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Increased copeptin may reflect vasopressin-related metabolic changes after bariatric surgery

Galbiati, Francesca; Becetti, Imen; Lauze, Meghan; Aulinas, Anna; Singhal, Vibha; Bredella, Miriam A; Lawson, Elizabeth A; Misra, Madhusmita
OBJECTIVE:Mechanisms underlying metabolic improvement following metabolic and bariatric surgery (MBS) may provide insight into novel therapies. Vasopressin improves body composition and protects against hypoglycemia. Associations of copeptin, a stable cleavage product of vasopressin, with BMI and insulin resistance suggest an adaptive increase in vasopressin to counteract metabolic disruption. To our knowledge, no study has investigated copeptin before and after MBS in humans. This study's aim was to investigate copeptin changes following MBS and associations with metabolic parameters. METHODS:) undergoing MBS (n = 34) or nonsurgical (NS) lifestyle management (n = 30). Fasting copeptin, hemoglobin A1c (HbA1c), homeostatic model assessment for insulin resistance (HOMA-IR), body composition, and resting energy expenditure (REE) were assessed. RESULTS:Over 12 months, copeptin increased more (time-by-treatment p = 0.017) whereas HbA1c and adiposity decreased more after MBS than NS (ps ≤ 0.036). Copeptin changes correlated negatively with percentage fat mass and REE changes (rho ≤ -0.29; ps ≤ 0.025) in the whole group, and they correlated positively with HbA1c and HOMA-IR (rho ≥ 0.41; false discovery rate-adjusted p = 0.05) and negatively with REE changes (rho = -0.55; false discovery rate-adjusted p = 0.036) in the MBS group. CONCLUSIONS:Increases in copeptin after weight loss in MBS compared with NS were associated with lower REE and higher HbA1c/HOMA-IR values. Vasopressin may contribute to MBS-related metabolic modifications.
PMID: 39725569
ISSN: 1930-739x
CID: 5767812

Changes in pancreatic steatosis by computed tomography 24 months after sleeve gastrectomy in youth with severe obesity

Becetti, Imen; Lopez Lopez, Ana Paola; Galbiati, Francesca; Pedreira, Clarissa C; Lauze, Meghan; Carreno, Karen Olivar; Huber, Florian A; Bitoun, Olivier; Lee, Hang; Carmine, Brian; Singhal, Vibha; Misra, Madhusmita; Bredella, Miriam A
BACKGROUND:Pancreatic steatosis has been associated with obesity and the metabolic syndrome. Studies in adults have demonstrated improvement in pancreatic steatosis following sleeve gastrectomy (SG) with concomitant improvement in glucose homeostasis. OBJECTIVES/OBJECTIVE:To examine changes in pancreatic steatosis in youth with severe obesity 24 months following SG. SETTING/METHODS:Academic hospital system. METHODS:Forty-seven youth (13-24 years) with severe obesity (37 females) were followed for 24 months; 23 had SG and 24 were nonsurgical (NS) controls. Attenuations of the pancreas and spleen were measured using computed tomography (CT) at baseline, 12- and 24-month follow-up. Subjects underwent magnetic resonance imaging (MRI) for subcutaneous and visceral adipose tissue (SAT, VAT), dual energy x-ray absorptiometry (DXA) for body composition, blood sampling for glycated hemoglobin (A1C), and fasting and postprandial insulin and glucose. Linear mixed effects (LMEs) models were used to compare within- and between-group changes over 24 months. RESULTS:At baseline, SG had higher body mass index (BMI) versus NS (P = .033). Over 24 months, significant reductions were noted in weight, BMI, VAT, SAT, fat mass (FM), and lean mass (LM) in the SG versus NS groups (P ≤ .0001). There was a significant 24-month decrease in pancreatic steatosis in the SG group (P = .006). In the whole group, 24-month reductions in pancreatic steatosis correlated with BMI and FM decreases. No associations were found between pancreatic steatosis and glucose homeostasis parameters. CONCLUSIONS:Pancreatic steatosis measured by CT improved after SG in youth. Further studies are needed to understand the relationship between pancreatic steatosis and glucose homeostasis.
PMCID:11645188
PMID: 39358180
ISSN: 1878-7533
CID: 5762112

Corrigendum to "Original Article: The history of Women in Radiology (WIR) programs at two academic institutions: How we did it and how we merged best practices" [Current Problems in Diagnostic Radiology 54 (2025) 35-39]

Smith, Stacy E; Daye, Dania; Alvarez, Carmen; Magudia, Kirti A; Phillips, Catherine H; Rincon, Sandra; Bredella, Miriam A; Victoria, Teresa
PMID: 39732599
ISSN: 1535-6302
CID: 5768012

The history of Women in Radiology (WIR) programs at two academic institutions: How we did it and how we merged best practices

