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Articles 2281 - 2310 of 8083
Full-Text Articles in Medical Specialties
Construct And Predictive Validity Of The Kansas City Cardiomyopathy Questionnaire In Adult Congenital Heart Disease, Ryan D Byrne, Ajith P Nair, Stephen J Dolgner, Swati Choudhry, Edward J Hickey, Alexis C Wood, Savitri Fedson, Biykem Bozkurt, Christopher R Broda
Construct And Predictive Validity Of The Kansas City Cardiomyopathy Questionnaire In Adult Congenital Heart Disease, Ryan D Byrne, Ajith P Nair, Stephen J Dolgner, Swati Choudhry, Edward J Hickey, Alexis C Wood, Savitri Fedson, Biykem Bozkurt, Christopher R Broda
Faculty, Staff and Students Publications
Background: The Kansas City Cardiomyopathy Questionnaire (KCCQ) is an Food and Drug Administration-approved health status measure for patients with heart failure (HF) but has not been directly assessed in adult congenital heart disease (ACHD).
Objectives: This study evaluates construct and predictive validity of the KCCQ in ambulatory ACHD patients.
Methods: We performed cross-sectional and prospective cohort studies of ACHD patients who completed the KCCQ to assess construct and predictive validity, respectively. KCCQ scores were compared across ACHD complexity categories, disease characteristics and physiologic failure, and within 2 primary composite outcomes: death or all-cause hospitalization (DH) and death or interventional cardiac …
Epidemiology Of Shoulder Dislocations In The United States From 1990 To 2019: A Temporal Study Using The Global Burden Of Disease Database., Gabrielle Dykhouse, Ambrose Loc T Ngo, Phillip C Mckegg, Peter B Spencer, Arsalaan Sayyed, Taylor J Manes, Morgan Turnow, Nathaniel Long
Epidemiology Of Shoulder Dislocations In The United States From 1990 To 2019: A Temporal Study Using The Global Burden Of Disease Database., Gabrielle Dykhouse, Ambrose Loc T Ngo, Phillip C Mckegg, Peter B Spencer, Arsalaan Sayyed, Taylor J Manes, Morgan Turnow, Nathaniel Long
Surgery Articles
Introduction The shoulder joint is a common site for joint dislocation, with many individuals suffering from recurrent dislocations following treatment. The purpose of this study was to evaluate the epidemiology of shoulder dislocations in the United States from 1990 to 2019. Methods The Global Burden of Disease database was utilized to collect epidemiological data on shoulder dislocations in the United States (U.S.) from 1990 to 2019. These data included age-standardized rates of years lived with disability (YLDs), prevalence rates, and incidence rates per 100,000 people. Using the U.S. Census Bureau definitions, the data were stratified into four regions: the Northeast, …
Reconstruction Of A Pelvic Nonunion Secondary To Metastatic Breast Cancer And Palliative Radiation., Ronald Peirish, Landon Reading, Cesar Cereijo
Reconstruction Of A Pelvic Nonunion Secondary To Metastatic Breast Cancer And Palliative Radiation., Ronald Peirish, Landon Reading, Cesar Cereijo
Surgery Articles
Pathologic pelvic nonunions are uncommon, although they remain a difficult problem and require meticulous surgical planning and execution for desired outcomes. In this paper, we discuss a patient who sustained a pathologic pelvic insufficiency fracture secondary to radiation therapy for metastatic breast cancer, who subsequently developed a symptomatic nonunion that required surgical intervention secondary to debilitating pain and inability to ambulate. We also discuss the classification of insufficiency fractures of the pelvis to guide treatment, in addition to complications associated with surgical intervention. A 51-year-old female with a 12-year history of metastatic breast cancer. She presented to an outside facility …
Elbow Interpositional Arthroplasty Using An Achilles Tendon Allograft: A Case Report., Matthew Glazier, Morgan Turnow, Hunter Pharis, Taylor Manes, Hayden Schuette, Stephen Wiseman
Elbow Interpositional Arthroplasty Using An Achilles Tendon Allograft: A Case Report., Matthew Glazier, Morgan Turnow, Hunter Pharis, Taylor Manes, Hayden Schuette, Stephen Wiseman
Surgery Articles
INTRODUCTION: The treatment of post-traumatic elbow arthritis poses a significant challenge for orthopedic surgeons, especially in young active patients. Total elbow arthroplasty is often the recommended treatment option in older patients; however, interpositional arthroplasty remains a viable option in high-demand patients.
