Proceedings of IMPRS最新文献

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Trends in Thymic Epithelial Tumor Patients with Comorbid Autoimmune Disease 胸腺上皮肿瘤患者合并自身免疫性疾病的趋势
Proceedings of IMPRS Pub Date : 2024-01-11 DOI: 10.18060/27958
Aneesha Anand, Nikhitha Lavu, Kenneth A. Kesler, Patrick J. Loehrer
{"title":"Trends in Thymic Epithelial Tumor Patients with Comorbid Autoimmune Disease","authors":"Aneesha Anand, Nikhitha Lavu, Kenneth A. Kesler, Patrick J. Loehrer","doi":"10.18060/27958","DOIUrl":"https://doi.org/10.18060/27958","url":null,"abstract":"Thymic epithelial tumors (TETs) are rare malignancies originating from the thymus in the anterior mediastinum. TETs include thymic carcinoma and thymoma. Approximately 30-40% of thymomas have associated autoimmune paraneoplastic disorders, the most common being myasthenia gravis. A broad range of other paraneoplastic syndromes have also been reported. Currently, little is known about demographic or histological trends in thymoma patients with comorbid autoimmune disease. In this single institution retrospective chart review, we assessed the distribution of thymoma-associated paraneoplastic syndromes at the IU Simon Cancer Center (IUSCC) to identify trends within demographic and histological features. We created a database of IUSCC patients seen from 2000-2023 and identified 170 subjects with biopsy-proven malignant TET and associated autoimmune disease. Data was exported to excel and R for analysis. Factors analyzed included: age at diagnosis, sex assigned at birth, BMI, WHO (World Health Organization) classification, and Masaoka staging. Overall survival was also compared to matched controls without paraneoplastic syndrome. A total of 37 different paraneoplastic syndromes were identified in association with thymoma in IUSCC patients. The most prevalent was Myasthenia Gravis (110 patients), followed by Hypothyroidism (21 patients, 5 confirmed as Hashimoto’s thyroiditis), Good Syndrome (19 patients), and Pure Red Cell Aplasia (15 patients). Significant findings included: 36.4% of patients with paraneoplastic comorbidity had >1 paraneoplastic syndrome, 51.8% presented with Stage IV disease, and 40.4% had WHO Type B2 tumor pathology, with Type B3 being second most common (25%). No significant demographic associations were identified. 10-year survival of TET patients with paraneoplastic syndromes was not significantly different from those without (p= 0.721). These results indicate potential associations between thymoma staging and grading and development of paraneoplastic disease. Further analysis with a larger data set is warranted. Serum and blood test analysis may also elucidate reasons behind the development of paraneoplastic disease in thymoma patients. ","PeriodicalId":20522,"journal":{"name":"Proceedings of IMPRS","volume":"42 22","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139533550","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Brain activation during scene encoding fMRI in the Alzheimer’s disease continuum: Association with amyloid and tau burden in PE 阿尔茨海默氏症持续期场景编码 fMRI 过程中的大脑激活:与 PE 中淀粉样蛋白和 tau 负荷的关系
Proceedings of IMPRS Pub Date : 2024-01-11 DOI: 10.18060/27806
Mia S. Trueblood, A. Saykin, S. Risacher
{"title":"Brain activation during scene encoding fMRI in the Alzheimer’s disease continuum: Association with amyloid and tau burden in PE","authors":"Mia S. Trueblood, A. Saykin, S. Risacher","doi":"10.18060/27806","DOIUrl":"https://doi.org/10.18060/27806","url":null,"abstract":"Background and Hypothesis:This project assessed brain activation during a scene encoding task in 4 groups: older adults who were cognitively normal (CN), subjective cognitive decline (SCD), mild cognitive impairment (MCI), and dementia due to Alzheimer’s disease (AD). Associations between scene encoding related brain activation and tau, amyloid, and other biomarkers were analyzed. Our hypothesis was that higher levels of cerebral tau and amyloid would be associated with reduced scene encoding activation. In addition, we hypothesized that scene encoding activation would be significantly different between cognitively normal and cognitively impaired groups. \u0000Methods:234 individuals from the Indiana Memory and Aging Study (79 CN, 67 SCD, 70 MCI, and 18 AD) completed structural and functional MRI, clinical/cognitive assessment and biomarkers; 155 underwent amyloid ([18F]florbetapir/[18F]florbetaben) PET, while 111 also underwent [18F]flortaucipir PET. For the fMRI scene encoding task, participants