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2025

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Articles 4471 - 4500 of 8091

Full-Text Articles in Medical Specialties

Technology Dependence Among Hospitalized Us Children., Emily J. Goodwin, Isabella Zaniletti, Margaret Wright, Matt Hall, Jeffrey D. Colvin May 2025

Technology Dependence Among Hospitalized Us Children., Emily J. Goodwin, Isabella Zaniletti, Margaret Wright, Matt Hall, Jeffrey D. Colvin

Manuscripts, Articles, Book Chapters and Other Papers

No abstract provided.


Successful Flexible Bronchoscopic Extraction Of A Dental Foreign Body Aspirated Into The Left Mainstem Bronchus, Alexys Bolden, Hayden Cooper, Lynnetta Payne, Mark Coomes, Mark Cooper Apr 2025

Successful Flexible Bronchoscopic Extraction Of A Dental Foreign Body Aspirated Into The Left Mainstem Bronchus, Alexys Bolden, Hayden Cooper, Lynnetta Payne, Mark Coomes, Mark Cooper

Marshall Journal of Medicine

Foreign body aspiration (FBA) is a potentially life-threatening emergency that commonly occurs in children but varies widely in clinical presentation. Rapid diagnosis and intervention are of the utmost importance to prevent complications such as airway obstruction, infection, and lung injury. While uncommon in adults, most encountered causes occur in the setting of intoxication, neuromuscular weakness, or iatrogenic dental work. Those with dental prostheses are especially susceptible due to the partially attached nature, rendering the risk of accidental dislodgement. This report discusses an uncommon case wherein an 82-year-old male aspirated a dental bridge into his left mainstem bronchus during routine dental …


From Molars To Bronchus; The Tale Of An Aspirated Dental Instrument, Yisroel Grabie, Sudeep Acharya, Fasih Sami Siddiqui, Gabriel A. Chavez Reyna, Michel Chalhoub Apr 2025

From Molars To Bronchus; The Tale Of An Aspirated Dental Instrument, Yisroel Grabie, Sudeep Acharya, Fasih Sami Siddiqui, Gabriel A. Chavez Reyna, Michel Chalhoub

HCA Healthcare Journal of Medicine

Background

Aspiration of dental instruments is a rare event that carries potentially serious complications when it occurs, especially in older patients, where protective reflexes are diminished. Clinical management may be difficult because of the risk of granulation tissue and different retrieval strategies according to the object’s characteristics. In this report, we describe the case of an 84-year-old man who aspirated a dental bur during a routine dental procedure, necessitating immediate intervention. Timely and precise management was essential to avert severe complications.

Case Presentation

During a routine dental procedure, an 84-year-old man aspirated a bud-shaped cross-cut carbide dental bur. Despite initial …


Using Point-Of-Care Ultrasound For The Medical Management Of Marathoners And Spectators: A Case Series, Jacob D. Pope, Casey Wilson, Kelsey Daller, Jonathan Hardin, Steven Rickett Apr 2025

Using Point-Of-Care Ultrasound For The Medical Management Of Marathoners And Spectators: A Case Series, Jacob D. Pope, Casey Wilson, Kelsey Daller, Jonathan Hardin, Steven Rickett

HCA Healthcare Journal of Medicine

Background

Temporary field hospitals play a crucial role in providing medical care to individuals who experience illnesses and injuries during mass gathering events. Handheld point-of-care ultrasound (POCUS) devices offer an affordable and portable adjunct for emergency care. We present multiple patients from a field hospital during a marathon event in which handheld POCUS devices changed clinical management.

Case Presentation

A 75-year-old man who had fallen was able to be discharged after a lung exam confirmed no rib fractures or pneumothorax. A hypotensive and hypoglycemic 21-year-old man had an echocardiogram confirming volume depletion. He received treatment, and a repeat exam demonstrated …


A Case Of A Massive Right Atrial Thrombus Removal Under Transesophageal Echocardiographic Guidance, Justin Phillips, Max Kabolowsky, Alex M. Hendon, Samantha Arzillo Apr 2025

A Case Of A Massive Right Atrial Thrombus Removal Under Transesophageal Echocardiographic Guidance, Justin Phillips, Max Kabolowsky, Alex M. Hendon, Samantha Arzillo

HCA Healthcare Journal of Medicine

Background

With the advent of catheter guided interventions, practitioners have added another tool alongside chemical lysis and surgical removal to reduce the clot burden of patients with large emboli and thrombi. Due to comorbid conditions, many patients are poor candidates for surgical or chemical clot treatment but may present optimally for catheter-based thromboembolectomy. In this case, we highlight the benefits of mechanical thrombectomy with transesophageal echocardiographic guidance to reduce the clot burden of a patient who would otherwise be considered a poor candidate for surgical or chemical treatment.

