Background:
Tracheostomy is a high-risk procedure in children under three years old, with a rate of major post-operative complications as high as 24%. The rate of accidental decannulation (AD), a common complication of tracheostomy associated with...
Background
Despite causing significant morbidity and mortality, non-alcoholic fatty liver disease (NAFLD) is significantly underdiagnosed. Clinical indices developed to easily identify patients with hepatic steatosis and risk for more advanced disease...
Background: It remains unclear whether food insecurity as a marker of poverty is a barrier to accessing health care in low-resource settings, or rather increases care utilization due to more frequent need for care. This study used baseline data from...
Funding: National Institutes of Health/National Cancer Institute StARR Program R38 (5R38-CA245204 to E.J.V.); National Institutes of Health/National Cancer Institute (K08-CA2560450 to Z.J.R.).
Background: Primary central nervous system lymphoma...
Purpose
The diagnosis of neurodegenerative diseases is largely based on clinical suspicion with limited confirmation antemortem. However, neuropathological changes occur years prior to disease presentation. Changes in the retina, an embryologically...
Purpose: Few studies have looked at repeatability of the choroidal vascularity index (CVI) in different OCT imaging modalities. We performed a retrospective image analysis to compare a handheld swept-source research OCT system (UC3) to a gold standard...
Introduction: The Lancet Commission on Global Surgery (2015) outlined several factors needed to sustain a workforce in austere settings. Yet, there is a paucity of literature exploring the personal narratives of these workforce members. There is...
Background
Anthracyclines are effective chemotherapeutics used in >60% of pediatric cancer cases but have a well-documented risk of cardiotoxicity. Existing cardiotoxicity risk calculators do not include cardiovascular risk factors present at the...
Introduction: Prosthetic joint infection (PJI) following joint arthroplasty is a devastating complication. Prior studies have documented an association between PJI and increased prevalence of preoperative depression and elevated risk of new mental...
Antibodies perform both neutralizing and non-neutralizing functions that protect against certain pathogens. A human antibody directed at the SARS-CoV-2 spike protein N-terminal domain (NTD), DH1052, was recently shown to be non-neutralizing yet...
Introduction: While obesity and chronic hypertension are often viewed as confounding the observed relationship between race and maternal morbidity, evidence suggests racism drives development of maternal morbidity risk factors, including obesity and...
Childhood Disintegrative Disorder (CDD) is a poorly understood neurobehavioral disorder of early childhood characterized by acute to subacute profound regression in previously developed language, social behavior, and adaptive functions. The etiology of...
Healthcare inequities in the US impact access to medical treatment for pediatric patients, particularly in conditions like adolescent idiopathic scoliosis (AIS) where nonoperative management is effective. AIS affects 3% of the pediatric population,...
Introduction:
It is currently unclear if postoperative pain experience differs in patients undergoing primary versus repeat cesarean deliveries, with prior studies reporting conflicting results. For instance, some studies have suggested that repeat...
PURPOSE: Three-dimensional (3D) printing enables surgeons to take a more individualized approach to patient management. Commercially available scanning systems can be prohibitively expensive. Fortunately, high-quality 3D imaging is becoming...
INTRODUCTION
Recently, dual-plating of displaced clavicle fractures has become a popular construct to reduce implant prominence while optimizing balanced fixation. Traditionally patients have a limited weight bearing period after clavicle fracture...
Background: While Kambin’s triangle has become an ever more important anatomic window given its proximity to the nerve root, there have been limited studies examining the effect of disease on the corridor. Recent studies have begun implementing 3D...
Background: Optical Coherence Tomography (OCT) is a routine and vital part of the Ophthalmology exam. OCT generates contrast by using light interference generated by tissue reflectivity; simply, it can be thought of akin to ultrasound, but using...
Introduction: Patients with adult congenital heart disease (ACHD) often develop atrial arrhythmias, including focal atrial tachycardia (FAT). In non-ACHD patients, algorithms using surface ECG P-wave morphology are helpful to predict FAT location to...