CASE REPORT: We report a case of a 50-year-old male who presented after the development of post-traumatic arthritis of the elbow after multiple prior surgeries. He was treated with an interpositional arthroplasty using an Achilles tendon graft and allowed immediate range of motion as tolerated in a hinged elbow brace without the use of any form of distraction external …
Optimising Exercise For Managing Chemotherapy-Induced Peripheral Neuropathy In People Diagnosed With Cancer, Dhiaan Sidhu, Jodie Cochrane Wilkie, Jena Buchan, Kellie Toohey
Optimising Exercise For Managing Chemotherapy-Induced Peripheral Neuropathy In People Diagnosed With Cancer, Dhiaan Sidhu, Jodie Cochrane Wilkie, Jena Buchan, Kellie Toohey
Research outputs 2022 to 2026
Background: Chemotherapy-induced peripheral neuropathy is a common and debilitating side effect of cancer treatment. While exercise has shown promise in alleviating this burden, it remains underutilised in clinical practice due to the lack of accessible, clinician-friendly guidance. Aim: This review aimed to synthesise current evidence on exercise interventions for managing chemotherapy-induced peripheral neuropathy and provide practical insights to support clinicians in integrating these approaches into patient care. Methods: A search was conducted across MEDLINE, CINAHL, and SPORTDiscus using keywords related to exercise and CIPN. Studies were included if they involved adults receiving neurotoxic chemotherapy and exercise-based interventions. Two authors independently …
Exploring Behavioural Motivations Of Treatment Refusal In Cancer: A Q-Methodological Approach, Ruby Koyllor A. Gleeson, Nicolas H. Hart, Darren Haywood, Frank D. Baughman
Exploring Behavioural Motivations Of Treatment Refusal In Cancer: A Q-Methodological Approach, Ruby Koyllor A. Gleeson, Nicolas H. Hart, Darren Haywood, Frank D. Baughman
Research outputs 2022 to 2026
Background: Cancer treatment refusal is known to lower survival rates and increase cancer symptoms in individuals with cancer. Behavioural motivations of treatment refusal need to be elucidated for better cancer care. Using Q-methodology, a mixed methods research approach, we explored behavioural motivations of treatment refusal in individuals diagnosed with cancer. Method: Thirty-nine individuals (n = 39; age = 49.2 ± 12.2 years) were recruited from Australia, the UK, and the USA, who had refused cancer treatment within the past decade. Participants completed an online demographic questionnaire and a Q-sort activity which required the organisation and ranking of 44 statements on …
Multivariate Optical Imaging Of The Oxygen-Metabolism Axis, Jesse D. Ivers
Multivariate Optical Imaging Of The Oxygen-Metabolism Axis, Jesse D. Ivers
Graduate Theses and Dissertations
Metabolic reprogramming is a characteristic hallmark of multiple pathologies and promotes disease progression, survival, and severity. Current methods to investigate metabolic reprogramming, however, require reductions of dimensionality both because of instrumentation limitations and analysis tools. This work aims to define a blueprint for high dimensional study of the oxygen metabolism axis to enable more sensitive study metabolic reprogramming. We hypothesized (1) multivariate imaging of metabolic and oxygenation metrics in ex vivo tissue sections would elucidate differences in resistant and sensitive head and neck squamous cell carcinoma (HNSCC) xenografts that traditional uni-variate methods miss and (2) an engineered hyperspectral darkfield microscopy …
Changes In Post-Transplant Serum Testosterone Levels In Men Undergoing Lung Transplantation: A Pilot Study Using The Trinetx Research Network, Austin Thompson, Danly Omil-Lima, Jaime Abraham Perez, Erin Jesse, Mohit Khera, Kenneth Chavin, Nannan Thirumavalavan
Changes In Post-Transplant Serum Testosterone Levels In Men Undergoing Lung Transplantation: A Pilot Study Using The Trinetx Research Network, Austin Thompson, Danly Omil-Lima, Jaime Abraham Perez, Erin Jesse, Mohit Khera, Kenneth Chavin, Nannan Thirumavalavan
Faculty, Staff and Students Publications
Hypogonadism is understudied in men requiring solid organ transplants, particularly among lung transplant recipients. Improvement in serum testosterone levels has been reported in kidney and liver transplantation. Using the TriNetX Research Network, we performed a retrospective cohort study to evaluate the incidence of peri-transplant hypogonadism and the natural course of serum testosterone following successful lung transplantation. Men aged ≥ 18 with a lung transplant and total testosterone drawn within one year pre- and post-transplant were included. Men with receipt of testosterone therapy were excluded. A low testosterone (< 300 ng/dL) and normal testosterone (≥300 ng/dL) cohort was created before employing descriptive and analytic statistics to investigate the incidence of peri-transplant hypogonadism and the change in serum testosterone levels following lung transplantation. In our entire cohort, lung transplantation was not associated with a significant increase in post-transplant serum testosterone (329.86 ± 162.56 ng/dL pre-transplant and 355.13 ± 216.11 ng/dL post-transplant, p = 0.483). The number of men with low testosterone decreased by 9.8% following lung transplantation but was not significant, p = 0.404. In this pilot study, no significant change in the number of hypogonadal men nor serum testosterone levels was observed among men undergoing lung transplantation.
