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Implementing A Pre-Exposure Prophylaxis Intervention For Safer Conception Among Hiv Serodiscordant Couples: Recommendations For Health Care Providers, Mari-Lynn Drainoni, Dea L. Biancarelli, Ashley A. Leech, Meg Sullivan, Angela R. Bazzi 2018 Boston University School of Public Health

Implementing A Pre-Exposure Prophylaxis Intervention For Safer Conception Among Hiv Serodiscordant Couples: Recommendations For Health Care Providers, Mari-Lynn Drainoni, Dea L. Biancarelli, Ashley A. Leech, Meg Sullivan, Angela R. Bazzi

Journal of Health Disparities Research and Practice

Couples in HIV serodiscordant relationships frequently desire children. Although partners who are virally suppressed pose almost no risk of transmitting HIV to their partners, partners who are inconsistently on therapy may transmit HIV to their partners when attempting to conceive. Pre-exposure prophylaxis (PrEP) is an available safer conception strategy for these couples but is not consistently offered. We sought to better understand barriers to PrEP implementation for couples seeking conception and patient perceptions on what providers could do to encourage use. We conducted in-depth, qualitative interviews with 11 participants representing six couples taking PrEP for safer conception in a safety-net ...


High-Volume Hemofiltration Is Not Preferred For Hypertriglyceridemia-Induced Pancreatitis, Ian N. Monk 2018 Wayne State University School of Medicine

High-Volume Hemofiltration Is Not Preferred For Hypertriglyceridemia-Induced Pancreatitis, Ian N. Monk

Clinical Research in Practice: The Journal of Team Hippocrates

A critical appraisal and clinical application of He WH, Yu M, Zhu Y, et al. Emergent triglyceride-lowering therapy with early high-volume hemofiltration against low-molecular-weight heparin combined with insulin in hypertriglyceridemic pancreatitis: A prospective randomized controlled trial. J Clin Gastroenterol. 2016;50(9):772-778. doi: 10.1097/MCG.0000000000000552.


Translational Research: Ethical Considerations, Yiqing Dong 2018 University of Puget Sound

Translational Research: Ethical Considerations, Yiqing Dong

Honors Program Theses

Translational research (TR) is a new categorization for the efforts of biomedical research and emphasizes efficiency in achieving population health improvements through the application of basic science knowledge in clinical practice. It will be argued that the current emphasis on speed and collaboration with industry established by national policies provides challenges to maintaining the integrity of scientific research. There is no agreed upon definition of TR and the current standard of judging the success of TR focuses on product production. I propose that the principles of beneficence and responsive justice should be used to inform the values of TR and ...


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Letter To The Editor: Patient And Staff Experiences With Inpatient Video Monitoring, Eric Shoemaker MD, Aysha Athar DO, Jonathon Brewis MD, Daniel Angell DO, Rana Zaban DO 2018 Annapolis Family Medicine Residency, Beaumont Wayne Hospital

Letter To The Editor: Patient And Staff Experiences With Inpatient Video Monitoring, Eric Shoemaker Md, Aysha Athar Do, Jonathon Brewis Md, Daniel Angell Do, Rana Zaban Do

Clinical Research in Practice: The Journal of Team Hippocrates

We describe the patient experience with remote video monitoring on a general practice inpatient floor in the hospital. We raise questions about unexplored areas relevant to this practice.


Letter To The Editor: Management Of Pfo: More Evidence, Same Recommendation, Halima Ali, MD 2018 Beaumont Wayne Family Medicine Residency

Letter To The Editor: Management Of Pfo: More Evidence, Same Recommendation, Halima Ali, Md

Clinical Research in Practice: The Journal of Team Hippocrates

The author offers more evidence to support Zhang's assertion in CRP 3(2) that closure of patent foramen ovale or medical therapy alone are both appropriate choices for preventing recurrent cryptogenic strokes (https://doi.org/10.22237/crp/1518739380).