were asked to view and remember a set of images. A one-way ANOVA test was used to analyze scene encoding related activation differences among the 4 groups. Regression was used to identify associations between scene encoding activation and tau and amyloid deposition. \u0000Results:Significant differences in activation were observed between the MCI and CN groups, including less activation in widespread regions during the task and reduced deactivation in the default mode network (DMN) in MCI participants relative to CN. Significant associations between higher amyloid and tau deposition and altered scene encoding activation were also observed. \u0000Conclusion and Potential Impact:Cognitive decline is associated with activation changes during scene encoding, as well as reduced deactivation in the DMN, especially in the posterior cingulate region. Higher cerebral amyloid and tau deposition predicted decreased scene encoding related activation. These findings are consistent with models linking cognitive status, functional brain activation during episodic encoding, and pathophysiological processes in the AD continuum.","PeriodicalId":20522,"journal":{"name":"Proceedings of IMPRS","volume":"44 12","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139533743","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
YebC Modulates OspC and VlsE Inverse Regulation and VlsE Expression in Persistent Lyme Disease YebC 在持续性莱姆病中调节 OspC 和 VlsE 的反向调节以及 VlsE 的表达
Proceedings of IMPRS Pub Date : 2024-01-11 DOI: 10.18060/27717
Andrew Zoss, S. Raghunandanan, X. F. Yang
{"title":"YebC Modulates OspC and VlsE Inverse Regulation and VlsE Expression in Persistent Lyme Disease","authors":"Andrew Zoss, S. Raghunandanan, X. F. Yang","doi":"10.18060/27717","DOIUrl":"https://doi.org/10.18060/27717","url":null,"abstract":"Background & Hypothesis: Lyme disease, caused by the bacterium Borrelia burgdorferi, is the most common vector-borne infectious disease in the United States. Although easily treated with antibiotics, undiagnosed cases may develop into persistent infections with complications including Lyme carditis, neuroborreliosis, & arthritis. VlsE antigen variation is one of the major mechanisms employed by B. burgdorferi to establish persistent infection. We hypothesize that YebC modulates VlsE expression and antigen variation, enabling the shift from acute to persistent infection. \u0000Materials & Methods: C3H/HeN or C3H/SCID mice were infected with the B. burgdorferi strain 5A4NP1, yebC mutant, and yebC complement at a dose of 105 or 106 spirochetes. Mice were sacrificed at days 7, 30, 60, and 90 post-infection and tissue samples were subjected to RNA and DNA extraction. \u0000Results: YebC levels were closely associated with the upregulation of vlsE and the downregulation of ospC in vitro and in vivo. The yebC mutant displayed loss of infectivity in C3H/HeN mice, and reduced VlsE antigen variation. \u0000Conclusion & Impact: This data demonstrates that YebC of B burgdorferi can regulate the frequency of vlsE recombination and modulates the inverse regulation of OspC and VlsE. This new factor may serve as an avenue for developing drugs which can target vlsE recombination to combat complications of persistent Lyme disease.","PeriodicalId":20522,"journal":{"name":"Proceedings of IMPRS","volume":"34 16","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139533885","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Comparing Complication Rates of Transcatheter Aortic Valve Replacement to Surgical Aortic Valve Replacement 经导管主动脉瓣置换术与外科主动脉瓣置换术并发症发生率的比较
Proceedings of IMPRS Pub Date : 2024-01-11 DOI: 10.18060/27857
Jacob Hedberg, James Butler
{"title":"Comparing Complication Rates of Transcatheter Aortic Valve Replacement to Surgical Aortic Valve Replacement","authors":"Jacob Hedberg, James Butler","doi":"10.18060/27857","DOIUrl":"https://doi.org/10.18060/27857","url":null,"abstract":"Background/Objective: Transcatheter aortic valve replacement (TAVR) and surgical aortic valve replacement (SAVR) are the two procedures used to treat severe symptomatic aortic stenosis. One of the most feared outcomes of both procedures is stroke. Conduction abnormalities and arrhythmias after TAVR are relatively common, but few studies have been done comparing the rate of these events between TAVR and SAVR. The objective of our study is to find if there are any differences between the rates of stroke, conduction abnormalities, and arrhythmias between patients that have undergone TAVR and patients that have undergone SAVR.