2,079 results match your criteria: "Lerner College of Medicine of Case Western Reserve University[Affiliation]"

Cardiac Rehabilitation for Persons with Stroke: A Cost-Effectiveness Analysis.

Clin Rehabil

January 2025

Cleveland Clinic, Department of Physical Medicine and Rehabilitation, Neurological Institute, Cleveland, OH, USA.

Objective: To investigate the cost-effectiveness of a cardiac rehabilitation program in individuals with stroke compared with customary care.

Design: A Markov model was created using a 30-year time horizon, with cycle lengths of 1 year to determine the effectiveness and cost-effectiveness of a cardiac rehabilitation program in persons with stroke. Input parameters were based on recently published literature.

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How can I better recognize and manage delirium in my hospitalized patients?

Cleve Clin J Med

January 2025

Attending Physician, UPMC Mercy Consultation-Liaison Psychiatry Service, Pittsburgh, PA; Assistant Professor, Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA

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Classic diabetic ketoacidosis and the euglycemic variant: Something old, something new.

Cleve Clin J Med

January 2025

Department of Endocrinology, Diabetes, and Metabolism, Cleveland Clinic, Cleveland, OH; Clinical Assistant Professor, Cleveland Clinic Lerner College of Medicine of Case Western Reserve University, Cleveland, OH.

Diabetic ketoacidosis (DKA) was historically considered a condition typical of type 1 diabetes. However, patients with type 2 diabetes may present with DKA, usually with higher blood glucose levels and milder ketoacidosis. With the increased use of sodium-glucose cotransporter 2 (SGLT-2) inhibitors, the variant euglycemic DKA has been described.

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Diuretic management protocol to improve quality and safety in managing acute heart failure in an integrated health system: An implementation science approach.

Int J Cardiol

December 2024

Department of Cardiovascular and Metabolic Sciences, Lerner Research Institute, Cleveland Clinic, Cleveland, OH, United States of America; Department of Cardiovascular Medicine, Heart Vascular & Thoracic Institute, Cleveland Clinic, Cleveland, OH, United States of America; Cleveland Clinic Lerner College of Medicine of Case Western Reserve University, Cleveland, OH, United States of America. Electronic address:

Background: Effective and timely decongestion in acute heart failure (AHF) coupled with careful discharge planning is critical in the successful treatment of patients hospitalized for AHF. We leveraged an implementation science framework to develop a health system-wide diuretic management protocol (DMP) based on emerging clinical evidence.

Methods: We conducted stakeholder interviews using the Integrated Promoting Action on Research Implementation in Health Services (iPARiHS) Framework.

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Multiple myeloma (MM) is a complex hematological malignancy of clonal plasma cells driven by alterations to the chromosomal material leading to uncontrolled proliferation in the bone marrow. Ethnic and racial disparities persist in the prevalence, diagnosis, management, and outcomes of MM. These disparities are multifaceted and intersect with various factors, including demographics, geography, socioeconomic status, genetics, and access to healthcare.

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Background: With increased early detection efforts, surgery for early-stage lung cancer is expected to rise. Pafolacianine is the first FDA approved targeted optical imaging agent indicated as an adjunct for intraoperative identification of malignant and nonmalignant pulmonary lesions in adult patients with known or suspected cancer in the lung.

Methods: This is a retrospective review of the malignant and nonmalignant lesions identified by pafolacianine with intraoperative molecular imaging (IMI) in the multi-center Phase 2 and Phase 3 ELUCIDATE clinical trials.

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WD repeat domain 5 (WDR5) inhibitors: a patent review (2016-present).

Expert Opin Ther Pat

January 2025

Center for Therapeutics Discovery, Lerner Research Institute, Cleveland Clinic, Cleveland, OH, USA.

Introduction: WDR5 is an epigenetic scaffolding protein that has attracted significant interest as an anti-cancer drug target, especially in MLL-rearranged leukemias. The most druggable 'WIN-site' on WDR5, which tethers WDR5 to chromatin, has been successfully targeted with multiple classes of exquisitely potent small-molecule protein-protein interaction inhibitors. Earlier progress has also been made on the development of WDR5 degraders and inhibitors at the 'WBM-site' on the opposite face of WDR5.

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We Would Like You to Get on Board.

J Rheumatol

December 2024

Soumya Chatterjee, MD, MS, Professor of Medicine, Cleveland Clinic Lerner College of Medicine of Case Western Reserve University, Rheumatology Fellowship Program Director, Department of Rheumatic and Immunologic Diseases, Medical Specialty Institute, Cleveland Clinic, Cleveland, Ohio, USA.

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Atrial Fibrillation: A Review.

JAMA

December 2024

Section of Cardiovascular Medicine, Department of Medicine, Boston Medical Center, Boston University Chobanian & Avedisian School of Medicine, Boston, Massachusetts.

Importance: In the US, approximately 10.55 million adults have atrial fibrillation (AF). AF is associated with significantly increased risk of stroke, heart failure, myocardial infarction, dementia, chronic kidney disease, and mortality.

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Unlabelled: During activation, the T cell transmembrane receptor CD6 becomes incorporated into the T cell immunological synapse where it can exert both co-stimulatory and co-inhibitory functions. Given the ability of CD6 to carry out opposing functions, this study sought to determine how CD6 regulates early T cell activation in response to viral infection. Infection of CD6-deficient mice with a neurotropic murine coronavirus resulted in greater activation and expansion of CD4 T cells in the draining lymph nodes.

