Digital Commons Network^™

Addendum Guidelines For The Prevention Of Peanut Allergy In The United States: Report Of The National Institute Of Allergy And Infectious Diseases–Sponsored Expert Panel, Alkis Togias, Susan F. Cooper, Maria L. Acebal, Amal Assa'ad, James R. Baker, Lisa A. Beck, Julie Block, Carol Byrd-Bredbenner, Edmond S. Chan, Lawrence F. Eichenfield, David M Fleischer, George J. Fuchs Iii, Glenn T. Furuta, Matthew J. Greenhawt, Ruchi S. Gupta, Michele Habich, Stacie M. Jones, Kari Keaton, Antonella Muraro, Marshall Plaut, Lanny J. Rosenwasser, Daniel Rotrosen, Hugh A. Sampson, Lynda C. Schneider, Scott H. Sicherer, Robert Sidbury, Jonathan Spergel, David R. Stukus, Carina Venter, Joshua A. Boyce

Pediatrics Faculty Publications

Background: Food allergy is an important public health problem because it affects children and adults, can be severe and even life-threatening, and may be increasing in prevalence. Beginning in 2008, the National Institute of Allergy and Infectious Diseases, working with other organizations and advocacy groups, led the development of the first clinical guidelines for the diagnosis and management of food allergy. A recent landmark clinical trial and other emerging data suggest that peanut allergy can be prevented through introduction of peanut-containing foods beginning in infancy.

Objectives: Prompted by these findings, along with 25 professional organizations, federal agencies, and patient advocacy …

Caphosol For Prevention Of Oral Mucositis In Pediatric Myeloablative Haematopoietic Cell Transplantation., Nathaniel Treister, Michael Nieder, Christina Baggott, Ellen Olson, Lu Chen, Ha Dang, Mark Krailo, Amanda August, Lillian Sung

Manuscripts, Articles, Book Chapters and Other Papers

BACKGROUND: The primary objective was to determine whether topically administered Caphosol, rinsed orally four times daily at the initiation of conditioning, reduces the duration of severe oral mucositis (OM) compared with placebo among children and adolescents undergoing haematopoietic cell transplantation (HCT).

METHODS: This was a Children's Oncology Group multicentre randomised double-blinded placebo-controlled clinical trial. Patients between the ages of 4 and 21 years who were scheduled to undergo myeloablative HCT for any indication were randomised to Caphosol or placebo saline rinses four times daily from initiation of conditioning through day +20. Subjects were assessed daily for OM using the World …

Increased Ros Production In Non-Polarized Mammary Epithelial Cells Induces Monocyte Infiltration In 3d Culture, Linzhang Li, Jie Chen, Gaofeng Xiong, Daret K. St. Clair, Wei Xu, Ren Xu

Markey Cancer Center Faculty Publications

Loss of epithelial cell polarity promotes cell invasion and cancer dissemination. Therefore, identification of factors that disrupt polarized acinar formation is crucial. Reactive oxygen species (ROS) drive cancer progression and promote inflammation. Here, we show that the non-polarized breast cancer cell line T4-2 generates significantly higher ROS levels than polarized S1 and T4R cells in three-dimensional (3D) culture, accompanied by induction of the nuclear factor κB (NF-κB) pathway and cytokine expression. Minimizing ROS in T4-2 cells with antioxidants reestablished basal polarity and inhibited cell proliferation. Introducing constitutively activated RAC1 disrupted cell polarity and increased ROS levels, indicating that RAC1 is …

Performance-Enhancing Drugs: A Review, G Keith Gill

UNM Orthopaedic Research Journal

Performance-enhancing drugs and substances have been an integral part of athletics and society. The immense popularity and financial compensation associated with success in sports often results in a desire to win at all costs, which stimulates a never-ending appetite for use of ergogenic aids. Athletes have experimented with these substances (ranging from over-the-counter supplements to anabolic-androgenic steroids and beyond) if a possibility of advantage exists, whether scientifically or theoretically supported. As the technology to create new designer drugs becomes more available, the ability to test for the presence of these substances lags slightly behind. The knowledge base of sports-medicine physicians …

