Medical Specialties Commons^™

Safety And Efficacy Of A 3-Dimensional Stent Retriever With Aspiration-Based Thrombectomy Vs Aspiration-Based Thrombectomy Alone In Acute Ischemic Stroke Intervention A Randomized Clinical Trial, R. G. Nogueira, D. Frei, J. F. Kirmani, O. Zaidat, D. Lopes, A. S. Turk, D. Heck, B. Mason, D. Langer, A. Siddiqui, +9 Additional Authors

Journal Articles

No abstract provided.

First Results On Survival From A Large Phase 3 Clinical Trial Of An Autologous Dendritic Cell Vaccine In Newly Diagnosed Glioblastoma, L. M. Liau, K. Ashkan, D. D. Tran, J. L. Campian, J. E. Trusheim, C. S. Cobbs, J. A. Heth, M. Salacz, M. Schulder, M. L. Bosch, +59 Additional Authors

Journal Articles

© 2018 The Author(s). Background: Standard therapy for glioblastoma includes surgery, radiotherapy, and temozolomide. This Phase 3 trial evaluates the addition of an autologous tumor lysate-pulsed dendritic cell vaccine (DCVax®-L) to standard therapy for newly diagnosed glioblastoma. Methods: After surgery and chemoradiotherapy, patients were randomized (2:1) to receive temozolomide plus DCVax-L (n = 232) or temozolomide and placebo (n = 99). Following recurrence, all patients were allowed to receive DCVax-L, without unblinding. The primary endpoint was progression free survival (PFS); the secondary endpoint was overall survival (OS). Results: For the intent-to-treat (ITT) population (n = 331), median OS (mOS) was …

Aerobic Exercise Training And Inducible Inflammation: Results Of A Randomized Controlled Trial In Healthy, Young Adults., R. P. Sloan, P. A. Shapiro, P. S. Mckinley, M. Bartels, D. Shimbo, V. Lauriola, W. Karmally, M. Pavlicova, C. J. Choi, K. J. Tracey, +3 Additional Authors

Journal Articles

Background Consensus panels regularly recommend aerobic exercise for its health-promoting properties, due in part to presumed anti-inflammatory effects, but many studies show no such effect, possibly related to study differences in participants, interventions, inflammatory markers, and statistical approaches. This variability makes an unequivocal determination of the anti-inflammatory effects of aerobic training elusive. Methods and Results We conducted a randomized controlled trial of 12 weeks of aerobic exercise training or a wait list control condition followed by 4 weeks of sedentary deconditioning on lipopolysaccharide (0, 0.1, and 1.0 ng/mL)-inducible tumor necrosis factor-α (TNF-α) and interleukin-6 (IL-6), and on toll-like receptor 4 …

Deep Neck Space Infections-A Study In Diabetic Population In A Tertiary Care Centre, K. Sharma, D. Das, M. Joshi, D. Barman, A. J. Sarma

Journal Articles

© 2017, Association of Otolaryngologists of India. This study is intended to analyze the clinical profile and outcomes of deep neck space infection in diabetic patients in our tertiary care centre. A prospective study of 1 year duration from 30th September 2015 to 30th September 2016 at department of Otorhinolaryngology, Gauhati Medical College and Hospital, Guwahati. A total of 45 diabetic patients who presented with DNSI are included in this study. Their demographic profile, etiology, bacteriology, treatment, duration of hospital stay, complications and outcomes have been analyzed. 45 patients were recorded; 32 (71.11%) were men, and 13 (45%) were women, …

Retrospective Chart Review Of Synthetic Cannabinoid Intoxication With Toxicologic Analysis, P. Sud, M. Gordon, L. Tortora, M. Stripp, D. Borg, A. Berman

Journal Articles

© 2018 Sud et al. Introduction: Use of synthetic cannabinoids (SC) has recently emerged as a new drug epidemic. Our emergency departments (EDs) received a surge of SC users presenting with lethargy and bradycardia, contrasting prior reports of SC-induced tachycardia and agitation.Our goal was to describe these novel presentations and characterize the compounds. Methods: We present a case series of patients with SC intoxication who presented to our toxicology service covering two tertiary care EDs between 2/11/2015 and 6/23/2015. A retrospective chart review recorded initial vital signs, chief complaint and clinical course. Urine, blood and xenobiotic samples were analyzed using …