Global Cardiac Anesthesia Workforce Assessment: A Cross-Sectional Observational Survey Study, Alexander J C Mittnacht, Carolina S Romero Garcia, Joshua B Cadwell, Jiapeng Huang, Iwan Sofjan, Mohamed R Eltahan, Hong Liu, Chirojit Mukherjee, Fabio Guarracino, Andrew Shaw, Pablo Motta, International Academy Of Cardiac Anaesthesiologists (Iaca) Global Survey Team
Global Cardiac Anesthesia Workforce Assessment: A Cross-Sectional Observational Survey Study, Alexander J C Mittnacht, Carolina S Romero Garcia, Joshua B Cadwell, Jiapeng Huang, Iwan Sofjan, Mohamed R Eltahan, Hong Liu, Chirojit Mukherjee, Fabio Guarracino, Andrew Shaw, Pablo Motta, International Academy Of Cardiac Anaesthesiologists (Iaca) Global Survey Team
Faculty, Staff and Students Publications
Objective: The primary aim of this survey was to assess the demographics, training background, practice setting, and work environment of cardiac anesthesiologists globally.
Design: Cross-sectional study of the global cardiac anesthesia workforce. A multilingual web-based survey was conducted between June 1 and December 31, 2023.
Setting: The survey was distributed via cardiac anesthesia societies, special interest groups, and social media using a non-probabilistic sample and with snowballing techniques.
Participants: Anesthesiologists actively practicing cardiac anesthesia.
Interventions: None.
Measurements and main results: In total, 3,430 participants from 99 countries responded. Results were summarized as descriptive data comparing geographical regions, and noticeable differences …
Experiences Of The Emergency Department Environment: A Qualitative Study With Caregivers Of People With Dementia, Anita N Chary, Michelle Suh, Annika Bhananker, Norvin Hernandez, Ana Paulina Rivera, Ed Boyer, Mark E Kunik, Manish N Shah, Christine Ritchie, Aanand D Naik, Shan W Liu, Maura Kennedy
Experiences Of The Emergency Department Environment: A Qualitative Study With Caregivers Of People With Dementia, Anita N Chary, Michelle Suh, Annika Bhananker, Norvin Hernandez, Ana Paulina Rivera, Ed Boyer, Mark E Kunik, Manish N Shah, Christine Ritchie, Aanand D Naik, Shan W Liu, Maura Kennedy
Faculty, Staff and Students Publications
ED crowding and boarding adversely impact older patients' care and outcomes. Little is known about how ED crowding impacts persons living with dementia, a vulnerable population. This study sought to explore ED experiences of caregivers of people with dementia during a period of ED crowding and boarding. We performed semi-structured interviews with caregivers of people with dementia with an ED visit during a period of ED crowding and boarding at two public hospitals experiencing a threefold increase in boarding from pre-pandemic levels. Participants were recruited via chart review. We coded data using an inductive approach. Three themes emerged from 29 …
Outcomes And Resource Utilization In Hyperkalemic Emergency Department Patients Treated With Patiromer Or Sodium Zirconium Cyclosilicate, William Frank Peacock, Zubaid Rafique, Julie Gayle, James Neuenschwander, Harold Brown, Jennifer Kammerer, Jeffrey Budden, Ning Rosenthal
Outcomes And Resource Utilization In Hyperkalemic Emergency Department Patients Treated With Patiromer Or Sodium Zirconium Cyclosilicate, William Frank Peacock, Zubaid Rafique, Julie Gayle, James Neuenschwander, Harold Brown, Jennifer Kammerer, Jeffrey Budden, Ning Rosenthal
Faculty, Staff and Students Publications
OBJECTIVES: Hyperkalemia (HK) is a life-threatening condition commonly treated in emergency department (ED). Real-world outcomes associated with ED administration of potassium binders are limited. This study assessed ED discharge disposition and resource utilization in hyperkalemic ED patients treated with patiromer or sodium zirconium cyclosilicate (SZC).
