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2024

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Full-Text Articles in Medical Specialties

Pediatric Site Response To Rapid Implementation Of Decentralized Clinical Trials, Abby Kietzman, An-Lin Cheng Mar 2024

Pediatric Site Response To Rapid Implementation Of Decentralized Clinical Trials, Abby Kietzman, An-Lin Cheng

Posters

In 2020, the COVID-19 pandemic drastically altered the way clinical research is conducted through a widespread adoption of telemedicine practices. Using telehealth/telemedicine services allowed researchers to conduct “decentralized clinical trials”, or DCTs, for all or portions of study protocol procedures while maintaining safety measures implemented for pandemic control. However, current review of available literature details the explosion in use of decentralized clinical trials, resulting in gaps in evidence-based outcomes and lack of standardization across research entities. While sponsors and contract research organizations (CROs) tend to lead the charge around adoption of DCTs, research sites are hesitant to make the transition …


Assessing The Influence Of Covid-19 Lockdown Measures On Cognition And Behavior In School Age Children In Arba Minch Health And Demographic Surveillance Site, Southern Ethiopia: A Cross-Sectional Study, Befikadu Tariku Gutema, Eshetu Zerihun Tariku, Zeleke Aschalew Melketsedik, Bruno Levecke, Stefaan De Henauw, Amina Abubakar, Souheila Abbeddou Mar 2024

Assessing The Influence Of Covid-19 Lockdown Measures On Cognition And Behavior In School Age Children In Arba Minch Health And Demographic Surveillance Site, Southern Ethiopia: A Cross-Sectional Study, Befikadu Tariku Gutema, Eshetu Zerihun Tariku, Zeleke Aschalew Melketsedik, Bruno Levecke, Stefaan De Henauw, Amina Abubakar, Souheila Abbeddou

Institute for Human Development, East Africa

Ethiopian schools were closed for nearly 40 weeks as a measure to control the COVID-19 pandemic. The objective of the study was to evaluate the role of COVID-19 pandemic’s restrictive measures on cognition and behavioral difficulties of schoolchildren in Arba Minch Health and Demographic Surveillance Site. Two cross-sectional surveys were conducted in November 2019 (pre-COVID-19-lockdown) and November 2020 (post-COVID-19 lockdown). Data were collected both at the school and homes of the children. Cognitive development of the children was assessed using digit span, Raven’s coloured progressive matrices (RCPM) and Visual search using cancellation task. Behavioral difficulties score of the children was …


Abdominal Wall Endometriosis In Cesarean Scar: A Case Report, Willbroad Kyejo, Brenda Moshi, Euphraim Massanga, Gregory Ntiyakunze, Miriam Mgonja, Munawar Kaguta, Ernest Mdachi Mar 2024

Abdominal Wall Endometriosis In Cesarean Scar: A Case Report, Willbroad Kyejo, Brenda Moshi, Euphraim Massanga, Gregory Ntiyakunze, Miriam Mgonja, Munawar Kaguta, Ernest Mdachi

Family Medicine, East Africa

Abdominal wall endometriosis refers to the presence of endometrial tissue within surgical scars, most commonly occurring following gynecological procedures such as cesarean sections. This case report presents a rare case of abdominal wall endometriosis in a cesarean scar. The patient, a 32-year-old woman with a history of two previous cesarean sections, presented with cyclic pain and swelling in the lower abdominal region. Physical examination revealed a tender, well-defined mass within the cesarean scar. Surgical excision of the mass was performed, and histopathological examination confirmed the presence of endometrial tissue. This case highlights the importance of considering abdominal wall endometriosis in …


Virtual Reality For Pain Management During High-Resolution Manometry: A Randomized Clinical Trial, Ilan Palte, Sarah Stewart, Hal Rives, James A Curtis, Necati Enver, Andrew Tritter, Katerina Andreadis, Valentina Mocchetti, Felice Schnoll-Sussman, Amir Soumekh, Rasa Zarnegar, Philip Katz, Anaïs Rameau Mar 2024

Virtual Reality For Pain Management During High-Resolution Manometry: A Randomized Clinical Trial, Ilan Palte, Sarah Stewart, Hal Rives, James A Curtis, Necati Enver, Andrew Tritter, Katerina Andreadis, Valentina Mocchetti, Felice Schnoll-Sussman, Amir Soumekh, Rasa Zarnegar, Philip Katz, Anaïs Rameau

Faculty, Staff and Student Publications

Objective: High-resolution esophageal manometry (HRM) is the gold standard for the diagnosis of esophageal motility disorders. HRM is typically performed in the office with local anesthesia only, and many patients find it unpleasant and painful. The aim of this study was to examine the effects of the use of a virtual reality (VR) headset on pain and anxiety outcomes in patients with dysphagia undergoing HRM.

