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Bilateral Adrenal Hemorrhage In A Patient With Antiphospholipid Syndrome, Silpa Yalamanchili, MD 2016 Thomas Jefferson University

Bilateral Adrenal Hemorrhage In A Patient With Antiphospholipid Syndrome, Silpa Yalamanchili, Md

The Medicine Forum

INTRODUCTION

Bilateral adrenal hemorrhage is relatively uncommon, with a reported incidence in the United States of 0.3-1.8% in hospital post-mortems1.Clinical manifestations of adrenal hemorrhage are widely variable, making diagnosis a challenge. Left undiagnosed and untreated, bilateral adrenal hemorrhage may lead to cardiovascular collapse and/or death. Here we present a rare case of bilateral adrenal hemorrhage in a patient with antiphospholipid syndrome; the aim of this case, and the corresponding literature review, is to highlight risk factors for and management of this condition.


Amiodarone-Induced Thyrotoxicosis And Ventricular Arrhythmias: Case Report And Review Of The Literature, Ashish Shah, MD 2016 Thomas Jefferson University

Amiodarone-Induced Thyrotoxicosis And Ventricular Arrhythmias: Case Report And Review Of The Literature, Ashish Shah, Md

The Medicine Forum

INTRODUCTION

Amiodarone is a common drug used to treat arrhythmias and its side effects are diverse. An important adverse effect is amiodarone-induced thyrotoxicosis (AIT), which can potentially lead to a pro-arrythmogenic state. There have been limited studies on the pathogenesis of how thyrotoxicosis increases the risk of ventricular arrhythmias, which causes providers to face a therapeutic challenge in patients who require this medication for the prevention of life threatening arrhythmias. This case report will present a patient with a left ventricular assist device (LVAD) who had recurrent ventricular arrhythmias on chronic amiodarone therapy in the setting of AIT.


Preventing And Treating Type 2 Diabetes Through A Physically Active Lifestyle, Raymond W. Leung, Jim Kamla, Man-Cheong Lee, Jennifer Y. Mak 2016 Marshall University

Preventing And Treating Type 2 Diabetes Through A Physically Active Lifestyle, Raymond W. Leung, Jim Kamla, Man-Cheong Lee, Jennifer Y. Mak

Jennifer Y Mak

By the late 1960s, the increasing number of type 2 diabetic cases in children and adolescents rapidly presented a signifi cant public health issue recognized by the American Diabetes Association (2000). Since then, the prevalence of pediatric type 2 diabetes appears to be on the rise not only in the United States but all around the world (Gungor et al., 2005). In the United States, an increase from fewer than four percent to more than 50 percent of new cases of type 2 diabetes in the pediatric population was reported between the years of 1982 and 1998 (American Diabetes Association ...


Type I Diabetes In Children And Vitamin D, Ashley B. Litchfield, Rebecca M. Hayes, Franklin D. Shuler MD, PhD, Susan L. Flesher MD 2016 Marshall University

Type I Diabetes In Children And Vitamin D, Ashley B. Litchfield, Rebecca M. Hayes, Franklin D. Shuler Md, Phd, Susan L. Flesher Md

Susan L Flesher, MD

Vitamin D deficiency is associated with multiple childhood diseases including type 1 diabetes mellitus (T1DM). T1DM in children is becoming more prevalent, with a 23% increase nationally from 2001 to 2009. Similarly, West Virginia has had an 8.1% increase in children with type 1Diabetes from 2008/2009 to 2010/2011. This article highlights the association between vitamin D and type 1 diabetes and discusses vitamin D’s potential role in the reduction and management of T1DM in children.


Comparison Of Diabetic Remission Rates Following Roux En-Y Gastric Bypass And Longitudinal Sleeve Gastrectomy, Zachary Weitzner, Julie Flahive, Gordon Fitzgerald, Donald Czerniach, Philip Cohen, John Kelly, Richard A. Perugini 2016 University of Massachusetts Medical School

Comparison Of Diabetic Remission Rates Following Roux En-Y Gastric Bypass And Longitudinal Sleeve Gastrectomy, Zachary Weitzner, Julie Flahive, Gordon Fitzgerald, Donald Czerniach, Philip Cohen, John Kelly, Richard A. Perugini

UMass Center for Clinical and Translational Science Research Retreat

Introduction: Bariatric surgery is being increasingly investigated as treatment for Type II Diabetes Mellitus (T2DM). As Sleeve Gastrectomy (SG) surpasses Roux-en-Y Gastric Bypass (RYGB) as the new standard in bariatric surgery, it is still unknown if its efficacy in achieving remission is comparable to RYGB. This study compared diabetic remission rates between SG and RYGB in order to identify the predictive factors for remission and the mechanisms of achieving remission.

