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From Cure To Crisis: A Case Of Severe Hypoxic Respiratory Failure Due To Daptomycin-Associated Eosinophilic Pneumonitis, Muneeba Ali, Md, Enad Haddad, Md, Warda Naqvi, Md, Conrad Reed, Md Jun 2025

From Cure To Crisis: A Case Of Severe Hypoxic Respiratory Failure Due To Daptomycin-Associated Eosinophilic Pneumonitis, Muneeba Ali, Md, Enad Haddad, Md, Warda Naqvi, Md, Conrad Reed, Md

The Medicine Forum

Daptomycin is a cyclic lipopeptide antibiotic that commonly treats Gram-positive infections. Most frequently prescribed for osteoarticular infections.1 Daptomycin is associated with numerous side effects, including myopathy, rhabdomyolysis, eosinophilic pneumonia, and anaphylactic hypersensitivity reactions.1 Daptomycin-induced eosinophilic pneumonitis (DIEP) is a rare but potentially life-threatening adverse effect associated with prolonged use.2 There are several established criteria for diagnosing this medical condition. However, the variation in its clinical presentation, coupled with the favorable outcomes of early diagnosis and the severe consequences of delayed diagnosis, emphasizes the need for further discussions. This case highlights the importance of monitoring patients on prolonged daptomycin …


A Patient With Recently Diagnosed Hiv Found To Have Cryptococcus Meningitis With Course Complicated By Pneumocystis Jirovecii Pneumonia, Cmv Colitis, And Kaposi Sarcoma, Benjamin Richter, Md Jun 2025

A Patient With Recently Diagnosed Hiv Found To Have Cryptococcus Meningitis With Course Complicated By Pneumocystis Jirovecii Pneumonia, Cmv Colitis, And Kaposi Sarcoma, Benjamin Richter, Md

The Medicine Forum

Opportunistic infections (OIs) remain a major cause of morbidity and mortality in individuals with advanced human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS), particularly in those with severe immunosuppression. Among the most life-threatening OIs are cryptococcal meningitis, Pneumocystis jirovecii pneumonia (PJP), cytomegalovirus (CMV) colitis, and Kaposi sarcoma (KS), each of which poses significant diagnostic and therapeutic challenges.

Here is a case of a man with recently diagnosed HIV who was admitted to the hospital with a chief complaint of headache and was found to have cryptococcal meningitis with a hospital course complicated by Pneumocystis jirovecii pneumonia (PJP), CMV colitis, and Kaposi sarcoma. …


A Case Of Varicella Zoster Virus Meningitis Presenting As Idiopathic Vocal Fold Paralysis, Dustin Sneed, Md, M. D. Kilpatrick, Md, Alicia Bao, Md Jun 2025

A Case Of Varicella Zoster Virus Meningitis Presenting As Idiopathic Vocal Fold Paralysis, Dustin Sneed, Md, M. D. Kilpatrick, Md, Alicia Bao, Md

The Medicine Forum

The typical presentation of a patient with herpes zoster, the reactivation of varicella zoster virus (VZV), involves a painful dermatomal vesicular rash known as shingles. However, as the following case demonstrates, VZV reactivation can present with atypical symptoms, sometimes without the characteristic rash. This presentation is known as zoster sine herpete. This case focuses on a patient presenting with dysphagia and dysphonia, who was diagnosed with VZV meningitis with suspected laryngeal involvement. We discuss workup and treatment for this disease, and the importance of a wide differential and multidisciplinary consultation to improve patient outcomes.


Complexities In Alcoholic Necrotizing Pancreatitis: A Case Report Of Severe Vascular And Infectious Complications, Dawood Tahir, Md, Shravya Ginnaram, Md, Jacob Lipkin, Md Jun 2025

Complexities In Alcoholic Necrotizing Pancreatitis: A Case Report Of Severe Vascular And Infectious Complications, Dawood Tahir, Md, Shravya Ginnaram, Md, Jacob Lipkin, Md

The Medicine Forum

Acute pancreatitis (AP) incidence has been increasing, with an annual incidence of approximately 5 to 40 cases per 100,000.1 Several complications occur with AP, including splanchnic vein thrombosis (SVT), pseudocyst, and pseudoaneurysm (PSA). Moreover, 15-20% of patients develop necrotizing pancreatitis (NP) following an episode of AP with a mortality rate of up to 32%,2 which can be further complicated by infected necrosis in up to one-third of patients.2 Hemorrhage is estimated to occur in less than 6% of patients with NP by pseudoaneurysm.3 The endoscopic step-up approach is the standard treatment for walled-off necrosis, whereas alternative …


Table Of Contents: The Medicine Forum, Volume 26, 2024-2025 Jun 2025

Table Of Contents: The Medicine Forum, Volume 26, 2024-2025

The Medicine Forum

Table of Contents: The Medicine Forum, Volume 26, 2024-2025


The Medicine Forum: Volume 26 Jun 2025

The Medicine Forum: Volume 26

The Medicine Forum

The Journal of Thomas Jefferson University Hospital - Department of Internal Medicine, Volume 26, 2024-2025