Case Presentation

This case follows a 78-year-old man with a past medical …


Pembrolizumab-Associated Acute Esophageal Necrosis: A Case Report And Literature Review, Mark Tawfik, Elie Bou Sanayeh, Stephanie Chain, Ahmed Elfiky, Stephen Mulrooney Apr 2025

Pembrolizumab-Associated Acute Esophageal Necrosis: A Case Report And Literature Review, Mark Tawfik, Elie Bou Sanayeh, Stephanie Chain, Ahmed Elfiky, Stephen Mulrooney

HCA Healthcare Journal of Medicine

Background

Immune checkpoint inhibitors (ICIs) have revolutionized cancer treatment. They pose challenges, particularly in the form of immune-related adverse events (irAEs). Although cases of gastrointestinal irAEs have been well-documented, acute esophageal necrosis (AEN) characterized by a circumferential blackening and fragility of the esophagus, weeks after immunotherapy discontinuation, has not been reported.

Case Presentation

A 75-year-old diabetic male who was recently diagnosed with high-grade papillary urothelial cancer with liver and retroperitoneal metastases and had undergone radical cystectomy with ileal conduit urinary diversion, presented to the hospital for sepsis secondary to a urinary tract infection. While in the hospital, he experienced hematemesis, …


Resolution Of Patient’S Anaphylaxis To The Moderna Covid-19 Vaccine By Desensitization, Stefan M. Pienkowski, Marek M. Pienkowski Apr 2025

Resolution Of Patient’S Anaphylaxis To The Moderna Covid-19 Vaccine By Desensitization, Stefan M. Pienkowski, Marek M. Pienkowski

HCA Healthcare Journal of Medicine

Introduction

Management of patients with rare anaphylaxis to COVID-19 vaccines creates a challenge. Desensitization to medications and vaccines has proven to be effective in managing anaphylactic reactions in selected individuals with a high benefit-to-risk ratio. A previous report described the successful administration of the Moderna modified messenger RNA (MmRNA) COVID-19 vaccine via a graded dose protocol to a patient with previous anaphylaxis to the MmRNA vaccine. Our report describes successful desensitization to the MmRNA vaccine followed by administration of the full dose MmRNA vaccine.

Case Presentation

A patient with a history of chronic allergies and anaphylaxis due to insect sting …


Guillain-Barré Syndrome Following Moderna Spikevax Messenger Rna Covid-19 Vaccine: A Case Analysis, Jamie Lee Aldakkour, Alvin Boyd Newman-Caro, Hector Gonzalez-Montalvo, Usama Bardan, Guruswamy Ramamurthy Apr 2025

Guillain-Barré Syndrome Following Moderna Spikevax Messenger Rna Covid-19 Vaccine: A Case Analysis, Jamie Lee Aldakkour, Alvin Boyd Newman-Caro, Hector Gonzalez-Montalvo, Usama Bardan, Guruswamy Ramamurthy

HCA Healthcare Journal of Medicine

Background

Guillain-Barré Syndrome (GBS) is an acute autoimmune polyneuropathy. Cases of GBS have been reported following administration of the vaccines for swine influenza, seasonal influenza, hemagglutinin type 1 and neuraminidase type 1, and meningococcal disease. Despite these links, a causal relationship has not been confirmed.

Case Presentation

We present a case of a 70-year-old woman who presented with progressive bilateral ascending weakness and numbness and reported receiving the first dose of the Moderna COVID-19 vaccine 2 weeks prior to presentation.