Doacs Least Harmful For Patients With Calciphylaxis On Hemodialysis Needing Anticoagulation, Mona Fayad 2018 Wayne State University School of Medicine

Doacs Least Harmful For Patients With Calciphylaxis On Hemodialysis Needing Anticoagulation, Mona Fayad

Clinical Research in Practice: The Journal of Team Hippocrates

A critical appraisal and clinical application of King BJ, El-Azhary RA, Mcevoy MT, et al. Direct oral anticoagulant medications in calciphylaxis. International Journal of Dermatology. 30 August 2017;56(1):1065-1070. doi: 10.1111/ijd.13685


New Targets For Resolution Of Airway Remodeling In Obstructive Lung Diseases., Ajay P. Nayak, Deepak A. Deshpande, Raymond B. Penn 2018 Thomas Jefferson University

New Targets For Resolution Of Airway Remodeling In Obstructive Lung Diseases., Ajay P. Nayak, Deepak A. Deshpande, Raymond B. Penn

Center for Translational Medicine Faculty Papers

Airway remodeling (AR) is a progressive pathological feature of the obstructive lung diseases, including asthma and chronic obstructive pulmonary disease (COPD). The pathology manifests itself in the form of significant, progressive, and (to date) seemingly irreversible changes to distinct respiratory structural compartments. Consequently, AR correlates with disease severity and the gradual decline in pulmonary function associated with asthma and COPD. Although current asthma/COPD drugs manage airway contraction and inflammation, none of these effectively prevent or reverse features of AR. In this review, we provide a brief overview of the features and putative mechanisms affecting AR. We further discuss recently ...


First Results On Survival From A Large Phase 3 Clinical Trial Of An Autologous Dendritic Cell Vaccine In Newly Diagnosed Glioblastoma., Linda M. Liau, Keyoumars Ashkan, David D. Tran, Jian L. Campian, John E. Trusheim, Charles S. Cobbs, Jason A. Heth, Michael Salacz, Sarah Taylor, Stacy D. D'Andre, Fabio M. Iwamoto, Edward J. Dropcho, Yaron A. Moshel, Kevin A. Walter, Clement P. Pillainayagam, Robert Aiken, Rekha Chaudhary, Samuel A. Goldlust, Daniela A. Bota, Paul Duic, Jai Grewal, Heinrich Elinzano, Steven A. Toms, Kevin O. Lillehei, Tom Mikkelsen, Tobias Walbert, Steven R. Abram, Andrew J. Brenner, Steven Brem, Matthew G. Ewend, Simon Khagi, Jana Portnow, Lyndon J. Kim, William G. Loudon, Reid C. Thompson, David E Avigan, Karen L. Fink, Francois J. Geoffroy, Scott Lindhorst, Jose Lutzky, Andrew E. Sloan, Gabriele Schackert, Dietmar Krex, Hans-Jorg Meisel, Julian Wu, Raphael P Davis, Christopher Duma, Arnold B. Etame, David Mathieu, Santosh Kesari, David Piccioni, Manfred Westphal, David S. Baskin, Pamela Z. New, Michel Lacroix, Sven-Axel May, Timothy J. Pluard, Victor Tse, Richard M. Green, John L. Villano, Michael Pearlman, Kevin Petrecca, Michael Schulder, Lynne P Taylor, Anthony E. Maida, Robert M. Prins, Timothy F. Cloughesy, Paul Mulholland, Marnix L. Bosch 2018 University of California Los Angeles

First Results On Survival From A Large Phase 3 Clinical Trial Of An Autologous Dendritic Cell Vaccine In Newly Diagnosed Glioblastoma., Linda M. Liau, Keyoumars Ashkan, David D. Tran, Jian L. Campian, John E. Trusheim, Charles S. Cobbs, Jason A. Heth, Michael Salacz, Sarah Taylor, Stacy D. D'Andre, Fabio M. Iwamoto, Edward J. Dropcho, Yaron A. Moshel, Kevin A. Walter, Clement P. Pillainayagam, Robert Aiken, Rekha Chaudhary, Samuel A. Goldlust, Daniela A. Bota, Paul Duic, Jai Grewal, Heinrich Elinzano, Steven A. Toms, Kevin O. Lillehei, Tom Mikkelsen, Tobias Walbert, Steven R. Abram, Andrew J. Brenner, Steven Brem, Matthew G. Ewend, Simon Khagi, Jana Portnow, Lyndon J. Kim, William G. Loudon, Reid C. Thompson, David E Avigan, Karen L. Fink, Francois J. Geoffroy, Scott Lindhorst, Jose Lutzky, Andrew E. Sloan, Gabriele Schackert, Dietmar Krex, Hans-Jorg Meisel, Julian Wu, Raphael P Davis, Christopher Duma, Arnold B. Etame, David Mathieu, Santosh Kesari, David Piccioni, Manfred Westphal, David S. Baskin, Pamela Z. New, Michel Lacroix, Sven-Axel May, Timothy J. Pluard, Victor Tse, Richard M. Green, John L. Villano, Michael Pearlman, Kevin Petrecca, Michael Schulder, Lynne P Taylor, Anthony E. Maida, Robert M. Prins, Timothy F. Cloughesy, Paul Mulholland, Marnix L. Bosch

