Medical Specialties Commons^™

Individual And Joint Associations Of High-Sensitivity Troponin I And High-Sensitivity Troponin T With Cardiac Phenotypes And Outcomes In The General Population: An Analysis From The Dallas Heart Study, Rebecca Vigen, Colby Ayers, Jarett Berry, Anand Rohatgi, Vijay Nambi, Christie M Ballantyne, Torbjorn Omland, Christopher R De Filippi, James De Lemos

Faculty, Staff and Students Publications

Background: High-sensitivity troponin I (hs-cTnI) and T (hs-cTnT) provide complementary information regarding cardiovascular disease risk. The explanation for their distinct risk profiles is incompletely understood.

Methods and results: hs-cTnI and hs-cTnT were measured in Dallas Heart Study participants. Associations of hs-cTnI and hs-cTnT with demographics and phenotypes were assessed using linear regression. Associations with incident heart failure, atherosclerotic cardiovascular disease, global cardiovascular disease, and cardiovascular and all-cause mortality were assessed using Cox models. Among 3276 participants (56% women, 50% Black persons, median age 43 years), the correlation between hs-cTnI and hs-cTnT was modest (Spearman rho=0.35). Variables associated with hs-cTnI but …

A Mechanistic Lnk Between Inflammation And Atrial Fibrillation?, Joshua A Keefe, Shuai Zhao, Xander H T Wehrens

Faculty, Staff and Students Publications

No abstract provided.

Addressing Disparities In Pediatric Congenital Heart Disease: A Call For Equitable Health Care, Devyani Chowdhury, Pietro A Elliott, S Yukiko Asaki, Shahnawaz Amdani, Quang-Tuyen Nguyen, Christina Ronai, Seda Tierney, Victor Y Levy, Kriti Puri, Carolyn A Altman, Jonathan N Johnson, Julie S Glickstein

Faculty, Staff and Students Publications

While significant progress has been made in reducing disparities within the US health care system, notable gaps remain. This article explores existing disparities within pediatric congenital heart disease care. Congenital heart disease, the most common birth defect and a leading cause of infant death, has garnered substantial attention, revealing certain disparities within the US health care system. Factors such as race, ethnicity, insurance coverage, socioeconomic status, and geographic location are all commonalities that significantly affect health disparities in pediatric congenital heart disease. This comprehensive review sheds light on disparities from diverse perspectives in pediatric care, demonstrates the inequities and inequalities …

2024-2025 Pediatric Subspecialty Trainees, Children's Mercy Kansas City

Residents and Fellows Portraits

Photo composites of the graduate pediatric trainees in advanced non-invasive imaging, adolescent medicine, allergy/immunology, child abuse pediatrics, child neurology, clinical neuro-psychology, clinical child psychology, clinical child psychology internship, developmental-behavioral, epilepsy, headache medicine, hospice & palliative care, laboratory genetics & genomics, pediatric anesthesiology, pediatric bioethics, neonatal-perinatal medicine, pediatric adolescent gynecology, pediatric cardiology, pediatric clinical pharmacology, pediatric critical care medicine, pediatric dentistry, pediatric emergency medicine, pediatric endocrinology, pediatric gastroenterology, pediatric hematology/oncology, pediatric hospital medicine, pediatric EM/child abuse, pediatric infectious diseases, pediatric nephrology, pediatric ophthalmology; pediatric optometry, pediatric orthopedic surgery, pediatric otolaryngology, pediatric pathology, pediatric pulmonology, pediatric rehabilitation, pediatric sports medicine, pediatric surgery, …

A Prognostic Model For Use Before Elective Surgery To Estimate The Risk Of Postoperative Pulmonary Complications (Gsu-Pulmonary Score), Nihr Global Health Research Unit On Global Surgery, Starsurg Collaborative

Department of Surgery Faculty Publications

Background: Pulmonary complications are the most common cause of death after surgery. This study aimed to derive and externally validate a novel prognostic model that can be used before elective surgery to estimate the risk of postoperative pulmonary complications and to support resource allocation and prioritisation during pandemic recovery. Methods: Data from an international, prospective cohort study were used to develop a novel prognostic risk model for pulmonary complications after elective surgery in adult patients (aged ≥18 years) across all operation and disease types. The primary outcome measure was postoperative pulmonary complications at 30 days after surgery, which was a …

Enhancing Art & Creative Expression Engagement In An Inpatient Pediatric Setting, Aileen Bolosan, Susan Macdermott

