97,564 results match your criteria Cleveland Clinic Journal of Medicine[Journal]


Left Atrial Appendage Closure Device Implantation in Patients with Prior Intracranial Hemorrhage.

Heart Rhythm 2018 Nov 19. Epub 2018 Nov 19.

Section of Cardiac Pacing and Electrophysiology, Heart and Vascular Institute, Cleveland Clinic Foundation, Cleveland, OH. Electronic address:

Background: The Watchman™ device (Boston Scientific, MN), used for left atrial appendage closure (LAAC) was approved for stroke prevention in patients with atrial fibrillation (AF) and an appropriate rationale to avoid long-term oral anticoagulation. Patients with AF and prior intracranial hemorrhage (ICH) were excluded from clinical trials due to perceived risks of peri-operative anticoagulation.

Objective: We studied the efficacy and safety of LAAC using Watchman™ in patients with AF and prior ICH. Read More

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November 2018

Cytochrome P450 epoxygenases and cancer: A genetic and a molecular perspective.

Pharmacol Ther 2018 Dec 3. Epub 2018 Dec 3.

Division of Nephrology and Hypertension, Department of Medicine, Vanderbilt University Medical Center, Nashville, Tennessee;; Department of Veterans Affairs, Nashville, TN, USA. Electronic address:

Cytochrome CYP450 epoxygenases catalyze the epoxidation of polyunsaturated fatty acids including arachidonic acid, eicosapentaenoic acid, and docosahexaenoic acid. The arachidonic acid-derived products are potent pro-angiogenic lipids and promote tumor development and growth. On the other hand, eicosapentaenoic acid- and docosahexaenoic acid-derived products inhibit angiogenesis and play a protective role in certain pathological conditions including cancer. Read More

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December 2018
1 Read

Solriamfetol for Excessive Sleepiness in Obstructive Sleep Apnea (TONES 3): A Randomized Controlled Trial.

Am J Respir Crit Care Med 2018 Dec 6. Epub 2018 Dec 6.

Case Western Reserve University, Cleveland, Ohio, United States.

Rationale: Primary treatment of obstructive sleep apnea can be accompanied by a persistence of excessive sleepiness despite adherence. Furthermore, effectiveness of sleep apnea treatment is limited by poor adherence. Currently available pharmacologic options for the treatment of sleepiness in this population are limited. Read More

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December 2018

Incidence of adverse events attributable to bupivacaine liposome injectable suspension or plain bupivacaine for postoperative pain in pediatric surgical patients: a retrospective matched cohort analysis.

Paediatr Anaesth 2018 Dec 6. Epub 2018 Dec 6.

Departments of Outcomes Research, Cleveland Clinic, Cleveland, Ohio, United States.

Background: Surgical wound infiltration with local anesthetics is common as part of multimodal analgesia and enhanced recovery pathways in pediatric surgical patients. Liposomal bupivacaine can provide up to 92 hours of pain relief, and was approved by the U.S Food and Drug Administration for local infiltration in adults. Read More

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December 2018

Dermatologic manifestations in end stage renal disease.

Hemodial Int 2018 Dec 6. Epub 2018 Dec 6.

Department of Nephrology, Cleveland Clinic Akron General, Akron, Ohio, USA.

Skin manifestations are commonly seen in end stage renal disease (ESRD). Skin involvement in this population can be extensive and dramatically worsen quality of life. Close observation of the skin and nails of ESRD patients by clinicians allows for timely diagnosis and treatment, which ultimately improves quality of life and reduces mortality. Read More

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December 2018
2 Reads

Safety of Sports for Young Patients With Implantable Cardioverter-Defibrillators.

Circ Arrhythm Electrophysiol 2018 Nov;11(11):e006305

Yale University School of Medicine, New Haven, CT (J.D., C.B., L.S., F.L., R.J.L.).

Background: Despite safety concerns, many young patients with implantable cardioverter-defibrillators (ICDs) participate in sports. We undertook a prospective, multinational registry to determine the incidence of serious adverse events because of sports participation. The primary end points were death or resuscitated arrest during sports or injury during sports because of arrhythmia or shock. Read More

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November 2018

Prevalence of Small Intestine Carcinoid Tumors: A US Population-Based Study 2012-2017.

