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Full-Text Articles in Medicine and Health Sciences

Persistent Opioid Use In Cataract Surgery Pain Management And The Role Of Nonopioid Alternatives, Richard S Davidson, Kendall Donaldson, Maggie Jeffries, Sumitra Khandelwal, Michael Raizman, Yasaira Rodriguez Torres, Terry Kim Jun 2022

Persistent Opioid Use In Cataract Surgery Pain Management And The Role Of Nonopioid Alternatives, Richard S Davidson, Kendall Donaldson, Maggie Jeffries, Sumitra Khandelwal, Michael Raizman, Yasaira Rodriguez Torres, Terry Kim

Faculty, Staff and Students Publications

Cataracts are a leading cause of preventable blindness globally. Although care varies between developing and industrialized countries, surgery is the single effective approach to treating cataracts. From the earliest documented primitive cataract removals to today's advanced techniques, cataract surgery has evolved dramatically. As surgical techniques have developed, so have approaches to surgical pain management. With current cataract surgical procedures and advanced technology, anesthesia and intraoperative pain management have shifted to topical/intracameral anesthetics, with or without low-dose systemic analgesia and anxiolysis. Despite this, pain and discomfort persist in some patients and are underappreciated in modern cataract surgery. Although pain management has …


Regional Anesthesia For Sickle Cell Disease Vaso-Occlusive Crisis: A Single-Center Case Series, Cecile Karsenty, Venée N Tubman, Chyong-Jy Joyce Liu, Titilope Fasipe, Karla E K Wyatt Jun 2022

Regional Anesthesia For Sickle Cell Disease Vaso-Occlusive Crisis: A Single-Center Case Series, Cecile Karsenty, Venée N Tubman, Chyong-Jy Joyce Liu, Titilope Fasipe, Karla E K Wyatt

Faculty, Staff and Students Publications

Pain management is challenging for patients with sickle cell disease (SCD) who present in vaso-occlusive crisis (VOC). Opioid therapy is highly effective, nevertheless undesirable side effects can hinder their effectiveness. Regional anesthesia with deposition of perineural anesthetic offers nociceptive blockade, local vasodilatation, and reduces the inflammatory response. Among pediatric patients, continuous peripheral nerve block (CPNB) for perioperative adjunctive analgesia is safe. Herein, we describe the trajectory of a cohort of pediatric SCD patients with opioid-refractory upper-extremity VOC following placement of CPNBs for analgesia; highlighting reduced opioid consumption, improved pain scores, and decreased length of hospitalization.


Impact Of A Rapid High-Sensitivity Troponin Pathway On Patient Flow In An Urban Emergency Department, Edward Hyun Suh, Aleksandr M Tichter, Lauren S Ranard, Andrew Amaranto, Betty C Chang, Phong Anh Huynh, Alexander Kratz, Rebekah Jihae Lee, Leroy E Rabbani, Dana Sacco, Andrew J Einstein Jun 2022

Impact Of A Rapid High-Sensitivity Troponin Pathway On Patient Flow In An Urban Emergency Department, Edward Hyun Suh, Aleksandr M Tichter, Lauren S Ranard, Andrew Amaranto, Betty C Chang, Phong Anh Huynh, Alexander Kratz, Rebekah Jihae Lee, Leroy E Rabbani, Dana Sacco, Andrew J Einstein

Faculty, Staff and Students Publications

STUDY OBJECTIVE: To evaluate whether the introduction of a 1-hour high-sensitivity cardiac troponin-T (hs-TnT) pathway for patients who present to the emergency department (ED) with suspected acute coronary syndrome (ACS) improves ED patient flow without changing the rate of "missed" major adverse cardiac events (MACE), compared to use of conventional cardiac troponin with an associated 3-hour pathway.

METHODS: This was a prospective, uncontrolled observational study conducted before and after implementation of a 1-hour hs-TnT pathway at a high-volume urban ED. Patients undergoing evaluation for ACS in the ED were enrolled during their initial visit and clinical outcomes were assessed at …


Syphilis In The Esophagus, Ronan Allencherril, Paul Nicholls, Shilpa Jain, Robert Sealock, Priti Dangayach Jun 2022

Syphilis In The Esophagus, Ronan Allencherril, Paul Nicholls, Shilpa Jain, Robert Sealock, Priti Dangayach

Faculty, Staff and Students Publications

This report documents a unique case of syphilis with esophageal involvement. Such a presentation is exceedingly rare in the modern era, particularly among patients without human immunodeficiency virus. Most instances were documented in the 1900s and earlier. Our patient presented with months of odynophagia and recurrent oral lesions. He was found to have a sizeable esophageal ulcer on endoscopy, with biopsy confirming the diagnosis of syphilis. His symptoms quickly resolved with intramuscular penicillin. This case highlights the importance of keeping a broad differential for odynophagia and suspicious lesions, cutaneous or mucosal.