Smith, Stacy E; Daye, Dania; Alvarez, Carmen; Magudia, Kirti A; Phillips, Catherine H; Rincon, Sandra; Bredella, Miriam A; Victoria, Teresa
RATIONALE/BACKGROUND:The percentage of women in radiology has remained at 25 % for decades. Our institutions identified the need to recruit, support and retain women in our departments in order to change this status quo. METHODS:Our institutions created two different frameworks for Women in Radiology (WIR) programs in order to meet the needs of each distinct department. The organizational structure (trainee led vs faculty led and hybrid), the need for departmental chair support, and types of events and speakers are outlined with unique programs provided by each institution. Collaboration with established programs for women within the institutions and within the region was utilized to support the developing programs. RESULTS:Each of the (WIR) programs has been successful in creating community, impact and sustainable programming, including a peer and faculty mentoring programs for all genders, improvements in gender equity in the workplace, the implementation of trainee parental support programs, and an overall increase in the percentage of women trainees and faculty. Over the last 3 years, the integration of the two programs into a single Women in Radiology program, also encompassing the new enterprise radiology group, has led the way during the initiation of a large institutional merger from two institutions to one large institution. OUTCOMES/RESULTS:We have provided two frameworks for developing a successful women in radiology program as well as a roadmap for combining best practices in a time of change and institutional merger at a major academic institution.
PMID: 39608928
ISSN: 1535-6302
CID: 5763592

Metabolic Adaptation and Its Determinants in Adolescents Two Years After Sleeve Gastrectomy

Singhal, Vibha; Pedreira, Clarissa C; Tuli, Shubhangi; Abou Haidar, Lea; Lopez, Ana Lopez; Lauze, Meghan; Lee, Hang; Bredella, Miriam A; Misra, Madhusmita
PMCID:11722852
PMID: 39796509
ISSN: 2072-6643
CID: 5775442

Cortisol/Cortisone Ratio in Youth with Obesity One Year Following Sleeve Gastrectomy

Lopez Lopez, Ana Paola; Lauze, Meghan; Bredella, Miriam A; Misra, Madhusmita; Singhal, Vibha
PMID: 39163292
ISSN: 1557-8518
CID: 5680592

Status and perceptions of work from home in three academic musculoskeletal radiology divisions

Smith, Stacy E; Bredella, Miriam A; Collins, Jamie E; Deshmukh, Swati D
OBJECTIVE:The objective of this study is to assess the status and perception of work from home (WFH) in three academic musculoskeletal radiology divisions. MATERIALS AND METHODS/METHODS:A 17-item anonymous online survey related to WFH was administered to all musculoskeletal (MSK) faculty (n = 27) of three academic radiology divisions between April and July 2023. Survey items included demographics, clinical work environment, presence of a WFH policy, number of days WFH and desired WFH days, commute, perceived benefits and drawbacks of WFH, and symptoms of burnout. Statistical analysis included the Cochrane-Armitage trend test and Fisher exact test. The study was exempt from IRB approval. RESULTS:The survey response rate was 85% (57% men, 57% white, 57% established career, defined by > 10 years in practice). In 47%, an informal policy allowed WHF on certain rotations including moonlighting/call. Seventeen percent had no opportunity to WFH. WFH 1-2 days/week was reported in 73% of respondents while 27% did not WFH. None of the respondents worked from home more than 2 days/week. Women worked from home more compared to men (p = 0.02). Perceived advantages of WFH included efficiency (no commute/parking) (76%), flexibility (52%), autonomy (33%), and increased productivity (29%). Fifty-seven percent preferred in-person read out particularly for first year trainees, with 52% preferring a virtual or hybrid model. CONCLUSION/CONCLUSIONS:WFH is common in academic MSK practices and perceived to be beneficial to MSK faculty. These findings should be taken into consideration when designing WFH policies.
PMID: 39289200
ISSN: 1432-2161
CID: 5720602

Status and perceptions of work from home in three academic musculoskeletal radiology divisions

Smith, Stacy E; Bredella, Miriam A; Collins, Jamie E; Deshmukh, Swati D
OBJECTIVE:The objective of this study is to assess the status and perception of work from home (WFH) in three academic musculoskeletal radiology divisions. MATERIALS AND METHODS/METHODS:A 17-item anonymous online survey related to WFH was administered to all musculoskeletal (MSK) faculty (n = 27) of three academic radiology divisions between April and July 2023. Survey items included demographics, clinical work environment, presence of a WFH policy, number of days WFH and desired WFH days, commute, perceived benefits and drawbacks of WFH, and symptoms of burnout. Statistical analysis included the Cochrane-Armitage trend test and Fisher exact test. The study was exempt from IRB approval. RESULTS:The survey response rate was 85% (57% men, 57% white, 57% established career, defined by > 10 years in practice). In 47%, an informal policy allowed WHF on certain rotations including moonlighting/call. Seventeen percent had no opportunity to WFH. WFH 1-2 days/week was reported in 73% of respondents while 27% did not WFH. None of the respondents worked from home more than 2 days/week. Women worked from home more compared to men (p = 0.02). Perceived advantages of WFH included efficiency (no commute/parking) (76%), flexibility (52%), autonomy (33%), and increased productivity (29%). Fifty-seven percent preferred in-person read out particularly for first year trainees, with 52% preferring a virtual or hybrid model. CONCLUSION/CONCLUSIONS:WFH is common in academic MSK practices and perceived to be beneficial to MSK faculty. These findings should be taken into consideration when designing WFH policies.
PMID: 39289200
ISSN: 1432-2161
CID: 5720612

