Demographic Variation In Continuous Glucose Monitoring Utilisation Among Patients With Type 1 Diabetes From A Us Regional Academic Medical Centre: A Retrospective Cohort Study, 2018–2021, Omer Atac, Kory R. Heier, Daniela Moga, John L. Fowlkes, Min-Woong Sohn, Aaron J. Kruse-Diehr, Teresa M. Waters, Mary E. Lacy

Health Management and Policy Faculty Publications

Objective: While continuous glucose monitoring (CGM) utilisation has been increasing among patients with type 1 diabetes (T1D), few studies have examined patterns of use across age, race/ethnicity and insurance status together. In this study, we examine CGM utilisation among patients with T1D from a regional academic medical centre across all insurance types.

Design and Setting: This is a retrospective cohort study including both paediatric and adult patients with T1D who visited a regional academic medical centre between 1 January 2018 and 31 December 2021.

Methods: Patients were followed from the date of their first T1D encounter during the study period …

Plasma S100Β Is A Predictor For Pathology And Cognitive Decline In Alzheimer’S Disease, Geetika Nehra, Bryan J. Maloney, Rebecca Smith, Wijitra Chumboatong, Erin L. Abner, Peter T. Nelson, Björn Bauer, Anika M. S. Hartz

UK CARES Faculty Publications

Background Blood–brain barrier dysfunction is one characteristic of Alzheimer’s disease (AD) and is recognized as both a cause and consequence of the pathological cascade leading to cognitive decline. The goal of this study was to assess markers for barrier dysfunction in postmortem tissue samples from research participants who were either cognitively normal individuals (CNI) or diagnosed with AD at the time of autopsy and determine to what extent these markers are associated with AD neuropathologic changes (ADNC) and cognitive impairment.

Methods We used postmortem brain tissue and plasma samples from 19 participants: 9 CNI and 10 AD dementia patients who …

Artesunate Enhances The Efficacy Of Enzalutamide In Advanced Prostate Cancer, Xinyi Wang, Jinghui Liu, Fengyi Mao, Yifan Kong, Qiongsi Zhang, Chaohao Li, Daheng He, Chi Wang, Yanquan Zhang, Ruixin Wang, Sally R. Ellingson, Qiou Wei, Zhiguo Li, Xiaoqi Liu

Toxicology and Cancer Biology Faculty Publications

Prostate cancer (PCa) is one of the leading causes of death among men worldwide. Treatments targeting the androgen receptor pathway remain the standard therapy for PCa patients. Enzalutamide (ENZ), a second-generation androgen receptor inhibitor, was developed to treat castration-resistant prostate cancer. However, while patients initially respond to ENZ, drug resistance typically develops within a few months. Artesunate (ART), a semisynthetic derivative of the Artemisinin plant, is approved for antimalaria treatment. In this study, we conducted an FDA-approved drug screening and identified ART as a potential candidate for overcoming ENZ resistance in PCa. Mechanistically, ART induces the degradation of c-Myc, enhancing …

Metformin In Overcoming Enzalutamide Resistance In Castration-Resistant Prostate Cancer, Kendall Simpson, Derek B. Allison, Daheng He, Jinpeng Liu, Chi Wang, Xiaoqi Liu

Markey Cancer Center Faculty Publications

Androgen deprivation is the standard treatment for patients with prostate cancer. However, the disease eventually progresses as castration-resistant prostate cancer (CRPC). Enzalutamide, an androgen receptor inhibitor, is a typical drug for treating CRPC and with continuous reliance on the drug, can lead to enzalutamide resistance. This highlights the necessity for developing novel therapeutic targets to combat the gain of resistance. Metformin has been recently investigated for its potential antitumorigenic effects in many cancer types. In this study, we used enzalutamide and metformin in combination to explore the possible rescued efficacy of enzalutamide in the treatment of enzalutamide-resistant CRPC. We first …