Atomic Structure Of The Leishmania Spp Hsp100 N-Domain, Jonathan M Mercado, Sukyeong Lee, Changsoo Chang, Nuri Sung, Lynn Soong, Andre Catic, Francis T F Tsai Jun 2022

Atomic Structure Of The Leishmania Spp Hsp100 N-Domain, Jonathan M Mercado, Sukyeong Lee, Changsoo Chang, Nuri Sung, Lynn Soong, Andre Catic, Francis T F Tsai

Faculty, Staff and Students Publications

Hsp100 is an ATP-dependent unfoldase that promotes protein disaggregation or facilitates the unfolding of aggregation-prone polypeptides marked for degradation. Recently, new Hsp100 functions are emerging. In Plasmodium, an Hsp100 drives malaria protein export, presenting a novel drug target. Whether Hsp100 has a similar function in other protists is unknown. We present the 1.06 Å resolution crystal structure of the Hsp100 N-domain from Leishmania spp., the causative agent of leishmaniasis in humans. Our structure reveals a network of methionines and aromatic amino acids that define the putative substrate-binding site and likely evolved to protect Hsp100 from oxidative damage in host immune …


Circadian Clock, Diurnal Glucose Metabolic Rhythm, And Dawn Phenomenon, Fei Peng, Xin Li, Fang Xiao, Ruxing Zhao, Zheng Sun Jun 2022

Circadian Clock, Diurnal Glucose Metabolic Rhythm, And Dawn Phenomenon, Fei Peng, Xin Li, Fang Xiao, Ruxing Zhao, Zheng Sun

Faculty, Staff and Students Publications

The circadian clock provides cue-independent anticipatory signals for diurnal rhythms of baseline glucose levels and glucose tolerance. The central circadian clock is located in the hypothalamic suprachiasmatic nucleus (SCN), which comprises primarily GABAergic neurons. The SCN clock regulates physiological diurnal rhythms of endogenous glucose production (EGP) and hepatic insulin sensitivity through neurohumoral mechanisms. Disruption of the molecular circadian clock is associated with the extended dawn phenomenon (DP) in type 2 diabetes (T2D), referring to hyperglycemia in the early morning without nocturnal hypoglycemia. The DP affects nearly half of patients with diabetes, with poorly defined etiology and a lack of targeted …


A Novel Crosstalk Between Autophagosomes And Phagosomes That Facilitates The Clearance Of Apoptotic Cells, Zheng Zhou, Omar Peña-Ramos Jun 2022

A Novel Crosstalk Between Autophagosomes And Phagosomes That Facilitates The Clearance Of Apoptotic Cells, Zheng Zhou, Omar Peña-Ramos

Faculty, Staff and Students Publications

During an animal's life, many cells undergo apoptosis, a form of genetically programmed cell death. These cells are swiftly engulfed by other cells through phagocytosis and subsequently degraded inside phagosomes. Phagocytosis and macroautophagy/autophagy are two different cellular events: whereas phagocytosis is a cell-eat-cell event, autophagy, or "self-eating", occurs within one cell, resulting in the enveloping of protein aggregates or damaged organelles within double-membrane autophagosomes. Despite this critical difference, these two events share common features: (1) both are means of safe garbage disposal; (2) both phagosomes and autophagosomes fuse to lysosomes, which drive the degradation of their contents; and (3) both …


Peripheral Extracorporeal Membrane Oxygenation Support Expands The Application Of Robot-Assisted Coronary Artery Bypass, Vivek Patel, Zachary Gray, Mahboob Alam, Guilherme Vianna Silva, Leo Simpson, Kenneth Liao Jun 2022

Peripheral Extracorporeal Membrane Oxygenation Support Expands The Application Of Robot-Assisted Coronary Artery Bypass, Vivek Patel, Zachary Gray, Mahboob Alam, Guilherme Vianna Silva, Leo Simpson, Kenneth Liao

Faculty, Staff and Students Publications

OBJECTIVE: Robot-assisted coronary artery bypass (RCAB) is typically not offered to higher risk patients with reduced cardiopulmonary function, critical coronary artery disease, and challenging chest wall anatomy. In this study, we report the novel use of nonemergency intraoperative peripheral extracorporeal membrane oxygenation as partial cardiopulmonary support during RCAB for patients who were considered high-risk candidates for conventional CAB and at the same time not eligible for RCAB without cardiopulmonary support.

METHODS: Forty-five high risk patients (mean age, 68 years; Society of Thoracic Surgeons score, 6.27%; ejection fraction, 45%) underwent RCAB with nonemergency peripheral extracorporeal membrane oxygenation support for the following …


Aberrant Fibrin Clot Structure Visualized Ex Vivo In Critically Ill Patients With Severe Acute Respiratory Syndrome Coronavirus 2 Infection, Lisa S Brubaker, Arun Saini, Trung C Nguyen, Marina Martinez-Vargas, Fong W Lam, Qizhi Yao, Michele M Loor, Todd K Rosengart, Miguel A Cruz Jun 2022

Aberrant Fibrin Clot Structure Visualized Ex Vivo In Critically Ill Patients With Severe Acute Respiratory Syndrome Coronavirus 2 Infection, Lisa S Brubaker, Arun Saini, Trung C Nguyen, Marina Martinez-Vargas, Fong W Lam, Qizhi Yao, Michele M Loor, Todd K Rosengart, Miguel A Cruz

Faculty, Staff and Students Publications

OBJECTIVES: Disseminated fibrin-rich microthrombi have been reported in patients who died from COVID-19. Our objective is to determine whether the fibrin clot structure and function differ between critically ill patients with or without COVID-19 and to correlate the structure with clinical coagulation biomarkers.