TABLE OF CONTENTS

  • Research Studies
  • Case Reports
  • Humanities & Reflections


The Effect Of Sars-Cov-2 Reinfection On Long-Term Symptoms In The Innovative Support For Patients With Sars-Cov-2 Infections Registry (Inspire), John J. Openshaw, Ji Chen, Robert Rodriguez, Michael Gottlieb, Kalyani Mccullough, Michelle Santangelo, Mandy J. Hill, Kristyn Gatling, Ahamed H. Idris, Samuel Mcdonald, Lauren E. Wisk, Jonathan Dyal, Ralph C. Wang, Kristin L. Rising, Efrat Kean, Kelli N. O'Laughlin, Kari A. Stephens, Caitlin Malicki, Zhenqiu Lin, Erica S. Spatz, Huihui Yu, Robert A. Weinstein, Joann Elmore Jun 2025

The Effect Of Sars-Cov-2 Reinfection On Long-Term Symptoms In The Innovative Support For Patients With Sars-Cov-2 Infections Registry (Inspire), John J. Openshaw, Ji Chen, Robert Rodriguez, Michael Gottlieb, Kalyani Mccullough, Michelle Santangelo, Mandy J. Hill, Kristyn Gatling, Ahamed H. Idris, Samuel Mcdonald, Lauren E. Wisk, Jonathan Dyal, Ralph C. Wang, Kristin L. Rising, Efrat Kean, Kelli N. O'Laughlin, Kari A. Stephens, Caitlin Malicki, Zhenqiu Lin, Erica S. Spatz, Huihui Yu, Robert A. Weinstein, Joann Elmore

Department of Emergency Medicine Faculty Papers

BACKGROUND: The clinical consequences of repeated severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection are not clear, especially as they relate to long-term symptoms after infection. We analyzed data collected for the Innovative Support for Patients with SARS-CoV-2 Infections Registry (INSPIRE) to determine whether reinfection changes the likelihood of symptoms 3-6 months after reinfection compared with the likelihood in individuals experiencing a single infection.

METHODS: Individuals reporting a single SARS-CoV-2 infection or a single reinfection were included in this analysis. A positive SARS-CoV-2 test occurring ≥90 days after a first infection was considered a reinfection. Outcomes included severe fatigue (fatigue …


Therapy, Safety, And Logistics Of Preoperative Vs Postoperative Stereotactic Radiation Therapy: A Preliminary Analysis Of A Randomized Clinical Trial, Debra Nana Yeboa, Jing Li, Ruitao Lin, Sujit S Prabhu, Thomas H Beckham, Kristina Woodhouse, Todd Allen Swanson, Jeffrey S Weinberg, Xuemei Wang, Xiaohan Chi, Chinenye Lynette Ejezie, Dima Suki, Chenyang Wang, Chibawanye Ene, Ian E Mccutcheon, Susan Mcgovern, Mary Frances Mcaleer, Martin Tom, Amol Ghia, Subha Perni, Wen Jiang, Brian De, Caroline Chung, Betty Y S Kim, Barbara J O'Brien, Jason T Huse, Jeffrey S Wefel, Laurence Court, Hussein Tawbi, Filip Janku, Nandita Guha-Thakurta, J Matthew Debnam, Jason Johnson, Ceylan Altintas Taslicay, Christopher Alvarez-Breckenridge, Shaan M Raza, Amy B Heimberger, Franco Demonte, Robert North, Tina M Briere, John F De Groot, Raymond Sawaya, David Grosshans, Frederick F Lang, Ganesh Rao, Sherise D Ferguson Jun 2025

Therapy, Safety, And Logistics Of Preoperative Vs Postoperative Stereotactic Radiation Therapy: A Preliminary Analysis Of A Randomized Clinical Trial, Debra Nana Yeboa, Jing Li, Ruitao Lin, Sujit S Prabhu, Thomas H Beckham, Kristina Woodhouse, Todd Allen Swanson, Jeffrey S Weinberg, Xuemei Wang, Xiaohan Chi, Chinenye Lynette Ejezie, Dima Suki, Chenyang Wang, Chibawanye Ene, Ian E Mccutcheon, Susan Mcgovern, Mary Frances Mcaleer, Martin Tom, Amol Ghia, Subha Perni, Wen Jiang, Brian De, Caroline Chung, Betty Y S Kim, Barbara J O'Brien, Jason T Huse, Jeffrey S Wefel, Laurence Court, Hussein Tawbi, Filip Janku, Nandita Guha-Thakurta, J Matthew Debnam, Jason Johnson, Ceylan Altintas Taslicay, Christopher Alvarez-Breckenridge, Shaan M Raza, Amy B Heimberger, Franco Demonte, Robert North, Tina M Briere, John F De Groot, Raymond Sawaya, David Grosshans, Frederick F Lang, Ganesh Rao, Sherise D Ferguson

Faculty, Staff and Student Publications

Importance: Preoperative stereotactic radiation therapy (SRT) vs postoperative SRT logistics and toxic effects provides clinically significant data on management outcomes.