Methods: Patients with dysphagia were prospectively recruited and randomized to undergo HRM with and without VR distraction. Data collected included the State-Trait Anxiety Inventory-6 (STAI-6), the Short-Form McGill Pain Questionnaire, heart rate, and galvanic skin …


Quantifying Health Facility Service Readiness For Small And Sick Newborn Care: Comparing Standards-Based And Who Level-2 + Scoring For 64 Hospitals Implementing With Nest360 In Kenya, Malawi, Nigeria, And Tanzania, Rebecca E. Penzias, Christine Bohne, Edith Gicheha, Elizabeth Molyneux, David Gathara, Samuel K. Ngwala, Evelyn Zimba, Ekran Rashid, Opeyemi Odedere, Olabisi Dosunmu Mar 2024

Quantifying Health Facility Service Readiness For Small And Sick Newborn Care: Comparing Standards-Based And Who Level-2 + Scoring For 64 Hospitals Implementing With Nest360 In Kenya, Malawi, Nigeria, And Tanzania, Rebecca E. Penzias, Christine Bohne, Edith Gicheha, Elizabeth Molyneux, David Gathara, Samuel K. Ngwala, Evelyn Zimba, Ekran Rashid, Opeyemi Odedere, Olabisi Dosunmu

Paediatrics and Child Health, East Africa

Background: Service readiness tools are important for assessing hospital capacity to provide quality small and sick newborn care (SSNC). Lack of summary scoring approaches for SSNC service readiness means we are unable to track national targets such as the Every Newborn Action Plan targets.

Methods: A health facility assessment (HFA) tool was co-designed by Newborn Essential Solutions and Technologies (NEST360) and UNICEF with four African governments. Data were collected in 68 NEST360-implementing neonatal units in Kenya, Malawi, Nigeria, and Tanzania (September 2019-March 2021). Two summary scoring approaches were developed: a) standards-based, including items for SSNC service readiness by health system …


Safety Of Ambulatory Surgery For Obstructive Sleep Apnea: A Retrospective Review, Dylan Gregory Bertoni, Emily Garvey, Neha Garg, Dev Amin, Sruti Tekumalla, Derek Mann, Bita Naimi, Tingting Zhan, Patrick Hunt, Maurits Boon, Colin Huntley Mar 2024

Safety Of Ambulatory Surgery For Obstructive Sleep Apnea: A Retrospective Review, Dylan Gregory Bertoni, Emily Garvey, Neha Garg, Dev Amin, Sruti Tekumalla, Derek Mann, Bita Naimi, Tingting Zhan, Patrick Hunt, Maurits Boon, Colin Huntley

Jefferson Hospital Staff Papers and Presentations

OBJECTIVE: Assess the safety of ambulatory surgery performed for obstructive sleep apnea.

STUDY DESIGN: Retrospective chart review.

SETTING: Tertiary care hospital.

METHODS: Demographic data including age, gender, race, body mass index, insurance status, socioeconomic status, and distance traveled for surgery was collected, as well as comorbidities, and apnea-hypopnea index (AHI). Outcome variables included continuous positive airway pressure reinitiation, planned/unplanned postoperative admission, emergency department (ED) presentation, or readmission within 7 and 14 days of surgery.

RESULTS: A total of 601 patients were included, who underwent sleep surgery between 2017 and 2022. The median age was 55 years [interquartile range: 19]. A …


Comparison Of Short-Arm Immobilization And Long-Arm Immobilization In Conservatively Managed Distal Radius Fractures: A Meta-Analysis And Systematic Review., Yash P Chaudhry, Genoveffa R Morway, Efstratios A Papadelis, Nikki A Doerr, Kenneth W Graf, Rakesh P Mashru, Henry J Dolch Mar 2024

Comparison Of Short-Arm Immobilization And Long-Arm Immobilization In Conservatively Managed Distal Radius Fractures: A Meta-Analysis And Systematic Review., Yash P Chaudhry, Genoveffa R Morway, Efstratios A Papadelis, Nikki A Doerr, Kenneth W Graf, Rakesh P Mashru, Henry J Dolch