Methods: This was a retrospective cohort study comparing all diabetic patients undergoing RYGB and SG at an academic medical center from 1/1/11-7/1/15. Patients were followed preoperatively ...


Differences In Complication Rates Between Roux-En-Y Gastric Bypass And Longitudinal Sleeve Gastrectomy, Zachary Weitzner, Julie Flahive, Gordon Fitzgerald, Donald Czerniach, Philip Cohen, John Kelly, Richard A. Perugini 2016 University of Massachusetts Medical School

Differences In Complication Rates Between Roux-En-Y Gastric Bypass And Longitudinal Sleeve Gastrectomy, Zachary Weitzner, Julie Flahive, Gordon Fitzgerald, Donald Czerniach, Philip Cohen, John Kelly, Richard A. Perugini

UMass Center for Clinical and Translational Science Research Retreat

Introduction: Sleeve Gastrectomy (SG) has surpassed Roux-en-Y Gastric Bypass (RYGB) as the most commonly performed bariatric operation. Though the beneficial effect of SG on Type 2 Diabetes Mellitus is less than that of RYGB, it is perceived to have a lower complication rate. The purpose of this study was to quantify the complication rates between of SG and RYGB in a severely obese diabetic population.

Methods: This was a retrospective cohort study that included all diabetic patients undergoing RYGB and SG at an academic medical center from January 1, 2011 to July 1, 2015. Patients were followed at 6 week ...


Electronic Communication Systems: Energizing The Patient With Diabetes To Engage In Their Own Health Care, Michael J. Thompson 2016 University of Massachusetts Medical School

Electronic Communication Systems: Energizing The Patient With Diabetes To Engage In Their Own Health Care, Michael J. Thompson

UMass Center for Clinical and Translational Science Research Retreat

As part of the mini-symposium entitled "Interdiscipllinary Mobile Health and Sensing Research," Dr. Thompson discusses his work in mobile diabetes monitoring.


Impact Of The Heart Watch Program On Patients At Risk Of Developing Metabolic Syndrome, Prediabetes Or Cardiovascular Disease, Jennifer T. Fink, Kathryn K. Havens, Julia A. Schumacher, Renee E. Walker, George L. Morris III, David A. Nelson, Maharaj Singh, Ron A. Cisler 2016 University of Wisconsin-Milwaukee

Impact Of The Heart Watch Program On Patients At Risk Of Developing Metabolic Syndrome, Prediabetes Or Cardiovascular Disease, Jennifer T. Fink, Kathryn K. Havens, Julia A. Schumacher, Renee E. Walker, George L. Morris Iii, David A. Nelson, Maharaj Singh, Ron A. Cisler

Maharaj Singh

Purpose

Metabolic syndrome is a set of metabolic risk factors associated with increased risk of developing cardiovascular disease and type 2 diabetes mellitus. We retrospectively evaluated the effectiveness of a lifestyle modification program (Heart WATCH) geared toward reducing development of chronic disease in women deemed at risk for metabolic syndrome, prediabetes and/or cardiovascular disease.

Methods

Our institution’s Heart WATCH program consists of screening sessions with a multidisciplinary team (physician/nurse, nutritionist and psychologist), a minimum of three visits with a nurse practitioner and weekly follow-up phone calls for a 14-week period. Sociodemographic variables were obtained at initial visit ...


An N Of One: My Review Of Management Of Type 1 Diabetes, Myself As Patient, Jarred Daugherty 2016 Butler University

An N Of One: My Review Of Management Of Type 1 Diabetes, Myself As Patient, Jarred Daugherty

BU Well

As technology has advanced, so has the management of diabetes. Insulin, the essential medication for type 1 diabetes, is marketed in an array of formulations and devices. Continuous glucose monitors (CGM) can be inserted to measure blood glucose every 5 minutes. The rise of social media has given diabetics online support groups, where they can share their story and learn from others overcoming similar challenges. So, how well do the current diabetes management strategies work? My name Is Jarred and I’m a type 1 diabetic. I have tried many of these products and this article is a review of ...