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Preparing Physicians for the Climate Crisis: Next Steps for the Graduate Medical Education Community.

J Grad Med Educ

December 2024

is Professor of Medicine, Cleveland Clinic Lerner College of Medicine of Case Western Reserve University School of Medicine, Director, Office of Educator and Scholar Development, Education Institute, Cleveland Clinic, Cleveland, Ohio, USA, and Climate Change and GME Supplement Guest Editor, JGME, Chicago, Illinois, USA.

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Background: Despite advances in ablation and other therapies for AF, progression of atrial fibrillation (AF) remains a significant clinical problem, associated with worse prognosis and worse treatment outcomes. Upstream therapies targeting inflammatory or antifibrotic mechanisms have been disappointing in preventing AF progression, but more recently genetic and genomic studies in AF suggest novel cellular and metabolic stress targets, supporting prior studies of lifestyle and risk factor modification (LRFM) for AF. However, while obesity is a significant risk factor, weight loss and risk factor modification have not been successfully applied in a US population with AF.

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Objective: The need for safe and reliable mechanical circulatory support (MCS) for smaller children with severe heart failure (HF) is well defined. More specifically, in pediatric patients with advanced congenital HF, there is no implantable total artificial heart (TAH) device available for small patients. Herein, we report the development of the infant continuous-flow total artificial heart (I-CFTAH), a fully implantable in infants and newborns.

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Idiopathic Intracranial Hypertension Is Associated With an Increased Risk of Hypertensive Pregnancy Disorders.

J Neuroophthalmol

December 2024

Department of Population and Quantitative Health Sciences (JKS), Case Western Reserve University, Cleveland, Ohio; Case Western Reserve School of Medicine (JKS, IT, TA, JR, JC), Cleveland, Ohio; Center for Ophthalmic Bioinformatics (JKS, RPS, KET), Cole Eye Institute, Cleveland Clinic, Cleveland, Ohio; Departments of Internal Medicine, Pediatrics, and Population and Quantitative Health Sciences (DCK), Case Western Reserve University, Cleveland, Ohio; The Center for Clinical Informatics Research and Education (DCK), The MetroHealth System, Cleveland, Ohio; Cleveland Clinic Cole Eye Institute (RPS, KET, DAC), Cleveland, Ohio; Cleveland Clinic Lerner College of Medicine of Case Western Reserve University (RPS, KET, DAC), Cleveland Ohio; and Cleveland Clinic Martin Hospitals (RPS), Cleveland Clinic, Stuart, FL.

Article Synopsis
  • Idiopathic intracranial hypertension (IIH) primarily affects overweight or obese women of reproductive age, making it crucial to investigate its relationship with pregnancy.
  • A study examined the incidence of IIH development during pregnancy and its association with hypertensive disorders, finding that 7% of IIH patients experienced new onset IIH during their pregnancies.
  • IIH patients had significantly higher risks for various hypertensive disorders like eclampsia, preeclampsia, and HELLP syndrome, as well as complications like ectopic pregnancies and miscarriages, even when controlling for obesity and migraine factors.
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Clinical studies of the urinary tract microbiome, termed urobiome, suggest a direct, antibiotic-dependent, impact of the urobiome on kidney physiology. However, evidence for kidney bacteria comes from indirect sources or infected tissue. Further, it is unclear how antibiotics impact kidney bacteria.

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Purpose: To report a complex case of serpiginous-like choroiditis (SLC) in a patient with anti-neutrophil cytoplasmic antibody (ANCA)-anti-proteinase 3 (PR3)-associated vasculitis with systemic involvement.

Methods: Case report.

Results: A 40-year-old male from a tuberculosis (TB)-endemic region presented with bilateral active SLC lesions.

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The authors reply.

Crit Care Med

December 2024

Department of Pharmacy and Health Systems Sciences, Bouve College of Health Sciences, Northeastern University, Boston, MA.

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Article Synopsis
  • Atrial fibrillation (AF) often recurs after catheter ablation, and the study investigates how changes in the pulmonary vein (PV) structure, highlighted by artificial intelligence (AI), relate to this recurrence.* -
  • Two AI models were used to analyze CT images from 809 patients, examining features of primary and secondary PV branches to determine their link to AF recurrence post-ablation.* -
  • The findings suggest that morphological features of primary PV branches have a significant association with AF recurrence, indicating potential pathways for improving patient outcomes after ablation.*
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Article Synopsis
  • * By analyzing data from the Million Veteran Program and other cohorts, the study identifies 63 genetic loci linked to AMD, including 30 that were previously unknown, highlighting significant differences in risk among various ancestries.
  • * The findings reveal that certain genetic risk factors, like those found in the CFH locus, have varying effects based on ancestry, suggesting that targeted therapies could be developed by considering these genetic differences.
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In Reply: Diabetic retinopathy: Screening, prevention, and treatment.

Cleve Clin J Med

December 2024

Vice President, Chief Medical Officer, Cleveland Clinic Martin Hospitals, Cleveland Clinic Florida, Stuart, FL; Professor, Cleveland Clinic Lerner College of Medicine of Case Western Reserve University, Cleveland, OH.

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