Medical Specialties Commons^™

Antibodies Gone Rogue: Autoimmunity Pairs With Antibiotic Allergy, Shubhank Goyal, Jose Jonathan Loayza Pintado, Cesar Uribe

Research Colloquium

Background: Autoimmune autonomic ganglionopathy (AAG) is a rare and complex disorder marked by severe dysautonomia, profoundly affecting a patient's quality of life. Treatment typically involves immunoglobulin (IVIG) infusions, which play a critical role in managing symptoms and improving patient outcomes. Managing AAG alongside acute infections such as cystitis, especially in patients with complicated drug allergies and sensitivities, presents unique clinical challenges. This case is noteworthy due to the patient’s rare combination of autoimmune autonomic ganglionopathy, chronic orthostatic hypotension, and a history of severe allergic reactions to antibiotics, complicating both infection management and treatment planning. The use of immunoglobulins in the …

A Vascular Puzzle: Identifying High-Output Heart Failure In A Patient With End-Stage Renal Disease And A Fresh Arteriovenous Fistula, Carlos Luis Alejos Aguero, Khiem Ng, Jennifer Rojas Huen, Liza Salloum, James Stone

Research Colloquium

Introduction: We present a case highlighting high-output heart failure secondary to an acquired arteriovenous fistula for dialysis. High-output cardiac failure is a less common form of heart failure characterized by the heart pumping an increased volume of blood but failing to meet the body's metabolic demands.

Case presentation: A 74-year-old female with a history of hypertension, dyslipidemia, type 2 Diabetes, and end-stage renal disease (ESRD) on hemodialysis via a left arteriovenous fistula. She presented with worsening dyspnea over 2-3 months, initially relieved post-dialysis but progressing to dyspnea at rest, orthopnea, and paroxysmal nocturnal dyspnea despite dialysis compliance. Physical exam revealed …

A Novel Technique Utilizing External Fixation For Intramedullary Total Femur Arthroplasty, Blake Martin, Matthew Hnatow, Emma Herrera

Research Colloquium

Background: Total femur replacement (TFR) exists as a salvage procedure option after multiple failed hip and knee arthroplasties. It can restore a patient’s quality of life and function but is associated with a high complication rate. Historically, the procedure has been performed utilizing en bloc resection of the femur. More recently, intramedullary TFR has been utilized as a method of preserving critical soft tissue attachments. More studies are needed describing intramedullary TFR as to enhance the technique and outcomes for future procedures. We describe a case of intramedullary TFR utilizing external fixation as a means of maintaining critical aspects of …

Blast And Bursts: Unveiling Splenic Rupture In Blastic Plasmacytoid Dendritic Cell Neoplasia, Abdulahi Hassan, Matthew Simpson, Rahim Jiwani, Abigail Arrigo, Palgun Nisarga, Olukemi A. Esan, Anna Koget

Journal of Community Hospital Internal Medicine Perspectives

Blastic Plasmacytoid Dendritic Cell Neoplasm (BPDCN) is a rare hematologic cancer, accounting for less than 1% of acute leukemias in the U.S. Diagnosis involves detecting markers like CD123, CD4, CD56, TCL1, and TCF4. Treatment typically involved acute leukemia therapies, but Tagraxofusp, a targeted therapy, was recently approved. Despite advancements, prognosis remains grim, with a median survival of around 1 year. Atraumatic splenic rupture (ASR) is a rare complication of this condition, with only five cases reported from 1994 to 2018. Here we present a case of BPDCN complicated by ASR. This case emphasizes the challenges of diagnosing and treating BPDCN, …

Viscous Vengeance: A Case Report Of Hyperviscosity Syndrome In Iga Lambda Multiple Myeloma, Afoma Onyechi, Jessica Ohemeng-Dapaah, Ayesha Kang, Alexandre Lacasse, Ranju Kunwor

Journal of Community Hospital Internal Medicine Perspectives

Multiple myeloma (MM) is a relatively uncommon neoplastic proliferation of monoclonal plasma cells. Common manifestations are related to infiltration of plasma cells into bones and other organs, causing an increased total serum protein concentration, hypercalcemia, kidney injury, and anemia. The most common type of MM is IgG Kappa, and the second most common type is the IgA subtype. Hyperviscosity (HVS) is a rare presentation of MM and management includes prompt plasmapheresis, resulting in significant reduction of serum viscosity and symptomatic relief. We present a case of IgA Lambda MM presenting with HVS.

