Medicine and Health Sciences Commons^™

Senescent Fibroblasts In Aging And Pulmonary Fibrosis, Sara B. Palega, Aiwei Y. Borengasser, Yan Y. Sanders

Department of Biomedical and Translational Sciences Faculty Publications

Aging is a major risk factor for many chronic lung diseases, including Idiopathic Pulmonary Fibrosis (IPF), a fatal and incurable disease characterized by progressive fibrotic remodeling. Age-associated structural alterations, impaired regenerative capacity, and dysregulated cellular signaling collectively create a pro-fibrotic microenvironment. A central driver of this pathological shift is the accumulation of senescent cells, which undergo irreversible growth arrest and develop a robust pro-inflammatory senescence-associated secretory phenotype (SASP). Emerging evidence identifies senescent lung fibroblasts as critical mediators of IPF pathogenesis. These cells promote excessive extracellular matrix deposition, myofibroblast differentiation, and tissue stiffening, while simultaneously impairing epithelial regeneration. Together, these effects …

Lipid And Foam Cell Accumulation As Novel Pathological Features Of Benign Prostatic Hyperplasia, Dita Julianingsih, Samara V. Silver, Thaissa Horne, Kasun Gunawardena, Savannah Ward, Alicia Malewska, Douglas Strand, Julius Nyalwidhe, Ilya Sobol, Petra Popovics

Department of Biomedical and Translational Sciences Faculty Publications

Background

Benign prostatic hyperplasia (BPH) encompasses a heterogeneous set of pathological processes that instigate lower urinary tract symptoms (LUTS). Using a mouse model of steroid hormone imbalance-induced lower urinary tract dysfunction, we identified luminal lipid-laden foamy macrophages, although their presence and contribution to human pathology have not yet been established. The objective of this study was to determine whether luminal macrophages are associated with human BPH and to assess how lipid accumulation relates to underlying pathological features and clinical parameters.

Methods

Whole-mount tissue sections from simple prostatectomy specimens and prostates from healthy donors were used to evaluate the association of …

Mental Health And Art Adherence In A Multisite International Study: The Mediating Roles Of Social Support And Substance Use In People With Hiv, Joseph Awad, Wenxiu Sun, Diane Santa Maria, Rebecca Schnall, Panta Apiruknapanond, Tongyao Wang, Claudia Patricia Valencia, Christine Horvat Davey, Solymar Solis Baez, Sheila Shaibu

School of Nursing & Midwifery, East Africa

ART adherence, essential to preventing disease progression for people living with HIV (PLHIV), remains challenged by factors like poor mental health condition, insufficient social support, and substance use. This study investigates the roles of social support and substance use as mediators in the relationship between mental health and antiretroviral therapy (ART) adherence among PLHIV in a multisite, international context. Cross-sectional data from N = 1598 PLHIV across eight countries were analyzed using parallel mediation analyses in R. Results indicated that both social support and substance use independently mediated the relationship between mental health and ART adherence. Hallucinogens mediated the mental …

Prepregnancy Overweight And Obesity In Kuwait Birth Cohort Study, Abdullah Al-Taiar, Ali H. Ziyab, Eelaf A. Husain, Maryam M.Y. Mohammad, Maryem A. Shamsah, Noor Salah Alali, Reem Sharaf-Alddin, Majeda S. Hammoud

Epidemiology, Biostatistics, & Environmental Health Faculty Publications

Objectives: This study aimed to estimate the prevalence of prepregnancy obesity and overweight, and to identify a set of sociodemographic factors that could guide weight management interventions for women prior to conception.

