Medical Specialties Commons^™

The Clinical Phenotype Of Motor Neurone Disease In A Kenyan Hospital – Based Population, Effie Nailah Kamadi

Master of Medicine in Internal Medicine

Introduction: Motor Neurone Disease (MND) is a rare, disabling and incurable illness marked by relentless degeneration of motor neurons with loss of voluntary motor function and eventual death. In the West, patient demographics and clinical characteristics are well documented. Available African research is mostly for North, West and South Africa with a knowledge gap existing on the East African illness. This study characterized MND phenotype in a Kenyan population.

Objectives: To describe the clinical phenotype and outcomes of MND in a Kenyan hospital-based population.

Methods: The medical charts of all adult MND patients assessed at AKUHN between …

Detection Rate And Patterns Of Biochemical Recurrence Of Prostate Cancer Using 18f-Psma-1007 Pet/Ct At A Tertiary Teaching Hospital In Sub-Saharan Africa., Lynet Wairimu Barasa

Master of Medicine in Imaging and Diagnostic Radiology

Background: Rising PSA levels following local therapy with curative intent are seen in about one third of men previously treated for prostate cancer, indicative of disease recurrence. This is usually not detectable through imaging modalities like computed tomography (CT) or magnetic resonance imaging (MRI). Several studies show high detection rates of recurrence with 18F-PSMA-1007 PET/CT, one of the novel PET imaging modalities for prostate cancer. No studies, however, have been done to show the patterns of recurrence in the Sub-Saharan African population in whom prostate cancer is known to occur earlier and be more aggressive. Biochemical recurrence almost always …

Comparison Of Positivity Rate Of Dual Phase Sestamibi Versus Dual Tracer Pertechnetate/Sestamibi In Identification Of Parathyroid Adenomas., Naomi Chirindo Chikuro

Master of Medicine in Imaging and Diagnostic Radiology

Background 

Parathyroid adenomas are the commonest cause of primary hyperparathyroidism. The primary mode of treatment is surgical excision which can only be achieved with pre surgical localization of adenomas. Ultrasound, CT and MRI can be used but the most sensitive and specific imaging modality is parathyroid scintigraphy with use of Sestamibi labelled with technetium 99 metastable radionuclide. A few studies have been done comparing dual phase, dual tracer and combined dual phase/tracer protocols with an apparent lack of consensus on which is superior.

Objectives

This study aimed to compare the positivity rates of the mentioned parathyroid scintigraphy protocols and identify …

The Prevalence And The Predictors Of Diabetes Distress In Patients With Type 2 Diabetes Attending Diabetes Clinics At A Tertiary Private Hospital In Nairobi, Kenya., Soulthy Azamkhan Mohamed

Master of Medicine in Family Medicine

Background Diabetes distress encompasses a spectrum of emotional and psychological challenges faced by individuals managing diabetes, including anxiety, stress, depression, frustration, and feelings of helplessness. This distress arises from the constant demands of monitoring blood sugar levels, managing medications, adhering to dietary restrictions, engaging in regular physical activity, and navigating potential complications. Social and emotional factors such as stigma, discrimination, and concerns about future health further contribute to this burden. Factors like fear of hypoglycemia, financial strain, fluctuating blood sugar levels, anxiety about complications, and impacts on personal relationships exacerbate diabetes distress. Left unaddressed, diabetes distress can lead to poor …

Comparison Of The Use Of Therapeutic Plasma Exchange To Intravenous Immunoglobulin For Autoimmune Neurological Conditions At A Tertiary Hospital In Kenya., Swafiya Salim Busaidy

Master of Medicine in Internal Medicine

Background 

Plasma exchange (Barth et al.) and Intravenous Immunoglobulin (Barth et al.) have emerged as favored therapeutic options for autoimmune neurological conditions. Neurological conditions cause high morbidity and mortality in the sub-Saharan region. The utilization of these treatment options in Sub-Saharan Africa remains relatively unknown. We can determine the most efficient treatments with minimal cost implications by comparing the two treatment modalities in our setup.

