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Full-Text Articles in Medicine and Health Sciences

Preliminary Development Of A Questionnaire Measuring Patient Views Of Participation In Clinical Trials, Judith Arnetz, Sukhesh Sudan, Courtney Goetz, Bengt Arnetz, Laura Gowland, Suzanne Manji, Samiran Ghosh Oct 2019

Preliminary Development Of A Questionnaire Measuring Patient Views Of Participation In Clinical Trials, Judith Arnetz, Sukhesh Sudan, Courtney Goetz, Bengt Arnetz, Laura Gowland, Suzanne Manji, Samiran Ghosh

Faculty, Staff and Student Publications

OBJECTIVE: This study aimed to develop a questionnaire for measuring patient perceptions of participating in clinical trials. Development was based on earlier research on patient views of involvement in medical care and a literature review. Patients were recruited from an ongoing clinical trial focused on cardiovascular illness and from an outpatient psychiatry department. Factor analysis was conducted on a pilot version of the questionnaire in 2016 and on a revised version in 2017.

RESULTS: A total of 53 patients were recruited for the pilot study and 55 were recruited for the main study, substantially below the goal of 100 participants. …


Tinnitus And Self-Perceived Hearing Handicap In Firefighters: A Cross-Sectional Study, Samson Jamesdaniel, Kareem G Elhage, Rita Rosati, Samiran Ghosh, Bengt Arnetz, James Blessman Oct 2019

Tinnitus And Self-Perceived Hearing Handicap In Firefighters: A Cross-Sectional Study, Samson Jamesdaniel, Kareem G Elhage, Rita Rosati, Samiran Ghosh, Bengt Arnetz, James Blessman

Faculty, Staff and Student Publications

Firefighters are susceptible to auditory dysfunction due to long-term exposure to noise from sirens, air horns, equipment, and tools used in forcible entry, ventilation, and extrication. In addition, they are exposed to ototoxic chemicals, particularly, during overhaul operations. Studies indicate that 40% of firefighters have hearing loss in the noise-sensitive frequencies of 4 and 6 kHz. Noise-induced hearing loss (NIHL) is often accompanied by tinnitus, which is characterized by ringing noise in the ears. The presence of phantom sounds can adversely affect the performance of firefighters. However, there has been limited research conducted on the prevalence of tinnitus in firefighters. …


Energy Balance Related Lifestyle Factors And Risk Of Endometrial And Colorectal Cancer Among Individuals With Lynch Syndrome: A Systematic Review, Adriana M Coletta, Susan K Peterson, Leticia A Gatus, Kate J Krause, Susan M Schembre, Susan C Gilchrist, Mala Pande, Eduardo Vilar, Y Nancy You, Miguel A Rodriguez-Bigas, Larkin L Strong, Patrick M Lynch, Karen H Lu, Karen Basen-Engquist Oct 2019

Energy Balance Related Lifestyle Factors And Risk Of Endometrial And Colorectal Cancer Among Individuals With Lynch Syndrome: A Systematic Review, Adriana M Coletta, Susan K Peterson, Leticia A Gatus, Kate J Krause, Susan M Schembre, Susan C Gilchrist, Mala Pande, Eduardo Vilar, Y Nancy You, Miguel A Rodriguez-Bigas, Larkin L Strong, Patrick M Lynch, Karen H Lu, Karen Basen-Engquist

Faculty, Staff and Student Publications

Lifestyle factors related to energy balance, such as excess body weight, poor diet, and physical inactivity, are associated with risk of sporadic endometrial cancer (EC) and colorectal cancer (CRC). There are limited data on energy balance-related lifestyle factors and EC or CRC risk among individuals with lynch syndrome, who are at extraordinarily higher risk of developing EC or CRC. We conducted a systematic review of evidence related to weight status, weight change, dietary habits, and physical activity on EC and CRC risk among individuals with lynch syndrome. Findings are reported narratively. We searched Medline, EMBASE, CENTRAL, PubMed, and clinicaltrials.gov up …


Temperature, Placental Abruption And Stillbirth, Amal Rammah, Kristina W Whitworth, Inkyu Han, Wenyaw Chan, Judy Wendt Hess, Elaine Symanski Oct 2019

Temperature, Placental Abruption And Stillbirth, Amal Rammah, Kristina W Whitworth, Inkyu Han, Wenyaw Chan, Judy Wendt Hess, Elaine Symanski

Faculty, Staff and Student Publications

BACKGROUND: Pregnant women may be vulnerable to changes in ambient temperature and warming climates. Recent evidence suggests that temperature increases are associated with placental abruption, a risk factor for stillbirth.

OBJECTIVES: We investigated the effect of acute exposures to apparent temperature on stillbirths in Harris County, Texas, 2008-2013.

