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A Case Of A Nonpetrous Cholesterol Granuloma Presenting As A Temporal Mass, Nathaniel Reeve, Jacob Kahane, Matthew Ng Dec 2020

A Case Of A Nonpetrous Cholesterol Granuloma Presenting As A Temporal Mass, Nathaniel Reeve, Jacob Kahane, Matthew Ng

School of Medicine Faculty Publications

Objective. A case of a skull base cholesterol granuloma (CG) of the squamosal temporal bone. This is the first ever reported case of CG in a well-pneumatized squamous temporal bone. Design. Case report and review of the literature. Discussion. CG is a cystic mass typically found in the petrous apex and occasionally in the paranasal sinuses and orbit. Experience with the treatment of these expansile and inflammatory processes has largely been garnered from those occurring in the petrous apex, where they are surgically drained, via a transtympanic, transmastoid, or middle fossa approach. We report a case of cholesterol granuloma situated …


Retraction Note: Identification Of De Novo Mutations In Prenatal Neurodevelopment-Associated Genes In Schizophrenia In Two Han Chinese Patient-Sibling Family-Based Cohorts (Translational Psychiatry, (2020), 10, 1, (307), 10.1038/S41398-020-00987-Z), Shan Jiang, Daizhan Zhou, Yin Ying Wang, Peilin Jia, Chunling Wan, Xingwang Li, Guang He, Dongmei Cao, Xiaoqian Jiang, Kenneth S. Kendler, Ming Tsuang, Travis Mize, Jain Shing Wu, Yimei Lu, Lin He, Jingchun Chen, Zhongming Zhao, Xiangning Chen Dec 2020

Retraction Note: Identification Of De Novo Mutations In Prenatal Neurodevelopment-Associated Genes In Schizophrenia In Two Han Chinese Patient-Sibling Family-Based Cohorts (Translational Psychiatry, (2020), 10, 1, (307), 10.1038/S41398-020-00987-Z), Shan Jiang, Daizhan Zhou, Yin Ying Wang, Peilin Jia, Chunling Wan, Xingwang Li, Guang He, Dongmei Cao, Xiaoqian Jiang, Kenneth S. Kendler, Ming Tsuang, Travis Mize, Jain Shing Wu, Yimei Lu, Lin He, Jingchun Chen, Zhongming Zhao, Xiangning Chen

School of Medicine Faculty Publications

© 2020, The Author(s). This article1 has been retracted at the request of Authors Xingwang Li and Lin He. After publication, it was realized that approval to use data from the NSFC-NIH Sino-US cooperation project (Project No. 81361120389) was not obtained from the data owners. Authors Dongmei Cao, Xiangning Chen, Lin He, Kenneth Kendler, Xingwang Li, Travis Mize, Chunling Wan and Jain-Shing Wu agree to this retraction. Authors Shan Jiang, Jingchun Chen and Zongming Zhao do not agree to this retraction. Authors Guang He, Peilin Jia, Xiaoqian Jiang, Yimei Lu, Ming Tsuang, Yin-Ying Wang and Daizhan Zhou did not respond …


Metastatic Squamous Cell Carcinoma: A Cautionary Tale, Colby Shreve, Chase Shropshire, David G. Cotter Oct 2020

Metastatic Squamous Cell Carcinoma: A Cautionary Tale, Colby Shreve, Chase Shropshire, David G. Cotter

School of Medicine Faculty Publications

Cutaneous squamous cell carcinoma (cSCC) typically arises from a malignant proliferation of keratinocytes. It is the second most common cancer in the United States and typically affects older white men. Risk factors for cSCC include ultraviolet radiation exposure, light skin tone, and immunosuppression. Although metastasis in cSCC is rare, primary tumor characteristics such as location, size, and depth of invasion, among others, can help risk-stratify lesions for local recurrence, metastatic events, and death. We present a case of primary cutaneous metastatic squamous cell carcinoma masquerading as a cyst on the left temple of a 73-year-old Caucasian man following numerous treatments …