\u0000Methods: The CRC/Sidus Real World Evidence Cardiology Dataset was used to obtain samples for this project. Patients who underwent TAVR and SAVR were identified using CPT codes. These two cohorts of patients were tracked for complications between 0 to 30 days after the procedure and between 0 days to 1 year after the procedure using ICD-10 codes.\u0000Results: Patients who underwent TAVR (n=3621) were much more likely to have conduction disorders and arrhythmias both in the 0-30 day range and 0 days-1 year range after the procedure compared to patients who underwent SAVR (n=2137). Cerebral infarction and transient cerebral ischemic attack rates were also higher in the TAVR group. Mortality rates for TAVR were lower than mortality rates for SAVR, both 30 days and 1 year after the procedure.\u0000Conclusion/Impact: TAVR has revolutionized aortic valve replacement and allowed many patients with aortic stenosis (many of whom are at high surgical risk) a minimally invasive option to improve their quality of life. Finding ways to reduce the rates of stroke, arrhythmias, and conduction abnormalities; for example, through improved devices and techniques, and improvedanti-thrombotic therapy, is extremely important as TAVR becomes more and more widely utilized.","PeriodicalId":20522,"journal":{"name":"Proceedings of IMPRS","volume":"46 19","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139534070","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Deciphering the Immune Microenvironment of NF1-associated Peripheral Nerve Sheath Tumors: Identifying Early Biomarkers of Disease Progression and Malignant Transformation 解密 NF1 相关周围神经鞘瘤的免疫微环境:识别疾病进展和恶性转化的早期生物标志物
Proceedings of IMPRS Pub Date : 2024-01-11 DOI: 10.18060/27748
Janak Mukherji, Dana K. Mitchell, Emily White, Breanne Burgess, Abbi E Smith, Eric A Albright, Jaffar Khan, Andrew Horvai, D. W. Clapp, Steve Angus, Steven Rhodes
{"title":"Deciphering the Immune Microenvironment of NF1-associated Peripheral Nerve Sheath Tumors: Identifying Early Biomarkers of Disease Progression and Malignant Transformation","authors":"Janak Mukherji, Dana K. Mitchell, Emily White, Breanne Burgess, Abbi E Smith, Eric A Albright, Jaffar Khan, Andrew Horvai, D. W. Clapp, Steve Angus, Steven Rhodes","doi":"10.18060/27748","DOIUrl":"https://doi.org/10.18060/27748","url":null,"abstract":"Background/Objective:Neurofibromatosis type 1 (NF1) is a multisystem disorder that affects ~1/3000 newborns. Plexiform neurofibromas (PN) are present in about half of cases and can transform (lifetime risk of 8-13%) into malignant peripheral nerve sheath tumor (MPNST), a highly aggressive and metastatic sarcoma with poor survival. Unfortunately, there are currently no reliable biomarkers to identify PN at risk of undergoing malignant transformation. Our research has revealed that a subset of benign-appearing and atypical PN exhibit deregulated immune surveillance and T-cell infiltration that precede malignant transformation. In this study, we are analyzing tumor microenvironment and immune landscape in NF1-related tissue specimens to identify biomarkers of disease progression. To power these studies, this project focused on constructing a dataset of NF1-related samples to be analyzed. \u0000Methods:701 patients were identified via Cerner billing codes and pathology archives. De-identified clinical data, including presenting symptoms, relevant clinical history, pathology diagnoses, disease features, prior chemotherapeutics/radiation, prior gene profiling, and imaging features were collected. \u0000Results: We selected 86 patients with a total of 175 samples. 81% of patients had a clinical diagnosis of NF1, and 6% had a history of MPNST. Out of the 175 samples, 54 were in the head and neck, 42 in the thorax, 28 in the lower extremity, 27 in the upper extremity, 26 in the pelvis/abdomen, and 15 in the paraspinal region. The leading causes of procedures were pain (41%), growth (40%), and concern for malignancy (27%). The most common tissue diagnoses were neurofibroma (51.4%), PN (20%), and undefined-grade MPNST (11%). Out of the 46 MPNSTs, 30 were primary tumors, 4 metastases, and 12 local recurrences. \u0000Conclusion and Potential Impact:The results of this study will provide valuable insights to inform preclinical models of NF1-tumorigenesis to validate these findings and identify novel treatment approaches for individuals affected by these rare but devastating tumors.","PeriodicalId":20522,"journal":{"name":"Proceedings of IMPRS","volume":"47 13","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139534083","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Length of Stay Index – A Retrospective Chart Review on In-patient Dermatology Consults 住院时间指数--皮肤科住院会诊病历回顾
