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Pathological Conditions, Signs and Symptoms Commons

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Substantial Increase In Compliance With Saturated Fatty Acid Intake Recommendations After One Year Following The American Heart Association Diet, Miaomiao Zhao, David E. Chiriboga, Barbara C. Olendzki, Bin Xie, Yawen Li, Lisa Jo McGonigal, Ana Maldonado-Contreras, Yunsheng Ma 2018 University of Massachusetts Medical School

Substantial Increase In Compliance With Saturated Fatty Acid Intake Recommendations After One Year Following The American Heart Association Diet, Miaomiao Zhao, David E. Chiriboga, Barbara C. Olendzki, Bin Xie, Yawen Li, Lisa Jo Mcgonigal, Ana Maldonado-Contreras, Yunsheng Ma

Open Access Articles

The American Heart Association (AHA) dietary guidelines recommend 30(-)35% of energy intake (%E) be from total fat, < 7%E from saturated fatty acids (SFA), and < 1%E from trans fatty acid (TFA). This study evaluates the effect of AHA dietary counselling on fat intake. Between 2009 and 2014, 119 obese adults with metabolic syndrome (MetS), (71% women, average 52.5 years of age, and 34.9 kg/m(2) of body mass index), received individual and group counselling on the AHA diet, over a one-year study period. Each participant attended 2 individual sessions (months 1 and 12) and 12 group sessions, at one-month intervals. At baseline and one-year, we collected three random 24-h diet recalls (two weekdays and one weekend day). Fat intake patterns over time were analyzed using paired-t test and linear mixed-effect models. There was significant variation on SFA and TFA intake per meal, being highest at dinner, in restaurants, and on weekends. Over the one-year study period, daily intake of total fat, SFA, and TFA decreased by 27%, 37% and 41%, respectively (p-value < 0.01, each). Correspondingly, the percentage of participants complying with AHA's recommendations, increased from 25.2% to 40.2% for total fat (p-value = 0.02); from 2.5% to 20.7% for SFA (p-value < 0.01); and from 45.4% to 62% for TFA (p-value = 0.02). Additionally, SFA intake for all meal types at home decreased significantly (p-value < 0.05, each). AHA dietary counselling significantly increased the compliance with AHA dietary guidelines, with an eightfold increase in compliance in SFA intake. Nonetheless, ~80% of our participants still exceeded the recommended SFA intake. Substantial efforts are needed to encourage low-SFA and low-TFA food preparation at home, with strong public health policies to decrease SFA and TFA in restaurants and prepared foods.


First Case Of Pleural Empyema Caused By Staphylococcus Simulans: Review Of The Literature, Amos Lal, Jamal Akhtar, Ashfaq Ullah, George Abraham 2018 Saint Vincent Hospital

First Case Of Pleural Empyema Caused By Staphylococcus Simulans: Review Of The Literature, Amos Lal, Jamal Akhtar, Ashfaq Ullah, George Abraham

Open Access Articles

Staphylococcus simulans is a coagulase-negative organism, mainly an animal pathogen. Reports of human infection have been infrequent, mainly in patients with repeated animal contact. We report the first case of pleural empyema in an elderly woman. S. simulans tends to cause more severe infection because of a biofilm layer which helps in adherence and colonization of smooth surfaces, especially prosthetic devices, shunts, and catheters. The challenging problem even after CoNS isolation and identification is the assessment of their clinical relevance. Major factors that inhibit the penetration of antibiotics is the large-sized effusions/empyema, thickness of pleura, and the nature of ...


Association Between Sarcopenia And Functional Status In Liver Transplant Patients, Natasha H. Dolgin, Andrew J. Smith, Samantha G. Harrington, Babak Movahedi, Paulo N.A. Martins, Adel Bozorgzadeh 2018 University of Massachusetts Medical School

Association Between Sarcopenia And Functional Status In Liver Transplant Patients, Natasha H. Dolgin, Andrew J. Smith, Samantha G. Harrington, Babak Movahedi, Paulo N.A. Martins, Adel Bozorgzadeh

Open Access Articles

OBJECTIVES: A growing body of evidence shows that frailty and functional performance predict liver transplant outcomes. The Organ Procurement and Transplant Network uses the Karnofsky Performance Status scale to adjust for transplant center case mix in assessing quality measures. This study explores the strength of the relationship between Karnofsky Performance Status scores and objective measures of frailty.

