Douglas Landsittel's research while affiliated with Indiana University Bloomington and other places
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Publications (100)
Background:
Malignant mesothelioma is associated with environmental and occupational exposure to certain mineral fibers, especially asbestos. This study aims to examine work histories of mesothelioma patients and their survival time.
Method:
Using the NIOSH Industry and Occupation Computerized Coding System, we mapped occupations and industries...
Objectives:
The COVID-19 pandemic threatened standard hospital operations. We sought to understand how this stress was perceived and manifested within individual hospitals and in relation to local viral activity.
Design:
Prospective weekly hospital stress survey, November 2020-June 2022.
Setting:
Society of Critical Care Medicine's Discovery S...
New image-derived biomarkers for patients affected by autosomal dominant polycystic kidney disease are needed to improve current clinical management. The measurement of total kidney volume (TKV) provides critical information for clinicians to drive care decisions. However, patients with similar TKV may present with very different phenotypes, often...
Purpose:
To apply target trial emulation to explore the potential impact of eligibility criteria on the primary outcome of a randomized controlled trial.
Methods:
Simulations of a real-world explanatory trial of transarterial radioembolization for advanced unresectable hepatocellular carcinoma with portal vein invasion were performed to examine...
Vascular dysfunction and capillary leak are common in critically ill COVID-19 patients, but identification of endothelial pathways involved in COVID-19 pathogenesis has been limited. Angiopoietin-like 4 (ANGPTL4) is a protein secreted in response to hypoxic and nutrient-poor conditions that has a variety of biological effects including vascular inj...
The outcomes of patients with moderate renal impairment and the impact of liver disease etiology on renal function recovery after liver transplant alone (LTA) are largely unknown. We explored whether NAFLD patients with pre-LTA moderate renal dysfunction (GFR 25–45 ml/min/1.73 m2) may be more susceptible to develop post-LTA severe renal dysfunction...
Respiratory virus infections cause significant morbidity and mortality ranging from mild uncomplicated acute respiratory illness to severe complications, such as acute respiratory distress syndrome, multiple organ failure, and death during epidemics and pandemics. We present a protocol to systematically study patients with severe acute respiratory...
The optimal staffing model for physicians in the ICU is unknown. Patient-to-intensivist ratios may offer a simple measure of workload and be associated with patient mortality and physician burnout. To evaluate the association of physician workload, as measured by the patient-to-intensivist ratio, with physician burnout and patient mortality.
Desig...
Importance:
The 23rd Acute Disease Quality Initiative (ADQI-23) consensus conference proposed a framework to integrate biomarkers into the staging of acute kidney injury (AKI). It is unknown whether tissue inhibitor of metalloproteinases 2 (TIMP-2) and insulinlike growth factor binding protein 7 (IGFBP7) could be used for staging.
Objective:
To...
Background and objectives
The progression of polycystic liver disease is not well understood. The purpose of the study is to evaluate the associations of polycystic liver progression with other disease progression variables and classify liver progression on the basis of patient's age, height-adjusted liver cystic volume, and height-adjusted liver v...
Purpose
Examine National Cancer Database (NCDB) data to comparatively evaluate overall survival (OS) between transarterial radioembolization (TARE) and systemic therapy in hepatocellular carcinoma (HCC) with major vascular invasion (HCC-MVI).
Materials and Methods
1514 HCC-MVI patients receiving first-line TARE or systemic therapy were identified...
Background
Rheumatoid arthritis (RA) is independently associated with an increased risk of cardiovascular disease (CVD). One of the early stages of atherosclerosis is endothelial dysfunction, which is increased in RA. Using drugs to target endothelial dysfunction is a promising novel strategy for CVD prevention in RA. Sildenafil has been shown to i...
Alloimmune responses driven by donor-specific antibodies (DSAs) can lead to antibody-mediated rejection (ABMR) in organ transplantation. Yet, the cellular states underlying alloreactive B cell responses and the molecular components controlling them remain unclear. Using high dimensional profiling of B cells in a cohort of 96 kidney transplant recip...
Early immunological biomarkers that predict rejection and chronic allograft loss are needed to inform preemptive therapy and improve long-term outcomes. Here, we prospectively examined the ratio of interleukin-10 (IL-10) to tumor necrosis factor–α (TNFα) produced by transitional-1 B cells (T1B) 3 months after transplantation as a predictive biomark...
Introduction
Autosomal dominant polycystic kidney disease (ADPKD) is characterized by progressive cyst growth and loss of functioning renal mass, but decline in GFR and onset of ESRD occur late in the disease. Thus, there is a great need for early prognostic biomarkers in this disorder.
Methods
We measured baseline serum FGF23 in 192 ADPKD patient...
