Medicine and Health Sciences Commons^™

Investigation Of Sex Differences In The Expression Of Rora And Its Transcriptional Targets In The Brain As A Potential Contributor To The Sex Bias In Autism, Valerie W. Hu, Tewarit Sarachana, Rachel Sherrard, Kristen M. Kocher

Medicine Faculty Publications

Background

Autism spectrum disorder (ASD) is a neurodevelopmental condition characterized by significant impairment in reciprocal social interactions and communication coupled with stereotyped, repetitive behaviors and restricted interests. Although genomic and functional studies are beginning to reveal some of the genetic complexity and underlying pathobiology of ASD, the consistently reported male bias of ASD remains an enigma. We have recently proposed that retinoic acid-related orphan receptor alpha (RORA), which is reduced in the brain and lymphoblastoid cell lines of multiple cohorts of individuals with ASD and oppositely regulated by male and female hormones, might contribute to the sex bias …

Discharge Education Curriculum For Residents Rotating On An Inpatient Pediatric Ward, Kaitlin Widmer, Priti Bhansali, Julie Noffsinger

E-Learning Modules

Adult literature has demonstrated that patient preferences and understanding of discharge instructions can impact success of discharge and even predict return ER visits. There is very little data in pediatric literature describing what information should be discussed with families when providing discharge instructions, and most pediatric residents do not receive formal education on the topic. This curriculum is designed as a brief educational intervention that can improve residents’ comfort and skills in providing discharge education to families. The materials include both how to present the curriculum and tools to assess resident knowledge, behaviors and attitudes regarding discharge education as well …

Himmelfarb Library Liaison Letter - May 2015, George Washington University, Himmelfarb Health Sciences Library

Himmelfarb Library Liaison Letters

No abstract provided.

Association Between Inflammation And Cardiac Geometry In Chronic Kidney Disease: Findings From The Cric Study., Jayanta Gupta, Elizabeth Dominic, Jeffrey C. Fink, Akinlolu O. Ojo, Ian R. Barrows, Muredach Reilly, Raymond R. Townsend, Marshall Joffe, Sylvia Rosas, Melanie Wolman, Samir Patel, Martin Keane, Harold I. Feldman, John W. Kusek, Dominic S. Raj

Medicine Faculty Publications

Background

Left ventricular hypertrophy (LVH) and myocardial contractile dysfunction are independent predictors of mortality in patients with chronic kidney disease (CKD). The association between inflammatory biomarkers and cardiac geometry has not yet been studied in a large cohort of CKD patients with a wide range of kidney function.

Methods

Plasma levels of interleukin (IL)-1β, IL-1 receptor antagonist (IL-1RA), IL-6, tumor necrosis factor (TNF)-α, transforming growth factor (TGF)-β, high-sensitivity C-Reactive protein (hs-CRP), fibrinogen and serum albumin were measured in 3,939 Chronic Renal Insufficiency Cohort study participants. Echocardiography was performed according to the recommendations of the American Society of Echocardiography and interpreted …

A Microrna Profile Associated With Opisthorchis Viverrini-Induced Cholangiocarcinoma In Tissue And Plasma., Jordan Plieskatt, Gabriel Rinaldi, Yanjun Feng, Jin Peng, Samantha Easley, Xinying Jia, Jeremy Potriquet, Chawalit Pairojkul, Vajarabhongsa Bhudhisawasdi, Banchob Sripa, Paul J Brindley, Jeffrey Bethony, Jason Mulvenna

Microbiology, Immunology, and Tropical Medicine Faculty Publications

Background

Intrahepatic cholangiocarcinoma (ICC) is a highly aggressive tumor of the bile duct, and a significant public health problem in East Asia, where it is associated with infection by the parasiteOpisthorchis viverrini. ICC is often detected at an advanced stage and with a poor prognosis, making a biomarker for early detection a priority.