Screening Diabetic And Hypertensive Patients For Ocular Pathology Using Telemedicine Technology In Rural West Virginia: A Retrospective Chart Review, Rezwan Ahmed MD, Stephen M. Petrany, Russell Fry II, Michael Krasnow DO, PhD 2016 Marshall University

Screening Diabetic And Hypertensive Patients For Ocular Pathology Using Telemedicine Technology In Rural West Virginia: A Retrospective Chart Review, Rezwan Ahmed Md, Stephen M. Petrany, Russell Fry Ii, Michael Krasnow Do, Phd

Russell L. Fry, II

Abstract: Purpose: There is a disparity between the number of people who need healthcare and availability of medical services in rural areas. This paper describes the experience of using telemedicine technologies for ophthalmologic evaluation in diabetic and hypertensive patients presenting to a community health center in rural West Virginia.

Methods: A registered nurse at a community health center in McDowell County, WV was trained to use a retinal camera to capture high-resolution digital images of the retina. Patients with diabetes or hypertension were screened during their routine primary care visits. Retinal photos were transmitted to an ophthalmologist for review and ...


Screening Diabetic And Hypertensive Patients For Ocular Pathology Using Telemedicine Technology In Rural West Virginia: A Retrospective Chart Review, Rezwan Ahmed MD, Stephen M. Petrany, Russell Fry II, Michael Krasnow DO, PhD 2016 Marshall University

Screening Diabetic And Hypertensive Patients For Ocular Pathology Using Telemedicine Technology In Rural West Virginia: A Retrospective Chart Review, Rezwan Ahmed Md, Stephen M. Petrany, Russell Fry Ii, Michael Krasnow Do, Phd

Stephen M. Petrany MD

Abstract: Purpose: There is a disparity between the number of people who need healthcare and availability of medical services in rural areas. This paper describes the experience of using telemedicine technologies for ophthalmologic evaluation in diabetic and hypertensive patients presenting to a community health center in rural West Virginia.

Methods: A registered nurse at a community health center in McDowell County, WV was trained to use a retinal camera to capture high-resolution digital images of the retina. Patients with diabetes or hypertension were screened during their routine primary care visits. Retinal photos were transmitted to an ophthalmologist for review and ...


The Role Of 5-Alpha Reductase 3 In Steroid Metabolism, zahi mitri 2016 The University of Texas Graduate School of Biomedical Sciences at Houston

The Role Of 5-Alpha Reductase 3 In Steroid Metabolism, Zahi Mitri

UT GSBS Dissertations and Theses (Open Access)

Background

The growth and development of prostate cancer is largely driven by androgen mediated signaling. The 5-alpha reductase family of enzymes plays an essential role in the conversion of testosterone to the more potent androgen, 5-alpha dihydrotestosterone (DHT), which is capable of binding the androgen receptor to activate gene targets and downstream signaling. This study aimed to evaluate the role of 5-alpha reductase 3 (SRD5A3), a novel member of the 5-alpha reductase family, in steroid metabolism and prostate carcinogenesis.

Materials and Methods

HEK293 cells were transfected with the SRD5A3 human cDNA ORF Clone from OriGene. Steroid substrates (testosterone, progesterone, androstenedione ...


Association Between First Trimester Pregnancy Associated Plasma Protein–A (Papp-A) And Gestational Diabetes Mellitus Development, Aylin Sert, Katherine Leung, Molly E. Waring, Raziel Rojas-Rodriguez, Silvia Corvera, Tiffany A. Moore Simas 2016 University of Massachusetts Medical School

Association Between First Trimester Pregnancy Associated Plasma Protein–A (Papp-A) And Gestational Diabetes Mellitus Development, Aylin Sert, Katherine Leung, Molly E. Waring, Raziel Rojas-Rodriguez, Silvia Corvera, Tiffany A. Moore Simas

Senior Scholars Program

Background: Gestational diabetes (GDM) is a common pregnancy complication with significant cardiometabolic consequences for mothers and offspring. Previous research from our group suggests that adipose tissue IGFBP-5 and its unique metalloprotease PAPP-A (Pregnancy Associated Plasma Protein-A) may play mechanistic roles in GDM development by regulating functional IGF-1 levels and lipid storage and metabolism.