Methods 

This retrospective descriptive chart review took place at Aga Khan University Hospital. It encompassed all patients admitted between 1st January 2011 and 31st December 2023 who had a neurological condition that necessitated treatment with …

Diagnostic Accuracy Of 18f-Fdg Pet-Ct Compared To Ultrasound In Identification Of Metastatic Axillary Lymph Nodes In Newly Diagnosed Breast Cancer Patients., Sarah Muthii Kibe

Master of Medicine in Imaging and Diagnostic Radiology

Background: Determination of axillary lymph node metastasis is a crucial part of breast cancer staging as it is the most important marker of overall recurrence and survival. Although axillary ultrasound (AUS) is the imaging reference standard, it has a wide range of sensitivity necessitating evaluation of other imaging modalities that may be used as adjuncts.18F-FDG PET-CT is recommended for use in metastatic and recurrent breast cancer with infrequent use in early disease due to its low spatial resolution for small axillary lymph nodes. The aim of this it study is to evaluate the diagnostic accuracy of axillary ultrasound compared …

Dementia In A Resource-Constrained Sub-Saharan African Setting: A Comprehensive Retrospective Analysis Of Prevalence, Risk Factors, And Management At The Only Neuropsychiatric Facility In Northeastern Nigeria, Ibrahim Abdu Wakawa, Umar Baba Musami, Suleiman Hamidu Kwairanga, Placidus Nwankuba Ogualili, Mohammed Yusuf Mahmood, Muhammad Abba Fugu, Mohammed Mala Gimba, Muktar Mohammed Allamin, Zaharadeen Umar Abbas, Chinedu Momoh

Brain and Mind Institute

INTRODUCTION: Dementia prevalence is increasing in sub-Saharan Africa, poten-tially due to population growth and aging. Resource-constrained settings such asNortheastern Nigeria face challenges in dementia management.

METHODS: We assessed dementia burden and management at the Federal Neuropsy-chiatric Hospital Maiduguri, the only neuropsychiatric facility in Northeastern Nigeria.This retrospective analysis included patient records from 1999 to 2023 for individuals60 year of age and older with a dementia diagnosis.

RESULTS: Of the 1216 cases reported, Alzheimer’s disease (60.5%) was the mostcommon subtype, followed by vascular dementia (24.5%). Hypertension (41.6%) wasthe most frequent comorbidity. Memory loss was present in all cases, whereasbehavioral …

Substance Use Among Healthcare Professionals: A Cross-Sectional Study In Kenya, Jasmit Shah, Cynthia Smith, Cyprian Mostert, Linda Khakali, Zul Merali, Sayed Karar

Brain and Mind Institute

Substance use among healthcare professionals, including alcohol, tobacco, marijuana, benzodiazepines etc., is a rising concern. The immensity of substance use is not yet clear, though recently, studies conducted on medical students and physician trainees show that 10% to 15% of all healthcare professionals misuse drugs at some point in their career, and that 6% to 8% of physicians have a substance use disorder. Substance use has a direct impact on relationships, physical health, and job performance, and is associated with depression, burnout, and decreased career satisfaction. The aim of this study was to shed light on the prevalence of substance …

Cilostazol After Endovascular Therapy For Femoropopliteal Peripheral Arterial Disease: A Systematic Review And Meta-Analysis, Christian D. Cerecedo, Aaron Silva, Valentine S. Alia, Ana Vargas, Alejandro Garza, Omar El Shazly, Alejandro J. Candil

School of Medicine Publications

Background

Endovascular therapy (ET) outcomes for femoropopliteal peripheral arterial disease (FP-PAD) remain suboptimal. Cilostazol therapy may improve patency rates and decrease major adverse limb events after ET for FP-PAD. Our goal was to analyze published studies evaluating the use of cilostazol after ET for FP-PAD.

Methods

We searched MEDLINE, EMBASE, and CENTRAL for randomized and observational studies (OSs) evaluating cilostazol therapy after ET for FP-PAD. We only included OSs adjusting for confounding variables. We analyzed observational and randomized studies separately and explored heterogeneity by estimating an I2 statistic. A fixed-effects model was chosen if the I2 statistic was low. If …

A Case Of Peristomal Pyoderma Gangrenosum With Histological Features Of Pseudoxanthoma Elasticum., Kelly M Kimball, Matthew J Franklin

Ambulatory and Primary Care Articles

No abstract provided.

