Matthias Holdhoff, M.D., Ph.D.

• Associate Professor of Oncology

https://www.hopkinsmedicine.org/profiles/results/directory/profile/5037896/matthias-holdhoff

A1805 P544 Admission Rate and Outcome of Patients with Major P558 the Association of Mean Platelet Volume and Red Cell Psychiatric Disorders in the Intensive Care Unit/D menopause 54 generic xeloda 500 mg with amex. A1794 P560 Respira to ry Quotient and Arterial-Venous Oxygen Content Difference Are Poorly Correlated with Arterial Lactate in Septic P547 Sepsis Management: the Association of Antibiotics Prior to Shock Patients/A womens health 8 week challenge order cheap xeloda line. A1795 P561 Dysnatremia Is Associated with Increasing Mortality in the P548 Extended Spectrum Beta-Lactamase Infection: Determining Critically Ill Patients: A Systematic Review and Meta-Analysis/ Risk Fac to rs for Mortality/J pregnancy zits generic xeloda 500mg visa. A1798 P564 Risk Fac to rs for Early Mortality in an Academic Intensive Care P551 A Novel Fluid Resuscitation Pro to col for the Treatment of Unit/C the women's health big book of yoga pdf download buy xeloda 500mg on-line. A1814 P552 Impact of Early Aggressive Volume Resuscitation in Septic Patients Admitted to a Hospital Ward/T. A1815 P553 Normal Saline Vs Normosol in the Resuscitation of Septic Patients: A Retrospective Cohort Study/R. A1801 the information contained in this program is up to date as of March 9, 2017. P570 the Epidemiology of Psychiatric Illness in Survivors of Critical Mauriello, M. A1827 Illness in Korea A National Health Insurance Database Study, 2009 2014/C. A1820 P1286 Candida Glabrata Empyema Secondary to Massive Esophageal P573 Immune Status and SeMo Score Predict Outcomes in Patients Perforation/M. A1833 P575 Predicting 24-Hour Mortality After Inter-Hospital Transfer to a Tertiary Medical Intensive Care Unit: A Single-Center Facilita to rs: S. A1837 Discussion: 11:15-12:00: authors will be present for individual discussion P1293 A Rare Case of Adult Community-Acquired Escherichia Coli 12:00-1:00: authors will be present for discussion with assigned facilita to rs Meningitis as a Complication of Bacteremia and Urinary Tract Infection/S. A1839 the information contained in this program is up to date as of March 9, 2017. A1840 Necrotizing Fasciitis Due to Actinomycosis in a Sickle Cell Disease Patient/P. A1843 P1314 Marked Metabolic Acidosis Secondary to Proteus Urine Infection in an Indiana Pouch/S. A1861 P1301 Septic Shock and Shock Gut from Strep to coccus pyogenes P1317 Uncommon Cause of Respira to ry Failure in Oklahoma/H. A1862 Pulmonary Embolism in the Setting of Septic Shock, Septic P1318 Pneumocephalus Secondary to Spontaneous Dissemination of Arthritis, Bacterial Endocarditis, and Methicillin Sensitive Clostridium Septicum/J. A1864 P1304 Back Pain in an Immunocompetent Patient: An Unusual Case of Mediastinitis/S. A1865 P1305 A Case of Edwardsiella Bacteremia and Septic Shock: A Fatal Food Borne Infection/M. A1866 P1306 Disseminated Nocardia Cyriacigeorgica Associated with P1322 A Fatal Case of Necrotizing Fasciitis/N. A1851 P1323 Diffuse Ischemic Limb Gangrene with Palpable Pulses in a P1307 Vertebral Perforation and Osteomyelitis from Abandoned Lead Patient with Septic Shock/D. A1852 P1324 Sepsis Precipitating Valproic Acid Induced P1308 A 38-Year-Old Man with Duodenal Perforation and Sepsis: An Thrombocy to penia/S. A1854 P1327 Too Hot to Handle: 10 Month Old Presenting with Fever of 45 P1310 Purpura Fulminans Resulting from Pasteurella Mul to coda Degrees Celsius/R. A1872 the information contained in this program is up to date as of March 9, 2017. A1885 Discussion: 11:15-12:00: authors will be present for individual discussion P590 Descriptive Study of Fac to rs Associated with Self Extubations 12:00-1:00: authors will be present for discussion with assigned facilita to rs in a Diverse Population/B. A1888 During Single Liquid Swallows After Oral Endotracheal P593 Parallel Pilot Screening Frequency Trials in Elderly and Intubation/M. P582 Diaphragm Ultrasound as a Predic to r of Liberation from Prolonged Mechanical Ventilation/M. A1878 12:00-1:00: authors will be present for discussion with assigned facilita to rs P583 Respira to ry Rate Variation as a Predictive Tool for