Dig Dis Sci 2018 Dec 5. Epub 2018 Dec 5.

Division of Gastroenterology and Liver Disease, Department of Medicine, University Hospitals Cleveland Medical Center, Case Western Reserve University, 11100 Euclid Avenue, Wearn 244, Cleveland, OH, 44106, USA.

Background And Aims: Most carcinoid tumors of the gastrointestinal tract are located in the small bowel (SB). Epidemiological studies of these tumors have been limited by small sample sizes. Our aim was to evaluate the epidemiology of SB carcinoids (SBCs) using a large database. Read More

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December 2018

Conditional Haploinsufficiency of β-Catenin Aggravates Neuronal Damage in a Paraquat-Based Mouse Model of Parkinson Disease.

Mol Neurobiol 2018 Dec 6. Epub 2018 Dec 6.

Department of Pathology, Case Western Reserve University, 2103 Cornell Road, Cleveland, OH, 44106, USA.

The canonical Wnt pathway is critical for both the development and adulthood survival and homeostatic maintenance of the midbrain dopaminergic (DA) neurons. Expanding evidence has demonstrated that genetic factors associated with familial Parkinson disease (PD) deregulate this important pathway, suggesting that a disturbed canonical Wnt pathway is likely involved in PD pathogenesis; yet, the specific role of this pathway in sporadic PD remains unclear. In this study, we aimed to determine the effects of specific inhibition of the canonical pathway by hemizygous knockout of β-catenin, the obligatory component of the canonical Wnt pathway, on paraquat (PQ)-induced DA neuronal degeneration in the substantia nigra in vivo. Read More

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December 2018

MRI Presentation of Infectious Intracranial Aneurysms in Infective Endocarditis.

Neurocrit Care 2018 Dec 5. Epub 2018 Dec 5.

Cerebrovascular Center, Neurological Institute, Cleveland Clinic, Cleveland, OH, USA.

Background: The radiographic appearance of infectious intracranial aneurysms (IIAs) of infective endocarditis (IE) on magnetic resonance imaging (MRI) of brain is varied. We aimed to describe the IIA-specific MRI features in a series of patients with IIAs.

Methods: Records of patients with active IE who had digital subtraction angiography (DSA) at a tertiary medical center from January 2011 to December 2016 were reviewed. Read More

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December 2018
1 Read

Targeted Delivery of Bioactive Molecules for Vascular Intervention and Tissue Engineering.

Front Pharmacol 2018 21;9:1329. Epub 2018 Nov 21.

Department of Biomedical Engineering, Worcester Polytechnic Institute, Worcester, MA, United States.

Cardiovascular diseases are the leading cause of death in the United States. Treatment often requires surgical interventions to re-open occluded vessels, bypass severe occlusions, or stabilize aneurysms. Despite the short-term success of such interventions, many ultimately fail due to thrombosis or restenosis (following stent placement), or incomplete healing (such as after aneurysm coil placement). Read More

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November 2018

Concussion rates and effects on player performance in Major League Baseball players.

Open Access J Sports Med 2018 13;9:253-260. Epub 2018 Nov 13.

Beaumont Health System, Detroit, MI, USA.

Background: Major League Baseball (MLB) players are throwing the ball faster and hitting harder than ever before. Although some safety measures have been implemented, by decreasing the 15 days on the disabled list (DL) to the 7 days on the DL, concussion rates remain high across positions and may impact player performance. Our hypothesis was, there would be an increase in concussion incidence following implementation of the 7 day DL, but this would not have a negative impact on player's postconcussion performance. Read More

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November 2018

Structural and molecular mechanisms for the control of eukaryotic 5'-3' mRNA decay.

Nat Struct Mol Biol 2018 Dec 5. Epub 2018 Dec 5.

Department of Pharmaceutical Chemistry, University of California, San Francisco, San Francisco, CA, USA.