Conclusion

At the time of writing, this is the first reported case of GBS following the Moderna Spikevax COVID-19 vaccine. …


Intracolonic Migration Of A Dislocated Acetabular Cup Prosthesis, Jack R. Lubka, Cyrus Tamboli, Philip Brunetti, Sarosh Tamboli, Alex Davis, Hamish Patel, Olugbenga Oyesanmi, Michael Strobbe, Shaival Thakore, Subhasis Misra, Jeffrey Mino Apr 2025

Intracolonic Migration Of A Dislocated Acetabular Cup Prosthesis, Jack R. Lubka, Cyrus Tamboli, Philip Brunetti, Sarosh Tamboli, Alex Davis, Hamish Patel, Olugbenga Oyesanmi, Michael Strobbe, Shaival Thakore, Subhasis Misra, Jeffrey Mino

HCA Healthcare Journal of Medicine

Background

Acetabular cup migration is a rare complication of hip replacement surgery. If the acetabular socket of the ilium is weak, the prosthesis can erode or pass through it. There have been multiple reports of acetabular cup prosthesis migration to the colon, creating a coloarticular fistula between the hip joint and the cecum, sigmoid colon, or rectum. We report a rare presentation of a complete intracolonic migration of a prosthetic acetabular cup without creating a fistula.

Case Presentation

A 53-year-old female patient with a remote history of a total right hip replacement presented with abdominal pain and rectal bleeding. Computed …


A Rare Instance Of Streptococcus Agalactiae Pyomyoma In A Postmenopausal Patient: A Case Report, Mariah Piazza, Sai V. Nagula, Madeleine Salzberg, Darren Preuninger Apr 2025

A Rare Instance Of Streptococcus Agalactiae Pyomyoma In A Postmenopausal Patient: A Case Report, Mariah Piazza, Sai V. Nagula, Madeleine Salzberg, Darren Preuninger

HCA Healthcare Journal of Medicine

Background

Pyomyoma is a rare, but potentially fatal, complication of uterine leiomyoma. Most cases occur in postpartum or postmenopausal patients with vascular disease and arise due to infarction and infection of existing fibroids. The proposed diagnostic triad for pyomyoma includes 1) sepsis or bacteremia; 2) uterine leiomyomata; and 3) no other apparent source of infection. We present a case of a postmenopausal patient who presented with the aforementioned triad and was found to have a pyomyoma, positive for Streptococcus agalactiae.

Case Presentation

A 67-year-old woman with no known past medical history presented to the emergency department for altered mental …


Utility Of Incorporating Radiological Findings Of Right Heart Strain In Patients With Acute Pulmonary Embolism For Risk Stratification Of Adverse Outcomes: A Retrospective Analysis, Joshua Amaya, Sameer Allahabadi, Daniel L. Habenicht, John Hunton, Amal M. Khan, Subhash Venigalla, Curran Reddy, Jeremy V. Doan, Grace Wang, Daniel R. Eickenhorst, Shovendra Gautam Apr 2025

Utility Of Incorporating Radiological Findings Of Right Heart Strain In Patients With Acute Pulmonary Embolism For Risk Stratification Of Adverse Outcomes: A Retrospective Analysis, Joshua Amaya, Sameer Allahabadi, Daniel L. Habenicht, John Hunton, Amal M. Khan, Subhash Venigalla, Curran Reddy, Jeremy V. Doan, Grace Wang, Daniel R. Eickenhorst, Shovendra Gautam

HCA Healthcare Journal of Medicine

Background

Right heart (RH) strain in the setting of pulmonary embolisms can significantly increase the risk of mortality. Thus, screening for risk of complications in these patients is crucial. The goal of our study was to assess the strength of specific diagnostic findings of RH strain for predicting adverse outcomes including mortality, hospital length of stay, and the requirement of advanced interventions.

Methods

A single-center, retrospective cohort study of 81 patients diagnosed with acute pulmonary embolism with RH strain on computed tomography pulmonary angiogram (CTPA) from September 12, 2019, to August 30, 2023. Data were collected on patient computed tomography …


Combating Physician Burnout And Fostering Wellness In Graduate Medical Education For Resident Physicians, Abdulaziz Mheir, Zohare Khan, Franklin Hernandez, Alaa Mohamed, Chandan Mitra Apr 2025

Combating Physician Burnout And Fostering Wellness In Graduate Medical Education For Resident Physicians, Abdulaziz Mheir, Zohare Khan, Franklin Hernandez, Alaa Mohamed, Chandan Mitra

HCA Healthcare Journal of Medicine

Background

Over the last 2 decades, there has been a cultural shift in the graduate medical education (GME) space, focusing on an important facet: physician burnout. Burnout is defined as a combination of emotional exhaustion, depersonalization, and a lack of personal accomplishment. With increasing awareness of physician burnout, various wellness initiatives have begun to be implemented throughout training programs, and their results have been measured for effectiveness in reducing burnout rates. Due to the increasing rates of burnout emerging throughout GME programs, an initiative to evaluate our internal medicine (IM) residency on this matter was discussed with all residents at …