Elevated Serum Il-21 Levels Are Associated With Stable Immune Status In Kidney Transplant Recipients And A Mouse Model Of Kidney Transplantation, Luying Guo, Junhao Lv, Jian Zhang, Hao Deng, Shi Feng, Shuaihui Liu, Pengpeng Yan, Jingyi Zhou, Hui Chen, Meifang Wang, Qin Zhou, Huiping Wang, Jianghua Chen, Yu Kuang, Jia Shen, Rendwing Wang Sep 2020

Elevated Serum Il-21 Levels Are Associated With Stable Immune Status In Kidney Transplant Recipients And A Mouse Model Of Kidney Transplantation, Luying Guo, Junhao Lv, Jian Zhang, Hao Deng, Shi Feng, Shuaihui Liu, Pengpeng Yan, Jingyi Zhou, Hui Chen, Meifang Wang, Qin Zhou, Huiping Wang, Jianghua Chen, Yu Kuang, Jia Shen, Rendwing Wang

School of Medicine Faculty Publications

Allograft rejection after renal transplantation remains a challenge to overcome. Interleukin (IL)-21, a cytokine with pleiotropic effects, maintains immune homeostasis post-transplantation. Here, we report higher levels of IL-21 in kidney transplant recipients with non-rejection (NR) than in recipients with T cell-mediated rejection (TCMR, P < 0.001) and antibody-mediated rejection (ABMR, P = 0.005). We observed a negative correlation between IL-21 and creatinine (Cr) levels (P = 0.016). The receiving operating characteristic (ROC) curve showed a promising diagnostic value of IL-21 to identify acute rejection with an area under the curve (AUC) of 0.822 (P < 0.001). In contrast, exogenous administration of IL-21 accelerated acute rejection in a comparative translational kidney transplant (KT) mouse model. Reduced IL-21 levels in the peripheral blood were observed in KT mice after IL-21 injection. Further analysis revealed that increased IL-21 levels in the spleen induced proliferation of CD4+ T cells and CD19+ B cells after IL-21 treatment. Our findings suggest a critical function of IL-21 in kidney transplantation and the potential involvement of the IL-21/IL-21R pathway in acute rejection management.


Tricyclic Antidepressant Use And Risk Of Fractures: A Meta-Analysis Of Cohort Studies Through The Use Of Both Frequentist And Bayesian Approaches, Qing Wu, Yingke Xu, Yueyang Bao, Jovan Alvarez, Mikee Lianne Gonzales Aug 2020

Tricyclic Antidepressant Use And Risk Of Fractures: A Meta-Analysis Of Cohort Studies Through The Use Of Both Frequentist And Bayesian Approaches, Qing Wu, Yingke Xu, Yueyang Bao, Jovan Alvarez, Mikee Lianne Gonzales

School of Medicine Faculty Publications

Background: Research findings regarding the association between tricyclic antidepressant (TCA) treatment and the risk of fracture are not consistent; we aimed to assess whether people who take TCAs are at an increased fracture risk. Methods: Relevant studies published through June 2020 were identified through database searches of MEDLINE, EMBASE, Scopus, PsycINFO, ISI Web of Science, WorldCat Dissertations and Theses from each database’s inception, as well as through manual searches of relevant reference lists. Two researchers independently performed literature searches, study selection, data abstraction and study appraisal by using a standardized protocol. Frequentist and Bayesian hierarchical random-effects models were used for …


Bk Virus Nephropathy: Prevalence, Impact And Management Strategies, Rajeev Sharma, Mareena Zachariah Aug 2020

Bk Virus Nephropathy: Prevalence, Impact And Management Strategies, Rajeev Sharma, Mareena Zachariah

School of Medicine Faculty Publications

BK virus reactivation as a result of therapeutic immunosuppression following renal transplant can result in BK polyomavirus nephropathy and renal allograft loss. This is a complex and challenging clinical problem with a range of management options and practices reported in literature. The current standard for early diagnosis and treatment is surveillance by measuring viral DNA in blood using qPCR. Immunosuppression reduction is the cornerstone of effective management but is associated with a risk of acute rejection following treatment.


