A Single Center, Non-randomized Study to Evaluate the Safety and Efficacy of Left Gastric Artery Embolization, to Promote Short-term Weight Loss in Obese Patients With Nonalcoholic Steatohepatitis (NASH) and Thereby Improve NASH

Obesity is an epidemic in the US. With progression of obesity, Nonalcoholic steatohepatitis (NASH) has been a growing public health issue. Presently there is no cure for NASH.Prevention of progression of fibrosis in NASH is crucial, as they are at a high risk for cirrhosis and may need liver transplant.
Recent studies have shown that blocking blood vessels to a particular portion of the stomach (bariatric or left gastric artery embolization) can temporarily decrease levels of the appetite inducing hormone ghrelin, and result in weight loss.The purpose of this study is to determine if Left gastric artery embolization (LGAE) in patients with obesity and NASH leads to clinically significant weight loss with improvement of NASH.

Start Date01 Jun 2025

Sponsor / Collaborator

St. Louis University

NCT06859528

/ RecruitingNot ApplicableIIT

Step Up to PD: a Community-based Walking Program to for People with Parkinson's Disease.

This study will investigate the feasibility of a 6-month community walking program for people with Parkinson's disease (PwP) and their care partners in greater Saint Louis, Missouri region. The walking program will consist of weekly, organized walking groups at the Missouri Botanical Gardens. Participants in the program will use Nordic walking poles during the walks. The walking group(s) will meet once per week and will be supervised by walking group leaders from Saint Louis University. Participants will be given a smart watch to wear that will help step counts will be tracked in real-time. The program is designed to get PwP out of their homes, cultivate a culture of connection with others with Parkinson's disease (PD), and to be collectively accountable for a common goal toward increasing their physical and social engagement in their communities.

Start Date01 Apr 2025

Sponsor / Collaborator

St. Louis University

NCT06777823

/ Not yet recruitingNot ApplicableIIT

Rejection Sensitivity and Puberty in Mental Health Vulnerability to Social Media Experiences in Early Adolescent Girls

This longitudinal study is designed to test bidirectional relationships between preteen girls' mental health and social media experiences. We will explore how pubertal development and experiences of rejection influence these relationships.

Start Date01 Feb 2025

Sponsor / Collaborator

Washington University School of Medicine

[+2]

100 Clinical Results associated with St. Louis University

0 Patents (Medical) associated with St. Louis University

20,145

Literatures (Medical) associated with St. Louis University

01 Dec 2025·CHILDS NERVOUS SYSTEM

Intraoperative neuromonitoring is not a useful adjunct for Chiari malformation decompressive surgery: a cost–benefit and legal analysis

Article

Author: Lackland, Tyler N ; Mattei, Tobias A ; Patel, Mayur S ; Prim, Michael ; Botterbush, Kathleen S ; Shorey, Matthew ; Mercier, Philippe A ; Al-Hammadi, Noor

OBJECTIVES:

Posterior fossa decompression is currently an operative treatment of choice for Chiari Malformation I (CM1). However, there is controversy surrounding the possible benefits of employing intraoperative neuromonitoring (INM) for this type of procedure. In addition to presenting our single-center experience on the use of INM, we analyze the cost associated with INM in Chiari Malformation (CM) decompression surgery using the Healthcare Cost and Utilization Project (HCUP) database and discuss the legal implications of somatosensory evoked potentials (SSEP) monitoring during decompression for CM1.

METHODS:

We conducted a retrospective review of all patients undergoing CM1 decompression with SSEP neuromonitoring from 2011 to 2018. We collected patient characteristics, hospital charges, and surgical cost data from the HCUP database for patients undergoing CM decompression. Finally, we performed a review within the Thompson Reuters Westlaw Edge database for reported litigation involving INM for CM decompression.

