Medicine and Health Sciences Commons^™

Letter: When Less Is More: Dexamethasone Dosing For Brain Tumors, Minesh Mehta

Minesh Mehta

No abstract provided.

Prediction Of Anal Cancer Recurrence After Chemoradiotherapy Using Quantitative Image Features Extracted From Serial (18)F-Fdg Pet/Ct, Michael Chuong

Michael Chuong

No abstract provided.

Lack Of Efficacy Of The Neutropenic Diet In Decreasing Infections Among Cancer Patients: A Systematic Review, Muni Rubens, Anshul Saxena, Peter Mcgranaghan, Emir Veledar, Ana Viamonte Ros, Rupesh Kotecha

Rupesh Kotecha

No abstract provided.

Detecting, Preventing, And Treating Sexually Transmitted Diseases Among Adolescent Arrestees: An Unmet Public Health Need, Christopher Salvatore, Steven Belenko, Richard Dembo, Matthew Rollie, Kristina Childs

Christopher Salvatore

Studies of detained and incarcerated adolescent offenders in the United States indicate that these juveniles have an elevated risk of sexually transmitted diseases (STDs). However, many more arrestees enter the “front end” of the juvenile justice system that is detained or incarcerated, and research into the STD risk profiles and service needs of this larger group is lacking. An expansion of STD testing (including of asymptomatic youths), prevention, and treatment is needed, as is improved knowledge about gender- and race-specific services. A pilot program in Florida has shown that juvenile justice and public health systems can collaborate to implement STD …

Medically Tailored Meals As A Prescription For Treatment Of Food-Insecure Type 2 Diabetics, Leslie J. Rabaut

Aurora Family Medicine Residents

Type 2 diabetes mellitus is an immense burden to the health of our population and to our current health care system, and the weight of this burden is only projected to multiply in coming years. A nutritious diet is an indispensable aspect of diabetes treatment, and the lack of access to food engenders poor disease-state control, which correlates with increased health care utilization. Interventions aimed at improving access to food through medically tailored meals (MTMs) have demonstrated effectiveness in improving the health of food-insecure type 2 diabetic patients and reducing health care costs. Further studies are necessary to increase the …

Using An Automated Model To Identify Older Patients At Risk For 30-Day Hospital Readmission And 30-Day Mortality, Ariba Khan, Mary L. Hook, Maharaj Singh, Marsha Vollbrecht, Aaron Malsch, Michael L. Malone

Mary Hook

Background: A real-time electronic health record (EHR) predictive model that identifies older patients at risk for readmission and mortality may assist the health care team in improved patient care.

Purpose: This study was performed to generate an automated 30-day readmission and 30-day mortality risk model using data from the EHR in hospitalized older adults.

Methods: This was a retrospective cohort study. Included were patients age 65 years and older admitted to the hospital from July 2012 to December 2013. An automated predictive model was derived from variables collected from the EHR including socioeconomic factors, medical diagnoses and health care utilization. …

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Proton Pump Inhibitors Increase The Severity Of Hepatic Encephalopathy In Cirrhotic Patients, Matthew J. Fasullo, Prashanth Rau, Dong-Qi Liu, Erik Holzwanger, Jomol Mathew, Yurima Guilarte-Walker, Gyongyi Szabo

Gyongyi Szabo

BACKGROUND: Liver cirrhosis is the late stage of hepatic fibrosis and is characterized by portal hypertension that can clinically lead to decompensation in the form of ascites, esophageal/gastric varices or encephalopathy. The most common sequelae associated with liver cirrhosis are neurologic and neuropsychiatric impairments labeled as hepatic encephalopathy (HE). Well established triggers for HE include infection, gastrointestinal bleeding, constipation, and medications. Alterations to the gut microbiome is one of the leading ammonia producers in the body, and therefore may make patients more susceptible to HE.

AIM: To investigate the relationship between the use of proton pump inhibitors (PPIs) and HE …

Robustness Of A Newly Proposed Risk Schema For Lymphatic Dissemination In Endometrioid Endometrial Cancer, Danielle M. Greer, Jessica J.F. Kram, Callie M. Cox Bauer, Scott A. Kamelle

Aurora Ob/Gyn Faculty

Background: Surgical management for endometrioid endometrial cancer (EEC) includes complete lymph node dissection for all patients at risk of lymphatic dissemination. The standard risk schema, defined by Mayo Clinic, identifies low-risk patients as those with grade 1/2 EEC, myometrial invasion (MI) ≤ 50%, and tumor diameter (TD) ≤ 2 cm. We recently proposed (and published) a risk schema containing modified forms of grade, MI and TD that suggests a significant decrease in false-negative rate and need for lymphadenectomy in low-risk women.

