Medical Specialties Commons^™

Proportion Of Us Hospitalized Medically Ill Patients Who May Qualify For Extended Thromboprophylaxis, B. Miao, B. Chalupadi, B. Clark, A. Descoteaux, D. Huang, S. Ilham, B. Ly, A. C. Spyropoulos, C. I. Coleman

Journal Articles

© The Author(s) 2019. Extended thromboprophylaxis with oral anticoagulation can reduce the risk of symptomatic venous thromboembolism (VTE) in high-risk patients. We sought to estimate the proportion of medically ill patients in the United States who might qualify for extended thromboprophylaxis according to the criteria used in the Medically-Ill Patient Assessment of Rivaroxaban versus Placebo in Reducing Post-Discharge Venous ThromboEmbolism Risk (MARINER) trial. We analyzed 2014 National Inpatient Sample (NIS) data that provide a 20% weighted annual sample of all discharges from US acute-care hospitals. Hospitalizations for acute medically ill patients were identified as those with a primary discharge diagnosis …

Eribulin Versus Dacarbazine In Patients With Leiomyosarcoma: Subgroup Analysis From A Phase 3, Open-Label, Randomised Study, J. Blay, P. Schoffski, S. Bauer, A. Krarup-Hansen, C. Benson, D. R. D'Adamo, Y. Jia, R. G. Maki

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No abstract provided.

Care Team Perspectives And Acceptance Of Telehealth In Scaling A Home-Based Primary Care Program: Qualitative Study, A. Kozikowski, J. Shotwell, E. Wool, J. C. Slaboda, K. A. Abrashkin, K. Rhodes, K. L. Smith, R. Pekmezaris, G. J. Norman

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No abstract provided.

Outcomes With Ibrutinib By Line Of Therapy And Post-Ibrutinib Discontinuation In Patients With Chronic Lymphocytic Leukemia: Phase 3 Analysis, S. M. O'Brien, J. C. Byrd, P. Hillmen, S. Coutre, J. R. Brown, P. M. Barr, J. C. Barrientos, S. Devereux, T. Robak, J. A. Burger, +8 Additional Authors

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No abstract provided.

Humanizing The Intensive Care Unit, M. E. Wilson, S. Beesley, A. Grow, E. Rubin, R. O. Hopkins, N. Hajizadeh, S. M. Brown

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No abstract provided.

Phase Iii, Multicentre, Randomised, Double-Blind, Placebo-Controlled, 104-Week Study Of Subcutaneous Belimumab Administered In Combination With Rituximab In Adults With Systemic Lupus Erythematosus (Sle): Bliss-Believe Study Protocol, Y. K. Onno Teng, I. N. Bruce, B. Diamond, R. A. Furie, R. F. Van Vollenhoven, D. Gordon, J. Groark, R. B. Henderson, M. Oldham, P. P. Tak

Journal Articles

© 2019 Author(s) (or their employer(s)). Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. Introduction Belimumab, an anti-B-lymphocyte-stimulator antibody, is approved for the treatment of active, autoantibody-positive systemic lupus erythematosus (SLE). Rituximab, a B cell-depleting anti-CD20 antibody, remains in the SLE treatment armamentarium despite failed trials in lupus nephritis and extrarenal lupus. These biologics, which operate through complementary mechanisms, might result in an enhanced depletion of circulating and tissue-resident autoreactive B lymphocytes when administered together. Thus, belimumab and rituximab combination may be a highly effective treatment of SLE. This study aims to evaluate …

Long-Term Studies Assessing Outcomes Of Ibrutinib Therapy In Patients With Del(11q) Chronic Lymphocytic Leukemia, T. J. Kipps, G. Fraser, S. E. Coutre, J. R. Brown, J. C. Barrientos, P. M. Barr, J. C. Byrd, S. M. O'Brien, M. S. Dilhuydy, M. Hallek, +16 Additional Authors

Journal Articles

© 2019 A pooled analysis of 1238 patients with chronic lymphocytic leukemia/small lymphocytic lymphoma from three phase 3 studies found that genomic risk factors were not associated with shorter progression-free survival (PFS) or overall survival for patients treated with ibrutinib. Ibrutinib-treated patients with del(11q) were found to have a longer PFS than those without del(11q). These results suggest less prognostic relevance for certain genomic risk factors with ibrutinib treatment.

