Medical Specialties Commons^™

High-Dose Oral Pyrophosphate Inhibits Connective Tissue Calcification In Abcc6 Null Mice But May Affect Bone Structure, Ibtesam Rajpar, Nicholas Yancy, Jacob Beiriger, Christina Shao, Syed Naqvi, Deana Mancuso, Fatemeh Niaziorimi, Ryan E Tomlinson, Koen Van De Wetering

Department of Orthopaedic Surgery Faculty Papers

Pseudoxanthoma elasticum (PXE) is a rare inherited disorder marked by abnormal calcium phosphate deposition in soft connective tissues, particularly the skin, arteries, and eyes. It is caused by inactivating mutations in the ABCC6 gene, which encodes a hepatic efflux transporter. Loss of ABCC6 function leads to reduced plasma levels of pyrophosphate (PPi), a key inhibitor of calcification, thereby promoting ectopic mineralization. Oral PPi therapy has emerged as a potential treatment, but its effectiveness is uncertain. Most ingested PPi is hydrolyzed in the gut to inorganic phosphate, which may worsen calcification. Moreover, its impact on mineralized tissues remains largely unexplored. Abcc6−/− …

Tumor-Infiltrating Bacteria Disrupt Cancer Epithelial Cell Interactions And Induce Cell-Cycle Arrest, Jorge Luis Galeano Niño, Falk Ponath, Victor A Ajisafe, Clara R Becker, Andrew G Kempchinsky, Martha A Zepeda-Rivera, Javier A Gomez, Hanrui Wu, Jessica G Terrazas, Heather Bouzek, Elizabeth Cromwell, Pritha Chanana, Matthew Wong, Ashish Damania, Michael G White, Y Nancy You, Scott Kopetz, Nadim J Ajami, Jennifer A Wargo, Christopher D Johnston, Susan Bullman

Faculty, Staff and Student Publications

Tumor-infiltrating bacteria are increasingly recognized as modulators of cancer progression and therapy resistance. We describe a mechanism by which extracellular intratumoral bacteria, including Fusobacterium, modulate cancer epithelial cell behavior. Spatial imaging and single-cell spatial transcriptomics show that these bacteria predominantly localize extracellularly within tumor microniches of colorectal and oral cancers, characterized by reduced cell density, transcriptional activity, and proliferation. In vitro, Fusobacterium nucleatum disrupts epithelial contacts, inducing G0-G1 arrest and transcriptional quiescence. This state confers 5-fluorouracil resistance and remodels the tumor microenvironment. Findings were validated by live-cell imaging, spatial profiling, mouse models, and a 52-patient colorectal cancer cohort. Transcriptomics reveals …

Spatial Omics At The Forefront: Emerging Technologies, Analytical Innovations, And Clinical Applications, Yunhe Liu, Yibo Dai, Linghua Wang

Faculty, Staff and Student Publications

Spatial omics transforms our understanding of cancer by revealing how tumor cells and the microenvironment are organized, interact, and evolve within tissues. Here, we synthesize advances in spatial technologies that map tumor ecosystems with unprecedented fidelity. We highlighted analytical breakthroughs-including multimodal integration and emerging spatial foundation models-that resolve functional niches and spatial communities, converting spatial patterns into mechanistic insights. We summarize how spatially organized features, from immune hubs to microbiota and neural interfaces, shape tumor evolution and clinical outcomes. We then outline how spatial approaches illuminate precancer biology, metastatic adaptation, and therapy response. Bridging discovery and translation, we provide a …

Tet2-Mutant Clonal Hematopoiesis Enhances Macrophage Antigen Presentation And Improves Immune Checkpoint Therapy In Solid Tumors, Shelley Herbrich, Mehdi Chaib, Swetha Anandhan, Samuel W Andrewes, Ashwat Nagarajan, Baoxiang Guan, Nishant Gandhi, Jared Gilliam, Milan Radovich, Padmanee Sharma