Purpose: Evaluate robustness of our proposed schema for lymphatic dissemination risk stratification in a subsequent EEC patient cohort.

Methods: …

Advocate Aurora Apc Grand Rounds Dm Pharm Update 7 2019 Chojnacki.Pptx, Carl Chojnacki

Carl Chojnacki, MBA, MSN, APNP, ANP-BC, AWLS

Iiv-6 Inhibits Nf-Kappab Responses In Drosophila, Cara C. West, Florentina Rus, Ying Chen, Anni Kleino, Monique Gangloff, Don B. Gammon, Neal S. Silverman

Neal Silverman

The host immune response and virus-encoded immune evasion proteins pose constant, mutual selective pressure on each other. Virally encoded immune evasion proteins also indicate which host pathways must be inhibited to allow for viral replication. Here, we show that IIV-6 is capable of inhibiting the two Drosophila NF-kappaB signaling pathways, Imd and Toll. Antimicrobial peptide (AMP) gene induction downstream of either pathway is suppressed when cells infected with IIV-6 are also stimulated with Toll or Imd ligands. We find that cleavage of both Imd and Relish, as well as Relish nuclear translocation, three key points in Imd signal transduction, occur …

Control Of Antiviral Innate Immune Response By Protein Geranylgeranylation, Shigao Yang, Zhaozhao Jiang, Katherine A. Fitzgerald, Donghai Wang

Katherine A. Fitzgerald

The mitochondrial antiviral signaling protein (MAVS) orchestrates host antiviral innate immune response to RNA virus infection. However, how MAVS signaling is controlled to eradicate virus while preventing self-destructive inflammation remains obscure. Here, we show that protein geranylgeranylation, a posttranslational lipid modification of proteins, limits MAVS-mediated immune signaling by targeting Rho family small guanosine triphosphatase Rac1 into the mitochondria-associated endoplasmic reticulum (ER) membranes (MAMs) at the mitochondria-ER junction. Protein geranylgeranylation and subsequent palmitoylation promote Rac1 translocation into MAMs upon viral infection. MAM-localized Rac1 limits MAVS' interaction with E3 ligase Trim31 and hence inhibits MAVS ubiquitination, aggregation, and activation. Rac1 also facilitates …

Segmental Distribution Of Hepatocellular Carcinoma Correlates With Microvascular Invasion In Liver Explants Undergoing Transplantation, Yasir Al-Azzawai, Eva Rouanet, Ryan J. Hendrix, Lidia Spaho, Hesham Malik, Deepika Devuni, Gyongyi Szabo, Graham Barnard

Gyongyi Szabo

Introduction: Microvascular invasion (MVI) in hepatocellular carcinoma (HCC) patients is a poor prognostic factor after liver transplantation and/or resection. Any correlation between MVI and segmental location of HCC has yet to be studied. Our aim is to evaluate the segmental location of HCC and any correlation with the presence of MVI, portal vein thrombosis (PVT) in explanted livers, and the recurrence of HCC after transplantation. Another objective of the study is to assess the treatment history (ablation or transarterial chemoembolization (TACE)) and size of the tumor with respect to the risk of MVI.

Methods: A single center, retrospective chart review, …

Changes In Anticoagulant Utilization Among United States Nursing Home Residents With Atrial Fibrillation From 2011 To 2016, Matthew Alcusky, David D. Mcmanus, Anne L. Hume, Marc Fisher, Jennifer Tjia, Kate L. Lapane

Jennifer Tjia

Background: Nursing home residents with atrial fibrillation are at high risk for ischemic stroke and bleeding events. The most recent national estimate (2004) indicated less than one third of this high-risk population was anticoagulated. Whether direct-acting oral anticoagulant ( DOAC ) use has disseminated into nursing homes and increased anticoagulant use is unknown.

Methods and Results: A repeated cross-sectional design was used to estimate the point prevalence of oral anticoagulant use on July 1 and December 31 of calendar years 2011 to 2016 among Medicare fee-for-service beneficiaries with atrial fibrillation residing in long-stay nursing homes. Nursing home residence was determined …

The Global Burden Of Scabies: A Cross-Sectional Analysis From The Global Burden Of Disease Study 2015., Chante Karimkhani, Danny V Colombara, Aaron M Drucker, Scott A Norton, Roderick Hay, Daniel Engelman, Andrew Steer, Margot Whitfeld, Mohsen Naghavi, Robert P Dellavalle

Daniel T. Engelman MD

Background

Numerous population-based studies have documented high prevalence of scabies in overcrowded settings, particularly among children and in tropical regions. We provide an estimate of the global burden of scabies using data from the Global Burden of Disease (GBD) Study 2015.