Successful Facilita to rs: J. Demoule, Montreal, Canada, P596 Higher Expira to ry End-Tidal Oxygen Correlates with Worse p. A1881 P597 Outcomes Reported in Studies on Mechanical Ventilation in Pregnant and Postpartum Patients: A Systematic Review/J. A1892 the information contained in this program is up to date as of March 9, 2017. A1899 P600 Health Care Costs and Outcomes for Patients Undergoing P610 Grading Severity of Dias to lic Dysfunction in Sepsis Using Old, Tracheos to my in an Australian Tertiary Level Referral New, and Simplified Definitions/M. Surgical P612 Performance of the Respira to ry Shock Index, a New Derived Medicare Patients/S. A1896 P614 the Evolving Definition of Septic Shock: A Focus on the New Centers for Medicare and Medicaid Services Sepsis Core P603 Effects of Refrac to ry Hypoxemia Pro to col in Timing of Proning Measure Definition/J. A1897 P615 Diagnosis by Coin Flip the Chasm Between the Diagnosis of P604 Acute Respira to ry Distress Syndrome In Patients With Severe Sespis or Septic Shock by Medical Coders Vs. A1905 P605 Spontaneous Breathing and Hospital Mortality in Early Acute P616 Identifying Poor Outcomes in Elderly Patients with Sepsis/N. A1912 the information contained in this program is up to date as of March 9, 2017. A1920 P624 Sequential Organ Failure Assessment Score for Successful P1331 Escherichia Coli Endocarditis Complicated by Endophthalmitis Weaning in Prolonged Mechanical Ventilation Patients/C. A1922 P625 Does the Inflamma to ry Response Differ in Septic and Non-Septic Insultsfi A1915 Endocarditis Complicated by Ischemic Stroke and Subarachnoid Hemorrhage: Case Report and Review of the P626 Evaluation of the Quick Sequential Organ Failure Assessment Literature/G. A1918 P1336 Acquired Left Ventricular Outflow Tract to Right Atrial Fistula P629 Treatment Delay-Associated Mortality During Statewide Due to Tricuspid Valve Endocarditis/O. A1928 P631 New York State Sepsis Regulations: How Often Are P1339 Constrictive Pericarditis Manifesting as a Recurrent Unilateral Recognized Sepsis Cases Submitted Under Mandated Pleural Effusion/A. P1342 Rare Case of Cardiac Tamponade Due to a Transudative Effusion in a Patient with Nephrotic Syndrome/M. Discussion: 11:15-12:00: authors will be present for individual discussion Ganesh, L. A1932 12:00-1:00: authors will be present for discussion with assigned facilita to rs P1343 Cardiac Tamponade from Anaerobic Purulent Pericarditis/L. Silva, PhD, Rio de Janeiro, Brazil P1344 Rapidly Evolving Cardiac Tamponade in a Case of Viral P1329 Right Sided Mural Bacterial Endocarditis: An Unusual Location Pericarditis/E. A1919 the information contained in this program is up to date as of March 9, 2017. A1952 P1346 Takotsubo Cardiomyopathy in a Patient with Amyotrophic P1363 Left Atrial Myxoma A Ticking Time Bomb/I. A1936 P1364 Uncommon Cause of Right ventricular Outflow Tract Obstruction in a Young Female/S. A1956 P1349 Takotsubo Cardiomyopathy as a Complication of Kidney P1367 Obstructive Shock in a Patient Presenting with Rectal Bleeding Transplant in a Young Anorexic Patient/J. A1957 P1350 Immediate Reversal of Cheyne-S to kes Respiration by P1368 Fibrotic Lung Disease Due to Pulmonary Vein Stenosis Me to prolol in a Patient with Obstructive Cardiomyopathy, Following Catheter Ablation for Atrial Fibrillation/K. A1946 Area M, Hall B-C (Middle Building, Lower Level) P1357 Pulmonary Hypertension Associated with D-Transposition of Viewing: Posters will be on display for entire session. Huang, Discussion: 11:15-12:00: authors will be present for individual discussion P. A1947 12:00-1:00: authors will be present for discussion with assigned facilita to rs P1358 Congenital Absence of Left Coronary Artery: A Rare Coronary Circulation Anomaly/W. A1963 P1361 A Giant Atrial Myxoma Presenting with Recurrent Positional P1375 Post Myocardial Infarction Ventricular Septal Defect: A Case Syncope and Causing Cardiac Arrest/L. A1951 the information contained in this program is up to date as of March 9, 2017. Gupta, Ghaziabad, India, P1395 End Tidal Carbon Dioxide as an Early Diagnostic Tool in p. A1971 P1398 Postpartum Pulmonary Embolism in a Patient with Reactive P1383 Type B Aotic Dissection Identified Following Cardiac Ablation Thrombocy to sis/A.

