Medicine and Health Sciences Commons^™

Fluid Biomarkers In Cerebral Amyloid Angiopathy, Seyed M. Savar, Bin Ma, Eugene Hone, Farzana Jahan, Shaun Markovic, Steve Pedrini, Soudabeh Shemehsavar, Vandhana Easwaran, Kevin Taddei, Samantha Gardener, Jasmeer P. Chhatwal, Ellis S. Van Etten, Matthias J. P. Van Osch, Daniel Clarke, Anastazija Gnjec, Mark A. Van Buchem, Marieke J. H. Wermer, Graeme J. Hankey, Steven M. Greenberg, Ralph N. Martins, Hamid R. Sohrabi

Research outputs 2022 to 2026

Cerebral amyloid angiopathy (CAA) is a type of cerebrovascular disorder characterised by the accumulation of amyloid within the leptomeninges and small/medium-sized cerebral blood vessels. Typically, cerebral haemorrhages are one of the first clinical manifestations of CAA, posing a considerable challenge to the timely diagnosis of CAA as the bleedings only occur during the later disease stages. Fluid biomarkers may change prior to imaging biomarkers, and therefore, they could be the future of CAA diagnosis. Additionally, they can be used as primary outcome markers in prospective clinical trials. Among fluid biomarkers, blood-based biomarkers offer a distinct advantage over cerebrospinal fluid biomarkers …

Primary Adrenal Angiosarcoma: A Case Report And Review Of The Literature, Zunaira Naeem, Joon Yau Leong, Arianna Morton, Alaa Hrizat, Eric Shiffrin, Andrew Gomella, Peter Mccue, Mark Mann, Li Li

Department of Pathology, Anatomy, and Cell Biology Faculty Papers

Primary adrenal angiosarcoma is an extremely rare malignant tumor with challenging diagnosis. A 66-year-old woman had a 4.3 cm right adrenal mass suspicious for adrenal cortical carcinoma. Pathological examination demonstrated a hemorrhagic adrenal cyst with numerous irregularly shaped anastomosing vascular channels lined by atypical endothelial cells that had frequent atypical mitotic figures (12/10 HPF, Ki67 10%). The tumor cells were positive for CD31, ERG, and FLI-1, but negative for adrenal and other tumor lineage markers by immunohistochemistry. NGS fusion gene testing ruled out epithelioid hemangioendothelioma. Accurate diagnosis and differential inclusion are important for appropriate treatment of this rare tumor.

Educational Case: Ovarian Neoplasms: A Series Of Educational Cases To Review Malignancies Of Epithelial, Stromal, And Germ Cell Origin, Jordyn B. Tumas, Joanna Chan

Department of Pathology, Anatomy, and Cell Biology Faculty Papers

No abstract provided.

Patterns And Implications Of Neurological Examination Findings In Autosomal Dominant Alzheimer Disease, Jonathan Vöglein, Nicolai Franzmeier, John C. Morris, Marianne Dieterich, Eric Mcdade, Mikael Simons, Oliver Preische, Anna Hofmann, Jason Hassenstab, Tammie L. Benzinger, Anne Fagan, James M. Noble, Sarah B. Berman, Neill R. Graff-Radford, Bernardino Ghetti, Martin R. Farlow, Jasmeer P. Chhatwal, Stephen Salloway, Chengjie Xiong, Celeste M. Karch, Nigel Cairns, Richard J. Perrin, Gregory Day, Ralph Martins, Raquel Sanchez-Valle, Hiroshi Mori, Hiroyuki Shimada, Takeshi Ikeuchi, Kazushi Suzuki, Peter R. Schofield, Colin L. Masters, Alison Goate, Virginia Buckles, Nick C. Fox, Patricio Chrem, Ricardo Allegri, John M. Ringman, Igor Yakushev, Christoph Laske, Mathias Jucker, Günter Höglinger, Randall L. Bateman, Adrian Danek, Johannes Levin, Dominantly Inherited Alzheimer Network

Research outputs 2022 to 2026

Introduction:

As knowledge about neurological examination findings in autosomal dominant Alzheimer disease (ADAD) is incomplete, we aimed to determine the frequency and significance of neurological examination findings in ADAD.