METHODS: We performed a retrospective cohort study using discharge data from 230 hospitals in the Premier PINC AI Healthcare Database. ED patients were included if they were ≥18 years old, had potassium ≥5 mEq/L, and received patiromer/SZC during January 1, 2019 to December 31, 2021. Descriptive statistics and multivariable logistic regression analysis were used to …
Are There Rural-Urban Disparities In Cardiovascular Disease Hospitalization And Other Outcomes In People With Gout? A Nationwide Us Study, Jasvinder A Singh, Sumanth R Chandrupatla
Are There Rural-Urban Disparities In Cardiovascular Disease Hospitalization And Other Outcomes In People With Gout? A Nationwide Us Study, Jasvinder A Singh, Sumanth R Chandrupatla
Faculty, Staff and Students Publications
Objective: The objective of this study was to assess whether rural vs urban patient residence is associated with the risk of myocardial infarction (MI) hospitalization and other outcomes in people with gout.
Methods: We used the 2016-2019 U.S. National Inpatient Sample (NIS) database to assess whether rural patient residence is associated with a higher risk of MI hospitalizations in gout, while adjusting for demographics (age, sex, race), comorbidity, median household income, insurance payer, and hospital characteristics (location and teaching status, bed size, hospital control, and hospital region). We calculated adjusted odds ratios (aORs) and 95% CIs (CIs).
Results: We found …
Standard Cardiovascular Risk Prediction Scores Underestimate Risk In Immune-Mediated Thrombotic Thrombocytopenic Purpura Survivors, Binish Javed, Jenna Brown, Jay Meade, Vijay Nambi, Ang Li, Shruti Chaturvedi, Senthil Sukumar
Standard Cardiovascular Risk Prediction Scores Underestimate Risk In Immune-Mediated Thrombotic Thrombocytopenic Purpura Survivors, Binish Javed, Jenna Brown, Jay Meade, Vijay Nambi, Ang Li, Shruti Chaturvedi, Senthil Sukumar
Faculty, Staff and Students Publications
Background: Immune-mediated thrombotic thrombocytopenic purpura (iTTP) is a rare hematologic disorder with improved survival due to advancements in treatment. However, long-term cardiovascular morbidity and mortality remain significant. Established cardiovascular risk calculators, such as the 2008 Framingham Heart Study (FHS) global cardiovascular disease (CVD) and the American College of Cardiology/American Heart Association (ACC/AHA) atherosclerotic CVD (ASCVD) risk estimators, may not adequately account for the elevated and unique cardiovascular risks in iTTP survivors.
Objectives: To evaluate the discrimination and calibration of the ACC/AHA ASCVD and FHS global CVD models in predicting major adverse cardiovascular events (MACEs) among iTTP survivors.
Methods: This retrospective …
Stool-Based Molecular Tuberculosis Treatment Monitoring: A Faster Means For Detecting Persistent Mycobacteria Compared To Phenotypic Culture, Clement Gascua Adu Gyamfi, Abigail Seeger, Durbbin Mulengwa, Anca Vasiliu, Lucia Carratala-Castro, Bariki Mtafya, Nontobeko Maphalala, Shilzia Munguambe, Belen Saavedra, Tara Ness, Gugu Maphalala, Sozinho Acacio, Edson Mambuque, Joanna Ehrlich, Rojelio Mejia, Mangaliso Ziyane, H Lester Kirchner, Christoph Lange, Alexander Kay, Alberto L Garcia-Basteiro, Anna Mandalakas, Andrew R Dinardo
Stool-Based Molecular Tuberculosis Treatment Monitoring: A Faster Means For Detecting Persistent Mycobacteria Compared To Phenotypic Culture, Clement Gascua Adu Gyamfi, Abigail Seeger, Durbbin Mulengwa, Anca Vasiliu, Lucia Carratala-Castro, Bariki Mtafya, Nontobeko Maphalala, Shilzia Munguambe, Belen Saavedra, Tara Ness, Gugu Maphalala, Sozinho Acacio, Edson Mambuque, Joanna Ehrlich, Rojelio Mejia, Mangaliso Ziyane, H Lester Kirchner, Christoph Lange, Alexander Kay, Alberto L Garcia-Basteiro, Anna Mandalakas, Andrew R Dinardo
Faculty, Staff and Students Publications
Background: Tuberculosis (TB) treatment monitoring is hindered by the lack of a rapidly measured biomarker that accurately predicts clinically relevant outcomes. Symptom screening poorly correlates with bacillary burden. Although culture is a direct measure of viable bacillary burden, the long turnaround time makes it clinically irrelevant.