Status and perceptions of work from home in three academic musculoskeletal radiology divisions

Smith, Stacy E; Bredella, Miriam A; Collins, Jamie E; Deshmukh, Swati D
OBJECTIVE:The objective of this study is to assess the status and perception of work from home (WFH) in three academic musculoskeletal radiology divisions. MATERIALS AND METHODS/METHODS:A 17-item anonymous online survey related to WFH was administered to all musculoskeletal (MSK) faculty (n = 27) of three academic radiology divisions between April and July 2023. Survey items included demographics, clinical work environment, presence of a WFH policy, number of days WFH and desired WFH days, commute, perceived benefits and drawbacks of WFH, and symptoms of burnout. Statistical analysis included the Cochrane-Armitage trend test and Fisher exact test. The study was exempt from IRB approval. RESULTS:The survey response rate was 85% (57% men, 57% white, 57% established career, defined by > 10 years in practice). In 47%, an informal policy allowed WHF on certain rotations including moonlighting/call. Seventeen percent had no opportunity to WFH. WFH 1-2 days/week was reported in 73% of respondents while 27% did not WFH. None of the respondents worked from home more than 2 days/week. Women worked from home more compared to men (p = 0.02). Perceived advantages of WFH included efficiency (no commute/parking) (76%), flexibility (52%), autonomy (33%), and increased productivity (29%). Fifty-seven percent preferred in-person read out particularly for first year trainees, with 52% preferring a virtual or hybrid model. CONCLUSION/CONCLUSIONS:WFH is common in academic MSK practices and perceived to be beneficial to MSK faculty. These findings should be taken into consideration when designing WFH policies.
PMID: 39289200
ISSN: 1432-2161
CID: 5720592

AI-based opportunistic quantitative image analysis of lung cancer screening CTs to reduce disparities in osteoporosis screening

Huber, Florian A; Bunnell, Katherine M; Garrett, John W; Flores, Efren J; Summers, Ronald M; Pickhardt, Perry J; Bredella, Miriam A
Osteoporosis is underdiagnosed, especially in ethnic and racial minorities who are thought to be protected against bone loss, but often have worse outcomes after an osteoporotic fracture. We aimed to determine the prevalence of osteoporosis by opportunistic CT in patients who underwent lung cancer screening (LCS) using non-contrast CT in the Northeastern United States. Demographics including race and ethnicity were retrieved. We assessed trabecular bone and body composition using a fully-automated artificial intelligence algorithm. ROIs were placed at T12 vertebral body for attenuation measurements in Hounsfield Units (HU). Two validated thresholds were used to diagnose osteoporosis: high-sensitivity threshold (115-165 HU) and high specificity threshold (<115 HU). We performed descriptive statistics and ANOVA to compare differences across sex, race, ethnicity, and income class according to neighborhoods' mean household incomes. Forward stepwise regression modeling was used to determine body composition predictors of trabecular attenuation. We included 3708 patients (mean age 64 ± 7 years, 54 % males) who underwent LCS, had available demographic information and an evaluable CT for trabecular attenuation analysis. Using the high sensitivity threshold, osteoporosis was more prevalent in females (74 % vs. 65 % in males, p < 0.0001) and Whites (72 % vs 49 % non-Whites, p < 0.0001). However, osteoporosis was present across all races (38 % Black, 55 % Asian, 56 % Hispanic) and affected all income classes (69 %, 69 %, and 91 % in low, medium, and high-income class, respectively). High visceral/subcutaneous fat-ratio, aortic calcification, and hepatic steatosis were associated with low trabecular attenuation (p < 0.01), whereas muscle mass was positively associated with trabecular attenuation (p < 0.01). In conclusion, osteoporosis is prevalent across all races, income classes and both sexes in patients undergoing LCS. Opportunistic CT using a fully-automated algorithm and uniform imaging protocol is able to detect osteoporosis and body composition without additional testing or radiation. Early identification of patients traditionally thought to be at low risk for bone loss will allow for initiating appropriate treatment to prevent future fragility fractures. CLINICALTRIALS.GOV IDENTIFIER: N/A.
PMCID:11227387
PMID: 38925254
ISSN: 1873-2763
CID: 5684912