RESULTS:

None of the 110 patients submitted to surgery for CM1 at our institution had any significant SSEP changes intraoperatively or developed post-operative neurological deterioration. There were higher mean total hospital charges and surgical costs associated with INM ($31,272) for patients who received INM compared to patients who did not receive INM ($24,112). A careful review of the Westlaw database with multiple-word search strategies revealed no reported medical malpractice claims regarding the absence of SSEP neuromonitoring in a CM decompression procedure.

CONCLUSION:

Using data collected at our institution and the HCUP national database, we showed that intraoperative neuromonitoring did not affect surgical planning and decision-making or post operative care, while adding unnecessary costs to CM decompression procedures. The absence of reported malpractice claims targeting the lack of neuromonitoring in CM cases suggests that SSEP neuromonitoring during CM may be unnecessary. We propose that neuromonitoring should not be used for routine CM decompression.

01 Mar 2025·CLINICAL IMAGING

Management of renal cell carcinoma with ablation in comparison to nephrectomy: A 5-year analysis of inpatient procedural data to evaluate utilization disparities in the United States

Article

Author: Brea, Allison ; Davis, Samuel R ; Elhakim, Tarig S ; Uppot, Raul N ; Daye, Dania ; Dezube, Michael ; Mort, Ana ; Fidelis, Wilton ; Mohagheghtabar, Maryam ; Tabari, Azadeh ; Arellano, Ronald S ; Lodhi, Taha

PURPOSE:

To perform a nationwide analysis of ablation compared to partial and total nephrectomy for the management of renal cell carcinoma (RCC) to evaluate utilization trends and disparities in the USA.

MATERIALS AND METHODS:

The 2016-2020 National Inpatient Sample was analyzed. Using ICD-10, we identified the diagnosis of RCC then analyzed the utilization trends of ablation and nephrectomies (both partial and complete). To determine if any disparities exist, a multivariate logistic regression was performed to assess the influence of age, sex, race, income, payer, illness severity, geographical location, and hospital factors.

RESULTS:

From the 183,885 inpatient encounters with RCC, 3045 (1.65 %) underwent ablation, 70,080 (38.1 %) underwent partial nephrectomy, and 110,760 (60.2 %) underwent total nephrectomy. There was no significant difference in the sex between all groups. There was a statistically significant difference in the mean age of those undergoing ablation (67.30, SD = 12.05) versus those undergoing partial nephrectomy (59.27, SD = 13.26) and total nephrectomy (62.22, SD = 14.42) (OR: 1.04, 95%CI: 1.03-1.05, P < 0.001). Compared to White patients, Hispanic and African Americans were more likely to undergo ablation versus nephrectomy (OR: 1.52, 95%CI: 1.16-1.98, P = 0.002 and OR: 1.65, 95%CI: 1.28-2.13, P < 0.001, respectively). Compared to patients on private insurance, those on Medicaid and Medicare were more likely to have ablation than nephrectomy (OR: 1.85, 95%CI: 1.31-2.61, P < 0.001, and OR: 1.62, 95%CI: 1.26-2.08, P < 0.001, respectively). Furthermore, patients were less likely to undergo ablation than nephrectomies in 2020 compared to 2016 (OR: 0.69, 95%CI: 0.53-0.90, P = 0.006).

CONCLUSION:

Since 2016, there has been a decreasing trend in the use of ablation for treating RCC in hospitalized patients. Those undergoing ablation tend to be older, African American, Hispanic, and insured by Medicare or Medicaid. Further research is needed to ensure equitable access for optimal treatment of RCC.

01 Mar 2025·AMERICAN HEART JOURNAL

Rationale and design of the DEFIANCE study: A randomized controlled trial of mechanical thrombectomy versus anticoagulation alone for iliofemoral deep vein thrombosis

Article

Author: Pereira, Keith ; Black, Stephen ; Marko, Xhorlina ; D'Souza, Donna ; Tu, Thomas ; Weinberg, Ido ; Noor, Sonya ; Markovitz, Craig D ; Abramowitz, Steven D ; Rosenberg, Stuart P ; Silver, Mitchell J

BACKGROUND:

Deep vein thrombosis (DVT) is a common medical condition that is associated with clinically significant sequelae, including postthrombotic syndrome (PTS). Anticoagulation alone remains the guideline-recommended treatment for many patients with iliofemoral DVT. Recent technological advances have led to an increase in the use of mechanical thrombectomy for DVT, but mechanical thrombectomy-based procedures have not yet been compared with standard-of-care anticoagulation therapy in randomized studies.

