Digital Commons Network^™

Why Does Obesity Lead To Hypertension? Further Lessons From The Intersalt Study., Preeya T. Shah, Anna P. Shapiro, Zeid Khitan Md, Prasanna Santhanam Md, Joseph I. Shapiro Md

Marshall Journal of Medicine

Objectives

To analyze correlations between major determinants of blood pressure (BP), in efforts to generate and compare predictive models that explain for variance in systolic, diastolic, and mean BP amongst participants of the Intersalt study.

Methods

Data from the Intersalt study, consisting of nearly 10,000 subjects from 32 different countries, were reviewed and analyzed. Published mean values of 24 hour urinary electrolyte excretion (Na+, K+), 24 hour urine creatinine excretion, body mass index (BMI, kg/m^2), and blood pressure data were extracted and imported into Matlab™ for stepwise linear regression analysis.

Results

As shown earlier, strong correlations between urinary sodium excretion …

The Relationship Between Foot Arch Measurements And Walking Parameters In Children, Simone V. Gill, Sara Keimig, Damian Kelty-Stephen, Ya-Ching Hung, Jeremy M. Desilva

Publications and Research

Background: Walking mechanics are influenced by body morphology. Foot arch height is one aspect of body morphology central to walking. However, generalizations about the relationship between arch height and walking are limited due to previous methodologies used for measuring the arch and the populations that have been studied. To gain the knowledge needed to support healthy gait in children and adults, we need to understand this relationship in unimpaired, typically developing children and adults using dynamic measures. The purpose of the current study was to examine the relationship between arch height and gait in a sample of healthy children …

Reducing Gastrointestinal Anastomotic Leak Rates: Review Of Challenges And Solutions, Benjamin Philllips

Department of Surgery Faculty Papers

Various techniques and interventions have been developed in an effort to obviate gastrointestinal anastomotic leaks. This review is intended to delineate potential modifications that can be made to reduce the risk of anastomotic leaks following gastrointestinal surgery. It may also serve to aid in identifying patients who are at increased risk of anastomotic leak. Modifiable risk factors for leak discussed include malnutrition, smoking, steroid use, bowel preparation, chemotherapy, duration of surgery, use of pressors, intravenous fluid administration, blood transfusion, and surgical anastomotic technique. Based upon literature review, operative techniques should include minimizing operative time, reducing ischemia, and utilizing stapled anastomoses. …

Harvesting Health: A Community-Based Participatory Evaluation Of The Veggie Rx Program, Natalie Royal, Kristin Brown, Fanny Rodriguez, Bianca Fernandez, Leticia Valle, Elizur Bello

Articles, Abstracts, and Reports

No abstract provided.

Obesity-Induced Colorectal Cancer Is Driven By Caloric Silencing Of The Guanylin-Gucy2c Paracrine Signaling Axis., Jieru E. Lin, Francheska Colon-Gonzalez, Erik S. Blomain, Gilbert W. Kim, Amanda Aing, Brian Stoecker, Justin Rock, Adam E. Snook, Tingting Zhan, Terry M. Hyslop, Michal Tomczak, Richard S. Blumberg, Scott A. Waldman

Department of Pharmacology and Experimental Therapeutics Faculty Papers

Obesity is a well-known risk factor for colorectal cancer but precisely how it influences risks of malignancy remains unclear. During colon cancer development in humans or animals, attenuation of the colonic cell surface receptor guanylyl cyclase C (GUCY2C) that occurs due to loss of its paracrine hormone ligand guanylin contributes universally to malignant progression. In this study, we explored a link between obesity and GUCY2C silencing in colorectal cancer. Using genetically engineered mice on different diets, we found that diet-induced obesity caused a loss of guanylin expression in the colon with subsequent GUCY2C silencing, epithelial dysfunction, and tumorigenesis. Mechanistic investigations …

Non-Alcoholic Fatty Liver Disease Induces Signs Of Alzheimer’S Disease (Ad) In Wild-Type Mice And Accelerates Pathological Signs Of Ad In An Ad Model, Do-Geun Kim, Antje Krenz, Leon E. Toussaint, Kirk J. Maurer

Dartmouth Scholarship

Background: Non-alcoholic fatty liver disease (NAFLD) is a chronic liver disease afflicting about one third of the world's population and 30 % of the US population. It is induced by consumption of high-lipid diets and is characterized by liver inflammation and subsequent liver pathology. Obesity and consumption of a high-fat diet are known to increase the risk of Alzheimer's disease (AD). Here, we investigated NAFLD-induced liver inflammation in the pathogenesis of AD.

