3,306 results match your criteria: "University of Pennsylvania Medical Center.[Affiliation]"

Article Synopsis
  • Peripancreatic adipose tissue (PAT), which accumulates with obesity, negatively affects metabolic health and beta cell function, highlighting its significance compared to subcutaneous adipose tissue (SAT).
  • PAT secretes higher levels of inflammatory substances and certain adipokines linked to poor metabolic outcomes, with variations in islet insulin secretion observed between male and female donors.
  • RNA sequencing reveals that PAT influences gene transcription and lipid metabolism in islets in a sex-dependent manner, suggesting different metabolic impacts compared to SAT.
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Defining ideal middle cerebral artery bifurcation aneurysm size for Woven EndoBridge embolization.

J Neurosurg

October 2024

3Neuroendovascular Program, Massachusetts General Hospital & Brigham and Women's Hospital, Harvard University, Boston, Massachusetts.

Article Synopsis
  • The study aimed to identify the optimal sizes for middle cerebral artery (MCA) bifurcation aneurysms that are most suitable for treatment with the Woven EndoBridge (WEB) device, focusing on aneurysm width and neck dimensions.
  • Using a large retrospective database, the researchers analyzed unruptured MCA bifurcation aneurysms and established ideal cutoff values of 6.1 mm for width and 4.6 mm for neck size regarding treatment effectiveness.
  • Findings indicated that aneurysms smaller than these cutoff values had significantly higher rates of occlusion (93% for width and 90% for neck) and lower retreatment rates compared to larger aneurysms, highlighting the importance of
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Background: Black/African American adults are underrepresented in oncology clinical trials in the United States, despite efforts at narrowing this disparity.

Objective: This study aims to explore differences in how Black/African American oncology patients perceive clinical trials to improve support for the clinical trial participation decision-making process.

Methods: As part of a larger randomized controlled trial, a total of 244 adult oncology patients receiving active treatment or follow-up care completed a cross-sectional baseline survey on sociodemographic characteristics, clinical trial knowledge, health literacy, perceptions of cancer clinical trials, patient activation, patient advocacy, health care self-efficacy, decisional conflict, and clinical trial intentions.

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Article Synopsis
  • - The study aimed to create a predictive calculator to determine the chances of achieving adequate occlusion (Raymond-Roy classification 1 or 2) when using the woven endobridge (WEB) device for intracranial aneurysms, drawing from a large dataset.
  • - Analyzed data from 356 patients across 30 centers worldwide revealed that larger aneurysm neck size and partial thrombosis were linked to lower chances of successful occlusion, while the calculator showed good predictive accuracy.
  • - The newly developed tool offers a valuable resource for clinicians to better estimate the success of using the WEB device in treating intracranial aneurysms, helping to enhance patient care.
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Treatment of large intracranial aneurysms using the Woven EndoBridge (WEB): a propensity score-matched analysis.

Neurosurg Rev

July 2024

Neuroendovascular Program, Massachusetts General Hospital & Brigham and Women's Hospital, Harvard University, Boston, MA, USA.

Article Synopsis
  • - The Woven EndoBridge (WEB) device is used for treating wide-neck intracranial bifurcation aneurysms smaller than 10 mm, but there's limited data on its effectiveness for larger aneurysms.
  • - A study reviewed data from the WorldWide WEB Consortium involving 898 patients to compare outcomes between small and large aneurysms, using propensity score matching (PSM) for accuracy.
  • - Results showed that large aneurysms had significantly lower rates of adequate occlusion and higher rates of retreatment compared to small aneurysms, suggesting that these findings could influence treatment choices and patient discussions in the future.
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Off-Label use of Woven EndoBridge device for intracranial brain aneurysm treatment: Modeling of occlusion outcome.

J Stroke Cerebrovasc Dis

November 2024

Department of Neurosurgery and Interventional Neuroradiology, Louisiana State University, Shreveport, LA, USA; Department of Neuroradiology, Massachusetts General Hospital & Brigham and Women's Hospital, Boston, MA, USA.

Article Synopsis
  • The Woven EndoBridge (WEB) device is being studied as a new treatment for intracranial aneurysms, particularly its effectiveness for off-label uses which require further investigation.
  • A study of 162 patients utilizing machine learning developed predictive models for successful occlusion after off-label WEB treatment, analyzing various factors linked to outcomes.
  • Findings indicated that larger neck diameter and the presence of daughter sacs significantly predicted poorer occlusion results, emphasizing the need for further validation to refine patient selection and treatment strategies.
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Predictors of Aneurysm Obliteration in Patients Treated with the WEB Device: Results of a Multicenter Retrospective Study.