Objective
To identify unmet health and social resource needs during a county-wide COVID-19 stay-at-home order and phased re-opening in Western Pennsylvania.
Methods
With public health, social service, and community partners connected through an ongoing academic-community collaborative, we developed and fielded a weekly repeated cross-sectional ele...
Background and objectives:
Root cause analysis involves evaluation of causal relationships between exposures (or interventions) and adverse outcomes, such as identification of direct (eg, medication orders missed) and root causes (eg, clinician's fatigue and workload) of adverse rare events. To assess causality requires either randomization or sop...
Background:
Although antibody-mediated rejection (ABMR) has been long recognized as a leading cause of allograft failure after kidney transplantation, the cellular and molecular processes underlying the induction of deleterious donor-specific antibody (DSA) responses remain poorly understood.
Methods:
Using high-dimensional flow cytometry, in vi...
Background:
A treatment option for ADPKD has highlighted the need to identify rapidly progressive patients. Kidney size/age and genotype have predictive power for renal outcomes, but their relative and additive value, plus associated trajectories of disease progression, are not well defined.
Methods:
The value of genotypic and/or kidney imaging...
Background:
The Mayo Clinic imaging classification of autosomal dominant polycystic kidney disease (ADPKD) uses height-adjusted total kidney volume (htTKV) and age to identify patients at highest risk for disease progression. However, this classification applies only to patients with typical diffuse cystic disease (class 1). Because htTKV poorly p...
Objective
Rheumatoid arthritis (RA) is associated with increased risk of cardiovascular disease. Adventitial vasa vasorum density (aVVD), the vessel density of the vasa vasorum, is a surrogate measure for atherosclerotic plaque vulnerability. The purpose of this study was to compare the adventitial vasa vasorum density (aVVD) in RA and non-RA contr...
Objectives:
Frailty and sarcopenia are known risk factors for adverse liver transplant outcomes and mortality. We hypothesized that frailty or sarcopenia could identify the risk for common serious transplant-related adverse respiratory events.
Methods:
For 107 patients (74 men, 33 women) transplanted over 1 year, we measured frailty with gait sp...
Background:
Levels of soluble urokinase plasminogen activator receptor (suPAR), an inflammation marker, are strongly predictive of incident kidney disease. Patients with autosomal dominant polycystic kidney disease (ADPKD) experience progressive decline in renal function, but rates of decline and outcomes vary greatly. Whether suPAR levels are pre...
Background : Malignant mesothelioma (MM) is a rare but deadly malignancy with about 3,000 new cases being diagnosed each year in the US. Very few studies have been performed to analyze factors associated with mesothelioma survival, especially for peritoneal presentation. The overarching aim of this study is to examine survival of the cohort of pati...
Background and objectives:
To evaluate the growth pattern of kidney cyst number and cyst volume in association with kidney size, demographics, and genotypes in autosomal dominant polycystic kidney disease.
Design, setting, participants, & measurements:
Kidney cyst number and cyst volume were measured from serial magnetic resonance images, giving...
Autosomal dominant polycystic kidney disease (ADPKD) is characterized by cyst and kidney growth, which is hypothesized to cause loss of functioning renal mass and eventually end-stage kidney disease. However, the time course of decline in glomerular filtration rate (GFR) is poorly defined. The Consortium for Radiologic Imaging Studies of Polycystic...
Background
Mean arterial pressure (MAP), bispectral index (BIS), and minimum alveolar concentration (MAC) represent valuable, yet dynamic intraoperative monitoring variables. They provide information related to poor outcomes when considered together, however their collective behavior across time has not been characterized.
Methods
We have develope...
Background
Caffeine has been proposed, based on in vitro cultured cell studies, to accelerate progression of autosomal dominant polycystic kidney disease (ADPKD) by increasing kidney size. Since ADPKD patients are advised to minimize caffeine intake, we investigated the effect of caffeine on disease progression in the Consortium for Radiologic Imag...
Background : Malignant mesothelioma (MM) is a rare but deadly malignancy with about 3,000 new cases being diagnosed each year in the US. Very few studies have been performed to analyze factors associated with mesothelioma survival, especially for peritoneal presentation. The overarching aim of this study is to examine survival of the cohort of pati...
Elevated PD1hiTh1-cTFH with EM phenotype results were confirmed in an independent cohort of thymoglobulin-induced KTx patients from UPMC. Cross-sectional phenotypic analyses were performed on the first blood sample obtained after DSA detection in the serum. Similar time points were selected for stable patients for comparison. (A) Mean ± SEM of cTFH...