Orthopedic Surgery Resident Research

Distal radius fractures are often treated conservatively with immobilization. Immobilizing above the elbow limits forearm rotation, though recent literature has suggested the effects on radiographic or functional outcomes may be negligible. This systematic review and meta-analysis aimed to analyze the radiographic and functional outcome scores of distal radius fractures managed with short-arm (SA) immobilization and long-arm (LA) immobilization. An electronic systematic search was performed of the PubMed and EMBASE databases from inception to October 5, 2022. All randomized controlled trials (RCTs) involving patients with acute distal radius fractures undergoing nonoperative treatment (involving application/maintenance of immobilization) comparing above-elbow versus below-elbow constructs …


Entrance Surface Air Kerma To Patients During Digital Radiographic Examinations In Tanzania, Atumaini Makoba, Ahmed Jusabani, Wilbroad Muhogora, Abdallah Kileo, Musa Ndukeki, Huruma Mammba, Hilda Makungu, Haika Maro, Erick Onoka, Miguta Ngulimi Mar 2024

Entrance Surface Air Kerma To Patients During Digital Radiographic Examinations In Tanzania, Atumaini Makoba, Ahmed Jusabani, Wilbroad Muhogora, Abdallah Kileo, Musa Ndukeki, Huruma Mammba, Hilda Makungu, Haika Maro, Erick Onoka, Miguta Ngulimi

Imaging & Diagnostic Radiology, East Africa

The aim of this study was to determine the entrance surface air kerma (ESAK) in adult patients during digital radiography and to evaluate the optimisation potential in five common X-ray examinations in Tanzania. Based on a sample of 240–610 patients, ESAK was estimated using X-ray tube output measurements, patient information and backscatter factors. The results show that the mean ESAK values were higher or comparable to data from the literature. The diagnostic reference values of ESAK for digital radiography were 0.31 mGy (chest PA), 4 mGy (lumbar spine AP), 5.4 mGy (lumbar spine LAT), 3.8 mGy (abdomen AP) and 2.4 …


Timing Of Decompressive Surgery In Patients With Acute Spinal Cord Injury: Systematic Review Update, Michael G Fehlings, Laureen D Hachem, Lindsay A Tetreault, Andrea C Skelly, Joseph R Dettori, Erika D Brodt, Shay Stabler-Morris, Britt J Redick, Nathan Evaniew, Allan R Martin, Benjamin Davies, Farzin Farahbakhsh, James D Guest, Daniel Graves, Radha Korupolu, Stephen L Mckenna, Brian K Kwon Mar 2024

Timing Of Decompressive Surgery In Patients With Acute Spinal Cord Injury: Systematic Review Update, Michael G Fehlings, Laureen D Hachem, Lindsay A Tetreault, Andrea C Skelly, Joseph R Dettori, Erika D Brodt, Shay Stabler-Morris, Britt J Redick, Nathan Evaniew, Allan R Martin, Benjamin Davies, Farzin Farahbakhsh, James D Guest, Daniel Graves, Radha Korupolu, Stephen L Mckenna, Brian K Kwon

Faculty, Staff and Student Publications

STUDY DESIGN: Systematic review and meta-analysis.

OBJECTIVE: Surgical decompression is a cornerstone in the management of patients with traumatic spinal cord injury (SCI); however, the influence of the timing of surgery on neurological recovery after acute SCI remains controversial. This systematic review aims to summarize current evidence on the effectiveness, safety, and cost-effectiveness of early (≤24 hours) or late (>24 hours) surgery in patients with acute traumatic SCI for all levels of the spine. Furthermore, this systematic review aims to evaluate the evidence with respect to the impact of ultra-early surgery (earlier than 24 hours from injury) on these …


Effectiveness Of Concurrent Ankle Arthroscopy During Open Reduction And Internal Fixation Of Malleolar Fractures In Prevention Of Common Short-Term Complications, Naohiro Shibuya, Daniel C. Jupiter Mar 2024

Effectiveness Of Concurrent Ankle Arthroscopy During Open Reduction And Internal Fixation Of Malleolar Fractures In Prevention Of Common Short-Term Complications, Naohiro Shibuya, Daniel C. Jupiter