Portable Multi-Parametric Microscopy For Noninvasive Metabolic And Vascular Imaging Of Orthotopic Tongue Cancer Models In Vivo, Pranto Soumik Saha, Jing Yan, Caigang Zhu

Markey Cancer Center Faculty Publications

Significance: Precise imaging of tumor metabolism with its vascular microenvironment becomes emerging critical for cancer research because increasing evidence shows that the key attribute that allows a tumor to survive therapies is metabolic and vascular reprogramming. However, there are surprisingly few imaging techniques available to provide a systems-level view of tumor metabolism and vasculature in vivo on small animals for cancer discoveries.

Aim: We aim to develop a new multi-parametric microscope that can faithfully recapitulate in vivo metabolic and vascular changes with a wide field of view and microscope-level resolution to advance cancer-related investigations. To maximize the ease and accessibility …

Dihydropyrimidine Enzyme Activity And Its Effect On Chemotherapy Toxicity: Importance Of Genetic Testing, Alexia Shamaei Zadeh, Danielle Roberts, Abby Williams, Deepali Pandey, John L. Villano

Markey Cancer Center Faculty Publications

Purpose

Patients with partial or complete DPD deficiency have decreased capacity to degrade fluorouracil and are at risk of developing toxicity, which can be even life-threatening.

Case

A 43-year-old man with moderately differentiated rectal adenocarcinoma on capecitabine presented to the emergency department with complaints of nausea, vomiting, diarrhea, weakness, and lower abdominal pain for several days. Laboratory findings include grade 4 neutropenia (ANC 10) and thrombocytopenia (platelets 36,000). Capecitabine is used as a component of first-line adjuvant therapy by approximately 2 million patients worldwide each year. Capecitabine is metabolized to fluorouracil via the enzyme dihydropyrimidine dehydrogenase (DPD). With worsening pancytopenia …

Astrovascular Decoupling In Awake 5×Fad Mice Is Associated With Reduced Astrocytic Calcium, Ruei-Lung Lin, Sophiya L. Sims, Nicholas A. Wright, Léopoldine B. Galopin, Blaine Weiss, Susan D. Kraner, Jacquelyn E. Rhinehart, Ting-Hsuan Lu, Pradoldej Sompol, Christopher M. Norris, Olivier Thibault

Pharmacology and Nutritional Sciences Faculty Publications

INTRODUCTION

Evidence points to dysregulated Ca²⁺ in neurons and astrocytes in models of amyloidosis. While most of these data were obtained in vitro or in vivo under anesthesia, less work has investigated these variables in awake ambulating mice.

METHODS

Astrocytic Ca²⁺ fluctuations (GCaMP8f) were imaged concomitantly with vasoreactivity in S1 on a two-photon microscope during rest and ambulation. Single-cell resolution variables were extracted using continuous wavelet transform and traditional ΔF/F measures.

RESULTS

Along with increases in amyloid beta (Aβ) accumulation, we found significant reductions in measures of astrocyte functional connectivity, pairwise correlations, and network synchronicity in older 5×FAD …

Advancing Clinical Trial Readiness In White Matter Disease And Related Dementias: Key Steps For Future Research Progress, Pradoldej Sompol, Gregory A. Jicha, Jason D. Hinman, Adam M. Brickman, Steven M. Greenberg, Konstantinos Arfanakis, Marion S. Buckwalter, Irene Lorenzo Llorente, Jeff D. Williamson, Michael S. Wolf, Eric E. Smith, Aditi Gupta, Margaret E. Flanagan, Miguel A. Vazquez, Jeffrey M. Burns, S. Thomas Carmichael, Frank C. Barone