5'-3' RNA decay pathways are critical for quality control and regulation of gene expression. Structural and biochemical studies have provided insights into the key nucleases that carry out deadenylation, decapping, and exonucleolysis during 5'-3' decay, but detailed understanding of how these activities are coordinated is only beginning to emerge. Here we review recent mechanistic insights into the control of 5'-3' RNA decay, including coupling between translation and decay, coordination between the complexes and activities that process 5' and 3' RNA termini, conformational control of enzymatic activity, liquid phase separation, and RNA modifications. Read More

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December 2018

Training the physician-scientist: views from program directors and aspiring young investigators.

JCI Insight 2018 Dec 6;3(23). Epub 2018 Dec 6.

Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, New York, USA.

There is growing concern that the physician-scientist is endangered due to a leaky training pipeline and prolonged time to scientific independence (1). The NIH Physician-Scientist Workforce Working Group has concluded that as many as 1,000 individuals will need to enter the pipeline each year to sustain the workforce (2). Moreover, surveys of postgraduate training programs document considerable variability in disposition and infrastructure (3). Read More

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December 2018

Murine -linked hydrocephalus is caused by hyperpermeability of the choroid plexus.

EMBO Mol Med 2018 Dec 5. Epub 2018 Dec 5.

Cardeza Center for Vascular Biology, Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, PA, USA

Though congenital hydrocephalus is heritable, it has been linked only to eight genes, one of which is Humans and mice that carry a truncated version of MPDZ incur severe hydrocephalus resulting in acute morbidity and lethality. We show by magnetic resonance imaging that contrast medium penetrates into the brain ventricles of mice carrying a loss-of-function mutation, whereas none is detected in the ventricles of normal mice, implying that the permeability of the choroid plexus epithelial cell monolayer is abnormally high. Comparative proteomic analysis of the cerebrospinal fluid of normal and hydrocephalic mice revealed up to a 53-fold increase in protein concentration, suggesting that transcytosis through the choroid plexus epithelial cells of KO mice is substantially higher than in normal mice. Read More

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December 2018
2 Reads

Noninvasive identification of seizure lateralization in children: Name that thing.

Neurology 2018 Dec 5. Epub 2018 Dec 5.

From the Department of Neurology (M.J.H.), Columbia University, New York; New York University (W.S.M.), NY; Tris Pharma, Inc. (W.T.S.), Monmouth Junction, NJ; Epilepsy Center (R.M.B.), and Department of Psychiatry and Psychology (P.K.), Cleveland Clinic, OH; Department of Psychology (C.M.S.), University of Florida Hospital for Children, Orlando; and Department of Psychology (M.L.S.), University of Toronto, Mississauga, Canada. W.S.M. is currently at Alberta Children's Hospital Research Institute, Canada. C.M.S. is currently at Space Coast Neuropsychology Center, Melbourne, FL.

Objective: With this prospective, observational study, we aimed to determine whether noninvasive language tasks, developed specifically for children, could reliably identify the hemisphere of seizure onset in pediatric epilepsy.

Methods: Seventy-eight children with unilateral epilepsy (44 left), aged 6-15 years (mean age = 11.8, SD = 2. Read More

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December 2018
1 Read

Long-term safety and activity of axicabtagene ciloleucel in refractory large B-cell lymphoma (ZUMA-1): a single-arm, multicentre, phase 1-2 trial.

Lancet Oncol 2018 Nov 30. Epub 2018 Nov 30.

University of Texas MD Anderson Cancer Center, Houston, TX, USA.

Background: Axicabtagene ciloleucel is an autologous anti-CD19 chimeric antigen receptor (CAR) T-cell therapy. In the previous analysis of the ZUMA-1 registrational study, with a median follow-up of 15·4 months (IQR 13·7-17·3), 89 (82%) of 108 assessable patients with refractory large B-cell lymphoma treated with axicabtagene ciloleucel achieved an objective response, and complete responses were noted in 63 (58%) patients. Here we report long-term activity and safety outcomes of the ZUMA-1 study. Read More

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November 2018

Ultrasound-guided quadratus lumborum plane block for congenital hip dislocation surgery: Dermatomes and osteotomes.

J Clin Anesth 2018 Nov 30;54:140. Epub 2018 Nov 30.

Anesthesiology Institute, Outcomes Research Department, Cleveland Clinic, Cleveland, OH, USA. Electronic address:

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November 2018

Therapeutic strategies for prion disease: a practical perspective.

