Medical Specialties Commons^™

General And Intensive Care Outcomes For Hospitalized Patients With Solid Organ Transplants With Covid-19, F. Mastroianni, D. E. Leisman, G. Fisler, M. Narasimhan

Journal Articles

© The Author(s) 2020. Purpose: COVID-19 has been associated with a dysregulated inflammatory response. Patients who have received solid-organ transplants are more susceptible to infections in general due to the use of immunosuppressants. We investigated factors associated with mechanical ventilation and outcomes in solid-organ transplant recipients with COVID-19. Materials and Methods: We conducted a retrospective cohort study of all solid-organ transplant recipients admitted with a diagnosis of COVID-19 in our 23-hospital health system over a 1-month period. Descriptive statistics were used to describe hospital course and laboratory results and bivariate comparisons were performed on variables to determine differences. Results: Twenty-two …

Guidance For Rebooting Electrophysiology Through The Covid-19 Pandemic From The Heart Rhythm Society And The American Heart Association Electrocardiography And Arrhythmias Committee Of The Council On Clinical Cardiology: Endorsed By The American College Of Cardiology, D. R. Lakkireddy, M. K. Chung, T. F. Deering, R. Gopinathannair, C. M. Albert, L. M. Epstein, C. V. Harding, J. L. Hurwitz, C. C. Jeffery, A. M. Russo, +9 Additional Authors

Journal Articles

© 2020 The Heart Rhythm Society, the American Heart Association, Inc., and the American College of Cardiology Foundation Coronavirus disease 2019 (COVID-19) has presented substantial challenges to patient care and impacted health care delivery, including cardiac electrophysiology practice throughout the globe. Based upon the undetermined course and regional variability of the pandemic, there is uncertainty as to how and when to resume and deliver electrophysiology services for arrhythmia patients. This joint document from representatives of the Heart Rhythm Society, American Heart Association, and American College of Cardiology seeks to provide guidance for clinicians and institutions reestablishing safe electrophysiological care. To …

Histopathological Evaluation Of Placentas After Diagnosis Of Maternal Sars-Cov-2 Infection., M. Gulersen, L. Prasannan, H. T. Tam, C. N. Metz, B. Rochelson, N. Meirowitz, W. Shan, M. Edelman, K. A. Millington

Journal Articles

Background:The impact of maternal SARS-CoV-2 infection on placental histopathology is not well known. Objectives:To determine if significant placental histopathological changes occur after diagnosis of SARS-CoV-2 infection in pregnancy and whether these changes are correlated with the presence or absence of symptoms associated with infection. Study Design:Retrospective cohort study of women diagnosed with SARS-CoV-2 infection who delivered at a single center from April 9th to April 27th, 2020, and had placental specimens reviewed by pathology. Women with singleton gestations and laboratory-confirmed SARS-CoV-2 infection were eligible for inclusion. Historical controls selected from a cohort of women who delivered 6 months prior to …

How Mental Health Care Should Change As A Consequence Of The Covid-19 Pandemic, C. Moreno, T. Wykes, S. Galderisi, M. Nordentoft, N. Crossley, N. Jones, M. Cannon, C. U. Correll, L. Byrne, C. Arango, +14 Additional Authors

Journal Articles

No abstract provided.

Predictors Of Gestational Weight Gain In A Low-Income Hispanic Population: Sociodemographic Characteristics, Health Behaviors, And Psychosocial Stressors, C. D. Dolin, R. S. Gross, A. L. Deierlein, L. T. Berube, M. Katzow, Y. Yaghoubian, S. G. Brubaker, M. J. Messito

Journal Articles

No abstract provided.

Safety And Tolerability Of Manual Push Administration Of Subcutaneous Igpro20 At High Infusion Rates In Patients With Primary Immunodeficiency: Findings From The Manual Push Administration Cohort Of The Hilo Study, J. Cowan, V. R. Bonagura, P. L. Lugar, P. J. Maglione, N. C. Patel, D. C. Vinh, J. H. Hofmann, M. Praus, M. A. Rojavin

Journal Articles

© 2020, The Author(s). Purpose: To evaluate the safety and tolerability of IgPro20 manual push (also known as rapid push) infusions at flow rates of 0.5–2.0 mL/min. Methods: Patients with primary immunodeficiency (PID) with previous experience administering IgPro20 (Hizentra®, CSL Behring, King of Prussia, PA, USA) were enrolled in the Hizentra® Label Optimization (HILO) study (NCT03033745) and assigned to Pump-assisted Volume Cohort, Pump-assisted Flow Rate Cohort, or Manual Push Flow Rate Cohort; this report describes the latter. Patients administered IgPro20 via manual push at 0.5, 1.0, and 2.0 mL/min/site for 4 weeks each. Responder rates (percentage of patients who completed …

Use Of Tetanus Toxoid, Reduced Diphtheria Toxoid, And Acellular Pertussis Vaccines: Updated Recommendations Of The Advisory Committee On Immunization Practices - United States, 2019, F. P. Havers, P. L. Moro, P. Hunter, S. Hariri, H. Bernstein

Journal Articles

No abstract provided.