METHODS:

The DEFIANCE study (ClinicalTrials.gov: NCT05701917) is an international and actively enrolling randomized controlled trial (RCT) in lower extremity DVT assessing an interventional strategy that includes mechanical thrombectomy with the ClotTriever System (Inari Medical, Irvine, CA) versus anticoagulation alone. Approximately 300 patients with unilateral iliofemoral DVT and symptom duration ≤ 12 weeks will be randomized 1:1. Study conduct includes an independent core laboratory for duplex ultrasound assessment, an independent medical monitor for safety adjudication, and evaluation of PTS severity on the Villalta scale using best clinical practices. The primary endpoint is a composite outcome structured as a hierarchal win ratio of 1) the occurrence of treatment failure or therapy escalation as adjudicated by the medical monitor, with failure defined as amputation or gangrene of the target leg or venous thromboembolism-related mortality, and 2) the assessment of PTS severity at the 6-month follow-up visit. In addition to being a component of the primary endpoint, the severity of PTS at 6 months is also evaluated as a stand-alone secondary endpoint. An additional secondary endpoint is a composite of outcomes at the 10-day visit and is structured as a hierarchal win ratio of 1) vessel compressibility on duplex ultrasound, 2) patient-reported pain, and 3) improvement of edema. The safety endpoints are access site complications requiring endovascular or surgical repair and the occurrence through the 30-day visit of mortality, major bleeding, or new symptomatic pulmonary embolism.

CONCLUSIONS:

DEFIANCE will be the first RCT to evaluate a mechanical thrombectomy-based interventional approach versus anticoagulation therapy alone for DVT. The results will inform the treatment of patients with iliofemoral DVT and the prevention of PTS-associated morbidity.

TRIAL REGISTRATION:

DEFIANCE: RCT of ClotTriever System Versus Anticoagulation In Deep Vein Thrombosis (DEFIANCE), ClinicalTrials.gov: NCT05701917, URL: https://clinicaltrials.gov/study/NCT05701917?cond=Deep%20Vein%20Thrombosis&term=defiance&rank=1.

News (Medical) associated with St. Louis University

13 Nov 2024

·www.drugs.com

Palliative Care Use Low in Patients With Heart Failure

WEDNESDAY, Nov. 13, 2024 -- Use of palliative care for heart failure remains low in the United States, according to a study recently published online in the Journal of the American Heart Association . Zidong Zhang, Ph.D., from the Saint Louis University School of Medicine, and colleagues investigated national palliative care use for adults with heart failure. A national all‐payer electronic health record database was used to identify 127,712 adults with newly diagnosed heart failure (2011 to 2018) and to determine when they received their first palliative care consultation and the associations with clinical factors following diagnosis of heart failure. During a median 792 days of follow-up, 18.3 percent of patients received palliative care consultation in five years. The researchers found that shorter time to receive palliative care consultation was associated with diagnoses of heart failure in 2016 to 2018 (compared with 2010 to 2015: adjusted hazard ratio [aHR], 1.421), as well as advanced heart failure diagnosis (aHR, 2.065), cardiogenic shock (aHR, 2.587), implantable cardioverter‐defibrillator use (aHR, 5.718), and visits at academic medical centers (aHR, 1.439). There was variance in palliative care uptake for early/moderate heart failure stages by race, geographics, payer, and selection of advanced treatments. "Barriers to palliative care should [be] addressed at a systemic level, including educating patients and providers on the role and benefits of palliative care consultation, expanding the palliative care service availability, making consensus practice guidelines, and reforming the payment method," the authors write. Abstract/Full Text Whatever your topic of interest, subscribe to our newsletters to get the best of Drugs.com in your inbox.

