Medical Specialties Commons^™

Hyperviscosity Syndrome Induced Bilateral Visual And Auditory Impairment In Therapy Resistant Waldenström Macroglobulinemia With Myd88 And Cxcr4 Mutations, Marie M Plante, Erinmarie O Kimbrough, Amit K Agarwal, Liuyan Jiang, Kirk Bourgeois, Greta C Stamper, Michael W Stewart, Han W Tun

Faculty, Staff and Student Publications

Hyperviscosity syndrome (HVS) is an emergent complication of Waldenström macroglobulinemia (WM) characterized by visual, neurologic, and rarely auditory impairment. We report a 69-year-old female with MYD88 and CXCR4-mutant WM who developed HVS resulting in bilateral blindness and deafness associated with neurologic manifestations including confusion, severe generalized weakness, and imbalance. Ophthalmologic evaluation revealed bilateral central retinal vein occlusion (CRVO), diffuse retinal hemorrhages, macular edema, and serous macular detachments (SMD). Magnetic resonance imaging of the brain showed bleeding in the inner ears. Management was challenging as her WM was resistant to systemic therapies including bendamustine + rituximab (BR) and rituximab + bortezomib …

Novel Compound Heterozygous Variants In The Ush2a Gene Associated With Autosomal Recessive Retinitis Pigmentosa Without Hearing Loss, Yanxia Huang, Lamei Yuan, Guiyun He, Yanna Cao, Xiong Deng, Hao Deng

Faculty, Staff and Student Publications

Background: Retinitis pigmentosa (RP) is a group of progressive inherited retinal dystrophies characterized by the primary degeneration of rod photoreceptors and the subsequent loss of cone photoreceptors because of cell death. It is caused by different mechanisms, including inflammation, apoptosis, necroptosis, pyroptosis, and autophagy. Variants in the usherin gene (USH2A) have been reported in autosomal recessive RP with or without hearing loss. In the present study, we aimed to identify causative variants in a Han-Chinese pedigree with autosomal recessive RP.

Methods: A six-member, three-generation Han-Chinese family with autosomal recessive RP was recruited. A full clinical examination, whole exome …

Refractory Thrombocytopenia During Liver Transplantation Requiring Splenectomy, Ivana Wrobleski Wilder, Alexander Reskallah, Catherine M Pivalizza, John S Bynon, Evan G Pivalizza

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Although thrombocytopenia is common in end-stage liver disease, severe, refractory thrombocytopenia during liver transplantation is rare, and if immune based, usually presents months or years later. This case describes an adult woman in whom preoperative evaluation had not determined an immune-related cause of thrombocytopenia. Clot strength was dramatically impaired as measured by thrombelastography during the transplant. Following a lack of response to repeat platelet transfusions, splenectomy was performed after graft reperfusion with rapid temporal restoration of clot strength. This case shows a severe manifestation of perioperative thrombocytopenia during liver transplantation and clinically guided management when measured clot strength is too …

Hypofibrinogenemia Following Injury In 186 Children And Adolescents: Identification Of The Phenotype, Current Outcomes, And Potential For Intervention, Justin Gerard, Jan-Michael Van Gent, Jessica Cardenas, Christian Gage, David E Meyer, Charles Cox, Charles E Wade, Bryan A Cotton

Faculty, Staff and Student Publications

OBJECTIVES: Recent studies evaluating fibrinogen replacement in trauma, along with newly available fibrinogen-based products, has led to an increase in debate on where products such as cryoprecipitate belong in our resuscitation strategies. We set out to define the phenotype and outcomes of those with hypofibrinogenemia and evaluate whether fibrinogen replacement should have a role in the initial administration of massive transfusion.