Department of Medical Oncology Faculty Papers

BACKGROUND: Standard therapy for glioblastoma includes surgery, radiotherapy, and temozolomide. This Phase 3 trial evaluates the addition of an autologous tumor lysate-pulsed dendritic cell vaccine (DCVax

METHODS: After surgery and chemoradiotherapy, patients were randomized (2:1) to receive temozolomide plus DCVax-L (n = 232) or temozolomide and placebo (n = 99). Following recurrence, all patients were allowed to receive DCVax-L, without unblinding. The primary endpoint was progression free survival (PFS); the secondary endpoint was overall survival (OS).

RESULTS: For the intent-to-treat (ITT) population (n = 331), median OS (mOS) was 23.1 months from surgery. Because of the cross-over trial design, nearly 90 ...


The Aging Initiative Experience: A Call For Sustained Support For Team Science Networks, Tullika Garg, Kathryn Anzuoni, Valentina Landyn, Alexandra Hajduk, Stephen Waring, Leah R. Hanson, Heather E. Whitson 2018 Geisinger Health System, Danville, PA

The Aging Initiative Experience: A Call For Sustained Support For Team Science Networks, Tullika Garg, Kathryn Anzuoni, Valentina Landyn, Alexandra Hajduk, Stephen Waring, Leah R. Hanson, Heather E. Whitson

Open Access Articles

Team science, defined as collaborative research efforts that leverage the expertise of diverse disciplines, is recognised as a critical means to address complex healthcare challenges, but the practical implementation of team science can be difficult. Our objective is to describe the barriers, solutions and lessons learned from our team science experience as applied to the complex and growing challenge of multiple chronic conditions (MCC). MCC is the presence of two or more chronic conditions that have a collective adverse effect on health status, function or quality of life, and that require complex healthcare management, decision-making or coordination. Due to the ...


Food Insecurity And Pre-Hypertension, Pre-Diabetes In Adult Women: Results From The 2007-2010 National Health And Nutrition Examination Survey, Michelle L. Redmond, PhD, MS, Fanglong Dong, PhD, Philip Twumasi-Ankrah, PhD, Robert B. Hines, PhD, MPH, Lisette T. Jacobson, PhD, MPA, MA, Elizabeth Ablah, PhD, MPH, Judy Johnston, MS, RD/LD, Tracie C. Collins, MD, MPH, MHCDS 2018 University of Kansas School of Medicine-Wichita

Food Insecurity And Pre-Hypertension, Pre-Diabetes In Adult Women: Results From The 2007-2010 National Health And Nutrition Examination Survey, Michelle L. Redmond, Phd, Ms, Fanglong Dong, Phd, Philip Twumasi-Ankrah, Phd, Robert B. Hines, Phd, Mph, Lisette T. Jacobson, Phd, Mpa, Ma, Elizabeth Ablah, Phd, Mph, Judy Johnston, Ms, Rd/Ld, Tracie C. Collins, Md, Mph, Mhcds

Journal of Health Disparities Research and Practice

Background

Being food insecure is generally defined as the limited or uncertain availability of safe and nutritious foods and is linked to poor nutrition and fully progressed diet-sensitive chronic diseases. However, little is known about the association between food insecurity and pre-clinical disease such as pre-hypertension and pre-diabetes. This study sought to examine the associations between food insecurity and pre-clinical disease among a racially/ethnically diverse population of women.

Methods

Using data from 2007-2010 NHANES, we examined associations between food security and pre-clinical disease among women 18-65 years. Chi-square tests were used to examine differences in demographic variables. Bivariate and ...


Strain Differences In Susceptibility To Cisplatin-Induced Renal Fibrosis, Gabrielle B. Oropilla 2018 University of Louisville

Strain Differences In Susceptibility To Cisplatin-Induced Renal Fibrosis, Gabrielle B. Oropilla

College of Arts & Sciences Senior Honors Theses

Cisplatin is a potent chemotherapeutic; the dose-limiting side effect of this drug is nephrotoxicity, causing acute kidney injury (AKI) in 30% of adult patients. Patients with cisplatin-induced AKI are more likely to develop end stage renal diseases, particularly chronic kidney disease (CKD), which is marked by the development of fibrosis. Currently, there are no therapeutic interventions for cisplatin-induced kidney injury, which may be due to limitations in the mouse model used to study this type of injury. We have previously developed a repeated dosing regimen of cisplatin (mice treated with 7 mg/kg once a week for 4 weeks, mice ...