MATERIALS AND METHODS: This observational study includes 136 adult, first-time liver transplant recipients at UMass Memorial (2006-2015) who had 2 abdominal computed tomography scans available (at < /= 90 days pretransplant and > /= 7 days before that). We analyzed the relationship between Karnofsky Performance Status and muscle wasting using absolute ...


Association Of Arginine Vasopressin With Low Atrial Natriuretic Peptide Levels, Left Ventricular Remodelling, And Outcomes In Adults With And Without Heart Failure, Julio A. Chirinos, Mayank Sardana, Garrett Oldland, Bilal Ansari, Jonathan Lee, Anila Hussain, Anique Mustafa, Scott R. Akers, Wen Wei, Edward G. Lakatta, Olga V. Fedorova 2018 University of Pennsylvania

Association Of Arginine Vasopressin With Low Atrial Natriuretic Peptide Levels, Left Ventricular Remodelling, And Outcomes In Adults With And Without Heart Failure, Julio A. Chirinos, Mayank Sardana, Garrett Oldland, Bilal Ansari, Jonathan Lee, Anila Hussain, Anique Mustafa, Scott R. Akers, Wen Wei, Edward G. Lakatta, Olga V. Fedorova

Open Access Articles

AIMS: The arginine vasopressin (AVP) pathway has been extensively studied in heart failure (HF) with reduced ejection fraction (HFrEF), but less is known about AVP in HF with preserved EF (HFpEF). Furthermore, the association between AVP and atrial natriuretic peptide (ANP, a well-known inhibitor of AVP secretion) in HF is unknown.

METHODS AND RESULTS: We studied subjects with HFpEF (n = 28) and HFrEF (n = 25) and without HF (n = 71). Left ventricular (LV) mass and left atrial (LA) volumes were measured with cardiac magnetic resonance imaging. Arginine vasopressin and ANP were measured with enzyme-linked immunosorbent assay. Arginine vasopressin levels were ...


Reduced Incidence And Better Liver Disease Outcomes Among Chronic Hcv Infected Patients Who Consume Cannabis, Adeyinka Adejumo, Oluwole Muyiwa Adegbala, Kelechi Lauretta Adejumo, Terence N. Bukong 2018 University of Massachusetts Medical School

Reduced Incidence And Better Liver Disease Outcomes Among Chronic Hcv Infected Patients Who Consume Cannabis, Adeyinka Adejumo, Oluwole Muyiwa Adegbala, Kelechi Lauretta Adejumo, Terence N. Bukong

Open Access Articles

Background and Aim: The effect of cannabis use on chronic liver disease (CLD) from Hepatitis C Virus (HCV) infection, the most common cause of CLD, has been controversial. Here, we investigated the impact of cannabis use on the prevalence of CLD among HCV infected individuals.

Methods: We analyzed hospital discharge records of adults (age > /= 18 years) with a positive HCV diagnosis. We evaluated records from 2007 to 2014 of the Nationwide Inpatient Sample (NIS). We excluded records with other causes of chronic liver diseases (alcohol, hemochromatosis, NAFLD, PBC, HBV, etc.). Of the 188,333 records, we matched cannabis users to ...


Harmonization Of Delirium Severity Instruments: A Comparison Of The Drs-R-98, Mdas, And Cam-S Using Item Response Theory, Alden L. Gross, Doug Tommet, Madeline D'Aquila, Eva Schmitt, Edward R. Marcantonio, Benjamin Helfand, Sharon K. Inouye, Richard N. Jones 2018 Johns Hopkins University

Harmonization Of Delirium Severity Instruments: A Comparison Of The Drs-R-98, Mdas, And Cam-S Using Item Response Theory, Alden L. Gross, Doug Tommet, Madeline D'Aquila, Eva Schmitt, Edward R. Marcantonio, Benjamin Helfand, Sharon K. Inouye, Richard N. Jones

Open Access Articles

BACKGROUND: This study aimed to describe the level of agreement of three commonly used delirium instruments: the Delirium Rating Scale-Revised-98 (DRS-R-98), Memorial Delirium Assessment Scale (MDAS), and Confusion Assessment Method-Severity (CAM-S).