METHODS: All patients/17-4/21 were reviewed. We then evaluated all patients who received emergency-release and massive transfusion protocol (MTP) products. Patients were defined as hypofibrinogenemic (HYPOFIB) if admission fibrinogen(r-TEG) angleHYPOFIB, the impact on outcomes, and whether early replacement improved mortality. …

Vital Signs For Pediatric Health: Chronic Absenteeism, Sara B Johnson, Anne Edwards, Tina Cheng, Kelly J Kelleher, Jennifer Kaminski, Erin G Fox

Faculty, Staff and Student Publications

No abstract provided.

Fascial Defect Closure During Ventral Hernia Repair: A Systematic Review Of Randomized Controlled Trials, Shin Jeong, Tunmi A Anwoju, Oscar A Olavarria, Natalia Cavagnaro, Naila H Dhanani, Nicole B Lyons, Zuhair Ali, Mike K Liang

Faculty, Staff and Student Publications

Background: During minimally invasive ventral hernia repair (VHR) it is unknown if a fascial defect closure, as opposed to a bridged repair (current care), is beneficial for patients. We sought to systematically review the published literature on the role of fascial defect closure during minimally invasive VHR.

Methods: PubMed, Embase, Scopus, Cochrane, and Clinicaltrials.gov were reviewed for randomized controlled trials (RCTs) that compared fascial defect closure with bridged repair. The primary outcome was major complications defined as deep/organ-space surgical site infections (SSIs), reoperations, hernia recurrences, or deaths. Secondary outcomes included SSI, seroma, eventration, hernia recurrence, post-operative pain, and quality of …

Quadricuspid Aortic Valve With Guarded Left Coronary Artery Ostium In An Infant With Myocardial Infarction, Anne Aurelie Tedga, Frank Pigula, Latasha Lewis, Thomas Richard Kimball

Faculty, Staff and Student Publications

• Anatomical variations of the aortic valve include unicuspid, bicuspid, and quadricuspid.
• The bicuspid aortic valve is most common and affects 1%-2% of the general population.
• QAV is generally an isolated malformation, and adults most commonly present with AR.
• Coronary anomalies have been reported in up to 10% of patients with QAV.
• Prompt and accurate imaging will lead to corrective surgery.

Virtual Teaching Together: Engaging Parents And Young Children In Stem Activities, Tricia A Zucker, Michael P Mesa, Michael A Assel, Cheryl Mccallum, Dana Demaster

Faculty, Staff and Student Publications

INTRODUCTION: Early informal learning experiences are essential for sparking long-term interest in science, technology, engineering, and math (STEM). In a prior study, we found more promising parent involvement outcomes when families of young children were provided with STEM family education events along with home STEM activity kits compared to providing workshops alone. This study was a conceptual replication using the same program-

METHODS: Museum informal science educators introduced four units via virtual video chat sessions linked to 12 hands-on STEM activities that were mailed to families randomly assigned to the treatment group. Half of the families were assigned to a …

A Comparative Study Of Cellular Diversity Between The Xenopus Pronephric And Mouse Metanephric Nephron, Mark E Corkins, Maryanne Achieng, Bridget D Delay, Vanja Krneta-Stankic, Margo P Cain, Brandy L Walker, Jichao Chen, Nils O Lindström, Rachel K Miller

Faculty, Staff and Student Publications

The kidney is an essential organ that ensures bodily fluid homeostasis and removes soluble waste products from the organism. Nephrons, the functional units of the kidney, comprise a blood filter, the glomerulus or glomus, and an epithelial tubule that processes the filtrate from the blood or coelom and selectively reabsorbs solutes, such as sugars, proteins, ions, and water, leaving waste products to be eliminated in the urine. Genes coding for transporters are segmentally expressed, enabling the nephron to sequentially process the filtrate. The Xenopus embryonic kidney, the pronephros, which consists of a single large nephron, has served as a valuable …

Non-Pharmacologic Approaches To Treatment Of Pediatric Functional Abdominal Pain Disorders, Partha Sarathi Chakraborty, Rhea Daniel, Fernando A Navarro