Revision Total Shoulder Arthroplasty Is Associated With Increased Thirty-Day Postoperative Complications And Wound Infections Relative To Primary Total Shoulder Arthroplasty, V. Boddapati, M. C. Fu, W. W. Schairer, L. V. Gulotta, D. M. Dines, J. S. Dines

Journal Articles

© 2017, Hospital for Special Surgery. Background: With an increasing volume of primary total shoulder arthroplasties (TSA), the number of revision TSA cases is expected to increase as well. However, the postoperative medical morbidity of revision TSA has not been clearly described. Questions/Purposes: The purpose of this study was to determine the rate of postoperative complications following revision TSA, relative to primary TSA. In addition, we sought to identify independent predictors of complications, as well as to compare operative time and postoperative length of stay between primary and revision TSA. Methods: Patients who underwent primary/revision TSA between 2005 and 2015 …

Septic Arthritis After Anterior Cruciate Ligament Reconstruction: Clinical And Functional Outcomes Based On Graft Retention Or Removal, B. R. Waterman, W. Arroyo, E. J. Cotter, M. A. Zacchilli, E. S. Garcia, B. D. Owens

Journal Articles

© 2018, © The Author(s) 2018. Background: There remains a debate over whether to retain the index anterior cruciate ligament (ACL) graft in the setting of septic arthritis. Purpose: To evaluate and compare clinical outcomes for the treatment of septic arthritis after ACL reconstruction (ACLR) in those with and without early graft retention. Study Design: Case series; Level of evidence, 4. Methods: The Military Health System was queried for all ACLR procedures performed between 2007 and 2013. Inclusion criteria required active military status, primary ACLR with secondary septic arthritis, and minimum 24-month surveillance. Demographic, clinical, and surgical variables were evaluated …

Somatic Mosaicism Of An Intragenic Fancb Duplication In Both Fibroblast And Peripheral Blood Cells Observed In A Fanconi Anemia Patient Leads To Milder Phenotype, R. S. Asur, D. C. Kimble, F. P. Lach, M. Jung, F. X. Donovan, A. Kamat, R. J. Noonan, J. W. Thomas, A. Vlachos, S. C. Chandrasekharappa, +4 Additional Authors

Journal Articles

© 2017 The Authors. Molecular Genetics & Genomic Medicine published by Wiley Periodicals, Inc. Background: Fanconi anemia (FA) is a rare disorder characterized by congenital malformations, progressive bone marrow failure, and predisposition to cancer. Patients harboring X-linked FANCB pathogenic variants usually present with severe congenital malformations resembling VACTERL syndrome with hydrocephalus. Methods: We employed the diepoxybutane (DEB) test for FA diagnosis, arrayCGH for detection of duplication, targeted capture and next-gen sequencing for defining the duplication breakpoint, PacBio sequencing of full-length FANCB aberrant transcript, FANCD2 ubiquitination and foci formation assays for the evaluation of FANCB protein function by viral transduction of …

Business Travel-Associated Illness: A Geosentinel Analysis, L. H. Chen, K. Leder, K. A. Barbre, P. Schlagenhauf, M. Libman, J. Keystone, M. Mendelson, P. Gautret, S. Hagmann, S. Kuhn, +81 Additional Authors

Journal Articles

© International Society of Travel Medicine, 2017. Published by Oxford University Press. All rights reserved. Background: Analysis of a large cohort of business travelers will help clinicians focus on frequent and serious illnesses. We aimed to describe travel-related health problems in business travelers. Methods: GeoSentinel Surveillance Network consists of 64 travel and tropical medicine clinics in 29 countries; descriptive analysis was performed on ill business travelers, defined as persons traveling for work, evaluated after international travel 1 January 1997 through 31 December 2014. Results: Among 12 203 business travelers seen 1997-2014 (14 045 eligible diagnoses), the majority (97%) were adults …

Enhanced Contribution Of Hla In Pediatric Onset Ulcerative Colitis, S. Venkateswaran, J. Prince, D. J. Cutler, U. M. Marigorta, D. T. Okou, S. Prahalad, D. Mack, B. Boyle, J. Markowitz, S. Kugathasan, +20 Additional Authors

