Medicine and Health Sciences Commons^™

Longitudinal Physical Performance And Blood Pressure Changes In Older Women: Findings Form The Women's Health Initiative., Deepika R Laddu, Michael J Lamonte, Bernhard Haring, Hajwa Kim, Peggy Cawthon, Jennifer W Bea, Hailey Banack, Jane A Cauley, Matthew A Allison, Lisa Warsinger Martin, Meryl S Leboff, Marcia L Stefanick, Shane A Phillips, Jun Ma

Medicine Faculty Publications

No abstract provided.

The Effects Of Atir Blocker On The Severity Of Covid-19 In Hypertensive Inpatients And Virulence Of Sars-Cov-2 In Hypertensive Hace2 Transgenic Mice., Xiaoliang Jiang, Huadong Li, Yong Liu, Linlin Bao, Lingjun Zhan, Hong Gao, Wei Deng, Jing Xue, Jiangning Liu, Xing Liu, Junli Li, Jie Wang, Shuang Wu, Mingzhe Yan, Wei Luo, Pedro A. Jose, Chuan Qin, Xiuhong Yang, Dingyu Zhang, Zhiwei Yang

Medicine Faculty Publications

No abstract provided.

Interprofessional Spiritual Care Education In Pediatric Hematology-Oncology: A Pilot Study., Csaba Szilagyi, Alex H Lion, Shelley E Varner Perez, Sarah Koch, Oladele Oyedele, James E Slaven, Kianna Montz, Joan E Haase, Christina M. Puchalski

Medicine Faculty Publications

No abstract provided.

Retaining Interest In Caring For Underserved Patients Among Future Medicine Subspecialists: Underserved Medicine And Public Health (Umph) Program., Jillian S. Catalanotti, David K. Popiel, April Barbour

Medicine Faculty Publications

No abstract provided.

Which Outcomes Are Most Important To Measure In Patients With Covid-19 And How And When Should These Be Measured? Development Of An International Standard Set Of Outcomes Measures For Clinical Use In Patients With Covid-19: A Report Of The International Consortium For Health Outcomes Measurement (Ichom) Covid-19 Working Group., William H Seligman, Luz Fialho, Nick Sillett, Christina Nielsen, Farhala M Baloch, Philip Collis, Ingel K M Demedts, Marcelo P Fleck, Maiara A Floriani, Lucinda E K Gabriel, Joel J Gagnier, Anju Keetharuth, Ana Londral, Ingvar I L Ludwig, Carlos Lumbreras, Alejandro Moscoso Daza, Nasreen Muhammad, Gisele A Nader Bastos, Christine W Owen, John H. Powers, Anne-Marie Russell, Michaela K Smith, Tracy Y-P Wang, Evan K Wong, Douglas C Woodhouse, Eyal Zimlichman, Kees Brinkman

Medicine Faculty Publications

No abstract provided.

Relationship Of Age, Atherosclerosis And Angiographic Stenosis Using Artificial Intelligence., Rebecca Jonas, James Earls, Hugo Marques, Hyuk-Jae Chang, Jung Hyun Choi, Joon-Hyung Doh, Ae-Young Her, Bon Kwon Koo, Chang-Wook Nam, Hyung-Bok Park, Sanghoon Shin, Jason Cole, Alessia Gimelli, Muhammad Akram Khan, Bin Lu, Yang Gao, Faisal Nabi, Ryo Nakazato, U Joseph Schoepf, Roel S Driessen, Michiel J Bom, Randall C Thompson, James J Jang, Michael Ridner, Chris Rowan, Erick Avelar, Philippe Généreux, Paul Knaapen, Guus A De Waard, Gianluca Pontone, Daniele Andreini, Mouaz H Al-Mallah, Robert Jennings, Tami R Crabtree, Todd C Villines, James K Min, Andrew D. Choi

Medicine Faculty Publications

No abstract provided.

Arthralgia Resolution Rate Following Chikungunya Virus Infection., Megan O'Driscoll, Henrik Salje, Aileen Y. Chang, Hugh Watson

Medicine Faculty Publications

No abstract provided.