AHA

23 Sep 2024

·www.healthcareitnews.com

HMIS integration with other public HIS sought and more India briefs

Integration of HMIS, other HIS portals sought India's Union Health secretary Apurva Chandra has called for the integration of the country's Health Management Information System with other health information systems in the public sector. This is to "reduce the burden of work of health functionaries and to ensure that the data are uploaded timely and analysed carefully," he said. The call followed the release of this year's Health Dynamics of India, a document that serves as a source of information on manpower and infrastructure within the National Health Mission. University of Mumbai launches AI project targeting PCOS, women's cancer The University of Mumbai seeks to develop AI models for the early detection of diseases in women. It was reported that the university has been reaching out to hospitals to form a network where it can tap patient case studies in building AI models. The AI, for example, could be utilised to gain a better understanding of polycystic ovary syndrome among Indian women. AI models to support the diagnosis of breast cancer and cervical cancer are also being considered. Besides hospitals, the University of Mumbai also seeks partnerships with other higher education institutions; it has recently signed memoranda of understanding with Purdue University and Saint Louis University and is looking to onboard the Indian Institute of Technology Bombay, which is currently working on a similar project. AI course for healthcare professionals launched The International Institute of Information Technology Hyderabad, one of India's leading institutes for AI research, has recently launched an online course on the basics of AI for healthcare professionals. With over 200 enrollees, the 12-week course aims to equip learners with the required skills to understand, evaluate, and apply AI technologies in clinical settings. The AI for Medical Professionals course, developed in collaboration with the institute's IHub-Data and the National Academy of Medical Sciences, will also offer certification. Cytecare Hospitals digitises staff training Cytecare Hospitals, a private surgical and cancer treatment centre in Bangalore, has partnered with MedLern to digitise healthcare staff training. Through their partnership, Cytecare's training protocols offer updated learning resources and digital training workflows. The digitised training programme has also supported Cytecare's recent completion of the audit of the National Accreditation Board for Hospitals and Healthcare Providers, which ensures the highest safety and quality standards of care for hospitals in India.

