Medicine and Health Sciences Commons^™

Chlormethine Gel In Combination With Other Therapies For Treatment Of Mycosis Fungoides: A Review With Patient Cases, Marco Ardigò, Neda Nikbakht, Miriam Teoli, Laura Gleason, Liliana Crisan, Christiane Querfeld

Department of Dermatology and Cutaneous Biology Faculty Papers

Topical chlormethine gel has been approved as monotherapy for treatment of adult patients with mycosis fungoides (MF), the most common form of cutaneous T-cell lymphoma. In clinical practice, chlormethine gel is often combined with other skin-directed or systemic therapies to optimize response and target recalcitrant lesions. Positive outcomes with combination regimens using chlormethine gel and topical corticosteroids, phototherapy, retinoids, methotrexate, or interferon-α have been reported in literature. However, there are no treatment guidelines on the use of combination regimens with chlormethine gel. To provide real-world evidence and guidance on the use of chlormethine gel combination regimens, several cases of patients …

Impact Of Genetic And Non-Genetic Factors On Phenotypic Diversity In Nbas-Associated Disease, Nicole Hammann, Dominic Lenz, Ivo Baric, Ellen Crushell, Carlo Dionisi Vici, Felix Distelmaier, Francois Feillet, Peter Freisinger, Maja Hempel, Anna L. Khoreva, Martin W. Laass, Yves Lacassie, Elke Lainka, Catherine Larson-Nath, Zhongdie Li, Patryk Lipiński, Eberhard Lurz, André Mégarbané, Susana Nobre, Giorgia Olivieri, Bianca Peters, Paolo Prontera, Lea D. Schlieben, Christine M. Seroogy, Cristina Sobacchi, Shigeru Suzuki, Christel Tran, Jerry Vockley

School of Medicine Faculty Publications

Biallelic pathogenic variants in neuroblastoma-amplified sequence (NBAS) cause a pleiotropic multisystem disorder. Three clinical subgroups have been defined correlating with the localisation of pathogenic variants in the NBAS gene; variants affecting the C-terminal region of NBAS result in SOPH syndrome (short stature, optic atrophy, Pelger-Huët anomaly), variants affecting the Sec 39 domain are associated with infantile liver failure syndrome type 2 (ILFS2) and variants affecting the ß-propeller domain give rise to a combined phenotype. However, there is still unexplained phenotypic diversity across the three subgroups, challenging the current concept of genotype-phenotype correlations in NBAS-associated disease. Therefore, besides examining the genetic …

Role Of Vitamins A, C, D, E In Cancer Prevention And Therapy: Therapeutic Potentials And Mechanisms Of Action, Wamidh H. Talib, Dima Abdulraheem Ahmed Jum’Ah, Zeena Shamil Attallah, Mohanned Sami Jallad, Lina T. Al Kury, Rawan Wamidh Hadi, Asma Ismail Mahmod

All Works

Cancer, a leading global cause of mortality, arises from intricate interactions between genetic and environmental factors, fueling uncontrolled cell growth. Amidst existing treatment limitations, vitamins have emerged as promising candidates for cancer prevention and treatment. This review focuses on Vitamins A, C, E, and D because of their protective activity against various types of cancer. They are essential as human metabolic coenzymes. Through a critical exploration of preclinical and clinical studies via PubMed and Google Scholar, the impact of these vitamins on cancer therapy was analyzed, unraveling their complicated mechanisms of action. Interestingly, vitamins impact immune function, antioxidant defense, inflammation, …

Development Of A Novel Covalently Bonded Conjugate Of Caprylic Acid Tripeptide (Isoleucine–Leucine–Aspartic Acid) For Wound-Compatible And Injectable Hydrogel To Accelerate Healing, Sachin B. Baravkar, Yan Lu, Abdul Razak Masoud, Qi Zhao, Jibao He, Song Hong

