Digital Commons Network^™

Perinatal Drug Abuse And Neonatal Drug Withdrawal, Samarth Shukla, Lisa B. Zirkin, Enrique Gomez Pomar

Pediatrics Faculty Publications

Drug abuse and addiction have significantly increased over the last few decades; specifically, opioid abuse and dependence have increased to epidemic proportions. This increased use of drugs includes women of childbearing age and those who are pregnant. Drug abuse during pregnancy is a serious health risk for both mother and newborn infant. Infants exposed to maternal drugs in fetal life develop signs of drug withdrawal during early neonatal life. This group of withdrawal signs is known as neonatal abstinence syndrome (NAS). Although NAS is not a fatal condition, it results in significant illness and prolonged hospitalization.

Current Strategies In Prevention Of Postoperative Infections In Spine Surgery., Kivanc Atesok, Efstathios Papavassiliou, Michael J Heffernan, Danny Tunmire, Irina Sitnikov, Nobuhiro Tanaka, Sakthivel Rajaram, Jason Pittman, Ziya L Gokaslan, Alexander Vaccaro, Steven Theiss

Rothman Institute Papers

Study Design: Narrative review.

Objectives: Postoperative surgical site infections (SSIs) are among the most common acute complications in spine surgery and have a devastating impact on outcomes. They can lead to increased morbidity and mortality as well as greater economic burden. Hence, preventive strategies to reduce the rate of SSIs after spine surgery have become vitally important. The purpose of this article was to summarize and critically analyze the available evidence related to current strategies in the prevention of SSIs after spine surgery.

Methods: A literature search utilizing Medline database was performed. Relevant studies from all the evidence levels have …

Over-Medicalization And Criminalization Of Birth In The United States: Exploring The Outcomes, Meg Wallace 20

Honor Scholar Theses

This paper will examine the effects that over-medicalization and criminalization have had on the state of giving birth in the United States. It will attempt to offer insight on why the United States ranks near the bottom of countries that are considered “developed” in maternal mortality rates and infant mortality rates, despite spending the highest percentage of gross national product on health care. The paper will analyze: the history behind the medicalization of birth in the United States, different methods of over-medicalization, the impacts of unnecessary medical interventions, different incentives driving medicalization, the history of criminalization of pregnant women, the …

Blood Cancers And Oral Health, Silvia Spivakovsky Dds, Gwen Nichols Md, Laura Romundstad Crnp, Msn, Elizabeth Kitlas Lmsw

The Journal of the Michigan Dental Association

Managing Blood Cancer Patients' Oral Complications: Preventive Strategies during and after Treatment

Blood cancers, encompassing leukemia, lymphoma, myeloma, myelodysplastic syndromes (MDS), and myeloproliferative neoplasms (MPN), bring complex challenges to patient management due to their impact on hematopoiesis, immunity, and overall health. This review focuses on equipping dental practitioners with essential insights into preventing and managing intricate oral manifestations during and after treatment. Patient care strategies are outlined for leukemia subtypes such as acute lymphoblastic leukemia (ALL), acute myeloid leukemia (AML), chronic lymphocytic leukemia (CLL), and chronic myeloid leukemia (CML), emphasizing the need for tailored dental approaches. In lymphomas encompassing Hodgkin …

Dentistry’S Supporting Role For Cancer Patients, Christopher J. Smiley

The Journal of the Michigan Dental Association

Cancer diagnosis overwhelms patients and caregivers. As the spouse of a patient with leukemia who received bone marrow transplant therapy, I share insights into the challenges these patients face. Oral healthcare professionals play a vital role during these trials. Dental teams, often at the oncology's behest, conduct comprehensive exams and treatments before cancer therapy starts. Providing timely and efficient dental care is essential to achieve clearance to proceed with cancer therapy. Dental infections can be catastrophic for these patients who may be immune compromised. Untreated oral issues could lead to hospitalization, jeopardizing treatment schedules. Advocating for patients' financial needs, often …