METHODS: We conducted a case-crossover study to investigate the association between temperature and stillbirth among 708 women. We used data from the National Climatic Data Center to estimate maternal exposure to daily average apparent temperature over the days (lag days 1 through 6) preceding the stillbirth event. We employed symmetric bidirectional sampling …


Adolescent Dating Violence Prevention Program For Early Adolescents: The Me & You Randomized Controlled Trial, 2014-2015, Melissa F Peskin, Christine M Markham, Ross Shegog, Elizabeth R Baumler, Robert C Addy, Jeff R Temple, Belinda Hernandez, Paula M Cuccaro, Melanie A Thiel, Efrat K Gabay, Susan R Tortolero Emery Oct 2019

Adolescent Dating Violence Prevention Program For Early Adolescents: The Me & You Randomized Controlled Trial, 2014-2015, Melissa F Peskin, Christine M Markham, Ross Shegog, Elizabeth R Baumler, Robert C Addy, Jeff R Temple, Belinda Hernandez, Paula M Cuccaro, Melanie A Thiel, Efrat K Gabay, Susan R Tortolero Emery

Faculty, Staff and Student Publications

Objectives. To test the efficacy of Me & You, a multilevel technology-enhanced adolescent dating violence (DV) intervention, in reducing DV perpetration and victimization among ethnic-minority early adolescent youths. We assessed secondary impact for specific DV types and psychosocial outcomes.

Methods. We conducted a group-randomized controlled trial of 10 middle schools from a large urban school district in Southeast Texas in 2014 to 2015. We used multilevel regression modeling; the final analytic sample comprised 709 sixth-grade students followed for 1 year.

Results. Among the total sample, odds of DV perpetration were lower among intervention students than among control students (adjusted odds …


Oral Delivery Of Xenon For Cardiovascular Protection, Xing Yin, Melanie R Moody, Valeria Hebert, Melvin E Klegerman, Yong-Jian Geng, Tammy R Dugas, David D Mcpherson, Hyunggun Kim, Shao-Ling Huang Oct 2019

Oral Delivery Of Xenon For Cardiovascular Protection, Xing Yin, Melanie R Moody, Valeria Hebert, Melvin E Klegerman, Yong-Jian Geng, Tammy R Dugas, David D Mcpherson, Hyunggun Kim, Shao-Ling Huang

Faculty, Staff and Student Publications

Cardiac hypertrophy often causes impairment of cardiac function. Xenon (Xe), a naturally occurring noble gas, is known to provide neurological and myocardial protection without side effects. The conventional method of Xe delivery by inhalation is not feasible on a chronic basis. We have developed an orally deliverable, effective Xe formulation for long-term administration. We employed 2-hydroxypropyl)-β-cyclodextrin (HPCD), which was dissolved in water to increase the Xe concentration in solution. The beneficial effects of long-term oral administration of Xe-enriched solutions on cardiovascular function were evaluated in vivo. HPCD increased Xe solubility from 0.22 mM to 0.67 mM (3.8-fold). Aged ApoE knockout …


Unexpected Diagnosis, Gauravpal S Gill, Rukma R Govindu, Ragai Fouda, Hussam M Ammar Sep 2019

Unexpected Diagnosis, Gauravpal S Gill, Rukma R Govindu, Ragai Fouda, Hussam M Ammar

Faculty, Staff and Student Publications

A 74-year-old man presented to the ER with an eight-month history of shortness of breath, cough, anorexia, and weight loss. He had emigrated from sub-Saharan African to the USA, where he was diagnosed and treated for coronary artery disease, heart failure, and stroke; was hospitalized several times; and underwent hernia surgery. Despite the complex care that he received in the USA for many years, the diagnosis of AIDS was continually missed for years, and the patient was eventually diagnosed at the age of 74.


Improving The Youth Hiv Prevention And Care Cascades: Innovative Designs In The Adolescent Trials Network For Hiv/Aids Interventions, Sylvie Naar, Michael G Hudgens, Ron Brookmeyer, April Idalski Carcone, Jason Chapman, Shrabanti Chowdhury, Andrea Ciaranello, W Scott Comulada, Samiran Ghosh, Keith J Horvath, Ladrea Ingram, Sara Legrand, Cathy J Reback, Kit Simpson, Bonita Stanton, Tyrel Starks, Dallas Swendeman Sep 2019

Improving The Youth Hiv Prevention And Care Cascades: Innovative Designs In The Adolescent Trials Network For Hiv/Aids Interventions, Sylvie Naar, Michael G Hudgens, Ron Brookmeyer, April Idalski Carcone, Jason Chapman, Shrabanti Chowdhury, Andrea Ciaranello, W Scott Comulada, Samiran Ghosh, Keith J Horvath, Ladrea Ingram, Sara Legrand, Cathy J Reback, Kit Simpson, Bonita Stanton, Tyrel Starks, Dallas Swendeman

Faculty, Staff and Student Publications

Dramatic decreases in HIV transmission are achievable with currently available biomedical and behavioral interventions, including antiretroviral therapy and pre-exposure prophylaxis. However, such decreases have not yet been realized among adolescents and young adults. The Adolescent Medicine Trials Network (ATN) for HIV/AIDS interventions is dedicated to research addressing the needs of youth at high risk for HIV acquisition as well as youth living with HIV. This article provides an overview of an array of efficient and effective designs across the translational spectrum that are utilized within the ATN. These designs maximize methodological rigor and real-world applicability of findings while minimizing resource …