DESIGN: A cross-sectional observational study. Platelet poor plasma was used to analyze fibrin clot structure; the functional implications were determined by quantifying clot turbidity and porosity.

SETTING: ICU at an academic medical center and an academic laboratory.

PATIENTS: Patients admitted from July 1 to August 1, 2020, to the ICU with severe acute respiratory syndrome coronavirus 2 …


Discovery Of The First Lyticstaphylococcus Pseudintermedius/ Staphylococcus Aureus Polyvalent Bacteriophages, Haroldo Hernandez Santos, Justin Clark, Austen Terwilliger, Anthony Maresso Jun 2022

Discovery Of The First Lyticstaphylococcus Pseudintermedius/ Staphylococcus Aureus Polyvalent Bacteriophages, Haroldo Hernandez Santos, Justin Clark, Austen Terwilliger, Anthony Maresso

Faculty, Staff and Students Publications

Background:

There are no verified lytic Staphylococcus pseudintermedius phages in the literature and few temperate phage genomes in databases. S. pseudintermedius is an opportunistic zoonotic pathogen of great importance in veterinary and human medicine.

Materials and Methods:

We discovered phages against canine-derived S. pseudintermedius isolates by screening dog feces, hair, and skin swabs. Fourteen new phages were isolated and characterized by genomic analysis, transmission electron microscopy, and host range determination.

Results:

Three phages—DH2, DH5, and DS10, a phage K variant—were predicted lytic by sequencing, a designation supported by mitomycin C induction. All three are S. pseudintermedius and Staphylococcus aureus polyvalent …


Risk For Post-Colonoscopy Irritable Bowel Syndrome In Patients With And Without Antibiotic Exposure: A Retrospective Cohort Study, Ravy K Vajravelu, Jordan M Shapiro, Josephine Ni, Shivani U Thanawala, James D Lewis, Hashem B El-Serag Jun 2022

Risk For Post-Colonoscopy Irritable Bowel Syndrome In Patients With And Without Antibiotic Exposure: A Retrospective Cohort Study, Ravy K Vajravelu, Jordan M Shapiro, Josephine Ni, Shivani U Thanawala, James D Lewis, Hashem B El-Serag

Faculty, Staff and Students Publications

BACKGROUND & AIMS: Laboratory studies have demonstrated that antibiotic use in conjunction with bowel purgatives causes alterations to the gut microbiota. Because gut microbiota changes may be a trigger for the development of irritable bowel syndrome (IBS), we sought to assess whether individuals who undergo bowel cleansing for colonoscopy and have concurrent antibiotic exposure develop IBS at higher rates than individuals who undergo colonoscopy without antibiotic exposure.

METHODS: We used data from Optum's de-identified Clinformatics Data Mart Database in the United States to study a cohort of 50- to 55-year-olds who underwent screening colonoscopy. Individuals exposed to antibiotics within 14 …


Social And Demographic Disparities In The Severity Of Multisystem Inflammatory Syndrome In Children, Fabio Savorgnan, Sebastian Acosta, Alexander Alali, Axel Moreira, Ananth Annapragada, Craig G Rusin, Saul Flores, Rohit S Loomba, Alvaro Moreira Jun 2022

Social And Demographic Disparities In The Severity Of Multisystem Inflammatory Syndrome In Children, Fabio Savorgnan, Sebastian Acosta, Alexander Alali, Axel Moreira, Ananth Annapragada, Craig G Rusin, Saul Flores, Rohit S Loomba, Alvaro Moreira

Faculty, Staff and Students Publications

Social constructs are known risk factors for multisystem inflammatory syndrome in children. A review of 206 patients demonstrated that children who were non-Hispanic Black, over the age of 12 years or living in a disadvantaged neighborhood associated with severe multisystem inflammatory syndrome in children (intensive care unit admission, intubation and/or vasopressor use).


Lmod2-Related Dilated Cardiomyopathy Presenting In Late Infancy, Erica Lay, Mahshid S Azamian, Susan W Denfield, William Dreyer, Joseph A Spinner, Debra Kearney, Lilei Zhang, Kim C Worley, Weimin Bi, Seema R Lalani Jun 2022

Lmod2-Related Dilated Cardiomyopathy Presenting In Late Infancy, Erica Lay, Mahshid S Azamian, Susan W Denfield, William Dreyer, Joseph A Spinner, Debra Kearney, Lilei Zhang, Kim C Worley, Weimin Bi, Seema R Lalani

