Medicine and Health Sciences Commons^™

Examination Of Reticulocytosis Among Chronically Transfused Children With Sickle Cell Anemia., Megha Kaushal, Colleen Byrnes, Zarir Khademian, Natalie Duncan, Naomi L. Luban, Jeffery L Miller, Ross Fasano, Emily R. Meier

Pediatrics Faculty Publications

Sickle cell anemia (SCA) is an inherited hemolytic anemia with compensatory reticulocytosis. Recent studies have shown that increased levels of reticulocytosis during infancy are associated with increased hospitalizations for SCA sequelae as well as cerebrovascular pathologies. In this study, absolute reticulocyte counts (ARC) measured prior to transfusion were analysed among a cohort of 29 pediatric SCA patients receiving chronic transfusion therapy (CTT) for primary and secondary stroke prevention. A cross-sectional flow cytometric analysis of the reticulocyte phenotype was also performed. Mean duration of CTT was 3.1 ± 2.6 years. Fifteen subjects with magnetic resonance angiography (MRA) -vasculopathy had significantly higher …

Proteomic Characterization Of Middle Ear Fluid Confirms Neutrophil Extracellular Traps As A Predominant Innate Immune Response In Chronic Otitis Media., Stephanie Val, Marian Poley, Kristy Brown, Rachel Choi, Stephanie Jeong, Annie Colberg-Poley, Mary C. Rose, Karuna C Panchapakesan, Joseph C. Devaney, Marcos Perez-Losada, Diego Preciado

Pediatrics Faculty Publications

BACKGROUND: Chronic Otitis Media (COM) is characterized by middle ear effusion (MEE) and conductive hearing loss. MEE reflect mucus hypersecretion, but global proteomic profiling of the mucosal components are limited.

OBJECTIVE: This study aimed at characterizing the proteome of MEEs from children with COM with the goal of elucidating important innate immune responses.

METHOD: MEEs were collected from children (n = 49) with COM undergoing myringotomy. Mass spectrometry was employed for proteomic profiling in nine samples. Independent samples were further analyzed by cytokine multiplex assay, immunoblotting, neutrophil elastase activity, next generation DNA sequencing, and/or immunofluorescence analysis.

RESULTS: 109 unique and …

Circulating Fibroblast Growth Factor-2, Hiv-Tat, And Vascular Endothelial Cell Growth Factor-A In Hiv-Infected Children With Renal Disease Activate Rho-A And Src In Cultured Renal Endothelial Cells., Jharna R Das, J Silvio Gutkind, Patricio E. Ray

Pediatrics Faculty Publications

Renal endothelial cells (REc) are the first target of HIV-1 in the kidney. The integrity of REc is maintained at least partially by heparin binding growth factors that bind to heparan sulfate proteoglycans located on their cell surface. However, previous studies showed that the accumulation of two heparin-binding growth factors, Vascular Endothelial Cell Growth Factor-A (VEGF-A) and Fibroblast Growth Factor-2 (FGF-2), in combination with the viral protein Tat, can precipitate the progression of HIV-renal diseases. Nonetheless, very little is known about how these factors affect the behavior of REc in HIV+ children. We carried out this study to determine how …

Do 6-8 Year Old Girls With Central Precocious Puberty Need Routine Brain Imaging?, Paul B. Kaplowitz

Pediatrics Faculty Publications

BACKGROUND: The subject of whether all girls with central precocious puberty (CPP) require brain imaging is controversial.

FINDINGS: A review of the major papers concerning this topic published since 1994 was conducted looking primarily at the frequency of occult intracranial lesions, particularly brain tumors, in girls with CPP. While CNS abnormalities are frequently noted (8-15 %), the proportion of previously unknown findings requiring intervention in 6-8 year old girls is very small, in the range of 0-2 %.

CONCLUSION: While MRI should still be done in boys and in girls with onset of puberty younger than age 6 and in …

Anticipated Resource Utilization For Injury Versus Non-Injury Pediatric Visits To Emergency Departments, Mark R. Zonfrillo, Michelle L. Macy, Lawrence J. Cook, Tomohiko Funai, Rachel Stanley, James M. Chamberlain, For The Pediatric Emergency Care Applied Research Network (Pecarn)

Pediatrics Faculty Publications

Background

Childhood injuries are increasingly treated in emergency departments (EDs) but the relationship between injury severity and ED resource utilization has not been evaluated. The objective of this study was to compare resource utilization for pediatric injury-related ED visits across injury-severity levels and with non-injury visits, using standardized, validated scales.