It's Not Just Facetime: Core Competencies For The Medical Virtualist, R. Sharma, S. Nachum, K. W. Davidson, M. Nochomovitz

Journal Articles

© 2019 The Author(s). New applications for virtual healthcare have resulted in an expansion of medical care beyond traditional healthcare settings. However, the rapid development of telemedicine as a field has resulted in poor standardization of the care provided through this new medium. The authors outline core competencies to be used in developing training programs for practicing physicians, medical students, and other clinicians using telemedicine as a medium for providing patient care. These competencies aim to provide a framework for defining a standard of care in telemedicine and the ultimate development of a certification in the field.

Increased Plasma Levels Of The Th2 Chemokine Ccl18 Associated With Low Cd4+T Cell Counts In Hiv-1-Infected Patients With A Suppressed Viral Load, P. Malhotra, P. Haslett, B. Sherry, D. H. Shepp, P. Barber, J. Abshier, U. Roy, H. Schmidtmayerova

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No abstract provided.

An Atypical Presentation Of Lichen Planus-Like Reaction From Pembrolizumab., M. Lee, N. Seetharamu

Journal Articles

Introduction:With the advent of immunotherapy, a new subtype of side effects called IRAEs or immune related adverse effects have become more common. They may present in various organ systems as colitis, pneumonitis, hypophysitis, and thyroiditis and commonly as dermatological reactions. Case:This is a case report of a lung cancer patient that was started on Pembrolizumab and developed shortly after what appeared to be clinically at first pustular psoriasis but on biopsy was confirmed to be lichen planus. She was discontinued on the Pembrolizumab and treated with both systemic and topical steroids and improved. Conclusion:This case highlights a cutaneous reaction from …

Randomized Controlled Trial Of Subcutaneous Epoetin Alfa-Epbx Versus Epoetin Alfa In End-Stage Kidney Disease, S. Fishbane, B. S. Spinowitz, W. A. Wisemandle, N. E. Martin

Journal Articles

© 2019 Introduction: This double-blind, randomized controlled trial compared the safety and efficacy of subcutaneous epoetin alfa-epbx, an epoetin alfa biosimilar, with the reference product, epoetin alfa, in hemodialysis patients with end-stage kidney disease (ESKD) and anemia who were receiving epoetin alfa maintenance treatment. Methods: Eligible patients (n = 320) were randomized (1:1) to subcutaneous epoetin alfa-epbx or epoetin alfa in a titration phase; patients who demonstrated stable subcutaneous dosing (n = 246) were re-randomized to receive subcutaneous epoetin alfa-epbx or epoetin alfa 1 to 3 times per week in a 16-week maintenance phase. Co-primary endpoints were least-squares mean difference …

Older-Patient-Specific Cancer Trials: A Pooled Analysis Of 2,277 Patients (A151715)., D. Dao, T. Zemla, A. Jatoi, R. A. Freedman, A. Hurria, H. Muss, H. J. Cohen, M. Citron, D. Budman, J. G. Le-Rademacher, +6 Additional Authors

Journal Articles

BACKGROUND: Less than 3% of older patients with cancer are enrolled in clinical trials. To reverse this underrepresentation, we compared older patients enrolled with older-patient-specific trials, defined as those designed for older patients with cancer, with those enrolled in age-unspecified trials.

MATERIALS AND METHODS: We focused on individual patient data from those ≥65 years (younger patients excluded) and included all Alliance phase III adjuvant breast cancer trials from 1985-2012.

RESULTS: Among 2,277 patients, 1,014 had been enrolled to older-patient-specific and 1,263 to age-unspecified trials. The median age (range) in the older-patient-specific trials was 72 (65-89) years compared with 68 (65-84) …

Comparative Effectiveness, Safety, And Costs Of Rivaroxaban And Warfarin Among Morbidly Obese Patients With Atrial Fibrillation., E. D. Peterson, V. Ashton, Y. Chen, B. Wu, A. C. Spyropoulos

Journal Articles

BACKGROUND: There are limited data regarding clinical outcomes and healthcare resource utilization of direct oral anticoagulants (DOACs) in patients with atrial fibrillation (AF) who are morbidly obese (body mass index >40 kg/m

METHODS: Using data from 2 US healthcare claims databases, we identified patients initiating rivaroxaban or warfarin who had ≥1 medical claim with an AF diagnosis, a diagnostic code for morbid obesity (ICD-9: 278.01, V85.4%; ICD-10: E66.01%, E66.2%, Z68.4%), and a minimum continuous enrollment of 12 months before and 3 months after treatment initiation. Patients were excluded if they had mitral stenosis, a mechanical heart valve procedure, an organ/tissue …