Use Of Pericranial Flaps With Dermal Substitute For Scalp Reconstruction: A Case Series, Kongkrit Chaiyasate Md, Facs, Lauren N. Oliver Do, Scott A. Kreitzberg Do, Mitchell Lyons Md, Joshua Goldman Md, Stephen M. Lu Md, Tracey Bastiaans Do, Christopher Lumley Do, Neil S. Sachanandani Md Aug 2020

Use Of Pericranial Flaps With Dermal Substitute For Scalp Reconstruction: A Case Series, Kongkrit Chaiyasate Md, Facs, Lauren N. Oliver Do, Scott A. Kreitzberg Do, Mitchell Lyons Md, Joshua Goldman Md, Stephen M. Lu Md, Tracey Bastiaans Do, Christopher Lumley Do, Neil S. Sachanandani Md

School of Medicine Faculty Publications

Background: Skin cancer incidence has been rapidly increasing over the past 2 decades, and the resulting defects from excision have significant aesthetic and functional implications. In particular, wound coverage for large scalp and forehead defects with calvarial exposure can lead to hairline distortion, contour irregularities, and alopecia. We describe a 2-stage technique for scalp reconstruction, which preserves the normal hairline, covers exposed bone with vascularized tissue, and restores an aesthetic soft-tissue contour. Methods: This is a retrospective case series of 13 adults with ages ranging from 50 to 89 years. All patients underwent Mohs surgery on the forehead or scalp …


Efficacy Of Manual Hemostasis For Percutaneous Axillary Artery Intra-Aortic Balloon Pump Removal, Rajiv Tayal, Michael Divita, Christoph W. Sossou, Alexis K. Okoh, Kelly Stelling, James M. Mccabe, Amir Kaki, Najam Wasty, David A. Baran Jul 2020

Efficacy Of Manual Hemostasis For Percutaneous Axillary Artery Intra-Aortic Balloon Pump Removal, Rajiv Tayal, Michael Divita, Christoph W. Sossou, Alexis K. Okoh, Kelly Stelling, James M. Mccabe, Amir Kaki, Najam Wasty, David A. Baran

School of Medicine Faculty Publications

Background. The prevalence of peripheral vascular disease has led to the re-emergence of percutaneous axillary vascular access as a suitable alternative access site to femoral artery. We sought to investigate the efficacy and safety of manual hemostasis in the axillary artery. Methods. Data were collected from a prospective internal registry of patients who had a Maquet® (Rastatt, Germany) Mega 50 cc intra-aortic balloon pumps (IABP) placed in the axillary artery position. They were anticoagulated with weight-based intravenous heparin to maintain an activated partial thromboplastin time (aPTT) of 50-80 seconds. Anticoagulation was discontinued 2 hours prior to the device explantation. Manual …


Polygenic Risk Scores For Subtyping Of Schizophrenia, Jingchun Chen, Travis Mize, Jain-Shing Wu, Elliot Hong, Vishwajit Nimgaonkar, Kenneth S. Kendler, Daniel Allen, Edwin Oh, Alison Netski, Xiangning Chen Jul 2020

Polygenic Risk Scores For Subtyping Of Schizophrenia, Jingchun Chen, Travis Mize, Jain-Shing Wu, Elliot Hong, Vishwajit Nimgaonkar, Kenneth S. Kendler, Daniel Allen, Edwin Oh, Alison Netski, Xiangning Chen

School of Medicine Faculty Publications

Schizophrenia is a complex disorder with many comorbid conditions. In this study, we used polygenic risk scores (PRSs) from schizophrenia and comorbid traits to explore consistent cluster structure in schizophrenia patients. With 10 comorbid traits, we found a stable 4-cluster structure in two datasets (MGS and SSCCS). When the same traits and parameters were applied for the patients in a clinical trial of antipsychotics, the CATIE study, a 5-cluster structure was observed. One of the 4 clusters found in the MGS and SSCCS was further split into two clusters in CATIE, while the other 3 clusters remained unchanged. For the …


