117 results match your criteria: "Medstar Harbor Hospital[Affiliation]"

Genetic and clinical correlates of two neuroanatomical AI dimensions in the Alzheimer's disease continuum.

Transl Psychiatry

October 2024

Artificial Intelligence in Biomedical Imaging Laboratory (AIBIL), Center for AI and Data Science for Integrated Diagnostics (AI2D), Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.

Article Synopsis
  • Alzheimer's disease (AD) exhibits varied brain atrophy patterns, identified through a semi-supervised learning technique (Surreal-GAN) that distinguishes between "diffuse-AD" (widespread atrophy) and "MTL-AD" (focal atrophy in the medial temporal lobe) dimensions in patients with mild cognitive impairment (MCI) and AD.
  • Only the "MTL-AD" dimension was linked to known AD genetic risk factors like APOE ε4, and both dimensions were later detected in asymptomatic individuals, revealing their association with different genetic and pathological mechanisms.
  • Aside from brain-related genes, up to 77 additional genes were identified in various organs, pointing to broader
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Article Synopsis
  • T-cell large granular lymphocytic (T-LGL) leukaemia is often linked to autoimmune disorders, with about one-third of patients also having rheumatoid arthritis (RA).
  • A notable portion of RA patients display clonal T-cell patterns, indicating a possible connection between the two conditions.
  • This text discusses a specific case of a patient with RA who was evaluated for low white blood cell count and enlarged spleen, ultimately leading to a diagnosis of T-LGL leukaemia.
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Background: Posttransplant lymphoproliferative disorder (PTLD), a term that encompasses a wide array of malignancies that occur after transplant, can be one of the most devastating transplant complications. While there have been major advancements in care, especially after the landmark PTLD-1 trial in 2012, there is a paucity of information on hospitalizations for PTLD and the changes in hospitalizations over time.

Methods: This retrospective cohort study used the National Inpatient Sample to identify hospitalizations for PTLD that occurred between 2009 and 2018.

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Brain aging patterns in a large and diverse cohort of 49,482 individuals.

Nat Med

October 2024

Artificial Intelligence in Biomedical Imaging Laboratory (AIBIL), Center for and Data Science for Integrated Diagnostics (AI2D), Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.

Article Synopsis
  • - The aging process of the brain is affected by lifestyle, environmental, genetic factors, and age-related diseases, with advanced imaging and AI techniques helping to reveal the complexities of neuroanatomical changes.
  • - A study involving nearly 50,000 participants identified five major patterns of brain atrophy, which are quantified using R-indices to analyze their connections to various biomedical, lifestyle, and genetic factors.
  • - These R-indices not only predict disease progression and mortality but also offer a new, nuanced framework for understanding brain aging, which may enhance personalized diagnostics and improve clinical trial strategies.
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Introduction: The USA has the highest age-standardized prevalence of inflammatory bowel disease (IBD). Both genetic and environmental factors have been implicated in IBD flares and multiple strategies are centered around avoiding dietary triggers to maintain remission. Chat-based artificial intelligence (CB-AI) has shown great potential in enhancing patient education in medicine.

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Prognostic Implications of Delirium After Left Ventricular Assist Device Implantation: A Retrospective Study.

J Acad Consult Liaison Psychiatry

December 2024

Georgetown University School of Medicine, Washington, DC; Palliative Care, MedStar Washington Hospital Center, Washington, DC.

Background: In critically ill patients, delirium is a prognostic indicator of morbidity and mortality.

Objective: This study investigates the impact of a delirium diagnosis on outcomes after left ventricular assist device (LVAD) implantation.

Methods: This retrospective study included all adult patients who received LVADs at our institution between January 2016 and December 2020.

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Background: Short bowel syndrome (SBS) hospitalizations are often complicated with sepsis. There is a significant paucity of data on adult SBS hospitalizations in the United States and across the globe.

Aim: To assess trends and outcomes of SBS hospitalizations complicated by sepsis in the United States.

