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Intelligent Health Monitoring Systems Via Flexible Hybrid Electronics And Machine Learning, Masoud Panahi 2024 Western Michigan University

Intelligent Health Monitoring Systems Via Flexible Hybrid Electronics And Machine Learning, Masoud Panahi

Dissertations

Advanced data analytics approaches, such as artificial intelligence (AI), are increasingly being integrated into all aspects of patient care. This integration is paving the way for minimally invasive or non-invasive treatment modalities. By combining recent advancements in fabrication technology and computing ingenuity, wearable devices now enable continuous health monitoring and provide data for AI-driven analysis. These intelligent devices seamlessly integrate with the Internet of Things (IoT), enabling remote or “at-home” patient monitoring.

This dissertation study investigates the integration of recent advancements in flexible hybrid electronics (FHE) and machine learning (ML) to develop intelligent health monitoring systems. The developed FHE-based health …


What Is The Evidence? Updates In The Use Of Antenatal Corticosteroids For Patients At Risk Of Preterm Birth, Moti Gulersen, Cynthia Gyamfi-Bannerman 2024 Thomas Jefferson University

What Is The Evidence? Updates In The Use Of Antenatal Corticosteroids For Patients At Risk Of Preterm Birth, Moti Gulersen, Cynthia Gyamfi-Bannerman

Department of Obstetrics and Gynecology Faculty Papers

Antenatal corticosteroids have long been considered one of the most important antenatal therapies available for pregnant patients at risk of preterm birth based on the associated reduction of neonatal morbidity and mortality following their administration. However, despite decades of research since their incorporation into routine clinical practice, a number of key questions related to antenatal corticosteroid use remain. These include evaluating the impact of antenatal corticosteroids at gestational ages outside of the previously recommended window of 24 0/7–33 6/7 weeks of gestation, determining factors associated with optimal steroid timing in order to reduce unnecessary exposure, alterations in its dosing regimen, …


A Clinician’S Guide To Pediatric And Adolescent Alopecia Areata Treatments, Heli A. Patel, Rishab R. Revankar, Jenna E. Koblinski, Benjamin Ungar, Emma Guttman-Yassky, Jamie B. MacKelfresh, Dirk Elston, Peter Lio 2024 Thomas Jefferson University

A Clinician’S Guide To Pediatric And Adolescent Alopecia Areata Treatments, Heli A. Patel, Rishab R. Revankar, Jenna E. Koblinski, Benjamin Ungar, Emma Guttman-Yassky, Jamie B. Mackelfresh, Dirk Elston, Peter Lio

Student Papers, Posters & Projects

Background: Available treatment options for pediatric alopecia areata are limited and may even exacerbate the physical and psychosocial burden. Objective: This article aimed to provide a treatment classification system and counseling recommendations. Recommendations: Topical corticosteroids are appropriate for initial treatment due to their ease of use and safety. Topical minoxidil and dithranol are often used as adjunctive treatments based on mixed data. Intralesional corticosteroids are effective for localized disease, but injections may be challenging in children. Contact immunotherapy, systemic corticosteroids, and immunosuppressive agents such as topical and oral Janus kinase (JAK) inhibitors, dupilumab, and low-dose methotrexate demonstrate varying effectiveness, adverse …


Akt Kinases As Therapeutic Targets, Dalal Hassan, Craig Menges, Joseph Testa, Alfonso Bellacosa 2024 Thomas Jefferson University

Akt Kinases As Therapeutic Targets, Dalal Hassan, Craig Menges, Joseph Testa, Alfonso Bellacosa

Student Papers, Posters & Projects

AKT, or protein kinase B, is a central node of the PI3K signaling pathway that is pivotal for a range of normal cellular physiologies that also underlie several pathological conditions, including inflammatory and autoimmune diseases, overgrowth syndromes, and neoplastic transformation. These pathologies, notably cancer, arise if either the activity of AKT or its positive or negative upstream or downstream regulators or effectors goes unchecked, superimposed on by its intersection with a slew of other pathways. Targeting the PI3K/AKT pathway is, therefore, a prudent countermeasure. AKT inhibitors have been tested in many clinical trials, primarily in combination with other drugs. While …


A Comprehensive Analysis Of In-Hospital Adverse Events After Scopolamine Administration: Insights From A Retrospective Cohort Study Using A Large Nationwide Inpatient Database, George Sun, Marc Torjman, Kevin Min 2024 Thomas Jefferson University

