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Risk Of Major Adverse Cardiovascular Events And Major Hemorrhage Among White And Black Patients Undergoing Percutaneous Coronary Intervention, Anping Cai, Chrisly Dillon, William B. Hillegass, Mark Beasley, Brigitta C. Brott, Vera A. Bittner, Gilbert J. Perry, Ganesh V. Halade, Sumanth D. Prabhu, Nita A. Limdi

Internal Medicine Faculty Publications

Background: Data on racial disparities in major adverse cardiovascular events (MACE) and major hemorrhage (HEM) after percutaneous coronary intervention are limited. Factors contributing to these disparities are unknown. Methods and Results: PRiME-GGAT (Pharmacogenomic Resource to Improve Medication Effectiveness–Genotype-Guided Antiplatelet Therapy) is a prospective cohort. Patients aged ≥18 years undergoing percutaneous coronary intervention were enrolled and followed for up to 1 year. Racial disparities in risk of MACE and HEM were assessed using an incident rate ratio. Sequential cumulative adjustment analyses were performed to identify factors contributing to these disparities. Data from 919 patients were included in the analysis. Compared with …

Bone Benefits Of Fish Oil Supplementation Depend On Its Epa And Dha Content, Haissam Abou-Saleh, Allal Ouhtit, Ganesh V. Halade, Md Mizanur Rahman

Internal Medicine Faculty Publications

Licensee MDPI, Basel, Switzerland. The preventive effect of high-dose (9%) regular-fish oil (FO) against bone loss during aging has been demonstrated, but the effects of a low-dose (1%–4%) of a highly purified concentrated FO (CFO) has not been elucidated. The aim of this study was to determine the dose-dependent effect of a CFO against bone loss in C57BL/6 female mice during aging. Twelve-month old mice were fed with 1% and 4% CFO and 4% safflower oil (SFO) diets, including a group with a 4% regular-FO diet and a group with a lab chow diet for 12 months. Bone mineral density …

Immune Responsive Resolvin D1 Programs Peritoneal Macrophages And Cardiac Fibroblast Phenotypes In Diversified Metabolic Microenvironment, Vasundhara Kain, Ganesh V. Halade

Internal Medicine Faculty Publications

Bioactive lipid mediators derived from n-3 and n-6 fatty acids are known to modulate leukocytes. Metabolic transformation of essential fatty acids to endogenous bioactive molecules plays a major role in human health. Here we tested the potential of substrates; linoleic acid (LA) and docosahexaenoic acid (DHA) and their bioactive products; resolvin D1 (RvD1) and 12- S-hydroxyeicosatetraenoic acids (HETE) to modulate macrophage plasticity and cardiac fibroblast phenotype in presence or absence of lipid metabolizing enzyme 12/15-lipoxygenase (LOX). Peritoneal macrophages and cardiac fibroblasts were isolated from wild-type (C57BL/6J) and 12/15LOX −/− mice and treated with DHA, LA, 12(S)-HETE, and RvD1 for 4, …

Pretreatment Of Carprofen Impaired Initiation Of Inflammatory- And Overlapping Resolution Response And Promoted Cardiorenal Syndrome In Heart Failure, Veena Krishnan, David Booker, Gabrielle Cunningham, Jeevan Kumar Jadapalli, Vasundhara Kain, Amanda B. Pullen, Ganesh V. Halade

Internal Medicine Faculty Publications

Non-Steroidal Anti-Inflammatory Drugs (NSAIDs) are commonly used to control pain, inflammation, and limit the cardinal signs of injury in humans. However, prolonged use of NSAIDs increases the risk of heart attack (myocardial infarction; MI) and the subsequent risk of heart and renal failure. The molecular and cellular mechanism of action for this adverse effect, particularly along the cardiorenal network, is incomplete. To define the mechanism, carprofen (CAP), an NSAID was administered at the dose of 5 mg/kg to C57BL/6 male mice for two weeks. After last dose of CAP treatment mice were subjected to permanent occlusion of coronary artery that …

Precision Delivery Of Ras-Inhibiting Sirna To Kras Driven Cancer Via Peptide-Based Nanoparticles, Matthew S. Strand, Bradley A. Krasnick, Hua Pan, Xiuli Zhang, Ye Bi, Candace Brooks, Christopher Wetzel, Narendra Sankpal, Timothy Fleming, S. Peter Goedegebuure, David G. Denardo, William E. Gillanders, William G. Hawkins, Samuel A. Wickline, Ryan C. Fields