Hypermetabolism In Critically Ill Patients With Covid-19 And The Effects Of Hypothermia: A Case Series, Pj Yu, H Cassiere, K Bocchieri, S Derosa, S Yar, A Hartman

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No abstract provided.

The Paradox Of Stemi Regionalization: Widened Disparities Despite Some Benefits, R. O. Roswell, R. Brown, S. Richardson

Journal Articles

No abstract provided.

Increased Inpatient Mortality For Cardiovascular Patients During The First Covid-19 Epidemic In New York, S. Richardson, J. S. Hirsch, M. Narasimhan, J M. Crawford, T Mcginn, K W. Davidson, V. Singh

Journal Articles

No abstract provided.

Development And Validation Of Clinical Scoring Tool To Predict Outcomes Of Treatment With Vedolizumab In Patients With Ulcerative Colitis., Parambir S Dulai, Siddharth Singh, Niels Vande Casteele, Joseph Meserve, Adam Winters, Shreya Chablaney, Satimai Aniwan, K. Sultan, A. Swaminath, Charlie Cao, +30 Additional Authors

Journal Articles

BACKGROUND & AIMS: We created and validated a clinical decision support tool (CDST) to predict outcomes of vedolizumab therapy for ulcerative colitis (UC).

METHODS: We performed logistic regression analyses of data from the GEMINI 1 trial, from 620 patients with UC who received vedolizumab induction and maintenance therapy (derivation cohort), to identify factors associated with corticosteroid-free remission (full Mayo score of 2 or less, no subscore above 1). We used these factors to develop a model to predict outcomes of treatment, which we called the vedolizumab CDST. We evaluated the correlation between exposure and efficacy. We validated the CDST in …

Computer-Assisted Planning For Minimally Invasive Anterior Two-Thirds Laser Corpus Callosotomy: A Feasibility Study With Probabilistic Tractography Validation: Automated Laser Callosotomy Trajectory Planning, V. N. Vakharia, R. E. Sparks, S. B. Vos, Y. Bezchlibnyk, A. D. Mehta, J. T. Willie, C. Wu, A. Sharan, S. Ourselin, J. S. Duncan

Journal Articles

© 2020 The Authors Background: Anterior two-thirds corpus callosotomy is an effective palliative neurosurgical procedure for drug-refractory epilepsy that is most commonly used to treat drop-attacks. Laser interstitial thermal therapy is a novel stereotactic ablative technique that has been utilised as a minimally invasive alternative to resective and disconnective open neurosurgery. Case series have reported success in performing laser anterior two-thirds corpus callosotomy. Computer-assisted planning algorithms may help to automate and optimise multi-trajectory planning for this procedure. Objective: To undertake a simulation-based feasibility study of computer-assisted corpus callostomy planning in comparison with expert manual plans in the same patients. Methods: …

Carotid Revascularization And Its Effect On Cognitive Function: A Prospective Nonrandomized Multicenter Clinical Study, J. L. Whooley, B. C. David, H. H. Woo, B. L. Hoh, K. B. Raftery, A. Hussain Siddiqui, M. Westerveld, S. Amin-Hanjani, Z. Ghogawala

Journal Articles

© 2020 The Author(s) Background: There is conflicting data on the effect of carotid revascularization on cognitive function. Objective: To examine cerebral blood flow and cognitive function after carotid revascularization. Methods: Patients with unilateral, asymptomatic hemodynamically significant carotid artery stenosis (80% by computed tomography angiography or magnetic resonance angiography) were eligible. Cerebral blood flow was measured preoperatively and 1 month postoperatively using quantitative phase contrast magnetic resonance angiography. Preoperative flow impairment was defined as ipsilateral flow at least 20% less than contralateral flow (ie, an ipsilateral and/or contralateral flow ratio ≤0.8). Significant improvement in blood flow was defined as at …