A Comprehensive Analysis Of In-Hospital Adverse Events After Scopolamine Administration: Insights From A Retrospective Cohort Study Using A Large Nationwide Inpatient Database, George Sun, Marc Torjman, Kevin Min

Department of Anesthesiology Faculty Papers

BACKGROUND: Scopolamine is a widely used antiemetic in anesthetic practice, particularly for postoperative and post-discharge nausea and vomiting. Despite its frequent usage and recognized efficacy, concerns have emerged regarding the potential for increased side effects, particularly in elderly patients. Further research is needed to assess safety and determine age thresholds for adverse events. This study hypothesizes associations between perioperative scopolamine use, worse clinical outcomes, increased pneumonia, delirium, urinary retention, and readmissions.

METHODS: A large, retrospective cohort study was performed using the TriNetX Analytics Network database on patients undergoing major surgical procedures between Jan 1, 2009, and March 21, 2018, to …


Evaluating The Superiority Of Multimodal Analgesia Over Opioid-Based Analgesia In Postoperative Pain Management For Total Knee Arthroplasty: A Comprehensive Integrative Review, Janna Smith, Mahdi Mofazali, Nya-Qien Smith 2024 Kennesaw State University

Evaluating The Superiority Of Multimodal Analgesia Over Opioid-Based Analgesia In Postoperative Pain Management For Total Knee Arthroplasty: A Comprehensive Integrative Review, Janna Smith, Mahdi Mofazali, Nya-Qien Smith

Master's Projects

With total knee arthroplasty (TKA), postoperative pain management is so important for optimal recovery and patient outcomes. This integrative review evaluates the effectiveness of multimodal analgesia (MMA) compared to traditional opioid-based analgesia in reducing pain and opioid consumption post-TKA. Research shows that MMA is very effective at providing adequate pain relief, reducing side effects, and also decreasing opioid use. MMA also addresses both the specific needs of individual patients and the broader public health issue of opioid dependence. However, a significant barrier to widespread adoption is the absence of standardized protocols. This review sets forth the importance of coming up …


Pediatric Renal Cell Carcinoma (Prcc) Subpopulation Environmental Differentials In Survival Disadvantage Of Black/African American Children In The United States: Large-Cohort Evidence, Laurens Holmes, Phatismo Masire, Arieanna Eaton, Robert Mason, Mackenzie Holmes, Justin William, Maura Poleon, Michael Enwere 2024 Thomas Jefferson University

Pediatric Renal Cell Carcinoma (Prcc) Subpopulation Environmental Differentials In Survival Disadvantage Of Black/African American Children In The United States: Large-Cohort Evidence, Laurens Holmes, Phatismo Masire, Arieanna Eaton, Robert Mason, Mackenzie Holmes, Justin William, Maura Poleon, Michael Enwere

College of Population Health Faculty Papers

OBJECTIVE: Renal cell carcinoma (RCC) is a rare but severe and aggressive pediatric malignancy. While incidence is uncommon, survival is relatively low with respect to acute lymphocytic leukemia (ALL), AML, lymphoma, ependymoma, glioblastoma, and Wilms Tumor. The pediatric renal cell carcinoma (pRCC) incidence, cumulative incidence (period prevalence), and mortality vary by health disparities' indicators, namely sex, race, ethnicity, age at tumor diagnosis, and social determinants of health (SDHs) as well as Epigenomic Determinants of Health (EDHs). However, studies are unavailable on some pRCC risk determinants, such as area of residence and socio-economic status (SES). The current study aimed at assessing …


Effect Of Patient Resilience On Functional Outcomes After Meniscectomy, Adeeb Hanna, Andres Perez, Alice He, John Sonnier, Henson Destine, Rahul Muchintala, Ralph Cook, Sean Bryan, Fotios Tjoumakaris, Kevin Freedman 2024 Thomas Jefferson University

Effect Of Patient Resilience On Functional Outcomes After Meniscectomy, Adeeb Hanna, Andres Perez, Alice He, John Sonnier, Henson Destine, Rahul Muchintala, Ralph Cook, Sean Bryan, Fotios Tjoumakaris, Kevin Freedman

Rothman Institute Papers

BACKGROUND: Recent literature has identified that patient resilience may affect outcomes after meniscectomy. Research into psychological risk factors for poor surgical outcomes has been a focus in orthopaedic surgery.