Methods

We have comprehensively profiled miRNA expression levels in ICC tumor tissue using small RNA-Seq and validated these profiles using quantitative PCR on matched plasma samples.

Results

Distinct miRNA profiles were associated with increasing histological differentiation of ICC tumor tissue. We also observed that histologically …

Translation Initiation Complex Eif4f Is A Therapeutic Target For Dual Mtor Kinase Inhibitors In Non-Hodgkin Lymphoma., Christos Demosthenous, Jing Jing Han, Mary J Stenson, Matthew J Maurer, Linda E Wellik, Brian Link, Kristen Hege, Ahmet Dogan, Eduardo Sotomayor, Thomas Witzig, Mamta Gupta

Medicine Faculty Publications

Deregulated mRNA translation has been implicated in disease development and in part is controlled by a eukaryotic initiation complex eIF4F (composed of eIF4E, eIF4G and eIF4A). We demonstrate here that the cap bound fraction from lymphoma cells was enriched with eIF4G and eIF4E indicating that lymphoma cells exist in an activated translational state. Moreover, 77% (110/142) of diffuse large B cell lymphoma tumors expressed eIF4E and this was associated with an inferior event free survival. Over-expression of wild-type eIF4E (eIF4E(WT)) but not cap-mutant eIF4E (eIF4E(cap mutant)) increased the activation of the eIF4F complex. Treatment with the active-site dual mTOR inhibitor …

Is It Ethical To Hold A Person Culpable For His Actions If He Cannot Recognize Right And Wrong, Tabitha E.H. Moses

Student Works

The field of neuroscience has opened up a proverbial can of worms when it comes to questions of free will and culpability. The more we know about the mind the more it appears that no one has any real choice in their actions. The ethical implications of this assumption are astronomical. Guilt and culpability come into question; it would seem unjust to punish a person for a crime if he had no choice but to commit it. While these are interesting questions for an ethicist they are impractical for society as they might affect how society functions. As such, the …

Occupational Health Risk Factors For Schistosomiasis: Systematic Review And Analysis, Sarah Grace Sawyer, Amira Roess, Gisela Butera

GW Research Days 2015

Schistosomiasis is a neglected tropical disease caused by a parasitic flatworm which afflicts over 200 million people in the poorest regions of Africa. Carried by snails living in fresh, stagnant water, the parasite penetrates human skin upon contact, causing the victim to suffer a range of symptoms including diarrhea, blood in the urine, and eventual death. Despite its prevalence, schistosomiasis is preventable, treatable, and curable once a control program is implemented. Substantial reduction of schistosomiasis would relieve suffering and produce many socio-economic benefits, including higher productivity and higher school attendance rates. Disease transmission is directly tied to the environment, and …

Can Electronic Health Records Systems Support New Payment Methods For Health Centers?, Peter Shin, Feygele Jacobs, Jeffrey Barnes, James B. Welsh, Lisa Perry, Scott D. Morgan

Geiger Gibson/RCHN Community Health Foundation Research Collaborative

This study assessed the feasibility and usefulness of combining electronic health record (EHR) data with federal cost report data for the purposes of: 1) quantifying the provision of enabling services; and 2) for use as the basis of community health center payment rate-setting. The study used EHR data derived from the Center for Primary Care Informatics to isolate enabling services and perform the end-to-end analysis that might be required to develop or evaluate reimbursement rates. The study revealed that data extracted from federal cost reports combined with data from the EHR fall short of providing the information required to reasonably …

Targeted Single Molecule Sequencing Methodology For Ovarian Hyperstimulation Syndrome., Funda Orkunoglu-Suer, Arthur F. Harralson, David Frankfurter, Paul Gindoff, Travis J. O'Brien

Genomics and Precision Medicine Faculty Publications

BACKGROUND: One of the most significant issues surrounding next generation sequencing is the cost and the difficulty assembling short read lengths. Targeted capture enrichment of longer fragments using single molecule sequencing (SMS) is expected to improve both sequence assembly and base-call accuracy but, at present, there are very few examples of successful application of these technologic advances in translational research and clinical testing. We developed a targeted single molecule sequencing (T-SMS) panel for genes implicated in ovarian response to controlled ovarian hyperstimulation (COH) for infertility.