The Α7 Nicotinic Acetylcholine Receptor Agonist, Gts-21, Attenuates Hyperoxia-Induced Acute Inflammatory Lung Injury By Alleviating The Accumulation Of Hmgb1 In The Airways And The Circulation, R. A. Sitapara, A. G. Gauthier, S. I. Valdés-Ferrer, M. Lin, V. Patel, M. Wang, A. T. Martino, K. J. Tracey, V. A. Pavlov, L. L. Mantell, +2 Additional Authors

Journal Articles

© 2020 The Author(s). Background: Oxygen therapy, using supraphysiological concentrations of oxygen (hyperoxia), is routinely administered to patients who require respiratory support including mechanical ventilation (MV). However, prolonged exposure to hyperoxia results in acute lung injury (ALI) and accumulation of high mobility group box 1 (HMGB1) in the airways. We previously showed that airway HMGB1 mediates hyperoxia-induced lung injury in a mouse model of ALI. Cholinergic signaling through the α7 nicotinic acetylcholine receptor (α7nAChR) attenuates several inflammatory conditions. The aim of this study was to determine whether 3-(2,4 dimethoxy-benzylidene)-anabaseine dihydrochloride, GTS-21, an α7nAChR partial agonist, inhibits hyperoxia-induced HMGB1 accumulation in …

Guidelines For The Management Of Severe Traumatic Brain Injury: 2020 Update Of The Decompressive Craniectomy Recommendations, G. W. Hawryluk, A. M. Rubiano, A. M. Totten, C. O'Reilly, J. S. Ullman, S. L. Bratton, R. Chesnut, O. A. Harris, N. Kissoon, J. Ghajar, +6 Additional Authors

Journal Articles

© Congress of Neurological Surgeons 2020. When the fourth edition of the Brain Trauma Foundation's Guidelines for the Management of Severe Traumatic Brain Injury were finalized in late 2016, it was known that the results of the RESCUEicp (Trial of Decompressive Craniectomy for Traumatic Intracranial Hypertension) randomized controlled trial of decompressive craniectomy would be public after the guidelines were released. The guideline authors decided to proceed with publication but to update the decompressive craniectomy recommendations later in the spirit of "living guidelines," whereby topics are updated more frequently, and between new editions, when important new evidence is published. The update …

Brain-Informed Speech Separation (Biss) For Enhancement Of Target Speaker In Multitalker Speech Perception, E. Ceolini, J. Hjortkjær, D. D. Wong, J. O'Sullivan, V. S. Raghavan, J. Herrero, A. D. Mehta, S. C. Liu, N. Mesgarani

Journal Articles

© 2020 Hearing-impaired people often struggle to follow the speech stream of an individual talker in noisy environments. Recent studies show that the brain tracks attended speech and that the attended talker can be decoded from neural data on a single-trial level. This raises the possibility of “neuro-steered” hearing devices in which the brain-decoded intention of a hearing-impaired listener is used to enhance the voice of the attended speaker from a speech separation front-end. So far, methods that use this paradigm have focused on optimizing the brain decoding and the acoustic speech separation independently. In this work, we propose a …

Estimating And Interpreting Nonlinear Receptive Field Of Sensory Neural Responses With Deep Neural Network Models, M. Keshishian, H. Akbari, B. Khalighinejad, J. L. Herrero, A. D. Mehta, N. Mesgarani

Journal Articles

No abstract provided.

Does Increasing Packing Density Using Larger Caliber Coils Improve Angiographic Results Of Embolization Of Intracranial Aneurysms At 1 Year: A Randomized Trial, J. Raymond, J. Ghostine, B. A. Van Adel, J. J. Shankar, D. Iancu, A. P. Mitha, P. Kvamme, R. D. Turner, H. H. Woo, T. E. Darsaut, +13 Additional Authors

Journal Articles

© 2020 American Society of Neuroradiology. All rights reserved. BACKGROUND AND PURPOSE: The impact of increased aneurysm packing density on angiographic outcomes has not been studied in a randomized trial. We sought to determine the potential for larger caliber coils to achieve higher packing densities and to improve the angiographic results of embolization of intracranial aneurysms at 1 year. MATERIALS AND METHODS: Does Embolization with Larger Coils Lead to Better Treatment of Aneurysms (DELTA) was an investigator-initiated multicenter prospective, parallel, randomized, controlled clinical trial. Patients had 4- to 12-mm unruptured aneurysms. Treatment allocation to either 15- (experimental) or 10-caliber coils …

