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2. Thyroid

Author

Ramonell, Kimberly M., Silverman, Michael, Saunders, Neil, Sharma, Jyotirmay, Hazen, Benjamin J., editor, Maithel, Shishir K., editor, Rajani, Ravi R., editor, and Srinivasan, Jahnavi, editor

Published
2023
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3. Parathyroid

Author

Codner, Jesse, Ohamadike, Chijioke, Ramonell, Kimberly M., Saunders, Neil, Sharma, Joe, Hazen, Benjamin J., editor, Maithel, Shishir K., editor, Rajani, Ravi R., editor, and Srinivasan, Jahnavi, editor

Published
2023
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11. Pancreas

Author

Ramonell, Kimberly M., Patel, Snehal, and Skandalakis, Lee J., editor

Published
2021
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15. Molecular‐derived risk of malignancy and the related positive call rate of indeterminate thyroid cytology diagnoses as quality metrics for individual cytopathologists.

Author

Ohori, N. Paul, Cuda, Jacqueline M., Bastacky, Sheldon I., Yip, Linwah, Karslioglu‐French, Esra, Morariu, Elena M., Ullal, Jagdeesh, Ramonell, Kimberly M., Carty, Sally E., Nikiforov, Yuri E., Schoedel, Karen E., and Seethala, Raja R.

Abstract

Background: Indeterminate thyroid cytopathology diagnoses represent differing degrees of risk that are corroborated by follow‐up studies. However, traditional cytologic–histologic correlation may overestimate the risk of malignancy (ROM) because only a subset of cases undergo resection. Alternatively, some molecular tests provide probability of malignancy data to calculate the molecular‐derived risk of malignancy (MDROM) and the positive call rate (PCR). The authors investigated MDROMs and PCRs of indeterminate diagnoses for individual cytopathologists as quality metrics. Methods: This study was approved by the Department of Pathology Quality Improvement Program. Thyroid cytopathology diagnoses and ThyroSeq v3 results were retrieved for each cytopathologist for a 2‐year period with at least 3 years of follow‐up for the atypia of undetermined significance (AUS), follicular neoplasia (FN), and follicular neoplasia, oncocytic‐type (ONC) cytopathologic diagnoses. MDROMs and PCRs were compared with reference ROMs and cytologic–histologic correlation outcomes. Results: The overall MDROMs (and ranges for cytopathologists) for the AUS, FN, and ONC categories were 13.4% (range, 5.8%–20.8%), 28.1% (range, 22.1%–36.7%), and 27.0% (range, 19.5%–41.5%), respectively, and most individual cytopathologists' MDROMs were within reference ROM ranges. However, PCRs more effectively parsed the differences in cytopathologists' ROM performance. Although the overall PCRs were not significantly different across cytopathologists (p =.06), the AUS PCRs were quite different (p =.002). By cytologic–histologic correlation, six of 55 resected cases (10.9%) were falsely negative, and there were no false‐positive cases. Conclusions: MDROMs and PCRs evaluate concordance with reference ROMs and with one another and provide individual feedback, which potentially facilitates quality improvement. Cytopathologists' molecular‐derived risk of malignancy and positive call rates provide insights regarding their practice patterns when compared with reference ranges stated in the Bethesda System for Reporting Thyroid Cytopathology. This feedback is a useful tool from which systems improvement may be developed. [ABSTRACT FROM AUTHOR]

Published
2024
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16. Molecular‐derived risk of malignancy and the related positive call rate of indeterminate thyroid cytology diagnoses as quality metrics for individual cytopathologists

Author

Ohori, N. Paul, primary, Cuda, Jacqueline M., additional, Bastacky, Sheldon I., additional, Yip, Linwah, additional, Karslioglu‐French, Esra, additional, Morariu, Elena M., additional, Ullal, Jagdeesh, additional, Ramonell, Kimberly M., additional, Carty, Sally E., additional, Nikiforov, Yuri E., additional, Schoedel, Karen E., additional, and Seethala, Raja R., additional

