Medical Specialties Commons^™

Designing A Multilingual Instructional Language Tool For Patient Communication In Interventional Radiology, Samuel Almodóvar, Ahlam Houssein, Gregg Khodorov, Md, Mba, Sahib Sohal, Md, Robert Pugliese, Pharmd, David Dwyer, Md

Alpha Omega Alpha Research Symposium Posters

Introduction: Current efforts to provide language-inclusive radiological care fall short, resulting in suboptimal imaging, increased procedural time, and greater radiation exposure. Inadequate language accessibility results in poor communication, suboptimal care, and increased patient dissatisfaction. A digital language tool was developed to provide patient instructions during interventional radiology (IR) procedures, addressing this gap and enhancing patient care.

Methods: Observations were carried out to better understand workflow during IR procedures and identify how to incorporate the tool. We conducted interviews with IR physicians, nurses, and technologists to gather common procedural phrases and patient instructions. Spanish and Mandarin were selected because they are …

Exploring Physician Views On Birth Method And Route Of Delivery, Vivian Nguyen, Vincenzo Berghella, Md

Alpha Omega Alpha Research Symposium Posters

Purpose: In the United States, rates of cesarean deliveries (CD) have been increasing. Despite recommendations from the American College of Obstetrics and Gynecology to prevent increasing rates of CDs, planned CD has been associated with lower rates of perinatal deaths and better maternal outcomes when compared to planned vaginal delivery (VD). However, the data is limited, so it is important that we conduct randomized controlled trials (RCTs) comparing maternal and perinatal outcomes in planned CD vs planned vaginal delivery (VD) for nulliparous, term, single, vertex pregnancies. The purpose of study is to survey obstetricians and gynecologists (ob/gyns) on their …

Exercise Performance In Ordinary Children And Adolescents: Baseline, Pandemic, And Post-Pandemic, Abby Skiena, Gina D'Aloisio, Ms, Takeshi Tsuda, Md

Alpha Omega Alpha Research Symposium Posters

Background: The COVID-19 pandemic might have created considerable negative impacts on the physical fitness of ordinary adolescents, which may pose a major threat to long-term cardiovascular health.

Methods: Healthy adolescents (ages 11 to 18) who underwent cardiopulmonary exercise testing (CPET) were grouped into baseline (~ 3/2020), pandemic (4/2020 ~12/2022), and post-pandemic (1/2023~ 5/2024) periods. Data are shown as mean ± standard deviation.

Results: Peak oxygen consumption (VO2/kg) and peak work rate (WR/kg) were significantly reduced during pandemic in both sexes and did not improve during post-pandemic in males (Table 1). The decline of peak oxygen pulse (OP/kg) …

Characterizing The Effects Of Antimuscarinics On Rhoa Signaling, Zuhra Tukhtamisheva, Elizabeth L. Mcduffie, Jordan Lee, Steven S. An, Reynold A. Panettieri Jr., Charles Scott

Alpha Omega Alpha Research Symposium Posters

Purpose: Airway hyperresponsiveness in asthma is driven by acetylcholine-mediated activation of the muscarinic acetylcholine 3 receptor (M3R), promoting bronchoconstriction, mucus hypersecretion, and airway remodeling. Despite directly targeting this pathway, antimuscarinics remain adjunctive rather than first-line therapy, suggesting a disconnect between biological rationale and clinical efficacy. Recent work from the Scott Lab at Thomas Jefferson University demonstrates that M3R in human airway smooth muscle (HASM) cells drives muscle shortening through G_12/13–driven RhoA signaling rather than through G_q/11-dependent calcium flux. We therefore investigated whether clinically prescribed antimuscarinics effectively inhibit G_12/13-dependent RhoA signaling in HASM cells.

Methods: …

Interrelationship Between Body Mass Index, Venous Sinus Pressures, Craniospinal Elastance, And Intracranial Pressure In Idiopathic Intracranial Hypertension, Rachel Wang, Ba, Bs, Scott W. Keith, Phd, Pascal M. Jabbour, Md, Stavropoula I. Tjoumakaris, Md, Michael J. Marmura, Md, Michael R. Gooch, Md, Hsiangkuo Yuan, Md, Phd

Alpha Omega Alpha Research Symposium Posters

Purpose: To investigate the interrelationship between body mass index (BMI), venous sinus pressure (VSP), and craniospinal elastance in determining lumbar puncture opening pressure (LP OP) in idiopathic intracranial hypertension (IIH).