Hierarchical Modeling Versus Regression Analysis For Evaluating Results Of Orthopaedic Studies That Use The National Inpatient Sample, Joshua W. Hustedt, Kade Mcquivey, John C. Hustedt

UNM Orthopaedic Research Journal

Background: Owing to its hierarchical sampling structure, the National Inpatient Sample (NIS) often involves clusters of study data. We aimed to (1) understand the statistical methods of currently published orthopaedic studies using NIS and (2) examine the role of hierarchical modeling versus traditional regression analysis in a retrospective cohort of patients from NIS.

Methods: We conducted a systematic review to examine statistical methods of orthopaedic studies (published between 2005 and 2014) using NIS. Ultimately, 132 studies were identified. We noted percentages of studies that used hierarchical modeling versus traditional regression analysis. Using NIS, we identified a retrospective cohort of patients …

Health Literacy And Medication Administration Knowledge Of Unlicensed Health Care Workers In Assisted Living Facilities, Lynsey Jae Kissinger, Kelsey Walczak

All Electronic Theses and Dissertations

The purpose of this research was to determine the health literacy and medication administration knowledge of unlicensed health care workers such as certified nursing assistants and non-certified caregivers working in assisted living facilities in Minnesota. Currently, there is a lack of research about both the health literacy and medication administration knowledge of unlicensed health care workers. Unlicensed health care workers in assisted living facilities provide healthcare assistance to the elderly and may provide services such as medication administration, blood glucose monitoring, and assistance with activities of daily living. This research utilized the Newest Vital Sign (NVS) assessment to determine the …

Obstacles To Preventing Obesity In Children Aged 2 To 5 Years: Latino Mothers’ And Fathers’ Experiences And Perceptions Of Their Urban Environments, Carlos Penilla, Jeanne M. Tschann, Emma V. Sanchez-Vaznaugh, Elena Flores, Emily J. Ozer

School of Education Faculty Research

Background

The prevalence of obesity among Latino children is alarmingly high, when compared to non-Latino White children. Low-income Latino parents living in urban areas, even if they are well-educated, face obstacles that shape familial health behaviors. This study used qualitative methods to explore parents’ experiences in providing meals and opportunities to play to their children aged 2 to 5 years. In contrast to most prior studies, this study examined perceptions of familial behaviors among both mothers and fathers.

Methods

An ecological framework for exploring the associations of parental feeding behaviors and children’s weight informed this study. An interview guide was …

Febrile Rhinovirus Illness During Pregnancy Is Associated With Low Birth Weight In Nepal., Erin K Philpott, Janet A Englund, Joanne Katz, James Tielsch, Subarna Khatry, Stephen C Leclerq, Laxman Shrestha, Jane Kuypers, Amalia S Magaret, Mark C Steinhoff, Helen Y Chu

Global Health Faculty Publications

BACKGROUND: Adverse birth outcomes, including low birth weight (LBW), defined as <2500 >grams, small-for-gestational-age (SGA), and prematurity, contribute to 60%-80% of infant mortality worldwide and may be related to infections during pregnancy. The aim of this study was to assess whether febrile human rhinovirus (HRV) illness is associated with adverse birth outcomes.

METHODS: Active household-based weekly surveillance was performed for respiratory illness episodes in pregnant women as part of a community-based, prospective, randomized trial of maternal influenza immunization in rural Nepal. Rhinovirus (HRV) febrile illness episodes were defined as fever plus cough, sore throat, runny nose, and/or myalgia with HRV detected …

The Impact Of Wmed Family Medicine Obesity Clinic On Weight Loss And Patient's Overall Health In The Family Health Center, Kalamazoo, Mi, Latifa Pacheco Do, Abigail Annan Md

Research Day

No abstract provided.