Faculty, Staff and Students Publications

Leiomodin-2 (LMOD2) is an important regulator of the thin filament length, known to promote elongation of actin through polymerization at pointed ends. Mice with Lmod2 deficiency die around 3 weeks of age due to severe dilated cardiomyopathy (DCM), resulting from decreased heart contractility due to shorter thin filaments. To date, there have been three infants from two families reported with biallelic variants in LMOD2, presenting with perinatal onset DCM. Here, we describe a third family with a child harboring a previously described homozygous frameshift variant, c.1243_1244delCT (p.L415Vfs*108) with DCM, presenting later in infancy at 9 months of age. Family history …


A Novel Automated Junctional Ectopic Tachycardia Detection Tool For Children With Congenital Heart Disease, Jamie L S Waugh, Raajen Patel, Yilong Ju, Ankit B Patel, Craig G Rusin, Parag N Jain Jun 2022

A Novel Automated Junctional Ectopic Tachycardia Detection Tool For Children With Congenital Heart Disease, Jamie L S Waugh, Raajen Patel, Yilong Ju, Ankit B Patel, Craig G Rusin, Parag N Jain

Faculty, Staff and Students Publications

BACKGROUND: Junctional ectopic tachycardia (JET) is a prevalent life-threatening arrhythmia in children with congenital heart disease (CHD), with marked resemblance to normal sinus rhythm (NSR) often leading to delay in diagnosis.

OBJECTIVE: To develop a novel automated arrhythmia detection tool to identify JET.

METHODS: A single-center retrospective cohort study of children with CHD was performed. Electrocardiographic (ECG) data produced by bedside monitors is captured automatically by the Sickbay platform. Based on the detection of R and P wave peaks, 2 interpretable ECG features are calculated: P prominence median and PR interval interquartile range (IQR). These features are used as input …


Prune1 C933g>A Synonymous Variant Induces Exon 7 Skipping, Disrupts The Dhha2 Domain, And Leads To An Atypical Nmihba Syndrome Presentation: Case Report And Review Of The Literature, Christina L Magyar, David R Murdock, Lindsay C Burrage, Hongzheng Dai, Seema R Lalani, Richard A Lewis, Yuezhen Lin, Marcela F Astudillo, Jill A Rosenfeld, Alyssa A Tran, James B Gibson, Undiagnosed Diseases Network, Carlos A Bacino, Brendan H Lee, Hsiao-Tuan Chao Jun 2022

Prune1 C933g>A Synonymous Variant Induces Exon 7 Skipping, Disrupts The Dhha2 Domain, And Leads To An Atypical Nmihba Syndrome Presentation: Case Report And Review Of The Literature, Christina L Magyar, David R Murdock, Lindsay C Burrage, Hongzheng Dai, Seema R Lalani, Richard A Lewis, Yuezhen Lin, Marcela F Astudillo, Jill A Rosenfeld, Alyssa A Tran, James B Gibson, Undiagnosed Diseases Network, Carlos A Bacino, Brendan H Lee, Hsiao-Tuan Chao

Faculty, Staff and Students Publications

Prune exopolyphosphatase-1 (PRUNE1) encodes a member of the aspartic acid-histidine-histidine (DHH) phosphodiesterase superfamily that regulates cell migration and proliferation during brain development. In 2015, biallelic PRUNE1 loss-of-function variants were identified to cause the neurodevelopmental disorder with microcephaly, hypotonia, and variable brain abnormalities (NMIHBA, OMIM#617481). NMIHBA is characterized by the namesake features and structural brain anomalies including thinning of the corpus callosum, cerebral and cerebellar atrophy, and delayed myelination. To date, 47 individuals have been reported in the literature, but the phenotypic spectrum of PRUNE1-related disorders and their causative variants remains to be characterized fully. Here, we report a novel homozygous …


Pdxnet Portal: Patient-Derived Xenograft Model, Data, Workflow And Tool Discovery, Soner Koc, Michael W Lloyd, Jeffrey W Grover, Nan Xiao, Sara Seepo, Sai Lakshmi Subramanian, Manisha Ray, Christian Frech, John Digiovanna, Phillip Webster, Steven Neuhauser, Anuj Srivastava, Xing Yi Woo, Brian J Sanderson, Brian White, Paul Lott, Lacey E Dobrolecki, Heidi Dowst, Pdxnet Consortium;, Yvonne A Evrard, Tiffany A Wallace, Jeffrey A Moscow, James H Doroshow, Nicholas Mitsiades, Salma Kaochar, Chong-Xian Pan, Moon S Chen, Luis Carvajal-Carmona, Alana L Welm, Bryan E Welm, Michael T Lewis, Ramaswamy Govindan, Li Ding, Shunqiang Li, Meenhard Herlyn, Michael A Davies, Jack Roth, Funda Meric-Bernstam, Peter N Robinson, Carol J Bult, Brandi Davis-Dusenbery, Dennis A Dean, Jeffrey H Chuang Jun 2022