Background: In the United States, significant disparities exist in gastric cancer incidence and mortality between Black Americans and non-Hispanic White Americans. Helicobacter pylori (Hp) infection is the greatest risk factor for developing gastric...
Background: Periprosthetic joint infection (PJI) in total knee arthroplasty (TKA) may result in 2-stage revision surgery. There is limited data describing outcomes when the first stage is completed at an outside hospital and the patient is referred to...
Acknowledgement: This project received NIH funding for Cancer Disparities research P20-CA251657
Background: Helicobacter pylori (Hp) is the strongest risk factor for non-cardia gastric adenocarcinoma, the cancer with the greatest racial disparity...
Background
Neurosurgical resection of tumors requires discernment of tumor from healthy tissue. Endogenous fluorophores exist in different concentrations in tissue enabling the classification of tissue type via excitation with a low power laser. The...
Introduction:
In the pediatric otolaryngology setting, health literacy of patients and guardians has been shown to be overall highly proficient but has not been thoroughly examined at the level of understanding of the actual procedures being...
Background: Frontotemporal dementia (FTD) is a progressive neurodegenerative disorder that affects the frontal and temporal lobes of the brain, leading to cognitive decline and personality changes. Early detection of FTD is critical for initiating...
Background: Social media utilization in plastic surgery training has been growing exponentially since 2010. The importance of social media for integrated plastic surgery residency programs has already been well-demonstrated in the literature, with...
Background: One of the most common but least studied complications of diabetes is diabetic bladder dysfunction. Current therapies for diabetic bladder dysfunction include glucose control and symptom-based interventions. However, there is mixed data on...
Background: Lung cancer risk classification is an increasingly important area of research as low-dose thoracic CT screening programs become standard of care for patients at high risk for lung cancer. There is limited availability of large, annotated...
Background: Chondrosarcoma (CSA) lacks effective systemic therapies for metastatic disease. Thus, novel targets are necessary. Our previous work identified overexpression of Leukocyte Cytosolic Protein 1 (LCP1) in metastasizing CSAs and expression...
Introduction
Digital health solutions have been shown to improve outcomes for chronic medical conditions, but relatively few solutions have been validated for patients undergoing surgery. The digital health platform ManageMySurgery (MMS) has been...
Background: Tattooing is a widespread practice and has increased in popularity over time. A recent poll suggests that 30% of Americans have at least one tattoo, which has increased from 21% reported in 2012. Many lesions have been described in relation...
Introduction
Allostasis is the process by which the body responds to environmental stressors to maintain physiological functioning. When allostasis is maintained at a moderate level, it serves as a beneficial mechanism to cope with the daily stresses...
Background
Out-of-pocket (OOP) costs have been increasing for commercially insured people. These high OOP costs are associated with suboptimal outcomes, particularly impacting low-income patients with diabetes. An increasing number of employers are...
Introduction:
Chronic myeloid neoplasia (CMN) describes the clonal outgrowth of blood cells from abnormal hematopoietic stem cells and includes both malignancies and pre-malignant states. Previous work has associated CMN with surgically-relevant...
Background
Severe and life-threatening illness can be a significant source of suffering for patients. This suffering can include mental anxiety, financial strain, and spiritual questioning. Between one third and one half of Americans will die because...
Background:
Pediatric traumas are often high-acuity, but low-frequency compared to adult trauma activations. This is reflected by the relatively limited experience with these events during training. While some principles of trauma resuscitation are...
Introduction: Diving is a physically demanding activity requiring much energy and stamina. A fit diver is less likely to become fatigued during a dive, which reduces the risk of accidents and injuries. Few studies have been performed to compare...
Background: Eating disorders (EDs) are widely prevalent in the US, have some of the highest mortality rates reported among psychiatric illnesses, and can be exacerbated by stigmatization against EDs. Similarly, obesity is generally recognized as a...
Background
Approximately 37 million people are infected with HIV-1, which causes acquired
immunodeficiency syndrome (AIDS) and is among leading global causes of both mortality and
burden. While combined antiretroviral therapy (cART) has extended...
