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A Broad-Spectrum Antiviral Molecule, Ql47, Selectively Inhibits Eukaryotic Translation, Mélissanne De Wispelaere, Margot Carocci, Dominique J Burri, William J Neidermyer, Calla M Olson, Imme Roggenbach, Yanke Liang, Jinhua Wang, Sean P J Whelan, Nathanael S Gray, Priscilla L Yang Feb 2020

A Broad-Spectrum Antiviral Molecule, Ql47, Selectively Inhibits Eukaryotic Translation, Mélissanne De Wispelaere, Margot Carocci, Dominique J Burri, William J Neidermyer, Calla M Olson, Imme Roggenbach, Yanke Liang, Jinhua Wang, Sean P J Whelan, Nathanael S Gray, Priscilla L Yang

Faculty, Staff and Students Publications

Small-molecule inhibitors of translation are critical tools to study the molecular mechanisms of protein synthesis. In this study, we sought to characterize how QL47, a host-targeted, small-molecule antiviral agent, inhibits steady-state viral protein expression. We demonstrate that this small molecule broadly inhibits both viral and host protein synthesis and targets a translation step specific to eukaryotic cells. We show that QL47 inhibits protein neosynthesis initiated by both canonical cap-driven and noncanonical initiation strategies, most likely by targeting an early step in translation elongation. Our findings thus establish QL47 as a new small-molecule inhibitor that can be utilized to probe the …


Association Of Time-Varying Blood Pressure With Chronic Kidney Disease Progression In Children., Ben Christopher Reynolds, Jennifer Lynn Roem, Derek Kai Sing Ng, Mina Matsuda-Abedini, Joseph Thomas Flynn, Susan Lynn Furth, Bradley A. Warady, Rulan Savita Parekh Feb 2020

Association Of Time-Varying Blood Pressure With Chronic Kidney Disease Progression In Children., Ben Christopher Reynolds, Jennifer Lynn Roem, Derek Kai Sing Ng, Mina Matsuda-Abedini, Joseph Thomas Flynn, Susan Lynn Furth, Bradley A. Warady, Rulan Savita Parekh

Manuscripts, Articles, Book Chapters and Other Papers

Importance: Optimal blood pressure (BP) management in children with chronic kidney disease (CKD) slows progression to end-stage renal disease. Studies often base progression risk on a single baseline BP measurement, which may underestimate risk.

Objective: To determine whether time-varying BP measurements are associated with a higher risk of progression of CKD than baseline BP measurements.

Design, Setting, and Participants: The ongoing longitudinal, prospective cohort study Chronic Kidney Disease in Children (CKID) recruited children from January 19, 2005, through March 19, 2014, from pediatric nephrology centers across North America, with data collected at annual study visits. Participants included children aged 1 …


The Role Of Noninvasive Tests For Differentiating Nash From Nafl And Diagnosing Advanced Fibrosis Among Patients With Nafld, Maya Balakrishnan, Rohit Loomba Feb 2020

The Role Of Noninvasive Tests For Differentiating Nash From Nafl And Diagnosing Advanced Fibrosis Among Patients With Nafld, Maya Balakrishnan, Rohit Loomba

Faculty, Staff and Students Publications

Assessing for the presence of non-alcoholic steatohepatitis (NASH) and the presence of advanced fibrosis is vital among patients with non-alcoholic fatty liver disease (NAFLD) as each is predictive of disease outcomes. A liver biopsy is the gold standard method for doing so but is impossible to perform among all patients with NAFLD. Reliable methods for noninvasively detecting for the presence of NASH and advanced fibrosis are thus a pressing need. The search for noninvasive tests has been more successful for advanced fibrosis than for NASH. Clinical prediction models and elastography have acceptable accuracy for ruling out advanced fibrosis; when used …


De Novo Mutations Across 1,465 Diverse Genomes Reveal Mutational Insights And Reductions In The Amish Founder Population, Michael D Kessler, Douglas P Loesch, James A Perry, Nancy L Heard-Costa, Daniel Taliun, Brian E Cade, Heming Wang, Michelle Daya, John Ziniti, Soma Datta, Juan C Celedón, Manuel E Soto-Quiros, Lydiana Avila, Scott T Weiss, Kathleen Barnes, Susan S Redline, Ramachandran S Vasan, Andrew D Johnson, Rasika A Mathias, Ryan Hernandez, James G Wilson, Deborah A Nickerson, Goncalo Abecasis, Sharon R Browning, Sebastian Zöllner, Jeffrey R O'Connell, Braxton D Mitchell, Timothy D O'Connor Feb 2020

De Novo Mutations Across 1,465 Diverse Genomes Reveal Mutational Insights And Reductions In The Amish Founder Population, Michael D Kessler, Douglas P Loesch, James A Perry, Nancy L Heard-Costa, Daniel Taliun, Brian E Cade, Heming Wang, Michelle Daya, John Ziniti, Soma Datta, Juan C Celedón, Manuel E Soto-Quiros, Lydiana Avila, Scott T Weiss, Kathleen Barnes, Susan S Redline, Ramachandran S Vasan, Andrew D Johnson, Rasika A Mathias, Ryan Hernandez, James G Wilson, Deborah A Nickerson, Goncalo Abecasis, Sharon R Browning, Sebastian Zöllner, Jeffrey R O'Connell, Braxton D Mitchell, Timothy D O'Connor

