717 results match your criteria: "Perelman School of Medicine of the University of Pennsylvania.[Affiliation]"

Substance use disorders (SUDs) are heterogeneous across multiple functional domains. Various frameworks posit that domains (e.g.

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  • Infliximab (IFX) biosimilars are used to treat inflammatory bowel disease (IBD) and are generally cheaper than original IFX, but concerns about switching between the two products persist.
  • A systematic review of studies conducted between 2012 and 2022 found that switching from originator to biosimilar IFX did not significantly affect treatment effectiveness or safety, with reported adverse events being consistent with known profiles.
  • Most studies concluded that outcomes for clinical effectiveness, patient-reported results, and safety after switching were comparable to those of the original IFX, although there is limited data on patients who switch multiple times.
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Objectives: To present recommendations and consensus statements with supporting literature for the clinical management of neonates and children supported with extracorporeal membrane oxygenation (ECMO) from the Pediatric ECMO Anticoagulation CollaborativE (PEACE) consensus conference.

Data Sources: Systematic review was performed using PubMed, Embase, and Cochrane Library (CENTRAL) databases from January 1988 to May 2021, followed by serial meetings of international, interprofessional experts in the management ECMO for critically ill children.

Study Selection: The management of ECMO anticoagulation for critically ill children.

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Novel Combination Treatment for Melanoma: FLASH Radiotherapy and Immunotherapy Delivered by a Radiopaque and Radiation Responsive Hydrogel.

Chem Mater

November 2023

Department of Radiology, University of Pennsylvania, Philadelphia, Pennsylvania 19104, United States; Department of Bioengineering, University of Pennsylvania, Philadelphia, Pennsylvania 19104, United States.

Immunotherapies have become the standard treatment for melanoma. To further improve patient responses, combinations of immunotherapies and radiotherapy (RT) are being studied, since radiotherapies can potentially provide additional immune stimulation, in addition to direct antitumor effects. FLASH-RT is a novel, ultrahigh dose rate, radiation delivery approach, with the potential of at least equivalent tumor control efficacy and reduced damage to healthy tissue.

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Background: First generation Bruton tyrosine kinase inhibitors (BTKi) such as ibrutinib have been associated with cardiovascular toxicities. Newer generation BTKi (e.g.

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ACR Appropriateness Criteria® Imaging of Invasive Breast Cancer.

J Am Coll Radiol

June 2024

Specialty Chair, Boston University School of Medicine, Boston, Massachusetts.

As the proportion of women diagnosed with invasive breast cancer increases, the role of imaging for staging and surveillance purposes should be determined based on evidence-based guidelines. It is important to understand the indications for extent of disease evaluation and staging, as unnecessary imaging can delay care and even result in adverse outcomes. In asymptomatic patients that received treatment for curative intent, there is no role for imaging to screen for distant recurrence.

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22q11 Deletion Syndrome (22q11DS) is the most common microdeletion syndrome with broad phenotypic variability, leading to significant morbidity and some mortality. The varied health problems associated with 22q11DS and the evolving phenotype (both medical and developmental/behavioural) across the lifespan can strongly impact the mental health of patients as well as their caregivers. Like caregivers of children with other chronic diseases, caregivers of children with 22q11DS may experience an increased risk of traumatisation and mental health symptoms.

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Improving measurement of functional status among older adults in primary care: A pilot study.

PLoS One

May 2024

San Francisco VA Health Care System, San Francisco, California, United States of America.

Despite its importance for clinical care and outcomes among older adults, functional status-the ability to perform basic activities of daily living (ADLs) and instrumental ADLs (IADLs)-is seldom routinely measured in primary care settings. The objective of this study was to pilot test a person-centered, interprofessional intervention to improve identification and management of functional impairment among older adults in Veterans Affairs (VA) primary care practices. The four-component intervention included (1) an interprofessional educational session; (2) routine, standardized functional status measurement among patients aged ≥75; (3) annual screening by nurses using a standardized instrument and follow-up assessment by primary care providers; and (4) electronic tools and templates to facilitate increased identification and improved management of functional impairment.

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Article Synopsis
  • Meningomyelocele is a serious neural tube defect and the most common structural birth defect affecting the central nervous system.
  • The Spina Bifida Sequencing Consortium found that deletions on chromosome 22q11.2 increase the risk of meningomyelocele by 23 times compared to the general population.
  • Research indicates that the deletion of specific genes in this region, combined with a lack of maternal folate, can significantly increase the risk of neural tube defects in offspring.
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The influence of primary language on postoperative stroke outcomes.

Am J Surg

August 2024

Department of Surgery, Perelman School of Medicine of the University of Pennsylvania, Philadelphia, PA, USA; Center for Surgery and Health Economics, University of Pennsylvania, Philadelphia, PA, USA; Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia, PA, USA.

Background: Language barriers have the potential to influence acute stroke outcomes. Thus, we examined postoperative stroke outcomes among non-English primary language speakers.

