Faculty Bibliography
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school:LISOM
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14180
Histology of amiodarone-induced liver injury revisited: A retrospective morphologic analysis
Amiodarone-induced liver injury (AILI) is a known risk of amiodarone therapy, with presentations ranging from asymptomatic aminotransferase elevations to severe or fatal hepatitis and cirrhosis. Due to limited understanding of its histopathologic features, we conducted a retrospective cross-sectional re-analysis of liver biopsy samples from patients on amiodarone from two centers. Of the 48 liver biopsy samples, 42 (87%) exhibited histologic evidence of AILI. All patients showed minimal or mild macrovesicular steatosis. Ballooned hepatocytes were observed in 36 cases (86%), with 25 (69%) displaying a periportal distribution, 8 (22%) centrilobular, and 3 (8%) panacinar in distribution. Mallory-Denk bodies were found in 36 samples (76%)-18 (50%) were numerous and 18 (50%) multiple. Cholestasis was present in 10 patients, 7 (70%) of whom died. In contrast, 10 (31%) of the 32 patients without cholestasis died. This represents a significantly increased mortality risk for patients with AILI and cholestasis (p = 0.03). While AILI shares features with the more generally known metabolic dysfunction-associated steatotic liver disease, our findings indicate that a prominence of periportal distribution of ballooned hepatocytes and Mallory-Denk bodies despite a minimum of macrovesicular steatosis are characteristic of AILI. Furthermore, cholestasis in biopsy samples may suggest a poorer prognosis in patients on amiodarone.
PMID: 41671912
ISSN: 1532-8198
CID: 6002282
Simufilam in Alzheimer's Disease: Assessment of Efficacy of a Controversial Drug in Human Neuronal Cell Culture
PMCID:12944517
PMID: 41754821
ISSN: 1424-8247
CID: 6010462
The International Guideline for the Definition, Classification, Diagnosis and Management of Urticaria
This update and revision of the international guideline for urticaria was developed in accordance with the methods recommended by Cochrane and the Grading of Recommendations Assessment, Development and Evaluation (GRADE) working group. It is an initiative of the Global Allergy and Asthma Excellence Network (GA2LEN) and its Urticaria and Angioedema Centers of Reference and Excellence (UCAREs and ACAREs), with the participation of 210 delegates from 107 national and international societies, from 59 countries. The consensus conference was held on December 6th, 2024. This guideline was acknowledged and accepted by the European Union of Medical Specialists (UEMS). Urticaria is a frequent, mast cell-driven disease, defined by a rapid appearance of wheals, angioedema, or both. The lifetime prevalence of acute urticaria is estimated to be approximately 20%. Chronic urticaria, categorized as either chronic spontaneous urticaria or chronic inducible urticaria, is disabling, impairs quality of life, and affects performance at work and school, however, novel therapies are available. This updated version of the international guideline for urticaria covers the definition and classification of urticaria and outlines expert-guided and evidence-based diagnostic and therapeutic approaches for the different subtypes of urticaria.
PMID: 41649409
ISSN: 1398-9995
CID: 6000592
Exploring Sex Differences in Stroke Outcomes: A Comprehensive Analysis From the SPAN 1 Trial
BACKGROUND:Stroke is a sexually dimorphic disease, with different risk factors, incidence, outcomes, and treatment responses in men and women. While sex differences have been documented in preclinical studies, these findings often come from single-site studies with small sample sizes and require validation across diverse research settings. METHODS:We used data from the SPAN (Stroke Preclinical Assessment Network), a randomized, placebo-controlled, blinded, multilaboratory trial, to determine if sex differences in neurological outcomes are present in preclinical stroke models. We analyzed data from 665 stroke animals treated with saline, including young mice, diet-induced obese mice, aging mice, young rats, and spontaneously hypertensive rats. We compared the corner test index and brain morphology between the sexes using linear random effect models and assessed the mortality rate using Cox proportional hazard regression models. RESULTS:No significant sex differences were found in neurological outcome measured with the corner test on either day 7 or day 30 after stroke, regardless of the mouse or rat stroke model used. Additionally, female and male mice exhibited similar infarct sizes on day 2 magnetic resonance imaging and on brain atrophy measures on day 30 after stroke, indicating a lack of sex differences in brain injury. Similarly, no sex differences were observed in acute or chronic sensorimotor or tissue outcomes in young rats. In 1 subanalysis, sex differences were seen in the spontaneously hypertensive rats cohort. Female rats exhibited a higher corner test index on day 30 than males, indicating more severe sensorimotor injury. CONCLUSIONS:In this multicenter preclinical study, we did not detect sex differences in stroke outcomes in mice, although sex differences in behavioral outcomes were observed in spontaneously hypertensive rats. These findings highlight that sex differences may be model-specific and subtle, emphasizing the need for methodological consistency and thoughtful inclusion of diverse animal models in translational stroke research to better understand if sex-specific responses contribute to stroke outcomes.