School of Medicine Faculty Publications

Third-degree burn injuries pose a significant health threat. Safer, easier-to-use, and more effective techniques are urgently needed for their treatment. We hypothesized that covalently bonded conjugates of fatty acids and tripeptides can form wound-compatible hydrogels that can accelerate healing. We first designed conjugated structures as fatty acid–aminoacid1–amonoacid2–aspartate amphiphiles (Cn acid–AA1–AA2–D), which were potentially capable of self-assembling into hydrogels according to the structure and properties of each moiety. We then generated 14 novel conjugates based on this design by using two Fmoc/tBu solid-phase peptide synthesis techniques; we verified their structures and purities through liquid chromatography with tandem mass spectrometry and nuclear …

Determining The Feasibility Of A Codesigned And Personalised Intervention (Veg4me) To Improve Vegetable Intake In Young Adults Living In Rural Australian Communities: Protocol For A Randomised Controlled Trial, Katherine M. Livingstone, Jonathan C. Rawstorn, Stephanie R. Partridge, Yuxin Zhang, Eric O, Stephanie L. Godrich, Sarah A. Mcnaughton, Gilly A. Hendrie, Kate Dullaghan, Gavin Abbott, Lauren C. Blekkenhorst, Ralph Maddison, Scott Barnett, John C. Mathers, Laura Alston

Research outputs 2022 to 2026

INTRODUCTION: Diets low in vegetables are a main contributor to the health burden experienced by young adults in rural communities. Digital health interventions provide an accessible delivery model that can be personalised to meet the diverse preferences of young adults. A personalisable digital vegetable intake intervention (Veg4Me) was codesigned to meet the needs of young adults living in rural communities. This study will determine the feasibility of delivering a personalised Veg4Me programme and compare preliminary effects with a non-personalised Veg4Me (control). METHODS AND ANALYSIS: A 12-week assessor-blinded, two-arm, parallel randomised controlled trial will be undertaken from August 2023 until April …

An Exploratory Metabolomic Comparison Of Participants With Fast Or Absent Functional Progression From 2care, A Randomized, Double-Blind Clinical Trial In Huntington's Disease., Andrew Mcgarry, Krystal Hunter, John Gaughan, Peggy Auinger, Thomas N Ferraro, Basant Pradhan, Luigi Ferrucci, Josephine M Egan, Ruin Moaddel

Cooper Medical School of Rowan University Faculty Scholarship

Huntington's disease (HD) is increasingly recognized for diverse pathology outside of the nervous system. To describe the biology of HD in relation to functional progression, we previously analyzed the plasma and CSF metabolome in a cross-sectional study of participants who had various degrees of functional impairment. Here, we carried out an exploratory study in plasma from HD individuals over a 3-year time frame to assess whether differences exist between those with fast or absent clinical progression. There were more differences in circulating metabolite levels for fast progressors compared to absent progressors (111 vs 20, nominal p < 0.05). All metabolite changes in faster progressors were decreases, whereas some metabolite concentrations increased in absent progressors. Many of the metabolite levels that decreased in the fast progressors were higher at Screening compared to absent progressors but ended up lower by Year 3. Changes in faster progression suggest greater oxidative stress and inflammation (kynurenine, diacylglycerides, cysteine), disturbances in nitric oxide and urea metabolism (arginine, citrulline, ornithine, GABR), lower polyamines (putrescine and spermine), elevated glucose, and deficient AMPK signaling. Metabolomic differences between fast and absent progressors suggest the possibility of predicting functional decline in HD, and possibly delaying it with interventions to augment arginine, polyamines, and glucose regulation.

Lung Cancer Masquerading As Thoracolumbar Pain Detected In An Outpatient Physical Therapy Setting, Jeremiah Blankenship

Asian Journal of Physical Therapy

Study Design: Case Study. Background: This case report describes the clinical course of a patient with right low back pain (LBP) and the use of clinical evaluation findings to initiate medical referral resulting in a diagnosis of cancer presenting as mechanical low back pain. Diagnosis: A 59-year-old male with primary complaints of progressive right-sided LBP affecting his job, sleep, and daily activities was seen by a physical therapist in an outpatient setting. The components of the patient’s history and physical examination were consistent with mechanical thoracolumbar dysfunction. However, clustered examination findings suggested the possibility of a more serious underlying disease. …