INTRODUCTION: The urogenital microbiome, including microbes in the urinary bladder and vagina, demonstrates variations that are linked to aging. While prior studies have shown how the composition of the vaginal microbiome changes after menopause, less...
Background: Progress towards value-based care in orthopaedics requires knowledge on surgical care costs as well as drivers of costs. Therefore, the purpose of this study was to assess 90-day health system costs in primary total elbow arthroplasty...
Background
Desirability of outcome ranking (DOOR) is a novel approach to clinical trial design that incorporates safety and efficacy assessments into an ordinal ranking system to evaluate overall outcomes of clinical trial participants. Here, we...
Background:
Weight loss is commonly recommended before total knee arthroplasty (TKA) despite inconsistent evidence for better outcomes. The purpose of this study was to examine the impact of weight loss before TKA on adverse events and...
People with Limited English Proficiency (LEP) are at risk for suboptimal health outcomes, health care disparities in health care access, and face intersecting challenges in the healthcare system. More than 25 million individuals report LEP and Latinos...
Objective:
Postpartum mood disorders, including depression, anxiety, and postpartum psychosis, affect up to 20% of new mothers. Despite the prevalence and potential severity of postpartum mood disorders, they often go undetected and untreated....
Funding for this work was provided by Duke Global Health Institute and Duke Global Neurosurgery and Neurology.
Background: Traumatic brain injury (TBI) accounts for the majority of Uganda’s neurosurgical disease burden; however, invasive...
Scholarship/funding: This research did not receive any specific grant or scholarship from funding agencies in the public, commercial or not-for-profit sectors.
Background: Sleep disturbance, such as insomnia and short sleep duration, is increasing...
Background: Measures of physiologic reserve have been shown to predict morbidity, mortality, and other negative outcomes following surgery in older adults. However, few studies have investigated predictors of physical resilience, defined as functional...
Background: Misinformation about the safety of hormone replacement therapy (HRT) for germline BRCA mutation carriers without a personal history of cancer may result in inaccurate counseling and hesitancy to prescribe HRT following risk-reducing...
The APOE4 allele is the most common genetic risk factor for late-onset Alzheimer’s Disease (AD), and it is thought to contribute via pathways such as neuroinflammation and exacerbation of underlying AD pathology. An apoE mimetic peptide called CN-105...
Background:
Merkel cell carcinoma (MCC) is a highly aggressive form of skin cancer. For years, the surgical treatment of MCC has born similarity to the management of melanoma. We aimed to compare the trend in performance of complete lymph node...
My research was supported by the National Institute on Minority Health and Health Disparities of the National Institutes of Health under Award Number R01MD012249. My research was also funded by the Dr. Bernard J. Carroll Research Scholarship in...
Background: While low-value care (LVC) is a significant component of wasteful healthcare spending in the United States, much of the existing research focuses on de-implementation methods, without a deep understanding of factors which influence or drive...
Background: Therapy de-escalation may be appropriate for select older patients with breast cancer. With the increasing utilization of genomic assays, such as the Oncotype DX Recurrence Score (RS), the relevance of anatomic staging has been questioned....
Sexual prejudice entails attitudes, beliefs, or behaviors that reflect, foster, or promote negative or pejorative stereotypes about LGBTQ+ individuals. This study investigates the prevalence of sexual prejudice among medical students in the...
Background:
Placenta accreta spectrum (PAS) is a rare condition where the placenta becomes abnormally attached to the uterine wall. PAS complicates approximately 3 per 1000 deliveries in the United States, and its incidence is rising due to...
Background: Procedural skills are an essential aspect of medical student education. Previous studies, including a 2016 study at Duke, have shown that medical students have been underexposed to procedural skills training. We aimed to perform a follow-up...
Background: Children with medical complexity (CMC) have high rates of healthcare utilization, leading to disruption of school and work attendance for both CMC and their families. Past studies have attempted to quantify disruption to patients’ and...
Background: rLI-RADS is a recently proposed revised version of LI-RADS that was originally derived from a single center with a hepatitis B virus (HBV)-predominant patient population. This study evaluates and compares the performance of LI-RADS v2018...