Faculty, Staff and Student Publications

Functional abdominal pain disorders (FAPDs) affect up to 25% of children in the United States. These disorders are more recently known as disorders of "brain-gut" interaction. The diagnosis is based on the ROME IV criteria, and requires the absence of an organic condition to explain the symptoms. Although these disorders are not completely understood, several factors have been involved in the pathophysiology including disordered gut motility, visceral hypersensitivity, allergies, anxiety/stress, gastrointestinal infection/inflammation, as well dysbiosis of the gut microbiome. The pharmacologic and non-pharmacologic treatments for FAPDs are directed to modifying these pathophysiologic mechanisms. This review aims to summarize the non-pharmacologic …

A Deep Learning Approach To Predict Collateral Flow In Stroke Patients Using Radiomic Features From Perfusion Images, Giles Tetteh, Fernando Navarro, Raphael Meier, Johannes Kaesmacher, Johannes C Paetzold, Jan S Kirschke, Claus Zimmer, Roland Wiest, Bjoern H Menze

Faculty, Staff and Student Publications

Collateral circulation results from specialized anastomotic channels which are capable of providing oxygenated blood to regions with compromised blood flow caused by arterial obstruction. The quality of collateral circulation has been established as a key factor in determining the likelihood of a favorable clinical outcome and goes a long way to determining the choice of a stroke care model. Though many imaging and grading methods exist for quantifying collateral blood flow, the actual grading is mostly done through manual inspection. This approach is associated with a number of challenges. First, it is time-consuming. Second, there is a high tendency for …

The Economic Case For Hospital Discharge Services For People Experiencing Homelessness In England: An In-Depth Analysis With Different Service Configurations Providing Specialist Care, Joshua X Samuels, Jonathan J-M Calede, Robert M Hunt

Faculty, Staff and Student Publications

Dipodomyine heteromyids (kangaroo rats and mice) are a diverse group of arid-adapted ricochetal rodents of North America. Here, a new genus and species of a large dipodomyine is reported from early Miocene-aged deposits of the John Day Formation in Oregon that represents the earliest record of the subfamily. The taxon is known from a single specimen consisting of a nearly complete skull, dentary, partial pes, and caudal vertebra. The specimen is characterized by a mosaic of ancestral and highly derived cranial features of heteromyids. Specifically, the dental morphology and some cranial characteristics are similar to early heteromyids, but other aspects …

Intraventricular Endoscopy And Intraventricular Antibiotics In The Treatment Of Multiloculated Hydrocephalus With Ventriculitis In A Neonate And An Infant: Two Case Reports, Doriam Alejandrino Perera Valdivia, Luis Roberto Zapata Vega, Edgar Abraham Herrera Pérez

Faculty, Staff and Student Publications

BACKGROUND: We present two pediatric cases, a neonate and an infant, who presented with treatment-refractory ventriculitis and multiloculated hydrocephalus treated with simultaneous intraventricular endoscopy and antibiotics. This is the first report of this combined therapy in children.

CASE DESCRIPTION: Using intraventricular endoscopic surgery and antibiotics, hydrocephalus was treated with a minimum number of ventricular shunt systems. In addition, treatment-refractory ventriculitis was treated in both patients using intraventricular antibiotics.

CONCLUSION: Endoscopic surgery and intraventricular antibiotic administration are useful strategies for treating multiloculated hydrocephalus and ventriculitis in children.

The Insulin And Igf Signaling Pathway Sustains Breast Cancer Stem Cells By Irs2/Pi3k-Mediated Regulation Of Myc, Manoj Sivan, Stefano Negrini, Carlotte Kiekens, Fary Khan, Gerard E Francisco, Francesca Gimigliano

Faculty, Staff and Student Publications

No abstract provided.