Artificial Intelligence In Surgical Coding: Evaluating Large Language Models For Current Procedural Terminology Accuracy In Hand Surgery, Emily Isch, Jamie Lee, D. Mitchell Self, Abhijeet Sambangi, Theodore E. Habarth-Morales, John R. Vaile, E. J. Caterson

Department of Surgery Faculty Papers

PURPOSE: The advent of large language models (LLMs) like ChatGPT has introduced notable advancements in various surgical disciplines. These developments have led to an increased interest in the use of LLMs for Current Procedural Terminology (CPT) coding in surgery. With CPT coding being a complex and time-consuming process, often exacerbated by the scarcity of professional coders, there is a pressing need for innovative solutions to enhance coding efficiency and accuracy.

METHODS: This observational study evaluated the effectiveness of five publicly available large language models-Perplexity.AI, Bard, BingAI, ChatGPT 3.5, and ChatGPT 4.0-in accurately identifying CPT codes for hand surgery procedures. A …

Under Pressure: A Rare Presentation Of Crude Oil Injection Injury To The Foot Secondary To Pressure Washer Injury, Stephanie N. Campbell, Heather V. Tran, Nikita V. Gambhir, Connor Krolikowski

School of Podiatric Medicine Publications

No abstract provided.

Data Reporting Quality And Semantic Interoperability Increase With Community-Based Data Elements (Codes). Analysis Of The Open Data Commons For Spinal Cord Injury (Odc-Sci), Anushka Sheoran, Kenneth A. Fond, Lex Maliga Davis, J. R. Huie, Romana Vavrek, P. J. Axtman, Vance P. Lemmon, John L. Bixby, Ubbo Visser, John C. Gensel, Karim Fouad, Adam R. Ferguson, Jeffrey S. Grethe, Anita Bandrowski, Maryann E. Martone, Abel Torres-Espin

Neurology Faculty Publications

Data interoperability is crucial for effectively combining data for scientific inquiry. To facilitate interoperability, data standards such as a common definition of variables are often developed. The Open Data Commons for Spinal Cord Injury (odc-sci.org) has established an initial set of community-based data elements (CoDEs)—a minimal set of variables for sharing—to promote data interoperability in SCI research, aligning with FAIR (Findable, Accessible, Interoperable, and Reusable) data principles. We sought to understand the use of CoDEs by the SCI community to inform current standards adherence and future standards development. We systematically analyzed 39 public datasets in relation to 17 required CoDEs …

Sociodemographic Factors Associated With Prenatal Care Utilization In Arkansas, United States., Pearl A Mcelfish, Aaron Caldwell, Donya Watson, Jonathan Langner, Jennifer Callaghan-Koru, Austin Porter, Don E Willis, Jennifer A Andersen, Nicola L Hawley, James P Selig, Amir Forati, Maria R Alcala, Lanita White, Enrique Gomez-Pomar, Clare C Brown

Pediatrics Faculty Publications

OBJECTIVES: This study examines prenatal care utilization differences in Arkansas.

METHODS: Birth records data from the National Center for Health Statistics were used. The study population consisted of singleton live births in Arkansas from 2014 to 2022. Primary outcomes included number of prenatal visits, fewer than the recommended number of prenatal visits, late prenatal care, and no prenatal care. Summary statistics were computed, and adjusted rates ratios were calculated adjusting for maternal age, maternal education, and parity for payer, race/ethnicity, and rural/urban residence.

RESULTS: Mothers with a Medicaid-covered birth had 0.90 times fewer prenatal care visits and were 1.26 times …

Sociodemographic Factors Associated With Prenatal Care Utilization In Arkansas, United States., Pearl A Mcelfish, Aaron Caldwell, Donya Watson, Jonathan Langner, Jennifer Callaghan-Koru, Austin Porter, Don E Willis, Jennifer A Andersen, Nicola L Hawley, James P Selig, Amir Forati, Maria R Alcala, Lanita White, Enrique Gomez-Pomar, Clare C Brown

Pediatrics Faculty Publications

OBJECTIVES: This study examines prenatal care utilization differences in Arkansas.