12 Sep 2024

·www.globenewswire.com

VitalCaring’s AI-driven Cognitive Care Pilot Shows Promising Results

National leader in home health and hospice care to extend AI-enabled speech, language, and cognitive therapy initiative across its networkDALLAS and LEXINGTON, Mass., Sept. 12, 2024 (GLOBE NEWSWIRE) -- VitalCaring, a leading national home health and hospice care provider, has unveiled the results of a seven-month AI-driven cognitive care pilot program that delivered enhanced personalized therapy to patients living with cognitive disorders. Through the pilot, VitalCaring deployed Constant Therapy’s digital speech, language, and cognitive therapy platform as part of its home-based services for select patients. Significant cognitive gains Patients in the program showed statistically significant cognitive improvements, including: A 35% increase in Montreal Cognitive Assessment (MoCA)* (average score)A 33% increase in Saint Louis University Mental Status (SLUMS)* (average score)Improvement by at least one cognitive level (55% of patients)Achievement of normal cognitive functional score by discharge (35% of patients) “This pilot program was tailored to fast-track our patients’ journey to regaining independence safely in their homes,” said Janice Riggins, Chief Clinical Officer at VitalCaring. “Adding innovative tools like the Constant Therapy platform to our existing care plans for cognitive issues and neurological disorders extends the exceptional work of our therapists.” A valuable complement to clinician-supervised therapy Patients’ ability to independently access Constant Therapy’s therapeutic exercises at home has proven to be a valuable and meaningful complement to clinician-supervised therapy. The aim of the VitalCaring Cognitive Care pilot program was to determine how additional therapy tools could accelerate recovery and maximize cognitive functioning for VitalCaring patients with dementia-related diseases or those recovering from stroke or other brain injuries. On average, each patient in the pilot program was able to access an additional 11 hours of digital therapy on their own. Due to the success of this pilot, VitalCaring will explore opportunities to extend the initiative across its network. “VitalCaring stands at the forefront of home healthcare innovation, transforming patient experiences and outcomes with advanced technological and analytical approaches,” said Veera Anantha, Founder and CEO of Constant Therapy Health. Our platform supports their practice of providing outstanding, individualized treatment to patients affected by neurological conditions or brain injuries.” What Caregivers and Family are Saying: “My mother’s ability to hold conversations with friends and family improved significantly after using the AI-driven tools.” The patient’s MoCA score rose from 16 to 27 – moderate cognitive impairment to normal cognitive ability.“Thanks to the AI therapy, my uncle regained his motor skills. He can now operate mobile phones and stay connected with loved ones.” The patient’s MoCA score improved from 14 to 26 – moderate cognitive impairment to normal cognitive ability.“Our family noticed remarkable cognitive improvements in my grandfather. He’s better at following events and recalling important information.” The patient’s MoCA score jumped from 17 to 25 – moderate to mild cognitive impairment. About the VitalCaring Cognitive Care Pilot ProgramThe pilot program ran from October 2023 through May 2024 and included 52 patients aged 54 to 92, with an average age of 77.45. Patients had various primary diagnoses, including cerebral infarction, brain tumors, dementia (including Alzheimer’s disease), Parkinson’s disease, encephalitis, encephalopathy, and mild cognitive impairment (MCI). Patients’ performance was measured by the Montreal Cognitive Assessment/MoCA and the Saint Louis University Mental Status/SLUMS cognitive screening. About Constant Therapy Health Constant Therapy Health is a next-generation digital health company whose technology is clinically proven to improve the efficacy of cognitive, speech, and language therapy, as well as increase access to and reduce the cost of therapy. Constant Therapy, an award-winning mobile program, uses patented AI technology to deliver personalized exercises that rebuild cognitive and speech function for individuals recovering from stroke or traumatic brain injury (TBI) or living with aphasia, dementia, and other neurological conditions. Built by a team of top neuroscientists at Boston University, Constant Therapy is used by tens of thousands of patients as prescribed by their clinicians, helping to create the world’s largest brain rehabilitation database, and providing insights that can improve the effectiveness and efficiency of brain rehabilitation. About VitalCaring VitalCaring delivers compassionate, high-quality home-based healthcare to patients in the comfort of their own homes. By bringing together like-minded people who are called to care and supported by a positive organizational culture, VitalCaring is positioned to deliver an exceptional patient experience at every encounter. VitalCaring is a national leader in the home health and hospice industry, serving patients throughout the Southern United States, including Texas, Oklahoma, Louisiana, Mississippi, Alabama, and Florida. From its base in the South, VitalCaring is expanding to serve even more communities nationwide. Media Contacts For More Information: Nancy LecroyKelly FavilleVP, Marketing & CommunicationsFourSeventeen CommunicationsVitalCaringOn behalf of Constant Therapy HealthO 469.839.3777M 978-621-6667Nancy.lecroy@vitalcaring.comkelly@constanttherapy.com PDF available: http://ml.globenewswire.com/Resource/Download/8be6ba46-3c72-477a-8984-9805e622c611 Photos accompanying this announcement are available at: https://www.globenewswire.com/NewsRoom/AttachmentNg/9ae6af81-a04e-4de4-964b-acdb345f44e5 https://www.globenewswire.com/NewsRoom/AttachmentNg/38d0d694-5797-4dfa-a3a6-d9ce3adbfc66 https://www.globenewswire.com/NewsRoom/AttachmentNg/e7a21ad3-3950-479b-a908-53429ed84de2

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SLU-PP-915 ( Estrogen-related receptors )	Metabolic Diseases More	Preclinical
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