Portable Head Computed Tomography Protocol For Trauma, Christian Quinones, Alexander Bolufer, Cory Hewitt, Sagun Tuli Apr 2025

Portable Head Computed Tomography Protocol For Trauma, Christian Quinones, Alexander Bolufer, Cory Hewitt, Sagun Tuli

HCA Healthcare Journal of Medicine

The use of portable computed tomography (CT) scanners has been shown to reduce risks associated with intrahospital transport and to expedite imaging in critically ill patients. While their use is established in intensive care units, their utility on intraoperative trauma patients remains underexplored. This paper reviews existing literature on portable CT use, defines appropriate clinical indications, outlines contraindications, and identifies quality metrics and implementation challenges. It also presents a proposed protocol for integrating portable head CT imaging into trauma workflows, focusing on early identification of intracranial or spinal injuries in the operating room. The development and analysis of standardized protocols …


Contrasting Patients' And Healthcare Professionals' Experience In Hematological Cancer Care Pathway: A Narrative Study, Karine Bilodeau, Cynthia Henriksen, Camilia Aloisio Alves, Charlotte Gélinas-Gagné, Lynda Piché, Jacinthe Pepin, Virginia Lee, Marie-France Vachon, Nathalie Folch, Marie-Pascale Pomey, Nicolas Fernandez Apr 2025

Contrasting Patients' And Healthcare Professionals' Experience In Hematological Cancer Care Pathway: A Narrative Study, Karine Bilodeau, Cynthia Henriksen, Camilia Aloisio Alves, Charlotte Gélinas-Gagné, Lynda Piché, Jacinthe Pepin, Virginia Lee, Marie-France Vachon, Nathalie Folch, Marie-Pascale Pomey, Nicolas Fernandez

Patient Experience Journal

Hematological cancers represent 10% of cancers diagnosed in Canada. Treatments involve complex care pathways and various modalities as well as the management and monitoring of multiple side effects. There is limited understanding of these pathways from the perspectives of the people living with cancer (PLC) and the healthcare professional (HCP). The aim of this article is to contrast the experiences of PLCs and HCPs in the context of hematological cancer care pathway. Narrative study approach was chosen for this exploratory study. Twenty-one narratives were co-created with PLCs (n = 12) and HCPs (n = 9). A structural and comparative analysis …


Opportunities And Challenges For E-Health In Hip And Knee Arthroplasty - A Summary Of Recent Literature Review, José Miguel Seguro, Márcia Pestana Santos Apr 2025

Opportunities And Challenges For E-Health In Hip And Knee Arthroplasty - A Summary Of Recent Literature Review, José Miguel Seguro, Márcia Pestana Santos

Patient Experience Journal

Introduction: The integration of health technologies and e-health into health education is becoming increasingly used. Objective: To identify the e-health challenges and opportunities related to hip and knee arthroplasty patient care. Methods: A narrative literature review was conducted. Results: Included 13 primary studies on teleconsultation and the use of digital applications to support patients undergoing knee or hip arthroplasty. Discussion: E-health resources are increasingly vital in supporting arthroplasty patients throughout their surgical journey, from preoperative preparation to recovery. Teleconsultations and patient-support apps enhance access to care, improve efficiency, reduce costs, and boost patient satisfaction. The …


Patient Similarity Analysis And Decision Support Dashboards In Cancer Care: Patients' And Other Stakeholders' Perspectives, Karol Jan Czuba Dr, Te Hao Apaapa-Timu Mrs, Rachel B. Owens, Robert Matthew Strother Dr, Ryan P. Radecki Dr Apr 2025

Patient Similarity Analysis And Decision Support Dashboards In Cancer Care: Patients' And Other Stakeholders' Perspectives, Karol Jan Czuba Dr, Te Hao Apaapa-Timu Mrs, Rachel B. Owens, Robert Matthew Strother Dr, Ryan P. Radecki Dr

Patient Experience Journal

Patient Similarity Analysis can be used to develop personalised aids for patients and clinicians making complex healthcare decisions, including those encountered in the oncology domain. However, little is known about patients’ views on how insights derived through Patient Similarity Analysis may be incorporated into decision making at the point of care. In this study, we developed a set of Patient Similarity-based dashboard mock-ups and consulted oncology stakeholders in Aotearoa New Zealand regarding acceptability. Aim: To explore oncology stakeholders’ (patients, clinicians, researchers and advocates) perspectives on the acceptability of using Patient Similarity-based decision dashboards to guide decision making. Methods: This is …