School of Podiatric Medicine Publications

Rotational malleolar fractures result in a high prevalence of intra-articular pathologies; therefore, routine arthroscopic assessment may be beneficial in the surgical treatment of ankle fractures. However, the clinical studies regarding the effectiveness of arthroscopy thus far have mixed results. We investigated the efficacy of concurrent arthroscopy during the treatment of malleolar fractures using a large U.S. healthcare data set. Those who had arthroscopy were compared with those who did not, during the surgical treatment of malleolar fractures, while adjusting for covariates of clinical relevance. The analysis showed that concurrent arthroscopy is protective against postoperative repeat surgery (OR = 0.13, 95CI …


Understanding The Impact Of Adverse Childhood Experiences On Non-Suicidal Self-Injury In Youth: A Systematic Review, Sadia Suhail Usmani, Meghana Mehendale, Mahnoor Yousif Shaikh, Sourav Sudan, Prathima Guntipalli, Lara Ouellette, Anem Sajid Malik, Naila Siddiqi, Namrata Walia, Kaushal Shah, Fahimeh Saeed, Domenico De Berardis, Sheikh Shoib Mar 2024

Understanding The Impact Of Adverse Childhood Experiences On Non-Suicidal Self-Injury In Youth: A Systematic Review, Sadia Suhail Usmani, Meghana Mehendale, Mahnoor Yousif Shaikh, Sourav Sudan, Prathima Guntipalli, Lara Ouellette, Anem Sajid Malik, Naila Siddiqi, Namrata Walia, Kaushal Shah, Fahimeh Saeed, Domenico De Berardis, Sheikh Shoib

Library Staff Publications

OBJECTIVE: Non-suicidal self-injury (NSSI), defined as a deliberate destruction of one's own body without a suicidal intent, is a global public health issue. Adverse childhood events (ACEs) have been shown to be associated with various mental illnesses; however, to date the impact of such events on NSSI in youth has not been reviewed.

METHODS: We conducted a systematic review, searched 5 databases for published articles evaluating ACE and NSSI in youth less than or equal to 21 years of age. After screening 247 articles, we included 21 unique articles in this systematic review.

RESULTS: Increasing ACE score, physical, sexual or …


Wilson’S Disease Presenting As Status Epilepticus: A Case Report, Iqra Athar, Neelma Naz Khattak, Hania Batool, Tehreem Farah, Tashfain Shifa, Zukhruf Zayian Mar 2024

Wilson’S Disease Presenting As Status Epilepticus: A Case Report, Iqra Athar, Neelma Naz Khattak, Hania Batool, Tehreem Farah, Tashfain Shifa, Zukhruf Zayian

Pakistan Journal of Neurological Sciences (PJNS)

ABSTRACT

Wilson’s disease (WD) is a rare disorder of copper metabolism, caused by a mutation in the ATPB7 gene, resulting in a defect in copper elimination leading to its accumulation in various organs, with the liver being the most common. Here, we describe a case of a 19-year-old boy who presented with a history of hallucinations and status epilepticus. Initial investigations were normal, but due to a rising trend in alanine transaminase (ALT), a slit lamp examination was performed, revealing Kayser-Fleischer (KF) rings in the eyes. The patient was diagnosed with WD due to the presence of these KF rings …


Atypical Facio-Scapulo-Humeral Dystrophy With Facial Sparing: A Case Report, Umer Younas, Asma Aamir, Farooq Azam Rathore Mar 2024

Atypical Facio-Scapulo-Humeral Dystrophy With Facial Sparing: A Case Report, Umer Younas, Asma Aamir, Farooq Azam Rathore

Pakistan Journal of Neurological Sciences (PJNS)

ABSTRACT

Facio-Scapulo-Humeral Dystrophy (FSHD) is an autosomal dominant and third most common inherited muscular dystrophy. Typical phenotype of FSHD initially affects the muscles of the face and upper arm. Atypical FSHD refers to genetically confirmed FSHD with phenotypic variations. Scapulo-Humeral Dystrophy (SHD) is the most common atypical form of FSDH characterized by no facial muscle weakness on clinical examination, while other signs remain consistent with FSHD. We report a 31-year-old male who presented with foot drop and had an unexpected presentation as SHD. Provisional diagnosis of SHD was based on careful medical history, physical examination findings, modest rise in muscle …


Role Of Minimal F-Wave Latency In The Electrodiagnosis Of Polyneuropathy, Areeba Qaiser, Safia Bano, Muhammad Imran Khan, Ahsan Numan Mar 2024

Role Of Minimal F-Wave Latency In The Electrodiagnosis Of Polyneuropathy, Areeba Qaiser, Safia Bano, Muhammad Imran Khan, Ahsan Numan

Pakistan Journal of Neurological Sciences (PJNS)

ABSTRACT

Background and Objective:

Polyneuropathy is a debilitating condition that causes damage to more than two peripheral nerves in the body. The objective of this research was to detect the role of minimal F-wave latency as compared with other nerve conduction parameters for the electro-diagnosis of polyneuropathies.