Published
2023
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17. Molecular Testing Predicts Incomplete Response to Initial Therapy in Differentiated Thyroid Carcinoma Without Lateral Neck or Distant Metastasis at Presentation: Retrospective Cohort Study

Author

Liu, Jason B., primary, Baugh, Katherine A., additional, Ramonell, Kimberly M., additional, McCoy, Kelly L., additional, Karslioglu-French, Esra, additional, Morariu, Elena M., additional, Ohori, N. Paul, additional, Nikiforova, Marina N., additional, Nikiforov, Yuri E., additional, Carty, Sally E., additional, and Yip, Linwah, additional

Published
2023
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20. Junctional adhesion molecule-A deletion increases phagocytosis and improves survival in a murine model of sepsis

Author

Klingensmith, Nathan J., primary, Fay, Katherine T., additional, Swift, David A., additional, Bazzano, Julia M.R., additional, Lyons, John D., additional, Chen, Ching-wen, additional, Meng, Mei, additional, Ramonell, Kimberly M., additional, Liang, Zhe, additional, Burd, Eileen M., additional, Parkos, Charles A., additional, Ford, Mandy L., additional, and Coopersmith, Craig M., additional

Published
2022
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27. A single institution experience with papillary thyroid cancer: Are outcomes better at comprehensive cancer centers?

Author

Aryanpour, Zain, primary, Asban, Ammar, additional, Boyd, Carter, additional, Herring, Brendon, additional, Eustace, Nicholas, additional, Carmona Matos, Danilea M., additional, McCaw, Tyler, additional, Ramonell, Kimberly M., additional, Fazendin, Jessica M., additional, Lindeman, Brenessa, additional, Iyer, Pallavi, additional, and Chen, Herbert, additional

Published
2021
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33. Parathyroid Imaging Practices for Primary Hyperparathyroidism Without Previous Operations Among Endocrine Surgery Program Directors

Author

Obiarinze, Ruth, Chen, Herbert, Lindeman, Brenessa, Fazendin, Jessica, and Ramonell, Kimberly M.

Abstract

Background Attempts at preoperative localization of abnormal parathyroid gland(s) in primary hyperparathyroidism (pHPT) can be performed with a variety of modalities. Study utilization is surgeon-specific with highly variable opinions in parathyroid surgery. As more people are diagnosed with pHPT, the complexity of the disease has given rise to variation in management. This heterogeneity raises the question of the true clinical practice of imaging among individual endocrine surgeons.Methods To better understand the preoperative parathyroid imaging practices of endocrine surgeons, an email-based survey was disseminated to the program directors of 22 American Association of Endocrine Surgeons fellowship programs querying them on their initial diagnostic test of choice for pHPT. Clinical support team members from each respective program were subsequently contacted and answers were compared.Results Sixty-eight percent (15/22) of clinical team members recommended either an additional (12/15) or different imaging test (3/15) than what was recommended by their institution’s endocrine surgeon. The most common initial imaging test that was repeated by both the endocrine surgeon and clinical team member was neck ultrasound; 33% of clinical team members (7/22) responded concordantly to their surgeon with ultrasound as the initial recommendation.Discussion Significant variability exists in the preoperative approach to patients with hyperparathyroidism. Here, we demonstrate that inconsistency in preoperative imaging recommendations even extends to within an individual surgeon’s practice based on the impact of the clinical support team, highlighting the role for improved clinical protocols within an institution’s clinical team.

Published
2023
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39. Development and Validation of a Risk Calculator for Renal Complications after Colorectal Surgery Using the National Surgical Quality Improvement Program Participant Use Files

Author

Ramonell, Kimberly M., primary, Fang, Shuyang, additional, Perez, Sebastian D., additional, Srinivasan, Jahnavi K., additional, Sullivan, Patrick S., additional, Galloway, John R., additional, Staley, Charles A., additional, Lin, Edward, additional, Sharma, Jyotirmay, additional, Sweeney, John F., additional, and Shaffer, Virginia O., additional

Published
2016
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40. Attrition of memory CD8 T cells during sepsis requires LFA-1

Author

Serbanescu, Mara A, primary, Ramonell, Kimberly M, additional, Hadley, Annette, additional, Margoles, Lindsay M, additional, Mittal, Rohit, additional, Lyons, John D, additional, Liang, Zhe, additional, Coopersmith, Craig M, additional, Ford, Mandy L, additional, and McConnell, Kevin W, additional

Published
2016
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41. CXCR4 blockade decreases CD4+ T cell exhaustion and improves survival in a murine model of polymicrobial sepsis.