Pdxnet Portal: Patient-Derived Xenograft Model, Data, Workflow And Tool Discovery, Soner Koc, Michael W Lloyd, Jeffrey W Grover, Nan Xiao, Sara Seepo, Sai Lakshmi Subramanian, Manisha Ray, Christian Frech, John Digiovanna, Phillip Webster, Steven Neuhauser, Anuj Srivastava, Xing Yi Woo, Brian J Sanderson, Brian White, Paul Lott, Lacey E Dobrolecki, Heidi Dowst, Pdxnet Consortium;, Yvonne A Evrard, Tiffany A Wallace, Jeffrey A Moscow, James H Doroshow, Nicholas Mitsiades, Salma Kaochar, Chong-Xian Pan, Moon S Chen, Luis Carvajal-Carmona, Alana L Welm, Bryan E Welm, Michael T Lewis, Ramaswamy Govindan, Li Ding, Shunqiang Li, Meenhard Herlyn, Michael A Davies, Jack Roth, Funda Meric-Bernstam, Peter N Robinson, Carol J Bult, Brandi Davis-Dusenbery, Dennis A Dean, Jeffrey H Chuang

Faculty, Staff and Students Publications

We created the PDX Network (PDXNet) portal (https://portal.pdxnetwork.org/) to centralize access to the National Cancer Institute-funded PDXNet consortium resources, to facilitate collaboration among researchers and to make these data easily available for research. The portal includes sections for resources, analysis results, metrics for PDXNet activities, data processing protocols and training materials for processing PDX data. Currently, the portal contains PDXNet model information and data resources from 334 new models across 33 cancer types. Tissue samples of these models were deposited in the NCI's Patient-Derived Model Repository (PDMR) for public access. These models have 2134 associated sequencing files from 873 samples …


Aberrant Uterine Folding In Mice Disrupts Implantation Chamber Formation And Alignment Of Embryo-Uterine Axes, Manoj K Madhavan, Francesco J Demayo, John P Lydon, Niraj R Joshi, Asgerally T Fazleabas, Ripla Arora Jun 2022

Aberrant Uterine Folding In Mice Disrupts Implantation Chamber Formation And Alignment Of Embryo-Uterine Axes, Manoj K Madhavan, Francesco J Demayo, John P Lydon, Niraj R Joshi, Asgerally T Fazleabas, Ripla Arora

Faculty, Staff and Students Publications

The uterine luminal epithelium folds characteristically in mammals, including humans, horses and rodents. Improper uterine folding in horses results in pregnancy failure, but the precise function of folds remains unknown. Here, we uncover dynamic changes in the 3D uterine folding pattern during early pregnancy with the entire lumen forming pre-implantation transverse folds along the mesometrial-antimesometrial axis. Using a time course, we show that transverse folds are formed before embryo spacing, whereas implantation chambers form as the embryo begins attachment. Thus, folds and chambers are two distinct structures. Transverse folds resolve to form a flat implantation region, after which an embryo …


Information Is Power: The Experiences, Attitudes And Needs Of Individuals Who Chose To Have Prenatal Genomic Sequencing For Fetal Anomalies, Catherine G Kernie, Julia Wynn, Allison Rosenbaum, Jessica De Voest, Stephanie Galloway, Jessica Giordano, Samantha Stover, Lauren Westerfield, Kelly Gilmore, Ronald J Wapner, Ignatia B Van Den Veyver, Neeta L Vora, Rebecca G Clifton, Aaron B Caughey, Wendy K Chung Jun 2022

Information Is Power: The Experiences, Attitudes And Needs Of Individuals Who Chose To Have Prenatal Genomic Sequencing For Fetal Anomalies, Catherine G Kernie, Julia Wynn, Allison Rosenbaum, Jessica De Voest, Stephanie Galloway, Jessica Giordano, Samantha Stover, Lauren Westerfield, Kelly Gilmore, Ronald J Wapner, Ignatia B Van Den Veyver, Neeta L Vora, Rebecca G Clifton, Aaron B Caughey, Wendy K Chung

Faculty, Staff and Students Publications

OBJECTIVE: This study sought to evaluate the experiences of individuals who chose to participate in a study and receive prenatal genomic sequencing (pGS) for fetuses with congenital structural anomalies.

METHOD: Individuals who received research results of prenatal sequencing were invited to participate in semi-structured interviews about their experiences. A constructivist grounded theory approach was used to code and analyze interviews.

RESULTS: Thirty-three participants from 27 pregnancies were interviewed. Participants were motivated to enroll in the study to find out more about their fetus' condition and prepare for the future. The waiting period was a time of significant anxiety for participants. …


Comparative Ligandomics Implicates Secretogranin Iii As A Disease-Restricted Angiogenic Factor In Laser-Induced Choroidal Neovascularization, Liyang Ji, Prabuddha Waduge, Wencui Wan, Hong Tian, Jin Li, Jinsong Zhang, Rui Chen, Wei Li Jun 2022

Comparative Ligandomics Implicates Secretogranin Iii As A Disease-Restricted Angiogenic Factor In Laser-Induced Choroidal Neovascularization, Liyang Ji, Prabuddha Waduge, Wencui Wan, Hong Tian, Jin Li, Jinsong Zhang, Rui Chen, Wei Li