Proceedings Of The 23rd International Conference Of Public Health Sciences

Journal of Health Research

Chulalongkorn University aims to be a prominent national institution with global recognition. Its primary focus is on producing knowledge and innovation that are crucial for the creative and sustainable development of Thai society. To achieve this vision, the university consistently provides support to all of its faculties, institutes, colleges, and other entities in carrying out a range of academic activities, including in-class teaching, research, and conferences, such as the one we are gathered for today. With a primary focus on graduate-level teaching in the field of public health and public health sciences, the College of Public Health Sciences is a …

Development And Validation Of The Pain Resilience And Optimism Scale (Pros), Wonjin Seo

Electronic Thesis and Dissertation Repository

Numerous self-report questionnaires have been used in pain research to explore patients' experiences. However, these questionnaires often employ negatively worded items that can potentially worsen patients' distress. In response to the emergence of positive psychology, this thesis aimed to develop a new questionnaire that adopts a positive and strengths-focused approach, incorporating resilience, to replace the negative items found in existing tools such as the Pain Catastrophizing Scale (PCS). First, the effectiveness of the Connor-Davidson Resilience Scale (CD-RISC) in measuring resilience following trauma was assessed through a systematic review using the COnsensus-based Standards for the selection of health status Measurement INstruments …

Sports-Related Concussion Management And Guideline Awareness In The Primary Care Setting, Stephanie K. Eble, Oleksandra Pashchenko, William Patterson, Christina T. Holt, William Dexter, Kristine Karlson

Journal of Maine Medical Center

No abstract provided.

Use Of Syringe Service Programs In Rural Vs Urban Maine: A Harm-Reduction Study, Lisa W. Miller, Kim Murray, Emma Daybranch, Kinna Thakarar

Journal of Maine Medical Center

Introduction: Syringe service programs (SSPs) reduce HIV and viral hepatitis transmission, as well as the prevalence of improperly disposed needles and needle stick injuries among first responders. Infections associated with injection drug use are rising in rural areas, including Maine, leading to concerns that SSP services are difficult to access for rural residents.

Methods: A cross-sectional survey of 101 participants hospitalized with infections associated with injection drug use at 4 hospitals in Maine was collected over a 15-month period. Descriptive analyses were performed. Statistical analyses were completed using Fisher’s exact tests, Pearson’s chi-squared tests, and Student’s t tests.

Results: Of …

Barriers To Care For Children With Cerebral Palsy In The Rural State Of Maine: A Mixed-Methods Study, Rayne L. Whitten, Anya K. Cutler, Alexa K. Craig

Journal of Maine Medical Center

Introduction: Guidelines on orthopedic hip surveillance in children with cerebral palsy have been published to minimize the effects of cerebral palsy and maximize quality of life. Researchers aimed to identify barriers to cerebral palsy care and to assess adherence to national hip-surveillance guidelines among a small subset of children with cerebral palsy who live in a rural state.

Methods: Parents of children with cerebral palsy were interviewed, and thematic analyses were performed on the recorded transcripts. Patient-specific data about imaging and demographics were manually extracted from the electronic health record to perform a mixed-methods analysis.

Results: Twenty-one parents were interviewed, …

Victor A. Mckusick, Md And The Osler Medical Service – Firm System Threads Between Baltimore And Maine: The 15th Annual Mckusick Lecture, Scot C. Remick

Journal of Maine Medical Center

No abstract provided.

The Epidemic Of Gun Violence And The Role Of Health Care Professionals, Daniel Meyer, Kurt Granhke

Journal of Maine Medical Center

No abstract provided.