Unraveling The Functional Role Of The Orphan Solute Carrier, Slc22a24 In The Transport Of Steroid Conjugates Through Metabolomic And Genome-Wide Association Studies, Sook Wah Yee, Adrian Stecula, Huan-Chieh Chien, Ling Zou, Elena V Feofanova, Marjolein Van Borselen, Kit Wun Kathy Cheung, Noha A Yousri, Karsten Suhre, Jason M Kinchen, Eric Boerwinkle, Roshanak Irannejad, Bing Yu, Kathleen M Giacomini Sep 2019

Unraveling The Functional Role Of The Orphan Solute Carrier, Slc22a24 In The Transport Of Steroid Conjugates Through Metabolomic And Genome-Wide Association Studies, Sook Wah Yee, Adrian Stecula, Huan-Chieh Chien, Ling Zou, Elena V Feofanova, Marjolein Van Borselen, Kit Wun Kathy Cheung, Noha A Yousri, Karsten Suhre, Jason M Kinchen, Eric Boerwinkle, Roshanak Irannejad, Bing Yu, Kathleen M Giacomini

Faculty, Staff and Student Publications

Variation in steroid hormone levels has wide implications for health and disease. The genes encoding the proteins involved in steroid disposition represent key determinants of interindividual variation in steroid levels and ultimately, their effects. Beginning with metabolomic data from genome-wide association studies (GWAS), we observed that genetic variants in the orphan transporter, SLC22A24 were significantly associated with levels of androsterone glucuronide and etiocholanolone glucuronide (sentinel SNPs p-value


Pm25 Metal Constituent Exposure And Stillbirth Risk In Harris County, Texas, Amal Rammah, Kristina W Whitworth, Inkyu Han, Wenyaw Chan, Elaine Symanski Sep 2019

Pm25 Metal Constituent Exposure And Stillbirth Risk In Harris County, Texas, Amal Rammah, Kristina W Whitworth, Inkyu Han, Wenyaw Chan, Elaine Symanski

Faculty, Staff and Student Publications

There is limited evidence on the role of exposure to chemical constituents of fine particulate matter (PM


Infant With Protein C Deficiency And Stroke In The Setting Of Iron Deficiency Anemia, Tahseen Jalal Karim, Dustin J Paul, Regina M Troxell, Rajan Patel, Ian J Butler Sep 2019

Infant With Protein C Deficiency And Stroke In The Setting Of Iron Deficiency Anemia, Tahseen Jalal Karim, Dustin J Paul, Regina M Troxell, Rajan Patel, Ian J Butler

Faculty, Staff and Student Publications

We report an 18-month-old infant with ischemic stroke, neurocognitive impairment, and psychomotor retardation in the setting of severe iron deficiency anemia. Although an uncommon outcome in anemic children, stroke is important to consider as a cause for developmental delay in children with iron deficiency anemia.


Epstein-Barr Virus-Positive Large Cell Neuroendocrine Carcinoma Of The Nasopharynx: Report Of One Case And Review Of The Literature, Zhenjian Cai, Mei Lin, Angel I Blanco, Jing Liu, Hui Zhu Sep 2019

Epstein-Barr Virus-Positive Large Cell Neuroendocrine Carcinoma Of The Nasopharynx: Report Of One Case And Review Of The Literature, Zhenjian Cai, Mei Lin, Angel I Blanco, Jing Liu, Hui Zhu

Faculty, Staff and Student Publications

Epstein-Barr Virus (EBV)-positive neuroendocrine carcinoma (NEC) of the nasopharynx is exceedingly rare, only two cases have been reported in the literature. While EBV infection is strongly associated with nasopharyngeal carcinoma, which is carcinoma with squamous differentiation, the link between EBV and NEC is not well known, and can be diagnostically challenging. In this study, we report the third case of EBV-positive large cell NEC of nasopharynx with neck lymph node metastasis. The patient was treated with combined radiation and chemotherapy and showed complete clinical and radiological response. Similar treatment response has been reported in another patient with high stage EBV-positive …


Vitamin D Status And Risk Of Incident Tuberculosis Disease: A Nested Case-Control Study, Systematic Review, And Individual-Participant Data Meta-Analysis, Omowunmi Aibana, Chuan-Chin Huang, Said Aboud, Alberto Arnedo-Pena, Mercedes C Becerra, Juan Bautista Bellido-Blasco, Ramesh Bhosale, Roger Calderon, Silvia Chiang, Carmen Contreras, Ganmaa Davaasambuu, Wafaie W Fawzi, Molly F Franke, Jerome T Galea, Daniel Garcia-Ferrer, Maria Gil-Fortuño, Barbará Gomila-Sard, Amita Gupta, Nikhil Gupte, Rabia Hussain, Jesus Iborra-Millet, Najeeha T Iqbal, Jose Vicente Juan-Cerdán, Aarti Kinikar, Leonid Lecca, Vidya Mave, Noemi Meseguer-Ferrer, Grace Montepiedra, Ferdinand M Mugusi, Olumuyiwa A Owolabi, Julie Parsonnet, Freddy Roach-Poblete, Maria Angeles Romeu-García, Stephen A Spector, Christopher R Sudfeld, Mark W Tenforde, Toyin O Togun, Rosa Yataco, Zibiao Zhang, Megan B Murray Sep 2019