Pharmacology and Nutritional Sciences Faculty Publications

White matter disease, a broad-spectrum term that covers various types of white matter lesions and degeneration, is strongly related to age-related neurodegenerative disorders including Alzheimer’s disease (AD), and vascular contributions to cognitive impairment and dementia (VCID) and Alzheimer’s related dementias (ADRD). There is no specific treatment for white matter disease. Therefore, basic research and clinical studies are essential for future outcomes. Since its formation in 2020, the Albert Research Institute for White Matter and Cognition (ARIWMC) mission has been to support white matter research by providing a forum for communication where basic and clinical scientists meet to discuss and debate …

Description Of Implementing A Mail-Based Overdose Education And Naloxone Distribution Program In Community Supervision Settings During Covid-19, Carrie B. Oser, Margaret Louise Mcgladrey, Douglas Oyler, Hannah K. Knudsen, Sharon L. Walsh, Susannah Stitzer, Michael Goetz, Marisa Booty, Erica Hargis, Sarah Johnson, Michele Staton, Patricia R. Freeman

Behavioral Science Faculty Publications

Introduction: This study uses the Exploration, Preparation, Implementation , and Sustainment (EPIS) model to retrospectively describe the mail-based overdose education and naloxone distribution (OEND) program developed in collaboration with the Kentucky Department of Corrections (DOC) for use in the HEALing Communities Study in Kentucky (HCS-KY) and details the reach of this innovative delivery model.

Methods: HCS-KY is a community-engaged cluster-randomized trial assessing the effects of implementing evidence-based practices, including OEND, on overdose death reduction across 16 communities highly impacted by the opioid epidemic in Kentucky. ⁶ The study launch coincided with the COVID-19 pandemic. All coalitions in the 16 HCS-KY …

A Knowledge-Based Planning Model To Identify Fraction-Reduction Opportunities In Brain Stereotactic Radiotherapy, Shane Mccarthy, William St. Clair, Damodar Pokhrel

Radiation Medicine Faculty Publications

Objective: To develop and validate a HyperArc-based RapidPlan (HARP) model for three-fraction brain stereotactic radiotherapy (SRT) plans to then use to replan previously treated five-fraction SRT plans. Demonstrating the possibility of reducing the number of fractions while achieving acceptable organs-at-risk (OAR) doses with improved target biological effective dose (BED) to brain lesions. Methods: Thirty-nine high-quality clinical three-fraction HyperArc brain SRT plans (24–27 Gy) were used to train the HARP model, with a separate 10 plans used to validate its effectiveness. Fifty-eight five-fraction HyperArc brain SRT plans (30–40 Gy) attempted to be retrospectively replanned for three fractions scheme using the HARP …

An Investigation Into The Feasibility And Efficacy Of Stereotactic Radiosurgery For 1–3 Cm Single Brain Lesions On The Ring-Mounted Halcyon Linac, Kristin J. Hazelwood, Shane Mccarthy, Josh Misa, David Castelvetere, William St. Clair, Damodar Pokhrel

Radiation Medicine Faculty Publications

Purpose: An evaluation of the accuracy, safety, and efficiency of the Halcyon ring delivery system (RDS) for stereotactic radiosurgery (SRS) treatment to relatively small (1–3 cm) brain lesions.

Methods: After completing the extensive in-house quality assurance checks including Winston–Lutz test and independent dose verification via MD Anderson IROC SRS head phantom irradiation on Halcyon, fifteen brain SRS patients previously treated with a single dose of 20 Gy on TrueBeam (6MV-FFF) with HyperArc geometry were retrospectively replanned on Halcyon (6MV-FFF). Plan quality metrics including conformity index (CI), gradient index (GI), gradient distance (GD), PTV coverage, gross tumor volume (GTV) dose, heterogeneity …

A Predictive Quality Assurance Model For Patient-Specific Gamma Passing Rate Of Hyperarc-Based Stereotactic Radiotherapy And Radiosurgery Of Brain Metastases, Shane Mccarthy, Brent Harrison, Damodar Pokhrel

Radiation Medicine Faculty Publications

Objective: Measurement-based patient specific quality assurance (PSQA) is an increasingly debated topic among medical physicists. Developments like online adaptive radiotherapy and same-day stereotactic treatments limit the time to do measurement-based PSQA. Herein, we develop a predictive machine learning model to supplement PSQA by predicting the gamma passing rate (GPR) per stereotactic arc. This streamlines PSQA, providing planners the insight to replan potentially sub-optimal plans, to mitigate machine time inefficiencies.