End-Of-Life Training In Us Internal Medicine Residency Programs: A National Study, Derek Cegelka, Timothy R. Jordan, Jiunn-Jye Sheu, Joseph A. Dake, Ragheb Assaly

Faculty Publications

Background: End-of-life care is a required and important component of medical training for internal medicine residents; many of whom will go on to provide care for adults at the end-of-life stage. Although a body of past research suggests that physician training in end-of-life care needs significant improvement, a comprehensive national study of end-of-life education within US internal medicine residency programs has never been published.

Objective: To determine the status of end-of-life education in internal medicine residency programs in the United States.

Method: The study was a cross-sectional, observational study of all internal medicine Residency Program Directors in the US as …

The Role Of Open Abdomen In Non-Trauma Patient: Wses Consensus Paper, Federico Coccolini, Giulia Montori, Marco Ceresoli, Fausto Catena, Ernest E. Moore, Rao Ivatury, Walter Biffl, Andrew Peitzman, Raul Coimbra, Sandro Rizoli, Yoram Kluger, Fikri M. Abu-Zidan, Massimo Sartelli, Marc De Moya, George Velmahos, Gustavo Pereira Fraga, Bruno M. Pereira, Ari Leppaniemi, Marja A. Boermeester, Andrew W. Kirkpatrick, Ron Maier, Miklosh Bala, Boris Sakakushev, Vladimir Khokha, Manu Malbrain, Vanni Agnoletti, Ignacio Martin-Loeches, Michael Sugrue, Salomone Di Saverio, Ewen Griffiths, Kjetil Soreide, John E. Mazuski, Addison K. May, Philippe Montravers, Rita Maria Melotti, Michele Pisano, Francesco Salvetti, Gianmariano Marchesi, Tino M. Valetti, Thomas Scalea, Osvaldo Chiara, Jeffry L. Kashuk, Luca Ansaloni

Surgery Publications

The open abdomen (OA) is defined as intentional decision to leave the fascial edges of the abdomen un-approximated after laparotomy (laparostomy). The abdominal contents are potentially exposed and therefore must be protected with a temporary coverage, which is referred to as temporal abdominal closure (TAC). OA use remains widely debated with many specific details deserving detailed assessment and clarification. To date, in patients with intra-abdominal emergencies, the OA has not been formally endorsed for routine utilization; although, utilization is seemingly increasing. Therefore, the World Society of Emergency Surgery (WSES), Abdominal Compartment Society (WSACS) and the Donegal Research Academy united a …

State Of Harmonization Of 24 Serum Albumin Measurement Procedures And Implications For Medical Decisions, Lorin M. Bachmann, Min Yu, James C. Boyd, David E. Bruns, W. Greg Miller

Pathology Publications

BACKGROUND: Measurements of serum and plasma albumin are widely used in medicine, including as indicators of quality of patient care in renal dialysis centers.

METHODS: Pools were prepared from residual patient serum (n = 50) and heparin plasma (n = 48) from patients without renal disease, and serum from patients with kidney failure before hemodialysis (n = 53). Albumin was measured in all samples and in ERM-DA470k/IFCC reference material (RM) by 3 immunochemical, 9 bromcresol green (BCG), and 12 bromcresol purple (BCP) methods.

RESULTS: Two of 3 immunochemical procedures, 5 of 9 BCG, and 10 of 12 BCP methods recovered …

Quality Of Life In Chronic Pancreatitis Is Determined By Constant Pain, Disability/Unemployment, Current Smoking, And Associated Co-Morbidities, Jorge D. Machicado, Stephen T. Amann, Michelle A. Anderson, Judah Abberbock, Stuart Sherman, Darwin L. Conwell, Gregory A. Cote, Vikesh K. Singh, Michele D. Lewis, Samer Alkaade, Bimaljit S. Sandhu, Nalini M. Guda, Thiruvengadam Muniraj, Gong Tang, John Baillie, Randall E. Brand, Timothy B. Gardner, Andres Gelrud, Christopher E. Forsmark, Peter A. Banks, Adam Slivka, C. Mel Wilcox, David C. Whitcomb, Dhiraj Yadav

Pathology Publications

OBJECTIVES: Chronic pancreatitis (CP) has a profound independent effect on quality of life (QOL). Our aim was to identify factors that impact the QOL in CP patients.