Objective: To determine preoperative SRT logistics and safety profile compared with postoperative in patients with brain metastases.

Design, setting, and participants: This single-institution phase 3 randomized clinical trial included patients 18 years and older and undergoing a planned surgical resection. Patients were required to have an Eastern Cooperative Oncology Group Performance Status score of 2 or greater and be candidates for SRT within 30 days of surgical resection. Patients with radiosensitive histologies (eg, small cell lung cancer and lymphoma), brain …


Btp2 Restricts Tulane Virus And Human Norovirus Replication Independent Of Store-Operated Calcium Entry, Francesca J Scribano, J Thomas Gebert, Kristen A Engevik, Nicole M Hayes, Jorge Villanueva, Son Pham, Soni Kaundal, Janam J Dave, B V Venkataram Prasad, Mary K Estes, Sasirekha Ramani, Joseph M Hyser Jun 2025

Btp2 Restricts Tulane Virus And Human Norovirus Replication Independent Of Store-Operated Calcium Entry, Francesca J Scribano, J Thomas Gebert, Kristen A Engevik, Nicole M Hayes, Jorge Villanueva, Son Pham, Soni Kaundal, Janam J Dave, B V Venkataram Prasad, Mary K Estes, Sasirekha Ramani, Joseph M Hyser

Faculty, Staff and Students Publications

Human norovirus is the leading cause of viral gastroenteritis across all age groups. While there is a need for human norovirus antivirals, therapeutic development has been hindered by a lack of cell culture systems and animal models of infection. Surrogate viruses, such as Tulane virus (TV), have provided tractable systems to screen potential antiviral compounds. Our previous work demonstrated that TV encodes a viral ion channel, which dysregulates cytosolic calcium signaling. We set out to investigate whether host pathways triggered by viral ion channel activity, including store-operated calcium entry (SOCE), play a role in virus replication. Using pharmacologic inhibitors and …


Performance Of A Novel Stool Quantitative Polymerase Chain Reaction Assay For Pediatric Tuberculosis Detection In Sub-Saharan Africa, Anca Vasiliu, Lucia Carratala-Castro, Abigail Seeger, Joanna Ehrlich, Babongile Nkala, Tara Ness, Miguel Mario Cumbe, Durbbin Mulengwa, Shilzia Munguambe, Bariki Mtafya, Edson Mambuque, Nosisa Shiba, Sozinho Acacio, Lilian Komba, Clement Gascua Adu-Gyamfi, H Lester Kirchner, Christoph Lange, Andrew R Dinardo, Alberto L Garcia-Basteiro, Anna Maria Mandalakas, Alexander Kay Jun 2025

Performance Of A Novel Stool Quantitative Polymerase Chain Reaction Assay For Pediatric Tuberculosis Detection In Sub-Saharan Africa, Anca Vasiliu, Lucia Carratala-Castro, Abigail Seeger, Joanna Ehrlich, Babongile Nkala, Tara Ness, Miguel Mario Cumbe, Durbbin Mulengwa, Shilzia Munguambe, Bariki Mtafya, Edson Mambuque, Nosisa Shiba, Sozinho Acacio, Lilian Komba, Clement Gascua Adu-Gyamfi, H Lester Kirchner, Christoph Lange, Andrew R Dinardo, Alberto L Garcia-Basteiro, Anna Maria Mandalakas, Alexander Kay

Faculty, Staff and Students Publications

Background: Children have paucibacillary tuberculosis and cannot provide expectorated sputum. Invasive specimen collection, by gastric aspiration or sputum induction, has a low diagnostic yield. In this study, we aimed to evaluate the diagnostic performance and additive yield of a novel stool-based assay in children diagnosed with tuberculosis in sub-Saharan Africa.

Methods: We conducted a prospective case-control study from October 2020 to June 2023 in Eswatini, Mozambique, and Tanzania. Children under 15 years newly diagnosed with tuberculosis completed clinical examination, chest radiography, culture, sputum Xpert Ultra, stool Xpert Ultra, and stool-based quantitative polymerase chain reaction (stool qPCR) assessment. Stool qPCR sensitivity …


A Tubo-Ovarian Abscess In Aplastic Anemia Presenting As Fever Of Unknown Origin, Rashi Mittal, Saurabh Kumar Gautam, Prasan Kumar Panda, Latika Chawla Jun 2025

A Tubo-Ovarian Abscess In Aplastic Anemia Presenting As Fever Of Unknown Origin, Rashi Mittal, Saurabh Kumar Gautam, Prasan Kumar Panda, Latika Chawla

Chulalongkorn Medical Journal

This report describes a complex case of a tubo-ovarian abscess (TOA) presenting atypically as fever of unknown origin (FUO) in a young woman initially diagnosed with severe aplastic anemia. The case involved protracted febrile illness, heavy menstrual bleeding, and pancytopenia. Identification of an Escherichia coli tubo-ovarian abscess, rather than tuberculosis, emphasized the need for a thorough evaluation in atypical presentations of TOA. Negative tuberculosis tests highlighted the variety of possible microbial etiologies. The resolution of fever following drainage and tailored antibiotic therapy, along with timely surgical intervention, demonstrated the importance of specific management strategies in such cases. Awareness of the …