Faculty, Staff and Students Publications

Choroidal neovascularization (CNV) is a leading cause of vision loss in the elderly. All approved anti-angiogenic drug therapies for CNV target vascular endothelial growth factor (VEGF) but confer limited efficacy. Identification of other CNV-related angiogenic factors will facilitate the development of VEGF-independent alternative therapies. Here, we applied comparative ligandomics to live mice with or without laser-induced CNV for global mapping of CNV-selective endothelial ligands. Secretogranin III (Scg3) previously identified by the same approach as a diabetes-restricted angiogenic factor was mapped with more than 935-fold increase in binding to CNV vessels compared to healthy choriocapillaris. A novel in vivo ligand binding …


Impact Of The Covid-19 Pandemic On Visual Outcomes Of Diabetic Macular Edema Patients At A Tertiary Care Veterans Affairs Center, Philip Zhou, Jie Gao, Xiaofan Huang, Kristen A Staggers, Kristin Biggerstaff, Silvia Orengo-Nania, Roomasa Channa Jun 2022

Impact Of The Covid-19 Pandemic On Visual Outcomes Of Diabetic Macular Edema Patients At A Tertiary Care Veterans Affairs Center, Philip Zhou, Jie Gao, Xiaofan Huang, Kristen A Staggers, Kristin Biggerstaff, Silvia Orengo-Nania, Roomasa Channa

Faculty, Staff and Students Publications

PURPOSE: There are limited studies on factors that impacted retina clinic patient outcomes during the COVID-19 pandemic. We aimed to evaluate visual and anatomic outcomes in patients with diabetic macular edema (DME) requiring anti-VEGF injections at the veterans' affairs tertiary care eye clinic in Houston, TX.

METHODS: Patient volume from April 2020 was compared to that of April 2019 to determine attendance changes. To evaluate outcomes, we reviewed patients with DME who had scheduled appointments during April 2020. We tracked changes in central foveal thickness (CFT) and Snellen visual acuity (VA) measurements. Patient outcomes were classified as poor (defined as …


Mucosal Immunology Of The Ocular Surface, Cintia S De Paiva, Anthony J St Leger, Rachel R Caspi Jun 2022

Mucosal Immunology Of The Ocular Surface, Cintia S De Paiva, Anthony J St Leger, Rachel R Caspi

Faculty, Staff and Students Publications

The eye is a sensory organ exposed to the environment and protected by a mucosal tissue barrier. While it shares a number of features with other mucosal tissues, the ocular mucosal system, composed of the conjunctiva, Meibomian glands, and lacrimal glands, is specialized to address the unique needs of (a) lubrication and (b) host defense of the ocular surface. Not surprisingly, most challenges, physical and immunological, to the homeostasis of the eye fall into those two categories. Dry eye, a dysfunction of the lacrimal glands and/or Meibomian glands, which can both cause, or arise from, sensory defects, including those caused …


Co-Transmitting Neurons In The Lateral Septal Nucleus Exhibit Features Of Neurotransmitter Switching, Patrick J Hunt, Mikhail Kochukov, Brandon T Pekarek, Benjamin D W Belfort, Juan M Romero, Jessica L Swanson, Benjamin R Arenkiel Jun 2022

Co-Transmitting Neurons In The Lateral Septal Nucleus Exhibit Features Of Neurotransmitter Switching, Patrick J Hunt, Mikhail Kochukov, Brandon T Pekarek, Benjamin D W Belfort, Juan M Romero, Jessica L Swanson, Benjamin R Arenkiel

Faculty, Staff and Students Publications

The lateral septal nucleus (LSN) is a highly interconnected region of the central brain whose activity regulates widespread circuitry. As such, the mechanisms that govern neuronal activity within the LSN have far-reaching implications on numerous brain-wide nuclei, circuits, and behaviors. We found that GABAergic neurons within the LSN express markers that mediate the release of acetylcholine (ACh). Moreover, we show that these vGATLSN neurons release both GABA and ACh onto local glutamatergic LSN neurons. Using both short-term and long-term neuronal labeling techniques we observed expression of the cholinergic neuron marker Choline Acetyltransferase (ChAT) in vGATLSN neurons. These findings provide evidence …


Evolution Of International Pediatric Endoscopic Practice Changes During The Coronavirus Disease 2019 Pandemic, Wenly Ruan, Douglas S Fishman, Diana G Lerner, Raoul I Furlano, Mike Thomson, Catharine M Walsh Jun 2022

Evolution Of International Pediatric Endoscopic Practice Changes During The Coronavirus Disease 2019 Pandemic, Wenly Ruan, Douglas S Fishman, Diana G Lerner, Raoul I Furlano, Mike Thomson, Catharine M Walsh

Faculty, Staff and Students Publications

OBJECTIVES: The coronavirus disease 2019 (COVID-19) pandemic has drastically altered endoscopic practices. We initially reported the international impact of COVID-19 on pediatric endoscopic practice. This follow-up study aimed to assess changes 7 months following the initial survey to delineate practice change patterns as the pandemic evolved.

METHODS: Pediatric gastroenterologists who responded to the initial survey were re-surveyed seven months later using Research Electronic Data Capture (REDCap). The survey recorded information on changes in pediatric endoscopic practice patterns, including COVID-19 screening and testing processes and personal protective equipment (PPE) utilization. Additionally, endoscopists' risk tolerance of COVID-19 transmission was evaluated.