Vitamin D Status And Risk Of Incident Tuberculosis Disease: A Nested Case-Control Study, Systematic Review, And Individual-Participant Data Meta-Analysis, Omowunmi Aibana, Chuan-Chin Huang, Said Aboud, Alberto Arnedo-Pena, Mercedes C Becerra, Juan Bautista Bellido-Blasco, Ramesh Bhosale, Roger Calderon, Silvia Chiang, Carmen Contreras, Ganmaa Davaasambuu, Wafaie W Fawzi, Molly F Franke, Jerome T Galea, Daniel Garcia-Ferrer, Maria Gil-Fortuño, Barbará Gomila-Sard, Amita Gupta, Nikhil Gupte, Rabia Hussain, Jesus Iborra-Millet, Najeeha T Iqbal, Jose Vicente Juan-Cerdán, Aarti Kinikar, Leonid Lecca, Vidya Mave, Noemi Meseguer-Ferrer, Grace Montepiedra, Ferdinand M Mugusi, Olumuyiwa A Owolabi, Julie Parsonnet, Freddy Roach-Poblete, Maria Angeles Romeu-García, Stephen A Spector, Christopher R Sudfeld, Mark W Tenforde, Toyin O Togun, Rosa Yataco, Zibiao Zhang, Megan B Murray

Faculty, Staff and Student Publications

BACKGROUND: Few studies have evaluated the association between preexisting vitamin D deficiency and incident tuberculosis (TB). We assessed the impact of baseline vitamins D levels on TB disease risk.

METHODS AND FINDINGS: We assessed the association between baseline vitamin D and incident TB in a prospective cohort of 6,751 HIV-negative household contacts of TB patients enrolled between September 1, 2009, and August 29, 2012, in Lima, Peru. We screened for TB disease at 2, 6, and 12 months after enrollment. We defined cases as household contacts who developed TB disease at least 15 days after enrollment of the index patient. …


Nuclear Receptor Subfamily 4 Group A Member 2 Inhibits Activation Of Erk Signaling And Cell Growth In Response To Β-Adrenergic Stimulation In Adult Rat Cardiomyocytes, Sadia Ashraf, Yassmin K Hegazy, Romain Harmancey Sep 2019

Nuclear Receptor Subfamily 4 Group A Member 2 Inhibits Activation Of Erk Signaling And Cell Growth In Response To Β-Adrenergic Stimulation In Adult Rat Cardiomyocytes, Sadia Ashraf, Yassmin K Hegazy, Romain Harmancey

Faculty, Staff and Student Publications

Sustained elevation of sympathetic activity is an important contributor to pathological cardiac hypertrophy, ventricular arrhythmias, and left ventricular contractile dysfunction in chronic heart failure. The orphan nuclear receptor NR4A2 is an immediate early-response gene activated in the heart under β-adrenergic stimulation. The goal of this study was to identify the transcriptional remodeling events induced by increased NR4A2 expression in cardiomyocytes and their impact on the physiological response of those cells to sustained β-adrenergic stimulation. Treatment of adult rat ventricular myocytes with isoproterenol induced a rapid (<4 >h) increase in NR4A2 levels that was accompanied by a transient (<24 >h) increase …


Indications For Lung Transplant Referral And Listing, Omar Shweish, Goutham Dronavalli Sep 2019

Indications For Lung Transplant Referral And Listing, Omar Shweish, Goutham Dronavalli

Faculty, Staff and Student Publications

Lung transplantation is a valuable therapeutic option for many patients with severe lung disease who have exhausted other medical or surgical therapies. However, since lungs are not a manufacturable organ like artificial heart valves or left ventricular assist devices, and since they are a limited resource compared to number of patients requiring the organs, the Department of Health and Human Services set the Final Rule of organ allocation in 1998. This led to development and implementation of Lung Allocation Score (LAS) in 2005. The score broadly divides lung diseases into 4 diagnostic criteria with a coefficient factor given to each …


Low-Cost, High-Resolution Imaging For Detecting Cervical Precancer In Medically-Underserved Areas Of Texas, Sonia G Parra, Ana M Rodriguez, Katelin D Cherry, Richard A Schwarz, Rose M Gowen, Laura B Guerra, Andrea M Milbourne, Paul A Toscano, Susan P Fisher-Hoch, Kathleen M Schmeler, Rebecca R Richards-Kortum Sep 2019

Low-Cost, High-Resolution Imaging For Detecting Cervical Precancer In Medically-Underserved Areas Of Texas, Sonia G Parra, Ana M Rodriguez, Katelin D Cherry, Richard A Schwarz, Rose M Gowen, Laura B Guerra, Andrea M Milbourne, Paul A Toscano, Susan P Fisher-Hoch, Kathleen M Schmeler, Rebecca R Richards-Kortum

Faculty, Staff and Student Publications

OBJECTIVE: Cervical cancer rates in the United States have declined since the 1940's, however, cervical cancer incidence remains elevated in medically-underserved areas, especially in the Rio Grande Valley (RGV) along the Texas-Mexico border. High-resolution microendoscopy (HRME) is a low-cost, in vivo imaging technique that can identify high-grade precancerous cervical lesions (CIN2+) at the point-of-care. The goal of this study was to evaluate the performance of HRME in medically-underserved areas in Texas, comparing results to a tertiary academic medical center.