Summer 2024 OTD Capstone Symposium

The purpose of this capstone project is to enhance art and creative expressive engagement within an inpatient pediatric setting. A primary focus for occupational therapy in children’s hospitals is on activities of daily living and other tasks associated with independent living (O’Brien & Kuhaneck, 2020). Creative activities such as art have been historically used throughout occupational therapy, however, the use of art and creative expression has declined in recent decades (Müllersdorf & Ivarsson, 2016). The presented capstone project focused on developing a culturally responsive, trauma-informed, occupation-based, art-focused program in an inpatient pediatric setting for children and families by integrating and …

Ocular Gene Transfer In The Spotlight: Implications Of Newspaper Content For Clinical Communications, Shelly Benjaminy, Tania M. Bubela

Office of the Provost

Background: Ocular gene transfer clinical trials are raising hopes for blindness treatments and attracting media attention. News media provide an accessible health information source for patients and the public, but are often criticized for overemphasizing benefits and underplaying risks of novel biomedical interventions. Overly optimistic portrayals of unproven interventions may influence public and patient expectations; the latter may cause patients to downplay risks and over-emphasize benefits, with implications for informed consent for clinical trials. We analyze the news media communications landscape about ocular gene transfer and make recommendations for improving communications between clinicians and potential trial participants in light of …

Assessing Association Between Socio-Demographic Variables And Contraceptive Usage In Married Men Residing In Korangi District, Karachi, Pakistan, Fahmida Khawaja, Gloria Noble Khan, Alia Nasir, Kiran Khowaja

Journal of Asian Midwives (JAM)

Background: Population growth remains an alarming concern for Pakistan as it not only exhausts scarce resources but further impedes socioeconomic development. One potential solution is to advance modern Family Planning (FP), which in the Pakistani context requires specific and rigorous attention towards male contraception in conjunction with female family planning usage. This study aims to determine the association between socio demographic factors and contraceptive use in married men of squatter settlement of Korangi Karachi.
Methods and Materials: A cross-sectional study was carried out from March, 2017 to June 2017, using a non-probability convenience sampling technique to select married men …

Heparin-Binding Protein Stratifies Mortality Risk Among Ugandan Children Hospitalized With Respiratory Distress, Hridesh Mishra, Núria Balanza, Caroline Francis, Kathleen Zhong, Julie Wright, Andrea Conroy, Robert Opoka, Quique Bassat, Sophie Namasopo, Kevin Kain

Paediatrics and Child Health, East Africa

Background Current prognostic tools do not reliably and objectively identify children with pneumonia at risk of a severe or life-threatening episode. Heparin-binding protein (HBP) is a host immune protein that is released in response to infection. We hypothesized that measuring HBP concentrations at hospital admission could help risk-stratify children with pneumonia and identify those at higher risk of an adverse prognosis.

Methods We evaluated the prognostic accuracy of HBP for predicting in-hospital mortality among children with respiratory distress, and whether HBP could improve the accuracy of validated composite clinical severity scores.

Results Of 778 Ugandan children under 5 years of …

The Ugandan Sickle Pan-African Research Consortium Registry: Design, Development, And Lessons, Mike Nsubuga, Henry Mutegeki, Daudi Jjingo, Deogratias Munube, Ruth Namazzi, Robert Opoka, Philip Kasirye, Grace Ndeezi, Heather Hume, Ezekiel Mupere

Paediatrics and Child Health, East Africa

Background Sub-Saharan Africa bears the highest burden of sickle cell disease (SCD) globally with Nigeria, Democratic Republic of Congo, Tanzania, Uganda being the most affected countries. Uganda reports approximately 20,000 SCD births annually, constituting 6.67% of reported global SCD births. Despite this, there is a paucity of comprehensive data on SCD from the African continent. SCD registries offer a promising avenue for conducting prospective studies, elucidating disease severity patterns, and evaluating the intricate interplay of social, environmental, and genetic factors. This paper describes the establishment of the Sickle Pan Africa Research Consortium (SPARCo) Uganda registry, encompassing its design, development, data …

Perioperative Cannabis Use In Bariatric Patients: A Review Of Outcomes And Proposed Clinical Pathway For Management, Meghan H. Maceyko, Marc Neff, Jonathan Halevy, Marguerite Dunham

Jefferson Health - New Jersey Papers

Legalization of marijuana has led to increased prevalence of medical and recreational cannabis use, underscoring the importance for anesthesiologists, surgeons, and perioperative physicians to understand the effects of this drug in patient care. Bariatric surgical patients represent a unique target population to understand peri-operative cannabis use and its effects as these patients undergo an extensive preoperative psychological and nutritional evaluation. Standardized guidelines on cannabis use in bariatric surgery are lacking and many clinicians remain uncertain on how to handle cannabis use in the peri-operative period. Here, we summarize the data on cannabis use in bariatric patients, specifically exploring anesthetic considerations, …