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Hypercalcemia is a frequent complication of solid tumors and hematologic malignancies yet is only rarely associated with endometrial clear cell carcinoma. Here we report on a 70-year-old female who presented in the context of hip fracture and was incidentally found to have humoral hypercalcemia of malignancy secondary to endometrial clear cell carcinoma. This rare association makes endometrial cancer one of the differential diagnoses to be considered when assessing incidentally found symptomatic or asymptomatic hypercalcemia in the appropriate patient population.

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The Unseen Danger of Methotrexate Toxicity.

J Community Hosp Intern Med Perspect

November 2023

Hospital Medicine, MedStar Harbor Hospital, USA.

Methotrexate is a commonly prescribed immunosuppressant and chemotherapy agent, which is closely monitored by healthcare providers for its adverse effects. As a result, methotrexate toxicity occurs infrequently. We present a case of a 51-year-old woman with a past medical history of rheumatoid arthritis on methotrexate and prednisone.

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Bringing Delirium to Light: Impact of CAM-ICU Tool to Improve Care Coordination.

Prof Case Manag

May 2024

Theresa Savino, DNP, RN, CPHQ, CPXP, FNAHQ, is Director of Service Excellence and Patient Experience at Middlesex Health, Middletown, Connecticut. She is also an adjunct nursing faculty member at the University of Connecticut.

Background: Delirium is a serious complication in patients in the critical care unit (CCU) that may lead to prolonged hospitalization if left undetected. The CCU at our hospital does not have a framework for determining delirium that could affect patient outcomes and discharge planning.

Primary Practice Setting: CCU in a community hospital.

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Five dominant dimensions of brain aging are identified via deep learning: associations with clinical, lifestyle, and genetic measures.

medRxiv

December 2023

Artificial Intelligence in Biomedical Imaging Laboratory (AIBIL), Center for and Data Science for Integrated Diagnostics (AID), Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.

Brain aging is a complex process influenced by various lifestyle, environmental, and genetic factors, as well as by age-related and often co-existing pathologies. MRI and, more recently, AI methods have been instrumental in understanding the neuroanatomical changes that occur during aging in large and diverse populations. However, the multiplicity and mutual overlap of both pathologic processes and affected brain regions make it difficult to precisely characterize the underlying neurodegenerative profile of an individual from an MRI scan.

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Introduction: Prior bariatric surgery (PBS) status in obese patients is thought to curtail the risk of cardiovascular events, but its role in change of outcomes of patients with obesity developing new acute cardiac events such as cardiac arrests (CA) remains largely unknown.

Methods: Hospitalizations among adult patients with obesity and CA were identified retrospectively using the National Inpatient Sample (2015 October-2017 December). Propensity-matched analysis (1:1) was performed for sociodemographic/hospital characteristics to identify two cohorts, with (PBS+) or without (PBS-) status.

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Gene-SGAN: discovering disease subtypes with imaging and genetic signatures via multi-view weakly-supervised deep clustering.

Nat Commun

January 2024

Artificial Intelligence in Biomedical Imaging Laboratory (AIBIL), Center for and Data Science for Integrated Diagnostics (AI2D), Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.

Article Synopsis
  • Disease heterogeneity poses significant challenges for accurately diagnosing and treating neurologic and neuropsychiatric conditions, as different individuals can exhibit distinct brain phenotypes.
  • The study introduces Gene-SGAN, a method that utilizes phenotypic and genetic data to identify disease subtypes while linking them to genetic factors and biological signatures.
  • Validation results show Gene-SGAN's effectiveness in analyzing data from 28,858 individuals, revealing unique brain phenotypes in Alzheimer's disease and hypertension related to distinct neuroanatomical patterns and genetic determinants.
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Ceftriaxone-induced encephalopathy is a rare but known adverse effect secondary to neurotoxicity, especially in patients with end-stage renal disease (ESRD) on hemodialysis. The common presenting symptoms include myoclonus, psychosis, and seizures. We are presenting a case of a 77-year-old female patient who presented with confusion and jerky movements of her lips and extremities.