Methods:

In this descriptive, prospective cross-sectional study, 80 consecutive patients with clinical diagnosis of polyneuropathy (both acute and chronic) between July and December 2023, presenting to the Neurology Department at King Edward Medical University were enrolled. Patients with clinical diagnosis of cervical/lumbar radiculopathies, plexopathies, compressive myelopathy , neuromuscular junction diseases, motor neuron disorders, …


Analyzing The Impact Of Pulse Steroid Therapy On Relapse Rates And Disease Progression In Relapsing-Remitting Multiple Sclerosis: A Comprehensive Retrospective Study, Sana Ghous, Anjlee Shankar, Abdul Rahman Soomro, Abdul Qadir Baloch, Asif Ali, Alam Ibrahim Siddiqui Mar 2024

Analyzing The Impact Of Pulse Steroid Therapy On Relapse Rates And Disease Progression In Relapsing-Remitting Multiple Sclerosis: A Comprehensive Retrospective Study, Sana Ghous, Anjlee Shankar, Abdul Rahman Soomro, Abdul Qadir Baloch, Asif Ali, Alam Ibrahim Siddiqui

Pakistan Journal of Neurological Sciences (PJNS)

ABSTRACT

Background and Objective:

Relapsing remitting MS (RRMS) is characterized by recurrent relapses with remissions. Over an extended time-frame, high-dose steroid administration has primarily centered on the treatment of acute relapses, rather than relapse prevention. The objective of this retrospective study is to assess the long-term impact of administering three monthly pulse steroid therapy for three days on relapse rates and the Expanded Disability Status Scale (EDSS) scores in patients with RRMS.

Methods:

This study was conducted at Neurology ward of Chandka Medical College Hospital in Larkana from January 2021 to January 2023. A retrospective analysis of historical patient data, …


Abdominal Aortic Aneurysms And Platelets: Infiltration, Inflammation, And Elastin Disintegration, Bowen Li, Hong S. Lu, Alan Daugherty Mar 2024

Abdominal Aortic Aneurysms And Platelets: Infiltration, Inflammation, And Elastin Disintegration, Bowen Li, Hong S. Lu, Alan Daugherty

Saha Cardiovascular Research Center Faculty Publications

No abstract provided.


The Internist's Post V.1 N.1, The University Of Texas Rio Grande Valley. School Of Medicine, Diana Othon Martinez, Roque Mifuji Lira, Jian Garcia Cruz, Edgar Dorsey Trevino, Eunbee Cho Mar 2024

The Internist's Post V.1 N.1, The University Of Texas Rio Grande Valley. School Of Medicine, Diana Othon Martinez, Roque Mifuji Lira, Jian Garcia Cruz, Edgar Dorsey Trevino, Eunbee Cho

School of Medicine Publications

No abstract provided.


Anatomic Factors Associated With Degeneration And Fraying Of The Coracoacromial Ligament, Ryan Lopez, Jaspal Singh, Mohammad Ghoraishian, Thema Nicholson, Stephen Gates, Surena Namdari Mar 2024

Anatomic Factors Associated With Degeneration And Fraying Of The Coracoacromial Ligament, Ryan Lopez, Jaspal Singh, Mohammad Ghoraishian, Thema Nicholson, Stephen Gates, Surena Namdari

Rothman Institute Papers

BACKGROUND: The coracoacromial ligament (CAL) is frequently observed to be damaged during arthroscopy and it is unclear how demographic, anatomic, and radiographic factors are related to CAL degeneration in full-thickness rotator cuff tears.