Methods

A retrospective analysis of 2004-2008 ED visits from the Pediatric Emergency Care Applied Research Network Core Data Project. Maximum Abbreviated Injury Scale severity (MAIS) and Severity Classification System (SCS) scores were calculated and compared. MAIS and SCS are ordinal scales from 1 (minor injury) to 6, and 1 (low …

Molecular And Behavioral Profiling Of Dbx1-Derived Neurons In The Arcuate, Lateral And Ventromedial Hypothalamic Nuclei., Katie Sokolowski, Tuyen Tran, Shigeyuki Esumi, Yasmin Kamal, Livio Oboti, Julieta Lischinsky, Meredith Goodrich, Andrew Lam, Margaret Carter, Yasushi Nakagawa, Joshua G. Corbin

Pediatrics Faculty Publications

BACKGROUND: Neurons in the hypothalamus function to regulate the state of the animal during both learned and innate behaviors, and alterations in hypothalamic development may contribute to pathological conditions such as anxiety, depression or obesity. Despite many studies of hypothalamic development and function, the link between embryonic development and innate behaviors remains unexplored. Here, focusing on the embryonically expressed homeodomain-containing gene Developing Brain Homeobox 1 (Dbx1), we explored the relationship between embryonic lineage, post-natal neuronal identity and lineage-specific responses to innate cues. We found that Dbx1 is widely expressed across multiple developing hypothalamic subdomains. Using standard and inducible fate-mapping to …

"When Should I Tell?": Perspectives On Disclosure To Their Children Among Parents With Perinatally Acquired Hiv., Cynthia D Fair, Hannah Allen, Constance Trexler, Janet Osherow, Lawrence D'Angelo

Pediatrics Faculty Publications

Adolescents and young adults (AYA) with perinatally acquired HIV (PHIV) engage in developmentally expected behaviors, such as establishing relationships and having children. Previous research has focused on pregnancy management/outcomes of AYA with PHIV. However, little research has focused on the parenting experiences of this emerging cohort and on their views of disclosure to their offspring. This article examines data from a pilot study of five AYA parents with PHIV on disclosure to their child(ren) (n = 7, 6 HIV-negative). Disclosure of their own HIV status to their children is on the minds of parents with PHIV. However, few currently have …

The Clinical Outcome Study For Dysferlinopathy, Elizabeth Harris, Catherine Bladen, Anna Mayhew, Meredith James, Karen Bettinson, Avital Cnaan, The Jain Cos Consortium

Pediatrics Faculty Publications

Objective: To describe the baseline clinical and functional characteristics of an international cohort of 193 patients with dysferlinopathy.

Methods: The Clinical Outcome Study for dysferlinopathy (COS) is an international multicenter study of this disease, evaluating patients with genetically confirmed dysferlinopathy over 3 years. We present a cross-sectional analysis of 193 patients derived from their baseline clinical and functional assessments.

Results: There is a high degree of variability in disease onset, pattern of weakness, and rate of progression. No factor, such as mutation class, protein expression, or age at onset, accounted for this variability. Among patients with clinical diagnoses of Miyoshi …

Incidence Of X And Y Chromosomal Aneuploidy In A Large Child Bearing Population., Carole Samango-Sprouse, Eser Kırkızlar, Megan P Hall, Patrick Lawson, Zachary Demko, Susan M Zneimer, Kirsten J Curnow, Susan Gross, Andrea Gropman

Pediatrics Faculty Publications

BACKGROUND: X&Y chromosomal aneuploidies are among the most common human whole-chromosomal copy number changes, but the population-based incidence and prevalence in the child-bearing population is unclear.

METHODS: This retrospective analysis of prospectively collected data leveraged a routine non-invasive prenatal test (NIPT) using parental genotyping to estimate the population-based incidence of X&Y chromosome variations in this population referred for NIPT (generally due to advanced maternal age).