Type I Interferon Protects Against Bone Loss In Periodontitis By Mitigating An Interleukin (Il)-17-Neutrophil Axis, Jinmei Zhang, Qiong Ding, Angela X Wang, Maoxuan Lin, Ning Yu, Kevin Moss, Megumi A Williamson, Di Miao, Julie T Marchesan, Erliang Zeng, Wei Shi, Hongli Sun, Yu Leo Lei, Shaoping Zhang Jun 2025

Type I Interferon Protects Against Bone Loss In Periodontitis By Mitigating An Interleukin (Il)-17-Neutrophil Axis, Jinmei Zhang, Qiong Ding, Angela X Wang, Maoxuan Lin, Ning Yu, Kevin Moss, Megumi A Williamson, Di Miao, Julie T Marchesan, Erliang Zeng, Wei Shi, Hongli Sun, Yu Leo Lei, Shaoping Zhang

Faculty, Staff and Student Publications

Type I interferons (IFNs-I), a group of pleiotropic cytokines, critically modulate host response in various inflammatory diseases. However, the role of the IFN-I pathway in periodontitis remains largely unknown. In this report, we describe that the IFN-β levels in the gingival crevicular fluid of human subjects were negatively associated with periodontitis and clinical gingival inflammation. Disruption of IFN-I signaling worsened alveolar bone resorption in a ligature-induced periodontitis murine model. Deficiency of the IFN-I pathway resulted in an exaggerated inflammatory response in myeloid cells and drastically increased the interleukin-17 (IL-17)-mediated neutrophil recruitment in the gingiva. We further identified that the myeloid …


Who Seeks Help? A Sociodemographic Analysis Of Cannabis Use Disorder Treatment In New York, Ayodele Atolagbe, Ekenedilichukwu Theresa Emembolu, Stanley Nkemjika Jun 2025

Who Seeks Help? A Sociodemographic Analysis Of Cannabis Use Disorder Treatment In New York, Ayodele Atolagbe, Ekenedilichukwu Theresa Emembolu, Stanley Nkemjika

Department of Psychiatry and Human Behavior Faculty Papers

Introduction: Cannabis use disorder (CUD) is being increasingly diagnosed in the United States, but access to treatment remains unequal, particularly in New York. Identifying the factors that contribute to disparities in receiving treatment for CUD among different population groups is essential for ensuring effective and targeted interventions. This study explores the sociodemographic factors influencing treatment utilization for CUD in New York.

Methods: Data for this study were retrieved from the 2018 Treatment Episode Data Set—Discharges (TEDS-D) of the U.S. Substance Abuse and Mental Health Services Administration (SAMHSA). Sample size for the study is 422,319 people with CUD. Logistic regression analysis …


Parallel Use Of Low-Complexity Automated Nucleic Acid Amplification Tests On Respiratory And Stool Samples With Or Without Lateral Flow Lipoarabinomannan Assays To Detect Pulmonary Tuberculosis Disease In Children, Laura Olbrich, Bada Yang, Hayley Poore, Alia Razid, Brittney Sweetser, Mathias Weis Damkjær, Alexander W Kay, Johanna Åhsberg, Ruvandhi R Nathavitharana, Ian Schiller, Nandini Dendukuri, Andreas Lundh, Maunank Shah, Stephanie Bjerrum, Devan Jaganath Jun 2025

Parallel Use Of Low-Complexity Automated Nucleic Acid Amplification Tests On Respiratory And Stool Samples With Or Without Lateral Flow Lipoarabinomannan Assays To Detect Pulmonary Tuberculosis Disease In Children, Laura Olbrich, Bada Yang, Hayley Poore, Alia Razid, Brittney Sweetser, Mathias Weis Damkjær, Alexander W Kay, Johanna Åhsberg, Ruvandhi R Nathavitharana, Ian Schiller, Nandini Dendukuri, Andreas Lundh, Maunank Shah, Stephanie Bjerrum, Devan Jaganath

Faculty, Staff and Students Publications

Background: Low-complexity automated nucleic acid amplification tests (LC-aNAATs) are molecular assays widely used to diagnose tuberculosis disease in children. The lateral flow urine lipoarabinomannan assay (LF-LAM) is recommended for use amongst children with HIV. Previous systematic reviews have assessed the diagnostic accuracy of LC-aNAATs and LF-LAM separately in children, but in clinical practice the tests may be used concurrently, i.e. in 'parallel'.

Objectives: To compare the diagnostic accuracy of the parallel use of LC-aNAAT on respiratory and stool specimens in children, and with LF-LAM on urine amongst children with HIV, versus each assay alone for detecting pulmonary tuberculosis disease.