RESULTS: Seventy-five …


Unique Case Of Spontaneous Basilar Artery Stroke In An Operated Child With Craniopharyngioma, Krishna Shah, Shrey Jain, Ajit K Sinha Jun 2022

Unique Case Of Spontaneous Basilar Artery Stroke In An Operated Child With Craniopharyngioma, Krishna Shah, Shrey Jain, Ajit K Sinha

Faculty, Staff and Students Publications

Craniopharyngiomas are the most commonly presented nonglial tumors in child patients. They cause significant morbidity and mortality, both before and after surgery. The most common immediate postsurgery complications are attributable to pituitary insufficiency. Neurovascular complications account for only 2.7 to 2.9% surgical cases, and usually involve the vessels of the Circle of Willis. Thrombosis or vasospasm of the vessels of posterior circulation is unheard of. Here, we are reporting a unique case of a child with craniopharyngioma who developed acute spontaneous basilar artery thrombosis and posterior circulation stroke 6 days after surgery.


Why Not Dipyridamole: A Review Of Current Guidelines And Re-Evaluation Of Utility In The Modern Era, Mahmoud Allahham, A Lerman, D Atar, Y Birnbaum Jun 2022

Why Not Dipyridamole: A Review Of Current Guidelines And Re-Evaluation Of Utility In The Modern Era, Mahmoud Allahham, A Lerman, D Atar, Y Birnbaum

Faculty, Staff and Students Publications

Dipyridamole is an old anti-platelet and coronary vasodilator agent that inhibits platelet phosphodiesterase and increases interstitial adenosine levels. Its use in coronary artery disease (CAD) has fallen out of practice in the modern era with the advent of new anti-platelet agents, and most modern guidelines on the management of CAD either neglect to comment on its utility or outright recommend against it. The majority of the studies used in these guidelines are outdated and took place in an era when high doses of aspirin were used and statins were not widely utilized. There is growing evidence in rat models of …


Constitutive Loss Of Dnmt3a Causes Morbid Obesity Through Misregulation Of Adipogenesis, Ayala Tovy, Jaime M Reyes, Linda Zhang, Yung-Hsin Huang, Carina Rosas, Alexes C Daquinag, Anna Guzman, Raghav Ramabadran, Chun-Wei Chen, Tianpeng Gu, Sinjini Gupta, Laura Ortinau, Dongsu Park, Aaron R Cox, Rachel E Rau, Sean M Hartig, Mikhail G Kolonin, Margaret A Goodell May 2022

Constitutive Loss Of Dnmt3a Causes Morbid Obesity Through Misregulation Of Adipogenesis, Ayala Tovy, Jaime M Reyes, Linda Zhang, Yung-Hsin Huang, Carina Rosas, Alexes C Daquinag, Anna Guzman, Raghav Ramabadran, Chun-Wei Chen, Tianpeng Gu, Sinjini Gupta, Laura Ortinau, Dongsu Park, Aaron R Cox, Rachel E Rau, Sean M Hartig, Mikhail G Kolonin, Margaret A Goodell

Faculty, Staff and Students Publications

DNA Methyltransferase 3 A (DNMT3A) is an important facilitator of differentiation of both embryonic and hematopoietic stem cells. Heterozygous germline mutations in DNMT3A lead to Tatton-Brown-Rahman Syndrome (TBRS), characterized by obesity and excessive height. While DNMT3A is known to impact feeding behavior via the hypothalamus, here we investigated a role in adipocyte progenitors utilizing heterozygous knockout mice that recapitulate cardinal TBRS phenotypes. These mice become morbidly obese due to adipocyte enlargement and tissue expansion. Adipose tissue in these mice exhibited defects in preadipocyte maturation and precocious activation of inflammatory gene networks, including interleukin-6 signaling. Adipocyte progenitor cell lines lacking DNMT3A …


Poloxamer 407 Induces Hypertriglyceridemia But Decreases Atherosclerosis In Ldlr -/- Mice, Xueying Peng, Zeqin Lian, Xiao-Yuan Dai Perrard, Yunjie Xiao, Jing Ni, Veronica O'Brien, Henry Dong, Henry J Pownall, Christie M Ballantyne, Huaizhu Wu May 2022

Poloxamer 407 Induces Hypertriglyceridemia But Decreases Atherosclerosis In Ldlr -/- Mice, Xueying Peng, Zeqin Lian, Xiao-Yuan Dai Perrard, Yunjie Xiao, Jing Ni, Veronica O'Brien, Henry Dong, Henry J Pownall, Christie M Ballantyne, Huaizhu Wu

Faculty, Staff and Students Publications

Background: Hypertriglyceridemia (HTG) increases the risk for atherosclerotic cardiovascular disease, but underlying mechanisms are incompletely understood. Circulating monocytes play an important role in atherogenesis by infiltrating arterial walls, where they differentiate into macrophages. We tested the hypothesis that HTG is mechanistically linked to atherogenesis by altering the monocyte phenotype and infiltration into atherosclerotic lesions in a model of diet-induced atherogenesis in Ldlr−/− mice. Methods: HTG was induced in male Ldlr−/− mice, fed a Western, high-fat high-cholesterol diet, by daily injection of poloxamer 407 (P407), a lipoprotein lipase inhibitor, for seven weeks. Atherosclerosis, monocyte phenotypes, and monocyte migration into atherosclerotic lesions …