Curr Opin Pharmacol 2018 Nov 30;44:15-19. Epub 2018 Nov 30.

Department of Neurology, University Hospitals Cleveland Medical Center, 3619 Park East Drive, Suite 206, Beachwood, OH 44122, USA.

Human prion diseases are usually rapid neurodegenerative illnesses that are invariably fatal. Despite several clinical trials, no effective treatment has been discovered in humans. Although prior clinical trials have not been successful, they provided information that is vital for the formation of future clinical trials. Read More

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November 2018

Transformation of Recurrent Respiratory Papillomatosis: Squamous Cell Carcinoma in a Pregnant Teen.

Ann Thorac Surg 2018 Nov 30. Epub 2018 Nov 30.

Department of Cardiothoracic Surgery, Heart and Vascular Institute, Cleveland Clinic. Cleveland. Ohio. United States. Electronic address:

Recurrent Respiratory Papillomatosis (RRP) is a rare intractable benign disease with a bimodal age distribution. We present a rare case of malignant transformation of juvenile-onset RRP in a 19-year old pregnant female, who was found to have a right upper lobe mass and cavitary nodules bilaterally that were biopsy proven to be node negative, multifocal squamous cell carcinoma. In her second trimester, she underwent Video Assisted Thoracoscopic (VATS) right upper lobectomy and middle lobe lateral segmentectomy, followed by left lower lobe segmentectomy nine months later. Read More

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November 2018

What Causes LVAD-Associated Ischemic Stroke? Surgery, Pump Thrombosis, Antithrombotics, and Infectionsa.

ASAIO J 2018 Nov 28. Epub 2018 Nov 28.

Cerebrovascular Center of the Neurological Institute, Cleveland Clinic, Cleveland, Ohio.

Acute ischemic stroke (AIS) is a major complication in left ventricular assist device (LVAD) population. A better understanding of clinical risk factors associated with AIS may help mitigate risk of stroke. We reviewed prospectively collected data of 477 LVAD patients from a tertiary center from October 1, 2004 to December 31, 2016. Read More

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November 2018

In Response.

Anesth Analg 2018 Nov 30. Epub 2018 Nov 30.

Department of Quantitative Health Sciences, Department of Outcomes Research, Cleveland Clinic, Cleveland, Ohio Department of Critical Care, Turkish Ministry of Health, Health Sciences University, Dr Suat Seren Chest Diseases and Chest Surgery, Training and Research Hospital, Izmir, Turkey Department of Quantitative Health Sciences, Department of Outcomes Research, Cleveland Clinic, Cleveland, Ohio Department of Outcomes Research, Anesthesiology Institute, Cleveland Clinic, Cleveland, Ohio.

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November 2018

Pharmacological Interventions for Neonatal Abstinence Syndrome.

J Addict Nurs 2018 Oct/Dec;29(4):231-232

Catherine Butcher, PharmD(c), Marshall University School of Pharmacy, Huntington, West Virginia. Leesa Prunty, PharmD, Home Care Services, University Hospitals Rainbow Babies and Children Hospital, Cleveland, Ohio. Omar Attarabeen, PhD, Charles "C. K." Babcock, PharmD, and Isha Patel, PhD, Department of Pharmacy Practice, Research, & Administration, Marshall University School of Pharmacy, Huntington, West Virginia.

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December 2018

Augmented External Fixation of Ulnar Carpometacarpal Joint Fracture Dislocations.

Tech Hand Up Extrem Surg 2018 Nov 30. Epub 2018 Nov 30.

Cleveland Clinic.

Ulnar-sided carpometacarpal (CMC) joint fracture dislocations are relatively uncommon, frequently associated with fractures of the metacarpal base and/or hamate, and often sustained by young male individuals secondary to striking a hard object. The complexity of ulnar-sided CMC fracture dislocations necessitates careful restitution of anatomic alignment and joint congruency for mobility and stability. Miniaturization of the external fixation device has allowed application to the hand. Read More

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November 2018
1 Read

Structural heart disease: one valve does not fit all.

