Medical Specialties Commons^™

Stevens-Johnson Syndrome/Toxic Epidermal Necrolysis In An Orthotopic Liver Transplant Recipient: A Case Report, Chun-Sing Huang, Emily Strouphauer, Christine O'Mahony, Nhu T N Galván, Ronald Cotton, John Goss, Abbas Rana

Faculty, Staff and Students Publications

Stevens-Johnson syndrome/toxic epidermal necrolysis (SJS/TEN) is a rare spectrum of acute, mucocutaneous drug reactions characterized by epidermal necrosis of the skin and mucous membranes with progressive multiorgan failure. Cutaneous presentation of SJS/TEN is similar to that of acute graft-versus-host disease, creating a diagnostic dilemma in solid-organ transplant recipients presenting with diffuse, erythematous eruptions, skin sloughing, and systemic sequelae, reflective of both diseases. This case report details a 48-year-old woman post-orthotopic liver transplantation (OLT) who developed a diffuse, painful, morbilliform rash with progressive desquamation, along with corresponding pathological analysis indicative of SJS/TEN. There are few documented reports of SJS/TEN in solid-organ …

Mfgm-Enriched Whey Displays Antiviral Activity Against Common Pediatric Viruses, Evelien Kramer, Ketki Patil, Vassilis Triantis, Jan A H Bastiaans, Michela Mazzon, Sasirekha Ramani, Tim T Lambers

Faculty, Staff and Students Publications

BACKGROUND: Among the most common mucosal viral infections in infants are rotavirus, one of the main causes of severe gastroenteritis in infants and children up to 5 years, and respiratory syncytial virus (RSV), one of the leading causes of lower respiratory tract infections. Both human milk and bovine milk derived factors may provide protection against mucosal viral infections. More recently, a similar activity of milk derived proteins was suggested for SARS-CoV-2. The goal of the current study was to test antiviral activity of the bovine milkfat globule membrane (MFGM) against rotavirus, RSV and SARS-CoV-2 and to further characterize MFGM-enriched whey …

Mitochondrial-Related Hub Genes In Dermatomyositis: Muscle And Skin Datasets-Based Identification And In Vivo Validation, Shuo Wang, Yiping Tang, Xixi Chen, Siyuan Song, Xi Chen, Qiao Zhou, Li Zeng

Faculty, Staff and Students Publications

Background: Mitochondrial dysfunction has been implicated in the pathogenesis of dermatomyositis (DM), a rare autoimmune disease affecting the skin and muscles. However, the genetic basis underlying dysfunctional mitochondria and the development of DM remains incomplete.

Methods: The datasets of DM muscle and skin tissues were retrieved from the Gene Expression Omnibus database. The mitochondrial related genes (MRGs) were retrieved from MitoCarta. DM-related modules in muscle and skin tissues were identified with the analysis of weighted gene co-expression network (WGCNA), and then compared with the MRGs to obtain the overlapping mitochondrial related module genes (mito-MGs). Subsequently, differential expression genes (DEGs) obtained …

Achieving Surgical, Obstetric, Trauma, And Anesthesia (Sota) Care For All In South Asia, Siddhesh Zadey, Shirish Rao, Isha Gondi, Natalie Sheneman, Chaitrali Patil, Anveshi Nayan, Himanshu Iyer, Arti Raj Kumar, Arun Prasad, G Allen Finley, Chellapuram Raja Krishna Prasad, Chintamani, Dhananjaya Sharma, Dhruva Ghosh, Gnanaraj Jesudian, Irum Fatima, Jogi Pattisapu, Justin Sangwook Ko, Lovenish Bains, Mashal Shah, Mohammed Shadrul Alam, Narmada Hadigal, Naveen Malhotra, Nilmini Wijesuriya, Prateek Shukla, Sadaf Khan, Sunil Pandya, Tariq Khan, Tashi Tenzin, Venkat Raja Hadiga, Daniel Peterson

Faculty, Staff and Students Publications

South Asia is a demographically crucial, economically aspiring, and socio-culturally diverse region in the world. The region contributes to a large burden of surgically-treatable disease conditions. A large number of people in South Asia cannot access safe and affordable surgical, obstetric, trauma, and anesthesia (SOTA) care when in need. Yet, attention to the region in Global Surgery and Global Health is limited. Here, we assess the status of SOTA care in South Asia. We summarize the evidence on SOTA care indicators and planning. Region-wide, as well as country-specific challenges are highlighted. We also discuss potential directions-initiatives and innovations-toward addressing these …