An Updated Examination Of The Perception Of Barriers For Pharmacogenomics Implementation And The Usefulness Of Drug/Gene Pairs In Latin America And The Caribbean, Aimeé Salas-Hernández, Macarena Galleguillos, Matías Carrasco, Andrés López-Cortés, María Ana Redal, Dora Fonseca-Mendoza, Patricia Esperón, Farith González-Martínez, Ismael Lares-Asseff, Alberto Lazarowski, Verónica Loera-Castañeda, Diadelis Remírez, Matías F Martínez, Rodrigo Vargas, Fabricio Rios-Santos, Antonio Macho, Juan P Cayún, Germán R Perez, Carolina Gutierrez, Leslie C Cerpa, Tamara Leiva, Susan Calfunao, Lesly Xajil, Christopher Sandoval, Marcelo Suárez, Ariana Gonzalez, Gabriela Echeverría-Garcés, Luis Sullón-Dextre, Eugenia Cordero-García, Alexis R Morales, Andrea Avendaño, Enrique Sánchez, Laura C Bastone, Cesar Lara, Patricia Zuluaga-Arias, Ana María Soler, Julio Da Luz, Gabriela Burgueño-Rodríguez, Marcelo Vital, Elizabeth Reyes-Reyes, Alexander Huaccha, Yeimy V Ariza, Naomi Tzul, Ana L Rendón, Roberto Serrano, Larissa Acosta, Angelo Motta-Pardo, Leonardo Beltrán-Angarita, Erika Brand, Miguel A Jiménez, Gladys Maribel Hidalgo-Lozada, Marina M J Romero-Prado, Karla Escobar-Castro, Mariel Umaña-Rivas, Juan D Vivas, Paola Lagos, Yineth Ballén Martínez, Sharleth Quesada, Camila Calfio, Maria L Arias, María A Lavanderos, Dante D Cáceres, Alberto Salazar-Granara, Nelson M Varela, Luis A Quiñones

Faculty, Staff and Student Publications

Pharmacogenomics (PGx) is considered an emergent field in developing countries. Research on PGx in the Latin American and the Caribbean (LAC) region remains scarce, with limited information in some populations. Thus, extrapolations are complicated, especially in mixed populations. In this paper, we reviewed and analyzed pharmacogenomic knowledge among the LAC scientific and clinical community and examined barriers to clinical application. We performed a search for publications and clinical trials in the field worldwide and evaluated the contribution of LAC. Next, we conducted a regional structured survey that evaluated a list of 14 potential barriers to the clinical implementation of biomarkers …

Preexisting Depression And Ambulatory Status After Stroke: Florida-Puerto Rico Collaboration To Reduce Stroke Disparities, Amy K Starosciak, Kefeng Wang, Hao Ying, Kaushik Ravipati, Samantha Spring, Carolina M Gutierrez, Hannah Gardener, David Z Rose, Dianne Foster, Chuanhui Dong, Angus Jameson, Ayham Alkhachroum, Jose G Romano, Ralph L Sacco, Tatjana Rundek, Negar Asdaghi

Faculty, Staff and Student Publications

OBJECTIVE: Stroke is a global public health burden, and therefore it is critical to identify modifiable risk factors to reduce stroke incidence and improve outcomes. Depression is such a risk factor; however, the association between preexisting depression and stroke outcomes, such as independent ambulation, is not well studied, especially among racial-ethnic minority groups. To address this gap in the literature, effects of preexisting depression on ambulatory status at hospital discharge after stroke were evaluated among individuals participating in the racially and ethnically diverse Florida-Puerto Rico Collaboration to Reduce Stroke Disparities project.

METHODS: Data were analyzed from a total of 42,031 …

Head And Neck Cancer Online Support Groups: Disparities In Participation And Impact On Patients, Benjamin Tam, Matthew Lin, Carlos Castellanos, Ruben Ulloa, Niels Kokot, Kevin Hur

Faculty, Staff and Student Publications

OBJECTIVE: To characterize the users of the head and neck cancer (HNC) online support group (OSG) and describe the perceived benefits of membership.

STUDY DESIGN: Cross-sectional.

SETTING: Online.