Curr Opin Support Palliat Care 2018 Dec 4. Epub 2018 Dec 4.

University Hospitals Cleveland Medical Center/Harrington Heart & Vascular Institute, Cleveland, Ohio, USA.

Purpose Of Review: Highlight the difficulties patients, physicians, and the global economy face in relation to treatment of structural heart diseases. It is easy to be carried away by the excitement of medical advancement; however, it is difficult to demonstrate restraint. Transcatheter aortic valve replacement (TAVR) is a modern marvel that can help many patients when utilized appropriately. Read More

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December 2018
6 Reads

Intra-operative tachycardia is not associated with a composite of myocardial injury and mortality after noncardiac surgery: A retrospective cohort analysis.

Eur J Anaesthesiol 2018 Nov 30. Epub 2018 Nov 30.

From the Department of Outcomes Research (KR, AT, NMZ, GM, AK, DIS), Department of General Anaesthesiology (KR, AT, AK), Anaesthesiology Institute, Cleveland Clinic, Outcomes Research Consortium, Cleveland, Ohio, USA (HOY, M-HH), Department of Critical Care, Dr. Suat Seren Chest Disease and Thoracic Surgery Education and Research Hospital, Izmir, Turkey (HOY), Department of Quantitative Health Sciences, Cleveland Clinic, Cleveland, Ohio, USA (NMZ, GM) and Department of Anaesthesiology, National Taiwan University Hospital, Taipei, Taiwan (M-HH).

Background: Myocardial injury after noncardiac surgery (MINS) is a major contributor to peri-operative morbidity and mortality with a reported incidence of about 8%. Tachycardia increases myocardial oxygen demand, and decreases oxygen supply, and is therefore a potential cause of MINS.

Objective: We tested the hypothesis that there is an association between intra-operative area above a heart rate (HR) of 90 bpm and a composite of MINS and in-hospital all-cause mortality. Read More

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November 2018

Chemogenetic silencing of hippocampal neurons suppresses epileptic neural circuits.

J Clin Invest 2018 Dec 3. Epub 2018 Dec 3.

Department of Neurosciences, Cleveland Clinic, Cleveland, Ohio, USA.

We investigated how pathological changes in newborn hippocampal dentate granule cells (DGCs) lead to epilepsy. Using a rabies virus-mediated retrograde tracing system and a designer receptors exclusively activated by designer drugs (DREADD) chemogenetic method, we demonstrated that newborn hippocampal DGCs are required for the formation of epileptic neural circuits and the induction of spontaneous recurrent seizures (SRS). A rabies virus-mediated mapping study revealed that aberrant circuit integration of hippocampal newborn DGCs formed excessive de novo excitatory connections as well as recurrent excitatory loops, allowing the hippocampus to produce, amplify, and propagate excessive recurrent excitatory signals. Read More

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December 2018
2 Reads

Evidence of retinal degeneration in Wolfram syndrome.

Ophthalmic Genet 2018 Dec 3:1-5. Epub 2018 Dec 3.

b Cole Eye Institute , Cleveland Clinic , Cleveland , OH , USA.

Purpose: Wolfram syndrome is characterized by early onset diabetes mellitus, diabetes insipidus, deafness, and optic atrophy, but retinal degeneration has not been described as a major component of the phenotype. We present two cases with Wolfram syndrome and evidence of retinal degeneration.

Materials And Methods: Observational case series. Read More

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December 2018

High-Risk Comorbidity Combinations in Older Patients Undergoing Emergency General Surgery.

J Am Geriatr Soc 2018 Dec 2. Epub 2018 Dec 2.

Department of Population and Quantitative Health Sciences, Case Western Reserve University School of Medicine, Cleveland, Ohio.

Background/objectives: Over a million older patients in the United States are admitted yearly for emergency general surgery (EGS) conditions. Seven procedure types dominate: colon, small bowel, gallbladder, ulcer disease, adhesiolysis, appendix, and laparotomy operations. A higher comorbidity burden is known to increase mortality in this population, but the impact of specific comorbidity combinations is unknown. Read More

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December 2018
2 Reads

Induction of Krüppel-like factor 2 reduces K/BxN serum-induced arthritis.