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Article Synopsis
  • * The procedure combines mechanical techniques with pharmacologic thrombolysis, leading to quicker treatment times, but it can have common complications like hemorrhage and dissection.
  • * A rare but serious complication, acute pancreatitis, was noted in a case following this procedure, resulting in hospitalization and intensive care treatment.
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OVCH1 Antisense RNA 1 is differentially expressed between non-frail and frail old adults.

Geroscience

April 2024

National Institute on Aging, National Institutes of Health, MedStar Harbor Hospital 5th floor, 3001 S. Hanover Street, Baltimore, MD, 21225, USA.

While some old adults stay healthy and non-frail up to late in life, others experience multimorbidity and frailty often accompanied by a pro-inflammatory state. The underlying molecular mechanisms for those differences are still obscure. Here, we used gene expression analysis to understand the molecular underpinning between non-frail and frail individuals in old age.

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Cardiac amyloidosis is a rare condition with an estimated incidence of 18-55 per 100 000 person-years. It is associated with either immunoglobulin light chain (AL) or transthyretin amyloid (ATTR), both of which result in a restrictive cardiomyopathy complicated initially by diastolic dysfunction and subsequently followed by biventricular systolic heart failure. Untreated cardiac amyloidosis carries an extremely poor prognosis with an estimated median survival time of less than 1 year in AL and 4 years in ATTR amyloidosis.

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The Heart Block Hat-Trick: A Case of Alternating First-, Second-, and Third-Degree Heart Blocks.

Case Rep Cardiol

June 2023

MedStar Health Internal Medicine Residency Program, Baltimore, MD, USA.

Article Synopsis
  • Idiopathic third-degree AV block is rare, especially in younger patients, and can sometimes alternate with first- and second-degree blocks, as seen in a 39-year-old man.
  • After thorough testing showed no clear underlying cause, a pacemaker was implanted to manage his fluctuating heart block conditions.
  • The case emphasizes the potential genetic factors linked to AV block and introduces left bundle branch area pacing (LBBAP) as a promising new method for effective heart pacing.
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Physiological Dysregulation Proceeds and Predicts Health Outcomes Similarly in Chinese and Western Populations.

J Gerontol A Biol Sci Med Sci

January 2024

PRIMUS Research Group, Department of Family Medicine, University of Sherbrooke, Sherbrooke, Quebec J1H 5N4, Canada.

Background: A decade ago, we proposed an index of physiological dysregulation based on Mahalanobis distance (DM) that measures how far from the norm an individual biomarker profile is. While extensive validation has been performed, focus was mostly on Western populations with little comparison to developing countries, particularly at a physiological system level. The degree to which the approach would work in other sociocultural contexts and the similarity of dysregulation signatures across diverse populations are still open questions.

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The purpose of this study was to evaluate 2 national in-patient cohorts of young adults (18-44 years) hospitalized with acute myocardial infarction (AMI) a decade apart to highlight its prevalence, associated comorbidities, and in-hospital outcomes. We identified hospitalizations for AMI in young adults in 2007 and 2017 using the weighted data from the National Inpatient Sample. We compared admission rates, sociodemographic characteristics, in-hospital morbidity, complications, mortality, rate of coronary interventions, and healthcare utilization between the 2 cohorts.

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A systematic review on the effectiveness of diet and exercise in the management of obesity.

Diabetes Metab Syndr

April 2023

Meninnger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX, USA. Electronic address:

Background And Aims: Obesity is a worldwide epidemic and has quickly become a clinical and public health challenge. The primary concern is the effect of obesity on quality of life. This review assesses the effectiveness of interventions such as exercise and diet in the management of obesity.

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Recurrent Episodes of Transient Global Amnesia: A Rare Clinical Entity.

J Community Hosp Intern Med Perspect

November 2022

Department of Medicine, MedStar Harbor Hospital, 3001 S Hanover St, Baltimore, MD, 21225, USA.

Transient global amnesia (TGA) is a syndrome characterized by anterograde amnesia with otherwise intact cognitive function, resolving within 24 h of onset, occurring in the absence of neurological changes. Recurrent episodes remain rare. We report an interesting case of recurrent episodes of TGA in a 63-year-old woman presenting with altered mental status.

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