Faculty, Staff and Student Publications

Clonal hematopoiesis (CH) is detectable in upwards of 20% of patients with solid tumors and is associated with worsened prognosis; however, its role in tumor immunology and immune checkpoint therapy (ICT) is unknown. Using a bone marrow chimera model of Tet2+/mut CH in mice with solid tumors, we found the Tet2-mutant myeloid cells are abundant in the tumor microenvironment and contributed to an improved response to ICT. Mechanistically, Tet2+/mut macrophages inside the tumor act as immunogenic antigen-presenting cells that more effectively cross-prime naive CD8+ T cells in response to IFNγ. In human cohorts of 35,971 non-small cell lung cancer patients …

Adipose Stromal Cell-Derived Cancer-Associated Fibroblasts Promote Pancreatic Adenocarcinoma Progression Through Sfrp4 Signaling, Joseph Rupert, Lingyi Cai, Alexes C Daquinag, Dimitris Anastassiou, Mikhail G Kolonin

Faculty, Staff and Student Publications

Background/objectives: Progression of pancreatic ductal adenocarcinoma (PDAC) and other carcinomas relies on cancer-associated fibroblasts (CAFs). A subset of CAFs is derived from adipose stromal cells (ASCs) recruited by tumors and the ASC-CAF conversion has been associated with invasiveness and poor prognosis.

Methods: To explore the underlying molecular mechanisms, we used a model based on primary ASCs derived from human visceral adipose tissue co-cultured with human PDAC cell line Capan-1. To investigate cancer progression in vivo, we also used mice orthotopically grafted with mouse KPC cells.

Results: Genomic analysis revealed that Capan-1 co-culture induces Wnt and TGFβ signaling and extracellular matrix …

Chek2 Loss Endows Chemotherapy Resistance To Hematopoietic Stem Cells, Jing Zhou, Tianyuan Hu, Dian Li, Sanming Li, Minhua Li, Xiangguo Shi, Daisuke Nakada

Faculty, Staff and Students Publications

Individuals with history of chemo- or radiotherapy frequently exhibit somatic mosaicism in the blood, often involving mutations in genes responsible for DNA damage responses (DDR), such as CHEK2. However, the mechanisms by which CHEK2 mutations promote the expansion of mutant cells following chemo- or radiotherapy remain poorly understood. Here, we demonstrate that loss of CHEK2 confers resistance to chemotherapy in hematopoietic stem and progenitor cells (HSPCs). Through a CRISPR-based screen, we identified CHEK2 as a gene whose loss enhances resistance to cytotoxic chemotherapies. A complementary drug screen revealed that CHEK2-mutant cells are also resistant to DNA hypomethylating agents. Chek2-deficient HSPCs …

Germline Hla Heterozygosity Is Associated With Decreased Lung Cancer Risk, Taotao Tan, Vikram R Shaw, Jinyoung Byun, Hyun-Sung Lee, Younghun Han, Yafang Li, Rayjean J Hung, David C Christiani, Xin-An Wang, Mattias Johansson, Xiangjun Xiao, David Zaridze, Stig Egil Bojesen, Sanjay Shete, Demetrios Albanes, Melinda C Aldrich, Adonina Tardon, Guillermo Fernandez-Tardon, Loïc Le Marchand, Gad Rennert, Heike Bickeböller, H-Erich Wichmann, Angela Risch, John K Field, Michael Davies, Penella Woll, Lambertus A Kiemeney, Aage Haugen, Shanbeh Zienolddiny, Stephen Lam, Mikael Johansson, Kjell Grankvist, Matthew B Schabath, Angeline Andrew, Philip Lazarus, Susanne M Arnold, Dakai Zhu, Maria Teresa Landi, James Mckay, Christopher Amos, Chao Cheng