Journal Articles

© 2018 Crohn's & Colitis Foundation. Published by Oxford University Press on behalf of Crohn's & Colitis Foundation. Background The genetic contributions to pediatric onset ulcerative colitis (UC), characterized by severe disease and extensive colonic involvement, are largely unknown. In adult onset UC, Genome Wide Association Study (GWAS) has identified numerous loci, most of which have a modest susceptibility risk (OR 0.84-1.14), with the exception of the human leukocyte antigen (HLA) region on Chromosome 6 (OR 3.59). Method To study the genetic contribution to exclusive pediatric onset UC, a GWAS was performed on 466 cases with 2099 healthy controls using …

Barriers To Adherence In Juvenile Idiopathic Arthritis: A Multicenter Collaborative Experience And Preliminary Results, L. A. Favier, J. Taylor, K. L. Rich, K. B. Jones, S. S. Vora, J. G. Harris, B. S. Gottlieb, L. Robbins, J. T. Lai, A. C. Modi, +7 Additional Authors

Journal Articles

© 2018. All rights reserved. Objective. Nonadherence is currently an underrecognized and potentially modifiable obstacle to care in juvenile idiopathic arthritis (JIA). The purpose of our study was to design and implement a standardized approach to identifying adherence barriers for youth with JIA across 7 pediatric rheumatology clinics through the Pediatric Rheumatology Care and Outcomes Improvement Network (PR-COIN) and to assess the frequency of adherence barriers in patients and their caregivers across treatment modalities. Methods. An iterative process using coproduction among parents and providers of patients with JIA was used to design the Barriers Assessment Tool to screen for adherence …

Increased Prevalence Of Congenital Heart Disease In Children With Diamond Blackfan Anemia Suggests Unrecognized Diamond Blackfan Anemia As A Cause Of Congenital Heart Disease In The General Population: A Report Of The Diamond Blackfan Anemia Registry., A. Vlachos, D. S. Osorio, E. Atsidaftos, J. Kang, M. L. Lababidi, H. S. Seiden, D. Gruber, B. E. Glader, K. Onel, J. M. Lipton, +6 Additional Authors

Journal Articles

No abstract provided.

A Functional Assay For The Clinical Annotation Of Genetic Variants Of Uncertain Significance In Diamond–Blackfan Anemia, A. Aspesi, M. Betti, M. Sculco, C. Actis, C. Olgasi, M. W. Wlodarski, A. Vlachos, J. M. Lipton, U. Ramenghi, I. Dianzani, +3 Additional Authors

Journal Articles

© 2018 The Authors. Human Mutation published by Wiley Periodicals, Inc. Diamond–Blackfan anemia (DBA) is a rare genetic hypoplasia of erythroid progenitors characterized by mild to severe anemia and associated with congenital malformations. Clinical manifestations in DBA patients are quite variable and genetic testing has become a critical factor in establishing a diagnosis of DBA. The majority of DBA cases are due to heterozygous loss-of-function mutations in ribosomal protein (RP) genes. Causative mutations are fairly straightforward to identify in the case of large deletions and frameshift and nonsense mutations found early in a protein coding sequence, but diagnosis becomes more …

Minimum Quality Threshold In Pre-Clinical Sepsis Studies (Mqtipss): An International Expert Consensus Initiative For Improvement Of Animal Modeling In Sepsis, M. F. Osuchowski, A. Ayala, S. Bahrami, M. Bauer, M. Boros, J. M. Cavaillon, I. H. Chaudry, C. Deutschman, P. Wang, B. Zingarelli, +21 Additional Authors

Journal Articles

© 2018, The Author(s). Purpose: Pre-clinical animal studies precede the majority of clinical trials. While the clinical sepsis definitions and recommended treatments are regularly updated, a systematic review of pre-clinical models of sepsis has not been done and clear modeling guidelines are lacking. To address this deficit, a Wiggers-Bernard Conference on pre-clinical sepsis modeling was held in Vienna in May, 2017. The conference goal was to identify limitations of pre-clinical sepsis models and to propose a set of guidelines, defined as the “Minimum Quality Threshold in Pre-Clinical Sepsis Studies” (MQTiPSS), to enhance translational value of these models. Methods: 31 experts …