Oral Complications In Cancer Patients: A Review Of Practical Interventions In The Dental Setting, Caroline Bissonnette Dds, Kristin Mcnamara Dds, John Kalmar Dmd, Phd

The Journal of the Michigan Dental Association

Cancer prevalence in the United States is significant, with an estimated 40% of the population experiencing this diagnosis at some point in their lives. In 2020 alone, 1,806,590 new cancer cases were projected, encompassing 53,260 cases involving oral and oropharyngeal malignancies. Amidst barriers like financial constraints and irregular dental visits (highlighted by a 2014 American Dental Association survey indicating that 32.3% of the general population avoids yearly dentist appointments), patients battling cancer often encounter not just routine dental needs, but the intricate challenges arising from their malignancy and treatments. Dental professionals, pivotal in orchestrating optimal treatment strategies for cancer patients, …

Association Of Dairy Consumption With Metabolic Syndrome, Hypertension And Diabetes In 147 812 Individuals From 21 Countries, Balaji Bhavadharini, Mahshid Dehghan, Andrew Mente, Sumathy Rangarajan, Patrick Sheridan, Viswanathan Mohan, Romaina Iqbal, Rajeev Gupta, Scott Lear, Edelweiss Wentzel-Viljoen

Community Health Sciences

Objective: Our aims were to assess the association of dairy intake with prevalence of metabolic syndrome (MetS) (cross-sectionally) and with incident hypertension and incident diabetes (prospectively) in a large multinational cohort study.
Methods: The Prospective Urban Rural Epidemiology (PURE) study is a prospective epidemiological study of individuals aged 35 and 70 years from 21 countries on five continents, with a median follow-up of 9.1 years. In the cross-sectional analyses, we assessed the association of dairy intake with prevalent MetS and its components among individuals with information on the five MetS components (n=112 922). For the prospective analyses, we …

Provider Attitudes And Practice Patterns For Direct-Acting Antiviral Therapy For Patients With Hepatocellular Carcinoma, Naim Alkhouri, Whitney Jackson, Neehar D Parikh, Neil Mehta, Reena Salgia, Andres Duarte-Rojo, Laura Kulik, Mina Rakoski, Adnan Said, Omobonike Oloruntoba, George N Ioannou, Maarouf A Hoteit, Andrew M Moon, Amol S Rangnekar, Sheila L Eswaran, Elizabeth Zheng, Janice H Jou, James Hanje, Anjana Pillai, Ruben Hernaez, Robert Wong, Steven Scaglione, Hrishikesh Samant, Devika Kapuria, Shaun Chandna, Russell Rosenblatt, Veeral Ajmera, Catherine T Frenette, Sanjaya K Satapathy, Parvez Mantry, Prasun Jalal, Binu V John, Oren K Fix, Michael Leise, Christina C Lindenmeyer, Avegail Flores, Nayan Patel, Z Gordon Jiang, Nyan Latt, Renumathy Dhanasekaran, Mobolaji Odewole, Sofia Kagan, Jorge A Marrero, Amit G Singal

Faculty, Staff and Students Publications

BACKGROUND & AIMS: Direct-acting antivirals (DAAs) are effective against hepatitis C virus and sustained virologic response is associated with reduced incidence of hepatocellular carcinoma (HCC). However, there is controversy over the use of DAAs in patients with active or treated HCC and uncertainty about optimal management of these patients. We aimed to characterize attitudes and practice patterns of hepatology practitioners in the United States regarding the use of DAAs in patients with HCC.

