Reverse Palmaris Longus Involving Guyon’S Canal Causing Ulnar Nerve Compression, David Peberdy, Sameer Gujral

Western Journal of Orthopaedics

The authors present a case of reverse palmaris longus muscle (RPLM) with consequential compression of the ulnar nerve within Guyon’s canal. They report clinical findings, investigations, including magnetic resonance imagining and functional assessments, and intraoperative findings. The authors found improved sensory and motor function following excision of RPLM. There are few previous case reports regarding RPLM and concomitant compression of the ulnar nerve within Guyon’s canal.

Synovial Fluid Inflammatory Profiles Did Not Differ Between Isolated Anterior Cruciate Ligament And Multi-Ligament Knee Injuries, Cale A. Jacobs, Robert C. Schenck Jr., Leorrie A. Watson, Caitlin E.W. Conley, Darren L. Johnson, Austin V. Stone, Christian Lattermann, Dustin L. Richter

Western Journal of Orthopaedics

Background: Postoperative arthrofibrosis is more common following surgical treatment of multi-ligament knee injury (MLKI) than isolated anterior cruciate ligament (ACL) injury. It has been proposed that the increased prevalence of postoperative arthrofibrosis after MLKIs may be due to increased inflammation secondary to greater trauma to the joint. The purpose of this study was to compare synovial concentrations of pro-inflammatory and anti-inflammatory cytokines between patients with MLKI and ACL injuries.

Methods: Synovial fluid was aspirated from the operative knee at the time of surgery from 14 patients with MLKI and 10 patients with isolated ACL injury. Structures injured, the time between …

Why You Should Use The New Ota Open Fracture Classification (Ofc3), Thomas A. Decoster, Meir Marmor

Western Journal of Orthopaedics

Open fracture classification has traditionally used a modified Gustilo Classification (GOFC). There are many recognized problems with the Gustilo classification. The Orthopaedic Trauma Association (OTA) produced an open fracture Classification (OTA OFC) in 2010 to overcome problems with GOFC. However, it has not been widely adapted, partially because there are too many categories. The OTA OFC has proven to be more effective in identifying particular parameters that affect outcome and treatment for open fractures than GOFC. Numerous authors have called for a reconciliation of the two classifications. The OTA Classification Committee has proposed a modification called the OTA OFC3, which …

Back Matter, Arianna Medina

Western Journal of Orthopaedics

No abstract provided.

Front Matter, Arianna Medina

Western Journal of Orthopaedics

No abstract provided.

Long-Term Success In Managing Midfoot Lateral Column Arthritis: A Case Report, Damian Fountain, Cesar Cardenas, Nicholas Brady, Katherine Gavin, Richard Miller

Western Journal of Orthopaedics

The lateral column of the midfoot is crucial for midfoot mobility and foot stability. Although there are several nonoperative treatment options for arthritis that is isolated to the lateral column cuboid-metatarsal joints, there is a lack of consensus on the best operative intervention, given the rare nature of the disease. The patient in this case initially presented to clinic in 2007 with a significant history of lateral midfoot pain in the fourth and fifth metatarsal cuboid region. Despite nonoperative interventions, her symptoms progressed, and in January of 2009, she elected to undergo interpositional arthroplasty of left fourth and fifth metatarsal …

Echocardiographic Predictive Factors Of Worsening Outcome In Type 1 Cardiorenal Syndrome, Saoussen Antit, Sabrine Bousnina, Marwa Fathi, Ridha Fekih, Elhem Boussabeh, Lilia Zakhama

Journal of the Saudi Heart Association

Introduction: Type 1 cardiorenal syndrome (CRS) is defined as acute decompensated heart failure (AHF) leading to secondary acute kidney injury. Few studies have evaluated the reliability of transthoracic echocardiography (TTE) in assessing outcomes in patients with type 1 CRS. We sought to identify echocardiographic predictors of outcomes (death and rehospitalization) in patients with type 1 CRS. Methods: This was a prospective longitudinal monocentric study, conducted from December 2020 to December 2022 in the cardiology department of the Internal Security Forces Hospital in Marsa, Tunisia. 68 patients with type 1 CRS were included prospectively. Physical, biological, and echocardiographic data were collected …

Targeting Neddylation And Sumoylation In Chemoresistant Triple Negative Breast Cancer, Reid T Powell, Amanda L Rinkenbaugh, Lei Guo, Shirong Cai, Jiansu Shao, Xinhui Zhou, Xiaomei Zhang, Sabrina Jeter-Jones, Chunxiao Fu, Yuan Qi, Faiza Baameur Hancock, Jason B White, Clifford Stephan, Peter J Davies, Stacy Moulder, W Fraser Symmans, Jeffrey T Chang, Helen Piwnica-Worms