METHODS: A prospective study was conducted of patients at a single institution undergoing shoulder arthroscopy for first-time, full-thickness rotator cuff tears. We evaluated preoperative anteroposterior radiographs to obtain critical shoulder angle, glenoid inclination, acromial index, acromiohumeral distance, lateral acromial angle, and acromial morphology. We documented CAL quality, rotator cuff tear size and pattern during arthroscopy. Multiple logistic regression was used to identify predictive factors for encountering severe …


Surgical Site Infections Post Cesarean Section And Associated Risk Factors: A Retrospective Case-Control Study At A Tertiary Hospital In Kenya., David Odada, Jasmit Shah, Annastacia Mbithi, Reena Shah Mar 2024

Surgical Site Infections Post Cesarean Section And Associated Risk Factors: A Retrospective Case-Control Study At A Tertiary Hospital In Kenya., David Odada, Jasmit Shah, Annastacia Mbithi, Reena Shah

School of Nursing & Midwifery, East Africa

Background: Surgical site infection is a common healthcare-associated infection that affects maternal health, yet it can be prevented or controlled. Caesarian sections are most likely to develop surgical site infections. The rates of delivery by caesarian section in reported to be higher that the acceptable rates in some healthcare facilities. Risk factors for surgical site infections can be identified and modified to reduce the occurrence of surgical site infections. This study aims to determine the risk factors that contribute to surgical site infections post caesarian section in a tertiary teaching hospital in Kenya.

Methods: This was a retrospective case-control (1:2 …


Severe Stiff-Person Syndrome After Covid: The First Video-Documented Covid Exacerbation And Viral Implications, Marinos C. Dalakas Mar 2024

Severe Stiff-Person Syndrome After Covid: The First Video-Documented Covid Exacerbation And Viral Implications, Marinos C. Dalakas

Department of Neurology Faculty Papers

OBJECTIVES: To describe a patient with mild GAD-positive stiff-leg syndrome (SLS) who developed severely disabling stiff-person syndrome (SPS) 1 week after mild COVID-19 and discuss the impact of viral implications.

METHODS: Video-documented serial clinical observations at baseline, after acute COVID-19, and after IVIG treatments.

RESULTS: A 39-year-old man with left-SLS was stable during a 2-year follow-up with low-dose antispasmodics, working fully and functioning normally, even able to run. One week after mild COVID-19, he started to experience generalized SPS symptomatology that steadily worsened the following 2-3 weeks, becoming unable to walk, requiring a walker, with significant thoracolumbar and bilateral leg …


Midterm Outcomes Of Suture Anchor Fixation For Displaced Olecranon Fractures, Michael Gutman, Jacob Kirsch, Jonathan Koa, Mohamad Fares, Joseph Abboud Mar 2024

Midterm Outcomes Of Suture Anchor Fixation For Displaced Olecranon Fractures, Michael Gutman, Jacob Kirsch, Jonathan Koa, Mohamad Fares, Joseph Abboud

Department of Orthopaedic Surgery Faculty Papers

BACKGROUND: Displaced olecranon fractures constitute a challenging problem for elbow surgeons. The purpose of this study is to evaluate the role of suture anchor fixation for treating patients with displaced olecranon fractures.

METHODS: A retrospective review was performed for all consecutive patients with displaced olecranon fractures treated with suture anchor fixation with at least 2 years of clinical follow-up. Surgical repair was performed acutely in all cases with nonmetallic suture anchors in a double-row configuration utilizing suture augmentation via the triceps tendon. Osseous union and perioperative complications were uniformly assessed.

RESULTS: Suture anchor fixation was performed on 17 patients with …


Functional Movement Disorders: Understanding, Approach And Diagnosis, Hudaibiya Ayub, Talbiya Ayub, Rasheed Azhar Mar 2024

Functional Movement Disorders: Understanding, Approach And Diagnosis, Hudaibiya Ayub, Talbiya Ayub, Rasheed Azhar

Pakistan Journal of Neurological Sciences (PJNS)

ABSTRACT

This commentary offers a comprehensive examination of Functional Movement Disorders (FMD) and explores recent advancements in our understanding and treatment of these intricate syndromes. FMDs challenge clinicians due to their variable nature and diverse clinical presentations, often intertwined with psychological factors. Impairments in motor intention and agency must be considered when providing care. Recognizing that non-motor symptoms can have a major impact on a patient's quality of life is equally important. Recognizing FMDs as multi-faceted conditions requiring multidisciplinary care allows consideration of cognitive, social, and demographic aspects.