Internal Medicine Faculty Publications

Over 95% of pancreatic adenocarcinomas (PDACs), as well as a large fraction of other tumor types, such as colorectal adenocarcinoma, are driven by KRAS activation. However, no direct RAS inhibitors exist for cancer therapy. Furthermore, the delivery of therapeutic agents of any kind to PDAC in particular has been hindered by the extensive desmoplasia and resultant drug delivery challenges that accompanies these tumors. Small interfering RNA (siRNA) is a promising modality for anti-neoplastic therapy due to its precision and wide range of potential therapeutic targets. Unfortunately, siRNA therapy is limited by low serum half-life, vulnerability to intracellular digestion, and transient …

Distinct Effects Of Acute Versus Chronic Corticosterone Exposure On Zebra Finch Responses To West Nile Virus, Lynn B. Martin, Meredith E. Kernbach, Thomas R. Unnasch

Internal Medicine Faculty Publications

Wild animals are exposed to both short- (acute) and long-term (chronic) stressors. The glucocorticoid hormones, such as corticosterone (CORT), facilitate coping with such stressors, but these hormones can have quite distinct effects contingent on the duration of their elevation. Previously, we found that experimental elevation of CORT for 2 days (via implantation) affected zebra finch (Taeniopygia guttata) responses to West Nile virus (WNV). CORT-elevated birds had higher viremia for at least 2 days longer than controls, and West Nile virus (WNV)-associated mortality occurred only in CORT-elevated birds. Here, we queried how acute elevations of CORT, via injection an …

Directional Transmission Of Ultra-High Frequency Acoustic Signals Based On Metamaterial Structure, Jianning Han, Peng Yang, Jing-Zhi Wu, Tao Wang, Jing Wang

Internal Medicine Faculty Publications

Cell photoacoustic detection of acoustic signals has serious problems of transmission loss and difficulty in acquisition. Based on the acoustic transmission characteristics of acoustic supermaterials, the acoustic wave directional transmission model is designed using COMSOL software, and a finite element simulation experiment was carried out. Experiments show that the model designed in this paper has good sound wave focusing and acoustic wave directional transmission effects. According to the specific application in different environments, this paper designs a variety of transmission models with different structures and carries out comparative experiments to verify the influence of complex model structures on the directional …

The Epidemiology, Demographics, And Geographical Distribution Of Human Non-Tuberculosis Mycobacteria (Ntm) Disease In The Endemic Central Florida Region, Cristina Vanessa, Greg Matthew E. Teo, Jamie P. Morano, Beata Casanas, Sadaf Aslam, Jose Montero, Kristen Zeitler, Ripal Jariwala, Anthony Cannella

Internal Medicine Faculty Publications

Background: Of the >100,000 people in the United States infected yearly with non-tuberculosis mycobacteria (NTM), Florida has the highest yearly incidence and prevalence of NTM disease. However, little has been documented on the epidemiology and distribution of NTM disease within Central Florida. Methods: A retrospective case review study was conducted from January, 2011 to December, 2017 at a large tertiary acute care medical center in Tampa, Florida to identify all NTM infection cases. Demographics (age, sex at birth, ethnicity), comorbidities, HIV testing status, residential zip code, NTM species, and specimen sources were collected. Results: Of the 507 isolates, Mycobacterium abscessus …

Comparison Between Signature Cytokines Of Nasal Tissues In Subtypes Of Chronic Rhinosinusitis, Dong-Kyu Kim, Kyoung Mi Eun, Min-Kyung Kim, Deuktae Cho, Sun A. Han, Sang-Yoon Han, Yuju Seo, Dong-Han Lee, Seong Ho Cho, Dae Woo Kim

Internal Medicine Faculty Publications

Purpose: Endotype in chronic rhinosinusitis (CRS) has been established in the last decade. However, the exact immunologic profile of CRS still has controversy because it has a considerable immunologic heterogeneity. Therefore, we investigated various inflammatory mediators according to different nasal tissues in chronic rhinosinusitis and compared them within the same subject. Methods: We collected uncinate process mucosa (UP) and nasal polyp (NP) tissues from controls, CRS without NP (CRSsNP) and CRS with NP (CRSwNP). Expression levels of 28 inflammatory mediators including T helper (Th) 1, Th2, Th17, proinflammatory cytokines and remodeling markers were determined by multiplex immunoassay and were analyzed …