Methods: The TB treatment monitoring potential of stool-based, quantitative polymerase chain reaction (qPCR) was prospectively assessed among 231 participants of all ages from Eswatini, Tanzania, and Mozambique with microbiologically confirmed TB. Stool qPCR results were compared to sputum culture, persistent symptoms, drug resistance, and World Health Organization TB outcomes.
Results: Quantitative bacillary burden measured …
The Resilience Of The Human Lungs: Evolution, Smoke, And Disease, Joan B Soriano, Francesca Polverino
The Resilience Of The Human Lungs: Evolution, Smoke, And Disease, Joan B Soriano, Francesca Polverino
Faculty, Staff and Students Publications
No abstract provided.
Molecular Maestro In The Lung: The Sphingolipid Rheostat, Joselyn Rojas-Quintero, Francesca Polverino
Molecular Maestro In The Lung: The Sphingolipid Rheostat, Joselyn Rojas-Quintero, Francesca Polverino
Faculty, Staff and Students Publications
No abstract provided.
Incidence, Predictors, And Indications Of Permanent Pacemaker Implantation Following Orthotopic Heart Transplantation: A Single-Center Experience, Iriagbonse Rotimi Asemota, Siddharth Das, Michelle Nsahlai, Edward Graviss, Duc T Nguyen, Paul A Schurmann, Rayan Yousefzai
Incidence, Predictors, And Indications Of Permanent Pacemaker Implantation Following Orthotopic Heart Transplantation: A Single-Center Experience, Iriagbonse Rotimi Asemota, Siddharth Das, Michelle Nsahlai, Edward Graviss, Duc T Nguyen, Paul A Schurmann, Rayan Yousefzai
Faculty, Staff and Students Publications
In the modern era of orthotopic heart transplantation (OHT) with bicaval anastomosis, there is a paucity of data on permanent pacemaker implantation (PPI) in this population. This is a retrospective study describing the incidence, indication, and predictors in patients who underwent PPI after OHT. Using the transplant database from our institution between January 2016 and December 2022, 370 patients who had de-novo OHT were identified. The incidence of PPI post-OHT was 8.1% (n = 30 patients). The average time from OHT to PPI was 30.5 days. The most common indication for PPI was sinus node dysfunction, accounting for 83% …
Plain Language Summary About Glp-1 Treatments In People With Metabolic Dysfunction-Associated Steatotic Liver Disease, Layla A Abushamat, Pir Ahmad Shah, Robert H Eckel, Stephen A Harrison, Diana Barb
Plain Language Summary About Glp-1 Treatments In People With Metabolic Dysfunction-Associated Steatotic Liver Disease, Layla A Abushamat, Pir Ahmad Shah, Robert H Eckel, Stephen A Harrison, Diana Barb
Faculty, Staff and Students Publications
No abstract provided.
Crispr-Cas9 Engineering Of Human T Regulatory Cells – Design And Optimization Of A Manufacturing Process, Ortal Shimon, Adam M Dean, Shoshana Cohen, Aiden L Moser, Clifford C Dacso, Yosi Gilad, David M Lonard, Bert W O'Malley
Crispr-Cas9 Engineering Of Human T Regulatory Cells – Design And Optimization Of A Manufacturing Process, Ortal Shimon, Adam M Dean, Shoshana Cohen, Aiden L Moser, Clifford C Dacso, Yosi Gilad, David M Lonard, Bert W O'Malley
Faculty, Staff and Students Publications
Regulatory T cells (Tregs) are a subset of CD4 + T cells that comprise 5-10 % of the total CD4 + T cell population. Tregs, which are critically important for the maintenance of immune tolerance and immune homeostasis, are distinguished from other subtypes of CD4 + T cells by the expression of the transcription factor FOXP3. Because of the centrality to immunoregulation, Tregs have gained increasing attention as promising targets for clinical applications in autoimmune diseases, transplant rejection and graft-versus-host disease (GvHD). However, the essential role of Tregs in the complex network of the immune system implies their targeting as …
A Simple, Interpretable Machine Learning Model Based On Clinical Factors Accurately Predicts Incident Dysplasia Or Malignancy In Barrett's Esophagus, Ashwin Rao, Jasmine Haydel, Samuel Ma, Aaron P Thrift, Theresa Nguyen-Wenker, Hashem B El-Serag
A Simple, Interpretable Machine Learning Model Based On Clinical Factors Accurately Predicts Incident Dysplasia Or Malignancy In Barrett's Esophagus, Ashwin Rao, Jasmine Haydel, Samuel Ma, Aaron P Thrift, Theresa Nguyen-Wenker, Hashem B El-Serag
Faculty, Staff and Students Publications
Purpose: Identifying patients likely to develop dysplasia or malignancy is critical for effective surveillance in patients with Barrett's Esophagus (BE). However, current predictive models are limited. We evaluated the performance of machine learning (ML) models in predicting incident dysplasia or malignancy in a cohort of veteran patients with BE.
