9,852 results match your criteria: "University of Pennsylvania Perelman[Affiliation]"

Examining the effects of race/ethnicity and other factors on outcomes of care for complex regional pain syndrome type 1 in the United States.

PLOS Glob Public Health

January 2025

Collaboration for Outcomes Research and Evaluation (CORE), Faculty of Pharmaceutical Sciences, University of British Columbia, Vancouver, British Columbia, Canada.

Complex regional pain syndrome is a chronic pain disorder marked by symptoms such as swelling, impaired motor function, and sympathetic dysfunction. Our primary objective was to determine the total number of complex regional pain syndrome type 1 (CRPS-1) emergency department (ED) visits and hospitalizations by race/ethnicity, as well as to assess sex and age distributions by race/ethnicity. Secondary objectives were to examine whether race/ethnicity, as well as select characteristics, are associated with hospitalization and longer length of stay.

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Diffuse intrinsic pontine glioma (DIPG) is a fatal central nervous system (CNS) tumor that confers a median survival of 11 months. As B7-H3 is expressed on pediatric CNS tumors, we conducted BrainChild-03, a single-center, dose-escalation phase 1 clinical trial of repetitive intracerebroventricular (ICV) dosing of B7-H3-targeting chimeric antigen receptor T cells (B7-H3 CAR T cells) for children with recurrent or refractory CNS tumors and DIPG. Here we report results from Arm C, restricted to patients with DIPG.

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Background: Following maternal COVID-19 vaccination, the persistence of antibodies in sera and breast milk for mothers and infants is not well characterized. We sought to describe the persistence of antibodies through 2 months after delivery in maternal and infant serum and breast milk following maternal COVID-19 mRNA vaccination and to examine differences by receipt of booster dose during pregnancy or postpartum.

Methods: This is a prospective cohort study with enrollment from July 2021 to January 2022 at 9 US academic sites.

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Philadelphia chromosome-like B-cell acute lymphoblastic leukemia (Ph-like ALL) is driven by genetic alterations that induce constitutive kinase signaling and is associated with chemoresistance and high relapse risk in children and adults. Preclinical studies in the most common CRLF2-rearranged/JAK pathway-activated Ph-like ALL subtype have shown variable responses to JAK inhibitor-based therapies, suggesting incomplete oncogene addiction and highlighting a need to elucidate alternative biologic dependencies and therapeutic vulnerabilities, while the ABL-class Ph-like ALL subtype appears preferentially sensitive to SRC/ABL- or PDGFRB-targeting inhibitors. Which patients may be responsive versus resistant to tyrosine kinase inhibitor (TKI)-based precision medicine approaches remains a critical knowledge gap.

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Sepsis and Septic Shock.

N Engl J Med

December 2024

From the Division of Pulmonary, Allergy, and Critical Care Medicine and the Center for Translational Lung Biology, Lung Biology Institute, University of Pennsylvania Perelman School of Medicine, Philadelphia (N.J.M.); and the Department of Internal Medicine, University of Michigan, and VA Center for Clinical Management Research - both in Ann Arbor (H.C.P.).

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Effect of mRNA formulated with lipid nanoparticles on the transcriptomic and epigenetic profiles of F4/80 liver-associated macrophages.

Sci Rep

January 2025

Center of Excellence in Vaccine Research and Development (Chula Vaccine Research Center-Chula VRC), Faculty of Medicine, Chulalongkorn University, Bangkok, 10330, Thailand.

Delivery of an mRNA formulated with lipid nanoparticles (LNPs) induces robust humoral and cell-mediated branches of the immune response. Depending on the LNP formula, mRNA encoding proteins can be detected in the liver upon intramuscular administration of mRNA/LNP in mice. This study investigated the impact of mRNA/LNP administration on liver-associated macrophages at the transcriptomic and epigenetic levels in a mouse model.

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Purpose: Anticholinergic medication use measured via the Anticholinergic Cognitive Burden (ACB) scale has been associated with an increased dementia incidence in older adults but has not been explored specifically for Parkinson disease dementia (PDD). We used adjusted Cox models to estimate the risk of incident PDD associated with demographic factors, clinical characteristics, and time-varying total ACB in a longitudinal, deeply-phenotyped prospective PD cohort.

Major Findings: 56.

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Rationale: Patients with sepsis and/or acute respiratory failure are at high risk for death or long hospital stays, yet limited evidence exists to guide triage to intensive care units (ICUs) or general medical wards for the majority of these patients who do not initially require life support.