Journal Articles

Triple negative breast cancer (TNBC) accounts for 15-20% of breast cancer cases in the United States. Systemic neoadjuvant chemotherapy (NACT), with or without immunotherapy, is the current standard of care for patients with early-stage TNBC. However, up to 70% of TNBC patients have significant residual disease once NACT is completed, which is associated with a high risk of developing recurrence within two to three years of surgical resection. To identify targetable vulnerabilities in chemoresistant TNBC, we generated longitudinal patient-derived xenograft (PDX) models from TNBC tumors before and after patients received NACT. We then compiled transcriptomes and drug response profiles for …

Human Neutralizing Antibodies Target A Conserved Lateral Patch On H7n9 Hemagglutinin Head, Manxue Jia, Hanjun Zhao, Nicholas C Morano, Hong Lu, Yin-Ming Lui, Haijuan Du, Jordan E Becker, Kwok-Yung Yuen, David D Ho, Peter D Kwong, Lawrence Shapiro, Kelvin Kai-Wang To, Xueling Wu

Journal Articles

Avian influenza A virus H7N9 causes severe human infections with >30% fatality. Currently, there is no H7N9-specific prevention or treatment for humans. Here, from a 2013 H7N9 convalescent case in Hong Kong, we isolate four hemagglutinin (HA)-reactive monoclonal antibodies (mAbs), with three directed to the globular head domain (HA1) and one to the stalk domain (HA2). Two clonally related HA1-directed mAbs, H7.HK1 and H7.HK2, potently neutralize H7N9 and protect female mice from lethal H7N9/AH1 challenge. Cryo-EM structures reveal that H7.HK1 and H7.HK2 bind to a β14-centered surface and disrupt the 220-loop that makes hydrophobic contacts with sialic acid on an …

A Novel Consumer-Centric Metric For Evaluating Hearing Device Audio Performance, Vinaya Manchaiah, Steve Taddei, Abram Bailey, De Wet Swanepoel, Hansapani Rodrigo

School of Mathematical and Statistical Sciences Faculty Publications and Presentations

Background and Aim: The emergence of direct-to-consumer hearing devices has introduced confusion in making appropriate choices, highlighting the need for users to be well-informed for optimal device selection. Currently, no established metric offers insights into the sound performance of these devices. This study aimed to introduce and assess a novel consumer-centric metric (i.e., SoundScore) for hearing device audio performance.

Method: The SoundScore metric was created based on five dimensions of hearing device audio performance (i.e., speech benefit in quiet and moderate, speech benefit in loud, own voice perception, feedback control, streamed music sound quality). Tests were conducted under lab conditions …

T-Cell Redirecting Bispecific Antibodies: A Review Of A Novel Class Of Immuno-Oncology For Advanced Prostate Cancer, Julia Palecki, Amman Bhasin, Andrew Bernstein, Patrick Mille, William Tester, William Kelly, Kevin Zarrabi

Kimmel Cancer Center Faculty Papers

Novel T-cell immunotherapies such as bispecific T-cell engagers (BiTEs) are emerging as promising therapeutic strategies for prostate cancer. BiTEs are engineered bispecific antibodies containing two distinct binding domains that allow for concurrent binding to tumor-associated antigens (TAAs) as well as immune effector cells, thus promoting an immune response against cancer cells. Prostate cancer is rich in tumor associated antigens such as, but not limited to, PSMA, PSCA, hK2, and STEAP1 and there is strong biologic rationale for employment of T-cell redirecting BiTEs within the prostate cancer disease space. Early generation BiTE constructs employed in clinical study have demonstrated meaningful antitumor …

The Gender Spectrum Of In-Hospital Survival Post Primary Percutaneous Coronary Intervention For St Elevation Myocardial Infarction: Exploring Age-Driven Trends, Iva Patel, Pooja Vyas, Karthik Natarajan, Kewal Kanabar, Vishal Sharma, Sharad Jain, Dinesh Joshi, Swati Dahiya, Siva Nagendra Borra