Future Directions For Emergency Medical Services Development In Low- And Middle-Income Countries, Peter Delaney, Jon Moussally, Benjamin Wachira

Emergency Medicine, East Africa

The lack of prehospital care access in low- and middle-income countries is one of the greatest unmet needs and, therefore, one of the most urgent priorities in global health. Establishing emergency medical services in low- and middle-income countries poses significant challenges and complexities, requiring solutions tailored to prevailing conditions, informed by needs assessments, and adapted to meet local demands in a culturally appropriate and sustainable manner. In areas without existing emergency medical services, patients must rely on informal networks of untrained bystanders and community members to provide first aid and transport to definitive care. Since 2005, training lay first responders …

New Labor Curves Of Dilation And Station To Improve The Accuracy Of Predicting Labor Progress., Emily F Hamilton, Tilekbek Zhoroev, Philip A Warrick, Adi L Tarca, Thomas J Garite, Aaron B Caughey, Jason Melillo, Mona Prasad, Duncan Neilson, Peter Singson, Kimberlee Mckay, Roberto Romero

Women’s Health Articles

BACKGROUND: The diagnosis of failure to progress, the most common indication for intrapartum cesarean delivery, is based on the assessment of cervical dilation and station over time. Labor curves serve as references for expected changes in dilation and fetal descent. The labor curves of Friedman, Zhang et al, and others are based on time alone and derived from mothers with spontaneous labor onset. However, labor induction is now common, and clinicians also consider other factors when assessing labor progress. Labor curves that consider the use of labor induction and other factors that influence labor progress have the potential to be …

Call Me Dr Ishmael: Trends In Electronic Health Record Notes Available At Emergency Department Visits And Admissions, Brian W Patterson, Daniel J Hekman, Frank J Liao, Azita G Hamedani, Manish N Shah, Majid Afshar

Faculty, Staff and Student Publications

OBJECTIVES: Numerous studies have identified information overload as a key issue for electronic health records (EHRs). This study describes the amount of text data across all notes available to emergency physicians in the EHR, trended over the time since EHR establishment.

MATERIALS AND METHODS: We conducted a retrospective analysis of EHR data from a large healthcare system, examining the number of notes and a corresponding number of total words and total tokens across all notes available to physicians during patient encounters in the emergency department (ED). We assessed the change in these metrics over a 17-year period between 2006 and …

Multicountry Spread Of Influenza A(H1n1)Pdm09 Viruses With Reduced Oseltamivir Inhibition, May 2023-February 2024, Mira C Patel, Ha T Nguyen, Philippe Noriel Q Pascua, Rongyuan Gao, John Steel, Rebecca J Kondor, Larisa V Gubareva

Faculty, Staff and Student Publications

Since May 2023, a novel combination of neuraminidase mutations, I223V + S247N, has been detected in influenza A(H1N1)pdm09 viruses collected in countries spanning 5 continents, mostly in Europe (67/101). The viruses belong to 2 phylogenetically distinct groups and display ≈13-fold reduced inhibition by oseltamivir while retaining normal susceptibility to other antiviral drugs.

Issue 9: Pulmonary & Critical Care Insider, Bharat Bajantri Md, Sarah Ellsworth-Hoffman Mls, Ya Gao Md, Sivaprakash Sivaji Do, Caleb Hoppe Pharmd

Critical Care & Pulmonary

Pulmonary & Critical Care Insider Issue 9

Compiled by Bharat Bajantri, MD, and librarian Sarah Ellsworth, MLS for the clinicians of the Pulmonary and Critical Care team of Parkview.

The Pulmonary & Critical Care Insider newsletter was created by Dr. Bharat Bajantri, MD and Sarah Ellsworth, MLS in 2023 as a form of current awareness for current practice at our hospital, Parkview Health.

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Topics:

VIEWPOINTS:

Non-Shockable Cardiac Arrest Management

Try and try again till CPAP succeeds!

ORIGINAL STUDY SUMMARY & PERSPECTIVE:

Fungal Pneumonias in the ICU: Clinical Insights and Diagnostic Strategies.

ARDS Update and Guidance

SNAPSHOTS:

Making sure massive …

Sexual Well-Being And High-Risk Behaviors : An Exploratory Mixed Methods Study For Questionnaire Development, Stephan R Smith

Covenant Nurses Week 2024

No abstract provided.