Aim: To examine the relationship between circulating PAPP-A levels and GDM development. We hypothesized that high first trimester PAPP-A levels would be associated with decreased GDM risk.

Methods: A retrospective cohort of women delivering singleton gestations at UMass Memorial Healthcare (2009, 2010, 2014 ...


Neuropathy Detection, Quality Of Life Tools & Treatment For Type 2 Diabetes, Jennifer J. Brown 2016 Old Dominion University

Neuropathy Detection, Quality Of Life Tools & Treatment For Type 2 Diabetes, Jennifer J. Brown

Human Movement Sciences Theses & Dissertations

Type 2 diabetes (T2D) mellitus has become the epidemic of the new millennium, with an estimated 382 million people affected worldwide as of 2013, and statistics projected towards 592 million by the year 2035. With the development of diabetes, complications have risen, with diabetic neuropathy becoming one of the most prevalent, affecting between 10–90% of those with the disease. Diabetic peripheral neuropathy (DPN) is difficult to detect in early stages of pathology, yet devastating once significant damage has taken place. Cardiac autonomic neuropathy (CAN), which is often silent, is associated with autonomic nervous system (ANS) dysfunction and increased risk ...


Is Androgen Excess Masked In Alopecia Areata Patients: A Retrospective Data Analysis Of 1,587 Patients, G. Cheyana Ranasinghe, Melissa Piliang, Wilma Bergfeld 2016 George Washington University

Is Androgen Excess Masked In Alopecia Areata Patients: A Retrospective Data Analysis Of 1,587 Patients, G. Cheyana Ranasinghe, Melissa Piliang, Wilma Bergfeld

GW Research Days 2016 - Present

Studies on the pathophysiology and comorbidities associated with alopecia areata (AA) are limited. The purpose of this study was to determine the prevalence of androgen excess in AA and its subtypes, in relation to demographics and comorbidities. Medical records of 1,587 Patchy AA, AT, AU, and ophiasis patients seen in the Department of Dermatology at the Cleveland Clinic Foundation in Ohio between 2005 and 2015 were reviewed. Out of this cohort, 226 patients met the inclusion criteria. There is evidence that patients with AA had significantly greater prevalence of polycystic ovary syndrome (PCOS) than the general population (p<0.001). Androgen excess was identified in 42.5% (n=96) of the 226 patients with AA or any subtype (p<0.001). The androgen excess group was significantly more likely to present with irregular menses, hirsutism, adult acne, PCOS, and/or ovarian cysts (p<0.001). This study was limited by being retrospective. Our study demonstrated that AA is associated with androgen excess.


Disease-Management In Family Medicine Clinics Through The Addition Of A Health Coach: A Pilot Study, Crystal Cichon, Jessica Kram, Tiffany Mullen, Pamela Voelkers, Kristin Magliocco, Kiley Bernhard, Dennis Baumgardner 2016 Department of Family Medicine, Aurora Health Care

Disease-Management In Family Medicine Clinics Through The Addition Of A Health Coach: A Pilot Study, Crystal Cichon, Jessica Kram, Tiffany Mullen, Pamela Voelkers, Kristin Magliocco, Kiley Bernhard, Dennis Baumgardner

Dennis Baumgardner

Background: In the United States, more than 80% of health care spending is focused on the management of chronic illnesses such as hypertension, diabetes and hyperlipidemia. Controlling these chronic diseases can lead to better health outcomes and decrease the number of preventable deaths. Patient self-management has shown to improve clinical outcomes. In a primary care setting, a multidisciplinary approach can more effectively educate patients on improving their health. Purpose: To assess the impact of a health coach in a primary care setting as it relates to clinical outcomes. Methods: Patients from two Aurora family medicine clinics were referred to a ...


