Medical Specialties Commons^™

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

Journal Articles

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

Journal Articles

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 …

Quantifying The Impact Of Patient-Specific Factors And Disease Severity On Clinical Decision Making In Cuff Tear Arthropathy: A Case-Based Survey, A. P. Schumaier, Y. H. Bedeir, J. S. Dines, K. Kenter, L. V. Gulotta, D. M. Dines, B. M. Grawe

Journal Articles

© 2019, The Author(s). Background: Rotator cuff tears are a common cause of disability. Some patients with massive and irreparable tears can develop cuff tear arthropathy (CTA), which makes management more challenging. Questions/Purposes: We sought to examine how orthopedists determine treatment for patients with CTA. Specifically, we investigated (1) the effect of patient age, symptoms, activity level, range of motion, and radiographic findings on the decision making of shoulder specialists and (2) the observer reliability of the Seebauer and Hamada grading systems. Methods: Five shoulder surgeons were each sent 108 simulated patient cases. Each simulated patient had a different combination …

Full-Body Radiographic Analysis Of Postoperative Deviations From Age-Adjusted Alignment Goals In Adult Spinal Deformity Correction And Related Compensatory Recruitment., P. G. Passias, C. M. Jalai, B. G. Diebo, D. L. Cruz, G. W. Poorman, A. J. Buckland, L. M. Day, J. H. Oren, T. J. Errico, V. Lafage, +8 Additional Authors

Journal Articles

Background: Full-body stereographs for adult spinal deformity (ASD) have enhanced global deformity and lower-limb compensation associations. The advent of age-adjusted goals for classic ASD parameters (sagittal vertical axis, pelvic tilt, spino-pelvic mismatch [PI-LL]) has enabled individualized evaluation of successful versus failed realignment, though these remain to be radiographically assessed postoperatively. This study analyzes pre- and postoperative sagittal alignment to quantify patient-specific correction against age-adjusted goals, and presents differences in compensation in patients whose postoperative profile deviates from targets.

Methods: Single-center retrospective review of ASD patients ≥ 18 years with biplanar full-body stereographic x-rays. Inclusion: ≥ 4 levels fused, complete baseline …

Differentiating Noninvasive Follicular Thyroid Neoplasm With Papillary-Like Nuclear Features From Classic Papillary Thyroid Carcinoma: Analysis Of Cytomorphologic Descriptions Using A Novel Machine-Learning Approach., S. Maleki, A. Zandvakili, S. Gera, S. D. Khutti, A. Gersten, S. N. Khader

Journal Articles

Background:Recent studies show various cytomorphologic features that can assist in the differentiation of classic papillary thyroid carcinoma (cPTC) from noninvasive follicular thyroid neoplasm with papillary-like nuclear features (NIFTP). Differentiating these two entities changes the clinical management significantly. We evaluated the performance of support vector machine (SVM), a machine learning algorithm, in differentiating cases of NIFTP and encapsulated follicular variant of papillary thyroid carcinoma with no capsular or lymphovascular invasion (EFVPTC) from cases of cPTC with the use of microscopic descriptions. SVM is a supervised learning algorithm used in classification problems. It assigns the input data to one of two categories …

The Conscientious Autopsy., A. K. Williamson

Journal Articles

No abstract provided.

Practical Guidance For Clinical Microbiology Laboratories: Viruses Causing Acute Respiratory Tract Infections, C. L. Charlton, E. Babady, C. C. Ginocchio, T. F. Hatchette, R. C. Jerris, Y. Li, M. Loeffelholz, Y. S. Mccarter, M. B. Miller, S. J. Drews, +4 Additional Authors

Journal Articles

No abstract provided.

Prevalence Of Cardiovascular Disease Risk Factors In Childhood Glomerular Diseases, I. F. Ashoor, S. A. Mansfield, M. M. O'Shaughnessy, R. S. Parekh, J. Zee, T. L. Vasylyeva, A. J. Kogon, C. B. Sethna, L. M. Guay-Woodford, +170 Additional Authors

Journal Articles

No abstract provided.

Hydroxyurea For Children With Sickle Cell Anemia In Sub-Saharan Africa, L. Tshilolo, G. Tomlinson, T. N. Williams, B. Santos, P. Olupot-Olupot, A. Lane, B. Aygun, S. E. Stuber, K. Mcelhinney, +59 Additional Authors

Journal Articles

No abstract provided.

Psychosocial Screening In Disorders/Differences Of Sex Development: Psychometric Evaluation Of The Psychosocial Assessment Tool, M. M. Ernst, M. Gardner, C. A. Mara, E. C. Délot, P. Y. Fechner, M. Fox, M. M. Rutter, P. W. Speiser, C. Foley, B. Yashar, +24 Additional Authors

Journal Articles

© 2019 S. Karger AG, Basel. Background/Aims: Utilization of a psychosocial screener to identify families affected by a disorder/difference of sex development (DSD) and at risk for adjustment challenges may facilitate efficient use of team resources to optimize care. The Psychosocial Assessment Tool (PAT) has been used in other pediatric conditions. The current study explored the reliability and validity of the PAT (modified for use within the DSD population; PAT-DSD). Methods: Participants were 197 families enrolled in the DSD-Translational Research Network (DSD-TRN) who completed a PAT-DSD during a DSD clinic visit. Psychosocial data were extracted from the DSD-TRN clinical registry. …