Tender And Swollen Joint Counts Are Poorly Associated With Disability In Chikungunya Arthritis Compared To Rheumatoid Arthritis., Hugh Watson, Ramão Luciano Nogueira-Hayd, Maony Rodrigues-Moreno, Felipe Naveca, Giulia Calusi, Karol Suchowiecki, Gary S. Firestein, Gary Simon, Aileen Y. Chang

Medicine Faculty Publications

Chronic rheumatological manifestations similar to those of rheumatoid arthritis (RA) are described after chikungunya virus infection. We aimed to compare the relevance of joint counts and symptoms to clinical outcomes in RA and chronic chikungunya disease. Forty patients with chronic chikungunya arthralgia and 40 patients with RA were enrolled in a cross-sectional study. The association of tenderness and swelling, clinically assessed in 28 joints, and patient evaluations of pain and musculoskeletal stiffness with modified Health Assessment Questionnaire (HAQ) and quality of life (QoL) assessments were investigated. Tender and swollen joint counts, pain and stiffness scores were all associated with the …

Rna Sequencing Of Blood In Coronary Artery Disease: Involvement Of Regulatory T Cell Imbalance., Timothy A Mccaffrey, Ian Toma, Zhaoquing Yang, Richard Katz, Jonathan Reiner, Ramesh Mazhari, Palak Shah, Michael Tackett, Dan Jones, Tisha Jepson, Zachary Falk, Richard Wargodsky, Dmitry Shtakalo, Denis Antonets, Justin Ertle, Ju H Kim, Yinglei Lai, Zeynep Arslan, Emily Aledort, Maha Alfaraidy, Georges St Laurent

Medicine Faculty Publications

BACKGROUND: Cardiovascular disease had a global prevalence of 523 million cases and 18.6 million deaths in 2019. The current standard for diagnosing coronary artery disease (CAD) is coronary angiography. Surprisingly, despite well-established clinical indications, up to 40% of the one million invasive cardiac catheterizations return a result of 'no blockage'. The present studies employed RNA sequencing of whole blood to identify an RNA signature in patients with angiographically confirmed CAD.

METHODS: Whole blood RNA was depleted of ribosomal RNA (rRNA) and analyzed by single-molecule sequencing of RNA (RNAseq) to identify transcripts associated with CAD (TRACs) in a discovery group of …

Persistent Joint Pain Following Arthropod Virus Infections., Karol Suchowiecki, St Patrick Reid, Gary L. Simon, Gary S Firestein, Aileen Chang

Medicine Faculty Publications

No abstract provided.

Frequency Of Cd19, Qianzi Zhao, Lawrence K Jung

Medicine Faculty Publications

BACKGROUND: To understand the relationship between regulatory B cells (Bregs) and juvenile idiopathic arthritis (JIA), we analyzed the percentages of Bregs and their function in peripheral blood (PB) and synovial fluid (SF) of JIA patients.

METHODS: Twenty-one JIA patients and 11 children with growing pain but without known rheumatic diseases as controls were included. The B cell phenotype and intracellular production of IL-10 of Bregs were assessed by flow cytometry. Mononuclear cells from PB and SF were stimulated to produce IL-10 in vitro for the identification of IL-10- producing regulatory B cells.

RESULTS: The percentage of CD24

CONCLUSIONS: The inability …

Analysis Of The Immunological Biomarker Profile During Acute Zika Virus Infection Reveals The Overexpression Of Cxcl10, A Chemokine Linked To Neuronal Damage., Felipe Gomes Naveca, Gemilson Soares Pontes, Aileen Yu-Hen Chang, George Allan Villarouco Da Silva, Valdinete Alves Do Nascimento, Dana Cristina Da Silva Monteiro, +Several Additional Authors

Medicine Faculty Publications

BACKGROUND: Infection with Zika virus (ZIKV) manifests in a broad spectrum of disease ranging from mild illness to severe neurological complications and little is known about Zika immunopathogenesis.

OBJECTIVES: To define the immunologic biomarkers that correlate with acute ZIKV infection.

METHODS: We characterized the levels of circulating cytokines, chemokines, and growth factors in 54 infected patients of both genders at five different time points after symptom onset using microbeads multiplex immunoassay; comparison to 100 age-matched controls was performed for statistical analysis and data mining.