Investigation On The Epigenetic Mechanisms Modified By Dietary Phytochemicals In Inhibiting Mammary Cancer, Mohammad Mijanur Rahman

All ETDs from UAB

Breast cancer (BC) is global burden for the health of women. It is the most commonly diagnosed cancer in women and the second leading cause of cancer mortality among women in the United States. One in every eight women in the USA has a chance of developing invasive BC in her lifetime. The limitations of the available therapeutics for BC treatment have brought the dietary prevention of BC to the attention of the scientific community as a safe, natural, and easy to implement therapeutic strategy. In this regard, our laboratory with many other laboratories have demonstrated the anti-BC effect of …

Proteomic Characterization Of Antibody Drug Conjugate Target Expression Profiles In Small Cell Lung Cancer (Sclc), Edwin Lin, Atulya A. Khosla, Nina K. Smrecek, Abdul Rafeh Naqash, Kaushal Parikh, Yanis Boumber, Muhammad Khalil, Aakash Desai

Conference Presentation Abstracts

No abstract provided.

Hyperglycemia And Venous Thromboembolism, Neha Panchagnula, William Philip Brasher

Faculty, Staff and Students Publications

Patients with diabetes mellitus (DM) have chronically increased blood glucose and multiple physiologic alterations that place them at elevated risk for vascular disease. Traditionally, this vascular risk has mainly referred to chronic atherosclerosis and embolic arterial disease. Retrospective studies have suggested an increased risk of a pulmonary embolism (PE) and deep vein thrombosis (DVT), collectively termed venous thromboembolism (VTE), in patients with DM, but this association has been difficult to demonstrate with comorbidities such as obesity in meta-analysis. Clinical studies have demonstrated worse outcomes for patients with DM who suffer from VTE. In vitro studies show multiple physiologic abnormalities with …

Traumatic Brain Injury And Variants Of Shock Index, Sai Doppalapudi, Muhammad Adrish

Faculty, Staff and Students Publications

Traumatic Brain Injury is a major cause of death and long-term disability. The early identification of patients at high risk of mortality is important for both management and prognosis. Although many modified scoring systems have been developed for improving the prediction accuracy in patients with trauma, few studies have focused on prediction accuracy and application in patients with traumatic brain injury. The shock index (SI) which was first introduced in the 1960s has shown to strongly correlate degree of circulatory shock with increasing SI. In this editorial we comment on a publication by Carteri et al wherein they perform a …

Cardiomyocyte-Derived Small Extracellular Vesicle: A New Mechanism Driving Diabetic Cardiac Fibrosis And Cardiomyopathy, Yu Li, Yunhui Du, Yang Liu, Xiuhuan Chen, Xinxin Li, Yanru Duan, Yanwen Qin, Huirong Liu, Xinliang Ma, Shaoping Nie, Huina Zhang

Department of Emergency Medicine Faculty Papers

Rationale: Diabetic cardiomyopathy is one of the major diabetic cardiovascular complications in which fibrosis plays a critical pathogenetic role. However, the precise mechanisms by which diabetes triggers cardiac fibrosis in the heart remain elusive. Small extracellular vesicles (sEVs) play an important role in the cellular communication. Nevertheless, whether and how diabetes may adversely alter sEVs-mediated cardiomyocyte-fibroblast communication, promoting diabetic cardiac fibrosis and contributing to diabetic cardiomyopathy, has not been previously investigated. Methods and results: High-fat diet (HFD)-induced and genetic (db/db) type 2 diabetic models were utilized. Cardiomyocyte sEVs (Myo-sEVs) were isolated by ultracentrifugation. Normal cardiomyocyte-derived Myo-sEVs attenuated diabetic cardiac fibrosis …