Utility Of Inflammatory Markers To Predict Adverse Outcome In Acute Pancreatitis: A Retrospective Study In A Single Academic Center, Mohamad Mubder, Banreet Dhindsa, Danny Nguyen, Syed Saghir, Chad Cross, Ranjit Makar, Gordon Ohning Jul 2020

Utility Of Inflammatory Markers To Predict Adverse Outcome In Acute Pancreatitis: A Retrospective Study In A Single Academic Center, Mohamad Mubder, Banreet Dhindsa, Danny Nguyen, Syed Saghir, Chad Cross, Ranjit Makar, Gordon Ohning

School of Medicine Faculty Publications

Background/Aim: Acute pancreatitis (AP) is a commonly encountered emergency where early identification of complicated cases is important. Inflammatory markers like lymphocyte to monocyte ratio (LMR) and neutrophil to lymphocyte ratio (NLR) are simple and readily available markers. In this study, we evaluated the utility of these markers in the early identification of patients with complicated AP. Patients and Methods: All patients with a diagnosis of AP admitted to the University Medical Center in Las Vegas/Nevada between August 2015 and September 2018 were identified using ICD-10 codes. Medical records were reviewed retrospectively. Epidemiological measures and their associated confidence intervals were calculated …


Sound Levels With Aural Suctioning: Effects Of Suction Size, Canal Moisture, And Distance From The Eardrum, Allen Young Md, Nathaniel H. Reeve Md, Albert Yang Md, Jacob Kahane Md, Chad Cross Phd, Anita Albanese Bs, Matthew Ng Jul 2020

Sound Levels With Aural Suctioning: Effects Of Suction Size, Canal Moisture, And Distance From The Eardrum, Allen Young Md, Nathaniel H. Reeve Md, Albert Yang Md, Jacob Kahane Md, Chad Cross Phd, Anita Albanese Bs, Matthew Ng

School of Medicine Faculty Publications

Objective To determine sound levels resulting from aural suctioning of the external auditory canal. Methods Unweighted decibels (dB) and A‐weighted decibels (dBA) sound pressure level measurements were recorded using a retrotympanic microphone in cadaveric human temporal bones. Sound measurements were made with common otologic suctions, size 3, 5, and 7 French, within the external ear canal at the tympanic membrane, 5, and 10 mm from the tympanic membrane in the dry condition. In the wet condition, the ear canal was filled with fluid and completely suctioned clear to determine sound effects of suctioning liquid from the ear canal. Results Sound …


Exogenous Lipoid Pneumonia Complicated By Mineral Oil Asperation In A Patient With Chronic Constipation: A Case Report And Review, Hafiz Muhammad Jeelani, Muhammad Mubbashir Sheikh, Belaal Sheikh, Hafiz Mahboob, Anchit Bharat Jul 2020

Exogenous Lipoid Pneumonia Complicated By Mineral Oil Asperation In A Patient With Chronic Constipation: A Case Report And Review, Hafiz Muhammad Jeelani, Muhammad Mubbashir Sheikh, Belaal Sheikh, Hafiz Mahboob, Anchit Bharat

School of Medicine Faculty Publications

Exogenous lipoid pneumonia is a rare and frequently misdiagnosed lung disease. It occurs as an inflammatory reaction secondary to either aspiration or inhalation of lipids. Our patient had a history significant for recurrent pneumonia and the use of mineral oil for chronic constipation. A chest computed tomography showed multifocal consolidative opacities with areas of low attenuation, highly suspicious of exogenous lipid pneumonia. The diagnosis was confirmed with combined bronchoalveolar lavage and transbronchial lung biopsy that showed lipid-laden macrophages consistent with exogenous lipoid pneumonia. After thorough medication review, apart from mineral oil, no other contributing factors were found. A diagnosis of …