RESULTS: From 141,916 women and 29,336 men, 119 X&Y chromosomal abnormalities (prevalence: 1 in 1,439) were identified. Maternal findings include: 43 cases of 45,X (40 mosaic); 30 cases of 47,XXX (12 mosaic); 3 cases of …

Safe Infant Sleep Interventions: What Is The Evidence For Successful Behavior Change?, Rachel Y. Moon, Fern R Hauck, Eve R Colson

Pediatrics Faculty Publications

Sudden infant death syndrome (SIDS) and other sleep-related infant deaths, such as accidental suffocation and strangulation in bed and ill-defined deaths, account for >4000 deaths annually in the USA. Evidence-based recommendations for reducing the risk of sleep-related deaths have been published, but some caregivers resist adoption of these recommendations. Multiple interventions to change infant sleep-related practices of parents and professionals have been implemented. In this review, we will discuss illustrative examples of safe infant sleep interventions and evidence of their effectiveness. Facilitators of and barriers to change, as well as the limitations of the data currently available for these interventions, …

Age-Related Effect Of Viral-Induced Wheezing In Severe Prematurity, Geovanny F. Perez, Amisha Jain, Bassem Kurdi, Rosemary Megalaa, Krishna Pancham, Shehlanoor Huseni, Natalia Isaza, Carlos E. Rodriguez-Martinez, Mary C. Rose, Dinesh Pillai, Gustavo Nino

Pediatrics Faculty Publications

Premature children are prone to severe viral respiratory infections in early life, but the age at which susceptibility peaks and disappears for each pathogen is unclear.

Methods: A retrospective analysis was performed of the age distribution and clinical features of acute viral respiratory infections in full-term and premature children, aged zero to seven years.

Results: The study comprised of a total of 630 hospitalizations (n = 580 children). Sixty-seven percent of these hospitalizations occurred in children born full-term (>37 weeks), 12% in preterm (32–37 weeks) and 21% in severely premature children (<32 weeks). The most common viruses identified were rhinovirus (RV; 60%) and respiratory syncytial virus (RSV; 17%). Age-distribution analysis of each virus identified that severely premature children had a higher relative frequency of RV and RSV in their first three years, relative to preterm or full-term children. Additionally, the probability of RV- or RSV-induced wheezing was higher overall in severely premature children less than three years old.

Conclusions: Our results indicate that the vulnerability …

Dc Beadm1™: Towards An Optimal Transcatheter Hepatic Tumour Therapy., Andrew L Lewis, Matthew R Dreher, Vincent O'Byrne, David Grey, Marcus Caine, Anthony Dunn, Yiqing Tang, Brenda Hall, Kirk D Fowers, Carmen Gacchina Johnson, Karun V. Sharma, Bradford J Wood

Pediatrics Faculty Publications

Clinical use of DC Bead™ loaded with doxorubicin (DEBDOX™) or irinotecan (DEBIRI™), for the treatment of primary and secondary tumours of the liver respectively, is showing great promise. Recently there has been a tendency to select smaller bead size ranges to treat tumours in an effort to allow more drug dose to be administered, improve tumoural penetration and resultant drug delivery and tumour coverage. Herein we describe the development and performance characterisation of a new DC Bead size range (DC BeadM1 (TM), 70-150 μm) capable of an increased bead delivery in the distal vasculature, corresponding to greater tumour coverage and …

Interrater Reliability Of Quantitative Ultrasound Using Force Feedback Among Examiners With Varied Levels Of Experience, Michael O. Harris-Love, Catheeja Ismail, Reza Monfaredi, Haniel J. Hernandez, Donte Pennington, Paula Woletz, Valerie Mcintosh, Bernadette Adams, Marc R. Blackman

Exercise and Nutrition Sciences Faculty Publications

Background. Quantitative ultrasound measures are influenced by multiple external factors including examiner scanning force. Force feedback may foster the acquisition of reliable morphometry measures under a variety of scanning conditions. The purpose of this study was to determine the reliability of force-feedback image acquisition and morphometry over a range of examiner-generated forces using a muscle tissuemimicking ultrasound phantom.