METHODS: We used data on 1,024 CP patients enrolled in the three NAPS2 studies. Information on demographics, risk factors, co-morbidities, disease phenotype, and treatments was obtained from responses to structured questionnaires. Physical and mental component summary (PCS and MCS, respectively) scores generated using responses to the Short Form-12 (SF-12) survey were used to assess QOL at enrollment. Multivariable linear regression models determined independent predictors of QOL.

RESULTS: Mean PCS and MCS scores were …

Oral Health And Aging, Edward F. Ansello

Director's Editorials from Age in Action

The sooner we recognize the importance of oral health to our well-being as older adults, the better we age. We need to consider our dentist as part of our health care team. For those of us in health professions, we should work together more to incorporate oral health into primary care.

Safe Driving For The Mature Adult: Selected Issues, Rebecca Parsio

Case Studies from Age in Action

Educational Objectives

1. Examine issues related to aging and driving assessment.

2. Review Virginia’s Mature Drivers Study.

3. Discuss the levels of care for prevention of driving disability and resources available at each level.

4. Explore the impact of medications and substances (both prescribed and not prescribed) on driving ability.

Enriched Environment And Stress Exposure Influence Splenic B Lymphocyte Composition., Blake T Gurfein, Burcu Hasdemir, Jeffrey M Milush, Chadi Touma, Rupert Palme, Douglas F Nixon, Nicholas Darcel, Frederick M Hecht, Aditi Bhargava

Microbiology, Immunology, and Tropical Medicine Faculty Publications

Prolonged chronic stress has deleterious effects on immune function and is associated with numerous negative health outcomes. The spleen harbors one-fourth of the body’s lymphocytes and mediates both innate and adaptive immune responses. However, the subset of splenic lymphocytes that respond, either adaptively or maladaptively, to various stressors remains largely unknown. Here we investigated the effects of unpredictable chronic mild stress (CMS) exposure on spleen composition in male mice housed in two different caging conditions: standard caging (Cntl) and enriched environment (EE). EE-caged mice exhibited the greatest absolute number of splenocytes and CMS exposure significantly lowered splenocyte numbers in both …

Schistosoma Mansoni Reinfection: Analysis Of Risk Factors By Classification And Regression Tree (Cart) Modeling., Andréa Gazzinelli, Roberta Oliveira-Prado, Leonardo Ferreira Matoso, Bráulio M Veloso, Gisele Andrade, Helmut Kloos, Jeffrey M Bethony, Renato M Assunção, Rodrigo Correa-Oliveira

Microbiology, Immunology, and Tropical Medicine Faculty Publications

Praziquantel (PZQ) is an effective chemotherapy for schistosomiasis mansoni and a mainstay for its control and potential elimination. However, it does not prevent against reinfection, which can occur rapidly in areas with active transmission. A guide to ranking the risk factors for Schistosoma mansoni reinfection would greatly contribute to prioritizing resources and focusing prevention and control measures to prevent rapid reinfection. The objective of the current study was to explore the relationship among the socioeconomic, demographic, and epidemiological factors that can influence reinfection by S. mansoni one year after successful treatment with PZQ in school-aged children in Northeastern Minas …

Ancylostoma Ceylanicum Infective Third-Stage Larvae Are Activated By Co-Culture With Ht-29-Mtx Intestinal Epithelial Cells, Caitlin Feather, John M. Hawdon, John March

Microbiology, Immunology, and Tropical Medicine Faculty Publications

Background

Human hookworm larvae arrest development until they enter an appropriate host. This makes it difficult to access the larvae for studying larval development or host-parasite interactions. While there are in vivo and in vitro animal models of human hookworm infection, there is currently no human, in vitro model. While animal models have provided much insight into hookworm biology, there are limitations to how closely this can replicate human infection. Therefore, we have developed a human, in vitro model of the initial phase of hookworm infection using intestinal epithelial cell culture.