Methods: A single-center retrospective chart review was conducted to identify patients who received venous manometry (8/2021-11/2025) followed by LP within 7 days before stenting. VSPs were measured at standardized locations, including the torcula (TP) and sigmoid/jugular (SIJ) sinuses. Elastance was calculated as (OP – closing pressure)/volume of CSF removed. Statistical analysis (JASP 0.19.3) was performed using generalized linear model (Gaussian identity; scaled center) to assess relationships between LP OP, BMI, …

Comparative Analysis Of Fsrt And Srs For Vestibular Schwannoma Using A Large Multi-Institutional Dataset, Ian Argento, Bs, Daniel Uralov, Md, Jacob Beiriger, Md, Anika Walia, Bs, Kalena Liu, Bs, Wenyin Shi, Md, Jacob B. Hunter, Md

Alpha Omega Alpha Research Symposium Posters

Purpose: Stereotactic radiosurgery (SRS) and fractionated stereotactic radiotherapy (FSRT) both achieve high control rates of vestibular schwannomas (VS), but their comparative effects on functional outcomes remain uncertain. Prior studies are limited by small sample sizes and heterogeneous methods.

Methods: Deidentified data were analyzed from 100 healthcare organizations through TriNetX. Adults with VS (ICD-10: D33.3) and sensorineural hearing loss (H90.A/H90.1–H90.8) were included. Patients with neurofibromatosis or prior surgical resection were excluded. Treatment cohorts consisted of single-session SRS or ≥2-sessions of FSRT. Propensity score matching (1:1) yielded 909 patients per cohort. Outcomes—including hearing loss, cerebral edema, hydrocephalus, and cranial nerve …

Neck Circumference As A Novel Predictor Of Cardiovascular Risk Assessed Using Framingham And Prevent Equations, Stephen Garrova, Roshaan Gilani, Steven Muller, Jean Pierre Charpentier, Brian Fedgchin, Glenn Cooper, Cindy Cheng

Alpha Omega Alpha Research Symposium Posters

Purpose: While body mass index (BMI) and waist circumference (WC) are standard clinical tools for anthropometric cardiovascular risk assessment, they are limited by measurement variability and patient discomfort. Neck circumference (NC) may offer a novel, convenient, and accurate alternative anthropometric measure for assessment of cardiovascular risk.

Methods: Standardized anthropometric measurements (NC, WC, BMI) were obtained by trained medical students from eligible patients (n = 110, 68% female, 75% African American) from primary care and cardiology offices in an IRB-approved cohort study with retrospective chart review. Electronic medical record data extraction via double data entry was used to calculate cardiovascular …

Jefferson Heart Health (Jhh): A Successful Student-Delivered Motivational Interviewing Pilot Program To Lower Cardiovascular Disease (Cvd) Risk, Nicholas Tomasko, Bs, Cindy Cheng, Md, Phd, Rafael Hernandez, Bs, Alessandra Sapon, Bs

Alpha Omega Alpha Research Symposium Posters

Purpose: The Jefferson Heart Health (JHH) program utilizes student health coaching by trained undergraduate and medical students supporting patients to sustain lifestyle changes and subsequently determine: how can we effectively educate patients by improving adherence to lifestyle recommendations? Also, what is the effectiveness of student-delivered health coaching for reducing patient cardiovascular risk? With our unique student-delivered program, we promote cost-effective lifestyle interventions for lowering overall cardiovascular disease (CVD) burden.

Methods: We successfully completed a four-week pilot with consistent patient attendance. Certified student JHH coaches, supervised by the certified obesity-management specialist and principal investigator, met weekly with 23 patients: 82.6% female/17.4% …

Systematic Evaluation Of Batch Effects In The Cancer Genome Atlas Program Underscores The Need For Batch-Controlled Analysis, Zhongxuan Chen, Stepan Nersisyan, Isidore Rigoutsos, Eric Londin

Alpha Omega Alpha Research Symposium Posters

Purpose: To systematically assess the impact of batch effects on differential expression of isomiR, mRNA, and non-coding RNA (sncRNA) across 13 The Cancer Genome Atlas (TCGA) cancer types and develop a standardized, batch-controlled analysis protocol for TCGA datasets.