J Cell Mol Med 2018 Dec 3. Epub 2018 Dec 3.

Department of Pharmaceutical Sciences, School of Pharmacy, Texas Tech University Health Sciences Center, Amarillo, Texas.

Krüppel-like factor 2 (KLF2) critically regulates activation and function of monocyte, which plays important pathogenic role in progressive joint destruction in rheumatoid arthritis (RA). It is yet to be established the molecular basis of KLF2-mediated regulation of monocytes in RA pathogenesis. Herein, we show that a class of compound, HDAC inhibitors (HDACi) induced KLF2 expression in monocytes both in vitro and in vivo. Read More

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December 2018

Report from the American Society of Transplantation on Frailty in Solid Organ Transplantation.

Am J Transplant 2018 Dec 1. Epub 2018 Dec 1.

University of California at San Francisco, San Francisco, CA, USA.

A consensus conference on frailty in kidney, liver, heart and lung transplantation, sponsored by the American Society of Transplantation (AST) and endorsed by the American Society of Nephrology (ASN), the American Society of Transplant Surgeons (ASTS) and the Canadian Society of Transplantation (CST), took place on February 11, 2018 in Phoenix, Arizona. Input from the transplant community through scheduled conference calls enabled wide discussion of current concepts in frailty, exploration of best practices for frailty risk assessment of transplant candidates and for management after transplant, and development of ideas for future research. A current understanding of frailty was compiled by each of the solid organ groups and is presented in this paper. Read More

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December 2018
1 Read

Diagnosis of covert hepatic encephalopathy: a multi-center study testing the utility of single versus combined testing.

Metab Brain Dis 2018 Nov 30. Epub 2018 Nov 30.

Division of Gastroenterology, Hepatology and Nutrition, Virginia Commonwealth University and McGuire VA Medical Center, 1201 Broad Rock Boulevard, Richmond, Virginia, 23249, USA.

Covert hepatic encephalopathy (CHE) affects cognition in a multidimensional fashion. Current guidelines recommend performing Psychometric Hepatic Encephalopathy Score (PHES) and a second test to diagnose CHE for multi-center trials. We aimed to determine if a two-test combination strategy improved CHE diagnosis agreement, and accuracy to predict overt hepatic encephalopathy (OHE), compared to single testing. Read More

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November 2018

Robotic totally endoscopic coronary artery bypass grafting (TECAB) of the left anterior descending and right coronary artery system using an arterial Y-graft technique.

Ann Cardiothorac Surg 2018 Sep;7(5):700-703

Heart and Vascular Institute, Cleveland Clinic Abu Dhabi, Abu Dhabi, United Arab Emirates.

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September 2018
2 Reads

Massive hemoptysis in pulmonary infections: bronchial artery embolization.

J Thorac Dis 2018 Oct;10(Suppl 28):S3458-S3464

Imaging Institute, Cleveland Clinic, Cleveland, OH, USA.

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October 2018

Early discharge after lung resection is safe: 10-year experience.

J Thorac Dis 2018 Oct;10(10):5870-5878

Division of Thoracic and Esophageal Surgery, Department of Surgery, University Hospitals Cleveland Medical Center and Case Western Reserve School of Medicine, Cleveland, OH, USA.

Background: The average hospitalization after lung resection is 6 days, but some patients are discharged early in the post-operative period. The patient factors associated with early discharge (ED) and the safety of this approach are unknown. We hypothesized that specific patient populations are associated with ED, and that complications in this practice are low. Read More

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October 2018

Atrial Fibrillation and Objective Sleep Quality by Slow Wave Sleep.

J Atr Fibrillation 2018 Aug 31;11(2):2031. Epub 2018 Aug 31.

Cardiovascular Division, Department of Medicine, University of Virginia.

Background: Self-reported poor sleep quality has been suggested in patients with AF. Slow wave sleep (SWS) is considered the most restorative sleep stage and represents an important objective measure of sleep quality. The aim of this study was to compare quantity of SWS between patients with and without AF. Read More

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August 2018
2 Reads

Calcified stylohyoid ligament: A rare presentation as a thick cord-like structure during anterior cervical discectomy and fusion.