Proceedings of IMPRS Pub Date : 2024-01-11 DOI: 10.18060/27951
Cynthia Cahya, Edita Newton
{"title":"Length of Stay Index – A Retrospective Chart Review on In-patient Dermatology Consults","authors":"Cynthia Cahya, Edita Newton","doi":"10.18060/27951","DOIUrl":"https://doi.org/10.18060/27951","url":null,"abstract":"Background and Objective: In monitoring inpatient care quality and efficiency, one metric of interest is Length of Stay (LOS) by diagnosis-related group (DRG) system and how this compares to peer institutions. Vizient Inc. provides a source of such benchmarking - collecting and analyzing individual case-level data from community and academic medical center hospitals nationwide. Using this data, Vizient calculates an expected LOS by DRGs and adjusts for severity of illness and other factors for inter-hospital comparison. Because LOS reduction is an important mechanism for improving outcomes and efficiency of care, The Department of Dermatology would like to understand which dermatologic consults are exceeding the Vizient expected LOS (LOS index > 1).   \u0000Project Methods: Consecutive charts of 663 patients with dermatology-related diagnoses in the inpatient setting at IU University and Methodist Hospitals between January 2021 and January 2023 were reviewed. Parameters identified included: category of dermatologic disorder, LOS index, time to consult, and quarter of encounter. Data was organized and analyzed using paired t-tests, linear regression, and descriptive statistics in JMP software.  \u0000Results: The mean LOS index for Dermatology inpatient consults was 1.89 (n=469). Patients whose dermatologic diagnosis fell under chronic wound, mechanical, infectious, drug adverse event, autoimmune, neoplasm, inflammatory, vascular, and blistering had a significant increase in observed length of stay compared to expected length of stay (p < 0.05). Time to dermatology consult was not found to correlate to shortening or prolonging LOS index.   \u0000Potential Impact: The data from this review will help direct the Department of Dermatology to the dermatologic consults with the highest need for potential interventions.  ","PeriodicalId":20522,"journal":{"name":"Proceedings of IMPRS","volume":"46 7","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139534110","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Incidence of Venous Thromboembolism and Hematoma Following Placement of Inflatable Penile Prosthetic: Safety of Perioperative Subcutaneous Heparin 放置充气阴茎假体后静脉血栓栓塞和血肿的发生率:围手术期皮下注射肝素的安全性
Proceedings of IMPRS Pub Date : 2024-01-11 DOI: 10.18060/27899
Jacob Good, Helen Bernie
{"title":"Incidence of Venous Thromboembolism and Hematoma Following Placement of Inflatable Penile Prosthetic: Safety of Perioperative Subcutaneous Heparin","authors":"Jacob Good, Helen Bernie","doi":"10.18060/27899","DOIUrl":"https://doi.org/10.18060/27899","url":null,"abstract":"Background/Objective: Patients undergoing inflatable penile prosthetic (IPP) surgery are at an increased risk for cardiovascular complications such as venous thromboembolism (VTE) following surgery due to pre-existing comorbidities associated with erectile dysfunction. The use of perioperative subcutaneous heparin (SqH) along with a surgical drain has been shown to be effective in preventing VTE in IPP patients, without increasing hematoma formation. Not all prosthetic surgeons utilize surgical drains postoperatively. In this study we aim to assess the safety and efficacy of perioperative SqH in preventing VTE in IPP patients without the use of a surgical drain. \u0000Methods: This was a retrospective review from January 2021-July 2023 of patients who underwent IPP placement or explant and replacement at a single institution. Patient demographics, comorbidities, Caprini risk factor scores, VTE risk factors, and 90-day postoperative complications, including hematoma formation, were reviewed. Statistical analyses were performed comparing these variables in men who received SqH and those who did not. \u0000Results: We reviewed data for 240 patients; 53% (n=127) received perioperative SqH. The incidence of VTE was 0.9% (1/113) in the non-SqH group, and no VTE was recorded in the group receiving SqH. There was no statistical significance in hematoma formation betweengroups (SqH 5.5% vs. non-SqH 6.2% p=.898). Beyond hypertension prevalence (SqH 74.8% vs. non-SqH 62.8% p=.045), there was no difference between comorbidities or Caprini risk factor scores (SqH 6.79 vs. non-SqH 6.82 p=.474) between groups (Table 1). 