Methods: WT and APP-Tg mice were fed with a standard diet (SD) or a high-fat diet (HFD) for 2, 5 months, or 1 year to induce NAFLD. Another …

Serum Amyloid A Impairs The Antiinflammatory Properties Of Hdl, Chang Yeop Han, Chongren Tang, Myriam E. Guevara, Hao Wei, Tomasz Wietecha, Baohai Shao, Savitha Subramanian, Mohamed Omer, Shari Wang, Kevin D. O'Brien, Santica M. Marcovina, Thomas N. Wight, Tomas Vaisar, Maria C. De Beer, Frederick C. De Beer, William R. Osborne, Keith B. Elkon, Alan Chait

Physiology Faculty Publications

HDL from healthy humans and lean mice inhibits palmitate-induced adipocyte inflammation; however, the effect of the inflammatory state on the functional properties of HDL on adipocytes is unknown. Here, we found that HDL from mice injected with AgNO₃ fails to inhibit palmitate-induced inflammation and reduces cholesterol efflux from 3T3-L1 adipocytes. Moreover, HDL isolated from obese mice with moderate inflammation and humans with systemic lupus erythematosus had similar effects. Since serum amyloid A (SAA) concentrations in HDL increase with inflammation, we investigated whether elevated SAA is a causal factor in HDL dysfunction. HDL from AgNO₃-injected mice lacking Saa1.1 …

Knowledge Of Behaviors That Contribute To A Healthy Pregnancy In Women Aged 18-25, Sarah K. Coffey, Rebecca Jennings

All Electronic Theses and Dissertations

Knowledge of behaviors that contribute to a healthy pregnancy may enhance the overall pregnancy experience. However, there are currently no studies that evaluate where discrepancies exist between current recommendations of behaviors contributing to healthy pregnancies and knowledge of those behaviors in women ages 18-25. The objective of this study was to determine where those discrepancies exist. Survey data of women’s knowledge was compared to current recommendations set forth by the American College of Obstetricians and Gynecologists (ACOG). The behaviors assessed included alcohol consumption, cigarette smoking, sleeping, caloric intake, exercise, caffeine intake, weight gain, and folic acid intake. This knowledge was …

Dietary Supplements: A Consumer Profile Of Knowledge And Use, Sarah J. Kucera, Yen Nguyen

All Electronic Theses and Dissertations

Alternative medicine, in the form of dietary supplements, is appealing to Americans. Supplements have been marketed as being natural promoters of general well-being, healing, and disease prevention. Even with minimal regulation and research, the majority of supplement use is self-prescribed, fueling an industry last estimated at $32.5 billion in 2012. The study explored the degree of consumer knowledge with regards to regulation, appropriate indications and dosages, and potential adverse effects of various dietary supplements. The study also sought to evaluate the relationship between supplement knowledge and demographic information as well as the extent of discussion about supplement use with a …

Dietary Total Isoflavone Intake Is Associated With Lower Systolic Blood Pressure: The Coronary Artery Risk Development In Young Adults (Cardia) Study, S. I. Richardson, L. M. Steffen, K. Swett, C. Smith, L. Burke, X. Zhou, J. M. Shikany, C. J. Rodriguez

Journal Articles

The effect of dietary isoflavone intake on systolic blood pressure (SBP) has not been studied in a large community-based cohort inclusive of African Americans. The authors analyzed data from the year 20 examination of the Coronary Artery Risk Development in Young Adults (CARDIA) study, including medical history, physical examination, and dietary intake surveys for 3142 participants. Multivariable linear regression models controlled for age, sex, body mass index, smoking, physical activity, and intakes of alcohol and total energy. Effect modification by race was tested. Overall, patients with hypertension had a lower daily intake of total dietary isoflavones (2.2+/-5.2 mg/d vs 4.1+/-11.7 …

Cf Healthcare Workers Feel Unprepared In Providing Suitable End Of Life Care And Desire More Education: Results Of A Nationwide Survey, J. Goggin, R. I. Cohen

Journal Articles

INTRODUCTION: Little is known about the depth of knowledge and preparedness of CF caregivers in delivering end of life and palliative care to CF patients and families. METHOD: Nationwide survey questionnaires for CF care providers using the CF Foundation Listserv electronic web-based tool. RESULTS: The majority of non-physician CF care providers (55%) had more than 15years of experience in their discipline and 84% of physician had greater than 15years of experience. The majority reported that they felt "somewhat" or "very" involved in palliative or end of life care in their current role. Yet, when asked whether they felt adequately prepared …