RESULTS: Target enrichment was carried out using droplet-base multiplex polymerase chain reaction (PCR) technology (RainDance®) …

Hepatitis C Virus Infection Screening Test Compliance At Primary Care Clinic, Talal Alzahrani, Brandon Rieders, Mohammed Fadlalla, Jason Gendell, Anne Cioletti

GW Research Days 2015

Introduction:

Hepatitis C Virus (HCV) is the most common cause of liver cirrhosis and hepatocellular carcinoma, and is the leading cause of liver transplantation in the US. About 3.2 million individuals are chronically infected with HCV. Most of these patients are unaware of their infection because they are largely asymptomatic. Approximately three-fourths of them were born between 1945-1965. Furthermore, with the advances in HCV treatment, it is imperative to identify chronically infected individuals in order to avert the long-term, costly, sequelae of the virus. The U.S. Preventive Services Task Force recently recommended a one-time screening test for HCV for those …

Blood, Brain And Now Bone – Learning More About An Often Overlooked Pathogen, Linda Lesky, Julianne Camba, Sarah De Los Santos, Alexander Fortenko, Talal Alzahrani

GW Research Days 2015

INTRODUCTION:

Arcanobacterium haemolyticum (previously Corynebacterium haemolyticum), a facultative anaerobe, Gram positive rod was first isolated from United States servicemen and indigenous populations of the South Pacific in 1946. Early reported cases detailed A. haemolyticum as a causative pathogen for exudative pharyngitis (most commonly in adolescents) and cutaneous infections. Osteomyelitis caused by A. haemolyticum has been described in less than five cases in the literature. Here, we describe our experience in diagnosing patient with osteomyelitis caused by A. haemolyticum.

CASE REPORT:

A 30-year-old man with a history of peripheral neuropathy, diabetic foot ulcers, methicillin-resistant S. aureus osteomyelitis and amputation of the …

Fast Food: A Source Of Exposure To Phthalates And Bisphenol A In A Nationally Representative Sample, Cassandra Phillips, Susanna Mitro, Ami R. Zota

GW Research Days 2015

Background: Certain phthalates and bisphenol A (BPA) are industrial chemicals widely used in consumer products that can adversely impact human health. Diet is hypothesized to be a major source of exposure but little is known about the impact of specific food sources. This study aims to investigate the association between fast food consumption with human exposure to high-molecular weight phthalates (di(2-ethylhexyl) phthalate (DEHP) and diisononyl phthalate (DINP)) and BPA, in 8876 participants, aged 6 to 85 years old, from the National Health and Nutrition Examination Survey (NHANES), 2003-2010.

Methodology: During the NHANES mobile exam, participants: 1) provided a spot urine …

Opisthorchiasis: An Overlooked Danger, Ludmila M. Ogorodova, Olga S. Fedorova, Banchob Sripa, Viatcheslav A. Mordvinov, Aleksei V. Katokhin, Paul J. Brindley, The Topic Consortium

Microbiology, Immunology, and Tropical Medicine Faculty Publications

No abstract provided.

Opisthorchiasis: An Overlooked Danger., Ludmila M Ogorodova, Olga S Fedorova, Banchob Sripa, Viatcheslav A Mordvinov, Aleksei V Katokhin, Jennifer Keiser, Peter Odermatt, Paul J. Brindley, Oleg A Mayboroda, Thirumalaisamy P Velavan, Maxim B Freidin, Alexey E Sazonov, Irina V Saltykova, Mariya Y Pakharukova, Yulia V Kovshirina, Kostas Kaloulis, Olga Y Krylova, Maria Yazdanbakhsh

Microbiology, Immunology, and Tropical Medicine Faculty Publications

No abstract provided.