METHODS: We used data from a prospective clinical research study, in which a team of trained lay interviewers administered each instrument along with supporting interview and cognitive assessments in the same group of patients daily while in the hospital (N = 352). We used item response theory methods to co-calibrate the instruments.

RESULTS: The latent traits underlying the three measures, capturing the severity of a delirium assessment, had a high ...


Impact Of Cigarette Smoking Status On Pain Intensity Among Veterans With And Without Hepatitis C, Shaina M. Lynch, Sarah M. Wilson, Eric C. DeRycke, Mary A. Driscoll, William C. Becker, Joseph L. Goulet, Robert D. Kerns, Kristin M. Mattocks, Cynthia A. Brandt, Harini Bathulapalli, Melissa Skanderson, Sally G. Haskell, Lori A. Bastian 2018 Medical College of Wisconsin

Impact Of Cigarette Smoking Status On Pain Intensity Among Veterans With And Without Hepatitis C, Shaina M. Lynch, Sarah M. Wilson, Eric C. Derycke, Mary A. Driscoll, William C. Becker, Joseph L. Goulet, Robert D. Kerns, Kristin M. Mattocks, Cynthia A. Brandt, Harini Bathulapalli, Melissa Skanderson, Sally G. Haskell, Lori A. Bastian

Population and Quantitative Health Sciences Publications

Objective: Chronic pain is a significant problem in patients living with hepatitis C virus (HCV). Tobacco smoking is an independent risk factor for high pain intensity among veterans. This study aims to examine the independent associations with smoking and HCV on pain intensity, as well as the interaction of smoking and HCV on the association with pain intensity.

Design/Particpants: Cross-sectional analysis of a cohort study of veterans of Operations Enduring Freedom/Iraqi Freedom/New Dawn (OEF/OIF/OND) who had at least one visit to a Veterans Health Administration (VHA) primary care clinic between 2001 and 2014.

Methods: HCV ...


Intestinal P-Glycoprotein Exports Endocannabinoids To Prevent Inflammation And Maintain Homeostasis, Rose L. Szabady, Christopher Louissaint, Anneke Lubben, Bailu Xie, Shaun Reeksting, Christine Tuohy, Zachary Demma, Sage Foley, Christina S. Faherty, Alejandro Llanos-Chea, Andrew J. Olive, Randall J. Mrsny, Beth A. McCormick 2018 University of Massachusetts Medical School

Intestinal P-Glycoprotein Exports Endocannabinoids To Prevent Inflammation And Maintain Homeostasis, Rose L. Szabady, Christopher Louissaint, Anneke Lubben, Bailu Xie, Shaun Reeksting, Christine Tuohy, Zachary Demma, Sage Foley, Christina S. Faherty, Alejandro Llanos-Chea, Andrew J. Olive, Randall J. Mrsny, Beth A. Mccormick

Open Access Articles

Neutrophil influx into the intestinal lumen is a critical response to infectious agents, but is also associated with severe intestinal damage observed in idiopathic inflammatory bowel disease. The chemoattractant hepoxilin A3, an eicosanoid secreted from intestinal epithelial cells by the apically restricted efflux pump multidrug resistance protein 2 (MRP2), mediates this neutrophil influx. Information about a possible counterbalance pathway that could signal the lack of or resolution of an apical inflammatory signal, however, has yet to be described. We now report a system with such hallmarks. Specifically, we identify endocannabinoids as the first known endogenous substrates of the apically restricted ...


Coping With Chronic Fungal Rhinosinusitis: Diagnosis To Therapy, Veronica Corcino, Leslie Beavin, Shengli Lu, Ashley Ross, Carmen V. Sciortino Jr. 2018 University of Louisville

Coping With Chronic Fungal Rhinosinusitis: Diagnosis To Therapy, Veronica Corcino, Leslie Beavin, Shengli Lu, Ashley Ross, Carmen V. Sciortino Jr.