Assessment Of Emergency Medicine Resident Performance In An Adult Simulation Using A Multisource Feedback Approach, Michael Jong, Nicole Elliott, Michael Nguyen, Terrence Goyke, Steven Johnson, Matthew Cook, Lisa Lindauer, Katie Best, Douglas Gernerd, Louis Morolla, Zachary Matuzsan, Bryan Kane

Internal Medicine Faculty Publications

Introduction: The Accreditation Council for Graduate Medical Education (ACGME) specifically notes multisource feedback (MSF) as a recommended means of resident assessment in the emergency medicine (EM) Milestones. High-fidelity simulation is an environment wherein residents can receive MSF from various types of healthcare professionals. Previously, the Queen’s Simulation Assessment Tool (QSAT) has been validated for faculty to assess residents in five categories: assessment; diagnostic actions; therapeutic actions; interpersonal communication, and overall assessment. We sought to determine whether the QSAT could be used to provide MSF using a standardized simulation case.

Methods: Prospectively after institutional review board approval, residents from a dual …

Alda-1 Attenuates Hyperoxia-Induced Mitochondrial Dysfunction In Lung Vascular Endothelial Cells, Sahebgowda Sidramagowda Patil, Helena Hernández-Cuervo, Jutaro Fukumoto, Venkata Ramireddy Narala, Smita Saji, Monica Borra, Matthew Alleyn, Muling Lin, Ramani Soundararajan, Richard Lockey, Narasaiah Kolliputi, Lakshmi Galam

Internal Medicine Faculty Publications

Acute lung injury (ALI) is a major cause of morbidity and mortality worldwide, especially in aged populations. Mitochondrial damage is one of the key features of ALI. Hyperoxia-induced lung injury model in mice has been widely used for ALI study because it features many ALI phenotypes including, but not limited to, mitochondrial and vascular endothelial cell damage. Recently, accumulating evidence has shown that mitochondrial aldehyde dehydrogenase 2 (ALDH2) has a protective effect against oxidative stress mediated cell damage in epithelial cells. However, it is not known whether ALDH2 protects against oxidative stress in vascular endothelial cells. In this current study, …

Immunological Characteristics In Refractory Chronic Rhinosinusitis With Nasal Polyps Undergoing Revision Surgeries, Gwanghui X Gwanghui Ryu, Dong-Kyu Kim, Hun-Jong Dhong, Kyoung Mi Eun, Seung-Kyu Chung, Dong-Young Kim, Chae-Seo Rhee, Seong-Ho Cho, Sang Duk Hong, Dae Woo Kim

Internal Medicine Faculty Publications

Purpose: Despite medical and surgical treatments, some cases of nasal polyps (NP) exhibit recidivism. However, the endotype of refractory chronic rhinosinusitis with NP (CRSwNP) remains unclear. Therefore, the objective of this study was to characterize the immunological profile of refractory CRSwNP. Methods: The control (n =23), primary NP group (pNP, n =70) and refractory NP group (rNP, n =86) were enrolled in this study. Patients who underwent revision surgeries due to failed maximal medical treatment after primary surgery were defined as the rNP group. A total of 18 inflammatory markers were investigated in nasal tissues using multiplex cytokine assay or …

Epigenetic Reader Complexes Of The Human Malaria Parasite, Plasmodium Falciparum, Wieteke Anna Maria Hoeijmakers, Jun Miao, Sabine Schmidt, Christa Geeke Toenhake, Sony Shrestha, Jeron Venhuizen, Rob Henderson, Jakob Birnbaum, Sonja Ghidelli-Disse, Gerard Drewes, Liwang Cui, Hendrik Gerard Stunnenberg, Tobias Spielmann, Richárd Bártfai

Internal Medicine Faculty Publications

Epigenetic regulatory mechanisms are central to the development and survival of all eukaryotic organisms. These mechanisms critically depend on the marking of chromatin domains with distinctive histone tail modifications (PTMs) and their recognition by effector protein complexes. Here we used quantitative proteomic approaches to unveil interactions between PTMs and associated reader protein complexes of Plasmodium falciparum, a unicellular parasite causing malaria. Histone peptide pull-downs with the most prominent and/or parasite-specific PTMs revealed the binding preference for 14 putative and novel reader proteins. Amongst others, they highlighted the acetylation-level-dependent recruitment of the BDP1/BDP2 complex and identified an PhD-finger protein (PHD …

Demographic Characteristics And Management Of Uninsured Patients With A History Of Melanoma, Noura Ayoubi, Abu-Sayeef Mirza, Mohammad Ayoub, Justin Swanson

Internal Medicine Faculty Publications

Aims and Objectives: Patients diagnosed with malignant melanoma often undergo regular follow-up care and skin checks to reduce the likelihood of recurrence. Yearly exams are more inconsistent and likely to be missed due to a lack of healthcare access and resources among the uninsured population. This study determined demographic characteristics of uninsured patients with a history of malignant melanoma. Follow-up was assessed in order to improve and ensure the highest quality of long-term care.

