solomon, Maheswari Senthil, David Ollila, David Edmonson, Melissa Lazar, Jukes Namm, Fangyong Li, Meghan Butler, Noreen Mcgowan, Maria Herrera, Yoana Avitan, Brian Yoder, Laura L. Walters, Tara Mcpartland, Victor Haddad, Hongwei Ma, Ming Xie, Anees Chagpar

Conference Presentation Abstracts

BACKGROUND: Molecular subtype in invasive breast cancer guides systemic therapy. It is unknown whether molecular subtype should also be considered to tailor surgical therapy. The present investigation was designed to evaluate whether breast cancer subtype impacted surgical margins in patients with invasive breast cancer stage I through III undergoing breast-conserving therapy.

METHODS: Data from 2 randomized trials evaluating cavity shave margins (CSM) on margin status in patients undergoing partial mastectomy (PM) were used for this analysis. Patients were included if invasive carcinoma was present in the PM specimen and data for all 3 receptors (ER, PR, and HER2) were known. …

Ultrasound Guided Laparoscopic Radiofrequency Ablation For Very Large Multi-Fibroid Uterus, Alia A. Shah, Jay E. Fisher

Conference Presentation Abstracts

Study Objective

This video describes the technique and advantages of laparoscopic radiofrequency ablation with ultrasound guidance for the treatment of very large multi-fibroid uteri.

Design

N/A

Setting

Large tertiary care hospital.

Patients or Participants

45-year-old gravida 2 para 0 female with menorrhagia, dysmenorrhea, and bulk symptoms secondary to a very large multi-fibroid uterus. She desired a minimally invasive and uterine conserving method to treat her symptoms.

Interventions

We performed laparoscopic radiofrequency ablation under ultrasound guidance for the patients’ multiple fibroids. The uterus was mapped ultrasonographically using the laparoscopic ultrasound transducer. Next, under laparoscopic visualization, the needle handpiece was inserted into …

Machine Learning Can Identify Abnormal Chromosomes To Facilitate Initial Screening In The Cytogenomics Laboratory, Mark Micale, Zhenhong Qu, Blake Martin

Conference Presentation Abstracts

Context: Artificial intelligence/machine learning (AI-ML) has made great strides in recent years with applications in diagnostic medicine. We tested the hypothesis that AI-ML can permit initial screening for structural chromosome abnormalities at various band levels of resolution. Such technology could markedly reduce the downstream laboratory workload and increase turnaround time in cases positive for a clinically significant chromosome abnormality.

Design: We utilized partial karyotypes of normal chromosomes 4, 5, 7, 9, 13, 21, and 22 and abnormal derivative chromosomes 9 and 22 from the t(9;22)(q34;q11.2) associated with chronic myeloid leukemia to train our AI-ML system to identify normal from abnormal …