METHODS: Birth records data from the National Center for Health Statistics were used. The study population consisted of singleton live births in Arkansas from 2014 to 2022. Primary outcomes included number of prenatal visits, fewer than the recommended number of prenatal visits, late prenatal care, and no prenatal care. Summary statistics were computed, and adjusted rates ratios were calculated adjusting for maternal age, maternal education, and parity for payer, race/ethnicity, and rural/urban residence.

RESULTS: Mothers with a Medicaid-covered birth had 0.90 times fewer prenatal care visits and were 1.26 times …

Viral Detection In Anterior Nasal Swabs Versus Nasopharyngeal Swabs In Children, Nicole Neeley, Abby Kietzman, Rangaraj Selvarangan, Dithi Banerjee, Jennifer Goldman, Jennifer Schuster

Posters

Background: Respiratory viruses are a significant cause of pediatric illness and healthcare utilization. Diagnostic testing for respiratory viruses is generally performed using nasopharyngeal (NP) specimens obtained by trained medical staff, limiting testing to medical settings. Evaluating additional sampling methods in children, such as anterior nasal swab (NS) specimens may expand access to diagnostic testing and aid public health surveillance. Methods: Eligible children hospitalized at Children’s Mercy Hospital in Kansas City who had a standard of care NP specimen collected for nucleic acid amplification testing for respiratory viruses were enrolled. Research NS specimens were obtained through self, caregiver, or staff collection. …

Rates Of Minimally Invasive Surgery After Introduction Of Robotic-Assisted Surgery For Common General Surgery Operations, Zhi Ven Fong, Elizabeth Wall-Wieler, Shaneeta Johnson, Richard Culbertson, Brian Mitzman

School of Public Health Faculty Publications

Importance: Many patients who would benefit from minimally invasive surgery (MIS) have open surgery; robotic-assisted surgery (RAS) addresses some of the limitations of laparoscopic surgery and could increase rates of MIS across different patient populations. Objective: To determine whether the introduction of RAS increases MIS rates and whether increases are seen across different patient populations undergoing common general surgery procedures. Design: A retrospective cohort study was performed to compare rates of MIS in the year before and after the index date for hospitals that did and did not introduce RAS. Generalized estimating equation regression models were used to compare rates …

A Study Of Secondary Traumatic Stress In Health Care Professionals In Long-Term Care., Bethany Proudfoot

Doctor of Social Work Capstone Projects

Secondary traumatic stress (STS) is a significant concern for healthcare professionals in long-term care (LTC) settings. This study explores the impact of STS on clinical staff, addressing the research question: How has STS affected employees within the LTC sector, and what resources or support can be provided to mitigate its effects? The study utilized a mixed-methods approach, combining survey data from clinical staff across five LTC facilities in Ohio, incorporating the survey data measuring levels of STS and qualitative responses. Findings revealed that 64% of participants experienced high to severe levels of STS, with symptoms including anxiety, depression, sleep disturbances, …

Insulin Receptor Responsiveness Governs Tgfβ-Induced Hepatic Stellate Cell Activation: Insulin Resistance Instigates Liver Fibrosis, Wang-Hsin Lee, Evelyn A. Bates, Zachary A. Kipp, Sally Pauss, Genesee J. Martinez, Cheavar A. Blair, Terry D. Hinds Jr.