Methods:

Frequencies of neurological examination findings were compared between symptomatic mutation carriers and non mutation carriers from the Dominantly Inherited Alzheimer Network (DIAN) to define AD neurological examination findings. AD neurological examination findings were analyzed regarding frequency, association with and predictive value regarding cognitive decline, and association with brain atrophy in symptomatic mutation carriers.

Results:

AD neurological examination findings included abnormal deep tendon reflexes, gait disturbance, pathological cranial nerve examination findings, …

Recent Advances In The Vibrational Spectroscopic Diagnosis Of Non-Small Cell Lung Cancer, Declan O'Dea, Fiona Lyng, Siobhan Nicholson, Finbar O'Connell, Aoife Maguire, Alison Malkin

Articles

Lung cancer is the leading cause of cancer deaths worldwide accounting for 1.69 million deaths in 2015. Studies have indicated a 5 year survival rate of 8%–15% in western countries, although a survival rate as low as 1% has been demonstrated for late stage diagnosis. With the advent of targeted therapies, it is imperative to accurately differentiate non-small cell lung cancer (NSCLC) subtypes in order to ensure efficacy of treatment for patients. Immunohistochemistry and molecular techniques for the diagnosis of NSCLC are increasingly part of the diagnostic algorithm and clinical work-up of lung cancer patients, however due to the limitation …

Complexity In Mood Disorder Diagnosis: Fmri Connectivity Networks Predicted Medication-Class Of Response In Complex Patients, E Osuch, S Gao, M Wammes, Jean Theberge, P Willimason, R J Neufeld, Y Du, J Sui, V Calhoun

Department of Medicine Publications

OBJECTIVE: This study determined the clinical utility of an fMRI classification algorithm predicting medication-class of response in patients with challenging mood diagnoses.

METHODS: Ninety-nine 16-27-year-olds underwent resting state fMRI scans in three groups-BD, MDD and healthy controls. A predictive algorithm was trained and cross-validated on the known-diagnosis patients using maximally spatially independent components (ICs), constructing a similarity matrix among subjects, partitioning the matrix in kernel space and optimizing support vector machine classifiers and IC combinations. This classifier was also applied to each of 12 new individual patients with unclear mood disorder diagnoses.

RESULTS: Classification within the known-diagnosis group was approximately …

Differential Diagnosis Of Auditory Processing Disorder In Children: A Literature Review, Jessica Glennon, Benjamin Kirby

AuD Capstone Projects - Communication Sciences and Disorders

Although there is no consensus on the definition of auditory processing disorder (APD), it is typically characterized by listening difficulties resulting from deficits in auditory perceptual processing of sounds in the central auditory nervous system. APD often co-occurs with other disabilities such as ADHD, dyslexia, and specific language impairment. Presenting symptoms can be very similar to these other disorder, complicating diagnosis. Due to the overlap of symptoms between APD and various other deficits, there are concerns that professionals in different fields are providing children with different labels for the same group of symptoms. Therefore, the aim of this literature review …

Burnout Syndrome And Depression, Renzo Bianchi, Irvin Sam Schonfeld, Eric Laurent

Publications and Research

In this chapter, we proposed an overview of burnout, from the introduction of the construct in the mid-1970s to the growing realization that the syndrome was better conceived of as a depressive condition. Recent studies have shown that the distinction between burnout and depression is problematic, both theoretically and empirically. The history of burnout research suggests that transdisciplinary communication and methodological standards should be strengthened to avoid the proliferation of constructs that, in fact, refer to the same phenomena. Construct proliferation, a transgression of the scientific canon of parsimony, is considered a major problem today because it undermines theory building …

Reproducible Network And Regional Topographies Of Abnormal Glucose Metabolism Associated With Progressive Supranuclear Palsy: Multivariate And Univariate Analyses In American And Chinese Patient Cohorts, J. Ge, J. Wu, S. Peng, P. Wu, J. Wang, H. Zhang, Y. Guan, D. Eidelberg, C. Zuo, Y. Ma

Journal Articles

No abstract provided.