Genotype-Specific Insertion Of Cytotoxic Genetic Elements Into Cancer Cells, Ryan Englander 2018 University of Connecticut

Genotype-Specific Insertion Of Cytotoxic Genetic Elements Into Cancer Cells, Ryan Englander

University Scholar Projects

The new gene editing system CRISPR/Cas9, composed of a complex composed of a guide RNA and the Cas9 endonuclease, promises to revolutionize biological research and potentially allow clinicians to directly modify patient DNA in vivo. While its applications in the treatment of genetic diseases and in modifying immune cells for immunotherapy are currently being explored, CRISPR/Cas9’s potential utility as a modular system for targeting tumor-specific mutated sequences has not as of yet been explored. While CRISPR/Cas9 is specific enough to target small insertions and deletions or gross chromosomal rearrangements, it is not specific enough to reliably ...


Cognitive Changes Following Multiple-Modality Exercise And Mind-Motor Training In Older Adults With Subjective Cognitive Complaints: The M4 Study, Narlon Cassio Boa Sorte Silva, Dawn P. Gill, Adrian M. Owen, Teresa Liu-Ambrose, Vladimir Hachinski, Ryosuke Shigematsu, Robert Petrella 2018 Western University

Cognitive Changes Following Multiple-Modality Exercise And Mind-Motor Training In Older Adults With Subjective Cognitive Complaints: The M4 Study, Narlon Cassio Boa Sorte Silva, Dawn P. Gill, Adrian M. Owen, Teresa Liu-Ambrose, Vladimir Hachinski, Ryosuke Shigematsu, Robert Petrella

Lifestyle Research Team

Background

We investigated the effects of multiple-modality exercise with additional mind-motor training on cognition in community-dwelling older adults with subjective cognitive complaints.

Methods

Participants (n = 127, mean age 67.5 [7.3] years, 71% women) were randomized to receive 45 minutes of multiple-modality exercise with additional 15 minutes of either mind-motor training (M4, n = 63) or control (balance, range of motion and breathing exercises [M2, n = 64]). In total, both groups exercised 60 minutes/day, 3 days/week, for 24 weeks. Standardized global cognitive functioning (GCF), concentration, reasoning, planning, and memory were assessed at 24 weeks and after a 28-week ...


Extending The Phenotypic Spectrum Of Sengers Syndrome: Congenital Lactic Acidosis With Synthetic Liver Dysfunction., David B Beck, Kristina Cusmano-Ozog, Nickie Andescavage, Eyby Leon 2018 George Washington University

Extending The Phenotypic Spectrum Of Sengers Syndrome: Congenital Lactic Acidosis With Synthetic Liver Dysfunction., David B Beck, Kristina Cusmano-Ozog, Nickie Andescavage, Eyby Leon

Pathology Faculty Publications

Sengers syndrome is a rare autosomal recessive mitochondrial disease characterized by lactic acidosis, hypertrophic cardiomyopathy and bilateral cataracts. We present here a case of neonatal demise, within the first day of life, who initially presented with severe lactic acidosis, with evidence of both chorioamnionitis and cardiogenic shock. Initial metabolic labs demonstrated a severe lactic acidosis prompting genetic testing which revealed a homozygous pathogenic variant for Sengers syndrome in


Non-Hispanic Black-White Disparities In Pain And Pain Management Among Newly Admitted Nursing Home Residents With Cancer, Deborah Mack, Jacob N. Hunnicutt, William M. Jesdale, Kate L. Lapane 2018 University of Massachusetts Medical School

Non-Hispanic Black-White Disparities In Pain And Pain Management Among Newly Admitted Nursing Home Residents With Cancer, Deborah Mack, Jacob N. Hunnicutt, William M. Jesdale, Kate L. Lapane

UMass Center for Clinical and Translational Science Supported Publications

Background: Racial disparities in pain management persist across health care settings and likely extend into nursing homes. No recent studies have evaluated racial disparities in pain management among residents with cancer in nursing homes at time of admission.

Methods: Using a cross-sectional study design, we compared reported pain and pain management between non-Hispanic White and non-Hispanic Black newly admitted nursing home residents with cancer (n=342,920) using the de-identified Minimum Data Set version 3.0. Pain management strategies included the use of scheduled analgesics, pro re nata analgesics, and non-pharmacological methods. Presence of pain was based on self-report when ...