Methods

We identified scabies epidemiological data sources from an extensive literature search and hospital insurance data and analysed data sources with a Bayesian meta-regression modelling tool, DisMod-MR 2·1, to yield prevalence estimates. We combined prevalence estimates with a disability weight, measuring disfigurement, itch, and pain caused by scabies, to produce years lived with disability (YLDs). With an assumed zero …

Survival And Prognostic Factors In Patients With Gastrointestinal Cancers And Brain Metastases: Have We Made Progress?, Michael Chuong, Minesh Mehta

Minesh Mehta

No abstract provided.

Management Of Patients With Brain Metastases From Non-Small Cell Lung Cancer And Adverse Prognostic Features: Multi-National Radiation Treatment Recommendations Are Heterogeneous, Minesh Mehta

Minesh Mehta

No abstract provided.

Genetic Discrimination: Why Bragdondoes Not Ensure Protection, Laura F. Rothstein

Laura Rothstein

No abstract provided.

Developing A Community-Based Screening And Referral Mechanism For Atrial Fibrillation In Low Resource Settings: “Smartphone Monitoring For Atrial Fibrillation In Real-Time – India (Smart-India)”, Apurv Soni, Nisha Fahey, Harshil Patel, Kandarp Talati, Anna Handorf, John A. Bostrom, Shyamsundar Raihatha, Ravi Shah, Sunil Karna, Robert J. Goldberg, Jeroan J. Allison, Ki Chon, Somashekhar M. Nimbalkar, David D. Mcmanus

Apurv Soni

BACKGROUND: Atrial fibrillation (AF), the world’s most common arrhythmia, often goes undetected and untreated in low-resource communities, including India. Moreover, AF is an important risk factor for stroke, which plagues an estimated 1.6 million Indians annually. As such, early detection of AF and management of high-risk patients is critically important to decrease stroke burden in individuals with AF.

OBJECTIVE: The objectives of this study are to evaluate the age- and sex-stratified epidemiology of AF in Anand District, Gujarat India; characterize the profile of individuals who are diagnosed with AF; and determine the performance of two mobile technologies for community-based AF …

High Burden Of Unrecognized Atrial Fibrillation In Rural India: An Innovative Community-Based Cross-Sectional Screening Program, Apurv Soni, Allison Earon, Anna Handorf, Nisha Fahey, Kandarp Talati, John Bostrom, Ki Chon, Craig Napolitano, Michael S. Chin, John Stephen Sullivan, Shyamsundar Raithatha, Robert J. Goldberg, Somashekhar Nimbalkar, Jeroan J. Allison, Sunil Thanvi, David D. Mcmanus

Apurv Soni

BACKGROUND: Atrial fibrillation, the world's most common arrhythmia, is a leading risk factor for stroke, a disease striking nearly 1.6 million Indians annually. Early detection and management of atrial fibrillation is a promising opportunity to prevent stroke but widespread screening programs in limited resource settings using conventional methods is difficult and costly.

OBJECTIVE: The objective of this study is to screen people for atrial fibrillation in rural western India using a US Food and Drug Administration-approved single-lead electrocardiography device, Alivecor.

METHODS: Residents from 6 villages in Anand District, Gujarat, India, comprised the base population. After obtaining informed consent, a team …

Using Mobile-Based Technology To Screen For Atrial Fibrillation In India, Apurv Soni

Apurv Soni

As part of the mini-symposium entitled "Interdiscipllinary Mobile Health and Sensing Research," this presentation discusses use of a novel smartphone app for cardiovascular screening in rural India.

Effect Of Monophasic Pulsed Current On Heel Pain And Functional Activities Caused By Plantar Fasciitis, Abdullah K. Alotaibi, Jerrold S. Petrofsky, Noha S. Daher, Everett Lohman, Michael S. Laymon, Hasan M. Syed

Hasan Syed, MD

Background: Plantar fasciitis (PF) is a soft tissue disorder considered to be one of the most common causes of inferior heel pain. The aim of this study was to investigate the effect of monophasic pulsed current (MPC) and MPC coupled with plantar fascia-specific stretching exercises (SE) on the treatment of PF.