The University of Louisville Journal of Respiratory Infections

No abstract provided.


The Epidemiology Of Infective Endocarditis Among People Who Inject Drugs In London, Ontario., Brian Hallam 2018 The University of Western Ontario

The Epidemiology Of Infective Endocarditis Among People Who Inject Drugs In London, Ontario., Brian Hallam

Electronic Thesis and Dissertation Repository

Infective endocarditis is an infectious disease that affects the valves of the heart. Injection drug use is currently a leading risk factor among patients with endocarditis. We conducted a prospective study using data from hospital chart records among patients with endocarditis in London, Ontario, which has a relatively high prevalence of people who inject drugs to assess the severity of the issue and the major risk factors of mortality pertaining to this population. This study had a sample size of 353 and included a review of the incidence of admissions of endocarditis, as well as a survival analysis, using both ...


Ripk1-Ripk3-Mlkl-Associated Necroptosis Drives Leishmania Infantum Killing In Neutrophils, Laiana A. Barbosa, Paloma P. Fiuza, Leticia J. Borges, Fellipe A. Rolim, Mayara B. Andrade, Nivea F. Luz, Graziele Quintela-Carvalho, Jonilson B. Lima, Roque P. Almeida, Francis Ka-Ming Chan, Marcelo T. Bozza, Valeria M. Borges, Deboraci B. Prates 2018 Federal University of Bahia

Ripk1-Ripk3-Mlkl-Associated Necroptosis Drives Leishmania Infantum Killing In Neutrophils, Laiana A. Barbosa, Paloma P. Fiuza, Leticia J. Borges, Fellipe A. Rolim, Mayara B. Andrade, Nivea F. Luz, Graziele Quintela-Carvalho, Jonilson B. Lima, Roque P. Almeida, Francis Ka-Ming Chan, Marcelo T. Bozza, Valeria M. Borges, Deboraci B. Prates

Open Access Articles

Necroptosis is a pro-inflammatory cell death, which happens in the context of caspase-8 inhibition, allowing activation of the receptor interacting protein kinase 1-receptor interacting protein kinase 3-mixed lineage kinase domain-like (RIPK1-RIPK3-MLKL) axis. Recently, necroptosis has emerged as a key component of resistance against pathogens including infected macrophage by Leishmania infantum, the ethiologic agent of Visceral leishmaniasis (VL). VL is the most severe form of Leishmaniasis, characterized by systemic inflammation and neutropenia. However, the role of neutrophil cell death in VL has not been characterized. Here, we showed that VL patients exhibited increased lactate dehydrogenase levels in the serum, a hallmark ...


Il-16/Mir-125a Axis Controls Neutrophil Recruitment In Pristane-Induced Lung Inflammation, Siobhan Smith, Hardy Kornfeld, Caroline A. Jefferies 2018 Royal College of Surgeons in Ireland

Il-16/Mir-125a Axis Controls Neutrophil Recruitment In Pristane-Induced Lung Inflammation, Siobhan Smith, Hardy Kornfeld, Caroline A. Jefferies

Open Access Articles

Severe lung inflammation and alveolar hemorrhage can be life-threatening in systemic lupus erythematosus (SLE) patients if not treated early and aggressively. Neutrophil influx is the driver key of this pathology, but little is known regarding the molecular events regulating this recruitment. Here, we uncover a role for IL-16/mir-125a in this pathology and show not only that IL-16 is a target for miR-125a but that reduced miR-125a expression in SLE patients associates with lung involvement. Furthermore, in the pristane model of acute "SLE-like" lung inflammation and alveolar hemorrhage, we observed reduced pulmonary miR-125a and enhanced IL-16 expression. Neutrophil infiltration was ...


The Pathology Of Cancer, Chi Young Ok, Bruce A. Woda, Elizabeth Kurian 2018 The University of Texas MD Anderson Cancer Center

The Pathology Of Cancer, Chi Young Ok, Bruce A. Woda, Elizabeth Kurian

Cancer Concepts: A Guidebook for the Non-Oncologist

Patients and physicians depend on pathologists to make the diagnosis of cancer and of the specific type of cancer. Pathologists are expert in pattern recognition and in the natural history of diseases, including cancers. This chapter in Cancer Concepts: A Guidebook for the Non-Oncologist will describe the pathology of cancer.