Results

Co-culture of the human hookworm Ancylostoma ceylanicum with …

Hypertension In The Pediatric Kidney Transplant Recipient., Olga Charnaya, Asha Moudgil

Pediatrics Faculty Publications

Hypertension after kidney transplant is a frequent occurrence in pediatric patients. It is a risk factor for graft loss and contributes to the significant burden of cardiovascular disease (CVD) in this population. The etiology of posttransplant hypertension is multifactorial including donor factors, recipient factors, medications, and lifestyle factors similar to those prevalent in the general population. Ambulatory blood pressure monitoring has emerged as the most reliable method for measuring hypertension in pediatric transplant recipients, and many consider it to be essential in the care of these patients. Recent technological advances including measurement of carotid intima-media thickness, pulse wave velocity, and …

Disorders Of Metal Metabolism, Carlos Ferreira, William A. Gahl

Pediatrics Faculty Publications

Trace elements are chemical elements needed in minute amounts for normal physiology. Some of the physiologically relevant trace elements include iodine, copper, iron, manganese, zinc, selenium, cobalt and molybdenum. Of these, some are metals, and in particular, transition metals. The different electron shells of an atom carry different energy levels, with those closest to the nucleus being lowest in energy. The number of electrons in the outermost shell determines the reactivity of such an atom. The electron shells are divided in sub-shells, and in particular the third shell has s, p and d sub-shells. Transition metals are strictly defined as …

Childhood Obesity: Physiological And Psychological Implications And Ethical Responsibilities, Connie S. Lewis

Journal of Health Ethics

Childhood obesity continues to be a health concern in the United States with physiological and psychological consequences. Research conducted in schools may address the physiological effects and exacerbate negative psychological effects, including weight bias and stigmatization. In the home, children are dependent on parents/caregivers to provide a healthy diet and exhibit a healthy lifestyle.The ethical theory, ethics of care, emphasizes dependence and interdependence on others, and ethical and moral responsibilities in the parent/child relationship. The assurance of ethical considerations involving children in research and parental provision for healthy dietary provision is of utmost importance. Any action or inaction that results …

Type 2 Diabetes In Native Americans: The Influence Of Historical And Cultural Factors On Incidence, Prevalence, And Strategies For Patient Education, Disease Prevention, And Management, Tim Olsen

Physician Assistant Scholarly Project Posters

Type 2 diabetes (DM2) was virtually nonexistent among Native American, Alaska Native, and Canadian First Nations people prior to the 1950s. Due to historical, cultural, environmental, and psychosocial factors, Native people suffer disproportionately higher rates of DM2 than other populations. This literature review aims to examine the influence of these factors and investigate whether insight and knowledge into them, as well as culturally sensitive approaches to disease education, prevention, and self-management can be beneficial to providers working among Native communities. The results suggested that culturally sensitive approaches are indeed of value in promoting more effective care, and that lack of …

Analysis Of Metabolic Syndrome As A Modifiable Risk Factor For Prostate Cancer, Michael Butler

Physician Assistant Scholarly Project Posters

• Prostate cancer and metabolic syndrome are both prevalent among men in developed countries with peak incidence after age 50.

• Prostate cancer has no known modifiable risk factors.

• Most risk factors for metabolic syndrome are modifiable.

• If metabolic syndrome is identified as contributing to the risk of prostate cancer it would give an element of self determination to men at risk for prostate cancer.

• Past studies provide conflicting results in the correlation between these two conditions.

• A literature review was performed to evaluate consistencies in current literature.

• Metabolic syndrome or its components do not …

Trends In Management Of Overweight And Obesity In Obstetrics & Gynecology, Family Medicine And Pediatrics 2011-2015, Steven Lindheim, Stephanie Welsh, Nan Jiang, Amanda Hawkins, Lisa Kellar, Rose Maxwell, Leah D. Whigham

Obstetrics and Gynecology Faculty Publications

Purpose: To assess for improvement in the screening and management of overweight and obesity in the past 5 years among Obstetrician-Gynecologists (OB-GYN), Family Physicians (FP), and Pediatricians (Peds).