Evaluating Referral Rates For Positive Postpartum Depression Screenings At Telehealth And Well-Child Visits: A Scoping Review, Rachel Macklin Barber, Mph, Bsn, Rn, Damaris Amber Brooks, Bsn, Rn, Ashli-Emeria Gary, Bsn, Rn, Margaret Harvey, Phd, Acnp-Bc, Chfn, Kate Fouquier Phd, Aprn, Cnm, Pmh-C, Facnm Apr 2025

Evaluating Referral Rates For Positive Postpartum Depression Screenings At Telehealth And Well-Child Visits: A Scoping Review, Rachel Macklin Barber, Mph, Bsn, Rn, Damaris Amber Brooks, Bsn, Rn, Ashli-Emeria Gary, Bsn, Rn, Margaret Harvey, Phd, Acnp-Bc, Chfn, Kate Fouquier Phd, Aprn, Cnm, Pmh-C, Facnm

Doctor of Nursing Practice Projects

Purpose/Background

Postpartum depression (PPD) affects one in nine women. It has distressing impacts, including behavioral and attachment issues and toveruse of healthcare services. PPD occurs within 4 weeks to 12 months postpartum. A scoping review was conducted to compare referral rates to mental health providers after PPD screenings were conducted via telehealth versus those completed at well-child visits.

Methods

Peer-reviewed articles published within five years before the initial search, beginning September 2022 and ending November 2024, were selected. Articles were sourced from several publications using an online library database with various MeSH terms and Boolean operators. Search results were narrowed …


A Deadly Case Of Encephalopathy, Brenna Ostertag, Md, Gita D Gelfer, Andrea Roast Apr 2025

A Deadly Case Of Encephalopathy, Brenna Ostertag, Md, Gita D Gelfer, Andrea Roast

Providence Portland Medical Center Internal Medicine 2025

Introduction: Human prion disease are heterogenous groups of neurodegenerative disorders characterized by spongiform degeneration, astrogliosis, and neuronal loss in the central nervous system from misfolding and subsequent spread of the prion protein. This disease manifests rapidly and is often accompanied by visual and speech abnormalities, gait changes, and progressive encephalopathy. It is always fatal. Around 400 people are diagnosed with prion disease in the United States annually. Recent innovations in diagnostics using Real-Time Quaking Induced Conversion (RT-QuIC) has allowed for antemortem diagnosis of prion disease. Case Presentation: A 66-year-old male with a history of alcohol use disorder in remission and …


Evaluating The Efficacy Of Htk (Histidine-Tryptophan-Ketoglutarate) And Potassium-Based Cardioplegia Solutions In Adult Cardiac Surgery: A Scoping Review Of Postoperative Outcomes, Efficiency, And Complications, Lauren Ryan Apr 2025

Evaluating The Efficacy Of Htk (Histidine-Tryptophan-Ketoglutarate) And Potassium-Based Cardioplegia Solutions In Adult Cardiac Surgery: A Scoping Review Of Postoperative Outcomes, Efficiency, And Complications, Lauren Ryan

Student Works

Background/Introduction: Cardioplegia solutions are integral to myocardial protection during cardiac surgery, particularly during ischemic periods induced by cardiopulmonary bypass (CPB). Histidine-Tryptophan-Ketoglutarate (HTK) solution and potassium-based solutions such as Del Nido, St. Thomas, 4:1, and Microplegia are widely utilized for their distinct biochemical mechanisms and protective properties. Despite their widespread application, variability in clinical outcomes and procedural contexts has led to uncertainty about the optimal choice of cardioplegia solution. This scoping review aims to compare HTK and potassium-based solutions, focusing on their efficacy, postoperative outcomes, and complications in adult patients undergoing coronary artery bypass graft (CABG) and valve surgeries, including minimally …


The Pernicious Right Should Pain, Julie Hwang, Md, Weiya Wysham, Md, Qian Leng, Md Apr 2025

The Pernicious Right Should Pain, Julie Hwang, Md, Weiya Wysham, Md, Qian Leng, Md