Methods: Data analysis and visualization were performed using Python v3.12. Plots were generated using matplotlib and seaborn. isomiR, mRNA, and sncRNA sequences across 13 TCGA cancer types were used. Principal Component Analysis (PCA) was performed using scikit-learn for dimensionality reduction. Differential expression was conducted using DESeq2 under the following protocols: 1) primary tumor samples vs matched normal samples processed in the same …

Elucidating The Binding Site Of The Arrestin-Biased Agonist Icl1-20, Kesara Wein, Roger Armen, Jeffrey L. Benovic, Charles P. Scott

Alpha Omega Alpha Research Symposium Posters

Background and Purpose: 6.7 million Americans live with congestive heart failure (CHF). In CHF, catecholamines are released into cardiac tissue, bind β-adrenergic receptors (βARs), and activate G-protein signaling cascades, causing ischemia and apoptosis. Accordingly, β-blockers are used to antagonize catecholamine binding to βARs and suppress apoptotic downstream effects. However, β-blockers have dose-limiting hypotension, bradycardia and fail to stimulate the cardioprotective β-arrestin signaling pathway. These limits create opportunities for the development of drugs that selectively stimulate β-arrestin signaling while suppressing cardiotoxic G protein signaling. We have previously reported a biased agonist of the β-arrestin pathway (ICL1-20) that selectively stimulates β-arrestin recruitment …

Survival Impact Of Intraoperative Co2 Dysregulation In Patients Undergoing Pancreaticoduodenectomy For Pancreatic Ductal Adenocarcinoma, Ashley Wetzel, Andrea Feci, Joseph Gorman, Isabel Lavine, Edoardo Manca, Richard Zheng, Md, Nader Hanna, Md, Harish Lavu, Md, Charles J. Yeo, Md, Avinoam Nevler, Md

Alpha Omega Alpha Research Symposium Posters

Purpose: Pancreatic ductal adenocarcinomas (PDAC) are aggressive malignancies with poor prognoses. Emerging evidence suggests tissue hypercapnia (elevated CO₂) promotes aggressive, treatment resistant tumor biology. End-tidal CO₂ (ETCO₂) offers a composite measure of ventilation, systemic perfusion, and tissue CO₂ production. During curative-intent pancreaticoduodenectomy, we hypothesized that intraoperative ETCO₂ could serve as a marker of tissue CO₂ dyscapnia; both low levels indicating decreased circulatory reserves and high levels indicating tissue hypercapnia may result in worse outcomes.

Methods: We conducted a retrospective review (2017-2023) of 343 patients undergoing pancreaticoduodenectomy for PDAC. Intraoperative ETCO₂ data …

Evaluating The Impact Of Bard1 Isoform Targeting On Pdac Growth And Response To Olaparib, Lily Zekavat, Samuel Zion, Boxuan Wei, Avinoam Nevler, Aditi Jain

Alpha Omega Alpha Research Symposium Posters

Background

• BRCA-Associated Ring Domain 1 (BARD1), a heterodimeric binding partner of the tumor suppressor BRCA1, plays an essential role in homologous recombination-mediated DNA repair. Mutations in BARD1 increase cancer susceptibility and result in a molecular phenotype that predicts sensitivity to poly (ADP-ribose) polymerase inhibition (PARPi), including Olaparib.
• Several alternatively spliced isoforms of BARD1, including BARD1δ and BARD1φ, have also been implicated in tumor progression. These isoforms, characterized by deletion of exons 2-6 and 3-6, respectively, lack the RING domain required for BRCA1 interaction (Figure 1). 
• Upregulation of BARD1 isoforms is associated with poor prognosis in several tumor types. However, the …

Primary Care Use And Clinical Outcomes In A Prevalent Cohort Of Patients Receiving Hemodialysis, Dustin Le, Hatem Najar, Zoheb Backer, Rohanit Singh, Byoungjun Kim, Morgan E. Grams, Laura Plantinga, Bernard G. Jaar

Division of Nephrology Faculty Papers

Rationale & Objective - Primary care is associated with improved health outcomes, but whether this is true for patients receiving dialysis is unclear. We evaluated the association of primary care use in the previous year and clinical outcomes using a prevalent cohort of patients receiving hemodialysis.