Faculty, Staff and Students Publications

Heterozygosity at human leukocyte antigen (HLA) loci may improve lung cancer immunosurveillance by increasing recognition of the tumor by the immune system. Previous studies utilizing data from population-level biobanks, such as the United Kingdom Biobank and FinnGen, have identified an association between germline HLA class-II heterozygosity and reduced lung cancer risk in smokers. In the present study, we evaluate the association between HLA heterozygosity and lung cancer in a large case-control study (15,302 cases; 14,580 controls) with imputed HLA allele-type information, comparing differences in HLA heterozygosity between smokers and non-smokers, amongst lung cancer subtypes, and at 2- and 4-digit HLA …

High-Sensitivity Cardiac Troponin I And Frailty: Associations With The Frailty Index And Fried Phenotype In Older Women, Jedd Pratt, Abadi K. Gebre, Carlos J. Toro-Huamanchumo, Elsa Dent, Trent Bozanich, Wai E. Lim, Elizabeth Byrnes, Julee Mcdonagh, Caleb Ferguson, Craig Sale, Kun Zhu, Carl Schultz, Richard L. Prince, Joshua R. Lewis, Marc Sim

Research outputs 2022 to 2026

Despite the nexus between cardiovascular health and frailty, the relevance of high-sensitivity cardiac troponin I (hs-cTnI), a biomarker of myocardial injury, to frailty is poorly understood. We examined whether hs-cTnI concentrations were associated with frailty in a well-characterized cohort of older women. A total of 1151 community-dwelling women from the Perth Longitudinal Study of Aging Women (mean age ± SD = 75.2 ± 2.7 years) were included. Frailty was operationalized using a validated frailty index (FI) of cumulative deficits and a modified Fried phenotype. Plasma hs-cTnI were categorized into quartiles. Cross-sectional associations between hs-cTnI quartiles and frailty were assessed using …

Dynamic Fib-4 Score Changes And Hcc Risk In Patients With Masld And Elevated Liver Enzymes: A Nationwide Cohort Study, Yee Hui Yeo, Hsiu J Ho, Tsai-Wei Huang, Teng-Yu Lee, Ju Dong Yang, George Cholankeril, Chien-Jen Chen, Hawi-I Yang, Chuen-Fei Chen, Hung-Chuen Chang, Chun-Ying Wu

Faculty, Staff and Students Publications

Introduction: Hepatocellular carcinoma (HCC) can develop in individuals with metabolic dysfunction-associated steatotic liver disease (MASLD) without cirrhosis, especially in those with elevated liver enzymes. However, there is currently no low-cost, scalable screening tool for this population. To address this need, we investigated the association between serial changes in FIB-4 (fibrosis-4) scores over a 3-year period and the risk of developing HCC in a large, diverse cohort of patients with MASLD without cirrhosis.

Methods: This study utilized a nationwide cohort from the National Health Insurance Research Database (NHIRD), including 810,698 patients with MASLD who had demographic and laboratory data at baseline …

A Case Of Listeria Monocytogenes Bacteremia In A Middle-Aged Woman With A History Of Primary Biliary Cholangitis, Caleb Smack, Jared T. Lausen, Aaron Mills

Eastern Virginia Medical Journal

In this report, we discuss the case of a patient with Listeria monocytogenes bacteremia likely resulting from primary biliary cholangitis (PBC) induced cirrhosis. We aim to bolster the body of literature on Listeria bacteremia and establish PBC as a risk factor for this rare complication. Our patient, who presented with sepsis, was subsequently found to have Listeria bacteremia and received intravenous antibiotic treatment of ampicillin for 3 total weeks with complete resolution of her disease. This is the first case suggesting that cirrhosis as a result of PBC may be an independent risk factor for Listeria bacteremia. In patients at …

Blood Product Transfusion And Coagulopathy In Children With Traumatic Brain Injury: A Narrative Review., Robert Marcel T. Huibonhoa, Niranjan Vijayakumar, Daniel Kelly, Oliver Karam, Madhuradhar Chegondi