METHODS: An administered survey with questions asking about demographics, cancer history, treatment choices, and feelings about OSGs was posted on the 5 largest HNC OSGs on Facebook.

RESULTS: A total of 97 participants completed the survey. Mean age was 57.8 years old (standard deviation = 10.7 years). Most participants were female (50.5%) and Caucasian (92.8%). This cohort was well educated with 65.5% holding at least a college degree. Annual income was high …

A Comparison Of One Year Outcomes Between Standardized Locomotor Training And Usual Care After Motor Incomplete Spinal Cord Injury: Community Participation, Quality Of Life And Re-Hospitalization, Candace Tefertiller, Meghan Rozwod, Sandra Wojciehowski, Mitch Sevigny, Susan Charlifue, Jessica M Ketchum, Jeffrey Berliner, Heather B Taylor, Andrea L Behrman, Susan Harkema, Gail Forrest, Mary Schmidt Read, Michelle Basso

Faculty, Staff and Student Publications

CONTEXT/OBJECTIVE: Spinal cord injury (SCI) often results in a significant loss of mobility and independence coinciding with reports of decreased quality of life (QOL), community participation, and medical complications often requiring re-hospitalization. Locomotor training (LT), the repetition of stepping-like patterning has shown beneficial effects for improving walking ability after motor incomplete SCI, but the potential impact of LT on psychosocial outcomes has not been well-established. The purpose of this study was to evaluate one year QOL, community participation and re-hospitalization outcomes between individuals who participated in a standardized LT program and those who received usual care (UC).

DESIGN/SETTING/PARTICIPANTS: A retrospective …

Novel Psychiatric Disorder 6 Months After Traumatic Brain Injury In Children And Adolescents, Jeffrey E Max, Imogen Drake, Florin Vaida, John R Hesselink, Linda Ewing-Cobbs, Russell J Schachar, Sandra B Chapman, Erin D Bigler, Elisabeth A Wilde, Ann E Saunders, Tony T Yang, Olga Tymofiyeva, Harvey S Levin

Faculty, Staff and Student Publications

OBJECTIVE: To investigate the factors predictive of novel psychiatric disorders in the interval 0-6 months following traumatic brain injury (TBI).

METHODS: Children ages 5-14 years consecutively hospitalized for mild to severe TBI at five hospitals were recruited. Participants were evaluated at baseline (soon after injury) for pre-injury characteristics including psychiatric disorders, socioeconomic status (SES), psychosocial adversity, family function, family psychiatric history, and adaptive function. In addition to the psychosocial variables, injury severity and lesion location detected with acquisition of a research MRI were measured to develop a biopsychosocial predictive model for development of novel psychiatric disorders. Psychiatric outcome, including occurrence …

Spike Timing Dependent Plasticity: A Consequence Of More Fundamental Learning Rules, Matthew E Foster, Ai Leen Choo, Sara A Smith

Faculty, Staff and Student Publications

Research points to negative associations between educational success, socioemotional functioning, and the severity of symptoms in some speech-language disorders (SLDs). Nonetheless, the majority of studies examining SLDs in children have focused on monolinguals. More research is needed to determine whether the scant findings among multilinguals are robust. The present study used parent report data from the U.S. National Survey of Children’s Health (2018 to 2020) to gain a better understanding of the impacts of SLD severity on indicators of academic success and socioemotional functioning among multilingual (n = 255) and English monolingual (n = 5,952) children with SLDs. …

Noise Characteristics In Spaceflight Multichannel Eeg, Patrique Fiedler, Jens Haueisen, Ana M Cebolla Alvarez, Guy Cheron, Pablo Cuesta, Fernando Maestú, Michael Funke

Faculty, Staff and Student Publications

The cognitive performance of the crew has a major impact on mission safety and success in space flight. Monitoring of cognitive performance during long-duration space flight therefore is of paramount importance and can be performed using compact state-of-the-art mobile EEG. However, signal quality of EEG may be compromised due to the vicinity to various electronic devices and constant movements. We compare noise characteristics between in-flight extraterrestrial microgravity and ground-level terrestrial electroencephalography (EEG) recordings. EEG data recordings from either aboard International Space Station (ISS) or on earth's surface, utilizing three EEG amplifiers and two electrode types, were compared. In-flight recordings showed …