Methods: We analyzed data from 598 patients newly diagnosed with non-dysplastic BE (NDBE), BE indefinite for dysplasia (BE-IND), and BE with non-persistent low-grade dysplasia (LGD) at the Michael DeBakey Veterans Affairs Medical Center from November 1990 to January 2019 with follow-up through January 2024. Progressors were patients who developed persistent LGD, …
Congestion And Sinonasal Illness In Outer Space: A Study On The International Space Station, Faizaan Khan, Koyal Ansingkar, Roshan Dongre, Zain Mehdi, Aatin K Dhanda, Kayla Powell, Tariq Syed, Samuel E Razmi, Isuru Somawardana, Jeffrey T Vrabec, David Hilmers, Omar G Ahmed, Masayoshi Takashima
Congestion And Sinonasal Illness In Outer Space: A Study On The International Space Station, Faizaan Khan, Koyal Ansingkar, Roshan Dongre, Zain Mehdi, Aatin K Dhanda, Kayla Powell, Tariq Syed, Samuel E Razmi, Isuru Somawardana, Jeffrey T Vrabec, David Hilmers, Omar G Ahmed, Masayoshi Takashima
Faculty, Staff and Students Publications
Objectives: This study aims to characterize quantitative data pertaining to sinonasal symptoms and their related medication use aboard the International Space Station (ISS). A secondary focus involves correlating these findings with mission parameters such as extravehicular activity (EVA) participation and mission duration.
Methods: This retrospective cohort study was conducted utilizing data requested from the National Aeronautics and Space Administration (NASA) Lifetime Surveillance of Astronaut Health (LSAH) program.
Results: Of 71 de-identified ISS astronauts beginning with Expedition 1 in the year 2000 through 62 in 2019, there were 754 logged medical events; 60 astronauts reported any type of sinonasal medical event …
An Electronic Trigger To Detect Telemedicine-Related Diagnostic Errors, Daniel R Murphy, Himabindu Kadiyala, Li Wei, Hardeep Singh
An Electronic Trigger To Detect Telemedicine-Related Diagnostic Errors, Daniel R Murphy, Himabindu Kadiyala, Li Wei, Hardeep Singh
Faculty, Staff and Students Publications
Introduction
The COVID-19 pandemic advanced the use of telehealth-facilitated care. However, little is known about how to measure safety of clinical diagnosis made through telehealth-facilitated primary care.Methods
We used the seven-step Safer Dx Trigger Tool framework to develop an electronic trigger (e-trigger) tool to identify potential missed opportunities for more timely diagnosis during primary care telehealth visits at a large Department of Veterans Affairs facility. We then applied the e-trigger algorithm to electronic health record data related to primary care visits during a 1-year period (1 April 2020–31 March 2021). The algorithm identified patients with unexpected visits within 10 …N-Acetylaspartate From Fat Cells Regulates Postprandial Body Temperature, Jessica B Felix, Pradip K Saha, Evelyn L De Groot, Lin Tan, Robert Sharp, Elizabeth S Anaya, Yafang Li, Holly Quang, Nooshin Saidi, Layla Abushamat, Christie M Ballantyne, Christopher I Amos, Philip L Lorenzi, Samuel Klein, Xia Gao, Sean M Hartig
N-Acetylaspartate From Fat Cells Regulates Postprandial Body Temperature, Jessica B Felix, Pradip K Saha, Evelyn L De Groot, Lin Tan, Robert Sharp, Elizabeth S Anaya, Yafang Li, Holly Quang, Nooshin Saidi, Layla Abushamat, Christie M Ballantyne, Christopher I Amos, Philip L Lorenzi, Samuel Klein, Xia Gao, Sean M Hartig
Faculty, Staff and Students Publications