Methods: 122 patients that had previously received HyperArc stereotactic radiosurgery/radiotherapy on a TrueBeam LINAC (Millenium 120 MLCs, 6MV-FFF) were used to generate a long short-term memory (LSTM) recurrent neural network to …

Automated Hippocampal Sparing Whole Brain Radiotherapy With Simultaneous Integrated Boost For Multiple Brain Metastases: Halcyon, Hyperarc On Truebeam, And Coplanar Truebeam, Shane Mccarthy, Ryan Clark, Anthony Magliari, William St. Clair, Damodar Pokhrel

Radiation Medicine Faculty Publications

Purpose: To demonstrate the ease and feasibility that hippocampal sparing whole brain (WB) simultaneous integrated boost (HSWB-SIB) plans can be generated using knowledge-based planning and Eclipse Scripting Application Programming Interface (ESAPI) for three different modalities, HyperArc on TrueBeam (TB-HA), a coplanar beam arrangement on TrueBeam (TB-Co), and the ring-mounted Halcyon LINAC (Hal).

Methods: Twelve patients with 2–14 brain metastases were retrospectively replanned for HSWB-SIB using a published HSWB RapidPlan model with modifications for the automated addition of SIB to metastases. Prescribed dose was 30 Gy to the WB planning target volume (PTV) and 50 Gy to the metastases in 10 …

Feasibility Of Treatment Planning With Hyperarc Stereotactic Radiosurgery Methods For Ocular Tumors, Chase Cochran, Shane Mccarthy, William St. Clair, Damodar Pokhrel

Radiation Medicine Faculty Publications

Purpose/objectives

Currently, ocular disease is primarily managed with COMS plaque brachytherapy. Various stereotactic radiosurgery (SRS) platforms have also been employed, yet widespread access remains a challenge. Herein, we demonstrate the feasibility of using the HyperArc SRS system to provide an additional platform for the treatment of ocular malignancies.

Materials/methods

Twenty previously treated COMS patients with ocular melanoma were selected for a retrospective HyperArc SRS planning study. The average gross tumor volume (GTV) derived from MRI was 1.19 ± 0.60 cc. Planning target volumes (PTV) were generated from a 2 mm expansion of the GTVs. HyperArc plans were created for a …

Establishing A Variant Allele Frequency Cutoff For Manual Curation Of Medical Exome Sequencing Data, Kate Sears, Caylin Hickey, Ryan Vincent, Jennifer Stocks-Candelaria, Jason Tate, Cody Bumgardner, Shulin Zhang, Justin B. Miller

Pathology and Laboratory Medicine Faculty Publications

Medical exome sequencing pipelines consist of various preprocessing steps to prioritize credible causal variants before a pathologist or variant curation scientist manually interprets potential findings that are then reported to patients. The variant allele frequency (VAF), reported as the fraction of sequencing reads supporting a variant call, can be used to screen for technical artifacts, yet a specific filtering threshold has yet to be established. A total of 13,122 manually curated variants, sequenced from 289 patients using the Agilent SureSelect Focused Exome enrichment kit at the University of Kentucky Clinical Genomics laboratory from October 2019 to May 2023, were evaluated. …

Converting “Nonlesional” Imaging Occult Epilepsy Into A Focal Lesional Entity Using Advanced Imaging Techniques: Illustrative Case, Muhammad Usman Khalid, Flavius D. Raslau, Valentinos Zachariou, David Powell, Zachary Winder, Ryan Cloyd, Sarah Helen Thomas, John Kuipers, Rachel Ward Mitchell, Riham H. El Khouli, Timothy J. Ainger, Sally Mathias, Farhan A. Mirza

Neurosurgery Faculty Publications

BACKGROUND To achieve the best possible outcome in surgical refractory epilepsy, the seizure onset zone must be accurately identified prior to treatment.