Genome-Wide Association Study Meta-Analysis Of Neurofilament Light (Nfl) Levels In Blood Reveals Novel Loci Related To Neurodegeneration, Shahzad Ahmad, Mohammad Aslam Imtiaz, Aniket Mishra, Ruiqi Wang, Marisol Herrera-Rivero, Joshua C Bis, Myriam Fornage, Gennady Roshchupkin, Edith Hofer, Mark Logue, W T Longstreth, Rui Xia, Vincent Bouteloup, Thomas Mosley, Lenore J Launer, Michael Khalil, Jens Kuhle, Robert A Rissman, Genevieve Chene, Carole Dufouil, Luc Djoussé, Michael J Lyons, Kenneth J Mukamal, William S Kremen, Carol E Franz, Reinhold Schmidt, Stephanie Debette, Monique M B Breteler, Klaus Berger, Qiong Yang, Sudha Seshadri, N Ahmad Aziz, Mohsen Ghanbari, M Arfan Ikram

Faculty, Staff and Student Publications

Neurofilament light chain (NfL) levels in circulation have been established as a sensitive biomarker of neuro-axonal damage across a range of neurodegenerative disorders. Elucidation of the genetic architecture of blood NfL levels could provide new insights into molecular mechanisms underlying neurodegenerative disorders. In this meta-analysis of genome-wide association studies (GWAS) of blood NfL levels from eleven cohorts of European ancestry, we identify two genome-wide significant loci at 16p12 (UMOD) and 17q24 (SLC39A11). We observe association of three loci at 1q43 (FMN2), 12q14, and 12q21 with blood NfL levels in the meta-analysis of African-American ancestry. In the trans-ethnic meta-analysis, we identify …

Improving Direct Oncolytic Effect Of Oncolytic Hsv To Overcome Therapeutic Resistance Of Brain Tumors, Sam Edward Gary

All ETDs from UAB

Central nervous system tumors, especially malignant brain tumors, account for the most years of potential life lost in adults and children with cancer. Malignant brain tumors are typically fatal cancers due to their highly aggressive nature, inability to obtain gross total resection, location in sensitive brain areas, and intra- and intertumoral heterogeneity, making therapeutic targeting difficult. High-grade glioma (HGG), malignant brain tumors of glial cell origin invariably recur due to intrinsic and adaptive resistance mechanisms against standard therapies. Therefore, novel treatments that overcome therapeutic resistance are desperately needed. One promising approach is oncolytic viruses (OVs), which achieve tumor regression by …

Hydrogen Peroxide Regulates Protein N-Glycosylation, Alexandria Hernandez-Nichols

All ETDs from UAB

N-glycosylation is a co- and post-translational modification wherein a variety of sugars are added to proteins in a linear pathway progressing from high mannose (HM) to hybrid, to complex type N-glycans. This modification is important to the understanding of protein maturation, stability, and function. Studies have shown that changes in cell N-glycomes, in particular, the HM N-glycan category, could be hallmarks of various pathologies. The biosynthetic pathway for N-glycosylation is well studied and the key enzymes involved in the progression of HM to hybrid N-glycans are the a-mannosidases. Little is understood about the regulation of this highly complex post-translational modification …

Interactions Between Oral Cancer Cells And Enterococcus Fecalis And Their Impact On Perineural Invasion, Sree Ramya Bhamidipaati

All ETDs from UAB

Oral and oropharyngeal squamous cell cancers (OSCC and OPSCC) are some of the most common cancers in the world. The overall 5-year survival rate is 68.5%, which drops to 39.3% in patients with later-stage cancers. This research aims to evaluate the effects of Enterococcus faecalis (E. faecalis) on the OSCC and OPSCC's tumor progression. E. faecalis is associated with asymptomatic, persistent endodontic infections and was found at a higher rate in OSCC patients. We hypothesize that cancer cells and Enterococcus faecalis (Ef) interact to affect the tumorigenic properties of oral cancer cells. OSCC cells from different parts of the oral …