Design, Sample, and Measurements: Pregnant women (N = 989) were recruited in the Kuwait Birth Cohort Study during the period June 2017 to February 2020. Prepregnancy weight and height were self-reported, while current weight and height were measured in a standardized procedure. Data on sociodemographic factors were collected through face-to-face interviews conducted by a trained data collector. Multinomial logistic regression was used to investigate the association between sociodemographic …

Characteristics Of Women Who Fast During Pregnancy: Findings From The Kuwait Birth Cohort Study, Abdullah Al-Taiar, Ali H. Ziyab, Reem Al Sabah, Ahmed N. Albatineh, James Blando, Majeda S. Hammoud

Epidemiology, Biostatistics, & Environmental Health Faculty Publications

Fasting during pregnancy is a widespread practice in Muslim communities, yet its health implications remain poorly understood. A lack of conceptual frameworks and limited understanding of the characteristics of women who fast during pregnancy have hindered research in this area. This study examines the differences in several nutritional biomarkers between women who fasted and those who did not and identifies factors associated with fasting behaviour. We analysed data from the Kuwait Birth Cohort in which information on fasting, sociodemographic characteristics and health behaviours was collected via structured interviews between 2017 and 2021. Clinical and laboratory data were extracted from medical …

The Current State Of Behavioral Health Curriculum Within Professional Athletic Training Programs, Bethany R. Rohl

Graduate Research Theses & Dissertations

Behavioral health concerns among adolescents and young adults have increased in recent years, placing greater expectations on athletic trainers (ATs) to recognize and respond to these conditions in clinical practice. Although accreditation standards require behavioral health competencies within professional athletic training education, variability may exist in how faculty are prepared to teach this content. This study examined athletic training faculty preparation for teaching behavioral health, how programs implement and assess behavioral health content, and faculty perceptions of student satisfaction with behavioral health education.

Consensual qualitative research method was used. Eleven athletic training faculty (9 females, 2 males; age = 37.91 …

A Case Of Post-Transplantation Lymphoproliferative Disorder Following Kidney Transplantation, Punam Raval, John Odhiambo, Hanika Patel, Ahmed Sokwala

Internal Medicine, East Africa

This was a case of a 65-year-old gentleman known to have diabetes mellitus and hypertension since 2012 and post renal transplantation in 2016. He had also been treated for hepatitis C infection in the past. His regular medications included nebivolol 5 mg once a day, tacrolimus 4 mg twice a day, mycophenolate mofetil 500 mg twice a day, prednisolone 5 mg once a day, and insulin–novomix 14 units in the morning and 6 units at night. He presented to a tertiary teaching hospital in Kenya in October 2023 with abdominal pain, vomiting, and constipation on and off for 6 months, …

Enhancing Skin Integrity In Medical Intensive Care Unit Patients, Chelsea Lannoo

Publications 2026-present

No abstract provided.

Myelin Oligodendrocyte Glycoprotein Antibody-Associated Disease Incidentally Diagnosed During Post-Stroke Rehabilitation: A Case Report, Ching-Yun Liao, Chung-Hao Chao, Chih-Chin Hsu

Rehabilitation Practice and Science

背景

髓鞘少突膠質細胞糖蛋白抗體相關疾病（MOGAD）是一種罕見的自體免疫發炎性疾病，主要涉及中樞神經系統（CNS），其主要特徵是視神經、腦部和脊髓脫髓鞘。我們報告一例最初疑似復發性中風的病例，該病例在住院中風復健期間最終確診為MOGAD。

病例概要

49歲女性，左側大腦半球梗塞，在中風後復健期間出現多次右側肢體肌力下降伴隨失語症。這些神經功能波動偏離了典型卒中的預期復健軌跡。卒中發作兩個月後行腦部磁振造影（MRI）檢查，結果顯示右側內囊後肢、腦橋及C1脊髓出現多處新發病灶。後續血清學檢查顯示抗髓鞘少突膠質細胞糖蛋白（MOG）IgG抗體陽性，而水通道蛋白4（AQP4）抗體陰性，確診為MOGAD。患者接受了甲潑尼龍治療及充分的復健治療，追蹤期間肌力顯著改善，未見脫髓鞘病灶復發。

結論

本案例凸顯了復健科醫師在早期發現類似中風的神經發炎性疾病的關鍵作用。復健科醫師處於獨特的領先地位，能夠透過持續的功能監測識別「危險信號」；任何偏離預期復健路徑或無法解釋的神經功能波動都應促使醫生進行進一步檢查。早期識別此類非典型模式，並及時進行免疫治療和多學科康復，可以預防永久性功能衰退，並優化長期預後。