METHODS: HRME was evaluated in five different outpatient clinical settings, two in Houston and three in the RGV, with medical providers …


Low-Cost, High-Resolution Imaging For Detecting Cervical Precancer In Medically-Underserved Areas Of Texas, Sonia G Parra, Ana M Rodriguez, Katelin D Cherry, Richard A Schwarz, Rose M Gowen, Laura B Guerra, Andrea M Milbourne, Paul A Toscano, Susan P Fisher-Hoch, Kathleen M Schmeler, Rebecca R Richards-Kortum Sep 2019

Low-Cost, High-Resolution Imaging For Detecting Cervical Precancer In Medically-Underserved Areas Of Texas, Sonia G Parra, Ana M Rodriguez, Katelin D Cherry, Richard A Schwarz, Rose M Gowen, Laura B Guerra, Andrea M Milbourne, Paul A Toscano, Susan P Fisher-Hoch, Kathleen M Schmeler, Rebecca R Richards-Kortum

Faculty, Staff and Student Publications

OBJECTIVE: Cervical cancer rates in the United States have declined since the 1940's, however, cervical cancer incidence remains elevated in medically-underserved areas, especially in the Rio Grande Valley (RGV) along the Texas-Mexico border. High-resolution microendoscopy (HRME) is a low-cost, in vivo imaging technique that can identify high-grade precancerous cervical lesions (CIN2+) at the point-of-care. The goal of this study was to evaluate the performance of HRME in medically-underserved areas in Texas, comparing results to a tertiary academic medical center.

METHODS: HRME was evaluated in five different outpatient clinical settings, two in Houston and three in the RGV, with medical providers …


Drunk Without Drinking: A Case Of Auto-Brewery Syndrome, Bobak J Akhavan, Luis Ostrosky-Zeichner, Eric J Thomas Sep 2019

Drunk Without Drinking: A Case Of Auto-Brewery Syndrome, Bobak J Akhavan, Luis Ostrosky-Zeichner, Eric J Thomas

Faculty, Staff and Student Publications

Information on auto-brewery syndrome is limited in the medical literature. This rare syndrome occurs when yeast overgrowth leads to ethanol fermentation in the gut. We present a patient presenting with symptoms of alcohol intoxication with objective laboratory data of elevated blood ethanol levels without a history of alcohol consumption. We reviewed the literature and have discussed the current diagnostic and therapeutic options.


Nuclear Receptor Subfamily 4 Group A Member 2 Inhibits Activation Of Erk Signaling And Cell Growth In Response To Β-Adrenergic Stimulation In Adult Rat Cardiomyocytes, Sadia Ashraf, Yassmin K Hegazy, Romain Harmancey Sep 2019

Nuclear Receptor Subfamily 4 Group A Member 2 Inhibits Activation Of Erk Signaling And Cell Growth In Response To Β-Adrenergic Stimulation In Adult Rat Cardiomyocytes, Sadia Ashraf, Yassmin K Hegazy, Romain Harmancey

Faculty, Staff and Student Publications

Sustained elevation of sympathetic activity is an important contributor to pathological cardiac hypertrophy, ventricular arrhythmias, and left ventricular contractile dysfunction in chronic heart failure. The orphan nuclear receptor NR4A2 is an immediate early-response gene activated in the heart under β-adrenergic stimulation. The goal of this study was to identify the transcriptional remodeling events induced by increased NR4A2 expression in cardiomyocytes and their impact on the physiological response of those cells to sustained β-adrenergic stimulation. Treatment of adult rat ventricular myocytes with isoproterenol induced a rapid (<4 >h) increase in NR4A2 levels that was accompanied by a transient (<24 >h) increase …


Blood Leukocyte Dna Methylation Predicts Risk Of Future Myocardial Infarction And Coronary Heart Disease, Golareh Agha, Michael M Mendelson, Cavin K Ward-Caviness, Roby Joehanes, Tianxiao Huan, Rahul Gondalia, Elias Salfati, Jennifer A Brody, Giovanni Fiorito, Jan Bressler, Brian H Chen, Symen Ligthart, Simonetta Guarrera, Elena Colicino, Allan C Just, Simone Wahl, Christian Gieger, Amy R Vandiver, Toshiko Tanaka, Dena G Hernandez, Luke C Pilling, Andrew B Singleton, Carlotta Sacerdote, Vittorio Krogh, Salvatore Panico, Rosario Tumino, Yun Li, Guosheng Zhang, James D Stewart, James S Floyd, Kerri L Wiggins, Jerome I Rotter, Michael Multhaup, Kelly Bakulski, Steven Horvath, Philip S Tsao, Devin M Absher, Pantel Vokonas, Joel Hirschhorn, M Daniele Fallin, Chunyu Liu, Stefania Bandinelli, Eric Boerwinkle, Abbas Dehghan, Joel D Schwartz, Bruce M Psaty, Andrew P Feinberg, Lifang Hou, Luigi Ferrucci, Nona Sotoodehnia, Giuseppe Matullo, Annette Peters, Myriam Fornage, Themistocles L Assimes, Eric A Whitsel, Daniel Levy, Andrea A Baccarelli Aug 2019