FINDINGS: ZIKV-infected patients present a striking systemic inflammatory response with high levels of pro-inflammatory mediators. Despite …

Tat Controls Transcriptional Persistence Of Unintegrated Hiv Genome In Primary Human Macrophages., Beatrix Meltzer, Deemah Dabbagh, Jia Guo, Fatah Kashanchi, Mudit Tyagi, Yuntao Wu

Medicine Faculty Publications

In HIV infected macrophages, a large population of viral genomes persists as the unintegrated form (uDNA) that is transcriptionally active. However, how this transcriptional activity is controlled remains unclear. In this report, we investigated whether Tat, the viral transactivator of transcription, is involved in uDNA transcription. We demonstrate that de novo Tat activity is generated from uDNA, and this uDNA-derived Tat (uTat) transactivates the uDNA LTR. In addition, uTat is required for the transcriptional persistence of uDNA that is assembled into repressive episomal minichromatin. In the absence of uTat, uDNA minichromatin is gradually silenced, but remains highly inducible by HDAC …

An Analysis Of The Effect Of Statins On The Risk Of Non-Hodgkin's Lymphoma In The Women's Health Initiative Cohort., Pinkal Desai, Robert Wallace, Matthew L Anderson, Barbara V Howard, Roberta Ray, Chunyuan Wu, Monika Safford, Lisa W Martin, Nicolas Schlecht, Simin Liu, Dominic Cirillo, Allison Jay, Joann E Manson, Michael S Simon

Medicine Faculty Publications

Statins have been shown to induce a phosphoprotein signature that modifies MYC (myelocytomatosis viral oncogene) activation and to have anti-inflammatory activity that may impact the risk of Non-Hodgkin's lymphoma (NHL). We analyzed the relationship between statins and risk of NHL using data from the Women's Health Initiative (WHI). The study population included 161,563 postmenopausal women ages 50-79 years from which 712 cases of NHL were diagnosed after 10.8 years of follow-up. Information on statin use and other risk factors was collected by self- and interviewer-administered questionnaires. Multivariable-adjusted HR and 95% CI evaluating the relationship between statin use at baseline, as …

Nephron Segment-Specific Gene Expression Using Aav Vectors., Laureano D Asico, Santiago Cuevas, Xiaobo Ma, Pedro A Jose, Ines Armando, Prasad R Konkalmatt

Medicine Faculty Publications

AAV9 vector provides efficient gene transfer in all segments of the renal nephron, with minimum expression in non-renal cells, when administered retrogradely via the ureter. It is important to restrict the transgene expression to the desired cell type within the kidney, so that the physiological endpoints represent the function of the transgene expressed in that specific cell type within kidney. We hypothesized that segment-specific gene expression within the kidney can be accomplished using the highly efficient AAV9 vectors carrying the promoters of genes that are expressed exclusively in the desired segment of the nephron in combination with administration by retrograde …

A Plant-Based Dietary Intervention Improves Beta-Cell Function And Insulin Resistance In Overweight Adults: A 16-Week Randomized Clinical Trial., Hana Kahleova, Andrea Tura, Martin Hill, Richard Holubkov, Neal D Barnard

Medicine Faculty Publications

The aim of this study was to test the effect of a plant-based dietary intervention on beta-cell function in overweight adults with no history of diabetes. Participants (n = 75) were randomized to follow a low-fat plant-based diet (n = 38) or to make no diet changes (n = 37) for 16 weeks. At baseline and 16 weeks, beta-cell function was quantified with a mathematical model. Using a standard meal test, insulin secretory rate was calculated by C-peptide deconvolution. The Homeostasis Model Assessment (HOMA-IR) index was used to assess insulin resistance while fasting. A marked increase in meal-stimulated insulin secretion …

Long-Term Exposure Of Fine Particulate Matter Causes Hypertension By Impaired Renal D1 Receptor-Mediated Sodium Excretion Via Upregulation Of G-Protein-Coupled Receptor Kinase Type 4 Expression In Sprague-Dawley Rats., Xi Lu, Zhengmeng Ye, Shuo Zheng, Hongmei Ren, Jing Zeng, Xinquan Wang, Pedro A Jose, Ken Chen, Chunyu Zeng

Medicine Faculty Publications

BACKGROUND: Epidemiological evidence supports an important association between air pollution exposure and hypertension. However, the mechanisms are not clear.