Study Design - Retrospective cohort study.

Setting & Participants - United States Renal Data System registry of prevalent patients requiring maintenance in-center on January 1, 2019, linked with Medicare claims data.

Exposure - Primary care use was defined as ≥ 1 outpatient visit to a provider with the specialty of Family, General, Geriatric, or …

Jackson-Pratt Drain-Related Challenges And A Potential Explanation For Associated Surgical Site Pain Variability Following Breast Mastectomy And Reconstruction, Spencer Haber, Bs, Krishna Koka, Bs, Elizabeth Simon, Bs, Devin Williams, Bs, Andrew Newman, Md

Alpha Omega Alpha Research Symposium Posters

Background: The Jackson-Pratt (JP) drain is a closed suction drain used in surgeries throughout the body. This prevents seroma formation through continual negative pressure drainage while resisting collapse and obstruction. JP drains are mainstays in breast reconstruction and mastectomy.

Methods: Through a literature review using keywords such as “Surgical Site Infection” (SSI), “Quality of Life” (QOL), and “Surgical Site Pain” (SSP), we summarized JP drain-related complications in breast reconstruction and mastectomy. Although the drain effectively reduces seroma formation, there has been a lack of innovation in addressing these issues. There is no standardized approach to JP drain post-operative care or …

National Landscape Of Pediatric And Adult Inpatient Sickle Cell Disease Care, Ashley M. Jenkins, Spoorthy Vangala, Matthew Mcintosh, Robert Legros, Sophie Lanzkron, Kevin Fiscella

Department of Medicine Faculty Papers

No abstract provided.

Clinical Features Of Infantile Epileptic Spasms Syndrome: A Systematic Review, Xiao Meng, Danielle S Takacs, Yashaswini Kelagere, Zihan Zhang, Sanjanaa Seshadri, Jiyeon Cha, Ming Li, Lei-Shih Chen

Faculty, Staff and Students Publications

Introduction

Infantile Epileptic Spasms Syndrome (IESS) is a severe epilepsy in children between one month and two years of age. Urgent referral of possible IESS cases from pediatricians and family physicians who care for children to neurologists for diagnosis and treatment has been shown to significantly improve patient health outcomes. Yet, a comprehensive list of IESS clinical features is lacking. We conducted a systematic review of studies to report IESS clinical features.

Methods

Articles from the MEDLINE Complete and Embase databases were searched from the earliest years of databases availability (1979) to July 31, 2024. We followed the Preferred Reporting …

Mom Is Developing Too: Preliminary Evidence For The Reciprocal Effects Of Infant Sensory Reactivity And Maternal Behavior, Emily C. Sweiss, Vincent Berardi, Elysia Poggi Davis, Curt A. Sandman, Laura M. Glynn

Psychology Faculty Articles and Research

Caregiver sensitivity to infant cues is well-established as a predictor of child development. Infants also actively influence their social environment, especially their caregivers, even from their earliest days. Sensory reactivity, characterized as hypo- (under) and hyper- (over) responding to environmental stimuli, is one domain of development that is likely to influence caregiver-infant interaction, due to its role in regulating emotions and responses to both physical and social stimuli. Although sensory reactivity could be an important target for improving caregiver-child interaction, the longitudinal, reciprocal relations between infant sensory reactivity and caregiver behaviors are currently unknown. In the present proof-of-concept study, we …

Clinician Perceptions Of Barriers And Strategies To Improve Pediatric Hypertension Detection, Abbas H. Zaidi, Erica D. Sood, Sarah De Ferranti, Fabliha Khurshan, Samuel Gidding, Varsha Zadokar, Jonathan M Miller, Anne E Kazak

Department of Pediatrics Faculty Papers

IMPORTANCE: Pediatric hypertension remains underrecognized despite its high prevalence (approximately 5%) and long-term cardiovascular implications. Although guidelines for screening and diagnosis exist, less than 25% of affected children are diagnosed, and more than half do not receive timely follow-up care. Clinician-specific implementation barriers and directly informed strategies, which may alleviate this gap, are insufficiently described.