PURPOSE/HYPOTHESIS: The purpose of this study was to examine the relationship between preoperative patient resilience and 2-year postoperative outcomes after arthroscopic meniscectomy. It was hypothesized that there would be no relationship between resilience and patient-reported outcomes after meniscectomy.

STUDY DESIGN: Cohort study; Level of evidence, 2.

METHODS: Patients who underwent meniscectomy between January and June 2020 at a single multicenter institution were identified, and those aged ≥18 years without evidence of …


Association Between Various Types Of Corticosteroids And Mortality For Severe Community-Acquired Pneumonia In Adults: A Systematic Review And Network Meta-Analysis, Peng Wang, Jun Wan, Qiaoyu You, Yuxin Zheng, Wenhao Xu, Jialing He, Liyuan Peng, Cuyubamba Dominguez Jorge Luis, Yuning Feng, Ping Xu, Xinrong Li, Weelic Chong, Yang Hai, Lu Jia, Fang Fang, Yu Zhang 2024 Thomas Jefferson University

Association Between Various Types Of Corticosteroids And Mortality For Severe Community-Acquired Pneumonia In Adults: A Systematic Review And Network Meta-Analysis, Peng Wang, Jun Wan, Qiaoyu You, Yuxin Zheng, Wenhao Xu, Jialing He, Liyuan Peng, Cuyubamba Dominguez Jorge Luis, Yuning Feng, Ping Xu, Xinrong Li, Weelic Chong, Yang Hai, Lu Jia, Fang Fang, Yu Zhang

Department of Medical Oncology Faculty Papers

OBJECTIVE: This study aims to conduct a systematic review and network meta-analysis to evaluate the efficacy and safety of specific corticosteroids, including but not limited to hydrocortisone, methylprednisolone, prednisolone, and dexamethasone, in the treatment of severe community-acquired pneumonia (SCAP). Efficacy will be assessed using specific outcomes, such as 30-day mortality and the requirement for mechanical ventilation. Safety evaluations will include adverse events like gastrointestinal bleeding and healthcare-associated infections. The study seeks to address the gaps identified in the latest guidelines regarding the optimal use of different corticosteroid types and to provide recommendations for clinical practice.

DATA SOURCES: This study conducted …


Atypical Presentation Of Spindle Cell Lipoma In A Young Male With A History Of Malignant Melanoma, Ty Theriot, John David Cattar, Lacey Falgout, Nicholas Culotta, Christopher Haas 2024 LSU Health Sciences Center - New Orleans

Atypical Presentation Of Spindle Cell Lipoma In A Young Male With A History Of Malignant Melanoma, Ty Theriot, John David Cattar, Lacey Falgout, Nicholas Culotta, Christopher Haas

School of Medicine Faculty Publications

Spindle cell lipoma (SCL) is a benign adipocytic tumor usually found in the subcutis of the posterior neck, upper back, and shoulder, predominantly in middle-aged males. This case report describes an atypical presentation of SCL in a 26-year-old male with a history of malignant melanoma. The patient presented with an erythematous plaque with central hyperpigmentation on the right upper arm, an uncommon location and presentation for SCL. Histopathological examination revealed an atypical myxoid spindle cell neoplasm with CD34 positivity and an overlying mildly atypical compound melanocytic nevus. The unusual clinical and histological features, combined with the patient's melanoma history, complicated …


Enhancing Immune Response And Survival In Hepatocellular Carcinoma With Novel Oncolytic Jurona Virus And Immune Checkpoint Blockade, Mulu Z. Tesfay, Yuguo Zhang, Khandoker U. Ferdous, Mika A. Taylor, Aleksandra Cios, Randal S. Shelton, Camila C. Simoes, Chelsae R. Watters, Oumar Barro, Natalie M. Elliott, Bahaa Mustafa, Jean Christopher Chamcheu, Alicia L. Graham, Charity L. Washam, Duah Alkam, Allen Gies, Stephanie D. Byrum, Emmanouil Giorgakis, Steven R. Post, Thomas Kelly, Jun Ying, Omeed Moaven, Chiswili Y. Chabu, Martin E. Fernandez-Zapico, Dan G. Duda, Lewis R. Roberts, Rang Govindarajan, Mitesh J. Borad, Martin J. Cannon, et al 2024 University of Arkansas for Medical Sciences (UAMS), Little Rock, AR