PMID: 41631765
ISSN: 2047-9980
CID: 5997812
Enhancing gastroenterology education through e-learning
E-learning has revolutionized medical education by providing flexible, accessible, and interactive learning opportunities. This article explores the transformative impact of e-learning on gastroenterology education, highlighting the advancements and benefits brought by the American Society for Gastrointestinal Endoscopy (ASGE) platforms. ASGE's e-learning platforms offer specialized content, interactive tools, and continuous updates, enhancing the learning experience for gastroenterologists.
PMID: 41632049
ISSN: 1097-6779
CID: 5999722
Against the Current: Celebrating Dr. Judah Folkman (1933-2008)
PMID: 41622510
ISSN: 1538-4683
CID: 5999432
Accountable Care Organization Efficiency on Entry and Shared Savings Bonuses
IMPORTANCE/UNASSIGNED:Spending benchmarks in the Medicare Shared Savings Program previously only considered an accountable care organization's (ACO) historical spending, potentially disadvantaging efficient organizations in favor of inefficient ones. To more sustainably reward efficient ACOs, benchmark calculation has evolved, such as the incorporation of average regional spending in 2017, but how benchmarking policy, and its changes, have affected the financial performance of ACOs across the efficiency spectrum remains unclear. OBJECTIVE/UNASSIGNED:To measure the association between ACO efficiency on entry (ie, the ratio of observed to expected spending) with earning a shared savings bonus. DESIGN, SETTING, AND PARTICIPANTS/UNASSIGNED:This cross-sectional study used a 20% national sample of Medicare claims to identify ACOs that participated in the Shared Savings Program for a minimum of 4 years between January 2013 and December 2020. ACOs were sorted in quartiles based on their observed to expected spending ratio in their first year of participants. Data analysis was conducted from July 2024 to May 2025. EXPOSURE/UNASSIGNED:Quartiles of ACO efficiency with a higher spending ratio denoting lower efficiency. MAIN OUTCOMES AND MEASURES/UNASSIGNED:The primary outcome was receipt of a shared savings bonus in the second, third, and fourth agreement years. Multivariable logistic regression was used to estimate the association between ACO efficiency quartiles and earning a bonus and how the regional benchmark adjustment in 2017 affected this association across measured agreement years. RESULTS/UNASSIGNED:Across 402 ACOs, the median (IQR) spending ratio was 1.000 (0.993- 1.005). After adjustment, the most efficient ACOs (ie, lowest quartile of the spending ratio) had an increased probability of earning a bonus from 24.4% (95% CI, 15.3%-33.4%) to 45.2% (95% CI, 35.4%-55.0%) after the 2017 introduction of the regional benchmark adjustment. However, the least efficient ACOs (ie, top quartile of the spending ratio) were significantly more likely to earn bonuses prior to (43.8%; 95% CI, 33.7%-53.9%) and after (60.7%; 95% CI, 51.3%-70.1%) the benchmarking change, without evidence that this gap narrowed. CONCLUSIONS AND RELEVANCE/UNASSIGNED:In this cross-sectional study, ACOs across the range of efficiency on entry had greater odds of earning bonuses after the introduction of the regional benchmark adjustment in 2017. However, less efficient ACOs had significantly greater odds of earning bonuses compared with more efficient ACOs, before and after the policy change.