94% of thepatients in this study were considered high risk for VTE. \u0000Conclusions: Perioperative SqH use without placement of a surgical drain was found to be safe and effective in preventing VTE in patients undergoing IPP surgery. There was no increased risk of hematoma formation or post-operative complications between the groups. Perioperative SqH should be considered in all patients undergoing IPP surgery.","PeriodicalId":20522,"journal":{"name":"Proceedings of IMPRS","volume":"32 18","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139534481","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Suppression of Inflammation-induced Abdominal Aortic Aneurysm Formation by Induction of Elastin Tolerance 通过诱导弹性蛋白耐受性抑制炎症诱发的腹主动脉瘤形成
Proceedings of IMPRS Pub Date : 2024-01-11 DOI: 10.18060/27734
Stone Chen, Theresa Doiron, Olivia Jimenez, Ali Sualeh, Jennifer Stashevsky, Mackenzie Madison, Chang-Hyundai Gil, Steven J. Miller, Michael Murphy
{"title":"Suppression of Inflammation-induced Abdominal Aortic Aneurysm Formation by Induction of Elastin Tolerance","authors":"Stone Chen, Theresa Doiron, Olivia Jimenez, Ali Sualeh, Jennifer Stashevsky, Mackenzie Madison, Chang-Hyundai Gil, Steven J. Miller, Michael Murphy","doi":"10.18060/27734","DOIUrl":"https://doi.org/10.18060/27734","url":null,"abstract":"Abdominal aortic aneurysm (AAA) is a vascular disease process whereby the aorta expands to apoint where rupture may occur. This serious condition is diagnosed in approximately 200,000 people in the United States per year and accounts for over 15,000 deaths annually. The only medical intervention proven to reduce the risk of AAA rupture is surgical repair; however, such repair is associated with high risk of death, reduced quality of life, and high expense. AAA is caused by the weakening of the artery wall due to inflammation-induced destruction of its structural components. Our clinical data shows increased levels of circulating elastin degradation products in patients with AAA, especially smokers, compared to risk factor matched controls. This observation led us to hypothesize that an immune reaction to elastin fragments initiates the inflammatory cascade in the aorta that leads to AAA formation. To test this hypothesis, C57BL/6 mice were injected with poly(lactide-co-glycolide) nanoparticle-encapsulated IL-10 to induce immune tolerance or nanoparticle-encapsulated control ovalbumin. Injection of elastin fragments was performed 7 days later to induce an immune response. AAA of the infrarenal aorta was induced by topical application of elastase during laparotomy procedure 14 days after nanoparticle injection. Aorta diameter was measured 16 days post-operatively with Microfil. Immunologic changes were evaluated by cytokine analysis, Tr1/Th17 cell ratio inperipheral blood, and splenic Th17 and Tr1 response to elastin. Based on prior work, we expect that induction of elastin tolerance using poly(lactide-co-glycolide) nanoparticle-encapsulated IL-10 will suppress abdominal aortic aneurysm expansion and promote an anti-inflammatoryenvironment characterized by increased Tr1/Th17 cell ratio, increased levels of anti-inflammatory cytokines, and decreased pro-inflammatory cytokine expression.","PeriodicalId":20522,"journal":{"name":"Proceedings of IMPRS","volume":" 3","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139625233","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Clinical Utility of Dupilumab for the Treatment of Eosinophilic Esophagitis in Pediatric Patients 杜匹单抗治疗小儿嗜酸性粒细胞食管炎的临床实用性
Proceedings of IMPRS Pub Date : 2024-01-11 DOI: 10.18060/27842
Alexa Becker, Paroma Bose