Disparities In Utilization Of Social Determinants Of Health Referrals Among Children In Immigrant Families, O. T. Uwemedimo, H. May

Journal Articles

© 2018 Uwemedimo and May. Objective: Children in immigrant families (CIF) are at elevated risk of experiencing adverse social determinants of health (SDH), particularly material hardship, which contribute to disparate health outcomes. Previous studies have found that SDH screening programs integrated into pediatric practices have increased receipt of social service resources. Few studies have examined use of social services in these programs among ethnically-diverse patient populations and associations with caregiver immigrant status or limited English proficiency (LEP). Methods: Caregivers of children (<18 >years) were routinely screened in a practice-based, SDH screening program offering referral, assisted navigation and follow-up support. Information …

Minimum Quality Threshold In Pre-Clinical Sepsis Studies (Mqtipss): An International Expert Consensus Initiative For Improvement Of Animal Modeling In Sepsis., M. F. Osuchowski, A. Ayala, S. Bahrami, M. Bauer, M. Boros, J. Cavaillon, I. H. Chaudry, C. S. Deutschman, P. Wang, B. Zingarelli, +21 Additional Authors

Journal Articles

Preclinical animal studies precede the majority of clinical trials. While the clinical definitions of sepsis and recommended treatments are regularly updated, a systematic review of preclinical models of sepsis has not been done and clear modeling guidelines are lacking. To address this deficit, a Wiggers-Bernard Conference on preclinical sepsis modeling was held in Vienna in May, 2017. The goal of the conference was to identify limitations of preclinical sepsis models and to propose a set of guidelines, defined as the "Minimum Quality Threshold in Preclinical Sepsis Studies" (MQTiPSS), to enhance translational value of these models. A total of 31 experts …

Minimum Quality Threshold In Pre-Clinical Sepsis Studies (Mqtipss): An International Expert Consensus Initiative For Improvement Of Animal Modeling In Sepsis., M. F. Osuchowski, A. Ayala, S. Bahrami, M. Bauer, M. Boros, J. Cavaillon, I. H. Chaudry, C. Deutschman, P. Wang, B. Zingarelli, +21 Additional Authors

Journal Articles

BACKGROUND:Pre-clinical animal studies precede the majority of clinical trials. While the clinical definitions of sepsis and recommended treatments are regularly updated, a systematic review of pre-clinical models of sepsis has not been done and clear modeling guidelines are lacking. OBJECTIVE:To address this deficit, a Wiggers-Bernard Conference on pre-clinical sepsis modeling was held in Vienna in May 2017. The goal of the conference was to identify limitations of pre-clinical sepsis models and to propose a set of guidelines, defined as the "Minimum Quality Threshold in Pre-Clinical Sepsis Studies" (MQTiPSS), to enhance translational value of these models. METHODS:A total of 31 experts …

Identification, Management, And Transition Of Care For Patients With Opioid Use Disorder In The Emergency Department, H. C. Duber, I. A. Barata, E. Cioe-Pena, S. Y. Liang, E. Ketcham, W. Macias-Konstantopoulos, S. A. Ryan, M. Stavros, L. K. Whiteside

Journal Articles

No abstract provided.

Hyposialylated Igg Activates Endothelial Igg Receptor Fcγriib To Promote Obesity-Induced Insulin Resistance, K. Tanigaki, A. Sacharidou, J. Peng, K. L. Chambliss, I. S. Yuhanna, D. Ghosh, M. Ahmed, A. J. Szalai, W. Vongpatanasin, C. Mineo, +10 Additional Authors

Journal Articles

Type 2 diabetes mellitus (T2DM) is a common complication of obesity. Here, we have shown that activation of the IgG receptor FcγRIIB in endothelium by hyposialylated IgG plays an important role in obesity-induced insulin resistance. Despite becoming obese on a high-fat diet (HFD), mice lacking FcγRIIB globally or selectively in endothelium were protected from insulin resistance as a result of the preservation of insulin delivery to skeletal muscle and resulting maintenance of muscle glucose disposal. IgG transfer in IgG-deficient mice implicated IgG as the pathogenetic ligand for endothelial FcγRIIB in obesity-induced insulin resistance. Moreover, IgG transferred from patients with T2DM …