Longitudinal data from DSA+ versus stable Tx recipients from thymoglobulin- and basiliximab-induced patients. The longitudinal data for each time point from patients are shown as mean ± SEM. Results from DSA+ patients are shown as black filled squares, whereas from stable patients as black filled triangles. (A) Percentage of Ki67 expression on cTFH...
UPMC cohort: demographics and clinical events.
cTFH memory distribution in patients with ESRD who developed or not DSA post-KTx independently of induction therapy. (A) % of overall memory (CD45RO+CD4+), cTFH cells, and the mean proportion of EM and CM ± SEM of HC (n = 11), ESRD-Stable (n = 26), and ESRD-DSA+ (n = 9). (B) Overall expression of % PD-1 divided into low, intermediate, and high expr...
KTx recipients that developed DSA post-Tx display elevated PD-1hiCXCR3+-cTFH cells. Cross-sectional phenotypic analyses were performed on the first blood sample obtained after DSA detection in the serum. Similar time points were selected for stable patients for comparison. Gating strategy to identify the percentage of PD-1hiCXCR3+ on cTFH and overa...
Introduction
The cellular events that contribute to generation of donor-specific anti-HLA antibodies (DSA) post-kidney transplantation (KTx) are not well understood. Characterization of such mechanisms could allow tailoring of immunosuppression to benefit sensitized patients.
Methods
We prospectively monitored circulating T follicular helper (cTFH...
Background : Malignant mesothelioma (MM) is a rare but deadly malignancy with about 3,000 new cases being diagnosed each year in the US. Very few studies have been performed to analyze factors associated with mesothelioma survival, especially for peritoneal presentation. The overarching aim of this study is to examine survival of the cohort of pati...
Background
Data on dialysis and renal transplantation (RT) after intestinal transplantation (IT) are sparse. Whether changes in immunosuppression and surgical techniques have modified these outcomes is unknown.
Methods
Two hundred eighty-eight adult intestinal transplants performed between 1990 and 2014 at the University of Pittsburgh were analyze...
Autosomal dominant polycystic kidney disease (ADPKD) is characterized by progressive enlargement of kidney cysts leading to chronic kidney disease (CKD) and end-stage renal disease (ESRD). Identification of an early biomarker that can predict progression of CKD is urgently needed. In an earlier Consortium for Radiologic Imaging Studies of Polycysti...
A number of publications have discussed approaches to training the scientific workforce in comparative effectiveness research (CER) and patient-centered outcomes research (PCOR). To meet this need, funders have offered resources for developing educational materials and establishing training programs. To extend these efforts into specific researcher...
Magnetic resonance imaging (MRI) examinations provide high-resolution information about the anatomic structure of the kidneys and are used to measure total kidney volume (TKV) in patients with Autosomal Dominant Polycystic Kidney Disease (ADPKD). Height-adjusted TKV (HtTKV) has become the gold-standard imaging biomarker for ADPKD progression at ear...
Methods:
Measures were collected using archival shift records, workplace injury data, and cross-sectional surveys from a nationally representative sample of 14 EMS agencies employing paramedics, prehospital nurses, and other EMS clinicians. One thousand EMS clinicians were selected at random to complete a teamwork survey for each of their recent p...
Human transitional B cells express relatively high IL-10 and low TNF-α levels, which correlate with B regulatory activity in vitro. Herein, we aim to further define B regulatory phenotype and determine whether B regulatory activity can serve as a prognostic marker for renal allograft dysfunction (graft loss or 2-fold fall in estimated glomerular fi...
Mobile health (mHealth) interventions may help transplant recipients follow their complex medical regimen. Pocket Personal Assistant for Tracking Health (Pocket PATH) is one such intervention, tailored for lung transplant recipients. A randomized controlled trial showed Pocket PATH's superiority to usual care for promoting the self-management behav...
Objectives:
Frailty is a known risk factor for major life-threatening liver transplant complications, deaths, and waitlist attrition. Whether frailty indicates risk for adverse outcomes in cirrhosis short of lethality is not well defined. We hypothesized that clinical measurements of frailty using gait speed and grip strength would indicate the ri...
Frailty with sarcopenia in cirrhosis causes liver transplant waitlist attrition and deaths. Regular physical activity is needed to protect cirrhotic patients from frailty. We subjectively assess physical performance in selecting patients for transplant listing, but do not know whether clinical assessments reflect the extent of activity patients act...
Background:
Improvements in renal allograft outcomes have permitted kidney transplantation after prior kidney allograft failure as well as after nonrenal solid organ transplantation. This study compares renal allograft outcomes in the 3 groups, that is, primary, repeat, and kidney after nonrenal solid organ transplantation, where transplant group...