Faculty, Staff and Student Publications

De novo mutations (DNMs), or mutations that appear in an individual despite not being seen in their parents, are an important source of genetic variation whose impact is relevant to studies of human evolution, genetics, and disease. Utilizing high-coverage whole-genome sequencing data as part of the Trans-Omics for Precision Medicine (TOPMed) Program, we called 93,325 single-nucleotide DNMs across 1,465 trios from an array of diverse human populations, and used them to directly estimate and analyze DNM counts, rates, and spectra. We find a significant positive correlation between local recombination rate and local DNM rate, and that DNM rate explains a …


Patients' Perspectives Of Tuberculosis Treatment Challenges And Barriers To Treatment Adherence In Ukraine: A Qualitative Study, Omowunmi Aibana, Emily Dauria, Tetiana Kiriazova, Olena Makarenko, Mariya Bachmaha, Natasha Rybak, Timothy Palen Flanigan, Vasyl Petrenko, Anne E Becker, Megan B Murray Feb 2020

Patients' Perspectives Of Tuberculosis Treatment Challenges And Barriers To Treatment Adherence In Ukraine: A Qualitative Study, Omowunmi Aibana, Emily Dauria, Tetiana Kiriazova, Olena Makarenko, Mariya Bachmaha, Natasha Rybak, Timothy Palen Flanigan, Vasyl Petrenko, Anne E Becker, Megan B Murray

Faculty, Staff and Student Publications

OBJECTIVES: To understand the challenges faced by patients with tuberculosis (TB) and factors that influence TB treatment adherence in Ukraine.

DESIGN: Qualitative study.

SETTING: TB treatment facilities in Kyiv Oblast, Ukraine.

PARTICIPANTS: Sixty adults who had undergone treatment for drug-sensitive TB between June 2012 and August 2015.

METHODS: We conducted semistructured, in-depth, individual interviews among a purposively selected clinical sample of patients previously treated for drug-sensitive TB. Interview content encompassed WHO's framework for barriers to adherence to long-term therapies and included questions about patient preferences and motivators concerning treatment adherence. We examined treatment experience across strata defined by previously identified …


Insights Image For "Evidence Of Increased Hypoxia Signalling In Fetal Liver From Maternal Nutrient Restriction In Mice"., Bethany N Radford, Victor K M Han Feb 2020

Insights Image For "Evidence Of Increased Hypoxia Signalling In Fetal Liver From Maternal Nutrient Restriction In Mice"., Bethany N Radford, Victor K M Han

Paediatrics Publications

No abstract provided.


Reactive Stepping After A Forward Fall In People Living With Incomplete Spinal Cord Injury Or Disease, Katherine Chan, Jae Woung Lee, Janelle Unger, Jaeeun Yoo, Kei Masani, Kristin E Musselman Feb 2020

Reactive Stepping After A Forward Fall In People Living With Incomplete Spinal Cord Injury Or Disease, Katherine Chan, Jae Woung Lee, Janelle Unger, Jaeeun Yoo, Kei Masani, Kristin E Musselman

Physical Therapy Publications

STUDY DESIGN: Cross sectional.

OBJECTIVES: To compare the reactive stepping ability of individuals living with incomplete spinal cord injury or disease (SCI/D) to that of sex- and age-matched able-bodied adults.

SETTING: A tertiary SCI/D rehabilitation center in Canada.

METHODS: Thirty-three individuals (20 with incomplete SCI/D) participated. Participants assumed a forward lean position in standing whilst 8-12% of their body weight was supported by a horizontal cable at waist height affixed to a rigid structure. The cable was released unexpectedly, simulating a forward fall and eliciting one or more reactive steps. Behavioral responses (i.e., single step versus non-single step) were compared …


Recommendations For Clinical Laboratory Testing For Protein C Deficiency, For The Subcommittee On Plasma Coagulation Inhibitors Of The Isth, Peter C. Cooper, Anna Pavlova, Gary W. Moore, Kieron P. Hickey, Richard A. Marlar Feb 2020

Recommendations For Clinical Laboratory Testing For Protein C Deficiency, For The Subcommittee On Plasma Coagulation Inhibitors Of The Isth, Peter C. Cooper, Anna Pavlova, Gary W. Moore, Kieron P. Hickey, Richard A. Marlar

Pathology Research and Scholarship

Inherited protein C (PC) deficiency increases risk of venous thromboembolism (VTE) by 5 to 10-fold in thrombosis-prone families; however, heterozygous PC deficiency alone does not determine that a subject has thrombophilia. Protein C deficient subjects, who lack additional inherited risk factors such as factor V Leiden or have no major acquired risk factors, may not suffer from VTE. In addition, PC deficiency may be acquired, often due to vitamin K antagonist treatment or liver disease. In contrast, homozygous or compound heterozygous PC deficiencies are rare and serious disorders, and affected infants are often in families with no history of PC …