Neurol India 2018 Nov-Dec;66(6):1850-1851

Department of Neurological Surgery, University Hospitals Cleveland Medical Center, Cleveland, Ohio, USA.

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December 2018

Bedside Nurse Acceptance of Intensive Care Unit Telemedicine Presence.

Crit Care Nurse 2018 Dec;38(6):e1-e4

Christina Canfield is the program manager for Cleveland Clinic's intensive care unit telemedicine program, Cleveland, Ohio. Sandra Galvin is the nurse manager of the coronary intensive care unit and the heart failure intensive care unit at Cleveland Clinic Main Campus.

Since 2010, health care organizations have rapidly adopted telemedicine as part of their health care delivery system to inpatients and outpatients. The application of telemedicine in the intensive care unit is often referred to as In telemedicine, nurses, nurse practitioners, physicians, and other health care professionals provide patient monitoring and intervention from a remote location. Tele-ICU presence has demonstrated positive outcomes such as increased adherence to evidence-based care and improved perception of support at the bedside. Read More

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December 2018

An ATF6-tPA pathway in hepatocytes contributes to systemic fibrinolysis and is repressed by DACH1.

Blood 2018 Dec 1. Epub 2018 Dec 1.

Department of Physiology and Department of Pathology and Cell Biology, Columbia University Medical Center, New York, NY, United States

Tissue-type plasminogen activator (tPA) is a major mediator of fibrinolysis and thereby prevents excessive coagulation without compromising hemostasis. Studies on tPA regulation have focused on its acute, local release by vascular cells in response to injury or other stimuli. However, very little is known about sources, regulation, and fibrinolytic function of non-injury-induced systemic plasma tPA. Read More

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December 2018

Ursolic Acid Promotes the Sensitization of rhTRAIL-resistant Triple-negative Breast Cancer.

Anticancer Res 2018 Dec;38(12):6789-6795

Department of Chemistry, Science and Research Center, Cleveland State University, Cleveland, OH, U.S.A.

Background/aim: Triple-negative breast cancer (TNBC) can be characterized as the deadliest breast cancer type considering the lack of efficacious therapeutics. Recombinant human tumor necrosis factor-related apoptosis-inducing ligand (rhTRAIL) is an encouraging anti-cancer therapeutic with the capacity to induce apoptosis in cancer cells but there are TNBCs less susceptible to rhTRAIL. The aim of this study was to assess the potential of the natural product ursolic acid (UA) to sensitize of rhTRAIL-resistant TNBCs. Read More

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December 2018

Strategies for Efficient Genome Editing Using CRISPR-Cas9.

Genetics 2018 Nov 30. Epub 2018 Nov 30.

University of California, Berkeley

The targetable DNA endonuclease CRISPR-Cas9 has transformed analysis of biological processes by enabling robust genome editing in model and non-model organisms. Although rules directing Cas9 to its target DNA via a guide RNA are straightforward, wide variation occurs in editing efficiency and repair outcomes for both imprecise error-prone repair and precise templated repair. We found that imprecise and precise DNA repair from double-stranded breaks (DSBs) is asymmetric, favoring repair in one direction. Read More

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November 2018
2 Reads

Ethical conundrums in pediatric genomics.

Hematology Am Soc Hematol Educ Program 2018 Nov;2018(1):301-306

Department of Pediatric Hematology, Oncology, and Blood and Marrow Transplantation, Cleveland Clinic Children's Hospital, Cleveland, OH.

Recent genomic discoveries have improved our understanding of many hematologic diseases and led to novel therapeutic options for many patients. The rapid decrease in the cost of genomic testing has enabled widespread use of clinical genomic testing. However, these advances are accompanied by concomitant challenging ethical concerns. Read More

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November 2018

The MDS genomics-prognosis symbiosis.

Authors:
Aziz Nazha

Hematology Am Soc Hematol Educ Program 2018 Nov;2018(1):270-276

Department of Hematology and Medical Oncology, Taussig Cancer Institute, Cleveland Clinic, Cleveland, OH.