Understanding Biopsychosocial Influences On Physical Activity And Quality Of Life In Breast Cancer Survivors, Erica A. Schleicher

All ETDs from UAB

Receiving a breast cancer diagnosis and subsequent treatment can be life-altering, presenting numerous challenges. Breast cancer treatments are effective at allowing women to live longer, but often impose long-term side-effects that survivors must manage for years. Exercise is an effective way to address many long-term side-effects of breast cancer treatment, yet 63-83% of breast cancer survivors do not meet recommended physical activity (PA) guidelines. Due to the complexity of cancer and treatment options, cancer-related factors have potential biopsychosocial impacts that can influence exercise habits, attitudes toward PA (i.e., social cognitive theory (SCT) constructs), and potentially quality of life (QoL). It …

Parp-1 Selectively Impairs Kras-Driven Phenotypic And Molecular Features In Intrahepatic Cholangiocarcinoma, Friederike L Keggenhoff, Darko Castven, Diana Becker, Stojan Stojkovic, Jovana Castven, Carolin Zimpel, Beate K Straub, Tiemo Gerber, Harald Langer, Patricia Hähnel, Thomas Kindler, Jörg Fahrer, Colm J O'Rourke, Ursula Ehmer, Anna Saborowski, Lichun Ma, Xin Wei Wang, Timo Gaiser, Matthias S Matter, Christian Sina, Stefanie Derer, Ju-Seog Lee, Stephanie Roessler, Bernd Kaina, Jesper B Andersen, Peter R Galle, Jens U Marquardt

Faculty, Staff and Student Publications

Objective: Intrahepatic cholangiocarcinoma (iCCA) is the second most common primary liver cancer with limited therapeutic options. KRAS mutations are among the most abundant genetic alterations in iCCA associated with poor clinical outcome and treatment response. Recent findings indicate that Poly(ADP-ribose)polymerase1 (PARP-1) is implicated in KRAS-driven cancers, but its exact role in cholangiocarcinogenesis remains undefined.

Design: PARP-1 inhibition was performed in patient-derived and established iCCA cells using RNAi, CRISPR/Cas9 and pharmacological inhibition in KRAS-mutant, non-mutant cells. In addition, Parp-1 knockout mice were combined with iCCA induction by hydrodynamic tail vein injection to evaluate an impact on phenotypic and molecular …

The Kras Mutational Spectrum And Its Clinical Implications In Pancreatic Cancer, Luigi Perelli, Giannicola Genovese, Giulio F Draetta

Faculty, Staff and Student Publications

In this issue of Cancer Cell, McIntyre et al. show that specific mutations in the KRAS proto-oncogene shape clinical progression of pancreatic ductal adenocarcinoma (PDAC). Importantly, they find that the KRASG12R mutation is enriched in early-stage PDAC, and it is characterized by distinctly activated molecular programs.

The Kras Mutational Spectrum And Its Clinical Implications In Pancreatic Cancer, Luigi Perelli, Giannicola Genovese, Giulio F Draetta

Faculty, Staff and Student Publications

In this issue of Cancer Cell, McIntyre et al. show that specific mutations in the KRAS proto-oncogene shape clinical progression of pancreatic ductal adenocarcinoma (PDAC). Importantly, they find that the KRASG12R mutation is enriched in early-stage PDAC, and it is characterized by distinctly activated molecular programs.