Journal of the Saudi Heart Association

Background: The study was aimed to evaluate gender difference and age & gender specific interaction of in-hospital outcomes of patients with ST elevation myocardial infarction (STEMI) undergoing primary percutaneous coronary intervention (PCI). Methods: This was a prospective cohort study of 1748 patients with STEMI undergoing primary PCI. The study was dichotomised according to gender to evaluate the difference in the outcome. The study was further stratified based on an age cut-off of 75 years to examine the age-specific gender relationship in survival outcomes. Independent variables for in-hospital mortality were analysed through logistic regression. Results: There were 314 (17.96%) females with …

Care Of The Critically Ill Nontrauma Patient: Improving Emergency Department Readiness And Patient Care Through The Implementation Of A Dedicated Resuscitation Bay, Martha H. Buck Rn, Bsn, Tcrn

Doctor of Nursing Practice Final Manuscripts

Current best practice among emergency departments worldwide includes the maintenance of a dedicated resuscitation space. This practice allows for team members and equipment to be ready at a moment’s notice to provide care to a patient in need of lifesaving interventions. This evidence-based performance improvement project seeks to implement this standard of care in a busy, urban emergency department in Southern California.

Prior to this study, patients at this facility were placed in the next available care space, without the maintenance of a dedicated resuscitation area for critically ill patients. Survey data evaluating staff levels of perceived readiness to care …

Honoring Veterans’ Wishes: Efficacy Of An Evidence-Based Shared Decision-Making Tool In Va Icu Goals-Of-Care Discussions, Stephanie Alexander, Anna Astashchanka Md, Venktesh Ramnath Md

Doctor of Nursing Practice Final Manuscripts

Abstract

Introduction: This Doctor of Nursing Practice project aimed to enhance the knowledge and confidence of the San Diego Veterans Health Administration’s (VASD) Intensive Care Unit (ICU) medical providers in goals-of-care discussions (GOCD). Additionally, this project aimed to improve the documentation of these discussions.

Background: Delays in GOCD can lead to futile medical and surgical interventions, inappropriate antibiotic use, and higher rates of mental health conditions in patients and their loved ones. Earlier GOCD are associated with lower ventilation and resuscitation rates, earlier hospice enrollment, reduced ICU admissions, lower financial costs, and better patient and caregiver quality of life. However, …

Hemoadsorption With Cytosorb As Part Of A Strategy To Improve Outcomes In Patients On Extracorporeal Membrane Oxygenation, Ruzica Mrkonjic

The VAD Journal

The exposure of a patient’s blood to the non-endothelialized surface of the extracorporeal membrane oxygenation (ECMO) system results in the production of pro-inflammatory and anti-inflammatory cytokines. This imbalance in pro- and anti-inflammatory cytokines leads to inflammatory response syndrome, which contributes to edema, vasoplegia, and multiple organ failure among other complications. Hemoadsorption therapy, with the use of CytoSorb^® (CytoSorbents) has emerged as a well-accepted treatment option that helps control pro-inflammatory response and improve outcomes for patients on ECMO. However, studies have shown that the potential of hemoadsorption is controversial and that it is crucial for clinicians to weigh the pros …

Improved Pediatric Icu Mortality Prediction For Respiratory Diseases: Machine Learning And Data Subdivision Insights, Johayra Prithula, Muhammad E H Chowdhury, Muhammad Salman Khan, Khalid Al-Ansari, Susu M Zughaier, Khandaker Reajul Islam, Abdulrahman Alqahtani

Journal Articles

The growing concern of pediatric mortality demands heightened preparedness in clinical settings, especially within intensive care units (ICUs). As respiratory-related admissions account for a substantial portion of pediatric illnesses, there is a pressing need to predict ICU mortality in these cases. This study based on data from 1188 patients, addresses this imperative using machine learning techniques and investigating different class balancing methods for pediatric ICU mortality prediction. This study employs the publicly accessible "Paediatric Intensive Care database" to train, validate, and test a machine learning model for predicting pediatric patient mortality. Features were ranked using three machine learning feature selection …

Quality Improvement Initiative For Anaphylaxis Treatment In A Pediatric Emergency Department, Kaitlyn Leahey, Jack Becker, Angela Kim

St. Chris Research Day

No abstract provided.

Using Autorefraction Data To Predict Strabismus With Deep Learning Technology, Ibrahim Chaudhry, Aaila I Chaudhry Dr

St. Chris Research Day

No abstract provided.