Providence Portland Medical Center Internal Medicine 2025

Case Presentation: •Background: Non-traumatic diaphragmatic rupture is a rare condition, only 28 cases previously reported •73 year old female presented to PCP via virtual visit with 6 weeks of gradually worsening shoulder pain despite recent steroid injection. During the virtual visit, patient was found with dyspnea on exertion •PMHx: Recurrent ovarian cancer (granulosa cell type) •Surgical Hx: Hysterectomy with BSO, Lap partial hepatectomy with cauterization of right diaphragm metastasis 7 years prior to presentation •Vitals: normal, on RA •Exam: No R shoulder focal tenderness or limited movement •Labs: CBC - WBC 13.7 with absolute neutrophil count 11.2. CMP - normal. …


A Retrospective Review Of Emergency Department Leave Against Medical Advice Cases: Tracking Pregnant Women Presenting With Opioid Use Disorder, Rastassia Armstrong Apr 2025

A Retrospective Review Of Emergency Department Leave Against Medical Advice Cases: Tracking Pregnant Women Presenting With Opioid Use Disorder, Rastassia Armstrong

MUSC Theses and Dissertations

Pregnant and post-partum women are not excluded from the growing number of individuals impacted by the opioid epidemic. The opioid epidemic is well understood as a widespread public health crisis. The impact has far-reaching effects beyond the individual user, data shows that there are serious implications for families, the healthcare system, taxpayers, and communities.

Pregnancy is a particularly vulnerable period in a woman’s healthcare journey, and for women struggling with opioid use disorder (OUD), it is an extremely high-risk time. Opioid misuse during pregnancy carries serious risks for both the mother and the infant. It is extremely important to identify …


The Impact Of Biomaterial Characteristics On Macrophage Phenotypes In Tissue Engineering: A Review, Julian Jackson, Hani Samarah, William Palmer, Zachary Kaplan, Marianna Nicodem, Parvesh Kumar, Spenser Short, Kelly Bridgham, Larry Harshyne, Joseph Curry Apr 2025

The Impact Of Biomaterial Characteristics On Macrophage Phenotypes In Tissue Engineering: A Review, Julian Jackson, Hani Samarah, William Palmer, Zachary Kaplan, Marianna Nicodem, Parvesh Kumar, Spenser Short, Kelly Bridgham, Larry Harshyne, Joseph Curry

Department of Otolaryngology - Head and Neck Surgery Faculty Papers

Macrophages are highly plastic cells central to pathogen removal, tissue regeneration, and inflammation, making them key targets in biomaterial design for improved clinical outcomes. Foreign body responses (FBRs) to implanted biomaterials often involve excessive macrophage-mediated inflammation, leading to fibrotic encapsulation, infection, and implant failure. Advances in tissue engineering demonstrate that macrophage polarization - the transition from pro-inflammatory M1 to anti-inflammatory M2 phenotypes - can be influenced by biomaterial properties to mitigate these responses and enhance regeneration. This review synthesizes the relationship between biomaterial properties, such as surface chemistry, structure, and stiffness, and their ability to modulate macrophage behavior. Key innovations, …


Use Of Interdisciplinary Rounds For The Identification Of Hospitalized Adults In Need Of Palliative Care, Brenda A. Blunt Apr 2025

Use Of Interdisciplinary Rounds For The Identification Of Hospitalized Adults In Need Of Palliative Care, Brenda A. Blunt

Evidence-Based Practice Project Reports

Palliative care (PC) is specialized care that aims to provide relief from the stress and symptoms of living with a serious illness (Center to Advance Palliative Care, 2022). PC services are often underutilized in the hospital, leaving a significant number of patients with unmet needs (Haranis et al, 2023; Kawashima & Evans, 2023; Smith et al, 2019). The purpose of this evidence-based practice project was to improve processes for identifying hospitalized patients for referral to specialty inpatient PC. The intervention involved interdisciplinary rounds (IDR) for adult inpatients on two medical-surgical (MESG) units in an 84-bed community hospital in suburban Milwaukee, …


Chemotherapy-Free Treatment With Radiotherapy And Immunotherapy For Locally Advanced Non-Small Cell Lung Cancer, M Zeeshan Ozair, Balazs Halmos, Angelica D'Aiello, Jaewon Yun, Andrea R Filippi, Andreas Rimner, Steven H Lin, Charles B Simone, Nitin Ohri Apr 2025

Chemotherapy-Free Treatment With Radiotherapy And Immunotherapy For Locally Advanced Non-Small Cell Lung Cancer, M Zeeshan Ozair, Balazs Halmos, Angelica D'Aiello, Jaewon Yun, Andrea R Filippi, Andreas Rimner, Steven H Lin, Charles B Simone, Nitin Ohri

Faculty, Staff and Student Publications

Background: Concurrent chemoradiotherapy (CRT) followed by immunotherapy is a standard treatment for locally advanced non-small cell lung cancer (LA-NSCLC), yet many patients are ineligible due to treatment-related toxicity or poor functional status. Chemotherapy-free approaches using radiotherapy (RT) and immunotherapy may offer a safer and equally effective alternative in select patient populations.