Manuscripts, Articles, Book Chapters and Other Papers

Traumatic brain injury (TBI) is a leading cause of critical illness and mortality in children. Transfusion of blood products, a common intervention in the management of pediatric TBI, has important implications for related principles, including trauma-induced coagulopathy, cerebral perfusion, and cerebral oxygen delivery. Knowledge gaps persist due to the limited availability of pediatric-specific data regarding blood product transfusion in TBI. In particular, there is a lack of prospective studies defining appropriate specific laboratory thresholds and transfusion targets, as well as insufficient evidence to guide the weighing of potential benefits against transfusion-related risks in this population. Although blood product transfusion in …

Policy, Misinformation, And Mortality: The Effects Of Abortion Restrictions On Maternal Outcomes, Gabrielle Samiratedu Dmsc, Mcms, Pa-C

Lynchburg Journal of Medical Science

The objective of this review is to evaluate the effects of restrictive abortion laws on maternal mortality and morbidity in the United States. Even before the landmark reversal of Roe v. Wade, the US had one of the highest maternal mortality rates among other high-income countries, and rates are expected to continue to rise in states with restrictive abortion policies. Electronic databases and public health data were analyzed to assess clinical outcomes, access to care, and disparities associated with abortion restrictions nationally and internationally. The findings suggest that states with highly restrictive abortion policies experience higher rates of maternal morbidity …

Circulating Tumor Dna: Reducing Burden In Hpv+ Oropharyngeal Cancer Surveillance, Liza M. Joseph Pa-C

Lynchburg Journal of Medical Science

This review examines the rising prevalence of human papillomavirus-related (HPV+) oropharyngeal squamous cell carcinoma (OPSCC) and evaluates the role of circulating tumor HPV DNA (ctHPVDNA) in diagnosis and post-treatment surveillance. A comprehensive literature search of electronic databases, including PubMed, Medline, Cochrane Library, and Google Scholar, identified studies that validated ctHPVDNA as a biomarker with high sensitivity and specificity, assessed its cost-effectiveness, and explored patient and provider perceptions. Clinical evidence supports that plasma-based ctHPVDNA is the most accurate method for detecting disease recurrence and quantifying tumor burden. Patient perception studies reported high confidence in ctHPVDNA testing, while providers viewed it as …

Grover's Disease: A Review Of The Current Treatment Options, Dustin Ross, Dmsc, Mph, Pa-C

Lynchburg Journal of Medical Science

Grover’s disease, also known as transient acantholytic dermatosis, is an uncommon dermatologic condition characterized by pruritic papulovesicular eruptions that predominantly affect the trunk of older adults. Although the disease is often self-limited, it may significantly impair quality of life. This review summarizes treatment options and emerging therapies for Grover’s disease reported in the literature since 2019. A comprehensive search of PubMed and MEDLINE identified 1,068 records, of which thirteen publications met inclusion criteria, including one systematic review, one narrative review, one nonrandomized controlled study, nine case reports, and one fact sheet, representing a total of 337 patients. The literature demonstrates …

Weight-Loss Efficacy Of Glp-1 Receptor Agonists Relative To Lifestyle-Based Interventions, Amy Betterton

Lynchburg Journal of Medical Science

ABSTRACT

This clinical review compares the effectiveness of glucagon-like peptide-1 receptor agonists (GLP-1 RAs) with traditional lifestyle modifications in managing obesity. This article also examines barriers to accessing the medications in both civilian and veteran populations. This clinical review was conducted through a wide-ranging review of the published literature, including clinical trials, observational studies, and review articles on lifestyle modifications, GLP-1 receptor agonists, and barriers to obesity treatment. While lifestyle modifications are generally considered a first-line approach and are cost-effective, they tend to yield only modest weight loss. In contrast, GLP-1 RAs offer significantly greater reductions in body weight as …