Results Of A Needs Assessment: Use Of Sexual Orientation And Gender Identity Data In Health Systems In Maine, Lucy Soule, Melissa Fairfield, Sivana Barron, Natalie Kuhn, Brandy Brown

Journal of Maine Medical Center

Introduction: Lesbian, gay, bisexual, transgender, queer, or questioning (LGBTQ+) patients experience significantly more health care disparities than non-LGBTQ+ patients. Although sexual orientation and gender identity data (SOGI) would help quantify and track these known disparities, there are no standardized methods for routinely and consistently including SOGI into health care management in Maine. Our needs assessment (1) evaluates the comfort of health care professionals (HCPs) in collecting SOGI and incorporating it into the medical record and (2) identifies barriers to SOGI collection.

Methods: An interprofessional team conducted a survey of Maine HCPs who identified as working directly with patients or patient …

A Life-Threatening Emergency Exacerbated By Untreated Mental Illness In A Low-Barrier Health Center, Brendan J. Prast, Byron Marshall

Journal of Maine Medical Center

Introduction: We report on a patient with untreated severe mental illness who presented with a life-threatening emergency: retained products of conception and hemorrhage.

Clinical Findings: A female patient experiencing homelessness developed life-threatening hemorrhage. Her mental illness impaired effective communication and treatment.

Clinical Course: The patient presented with fatigue, vaginal bleeding, and known retained products of conception. Her active mental illness complicated the situation as it limited effective communication and treatment due to delusions. She requested only treatment for an infectious cause of her symptoms. She refused most interventions and had a self-directed discharge from the hospital. Throughout this process, we …

Maine Medical Center Experience With Explantation Of Left Ventricular Assist Devices, Laura Onderko, Lauren Vickerson, Andrew Schwartzman

Journal of Maine Medical Center

No abstract provided.

Non-Ketotic Hyperglycemia Unmasks Hemichorea - A Reply, Ezhilkugan Ganessane, Sasikumar Mahalingam, Selva Ganesan

Journal of Community Hospital Internal Medicine Perspectives

No abstract for this article type

Association Of Depression With Myocardial Infarction With Non-Obstructive Coronary Arteries: A Systematic Review, Sarim Rashid, Khawaja Usama Maqbool, Umer Hassan, Subhan Ahmed, Hamayle Saeed, Fnu Avanteeka, Syed Muhammad Jawad Zaidi, Jahanzeb Malik, Amin Mehmoodi

Journal of Community Hospital Internal Medicine Perspectives

This systematic review examined the association between depression and myocardial infarction with non-obstructive coronary arteries (MINOCA). A comprehensive literature search was conducted using electronic databases, resulting in the inclusion of six small case-control and cohort studies reported from Spain, Australia, China, and Pakistan. The studies included various study designs, such as cohort studies, case-control studies, and prospective cohort studies. The results of the systematic review indicate a significant association between depression and MINOCA. Several studies reported a higher prevalence of depression among MINOCA patients compared to those with obstructive coronary artery disease. Additionally, depression was found to be associated with …

A Rare Case Of Iga Vasculitis In An Adult Patient With Mssa Bacteremia And Prostate Abscess, Maria E Mesalles, Erinolaoluwa F Araoye, Anees Siddiqi, Adrien Janvier

Journal of Community Hospital Internal Medicine Perspectives

IgA vasculitis, previously known as Henoch Schönlein Purpura (HSP), is a disease more common in children and occurs when IgA1 immune complexes attach to the walls of small blood vessels causing inflammation. This case report is of an adult male who presented with a purpuric rash affecting both legs, microhematuria, and knee pain. Blood cultures were positive for Methicillin-sensitive Staphylococcus aureus (MSSA). Computed tomography of the pelvis revealed a prostate abscess. Skin biopsy demonstrated IgA and C3 in the dermal vessels. To our knowledge, this is the first report of IgA vasculitis associated with MSSA bacteremia due to a prostate …

Autoimmune Hepatitis: An Unusual Presentation., Ahmed Ali Aziz, Muhammad Ali Aziz, Deep Mehta, Muhammad Humayoun Rashid