METHODS AND RESULTS: Our present study found that long-term exposure to fine particulate matter (PM2.5) causes hypertension and impairs renal sodium excretion, which might be ascribed to lower D1 receptor expression and higher D1 receptor phosphorylation, accompanied with a higher G-protein-coupled receptor kinase type 4 (GRK4) expression. The in vivo results were confirmed in in vitro studies (ie, PM2.5 increased basal and decreased D1 receptor mediated inhibitory effect on Na+-K+ ATPase activity, decreased D1 receptor expression, and increased D1 receptor phosphorylation …

Fluid Balance Concepts In Medicine: Principles And Practice., Maria-Eleni Roumelioti, Robert H Glew, Zeid J Khitan, Helbert Rondon-Berrios, Christos P Argyropoulos, Deepak Malhotra, Dominic S Raj, Emmanuel I Agaba, Mark Rohrscheib, Glen H Murata, Joseph I Shapiro, Antonios H Tzamaloukas

Medicine Faculty Publications

The regulation of body fluid balance is a key concern in health and disease and comprises three concepts. The first concept pertains to the relationship between total body water (TBW) and total effective solute and is expressed in terms of the tonicity of the body fluids. Disturbances in tonicity are the main factor responsible for changes in cell volume, which can critically affect brain cell function and survival. Solutes distributed almost exclusively in the extracellular compartment (mainly sodium salts) and in the intracellular compartment (mainly potassium salts) contribute to tonicity, while solutes distributed in TBW have no effect on tonicity. …

Sodium Bicarbonate Cotransporter Nbce2 Gene Variants Increase Sodium And Bicarbonate Transport In Human Renal Proximal Tubule Cells., John J Gildea, Peng Xu, Brandon A Kemp, Julia M Carlson, Hanh T Tran, Dora Bigler Wang, Christophe J Langouët-Astrié, Helen E Mcgrath, Robert M Carey, Pedro A Jose, Robin A Felder

Medicine Faculty Publications

RATIONALE: Salt sensitivity of blood pressure affects >30% of the hypertensive and >15% of the normotensive population. Variants of the electrogenic sodium bicarbonate cotransporter NBCe2 gene, SLC4A5, are associated with increased blood pressure in several ethnic groups. SLC4A5 variants are also highly associated with salt sensitivity, independent of hypertension. However, little is known about how NBCe2 contributes to salt sensitivity, although NBCe2 regulates renal tubular sodium bicarbonate transport. We hypothesized that SLC4A5 rs10177833 and rs7571842 increase NBCe2 expression and human renal proximal tubule cell (hRPTC) sodium transport and may be a cause of salt sensitivity of blood pressure.

OBJECTIVE: To …

Clozapine-Induced Myocarditis, Tanuka Datta, Allen J. Solomon

Medicine Faculty Publications

Approved in 1989 for the management of treatment-resistant schizophrenia, Clozapine is a last-line atypical antipsychotic drug used with increasing frequency. In addition to its well-known side effect of agranulocytosis, this drug also carries with it rare but serious adverse cardiovascular risk of myocarditis. We present a patient on Clozapine who was admitted to the cardiology service with chest pain, ST segment elevations and elevated troponin concerning for acute myocardial infarction. Evaluation with imaging revealed decreased left ventricular function, however, no coronary artery disease was present on catheterization; findings consistent with a diagnosis of myocarditis. Subsequent discontinuation of the patient’s Clozapine …

Percutaneous Management Of Ostial Stenosis Of The Left Internal Mammary Artery Graft, Tanuka Datta, Mohammed Gibreal, Ramesh Mazhari, Allen J. Solomon

Medicine Faculty Publications

A 61-year-old man, who had undergone coronary artery bypass surgery 10 years earlier, presented with a non-ST segment elevation myocardial infarction. He was treated with medical therapy and taken to the Cardiac Catheterization Laboratory. A left heart catheterization demonstrated an ostial stenosis in the left internal mammary artery graft, which was felt to be the culprit lesion. This was successfully repaired with a drug eluting stent. This case is presented as an unusual location for a de novo coronary stenosis. The pathophysiology of these lesions is not well understood.