Dying With Dignity: How Can We Deliver Values-Concordant End-Of-Life Care For Immigrant Patients In The United States?, Khushi Kohli, Erin Jay G. Feliciano, Nishwant Swami, Aditya Narayan, Tej A. Patel, Bhav Jain, Puneeth Iyengar, Julie Kanevsky, Paul L. Nguyen, Edward Christopher Dee

Ateneo School of Medicine and Public Health Publications

No abstract provided.

Status Epilepticus: Initial Management, Children's Mercy Kansas City

Clinical Pathways

No abstract provided.

Foreign Body Ingestion, Children's Mercy Kansas City

Clinical Pathways

No abstract provided.

Efficacy Of Tezepelumab In Patients With Severe, Uncontrolled Asthma Across Multiple Clinically Relevant Subgroups In The Navigator Study, Tara F Carr, Wendy C Moore, Monica Kraft, Guy Brusselle, Mario Castro, Geoffrey L Chupp, Michael E Wechsler, Gillian Hunter, Andrew W Lindsley, Jean-Pierre Llanos, Luke K Burke, Shradha Chandarana, Christopher S Ambrose

Faculty, Staff and Student Publications

INTRODUCTION: Many patients with severe asthma continue to experience symptoms and exacerbations despite treatment with standard-of-care therapy. In the phase 3 NAVIGATOR study, tezepelumab significantly reduced exacerbations over 52 weeks compared with placebo in patients with severe, uncontrolled asthma. This analysis assessed the efficacy of tezepelumab in reducing asthma exacerbations in various clinically relevant subgroups of patients in NAVIGATOR.

METHODS: NAVIGATOR was a phase 3, multicentre, randomized, double-blind, placebo-controlled study. Participants (12-80 years old) with severe, uncontrolled asthma were randomized 1:1 to receive tezepelumab 210 mg or placebo subcutaneously every 4 weeks for 52 weeks. Pre-specified and post hoc analyses …

Completion Of Pembrolizumab In Advanced Non-Small Cell Lung Cancer—Real World Outcomes After Two Years Of Therapy (Copilot), Andrew Fantoni, Lydia Warburton, Benjamin Solomon, Marliese Alexander, Meghana Maddula, Lauren Julia Brown, Ines Pires Da Silva, Adnan Nagrial, Farah Abu Al-Hial, Malinda Itchins, Nick Pavlakis, Samantha Bowyer

Research outputs 2022 to 2026

Background: Seminal trials with first-line pembrolizumab for metastatic non-small cell lung cancer (NSCLC) mandated a maximum two-years treatment. We describe real-world outcomes of a multi-site Australian cohort of patients who completed two-years of pembrolizumab. Methods: Retrospective data were collected from the national AUstralian Registry and biObank of thoRacic cAncers (AURORA). Primary endpoints were progression rate post pembrolizumab discontinuation; and progression free survival (PFS). Local treatment of oligoprogressive disease during pembrolizumab was allowed. Results: A total of 71 patients from six centers, median age 66.0 years, 49% male and 90% ECOG ≤ 1 were identified. Patients were Caucasian (82%) or Asian …

Use Of Cobalt(Iii) And Copper(Ii) Complexes With Thiosemicarbazone Ligands And Berberine Chloride As Anti-Cancer Agents Against Triple Negative Breast Cancer, Duaa Rashad Alajroush

Chemistry & Biochemistry Theses & Dissertations

It is a worrying fact that chemotherapeutic options for treating triple negative breast cancer are limited in nature, including the use of inorganic pharmaceuticals such as cisplatin and its analogues. It has been reported that cisplatin has undesirable side effects when used as a chemotherapeutic drug. As such, there is a need to use non-platinum-containing complexes as chemotherapeutic agents. Based on that issue, it has been reported by our research group and others that cobalt- and copper-containing complexes have shown great potential in anti-cancer properties when compared to cisplatin. In this research project, the cytotoxic effects of the following complexes: …

Management Of Malignant Pleural Effusion And Trapped Lung: A Survey Of Respiratory Physicians And Thoracic Surgeons In Australasia, Calvin Sidhu, Gavin Wright, Carolyn J. Peddle-Mcintyre, Ai Ling Tan, Yun Chor Gary Lee

Research outputs 2022 to 2026

Background:

Malignant pleural effusions (MPEs) are common, and a third of them have underlying trapped lung (TL). Management of MPE and TL is suspected to be heterogeneous. Understanding current practices in Australasia is important in guiding policies and future research.

Aims:

Electronic survey of Australia-New Zealand respiratory physicians, thoracic surgeons and their respective trainees to determine practice of MPE and TL management.