Journal of Community Hospital Internal Medicine Perspectives

Autoimmune hepatitis (AIH) is a chronic inflammatory liver disease that occurs in a bimodal age distribution in the second and fifth-sixth decade of life. The disease is more prevalent in females and presents with variable clinical manifestations ranging from being asymptomatic to acute liver failure. AIH is often overlooked and not worked up in elderly patients who present with liver failure. This can lead to increased morbidity and mortality in elderly patients. AIH should be considered as a differential diagnosis in patients who present with elevated transaminases regardless of age or gender as early recognition and treatment leads to improved …

Reverse Takotsubo Cardiomyopathy With Severe Dengue: Case Report From Pakistan., Warda Ajmal, Zahra Iftikhar, Asaad Akbar Khan

Journal of Community Hospital Internal Medicine Perspectives

Takotsubo Cardiomyopathy is an established transient cardiomyopathy found predominately in females with intense emotional and physical strain. It has four notable variants: Apical, Mid-Ventricular, Basal and Focal. Mid Ventricular variant is also referred to as Reverse Takotsubo Cardiomyopathy. Dengue is a viral arthopod-borne tropical disease endemic to Pakistan, with multiple reports of cardiovascular involvement. We report an atypical presentation of a 17 year old male, suffering from Dengue Fever, who presented to a tertiary care hospital with Reverse Takotsubo Cardiomyopathy.

Cases From A Community Hospital…Jchimp Series #2: 66-Year-Old Man With Recurrent Painful Rashes And Oral Ulcerations, Fatima Halilu, Jing Wu, Joseph Fuscaldo, Nathan Dunsmore, Zain Syed, Pauline Daley

Journal of Community Hospital Internal Medicine Perspectives

This is part of a series of case reports detailing scenarios from our community hospital. The cases are selected to feature clinical dilemmas, provide a review on what is currently known about the topic with expert perspective. A 66-year-old black man presented to the primary care clinic with his fourth episode of generalized painful rash and oral ulcerations without a diagnosis despite two emergency room (ED) visits alongside doxycycline treatment. Symptoms interfered with daily activities with skin exam notable for widespread erythematous patches and plaques. In office biopsies were obtained with final diagnosis of erythema multiforme. Etiologic workup revealed positive …

Rare Case Of Mycobacterium Avium Complex Peritonitis In A Patient With Multiple Myeloma Undergoing Peritoneal Dialysis, Sacide S. Ozgur, Nida Ansari, Dhruv Patel, Ryan Rahman, Raymond Shih

Journal of Community Hospital Internal Medicine Perspectives

Mycobacterium avium complex (MAC) infections can present as a variety of severe diseases. While it has a predilection for immunocompromised patients such as those with Human immunodeficiency virus (HIV), it can also affect immunocompetent patients as well. One of the rare yet severe diseases that MAC infections can present is MAC peritonitis. Often hard to distinguish from other causes of peritonitis, high clinical suspicion should be maintained for those who are susceptible. Here we present an 85-year-old female with a past medical history of end-stage renal disease on peritoneal dialysis who presented with nausea and vomiting. She was found to …

Reactive Arthritis After Mpox Vaccination, Indira Acharya, Lanaya Williams Smith, Chandralekha Banerjee, Lyn M. Camire, Radhika Vij

Journal of Community Hospital Internal Medicine Perspectives

Autoimmune inflammatory reaction after vaccination is a rare clinical entity. Reactive arthritis has been described after various vaccinations, but not after mpox vaccination. Here we present a case of recently diagnosed reactive arthritis after mpox vaccination that presented in the context of unrelenting fever and diarrhea complicated by migratory arthritis and anterior uveitis. We have reported this case to the Vaccine Adverse Event Reporting System (VAERS).