Endothelial Dysfunction Linked To Ventricular Dysfunction In Children With Sickle Cell Disease, A 3d Speckle Tracking Study., Antoine Abdelmassih, Mervat Haroun, Rasha Abdelraouf Abdelaziz Afifi, Gehan Hussein, Manal Abdelhameed, Marina George Asaad, Heba Tarabeh, Nourhan Essam El Din Taha, Nourine Diab, Noura Shebl, Raghda Fouda, Marianne Edward Yassa, Mohamed Ghobashy, Hala Agha

Journal of the Saudi Heart Association

Background

Sickle Cell Disease (SCD) is not a hematologic disease that occurs in isolation; it results in multi-organ complications. There is growing evidence of vascular stiffness as its underlying cause.

This study aimed to investigate the relationship between endothelial stiffness and LV dysfunction in SCD patients and to explore its pathophysiology, particularly regarding the depletion of vasodilators such as Nitric Oxide (NO).

Methodology

32 patients with established criteria for SCD and 40 healthy control subjects were selected for this case-control study. Comprehensive clinical assessment and assessment of endothelial function using Brachial Flow-mediated dilation (FMD) were performed, along with serum NO …

Mainehealth Cancer Care Network Ticket Intake Process, Lauren Couture, Brett Cropp, Gavin Carr, Ashok Kunche, Heather Boulier, Evelyn Taylor

Operations Transformation

The MaineHealth Cancer Care Network informatics team is manually submitting most reporting tickets for oncology customers. The current intake ticket process includes various communication channels to the business intelligence developers [BID] when a reporting need is identified resulting in workflow deficiencies and redundancies. As of FY23, MaineHealth has moved to a new ticket reporting system called ServiceHub which includes new customer self-service tools that have not yet been utilized.

Creating Capacity To Accommodate Additional Cardiac Catheterization Procedures, Kristin Anthony

Operations Transformation

Patient access to diagnostic outpatient (OP) cardiac catheterization is limited by a perceived lack of capacity. Outpatient cardiac cath pts flow through the ACU for pre/post procedure care. Current schedule limits pts that may be scheduled through the ACU to two OP procedures/day. Cardiologists request the ability to schedule beyond the two procedures/day allowed. Significant variation in pre/postoperative care orders exist amongst cardiologists resulting in variability in length of stay. Cardiac procedures are booked either as 60/90/120 minutes – Epic case averaging technology is not active in the cath lab. As a result, the case minutes in the cath lab …

Sustained Response To Atogepant In Episodic Migraine: Post Hoc Analyses Of A 12-Week Randomized Trial And A 52-Week Long-Term Safety Trial, Richard Lipton, Stephanie J. Nahas, Patricia Pozo-Rosich, Tanya Bilchik, Peter Mcallister, Michelle Finnegan, Yingyi Liu, Natty Chalermpalanupap, Brett Dabruzzo, David Dodick

Department of Neurology Faculty Papers

BACKGROUND: Atogepant is an oral calcitonin gene-related peptide receptor antagonist approved for the preventive treatment of migraine in adults. These analyses evaluated the proportions of clinical trial participants who experienced sustained responses to atogepant over 12 or 52 weeks of treatment.

METHODS: These were post hoc analyses of ADVANCE, a 12-week, double-blind, randomized trial of atogepant 10, 30, and 60 mg once daily vs. placebo for the preventive treatment of episodic migraine, and a separate open-label long-term safety (LTS) trial of atogepant 60 mg once daily over 52 weeks. The 60 mg dose of atogepant was used to detect safety …

Systematic-Narrative Hybrid Literature Review: Crosstalk Between Gastrointestinal Renin-Angiotensin And Dopaminergic Systems In The Regulation Of Intestinal Permeability By Tight Junctions, Nadia Khan, Magdalena Kurnik-Łucka, Gniewomir Latacz, Krzysztof Gil

Journal Articles

In the first part of this article, the role of intestinal epithelial tight junctions (TJs), together with gastrointestinal dopaminergic and renin-angiotensin systems, are narratively reviewed to provide sufficient background. In the second part, the current experimental data on the interplay between gastrointestinal (GI) dopaminergic and renin-angiotensin systems in the regulation of intestinal epithelial permeability are reviewed in a systematic manner using the PRISMA methodology. Experimental data confirmed the copresence of DOPA decarboxylase (DDC) and angiotensin converting enzyme 2 (ACE2) in human and rodent enterocytes. The intestinal barrier structure and integrity can be altered by angiotensin (1-7) and dopamine (DA). Both …

Early Cholestasis And Vitamin K Deficiency Secondary To Biliary Atresia Presenting As Coagulopathy And Thymic Hemorrhage, Abbey Elsbernd, Lauren Amos Md

Research Days

Background

Bleeding and progressive coagulopathy are established symptoms of early cholestasis, including extrahepatic biliary atresia. We present a patient with bleeding secondary to vitamin K deficiency and cholestasis-induced fat malabsorption with unusual presentation of mediastinal mass.