Funding: This work was supported by the National Institutes on Aging Northern California Institute for Research and Education grant R24AG064025, subaward STE2196-13(USDeN) (MM, SNH, LZ, AC, JMP); 5K23-AG058788 (Pavon) and the Veteran Affairs Health...
Gynecologic Cancer Research Fellowship
Background:
Human Papillomavirus (HPV) is the most common sexually transmitted infection in the United States and a known risk factor for cervical, vulvar, vaginal, penile, anal, and oropharyngeal cancers....
Introduction: In the United States, maternal morbidity and mortality is markedly higher for women of color than for White women. The presence of a doula has been associated with positive birthing outcomes and experiences for White individuals, but the...
Purpose: Prior cross-sectional studies have revealed decreased macular perfusion density (PFD) and increased peripapillary capillary PFD in Parkinson’s disease (PD). We assess longitudinal rate of change of retinal microvascular and structural...
Breast reconstruction is an important component of post-mastectomy cancer care
for many patients. Racial and ethnic disparities in breast reconstruction have been observed for
two decades without significant progress.
Methods: We conducted a...
Background: Peripheral nerve injury is a rare, but potentially devastating complication following shoulder arthroplasty, with patients possibly having worse patient-reported outcomes, residual neuropathic pain, sensorimotor deficits, and increased...
Background:
TIPS placement has been associated with risk of hepatic deterioration, although the mechanism is poorly understood. Diversion of portal flow from hepatic parenchyma is thought to be contributory, but proof of causality is challenging and...
Background: Interpersonal violence is an important public health concern that is often underreported to law enforcement, contributing to an incomplete understanding of violence in the community. The Cardiff Model for Violence Prevention, based on...
Background: Lung transplant recipients are at increased risk of MABC acquisition. The objective of this study was to analyze risk factors and outcomes of early post-transplant MABC acquisition.
Methods: We conducted a single center retrospective...
Background & Aims:
Gastroesophageal reflux disease (GERD) is associated with worse patient outcomes after lung transplant, though this may be mitigated by anti-reflux surgery. A testing strategy to maximize GERD detection is therefore desirable....
Background: Adverse childhood experiences (ACEs) have been linked to development of chronic liver disease later in life. Historically, this link was driven by increased risk behaviors for viral and alcohol-related liver disease (ALD). With the rise of...
Background: The use of the patient portal (PP) has given patients a more active role in their care by allowing patients to see their medications, test results, imaging, upcoming appointments, medical bills, and price estimates as well as communicate...
Purpose: To assess the use of spectral domain optical coherence tomography (OCT) to identify subretinal fibrosis.
Methods: Two masked Readers identified subretinal fibrosis using color fundus photography (CFP), fluorescein angiography (FA), and OCT...
Background: Highly sensitized patients face many barriers to kidney transplantation, including higher rates of antibody-mediated rejection after HLA-incompatible transplant. IdeS, an endopeptidase that cleaves IgG nonspecifically, has been trialed as...
Rationale: Temporal lobe epilepsy (TLE) is common, devastating, and often medically refractory. Despite years of work, disease modifying therapies still do not exist. Efforts to develop novel therapies have been hindered by the lack of understanding of...
Background: Palliative care (PC) is specialized care provided to individuals facing serious illness. PC focuses on providing relief from the symptoms and stress of the illness ultimately aiming to enhance the quality of life for patients and their...
Acknowledgement: This project received NIH funding for Cancer Disparities research P20-CA251657 and support from P30-CA014236
Background:
It is widely acknowledged that stress is relevant in the pathophysiology of gastrointestinal disorders such...
Background:
Eye cytology poses challenges due to lesion rarity, scanty specimens, and limited experience of many pathologists with ophthalmic cytopathology. This study seeks to assess the diagnostic performance of eye cytopathology.
Methods:
We...
Background: Phosphate is critical for many cellular functions, including ATP synthesis. Hypophosphatemia has been observed in many patients with acute pancreatitis, and we previously reported that a low phosphate diet fed to mice triggered...