Methods: A comprehensive literature review was conducted using PubMed, Google Scholar, and relevant conference proceedings focusing on trials between 2000 and 2024. Studies investigating chemotherapy-free regimens combining RT and immunotherapy in LA-NSCLC were analyzed, with emphasis on clinical outcomes, biomarker use, treatment sequencing, radiation dose/fractionation, and safety.

Results: Multiple …


Clinicians’ Perspectives Concerning Treatment Initiation And Escalation Strategies For Digital Ulcers In Patients With Systemic Sclerosis, Giulia Campanaro, Giulia Bandini, Alessia Alunno, Stefano Di Donato, Begonya Alcacer-Pitarch, Ilaria Galetti, Barbara Ruaro, Silvia Bellando Randone, Alberto Moggi Pignone, Marco Matucci-Cerinic, Zsuzsanna H Mcmahan, Michael Hughes Apr 2025

Clinicians’ Perspectives Concerning Treatment Initiation And Escalation Strategies For Digital Ulcers In Patients With Systemic Sclerosis, Giulia Campanaro, Giulia Bandini, Alessia Alunno, Stefano Di Donato, Begonya Alcacer-Pitarch, Ilaria Galetti, Barbara Ruaro, Silvia Bellando Randone, Alberto Moggi Pignone, Marco Matucci-Cerinic, Zsuzsanna H Mcmahan, Michael Hughes

Faculty, Staff and Student Publications

Objectives: Digital ulcers (DUs) are a major cause of pain and disability in systemic sclerosis (SSc) patients and remain a major treatment challenge. Our aim was to explore clinicians' perspectives towards treatment initiation and escalation, akin to a 'Treat to Target' (T2T) strategy.

Methods: SSc clinicians were invited to participate in an online survey.

Results: A total of 173 responses (75% rheumatologists) were obtained from 33 countries. When initiating a change in oral drug therapy for SSc-DUs, most (80%) respondents would consider adding new medication to existing treatment, and 50% would increase existing treatment dose. Time to assess the impact …


Development Of A Reference Standard To Assign Bacterial Versus Viral Infection Etiology Using An All-Inclusive Methodology For Comparison Of Novel Diagnostic Tool Performance, Coburn Allen, J Kate Deanehan, Yaniv Dotan, Matthew A Eisenberg, Andrew M Fine, Jonathan Isenberg, Ann Kane, Dani Kirshner, Todd W Lyons, Yasmin Maor, Ami Neuberger, Daniel G Ostermayer, Sharona Paz, Oded Scheuerman, Shachaf Shiber, Victoria A Statler, Michal Stein, Renata Yakubov, Shirly Yanai, Roy Navon, Lior Kellerman, Tanya M Gottlieb, Eran Eden Apr 2025

Development Of A Reference Standard To Assign Bacterial Versus Viral Infection Etiology Using An All-Inclusive Methodology For Comparison Of Novel Diagnostic Tool Performance, Coburn Allen, J Kate Deanehan, Yaniv Dotan, Matthew A Eisenberg, Andrew M Fine, Jonathan Isenberg, Ann Kane, Dani Kirshner, Todd W Lyons, Yasmin Maor, Ami Neuberger, Daniel G Ostermayer, Sharona Paz, Oded Scheuerman, Shachaf Shiber, Victoria A Statler, Michal Stein, Renata Yakubov, Shirly Yanai, Roy Navon, Lior Kellerman, Tanya M Gottlieb, Eran Eden

Faculty, Staff and Student Publications

Background: Diagnostic test evaluation requires a reference standard. We describe an approach for creating a reference standard for acute infection using unrestricted adjudication and apply it to compare biomarker tools.