OBJECTIVE: To identify clinician-reported barriers and actionable recommendations to improve pediatric hypertension detection and follow-up in primary care using the Consolidated Framework for Implementation Research.

DESIGN, SETTING, AND PARTICIPANTS: Semistructured qualitative interviews were conducted between November 1, 2022, and March 31, 2023, with health care …

Dispersion-Enhanced Nitrogen-Centered Photocatalysis Of The Direct Hydrogen Atom Transfer, Jiasong Zhang, Kaitong Zhuang, Ramon Trevino, Babu Raj Dhungana, Huiying Sun, Shuyu Yin, Yuting Li, Jacob A Sanchez, Xiaoyu Xia, Ramy Elerian, Yao Sun, Seth O Fremin, Chao Huang, Min He, Maosheng Cheng, Oleg V Larionov, Shengfei Jin

Faculty, Staff and Student Publications

The development of structurally distinct and modular photocatalysts for direct hydrogen atom transfer (HAT) has emerged as a key frontier in radical-mediated C-H functionalization of strong carbon-hydrogen bonds. Despite the largely untapped potential across the fields of organic synthesis, medicinal chemistry, and materials science, few classes of direct HAT photocatalysts are currently known, and the approaches to enhancing their photocatalytic activity remain underdeveloped. We report herein the development of nitrogen-centered direct HAT photocatalysts based on the acridine framework, which leverage a C9-ortho-biaryl substituent for enhancing the photocatalytic activity through stabilizing dispersion interactions with the substrate as the key steering effect. …

Osimertinib Activates A Tgf-Β2-Dependent Secretory Program That Drives Lung Adenocarcinoma Progression, Madhurima Ghosh, Chao Wu, Abhishek Kumar, Monique Nilsson, John V Heymach, Weina Zhao, Jiang Yu, Xin Liu, Na Ding, Shike Wang, Guan-Yu Xiao, Angelo Chen, Kate Grimley, William K Russell, Chad J Creighton, Xiaochao Tan, Jonathan M Kurie

Faculty, Staff and Student Publications

EGFR-mutant lung adenocarcinomas (LUADs) that are vulnerable to the EGFR antagonist osimertinib (Osi) eventually relapse, owing in part to the emergence of drug-tolerant persister (DTP) cells that arise through epigenetic mechanisms. Intratumoral DTP cells can herald a worse clinical outcome, but the way in which DTP cells influence LUAD progression remains unclear. Osi-resistant (OR) cells exhibit typical DTP cell features, including a propensity to undergo senescence and epithelial-mesenchymal transition (EMT), which can activate heightened secretory states. Therefore, we postulated that OR cells influence LUAD progression through paracrine mechanisms. To test this hypothesis, we utilized congenic pairs of EGFR-mutant LUAD cell …

The Impact Of Vascular Management On Postoperative Complications In Patients Undergoing Surgery For Retroperitoneal Leiomyosarcoma, Neha Malik, Seokhun Kim, Christopher P Scally, Emily Z Keung, Heather Lillemoe, Keila E Torres, Kelly K Hunt, Sophia Khan, Christina L Roland, Heather G Lyu

Faculty, Staff and Student Publications

Background: Retroperitoneal leiomyosarcomas are aggressive malignancies. Complete surgical resection with negative margins is crucial to decrease the risk of recurrence but can be risky due to vascular involvement. The aim of our study was to evaluate the different approaches to IVC and renal vein management and their impact on postoperative complications.

Methods: We performed a retrospective review of patients who underwent surgery for retroperitoneal leiomyosarcoma with IVC and/or renal vein involvement at our institution from 2016 to 2024. Patients were stratified by intraoperative vascular management, including ligation only versus varying forms of vascular reconstruction. Postoperative complications, including bleeding, transfusions, the …