Background
A significant proportion of women who undergo breast reconstruction after mastectomy are dissatisfied with the outcome. Understanding patient preferences for treatment is essential to shared decision-making; however, few methods allow for...
Background: Since the onset of the COVID-19 pandemic, telemedicine emerged as a promising approach to enhance diabetes healthcare delivery. However, little is known about the association of patient perception of telemedicine visits and modality of...
Background: Amyotrophic lateral sclerosis (ALS) prognosis is poor, but not all patients progress at equal rates. There are slow progressors, fast progressors, and even the rare reversals of ALS. Interestingly, increasing evidence suggests the...
Background: Early detection and intervention are associated with improved cognitive and behavioral outcomes in autistic children. Thus, it is important to understand factors influencing early screening tools designed to detect autism. Common screening...
Background: Acute management of moderate-severe traumatic brain injury (TBI) is aimed at preventing secondary injury that occurs after the primary insult.1 Multiple prospective and retrospective studies have found beta-blockers exposure during the...
Funding Acknowledgment: Funding for this study was provided by Carevive Systems, Inc. and Duke University.
Background: Treatment options for acute myeloid leukemia (AML) have changed markedly in the last 5 years with the advent of multiple novel...
Approximately 20% of patients who experience a shoulder instability event followed by subsequent shoulder stabilization surgery experience recurrent dislocation, decreased mobility, stiffness, pain, and or effusions secondary to post stabilization...
Background: Adult Polyglucosan Body Disease (APBD) is the adult-onset form of glycogen storage disease type IV (GSD IV) and is caused by biallelic pathogenic variants in GBE1 encoding for glycogen branching enzyme (GBE). Impaired GBE activity leads to...
Purpose:
The COVID-19 pandemic sparked an expeditious implementation of telemedicine, with various implications on care practices. Specifically, the influence of telemedicine on radiologic imaging utilization within rheumatology has not been...
Acknowledgements: We are grateful to the The Kay Yow Cancer “Cancers that Affect Women" Fund in partnership with the V Foundation for Cancer Research for their generous support of
the Endometrial Cancer Molecularly Targeted Therapy Consortium and...
Background
Addressing health related social needs (HRSN) is a considerable opportunity to improve patient outcomes. Previous research has shown that HRSN interventions result in improved health outcomes, reduced utilization, and decreased patient...
Background: Amyotrophic lateral sclerosis (ALS) is an adult-onset, relentless and almost universally fatal motor neuron disease. Rarely, patients with clinically proven ALS experience long, sustained improvement in their symptoms. These ALS “reversals”...
Background. Treatment of stage I-III breast cancer requires multimodality therapies as outlined in the National Comprehensive Cancer Network (NCCN). We evaluated the impact of receiving treatment at more than one facility and distance to that facility...
Introduction: The Coronal Plane Alignment of the Knee (CPAK) classification system is a potential method for “personalized alignment” in total knee arthroplasty (TKA). CPAK identifies several knee phenotypes through coronal plane measurements and can...
Introduction: In Tanzania, the HIV prevalence among women over 15 is 6.2% compared to 3.1% among men, and HIV prevalence increases during reproductive years, from 2.1% in women aged 15 to 24 to 12% in women aged 45-49. The perinatal period is critical...
Introduction: Maintaining premorbid proximal humeral positioning is an essential consideration of anatomic total shoulder arthroplasty (aTSA), as malposition of the prosthetic humeral head can result in poor clinical outcomes. Stemless aTSA prosthetic...
Background: Alternating hariants in the ATP1A3-encoded sodium-potassium ATPase type 3 (ATP1A3). While AHC was believed to primarily be a neurologic disease, some individuals can experience sudden unexplained death (SUD) which has been linked with...
Background: Uterine leiomyomata are benign tumors arising from smooth muscle that can significantly impact patients’ quality of life. Over the past two decades, uterine artery embolization (UAE) has risen as a minimally invasive alternative treatment...
Background: Cellular vaccines, primarily monocyte-derived dendritic cells (MoDC), have recently been realized as therapeutic cancer vaccines with modest clinical efficacy. Understanding the mechanism by which these vaccines lead to antigen presentation...