Safety And Immunogenicity Of The Oral, Inactivated, Enterotoxigenic Escherichia Coli Vaccine Etvax In Bangladeshi Children And Infants: A Double-Blind, Randomised, Placebo-Controlled Phase 1/2 Trial, Firdausi Qadri, Marjahan Akhtar, Taufiqur R Bhuiyan, Mohiul I Chowdhury, Tasnuva Ahmed, Tanzeem A Rafique, Arifuzzaman Khan, Sadia I A Rahman, Farhana Khanam, Anna Lundgren, Gudrun Wiklund, Joanna Kaim, Madeleine Löfstrand, Nils Carlin, A Louis Bourgeois, Nicole Maier, Alan Fix, Thomas Wierzba, Richard I Walker, Ann-Mari Svennerholm Feb 2020

Safety And Immunogenicity Of The Oral, Inactivated, Enterotoxigenic Escherichia Coli Vaccine Etvax In Bangladeshi Children And Infants: A Double-Blind, Randomised, Placebo-Controlled Phase 1/2 Trial, Firdausi Qadri, Marjahan Akhtar, Taufiqur R Bhuiyan, Mohiul I Chowdhury, Tasnuva Ahmed, Tanzeem A Rafique, Arifuzzaman Khan, Sadia I A Rahman, Farhana Khanam, Anna Lundgren, Gudrun Wiklund, Joanna Kaim, Madeleine Löfstrand, Nils Carlin, A Louis Bourgeois, Nicole Maier, Alan Fix, Thomas Wierzba, Richard I Walker, Ann-Mari Svennerholm

Faculty and Staff Publications

Background: Enterotoxigenic Escherichia coli causes diarrhoea, leading to substantial mortality and morbidity in children, but no specific vaccine exists. This trial tested an oral, inactivated, enterotoxigenic E coli vaccine (ETVAX), which has been previously shown to be safe and highly immuongenic in Swedish and Bangladeshi adults. We tested the safety and immunogenicity of ETVAX, consisting of four E coli strains overexpressing the most prevalent colonisation factors (CFA/I, CS3, CS5, and CS6) and a toxoid (LCTBA) administered with or without a double-mutant heat-labile enterotoxin (dmLT) as an adjuvant, in Bangladeshi children.

Methods: We did a randomised, double-blind, placebo-controlled, dose-escalation, age-descending, phase …


Age Of Acquisition Impacts The Brain Differently Depending On Neuroanatomical Metric, Hannah Claussenius-Kalman, Kelly A Vaughn, Pilar Archila-Suerte, Arturo E Hernandez Feb 2020

Age Of Acquisition Impacts The Brain Differently Depending On Neuroanatomical Metric, Hannah Claussenius-Kalman, Kelly A Vaughn, Pilar Archila-Suerte, Arturo E Hernandez

Faculty, Staff and Student Publications

Although researchers generally agree that a certain set of brain areas underlie bilingual language processing, there is discrepancy regarding what effect timing of language acquisition has on these regions. We aimed to investigate the neuroanatomical correlates of age of acquisition (AoA), which has been examined previously, but with inconsistent results, likely influenced by methodological differences across studies. We analyzed gray matter density, volume, and thickness using whole-brain linear models in 334 bilinguals and monolinguals. Neuroanatomical correlates of AoA differed depending on gray matter metric. Relative to early bilinguals, late bilinguals had thicker cortex in language processing and cognitive control regions, …


Outcomes Following Percutaneous Coronary Intervention In Patients With Cancer, Raymundo A Quintana, Dominique J Monlezun, Giovanni Davogustto, Humberto R Saenz, Francisco Lozano-Ruiz, Daisuke Sueta, Kenichi Tsujita, Uri Landes, Ali E Denktas, Mahboob Alam, David Paniagua, Daniel Addison, Hani Jneid Feb 2020

Outcomes Following Percutaneous Coronary Intervention In Patients With Cancer, Raymundo A Quintana, Dominique J Monlezun, Giovanni Davogustto, Humberto R Saenz, Francisco Lozano-Ruiz, Daisuke Sueta, Kenichi Tsujita, Uri Landes, Ali E Denktas, Mahboob Alam, David Paniagua, Daniel Addison, Hani Jneid

Faculty, Staff and Students Publications

BACKGROUND: Randomized clinical trials demonstrated the benefits of percutaneous coronary interventions (PCI) in diverse clinical settings. Patients with cancer were not routinely included in these studies.