Search …


Parallel Use Of Low-Complexity Automated Nucleic Acid Amplification Tests And Lateral Flow Urine Lipoarabinomannan Assays To Detect Tuberculosis Disease In Adults And Adolescents Living With Hiv, Stephanie Bjerrum, Bada Yang, Johanna Åhsberg, Laura Olbrich, Mathias Weis Damkjær, Ruvandhi R Nathavitharana, Tobias Broger, Ioana Diana Olaru, Brittney Sweetser, Hayley Poore, Alia Razid, Alexander W Kay, Claudia M Denkinger, Ian Schiller, Nandini Dendukuri, Devan Jaganath, Andreas Lundh, Maunank Shah Jun 2025

Parallel Use Of Low-Complexity Automated Nucleic Acid Amplification Tests And Lateral Flow Urine Lipoarabinomannan Assays To Detect Tuberculosis Disease In Adults And Adolescents Living With Hiv, Stephanie Bjerrum, Bada Yang, Johanna Åhsberg, Laura Olbrich, Mathias Weis Damkjær, Ruvandhi R Nathavitharana, Tobias Broger, Ioana Diana Olaru, Brittney Sweetser, Hayley Poore, Alia Razid, Alexander W Kay, Claudia M Denkinger, Ian Schiller, Nandini Dendukuri, Devan Jaganath, Andreas Lundh, Maunank Shah

Faculty, Staff and Students Publications

Background: Low-complexity automated nucleic acid amplification tests (LC-aNAATs) are molecular World Health Organization (WHO)-recommended rapid diagnostic tests (also known as mWRDs) widely used to diagnose tuberculosis disease. The lateral flow urine lipoarabinomannan assay (LF-LAM) is recommended by the WHO to assist in diagnosing tuberculosis disease amongst people with HIV. Previous systematic reviews have assessed the diagnostic accuracy of LC-aNAATs and LF-LAM used in isolation for the detection of tuberculosis, but in clinical practice the tests may be used in parallel (i.e. LC-aNAAT in combination with LF-LAM).

Objectives: To compare the diagnostic accuracy of the parallel use of LC-aNAAT on respiratory …


Determining Accurate Pore Structures Of Polypropylene Membrane For Ecmo Using Fe-Sem Under Optimized Conditions, Makoto Fukuda, Yoshiaki Nishite, Eri Murata, Koki Namekawa, Tomohiro Mori, Tsutomu Tanaka, Kiyotaka Sakai Jun 2025

Determining Accurate Pore Structures Of Polypropylene Membrane For Ecmo Using Fe-Sem Under Optimized Conditions, Makoto Fukuda, Yoshiaki Nishite, Eri Murata, Koki Namekawa, Tomohiro Mori, Tsutomu Tanaka, Kiyotaka Sakai

Children’s Nutrition Research Center Staff Publications

Long-term ECMOs are expected to be put into practical use in order to prepare for the next emerging severe infectious diseases after the novel coronavirus pandemic in 2019-2023. While polypropylene (PP) and polymethylpentene (PMP) are currently the mainstream materials for the hollow fiber membranes of ECMO, the PP membrane coated with a silicone layer on the outer surface has also been commercialized. In this study, we sought a method to accurately observe the detailed pore morphologies of the PP membrane by suppressing irreversible changes in the morphology in SEM observation, which is a general-purpose observation with higher resolution. As a …


Building Models, Building Capacity: A Review Of Participatory Machine Learning For Hiv Prevention, Mark Sendak, Meg Young, Jee Young Kim, Alifia Hasan, Clare Kelsey, Catherine O’Neal, Tonya Jagneaux, Wayne Wilbright, John Couk, Stephen Lim, Tamachia Davenport, Shirley Lolis, Jennifer Thomas, Shannon Widman, Suresh Balu, Meredith Clement, Lance Okeke Jun 2025

Building Models, Building Capacity: A Review Of Participatory Machine Learning For Hiv Prevention, Mark Sendak, Meg Young, Jee Young Kim, Alifia Hasan, Clare Kelsey, Catherine O’Neal, Tonya Jagneaux, Wayne Wilbright, John Couk, Stephen Lim, Tamachia Davenport, Shirley Lolis, Jennifer Thomas, Shannon Widman, Suresh Balu, Meredith Clement, Lance Okeke

School of Medicine Faculty Publications

A growing number of researchers and practitioners are embracing a “participatory turn” in machine learning (ML) to improve model development, prevent harm, and provide communities more influence over systems that impact them. In this paper, we explore the intersection of participatory practices in healthcare and the emerging focus on responsible AI with a focus on human immunodeficiency virus (HIV) care. We review the historical context of participation in HIV treatment and prevention, emphasizing how patient activism has shaped practices in this field. We then review participatory ML in HIV prevention and present a brief case study of a project designed …


Phage-Induced Protection Against Lethal Bacterial Reinfection, Yikun Xing, Haroldo J Hernandez Santos, Ling Qiu, Samantha R Ritter, Jacob J Zulk, Rachel Lahowetz, Kathryn A Patras, Austen L Terwilliger, Anthony W Maresso Jun 2025

Phage-Induced Protection Against Lethal Bacterial Reinfection, Yikun Xing, Haroldo J Hernandez Santos, Ling Qiu, Samantha R Ritter, Jacob J Zulk, Rachel Lahowetz, Kathryn A Patras, Austen L Terwilliger, Anthony W Maresso