A Concise Synthetic Method For Constructing 3-Substituted Piperazine-2-Acetic Acid Esters From 1,2-Diamines, Srinivas Chamakuri, Sunny Ann Tang, Kevin A Tran, Shiva Krishna Reddy Guduru, Peter K Bolin, Kevin R Mackenzie, Damian W Young May 2022

A Concise Synthetic Method For Constructing 3-Substituted Piperazine-2-Acetic Acid Esters From 1,2-Diamines, Srinivas Chamakuri, Sunny Ann Tang, Kevin A Tran, Shiva Krishna Reddy Guduru, Peter K Bolin, Kevin R Mackenzie, Damian W Young

Faculty, Staff and Students Publications

We report a short synthetic route for synthesizing 2,3-substituted piperazine acetic acid esters. Optically pure amino acids were efficiently converted into 1,2-diamines that could be utilized to deliver the title 2,3-substituted piperazines in five steps with a high enantiomeric purity. The novel route facilitated, for the first time, the synthesis of 3-phenyl substituted-2-piperazine acetic acid esters that were difficult to achieve using other methods; however, in this case, the products underwent racemization.


Maf1, A Repressor Of Rna Polymerase Iii-Dependent Transcription, Regulates Bone Mass, Ellen Phillips, Naseer Ahmad, Li Sun, James Iben, Christopher J Walkey, Aleksandra Rusin, Tony Yuen, Clifford J Rosen, Ian M Willis, Mone Zaidi, Deborah L Johnson May 2022

Maf1, A Repressor Of Rna Polymerase Iii-Dependent Transcription, Regulates Bone Mass, Ellen Phillips, Naseer Ahmad, Li Sun, James Iben, Christopher J Walkey, Aleksandra Rusin, Tony Yuen, Clifford J Rosen, Ian M Willis, Mone Zaidi, Deborah L Johnson

Faculty, Staff and Students Publications

MAF1, a key repressor of RNA polymerase (pol) III-mediated transcription, has been shown to promote mesoderm formation in vitro. Here, we show that MAF1 plays a critical role in regulating osteoblast differentiation and bone mass. Global deletion of MAF1 (Maf1-/- mice) produced a high bone mass phenotype. However, osteoblasts isolated from Maf1-/- mice showed reduced osteoblastogenesis ex vivo. Therefore, we determined the phenotype of mice overexpressing MAF1 in cells from the mesenchymal lineage (Prx1-Cre;LSL-MAF1 mice). These mice showed increased bone mass. Ex vivo, cells from these mice showed enhanced osteoblastogenesis concordant with their high …


Targeting Aberrant Replication And Dna Repair Events For Treating Breast Cancers, Subapriya Rajamanickam, Jun Hyoung Park, Panneerdoss Subbarayalu, Santosh Timilsina, Kaitlyn Bates, Pooja Yadav, Saif S R Nirzhor, Vijay Eedunuri, Tabrez A Mohammad, Kwang Hwa Jung, Benjamin Onyeagucha, Nourhan Abdelfattah, Raymond Benevides, Grace Lee, Yidong Chen, Ratna Vadlamudi, Andrew Brenner, Virginia Kaklamani, Ismail Jatoi, John Kuhn, Robert Hromas, Yogesh K Gupta, Benny A Kaipparettu, Jack L Arbiser, Manjeet K Rao May 2022

Targeting Aberrant Replication And Dna Repair Events For Treating Breast Cancers, Subapriya Rajamanickam, Jun Hyoung Park, Panneerdoss Subbarayalu, Santosh Timilsina, Kaitlyn Bates, Pooja Yadav, Saif S R Nirzhor, Vijay Eedunuri, Tabrez A Mohammad, Kwang Hwa Jung, Benjamin Onyeagucha, Nourhan Abdelfattah, Raymond Benevides, Grace Lee, Yidong Chen, Ratna Vadlamudi, Andrew Brenner, Virginia Kaklamani, Ismail Jatoi, John Kuhn, Robert Hromas, Yogesh K Gupta, Benny A Kaipparettu, Jack L Arbiser, Manjeet K Rao

Faculty, Staff and Students Publications

The major limitations of DNA-targeting chemotherapy drugs include life-threatening toxicity, acquired resistance and occurrence of secondary cancers. Here, we report a small molecule, Carbazole Blue (CB), that binds to DNA and inhibits cancer growth and metastasis by targeting DNA-related processes that tumor cells use but not the normal cells. We show that CB inhibits the expression of pro-tumorigenic genes that promote unchecked replication and aberrant DNA repair that cancer cells get addicted to survive. In contrast to chemotherapy drugs, systemic delivery of CB suppressed breast cancer growth and metastasis with no toxicity in pre-clinical mouse models. Using PDX and ex …