An Individual Data-Driven Virtual Resection Model Based On Epileptic Network Dynamics In Children With Intractable Epilepsy: A Magnetoencephalography Interictal Activity Application, Pablo Cuesta, Ricardo Bruña, Ekta Shah, Christopher Laohathai, Stephanie Garcia-Tarodo, Michael Funke, Gretchen Von Allmen, Fernando Maestú

Faculty, Staff and Student Publications

Epilepsy surgery continues to be a recommended treatment for intractable (medication-resistant) epilepsy; however, 30-70% of epilepsy surgery patients can continue to have seizures. Surgical failures are often associated with incomplete resection or inaccurate localization of the epileptogenic zone. This retrospective study aims to improve surgical outcome through in silico testing of surgical hypotheses through a personalized computational neurosurgery model created from individualized patient's magnetoencephalography recording and MRI. The framework assesses the extent of the epileptic network and evaluates underlying spike dynamics, resulting in identification of one single brain volume as a candidate for resection. Dynamic-locked networks were utilized for virtual …

Containment Measures During The Covid Pandemic: The Role Of Non-Pharmaceutical Health Policies, Michael Funke, Tai-Kuang Ho, Andrew Tsang

Faculty, Staff and Student Publications

Many countries have imposed a set of non-pharmaceutical health policy interventions in an effort to slow the spread of the COVID-19 pandemic. The objective of this paper is to examine the effects of the interventions, drawing on evidence from the OECD countries. A special feature here is the mechanism that underlies the impact of the containment policies. To this end, a causal mediation analysis decomposing the total effect into a direct and an indirect effect is conducted. The key finding is a dual cause-effect channel. On the one hand, there is a direct effect of the non-pharmaceutical interventions on the …

Delayed Presentation Of Berardinelli-Siep Lipodystrophy In An Adolescent Female, Courtney Cleary, Nadine Gordon, Sheela Gavvala

Faculty, Staff and Student Publications

Berardinelli-Siep syndrome (BSS) is a form of congenital generalized lipodystrophy that disrupts the pathways of lipid metabolism. It presents with physical exam findings, including muscular hypertrophy and lipoatrophy as well as serious metabolic consequences such as diabetes mellitus, hypertriglyceridemia, acute pancreatitis, hepatomegaly, and hepatic steatosis. Diagnosis generally occurs soon after birth or in childhood. The case presented is significant for a delayed diagnosis of suspected BSS Type 1 which is rather uncommon in a developed country. Due to the detrimental complications of BSS, such as hypertrophic cardiomyopathy, pancreatitis, and liver disease, early diagnosis and intervention are crucial. Pediatric providers must …

Comparison Of Two Lipid Emulsions On The Incidence Of Parenteral Nutrition Associated Cholestasis In Neonates, Joy Greenberg, Mamta Naik, John Chapman, Allison Davidson, Essam Imseis

Faculty, Staff and Student Publications

OBJECTIVE: Lipid emulsion contributes to parenteral nutrition associated cholestasis (PNAC). For decades, soybean oil-based intravenous lipid emulsion (SO-ILE) was the predominant product. Recently, a multicomponent lipid emulsion containing soybean oil, medium-chain triglycerides, olive oil and fish oil (SMOF-ILE) has been used off-label in neonatal care. This study evaluates the incidence of PNAC in neonates who received SMOF-ILE or SO-ILE.