Subcutaneous Insulin Use In Diabetic Ketoacidosis, Patrick Mcgrath

Lynchburg Journal of Medical Science

The reviewed literature focuses on the clinical application of subcutaneous (SQ) insulin, particularly rapid-acting insulin analogs (RAIAs), in treating selected patients with mild to moderate diabetic ketoacidosis (DKA). The use of SQ insulin offers a viable alternative to traditional intravenous (IV) insulin infusions, enabling DKA management outside intensive care unit (ICU) settings and reducing healthcare resource utilization. Current DKA management protocols emphasize comprehensive fluid resuscitation and correction of electrolyte imbalances, with IV regular insulin administered at 0.1 units/kg/hour. This review synthesizes findings from multicenter cohort studies, meta-analyses, and randomized controlled trials (RCTs) available via PubMed, focusing on adult patients diagnosed …

Brief Overview Of Assessment And Prognostication Tools For Palliative Care Oncology Patients, Nicole Schwensow

Lynchburg Journal of Medical Science

Patients with life-threatening illnesses can be at risk for the progression of their disease over time. Consequences of such an illness can include recurrent hospitalizations, poor symptom control, and a lack of understanding by the patient and family of the disease, its usual course, and prognosis. Palliative care is a philosophy of care intended to address these issues. While receiving palliative care, patients can continue to undergo treatments directed at a cure, whereas hospice patients no longer receive treatment for underlying diseases. Both approaches focus on symptom control. To best care for palliative patients over time, several outcome domains should …

Understanding Monoclonal Gammopathy Of Undetermined Significance, Scott Winkel Msph, Mhs, Pa-C

Lynchburg Journal of Medical Science

Monoclonal gammopathy of undetermined significance (MGUS) is a premalignant plasma cell disorder characterized by serum monoclonal protein (M-protein) levels less than 3.0 g/dL, less than 10% plasma cells in the bone marrow, and absence of end-organ damage. It mainly affects older adults and is often an incidental finding. While most cases remain indolent, a subset progresses to malignancies such as multiple myeloma, smoldering myeloma, AL amyloidosis, lymphoproliferative disorders, macroglobulinemia, and monoclonal gammopathy of renal significance. This review summarizes current insights into MGUS pathophysiology, risk factors, molecular mechanisms, clinical features, diagnostic approaches, including laboratory assessments and imaging, and emphasizes early detection …

Identification Of Cadm1 As An Immunotherapeutic Target And Evaluation Of A Novel Cadm1-Targeting Antibody-Drug Conjugate In Preclinical Osteosarcoma Models, Yifei Wang, Zhongting Zhang, Caterina Longo, Wendong Zhang, Qi Wang, Amer Najjar, Xiangjun Tian, Rossana N Lazcano Segura, Michael E Roth, Jonathan Gill, Douglas J Harrison, Zhaohui Xu, Yanhua Yi, Xin Zhou, Sylvester Jusu, Timothy M Stearns, Steven B Neuhauser, Carol J Bult, Jing Wang, Alexander J Lazar, Richard Gorlick

Faculty, Staff and Student Publications

Due to the paucity of validated cell surface osteosarcoma-specific targets, patients with this condition have long been excluded from the benefits of antibody-drug conjugate (ADC) therapy observed in patients with several solid and hematologic malignancies. Our comprehensive surfaceome profiling approach previously identified osteosarcoma-specific cell-surface antigens that are highly expressed in osteosarcomas but minimally expressed in normal tissues. As a result, one such antigen, CADM1, was selected for the generation of an ADC. We tested a CADM1-targeting ADC with a tesirine payload (SG3249) in vitro in osteosarcoma, rhabdomyosarcoma, and neuroblastoma patient-derived xenograft cell lines. In vivo, we tested six CADM1-expressing osteosarcoma …