PMCID:12947013
PMID: 41746643
ISSN: 2574-3805
CID: 6010372
Effect of Delayed Parathyroidectomy on Risk of Future Cardiovascular and Nephrolithiasis Interventions in Adults with Primary Hyperparathyroidism [Original Study]
OBJECTIVE:To determine whether the timing of parathyroid surgery impacts the risk of renal stone retreatment and cardiovascular interventions. SUMMARY BACKGROUND DATA/BACKGROUND:Long-term, untreated primary hyperparathyroidism is associated with significant morbidity including nephrolithiasis and cardiovascular disease. METHODS:We conducted a Population-based Cohort study of New York and California state-wide data from 2000-2020. Adult patients who underwent renal stone treatment and subsequently diagnosed with primary hyperparathyroidism (pHPT) and underwent parathyroidectomy (PTX) were included. Patients were excluded if PTX was prior to index stone procedure, they underwent second stone treatment within 6 months, with stage V CKD, with secondary or tertiary hyperparathyroidism, with prior kidney transplant or hemodialysis, or with prior cancer diagnosis. Rate of renal stone retreatment and cardiovascular interventions after PTX in pHPT patients with nephrolithiasis who underwent parathyroid surgery at ≤ 2 years and >2 years after index stone procedure was measured. RESULTS:We identified 2,093 patients who underwent first-time stone treatment and subsequent PTX. The median time to PTX was 560 days (IQR 187-1477) and follow-up was 7.4 years (IQR 4.5-13.1). Delaying PTX for more than 2 years increased the risk of renal stone retreatment by 59% (HR 1.59; P<0.001), increased the risk of experiencing coronary disease or associated interventions by 118% (HR=2.18; P=0.01), and increased the risk of experiencing an overall cardiovascular event by 52% (HR 1.52; P<0.01). CONCLUSIONS AND RELEVANCE/CONCLUSIONS:In symptomatic pHPT, delaying PTX significantly increases the risk of requiring future stone retreatment and cardiac/vascular surgical interventions. This highlights the importance of early surgical referral and multidisciplinary approaches to optimize outcomes and resource utilization in pHPT.
PMID: 39176567
ISSN: 1528-1140
CID: 5865572
Journal of the American Academy of Orthopaedic Surgeons. Global research & reviews. 2026:10(2).DOI: 10.5435/JAAOSGlobal-D-25-00187
Practice Patterns in Body Mass Index Optimization Among US Arthroplasty Surgeons: Results of a National American Association of Hip and Knee Surgeons Survey
INTRODUCTION/BACKGROUND:As total hip arthroplasty and total knee arthroplasty procedures are increasingly performed on younger patients with obesity, the optimal approach to preoperative weight management remains undefined. This study explores national trends among US arthroplasty surgeons regarding body mass index (BMI) cutoffs, weight optimization strategies, and weight loss medication usage. METHODS:A 28-question national survey was distributed through e-mail to members of the American Association of Hip and Knee Surgeons and shared on professional social media platforms (Facebook, ResearchGate, and LinkedIn) between January 1 and August 5, 2024. RESULTS:Regarding arthroplasty reconstruction fellowship training, 82.58% (441/534) of respondents were fellowship trained, 11.42% (61/534) were not fellowship trained, and 5.99% (32/534) trained in other specialties. In terms of BMI optimization strategies, 82.84% (n = 444/536) recommended structured diet and exercise programs, 77.99% (n = 418/536) recommended dietitian or weight loss specialist programs, and 52.61% (n = 282/536) advocated for bariatric surgery. For total hip arthroplasty, 45.13% of surgeons used a BMI cutoff <40 kg/m2 (n = 241/534), followed by 23.97% advocating for no strict cutoff (n = 128/534). For total knee arthroplasty, 41.65% reported using a cutoff of <40 kg/m2 (n = 222/533), with 24.39% (n = 130/533) reporting no strict BMI cutoff. In addition, 27.62% (n = 58/210) reported that their patients used weight loss medications such as GLP-1 agonists. Notably, 68.0% (n = 356/526) of surgeons allowed up to 1 to 2 years for BMI optimization before surgery. CONCLUSION/CONCLUSIONS:Although many arthroplasty surgeons use BMI cutoffs, many accommodate patients through nonsurgical interventions to facilitate weight loss. These findings indicate that many respondents report a multidisciplinary approach to preoperative BMI optimization.
PMCID:12915733
PMID: 41706617
ISSN: 2474-7661
CID: 6004762
Hidden Burden of Fallopian Tube Endometriosis: Prevalence and Associations with Pelvic Pathology
PMCID:12898751
PMID: 41682817
ISSN: 2077-0383
CID: 6002512