Blood Leukocyte Dna Methylation Predicts Risk Of Future Myocardial Infarction And Coronary Heart Disease, Golareh Agha, Michael M Mendelson, Cavin K Ward-Caviness, Roby Joehanes, Tianxiao Huan, Rahul Gondalia, Elias Salfati, Jennifer A Brody, Giovanni Fiorito, Jan Bressler, Brian H Chen, Symen Ligthart, Simonetta Guarrera, Elena Colicino, Allan C Just, Simone Wahl, Christian Gieger, Amy R Vandiver, Toshiko Tanaka, Dena G Hernandez, Luke C Pilling, Andrew B Singleton, Carlotta Sacerdote, Vittorio Krogh, Salvatore Panico, Rosario Tumino, Yun Li, Guosheng Zhang, James D Stewart, James S Floyd, Kerri L Wiggins, Jerome I Rotter, Michael Multhaup, Kelly Bakulski, Steven Horvath, Philip S Tsao, Devin M Absher, Pantel Vokonas, Joel Hirschhorn, M Daniele Fallin, Chunyu Liu, Stefania Bandinelli, Eric Boerwinkle, Abbas Dehghan, Joel D Schwartz, Bruce M Psaty, Andrew P Feinberg, Lifang Hou, Luigi Ferrucci, Nona Sotoodehnia, Giuseppe Matullo, Annette Peters, Myriam Fornage, Themistocles L Assimes, Eric A Whitsel, Daniel Levy, Andrea A Baccarelli

Faculty, Staff and Student Publications

BACKGROUND: DNA methylation is implicated in coronary heart disease (CHD), but current evidence is based on small, cross-sectional studies. We examined blood DNA methylation in relation to incident CHD across multiple prospective cohorts.

METHODS: Nine population-based cohorts from the United States and Europe profiled epigenome-wide blood leukocyte DNA methylation using the Illumina Infinium 450k microarray, and prospectively ascertained CHD events including coronary insufficiency/unstable angina, recognized myocardial infarction, coronary revascularization, and coronary death. Cohorts conducted race-specific analyses adjusted for age, sex, smoking, education, body mass index, blood cell type proportions, and technical variables. We conducted fixed-effect meta-analyses across cohorts.

RESULTS: Among …


Health Coaching To Encourage Obese Adults To Enroll In Commercially-Available Weight Management Programs: The Path To Health Study, Natalia I Heredia, Minjae Lee, Kevin O Hwang, Belinda M Reininger, Maria E Fernandez, Lorna H Mcneill Aug 2019

Health Coaching To Encourage Obese Adults To Enroll In Commercially-Available Weight Management Programs: The Path To Health Study, Natalia I Heredia, Minjae Lee, Kevin O Hwang, Belinda M Reininger, Maria E Fernandez, Lorna H Mcneill

Faculty, Staff and Student Publications

Physicians are recommended to screen and refer obese patients to weight management programs (WMPs). There are often limited referral options for physicians, though commercially-available WMPs could be a potential solution. The purpose of this study (Path to Health) was to evaluate the efficacy of health coaching to promote enrollment in commercially-available WMPs through a two-arm, RCT with obese patients (n = 168) randomly assigned to intervention (n = 84) or control groups (n = 84). Intervention participants received phone health coaching to help them select and enroll in WMPs. We collected data on program enrollment, weight, self-reported physical activity (PA), …


Preoccupation With Failure And Adherence To Shared Baselines: Measuring High-Reliability Organizational Culture, Jason M Etchegaray, Eric J Thomas, Jochen Profit Aug 2019

Preoccupation With Failure And Adherence To Shared Baselines: Measuring High-Reliability Organizational Culture, Jason M Etchegaray, Eric J Thomas, Jochen Profit

Faculty, Staff and Student Publications

OBJECTIVE: To create, administer, and psychometrically examine a survey to measure two new organizational culture factors - preoccupation with failure and adherence to shared baselines - in healthcare settings.

METHOD: Direct care providers (n = 4484) from a large healthcare system in the Southern United States completed a survey as part of their annual safety culture assessment.