N-acetylaspartate (NAA), the brain’s second most abundant metabolite, provides essential substrates for myelination through its hydrolysis1. However, the physiological roles of NAA in other tissues remain unknown. Here, we show that aspartoacylase (ASPA) expression in white adipose tissue (WAT) governs blood NAA levels for postprandial body temperature regulation. Genetic ablation of Aspa in mice resulted in systemically elevated NAA levels, and the ensuing accumulation in WAT stimulated pyrimidine production. Stable isotope tracing confirmed higher incorporation of glucose-derived carbon into pyrimidine metabolites in Aspa knockout cells. Additionally, serum NAA levels positively correlated with the abundance of the pyrimidine …
Developing Culturally Centered Outreach Materials For Rural Native Veterans, Alexandra B Caloudas, Kelley Arredondo, Gail Beauchamp, Sharon Anastas, Kathy Marchant-Miros, Kristen Frosio, Giselle Day, Katherine Bay, Stephanie Day, Jan Lindsay, Jay Shore
Developing Culturally Centered Outreach Materials For Rural Native Veterans, Alexandra B Caloudas, Kelley Arredondo, Gail Beauchamp, Sharon Anastas, Kathy Marchant-Miros, Kristen Frosio, Giselle Day, Katherine Bay, Stephanie Day, Jan Lindsay, Jay Shore
Faculty, Staff and Students Publications
Native Americans serve in the U.S. military at the highest rate per capita of any ethnoracial group and have elevated rates of mental health (MH) difficulties compared to other ethnoracial groups, including posttraumatic stress disorder, alcohol use disorders, and suicide. Almost half of Native Veterans live in rural areas; rurality is associated with significant barriers to MH services. Engaging in outreach with Native Veterans is an important pathway for connecting them with MH care, but the outreach process and educational materials must be culturally aligned to be more effective. We collaborated with partners at a rural Department of Veterans Affairs …
Hemorrhagic Gastropathy From Paclitaxel-Carboplatin Combination Chemotherapy, Kristeen Onyirioha, Maya Balakrishnan
Hemorrhagic Gastropathy From Paclitaxel-Carboplatin Combination Chemotherapy, Kristeen Onyirioha, Maya Balakrishnan
Faculty, Staff and Students Publications
A 58-year-old woman with endometrial cancer started on paclitaxel in combination with carboplatin chemotherapy, presented to the hospital with severe anemia and melena. An esophagogastroduodenoscopy with biopsies revealed diffuse gastric antrum hemorrhagic gastropathy without inflammatory changes. She had recurrent admissions with similar presentations during her chemotherapy. Her management included frequent blood transfusions, endoscopic Argon plasma coagulation to hemorrhagic lesions, and a prolonged course of proton pump inhibition to facilitate post-Argon plasma coagulation mucosal healing. Weeks after completing chemotherapy, her hemoglobin improved and recurrent upper gastrointestinal bleeding resolved. In this case, we identify a rare paclitaxel, in combination with carboplatin, associated …
Incidence Of And Risk Factors For Hospital-Acquired Bleeding In People With Cancer: A Systematic Review, Mansour Gergi, Jinah Kim, Amalia Dolan, Laura Haines, Ang Li, Neil A Zakai
Incidence Of And Risk Factors For Hospital-Acquired Bleeding In People With Cancer: A Systematic Review, Mansour Gergi, Jinah Kim, Amalia Dolan, Laura Haines, Ang Li, Neil A Zakai
Faculty, Staff and Students Publications
Background: Hospital-acquired (HA) bleeding (bleeding occurring during hospitalization) in cancer patients is poorly characterized, potentially increasing morbidity and mortality due to under- or overprescription of low-dose anticoagulation for venous thromboembolism prevention.
Objectives: To perform a systematic review and meta-analysis (as appropriate) to identify the incidence of and risk factors for HA bleeding in people with cancer.