Objectives: To identify factors that influence how hospitals triage patients with capacity-sensitive conditions and those factors that may account for observed ICU relative to ward, or ward relative to ICU, benefits for such patients.

Methods: We conducted an explanatory sequential mixed-methods study.

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Outcomes for Children With Congenital Heart Disease Undergoing Ventricular Assist Device Implantation: An ACTION Registry Analysis.

J Am Coll Cardiol

December 2024

Division of Cardiology, Department of Pediatrics, University of Pennsylvania Perelman School of Medicine, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA.

Background: There are no contemporary reports that highlight the national outcomes for children with congenital heart disease (CHD) undergoing ventricular assist device (VAD) implantation.

Objectives: This study sought to evaluate differences in VAD outcomes for children with CHD to those with non-CHD as well as those with univentricular CHD to those with biventricular CHD.

Methods: Data for CHD and non-CHD patients from the multicenter ACTION (Advanced Cardiac Therapies Improving Outcomes Network) undergoing VAD implantation from April 2018 to February 2023 were included.

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Background: Ampullary adenocarcinoma (AAC) typically presents at an early stage due to biliary obstruction and therefore might be specifically suitable for minimally invasive pancreatoduodenectomy (MIPD). However, studies assessing MIPD specifically for AAC, including the robotic and laparoscopic approach, are limited. The aim of this study is to compare short- and long-term oncological resection and perioperative outcomes of robotic (RPD), laparoscopic (LPD) and open pancreatoduodenectomy (OPD) performed specifically for AAC.

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Peroxiredoxin 6 (Prdx6), a unique non-seleno peroxidase, is a bifunctional protein with GSH peroxidase at pH 7.4 and calcium independent phospholipase A (aiPLA) activities at pH 4.0.

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Transcription repressor BACH2 redirects short-lived terminally differentiated effector into long-lived memory cells. We postulate that BACH2-mediated long-lived memory programs promote HIV-1 persistence in gut CD4+ T cells. We coupled single-cell DOGMA-seq and TREK-seq to capture chromatin accessibility, transcriptome, surface proteins, T cell receptor, HIV-1 DNA and HIV-1 RNA in 100,744 gut T cells from ten aviremic HIV-1+ individuals and five HIV-1- donors.

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Background And Objectives: Since the initial description of related hemiplegic migraine (HM), the phenotypic spectrum has expanded from mild episodes in neurotypical individuals to potentially life-threatening events frequently seen in individuals with developmental and epileptic encephalopathies. However, the overall longitudinal course throughout childhood remains unknown.

Methods: We analyzed HM and seizure history from electronic medical records in individuals with -related HM, delineating frequency and severity of events in monthly increments through a standardized approach.

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The Plight of "Dual Noneligible" People in the United States.

N Engl J Med

January 2025

From Brigham and Women's Hospital (D.E.V., J.F.F.) and the Department of Health Policy and Management, Harvard T.H. Chan School of Public Health (J.F.F.) - both in Boston; and the Department of General Internal Medicine, University of Pennsylvania Perelman School of Medicine, Philadelphia (E.T.R.).

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Article Synopsis
  • Coronary microvascular disease (CMVD) affects small blood vessels in the heart and can cause issues like ischemia or heart attacks without blocked arteries, leading to a need for better treatment options.
  • Current research in genetics, particularly through genome-wide association studies (GWAS) on coronary artery disease (CAD), has identified numerous genetic markers that could help understand and target therapies for CMVD.
  • The article suggests that more in-depth genetic studies specifically focused on CMVD are necessary, emphasizing the importance of diverse representation in research to further uncover its underlying mechanisms and potential treatments.
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Background: Delirium is a severe neuropsychiatric disorder associated with increased morbidity and mortality. Numerous precipitating factors and etiologies merge into the pathophysiology of this condition which can be marked by agitation and psychosis. Judicious use of antipsychotic medications such as intravenous haloperidol reduces these symptoms and distress in critically ill individuals.

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Early noninvasive ventilation in general wards for acute respiratory failure: an international, multicentre, open-label, randomised trial.

Br J Anaesth

January 2025

Department of Anesthesia and Intensive Care, IRCCS San Raffaele Scientific Institute, Milan, Italy; School of Medicine, Vita-Salute San Raffaele University, Milan, Italy.

Background: The impact of noninvasive ventilation (NIV) managed outside the intensive care unit in patients with early acute respiratory failure remains unclear. We aimed to determine whether adding early NIV prevents the progression to severe respiratory failure.