METHODS/RESULTS: Literature search of PubMed, Cochrane, Medline, SCOPUS, EMBASE, and ClinicalTrials was conducted to identify studies that assessed one-year all-cause, cardiovascular and non-cardiovascular mortality in patients with historical or active cancer. Using the random effects model, we computed risk ratios (RRs) and standardized mean differences and their 95% confidence intervals for the dichotomous and continuous measures and outcomes, respectively. Of 171 articles evaluated in total, 5 eligible studies were included in this meta-analysis. In …


Periodontal Inflammation: Integrating Genes And Dysbiosis, Shaoping Zhang, Ning Yu, Roger M Arce Feb 2020

Periodontal Inflammation: Integrating Genes And Dysbiosis, Shaoping Zhang, Ning Yu, Roger M Arce

Faculty, Staff and Student Publications

Biofilm bacteria co-evolve and reach a symbiosis with the host on the gingival surface. The disruption of the homeostatic relationship between plaque bacteria and the host can initiate and promote periodontal disease progression. Recent advances in sequencing technologies allow researchers to profile disease-associated microbial communities and quantify microbial metabolic activities and host transcriptional responses. In addition to confirming the findings from previous studies, new putative pathogens and novel genes that have not previously been associated with periodontitis, emerge. For example, multiple studies have reported that Synergistetes bacteria are associated with periodontitis. Genes involved in epithelial barrier defense were downregulated in …


Everolimus-Induced Pneumonitis: A Diagnostic Challenge, Andrew Gulde, Elshad Hasanov, Kayla Krug, Gus W Krucke Feb 2020

Everolimus-Induced Pneumonitis: A Diagnostic Challenge, Andrew Gulde, Elshad Hasanov, Kayla Krug, Gus W Krucke

Faculty, Staff and Student Publications

No abstract provided.


Assessing Lymphatic Route Of Csf Outflow And Peripheral Lymphatic Contractile Activity During Head-Down Tilt Using Near-Infrared Fluorescence Imaging, John C Rasmussen, Sunkuk Kwon, Amanda Pinal, Alexander Bareis, Fred C Velasquez, Christopher F Janssen, John R Morrow, Caroline E Fife, Ron J Karni, Eva M Sevick-Muraca Feb 2020

Assessing Lymphatic Route Of Csf Outflow And Peripheral Lymphatic Contractile Activity During Head-Down Tilt Using Near-Infrared Fluorescence Imaging, John C Rasmussen, Sunkuk Kwon, Amanda Pinal, Alexander Bareis, Fred C Velasquez, Christopher F Janssen, John R Morrow, Caroline E Fife, Ron J Karni, Eva M Sevick-Muraca

Faculty, Staff and Student Publications

Evidence overwhelmingly suggests that the lymphatics play a critical role in the clearance of cerebrospinal fluid (CSF) from the cranial space. Impairment of CSF outflow into the lymphatics is associated with a number of pathological conditions including spaceflight-associated neuro-ocular syndrome (SANS), a problem that limits long-duration spaceflight. We used near-infrared fluorescence lymphatic imaging (NIRFLI) to dynamically visualize the deep lymphatic drainage pathways shared by CSF outflow and disrupted during head-down tilt (HDT), a method used to mimic the cephalad fluid shift that occurs in microgravity. After validating CSF clearance into the lymph nodes of the neck in swine, a pilot …


Diagnostic Criteria For Detection Of Retinal Nerve Fibre Layer Thickness And Neuroretinal Rim Width Abnormalities In Glaucoma, Feihui Zheng, Marco Yu, Christopher Kai-Shun Leung Feb 2020

Diagnostic Criteria For Detection Of Retinal Nerve Fibre Layer Thickness And Neuroretinal Rim Width Abnormalities In Glaucoma, Feihui Zheng, Marco Yu, Christopher Kai-Shun Leung

Faculty, Staff and Student Publications

BACKGROUND/AIMS: Although measurements of the Bruch's membrane opening minimum rim width (BMO-MRW) and retinal nerve fibre layer thickness (RNFLT) with optical coherence tomography (OCT) have been widely adopted in the diagnostic evaluation of glaucoma, there is no consensus on the diagnostic criteria to define BMO-MRW and RNFLT abnormalities. This study investigated the sensitivities and specificities of different diagnostic criteria based on the OCT classification reports for detection of glaucoma.

METHODS: 340 eyes of 137 patients with glaucoma and 87 healthy individuals, all with axial length ≤26mm, had global and sectoral BMO-MRW and RNFLT measured with Spectralis OCT (Heidelberg Engineering). Six …


Final Two-Year Outcomes For The Sentry Bioconvertible Inferior Vena Cava Filter In Patients Requiring Temporary Protection From Pulmonary Embolism., Michael D Dake, Timothy P Murphy, Albrecht H Krämer, Michael D Darcy, Luke E Sewall, Michael A Curi, Matthew S Johnson, Frank Arena, James L Swischuk, Gary M Ansel, Mitchell J Silver, Souheil Saddekni, Jayson S Brower, Robert Mendes, Sentry Trial Investigators Feb 2020

Final Two-Year Outcomes For The Sentry Bioconvertible Inferior Vena Cava Filter In Patients Requiring Temporary Protection From Pulmonary Embolism., Michael D Dake, Timothy P Murphy, Albrecht H Krämer, Michael D Darcy, Luke E Sewall, Michael A Curi, Matthew S Johnson, Frank Arena, James L Swischuk, Gary M Ansel, Mitchell J Silver, Souheil Saddekni, Jayson S Brower, Robert Mendes, Sentry Trial Investigators

Heart and Vascular Articles

PURPOSE: To report final 2-year outcomes with the Sentry bioconvertible inferior vena cava (IVC) filter in patients requiring temporary protection against pulmonary embolism (PE).