Ballroom A (South Building menstrual and ovulation calendar order 500mg xeloda otc, Level 3) the information contained in this program is up to date as of March 9 menopause rash buy xeloda without prescription, 2017 pregnancy exercise videos purchase xeloda 500mg amex. Soon pregnancy spotting buy 500 mg xeloda otc, lung cancer care At the conclusion of this session, the participant will be able to : and research will be characterized by molecular diagnosis and targeted treatment and will be personalized, safe, effective and affordable. The new frontiers of critical care emphasize the potential impact on patients and Chairing: V. Three of the objectives of the session are to increase understanding of critical care physicians regarding 9:37 Lung Cancer Prevention: the Launch Pad for the Moonshot important long term outcomes after critical illness; provide attendees with to ols R. Leonards, Australia 11:05 General Discussion 10:15 Reduced Diffusion Capacity in Smokers with Preserved Spirometry R. This symposium focuses on the latest research on smokers, Pediatric pulmonologists; pediatric critical care specialists; neona to logists; with evidence of abnormalities in some despite normal spirometric lung function, respira to ry therapists; advanced practice nurses; registered nurses; nurse whether it is possible to identify those at risk of future lung function decline, and practitioners; physician assistants caring for patients with acute or chronic whether they warrant clinical intervention. For the most current session information, please visit the online program itinerary. In addition, pediatric fellowship programs from diverse fields Assemblies on Nursing; Behavioral Science and Health Services of pulmonary, critical care and neona to logy, often lack sufficient training in Research; Critical Care; Pulmonary Rehabilitation specific approaches to wards mechanical ventilation. This session intends to provide a comprehensive review of the currently available ventila to rs and the 9:15 a. Special emphasis will be given to patients with special Target Audience conditions such as preterm and term infants with diverse forms of acute Providers of lung health, those with clinical or research interests in Integrative respira to ry failure; bronchopulmonary dysplasia; pulmonary hypertension; Therapies, including registered nurses and advanced practice nurses congenital heart disease; airway problems. Adams, PhD, Sydney, Australia There will be a 5-minute discussion after each talk. A series of speakers will review evidence of cardio-pulmonary health With the growing prominence of quality improvement, an associated emphasis effects of greenhouse gas emissions and climate change, and identify has been on pay for performance. In this will discuss challenges and opportunities of the 2015 Paris Climate Agreement session, attendees will hear from experts on innovative research regarding pay for physicians, scientists and patients. The session will also highlight how the new sepsis definitions could We will have experts in their respective fields present lively, opposing points of impact future clinical trial design and bedside care. Finally, new research that view, based on their investigations as well as the general literature, to help will bring precision medicine to septic patients will be discussed. Researchers and clinicians interested in integrating drugs, devices and technologies in to health systems and practice this symposium will focus on the potential role of epigenetics in the epidemiology, clinical manifestations and phenotypic variance of several Objectives diseases affecting the respira to ry system. These examples will stress competencies and disciplines often overlooked in implementing advances in health science. A7601 9:15 Is Optimized Treatment of Exacerbations Enough to Optimize Prevention of Readmissionsfi A2890 Improve Right Ventricular Function in Patients with Acute Submassive Pulmonary Embolism/J. A7607 the information contained in this program is up to date as of March 9, 2017. Divangahi, PhD, Montreal, Canada Room 146 C (Middle Building, Street Level) Oral Presentations Chairing: M. Distress Syndrome Enrolled in a Trial of Helmet Versus Schwander, Mexico City, Mexico, p. A2896 10:15 the Injectable Contraceptive Medroxyprogesterone Acetate 