Comparative Performances Of Machine Learning Methods For Classifying Crohn Disease Patients Using Genome-Wide Genotyping Data, A. Romagnoni, S. Jégou, K. Van Steen, G. Wainrib, J. P. Hugot, L. Peyrin-Biroulet, M. Chamaillard, J. F. Colombel, S. Katz, Y. Sharma, +84 Additional Authors

Journal Articles

© 2019, The Author(s). Crohn Disease (CD) is a complex genetic disorder for which more than 140 genes have been identified using genome wide association studies (GWAS). However, the genetic architecture of the trait remains largely unknown. The recent development of machine learning (ML) approaches incited us to apply them to classify healthy and diseased people according to their genomic information. The Immunochip dataset containing 18,227 CD patients and 34,050 healthy controls enrolled and genotyped by the international Inflammatory Bowel Disease genetic consortium (IIBDGC) has been re-analyzed using a set of ML methods: penalized logistic regression (LR), gradient boosted trees …

Rivaroxaban Versus Warfarin Treatment Among Morbidly Obese Patients With Venous Thromboembolism: Comparative Effectiveness, Safety, And Costs., A. C. Spyropoulos, V. Ashton, Y. Chen, B. Wu, E. D. Peterson

Journal Articles

INTRODUCTION: Limited data exist on direct-acting oral anticoagulants in morbidly obese patients with venous thromboembolism (VTE). We compared clinical and health/economic outcomes with rivaroxaban versus warfarin for VTE treatment in morbidly obese patients.

MATERIALS AND METHODS: This retrospective 1:1 propensity score matched cohort study analyzed data from 2 US claims databases. VTE patients initiating rivaroxaban or warfarin were identified who had diagnosis codes for morbid obesity (ICD-9:278.01,V85.4; ICD-10:E66.01,E66.2,Z68.4) 12 months pre- or 3 months post-initiation and followed ≥3 months. Intent-to-treat (ITT) and on-treatment (OT) analyses were conducted using conditional logistic regression and generalized linear models to compare recurrent VTE and …

Response To Misused And Misleading: 100% Response Rate To Galcanezumab In Patients With Episodic Migraine, N. Rosen, E. Pearlman, D. Ruff, K. Day, A. J. Nagy

Journal Articles

No abstract provided.

Tele-Monitored Tdcs Rehabilitation: Feasibility, Challenges And Future Perspectives In Parkinson's Disease, A. Cucca, K. Sharma, S. Agarwal, A. S. Feigin, M. C. Biagioni

Journal Articles

© 2019 The Author(s). Transcranial direct current stimulation (tDCS) is a modality of non-invasive brain stimulation involving the application of low amplitude direct current via surface electrodes on the scalp. tDCS has been studied in healthy populations and in multiple brain disorders and has the potential to be a treatment for several neuropsychiatric conditions by virtue of its capability of influencing cognitive, motor and behavioral processes. tDCS is a generally safe technique when performed within standardized protocols in research or clinical settings. Furthermore, tDCS portability, high acceptability and user-friendly interface makes it highly appealing for telemedicine practices. The term "telemedicine" …

Sex-Related Differences In Homebound Advanced Parkinson's Disease Patients, L. Nwabuobi, W. Barbosa, M. Sweeney, S. Oyler, T. Meisel, A. Di Rocco, J. Chodosh, J. E. Fleisher

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No abstract provided.

Correction To: Sequencing And Curation Strategies For Identifying Candidate Glioblastoma Treatments (Vol 12, 56, 2019), M. O. Frank, T. Koyama, K. Rhrissorrakrai, N. Robine, F. Utro, A. Emde, B. Chen, J. Boockvar, A. Demopoulos, R. B. Darnell, +39 Additional Authors

Journal Articles

No abstract provided.

Prehospital Factors Associated With Discharge Outcomes: Baseline Data From The Andhra Pradesh Traumatic Brain Injury Project, K. Ram, K. Varaprasad, M. K. Krishna, N. Kannan, V. Sundar, M. Joseph, V. D. Sinha, D. Shukla, R. K. Narayan, M. S. Vavilala, +2 Additional Authors

Journal Articles

© 2019 The Authors Objective: Strategies to improve traumatic brain injury (TBI) outcomes in India are ill defined. The objective of this study was to examine baseline prehospital (PH) factors associated with outcomes from the Andhra Pradesh Traumatic Brain Injury Project. Methods: We conducted a prospective observational cohort study of adult patients with TBI admitted to the primary referral hospital. Modes of injury, prehospital care and transport, and factors associated with increased in-hospital mortality were evaluated. Poisson regression with robust error variance and adjusted attributable risk percent estimates determined factors associated with outcomes. Results: A total of 447 adults (38% …