MATERIALS AND METHODS: In a prospective multicenter trial, the Sentry filter was implanted in 129 patients with documented deep vein thrombosis (DVT) and/or PE (67.5%) or who were at temporary risk of developing DVT/PE (32.6%). Patients were monitored and bioconversion status ascertained by radiography, computed tomography (CT), and CT venography through 2 years.

RESULTS: The composite primary 6-month endpoint of clinical success was achieved in 97.4% (111/114) of patients. The rate of new symptomatic PE was …


Rationale And Design Of The Steroids To Reduce Systemic Inflammation After Infant Heart Surgery (Stress) Trial, Kevin D Hill, H Scott Baldwin, David P Bichel, Ryan J Butts, Reid C Chamberlain, Alicia M Ellis, Eric M Graham, Jesse Hickerson, Christoph P Hornik, Jeffrey P Jacobs, Marshall L Jacobs, Robert Db Jaquiss, Prince J Kannankeril, Sean M O'Brien, Rachel Torok, Joseph W Turek, Jennifer S Li, Stress Network Investigators Feb 2020

Rationale And Design Of The Steroids To Reduce Systemic Inflammation After Infant Heart Surgery (Stress) Trial, Kevin D Hill, H Scott Baldwin, David P Bichel, Ryan J Butts, Reid C Chamberlain, Alicia M Ellis, Eric M Graham, Jesse Hickerson, Christoph P Hornik, Jeffrey P Jacobs, Marshall L Jacobs, Robert Db Jaquiss, Prince J Kannankeril, Sean M O'Brien, Rachel Torok, Joseph W Turek, Jennifer S Li, Stress Network Investigators

Faculty, Staff and Students Publications

For decades, physicians have administered corticosteroids in the perioperative period to infants undergoing heart surgery with cardiopulmonary bypass (CPB) to reduce the postoperative systemic inflammatory response to CPB. Some question this practice because steroid efficacy has not been conclusively demonstrated and because some studies indicate that steroids could have harmful effects. STRESS is a randomized, placebo-controlled, double-blind, multicenter trial designed to evaluate safety and efficacy of perioperative steroids in infants (age < 1 year) undergoing heart surgery with CPB. Participants (planned enrollment = 1,200) are randomized 1:1 to methylprednisolone (30 mg/kg) administered into the CPB pump prime versus placebo. The trial is nested within the existing infrastructure of the Society of Thoracic Surgeons Congenital Heart Surgery Database. The primary outcome is a global rank score of mortality, major morbidities, and hospital length of stay with components ranked commensurate with their clinical severity. Secondary outcomes include several measures of major postoperative morbidity, postoperative hospital length of stay, and steroid-related safety outcomes including prevalence of hyperglycemia and postoperative infectious complications. STRESS will be one of the largest trials ever conducted in children with heart disease and will answer a decades-old question related to safety and efficacy of perioperative steroids in infants undergoing heart surgery with CPB. The pragmatic "trial within a registry" design may provide a mechanism for conducting low-cost, high-efficiency trials in a heretofore-understudied patient population.


Losartan Rescues Inflammation-Related Mucociliary Dysfunction In Relevant Models Of Cystic Fibrosis, Michael D Kim, Nathalie Baumlin, Makoto Yoshida, Deepika Polineni, Sebastian F Salathe, Joseph K David, Charles A Peloquin, Adam Wanner, John S Dennis, Juliette Sailland, Philip Whitney, Frank T Horrigan, Juan R Sabater, William M Abraham, Matthias Salathe Feb 2020

Losartan Rescues Inflammation-Related Mucociliary Dysfunction In Relevant Models Of Cystic Fibrosis, Michael D Kim, Nathalie Baumlin, Makoto Yoshida, Deepika Polineni, Sebastian F Salathe, Joseph K David, Charles A Peloquin, Adam Wanner, John S Dennis, Juliette Sailland, Philip Whitney, Frank T Horrigan, Juan R Sabater, William M Abraham, Matthias Salathe

Faculty, Staff and Students Publications

Rationale: Despite therapeutic progress in treating cystic fibrosis (CF) airway disease, airway inflammation with associated mucociliary dysfunction remains largely unaddressed. Inflammation reduces the activity of apically expressed large-conductance Ca2+-activated and voltage-dependent K+ (BK) channels, critical for mucociliary function in the absence of CFTR (CF transmembrane conductance regulator).

Objectives: To test losartan as an antiinflammatory therapy in CF using CF human bronchial epithelial cells and an ovine model of CF-like airway disease.