Age-Associated Temporal Decline In Butyrate-Producing Bacteria Plays A Key Pathogenic Role In The Onset And Progression Of Neuropathology And Memory Deficits In 3×Tg-Ad Mice, Paula M Chilton, Smita S Ghare, Benjamin T Charpentier, Scott A Myers, Aakarsha V Rao, Joseph F Petrosino, Kristi L Hoffman, John C Greenwell, Neetu Tyagi, Jyotirmaya Behera, Yali Wang, Lucy J Sloan, Jingwen Zhang, Christopher B Shields, Gregory E Cooper, Leila Gobejishvili, Scott R Whittemore, Craig J Mcclain, Shirish S Barve

Faculty, Staff and Students Publications

Alterations in the gut-microbiome-brain axis are increasingly being recognized to be involved in Alzheimer's disease (AD) pathogenesis. However, the functional consequences of enteric dysbiosis linking gut microbiota and brain pathology in AD progression remain largely undetermined. The present work investigated the causal role of age-associated temporal decline in butyrate-producing bacteria and butyrate in the etiopathogenesis of AD. Longitudinal metagenomics, neuropathological, and memory analyses were performed in the 3×Tg-AD mouse model. Metataxonomic analyses showed a significant temporal decline in the alpha diversity marked by a decrease in butyrate-producing bacterial communities and a concurrent reduction in cecal butyrate production. Inferred metagenomics analysis …

Comparing The Effects Of Two Initial Specimen Diversion Techniques On Blood Culture Contamination Rates And Clinical Outcomes-A Multicenter Study, Anthony Febres-Aldana, Patrycja Ashley, Eva Amenta, Megan Duffey, Theresa Sepulveda, Corina Lopez, Sabra Shay, Miriam Barrett, Todd Lasco, Takei Pipkins, Margaret Reed, Bradley Lembcke, Mayar Al Mohajer

Faculty, Staff and Students Publications

Although the initial specimen diversion device (ISDD) has been shown to reduce blood culture contamination (BCC) rates, its impact on clinical outcomes remains unclear. This multicenter study showed that ISDD significantly decreased BCC. However, there was no reduction in length of stay, days of therapy, or central line-associated bloodstream infections.

Detection Of Invasive Bartonella Infections With Next-Generation Sequencing Of Microbial Cell-Free Dna, Fernando H Centeno, Ahmed M Hamdi, Todd M Lasco, Mayar Al Mohajer

Faculty, Staff and Students Publications

We report 9 patients with invasive Bartonella infections, including 5 with endocarditis, who were diagnosed with microbial cell-free DNA next-generation sequencing and Bartonella serology studies. Diagnosis with plasma mcfDNA NGS enabled a faster clinical and laboratory diagnosis in 8 patients. Prompt diagnosis impacted antibiotic management in all 9 patients.

The Impact Of Direct Inoculation Of Ascites Into Blood Culture Bottles On Ascites Culture Positivity, Tyler Brehm, Todd Lasco, Mayar Al Mohajer

Faculty, Staff and Students Publications

OBJECTIVE: Assess whether direct inoculation of ascites into blood culture bottles would improve ascites culture yield.

DESIGN: Pre-post-study.

SETTING: The study was performed at a quaternary academic medical center in Houston, Texas, including all inpatient and emergency department encounters.

PATIENTS: Ascites cultures collected from November 2020 to December 2022 were reviewed and screened for spontaneous bacterial peritonitis. Patients were excluded if a prior ascites culture from the same patient was already included in the study or if there was evidence of secondary bacterial peritonitis.