Methods: Utilizing the Healthcare Cost and Utilization Project State Inpatient Database (2016-2019), we conducted a retrospective cohort study of adults diagnosed with a postoperative stroke in Michigan, Maryland, and New Jersey.

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Cell Senescence in Heterotopic Ossification.

Biomolecules

April 2024

Robert and Arlene Kogod Center on Aging, Mayo Clinic, Rochester, MN 55905, USA.

Article Synopsis
  • Heterotopic ossification (HO) is the abnormal formation of bone outside the usual skeleton, caused by genetic mutations or acquired factors like injury and aging.
  • Fibrodysplasia ossificans progressiva (FOP) is the most severe genetic form of HO, linked to specific mutations and characterized by relentless progression.
  • Cellular senescence, a key feature of aging that contributes to HO, may present new treatment opportunities by targeting these senescent cells for both FOP and acquired HO.
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Clinical features of 22q11.2 microdeletion syndrome (22q11.2DS) are highly variable between affected individuals and frequently include a subset of conotruncal and aortic arch anomalies.

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The US Food and Drug Administration (FDA)'s authorization of etranacogene dezaparvovec (Hemgenix) is a significant milestone, constituting not only the first FDA approval of a gene therapy for hemophilia but also the first approval of a liver-targeted adeno-associated virus vector gene therapy. This review summarizes the nonclinical studies and clinical development that supported regulatory clearance. Similar to other gene therapies for single gene disorders, both the short-term safety and the phenotypic improvement were unequivocal, justifying the modest-sized safety and efficacy database, which included 57 participants across the phase 2b (3 participants) and phase 3 (54 participants) studies.

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Background: Enlarged cavum septum pellucidum (CSP) and hypoplastic thymus are proposed extra-cardiac fetal markers for 22q11.2 deletion syndrome. We sought to determine if they were part of the fetal phenotype of our cohort of fetuses with 22q11.

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Background: The prevalence of functional impairment is increasing among middle-aged adults and is associated with adverse health outcomes. Primary care providers (PCPs) and geriatricians may have important insights about optimal approaches to caring for these patients, but little is known about their perspectives.

Objective: To examine PCPs' and geriatricians' perspectives on clinical needs and optimal approaches to care for middle-aged patients with functional impairment.

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Inflammatory Proteomic Analysis of 22q11.2 Deletion Syndrome.

J Clin Immunol

March 2024

Division of Allergy Immunology, ARC 1216-I CHOP Immunology, The Children's Hospital of Philadelphia, 3615 Civic Center Blvd., Philadelphia, PA, 19104, USA.

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Further research is needed to help improve both the standard of care and the outcome for patients with treatment-resistant depression. A particularly critical evidence gap exists with respect to whether pharmacological or non-pharmacological augmentation is superior to antidepressant switch, or vice-versa. The objective of this study was to compare the effectiveness of augmentation with aripiprazole or repetitive transcranial magnetic stimulation versus switching to the antidepressant venlafaxine XR (or duloxetine for those not eligible to receive venlafaxine) for treatment-resistant depression.

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Highlights in Ulcerative Colitis From the American College of Gastroenterology 2023 Annual Scientific Meeting: Commentary.

Gastroenterol Hepatol (N Y)

December 2023

Professor of Medicine Vice Chief, Division of Gastroenterology Development and Philanthropy Emeritus Director, Center for Inflammatory Bowel Disease The Raymond and Ruth Perelman School of Medicine of the University of Pennsylvania University of Pennsylvania Health System Hospital of the University of Pennsylvania Gastroenterology Division, Department of Internal Medicine Perelman Center for Advanced Medicine Philadelphia, Pennsylvania.

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Patients with sickle cell disease (SCD) and other anemias who receive blood transfusions are at risk of organ damage due to transfusional iron overload. Deferiprone is an iron chelator with a well-established safety and efficacy profile that is indicated for the treatment of transfusional iron overload. Here, we report safety data from the large-scale, retrospective Ferriprox® Total Care Registry, which involved all patients with SCD taking deferiprone following the 2011 approval of deferiprone in the United States through August 2020.

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Article Synopsis
  • CMV is prevalent in hematopoietic cell and solid organ transplant patients, leading to significant health complications despite current preventive measures.
  • New antiviral medications like Letermovir and Maribavir are changing the options for CMV management; Letermovir is good for prevention but not for treatment, while Maribavir is for treating resistant cases.
  • More research is necessary to understand how these new drugs can effectively and safely be used for CMV in pediatric transplant patients.
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Allogeneic hematopoietic cell transplantation (HCT) is no longer exclusively for the young. With an aging population, development of non-intensive remission-inducing strategies for hematologic malignancies, and novel graft-versus-host disease-prevention platforms, an older population of patients is pursuing HCT. The evolving population of HCT recipients requires an overhaul in the way we risk-stratify and optimize patients prior to HCT.

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