METHODS: We conducted a survey of hepatology providers at 47 tertiary care centers in 25 states. Surveys were sent to 476 providers and we received 279 responses …

Paediatric Respiratory Isolation: A Challenge For A Secondary Care Hospital! A Service Innovation Project, Nadia Mohammad, Shireen Mohammad, Arjumand Sohaila, Syed Mohammad Yousuf, Adnan Khan, Rahila Meghani, Kashif Sajwani, Khalil Ahmad, Ali Faisal Saleem Dr, Pawan Vash

Department of Paediatrics and Child Health

Objective: The aim of this project was to broaden the secondary care hospital's scope of services and provide safe, effective and quality care for the patient presenting with measles.
Methods: Six Sigma DMAIC [define measure, analyze, improve, and control (DMAIC)] methodology was used in this quality improvement project. The quality project was started in October 2015 using a Gantt chart quality tool.
Results: The paediatric team with the support of administration of the hospital has established isolation rooms and devised a policy for the care and management of patient with airborne infection to avoid cross transmission. During six months period …

Neurochemical Characterization Of Brainstem Pro-Opiomelanocortin Cells, Oliver Marston, Giles S H Yeo, Justin J Rochford, Alastair S Garfield, Lora K Heisler

Faculty, Staff and Student Publications

Genetic research has revealed pro-opiomelanocortin (POMC) to be a fundamental regulator of energy balance and body weight in mammals. Within the brain, POMC is primarily expressed in the arcuate nucleus of the hypothalamus (ARC), while a smaller population exists in the brainstem nucleus of the solitary tract (POMCNTS). We performed a neurochemical characterization of this understudied population of POMC cells using transgenic mice expressing green fluorescent protein (eGFP) under the control of a POMC promoter/enhancer (PomceGFP). Expression of endogenous Pomc mRNA in the nucleus of the solitary tract (NTS) PomceGFP cells was confirmed using fluorescence-activating cell sorting (FACS) followed by …

A Case Series Of Hyponatremia And Management In Hospitalized Patients, Jake N. Cho, Rebecca Ong, Izuchukwu Nwakoby

Nephrology

No abstract provided.

Length Of Stay Of Geriatric Patients With Gram-Negative Bacteremia: An Analytical Observation, Czeresna Heriawan Soejono

Jurnal Penyakit Dalam Indonesia

No abstract provided.

Utilizing Digital Health To Collect Electronic Patient-Reported Outcomes In Prostate Cancer: Single-Arm Pilot Trial, Christine Tran, Ms, Adam Dicker, Md, Phd, Benjamin Leiby, Phd, Eric Gressen, Md, Noelle Williams, Md, Heather Jim, Phd

Kimmel Cancer Center Faculty Papers

Background: Measuring patient-reported outcomes (PROs) requires an individual’s perspective on their symptoms, functional status, and quality of life. Digital health enables remote electronic PRO (ePRO) assessments as a clinical decision support tool to facilitate meaningful provider interactions and personalized treatment.

Objective: This study explored the feasibility and acceptability of collecting ePROs using validated health-related quality of life (HRQoL) questionnaires for prostate cancer.

Methods: Using Apple ResearchKit software, the Strength Through Insight app was created with content from validated HRQoL tools 26-item Expanded Prostate Cancer Index Composite (EPIC) or EPIC for Clinical Practice and 8-item Functional Assessment of Cancer Therapy Advanced …

Correlation Of Fibroblast Growth Factor-23 Levels With Hand Grip Strength In Twice Weekly Hemodialysis Patients, Aida Lydia, Donnie Lumban Gaol, Suhardjono Suhardjono, Murdani Abdullah

Jurnal Penyakit Dalam Indonesia

No abstract provided.

Associations Between Aquaglyceroporin Gene Polymorphisms And Risk Of Stroke Among Patients With Hypertension, Qingyun Tu, Li Yan, Chun Wang, Aohan Han, Yu Qin, Lan Cui, Quanyong Xiang

Department of Medical Oncology Faculty Papers

Background: Dysregulations ofAQP7andAQP9were found to be related to lipid metabolism abnormality, which had been provento be one of the mechanisms of stroke. However, limited epidemiological studies explore the associations betweenAQP7andAQP9and the risk of stroke among patients with hypertension in China.

Aims: We aimed to investigate the associations between genetic variants in AQP7andAQP9and the risk of stroke among patients with hypertension, as well as to explore gene-gene andgene-environment interactions.