INTERVENTION: In the pre-intervention period, ascites cultures were collected into a sterile container and inoculated onto/into …

A Novel System To Culture Human Intestinal Organoids Under Physiological Oxygen Content To Study Microbial-Host Interaction, Tatiana Y Fofanova, Umesh C Karandikar, Jennifer M Auchtung, Reid L Wilson, Antonio J Valentin, Robert A Britton, K Jane Grande-Allen, Mary K Estes, Kristi Hoffman, Sashirekha Ramani, Christopher J Stewart, Joseph F Petrosino

Faculty, Staff and Students Publications

Mechanistic investigation of host-microbe interactions in the human gut are hindered by difficulty of co-culturing microbes with intestinal epithelial cells. On one hand the gut bacteria are a mix of facultative, aerotolerant or obligate anaerobes, while the intestinal epithelium requires oxygen for growth and function. Thus, a coculture system that can recreate these contrasting oxygen requirements is critical step towards our understanding microbial-host interactions in the human gut. Here, we demonstrate Intestinal Organoid Physoxic Coculture (IOPC) system, a simple and cost-effective method for coculturing anaerobic intestinal bacteria with human intestinal organoids (HIOs). Using commensal anaerobes with varying degrees of oxygen …

Divergent Responses Of Human Intestinal Organoid Monolayers Using Commercial In Vitro Cytotoxicity Assays, Miranda A Lewis, Ketki Patil, Khalil Ettayebi, Mary K Estes, Robert L Atmar, Sasirekha Ramani

Faculty, Staff and Students Publications

In vitro models, such as primary cells and continuous cell lines routinely used for evaluating drug candidates, have limitations in their translational relevance to human diseases. Organotypic cultures are increasingly being used to assess therapeutics for various cancers and infectious diseases. Monitoring drug cytotoxicity in cell cultures is crucial in drug development, and several commercially available kits for cytotoxicity assessment offer distinct advantages and limitations. Given the complexity of organoid cultures, including donor-driven variability, we investigated drug-treated, tissue stem cell-derived human intestinal organoid responses with commonly used cell cytotoxicity assay kits. Using seven different compounds, we compared the cytotoxicity assay …

Dialysis Modality, Transplant Characteristics, And Incident Atrial Fibrillation After Kidney Transplant: An Observational Study Using Usrds Data, Leonardo Pozo Garcia, Sai Liu, Colin R Lenihan, Maria E Montez-Rath, Tara I Chang, Wolfgang C Winkelmayer, Pascale Khairallah

Faculty, Staff and Students Publications

RATIONALE & OBJECTIVE: Atrial fibrillation is the most common arrhythmia and is increasing in prevalence. The prevalence of atrial fibrillation is high among patients receiving dialysis, affecting ∼21.3% of the patients receiving hemodialysis and 15.5% of those receiving peritoneal dialysis. The association of previous dialysis modality with incident atrial fibrillation in patients after receiving their first kidney transplant has not been studied.

STUDY DESIGN: We used the United States Renal Data System to retrospectively identify adult, Medicare-insured patients who received their first kidney transplant between January 1, 2005, and September 30, 2012 and who had not previously been diagnosed with …

Treatment Guidelines For Hyponatremia: Stay The Course, Richard H Sterns, Helbert Rondon-Berrios, Horacio J Adrogué, Tomas Berl, Volker Burst, David M Cohen, Mirjam Christ-Crain, Martin Cuesta, Guy Decaux, Michael Emmett, Aoife Garrahy, Fabrice Gankam-Kengne, John K Hix, Ewout J Hoorn, Kamel S Kamel, Nicolaos E Madias, Alessandro Peri, Julie Refardt, Mitchell H Rosner, Mark Sherlock, Stephen M Silver, Alain Soupart, Chris J Thompson, Joseph G Verbalis

Faculty, Staff and Students Publications

International guidelines designed to minimize the risk of complications that can occur when correcting severe hyponatremia have been widely accepted for a decade. On the basis of the results of a recent large retrospective study of patients hospitalized with hyponatremia, it has been suggested that hyponatremia guidelines have gone too far in limiting the rate of rise of the serum sodium concentration; the need for therapeutic caution and frequent monitoring of the serum sodium concentration has been questioned. These assertions are reminiscent of a controversy that began many years ago. After reviewing the history of that controversy, the evidence supporting …

Early Immune Factors Associated With The Development Of Post-Acute Sequelae Of Sars-Cov-2 Infection In Hospitalized And Non-Hospitalized Individuals, Jacqueline M Leung, Michelle J Wu, Pouya Kheradpour, Chen Chen, Katherine A Drake, Gary Tong, Vanessa K Ridaura, Howard C Zisser, William A Conrad, Natalia Hudson, Jared Allen, Christopher Welberry, Celine Parsy-Kowalska, Isabel Macdonald, Victor F Tapson, James N Moy, Christopher R Defilippi, Ivan O Rosas, Mujeeb Basit, Jerry A Krishnan, Sairam Parthasarathy, Bellur S Prabhakar, Mirella Salvatore, Charles C Kim

Faculty, Staff and Students Publications

BACKGROUND: Infection by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) can lead to post-acute sequelae of SARS-CoV-2 (PASC) that can persist for weeks to years following initial viral infection. Clinical manifestations of PASC are heterogeneous and often involve multiple organs. While many hypotheses have been made on the mechanisms of PASC and its associated symptoms, the acute biological drivers of PASC are still unknown.