Methods: In this multinational, randomised, open-label controlled trial, adults with mild acute respiratory failure (arterial oxygen partial pressure/fraction of inspiratory oxygen [Pao/FiO] ratio ≥200) were enrolled across 11 hospitals in Italy, Greece, and Kazakhstan.

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Prescription opioids after surgery may pose a risk if left unused. However, prescribers rely on their best judgement in determining how much their patients need, often resulting in over-prescription of these medications. Opioid disposal is a strategy to reduce the risk of persistent use or misuse of opioids.

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ATLAS-seq: a microfluidic single-cell TCR screen for antigen-reactive TCRs.

Nat Commun

January 2025

Raymond G. Perelman Center for Cellular and Molecular Therapeutics, Children's Hospital of Philadelphia, Philadelphia, PA, USA.

Discovering antigen-reactive T cell receptors (TCRs) is central to developing effective engineered T cell immunotherapies. However, the conventional technologies for isolating antigen-reactive TCRs (i.e.

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Single-Cell Profiling of Lineages and Cell Types in the Vertebrate Brain.

Methods Mol Biol

January 2025

Department of Cell and Developmental Biology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.

Article Synopsis
  • CRISPR-Cas tools have been enhanced for tracking cell lineages during development, allowing for detailed analysis at single-cell resolution.
  • scGESTALTv2 integrates CRISPR-Cas9 editing of a lineage barcode with single-cell RNA sequencing (scRNA-seq) to track cellular development.
  • This method is applied in zebrafish brains, enabling the identification of cellular relationships among thousands of brain cells and various cell types.
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Macrophage Migration Inhibitory Factor and Interleukin 1-β mRNA Levels as Predictors of Antidepressant Treatment Response in Major Depression.

Psychopharmacol Bull

January 2025

Oslin, MD, Veterans Integrated Service Network 4, Mental Illness Research, Education and Clinical Center, Crescenz Veterans Affairs Medical Center and Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA.

Article Synopsis
  • The study examined the predictive value of cytokine levels (MIF and IL-1β) in determining responses to antidepressant treatment in 1,299 patients as part of a larger trial.
  • Despite initial findings from smaller studies indicating a link between these cytokines and treatment response, the current research found no significant associations with depression score changes or treatment outcomes.
  • The lack of replication raises doubts about the usefulness of these biomarkers in clinical settings for treating depression.
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Prediction of good neurological outcome after return of circulation following paediatric cardiac arrest: A systematic review and meta-analysis.

Resuscitation

December 2024

Department of Critical Care Medicine, Hospital for Sick Children, Department of Paediatrics, University of Toronto, Neurosciences and Mental Health Program, Research Institute Toronto, ON, Canada.

Aim: To evaluate the ability of blood-biomarkers, clinical examination, electrophysiology, or neuroimaging, assessed within 14 days from return of circulation to predict good neurological outcome in children following out- or in-hospital cardiac arrest.

Methods: Medline, EMBASE and Cochrane Trials databases were searched (2010-2023). Sensitivity and false positive rates (FPR) for good neurological outcome (defined as either 'no, mild, moderate disability or minimal change from baseline') in paediatric survivors were calculated for each predictor.

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A comprehensive evaluation for cognitive impairment should culminate with the communication of the diagnosis to patients and their care partners. This diagnostic disclosure sets the stage for subsequent care. Diagnostic disclosure for individuals with cognitive impairment due to Alzheimer's disease (AD) or AD-related dementias (ADRD) is particularly nuanced and requires a conscientious approach.

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Blood-based biomarkers (BBBMs) for Alzheimer's disease (AD) have the potential to revolutionize the detection and management of cognitive impairment. AD BBBMs are not currently recommended for use in primary care but may soon be as research demonstrates their clinical utility for differential diagnosis and patient management. To prepare for the incorporation of AD BBBMs into primary care, several practical challenges must be addressed.

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Rapid identification and phenotyping of nonalcoholic fatty liver disease patients using a machine-based approach in diverse healthcare systems.

Clin Transl Sci

January 2025

Division of Digestive and Liver Diseases, Department of Medicine, Center for Liver Disease and Transplantation, Columbia University Irving Medical Center, New York, New York, USA.

Nonalcoholic fatty liver disease (NAFLD) is the most common global cause of chronic liver disease and remains under-recognized within healthcare systems. Therapeutic interventions are rapidly advancing for its inflammatory phenotype, nonalcoholic steatohepatitis (NASH) at all stages of disease. Diagnosis codes alone fail to recognize and stratify at-risk patients accurately.

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