Markey Cancer Center Faculty Publications

The insulin receptor (INSR) has been shown to be hyperactive in hepatic stellate cells (HSCs) in humans and rodents with liver fibrosis. To explore HSC cellular mechanisms that INSR regulates during pro-fibrotic stimulation, we used CRISPR-Cas9 technology. We knocked out a portion of the INSR gene in human LX2 HSC cells (INSRe5- 8 KO) that regulates insulin responsiveness but not the insulin-like growth factor (IGF) or transforming growth factor-β (TGFβ) signaling. The INSRe5- 8 KO HSCs had significantly higher cell growth, BrdU incorporation, and lower TP53 expression that suppresses growth, and they also exhibited increased migration compared to the Scramble …

Lc-Ms Analysis Of Serum Lipidomic And Metabolomic Signatures In Pediatric Patients With Acute Lymphoblastic Leukemia, Feiyu Yan, Shengnan Wang, Yilin Wang, Yan Sun, Jing Yang, Lirong Sun, Yekaterina Y. Zaytseva, Pan Deng, Lingzhen Wang

Markey Cancer Center Faculty Publications

Background Acute lymphoblastic leukemia (ALL) is a prevalent hematologic malignancy that primarily affects children. The diagnosis and treatment of pediatric ALL remain challenging. This study aimed to identify differential lipids and metabolites that may hold potential for improving ALL treatment.

Methods In this retrospective case-control study, serum samples obtained from children with ALL and healthy controls were analyzed. Serum lipidome and metabolome alterations of ALL were analyzed by comparing pediatric patients with ALL with healthy controls based on liquid chromatography high-resolution mass spectrometry analysis of serum lipidomic and metabolomic signatures.

Results We identified 2,298 lipid features in the serum. Among …

Exploring Oxylipins In Host–Microbe Interactions And Their Impact On Infection And Immunity, Robert J. Neff, Christopher D. Radka

Markey Cancer Center Faculty Publications

Plasma lipids are essential components of biological systems, transported through interactions with proteins to maintain cellular functions. These lipids exist in various forms, such as fatty acids, glycerolipids, glycerophospholipids, sphingolipids, sterols, and prenol lipids, derived from dietary intake, adipose tissue, and biosynthesis. While the association between certain fatty acids and cardiovascular diseases has been widely recognized, polyunsaturated fatty acids (PUFAs) exhibit cardioprotective effects, reducing risks of arrhythmias and heart-related mortality. This is due to their role in the production of eicosanoids, which modulate inflammation. Chronic inflammation, particularly in obesity, is significantly influenced by fatty acids, with saturated fatty acids promoting …

Predicting The Pathway Involvement Of Compounds Annotated In The Reactome Knowledgebase, Erik D. Huckvale, Hunter N. B. Moseley

Markey Cancer Center Faculty Publications

Background/Objectives: Pathway annotations of non-macromolecular (relatively small) biomolecules facilitate biological and biomedical interpretation of metabolomics datasets. However, low pathway annotation levels of detected biomolecules hinder this type of interpretation. Thus, predicting the pathway involvement of detected but unannotated biomolecules has a high potential to improve metabolomics data analysis and omics integration. Past publications have only made use of the Kyoto Encyclopedia of Genes and Genomes-derived datasets to develop machine learning models to predict pathway involvement. However, to our knowledge, the Reactome knowledgebase has not been utilized to develop these types of predictive models.

Methods: We created a dataset ready for …

Characterization, Performance, And Toxicological Assessment Of Polysulfone-Sulfonated Polyether Ether Ketone Membranes For Water Separation Applications, Muhammad Usman Yousaf, Lucca Madeo Cortarelli, Nerissa I. Jebet, Jason M. Unrine, Nirupam Aich, Olga V. Tsyusko, Isabel C. Escobar

Markey Cancer Center Faculty Publications

The removal of small molecular weight charged compounds from aqueous solutions using membrane remains a challenge. In this study, polysulfone (PSf)- and sulfonated polyether ether ketone (SPEEK)-based membranes were fabricated via non- solvent induced phase separation process (NIPS) using N-Methyl-2-Pyrrolidone (NMP) as solvent and water as non-solvent. Membranes were characterized structurally and morphologically, followed by toxicity assessment conducted before and after filtration, both with and without annealing at various pH values to evaluate potential leaching of trapped solvent from the membrane pores. Additionally, membrane performance was characterized using binary mixtures of cationic and anionic dyes. The results demonstrated selective filtration …

Computational Design And In Vitro And In Vivo Characterization Of An Apoe-Based Synthetic High-Density Lipoprotein For Sepsis Therapy, Ling Guo, Yaxia Yuan, Fang Zhang, Chang-Guo Zhan, Xiangan Li