METHODS: We enrolled 494 patients with COVID-19 at their initial presentation to a hospital or clinic and followed them longitudinally to determine their development of PASC. From 341 patients, we conducted multi-omic profiling on peripheral blood …

Adipose Tissue Lymphocytes And Obesity, Feng Gao, Benjamin Litchfield, Huaizhu Wu

Faculty, Staff and Students Publications

Obesity is associated with chronic inflammation in adipose tissue (AT), mainly evidenced by infiltration and phenotypic changes of various types of immune cells. Macrophages are the major innate immune cells and represent the predominant immune cell population within AT. Lymphocytes, including T cells and B cells, are adaptive immune cells and constitute another important immune cell population in AT. In obesity, CD8+ effector memory T cells, CD4+ Th1 cells, and B2 cells are increased in AT and promote AT inflammation, while regulatory T cells and Th2 cells, which usually function as immune regulatory or type 2 inflammatory cells, are reduced …

Neutrophil-Derived Activin-A Moderates Their Pro-Netotic Activity And Attenuates Collateral Tissue Damage Caused By Influenza A Virus Infection, Georgios Divolis, Evgenia Synolaki, Athanasia Doulou, Ariana Gavriil, Christina C Giannouli, Anastasia Apostolidou, Martyn L Foster, Martin M Matzuk, Panagiotis Skendros, Ioanna-Evdokia Galani, Paschalis Sideras

Faculty, Staff and Students Publications

BACKGROUND: Pre-neutrophils, while developing in the bone marrow, transcribe the Inhba gene and synthesize Activin-A protein, which they store and release at the earliest stage of their activation in the periphery. However, the role of neutrophil-derived Activin-A is not completely understood.

METHODS:To address this issue, we developed a neutrophil-specific Activin-A-deficient animal model (S100a8-Cre/Inhba fl/fl mice) and analyzed the immune response to Influenza A virus (IAV) infection. More specifically, evaluation of body weight and lung mechanics, molecular and cellular analyses of bronchoalveolar lavage fluids, flow cytometry and cell sorting of lung cells, as well as histopathological analysis of lung tissues, …

Perspectives From Cystinosis: Access To Healthcare May Be A Confounding Factor For Variant Classification, Chen-Han Wilfred Wu, Alicja Tomaszewski, Louisa Stark, Fernando Scaglia, Ewa Elenberg, Fredrick R Schumaker

Faculty, Staff and Students Publications

Genetic variability persists across diverse populations, and it may impact the characterization of heritable diseases in different ancestral groups. Cystinosis is a metabolic disease caused by pathogenic variants in the CTNS gene causing the cellular accumulation of cystine. We attempted to assess the currently poorly characterized prevalence of cystinosis by employing a population genetics methodology. However, we encountered a significant challenge due to genetic variations across different populations, and the consideration of potential disparities in access to healthcare made our results inconclusive. Pathogenic CTNS variants were identified in a representative global population cohort using The Human Gene Mutation Database (HGMD) …

Designing A Best Possible Caregiver History To Facilitate Disposition Planning For Older Adults In Emergency Departments, Karen De Sola-Smith, Matthew Growdon, Anita N Chary, Jennifer D Portz, Kenneth Lam

Faculty, Staff and Students Publications

Introduction: Detailed information about caregivers is crucial for planning disposition from emergency departments (EDs), but it is unclear what specific information is useful for ED clinicians and how that information should be presented.