Methods: A retrospective pilot study was conducted, reviewing 150 charts of patients with overweight (body mass index [BMI] 25-29.9 kg/m2) and class I (BMI 30-34.9 kg/m2), class II (BMI 35-39.9 kg/m2), and class III obesity (BMI ≥ 40 kg/m2) between 2011 and 2015. Patients were from OB-GYN (n=50), Family Medicine, adult (FP-A) (n=50) and pediatric (FP-P) (n=28), and Peds (n=22) offices.

Results: 75% of patients were female; 35.5% had overweight, 40% had …

Why Does Oral Health In Long-Term Care Residents Matter? Talking Points For Administrators, American Dental Association

Action for Dental Health

No abstract provided.

Employing The Enzyme Cofactor Function Of Ascorbic Acid To Affect Oncogenic Pathways In Human Melanoma: Modulating Hypoxia Inducible Factor-1Α And Dna Demethylation To Reduce Malignant Potential, Adam Patrick Fischer

Theses, Dissertations and Capstones

Dioxygenase enzymes such as the HIF hydroxylases (PHD1-3, FIH) and the Ten-eleven translocation (TET1-3) enzymes regulate the activity of the hypoxia inducible factor-1_a (HIF1_a) transcription factor and the DNA methylation status of cells, respectively. Aberrant accumulation and activation of HIF-1_a can allow malignant cells to acquire attributes that promote progression, chemotherapy resistance, and survival, while aberrant hypermethylation of gene promoters can silence the expression of tumor suppressor genes essential to preventing tumorigenesis. Inadequate levels of intracellular ascorbic acid (AA), a necessary cofactor for optimal dioxygenase enzyme function, could potentiate these tumorigenic conditions. In fact, plasma levels …

Com Outlook Winter 2017, College Of Osteopathic Medicine

COM Outlook

No abstract provided.

Graduate Medical Education 2016-2017 Annual Report, Children's Mercy Hospital

GME Annual Reports

Annual report of the Children's Mercy Hospital Graduate Medical Education department, including pediatric residency, internal medicine/pediatrics residency, fellowship programs, medical students, continuing medical education, and library services.

Neuroprotection Through Flavonoid: Enhancement Of The Glyoxalase Pathway., Joel Frandsen, Prabagaran Narayanasamy

Journal Articles: Pathology and Microbiology

The glyoxalase pathway functions to detoxify reactive dicarbonyl compounds, most importantly methylglyoxal. The glyoxalase pathway is an antioxidant defense mechanism that is essential for neuroprotection. Excessive concentrations of methylglyoxal have deleterious effects on cells, leading to increased levels of inflammation and oxidative stress. Neurodegenerative diseases - including Alzheimer's, Parkinson's, Aging and Autism Spectrum Disorder - are often induced or exacerbated by accumulation of methylglyoxal. Antioxidant compounds possess several distinct mechanisms that enhance the glyoxalase pathway and function as neuroprotectants. Flavonoids are well-researched secondary plant metabolites that appear to be effective in reducing levels of oxidative stress and inflammation in neural …

Remote Lifestyle Counseling Influences Cardiovascular Health Outcomes In Youth With Overweight Or Obesity And Congenital Heart Disease, Luis Altamirano-Diaz, Meghan Rombeek, Stefanie De Jesus, Eva Welisch, Harry Prapavessis, Adam A Dempsey, Douglas Fraser, Michael R Miller, Kambiz Norozi

Paediatrics Publications

Background: Children with overweight/obesity and congenital heart disease (CHD) are at increased cardiovascular risk. A lifestyle intervention may help reduce these risks. We sought to determine the feasibility of a smartphone-based lifestyle intervention to improve cardiovascular health outcomes in children with overweight/obesity and CHD.

Methods: We examined the effect of bi-weekly nutrition and fitness counseling delivered

Results: Statistically significant decreases in waist circumference (WC), body mass index

Conclusion: The observed changes in anthropometry were positive with significant improvement to some cardiovascular and metabolic risk indicators. However, this was only observed in the operated group suggesting that other factors, such as …