Myelodysplastic syndromes (MDS) are clonal disorders characterized by the accumulation of complex genomic abnormalities that define disease phenotype, prognosis, and the risk of transformation to acute myeloid leukemia. The clinical manifestations and overall outcomes of MDS are very heterogeneous with an overall survival that can be measured in years for some patients to a few months for others. Prognostic scoring systems are important staging tools that aid physicians in their treatment recommendations and decision-making and can help patients understand their disease trajectory and expectations. Read More

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November 2018

Current approaches to prevent and treat GVHD after allogeneic stem cell transplantation.

Hematology Am Soc Hematol Educ Program 2018 Nov;2018(1):228-235

Blood and Marrow Transplant Program, Hematology and Medical Oncology, Taussig Cancer Institute, Cleveland Clinic, Cleveland, OH.

Allogeneic hematopoietic cell transplantation is a potentially curative therapy for many malignant and nonmalignant hematologic diseases. Graft-versus-host disease (GVHD) is a common complication after transplantation and remains a major cause of morbidity and mortality, limiting the success of a potentially curative transplant. This paper reviews the current and emerging strategies in GVHD prevention and treatment. Read More

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November 2018
1 Read

An exploration of concomitant psychiatric disorders in children with autism spectrum disorder.

Compr Psychiatry 2018 Nov 6;88:57-64. Epub 2018 Nov 6.

Emory University School of Medicine, Department of Pediatrics, United States of America. Electronic address:

Objective: We explored patterns of concomitant psychiatric disorders in a large sample of treatment-seeking children and adolescents with autism spectrum disorder (ASD).

Methods: Participants were 658 children with ASD (age 3-17 years; mean = 7.2 years) in one of six federally-funded multisite randomized clinical trials (RCT) between 1999 and 2014. Read More

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November 2018

Efficacy of Endoscopic Dilation of gastroduodenal Crohn's disease strictures: A Systematic Review and Meta-analysis of Individual Patient Data.

Clin Gastroenterol Hepatol 2018 Nov 29. Epub 2018 Nov 29.

Department of Inflammation and Immunity, Lerner Research Institute, Cleveland Clinic Foundation, Cleveland, Ohio, USA; Department of Gastroenterology, Hepatology & Nutrition, Digestive Diseases and Surgery Institute, Cleveland Clinic Foundation, Cleveland, Ohio, USA.

Background & Aims: Little is know about the effects of endoscopic balloon dilation (EBD) for strictures of the upper gastrointestinal (UGI) tract in patients with Crohn's disease (CD). We performed a pooled analysis of the efficacy and safety of EBD for UGI CD-associated strictures.

Methods: We searched the EMBASE, Medline and Cochrane library, as well as bibliographies of relevant articles, for cohort studies of adults with CD and strictures of the stomach, or duodenum (up to the ligament of Treitz) who underwent EBD through December 2016. Read More

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November 2018
1 Read

Connecting the Dots - Acute Abdomen, ST Elevation and a Consolidating Lung Mass.

Am J Med 2018 Nov 29. Epub 2018 Nov 29.

Department of Internal Medicine Internal Medicine Residency Program St Vincent Charity Medical Center Cleveland, OH, USA.

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November 2018

Hypothalamic POMC or MC4R deficiency impairs counterregulatory responses to hypoglycemia in mice.

Mol Metab 2018 Nov 20. Epub 2018 Nov 20.

Department of Molecular and Integrative Physiology, University of Michigan Medical School, Ann Arbor, MI, USA; Department of Medicine, Division of Endocrinology, Diabetes and Metabolism, University of Rochester School of Medicine and Dentistry, Rochester, NY, USA. Electronic address:

Objective: Life-threatening hypoglycemia is a major limiting factor in the management of diabetes. While it is known that counterregulatory responses to hypoglycemia are impaired in diabetes, molecular mechanisms underlying the reduced responses remain unclear. Given the established roles of the hypothalamic proopiomelanocortin (POMC)/melanocortin 4 receptor (MC4R) circuit in regulating sympathetic nervous system (SNS) activity and the SNS in stimulating counterregulatory responses to hypoglycemia, we hypothesized that hypothalamic POMC as well as MC4R, a receptor for POMC derived melanocyte stimulating hormones, is required for normal hypoglycemia counterregulation. Read More

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November 2018