Methods: We used a Design Thinking approach to develop a standardized format-which we call a "Best Possible Caregiver History" (BPCH)-for displaying useful caregiver information to ED clinicians. The key steps of this approach are needfinding, followed by iterative cycles of ideation, rapid prototyping, and testing. For needfinding, we used semi-structured interviews of four ED clinicians on current practices for discovering and documenting caregiver information. For ideation and …

A Woman With Bilateral Pheochromocytoma And Tuberous Sclerosis Complex, Maleeha Zahid, Shalini Koshy, Jawairia Shakil, Helmi S Khadra, Luan D Truong, Archana R Sadhu

Faculty, Staff and Students Publications

BACKGROUND/OBJECTIVE: Pheochromocytoma and paraganglioma (PPGL) are rare neuroendocrine tumors. Here, we report an unusual case of synchronous PPGL in an asymptomatic patient with tuberous sclerosis complex (TSC).

CASE REPORT: A 49-year-old woman with a history of TSC and end-stage renal disease was referred for evaluation of bilateral adrenal and retroperitoneal masses. She denied chest pain, palpitations, headaches, or previous hypertensive crisis. The laboratory test results showed a plasma normetanephrine level of 20.20 nmol/L (normal range, 0.00-0.89 nmol/L) and plasma chromogranin A level Chromogranin A (CgA) levels of 1518 ng/mL (normal range, 0-103 ng/mL). The plasma metanephrine level was normal. After …

An Interactive, Case-Based Workshop On The Patient Experience For Internal Medicine Residents, Julian Swanson, Doris Lin, Kristen A Staggers, Priti Dangayach

Faculty, Staff and Students Publications

INTRODUCTION: The technological revolution has narrowed the information gap between physician and patient. This has led to an evolution in medicine from paternalistic to patient-centric, with health care systems now prioritizing patient experience to achieve higher satisfaction scores. Therefore, it is imperative to start early in educating trainees on how to best address the holistic needs of the patient while also delivering high-quality care.

METHODS: We implemented a 1-hour workshop that was repeated weekly over 8 weeks to capture all internal medicine residents in our program. During the workshop, we reviewed the historical evolution of patient care from paternalistic to …

Clinical Utility Of Plasma Microbial Cell-Free Dna Sequencing In Determining Microbiologic Etiology Of Infectious Syndromes In Solid Organ Transplant Recipients, Jesal R Shah, Muhammad Rizwan Sohail, Todd Lasco, John A Goss, Mayar Al Mohajer, Sarwat Khalil

Faculty, Staff and Students Publications

BACKGROUND: Metagenomic next-generation sequencing (mNGS) is increasingly being used for microbial detection in various infectious syndromes. However, data regarding the use of mNGS in solid organ transplant recipients (SOTR) are lacking.

OBJECTIVES: To describe and analyze real-world clinical impact of mNGS using plasma microbial cell-free DNA (mcfDNA) in SOTR.Design: Retrospectively reviewed all adult SOTR who underwent mNGS testing using plasma mcfDNA at Baylor St Luke's Medical Center from March 2017 to February 2023.

METHODS: Clinical impact (positive, neutral, and negative) was assessed using standardized objective criteria. Three Infectious Diseases physicians independently performed clinical adjudication to determine the correlation of mcfDNA …

Spatial Transcriptomics Resolve An Emphysema-Specific Lymphoid Follicle B Cell Signature In Chronic Obstructive Pulmonary Disease, Joselyn Rojas-Quintero, Scott A Ochsner, Felicia New, Prajan Divakar, Chen Xi Yang, Tianshi David Wu, Jerid Robinson, Darshan Shimoga Chandrashekar, Nicholas E Banovich, Ivan O Rosas, Maor Sauler, Farrah Kheradmand, Amit Gaggar, Camilla Margaroli, Raul San Jose Estepar, Neil J Mckenna, Francesca Polverino

Faculty, Staff and Students Publications

Rationale

Within chronic obstructive pulmonary disease (COPD), emphysema is characterized by a significant yet partially understood B cell immune component.

Objectives

To characterize the transcriptomic signatures from lymphoid follicles (LFs) in ever-smokers without COPD and patients with COPD with varying degrees of emphysema.