Flipi24: A Modern Prognostic Model And Clinical Trial Enrichment Tool For Newly Diagnosed Follicular Lymphoma, Matthew J Maurer, Vit K Prochazka, Tarec Christoffer El-Galaly, Christopher R Flowers, Diego Villa, Emmanuel Bachy, Elliot J Cahn, Marguerite Fournier, Melissa C Larson, Caroline E Dietrich, Lasse Hjort Jakobsen, Hervé Ghesquières, Robert Kridel, Maher K Gandhi, Chan Y Cheah, Eliza A Hawkes, John F Seymour, Ciara L Freeman, Michael R Clausen, Björn E Wahlin, Jonathan W Friedberg, Carla Casulo, Thomas M Habermann, Yucai Wang, Loretta J Nastoupil, Peter De Nully Brown, David Belada, Andrea Janíková, Heidi Mocikova, Tomáš Fürst, Pierre Feugier, Hervé Tilly, Corinne Haioun, Andrew J Davies, Guillaume Cartron, Richard Burack, Dai Chihara, Peter Martin, Jonathon B Cohen, Izidore S Lossos, Brad S Kahl, Laurie H Sehn, Karin E Smedby, Gilles Salles, Marek Trneny, Brian K Link, Franck Morschhauser, James R Cerhan

Faculty, Staff and Student Publications

Purpose: Although most patients with follicular lymphoma (FL) can expect an indolent course, progressive lymphoma remains the primary cause of death during the first decade after diagnosis. Progression of disease within 24 months (POD24) of starting first-line (1L) immunochemotherapy defines a high-risk population with poor survival, but better risk stratification at diagnosis is needed.

Methods: The FLIPI24 model was developed and internally validated to predict 24-month event rates using individual data from 4,485 patients treated with 1L immunochemotherapy from 10 observational cohorts of FL. Overall and cause-specific survival was further evaluated in FLIPI24 risk groups. External validation in the 1L …

Il-18 Metabolically Reprograms Car-Expressing Natural Killer T Cells And Enhances Their Antitumor Activity, Gabriel A Barragán Bravo, David A De La Cerda, Elisa Landoni, Kshiti Dholakia, Piotr Humeniuk, Leidy D Caraballo Galva, Ying Wang, Gengwen Tian, Boning Yang, Linjie Guo, Michael S Wood, Xavier Rios, Xin Xu, Amy N Courtney, Erica J Di Pierro, Joan Jacob, Yi-Han Li, Akshaya Adaikkalavan, Norihiro Watanabe, Sufeng Mao, George Miles, Gianpietro Dotti, Leonid S Metelitsa

Faculty, Staff and Students Publications

Invariant natural killer T cells (NKTs) have intrinsic anti-tumor properties that make them promising candidates for chimeric antigen receptor (CAR) immunotherapies. Transgenic cytokine expression can enhance cellular therapy potency, and we hypothesized that co-expressing IL-18 alone or with IL-15 would boost CAR-NKT therapeutic potential. To test this, we generated retroviral constructs expressing IL-15 and/or IL-18 with an inducible caspase 9 safety switch and co-transduced them with a GD2-specific CAR into human NKTs. Co-expression of IL-18 or IL-15/IL-18 increased CAR-NKT cytotoxicity, proliferation, and cytokine secretion in vitro compared to IL-15 alone. IL-18 also enhanced GPC3.CAR and CD19.CAR NKT activity against hepatocellular …

Proton Versus Photon Radiotherapy For Patients With Oropharyngeal Cancer In The Usa: A Multicentre, Randomised, Open-Label, Non-Inferiority Phase 3 Trial, Steven J Frank, Paul M Busse, J Jack Lee, David I Rosenthal, Mike Hernandez, David M Swanson, Adam S Garden, G Brandon Gunn, Samir H Patel, James W Snider, Daniel J Ma, Jason K Molitoris, Nancy Y Lee, Upendra Parvathaneni, Mark W Mcdonald, Noah S Kalman, Alexander Lin, Nasiruddin Mohammed, Christina Henson, Christian Hyde, Gopal K Bajaj, Sanford R Katz, Roi Dagan, William H Morrison, Jay P Reddy, C David Fuller, Shalin J Shah, Jack Phan, Gregory M Chronowski, Lauren Mayo, Erich M Sturgis, Renata Ferrarotto, Xiaorong R Zhu, Xiaodong Zhang, Li Wang, Katherine A Hutcheson, Adel K El-Naggar, Amy C Moreno, Anna Lee, Michael T Spiotto, Neil D Gross, Stephen Y Lai, Jay J Liao, Jonathan Paly, Zhongxing Liao, Robert L Foote