OBSERVATIONS A 38-year-old man presented with tonic-clonic and focal seizures 2–3 times per month, refractory to antiseizure medications. Scalp EEG, MRI, PET, ictal SPECT, magnetoencephalography, and stereo-EEG (SEEG) did not provide conclusive seizure onset zone localization. Subsequently, the patient was included in the authors’ ongoing postictal arterial spin labeling (ASL) study and additional postprocessing was performed with a morphometric analysis program (MAP) and texture analysis. Using these results, the authors reexamined the original structural MR images, with attention …

New Insights Into The Ovulatory Process In The Human Ovary, Misung Jo, Mats Brännström, James W. Akins, Thomas E. Curry

UK CARES Faculty Publications

BACKGROUND: Successful ovulation is essential for natural conception and fertility. Defects in the ovulatory process are associated with various conditions of infertility or subfertility in women. However, our understanding of the intra-ovarian biochemical mechanisms underlying this process in women has lagged compared to our understanding of animal models. This has been largely due to the limited availability of human ovarian samples that can be used to examine changes across the ovulatory period and delineate the underlying cellular/molecular mechanisms in women. Despite this challenge, steady progress has been made to improve our knowledge of the ovulatory process in women by: (i) …

Clinicians Perspective On The Implementation Of Person-Centered Care In Persons With Aphasia, Carmen S. Alderman

Theses and Dissertations--Communication Sciences and Disorders

This paper examines speech-language pathologist perspective on implementing person-centered care for persons with aphasia. Person-centered care is based on the social model, which emphasizes the importance of including the client. The survey addressed clinicians’ use of person-centered care related to collaborative goal setting and treatment planning, as well as facilitators and barriers to implementing person-centered care for individuals with aphasia based on the view of practicing clinicians across a variety of settings. The results indicated most speech-language pathologists have heard of person-centered care, understand the importance of involving clients in goal setting, ask clients about their preferences when setting goals, …

Biomedical Relation Extraction In The Era Of (Large) Language Models, Yuhang Jiang

Theses and Dissertations--Computer Science

Biomedical relation extraction is a key task in information extraction supporting downstream applications such as knowledge discovery, information retrieval, and question answering. As such, improvements in relation extraction (RE) are expected to have major implications for other information needs in biomedicine. In this dis- sertation, we pursue biomedical relation extraction in several advanced settings with recent advances in large language models (LLMs) and retrieval augmented generation (RAG). First, we address an important slot filling task on social media that arose during the Covid-19 pandemic, using the idea of continuous prompts with encoder models. Next, we handle a tricky dynamic n-ary …

Efficacy Of Deferoxamine Mesylate In Serum And Serum-Free Media: Adult Ventral Root Schwann Cell Survival Following Hydrogen Peroxide-Induced Cell Death, Yee Hang Ethan Ma, Abhinay R. Putta, Cyrus H. H. Chan, Stephen R. Vidman, Paula V. Monje, Giles W. Plant

Neurosurgery Faculty Publications

Schwann cell (SC) transplantation shows promise in treating spinal cord injury as a pro-regenerative agent to allow host endogenous neurons to bridge over the lesion. However, SC transplants face significant oxidative stress facilitated by ROS in the lesion, leading to poor survival. deferoxamine mesylate (DFO) is a neuroprotective agent shown to reduce H₂O₂-induced cell death in serum-containing conditions. Here we show that DFO is not necessary to induce neuroprotection under serum-free conditions by cell survival quantification and phenotypic analysis via immunohistochemistry, Hif1α and collagen IV quantification via whole cell corrected total cell fluorescence, and cell death …

Injection-Related Infections And Self-Treatment Practices Among People Who Inject Drugs In Rural Appalachia, Laura C. Fanucchi, Jennifer R. Havens, Matthew Fahmy, April M. Young

Center on Drug and Alcohol Research Faculty Publications

In this study of self-reported serious injection-related infections among people who inject drugs in rural Appalachia (n = 463), 50% reported reusing syringes/needles, 70.6% ever had an injection-site abscess, and 44.4% of those with a recent abscess took nonprescribed antibiotics. The study identifies opportunities to improve harm reduction services.