Hypertonic Saline For Ischemic Stroke: A Review, Rameen Ata Bajwa, Angelina Jessani, Hanan Farzand Raja, Bisma Aziz Mar 2024

Hypertonic Saline For Ischemic Stroke: A Review, Rameen Ata Bajwa, Angelina Jessani, Hanan Farzand Raja, Bisma Aziz

Pakistan Journal of Neurological Sciences (PJNS)

ABSTRACT

Background and objective:

Elevated intracranial pressure (ICP) is a critical complication of ischemic stroke. This review article summarizes existing literature pertaining to the role of hypertonic saline (HTS) in lowering ICP in ischemic stroke patients.

Methods:

Studies were selected using a comprehensive search of several research databases. Studies conducted in adult (aged 18 and older) human patients receiving HTS osmotherapy for elevated ICP were included, encompassing a wide range of neurological conditions and various administration methods, durations, and concentrations of HTS.

Results:

We found HTS to reduce ICP in ischemic stroke patients, on par effectively, and in some studies, …


Of Hearth And Home: Professional Wellness After Hours, Timothy J. Ainger, Meriem Bensalem-Owen, Joanna Fong-Isariyawongse, Matthew William Luedke Mar 2024

Of Hearth And Home: Professional Wellness After Hours, Timothy J. Ainger, Meriem Bensalem-Owen, Joanna Fong-Isariyawongse, Matthew William Luedke

Neurology Faculty Publications

Burnout is a prevalent problem in the contemporary practice of medicine. Defined by the Agency for Healthcare Research and Quality as, “a long-term stress reaction marked by emotional exhaustion, depersonalization, and a lack of sense of personal accomplishment,” this multifactorial condition has significant implications for the clinicians who suffer it, their patients, and families. Neurologists suffer some of the highest rates of burnout. Burnout research on interventions often focus on the work environment. In this article, we will focus on burnout’s effects on home life and features of home life that can impact resiliency, specifically sleep hygiene.


Mnemonic Utilization In Stroke Education: Fast And Befast Adoption By Certified Comprehensive Stroke Centers, Christopher Hogge, Larry B. Goldstein, Sushanth R. Aroor Mar 2024

Mnemonic Utilization In Stroke Education: Fast And Befast Adoption By Certified Comprehensive Stroke Centers, Christopher Hogge, Larry B. Goldstein, Sushanth R. Aroor

Neurology Faculty Publications

Introduction: Symptom recognition and timely access to treatment are critical components of acute stroke care systems. Two mnemonics widely used in public educational campaigns for recognizing stroke symptoms include FAST (Face-Arm-Speech-Time) and BEFAST (Balance-Eyes-Face-Arm Speech-Time). The FAST mnemonic can miss up to 14% of strokes. BEFAST includes common posterior circulation stroke symptoms and has been implemented by several Comprehensive Stroke Centers (CSCs).

Methods: We sought to analyze the pattern of public educational materials available on the websites of US CSCs. The Joint Commission (JC) quality check website compiles a list containing the names and locations of the country’s 217 JC-certified …


A Case Of Parkinsonian Symptoms Secondary To Chronic Subdural Hematoma, Willbroad Kyejo, Frank Swai, Clement Mugisha, Philip Adebayo Mar 2024

A Case Of Parkinsonian Symptoms Secondary To Chronic Subdural Hematoma, Willbroad Kyejo, Frank Swai, Clement Mugisha, Philip Adebayo

Internal Medicine, East Africa

Chronic subdural hematoma is a known neurosurgical entity often associated with a spectrum of neurological manifestations. While primarily recognized for its characteristic accumulation of blood between the dura mater and arachnoid membrane, emerging literature suggests a rare association between chronic subdural hematoma and Parkinsonian symptoms. This report aims to underscore this unique neurological relationship by presenting a case of a 70-year-old male who developed Parkinsonism following chronic subdural hematoma post-head trauma. This case underscores the rare association between chronic subdural hematoma and Parkinsonian symptoms, emphasizing the importance of timely diagnosis and intervention in managing such cases.


Systolic Hypertension As Side Effect Of Topical Low Dose Atropine Drops, Barry Wasserman, Erik Massenzio, Karen Lee, David Plager Mar 2024

Systolic Hypertension As Side Effect Of Topical Low Dose Atropine Drops, Barry Wasserman, Erik Massenzio, Karen Lee, David Plager

Wills Eye Hospital Papers

PURPOSE: To present a case of increased systemic hypertension and pupil dilation related to low dose atropine eyedrops.