Faculty, Staff and Student Publications

Background: Radiotherapy is an integral component of treatment for oropharyngeal cancer. Toxicity from the current state-of-the-art photon radiotherapy, intensity-modulated radiation therapy (IMRT), has prompted the search for alternative, less toxic therapies. One such alternative that might de-intensify treatment is proton therapy. In this trial, we aimed to directly compare IMRT with intensity-modulated proton therapy (IMPT), both concurrent with systemic therapy, hypothesising comparable disease control and survival and lower toxicity.

Methods: This randomised, multicentre, open-label, non-inferiority, phase 3 trial was conducted in 21 sites (cancer centres or universities) in the USA. Patients (aged ≥18 years) with stage III or stage IV …

Repair Techniques For Acute Rupture Of The Patellar Tendon: A Systematic Review, Gaston Davis, Harrison S. Fellheimer, Christian Mccormick, Kevin B. Freedman

Rothman Institute Papers

BACKGROUND: Multiple techniques exist to repair acute tears of the patellar tendon. Surgical repair is required to reestablish full function of the extensor mechanism of the knee, and optimal results typically occur when the tear is repaired acutely.

PURPOSE: To systematically review the literature to evaluate treatment outcomes and complication rates after acute surgical repair of patellar tendon ruptures using suture anchor repair, transosseous repair, and end-to-end repair.

STUDY DESIGN: Scoping review; Level of evidence, 4.

METHODS: A systematic review was performed to analyze outcomes after patellar tendon repair in accordance with the PRISMA (Preferred Reporting Items for Systematic Reviews …

The Role Of Brain Magnetic Resonance Spectroscopy In Assessment Of Patients With Minimal Hepatic Encephalopathy, Zeinab Moustafa Moustafa Metwalli, Mohammed Emadeldeen, Waseem Mohamad Mahmoud El Gendy, Rania Mostafa Mahmoud, Heba Abdelaziz

Journal of Medicine in Scientific Research

Background: It appears that mild and hidden Hepatic Encephalopathy (HE) is present in up to 50% of patients with chronic liver disease. Tools that can predict when HE episodes would occur may enable early detection and clinically relevant preventative treatment. The brain's magnetic resonance spectroscopy (MRS) is considered a useful technique for providing a range of structural and functional assessments. Objective: To evaluate the role of brain magnetic resonance spectroscopy in assessment of metabolic changes in patients with chronic liver disease and minimal hepatic encephalopathy for better diagnosis and thus prevention of decline in cognitive functions and health related quality …

Effect Of Therapeutic Ultrasound Versus Anti-Inflammatory Drugs In The Treatment Of Trigger Finger. A Placebo Randomized-Controlled Trial., Eslam Elsayed Ali Shohda

Journal of Medicine in Scientific Research

Background: Trigger finger (TF) is a painful disorder that hinders the use of the entire hand. One of the most widely used modalities in the field of physiotherapy is therapeutic ultrasound (US); however, no randomized control trial has investigated the use of US in the treatment of TF. The objective of this trail is to determine the effect of therapeutic US on pain intensity and the frequency of daily finger clicking in patients with TF. Materials and Methods: A single-blind, randomized (1:1), placebo-controlled, clinical trial was conducted at a physiotherapy outpatient clinic at Alahrar Teaching Hospital in Zagazig, Egypt. Twenty …

Predictors Of Mortality Among Under-Five Children Hospitalized With Severe Community-Acquired Pneumonia. A Retrospective Observational Study, Marwa Taha