Reduction Of Vascular Inflammation, Ldl-C, Or Both For The Protection From Cardiovascular Events?, Andromachi Reklou, Michael Doumas, Konstantinos Imprialos, Konstantinos Stavropoulos, Dimitris Patoulias, Vasilios Athyros

Medicine Faculty Publications

Background:

Low density lipoprotein cholesterol (LDL-C) and low grade arterial inflammation are key pathogenic factors for atherosclerosis and its manifestation, cardiovascular disease (CVD).

Objective:

In this narrative review we assessed if decreasing LDL-C levels or inflammation or both is more effective in reducing CVD events.

Results:

In the Scandinavian Simvastatin Survival Study (4S), all statin trials of the 90s’ and the Further Cardiovascular Outcomes Research with PCSK9 Inhibition in Subjects with Elevated Risk (FOURIER) the benefit came from the LDL-C reduction. In the GREak and Atorvastatin Coronary heart disease Evaluation (GREACE), the Treating to New Targets (TNT), and the Justification …

Pediatric Rheumatology: Addressing The Transition To Adult-Orientated Health Care., Sara Sabbagh, Tova Ronis, Patience H White

Medicine Faculty Publications

The transition from pediatric to adult health care is often a challenging process due to multiple interwoven complexities, especially for children with chronic medical conditions. Health care transition (HCT) is a process of moving from a pediatric to an adult model of health care with or without a transfer to a new clinician. This paper focuses on what is known about HCT for youth and young adults (Y/YA) with rheumatic diseases within a larger context of HCT recommendations. HCT barriers for youth, families, and providers and current evidence for a structured HCT processes are reviewed. Practical advice is offered on …

Gut Microbiota And Cardiovascular Uremic Toxicities, Manuel T. Velasquez, Patricia Centron, Ian Barrows, Rama Dwivedi, Dominic S. Raj

Medicine Faculty Publications

Cardiovascular disease (CVD) remains a major cause of high morbidity and mortality in patients with chronic kidney disease (CKD). Numerous CVD risk factors in CKD patients have been described, but these do not fully explain the high pervasiveness of CVD or increased mortality rates in CKD patients. In CKD the loss of urinary excretory function results in the retention of various substances referred to as “uremic retention solutes”. Many of these molecules have been found to exert toxicity on virtually all organ systems of the human body, leading to the clinical syndrome of uremia. In recent years, an increasing body …

Prevalence Of Chronic Obstructive Pulmonary Disease (Copd) In China In 1990 And 2010., Kit Yee Chan, Xue Li, Wanjing Chen, Peige Song, Nuen Wing Katy Wong, Adrienne N Poon, Weiyan Jian, Ireneous N Soyiri, Simon Cousens, Davies Adeloye, Aziz Sheikh, Harry Campbell, Igor Rudan, Global Health Epidemiology Research Group (Gherg).

Medicine Faculty Publications

Background: Chronic obstructive pulmonary disease (COPD) is set to become the third most frequent cause of death and also the third largest cause of global morbidity by 2020. In China, where the population is aging rapidly, COPD has become one of the leading causes of disability and a large economic burden. An epidemiological assessment of the COPD in China is required, with a focus on the number of cases living with disease, main determinants of the disease and time trends.

Methods: We systematically searched large Chinese bibliographic databases and English databases to identify spirometry-based epidemiological studies of the prevalence of …

Clinical And Serological Features Of Systemic Sclerosis In A Multicenter African American Cohort: Analysis Of The Genome Research In African American Scleroderma Patients Clinical Database, Nadia Morgan, Ami Shah, Maureen Mayes, Robyn Domsic, Thomas Medsger, Victoria K. Shanmugam, +Several Additional Authors

Medicine Faculty Publications

Racial differences exist in the severity of systemic sclerosis (SSc). To enhance our knowledge about SSc in African Americans, we established a comprehensive clinical database from the largest multicenter cohort of African American SSc patients assembled to date (the Genome Research in African American Scleroderma Patients (GRASP) cohort).