Methods: Demographics and chronic disease diagnoses were extracted from 8,857 patients managed at eight free-clinics from the Tampa Bay Area during 2016 and 2017. Patients diagnosed …

Comparison Of Access And Linkage To Care Among People Living With Human Immunodeficiency Virus When Enrolled In Florida Aids Drug Assistance Program (Adap), Greg Matthew E Teo, Nisha Sunku, Suraj Nagaraj, Sadaf Aslam, Rahul Mhaskar, Liwei Chen, Zhi Zhou, Robert L. Cook, Jamie P. Morano, Charurut Somboonwit

Internal Medicine Faculty Publications

Background: The Southeast region of the United States contains nine out of the 10 states with the most severe syndemic of poverty and HIV infection.1 The Florida AIDS Drug Assistance Program (FL-ADAP) and Ryan White network are crucial for linkage to care services. Data from FL-ADAP are available but seldom published; thus this study quantifies this program’s impact on Florida PLWH access and linkage to care.

Methods: Data were obtained from the Florida Cohort, an ongoing cross-sectional survey among health clinics across the State of Florida from 2015 to 2018. Chi-square and binomial multivariate logistic regression analyses correlated anti-retroviral therapy …

A Case Series Of Staphylococcus Lugdunensis Infection In Cancer Patients At An Academic Cancer Institute In The United States, Dae Hyun Lee, Olga Klinkova, Jong-Wook Kim, Sowmya Nanjappa, John N. Greene

Internal Medicine Faculty Publications

Background: Staphylococcus lugdunensis is a coagulase-negative staphylococcus (CoNS) that is a part of the normal human skin flora. Even though it belongs to CoNS family, it can cause severe and destructive infections in a similar fashion to Staphylococcus aureus. Skin and soft tissue infections (SSTI), bacteremia and endocarditis are amongst the most common clinical presentations. Diagnosis and clinical presentation of infections caused by S. lugdunensis in cancer patients is limited. Materials and Methods: We performed a retrospective chart review of 24 patients who had cultures positive for S. lugdunensis. Out of 24 patients, 14 patients were diagnosed with …

Impact Of Availability Of Telehealth Programs On Documented Hiv Viral Suppression: A Cluster-Randomized Program Evaluation In The Veterans Health Administration, Michael E. Ohl, Kelly Richardson, Maria C. Rodriguez-Barradas, Roger Bedimo, Vincent Marconi, Jamie P. Morano, Michael P. Jones, Mary Vaughan-Sarrazin

Internal Medicine Faculty Publications

Background: Telehealth may improve care for people with HIV who live far from HIV specialty clinics. We conducted a cluster-randomized evaluation to determine the impact of availability of HIV telehealth programs on documented viral suppression in Veterans Administration clinics. Methods: In 2015–2016, people who previously traveled to HIV specialty clinics were offered telehealth visits in nearby primary care clinics. Patients were cluster-randomized to immediate telehealth availability (n = 925 patients in service areas of 13 primary care clinics offering telehealth) or availability 1 year later (n = 745 patients in 12 clinics). Measures during the evaluation year included telehealth use …

T2mr: A New Tool For Anti-Fungal Stewardshi, Ripal Jariwala, Kristen Zeitler, Jose Montero

Internal Medicine Faculty Publications

Background: Candidemia is associated with mortality rates between 30 and 50%. T2 magnetic resonance assay (T2MR) is a costly, rapid diagnostic technology that can detect the five most common Candida species in blood with a sensitivity of 91% and specificity of 99.4%. The clinical role of this tool remains unclear but this study shares our clinical experience with T2MR.

Methods: We conducted a retrospective chart review of patients with T2MR testing performed from April 25, 2017 through April 25, 2018. T2MR ordering was restricted to Infectious Diseases pharmacists and physicians without specific ordering criteria. Variables cataloged included the time between …