Methods

Lung sections from 40 patients with COPD and ever-smokers were used for LF proteomic and transcriptomic spatial profiling. Formalin- and O.C.T.-fixed lung samples obtained from biopsies or lung explants were assessed for LF presence. Emphysema measurements were obtained from clinical chest computed tomographic scans. High-confidence transcriptional target intersection analyses were conducted to resolve emphysema-induced transcriptional networks. …

Clinical Evaluation Of A Fully Electronic Microfluidic White Blood Cell Analyzer, Jianye Sui, Zhongtian Lin, Shahriar Azizpour, Fei Chen, Sunanda Gaur, Kelly Keene, Farzad Soleimani, Tanaya Bhowmick, Zubaid Rafique, Mehdi Javanmard

Faculty, Staff and Students Publications

The White Blood Cell (WBC) count is one of the key parameters signaling the health of the immune system. Abnormal WBC counts often signal a systemic insult to the body such as an underlying infection or an adverse side effect to medication. Typically, the blood collected is sent to a central lab for testing, and results come back within hours, which is often inconvenient and may delay time-sensitive diagnosis or treatment. Here, we present the CytoTracker, a fully electronic, microfluidic based instant WBC analyzer with the potential to be used at point-of-care. The CytoTracker is a lightweight, portable, affordable platform …

Sex-Specific Outcomes Of Lbbap Versus Biventricular Pacing: Results From I-Clas, Faiz A Subzposh, Parikshit S Sharma, Óscar Cano, Shunmuga Sundaram Ponnusamy, Bengt Herweg, Francesco Zanon, Marek Jastrzebski, Jiangang Zou, Mihail G Chelu, Kevin Vernooy, Zachary I Whinnett, Girish M Nair, Manuel Molina-Lerma, Karol Curila, Kenneth A Ellenbogen, Pugazhendhi Vijayaraman

Faculty, Staff and Students Publications

Background: Cardiac resynchronization therapy (CRT) using biventricular pacing (BVP) has been associated with greater clinical improvement in women than men. Recently, left bundle branch area pacing (LBBAP) has been shown to be an alternative form of CRT.

Objectives: The purpose of this study was to investigate sex-specific outcomes for death and heart failure events in a large, international, multicenter, cohort of patients undergoing CRT with BVP or LBBAP.

Methods: In this international study of 1,778 patients (575 female and 1203 male), sex-specific survival analysis was performed to compare the effect of LBBAP-CRT relative to BVP-CRT on the combined endpoint of …

Improving Neuropathological Analysis With Aβgan: Addressing Morphology Imbalance For Efficient Alzheimer's Disease Diagnosis, Sujatha Alla, Prasanthi Chidipudi, Nagesh Bheesetty, Vedvikash Reddy Velur, Joshit Mohanty, Puneeth Bheesetty, Marisha Jmukhadze, Narendra Lakshmana Gowda, Sai Gireesh Komaragiri

Engineering Management & Systems Engineering Faculty Publications

Histopathologists are experiencing a digital revolution in their field thanks to the digitization of Whole Slide Images (WSIs), which are microscope slides of tissue that can measure gigapixels in size. With so much high resolution data at their disposal, computer vision techniques can now be used to automate laboratory processes, create visual standards, and increase analysis throughput, all of which reduce the workload of pathologists [1]. The "gold" standard in neuropathology, particularly for Alzheimer's Disease- is pathological diagnosis made by looking at White Matter Inclusions (WSIs) in brain tissue. Semi-quantitative scoring in accordance with the standards established by the Consortium …

Demographic And Diagnostic Factors In Physical Therapy Attendance, William Leatherwood, Adrian Torres, Sofia Hidalgo Perea, Megan Paulus

Stony Brook Orthopaedic and Musculoskeletal Journal

Introduction: Previous studies have demonstrated physical therapy (PT) to be an effective nonoperative treatment for various orthopedic diagnoses. However, patients may dismiss PT in favor of another intervention for their injury. While there are many studies on PT, there is little data on patient compliance. This study aimed to elucidate patient compliance with a basic PT prescription and whether PT led to subjective injury improvement.

Methods: This is a retrospective study of patients seen in Stony Brook Orthopedic clinics from 08/01/2022 – 12/23/2022. Patients prescribed PT received a phone call six weeks after the PT prescription. The primary …

Intraoperative Nerve Stimulation As A Functional Assessment Of Acute Stretch Injury In The Rat Median Nerve, Matthew Gluck, Pierce J. Ferriter Jr., Christoph A. Schroen, Christina M. Beck, Zachary L. Bernstein, Todd A. Rubin, Michael R. Hausman, Paul J. Cagle

Stony Brook Orthopaedic and Musculoskeletal Journal

Introduction: Peripheral nerve injuries (PNIs) are common complications of upper extremity injuries, yet few clinical options exist to quickly and accurately assess motor nerve function intraoperatively. PNIs are a significant source of not only disability to the patient, but also cost. This study’s purpose was to evaluate the utility of intraoperative nerve stimulation in an
animal model.