10:00 Ramped Position Versus Sniffing Position During Decreases Peripheral Effec to r Cell-Mediated Mycobacterium Endotracheal Intubation of Critically Ill Adults: A Multicenter, Tuberculosis Containment Through Immunosuppression Randomized Trial/M. A2897 10:30 Alpha-1-Antitrypsin Increases Au to phagosome Number and 10:15 Preventing Reintubation: Role of Stratification of High-Risk for Production of Host-Protective Cy to kines in Mycobacterium Reintubation in the Selection of Appropriate Therapy A Post Intracellulare-Infected Macrophages/E. A2907 10:45 Impact of Nocturnal Dexmede to midine on Delirium Incidence Featured Speaker and Sleep Quality in Critically Ill Adults: A Randomized, Double-Blind, Placebo-Controlled Trial/Y. A2900 the information contained in this program is up to date as of March 9, 2017. A2909 Associated with Changes in Tissue-Resident Macrophages 9:45 the Role of Oxidative Stress in the Pathogenesis of Recurrent and Myogenic Progeni to rs/C. A2919 Co-Cultured with Asthmatic Airway Epithelial Cells Displays 10:15 Post-Infection Treatment with Liponucleotides Attenuates Enhanced Leukocyte Adhesion/S. A2922 10:45 Association Between Prenatal Ambient Nitrate Exposure and 11:00 Modulation of Lung Inflammation Ameliorates Onset of Child Asthma Is Modified by Maternal Stress in Influenza-Induced Mortality, Morbidity, and Lung Injury/S. A2914 11:00 Prenatal Vitamin D Supplementation Reduces Risk of Asthma/Recurrent Wheeze in Early Childhood: A Meta-Analysis of Two Randomized Controlled Trials/B. A2925 405 A Population Study of the Upper Airway Microbiota in 9:45 Undiagnosed Sleep Disorders in African Americans: the Bussel to n, Western Australia/E. A2936 10:00 Altitudinal Central Apneas and Adherence to Positive Airway 406 Effects of Short-Term Smoking Exposure on the Lung and Pressure Therapy/S. A2930 410 Disruption of the Gut Microbiome Augments Development of 11:00 Phenotyping from Polysomnography Predicts Obstructive Ventila to r-Induced Lung Injury in Mice/S. A2931 411 Dysbiosis Associated with the Acute Respira to ry Distress Syndrome: A Prospective Cohort Study in Adults/G. A2943 Room 151 B (Middle Building, Street Level) 413 the Role of Microbiota and Short Chain Fatty Acids in Pulmonary Responses to Ozone/Y. A2944 Poster Vieweing/Discussion 9:45-11:15 414 Increased Bacterial Load in the Small Intestine but Not Lungs Chairing: H. A2947 the information contained in this program is up to date as of March 9, 2017. A2961 421 Distinct Upper Airway Bacterial Microbiota Differentially Relate to Exacerbation and Rhinovirus Infection in Pediatric 606 ErbB2 Phosphorylation Is Impaired in Asthmatic Airway Asthmatics/K. A2952 607 Critical Role for Arginine Metabolism in a Combined Th2 and 422 Hyperoxia Causes Respira to ry Dysbiosis in a Murine Model of Th17 Airway Inflammation in the House Dust Mite Model/K. A2964 424 Ecological Bias in the Lung with Multiple Displacement 609 the Palmi to ylome in Obesity and Allergic Asthma/M. A2955 610 Evidence of a Dysfunctional Soluble Guanylate Cyclase in Human 425 Contraction of the Murine Airway Virome in the Absence of the Airway Smooth Muscle Cells Derived from Asthma/A. A2956 611 A Type-2 Inflamma to ry Background Alters the Functional Response of Airway Mast Cells/M. A2957 616 Mammalian Target of Rapamycin Is a Key Molecule for Eosinophil Differentiation in Bone Marrow/C. A2958 the information contained in this program is up to date as of March 9, 2017. A2975 704 Determinants of Asthma-Related Emergency Department 620 Lymphangiogenesis in Allergic Airway Inflammation: Return Visits in Adults: A Population-Based Study/C. A2988 624 Mouse Model of Human Enterovirus D68 Asthma 708 Among Hispanic Children with Asthma, Greater Maternal Exacerbation/C. A2992 Room 209 A-C (South Building, Level 2) 712 Asthma Status and Physical Activity in Urban Children/D. A2994 Visits for Asthma and Chronic Obstructive Pulmonary Disease 714 Who Is Readyfi A2995 the information contained in this program is up to date as of March 9, 2017. A2997 302 Empiric Use of Humidified High Flow Nasal Cannula 717 Stakeholder Engagement in Eight Comparative Effectiveness Post-Extubation in the Intensive Care Unit/M. A3000 305 Enteral Feeding During Noninvasive Ventilation in a 720 Effect of Exacerbation on Health Related Quality of Life in Randomized Clinical Trial of Helmet Ventilation in Acute Patients with Severe Asthma/L. A3001 306 Delirium and Sedative Requirements in a Trial of Helmet 721 Antibiotics for Asthma Exacerbations in the Acute Hospital A Versus Facemask Noninvasive Ventilation in Acute Hypoxic Multi-Center Service Evaluation/M. A3012 722 A Systematic Review of Inhaled Corticosteroid Adherence 307 Helmet Interface Increases Lung Volumes at Equivalent Interventions in Adult African-Americans/I. A3018 the information contained in this program is up to date as of March 9, 2017.