Limiting Antibiotic Use In Acute Sinusitis: Partly A Matter Of Vocabulary?, Dennis J. Baumgardner 2018 Aurora UW Medical Group, Aurora Health Care

Limiting Antibiotic Use In Acute Sinusitis: Partly A Matter Of Vocabulary?, Dennis J. Baumgardner

Journal of Patient-Centered Research and Reviews

In his issue introduction, the editor-in-chief of Journal of Patient-Centered Research and Reviews comments on an included article that describes the successful use of an electronic medical record best practice alert to reduce the rate of antibiotic prescription for acute sinusitis. Various methods previously tried to improve antibiotic stewardship in this illness are briefly reviewed. Borrowing on the model of acute bronchitis, it is suggested that a change in conveyed diagnostic vocabulary to “sinus cold” when describing acute sinusitis may help limit antibiotics for this predominantly viral infection.


Investigation Of Hnf-1b As A Diagnostic Biomarker For Pancreatic Ductal Adenocarcinoma, Michelle X. Yang, Ryan F. Coates, Abiy Ambaye, Juli-Anne Gardner, Richard Zubarick, Yuan Gao, Joan Skelly, James G. Liu, Mari Mino-Kenudson 2018 University of Massachusetts Medical School

Investigation Of Hnf-1b As A Diagnostic Biomarker For Pancreatic Ductal Adenocarcinoma, Michelle X. Yang, Ryan F. Coates, Abiy Ambaye, Juli-Anne Gardner, Richard Zubarick, Yuan Gao, Joan Skelly, James G. Liu, Mari Mino-Kenudson

Open Access Articles

Background: Diagnosing pancreatic ductal adenocarcinoma (PDAC) in the setting of metastasis with an unknown primary remains very challenging due to the lack of specific biomarkers. HNF-1B has been characterized as an important transcription factor for pancreatic development and was reported as a biomarker for clear cell subtype of PDAC.

Methods: To investigate the diagnostic role of HNF-1B for PDAC, we used tissue microarray (TMA) and immunohistochemistry (IHC) to characterize HNF-1B expression in a large cohort of carcinomas, including 127 primary PDACs, 47 biliary adenocarcinomas, 17 metastatic PDACs, and 231 non-pancreaticobiliary carcinomas.

Results: HNF-1B was expressed in 107 of 127 (84 ...


Quantitative Profiling Of The Lymph Node Clearance Capacity, Cristina C. Clement, Wei Wang, Monika Dzieciatkowska, Marco Cortese, Kirk C. Hansen, Aniuska Becerra, Sangeetha Thangaswamy, Irina Nizamutdinova, Jee-Young Moon, Lawrence J. Stern, Anatoliy A. Gashev, David Zawieja, Laura Santambrogio 2018 Albert Einstein College of Medicine

Quantitative Profiling Of The Lymph Node Clearance Capacity, Cristina C. Clement, Wei Wang, Monika Dzieciatkowska, Marco Cortese, Kirk C. Hansen, Aniuska Becerra, Sangeetha Thangaswamy, Irina Nizamutdinova, Jee-Young Moon, Lawrence J. Stern, Anatoliy A. Gashev, David Zawieja, Laura Santambrogio

Open Access Articles

Transport of tissue-derived lymphatic fluid and clearance by draining lymph nodes are pivotal for maintenance of fluid homeostasis in the body and for immune-surveillance of the self- and non-self-proteomes. Yet a quantitative analysis of nodal filtration of the tissue-derived proteome present in lymphatic fluid has not been reported. Here we quantified the efficiency of nodal clearance of the composite proteomic load using label-free and isotope-labeling proteomic analysis of pre-nodal and post-nodal samples collected by direct cannulation. These results were extended by quantitation of the filtration efficiency of fluorophore-labeled proteins, bacteria, and beads infused at physiological flow rates into pre-nodal lymphatic ...