Hydroxyurea Therapy For Children With Sickle Cell Anemia In Sub-Saharan Africa: Rationale And Design Of The Reach Trial, P. T. Mcgann, L. Tshilolo, B. Santos, G. A. Tomlinson, S. Stuber, T. Latham, B. Aygun, S. K. Obaro, P. Olupot-Olupot, R. E. Ware, +2 Additional Authors

Journal Articles

BACKGROUND: Sickle cell anemia (SCA) is an inherited hematological disorder that causes a large but neglected global health burden, particularly in Africa. Hydroxyurea represents the only available disease-modifying therapy for SCA, and has proven safety and efficacy in high-resource countries. In sub-Saharan Africa, there is minimal use of hydroxyurea, due to lack of data, absence of evidence-based guidelines, and inexperience among healthcare providers. PROCEDURE: A partnership was established between investigators in North America and sub-Saharan Africa, to develop a prospective multicenter research protocol designed to provide data on the safety, feasibility, and benefits of hydroxyurea for children with SCA. RESULTS: …

Burden And Depression Among Caregivers Of Visually Impaired Patients In A Canadian Population, Zainab Khan, Puneet S. Braich, Karim Rahim, Jaspreet S. Rayat, Lin Xing, Munir Iqbal, Karim Mohamed Mohamed, Sanjay Sharma, David Almeida

Ophthalmology Publications

Purpose/Background. This study reports the degree of burden and the proportion at risk for depression among individuals who provide care to visually impaired patients. Study Design. This is clinic-based, cross-sectional survey in a tertiary care hospital. Methods. Caregivers were considered unpaid family members for patients whose sole impairment was visual. Patients were stratified by vision in their better seeing eye into two groups: Group 1 had visual acuity between 6/18 and 6/60 and Group 2 were those who had 6/60 or worse. Burden was evaluated by the Burden Index of Caregivers and the prevalence of being at …

Burden And Depression Among Caregivers Of Visually Impaired Patients In A Canadian Population, Zainab Khan, Puneet S. Braich, Karim Rahim, Jaspreet S. Rayat, Lin Xing, Munir Iqbal, Karim Mohamed, Sanjay Sharma, David Almeida

Ophthalmology Publications

Purpose/Background. This study reports the degree of burden and the proportion at risk for depression among individuals who provide care to visually impaired patients. Study Design. This is clinic-based, cross-sectional survey in a tertiary care hospital. Methods. Caregivers were considered unpaid family members for patients whose sole impairment was visual. Patients were stratified by vision in their better seeing eye into two groups: Group 1 had visual acuity between 6/18 and 6/60 and Group 2 were those who had 6/60 or worse. Burden was evaluated by the Burden Index of Caregivers and the prevalence of being at risk for depression …

Neighborhood Walkability And Health, Edward F. Ansello

Director's Editorials from Age in Action

The apparent benefit of neighborhood walkability suggests that it may be an important health-related consideration in the lives of everyday people. Most of the elements in the walkability index reflect components in the environment, so these may be relevant across the continuum of impairments, meaning that walkable neighborhoods themselves may have positive impact on the daily lives of people with physical or intellectual disabilities.

Palliative Care Is More Care, Not Less, Rachel Selby-Penczak

Case Studies from Age in Action

Educational Objectives:

1. Discuss the origins of hospice and palliative care.

2. Compare and contrast Curative, Palliative, and Hospice Models of Care.

3. Identify when palliative care is appropriate.

Mutational Profiles Reveal An Aberrant Tgf-Β-Cea Regulated Pathway In Colon Adenomas., Jian Chen, Gottumukkala S Raju, Wilma Jogunoori, Shoujun Gu, Lopa Mishra, + 27 More

Surgery Faculty Publications

Mutational processes and signatures that drive early tumorigenesis are centrally important for early cancer prevention. Yet, to date, biomarkers and risk factors for polyps (adenomas) that inordinately and rapidly develop into colon cancer remain poorly defined. Here, we describe surprisingly high mutational profiles through whole-genome sequence (WGS) analysis in 2 of 4 pairs of benign colorectal adenoma tissue samples. Unsupervised hierarchical clustered transcriptomic analysis of a further 7 pairs of adenomas reveals distinct mutational signatures regardless of adenoma size. Transitional single nucleotide substitutions of C:G>T:A predominate in the adenoma mutational spectrum. Strikingly, we observe mutations in the TGF-β pathway …

Vitamin D Deficiency Promotes Liver Tumor Growth In Transforming Growth Factor-Β/Smad3-Deficient Mice Through Wnt And Toll-Like Receptor 7 Pathway Modulation., Jian Chen, Lior H Katz, Nina M Muñoz, Shoujun Gu, Ji-Hyun Shin, Lopa Mishra, +13 Additional Authors