Cpx-351 (Cytarabine And Daunorubicin) Liposome For Injection Versus Conventional Cytarabine Plus Daunorubicin In Older Patients With Newly Diagnosed Secondary Acute Myeloid Leukemia, J. E. Lancet, G. L. Uy, J. E. Cortes, L. F. Newell, T. L. Lin, E. K. Ritchie, R. K. Stuart, S. A. Strickland, J. E. Kolitz, B. C. Medeiros, +11 Additional Authors

Journal Articles

© 2018 by American Society of Clinical Oncology. Purpose CPX-351 is a dual-drug liposomal encapsulation of cytarabine and daunorubicin that delivers a synergistic 5:1 drug ratio into leukemia cells to a greater extent than normal bone marrow cells. Prior clinical studies demonstrated a sustained drug ratio and exposure in vivo and prolonged survival versus standard-of-care cytarabine plus daunorubicin chemotherapy (7+3 regimen) in older patients with newly diagnosed secondary acute myeloid leukemia (sAML). Patients and Methods In this open-label, randomized, phase III trial, 309 patients age 60 to 75 years with newly diagnosed high-risk/sAML received one to two induction cycles of …

Extended Follow-Up And Impact Of High-Risk Prognostic Factors From The Phase 3 Resonate Study In Patients With Previously Treated Cll/Sll, J. R. Brown, P. Hillmen, S. O'Brien, J. C. Barrientos, N. M. Reddy, S. E. Coutre, C. S. Tam, S. P. Mulligan, U. Jaeger, J. C. Byrd, +20 Additional Authors

Journal Articles

No abstract provided.

Extracorporeal Cellular Therapy (Elad) In Severe Alcoholic Hepatitis: A Multinational, Prospective, Controlled, Randomized Trial, J. Thompson, N. Jones, A. Al-Khafaji, S. Malik, D. Reich, S. Munoz, R. Macnicholas, T. Hassanein, A. Duddempudi, R. Subramanian, +33 Additional Authors

Journal Articles

No abstract provided.

Activity Of Pazopanib And Trabectedin In Advanced Alveolar Soft Part Sarcoma, S. Stacchiotti, O. Mir, A. Le Cesne, B. Vincenzi, A. Fedenko, R. G. Maki, N. Somaiah, S. Patel, M. Brahmi, A. Kawai, +13 Additional Authors

Journal Articles

No abstract provided.

Functional Variants In The Lrrk2 Gene Confer Shared Effects On Risk For Crohn's Disease And Parkinson's Disease, K. Y. Hui, H. Fernandez-Hernandez, J. Hu, A. Schaffner, N. Pankratz, N. Hsu, L. Chuang, S. Katz, T. Lencz, I. Peter, +41 Additional Authors

Journal Articles

No abstract provided.

Medication Discrepancies In Late-Stage Chronic Kidney Disease., J. Ibrahim, A. D. Hazzan, A. T. Mathew, V. Sakhiya, M. Zhang, C. Halinski, S. Fishbane

Journal Articles

Background: Late-stage chronic kidney disease (LS-CKD) can be defined by glomerular filtration rate (GFR) 0-30 mL/min. It is a period of risk for medication discrepancies because of frequent hospitalizations, fragmented medical care, inadequate communication and polypharmacy. In this study, we sought to characterize medication discrepancies in LS-CKD.

Methods: We analyzed all patients enrolled in Northwell Health's Healthy Transitions in LS-CKD program. All patients had estimated GFR 0-30 mL/min, not on dialysis. Medications were reviewed by a nurse at a home visit. Patients' medication usage and practice were compared with nephrologists' medication lists, and discrepancies were characterized. Patients were categorized as …

Erythrocyte-Bound C4d In Combination With Complement And Autoantibody Status For The Monitoring Of Sle., J. T. Merrill, M. A. Petri, J. Buyon, R. Ramsey-Goldman, K. Kalunian, C. Putterman, J. Conklin, R. A. Furie, T. Dervieux

Journal Articles

Background: We examined the usefulness of erythrocyte-bound C4d (EC4d) to monitor disease activity in SLE.