Associations Between Contralesional Neuroplasticity And Motor Impairment Through Deep Learning-Derived Mri Regional Brain Age In Chronic Stroke (Enigma): A Multicohort, Retrospective, Observational Study, Gilsoon Park, Mahir Khan, Justin Andrushko, Nerisa Banaj, Michael Borich, Lara Boyd, Amy Brodtmann, Truman Brown, Cathrin Buetefisch, Adriana Conforto, Steven Cramer, Michael Dimyan, Martin Domin, Miranda Donnelly, Natalia Egorova-Brumley, Elsa Ermer, Wuwei Feng, Fatemeh Geranmayeh, Colleen Hanlon, Brenton Hordacre, Neda Jahanshad, Steven Kautz, Mohamed Salah Khlif, Jingchun Liu, Martin Lotze, Bradley Macintosh, Feroze Mohamed, Jan Nordvik, Fabrizio Piras, Kate Revill, Andrew Robertson, Christian Schranz, Nicolas Schweighofer, Na Jin Seo, Surjo Soekadar, Shraddha Srivastava, Bethany Tavenner, Gregory Thielman, Sophia Thomopoulos, Daniela Vecchio, Emilio Werden, Lars Westlye, Carolee Winstein, George Wittenberg, Jennifer Ferris, Chunshui Yu, Paul Thompson, Sook-Lei Liew, Hosung Kim

Department of Radiology Faculty Papers

BACKGROUND: Stroke leads to complex chronic structural and functional brain changes that specifically affect motor outcomes. The brain predicted age difference (PAD) has emerged as a sensitive biomarker of both sensorimotor and cognitive function after stroke. Our previous study showed a higher global brain PAD associated with poorer motor function after stroke. However, the association between local stroke lesion load, regional brain age, and motor impairment is unclear. This study aimed to investigate the associations between focal lesion damage, regional brain PAD in both hemispheres, and motor outcomes in chronic stroke, and to identify key predictors of motor impairment.

METHODS: …

Glucagon-Like Peptide-1-Based Therapies And The Intersection Of Metabolic And Skin Disease, Ana Ormaza-Vera, Clinton W. Enos

Department Dermatology Faculty Publications

[Introduction] To the Editor: The development of the glucagon-like peptide-1 (GLP-1) receptor agonists (GLP-1RAs) and the dual glucose-dependent insulinotropic polypeptide/GLP-1RAs is revolutionizing the management of metabolic disease. Perhaps most impressive is that their clinical significance extends far beyond their approved indications and touches seemingly every organ system, even the skin.

Subfascial-Cutaneous Propeller Flap For Reconstruction Of Chronic Distal Lower-Limb Wounds With Exposed Bone: Two-Case Reports, Musa Machibya, Mike Kimambo, Irfan Rajput, Raymond Oyugi, Edwin Mrema

General Surgery, East Africa

Introduction and importance: Propeller perforator flaps provide a reliable reconstructive option for distal lower-limb soft-tissue defects, particularly in resource-limited settings where microsurgical free-flap reconstruction may not be readily available. These cases highlight the practical application of propeller perforator flaps in a low-resource setting, demonstrate key surgical decision-making processes, illustrate the management of flap-related complications, and report favorable functional outcomes following reconstruction of complex distal lower-limb wounds.

Case presentation: We present two patients with distal lower-limb wounds and exposed bone: a 33-year-old man with a post-traumatic medial malleolar defect reconstructed using a posterior tibial artery perforator propeller flap, and …

Triglyceride Glucose Index As A Predictor Of Insulin Resistance In Patients With Hypothyroidism, Nadeen El-Nakeeb, Mohammed A. Helaly, Ahmad S. Hasan, Rania Bahriz

Mansoura Medical Journal

Background: Thyroid hormones play a key role in glucose metabolism, and hypothyroidism is frequently associated with impaired insulin secretion, altered glucose disposal, and insulin resistance (IR).

Aim: This study aimed to assess insulin resistance in patients with hypothyroidism using the triglyceride–glucose (TyG) index in comparison with the homeostasis model assessment of insulin resistance (HOMA-IR).