Folliculin (Flcn) In Thyroid Tumors: Incidence, Significance, And Role As A Driver Gene And Secondary Alteration, Faisal Hassan, Camryn Slone, Robert J. Mcdonald, Julie C. Dueber, Adeel M. Ashraf, Melina Windon, Oliver J. Fackelmayer, Cortney Y. Lee, Therese J. Bocklage, Derek B. Allison

Pathology and Laboratory Medicine Faculty Publications

Thyroid carcinomas are driven by diverse molecular alterations, but the tumor suppressor gene folliculin (FLCN), best known for its role in Birt–Hogg–Dubé (BHD) syndrome, has received limited attention in thyroid tumors. Here, we describe two thyroid tumors with pathogenic FLCN alterations—one germline and one somatic—and analyze the broader prevalence and significance of FLCN in thyroid carcinomas using multiple large sequencing datasets, including ORIEN-AVATAR. Patient 1, with a germline FLCN mutation and a history of BHD syndrome, presented with a well-circumscribed oncocytic adenoma. Molecular testing confirmed biallelic FLCN inactivation, but no additional mutations or aggressive features were observed, and the patient …

Characterizing And Targeting The Non-Catalytic Functions Of Phosphatase Of Regenerating Liver 3 (Prl-3) In Oncogenesis And Cancer Progression, Jeffery T. Jolly

Theses and Dissertations--Molecular and Cellular Biochemistry

Phosphatase of Regenerating Liver 3 (PRL-3) is frequently upregulated in various cancers and is associated with poor patient prognosis. Although traditionally studied for its phosphatase activity, PRL-3 also interacts with the CNNM family of magnesium transporters through its catalytic site, and these two functions are mutually exclusive at any given time. Most previous studies relied on a commonly used PRL-3 mutation that disrupts both phosphatase activity and CNNM binding, making it challenging to determine which function drives its oncogenic effects. To address this gap in the field, I utilized a panel of PRL-3 mutants that selectively disrupt either phosphatase activity …

Alzheimer’S Disease And The Immune System: The Emerging Role Of Temra Cells, Edric D. Winford, Adam D. Bachstetter

Neuroscience Faculty Publications

No abstract provided.

The Impact Of A Geriatric Trauma Unit On Patient Outcomes, Shannon E. Johnson

DNP Projects

Abstract

Background: Traumatic injuries in the geriatric (> 65) patient population can have devastating effects. Only a small percentage of these patients return to independent ambulation and living. As the population continues to age and life expectancy continues to increase, the incidence of traumatic injuries in geriatric patients will continue to increase. Geriatric friendly hospital wards in several disciplines have been shown to reduce length of stay and improve patient outcomes. However, there has been no research surrounding geriatric trauma wards specifically.

Purpose: The purpose of this quality improvement project was to evaluate the impact of admitting geriatric trauma patients …

Complete High Thoracic Spinal Cord Injury Causes Bowel Dysfunction In Mice, Olivia Wireman, Ellie L. Sams, Lynnet E. Richey, Gabrielle V. Hammers, Andrew N. Stewart, William M. Bailey, Samir P. Patel, John C. Gensel