Multiple Myeloma In A Young Female Presenting With Neurological Symptoms., M. Lee, X. Zhang, V. Nguyen, M. Hartley-Brown

Journal Articles

Background:Multiple myeloma is overall the 14th most common malignancy but is rarely seen in those younger than 35 years. Those in the younger age group have been shown to have a more aggressive course but reportedly have had similar responses to treatment compared to older cohorts. Extramedullary plasmacytomas are discrete soft tissue masses of neoplastic monoclonal plasma cells that often occur in patients with multiple myeloma. Case:This case entails a young female with new diagnosis of multiple myeloma and multiple extramedullary plasmacytomas presenting with neurological symptoms. She was treated with CyBorD regimen but was refractory and progressed. Treatment was changed …

Molecular Testing For Acute Respiratory Tract Infections: Clinical And Diagnostic Recommendations From The Idsa's Diagnostics Committee., K. E. Hanson, M. M. Azar, R. Banerjee, A. Chou, R. C. Colgrove, C. C. Ginocchio, M. K. Hayden, M. Holodiny, S. Jain, Diagnostics Committee Of The Infectious Diseases S, +4 Additional Authors

Journal Articles

The clinical signs and symptoms of acute respiratory tract infections (RTIs) are not pathogen specific. Highly sensitive and specific nucleic acid amplification tests have become the diagnostic reference standard for viruses and translation of bacterial assays from basic research to routine clinical practice represents an exciting advance in respiratory medicine. Most recently, molecular diagnostics have played an essential role in the global health response to the novel coronavirus pandemic. How best to use newer molecular tests for RTI in combination with clinical judNorthwell Healthnt and traditional methods can be bewildering given the plethora of available assays and rapidly evolving technologies. …

Reevaluation Of The Us Pathologist Workforce Size, S. J. Robboy, D. Gross, J. Y. Park, E. Kittrie, J. M. Crawford, R. L. Johnson, M. B. Cohen, D. S. Karcher, R. D. Hoffman, W. S. Black-Schaffer, +1 Additional Author

Journal Articles

No abstract provided.

Gog 244-The Lymphedema And Gynecologic Cancer (Leg) Study: Incidence And Risk Factors In Newly Diagnosed Patients, J. W. Carlson, J. Kauderer, A. Hutson, J. Carter, J. Armer, S. Lockwood, S. Nolte, B. R. Stewart, L. Wenzel, R. R. Barakat, +9 Additional Authors

Journal Articles

© 2019 Elsevier Inc. Objectives: To evaluate the incidence and risk factors for lymphedema associated with surgery for gynecologic malignancies on GOG study 244. Methods: Women undergoing a lymph node dissection for endometrial, cervical, or vulvar cancer were eligible for enrollment. Leg volume was calculated from measurements at 10-cm intervals starting 10 cm above the bottom of the heel to the inguinal crease. Measurements were obtained preoperatively and postoperatively at 4–6 weeks, and at 3-, 6-, 9-, 12-, 18-, and 24- months. Lymphedema was defined as a limb volume change (LVC) ≥10% from baseline and categorized as mild: 10–19% LVC; …

Obesity And Sting1 Genotype Associate With 23-Valent Pneumococcal Vaccination Efficacy, M. Sebastian, C. J. Hsiao, H. S. Futch, R. S. Eisinger, L. Dumeny, S. Patel, M. Gobena, D. S. Katikaneni, L. Spiryda, M. L. Brantly, +4 Additional Authors

Journal Articles

© 2020, Sebastian etal. BACKGROUND. Obesity has been associated with attenuated vaccine responses and an increased risk of contracting pneumococcal pneumonia, but no study to our knowledge has assessed the impact of obesity and genetics on 23-valent pneumococcal vaccine (PPSV23) efficacy. We assessed the relationship of obesity (primary analysis) and stimulator of interferon genes (STING1) genotype (secondary analysis) on PPSV23 efficacy. METHODS. Nonobese (BMI 22-25 kg/m2) and obese participants (BMI ≥30 kg/m2) were given a single dose of PPSV23. Blood was drawn immediately prior to and 4-6 weeks after vaccination. Serum samples were used to assess PPSV23-specific antibodies. STING1 genotypes …

The Biomarker He4 (Wfdc2) Promotes A Pro-Angiogenic And Immunosuppressive Tumor Microenvironment Via Regulation Of Stat3 Target Genes, N. E. James, J. B. Emerson, A. D. Borgstadt, L. Beffa, M. T. Oliver, V. Hovanesian, A. Urh, R. K. Singh, R. Rowswell-Turner, J. R. Ribeiro, +3 Additional Authors