Project Give: Using A Virtual Genetics Service Platform To Reduce Health Inequities And Improve Access To Genomic Care In An Underserved Region Of Texas, Blake Vuocolo, Roberta Sierra, Daniel Brooks, Christopher Holder, Lauren Urbanski, Keila Rodriguez, Jose David Gamez, Surya Narayan Mulukutla, Ana Hernandez, Alberto Allegre, Humberto Hidalgo, Sarah Rodriguez, Sandy Magallan, Jeremy Gibson, Juan Carlos Bernini, Melanie Watson, Robert Nelson, Lizbeth Mellin-Sanchez, Nancy Garcia, Lori Berry, Hongzheng Dai, Claudia Soler-Alfonso, Kent Carter, Brendan Lee, Seema R Lalani

Faculty, Staff and Students Publications

BACKGROUND: The utilization of genomic information to improve health outcomes is progressively becoming more common in clinical practice. Nonetheless, disparities persist in accessing genetic services among ethnic minorities, individuals with low socioeconomic status, and other vulnerable populations. The Rio Grande Valley (RGV) at the Texas-Mexico border is predominantly Hispanic/Latino with a high poverty rate and very limited access to genetic services. Funded by the National Center for Advancing Translational Sciences, Project GIVE (Genetic Inclusion by Virtual Evaluation) was launched in 2022 to reduce the time to diagnosis and increase provider knowledge of genomics in this region, with the goal of …

Reimagining Critical Care: Trends And Shifts In 21st Century Medicine, Sai Doppalapudi, Bilal Khan, Muhammad Adrish

Faculty, Staff and Students Publications

Critical care medicine has undergone significant evaluation in the 21st century, primarily driven by advancements in technology, changes in healthcare delivery, and a deeper understanding of disease processes. Advancements in technology have revolutionized patient monitoring, diagnosis, and treatment in the critical care setting. From minimally invasive procedures to advances imaging techniques, clinicians now have access to a wide array of tools to assess and manage critically ill patients more effectively. In this editorial we comment on the review article published by Padte S et al wherein they concisely describe the latest developments in critical care medicine.

Fibrotic Response To Anti-Csf-1r Therapy Potentiates Glioblastoma Recurrence, Spencer S Watson, Anoek Zomer, Nadine Fournier, Joao Lourenco, Manfredo Quadroni, Agnieszka Chryplewicz, Sina Nassiri, Pauline Aubel, Simona Avanthay, Davide Croci, Erik Abels, Marike L D Broekman, Douglas Hanahan, Jason T Huse, Roy T Daniel, Monika E Hegi, Krisztian Homicsko, Giulia Cossu, Andreas F Hottinger, Johanna A Joyce

Faculty, Staff and Student Publications

Glioblastoma recurrence is currently inevitable despite extensive standard-of-care treatment. In preclinical studies, an alternative strategy of targeting tumor-associated macrophages and microglia through CSF-1R inhibition was previously found to regress established tumors and significantly increase overall survival. However, recurrences developed in ∼50% of mice in long-term studies, which were consistently associated with fibrotic scars. This fibrotic response is observed following multiple anti-glioma therapies in different preclinical models herein and in patient recurrence samples. Multi-omics analyses of the post-treatment tumor microenvironment identified fibrotic areas as pro-tumor survival niches that encapsulated surviving glioma cells, promoted dormancy, and inhibited immune surveillance. The fibrotic treatment …

Training Robust T1-Weighted Magnetic Resonance Imaging Liver Segmentation Models Using Ensembles Of Datasets With Different Contrast Protocols And Liver Disease Etiologies, Nihil Patel, Adrian Celaya, Mohamed Eltaher, Rachel Glenn, Kari Brewer Savannah, Kristy K Brock, Jessica I Sanchez, Tiffany L Calderone, Darrel Cleere, Ahmed Elsaiey, Matthew Cagley, Nakul Gupta, David Victor, Laura Beretta, Eugene J Koay, Tucker J Netherton, David T Fuentes

Faculty, Staff and Student Publications

Image segmentation of the liver is an important step in treatment planning for liver cancer. However, manual segmentation at a large scale is not practical, leading to increasing reliance on deep learning models to automatically segment the liver. This manuscript develops a generalizable deep learning model to segment the liver on T1-weighted MR images. In particular, three distinct deep learning architectures (nnUNet, PocketNet, Swin UNETR) were considered using data gathered from six geographically different institutions. A total of 819 T1-weighted MR images were gathered from both public and internal sources. Our experiments compared each architecture's testing performance when trained both …