Primary Cardiac Lymphoma: Importance Of Tissue Diagnosis, Lauren Mendelson, Emily Hsu, Hojune Chung, Andrew Hsu 2018 University of Massachusetts Medical School

Primary Cardiac Lymphoma: Importance Of Tissue Diagnosis, Lauren Mendelson, Emily Hsu, Hojune Chung, Andrew Hsu

Open Access Articles

Primary cardiac lymphoma (PCL) is a rare disease entity that can present with severe cardiac and cardioembolic symptoms. We present a 79-year-old male with history of polymalgia rheumatica on chronic prednisone who presented with a two-week history of progressively worsening dyspnea, cough, and a 10 pound weight loss. Transthoracic echocardiogram (TTE) and computed tomography (CT) of the chest showed a large mediastinal mass with invasion of the pericardium. A biopsy of an abdominal soft-tissue mass confirmed the diagnosis of PCL. The patient was treated with two cycles of rituximab plus cyclophosphamide, doxorubicin, vincristine, and prednisone (R-CHOP) which was complicated by ...


Fever Of Unknown Origin: Could It Be A Pheochromocytoma? A Case Report And Review Of The Literature, Uzma Mohammad Siddiqui, Stephany Matta, Mireya Wessolossky, Richard Haas 2018 University of Massachusetts Medical School

Fever Of Unknown Origin: Could It Be A Pheochromocytoma? A Case Report And Review Of The Literature, Uzma Mohammad Siddiqui, Stephany Matta, Mireya Wessolossky, Richard Haas

Open Access Articles

Pheochromocytomas are rare tumors that arise from the adrenal medulla, with an incidence of less than 1 per 100,000 person-years. These tumors are characterized by excess catecholamine secretion and classically present with the triad of headaches, palpitations, and sweating episodes. However, the clinical presentation can be quite variable. Herein, we present a patient who presented with persistent fevers. An adrenal mass was incidentally discovered during the extensive investigation for the fever of unknown origin. Consequently, blood and urine tests were done and found to be consistent with a pheochromocytoma. The resection of this pheochromocytoma resulted in resolution of fevers ...


Multiple Myeloma, Anne Doup 2018 Otterbein University

Multiple Myeloma, Anne Doup

Master of Science in Nursing (MSN) Student Scholarship

No abstract provided.


Therapeutic Benefit Of Apremilast On Enthesitis And Dactylitis In Patients With Psoriatic Arthritis: A Pooled Analysis Of The Palace 1-3 Studies, Dafna D. Gladman, Arthur Kavanaugh, Juan J. Gomez-Reino, Jurgen Wollenhaupt, Maurizio Cutolo, Georg Schett, Eric Lespessailles, Benoit Guerette, Nikolay Delev, Lichen Teng, Christopher J. Edwards, Charles Birbara, Philip J. Mease 2018 Toronto Western Hospital

Therapeutic Benefit Of Apremilast On Enthesitis And Dactylitis In Patients With Psoriatic Arthritis: A Pooled Analysis Of The Palace 1-3 Studies, Dafna D. Gladman, Arthur Kavanaugh, Juan J. Gomez-Reino, Jurgen Wollenhaupt, Maurizio Cutolo, Georg Schett, Eric Lespessailles, Benoit Guerette, Nikolay Delev, Lichen Teng, Christopher J. Edwards, Charles Birbara, Philip J. Mease

Open Access Articles

Objective: The Psoriatic Arthritis Long-term Assessment of Clinical Efficacy (PALACE) clinical trial programme findings demonstrated that apremilast, an oral phosphodiesterase 4 inhibitor, is effective for treating psoriatic arthritis (PsA). Enthesitis and dactylitis are difficult-to-treat features of PsA leading to disability and affecting quality of life. PALACE 1, 2 and 3 data were pooled to assess the efficacy of apremilast on enthesitis and dactylitis outcomes in patients with these conditions at baseline.

Methods: Patients with enthesitis (n=945) or dactylitis (n=633) at baseline were analysed after receiving double-blind treatment with placebo, apremilast 30 mg two times per day or apremilast ...


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