Methods: This case-control study was conducted on 100 participants (50 hypothyroid patients and 50 euthyroid controls), aged 18–60 years. All subjects underwent detailed clinical evaluation, anthropometric measurements, and fasting laboratory investigations including glucose, lipid profile, insulin, TSH, and free T4. Insulin resistance was assessed using TyG …

Epidemiology Of Closed Ruptured Tendoachilles, Hesham Mousad Alsakaan, Wael Mansour Wafa, Mohieb Sayed Ahmed, Ahmed El Sayed Magdy Elhawary

Mansoura Medical Journal

Background: To restore tendon function and avoid long-term impairment, early diagnosis and adequate treatment are crucial. The purpose of this study was to ascertain the incidence pattern of ATR and to pinpoint possible variables related to presentation and management approach.

Aim  identifying potential risk factors either patient or environmental related and to assess the incidence rate of ATR

Patients and Methods: This retrospective cross-sectional study was performed on 87 achilles tendon rupture patients. All the patients were subjected to full medical history taking. Clinical examination was performed including thompson test and Matles test and radiological investigations.

Results: The median age …

A Chicken Model For Non-Invasive Diagnosis Of Infant Developmental Dysplasia Of The Hip (Ddh) Using Acoustic Transmission Measurements, Aliza Shah

Honors Undergraduate Theses

Developmental dysplasia of the hip (DDH) is a condition characterized by abnormal development and stability of the hip joint. In a healthy infant, the femoral head (ball) fits securely within the acetabulum (socket of the pelvis), allowing for proper joint function. In DDH, the relationship is disrupted, ranging from mild acetabular dysplasia to partial (subluxation) or complete dislocation of the femoral head. This condition represents a range of structural abnormalities that develop during early growth. The integrity of the hip joint is essential for physical mobility, and disruption of this structure can lead to significant functional impairment. DDH may result …

Investigating The Role Of Traditional Chinese Herbal Medicine For Cancer Symptom Management In Older Adults: A Rapid Review, Isabelle C. Karshner

Honors Undergraduate Theses

Background: Patients with cancer often experience symptoms related to disease, complications, and treatment. One potential method of alleviating these symptoms is traditional Chinese herbal medications (TCHM). This rapid review explores the role of traditional Chinese herbal medications in treating cancer-related symptoms in older adults.

Purpose: The purpose of this rapid review is to gain and provide a better understanding of the effects of TCHM on cancer-symptom management in the older adult population. This review explores the association between TCHM and effects on cancer symptoms in older adults, including interactions, toxicity, and signs/symptoms of TCHM use that may be useful information …

Synthesis And Characterization Of Succinate Dehydrogenase Inhibitors H2/Z14 And C6/Z96 In Order To Combat Small Cell Lung Cancer, Lauren M. Graves

Honors Undergraduate Theses

The use of ubiquinone inhibitors to combat cancer is a recent development in medicinal science and procedures to efficiently synthesize these drugs remain limited. C6/Z96 and H2/Z14, two succinate dehydrogenase inhibitors, have been previously tested in vitro against NSCLC with positive results. Their similarity to ubiquinone is what makes them a strong candidate for a succinate dehydrogenase inhibitor at the ubiquinone binding site. The heterocyclic scaffolds and substituents are proposed to bind strongly through a combination of electronics, hydrogen-bonding, and fit, allowing them to bind well and prove to be more favorable than ubiquinone when competing for the Q-site. By …

A Position Statement On Endovascular Models And Effectiveness Metrics For Mechanical Thrombectomy Navigation, On Behalf Of The Stakeholder Taskforce For Artificial Intelligence-Assisted Robotic Thrombectomy (Start), Harry Robertshaw, Anna Barnes, Phil Blakelock, Raphael Blanc, Robert Crossley, Rebecca Fahrig, Ameer E. Hassan, Benjamin Jackson, Lennart Karstensen

School of Medicine Publications

Although we are making progress in overcoming infectious diseases and cancer, one of the major medical challenges of the mid-21st century will be the increasing prevalence of stroke. Occlusions in large vessels are especially debilitating, yet effective treatment—needed within hours to achieve best outcomes—remains limited because of geographic accessibility. One solution for improving timely access to mechanical thrombectomy in geographically diverse populations is the widespread deployment of robotic surgical systems. Artificial intelligence assistance may enable the safe and effective upskilling of operators in this emerging therapeutic delivery approach. Our aim was to establish consensus frameworks for developing and validating artificial …