This creates mul tiple treatment algorithms that vary with the extent of involvement menstrual calendar premium buy xeloda cheap. A Type 1 defciency represents mild thumb hypoplasia without discrete absence of structures buy women's health big book of exercises order xeloda 500mg with visa. Hypoplastic women's health clinic derby generic xeloda 500mg with mastercard, foating menopause 62 years old order xeloda toronto, and absent thumbs the main distinction between a thumb that can be reconstructed and a thumb that requires ablation. An unstable carpometacarpal joint negates the possibility of thumb reconstruction and is best treated by ablation and pollicization. Prehension or pinch develops between the index and long digits, and the index fnger tends to rotate out of the palm to resemble a thumb position. In equivocal cases, the decision is further complicated by the delayed ossifcation of the bones at the base of the thumb (trapezium and trap ezoid), which do not ossify until four to six years of age. The decision to ablate a hypoplastic thumb without a base is often a diffcult process for parents and care givers. Discussions with the surgeon and conversations with families who have made similar decisions are often helpful. The tight web space is corrected by opening the space between the thumb and index fnger. The metacarpophalangeal joint instability is corrected by ulnar collateral liga ment reconstruction. The defcient thenar muscles are supplanted by a tendon and/or muscle transfer from the ring or small fnger to the thumb (Figure 4). This early intervention takes advantage of the growing brain and its plasticity to adjust to the new thumb. In addition, early surgery avoids the development of compensa to ry side- to -side pinch pattern between adjacent fngers. Currently, the procedure is performed somewhere between 6 months and 2 years of age, dependent upon the health status of the child, degree of forearm defciency, and surgeon preference. A concomitant forearm deformity usually takes pre cedence for treatment, which delays index fnger pol licization. Pollicization requires meticulous surgical technique because the index fnger must be shortened, rotated, and reconstructed with the surrounding muscles to give the appearance and function of a thumb (Figure 5). A stiff index fnger will provide a stable thumb for gross grasp, but fne pinch is unlikely. In contrast, a mobile index fnger transferred to the thumb position can provide stability for grasp and mobility for fne pinch (Figure 6). A small extra phalanx that is normally shaped can be treated without surgery (Figure 7). Figure 7: Nine-year-old child with bilateral triphalangeal thumbs that are slightly angulated and longer than a normal thumb. A wedge-shaped extra phalanx causes deviation of the thumb, and treatment is rec ommended. Simple excision of the phalanx is not recommended as post-operative instability is common. Fusion of the abnormal phalanx with an adjacent phalanx along with removal of a wedge of bone is a better option. This pro cedure eliminates the extra joint, shortens the digit, and realigns the thumb. Thumb duplication Duplication of the thumb (pre-axial polydactyly) can be partial or complete and has been classifed in to various types depending on the degree of skeletal replication (Figure 8 and Table 2). In this classifcation, the extent of duplication is defned by whether the components are attached proximally (bifd) or completely separated (duplicated). Figure 8: One-year-old child with a duplicated right thumb prior to surgical correction. Treatment requires using portions of each component to construct a properly aligned and functional thumb. The soft tissues from the ablated thumb are used to augment the retained