{"title":"Clinical Utility of Dupilumab for the Treatment of Eosinophilic Esophagitis in Pediatric Patients","authors":"Alexa Becker, Paroma Bose","doi":"10.18060/27842","DOIUrl":"https://doi.org/10.18060/27842","url":null,"abstract":"Background:Eosinophilic esophagitis (EoE) is a chronic inflammatory disease of the esophagus characterized by symptoms of esophageal dysfunction and 15 or more eosinophils per high-powered field (HPF) on esophageal biopsy. Treatment options for EoE include proton pump inhibitors (PPIs), topical corticosteroids (TCS), dietary elimination, and dupilumab. Dupilumab is monoclonal antibody against IL-4 and IL-13 administered subcutaneously and was granted FDA approval for EoE in adults and adolescents recently in 2022. Outcomes of real-world, clinical use of dupilumab for EoE remains unknown. \u0000Objectives:To observe outcomes in pediatric patients with EoE treated with dupilumab. \u0000Methods:A retrospective cohort study of pediatric patients prescribed dupilumab for EoE was conducted. Medical records were reviewed for demographic and clinical information as well as endoscopic and histologic findings before and after dupilumab treatment. \u0000Results:A total of 28 patients were included (mean age 15y, 71.4% male). Mean baseline maximum eosinophils/HPF was 48 ± 41. 75% of patients were treated with combination therapy of EoE with diet elimination, PPIs, or TCS prior to being prescribed dupilumab. Prior authorization for dupilumab was required in 85.7% of cases. Ten patients had follow-up endoscopy with biopsy after starting dupilumab, and among these patients the mean maximum eosinophils/HPF with dupilumab significantly improved from 44 ± 37 to 13 ± 15 (p=0.027). Among 12 patients who had follow up clinic visits, two patients reported pain or swelling at injection sites, but no otheradverse events were reported \u0000Conclusions:Dupilumab significantly improves histologic findings of EoE and is well tolerated among pediatric patients. We hope for continued monitoring of these patients to understand the clinical utility of dupilumab for EoE over time.","PeriodicalId":20522,"journal":{"name":"Proceedings of IMPRS","volume":" 4","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139625523","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Analysis of Nutritional Composition and Glycemic Control in Patients with Gestational Diabetes Mellitus 妊娠糖尿病患者的营养成分和血糖控制分析
Proceedings of IMPRS Pub Date : 2024-01-11 DOI: 10.18060/27732
Evelyn McGuire, Brenda Smith, Christina Scifres
{"title":"Analysis of Nutritional Composition and Glycemic Control in Patients with Gestational Diabetes Mellitus","authors":"Evelyn McGuire, Brenda Smith, Christina Scifres","doi":"10.18060/27732","DOIUrl":"https://doi.org/10.18060/27732","url":null,"abstract":"Background:The association between meal content and glycemic control is not well-understood in pregnancy, limits our ability to counsel patients regarding the optimal diet. We therefore sought to evaluate the relationship between maternal dietary content and glycemic control. \u0000Methods:This is a secondary analysis of the GDM-MOMS study, which was a randomized controlled pilot trial that compared glycemic targets in 60 pregnant individuals with GDM and either overweight or obesity. During the pilot trial, participants wore a blinded continuous glucose monitor (CGM) for two five-day periods, with the first data collection between 12-32 weeks and the second data collection between 32-36 weeks. During the time that participants wore their CGM, they also collected 3-day food diaries with detailed information regarding intake and cooking technique. These food diaries are being entered into the Nutrition Data System for Research (NDSR) software, which analyzes nutritional composition for each meal. Glycemic control as assessed by CGM will then be assessed based on maternal nutritional intake. \u0000Results:The American Diabetes Association recommends a 2,000-calorie daily diet with a minimum of 175g of carbohydrates (with 35% of the total calories coming from carbohydrates), 71g of protein, and 28g of fat. Preliminary data extracted from NDSR includes nutritional analysis of 38 daily food diaries from 14 patients. 12/38 (31.6%) food logs show consumption of less than 35% of their total calories from carbohydrates, with the other 26 consuming 36-62%. Glycemic load can be used to assess how a patient’s diet affects their glycemic levels. 25/38 (65.8%) of food logs demonstrate a daily glycemic load (GL) of 100, with the other 13 showing daily GLs rangingfrom 108-252. \u0000Conclusions and Further Directions:Further analyses will assess post-meal glycemic response using both patient-monitored glucose values and reports from their CGM to determine which types of diets allow for optimal glycemic control.","PeriodicalId":20522,"journal":{"name":"Proceedings of IMPRS","volume":" 3","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139625643","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
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