Methods: Data and blood samples were collected from three different studies, each of which included longitudinal evaluations using the Physicians Global Assessment (PGA) of disease activity and the Safety of Estrogens in Lupus Erythematosus National Assessment (SELENA) SLE Disease Activity Index (SLEDAI), which was assessed without anti-double-stranded DNA (dsDNA) and low complement C3/C4 (clinical SELENA-SLEDAI). EC4d levels were determined using flow cytometry; other laboratory measures included antibodies to dsDNA, C3 and C4 proteins. Relationships between clinical SELENA-SLEDAI, PGA and the laboratory measures were analysed using …

Digital Stethoscope: Technology Update, S. Swarup, A. N. Makaryus

Journal Articles

© 2018 Swarup and Makaryus. Cardiovascular disease (CVD) is recognized as the leading cause of mortality throughout the world. About one-third of global mortality is attributable to CVD. In addition to clinical presentation, specific clinical exam findings can assist in treating and preventing CVD. CVD may initially manifest as pulmonary pathology, and thus, accurate cardiopulmonary auscultation is paramount to establishing accurate diagnosis. One of the most powerful tools available to physicians is the stethoscope. The stethoscope first emerged in the year 1818, invented by a French physician, René Laennec. Since then, the initial modest monaural wooden tube has evolved into …

Spontaneous Coronary Artery Dissection: Current State Of The Science: A Scientific Statement From The American Heart Association, S. N. Hayes, C. E. S. H. Kim, J. Saw, D. Adlam, C. Arslanian-Engoren, K. E. Economy, S. K. Ganesh, R. Gulati, J. H. Mieres, M. J. Wood, +5 Additional Authors

Journal Articles

© 2018 American Heart Association, Inc. Spontaneous coronary artery dissection (SCAD) has emerged as an important cause of acute coronary syndrome, myocardial infarction, and sudden death, particularly among young women and individuals with few conventional atherosclerotic risk factors. Patient-initiated research has spurred increased awareness of SCAD, and improved diagnostic capabilities and findings from large case series have led to changes in approaches to initial and long-term management and increasing evidence that SCAD not only is more common than previously believed but also must be evaluated and treated differently from atherosclerotic myocardial infarction. High rates of recurrent SCAD; its association with …

Real-World Clinical Utility And Impact On Clinical Decision-Making Of Coronary Computed Tomography Angiography-Derived Fractional Flow Reserve: Lessons From The Advance Registry., T. A. Fairbairn, K. Nieman, T. Akasaka, B. L. Nørgaard, D. S. Berman, G. Raff, L. M. Hurwitz-Koweek, G. Pontone, M. Poon, M. R. Patel, +13 Additional Authors

Journal Articles

Aims:Non-invasive assessment of stable chest pain patients is a critical determinant of resource utilization and clinical outcomes. Increasingly coronary computed tomography angiography (CCTA) with selective CCTA-derived fractional flow reserve (FFRCT) is being used. The ADVANCE Registry, is a large prospective examination of using a CCTA and FFRCT diagnostic pathway in real-world settings, with the aim of determining the impact of this pathway on decision-making, downstream invasive coronary angiography (ICA), revascularization, and major adverse cardiovascular events (MACE). Methods and results:A total of 5083 patients with symptoms concerning for coronary artery disease (CAD) and atherosclerosis on CCTA were enrolled at 38 international …

Effects Of Endovascular Cooling On Infarct Size In St-Segment Elevation Myocardial Infarction: A Patient-Level Pooled Analysis From Randomized Trials., M. Dae, W. O'Neill, C. L. Grines, S. Dixon, D. Erlinge, M. Noc, M. Holzer, A. Dee

Journal Articles

OBJECTIVES: This study sought to examine the relationship between temperature at reperfusion and infarct size.

BACKGROUND: Hypothermia consistently reduces infarct size when administered prior to reperfusion in animal studies, however, clinical results have been inconsistent.

METHODS: We performed a patient-level pooled analysis from six randomized control trials of endovascular cooling during primary percutaneous coronary intervention (PCI) for ST-segment elevation myocardial infarction (STEMI) in 629 patients in which infarct size was assessed within 1 month after randomization by either single-photon emission computed tomography (SPECT) or cardiac magnetic resonance imaging (cMR).

RESULTS: In anterior infarct patients, after controlling for variability between studies, …