thumb, includ ing the collateral ligament and muscles. Articular surface modifcation via osteo to my or joint recon to ur ing and tendon realignment are necessary to optimize thumb function. Irrespective of treatment, the recon structed thumb will be smaller than a normal thumb and usually will lack some motion. Radial Defciency the radius can be slightly smaller, considerably smaller, or absent. Complete 108 Fanconi Anemia: Guidelines for Diagnosis and Management Figures 9A and 9B: X-ray and clinical picture of an eight-year-old child with complete absence of the left radius and a perpendicular alignment between the hand and forearm. Table 3: Classification of Radial Deficiency Type X-ray findings Clinical Features I Distal radial epiphysis Minor radial deviation Short radius delayed in appearance. Mild shortening prominent clinical of radius without ulna feature requiring bowing. A Type I defciency is the mildest expression charac terized by mild radial shortening of the radius without considerable bowing of the ulna. Although minor radial deviation of the hand is apparent, considerable thumb hypoplasia may be evident. The forearm is always shorter as the ulna is approxi mately 60% of the normal length at birth. Forearm rotation is absent in partial or complete aplasia of the radius, although some rotation is evident through the carpus. The carpal bones are delayed in ossifcation with the scaphoid and trapezium often absent or hypoplastic. The neurovascular structures are also aberrant because the radial artery and nerve often are absent. An enlarged median nerve substitutes for the absent radial nerve and supplies a large dorsal branch for sensation to the radial aspect of the hand. This branch is positioned in the fold between the wrist and forearm, and knowledge of this subcuta neous location is critical during surgery along the radial aspect of the wrist. Slight shortening of the radius (Type I defciency) requires continued stretching and may need a tendon transfer to re-balance the wrist. The wrist assumes a position of severe radial deviation, which shortens an already undersized forearm, places the extrinsic fexor and extensor ten dons at an unfavorable angle, and creates functional defcits. The digital abnormali ties also require consideration during formulation of a treatment plan, as stiff fngers and a defcient thumb will hamper prehension and create additional functional impediment. Figure 10: Bilateral upper extremity splints fabricated to maintain wrists in straight alignment. The initial treatment for the absent radius is stretching, both by the therapist and the caregiver. Stretching is usually recommended every diaper change and is important to the overall success of treatment. Fabrication of a splint is diffcult in the new born with a shortened forearm, and is usually delayed until the forearm is long enough to accommodate a splint (Figure 10). If no treatment is rendered, the hand will develop a fxed perpendicular relationship to the forearm. Contraindica tions for surgical intervention are mild deformity with adequate support for the hand (Type 1) and an elbow extension contracture that prevents the hand from reaching the mouth. In these children, the radial devia tion of the wrist facilitates hand to mouth function and straightening would further impair this motion. Another contraindication to centralization is adults who have adjusted to their deformity. The procedure is typically performed at about one year of age, and the initial correction is impressive. Unfortu nately, the ability to maintain the correction and prevent recurrence has not been completely solved. Centraliza tion is performed by release of the tight aberrant radial musculotendinous units and anomalous contracted fbrous bands to allow passive correction of the over the end of the ulna (Figure 11A and B). In severe cases, adequate reduction can not be obtained and alternative measures are necessary. Surgical options include carpec to my, limited shaving of the distal ulna epiphysis or application of an exter nal fxa to r followed by post-operative distraction and delayed formal centralization. In fact, many cases of radial defciency with rigid deformity are treated with preliminary soft tissue distraction.

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