Tuberculosis Presenting As Multiple Pulmonary Nodules Mimicking Malignancy, Abdel Martinez Borrego, Fatimah Bello, Brandon Cantazaro, Luisa Montoya, Frank Mediola

School of Medicine Publications

Multiple pulmonary nodules often raise concern for metastatic malignancy; however, the differential diagnosis is broad and includes infectious, inflammatory, granulomatous, vascular, and benign etiologies. Tuberculosis (TB), although uncommon, can present with multiple nodules that closely mimic metastatic disease on advanced imaging, requiring careful clinicoradiologic and microbiologic correlation. We describe a woman in her 50s who presented with dyspnea and new-onset heart failure, in whom imaging revealed mediastinal lymphadenopathy and bilateral pulmonary nodules concerning for malignancy. Evaluation was limited by concurrent COVID-19 infection, and CT-guided biopsy demonstrated necrotizing granulomas without evidence of malignancy or infection. She later re-presented with fever and …

The Association Between Maternal-Fetal Medicine Physician Density And Pregnancy Outcomes, Tetsuya Kawakita, Rula Atwani, Misa Hayasaka, Lindsay Robbins, George Saade

Department of Obstetrics & Gynecology Faculty Publications

Objective

We sought to examine the association between maternal-fetal medicine (MFM) physician density and adverse pregnancy outcomes at the state level.

Study Design

This was a cross-sectional analysis of publicly available, state-level data from 2018 to 2021, including Natality, Multiple Cause-of-Death, and Fetal Death databases. The number of active MFM physicians per year was obtained for each state from the American Medical Association Masterfile. The primary exposure was the density of MFM per state, categorized into three groups: (1) low density (< 30 MFM physicians per 100,000 live births), (2) moderate density (30-59 MFM physicians per 100,000 live births), and (3) high density (≥60 MFM physicians per 100,000 live births). Our primary outcome was maternal mortality during pregnancy and up to 42 days postdelivery. Our secondary outcomes were pregnancy-related mortality up to 365 days postdelivery and stillbirth. We calculated adjusted incident rate ratios (aIRR) and average marginal effect (AME) with 95% confidence intervals (95% CI) using multivariable negative binomial mixed effects regression models.

Results

Overall, there were 14,792,743 live births, 3,440 maternal mortalities, 4,980 pregnancy-related mortalities, and 90,848 stillbirths included. The …

Mediating Effect Of Social Determinants Of Health Between Race And Phthalate Biomarkers In Pregnancy, Tetsuya Kawakita, Misa Hayasaka, Carole Barake, Trinity Soto, Jillian Fleming, Amir Lueth, Stevens Danielle, Alfred Abuhamad, Ann Pryzybylska, Elena Sinkovskaya, Kelly K. Ferguson, George Saade

Department of Obstetrics & Gynecology Faculty Publications

Introduction

Prenatal phthalate exposure is linked to adverse reproductive and developmental outcomes and is consistently higher among non‐Hispanic Black compared to non‐Hispanic White pregnant individuals, yet the factors responsible for these disparities are poorly characterized. We sought to quantify Black–White differences in repeated urinary concentrations of phthalate biomarkers during pregnancy and to estimate the extent to which neighborhood‐level social determinants of health (SDoH) mediate these disparities.

Methods

This secondary analysis used data from the Human Placenta Project Study, a prospective observational cohort study conducted at two academic institutions between 2016 and 2018. Eligible participants had singleton pregnancies, were recruited before …

Differential Impact Of Admission Type And Clinical Complexity On Diabetes Hospitalization Costs Among African American And Hispanic Patients In Southeastern Virginia, Ismail El Moudden, Asra Amidi, Reem Sharaf-Alddin, Michael C. Bittner, Qi Zhang

Department of Obstetrics & Gynecology Faculty Publications

Background

Diabetes mellitus (DM) imposes substantial healthcare costs with documented disparities among African Americans and Hispanic patients. To inform care delivery and resource allocation, this study identified hospitalization cost predictors among African American and Hispanic patients with diabetes in Southeastern Virginia.