Results:

Of the 132 respondents, 56% were respiratory physicians, 23% were surgeons and 20% were trainees. Many respondents defined TL as >25% or any level of incomplete lung expansion; 75% would use large-volume thoracentesis to determine whether TL …

Prognostic Value Of The 1-Min Sit-To-Stand Test To Predict Post-Operative Complications In Patients With Lung Cancer Elected For Lung Resection, Kirsten Quadflieg, Rachael Higgins, Eva Arents, Heleen Demeyer, Maarten Criel, Marc Daenen, David Ruttens, Michiel Thomeer, Dieter Stevens, Andrew Maiorana, Martijn A. Spruit, Vinicius Cavalheri, Chris Burtin

Research outputs 2022 to 2026

No abstract provided.

Transdermal Oestradiol And Exercise In Androgen Deprivation Therapy (Estracise): Protocol, Ilkka Jussila, Juha P. Ahtiainen, Eija K. Laakkonen, Aino Siltari, Antti Kaipia, Tiina Jokela, Minta Kärkkäinen, Rob Newton, Truls Raastad, Heini Huhtala, Teemu J. Murtola, Heikki Seikkula

Research outputs 2022 to 2026

Objective: To report the protocol of a study evaluating the efficacy of transdermal oestradiol (E2) gel in reducing the adverse effects of androgen deprivation therapy (ADT), specifically on sexual function, and to assess the utility of E2 in combination with supervised exercise. Study Design and Methods: The primary endpoint of this open-label Phase IIA randomized controlled trial is the efficacy of transdermal E2 gel. Secondary endpoints include: (i) the occurrence of ADT-induced adverse effects; (ii) the safety and tolerability of E2; (iii) the impact of E2 with or without exercise on physical, physiological, muscle, and systemic biomarkers; and (iv) quality …

Examining Enrollment & Engagement In A Hospital-Based Violence Prevention Intervention Study At A Level 1 Trauma Center, Leigh Frederick

Electronic Theses and Dissertations

BACKGROUND: Violence is a significant healthcare issue that affects the health and well-being of individuals, families, and communities. Violence prevention and intervention programs are a powerful way to stop the revolving door of violent injury in our hospitals and communities. The Health Alliance for Violence Intervention (HAVI), develops and connects violence intervention programs, promotes equity for victims of violence globally, and is dedicated to engaging patients during the window of opportunity when they are recovering in the hospital after a violent injury to reduce the chance of retaliation (related to the injury) and recurrence. A small body of research shows …

Development Of The Paediatric Society Of The African League Against Rheumatism (Paflar) Jia Registry And Clinical Profile Of Jia In Africa From The Paflar Jia Registry, Angela Migowa, Wafa Hamdi, Soad Hashad, Hala Etayari, Awatif Abushhaiwia, Hanene Ferjani, Dorra Nessib, Lobna Kharrat, Rachel Odhiambo, James Orwa

Paediatrics and Child Health, East Africa

No abstract provided.

Using An Artificial Intelligence (Ai) Tool (Chatgpt) To Identify The Main Indications And Side Effects Of Drugs, Mai Elzieny, Christian Santiago, Zhenhong Qu

Posters

This study evaluated the efficacy of ChatGPT, an AI powered language model (1), in retrieving drug information for pathology practice compared to UpToDate. The research focused on 160 commonly prescribed drugs, assessing the speed and accuracy of information retrieval. Results showed that ChatGPT efficiently provided indications and side effects of multiple drugs in batches within seconds, comparable to UpToDate's information but remarkably faster (2). The study suggests that ChatGPT is a promising valuable tool to help pathologists in accessing drug information, potentially improving diagnostic accuracy and work efficiency

Optimize Artificial Intelligence Language Model Use In Medical Board Exams: Insights From Instruction Quality And Domain Context Analysis, Zhenhong Qu, Mai Elzieny, Kanika Arora

Posters

Artificial intelligence language models (AI-LMs) show promise in medical education and clinical problem solving, but their performance in medical board exams has been inconsistent (1,2,3).

This study investigated how prompt engineering and providing essential reference material influence AI-LM performance on board exam questions.

We tested ChatGPT and Claude-2 on 360 questions in various formats under three conditions: simple prompt, elaborate CRAFTS prompt, and CRAFTS prompt with references (CRAFTS stands for context, role, action, format, tone, and style).

Results showed significant improvement in accuracy from simple prompts (67-83.5%) to CRAFTS prompts (76.2-92.5%) to CRAFTS prompts with references (97.3- 99.4%)

These findings …