Faculty, Staff and Students Publications

Bacteriophages, or phages, are viruses that target and infect bacteria. Due to a worldwide rise in antimicrobial resistance (AMR), phages have been proposed as a promising alternative to antibiotics for the treatment of resistant bacterial infections. Up to this point in history, phage use in preclinical animal studies, clinical trials, and emergency-use compassionate care cases has centered around the original observation from 1915 showing phage as lytic agent, and thus a treatment that kills bacteria. Here, we describe an activity associated with phage therapy that extends beyond lytic activity that results in long-term protection against reinfection. This activity is potent, …


Early Versus Late Vasopressor Initiation In Septic Shock – Elviss Study, Nathan Crawford, Brittanii Prahl, Jordan Amaro, Barbara Branneman, Jack Huber Jun 2025

Early Versus Late Vasopressor Initiation In Septic Shock – Elviss Study, Nathan Crawford, Brittanii Prahl, Jordan Amaro, Barbara Branneman, Jack Huber

2025 Swedish FISH (Fostering Interdisciplinary Solutions in Healthcare) Conference

No abstract provided.


Once-Daily Versus Twice-Daily Oral Vancomycin For Secondary Prevention Of Clostridioides Difficile Infection In Patients Treated With Systemic Antibiotics, Catherine Palmer Jun 2025

Once-Daily Versus Twice-Daily Oral Vancomycin For Secondary Prevention Of Clostridioides Difficile Infection In Patients Treated With Systemic Antibiotics, Catherine Palmer

2025 Swedish FISH (Fostering Interdisciplinary Solutions in Healthcare) Conference

No abstract provided.


Mutation Of Smarca4 Induces Cancer Cell-Intrinsic Defects In The Enhancer Landscape And Resistance To Immunotherapy, Yawen Wang, Ismail M Meraz, Md Qudratullah, Sasikumar Kotagiri, Yanyan Han, Yuanxin Xi, Jing Wang, Kadir C Akdemir, Jack A Roth, Yonathan Lissanu Jun 2025

Mutation Of Smarca4 Induces Cancer Cell-Intrinsic Defects In The Enhancer Landscape And Resistance To Immunotherapy, Yawen Wang, Ismail M Meraz, Md Qudratullah, Sasikumar Kotagiri, Yanyan Han, Yuanxin Xi, Jing Wang, Kadir C Akdemir, Jack A Roth, Yonathan Lissanu

Faculty, Staff and Student Publications

Cancer genomic studies have identified frequent alterations in genes encoding components of the SWI/SNF chromatin remodeling complex, including SMARCA4 and ARID1A. Importantly, clinical reports indicate that SMARCA4-mutant lung cancers respond poorly to immunotherapy and have dismal prognosis. In this study, we corroborated the clinical findings by using immune-humanized, syngeneic, and genetically engineered mouse models of lung cancer harboring SMARCA4 deficiency. Specifically, models with SMARCA4 loss showed decreased response to anti-PD-1 immunotherapy associated with significantly reduced infiltration of dendritic cells and CD4+ T cells into the tumor microenvironment. SMARCA4 loss in tumor cells led to profound downregulation of STING1, IL1β, and …


Present And Future Of Microbiome-Targeting Therapeutics, Lauren E Lynch, Rachel Lahowetz, Christian Maresso, Austen Terwilliger, Jason Pizzini, Valeria Melendez Hebib, Robert A Britton, Anthony W Maresso, Geoffrey A Preidis Jun 2025

Present And Future Of Microbiome-Targeting Therapeutics, Lauren E Lynch, Rachel Lahowetz, Christian Maresso, Austen Terwilliger, Jason Pizzini, Valeria Melendez Hebib, Robert A Britton, Anthony W Maresso, Geoffrey A Preidis

Children’s Nutrition Research Center Staff Publications

A large body of evidence suggests that single- and multiple-strain probiotics and synbiotics could have roles in the management of specific gastrointestinal disorders. However, ongoing concerns regarding the quality and heterogeneity of the clinical data, safety in vulnerable populations, and the lack of regulation of products containing live microbes are barriers to widespread clinical use. Safety and regulatory issues must be addressed and new technologies considered. One alternative future strategy is the use of synthetic bacterial communities, defined as manually assembled consortia of two or more bacteria originally derived from the human gastrointestinal tract. Synthetic bacterial communities can model functional, …


June 2025: Region 10 Emerging Special Pathogen Treatment Center (Resptc) At Providence Sacred Heart Medical Center & Children’S Hospital, Providence - Special Pathogens Program Jun 2025

June 2025: Region 10 Emerging Special Pathogen Treatment Center (Resptc) At Providence Sacred Heart Medical Center & Children’S Hospital, Providence - Special Pathogens Program

Special Pathogens Newsletters

REGION 10 SPECIAL PATHOGENS NEWSLETTER


Impact Of Cessation Of Caffeine Citrate Therapy On Intermittent Hypoxemia Patterns Among Preterm Infants Born Before 34 Weeks, Peter Kipkurui Mashep, Roseline Ochieng, Jesse Coleman, Mary Waiyego, Amy Sarah Ginsburg, Dorothy Chomba, Morris Ogero Ondieki, Grace Irimu, William Macharia, Mark Ansermino Jun 2025