Methods: Baseline blood samples were drawn from 211 cases with stroke and 633 matched controls. Genomic DNA was extracted by a commercially available kit. Genotyping of 5 single nucleotide polymorphisms (SNPs) in …

Relationship Between Quality Of Life And Nutritional Status On Chronic Kidney Disease Patients With Dialysis Type, Ratih Tri Kusuma Dewi, Wachid Putranto, Agung Susanto, Aryo Suseno, Bambang Purwanto, Rini Dwi Mangesti, Maia Thalia Giani, Muhammad Raditia Septian

Jurnal Penyakit Dalam Indonesia

No abstract provided.

Biliary Dyskinesia In Children And Adolescents: A Mini Review., David Simon, Craig A. Friesen, Jennifer Verrill Schurman, Jennifer Colombo

Manuscripts, Articles, Book Chapters and Other Papers

Introduction: While functional gallbladder disorder is a well-recognized and defined condition in adults, its pediatric analog, biliary dyskinesia, lacks uniformity in diagnosis. Yet, biliary dyskinesia is among the most common conditions resulting in cholecystectomy in youth and its frequency continues to rise. The primary aims of the current review were assess the efficacy of cholecystectomy in children diagnosed with biliary dyskinesia and the utility of cholescintigraphy in predicting outcomes.

Results: All previous studies assessing outcomes in youth with biliary dyskinesia have been retrospective and therefore of low quality. There is a lack of uniformity in patient selection. Short term follow-up …

Dietary Alterations Modulate The Microrna 29/30 And Igf-1/Akt Signaling Axis In Breast Cancer Liver Metastasis., Anuradha A. Shastri, Anthony Saleh, Jason E. Savage, Tiziana Deangelis, Kevin Camphausen, Nicole L. Simone

Department of Radiation Oncology Faculty Papers

Background: Metastatic cancer is incurable and understanding the molecular underpinnings is crucial to improving survival for our patients. The IGF-1/Akt signaling pathway is often impaired in cancer leading to its progression and metastases. Diet modification is known to alter the IGF-1/Akt pathway and affect the expression of microRNA involved in tumor initiation, growth and metastases. Liver metastases are one of the most common type of metastases in breast and colon cancer. In the present study, we looked at the effect of diet modification on the expression of microRNA in normal liver and liver with breast cancer metastases using in vivo …

Late Weaning And Maternal Closeness, Associated With Advanced Motor And Visual Maturation, Reinforce Autonomy In Healthy, 2-Year-Old Children, José Villar, Roseline Ochieng, Eleonora Staines-Urias, Michelle Fernandes, Marc Ratcliff, Manorama Purwar, Fernando Barros, Bernardo Horta, Maria Carvalho, Zulfiqar Ahmed Bhutta

Woman and Child Health

We studied neurodevelopmental outcomes and behaviours in healthy 2-year old children (N = 1306) from Brazil, India, Italy, Kenya and the UK participating in the INTERGROWTH-21^st Project. There was a positive independent relationship of duration of exclusive breastfeeding (EBF) and age at weaning with gross motor development, vision and autonomic physical activities, most evident if children were exclusively breastfed for ≥7 months or weaned at ≥7 months. There was no association with cognition, language or behaviour. Children exclusively breastfed from birth to6 months had, in a dose-effect pattern, adjusting for confounding factors, higher scores for "emotional reactivity". The positive …

Transcutaneous Auricular Vagus Nerve Stimulation-Paired Rehabilitation For Oromotor Feeding Problems In Newborns: An Open-Label Pilot Study, Bashar W. Badran, Dorothea D. Jenkins, Daniel Cook, Sean Thompson, Morgan Darcy, William H. Devries, Georgia Mappin, Philipp Summers, Marom Bikson, Mark S. George