African American SSc patients were enrolled retrospectively and prospectively over a 30-year period (1987–2016), from 18 academic centers throughout the United States. The cross-sectional prevalence of sociodemographic, clinical, and serological features was evaluated. Factors associated with clinically significant manifestations of SSc were assessed using multivariate logistic regression analyses.

The study population included …

Decentralised Training For Medical Students: A Scoping Review., Marietjie De Villiers, Susan Van Schalkwyk, Julia Blitz, Ian Couper, Kalavani Moodley, Zohray Talib, Taryn Young

Medicine Faculty Publications

BACKGROUND: Increasingly, medical students are trained at sites away from the tertiary academic health centre. A growing body of literature identifies the benefits of decentralised clinical training for students, the health services and the community. A scoping review was done to identify approaches to decentralised training, how these have been implemented and what the outcomes of these approaches have been in an effort to provide a knowledge base towards developing a model for decentralised training for undergraduate medical students in lower and middle-income countries (LMICs).

METHODS: Using a comprehensive search strategy, the following databases were searched, namely EBSCO Host, ERIC, …

Time In Therapeutic Range, As A Determinant Of All-Cause Mortality In Patients With Hypertension., Michael Doumas, Costas Tsioufis, Ross Fletcher, Richard Amdur, Charles Faselis, Vasilios Papademetriou

Medicine Faculty Publications

BACKGROUND: Accumulating evidence indicates that reducing systolic blood pressure (BP) tooutcomes; however, an optimal level has not yet been determined. Many population studies or post hoc analyses suggest a target systolic BP between 120 and 140 mm Hg with increased risk above and below that range. We tested the hypothesis that consistent control of systolic BP between 120 and 140 mm Hg-time in therapeutic range-is a strong determinant of all-cause mortality among US veterans.

METHODS AND RESULTS: A total of 689 051 individuals from 15 Veterans Administration Medical Centers were followed over a 10-year period. Participants were classified as hypertensive, …

Small-For-Gestational Age Prevalence Risk Factors In Central Appalachian States With Mountain-Top Mining., Hamid Ferdosi, Steve H Lamm, Nana Ama Afari-Dwamena, Elisabeth Dissen, Rusan Chen, Ji Li, Manning Feinleib

Medicine Faculty Publications

OBJECTIVES: To identify risk factors for small-for-gestational age (SGA) for counties in central Appalachian states (Kentucky (KY), Tennessee (TN), Virginia (VA), and West Virginia (WV)) with varied coal mining activities.

MATERIAL AND METHODS: Live birth certificate files (1990-2002) were used for obtaining SGA prevalence rates for mothers based on the coal mining activities of their counties of residence, mountain-top mining (MTM) activities, underground mining activities but no mountain-top mining activity (non-MTM), or having no mining activities (non-mining). Co-variable information, including maternal tobacco use, was also obtained from the live birth certificate. Adjusted odds ratios were obtained using multivariable logistic regression …

Patients' And Caregivers' Needs, Experiences, Preferences And Research Priorities In Spiritual Care: A Focus Group Study Across Nine Countries., Lucy Ellen Selman, Lisa Jane Brighton, Shane Sinclair, Ikali Karvinen, Richard Egan, Peter Speck, Richard A Powell, Ewa Deskur-Smielecka, Myra Glajchen, Shelly Adler, Christina Puchalski, Joy Hunter, Nancy Gikaara, Jonathon Hope

Medicine Faculty Publications

Background:

Spiritual distress is prevalent in advanced disease, but often neglected, resulting in unnecessary suffering. Evidence to inform spiritual care practices in palliative care is limited.

Aim:

To explore spiritual care needs, experiences, preferences and research priorities in an international sample of patients with life-limiting disease and family caregivers.

Design:

Focus group study.

Setting/participants:

Separate patient and caregiver focus groups were conducted at 11 sites in South Africa, Kenya, South Korea, the United States, Canada, the United Kingdom, Belgium, Finland and Poland. Discussions were transcribed, translated into English and analysed thematically.

Results:

A total of 74 patients participated: median age …