AJNR Am J Neuroradiol

July 2024

Division of Diagnostic and Therapeutic Neuroradiology, Department of Radiology, St. Michael's Hospital (J.D.B.D., N.M.C., J.S., V.M.P., A.A.D.), University of Toronto, Toronto, Ontario, Canada

Background And Purpose: Despite the numerous studies evaluating the occlusion rates of aneurysms following WEB embolization, there are limited studies identifying predictors of occlusion. Our purpose was to identify predictors of aneurysm occlusion and the need for retreatment.

Materials And Methods: This is a review of a prospectively maintained database across 30 academic institutions.

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Article Synopsis
  • - NIFTP is a newly classified thyroid neoplasm that has replaced the previous diagnosis of a certain type of thyroid cancer, with varying adoption rates noted across different global regions.
  • - A survey of 48 pathologists showed a 94% adoption rate for diagnosing NIFTP, with North American pathologists diagnosing it more frequently than those in Europe and Asia/Oceania.
  • - Significant differences exist in how pathologists assess nuclear features, especially for moderate changes, leading to regional variations in NIFTP diagnosis, with North American and European pathologists generally using lower thresholds for diagnosis compared to their counterparts in Asia/Oceania.
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Pituitary neuroendocrine tumors (PitNETs) exhibiting aggressive, treatment-refractory behavior are the rare subset that progress after surgery, conventional medical therapies, and an initial course of radiation and are characterized by unrelenting growth and/or metastatic dissemination. Two groups of patients with PitNETs were sequenced: a prospective group of patients (n = 66) who consented to sequencing prior to surgery and a retrospective group (n = 26) comprised of aggressive/higher risk PitNETs. A higher mutational burden and fraction of loss of heterozygosity (LOH) was found in the aggressive, treatment-refractory PitNETs compared to the benign tumors (p = 1.

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Article Synopsis
  • This study examined how taking antiplatelet medications before and after procedures affects the risk of thromboembolic complications (TECs) in patients treated with the Woven EndoBridge (WEB) device for specific brain aneurysms.
  • It analyzed data from multiple centers, involving a total of 1412 patients, to determine if antiplatelet drugs reduce the likelihood of TECs, finding that those who took them before the procedure had a significantly lower risk.
  • The study concluded that while preprocedural antiplatelet use significantly lowers the chances of TECs, the effect does not carry over when the medication is taken post-procedure.
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Patent Foramen Ovale Closure in Older Patients With Stroke: Patient Selection for Trial Feasibility.