Methods: Adults and children with suspected acute infection enrolled in three prospective studies at emergency departments and urgent cares were included. Adjudicators, blinded to C-reactive protein, procalcitonin, and MeMed BV (MMBV), labeled each case (bacterial/viral/non-infectious/indeterminate). Initial adjudication involved 3 adjudicators. Reference standard cohorts were defined: Microbiologically confirmed (3/3 adjudicators concur with high confidence and a concordant microbiological finding), unanimous (3/3 adjudicators concur with high confidence), suspected (3/3 adjudicators concur with …


Neurotransmitter Power Plays: The Synaptic Communication Nexus Shaping Brain Cancer, Jayanta Mondal, Jason T Huse Apr 2025

Neurotransmitter Power Plays: The Synaptic Communication Nexus Shaping Brain Cancer, Jayanta Mondal, Jason T Huse

Faculty, Staff and Student Publications

Gliomas and brain metastases are notorious for their dismal prognosis and low survival rates, a challenge exacerbated by our incomplete grasp of the complex dynamics that govern brain cancers. Recently, a groundbreaking paradigm shift has emerged, highlighting the crucial role of synaptic communication between neurons and brain tumor cells in reshaping neuronal signaling to favor tumor growth. This review delves into the pivotal interplay of synaptic mechanisms, focusing on excitatory glutamatergic and inhibitory GABAergic pathways. Glutamatergic synapses utilize glutamate to propagate excitatory signals, while GABAergic synapses employ gamma-aminobutyric acid (GABA) to inhibit neuronal firing. Glutamatergic signaling can be broadly classified …


Use Of Natural Language Processing To Identify Patients With Inflammatory Breast Cancer Across A Health-Care System, Ramez Kouzy, Megumi Kai, Huong T Le-Petross, Sadia Saleem, Wendy A Woodward Apr 2025

Use Of Natural Language Processing To Identify Patients With Inflammatory Breast Cancer Across A Health-Care System, Ramez Kouzy, Megumi Kai, Huong T Le-Petross, Sadia Saleem, Wendy A Woodward

Faculty, Staff and Student Publications

Early identification and referral of inflammatory breast cancer remains challenging within large health-care systems, limiting access to specialized care. We developed and evaluated an artificial intelligence-driven platform integrating natural language processing (NLP) with electronic health records to systematically identify potential inflammatory breast cancer patients across 5 campuses. Our platform analyzed 8 623 494 clinical notes, implementing a sequential review process: NLP screening followed by human validation and multidisciplinary confirmation. Initial NLP screening achieved 55.4% positive predictive value, improving to 78.4% with human-in-the-loop review. Notably, among 255 confirmed patients with inflammatory breast cancer, our system demonstrated 92.2% sensitivity, identifying 57 patients …


Bilateral Germ Cell Tumor Of The Testis: Biological And Clinical Implications For A Stem Versus Genetic Origin Of Cancers, Jamaal C Jackson, Darren Sanchez, Aron Y Joon, Marcos R Estecio, Andrew C Johns, Amishi Y Shah, Matthew Campbell, John F Ward, Louis L Pisters, Charles C Guo, Miao Zhang, Niki M Zacharias, Shi-Ming Tu Apr 2025

Bilateral Germ Cell Tumor Of The Testis: Biological And Clinical Implications For A Stem Versus Genetic Origin Of Cancers, Jamaal C Jackson, Darren Sanchez, Aron Y Joon, Marcos R Estecio, Andrew C Johns, Amishi Y Shah, Matthew Campbell, John F Ward, Louis L Pisters, Charles C Guo, Miao Zhang, Niki M Zacharias, Shi-Ming Tu

Faculty, Staff and Student Publications

Germ cell tumors of the testis (GCTs) provide an ideal tumor model to investigate the cellular versus genetic origin of cancers. In this single institutional study, we evaluated 38 patients with bilateral GCT, including tumors that occurred simultaneously (synchronous) and those occurring at different times (metachronous). For nine of these patients, DNA was isolated from the right and left GCT to determine the genomic and epigenetic differences between tissues using whole-exome sequencing (WES) and reduced representation bisulfite sequencing (RRBS). We found that seminomas and non-seminomas are molecularly distinct based on DNA methylation and not due to synchronous or metachronous disease. …


Cognitive Outcomes In Prostate Cancer Treatment: Insights From The Odenza Trial And Future Considerations, Bryan J Neth, Jeffrey S Wefel, Kevin T Nead Apr 2025

Cognitive Outcomes In Prostate Cancer Treatment: Insights From The Odenza Trial And Future Considerations, Bryan J Neth, Jeffrey S Wefel, Kevin T Nead

Faculty, Staff and Student Publications

No abstract provided.