Methods: Losartan’s antiinflammatory effectiveness to rescue BK activity and thus mucociliary function was tested in vitro using primary, fully redifferentiated human airway epithelial cells homozygous for …


Contemporary Nstemi Management: The Role Of The Hospitalist., Charles V Pollack, Alpesh Amin, Tracy Wang, Steven Deitelzweig, Marc Cohen, David Slattery, John Fanikos, Christopher Dilascia, Regan Tuder, Scott Kaatz Feb 2020

Contemporary Nstemi Management: The Role Of The Hospitalist., Charles V Pollack, Alpesh Amin, Tracy Wang, Steven Deitelzweig, Marc Cohen, David Slattery, John Fanikos, Christopher Dilascia, Regan Tuder, Scott Kaatz

Department of Emergency Medicine Faculty Papers

Non-ST-segment elevation myocardial infarction (NSTEMI) is defined as elevated cardiac biomarkers of necrosis in the absence of persistent ST-segment elevation in the setting of anginal symptoms or other acute event. It carries a poorer prognosis than most ST-segment elevation events, owing to the typical comorbidity burden of the older NSTEMI patients as well as diverse etiologies that add complexity to therapeutic decision-making. It may result from an acute atherothrombotic event ('Type 1') or as the result of other causes of mismatch of myocardial oxygen supply and demand ('Type 2'). Regardless of type and other clinical factors, the hospital medicine specialist …


Benefit Of Contact Force-Guided Catheter Ablation For Treating Premature Ventricular Contractions, Ziming Zhao, Xiaowei Liu, Lianjun Gao, Yutao Xi, Qi Chen, Dong Chang, Xianjie Xiao, Jie Cheng, Yanzong Yang, Yunlong Xia, Xiaomeng Yin Feb 2020

Benefit Of Contact Force-Guided Catheter Ablation For Treating Premature Ventricular Contractions, Ziming Zhao, Xiaowei Liu, Lianjun Gao, Yutao Xi, Qi Chen, Dong Chang, Xianjie Xiao, Jie Cheng, Yanzong Yang, Yunlong Xia, Xiaomeng Yin

The Texas Heart Institute Journal

We evaluated whether an irrigated contact force–sensing catheter would improve the safety and effectiveness of radiofrequency ablation of premature ventricular contractions originating from the right ventricular outflow tract.

We retrospectively reviewed the charts of patients with symptomatic premature ventricular contractions who underwent ablation with a contact force–sensing catheter (56 patients, SmartTouch) or conventional catheter (59 patients, ThermoCool) at our hospital from August 2013 through December 2015. During a mean follow-up of 16 ± 5 months, 3 patients in the conventional group had recurrences, compared with none in the contact force group. Complications occurred only in the conventional group (one steam …


Prognostic Value Of 6-Minute Walk Distance In Patients Undergoing Percutaneous Coronary Intervention: A Veterans Affairs Prospective Study, Tarun W Dasari, Bhavin Patel, Siddharth A Wayangankar, David Alexander, Yan D Zhao, Joann Schlegel, Cheuk Leung, Pedro Lozano, Faisal Latif, Udho Thadani Feb 2020

Prognostic Value Of 6-Minute Walk Distance In Patients Undergoing Percutaneous Coronary Intervention: A Veterans Affairs Prospective Study, Tarun W Dasari, Bhavin Patel, Siddharth A Wayangankar, David Alexander, Yan D Zhao, Joann Schlegel, Cheuk Leung, Pedro Lozano, Faisal Latif, Udho Thadani

The Texas Heart Institute Journal

The 6-minute walk distance (6MWD) test is a useful prognostic tool in chronic heart failure. Its usefulness after percutaneous coronary intervention is unknown.

In a prospective observational study, patients underwent a 6MWD test within 2 weeks after percutaneous coronary intervention. The primary endpoint was major adverse cardiovascular events (MACE) (death, acute coronary syndrome, and heart failure admission) at one year. Receiver operating characteristic curves and area under the curve were used to determine the 6MWD test's predictive power, and the Youden index was used to measure its effectiveness.

A total of 212 patients were enrolled (98% men; mean age, 65 …


Toward Actionable Practice Parameters For "Dual Diagnosis": Principles Of Assessment And Management For Co-Occurring Psychiatric And Intellectual/Developmental Disability., John N. Constantino, Shae Strom, Michael Bunis, Cy Nadler, Teresa Rodgers, Julia Lepage, Connie Cahalan, Amber Stockreef, Lucas Evans, Rachel Jones, Alyssa Wilson Feb 2020

Toward Actionable Practice Parameters For "Dual Diagnosis": Principles Of Assessment And Management For Co-Occurring Psychiatric And Intellectual/Developmental Disability., John N. Constantino, Shae Strom, Michael Bunis, Cy Nadler, Teresa Rodgers, Julia Lepage, Connie Cahalan, Amber Stockreef, Lucas Evans, Rachel Jones, Alyssa Wilson

Manuscripts, Articles, Book Chapters and Other Papers

PURPOSE OF REVIEW: Although treatment algorithms and parameters for best practice are readily available for all major syndromes of psychiatric impairment, the occurrence of psychiatric syndromes in individuals with intellectual and developmental disability (IDD) invokes serious contextual challenges for interpretation of symptoms, diagnosis, and optimization of treatment, both for clinicians and for the service sectors in which care and support of individuals with IDD are delivered. Recognizing that there exist very few definitive resources for best practice under the circumstance of this form of "dual diagnosis," the Missouri Department of Mental Health convened an expert panel to conduct a focused …


Modified Pull-Through Technique For Cardiac Resynchronization Therapy Upgrades In Patients With Occluded Access Veins, Guram Imnadze, Khaled Awad, Wolfgang Kranig, Irakli Giorgberidze Feb 2020