Visualization Of Fibronectin Assembly Using Crispr And Fluorescence Imaging, Brenda French, Sophie Astrof 2018 Thomas Jefferson University

Visualization Of Fibronectin Assembly Using Crispr And Fluorescence Imaging, Brenda French, Sophie Astrof

Sigma Xi

Objectives

Surprisingly, the mechanisms of fibronectin assembly remain largely unknown. This project aims to elucidate the process by which fibronectin assembles through fluorescent labeling. Fluorescent tags allow for the visualization of fibronectin to clarify how this extracellular matrix protein may influence migration and signaling.


Research Support Infrastructure: Implementing A Clinical Research Coordinating Center, Julio A. Ramirez, Paula Peyrani, William A. Mattingly, Forest W. Arnold, Timothy L. Wiemken, Robert R. Kelley, Leslie A. Wolf, Ruth M. Carrico, the Clinical Research Coordinating Center Team 2018 University of Louisville

Research Support Infrastructure: Implementing A Clinical Research Coordinating Center, Julio A. Ramirez, Paula Peyrani, William A. Mattingly, Forest W. Arnold, Timothy L. Wiemken, Robert R. Kelley, Leslie A. Wolf, Ruth M. Carrico, The Clinical Research Coordinating Center Team

The University of Louisville Journal of Respiratory Infections

Insufficient infrastructure is one of the challenges facing investigators in the field of clinical research. At the University of Louisville (UofL) Division of Infectious Diseases, we developed a multidisciplinary coordinating center with the aim to support investigators in all aspects of the clinical research process. The objective of this article is to describe the composition and the role of the different units of the UofL Clinical Research Coordinating Center. The different components of the Center can serve as a template for institutions interested in developing a clinical research support infrastructure.


Non-Resolving Community Acquired Pneumonia (Cap) Due To Blastomyces Dermatitidis (Pulmonary Blastomycosis): Case Report And Review Of Literature, Johnson Britto 2018 St. Elizabeth Physicians, Infectious Disease, Crestview Hills, KY, USA

Non-Resolving Community Acquired Pneumonia (Cap) Due To Blastomyces Dermatitidis (Pulmonary Blastomycosis): Case Report And Review Of Literature, Johnson Britto

The University of Louisville Journal of Respiratory Infections

In this case report, we describe a case of progressive acute pulmonary blastomycosis in a healthy adult living in Kentucky, initially presenting with flu like illness with a left sided consolidation, who did not respond to antibiotic therapy. Patient’s clinical condition deteriorated with development of necrotizing bronchopneumonia, mediastinal lymphadenopathy, tree-in-bud reticulonodularity and pleural effusion. A diagnosis of progressive pulmonary blastomycosis was established by radiological findings as well as transbronchial needle aspiration cytology and bronchoalveolar lavage culture demonstrating Blastomyces dermatitidis. Patient showed significant clinical improvement with resolution of pulmonary lesions on antifungal treatment. Since symptoms of blastomycosis are often similar ...


Mycobacterium Kansasii As The Primary Etiology Of Pulmonary Infections Due To Non-Tuberculous Mycobacterium (Ntm) In Patients Without Human Immunodeficiency Virus (Hiv): Experience From A Center In Buenos Aires, Argentina, Gabriel Yusti, Marcela Heres, Alejandra González, Mariano Fielli, Adrian Ceccato, Alejandra Zapata 2018 Alejandro Posadas National Hospital, Buenos Aires, Argentina

Mycobacterium Kansasii As The Primary Etiology Of Pulmonary Infections Due To Non-Tuberculous Mycobacterium (Ntm) In Patients Without Human Immunodeficiency Virus (Hiv): Experience From A Center In Buenos Aires, Argentina, Gabriel Yusti, Marcela Heres, Alejandra González, Mariano Fielli, Adrian Ceccato, Alejandra Zapata

The University of Louisville Journal of Respiratory Infections

Introduction: Pulmonary diseases due to non-tuberculous mycobacterium (NTM) lung infection in HIV-negative patients are rarely described in the literature. Currently, NTM consist of more than 150 species, and they are globally ubiquitous in both natural and man-made environments.The objective of this study was to define the most frequent species of NTM causing pulmonary disease in HIV-negative patients in the city of Buenos Aires, Argentina. The prevalence of pulmonary diseases caused by NTM is difficult to determine since the isolation of NTM does not necessarily indicate disease.

Methods: A retrospective review of all the respiratory cultures positive for NTM in ...


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