Impact Of Comorbidity Dyads On Heart Failure Treatment In Older Persons, Jerry Gurwitz, Alan Go, Sue Sung, Grace Tabada, Robert Goldberg, David Magid, David Smith, David McManus, Jane Saczynski, Bruce Barton 2016 Meyers Primary Care Institute

Impact Of Comorbidity Dyads On Heart Failure Treatment In Older Persons, Jerry Gurwitz, Alan Go, Sue Sung, Grace Tabada, Robert Goldberg, David Magid, David Smith, David Mcmanus, Jane Saczynski, Bruce Barton

Jerry H. Gurwitz

Background/Aims: The vast majority of heart failure (HF) patients suffer from multiple noncardiac comorbid conditions that may have important implications for clinical management. We assessed the clinical effectiveness and safety associated with the use of beta-blocker therapy for patients in a HF-chronic lung disease dyad group, and the clinical effectiveness and safety associated with the use of angiotensin-converting enzyme (ACE) inhibitors/angiotensin II receptor blockers (ARBs) for patients in a HF-chronic kidney disease (CKD) dyad group. Methods: We identified over 30,000 HF patients with a documented ejection fraction (EF) from four members of the Cardiovascular Research Network –– Kaiser ...


Impact Of Comorbidity Dyads On Heart Failure Treatment In Older Persons, Jerry Gurwitz, Alan Go, Sue Sung, Grace Tabada, Robert Goldberg, David Magid, David Smith, David McManus, Jane Saczynski, Bruce Barton 2016 Meyers Primary Care Institute

Impact Of Comorbidity Dyads On Heart Failure Treatment In Older Persons, Jerry Gurwitz, Alan Go, Sue Sung, Grace Tabada, Robert Goldberg, David Magid, David Smith, David Mcmanus, Jane Saczynski, Bruce Barton

Jane S. Saczynski

Background/Aims: The vast majority of heart failure (HF) patients suffer from multiple noncardiac comorbid conditions that may have important implications for clinical management. We assessed the clinical effectiveness and safety associated with the use of beta-blocker therapy for patients in a HF-chronic lung disease dyad group, and the clinical effectiveness and safety associated with the use of angiotensin-converting enzyme (ACE) inhibitors/angiotensin II receptor blockers (ARBs) for patients in a HF-chronic kidney disease (CKD) dyad group. Methods: We identified over 30,000 HF patients with a documented ejection fraction (EF) from four members of the Cardiovascular Research Network –– Kaiser ...


The Nondietary Determinants Of Vitamin D Status In Pediatric Inflammatory Bowel Disease, Lauren Veit, Louise Maranda, Benjamin Nwosu 2016 University of Massachusetts Medical School

The Nondietary Determinants Of Vitamin D Status In Pediatric Inflammatory Bowel Disease, Lauren Veit, Louise Maranda, Benjamin Nwosu

Benjamin U. Nwosu

OBJECTIVES: The aim of this study was to investigate the relationships between 25-hydroxy vitamin D (25[OH]D) and markers of vitamin D status in inflammatory bowel disease (IBD). METHODS: We conducted a retrospective case-control study of 59 pediatric patients with IBD (age 16.4 ± 2.2 y) and 116 controls (age 14.6 ± 4.4 y), to investigate the association between 25(OH)D and albuminemia for protein-losing enteropathy (PLE) and hepatic dysfunction; alanine transaminase (ALT) for hepatic inflammation; erythrocyte sedimentation rate (ESR) for intestinal inflammation; body mass index (BMI) for adiposity; seasons and skin pigmentation for insolation. Vitamin ...


Adiposity Is Associated With Early Reduction In Bone Mass In Pediatric Inflammatory Bowel Disease, Nithya Setty-Shah, Louise Maranda, Benjamin Nwosu 2016 University of Massachusetts Medical School

Adiposity Is Associated With Early Reduction In Bone Mass In Pediatric Inflammatory Bowel Disease, Nithya Setty-Shah, Louise Maranda, Benjamin Nwosu

Benjamin U. Nwosu

Background: The effect of adiposity on bone mass in the early phases of inflammatory bowel disease (IBD) in children and adolescents is unclear.

Aims: To determine the role of adiposity on bone mass in the first 3 years of diagnosis of IBD.

Hypothesis: Increased adiposity will be associated with increased bone mass in both the controls and IBD subjects.

Setting: University tertiary institution.

Methods: Height-adjusted bone mineral density (BMD) z-scores of 25 subjects, age 13.97 ± 2.70y, diagnosed with IBD for < 4 years were compared to 24 controls, age 13.65 ± 2.60y. Overweight was defined as BMI of ≥85th but <95th percentile, and obesity as BMI ≥95thpercentile. Severity of IBD was determined by the ...


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