Publications and Research

Neonates born premature or who suffer brain injury at birth often have oral feeding dysfunction and do not meet oral intake requirements needed for discharge. Low oral intake volumes result in extended stays in the hospital (>2 months) and can lead to surgical implant and explant of a gastrostomy tube (G-tube). Prior work suggests pairing vagus nerve stimulation (VNS) with motor activity accelerates functional improvements after stroke, and transcutaneous auricular VNS (taVNS) has emerged as promising noninvasive form of VNS. Pairing taVNS with bottle-feeding rehabilitation may improve oromotor coordination and lead to improved oral intake volumes, ultimately avoiding the …

Proteins Inform Survival-Based Differences In Patients With Glioblastoma, L. C. Stetson, Daniela M. Schlatzer, Peter Liao, Karen Devine, Kristin Waite, Marta E. Couce, Andrew E. Sloan, Mark R. Chance, Jill S. Barnholtz-Sloan

Faculty Scholarship

Background: Improving the care of patients with glioblastoma (GB) requires accurate and reliable predictors of patient prognosis. Unfortunately, while protein markers are an effective readout of cellular function, proteomics has been underutilized in GB prognostic marker discovery. Methods: For this study, GB patients were prospectively recruited and proteomics discovery using liquid chromatography-mass spectrometry analysis (LC-MS/MS) was performed for 27 patients including 13 short-term survivors (STS) (≤10 months) and 14 long-term survivors (LTS) (≥18 months). Results: Proteomics discovery identified 11 941 peptides in 2495 unique proteins, with 469 proteins exhibiting significant dysregulation when comparing STS to LTS. We verified the differential …

Management Of Childhood Migraine By Headache Specialist Versus Non-Headache Specialists, Kelly Valentini, Radhika Gutta, Gunjanpreet Kaur, Ahmad Farooqi, Lalitha Sivaswamy

Medical Student Research Symposium

This study aims to compare the management practices of a headache specialist with non-headache specialists in the treatment of pediatric migraine. The use of appropriate rescue medications and prophylactic agents, application of neuro-imaging, and short-term outcomes are compared in children treated by the two groups of physicians. A retrospective cohort study was conducted utilizing the electronic medical records of children 3-18 years of age with migraine, who were evaluated at a tertiary care children’s hospital from 2016-2018. Of the 849 patients that met the study criteria, 469 were classified as having chronic migraine or high-frequency episodic migraine and were followed …

Flavonoids And Other Polyphenols Act As Epigenetic Modifiers In Breast Cancer., Priyanga Selvakumar, Aja Badgeley, Paige Murphy, Hina Anwar, Urvashi Sharma, Katharine Lawrence, Ashakumary Lakshmikuttyamma

College of Pharmacy Faculty Papers

Breast cancer is a common cancer that occurs due to different epigenetic alterations and genetic mutations. Various epidemiological studies have demonstrated an inverse correlation between breast cancer incidence and flavonoid intake. The anti-cancer action of flavonoids, a class of polyphenolic compounds that are present in plants, as secondary metabolites has been a major topic of research for many years. Our review analysis demonstrates that flavonoids exhibit anti-cancer activity against breast cancer occurring in different ethnic populations. Breast cancer subtype and menopausal status are the key factors in inducing the flavonoid's anti-cancer action in breast cancer. The dose is another key …

Sleeping Time Is Associated With Functional Limitations In A National Sample Of Older Americans, Brenda M. Vincent, Nathaniel Johnson, Grant R. Tomkinson, Ryan Mcgrath, Brian C. Clark, Bong-Jin Choi

Education, Health & Behavior Studies Faculty Publications

Background: Engaging in healthy behaviors may help to preserve function during aging; however, it is not well understood how sleeping time is associated with functional capacity in older adults.

Aims: We sought to determine the association of sleeping time on functional limitation in a national sample of older Americans.