Markey Cancer Center Faculty Publications

Introduction: Septic patients have low levels of high-density lipoproteins (HDLs), which is a risk factor. Replenishing HDLs with synthetic HDLs (sHDLs) has shown promise as a therapy for sepsis. This study aimed to develop a computational approach to design and test new types of sHDLs for sepsis treatment. Methods: We used a three-step computational approach to design sHDL nanoparticles based on the structure of HDLs and their binding to endotoxins. We tested the efficacy of these sHDLs in two sepsis mouse models—cecal ligation and puncture (CLP)-induced and P. aeruginosa-induced sepsis models—and assessed their impact on inflammatory signaling in cells. Results: …

Artesunate Enhances The Efficacy Of Enzalutamide In Advanced Prostate Cancer, Xinyi Wang, Jinghui Liu, Fengyi Mao, Yifan Kong, Qiongsi Zhang, Chaohao Li, Daheng He, Chi Wang, Yanquan Zhang, Ruixin Wang, Sally R. Ellingson, Qiou Wei, Zhiguo Li, Xiaoqi Liu

Markey Cancer Center Faculty Publications

Prostate cancer (PCa) is one of the leading causes of death among men worldwide. Treatments targeting the androgen receptor pathway remain the standard therapy for PCa patients. Enzalutamide (ENZ), a second-generation androgen receptor inhibitor, was developed to treat castration-resistant prostate cancer. However, while patients initially respond to ENZ, drug resistance typically develops within a few months. Artesunate (ART), a semisynthetic derivative of the Artemisinin plant, is approved for antimalaria treatment. In this study, we conducted an FDA-approved drug screening and identified ART as a potential candidate for overcoming ENZ resistance in PCa. Mechanistically, ART induces the degradation of c-Myc, enhancing …

Development Of Mobility Scales For Infants And Children On Ecmo, Johanna I. Orrick, Debra E. Newton, Caroline Holton

Posters

Extracorporeal Membrane Oxygenation (ECMO) is a life-saving intervention commonly used in pediatric and neonatal intensive care; however, it presents unique challenges for maintaining patient mobility. Early mobility contributes to better long-term outcomes. Existing mobility scales by the Extracorporeal Life Support Organization (ELSO) are limited to patients aged 8 years and older, leaving a gap for younger populations. This study aimed to develop and validate mobility scales specifically for infants (< 2 years) and children aged 2-8 years undergoing ECMO therapy. Through a collaborative effort involving pediatric ECMO specialists, physicians, and critical care nurses, we adapted ELSO’s mobility criteria to be developmentally appropriate for these younger age groups. For infants, mobility benchmarks include passive and active limb movements, head control, and supported sitting. The criteria for children aged 2-8 is expanded to include sitting, supported standing, and age-appropriate gross motor activities. This scale provides graded levels of mobility that accommodate ECMO-specific safety considerations, allowing practitioners to chart interventions according to each child’s developmental and physiological capacity. The resulting scales are being pilot-tested at our large ECMO center, with data showing preliminary effectiveness at capturing the degree of mobility achieved during ECMO runs. This mobility scale fills a critical need by providing structured charting guidelines for mobilizing infants and young children on ECMO, promoting functional recovery and potential improvements in long-term developmental outcomes. Further studies are recommended to establish consistency across institutions and confirm the scale's impact on mobility outcomes in pediatric ECMO patients.

Pre-Hospital And Post-Hospital Quality Of Care In Traumatic Spinal Column And Cord Injuries In Iran, Arman Zeinaddini-Meymand, Vali Baigi, Mohammad Mehdi Mousavi-Nasab, Sina Shool, Mohsen Sadeghi-Naini, Zahra Azadmanjir, Seyed Behnam Jazayeri, Samuel Berchi Kankam, Mohammad Dashtkoohi, Aidin Shakeri, Esmail Fakharian, Leila Kouchakinejad-Eramsadati, Habibollah Pirnejad, Homayoun Sadeghi-Bazargani, Laleh Bagheri, Yasaman Pourandish, Malihe Amiri, Ahmad Pour-Rashidi, James Harrop, Vafa Rahimi-Movaghar

Department of Neurosurgery Faculty Papers

STUDY DESIGN: A retrospective study.