Methods

We analyzed 6,011 hospital discharges from the Virginia Health Information database (2016-2020) for adults aged 18-85 with diabetes. Discharges were classified by Medicare Severity Diagnosis-Related Groups: DM with complications/comorbidities (DCC, n = 3,328), DM with major complications/comorbidities (DMCC, n = 1,518), and DM without major complications/comorbidities (DWO, n = 1,165). Because cost distributions were right-skewed (skewness 3.5-8.24), we …

Contribution Of Comorbidities And Pregnancy Complications To Severe Maternal Morbidity In The United States, Tetsuya Kawakita, Sora A. Jones, Natsume Furukawa, George Saade

Department of Obstetrics & Gynecology Faculty Publications

Objective: To quantify the extent to which rising rates of severe maternal morbidity (SMM) in the United States from 2016 to 2022 are attributable to increasing prevalence of maternal risk factors, including advanced maternal age, obesity, pregestational diabetes mellitus, gestational diabetes, chronic hypertension, and hypertensive disorders of pregnancy (HDP).

Methods: We conducted a retrospective cohort study using the Nationwide Readmissions Database from 2016 to 2022, representing more than 25 million weighted delivery hospitalizations. The primary outcome of SMM was identified with the Centers for Disease Control and Prevention's 21-condition algorithm; a secondary outcome excluded transfusion to improve specificity. Temporal trends …

Cervicovaginal Lavage Fluid Iron And Manganese Levels In Women With And Without Vaginitis, Barbara Kozma, David Ratonyi, Bence Kozma, Peter Takacs, Attila G. Sipos

Department of Obstetrics & Gynecology Faculty Publications

Transition metals such as iron and manganese are critical for cellular metabolism, redox balance, and immune function, and they also influence host–pathogen interactions. Vaginitis is characterized by mucosal inflammation that may alter local trace-element homeostasis. We hypothesize that inflammatory conditions such as vaginitis may be associated with altered cervicovaginal iron and manganese levels. We performed a prospective, single-center cohort study at the University of Debrecen (Hungary) between April 2023 and April 2024, enrolling 80 women ≥ 18 years with vulvovaginal complaints. Participants were assessed at baseline and at weeks 4, 8, and 12 with clinical evaluation and cervicovaginal lavage (CVL) …

Estetrol (E4) For The Treatment Of Moderate To Severe Vasomotor Symptoms In Postmenopausal Women - Efficacy And Safety Results From The Phase 3 E4comfort I Multicenter, Placebo-Controlled Study, Tommaso Simoncini, Céline Bouchard, Marie Cloes, Mélanie Taziaux, Santiago Palacios, Sebastião Freitas De Medeiros, Valeriu Vrabii, David F. Archer, Nick Panay

Department of Obstetrics & Gynecology Faculty Publications

Objective

To evaluate the efficacy and safety of estetrol in reducing moderate to severe vasomotor symptoms in postmenopausal women.

Methods

Multicenter, randomized, parallel group (1:1:1), placebo-controlled, double-blind, phase 3 study in hysterectomized and non-hysterectomized participants aged 40-65 years. A total of 640 participants with seven or more moderate to severe hot flashes daily or 50 weekly received estetrol 15 mg, estetrol 20 mg, or placebo for 12 weeks. Co-primary endpoints were the change in frequency and severity of moderate to severe vasomotor symptoms from baseline to weeks 4 and 12. Comparisons versus placebo were made using a mixed-effects model for …

Evaluating The Mediating Role Of Gestational Phthalate And Replacement Biomarkers In The Associations Between Race/Ethnicity And Birthweight, Amir J. Lueth, Danielle R. Stevens, Sarahna A. Moyd, Elena Sinkovskaya, Ann Przybylska, Antonia M. Calafat, Julianne C. Botelho, George Saade, Alfred Abuhamad, Kelly K. Ferguson

Department of Obstetrics & Gynecology Faculty Publications

Background

Gestational exposure to phthalates is higher among non-Hispanic black (NHB) women than non-Hispanic white (NHW) women and may contribute to racial/ethnic differences in birthweight z-scores.

Objective

We aimed to investigate whether gestational phthalate and replacement biomarkers mediate the association between race/ethnicity and birthweight z-scores.