The Diagnostic Yield Of Endoscopic Ultrasound In Asymptomatic Patients With Unexplained Dilated Common Bile Duct, Or Double Duct Sign With Normal Transaminases A Retrospective Study From A Single Urban-Based University Endoscopy Center, Mina Fransawy Alkomos, Shaker Barham, Youssef Botros, Nader Mekheal, Ariana Tagliaferri, Alisa Farokhian, Hardikkumar M. Shah, Gabriel Melki, Yana Cavanagh, Walid Baddoura, Matthew Grossman

Journal of Community Hospital Internal Medicine Perspectives

Background Common bile duct dilatation alone or double duct sign (both CBD and dilated pancreatic duct dilatation ) and abnormal liver enzymes are highly predictive of biliary disease. This can be identified on ultrasound (US), CT scan, and/or magnetic resonance cholangiopancreatography (MRCP). Unexplained dilatation on imaging might warrant endoscopic ultrasound (EUS) to identify any occult causes. Supporting literature about the importance of using EUS in these conditions is evolving with no clear evidence-based approach to evaluate asymptomatic dilated ducts. We aim to investigate the diagnostic yield of EUS in unexplained CBD dilatation or double duct sign with normal liver enzymes. …

De-Implementation Of Fecal Occult Blood Testing In The Emergency Department And Hospital Units: A Quality Improvement Project, Adewale Ajumobi, Joline De Castro, Ammar Qureshi

Journal of Community Hospital Internal Medicine Perspectives

Background: Fecal occult blood tests (FOBT) are inappropriately used in patients with melena, hematochezia, coffee ground emesis, iron deficiency anemia, and diarrhea. The use of FOBT for reasons other than screening for colorectal cancer is considered low-value and unnecessary. Methods: Quality Improvement Project that utilized education, Best Practice Advisory (BPA) and modification of order sets in the electronic health record (EHR). The interventions were done in a sequential order based on the Plan-Do-Study-Act (PDSA) method. An annotated run chart was used to analyze the collected data. Results: Education and Best Practice Advisory within the EHR led to significant reduction in …

Contrasting Tick Species Behaviors: A Course-Based Undergraduate Research Experience (Cure), Sara Benham, Shovan Dutta, Rohan Maddamsetti, Clayton Wright, Alena Anderson, David T. Gauthier, Holly D. Gaff

Spora: A Journal of Biomathematics

Tick-borne diseases are on the rise throughout the world, and there is a need to better understand tick behavior in order to identify potential new interventions. Ticks have a complex life history and can survive months off-host. There is a lack of large-scale data on off-host tick behavior, which leaves a gap in understanding of tick biology outside of tick-host interactions. Introducing undergraduate students to authentic research early in their studies can help prepare them for independent inquiry in upper-level classes. To address the student needs and fill gaps in tick research, students in introductory biology courses recorded observations of …

High Flow Nasal Cannula And Non-Invasive Mechanical Ventilation In Management Of Covid-19 Associated Respiratory Failure, Hanady Mohammad Elfeky, Ayman Ahmed Rady, Ashraf Mohamed Mostafa, Menan Hany Nassar, Amany Ali Sultan

Menoufia Medical Journal

Objectives: To analyze the clinical data and outcomes of different non-invasive oxygen therapy modalities used for the treatment of type 1 respiratory failure associated with COVID 19 virus infection. Background: Despite the variety of oxygen delivery modes, there is still uncertainty regarding the benefit of HFNC as a non-invasive oxygen delivery method during the coronavirus pandemic. Methods: In 100 patients with ARF associated with COVID-19, We performed an observational prospective cohort study in which they divided into the NIV and HFNC groups. The primary outcome was treatment failure, characterized by switching to invasive mechanical ventilation or the other oxygen therapy …

Study Of Tp53 Gene Expression In Multiple Sclerosis Patients, Enas Said Essa, Safa Sayed Meshaal, Ahmed Nabil Mounir, Zahraa Azab Mohamed Abouelatta

Menoufia Medical Journal

Objectives: to evaluate the role of TP53 gene expression as a potential biomarker for multiple sclerosis. Background: Multiple sclerosis (MS) is the most prevalent non-traumatic illness among young adults. The frequency of MS and its socioeconomic effects are growing globally. Up until now, the diagnosis of MS has been considered a big challenge as it depends on a group of findings known as the McDonald criteria. However, none of those criteria is particularly specific to MS disease. This study aims to evaluate TP53 gene expression as a diagnostic marker for MS. Methods: Twenty-eight MS cases were recruited according to modified …