RESULTS: We provide evidence about the internal consistency (Cronbach's alpha ranged from .80 to .89) factor structure, concurrent validity (correlation with overall patient safety grade ranged from .60 to .67, p

CONCLUSIONS: We established evidence for internal consistency and validity of two new …


The Society Of Abdominal Radiology At 10 Years: Reflections, Status Report, And Look To The Future, Manju Ambelil, David M Saulino, Atilla Ertan, Andrew W Dupont, Mamoun Younes Aug 2019

The Society Of Abdominal Radiology At 10 Years: Reflections, Status Report, And Look To The Future, Manju Ambelil, David M Saulino, Atilla Ertan, Andrew W Dupont, Mamoun Younes

Faculty, Staff and Student Publications

CONTEXT.—: Recent studies examining immunohistochemical staining of colorectal biopsies for cytomegalovirus (CMV) reported that some cases showed only occasional small positive nuclei that were called equivocal for CMV.

OBJECTIVES.—: To determine the extent and clinical significance of equivocal CMV staining in colorectal biopsies.

DESIGN.—: Two-hundred twenty-one consecutive cases of colon and rectal biopsies that were stained for CMV by immunohistochemistry were retrieved from our files and reviewed. Staining results were recorded as negative, unequivocal, or equivocal. Results were correlated with clinicopathologic data, results of polymerase chain reaction studies for CMV, and treatment history.

RESULTS.—: Fifty-two cases (24% of all tested, …


Datagauge: A Practical Process For Systematically Designing And Implementing Quality Assessments Of Repurposed Clinical Data, Jose-Franck Diaz-Garelli, Elmer V Bernstam, Minjae Lee, Kevin O Hwang, Mohammad H Rahbar, Todd R Johnson Jul 2019

Datagauge: A Practical Process For Systematically Designing And Implementing Quality Assessments Of Repurposed Clinical Data, Jose-Franck Diaz-Garelli, Elmer V Bernstam, Minjae Lee, Kevin O Hwang, Mohammad H Rahbar, Todd R Johnson

Faculty, Staff and Student Publications

The well-known hazards of repurposing data make Data Quality (DQ) assessment a vital step towards ensuring valid results regardless of analytical methods. However, there is no systematic process to implement DQ assessments for secondary uses of clinical data. This paper presents DataGauge, a systematic process for designing and implementing DQ assessments to evaluate repurposed data for a specific secondary use. DataGauge is composed of five steps: (1) Define information needs, (2) Develop a formal Data Needs Model (DNM), (3) Use the DNM and DQ theory to develop goal-specific DQ assessment requirements, (4) Extract DNM-specified data, and (5) Evaluate according to …


Pyroglutamic Acidemia: An Underrecognized And Underdiagnosed Cause Of High Anion Gap Metabolic Acidosis - A Case Report And Review Of Literature, Sidish S Venkataraman, Rachel Regone, Hussam M Ammar, Rukma R Govindu Jul 2019

Pyroglutamic Acidemia: An Underrecognized And Underdiagnosed Cause Of High Anion Gap Metabolic Acidosis - A Case Report And Review Of Literature, Sidish S Venkataraman, Rachel Regone, Hussam M Ammar, Rukma R Govindu

Faculty, Staff and Student Publications

Pyroglutamic acidemia (oxoprolinemia) is an underrecognized cause of high anion gap acidosis resulting from derangement in the gamma-glutamyl cycle. Pyroglutamic acidemia is most commonly diagnosed in the pediatric population in patients with inherited autosomal recessive enzyme deficiencies. However, acquired pyroglutamic acidemia can present in the adult population. Patients often present with confusion, nausea, and vomiting as well as an elevated anion gap metabolic acidosis. This article describes a case of acquired pyroglutamic acidemia and emphasizes the need to consider this entity.


In Vitro Characterization Of Sonothrombolysis And Echocontrast Agents To Treat Ischemic Stroke, Himanshu Shekhar, Robert T Kleven, Tao Peng, Arunkumar Palaniappan, Kunal B Karani, Shaoling Huang, David D Mcpherson, Christy K Holland Jul 2019

In Vitro Characterization Of Sonothrombolysis And Echocontrast Agents To Treat Ischemic Stroke, Himanshu Shekhar, Robert T Kleven, Tao Peng, Arunkumar Palaniappan, Kunal B Karani, Shaoling Huang, David D Mcpherson, Christy K Holland

Faculty, Staff and Student Publications

The development of adjuvant techniques to improve thrombolytic efficacy is important for advancing ischemic stroke therapy. We characterized octafluoropropane and recombinant tissue plasminogen activator (rt-PA)-loaded echogenic liposomes (OFP t-ELIP) using differential interference and fluorescence microscopy, attenuation spectroscopy, and electrozone sensing. The loading of rt-PA in OFP t-ELIP was assessed using spectrophotometry. Further, it was tested whether the agent shields rt-PA against degradation by plasminogen activator inhibitor-1 (PAI-1). An in vitro system was used to assess whether ultrasound (US) combined with either Definity or OFP t-ELIP enhances rt-PA thrombolysis. Human whole blood clots were mounted in a flow system and visualized …


Microrna-374a, -4680, And -133b Suppress Cell Proliferation Through The Regulation Of Genes Associated With Human Cleft Palate In Cultured Human Palate Cells, Akiko Suzuki, Aimin Li, Mona Gajera, Nada Abdallah, Musi Zhang, Zhongming Zhao, Junichi Iwata Jul 2019

Microrna-374a, -4680, And -133b Suppress Cell Proliferation Through The Regulation Of Genes Associated With Human Cleft Palate In Cultured Human Palate Cells, Akiko Suzuki, Aimin Li, Mona Gajera, Nada Abdallah, Musi Zhang, Zhongming Zhao, Junichi Iwata

Faculty, Staff and Student Publications

BACKGROUND: Cleft palate (CP) is the second most common congenital birth defect; however, the relationship between CP-associated genes and epigenetic regulation remains largely unknown. In this study, we investigated the contribution of microRNAs (miRNAs) to cell proliferation and regulation of genes involved in CP development.