Methods: A systematic English-language search was conducted using Ovid MEDLINE, Ovid EMBASE, Google Scholar, and Cochrane Library. Keywords and controlled vocabulary related to bleeding risk in hospitalized cancer patients were iteratively refined. Studies assessing HA bleeding as a primary or coprimary endpoint were included, …
Nephrostomy (Pcn) Versus Nephroureteral Stent (Double Jj); An Ongoing Battle, Mohammad Ghasemi-Rad, Kelly Trinh, David Wynne, Mohadese Ahmadzade, Muhammad Hamza Shamim, Omar Guerrero, Ashley Bancroft, Shreya Ranganath, David Leon
Nephrostomy (Pcn) Versus Nephroureteral Stent (Double Jj); An Ongoing Battle, Mohammad Ghasemi-Rad, Kelly Trinh, David Wynne, Mohadese Ahmadzade, Muhammad Hamza Shamim, Omar Guerrero, Ashley Bancroft, Shreya Ranganath, David Leon
Faculty, Staff and Students Publications
In the realm of medical procedures for urinary obstructions, a distinct division of roles is evident: the vast majority of percutaneous nephrostomies (PCNs) are the domain of Interventional Radiology (IR), while the placement of double J stents (JJ stents) falls squarely under Urology. This division, however, is not without its complexities. When confronted with a patient suffering from a urinary obstruction, the decision-making process can become intricate. The underlying cause often fuels the debate: should IR intervene with a PCN, or should Urology place a JJ stent? Such decisions have profound implications for the individual patient.In this comprehensive review, we …
Definitions Of Cardiogenic Shock And Indications For Temporary Mechanical Circulatory Support: Joint Consensus Report Of The Perioperative Quality Initiative And The Enhanced Recovery After Surgery Cardiac Society, Michael C Grant, Charles Scott Brudney, Jaime Hernandez-Montfort, Stephanie O Ibekwe, Amanda Rea, Christian Stoppe, Alexander Zarbock, Andrew D Shaw, Daniel T Engelman, Manreet K Kanwar, Perioperative Quality Initiative (Poqi) And The Enhanced Recovery After Surgery (Eras) Cardiac Society Workgroup
Definitions Of Cardiogenic Shock And Indications For Temporary Mechanical Circulatory Support: Joint Consensus Report Of The Perioperative Quality Initiative And The Enhanced Recovery After Surgery Cardiac Society, Michael C Grant, Charles Scott Brudney, Jaime Hernandez-Montfort, Stephanie O Ibekwe, Amanda Rea, Christian Stoppe, Alexander Zarbock, Andrew D Shaw, Daniel T Engelman, Manreet K Kanwar, Perioperative Quality Initiative (Poqi) And The Enhanced Recovery After Surgery (Eras) Cardiac Society Workgroup
Faculty, Staff and Students Publications
Background: The management of patients with cardiogenic shock (CS) is complex and resource intensive, particularly given the recent surge in temporary mechanical circulatory support (tMCS) devices. This document was created to establish an approach to the assessment of CS to provide early and targeted therapies, including tMCS.
Methods: An interdisciplinary, international panel of experts, using a structured appraisal of the literature and a modified Delphi method, derived consensus regarding the assessment of CS based on pathophysiologic severity, etiology, and phenotypic clustering to guide escalation of care as well as identify those patients who might benefit from tMCS.
Results: Key principles …
Notice-Ed: Nurse Or Technician Insights Into Cognitive Evaluations In The Emergency Department, Sarah J Nessen, Anita N Chary, Annika R Bhananker, K Jane Muir, Lauren T Southerland, Kyra O'Brien, Ari B Friedman
Notice-Ed: Nurse Or Technician Insights Into Cognitive Evaluations In The Emergency Department, Sarah J Nessen, Anita N Chary, Annika R Bhananker, K Jane Muir, Lauren T Southerland, Kyra O'Brien, Ari B Friedman
Faculty, Staff and Students Publications
Background: Several strategies have been proposed to increase chronic cognitive impairment (CI) screening in the emergency department (ED). Our goal was to assess the feasibility and acceptability of implementing specific CI screening tools and strategies in the ED from an ED registered nurse and technician perspective.
Methods: We performed a qualitative study using semi-structured interviews with a purposive sample of ED nurses and ED technicians (EDTs). Participants worked at an urban academic hospital and were interviewed between November 2023 and March 2024. Interviews assessed participants' opinions on the feasibility and acceptability of CI screening and the use of machine learning …
Community-Engaged Medical Student Elective To Improve Knowledge And Attitudes Toward Individuals With Intellectual And Developmental Disabilities, Kathryn J Kemere, Nital Appelbaum, Priya Chandan, Elisha Acosta
Community-Engaged Medical Student Elective To Improve Knowledge And Attitudes Toward Individuals With Intellectual And Developmental Disabilities, Kathryn J Kemere, Nital Appelbaum, Priya Chandan, Elisha Acosta
Faculty, Staff and Students Publications
Individuals with intellectual and developmental disabilities (IDD) face multiple barriers to inclusion throughout life. One barrier is the medical knowledge and biases of adult healthcare providers with diagnoses traditionally associated with childhood. Medical school curricula have limited content related to IDD, and students have limited opportunities to engage with community organizations during their clinical years. Methods: We created a one-month clinical elective to address medical students' attitudes and knowledge regarding individuals with IDD using experiential learning. Students saw adult patients in our primary care clinic with a variety of IDD diagnoses and spent 30% of their time at community sites …