Journal of Medicine in Scientific Research

Background Severe community-acquired pneumonia (SCAP) remains a critical public health issue and a leading cause of childhood mortality and morbidity, especially in developing countries. Identifying predictors of death in children with SCAP and early recognition of high-risk patients could significantly improve survival rates. Objective This study aims to identify possible predictors of mortality in pediatric SCAP, facilitating the early recognition of high-risk children. Patients and Methods This retrospective observational study included 120 children under the age of five who were admitted with SCAP, based on World Health Organization (WHO) guidelines. Demographic data, clinical characteristics, laboratory findings, and hospital outcomes were …

Knowledge And Practice Of Breast Self-Examination Among Young Women Comes To General Surgery Clinic In Shebin El Kom Teaching Hospital, Shimaa M W Kalama

Journal of Medicine in Scientific Research

Background Breast cancer, which makes up 30.4% of newly diagnosed tumors, is one of the most common cancers among young girls. Every woman who is 20 years of age or older is thought to be at risk of getting breast cancer. This research is crosssectional. The Shebin-Elkom Teaching Hospital served as the study's site. Randomized sampling was used to enroll five hundred women for this study. To collect information, a self-administration questionnaire was employed. Objective:. to evaluate the women who visited the surgery clinic at Shebin El Kom Teaching Hospital's knowledge of breast cancer, BSE, and its function in early …

Influence Of Frailty On The Outcome Of Surgical Patients Over 70 Years Old With Admission Criteria In The Icu At Shebin El-Kom Teaching Hospital, Talal Ibrahim Mostafa Hagag Dr, Shimaa Mohamed Kalama

Journal of Medicine in Scientific Research

Background: In older adults, frailty is a complex condition marked by diminished functional reserves and heightened susceptibility to stressors. It is a more accurate predictor of unfavorable postoperative outcomes in the context of surgical operations than a patient's age or preexisting medical problems. Objectives: This study aimed to investigate the effects of frailty, as assessed by the Clinical Frailty Scale (CFS) and the 5-item Modified Frailty Index (MFI-5), on important clinical outcomes, including length of stay in the intensive care unit (ICU), hospitalization mortality, and the chance of readmission within 30 days, in older adults undergoing major abdominal surgeries. Methods: …

Ct Chest Findings And Laboratory Investigations Of Covid 19 Patients And Their Relation To The Clinical Outcome, Zeinab Moustafa Moustafa Metwalli, Mohammed Emadeldeen, Heba Abdelaziz, Nagwa M. Salah

Journal of Medicine in Scientific Research

For both the initial evaluation and follow-up in suspected COVID-19 cases, chest CT is strongly recommended. Additionally, the disease and its severity might be suspected using basic laboratory investigations. Better clinical results and appropriate management may result from all of this. Aim to evaluate the relation between the clinical outcome of COVID-19 patients, laboratory data, and the severity of CT chest findings. Methods 90 individuals who were referred to the radiodiagnosis department from the National Hepatology and Tropical Medicine Research Institute's Internal Medicine Department after PCR confirmed that they had COVID-19 were included in this retrospective study. Each patient was …

Outcomes Of Endoscopic Third Ventriculostomy (Etv) In Hydrocephalus Secondary To Aqueductal Stenosis After Age Of Anterior Fontanel Closure, Mohammad Abdulsalam Soliman, Eslam Abozeid Kandil, Mahmoud Moustafa Taha, Hassan Ahmed Abaza

Journal of Medicine in Scientific Research

Background: Non-communicated hydrocephalus secondary to aqueductal stenosis is common, for which endoscopic third ventriculostomy (ETV) has emerged as an effective surgical management. Objective: To evaluate the clinical outcomes of ETV in patients with obstructive hydrocephalus due to aqueductal stenosis in patients over 2 years of age. Methods: This retrospective study was conducted at our institution and included 57 patients older than 2 years who underwent ETV between 2017 and 2024. Demographic data, clinical presentation, and follow-up outcomes were analysed. ETV was considered successful if the patient remained shunt-free during the follow-up period. Results: The mean age was 22.8 ± 10.5 …