Modified Pull-Through Technique For Cardiac Resynchronization Therapy Upgrades In Patients With Occluded Access Veins, Guram Imnadze, Khaled Awad, Wolfgang Kranig, Irakli Giorgberidze

The Texas Heart Institute Journal

The number of procedures for upgrading implantable devices for cardiac resynchronization therapy has increased considerably during the last decade. A major challenge that operators face in these circumstances is occlusion of the access vein. We have modified a pull-through method to overcome this obstacle. Six consecutive patients with occluded access veins and well-developed collateral networks underwent a procedure in which the occluded vein was recanalized by snaring the existing atrial lead via transfemoral access. Upgrading the device was successful in all patients; none had intraprocedural complications. Our experience shows that our modified pull-through technique may be a feasible alternative for …


Obstruction Of 2 Coronary Arteries From Different Causes Immediately After Transapical Transcatheter Aortic Valve Replacement, Umihiko Kaneko, Ryuji Koshima, Hirosato Doi, Tsutomu Fujita Feb 2020

Obstruction Of 2 Coronary Arteries From Different Causes Immediately After Transapical Transcatheter Aortic Valve Replacement, Umihiko Kaneko, Ryuji Koshima, Hirosato Doi, Tsutomu Fujita

The Texas Heart Institute Journal

Coronary obstruction, a rare complication of transcatheter aortic valve replacement, can be fatal. Few data exist on this phenomenon, and, to date, authors have reported only single coronary lesions. We present a case in which 2 coronary arteries obstructed immediately after transapical transcatheter aortic valve replacement. The patient was an 81-year-old woman with symptomatic severe aortic stenosis who underwent transapical transcatheter aortic valve replacement. Immediately after an Edwards Sapien XT valve was deployed, she experienced sudden cardiogenic shock resulting from obstruction of the left main coronary artery ostium and the distal left anterior descending coronary artery. The left main obstruction …


A Retrospective Matched-Cohort Study Of 3994 Lower Extremity Wounds Of Multiple Etiologies Across 644 Institutions Comparing A Bioactive Human Skin Allograft, Theraskin, Plus Standard Of Care, To Standard Of Care Alone, Geoff C Gurtner, Aimee D Garcia, Katie Bakewell, Jason B Alarcon Feb 2020

A Retrospective Matched-Cohort Study Of 3994 Lower Extremity Wounds Of Multiple Etiologies Across 644 Institutions Comparing A Bioactive Human Skin Allograft, Theraskin, Plus Standard Of Care, To Standard Of Care Alone, Geoff C Gurtner, Aimee D Garcia, Katie Bakewell, Jason B Alarcon

Faculty, Staff and Students Publications

Most chronic wounds are related to comorbidities, for which no clinical trials are performed. This retrospective propensity matched-cohort study examined data from 2 074 000 lower extremity wounds across 644 institutions to determine the effectiveness of TheraSkin plus standard of care (SOC; n = 1997) versus SOC alone (n = 1997). Multivariate modelling comparing outcomes such as healing rates, percent area reductions (PARs), amputations, recidivism, treatment completion, and medical transfers were evaluated. A higher proportion of wounds in the treatment group compared with the controls were more likely to close (68.3% versus 60.3%), particularly wounds with exposed structures (64% versus …


Negative Pressure Wound Therapy With Instillation: International Consensus Guidelines Update., Paul J Kim, Christopher E Attinger, Thomas Constantine, Brett D Crist, Elizabeth Faust, Christoph R Hirche, Lawrence A Lavery, Valerie J Messina, Norihiko Ohura, Laurie J Punch, Garrett A Wirth, Ibby Younis, Luc Téot Feb 2020

Negative Pressure Wound Therapy With Instillation: International Consensus Guidelines Update., Paul J Kim, Christopher E Attinger, Thomas Constantine, Brett D Crist, Elizabeth Faust, Christoph R Hirche, Lawrence A Lavery, Valerie J Messina, Norihiko Ohura, Laurie J Punch, Garrett A Wirth, Ibby Younis, Luc Téot

2020-Current year OA Pubs

The use of negative pressure wound therapy with instillation and dwell time (NPWTi-d) has gained wider adoption and interest due in part to the increasing complexity of wounds and patient conditions. Best practices for the use of NPWTi-d have shifted in recent years based on a growing body of evidence and expanded worldwide experience with the technology. To better guide the use of NPWTi-d with all dressing and setting configurations, as well as solutions, there is a need to publish updated international consensus guidelines, which were last produced over 6 years ago. An international, multidisciplinary expert panel of clinicians was …


Whole Exome Sequencing Of Highly Aggregated Lung Cancer Families Reveals Linked Loci For Increased Cancer Risk On Chromosomes 12q, 7p, And 4q, Anthony M Musolf, Bilal A Moiz, Haiming Sun, Claudio W Pikielny, Yohan Bossé, Diptasri Mandal, Mariza De Andrade, Colette Gaba, Ping Yang, Yafang Li, Ming You, Ramaswamy Govindan, Richard K Wilson, Elena Y Kupert, Marshall W Anderson, Ann G Schwartz, Susan M Pinney, Christopher I Amos, Joan E Bailey-Wilson Feb 2020