Metabolic Differentiation Of Early Lyme Disease From Southern Tick-Associated Rash Illness (Stari), C Molins, L Ashton, Gary Wormser, B Andre, A Hess, J Belisle

NYMC Faculty Publications

Lyme disease, the most commonly reported vector-borne disease in the United States, results from infection with Borrelia burgdorferi. Early clinical diagnosis of this disease is largely based on the presence of an erythematous skin lesion for individuals in high-risk regions. This, however, can be confused with other illnesses including southern tick-associated rash illness (STARI), an illness that lacks a defined etiological agent or laboratory diagnostic test, and is coprevalent with Lyme disease in portions of the eastern United States. By applying an unbiased metabolomics approach with sera retrospectively obtained from well-characterized patients, we defined biochemical and diagnostic differences between early …

Is It Time To Consider The “Burnout Syndrome” A Distinct Illness?, Renzo Bianchi, Irvin Sam Schonfeld, Eric Laurent

Publications and Research

The “burnout syndrome” has been defined as a combination of emotional exhaustion, depersonalization, and reduced personal accomplishment caused by chronic occupational stress. Although there has been increasing medical interest in burnout over the last decades, it is argued in this paper that the syndrome cannot be elevated to the status of diagnostic category, based on (1) an analysis of the genesis of the burnout construct, (2) a review of the latest literature on burnout-depression overlap, (3) a questioning of the three-dimensional structure of the burnout syndrome, and (4) a critical examination of the notion that burnout is singularized by its …

Burnout-Depression Overlap: A Review, Renzo Bianchi, Irvin Sam Schonfeld, Eric Laurent

Publications and Research

Whether burnout is a form of depression or a distinct phenomenon is an object of controversy. The aim of the present article was to provide an up-to-date review of the literature dedicated to the question of burnout–depression overlap. A systematic literature search was carried out in PubMed, PsycINFO, and IngentaConnect. A total of 92 studies were identified as informing the issue of burnout–depression overlap. The current state of the art suggests that the distinction between burnout and depression is conceptually fragile. It is notably unclear how the state of burnout (i.e., the end stage …

A Knowledge-Based Clinical Toxicology Consultant For Diagnosing Multiple Exposures, Joel D. Schipper, Douglas D. Dankel Ii, A. Antonio Arroyo, Jay L. Schauben

Publications

Objective: This paper presents continued research toward the development of a knowledge-based system for the diagnosis of human toxic exposures. In particular, this research focuses on the challenging task of diagnosing exposures to multiple toxins. Although only 10% of toxic exposures in the United States involve multiple toxins, multiple exposures account for more than half of all toxin-related fatalities. Using simple medical mathematics, we seek to produce a practical decision support system capable of supplying useful information to aid in the diagnosis of complex cases involving multiple unknown substances.

Methods: The system is automatically trained using data mining …

A Knowledge-Based Clinical Toxicology Consultant For Diagnosing Single Exposures, Joel D. Schipper, Douglas D. Dankel Ii, A. Antonio Arroyo, Jay L. Schauben

Publications

Objective: Every year, toxic exposures kill twelve hundred Americans. To aid in the timely diagnosis and treatment of such exposures, this research investigates the feasibility of a knowledge-based system capable of generating differential diagnoses for human exposures involving unknown toxins.

Methods: Data mining techniques automatically extract prior probabilities and likelihood ratios from a database managed by the Florida Poison Information Center. Using observed clinical effects, the trained system produces a ranked list of plausible toxic exposures. The resulting system was evaluated using 30,152 single exposure cases. In addition, the effects of two filters for refining diagnosis based on …

Detection Of Amyloid In Abdominal Fat Pad Aspirates In Early Amyloidosis: Role Of Electron Microscopy And Congo Red Stained Cell Block Sections, Sumana Devata, Parameswaran Hari, Natalia Markelova, Rongshan Li, Richard Komorowski, Vinod B. Shidham

Department of Pathology

Background: Fine-needle aspiration biopsy (FNA) of the abdominal fat pad is a minimally invasive procedure to demonstrate tissue deposits of amyloid. However, protocols to evaluate amyloid in fat pad aspirates are not standardized, especially for detecting scant amyloid in early disease.