OBJECTIVES: The quality of care (QoC) for spinal column/cord injury patients is a major health care concern. This study aimed to implement the QoC assessment tool (QoCAT) in the National Spinal Cord/Column Injury Registry of Iran (NSCIR-IR) to define the current state of pre- and post-hospital QoC of individuals with Traumatic Spinal Column and Spinal Cord Injuries (TSC/SCIs).

METHODS: The QoCAT, previously developed by our team to measure the QoC in patients with TSC/SCIs, was implemented in the NSCIR-IR. The pre-hospital QoC was evaluated through a retrospective analysis of NSCIR-IR registry data. Telephone interviews and …

Case Series On Prosthetic Valve Thromboses Treated With Intravenous Thrombolysis At A Tertiary Teaching Hospital In Nairobi – Kenya, John Odhiambo, Salim Abdallah, Mzee Ngunga

Internal Medicine, East Africa

Valvular heart disease is a significant global health issue, particularly in developing countries where Rheumatic Heart Disease (RHD) is the leading cause. Valve replacement surgeries have increased, with mechanical prostheses favored for their durability. However, thromboembolism remains a critical complication post-surgery, with prosthetic valve thrombosis rates of 0.03% for bioprosthetic valves and between 0.5% to 8% for mechanical valves in the aortic and mitral position. This report details two cases of heart failure following valve replacement due to rheumatic heart disease. The first case involves a 42-year-old female who developed prosthetic valve thrombosis after discontinuing warfarin for menorrhagia postmechanical mitral …

Icu Admission Prediction For Patients With Kawasaki Disease Or Mis-C Using Machine Learning., Jiwon Woo, Rebecca Mosier, Rishima Mukherjee, Ashraf S. Harahsheh, Supriya S. Jain, Geetha Raghuveer, Balasubramanian Sundaram, Simon Lee, Michael A. Portman, Nagib Dahdah, Marianna Fabi, Todd T. Nowlen, Audrey Dionne, Mona El Ganzoury, Tyler H. Harris, Benjamin T. Barnes, Frederic Dallaire, Paul Dancey, Kambiz Norozi, Mahmoud Alsalehi, Elif Seda Selamet Tierney, Jacqueline R. Szmuszkovicz, Pei-Ni Jone, Deepa Prasad, Anji T. Yetman, Nilanjana Misra, Mark D. Hicar, Deepika Thacker, Nadine F. Choueiter, Elisa Fernandez Cooke, Daniel Mauriello, Tapas Mondal, Matthew D. Elias, Kimberly E. Mchugh, Shae A. Merves, Luis Martin Garrido-Garcia, Michael Khoury, Guillermo Larios, Bhargava Chinni, Kaashvi Pruthi, Wenyu Yang, Joseph Greenstein, Casey Taylor, Pedrom Farid, Brian W. Mccrindle, Cedric Manlhiot, International Kawasaki Disease Registry

Manuscripts, Articles, Book Chapters and Other Papers

BACKGROUND: Multisystem inflammatory syndrome in children (MIS-C) and Kawasaki disease (KD) show a broad spectrum of clinical severity, from a relatively benign clinical course to requiring admission to the intensive care unit (ICU). With either, clinical deterioration may be rapid and unexpected.

OBJECTIVES: The aim of the study was to develop a machine learning (ML) model to predict future ICU admission for patients with KD or MIS-C to augment clinical decision-making.

METHODS: We developed a prediction model for ICU admission using 2,539 patientsfeatures, we developed predictive snapshot and window ML models with logistic regression, XGBoost, and random forest. Performance was …

Massive Gastroduodenal Trichobezoar Removed With Hydrodissection: A Case Report, Seth Saylors, Cory Nonnemacher, Irene Isabel P. Lim

Manuscripts, Articles, Book Chapters and Other Papers

Introduction

Case presentation