A Very Rare Cause Of Pancytopenia., Talal Alzahrani, Dana Kay, Kelly Zhang, Linda Lesky

GW Research Days 2015

INTRODUCTION:

Levetiracetam (Keppra) is a pyrrolidone derivative and acts as an anti-epileptic medication by modulating neurotransmitter release. Pancytopenia is a very rare adverse effect caused by levetiracetam. There are fewer than four case reports in the medical literature discussing the association between levetiracetam and pancytopenia. The pathogenesis behind this relationship is unclear. Therefore, this case will serve to spread awareness of a rare cause of pancytopenia and to hypothesize how this medication causes pancytopenia.

CASE REPORT:

A brain MRI of a 79-year-old female with a medical history of hypertension, Type II diabetes, and CVA revealed a right temporoparietal mass. She …

Re-Expansion Pulmonary Edema, Talal Alzahrani, Nawaf Abaalkhail, Mayssam Nehme, Jalil Ahari

GW Research Days 2015

Re-expansion pulmonary edema (RPE) is a rare complication of therapeutic thoracentesis. Unfortunately, there is no definitive treatment modality for RPE. The high mortality rate, reported up to 21%, presses the issue for finding adequate prevention and treatment. Here we report a new management modality that is very useful for a patient with RPE.

Case Report: An 80-year-old man with a history of hypertension, atrial fibrillation, congestive heart failure with preserved ejection fraction, and sacral decubitus ulcer, who was admitted for surgical debridement of his ulcer. He developed hospital-acquired pneumonia and was resolved with antibiotics and aggressive hydration. He became hypoxic, …

Progressive Supranuclear Palsy Treatment- A Systematic Review, Samah Hassan Hajjar, James K. Cooper

GW Research Days 2015

Introduction

Progressive Supranuclear Palsy (PSP) is an uncommon neurodegenerative disease associated with postural instability, falling, and memory loss. Because of clinical similarities, it is often classified as atypical Parkinson's disease. PSP may present abruptly with a relatively rapid decline, leading to death in a few years. Different therapeutic approaches have been suggested for PSP, but their efficacy is unclear. To our knowledge, there has been no systematic review of PSP treatment.

Objective

To determine the effectiveness PSP treatments.

Methods

A systematic review of published literature was completed. We searched using PubMed and SCOPUS for related articles. The search terms are …

True Durability: Hiv Virologic Suppression In An Urban Clinic And Implications For Timing Of Intensive Adherence Efforts And Viral Load Monitoring, Debra A. Benator, Angelo Elmi, Manuel D. Rodriguez, Howard B. Gale, Virginia L. Kan, Heather J. Hoffman, Susan Tramazzo, Karen Hall, Angela Mcknight, Leah Squires

Medicine Faculty Publications

Although the majority of HIV-infected patients who begin potent antiretroviral therapy should expect long-term virologic suppression, the realities in practice are less certain. Durability of viral suppression was examined to define the best timing of targeted adherence strategies and intensive viral load monitoring in an urban clinic population with multiple challenges to ART adherence. We examined the risk of viral rebound for patients who achieved two consecutive viral loads lower than the lower limit of quantification (LLOQ) within 390 days. For 791 patients with two viral loads below the LLOQ, viral rebound >LLOQ from the first viral load was 36.9 …

A Six-Week Home Exercise Program Improves Endothelial Function And Cd34+ Circulating Progenitor Cells In Patients With Pre-Diabetes, Sabyasachi Sen, Sarah Witkowski, Ann Lagoy, Ashequl Islam

Medicine Faculty Publications

Background: Pre-diabetes is associated with endothelial dysfunction and affects endothelium-associated stem cells. Lifestyle modification has been shown to prevent the progression from pre-diabetes to overt type 2 diabetes; however, the effect of such interventions on CD34⁺ progenitor cells in pre-diabetes participants has not been tested. The purpose of this study was to determine whether a home-based 6-week exercise intervention improved vascular function, circulating number, function, and gene expression of circulating CD34⁺progenitor cells in patients with pre-diabetes.