Surgery Faculty Publications

Disruption of the TGF-β pathway is associated with liver fibrosis and suppression of liver tumorigenesis, conditions associated with low Vitamin D (VD) levels. However, potential contributions of VD to liver tumor progression in the context of TGF-β signaling remain unexplored. Our analyses of VD deprivation (VDD) in in vivo models of liver tumor formation revealed striking three-fold increases in tumor burden in Smad3(+/-) mice, with a three-fold increase in TLR7 expression compared to controls. ChIP and transcriptional assays confirm Smad3 binding at two TLR7 promoter SBE sites. Molecular interactions between TGF-β pathway and VDD were validated clinically, where an absence …

Cancer Care Annual Report 2015-16, Children's Mercy Hospital

Cancer Center Annual Reports

Annual report of cancer care and oncology services at the Children's Mercy Hospital, Kansas City MO, a pediatric medical center. This report has a focus on neuroblastoma.

Senior Wellness: The Golden Age, Angela Bourassa, Sarah Cummings, An Harmanli, Minh-Tam Le, Ellen Massey, Besen Sanga, Ahalya Somaskandan, Nkechi Uzoukwu, Kirk Williamson

ISCOPES Posters and Presentations

No abstract provided.

Testing The Feasibility Of Remote Patient Monitoring In Prenatal Care Using A Mobile App And Connected Devices: A Prospective Observational Trial, Kathryn Marko, Jill M. Krapf, Andrew C. Meltzer, Julia Oh, Nihar Ganju, Anjali Martinez, Sheetal Sheth, Nancy D. Gaba

Obstetrics and Gynecology Faculty Publications

BACKGROUND:

Excessive weight gain and elevated blood pressure are significant risk factors for adverse pregnancy outcomes such as gestational diabetes, premature birth, and preeclampsia. More effective strategies to facilitate adherence to gestational weight gain goals and monitor blood pressure may have a positive health benefit for pregnant women and their babies. The impact of utilizing a remote patient monitoring system to monitor blood pressure and weight gain as a component of prenatal care has not been previously assessed.

OBJECTIVE:

The objective of this study is to determine the feasibility of monitoring patients remotely in prenatal care using a mobile phone …

Dyslipidemia And Food Security In Low-Income Us Adolescents: National Health And Nutrition Examination Survey, 2003-2010., June M Tester, Barbara A Laraia, Cindy W Leung, Michele L. Mietus-Snyder

Pediatrics Faculty Publications

INTRODUCTION: Low levels of food security are associated with dyslipidemia and chronic disease in adults, particularly in women. There is a gap in knowledge about the relationship between food security among youth and dyslipidemia and chronic disease. We investigated the relationship between food security status and dyslipidemia among low-income adolescents.

METHODS: We analyzed data from adolescents aged 12 to 18 years (N = 1,072) from households with incomes at or below 200% of the federal poverty level from the National Health and Nutrition Examination Survey (NHANES) 2003-2010. We used logistic regression to examine the relationship between household food security status …

Discovery Of Metabolic Biomarkers For Duchenne Muscular Dystrophy Within A Natural History Study., Simina M. Boca, Maki Nishida, Michael Harris, Shruti Rao, Amrita Cheema, Kirandeep Gill, Haeri Seol, Lauren P. Morgenroth, Erik Henricson, Craig M. Mcdonald, Jean K. Mah, Paula R. Clemens, Eric P. Hoffman, Yetrib Hathout, Subha Madhavan

Pediatrics Faculty Publications

Serum metabolite profiling in Duchenne muscular dystrophy (DMD) may enable discovery of valuable molecular markers for disease progression and treatment response. Serum samples from 51 DMD patients from a natural history study and 22 age-matched healthy volunteers were profiled using liquid chromatography coupled to mass spectrometry (LC-MS) for discovery of novel circulating serum metabolites associated with DMD. Fourteen metabolites were found significantly altered (1% false discovery rate) in their levels between DMD patients and healthy controls while adjusting for age and study site and allowing for an interaction between disease status and age. Increased metabolites included arginine, creatine and unknown …

Safe Infant Sleep Interventions: What Is The Evidence For Successful Behavior Change?, Rachel Y. Moon, Fern R Hauck, Eve R Colson

Pediatrics Faculty Publications

Sudden infant death syndrome (SIDS) and other sleep-related infant deaths, such as accidental suffocation and strangulation in bed and ill-defined deaths, account for >4000 deaths annually in the USA. Evidence-based recommendations for reducing the risk of sleep-related deaths have been published, but some caregivers resist adoption of these recommendations. Multiple interventions to change infant sleep-related practices of parents and professionals have been implemented. In this review, we will discuss illustrative examples of safe infant sleep interventions and evidence of their effectiveness. Facilitators of and barriers to change, as well as the limitations of the data currently available for these interventions, …