OBSERVATIONS: A thirteen-year-old male with progressive myopia received atropine 0.05% ophthalmic drops to slow down myopia progression. He exhibited systemic systolic hypertension, photophobia, and bilateral nonreactive mydriasis. The atropine drops were discontinued, and his blood pressure and pupillary function normalized.

CONCLUSIONS AND IMPORTANCE: This case demonstrates sensitivity to low dose atropine with increased systemic blood pressure and pupillary dilation.


Heated Tobacco Product Iqos Induces Unique Metabolic Signatures In Human Bronchial Epithelial Cells, Erin O. Curley, Omran Abu Aboud, Kenneth J. Chmiel, Ajay P. Nayak, Oliver Fiehn, Amir A. Zeki, Pawan Sharma Mar 2024

Heated Tobacco Product Iqos Induces Unique Metabolic Signatures In Human Bronchial Epithelial Cells, Erin O. Curley, Omran Abu Aboud, Kenneth J. Chmiel, Ajay P. Nayak, Oliver Fiehn, Amir A. Zeki, Pawan Sharma

Center for Translational Medicine Faculty Papers

Metabolic signatures are lacking for heated tobacco products, making it crucial to identify new biosignatures of lung damage. This will enable the establishment of product-specific guidelines and an understanding of associated toxicity.


Global Trend In Exosome Isolation And Application: An Update Concept In Management Of Diseases, Mohammadhassan Omrani, Hanieh Beyrampour-Basmenj, Rana Jahanban-Esfahlan, Mahnaz Talebi, Mortaza Raeisi, Zeinab Aliyari Serej, Naeimeh Akbar-Gharalari, Sina Khodakarimi, Jiaqian Wu, Abbas Ebrahimi-Kalan Mar 2024

Global Trend In Exosome Isolation And Application: An Update Concept In Management Of Diseases, Mohammadhassan Omrani, Hanieh Beyrampour-Basmenj, Rana Jahanban-Esfahlan, Mahnaz Talebi, Mortaza Raeisi, Zeinab Aliyari Serej, Naeimeh Akbar-Gharalari, Sina Khodakarimi, Jiaqian Wu, Abbas Ebrahimi-Kalan

Faculty, Staff and Student Publications

Extracellular vesicles (EVs) secreted by various cells offer great potential for use in the diagnosis and treatment of disease. EVs are heterogeneous membranous vesicles. Exosomes are a subtype of EVs, 40-150 nm spherical vesicles with a lipid layer derived from endosomes. Exosomes, which are involved in signal transduction and maintain homeostasis, are released from almost all cells, tissues, and body fluids. Although several methods exist to isolate and characterize EVs and exosomes, each technique has significant drawbacks and limitations that prevent progress in the field. New approaches in the biology of EVs show great potential for isolating and characterizing EVs, …


Incidental Ring-Hyperenhancing Liver Micronodules At Ct Hepatic Arteriography-Guided Percutaneous Thermal Ablation Of Colorectal Liver Metastases, Jessica Albuquerque, Yuan-Mao Lin, Iwan Paolucci, Caleb S O'Connor, Ching-Wei Tzeng, Jean-Nicolas Vauthey, Kristy K Brock, Bruno C Odisio Mar 2024

Incidental Ring-Hyperenhancing Liver Micronodules At Ct Hepatic Arteriography-Guided Percutaneous Thermal Ablation Of Colorectal Liver Metastases, Jessica Albuquerque, Yuan-Mao Lin, Iwan Paolucci, Caleb S O'Connor, Ching-Wei Tzeng, Jean-Nicolas Vauthey, Kristy K Brock, Bruno C Odisio

Faculty, Staff and Student Publications

CT during hepatic arteriography (CTHA) is a highly sensitive imaging method for detecting colorectal liver metastases (CLMs), which supports its use during percutaneous thermal liver ablation. In contrast to its high sensitivity, its specificity for incidental small CLMs not detected at preablation cross-sectional imaging is believed to be low given the absence of specific imaging signatures and the common presence of pseudolesions. In this retrospective study of 22 patients (mean age, 55 years ± 10.6 [SD]; 63.6% male, 36.4% female) with CLMs undergoing CTHA-guided microwave percutaneous thermal ablation between November 2017 and October 2022, the authors provided a definition of …