Methods: A 20% stretch injury was induced in right median nerves using a custom-made stretch applicator, while left median nerves served as a control. A Checkpoint surgical nerve stimulator (Checkpoint Surgical, Cleveland, OH) was used to assess baseline nerve function in …

An Updated Ligament Evaluation Of Perilunate Instability, Emil S. Vutescu, Cris Min, Elias Georgas, Paul G. Arauz, Yi-Qian Qin, David E. Komatsu, Edward D. Wang

Stony Brook Orthopaedic and Musculoskeletal Journal

Introduction: Perilunate dislocations are rare and high-energy proximal carpal row injuries that are associated with long-term disability. The current accepted pathomechanism of this injury is progressive radial to ulnar intrinsic ligament tearing, as described by Mayfield in 1980. Since his description several other ligaments have been described as critical stabilizers of the proximal carpal row.

Purpose: To achieve perilunate instability in a biomechanical model and evaluate integrity of recently described carpal ligamentous stabilizers.

Methods: We tested six fresh-frozen cadaveric upper extremities and loaded them to failure in extension, ulnar deviation and carpal supination using a previously validated three-point …

Can Artificial Intelligence Create Research Hypotheses For Patellofemoral Instability?, Claire Parker, Sofia Hidalgo Perea, James Barsi

Stony Brook Orthopaedic and Musculoskeletal Journal

Introduction: The purpose of this study was to elucidate if artificial intelligence (AI) can generate novel research hypotheses regarding patellofemoral instability (PFI) in the pediatric population that have not previously been investigated. We hypothesized that AI would be able to generate new hypotheses that have not yet been presented or published.

Methods: In December of 2023, Chat Generative Pre-trained Transformer-3.5 (ChatGPT) was used to create a list of 25 research hypotheses about PFI in both the adult and pediatric population. The prompt used to generate the list of hypotheses was: “List 25 detailed and reproducible research ideas regarding …

Age-Related Differences In 30-Day Postoperative Complications Following Aseptic Revision Total Shoulder Arthroplasty: A Comparison Of Patients Under And Over 80 Years Old, Rachel A. Loyst, Patricia Cerri-Droz, Stephen H. Liu, Kenny Ling, Dorian Cohen, David E. Komatsu, Edward D. Wang

Stony Brook Orthopaedic and Musculoskeletal Journal

Introduction: This study investigates the association between patients < 80 years old and patients 80 years old and 30-day postoperative complications following aseptic revision total shoulder arthroplasty (TSA).

Materials and methods: All patients who underwent revision TSA between 2015 and 2022 from the American College of Surgeons National Surgical Quality Improvement (NSQIP) database were surveyed for this study. Patient demographics, comorbidities, and 30-day postoperative complication data were analyzed. Logistic regression was used to analyze the postoperative complications associated in patients greater than or equal to 80 years old.

Results: Compared to patients < 80 years old, patients 80 years old were independently associated with a significantly greater likelihood of experiencing any complication (odds ratio [OR] 1.61, 95% confidence interval [CI] 1.23-2.11; P < .001), non-home discharge (OR 3.68, 95% CI 2.58-5.25; P < .001), and length of stay (LOS) > 2 days (OR 1.57, 95% CI 1.18-2.10; P = 0.002).

Conclusions: Compared to patients < 80 years old, patients 80 years old were independently associated with a significantly greater likelihood of experiencing any complication, non-home discharge, and LOS > 2 days. A better understanding of the age as a risk factor …

Aging In Place With A Warming Climate: Housing Design And Policies For Aging With Extreme Heat, Nichole M. Kain

Antioch University Dissertations & Theses

Aging populations—particularly in areas prone to extreme heat—are facing unique residential challenges. In the past 10 years, extreme heat has killed more people in the United States (U.S.) than all other weather hazards combined, and it is expected to get hotter, with extreme heat events predicted to happen more often in the future. People over the age of 65 are disproportionately represented as the majority of heat victims, and are likely to perish in their own homes during these events. Every day, 10,000 people turn age 65 in the U.S. and many are choosing to age and retire in places …