Material and Methods: Forty-four participants (22 women and 22 men, with a mean age of 49 years) diagnosed with PF were randomly assigned to receive MPC (n=22) or MPC coupled with plantar fascia-specific SE (n=22). Prior to and after 4 weeks of treatment, participants underwent baseline evaluation; …

Stereotactic Radiosurgery With Concurrent Lapatinib Is Associated With Improved Local Control For Her2-Positive Breast Cancer Brain Metastases, Rupesh Kotecha

Rupesh Kotecha

No abstract provided.

Ten-Year Outcomes Of Moderately Hypofractionated (70 Gy In 28 Fractions) Intensity Modulated Radiotherapy For Localized Prostate Cancer, Rupesh Kotecha

Rupesh Kotecha

No abstract provided.

State Of The Art: The Evolving Role Of Rt In Combined Modality Therapy For Gbm, Minesh Mehta

Minesh Mehta

No abstract provided.

A Rare Case Of Metastases From A High-Grade Astrocytoma To The Pleura, Bones, And Liver Within Six Months Of Diagnosis, Jennifer L. Dotson, Ala Nijim, Krista L. Denning, Yousef R. Shweihat, Yehuda Lebowicz

Yehuda Z. Lebowicz, MD

High grade astrocytomas such as anaplastic astrocytoma and glioblastoma multiforme are aggressive central nervous system malignancies with a poor prognosis. Due to shortened survival times, their devastating effects are usually localized intracranially and rarely metastasize outside of the central nervous system. When metastases occur, they usually present in patients with longer survival times and they typically coincide with a primary site recurrence. We present a rare case of metastases from a high-grade astrocytoma/glioblastoma to the pleura, bones and liver within six months of diagnosis, without primary site recurrence.

A Rare Case Of Metastases From A High-Grade Astrocytoma To The Pleura, Bones, And Liver Within Six Months Of Diagnosis, Jennifer L. Dotson, Ala Nijim, Krista L. Denning, Yousef R. Shweihat, Yehuda Lebowicz

Krista L. Denning

High grade astrocytomas such as anaplastic astrocytoma and glioblastoma multiforme are aggressive central nervous system malignancies with a poor prognosis. Due to shortened survival times, their devastating effects are usually localized intracranially and rarely metastasize outside of the central nervous system. When metastases occur, they usually present in patients with longer survival times and they typically coincide with a primary site recurrence. We present a rare case of metastases from a high-grade astrocytoma/glioblastoma to the pleura, bones and liver within six months of diagnosis, without primary site recurrence.

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Role Of Serum Biomarkers In Early Detection Of Diabetic Cardiomyopathy In The West Virginian Population, Adam Shaver, Alexandra Nichols, Ellen A. Thompson, Amrita Mallick, Nandini Manne, Shanmuga Sundaram, Joseph I. Shapiro Md, Komal Sodhi

Joseph I Shapiro MD

Objectives: Diabetic cardiomyopathy (DCM) is an established complication of diabetes mellitus. In West Virginia, the especially high incidence of diabetes and heart failure validate the necessity of developing new strategies for earlier detection of DCM. Since most DCM patients remain asymptomatic until the later stages of the disease when the fibrotic complications become irreversible, we aimed to explore biomarkers that can identify early-stage DCM.

Methods: The patients were grouped into 4 categories based on clinical diabetic and cardiac parameters: Control, Diabetes (DM), Diastolic dysfunction (DD), and Diabetes with diastolic dysfunction (DM+DD), the last group being the preclinical DCM group.

Results: …

Role Of Serum Biomarkers In Early Detection Of Diabetic Cardiomyopathy In The West Virginian Population, Adam Shaver, Alexandra Nichols, Ellen A. Thompson, Amrita Mallick, Nandini Manne, Shanmuga Sundaram, Joseph I. Shapiro Md, Komal Sodhi

Komal Sodhi

Objectives: Diabetic cardiomyopathy (DCM) is an established complication of diabetes mellitus. In West Virginia, the especially high incidence of diabetes and heart failure validate the necessity of developing new strategies for earlier detection of DCM. Since most DCM patients remain asymptomatic until the later stages of the disease when the fibrotic complications become irreversible, we aimed to explore biomarkers that can identify early-stage DCM.

Methods: The patients were grouped into 4 categories based on clinical diabetic and cardiac parameters: Control, Diabetes (DM), Diastolic dysfunction (DD), and Diabetes with diastolic dysfunction (DM+DD), the last group being the preclinical DCM group.

Results: …