Cd8+ T Cells In The Tumor Microenvironment Modulate The Response To Endocrine Therapy In Breast Cancer, Fabiana Napolitano, Yunguan Wang, Dhivya R Sudhan, Paula I Gonzalez-Ericsson, Luigi Formisano, Nisha Unni, Shahbano Shakeel, James Z Zhu, Khushi Ahuja, Lei Guo, María Rosario Chica-Parrado, Yuki Matsunaga, Pamela Luna, Chang-Ching A Lin, Yasuaki Uemoto, Kyung-Min Lee, Hongli Ma, Nathaniel J Evans, Alberto Servetto, Saurabh Mendiratta, Spencer D Barnes, Roberto Bianco, Yisheng V Fang, Lin Xu, Jeon Lee, Tao Wang, Justin M Balko, Gordon B Mills, Marilyne Labrie, Ariella B Hanker, Carlos L Arteaga

Faculty, Staff and Student Publications

The role of the tumor immune microenvironment (TIME) in modulating responses to antiestrogen therapy in hormone receptor-positive (HR+) breast cancers remains unclear. We analyzed pre- and on-treatment biopsies from patients with HR+ breast cancer treated with letrozole to induce estrogen deprivation (ED). Stromal tumor-infiltrating lymphocytes, assessed by H&E staining, and immune-related gene sets, including IFN-γ signaling genes, measured by RNA-Seq, were increased in ED-resistant tumors. Cyclic immunofluorescence and spatial transcriptomics revealed an abundance of CD8+ T cells and enhanced antigen processing and immune gene signatures in ED-resistant tumors. In this group, the expression of CXCL9, CXCL10, and CXCL11 - chemokine …

Women's Preferences For Home-Based Self-Sampling Or Clinic-Based Testing For Cervical Cancer Screening, Joël Fokom Domgue, Monalisa Chandra, Olajumoke Oladoyin, Manali Desai, Robert Yu, Sanjay Shete

Faculty, Staff and Student Publications

Importance: While home-based self-sampling for cervical cancer screening is an evidence-based strategy proven to increase screening access and uptake, it is not currently recommended in the US despite recent Food and Drug Administration approval of the first at-home self-sampling device. Little nationally representative research has examined preference for and drivers of home-based self-sampling over clinic-based testing (the standard of care).

Objective: To assess women's perspectives about, reasons for considering, and factors associated with preferring at-home self-sampling for cervical cancer screening.

Design, setting, and participants: This population-based cross-sectional study used data from the 2024 Health Interview National Trends Survey (HINTS 7), …

Evidence Based Management Of High Ldl-C For Prevention Of Atherosclerotic Cardiovascular Disease In Adult Patients In Resident Run Clinic: A Qi Project, Astha Prasai, Sahej Manesh Singh Arora, Hafsa Jawaid, Aakriti Jain, Omofolarin Babayale, Nauman Naeem, Hina Ukrani, Nawid Latifi, Binita Neupane, Soon-Il Song, Gaurav Sharma

Advances in Clinical Medical Research and Healthcare Delivery

Background:

Atherosclerotic cardiovascular disease (ASCVD) remains the leading cause of death worldwide and in the United States, with significant healthcare and economic burden. Despite clear guideline recommendations, the implementation of ASCVD risk assessment and statin use for primary prevention remains suboptimal.

Methods:

A quality improvement project was conducted at a resident run clinic with an objective to improve ASCVD risk documentation and guideline-based lipid management. A total of 600 patients aged 40-75 years without a history of cardiovascular disease were randomly selected- 300 in the pre-intervention group and 300 in the post-intervention group. The intervention included didactic sessions and quick …

An Exploratory Study Of Social Determinants And Pediatric Lead Exposure In Chemung County, Ny, Jenna Mccracken, Anika Stundtner, Megan Kerbag, Madison Desantis, Jennifer Coseo, Richard Terry

Advances in Clinical Medical Research and Healthcare Delivery

Background: Lead exposure in children is a persistent public health concern due to its irreversible neurological and developmental effects. Children under 6 years old are particularly vulnerable due to frequent hand-to-mouth activity and increased environmental exposure. Existing literature suggests a relationship between adverse social determinants of health (SDOH), such as low parental education and residence in high-poverty areas, and elevated pediatric blood lead levels (BLLs). This study, subsidized through a community service grant from Excellus Blue Cross Blue Shield, aimed to examine the association between BLLs and SDOH among children screened at the ACCEL Community Health Clinic in Chemung County, …

Hallucinations And Diabetes – Could It Be The Hip? An Interesting Case Of Cobalt Poisoning, Mahrukh Tariq, Zauraiz Anjum