Neurology

May 2024

From the Predictive Analytics and Comparative Effectiveness (PACE) Center (A.Y.W., J.N., B.K., D.K., D.M.K.), Institute for Clinical Research and Health Policy Studies (ICRHPS), Tufts Medical Center, Boston, MA; Department of Clinical Neurology (P.M.R., L.L., S.M., L.E.S.), Oxford University, London, United Kingdom; Comprehensive Stroke Center and Department of Neurology (J.L.S.), David Geffen School of Medicine, University of California, Los Angeles; Comprehensive Stroke Center (S.E.K.), Department of Neurology, University of Pennsylvania Medical Center, Philadelphia; Division of Cardiology (J.C.), Department of Medicine, University of Colorado Denver, Aurora; Université Paris Cité (J.-L.M.), Institute of Psychiatry and Neuroscience of Paris (IPNP), INSERM U1266; GHU-Paris Psychiatrie et Neurosciences (J.-L.M.), Hôpital Sainte Anne; Département de Physiologie (G.D.), Hôpital Henri Mondor, Assistance Publique-Hôpitaux de Paris, Université Paris-Est Créteil (UPEC); Centre d'Investigations Cliniques (G.C.), Unité de Recherche Clinique, Hôpital Européen Georges-Pompidou, Assistance Publique-Hôpitaux de Paris, France; Department of Neurology (A.J.F.), Case Western Reserve University, Cleveland, OH; Division of Cardiovascular Medicine (H.C.H., B.L.), Perelman School of Medicine at the University of Pennsylvania, Philadelphia; Department of Population Health (P.J.), University of Oxford, United Kingdom; Department of Neurology (J.S.K.), Gangneung Asan Hospital, University of Ulsan College of Medicine; Department of Cardiology (P.H.L.), Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea; Department of Neurology (H.P.M.), Bern University Hospital; Medical Faculty (B.M.), University of Bern, Switzerland; Cardiology Department (M.R.), Weill Cornell Medical Center, Cornell, NY; Division of Cardiology (R.W.S.), Department of Medicine, UTHealth/McGovern Medical School and The Memorial Hermann Heart and Vascular Institute, Houston, TX; Department of Cardiology (L.S.), Rigshospitalet, Copenhagen University Hospital, Denmark; Division of Cardiology (J.-K.S.), Asan Medical Center Heart Institute, University of Ulsan College of Medicine, Seoul, South Korea; BHF Cardiovascular Epidemiology Unit (E.D.A.), Department of Public Health and Primary Care, University of Cambridge; Victor Phillip Dahdaleh Heart and Lung Research Institute (E.D.A.), BHF Centre of Research Excellence, School of Clinical Medicine, Addenbrooke's Hospital; NIHR Blood and Transplant Research Unit in Donor Health and Behaviour (E.D.A.), all University of Cambridge; Health Data Research UK Cambridge (E.D.A.), Wellcome Genome Campus and University of Cambridge, Hinxton; University of Cambridge (E.D.A.), United Kingdom; Health Data Science Centre (E.D.A.), Human Technopole, Milan, Italy; Department of Medicine (M.D., S.H.), Columbia University, College of Physicians and Surgeons, New York, NY; Department of Neurology (M.S.V.E.), Vagelos College of Physicians and Surgeons, and Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY; Division of Neurology-Stroke Program (C.J.), Department of Medicine, University Health Network, Toronto Western Hospital, Ontario, Canada; Stroke Center (P.M.), Neurology Service, Lausanne University Hospital; Department of Neurology (M.-L.M., K.N.), University of Bern; Department of Neurology (M.-L.M.), Stadtspital Zürich; Department of Neurology and Stroke Centre (K.N.), Cantonal Hospital Aarau, Switzerland; Sapienza University of Rome (F.P.), Italy; Department of Neurology (J.S.), Hospital Universitari de Girona Dr Josep Trueta - IDIBGI, Spain; Department of Neurology and Stroke Center (C.W.), University Duisburg-Essen, Germany; Department of Public Health (D.K.), Erasmus University Medical Center, Rotterdam, the Netherlands; and Department of Neurology (D.E.T.), Tufts Medical Center/Tufts University School of Medicine, Boston, MA.

Background And Objectives: Whether patent foramen ovale (PFO) closure benefits older patients with PFO and cryptogenic stroke is unknown because randomized controlled trials (RCTs) have predominantly enrolled patients younger than 60 years of age. Our objective was to estimate anticipated effects of PFO closure in older patients to predict the numbers needed to plan an RCT.

Methods: Effectiveness estimates are derived from major observational studies (Risk of Paradoxical Embolism [RoPE] Study and Oxford Vascular Study, together referred to as the "RoPE-Ox" database) and all 6 major RCTs (Systematic, Collaborative, PFO Closure Evaluation [SCOPE] Consortium).

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Context.—: Mesothelioma is an uncommon tumor that can be difficult to diagnose.

Objective.

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Risks of malignancy in the major nongynecologic cytopathology reporting systems: Critiques and discussions.

Cancer Cytopathol

August 2024

Department of Pathology, University of Pennsylvania Medical Center, Perelman School of Medicine, Philadelphia, Pennsylvania, USA.

Article Synopsis
  • The rise of standardized reporting in cytopathology has made risk stratification, especially risks of malignancy (ROM), crucial for clinical management decisions.
  • ROM calculations are mainly based on past studies with diverse patient groups, leading to potential biases and inconsistencies.
  • The authors critically evaluate the ROM estimates in various nongynecologic reporting systems, such as those for thyroid and salivary glands, emphasizing their limitations and questioning their practical utility in clinical settings.
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Background: The Woven EndoBridge (WEB) devices have been used for treating wide neck bifurcation aneurysms (WNBAs) with several generational enhancements to improve clinical outcomes. The original device dual-layer (WEB DL) was replaced by a single-layer (WEB SL) device in 2013. This study aimed to compare the effectiveness and safety of these devices in managing intracranial aneurysms.