Objective

Describe a case of late-onset vitamin K deficiency and cholestasis presenting as jaundice and coagulopathy with associated bleeding into thymic structures Design/Method

Case report

Results

A 4-week-old term male infant was brought to the ED with fussiness and bruising. Prior to presentation, he was afebrile and followed regularly with his primary care provider for jaundice below phototherapy thresholds. Infant received vitamin K at …

Pain Outcomes In Adolescents With Surgically Confirmed Endometriosis: A Single Site Retrospective Cohort Analysis, Madeline Ross, Samantha Janssen, Priya Suvarna, Adam Booser, Ashli Lawson

Research Days

Background: In adolescents with significant dysmenorrhea, empiric therapy via analgesics and hormonal medications is considered gold standard. However, those with refractory pain may have endometriosis. Thus, it is recommended to engage in shared medical decision making with these patients regarding diagnostic laparoscopy. If endometriosis is detected intraoperatively, these lesions are often fulgurated or excised. There currently is a paucity of data regarding the benefits of diagnostic laparoscopy and destruction of lesions in the adolescent population.

Objectives/Goal: To evaluate long-term pain management outcomes and care patterns in adolescent patients undergoing surgical evaluation for endometriosis.

Methods/Design: This was a single-site, retrospective cohort …

Association Of Respiratory Viral Testing And Antibiotic Use For Pediatric Patients Admitted For Acute Respiratory Illness Between 2017-2021 At Children’S Mercy-Kansas City, Edward Lyon, Brian Lee, Rangaraj Selvarangan, Jennifer Schuster

Research Days

Retrospective comparison of hospitalized pediatric patients who did or did not have clinical viral respiratory testing performed to understand if antibiotics were used differently between these groups.

Transition Skills Lab: A Telehealth Intervention For Improving Healthcare Transition In Youth With Special Health Care Needs, Angela Combs, Alaina Linafelter, Jordan Sevart, Michele H. Maddux

Research Days

The goal of this abstract is to evaluate youth skill-building and confidence across health care tasks through the virtual Transition Skills Lab.

Exploring The Role Of Pain On Physical Activity Among Youth With Acute Lymphoblastic Leukemia Using The Biopsychosocial Model, Anna E. Van Asselt, Renee Gilbert, Meghan Tokala, Jacee Weber, Meredith L. Dreyer Gillette, Robert C. Gibler, Carolyn R. Bates, Keith August

Research Days

The Role of Pain on Physical Activity in Pediatric ALL

Keywords: Biopsychosocial model, pediatric Acute Lymphoblastic Leukemia, pain, physical activity

Introduction: Engaging in physical activity (PA) during cancer treatment benefits a child’s physical and mental well-being (McLaughlin et al., 2021). However, engaging in PA may be challenging due to treatment and disease-related pain (Uhl et al., 2020). Pediatric cancer research has primarily focused on management of procedural and chronic pain, with fewer studies examining how pain may interfere with PA during treatment (Clews et al., 2022). The current study qualitatively investigated the impact of pain on PA using a …

Long-Term Physical And Emotional Functioning In Children Following Intensive Interdisciplinary Pain Treatment For Amplified Pain Syndrome, Sabrina Ung, Jacqueline Pabis Phd, Jenny Scheurich Phd, Dustin Wallace Phd

Research Days

The current study aimed to examine the efficacy of pediatric interdisciplinary pain treatment (IIPT) several years after treatment completion by exploring mean-level changes of physical and mental health functioning pre-intervention, post-intervention, and at follow-up 2 to 6 years after IIPT completion.

Delirium On Admission To The Cicu, Spencer Wittmeyer, Jaime Silva-Gburek, Kelly S. Tieves

Research Days

Background: Delirium is increasingly recognized in the pediatric cardiac intensive care unit (CICU) with an incidence up to 67% and is associated with worse outcomes including increased mortality, prolonged hospitalization, and increased rates of intubation and mechanical circulatory support. The Cornell Assessment for Pediatric Delirium (CAPD) is the only validated tool for the diagnosis of delirium in the pediatric population. The CAPD may be limited in children with developmental disabilities as it does not account for baseline ability in scoring. Prior work has identified low specificity for the CAPD in children with developmental disabilities and those requiring mechanical ventilation. This …