METHODS: This was a retrospective review of neonates who received SMOF-ILE or SO-ILE for at least 14 days. Patients receiving SMOF-ILE were matched based on gestational age (GA) and birth weight to a historical cohort receiving SO-ILE. The primary outcomes were …

Use Of Elamipretide In Patients Assigned Treatment In The Compassionate Use Program: Case Series In Pediatric Patients With Rare Orphan Diseases, Mary Kay Koenig, Sam Nick Russo, Kim L Mcbride, Hans Tomas Bjornsson, Brynja Bjork Gunnarsdottir, Amy Goldstein, Scott A Falk

Faculty, Staff and Student Publications

Several mitochondrial diseases are caused by pathogenic variants that impair membrane phospholipid remodeling, with no FDA-approved therapies. Elamipretide targets the inner mitochondrial membrane where it binds to cardiolipin, resulting in improved membrane stability, cellular respiration, and ATP production. In clinical trials, elamipretide produced clinical and functional improvements in adults and adolescents with mitochondrial disorders, such as primary mitochondrial myopathy and Barth syndrome; however, experience in younger patients is limited and to our knowledge, these are the first case reports on the safety and efficacy of elamipretide treatment in children under 12 years of age. We describe the use of elamipretide …

Total Reconstruction Of Lower Lip And Chin Following Firework Injury Using Composite Bilateral Radial Forearm-Fascia Lata Flaps: A Case Report, Michael M Talanker, Kasra N Fallah, Cassie A Hartline, Daniel J Freet

Faculty, Staff and Student Publications

BACKGROUND: Primary explosion injuries with fireworks can lead to devastating and geometrically complex facial traumas that present a challenge to the reconstructive surgeon. Our patient, a woman in her early thirties, was hit directly in her chin by a large artillery shell firework. This caused complete soft tissue loss of the lower lip and chin beyond the oral commissures, complicated further by a comminuted mandible fracture.

METHODS: After external fixation, our patient underwent a 2-stage reconstruction with a novel composite flap arrangement. Soft tissue coverage and lip reconstruction were performed with opposing bilateral radial forearm free flaps. The outer flap …

One-Stage Flexor Reconstruction With Anterolateral Thigh And Fascia Lata Rolls After High-Voltage Trauma: A Case Report, Michael M Talanker, Kasra N Fallah, Cassie A Hartline, Daniel J Freet

Faculty, Staff and Student Publications

BACKGROUND: Electrical injuries from high-voltage power lines are unique forms of trauma that can create challenging wounds for reconstructive surgeons. Our patients, a man in his late thirties (Patient 1) and a man in his early twenties (Patient 2), both sustained upper extremity injuries after contact with a high-voltage line.

METHODS: Despite minimal superficial damage, both patients required fasciotomies and debridement of the volar forearm, revealing segmental defects in most digital tendons as well as the distal median nerve. Free fasciocutaneous anterolateral thigh (ALT) flaps were harvested to ensure adequate wound coverage. Additionally, fascia lata grafts were taken from the …

Pregnancy And Diabetic Ketoacidosis: Fetal Jeopardy And Windows Of Opportunity, Ankia Coetzee, David R Hall, Eduard J Langenegger, Mari Van De Vyver, Magda Conradie

Faculty, Staff and Student Publications

BACKGROUND: Diabetic ketoacidosis (DKA) during pregnancy poses significant risks to both the mother and fetus, with an increased risk of fetal demise. Although more prevalent in women with Type I diabetes (T1D); those with Type 2 diabetes (T2D) and gestational diabetes mellitus (GDM) can also develop DKA. A lack of information about DKA during pregnancy exists worldwide, including in South Africa.

OBJECTIVE: This study examined the characteristics and outcomes associated with DKA during pregnancy.

METHODS: The study took place between 1 April 2020 and 1 October 2022. Pregnant women with DKA, admitted to Tygerberg Hospital's Obstetric Critical Care Unit (OCCU) …

The Gpcr–Gαs–Pka Signaling Axis Promotes T Cell Dysfunction And Cancer Immunotherapy Failure, Heather R Kregel, Lillian S Kao, Thaddeus J Puzio

Faculty, Staff and Student Publications

No abstract provided.