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Durable tolerance in kidney transplant recipients remains an important but elusive goal. We hypothesized that adding B cell depletion to T cell depletion would generate an immune milieu postreconstitution dominated by immature transitional B cells, favoring tolerance. The Immune Tolerance Network ITN039ST Research Study of ATG and Rituximab in Renal Transplantation was a prospective multicenter pilot study of live donor kidney transplant recipients who received induction with rabbit antithymocyte globulin and rituximab and initiated immunosuppression (IS) withdrawal (ISW) at 26 weeks.

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Article Synopsis
  • - This document serves as an evidence-based guideline for naming and classifying congenital bicuspid aortic valve and its associated conditions, aimed at a wide range of medical professionals.
  • - It is designed for use by pediatricians, cardiologists, surgeons, and researchers, ensuring clarity across various healthcare fields.
  • - The consensus is subject to updates as new research and key findings emerge, highlighting its dynamic nature in adapting to evolving medical knowledge.
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Article Synopsis
  • Most thyroid nodules are benign, but differentiating between benign and malignant nodules can prevent unnecessary surgeries; this study focused on a genetic classifier's performance for indeterminate thyroid nodules in Southeast Asia.
  • The study involved 132 patients and utilized ThyroSeq v3 for molecular testing on FNA samples, revealing that 56% of the nodules were histologically malignant, with varying mutation characteristics compared to North American patients.
  • The genomic testing showed a 42% potential avoidance of surgery for patients with Bethesda category III-IV nodules, indicating that molecular testing was a stronger predictor of malignancy than traditional clinical factors.
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The Impact of Frailty on Outcomes of Proximal Aortic Aneurysm Surgery: A Nationwide Analysis.

J Cardiovasc Dev Dis

January 2024

Division of Cardiac Surgery, Department of Surgery, Brigham and Women's Hospital, Harvard Medical School, Boston, MA 02115, USA.

(1) Background: This study examines frailty's impact on proximal aortic surgery outcomes. (2) Methods: All patients with a thoracic aortic aneurysm who underwent aortic root, ascending aorta, or arch surgery from the 2016-2017 National Inpatient Sample were included. Frailty was defined by the Adjusted Clinical Groups Frailty Indicator.

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Background: The Woven EndoBridge (WEB) device is frequently used for the treatment of intracranial aneurysms. Postoperative management, including the use of aspirin, varies among clinicians and institutions, but its impact on the outcomes of the WEB has not been thoroughly investigated.

Methods: This was a retrospective, multicenter study involving 30 academic institutions in North America, South America, and Europe.

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Supply Costs in Complex and Routine Inferior Vena Cava Filter Retrieval: 10 Years' Data from a Single Center.

J Vasc Interv Radiol

April 2024

Division of Interventional Radiology, Department of Radiology, University of Pennsylvania Medical Center, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania. Electronic address:

Purpose: To characterize the medical supply costs associated with inferior vena cava filter retrieval (IVCFR) using endobronchial forceps (EFs), a snare, or Recovery Cone (RC).

Materials And Methods: In total, 594 of 845 IVCFRs attempted at a tertiary referral hospital between October 1, 2012, and June 20, 2022 were categorized by intended retrieval strategy informed by, rotational cavography as follows: (a) EF (n = 312) for tilted or tip-embedded/strut-embedded filters and for long-dwelling closed-cell filters and (b) a snare (n = 255) or (c) RC (n = 27) for other well-positioned filters with or mostly without hooks, respectively. List prices of relevant supplies at time of retrieval were obtained or, rarely, estimated using a standard procedure.

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How New Developments in Pharmacology Receptor Theory Are Changing (Our Understanding of) Hypertension Therapy.

Am J Hypertens

March 2024

Department of Pharmacology and Toxicology, College of Osteopathic Medicine, Michigan State University, East Lansing, Michigan 48824-131, USA.

Background: Many hypertension therapeutics were developed prior to major advances in drug receptor theory. Moreover, newer drugs may take advantage of some of the newly understood modalities of receptor function.

Goal: The goal of this review is to provide an up-to-date summary of drug receptor theory.

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Article Synopsis
  • The study focuses on the use of Left Ventricular Assist Devices (LVAD) in advanced heart failure patients, particularly those with a history of ventricular tachyarrhythmia (VTA), and aims to improve outcomes through a new intra-operative ablation protocol.
  • Researchers designed a randomized clinical trial involving 100 LVAD candidates, comparing those receiving intra-operative VTA ablation against those receiving standard medical management.
  • The trial will track various outcomes for an average of 18 months post-surgery, assessing VTA recurrence, adverse events, right heart function, healthcare utilization, and quality of life.
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