Interrater Reliability Of Quantitative Ultrasound Using Force Feedback Among Examiners With Varied Levels Of Experience, Michael O. Harris-Love, Catheeja Ismail, Reza Monfaredi, Haniel J. Hernandez, Donte Pennington, Paula Woletz, Valerie Mcintosh, Bernadette Adams, Marc R. Blackman

Exercise and Nutrition Sciences Faculty Publications

Background. Quantitative ultrasound measures are influenced by multiple external factors including examiner scanning force. Force feedback may foster the acquisition of reliable morphometry measures under a variety of scanning conditions. The purpose of this study was to determine the reliability of force-feedback image acquisition and morphometry over a range of examiner-generated forces using a muscle tissuemimicking ultrasound phantom.

Methods. Sixty material thickness measures were acquired from a muscle tissue mimicking phantom using B-mode ultrasound scanning by six examiners with varied experience levels (i.e., experienced, intermediate, and novice). Estimates of interrater reliability and measurement error with force feedback scanning were determined …

Bone Health Promotion For Youth: A Primary Care Intervention, Kay G. Wilson

Doctor of Nursing Practice Projects

Obese youth have high rates of vitamin D and calcium deficiencies and are at risk for developing osteoporosis. Clinical guidelines are needed in primary pediatric care services to promote bone-healthy behaviors. The aim of this project was to: a) implement the infrastructure and processes for physiological monitoring, consistent parameter-based vitamin D & calcium supplementation, family education, and coaching, and b) evaluate the impact of bone promotion changes on patients and parents and the primary care delivery system. The project outcomes included modest gains in bone health awareness among staff, patients, and families. In addition, modifications to clinical pathways and related …

Radioresistance Of Brain Tumors, K. Kelley, J. Knisely, M. Symons, R. Ruggieri

Journal Articles

Radiation therapy (RT) is frequently used as part of the standard of care treatment of the majority of brain tumors. The efficacy of RT is limited by radioresistance and by normal tissue radiation tolerance. This is highlighted in pediatric brain tumors where the use of radiation is limited by the excessive toxicity to the developing brain. For these reasons, radiosensitization of tumor cells would be beneficial. In this review, we focus on radioresistance mechanisms intrinsic to tumor cells. We also evaluate existing approaches to induce radiosensitization and explore future avenues of investigation.

Inhibition Of Lipogenesis Reduces Inflammation And Organ Injury In Sepsis, J. P. Idrovo, W.L. Yang, A. Jacob, L. Corbo, Jeffrey Nicastro, Gene Coppa, P. Wang

Journal Articles

BACKGROUND: Sepsis is a life-threatening acute inflammatory condition associated with metabolic complications. Accumulation of free fatty acids (FFAs) induces inflammation and causes lipotoxic effects in the liver. Because fatty acid metabolism plays a role in the inflammatory response, we hypothesized that the administration of C75, a fatty acid synthase inhibitor, could alleviate the injury caused by sepsis. METHODS: Male mice were subjected to sepsis by cecal ligation and puncture (CLP). At 4 h after CLP, different doses of C75 (1- or 5-mg/kg body weight) or vehicle (20% dimethyl sulfoxide in saline) were injected intraperitoneally. Blood and liver tissues were collected …

Skin Conductance At Baseline And Post-Heel Lance Reflects Sympathetic Activation In Neonatal Opiate Withdrawal, C. N. Oji-Mmuo, E. J. Michael, J. Mclatchy, M. M. Lewis, J. E. Becker, K. K. Doheny

Journal Articles

AIM: Skin conductance (SC) provides an objective measure of autonomic system regulation through sympathetic-mediated filling of sweat glands. This study aimed to test the utility of SC to detect sympathetic activation in neonatal abstinence syndrome (NAS). METHODS: 14 term (mean, SE: 38.8 + 0.35 weeks gestational age) neonates with chronic prenatal opiate exposure were enrolled. SC (peaks/sec and mean of peaks) were measured at baseline, during heel lance/squeeze (HLS) and recovery from HLS at 24-48 (mean 38) hours of life prior to treatment for NAS. Blinded coders with established reliability assessed neonates using the Modified Finnegan Neonatal Scoring System (MFNSS). …

Elevate Wellness: Unlocking The Potential Of Creative Problem Solving To Improve Wellness In Residency Programs., B. Pathak, E. Parry, L. Block, S. V. Desai

Journal Articles

No abstract provided.