Methods: Patients (40 - 70 years, BMI of 25 - 39.9, n = 11) were enrolled in a 16-week randomized crossover …

Out And About In Medicine: Gw Out For Health, Michelle S. Davis, Daniel F. O'Neill, Robert Tollefson, Domenique Escobar, Chase Hiller, Lawrence R. Deyton

GW Research Days 2015

The time is right to devise and implement a more coordinated approach to LGBT patient care and health professional training within the Washington, DC metropolitan area and beyond. The following George Washington University School of Medicine and Health Sciences (GWSMHS) and Hospital (GWUH) LGBT Health Initiative proposal highlights possible strategies for addressing this need through a more centralized fashion. The seven focus areas proposed for the GW LGBT Health Initiative include: 1) Climate/Visibility; 2) Health Education; 3) Policy/Advocacy; 4) Community Outreach; 5) Research; 6) Patient Care; and 7) HIV/AIDS. A key stakeholder that is helping to realize this vision of …

Laparoscopic Surgery For Patients With Severe Chronic Obstructive Lung Disease, Talal S. Alzahrani, Victor S. Saxena, Alexander Cho, Guillermo Gutierrez

GW Research Days 2015

Introduction: Laparoscopy is a minimally invasive procedure that associated with decreased morbidity and hospital stays. There are over two million laparoscopic surgeries performed annually in the US. Several studies have shown that patients with mild (Stage I) to moderate (Stage II) Chronic Obstructive Pulmonary Disease (COPD) develop hypercapnia during laparoscopy procedures. However, hypercapnia in this population did not affect the rate of complication or prolonged hospital stay. We report a case of very severe (Stage IV) COPD, who developed an acute respiratory failure with an increase in hospital stay during a laparoscopic procedure. We write this to bring awareness to …

C-Anca Positive Necrotizing Crescentic Glomerulonephritis With Linear Immunoglobulin Staining, Akshita Mehta

GW Research Days 2015

Necrotizing crescentic glomerulonephritis is found in anti-glomerular basement membrane (GBM) disease (Type 1), immune complex (Type 2) deposition and anti-neutrophil cytoplasmic (ANCA)-related disease (Type 3).

ANCA positive glomerulonephritis is typically characterized on renal biopsy as pauci-immune, with mild or absent glomerular staining for immunoglobulin, or complement staining by immunofluorescence.

Rare cases of concomitant p-ANCA plus linear immunofluorescence pattern staining have been discussed, however none with prior association with c-ANCA.

We report a case of systemic c-ANCA pulmonary-renal syndrome with anti-GBM-disease-typical linear staining on renal biopsy immunofluorescence.

A Rare Case Of Non-Cardiogenic Pulmonary Edema, Talal Alzahrani, Kelly Zhang, Angela Ryan, Yasir Alfi, Jeffrey Zweig

GW Research Days 2015

INTRODUCTION:

Nephrotic syndrome is identified by a significant proteinuria more than 3.5 g/day, hypoalbuminemia less than 3.5 g/dl, and peripheral edema. It associated with risks of thrombosis, infection, and hyperlipidemia due to loss of plasma protein. Several studies have shown patients with nephrotic syndrome do not develop non-cardiogenic pulmonary edema. However, we report a case of nephrotic syndrome caused by diabetic nephropathy and presented with non-cariogenic pulmonary edema.

CASE REPORT:

A 37-year old man with a past medical history of diabetes mellitus, hypertension, dyslipidemia, Charcot foot, who presented with dyspnea, orthopnea, and non-productive cough for two days. He had been …

Medicine + Health, Spring 2015, George Washington University, School Of Medicine And Health Sciences, Office Of Communications And Marketing

Medicine + Health Magazine

No abstract provided.

