Medicine and Health Sciences Commons^™

A Coal Miner With Weakness, Fatigue, Nausea, Fever, Chills, Night Sweats And Dyspnea, Larry Nichols

Marshall Journal of Medicine

Delayed or missed diagnoses are a constant hazard in primary care. This is the case report of a 51-year-old coal miner, who presented as an ambulatory outpatient on a Friday with weakness, fatigue, nausea, fever, chills, night sweats and dyspnea. Chest x-ray on Saturday showed pneumonia and pleural effusion, while blood testing showed renal failure, but these results were not known by his physician until Monday, when he was hospitalized with severe sepsis due to fatal Austrian syndrome of pneumococcal pneumonia, endocarditis and meningitis. Analysis of the delay of diagnosis in this case suggests the possibility that a weekend effect …

Research Days At West Virginia’S Allopathic Medical Schools: Ten Year Publication Rates And Impact, Mohammad Halaibeh Md, Alexander H. Slocum Jr., Phd, Md, Yousif Mohammed Md, Zain N. Qazi Md, Franklin D. Shuler Md, Phd

Orthopaedics

Participation in research and scholarly activity is critical to successful medical student and resident matriculation and to faculty development. Both Marshall University and West Virginia University sponsor yearly peer-reviewed School of Medicine Research Days’ to support these missions. This article evaluates the successful publication of Research Day presentations for West Virginia’s Allopathic Medical Schools. Both Marshall University (MU) and West Virginia University’s (WVU) School of Medicine use a competitive review process for abstract selection ensuring high quality research is presented. Over a 10-year period, MU published 12% (74/616) of its abstracts while WVU published 22% (265/1185) of its abstracts. We …

Optimizing Heart Failure Outcomes Through Diet: A Review, Farley B. Neasman Iii

Marshall Journal of Medicine

Heart failure is a growing epidemic that will add significant monetary and human costs to an already overtaxed health-care system. Though promising new medications have recently been approved, this complex condition is largely preventable through aggressive risk factor modification, with diet being shown to have a greater effect than exercise. An underrated component of a healthy diet is the simple addition of nuts – the anti-inflammatory fatty acids, healthy proteins, and general availability have been shown to improve survival and reduce the primary risk factors contributing to heart failure, making the addition of nuts and legumes to the diet an …

Signalling Via The Osteopontin And High Mobility Group Box-1 Axis Drives The Fibrogenic Response To Liver Injury, Elena Arriazu, Xiaodong Ge, Tung-Ming Leung, Fernando Magdaleno, Aritz Lopategi, Yongke Lu, Naoto Kitamura, Raquel Urtasun, Neil Theise, Daniel J. Antoine, Natalia Nieto

Pharmacology, Physiology and Toxicology

Objective: Liver fibrosis is associated with significant collagen-I deposition largely produced by activated hepatic stellate cells (HSCs); yet, the link between hepatocyte damage and the HSC profibrogenic response remains unclear. Here we show significant induction of osteopontin (OPN) and high-mobility group box-1 (HMGB1) in liver fibrosis. Since OPN was identified as upstream of HMGB1, we hypothesised that OPN could participate in the pathogenesis of liver fibrosis by increasing HMGB1 to upregulate collagen-I expression. Design and results: Patients with long-term hepatitis C virus (HCV) progressing in disease stage displayed enhanced hepatic OPN and HMGB1 immunostaining, which correlated with fibrosis stage, whereas …

The Role And Mechanism Of Erythrocyte Invasion By Francisella Tularensis, Deanna M. Schmitt, Rebecca Barnes, Taylor Rogerson, Ashley Haught, Leanne K. Mazzella, Matthew Ford, Tricia Gilson, James W.-M. Birch, Anders Sjöstedt, Douglas S. Reed, Jonathan M. Franks, Donna B. Stolz, James Denvir, Jun Fan, Swanthana Rekulapally, Donald A. Primerano, Joseph Horzempa

Biochemistry and Microbiology

Francisella tularensis is an extremely virulent bacterium that can be transmitted naturally by blood sucking arthropods. During mammalian infection, F. tularensis infects numerous types of host cells, including erythrocytes. As erythrocytes do not undergo phagocytosis or endocytosis, it remains unknown how F. tularensisinvades these cells. Furthermore, the consequence of inhabiting the intracellular space of red blood cells (RBCs) has not been determined. Here, we provide evidence indicating that residing within an erythrocyte enhances the ability of F. tularensis to colonize ticks following a blood meal. Erythrocyte residence protected F. tularensis from a low pH environment similar to that of …