Spinal Cord and Brain Injury Research Center Faculty Publications

Bowel dysfunction, is a prevalent and life-impacting comorbidity of spinal cord injury (SCI) with no long-term treatment available. SCI-induced colon changes including motility and fibrosis are understudied as are strategies to address SCI bowel dysfunction. This need remains partly due to the lack of a mouse model that recapitulates the human condition. We hypothesized that a high thoracic spinal transection in mice would trigger bowel dysfunction with coincident colon pathology similar to humans and rats after SCI. We observed bowel dysfunction as increased fecal pellet numbers within the colon, smaller pellet size, and decreased motility. Fecal pellets numbers in the …

Third Party Negotiated Hospital Pricing In Rural And Urban Hospitals Within 12 U.S. States, Lindsey R. Hammerslag, Aaron P. Smith, Jeffrey C. Talbert

Rural & Underserved Health Research Center Publications

No abstract provided.

Trace Level Identifications Of N-Ethylnicotinamide In Racing Horses Associated With A Vitamin B3 Supplement: Case Reports And Analysis, Clara Fenger, Kimberly Brewer, Abelardo Morales-Briceño, Andreas F. Lehner, George A. Maylin, Robert Holland, Levent Dirikolu, Thomas Tobin

Maxwell H. Gluck Equine Research Center Faculty Publications

Nikethamide, N,N-diethyl-3-pyridinecarboxamide (Coramine®) is a central nervous system stimulant at one time used therapeutically in human medicine but no longer marketed in the US. Nikethamide is classified a Drug Class 1, Penalty Class A substance by the Association of Racing Commissioners International (ARCI) and as a Horseracing Integrity and Safety Authority (HISA) SO or banned Stimulant that lacks FDA approval. Identifications of Nikethamide or its metabolite N-Ethylnicotinamide in racing samples can result in significant penalties in horse racing. Nikethamide is rapidly metabolized to N-Ethylnicotinamide, which remains detectable in plasma and urine leading to its use as a regulatory “marker” of …

Defining An Irrelevant Plasma Concentration For Trichlormethiazide In Racing Horses – A Case Report And Analysis, Kimberly Brewer, Justin C. Holmes, Clara Fenger, Abelardo Morales-Briceño, Andreas F. Lehner, George A. Maylin, Robert Holland, Levent Dirikolu, Thomas Tobin

Maxwell H. Gluck Equine Research Center Faculty Publications

This communication reviews the matter of the clinical, pharmacological, and regulatory significance of a 4.95 nanogram/ml identification of trichlormethiazide in urine from a horse six days after administration of a compounded trichlormethiazide/ dexamethasone preparation. This combination of dexamethasone and trichlormethiazide has historically been widely used in bovine and equine medicine to reduce local inflammation and edema. The horse was administered an oral formulation of trichlormethiazide 400 mg /dexamethasone 10 mg per packet under veterinary supervision on days 7 and 6 before the race in question. Following the race, the post-race urine sample from the horse tested “positive” for trichlormethiazide at …

Trace Level Identifications Of N-Ethylnicotinamide In Racing Horses Associated With A Vitamin B3 Supplement: Case Reports And Analysis, Clara Fenger, Kimberly Brewer, Abelardo Morales-Briceño, Andreas F. Lehner, George A. Maylin, Robert Holland, Levent Dirikolu, Thomas Tobin

Maxwell H. Gluck Equine Research Center Faculty Publications

Nikethamide, N,N-diethyl-3-pyridinecarboxamide (Coramine®) is a central nervous system stimulant at one time used therapeutically in human medicine but no longer marketed in the US. Nikethamide is classified a Drug Class 1, Penalty Class A substance by the Association of Racing Commissioners International (ARCI) and as a Horseracing Integrity and Safety Authority (HISA) SO or banned Stimulant that lacks FDA approval. Identifications of Nikethamide or its metabolite N-Ethylnicotinamide in racing samples can result in significant penalties in horse racing. Nikethamide is rapidly metabolized to N-Ethylnicotinamide, which remains detectable in plasma and urine leading to its use as a regulatory “marker” of …