Enhancing Immune Response And Survival In Hepatocellular Carcinoma With Novel Oncolytic Jurona Virus And Immune Checkpoint Blockade, Mulu Z. Tesfay, Yuguo Zhang, Khandoker U. Ferdous, Mika A. Taylor, Aleksandra Cios, Randal S. Shelton, Camila C. Simoes, Chelsae R. Watters, Oumar Barro, Natalie M. Elliott, Bahaa Mustafa, Jean Christopher Chamcheu, Alicia L. Graham, Charity L. Washam, Duah Alkam, Allen Gies, Stephanie D. Byrum, Emmanouil Giorgakis, Steven R. Post, Thomas Kelly, Jun Ying, Omeed Moaven, Chiswili Y. Chabu, Martin E. Fernandez-Zapico, Dan G. Duda, Lewis R. Roberts, Rang Govindarajan, Mitesh J. Borad, Martin J. Cannon, Et Al

School of Medicine Faculty Publications

Members of the Vesiculovirus genus including Jurona virus (JURV) have emerged as promising immunotherapeutic agents, characterized by their tumor selectivity, fast kinetics, low seroprevalence, and minimal toxicity in humans. Here, we demonstrate that the administration of JURV leads to tumor regression in both hepatocellular carcinoma (HCC) xenograft and syngeneic models. Furthermore, our findings indicate that combining JURV and anti-PD-1 therapy reduced tumor burden and improved survival rates over JURV or anti-PD-1 alone in an orthotopic HCC model. Proteogenomic analysis of JURV-treated, murine HCC tumors demonstrates that the therapeutic effects of the combination of JURV and anti-PD-1 are predominantly driven by …


Pharmacological Interventions Alone Versus Lifestyle Modifications For Reduction In Atrial Fibrillation, Cody Alan Pike MSN, ENP-C, FNP-C, CEN, CFRN, CTRN, Margaret Harvey PhD, APRN, ACNP-BC, CHFN 2024 University of Tennessee Health Science Center

Pharmacological Interventions Alone Versus Lifestyle Modifications For Reduction In Atrial Fibrillation, Cody Alan Pike Msn, Enp-C, Fnp-C, Cen, Cfrn, Ctrn, Margaret Harvey Phd, Aprn, Acnp-Bc, Chfn

Doctor of Nursing Practice Projects

Purpose/Background

Atrial fibrillation is considered the most common arrythmia affecting individuals globally with an estimated occurrence of 12.1 million individuals by 2030 in the US alone (Joglar et al., 2023). Recent evidence suggests lifestyle modification in combination with pharmacological therapy may decrease the overall financial and health burdens associated with atrial fibrillation (Elliot et al., 2023). The aim of this scoping review is to examine the existing literature to evaluate prescription only versus prescription and lifestyle modifications and its effect of reducing negative health outcomes and overall burden of atrial fibrillation diagnoses.

Methods

Ten articles from 2014 through 2024 were …


Transcutaneous Electrical Nerve Stimulation For Prevention And Treatment Of Post-Herpetic Neuralgia: A Narrative Review, Alan D. Kaye, Rahib K. Islam, Victoria T. Tong, Brynne E. Tynes, Kelly R. Sala, Brennan Abbott, Chandni R. Patel, Isabella B. Lentz, Raju Behara, Shilpadevi Patil, Uzayr Wasif, Sahar Shekoohi, Giustino Varrassi 2024 Louisiana State University Health Sciences Center, Shreveport, LA

Transcutaneous Electrical Nerve Stimulation For Prevention And Treatment Of Post-Herpetic Neuralgia: A Narrative Review, Alan D. Kaye, Rahib K. Islam, Victoria T. Tong, Brynne E. Tynes, Kelly R. Sala, Brennan Abbott, Chandni R. Patel, Isabella B. Lentz, Raju Behara, Shilpadevi Patil, Uzayr Wasif, Sahar Shekoohi, Giustino Varrassi