Hemodynamic And Clinical Effects Of Selexipag In Children With Pulmonary Hypertension, Abraham Rothman, Gabriel Cruz, William N. Evans, Humberto Restrepo Feb 2020

Hemodynamic And Clinical Effects Of Selexipag In Children With Pulmonary Hypertension, Abraham Rothman, Gabriel Cruz, William N. Evans, Humberto Restrepo

School of Medicine Faculty Publications

Selexipag is an oral prostacyclin receptor agonist; it was recently approved for use in adults with pulmonary arterial hypertension. The safety and efficacy of selexipag has not yet been determined in the pediatric population. We describe short-term hemodynamic and clinical data with selexipag therapy in four pediatric patients with pulmonary hypertension. We reviewed clinical, echocardiographic, and hemodynamic data. One patient was transitioned from subcutaneous treprostinil to selexipag, and in three patients, selexipag was added as a third agent. Drug dosing was attained empirically based on patient body size. A follow-up catheterization was performed 12–18 months after initiation of selexipag therapy. …


Evaluating The Performance Of The Who International Reference Standard For Osteoporosis Diagnosis In Postmenopausal Women Of Varied Polygenic Score And Race, Qing Wu, Xiangxue Xiao, Yingke Xu Feb 2020

Evaluating The Performance Of The Who International Reference Standard For Osteoporosis Diagnosis In Postmenopausal Women Of Varied Polygenic Score And Race, Qing Wu, Xiangxue Xiao, Yingke Xu

School of Medicine Faculty Publications

Background: Whether the bone mineral density (BMD) T-score performs differently in osteoporosis classification in women of different genetic profiling and race background remains unclear. Methods: The genomic data in the Women’s Health Initiative study was analyzed (n = 2417). The polygenic score (PGS) was calculated from 63 BMD-associated single nucleotide polymorphisms (SNPs) for each participant. The World Health Organization′s (WHO) definition of osteoporosis (BMD T-score ≤ −2.5) was used to estimate the cumulative incidence of fracture. Results: T-score classification significantly underestimated the risk of major osteoporotic fracture (MOF) in the WHI study. An enormous underestimation was observed in African American …


Preoperative Maximization To Reduce Complications In Spinal Surgery, Sukanta Maitra, Christopher Mikhail, Samuel K. Cho, Michael D. Daubs Jan 2020

Preoperative Maximization To Reduce Complications In Spinal Surgery, Sukanta Maitra, Christopher Mikhail, Samuel K. Cho, Michael D. Daubs

School of Medicine Faculty Publications

Study design: Invited narrative review. Objectives: The aim of this review was to summarize current literature regarding risk factors that surgeons can optimize in the preoperative setting in the spinal surgery patient, in order to reduce complications and improve patient-reported outcomes. Methods: Review of the relevant literature by the authors. Results: Modifiable risk factors identified relative to the patient include obesity, malnutrition/nutrient deficiency, diabetes/hyperglycemia, preoperative anemia, vitamin D/DEXA (dual-energy radiograph absorptiometry), nicotine use/smoking, and opioid use/psychosocial factors. Conclusion: By maximizing a patient's physiological and psychological status prior to elective spine surgery, we may move closer to achieving the goals of …


Recent Advances In Understanding And Management Of Bronchopulmonary Dysplasia, Vineet Bhandari, Mitali Sahni Jan 2020

Recent Advances In Understanding And Management Of Bronchopulmonary Dysplasia, Vineet Bhandari, Mitali Sahni

School of Medicine Faculty Publications

© 2020 Sahni M and Bhandari V. In the current era, the survival of extremely low-birth-weight infants has increased considerably because of new advances in technology; however, these infants often develop chronic dysfunction of the lung, which is called bronchopulmonary dysplasia (BPD). BPD remains an important cause of neonatal mortality and morbidity despite newer and gentler modes of ventilation. BPD results from the exposure of immature lungs to various antenatal and postnatal factors that lead to an impairment in lung development and aberrant growth of lung parenchyma and vasculature. However, we still struggle with a uniform definition for BPD that …