Author

Ramonell, Kimberly M., Zhang, Wenxiao, Hadley, Annette, Chen, Ching-wen, Fay, Katherine T., Lyons, John D., Klingensmith, Nathan J., McConnell, Kevin W., Coopersmith, Craig M., and Ford, Mandy L.

Subjects
*CHEMOKINE receptors, *SEPTICEMIA treatment, *T cells, *CD4 antigen, *MULTIPLE organ failure, *ANTI-inflammatory agents, *ANIMAL models in research
Abstract

Sepsis is a dysregulated systemic response to infection involving many inflammatory pathways and the induction of counter-regulatory anti-inflammatory processes that results in a state of immune incompetence and can lead to multi-organ failure. CXCR4 is a chemokine receptor that, following ligation by CXCL12, directs cells to bone marrow niches and also plays an important role in T cell cosignaling and formation of the immunological synapse. Here, we investigated the expression and function of CXCR4 in a murine model of polymicrobial sepsis. Results indicate that CXCR4 is selectively upregulated on naïve CD4+ and CD8+ T cells and CD4+ central memory T cells following the induction of sepsis, and that CXCR4 antagonism resulted in a significant decrease in sepsis-induced mortality. We probed the mechanistic basis for these findings and found that CXCR4 antagonism significantly increased the number of peripheral CD4+ and CD8+ T cells following sepsis. Moreover, mice treated with the CXCR4 antagonist contained fewer PD-1+ LAG-3+ 2B4+ cells, suggesting that blockade of CXCR4 mitigates CD4+ T cell exhaustion during sepsis. Taken together, these results characterize CXCR4 as an important pathway that modulates immune dysfunction and mortality following sepsis, which may hold promise as a target for future therapeutic intervention in septic patients. [ABSTRACT FROM AUTHOR]

Published
2017
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42. Comparative utility of preoperative imaging in normocalcemic versus hypercalcemic primary hyperparathyroidism.

Author

Montgomery KB, Gillis A, Ramonell KM, Fazendin JM, Lindeman B, and Chen H

Subjects
Humans, Calcium, Parathyroid Hormone, Retrospective Studies, Parathyroidectomy, Hyperparathyroidism, Primary diagnostic imaging, Hyperparathyroidism, Primary surgery, Hyperparathyroidism, Primary complications, Hypercalcemia complications
Abstract

Background: Normocalcemic primary hyperparathyroidism (PHPT) has been shown to benefit from parathyroidectomy. PHPT may be localized preoperatively with various imaging modalities, but the utility of preoperative imaging in normocalcemic PHPT compared to hypercalcemic PHPT is not well defined., Methods: Retrospective review was performed on all PHPT patients who underwent parathyroidectomy from 2001 to 2019. Patients were stratified into normocalcemic and hypercalcemic groups. Patient and outcomes data were analyzed., Results: All 2218 patients in this database were included. 433 patients had normocalcemic PHPT (19.5%) and 1785 had hypercalcemic PHPT (80.5%). Among normocalcemic patients, equivalent cure rates were seen between patients with preoperative imaging versus those without (100% vs 99%). No differences in postoperative complications were demonstrated except for a slightly increase in transient hypocalcemia in patients without imaging., Conclusions: Normocalcemic PHPT patients had equivalent cure and similar complication rates with or without preoperative imaging compared to hypercalcemic patients. Routine localization studies in normocalcemic PHPT may be safely omitted in favor of exploration with intraoperative adjuncts by experienced surgeons., (Copyright © 2022 Elsevier Inc. All rights reserved.)

Published
2023
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