Novel Bioactive And Therapeutic Dental Polymeric Materials To Inhibit Periodontal Pathogens And Biofilms, M. Chi, M. Qi, A. Lan, P. Wang, M. D. Weir, M. A. Melo, X. Sun, B. Dong, C. Li, H. H. Xu, +2 Additional Authors

Journal Articles

© 2019 by the authors. Licensee MDPI, Basel, Switzerland. Periodontitis is a common infectious disease characterized by loss of tooth-supporting structures, which eventually leads to tooth loss. The heavy burden of periodontal disease and its negative consequence on the patient’s quality of life indicate a strong need for developing effective therapies. According to the World Health Organization, 10–15% of the global population suffers from severe periodontitis. Advances in understanding the etiology, epidemiology and microbiology of periodontal pocket flora have called for antibacterial therapeutic strategies for periodontitis treatment. Currently, antimicrobial strategies combining with polymer science have attracted tremendous interest in the …

Adaptation Of The Human Auditory Cortex To Changing Background Noise, B. Khalighinejad, J. L. Herrero, A. D. Mehta, N. Mesgarani

Journal Articles

No abstract provided.

Incins-Igf2 Promotes Cell Proliferation And Migration By Promoting G1/S Transition In Lung Cancer, S. Gao, Z. Lin, C. Li, Y. Wang, L. Yang, B. Zou, J. Chen, J. Li, D. Feng, G. Liu, +1 Additional Author

Journal Articles

© The Author(s) 2019. Long noncoding RNAs are capable of regulating gene expression at multiple levels. These RNA molecules are also involved in a variety of physiological and pathological processes. Emerging data demonstrate that a series of differentially expressed long noncoding RNAs are implicated in tumorigenesis. In the present study, we used microarray analysis to identify long noncoding RNAs that are dysregulated in non-small-cell lung cancer when compared to normal lung tissues. Accordingly, we performed quantitative real-time polymerase chain reaction to analyze the levels of long noncoding RNA and the cis target gene. We further found the oncogene property of …

Efficacy And Safety Of Ozanimod In Multiple Sclerosis: Dose-Blinded Extension Of A Randomized Phase Ii Study, J. A. Cohen, G. Comi, D. L. Arnold, A. Bar-Or, K. W. Selmaj, L. Steinman, E. K. Havrdová, B. A. Cree, B. E. Skolnick, L. Kappos, +4 Additional Authors

Journal Articles

© The Author(s), 2018. Background: Ozanimod, an oral immunomodulator, selectively targets sphingosine 1-phosphate receptors 1 and 5. Objective: Evaluate efficacy, safety, and tolerability of ozanimod in relapsing multiple sclerosis. Methods: In the RADIANCE Part A phase II study (NCT01628393), participants with relapsing multiple sclerosis were randomized (1:1:1) to once-daily ozanimod hydrochloride (0.5 or 1 mg) or placebo. After 24 weeks, participants could enter a 2-year, dose-blinded extension. Ozanimod-treated participants continued their assigned dose; placebo participants were re-randomized (1:1) to ozanimod hydrochloride 0.5 or 1 mg (equivalent to ozanimod 0.46 and 0.92 mg). Results: A total of 223 (89.6%) of the …

Septin 9 Isoforms Promote Tumorigenesis In Mammary Epithelial Cells By Increasing Migration And Ecm Degradation Through Metalloproteinase Secretion At Focal Adhesions, J. Marcus, M. Bejerano-Sagie, N. Patterson, S. Bagchi, V. V. Verkhusha, D. Connolly, G. L. Goldberg, A. Golden, V. P. Sharma, C. Montagna, +1 Additional Author

Journal Articles

© 2019, The Author(s), under exclusive licence to Springer Nature Limited. The cytoskeletal interacting protein Septin 9 (SEPT9), a member of the septin gene family, has been proposed to have oncogenic functions. It is a known hot spot of retroviral tagging insertion and a fusion partner of both de novo and therapy-induced mixed lineage leukemia (MLL). Of all septins, SEPT9 holds the strongest link to cancer, especially breast cancer. Murine models of breast cancer frequently exhibit SEPT9 amplification in the form of double minute chromosomes, and about 20% of human breast cancer display genomic amplification and protein over expression at …

Ischemic Necrosis Caused By Retroanastomotic Hernia After Subtotal Gastrectomy, S. H. Lee, S. C. Park, S. J. Lee, C. D. Kang, S. J. Nam, S. Y. Lee, S. K. Hong, S. K. Lee