Impact Of Cessation Of Caffeine Citrate Therapy On Intermittent Hypoxemia Patterns Among Preterm Infants Born Before 34 Weeks, Peter Kipkurui Mashep, Roseline Ochieng, Jesse Coleman, Mary Waiyego, Amy Sarah Ginsburg, Dorothy Chomba, Morris Ogero Ondieki, Grace Irimu, William Macharia, Mark Ansermino

Paediatrics and Child Health, East Africa

Introduction: Intermittent hypoxemia (IH) is defined as oxygen saturation (SpO2) drop ≥5% from the baseline (set at 90 s preceding the event) to a level less than 90% lasting for ≥5 s. Caffeine citrate, the standard of care for apnea of prematurity, reduces IH events. IH contributes to both short and long-term adverse neurologic outcomes. Standard patient monitors cannot detect IH events due to long averaging times.

Objective: Describe change in patterns of IH events in preterms < 34 weeks before and after cessation of caffeine citrate and factors associated.

Methods: Interrupted time series study design. Data was collected from 1 December 2022 to 30 June 2023. MASIMO RAD-G oximeter was …


Supplementation With Ready-To-Use Therapeutic Food Has No Effect On Adverse Outcomes Among Undernourished Children Aged 6–59 Months With Severe Pneumonia, Damalie Nalwanga, Elisa Giallongo, Victor Musiime, Sarah Kiguli, Peter Olupot-Olupot, Florence Alaroker, Robert Opoka, Abner Tagoola, Mainga Hamaluba, Christabel Mogaka Jun 2025

Supplementation With Ready-To-Use Therapeutic Food Has No Effect On Adverse Outcomes Among Undernourished Children Aged 6–59 Months With Severe Pneumonia, Damalie Nalwanga, Elisa Giallongo, Victor Musiime, Sarah Kiguli, Peter Olupot-Olupot, Florence Alaroker, Robert Opoka, Abner Tagoola, Mainga Hamaluba, Christabel Mogaka

Paediatrics and Child Health, East Africa

Objectives: To investigate the effect of supplementation with ready-to-use therapeutic food (RUTF) on adverse outcomes among undernourished children aged 6–59 months with severe pneumonia.

Methods: This secondary analysis of the COAST-Nutrition (ISRCTN10829073) included children hospitalized for severe pneumonia in Uganda and Kenya. Undernutrition was defined as having either a weight-for-age z score, height-for-age z score, or weight-for-height/length z score below the median of the WHO reference population (< 0) or mid-upper arm circumference (MUAC) below 13.5 cm. Participants were randomized to receive 1 sachet of RUTF daily for 8 weeks in addition to the usual diet (intervention) or usual diet alone (control). The primary composite outcome for adverse events was any one of mortality, re-admission, or deterioration of nutritional status by day 90 of follow-up.

Results: Of 846 main trial participants, 741 (88%) met the inclusion criteria (intervention: 374 versus control: 367). Of 687 (93%) participants in whom the primary outcome was assessed, 370 …


Down Syndrome In Africa: Challenges, Opportunities, And Future Directions, Eimear Mcglinchey, Salina Tewolde, Amanda He, Juan Fortea, Lingani Mbakile-Mahlanza, Ayda Tefera, Emmanuel Epenge, Jason Hassenstab, Rachel Maina, Zul Merali Jun 2025

Down Syndrome In Africa: Challenges, Opportunities, And Future Directions, Eimear Mcglinchey, Salina Tewolde, Amanda He, Juan Fortea, Lingani Mbakile-Mahlanza, Ayda Tefera, Emmanuel Epenge, Jason Hassenstab, Rachel Maina, Zul Merali

Brain and Mind Institute

INTRODUCTION: As life expectancy improves for people with Down syndrome (DS) in Africa, the risk of developing DS-associated Alzheimer’s disease (DSAD) will rise. There is a pressing need to plan for this emerging challenge, particularly in the context of existing health and social disparities.

METHODS: This work emerged from a pan-African collaboration, including discussions at the Brain Ageing and Dementia in Low- and Middle-Income Countries conference held in Nairobi in 2024, where stakeholders identified regional priorities for DS and dementia care.

RESULTS: Limited epidemiological, cognitive, biomarker data, delayed diagnoses, and gaps in specialized services may impact access …


Predictors And Prevention Of Neurological Disability In Adult Bacterial Meningitis: A Narrative Review With Clinical Perspective, Sadiq Ali Shah Jun 2025

Predictors And Prevention Of Neurological Disability In Adult Bacterial Meningitis: A Narrative Review With Clinical Perspective, Sadiq Ali Shah

Pakistan Journal of Neurological Sciences (PJNS)

Background and objective: Bacterial meningitis remains a neurological emergency in adults, with substantial mortality and long-term sequelae, including cognitive impairment, hearing loss, seizures, and focal deficits. The objective of this narrative review was to summarize current evidence on predictors of neurological disability and highlight strategies for prevention and long-term care.