Materials and Methods: We studied abdominal fat pad aspirates from 33 randomly selected patients in whom subsequent tissue biopsy, autopsy, and/or medical history for confirmation of amyloidosis (AL) were also available. All these cases were suspected to have early AL, but had negative results on abdominal fat pad aspirates evaluated by polarizing microscopy of Congo Red stained sections (CRPM). …

The Enigma Of Struma Ovarii, Lawrence M. Roth, Aleksander Talerman

Department of Pathology, Anatomy, and Cell Biology Faculty Papers

Since its first description in the early part of the twentieth century, struma ovarii has elicited considerable interest because of its many unique features; however, at present a number of aspects remain enigmatic. Although the typical presentation is that of a pelvic mass, unusual clinical manifestations such as hyperthyroidism, ascites, and Meigs' syndrome have been recognised. Uncommon macroscopic and especially histological patterns in struma can cause difficulties in diagnosis. Cystic strumas are challenging to diagnose both macroscopically and histologically. Proliferative changes within struma can be misdiagnosed as cancer. In regard to the occurrence of thyroid-type carcinoma in struma ovarii, precise …

A Hypothesis-Oriented Algorithm For Symptom-Based Diagnosis By Physical Therapists: Description And Case Series, Courtney D. Few, Todd E. Davenport, Hugh G. Watts

School of Pharmacy Faculty Articles

Study Design: Case series.

Subjects: Two patients referred to physical therapy with a diagnosis of lower back pain (LBP).

Background: The increasing role of physical therapists in primary care settings highlights the skills needed to determine the appropriateness of physical therapy for patients. A hypothesis-oriented algorithm for symptom-based diagnosis was developed for use by physical therapists. The goal of this process is to determine a diagnostic impression to guide decisions regarding patient disposition and physical therapist management. This case series demonstrates the process in two individuals with LBP referred to a community-based outpatient physical therapy clinic.

Diagnosis: Despite the fact …

Idiopathic Granulomatous Mastitis Masquerading As Carcinoma Of The Breast: A Case Report And Review Of The Literature., Richard Tuli, Brian J O'Hara, Janet Hines, Anne L Rosenberg

Department of Surgery Faculty Papers

BACKGROUND: Idiopathic granulomatous mastitis is an uncommon, benign entity with a diagnosis of exclusion. The typical clinical presentation of idiopathic granulomatous mastitis often mimics infection or malignancy. As a result, histopathological confirmation of idiopathic granulomatous mastitis combined with exclusion of infection, malignancy and other causes of granulomatous disease is absolutely necessary. CASE PRESENTATION: We present a case of a young woman with idiopathic granulomatous mastitis, initially mistaken for mastitis as well as breast carcinoma, and successfully treated with a course of corticosteroids. CONCLUSION: There is no clear clinical consensus regarding the ideal therapeutic management of idiopathic granulomatous mastitis. Treatment options …

Bullous Eruption On The Posterior Thigh, James Studdiford, Amber Stonehouse

Department of Family & Community Medicine Faculty Papers

No abstract provided.

Differential Diagnosis Of Orofacial Pain I: Associated With Intracranial And Extracranial Structures And Psychogenic Disorders, Rodolfo Acosta-Ortiz

HPD Articles

Orofacial Pain (OFP) is a common problem among the general population and represents a condition that is potentially debilitating and deteriorating. The correct diagnosis is the principal base for an adequate management; in patients with DOF this may be a simple task or a very complex and frustrating experience for both, clinician, and patient. However, the clinician's knowledge of all possible pain condition that can affect the orofacial region can facilitate the diagnostic process. It is important to emphasize that is very difficult to diagnose something unknown for the clinician and even though "common things occur commonly", it is not …