Journal Articles

After gastrojejunostomy, a small space can occur between the jejunum at the anastomosis site, the transverse mesocolon, and retroperitoneum, which may cause an intestinal hernia. This report presents a rare case of intestinal ischemic necrosis caused by retroanastomotic hernia after subtotal gastrectomy. A 56-year-old male was admitted to Kangwon National University Hospital with melena, abdominal pain, and nausea. His only relevant medical history was gastrectomy due to stomach cancer. Endoscopic findings revealed subtotal gastrectomy with Billroth-II reconstruction and a bluish edematous mucosal change with necrotic tissue in afferent and efferent loops including the anastomosis site. Abdominopelvic CT showed strangulation of …

Influence Of Bacterial Burden On Meibomian Gland Dysfunction And Ocular Surface Disease, A. Nattis, H. D. Perry, E. D. Rosenberg, E. D. Donnenfeld

Journal Articles

© 2019 Nattis et al. Purpose: Bacterial burden on the eyelid margin and within meibomian glands was evaluated for influence on specific ocular surface disease (OSD) markers across the meibomian gland dysfunction (MGD) spectrum. Methods: In this prospective, observational, single-center study, 40 patients were divided into 4 equal groups of 10 that encompassed increasingly worse MGD/OSD categories. All patients answered the standard Ocular Surface Disease Index questionnaire, and underwent tear osmolarity testing (TOT), Schirmer 1, matrix metalloproteinase 9 (MMP-9) testing, meibography, and lissamine green staining. Cultures of eyelid margins and meibomian gland secretions were directly plated on blood, chocolate, and …

Utility Of En-Face Imaging In Diagnosis Of Occult Macular Dystrophy With Rp1l1 Mutation: A Case Series, M. Z. Ruan, S. A. Hussnain, A. Thomas, M. Mansukhani, S. Tsang, L. Yannuzzi

Journal Articles

© 2019 The Authors Purpose: To report en-face imaging findings at the level of ellipsoid zone (EZ) in two cases of occult macular dystrophy (OMD) with retinitis pigmentosa 1-like 1 (RP1L1) p.Arg45Trp mutation. Observations: In both patients who presented with decreased vision, pupillary examination, intraocular pressure, and anterior examination were normal. Ophthalmoscopic examination showed prominent choroidal marking whereas fundus autofluorescence was unremarkable. Spectral domain optical coherence tomography (SD-OCT) showed subtle gaps between EZ and retinal pigment epithelium (RPE). The photoreceptor disruption became more evident with en-face imaging at the EZ plane. Conclusions and importance: This is a report of two …

The Fate And Prognostic Implications Of Hyperreflective Crystalline Deposits In Nonneovascular Age-Related Macular Degeneration, S. Fragiotta, P. Fernáandez-Avellaneda, M. P. Breazzano, C. A. Curcio, B. C. Leong, K. Kato, L. A. Yannuzzi, K. B. Freund

Journal Articles

© 2019 The Authors. All rights reserved. PURPOSE. To explore patterns of disease progression in nonneovascular age-related macular degeneration (AMD) associated with hyperreflective crystalline deposits (HCDs) in the subretinal pigment epithelium–basal laminar space. METHODS. Retrospective review of medical records, multimodal imaging, and longitudinal eyetracked near-infrared reflectance (NIR) and optical coherence tomography (OCT) spanning years. NIR/OCT images were analyzed with ImageJ software to identify HCD morphology and location. Associated macular complications were reviewed from the time of HCD detection to the most recent follow-up, using NIR/OCT. RESULTS. Thirty-three eyes with HCDs from 33 patients (mean age: 72 ± 7.5 years) had …

Cost-Effectiveness Analysis Of Needle Arthroscopy Versus Magnetic Resonance Imaging In The Diagnosis And Treatment Of Meniscal Tears Of The Knee, N. Amin, L. Mcintyre, T. Carter, J. Xerogeanes, J. Voigt

Journal Articles

© 2019 The Authors Purpose: To determine whether needle arthroscopy (NA) compared with magnetic resonance imaging (MRI) in the diagnosis and treatment of meniscal tears is cost-effective when evaluated over a 2-year period via patient-reported outcomes. The hypothesis is that improved diagnostic accuracy with NA would lead to less costly care and similar outcomes. Methods: A Markov model/decision tree analysis was performed using TreeAge Pro 2017 software. Patients were evaluated for degenerative and traumatic damage to the lateral/medial meniscus. Assumed sensitivities and specificities were derived from the medical literature. The direct costs for care were derived from the 2017 Medicare …