School of Medicine Faculty Publications

The present investigation evaluated transcutaneous electrical nerve stimulation (TENS) for the non-pharmacological treatment of post-herpetic neuralgia (PHN). PHN is the most common complication of the Herpes Zoster virus, affecting one in every five patients with shingles, and presents as intense neuropathic pain that can persist for 90 days or longer after the initial onset of symptoms. Current pharmacological treatment options are mainly limited to symptom management, including oral medications such as tricyclic antidepressants and gabapentinoid preparations, as well as topical options such as lidocaine or capsaicin. TENS is a minimally invasive, non-pharmacological electrical nerve stimulation device currently approved for the …


Takeout Or Delivery? Reoperation Rates In Lower Extremity Long Bone Osteomyelitis Treated With Debridement And Local Antibiotic Delivery Systems, Nolan M. Reinhart, Jackson P. Tate, Jacob S. Budin, Julianna E. Winter, Olivia C. Lee, William F. Sherman 2024 Tulane University School of Medicine, New Orleans, LA

Takeout Or Delivery? Reoperation Rates In Lower Extremity Long Bone Osteomyelitis Treated With Debridement And Local Antibiotic Delivery Systems, Nolan M. Reinhart, Jackson P. Tate, Jacob S. Budin, Julianna E. Winter, Olivia C. Lee, William F. Sherman

School of Medicine Faculty Publications

BACKGROUND: Early diagnosis and treatment of osteomyelitis is essential to prevent potential complications including sepsis, extensive bone resection, amputation, and death. Despite current treatment strategies for management of osteomyelitis, recurrence rates reported in the literature are upwards of 25 %. Current evidence comparing the efficacy of differing surgical treatments of osteomyelitis is inconclusive. The purpose of this study is to compare rates of re-debridement and amputation in patients who receive either debridement alone or debridement with placement of local antibiotic delivery systems as initial treatment for lower extremity long bone osteomyelitis. METHODS: A retrospective cohort study was performed to investigate …


Personhood, Politics, Assisted Reproduction, And The Law Post-Dobbs, Myrisha S. Lewis 2024 Professor of Law, William & Mary Law School; J.D., Columbia Law School; A.B., Harvard College.

Personhood, Politics, Assisted Reproduction, And The Law Post-Dobbs, Myrisha S. Lewis

Pace Law Review

With the end of the federal constitutional right to abortion, state legislatures and state courts have become far more important in the sphere of reproductive rights. Before Dobbs, anti-abortion advocates had significant (albeit increasingly porous) ceilings on what they could prohibit in relation to reproductive health care. A significant check on those actions is now gone.

In the wake of Dobbs, societal debates about personhood have increased and expanded in terms of their practical implications. Before Dobbs, anti-abortion advocates admitted that Roe and subsequent cases limited the scope of their arguments, especially in relation to the legality …


Dobbs And Sterilization Decision-Making: Understanding The Coercive Spillover Effects In Reproductive Choice, Thomas Wilson Williams 2024 Assistant Professor of Law at the American University Washington College of Law

Dobbs And Sterilization Decision-Making: Understanding The Coercive Spillover Effects In Reproductive Choice, Thomas Wilson Williams

Pace Law Review

The Supreme Court majority in Dobbs v. Jackson Women’s Health Organization argued their decision would have limited impact beyond abortion rights. This Article examines how Dobbs and subsequent state abortion restrictions are likely to increase women’s reliance on permanent sterilization procedures, particularly among already marginalized populations. Drawing on emerging data and historical context, I argue that some post-Dobbs sterilizations should be understood as effectively coerced by state policies, implicating reproductive justice concerns and potentially undermining fundamental rights established in Skinner v. Oklahoma. Then, I demonstrate how interdisciplinary bioethics frameworks and methodologies can help courts better understand the full …


Cardiopulmonary Exercise Testing In Pulmonary Arterial Hypertension And Chronic Thromboembolic Pulmonary Hypertension, Alexis Coulis, Shir Levanon, Gurshaun Randhawa, Yevgeniy Brailovsky, Farhan Raza, Estefania Oliveros 2024 Thomas Jefferson University

Cardiopulmonary Exercise Testing In Pulmonary Arterial Hypertension And Chronic Thromboembolic Pulmonary Hypertension, Alexis Coulis, Shir Levanon, Gurshaun Randhawa, Yevgeniy Brailovsky, Farhan Raza, Estefania Oliveros

Division of Cardiology Faculty Papers

Cardiopulmonary exercise testing allows for a comprehensive assessment of the mechanism of exercise limitation in pulmonary arterial hypertension and chronic thromboembolic pulmonary hypertension. Competitive pathophysiologic mechanisms may affect the clinical interpretation of cardiopulmonary disease as they relate to dyspnea, leg fatigue, and exercise intolerance.