Whole Exome Sequencing Of Highly Aggregated Lung Cancer Families Reveals Linked Loci For Increased Cancer Risk On Chromosomes 12q, 7p, And 4q, Anthony M Musolf, Bilal A Moiz, Haiming Sun, Claudio W Pikielny, Yohan Bossé, Diptasri Mandal, Mariza De Andrade, Colette Gaba, Ping Yang, Yafang Li, Ming You, Ramaswamy Govindan, Richard K Wilson, Elena Y Kupert, Marshall W Anderson, Ann G Schwartz, Susan M Pinney, Christopher I Amos, Joan E Bailey-Wilson

Faculty, Staff and Students Publications

BACKGROUND: Lung cancer kills more people than any other cancer in the United States. In addition to environmental factors, lung cancer has genetic risk factors as well, though the genetic etiology is still not well understood. We have performed whole exome sequencing on 262 individuals from 28 extended families with a family history of lung cancer.

METHODS: Parametric genetic linkage analysis was performed on these samples using two distinct analyses-the lung cancer only (LCO) analysis, where only patients with lung cancer were coded as affected, and the all aggregated cancers (AAC) analysis, where other cancers seen in the pedigree were …


A Characterization Of Gaucher Ips-Derived Astrocytes: Potential Implications For Parkinson's Disease, Elma Aflaki, Barbara K Stubblefield, Ryan P Mcglinchey, Benjamin Mcmahon, Daniel S Ory, Ellen Sidransky Feb 2020

A Characterization Of Gaucher Ips-Derived Astrocytes: Potential Implications For Parkinson's Disease, Elma Aflaki, Barbara K Stubblefield, Ryan P Mcglinchey, Benjamin Mcmahon, Daniel S Ory, Ellen Sidransky

2020-Current year OA Pubs

While astrocytes, the most abundant cells found in the brain, have many diverse functions, their role in the lysosomal storage disorder Gaucher disease (GD) has not been explored. GD, resulting from the inherited deficiency of the enzyme glucocerebrosidase and subsequent accumulation of glucosylceramide and its acylated derivative glucosylsphingosine, has both non-neuronopathic (GD1) and neuronopathic forms (GD2 and 3). Furthermore, mutations in GBA1, the gene mutated in GD, are an important risk factor for Parkinson's disease (PD). To elucidate the role of astrocytes in the disease pathogenesis, we generated iAstrocytes from induced pluripotent stem cells made from fibroblasts taken from controls …


Glopid-R Report On Chikungunya, O'Nyong-Nyong And Mayaro Virus, Part 5: Entomological Aspects, L. Pezzi, M. S. Diamond, Et Al. Feb 2020

Glopid-R Report On Chikungunya, O'Nyong-Nyong And Mayaro Virus, Part 5: Entomological Aspects, L. Pezzi, M. S. Diamond, Et Al.

2020-Current year OA Pubs

The GloPID-R (Global Research Collaboration for Infectious Disease Preparedness) chikungunya (CHIKV), o'nyong-nyong (ONNV) and Mayaro virus (MAYV) Working Group has been established to investigate natural history, epidemiology and clinical aspects of infection by these viruses. Here, we present a report dedicated to entomological aspects of CHIKV, ONNV and MAYV. Recent global expansion of chikungunya virus has been possible because CHIKV established a transmission cycle in urban settings using anthropophilic vectors such as Aedes albopictus and Aedes aegypti. MAYV and ONNV have a more limited geographic distribution, being confined to Africa (ONNV) and central-southern America (MAYV). ONNV is probably maintained through …


Redefining And Revisiting Cost Estimates Of Routine Art Care In Zambia: An Analysis Of Ten Clinics, Austin Tucker, Tannia Tembo, Radhika P Tampi, Jacob Mutale, Mpande Mukumba-Mwenechanya, Anjali Sharma, David W Dowdy, Carolyn B Moore, Elvin Geng, Charles B Holmes, Izukanji Sikazwe, Hojoon Sohn Feb 2020

Redefining And Revisiting Cost Estimates Of Routine Art Care In Zambia: An Analysis Of Ten Clinics, Austin Tucker, Tannia Tembo, Radhika P Tampi, Jacob Mutale, Mpande Mukumba-Mwenechanya, Anjali Sharma, David W Dowdy, Carolyn B Moore, Elvin Geng, Charles B Holmes, Izukanji Sikazwe, Hojoon Sohn

2020-Current year OA Pubs

INTRODUCTION: Accurate costing is key for programme planning and policy implementation. Since 2011, there have been major changes in eligibility criteria and treatment regimens with price reductions in ART drugs, programmatic changes resulting in clinical task-shifting and decentralization of ART delivery to peripheral health centres making existing evidence on ART care costs in Zambia out-of-date. As decision makers consider further changes in ART service delivery, it is important to understand the current drivers of costs for ART care. This study provides updates on costs of ART services for HIV-positive patients in Zambia.

METHODS: We evaluated costs, assessed from the health …