An Unusual Pulmonary Complication Of Statin Medication, Milliejoan Mongalo, Madhvi Shah, Lynne J. Goebel

Marshall Journal of Medicine

Statins or hydroxyl-methylglutaryl coenzyme A (HMG-CoA) reductase inhibitors have proven efficacy at decreasing cardiovascular morbidity and mortality. Although statins have been prescribed safely, there should be more awareness of the possible adverse effects. Recently, we encountered a patient who had unexplained dyspnea, weakness, and immobility. The patient’s symptoms were alleviated after discontinuing the statin medication. Although we have no concrete evidence that her symptoms were due to the medication, the temporal relationship of symptom improvement upon discontinuation of the statin, led us to the conclusion that it could potentially have been the cause. Unexplained dyspnea is not listed as an …

Cigarette Smoking And Cardio-Renal Events In Patients With Atherosclerotic Renal Artery Stenosis, Christopher A. Drummond, Pamela S. Brewster, Wencan He, Kaili Ren, Yanmei Xie, Katherine R. Tuttle, Steven T. Haller, Kenneth Jamerson, Lance D. Dworkin, Donald E. Cutlip, Timothy P. Murphy, Ralph B. D'Agostino Sr., William L. Henrich, Jiang Tian, Joseph I. Shapiro Md, Christopher J. Cooper

Biochemistry and Microbiology

Cigarette smoking causes cardiovascular disease and is associated with poor kidney function in individuals with diabetes mellitus and primary kidney diseases. However, the association of smoking on patients with atherosclerotic renal artery stenosis has not been studied. The current study utilized data from the Cardiovascular Outcomes in Renal Atherosclerotic Lesions (CORAL, NCT00081731) clinical trial to evaluate the effects of smoking on the risk of cardio-renal events and kidney function in this population. Baseline data showed that smokers (n = 277 out of 931) were significantly younger at enrollment than non-smokers (63.3±9.1 years vs 72.4±7.8 years; p<0.001). In addition, patients who smoke were also more likely to have bilateral renal artery stenoses and peripheral vascular disease (PVD). Longitudinal analysis showed that smokers experienced composite endpoint events (defined as first occurrence of: stroke; cardiovascular or renal death; myocardial infarction; hospitalization for congestive heart failure; permanent renal replacement; and progressive renal insufficiency defined as 30% reduction of GFR from baseline sustained for ≥ 60 days) at a substantially younger age compared to non-smokers (67.1±9.0 versus 76.1±7.9, p<0.001). Using linear regression and generalized linear modeling analysis controlled by age, sex, and ethnicity, smokers had significantly higher cystatin C levels (1.3±0.7 vs 1.2±0.9, p<0.01) whereas creatinine and estimated glomerular filtration rate (eGFR) were not different from non-smokers. From these data we conclude that smoking has a significant association with deleterious cardio-renal outcomes in patients with renovascular hypertension.

Na/K-Atpase Signaling And Salt Sensitivity: The Role Of Oxidative Stress, Jiang Liu, Yanling Yan, Ying Nie

Biochemistry and Microbiology

Other than genetic regulation of salt sensitivity of blood pressure, many factors have been shown to regulate renal sodium handling which contributes to long-term blood pressure regulation and have been extensively reviewed. Here we present our progress on the Na/K-ATPase signaling mediated sodium reabsorption in renal proximal tubules, from cardiotonic steroids-mediated to reactive oxygen species (ROS)-mediated Na/K-ATPase signaling that contributes to experimental salt sensitivity.

Charles A. Hoffman, M.D.: Physician, Leader, Humanist, Lawrence M. Wyner M.D.