Proteomics-Based Target Identification For Optimizing Bispecific Antibody Use In Nsclc, Atulya A. Khosla, Edwin Lin, Madhan Srinivasan Kumar, Jessy Deshane, Kayla Goliwas, Selvarangan Ponnazhagan, Ishmael Jaiyesimi, Aakash Desai

Conference Presentation Abstracts

No abstract provided.

Impact Of Race And Ethnicity On Financial Toxicity And Outcomes In Lung Cancer, Atulya A. Khosla, Nitya Batra, Rohit Singh, I Deshmukh, Avi Harisingani, Muni Rubens, Anjali Saxena, Venkataraghavan Ramamoorthy, Ishmael Jaiyesimi, Aakash Desai

Conference Presentation Abstracts

No abstract provided.

Novel Computed Tomography Angiography Parameter Is Associated With Low Cardiac Index In Patients With Chronic Thromboembolic Pulmonary Hypertension: A Retrospective Analysis, Estefania Oliveros, Michel Ibrahim, Carlos Manuel Romero, Paul Navo, Patricia Otero Valdes, Yevgeniy Brailovsky, Amir Darki, Riyaz Bashir, Anjali Vaidya, Paul Forfia, Chandra Dass

Division of Cardiology Faculty Papers

UNLABELLED: Chronic thromboembolic pulmonary hypertension (CTEPH) is a complication of incomplete resolution of acute pulmonary embolism. We hypothesize changes in CT Hounsfield Unit gradient (HU-Δ) created by the dispersion of IV contrast through the downstream blood pool correlate with cardiac index (CI). We sought to compare HU-Δ with invasively obtained CI.

METHODS: We completed a retrospective analysis of CTEPH patients in which individuals with low CI (<2.2-L/min/m²) were identified. Both absolute and fractional HU-Δ were derived from pulmonary CTA by subtracting the HU value of the left atrium (LA) and left ventricle (LV) from the main pulmonary artery …

Early Identification Of Hepatocellular Carcinoma Patients At High-Risk Of Recurrence Using The Adv Score: A Multicenter Retrospective Study, Shuya Cao, Zheyu Zhou, Chaobo Chen, Wenwen Li, Jinsong Liu, Jiawei Xu, Chunlong Zhao, Yihang Yuan, Zhenggang Xu, Huaiyu Wu, Guwei Ji, Xiaoliang Xu, Ke Wang

Faculty, Staff and Student Publications

BACKGROUND: Postoperative recurrence is a vital reason for poor 5-year overall survival in hepatocellular carcinoma (HCC) patients. The ADV score is considered a parameter that can quantify HCC aggressiveness. This study aimed to identify HCC patients at high-risk of recurrence early using the ADV score.

METHODS: The medical data of consecutive HCC patients undergoing hepatectomy from The First Affiliated Hospital of Nanjing Medical University (TFAHNJMU) and Nanjing Drum Tower Hospital (NJDTH) were retrospectively reviewed. Based on the status of microvascular invasion and the Edmondson-Steiner grade, HCC patients were divided into three groups: low-risk group (group 1: no risk factor exists), …

Barriers To Health Care Among Adults With Disabilities In Connecticut, Mary Beth Bruder Phd, Tara M. Lutz Phd, Kelly E. Ferreira Phd

Developmental Disabilities Network Journal

It is estimated that 25% of adults in the US are living with one or more disabilities. Persons with disabilities (PWD) have unmet health care needs, experience health disparities compared to those without disabilities. Barriers to quality health care include structural barriers such as access to transportation, physical access to facilities, and lack of accessible medical equipment. Other barriers include the knowledge, skills, beliefs, and attitudes of health care providers to meet the needs of PWD. To examine the barriers to health care experienced by adults with disabilities in Connecticut, the University of Connecticut Center for Excellence in Developmental Disabilities …