Journal Articles

© 2020, The Author(s). Epithelial ovarian cancer (EOC) is a highly lethal gynecologic malignancy arising from the fallopian tubes that has a high rate of chemoresistant recurrence and low five-year survival rate. The ovarian cancer biomarker HE4 is known to promote proliferation, metastasis, chemoresistance, and suppression of cytotoxic lymphocytes. In this study, we sought to examine the effects of HE4 on signaling within diverse cell types that compose the tumor microenvironment. HE4 was found to activate STAT3 signaling and promote upregulation of the pro-angiogenic STAT3 target genes IL8 and HIF1A in immune cells, ovarian cancer cells, and endothelial cells. Moreover, …

Racial Disparity In Pregnancy Risks And Complications In The Us: Temporal Changes During 2007-2018, E. Bornstein, Y. Eliner, F. A. Chervenak, A. Grunebaum

Journal Articles

No abstract provided.

Professionally Responsible Counseling When A Fetal Anomaly Is Diagnosed By Ultrasound, F. A. Chervenak, L. B. Mccullough, A. Kurjak

Journal Articles

© The Author(s). 2020. Ethics plays an essential role in the clinical management of pregnancies complicated by fetal anomalies diagnosed by ultrasound. Utilizing the prima facie ethical principles of beneficence and respect for autonomy, this paper first explicates the ethical concept of the fetus as a patient. This ethical concept provides the basis for a comprehensive approach to counseling pregnant women about the management of pregnancies complicated by fetal anomalies. Practical, ethically justified guidance is given for counseling about decisions both before and after viabilities.

Epithelial Cells In Endometriosis And Adenomyosis Upregulate Sting Expression, H. Qu, L. Li, T. Wang, T. Seckin, J. Segars, I. Shih

Journal Articles

No abstract provided.

Toward The Quadruple Aim: Impact Of A Humanistic Mentoring Program To Reduce Burnout And Foster Resilience., A. W. Menzin, M. Kline, C. George, J. Schindler, A. C. Yacht, A. Fornari

Journal Articles

Objective:To assess the effect of a faculty development program (Mentoring and Professionalism in Training [MAP-IT]) that fosters humanism in medicine on elements of burnout and the development of resilience. Participants and Methods:The cohort of participants was drawn from a cross-section of disciplines and represented a diverse group of health professionals, including physicians, nurses, physician assistants, pharmacists, psychologists, social workers, and chaplains. The 106 participants were divided into 12 groups, each of which was facilitated by two or three leaders. Each group completed the MAP-IT curriculum from October 1, 2017, through July 31, 2018. All participants and leaders completed the Connor-Davidson …

Pneumopericardium, Pneumomediastinum And Air Travel: A Case Report In A Patient With Gardner Syndrome, A. El Haj Chehade, G. Debal, W. Mansour, A. Avula, M. Chalhoub

Journal Articles

© 2020 The Author(s) Onboard aircraft medical emergencies are on the rise as commercial air traffic is increasing. However, thoracic injury secondary to air travel is extremely rare and, most reported injuries are cases of pneumothoraces. Spontaneous pneumomediastinum and pneumopericardium have been barely reported in the medical literature as a complication of air travel. We are reporting a case of spontaneous pneumopericardium and pneumomediastinum in a patient with Gardner's Syndrome after a flight from Central America to New York City. The patient presented with chest discomfort. He was managed conservatively with oxygen therapy as he was hemodynamically stable throughout his …

Eus Assessment For Intermediate Risk Of Choledocholithiasis After A Negative Magnetic Resonance Cholangiopancreatography, D. Wee, S. Izard, G. Grimaldi, K. Raphael, T. P. Lee, A. Trindade

Journal Articles

© 2020 SPRING MEDIA PUBLISHING CO. LTD | PUBLISHED BY WOLTERS KLUWER - MEDKNOW 291. Background and Aims: Guidelines recommend either EUS or magnetic resonance cholangiopancreatography (MRCP) for intermediate risk of choledocholithiasis. There is a lack of evidence that supports proceeding with EUS if the MRCP is negative and if clinical suspicion still exists. Methods: This is a retrospective study of all patients who underwent EUS to assess for choledocholithiasis at a tertiary care referral center from July 2013 to October 2019. Results: A total of 593 patients underwent EUS for evaluation for choledocholithiasis. Of the 593 patients, 35.2% (209/593) …