Methods: The analytical sample included 6,020 adults aged at least 65 years who participated in the 2007-2016 waves of the National Health and Nutrition Examination Survey. Respondents indicated their hours of sleep/week night and were categorized as <5, 5-6.5, 7-8, 8.5-9, and >9 hours of sleep/week night. Ability to complete 19 functional tasks …

Student Athlete Perceptions Of Athletic Trainers’ Competence Based On Appearance And Dress, Jennifer J. Rogers

Journal of Sports Medicine and Allied Health Sciences: Official Journal of the Ohio Athletic Trainers Association

Context: Physical appearance and dress attire may be a major influence on a person’s perception of an individual’s professional competence. Objective: To examine influence of Athletic Trainer (AT) physical appearance and dress attire on student-athletes’ perception of an AT’s competence. Design: Cross-Sectional Study Setting: NATA District 5 Participants: Student athletes (n=156; female: n=71; male: n=78) from NCAA Division III and NAIA institutions participated in the study. Interventions: Participants viewed one of four Body Mass Index (BMI) specific AT images [underweight BMI=18, normal weight BMI=24, overweight BMI=30, or an obese BMI=36] while answering 36 Student Athlete Response (SAR) Form survey questions …

The Effectiveness Of An Infrapatellar Strap On Reducing Pain Associated With Patellar Tendinopathy, Jenny Toonstra, Andrea Cripps

Journal of Sports Medicine and Allied Health Sciences: Official Journal of the Ohio Athletic Trainers Association

Purpose: To determine the effectiveness of an infrapatellar strap on pain reduction in participants with patellar tendinopathy. Methods: Articles were identified from PubMed, CINAHL, Medline, and SportDiscus using the string “((((patellar tendinitis OR patellar tendinopathy))) AND ((cho-pat strap OR infrapatellar strap OR compression device OR brace))) AND pain” from January 2009-January 2019, resulting in nine studies. After a review of the title and abstracts, six studies were reviewed in-depth. Of these articles, four studies met the inclusion criteria. Two independent reviewers assessed the level of evidence of included studies using the Oxford Center for Evidence-Based Medicine (2009). Changes in pain …

Gut Microbial Protein Expression In Response To Dietary Patterns In A Controlled Feeding Study: A Metaproteomic Approach, Hong Peng, Damon H May, William S Noble, Daniel Raftery, Sandi L Navarro, Marian L Neuhouser, Paul D Lampe, Johanna W Lampe, Ru Chen

Faculty, Staff and Students Publications

Although the gut microbiome has been associated with dietary patterns linked to health, microbial metabolism is not well characterized. This ancillary study was a proof of principle analysis for a novel application of metaproteomics to study microbial protein expression in a controlled dietary intervention. We measured the response of the microbiome to diet in a randomized crossover dietary intervention of a whole-grain, low glycemic load diet (WG) and a refined-grain, high glycemic load diet (RG). Total proteins in stools from 9 participants at the end of each diet period (

Therapeutic Potential Of Citrulline As An Arginine Supplement: A Clinical Pharmacology Review, Jahidur Rashid, Shaun S. Kumar, Kathleen M. Job, Xiaoxi Liu, Candice D. Fike, Catherine M. T. Sherwin

Pediatrics Faculty Publications

Supplemental arginine has shown promise as a safe therapeutic option to improve endogenous nitric oxide (NO) regulation in cardiovascular diseases associated with endothelial dysfunction. L-arginine, an endogenous amino acid, was reported in clinical studies in adults to improve cardiovascular function in hypertension, pulmonary hypertension, pre-eclampsia, angina, and mitochondrial encephalomyopathy, lactic acidosis and stroke-like episodes (MELAS) syndrome. L-citrulline, a natural precursor of L-arginine, is more bioavailable than L-arginine because of hepatic first-pass metabolism avoidance and longer circulation time. Although not yet well studied, arginine/citrulline has immense therapeutic potential in some life-threatening diseases of children. However, optimal clinical development of arginine or …

Acquired Zinc Deficiency With Concomitant Deficiencies Of Vitamin A, B1, And B6, Shane M. Swink Do, Kirsten S. Bellucci Md, Cynthia L. Bartus Md

Department of Medicine

No abstract provided.

Acquired Acrodermatitis Enteropathica, Diana A. Rivers Do, Kirsten S. Bellucci Md, Cynthia L. Bartus Md

Department of Medicine

No abstract provided.