Consensus Of The National Heart Center In Collaboration With The Saudi Arabian Cardiac Interventional Society On The Clinical Use Of Intracoronary Imaging, Mirvat Alasnag, Mognee Alameer, Ahmed Alshehri, Hind Alosaimi, Faisal Alqoofi, Hussain Alzayer, Wail Alkashkari, Adel Tash, Waqar H Ahmed

Journal of the Saudi Heart Association

Objectives: Studies show that intracoronary imaging (ICI)-guided PCI is associated with a significantly lower risk of stroke, Q-wave myocardial infarction, and death compared to angiography-guided PCI in the management of acute coronary syndromes, complex coronary lesions and left-main interventions. Despite these well-established clinical benefits, the utilization of ICI-guided PCI in Saudi Arabia remains suboptimal.

Methods: The National Heart Center (NHC) and the Saudi Arabian Cardiac Interventional Society (SACIS) gathered national experts to develop a consensus document on how to integrate ICI-guided PCI in routine clinical practice in Saudi Arabia. The consensus was based on the nominal group technique, whereby a …

Cardiac Manifestations And Outcomes Of Covid-19 Vaccine-Associated Myocarditis In The Young In The Usa: Longitudinal Results From The Myocarditis After Covid Vaccination (Maciv) Multicenter Study, Supriya S. Jain, Steven A. Anderson, Jeremy M. Steele, Hunter C. Wilson, Juan Carlos Muniz, Jonathan H. Soslow, Rebecca S. Beroukhim, Victoria Maksymiuk, Xander Jacquemyn, Olivia H. Frosch, Brian Fonseca, Ashraf S. Harahsheh, Sujatha Buddhe, Ravi C. Ashwath, Deepika Thacker, Shiraz A. Maskatia, Nilanjana Misra, Jennifer A. Su, Saira Siddiqui, Danish Vaiyani, Aswathy K. Vaikom-House, M. Jay Campbell, Jared Klein, Sihong Huang, Christopher Mathis, Matthew D. Cornicelli, Madhu Sharma, Lakshmi Nagaraju, Marla Johnston, Et Al

School of Medicine Faculty Publications

Background: We aimed to study the clinical characteristics, myocardial injury, and longitudinal outcomes of COVID-19 vaccine-associated myocarditis (C-VAM). Methods: In this longitudinal retrospective observational cohort multicenter study across 38 hospitals in the United States, 333 patients with C-VAM were compared with 100 patients with multisystem inflammatory syndrome in children (MIS-C). We included patients ≤ 30 years of age with a clinical diagnosis of acute myocarditis after COVID-19 vaccination based on clinical presentation, abnormal biomarkers and/or cardiovascular imaging findings. Demographics, past medical history, hospital course, biochemistry results, cardiovascular imaging, and follow-up information from April 2021 to November 2022 were collected. The …

Conducting Comparative Effectiveness, Multisite Palliative Care And Advance Care Planning Trials: Lessons Learned And Future Directions From Pcori-Funded Studies, Areej El-Jawahri, Brittany Waterman, Susan Enguidanos, Lisa Gibbs, Victor Navarro, Maren Olsen, Jennifer Temel, Annette Totten, Corita R. Grudzen

Department of Medicine Faculty Papers

The Patient-Centered Outcomes Research Institute (PCORI) funded multiple large-scale comparative effectiveness clinical trials evaluating palliative care (PC) and advance care planning (ACP) healthcare delivery models. This article provides an overview of the most common barriers our investigative teams encountered while implementing these trials and the strategies we utilized to overcome these challenges, with particular attention to identifying research partners for multisite trials; addressing contracting and regulatory issues; creating a team governance structure; training and engaging study staff across sites; recruiting, consenting, and enrolling study participants; collecting PC and ACP data and study outcomes; and managing multisite collaborations. The goal of …