Methods: A narrative literature review was conducted using PubMed, Scopus, and Google Scholar for English-language studies published between 2000 and 2025. Keywords included bacterial meningitis, neurological sequelae, predictors, and adults. A total of 40 studies were included after screening 200 abstracts . Key prospective studies, clinical trials, and reviews were …


Development And Mechanistic Investigation Of Recombinant Type Iii Humanized Collagen Gel For Mid-Facial Soft Tissue Repair, Qian Wang, Qifei An, Yuanzhou Wang, Jingbo Yang, Xiujuan Zhang, Shibo Jiang, Min Chen, Lu Lu, Yun Zhu Jun 2025

Development And Mechanistic Investigation Of Recombinant Type Iii Humanized Collagen Gel For Mid-Facial Soft Tissue Repair, Qian Wang, Qifei An, Yuanzhou Wang, Jingbo Yang, Xiujuan Zhang, Shibo Jiang, Min Chen, Lu Lu, Yun Zhu

Center for Translational Medicine Faculty Papers

Mid-facial depression is a key sign of facial aging, primarily caused by the loss of collagen leading to depletion of the extracellular matrix (ECM). However, the existing fillers for soft tissue augmentation have shown certain limitations in repairing mid-facial depression. Therefore, we herein report the development of a novel recombinant humanized type III collagen gel (C3Gel) through rational design and modification of a commercially available recombinant type III humanized collagen lyophilized fiber product. Both biological activity and tissue repair mechanisms of C3Gel were systematically evaluated in vitro and in vivo. C3Gel formed a dense fibrous structure around cells, significantly improving …


Association Of Sirt6 Expression With Risk Of Pneumonitis Induced By Radiotherapy In Cancer Patients, Fengyuan Yu, Zheng Gong, Yuan Li, Danial F Naseem, Chen Li, Miaowei Wen, Bingying Zhao, Zhezhe Xu, Shanshan Zhang, Rukun Zang, Ailu Wu, Qingxin Han, Shuhui Wu, Hongwei Li, Yipeng Song Jun 2025

Association Of Sirt6 Expression With Risk Of Pneumonitis Induced By Radiotherapy In Cancer Patients, Fengyuan Yu, Zheng Gong, Yuan Li, Danial F Naseem, Chen Li, Miaowei Wen, Bingying Zhao, Zhezhe Xu, Shanshan Zhang, Rukun Zang, Ailu Wu, Qingxin Han, Shuhui Wu, Hongwei Li, Yipeng Song

Faculty, Staff and Student Publications

Thoracic tumours represent a significant proportion of malignant cancers. While radiotherapy (RT) improves prognosis, it can also lead to side effects such as radiation-induced pneumonitis (RP). Since SIRT6 is involved in DNA repair, energy metabolism and inflammation, this study aims to investigate the expression of SIRT6 in lymphocytes as a potential biomarker and therapeutic target for RP. This study included 170 patients diagnosed with thoracic tumours, all of whom underwent thoracic RT. RP was evaluated and classified as severe RP (SRP) and lower as non-severe RP (NSRP). Analyses were performed using SPSS version 26.0 and the R. Among 170 patients …


Pharmacogenetics Of Plasma Dolutegravir Exposure During 1-Month Rifapentine/Isoniazid Treatment Of Latent Tuberculosis, Nia Covington, Anne F Luetkemeyer, Marjorie Z Imperial, Rodney Dawson, Yoninah Cramer, Sue Rosenkranz, Susan Swindells, Irina Gelmanova, Anchalee Avihingsanon, Roberto C Arduino, Wadzanai Samaneka, Kelly E Dooley, Rada Savic, Anthony T Podany, David W Haas Jun 2025

Pharmacogenetics Of Plasma Dolutegravir Exposure During 1-Month Rifapentine/Isoniazid Treatment Of Latent Tuberculosis, Nia Covington, Anne F Luetkemeyer, Marjorie Z Imperial, Rodney Dawson, Yoninah Cramer, Sue Rosenkranz, Susan Swindells, Irina Gelmanova, Anchalee Avihingsanon, Roberto C Arduino, Wadzanai Samaneka, Kelly E Dooley, Rada Savic, Anthony T Podany, David W Haas

Faculty, Staff and Student Publications

In Advancing Clinical Therapeutics Globally protocol A5372, a pharmacokinetic study of dolutegravir with 1-month of daily rifapentine/isoniazid, twice-daily dolutegravir offset the induction effects of rifapentine on plasma dolutegravir trough concentrations (C trough ). Here, we characterize the impact on dolutegravir C trough of UGT1A1 , AADAC , and NAT2 polymorphisms that affect dolutegravir, rifapentine, and isoniazid, respectively. People with HIV receiving dolutegravir-based antiretroviral therapy with an indication to treat latent tuberculosis underwent pharmacokinetic sampling during dolutegravir 50 mg once daily alone, and on day 28 of dolutegravir 50 mg twice daily with rifapentine/isoniazid. Multivariable linear regression models characterized genetic associations …