Ubiquitous L1 Mosaicism In Hippocampal Neurons., Kyle R. Upton, Daniel J. Gerhardt, J. Samuel Jesuadian, Sandra R. Richardson, Francisco J. Sánchez-Luque, Gabriela O. Bodea, Adam D. Ewing, Carmen Salvador-Palomeque, Marjo S. Van Der Knaap, Paul M. Brennan, Adeline Vanderver, Geoffrey J. Faulkner

Neurology Faculty Publications

Somatic LINE-1 (L1) retrotransposition during neurogenesis is a potential source of genotypic variation among neurons. As a neurogenic niche, the hippocampus supports pronounced L1 activity. However, the basal parameters and biological impact of L1-driven mosaicism remain unclear. Here, we performed single-cell retrotransposon capture sequencing (RC-seq) on individual human hippocampal neurons and glia, as well as cortical neurons. An estimated 13.7 somatic L1 insertions occurred per hippocampal neuron and carried the sequence hallmarks of target-primed reverse transcription. Notably, hippocampal neuron L1 insertions were specifically enriched in transcribed neuronal stem cell enhancers and hippocampus genes, increasing their probability of functional relevance. In …

True Durability: Hiv Virologic Suppression In An Urban Clinic And Implications For Timing Of Intensive Adherence Efforts And Viral Load Monitoring., Debra A Benator, Angelo Elmi, Manuel D Rodriguez, Howard B Gale, Virginia L. Kan, Heather J. Hoffman, Susan Tramazzo, Karen Hall, Angela Mcknight, Leah Squires

Medicine Faculty Publications

Although the majority of HIV-infected patients who begin potent antiretroviral therapy should expect long-term virologic suppression, the realities in practice are less certain. Durability of viral suppression was examined to define the best timing of targeted adherence strategies and intensive viral load monitoring in an urban clinic population with multiple challenges to ART adherence. We examined the risk of viral rebound for patients who achieved two consecutive viral loads lower than the lower limit of quantification (LLOQ) within 390 days. For 791 patients with two viral loads below the LLOQ, viral rebound >LLOQ from the first viral load was 36.9 …

The Predictive Value Of Current Haemoglobin Levels For Incident Tuberculosis And/Or Mortality During Long-Term Antiretroviral Therapy In South Africa: A Cohort Study, Andrew D. Kerkhoff, Robin Wood, Frank G. Cobelens, Ankur Gupta-Wright, Linda-Gail Bekker, Stephen D. Lawn

Medicine Faculty Publications

Background

Low haemoglobin concentrations may be predictive of incident tuberculosis (TB) and death in HIV-infected patients receiving antiretroviral therapy (ART), but data are limited and inconsistent. We examined these relationships retrospectively in a long-term South African ART cohort with multiple time-updated haemoglobin measurements.

Methods

Prospectively collected clinical data on patients receiving ART for up to 8 years in a community-based cohort were analysed. Time-updated haemoglobin concentrations, CD4 counts and HIV viral loads were recorded, and TB diagnoses and deaths from all causes were ascertained. Anaemia severity was classified using World Health Organization criteria. TB incidence and mortality rates were calculated …

Annual Report 2014, Forum Staff

National Health Policy Forum

This annual report describes the activities of the Forum during the 2014 calendar year, and provides a snapshot of our audience and resources.

Using Neuroscience To Create A Paradigm Shift In Addiction Treatment And Theory, Tabitha E.H. Moses

Student Works

Drug abuse has long fascinated philosophers and scientists. Many different models have attempted to elucidate the mechanism behind drug addiction and analyze whether an addict has a choice in his behavior. The problem with these models is that they seem to suggest only two ways of viewing addiction. These models suggest either that a person cannot control his addiction and is therefore deserving of treatment, or that suggest a person can control their addictions and is not deserving of treatment, and instead needs threats of punishment to stop their behavior. I believe these approaches are too simplistic and do not …