METHODS: In order to identify all genes for which mutations or association/linkage have been found in individuals with CP, we conducted a systematic literature search, followed by bioinformatics analyses for these genes. We validated the bioinformatics results experimentally by conducting cell proliferation assays and miRNA-gene regulatory analyses in cultured human palatal mesenchymal cells treated with …


The Influence Of Vitamin D Supplementation On Local And Systemic Inflammatory Markers In Periodontitis Patients: A Pilot Study, Mohamed M Meghil, Lance Hutchens, Anas Raed, Neha A Multani, Mythilypriya Rajendran, Haidong Zhu, Stephen Looney, Mahmoud Elashiry, Roger M Arce, Mark E Peacock, Yanbin Dong, Christopher W Cutler Jul 2019

The Influence Of Vitamin D Supplementation On Local And Systemic Inflammatory Markers In Periodontitis Patients: A Pilot Study, Mohamed M Meghil, Lance Hutchens, Anas Raed, Neha A Multani, Mythilypriya Rajendran, Haidong Zhu, Stephen Looney, Mahmoud Elashiry, Roger M Arce, Mark E Peacock, Yanbin Dong, Christopher W Cutler

Faculty, Staff and Student Publications

OBJECTIVES: Vitamin D deficiency/insufficiency is a worldwide public health issue that has been linked to numerous inflammatory disorders, including periodontitis. There is increasing support for a role for adequate vitamin D levels in overall health. Populations with darker skin color have a higher prevalence of vitamin D deficiency/insufficiency and periodontitis. The purpose of this small pilot study was to investigate the influence of 12 weeks of 25(OH)D vitamin D supplementation (VDS) on mediators of systemic inflammation in dark-skinned, periodontitis patients.

MATERIALS AND METHODS: A total of 23 patients with moderate to severe periodontitis were randomly assigned to the vitamin D …


Integrating Diverse Disciplines To Enhance Interprofessional Competency In Healthcare Delivery, Tiffany Champagne-Langabeer, Lee Revere, Mariya Tankimovich, Erica Yu, Robert Spears, Jennifer Lee Swails Jun 2019

Integrating Diverse Disciplines To Enhance Interprofessional Competency In Healthcare Delivery, Tiffany Champagne-Langabeer, Lee Revere, Mariya Tankimovich, Erica Yu, Robert Spears, Jennifer Lee Swails

Faculty, Staff and Student Publications

Interprofessional education (IPE) typically involves clinical simulation exercises with students from medical and nursing schools. Yet, healthcare requires patient-centered teams that include diverse disciplines. Students from public health and informatics are rarely incorporated into IPE, signaling a gap in current educational practices. In this study, we integrated students from administrative and non-clinical disciplines into traditional clinical simulations and measured the effect on communication and teamwork. From July 2017-July 2018, 408 students from five schools (medicine, nursing, dentistry, public health, and informatics) participated in one of eight three-hour IPE clinical simulations with Standardized Patients and electronic health record technologies. Data were …


Aminophylline Shortage And Current Recommendations For Reversal Of Vasodilator Stress: An Asnc Information Statement Endorsed By Scmr, Aiden Abidov, Vasken Dilsizian, Rami Doukky, W Lane Duvall, Christopher Dyke, Michael D Elliott, Fadi G Hage, Milena J Henzlova, Nils P Johnson, Ronald G Schwartz, Gregory S Thomas, Andrew J Einstein Jun 2019

Aminophylline Shortage And Current Recommendations For Reversal Of Vasodilator Stress: An Asnc Information Statement Endorsed By Scmr, Aiden Abidov, Vasken Dilsizian, Rami Doukky, W Lane Duvall, Christopher Dyke, Michael D Elliott, Fadi G Hage, Milena J Henzlova, Nils P Johnson, Ronald G Schwartz, Gregory S Thomas, Andrew J Einstein

Faculty, Staff and Student Publications

Pharmacologic reversal of serious or intolerable side effects (SISEs) from vasodilator stress is an important safety and comfort measure for patients experiencing such effects. While typically performed using intravenous aminophylline, recurrent shortages of this agent have led to a greater need to limit its use and consider alternative agents. This information statement provides background and recommendations addressing indications for vasodilator reversal, timing of a reversal agent, incidence of observed SISE with vasodilator stress, clinical and logistical considerations for aminophylline-based reversal, and alternative non-aminophylline based reversal protocols.