Methods

We analyzed data from 271 pregnancies in the Human Placenta and Phthalates study, a prospective cohort recruited from 2017 to 2020. Urinary phthalate metabolite concentrations were measured at up to eight time points during pregnancy and averaged to represent gestational exposure. Metabolites were grouped by parent compound. Linear regression models estimated associations in phthalate …

Dupilumab For Patients With Allergic Fungal Rhinosinusitis, Amber U. Luong, Joshua M. Levy, Sarah K. Wise, Joseph K. Han, Mamoru Yoshikawa, Luo Zhang, Rodney Schlosser, Prerna Ranganathan, Paula Dakin, Jennifer Maloney, George D. Yancopoulos, Andrew P. Fontenot, Neelam A. Phadke, Lacey R. Robinson

Department of Otolaryngology (ENT) Faculty Publications

Background

Allergic fungal rhinosinusitis (AFRS) is a severe subtype of chronic rhinosinusitis characterized by fungal hypersensitivity and accentuated type 2 inflammation. Dupilumab-a fully human monoclonal antibody blocking interleukin-4/13, approved for type 2 inflammatory diseases, including chronic rhinosinusitis with nasal polyps-may benefit patients with AFRS.

Objective

We sought to understand the effect of dupilumab in AFRS

Methods

In this phase 3 trial, patients with AFRS aged ≥6 years were randomized to dupilumab or matched placebo for 52 weeks. The primary end point was Lund-Mackay computed tomography (LMK-CT) score, quantifying sinus opacification, at 52 weeks. Secondary end points were multiplicity-controlled and hierarchically …

Dengue Fever With Normal Platelet Count In A Patient With Β-Thalassemia Trait: A Case Report., Pankaj Kumar Jain, Manoj Seval, Vikas Meena, Rajesh Kumar Yadav

Digital Journal of Clinical Medicine

Dengue fever is an arboviral infection caused by different serotypes of the dengue virus. Generally, it presents with a wide variety of symptoms ranging from undifferentiated fever to dengue shock syndrome associated with thrombocytopenia and hemoconcentration. But in patients with thalassemia, it presents with anemia due to hemolysis, rather than hemoconcentration. Here we present a case of an 18-year-old female diagnosed with Dengue fever with thalassemia trait, who presented with a normal platelet count and moderate microcytic anemia.

Limitations Of Plasma Exchange In Yellow Phosphorus-Induced Acute Liver Failure: A Case Report, Vihitha Vunnam, Swathi B.S

Digital Journal of Clinical Medicine

Yellow phosphorus is a highly toxic compound commonly used in rodenticides and is associated with significant morbidity and mortality following ingestion. Toxicity typically evolves through an initial gastrointestinal phase, a deceptive latent period, and a final phase characterized by fulminant hepatic failure and multiorgan dysfunction. We report the case of an 18-year-old male who intentionally ingested two tubes of Ratol containing 3% yellow phosphorus. After initial vomiting and transient clinical stability, he developed rapidly progressive acute liver failure with severe coagulopathy, conjugated hyperbilirubinemia, hepatic encephalopathy, acute pancreatitis, pancytopenia, acute kidney injury, metabolic derangements, and recurrent hypoglycemia. Serial laboratory trends demonstrated …

When Fever And Thrombocytopenia Are Not Infectious: A Case Of Vitamin B12 Deficiency Mimicking Tropical Fever, Ram Arvind Viswanathan Dr

Digital Journal of Clinical Medicine

Vitamin B12 deficiency is classically associated with megaloblastic anaemia and neurological manifestations; however, atypical presentations continue to pose diagnostic challenges. Fever in association with thrombocytopenia often prompts evaluation for infectious aetiologies such as dengue, malaria, or sepsis, particularly in tropical settings. We report a case of vitamin B12 deficiency presenting with pyrexia and isolated thrombocytopenia, initially suspected to be an infectious illness. Extensive evaluation failed to reveal an infective cause, and subsequent haematological workup demonstrated megaloblastic changes with low serum vitamin B12 levels. Remarkably, the patient showed rapid defervescence and normalisation of platelet counts following parenteral vitamin B12 therapy. This …