Transplantation of islets into the gastric submucosal space (GSMS) has several advantages (e.g., avoidance of the instant blood-mediated inflammatory response [IBMIR], ability to biopsy). The aim of this study was to determine whether endoscopic biopsy of islet allografts transplanted into the GSMS in diabetic pigs can provide histopathological and...
Autosomal dominant polycystic kidney disease (ADPKD) often results in ESRD but with a highly variable course. Mutations to PKD1 or PKD2 cause ADPKD; both loci have high levels of allelic heterogeneity. We evaluated genotype-phenotype correlations in 1119 patients (945 families) from the HALT Progression of PKD Study and the Consortium of Radiologic...
Objective:
We investigated the association between teammate familiarity and workplace injury in the emergency medical services (EMS) setting.
Methods:
From January 2011 to November 2013, we abstracted a mean of 29 months of shift records and Occupational Safety Health Administration injury logs from 14 EMS organisations with 37 total bases locat...
Background:
Preoperative anaemia is associated with adverse outcomes after surgery but outcomes after liver surgery specifically are not well established. We aimed to analyze the incidence of and effects of preoperative anemia on morbidity and mortality in patients undergoing liver resection.
Methods:
All elective hepatectomies performed for the...
Background & aims:
It is important to identify superficial (T1) gastroesophageal adenocarcinomas (EAC) that are most or least likely to metastasize to lymph nodes, to select appropriate therapy. We aimed to develop a risk stratification model for metastasis of superficial EAC to lymph nodes using pathologic features of the primary tumor.
Methods:...
To investigate whether an imaging measure of corticospinal tract (CST) injury in the acute phase can predict motor outcome at 3 month in comparison to clinical assessment of initial motor impairment.
A two-site prospective cohort study followed up a group of first-ever ischemic stroke patients using the Upper-Extremity Fugl-Meyer (UE-FM) Scale to m...
Identifying and intervening on modifiable risk factors may improve outcomes in lung transplantation (LTx), which, despite recent improvements, remain suboptimal. Evidence suggests that two modifiable risk factors, psychiatric disorders and nonadherence, may improve LTx outcomes in the short-term; however, neither has been explored in the long-term....
This special report describes the systematic approach the University of Pittsburgh and the University of Pittsburgh Medical Center (UPMC) undertook in creating an infrastructure for comparative effectiveness and patient-centered outcomes research resources. We specifically highlight the administrative structure, communication and training opportuni...
To determine whether sociodemographic and geographic factors are associated with referral for surgery and receipt of recommended surgical intervention.
Surgical interventions confer survival advantages compared with palliative therapies for hepatocellular carcinoma (HCC), but disparities exist in use of surgical intervention. Few have investigated...
Muscle wasting, sarcopenia, is common in advanced cirrhosis and predicts adverse outcomeswhile awaiting and following liver transplantation. Frequent post-transplant worsening of sarcopenia has attracted recent interest. It is unknown whether this serious problem is an expected metabolic consequence of transplantation or results from confounding co...
We sought to improve a previous algorithm to ascertain Parkinson's disease (PD) in the Cardiovascular Health Study by incorporating additional data from Medicare outpatient claims. We compared our results to the previous algorithm in terms of baseline prevalence and incidence of PD, as well as associations with baseline smoking characteristics.
Our...
Few studies have proposed methods for sample size determination and specification of passing criterion (e.g., number needed to pass from a given size panel) for respirator fit-tests. One approach is to account for between- and within- subject variability, and thus take full advantage of the multiple donning measurements within subject, using a rand...
The optimal approach to pre-operative imaging assessment of pancreatic cancer is unknown.
The aim of this meta-analysis was to assess accuracy and performance characteristics of EUS in determining nodal staging, vascular invasion, and prediction of resectability of pancreatic cancer. A secondary aim was to perform head to head comparison of perform...
Purpose:
To use direct observations of first prenatal visits to describe obstetric providers' adherence to the evidence-based clinical practice guideline for smoking cessation counseling recommended by the American College of Obstetricians and Gynecologists, the 5 A's (Ask, Advice, Assess, Assist, and Arrange).
Design:
Observational study using...
Autosomal dominant polycystic kidney disease (ADPKD) is characterized by increased total kidney volume (TKV) and renal failure. This study aimed to determine if height-adjusted TKV (htTKV) predicts the onset of renal insufficiency.
This prospective, observational, longitudinal, multicenter study included 241 adults with ADPKD and preserved renal fu...
The multifactorial etiology of bacterial vaginosis (BV) impedes development of effective treatment and prevention strategies. Herein, we evaluated the effects of herpes simplex virus type 2 (HSV-2), a suspected BV risk factor, on vaginal flora composition.
Correlations between HSV-2 infection and BV were prospectively explored among 12 HSV-2-sero...