Human Studies Of The Efficacy And Safety Of Stem Cells In The Treatment Of Diabetic Peripheral Neuropathy: A Systematic Review And Meta-Analysis, Seyed Danial Alizadeh, Shima Jahani, Mohammad Rezaei Zadeh Rukerd, Reza Tabrizi, Rasoul Masoomi, Seyedeh Zahra Banihashemian, Mahgol Sadat Hassan Zadeh Tabatabaei, Zahra Ghodsi, Ahmad Pour-Rashidi, James Harrop, Vafa Rahimi-Movaghar 2024 Thomas Jefferson University

Human Studies Of The Efficacy And Safety Of Stem Cells In The Treatment Of Diabetic Peripheral Neuropathy: A Systematic Review And Meta-Analysis, Seyed Danial Alizadeh, Shima Jahani, Mohammad Rezaei Zadeh Rukerd, Reza Tabrizi, Rasoul Masoomi, Seyedeh Zahra Banihashemian, Mahgol Sadat Hassan Zadeh Tabatabaei, Zahra Ghodsi, Ahmad Pour-Rashidi, James Harrop, Vafa Rahimi-Movaghar

Department of Neurosurgery Faculty Papers

OBJECTIVE: To assess the efficacy and safety of stem cell therapy in human studies for diabetic peripheral neuropathy (DPN).

METHODS: A comprehensive literature review was performed across multiple databases, including Ovid MEDLINE ALL, Embase via Ovid SP, Scopus, Web of Science Core Collection, and Cochrane CENTRAL, up to January 31, 2024. Keywords and controlled vocabularies related to diabetic neuropathy and stem cell therapy were used. Inclusion criteria encompassed all controlled trials examining stem cell therapy for DPN, excluding animal or in vitro studies, review papers, conference abstracts, and editor letters. Data extraction and risk of bias assessment were independently performed …


Convexity Dural Hemangioma: Illustrative Case, Ellery A. Hayden, Jack A. Leoni, Frank Culicchia 2024 LSU Health Sciences Center - New Orleans

Convexity Dural Hemangioma: Illustrative Case, Ellery A. Hayden, Jack A. Leoni, Frank Culicchia

School of Medicine Faculty Publications

BACKGROUND: Dural hemangiomas are a relatively rare form of intracranial mass, as hemangiomas tend to present in bone or as intraparenchymal lesions and only around 5%-13% have been reported to originate from the dura mater. Here, the authors present the case of a 46-year-old female who underwent craniotomy for a suspected convexity meningioma resection, which was unexpectedly found to be a dural capillary hemangioma. OBSERVATIONS: The patient was a 46-year-old female who presented with a left frontal intracranial mass found incidentally and showed significant growth over 4 years. The mass was suspected to be a meningioma as it was homogeneously …


Endovascular Removal Of A Symptomatic Intracranial Foreign Body Via Contact Aspiration: Illustrative Case, Jared M. Robichaux, Sarah E. Lawhon, Taylor W. Girolamo, Kapland Q. Owens, Lucido L. Ponce Mejia 2024 LSU Health Sciences Center - New Orleans

Endovascular Removal Of A Symptomatic Intracranial Foreign Body Via Contact Aspiration: Illustrative Case, Jared M. Robichaux, Sarah E. Lawhon, Taylor W. Girolamo, Kapland Q. Owens, Lucido L. Ponce Mejia

School of Medicine Faculty Publications

BACKGROUND: With the growing utilization of general endovascular techniques, iatrogenic endovascular foreign bodies have become more prevalent. Contact aspiration has proven to be a valuable technique in treating ischemic strokes by removing the intraluminal thrombus causing cerebral perfusion deficits and neurological symptoms. The authors present a case of the removal of a foreign body from the vasculature via contact aspiration, which had embolized in a delayed fashion after aortic valve replacement. OBSERVATIONS: A 54-year-old male developed intermittent left-sided weakness 8 days after aortic valve replacement. A head computed tomography scan showed a metallic foreign body within the origin of the …


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