Surgery

Physician role models are as important for the seasoned practitioner as they are for the recent medical school graduate. To this end, the life and career of Charles "Carl" A. Hoffman, M.D. (Fig. 1), American Urological Association (AUA) President 1967-1968, are legion. Dr. Hoffman had humble origins in the southern Ohio industrial town of Ironton. Born in 1904, he lost both parents before the age of 10 years, and was taken in by relatives. To help support his extended family, he got an after-school job at a local pharmacy (Fig. 2a), running errands and delivering prescriptions. The sight of people …

Comparative Study On The In Vitro Effects Of Pseudomonas Aeruginosa And Seaweed Alginates On Human Gut Microbiota, Shaofeng Bai, Huahai Chen, Liying Zhu, Wei Liu, Hongwei Yu, Xin Wang, Yeshi Yin

Biochemistry and Microbiology

Alginates pertain to organic polysaccharides that have been extensively used in food- and medicine-related industries. The present study obtained alginates from an alginate overproducing Pseudomonas aeruginosa PAO1 mutant by screening transposon mutagenesis libraries. The interaction between bacterial and seaweed alginates and gut microbiota were further studied by using an in vitro batch fermentation system. Thin-layer chromatography (TLC) analysis indicated that both bacterial and seaweed alginates can be completely degraded by fecal bacteria isolated from study volunteers, indicating that a minor structural difference between bacterial and seaweed alginates (O-acetylation and lack of G-G blocks) didn’t affect the digestion of alginates by …

The Assessment Of Medial Stability Of The Elbow Using Sonography And Three Clinical Tests, Andrew Michael Demoss

Theses, Dissertations and Capstones

Introduction: Injuries to the Ulnar Collateral Ligament of the elbow are a common occurrence in overhead throwing athletes. Clinical assessment of the medial elbow can be assisted using Sonography. Ultrasound imaging can be used to determine the width of the medial joint space. This study will determine whether altering the joint angle in the elbow during various clinical tests has an effect on the width of the medial joint space.

Methods: Ultrasound images of the non-dominant elbow were collected during three clinical tests of medial elbow stability; valgus stress test, weighted valgus test and the milking maneuver. The …

Employing The Enzyme Cofactor Function Of Ascorbic Acid To Affect Oncogenic Pathways In Human Melanoma: Modulating Hypoxia Inducible Factor-1Α And Dna Demethylation To Reduce Malignant Potential, Adam Patrick Fischer

Theses, Dissertations and Capstones

Dioxygenase enzymes such as the HIF hydroxylases (PHD1-3, FIH) and the Ten-eleven translocation (TET1-3) enzymes regulate the activity of the hypoxia inducible factor-1_a (HIF1_a) transcription factor and the DNA methylation status of cells, respectively. Aberrant accumulation and activation of HIF-1_a can allow malignant cells to acquire attributes that promote progression, chemotherapy resistance, and survival, while aberrant hypermethylation of gene promoters can silence the expression of tumor suppressor genes essential to preventing tumorigenesis. Inadequate levels of intracellular ascorbic acid (AA), a necessary cofactor for optimal dioxygenase enzyme function, could potentiate these tumorigenic conditions. In fact, plasma levels …

Local Sensitivity Analysis Of Acute Inflammation, James Martin

Theses, Dissertations and Capstones

The inflammatory response is the body's response to some pathogen or foreign invader. When infected by a pathogen, a healthy individual will mount a response with immunological factors to eliminate it. An inflammatory response that is either too strong or too weak can be detrimental to the individual's health. We will look at a qualitative mathematical model of the inflammatory response, in scenarios that represent varying disorders of the immune system. Using sensitivity analysis we determine which parameters of this model are most influential in the different scenarios. By determining which parameters are most influential we can suggest possible targets …

Doxorubicin Cytotoxicity In A Human Proximal Tubular Epithelial Cell Line Was Attenuated By The Natural Product Resveratrol, Morghan Schuyler Getty

Theses, Dissertations and Capstones

The cancer chemotherapeutic agent doxorubicin (DOX), Adriamycin, is part of the treatment regimen for breast, ovarian, small cell lung cancer and acute/chronic lymphoid leukemia. Adverse effects associated with DOX are cardiotoxicity and nephrotoxicity. Interventions are needed to reduce DOX nephrotoxicity. Resveratrol (RES) is a phytochemical contained in grapes, berries and nuts, which possesses antioxidant and anticancer properties. This study tested the hypothesis that RES will attenuate DOX renal cytotoxicity in human noncancerous renal proximal tubular epithelial (HK-2) cells and that RES will reduce DOX mediated changes in mitochondrial function. HK-2 cells were plated and grown for 48 hours (h). Cells …