Advances in Clinical Medical Research and Healthcare Delivery

Cobalt (Co) poisoning has been described historically in beer-drinkers when cobalt was used as an additive. In present times, this type of poisoning is usually caused by occupational exposure or metal prosthesis breakdown. We present a case of Co poisoning from metal prosthesis breakdown with exceptionally high levels, and thus, some unique symptoms. Interestingly our patient not only had symptoms commonly associated with Co poisoning, e.g., paresthesia, sensory-neural hearing loss, acute kidney failure, but also developed new onset diabetes, which is not commonly associated with this type of pathology. Moreover, when we had this patient under our care, we had …

Late Bioprosthetic Valve Migration- A Rare Entity After Tavi, Sahej Arora, Ghazi Khan, Jeremiah Depta

Advances in Clinical Medical Research and Healthcare Delivery

We present a case of hemolytic anemia due to a rare complication of late bioprosthetic valve migration, who underwent successful treatment with valve in valve transcatheter aortic valve implantation. Our patient with symptomatic moderate aortic stenosis underwent the index procedure a year ago and treated for bacteremia 3 months ago, presented with hemolytic anemia and echocardiography revealing aortic paravalvular leak. The hemolysis was attributed to Bioprosthetic valve dysfunction after a negative hematological workup. The patient's aortography revealed ventricular migration of the valve, not seen on a cardiac CT scan performed before. This was followed by a successful valve in valve …

Neuroinflammation And Its Role In Depression– A Review Of Emerging Biomarkers And Therapeutic Targets, Sophia M. Valerino

Advances in Clinical Medical Research and Healthcare Delivery

Major depressive disorder (MDD) is a prevalent and debilitating mental illness that affects millions globally. Traditionally, the pathophysiology of MDD was thought to be due primarily neurotransmitter imbalances. However, emerging research highlights the role of neuroinflammation in MDD pathogenesis. Elevated levels of pro-inflammatory cytokines, microglial activation, and blood-brain barrier dysfunction have been implicated in the etiology of MDD. Additionally, biomarkers such as C-reactive protein and neuroimaging findings further support the neuroinflammatory hypothesis. This growing body of evidence has led to increased interest in novel treatment approaches, including anti-inflammatory medications and lifestyle interventions, as potential therapeutic strategies. While selective serotonin reuptake …

Diagnostically Complex Case Of Trivalvular Infectious Endocarditis Complicated By Hiv, Hcv, Pulmonary Septic Emboli, And Epidural Abscess, Madison Baker, Natasha Singh, Rohail A. Baig, Justin Nistico

Advances in Clinical Medical Research and Healthcare Delivery

Background:

Infective endocarditis (IE) can be visualized on echocardiograms. However, there is a significant discrepancy between transthoracic and transesophageal echocardiograms. This imaging modality is also impacted by operator dependent factors. The risk of right sided endocarditis is elevated in people who inject drugs (PWID). In individuals with human immunodeficiency virus (HIV), there is an increased risk of IE, and there is also a relationship that has yet to be fully established between hepatitis C virus (HCV) and IE.

This report describes a woman with a history of IVDU who was diagnosed with HIV/AIDS, HCV, and sepsis secondary to methicillin-resistant Staphylococcus …

A Rare Case Of Gastrointestinal Stromal Tumor Outside The Gastrointestinal Tract, Ashton I. D'Souza, Jasdeep S. Bajwa, Basil George Verghese

Advances in Clinical Medical Research and Healthcare Delivery

Extra-gastrointestinal stromal tumors are rare mesenchymal tumors occurring outside the gastrointestinal tract, comprising ~5% of all gastrointestinal stromal tumors. A 65-year-old man undergoing evaluation for nephrolithiasis was incidentally found to have a 7.2 cm mesenteric mass proven to be gastrointestinal stromal tumors on biopsy. After limited response to imatinib, the patient underwent successful surgical resection. Mesenteric gastrointestinal stromal tumors often present larger and more aggressive, but in this instance, early incidental detection permitted effective intervention. This case highlights the diagnostic challenges posed by extra-gastrointestinal stromal tumors due to their atypical location and nonspecific symptoms. Extra-gastrointestinal stromal tumors should be considered …