Methods. Sixty material thickness measures were acquired from a muscle tissue mimicking phantom using B-mode ultrasound scanning by six examiners with varied experience levels (i.e., experienced, intermediate, and novice). Estimates of interrater reliability and measurement error with force feedback scanning were determined …

Simulation As Staff Development For Competency In Nursing Care Of Patients With Chest Tubes, Jennifer Dent

Doctor of Nursing Practice Projects

There is an estimated 98,000 to 400,000 hospital errors that result in patient harm or death annually (David, Gunnarsson, Waters, Horblyuk and Kaplan, 2013; James 2013). As a member of the health care team nurses coordinate and provide continual care to the hospitalized patient (American Association of Colleges of Nursing, 2011; Parker, 2014). Patient safety is promoted when nurses are competent in their knowledge, skills, attitude, and performance related to evidence-based practice, protocols, and standards of care (; American Nurses Association, n.d; Schroeter, 2009). The purpose of this evidence-based project was to promote patent safety by developing and maintaining competency …

Implementation Of Community-Based Education To Promote Colorectal Cancer Knowledge And Screening Rates, Marsha Woodall

Doctor of Nursing Practice Projects

Colorectal cancer (CRC) is the third most commonly diagnosed cancer and the second-leading cause of cancer death for both men and women in Kentucky and in the US. Although early detection and diagnosis greatly affect survival rates, only about half (58.2%) of the US population participates in screening (Screening Rates, 2016). Two of the previously reported barriers with colorectal cancer screening are provider neglect to fully educate patients on the need for screening and patient compliance with screening recommendations. The purpose of this capstone project was to implement community-based CRC education and screening. Watson’s Human Caring Theory and Prochaska and …

Do Health Reforms Impact Cost Consciousness Of Health Care Professionals? Results From A Nation-Wide Survey In The Balkans, Mihajlo Jakovljevic, Mira Vukovic, Chia-Ching Chen, Tetsuji Yamada

NYMC Faculty Publications

BACKGROUND: Serbia, as the largest market of the Western Balkans, has entered socioeconomic transition with substantial delay compared to most of Eastern Europe. Its health system reform efforts were bold during the past 15 years, but their results were inconsistent in various areas. The two waves of global recession that hit Balkan economies ultimately reflected to the financial situation of healthcare. Serious difficulties in providing accessible medical care to the citizens became a reality. A large part of the unbearable expenses actually belongs to the overt prescription of pharmaceuticals and various laboratory and imaging diagnostic procedures requested by physicians. Therefore, …

Renal Artery Stenosis In A Young Female Without Fibromuscular Dysplasia With Literature Review, Paloma Peralta, Matthew Cholankeril, Daniel Goldberg, Jayanth Koneru, Fayez Shamoon

NYMC Faculty Publications

Renal artery stenosis (RAS) is rare in young patients without fibromuscular dysplasia (FMD). RAS is primarily classified as having two major etiologies, namely, atherosclerosis and FMD, with 90% and 10%, respectively. We report a case of a female in her mid 20s who developed hypertension due to RAS with no evidence of FMD or underlying renal dysfunction and underwent successful angioplasty and stenting.

Uric Acid-Induced Adipocyte Dysfunction Is Attenuated By Ho-1 Upregulation: Potential Role Of Antioxidant Therapy To Target Obesity, Komal Sodhi, Jordan Hilgefort, Sarah Stevens, Morghan Getty, Nader G. Abraham, Zeid Khitan

NYMC Faculty Publications

Increased uric acid levels have been implicated in the pathogenesis of metabolic syndrome. To examine the mechanisms by which this occurs, we hypothesized that an increase in heme oxygenase 1, a potent antioxidant gene, will decrease uric acid levels and adipocyte dysfunction via suppression of ROS and xanthine oxidase (XO) levels. We examined the effect of uric acid on adipogenesis in human mesenchymal stem cells (MSCs) in the presence and absence of cobalt protoporphyrin (CoPP), an HO-1 inducer, and tin mesoporphyrin (SnMP), an HO activity inhibitor. Uric acid increased adipogenesis by increasing NADPH oxidase expression and elevation in the adipogenesis …

Triumph Over Tragedy: The Odyssey Of An Academic Physician, William H. Frishman

NYMC Faculty Publications

Triumph Over Tragedy: The Odyssey of an Academic Physician is the remarkable new memoir written by William H. Frishman, M.D., currently the Director of Medicine at Westchester Medical Center and the Rosenthal Professor and Chairman of the Department of Medicine at New York Medical College in Valhalla, New York, positions he has held for almost 20 years.

Dr. Frishman is a devotee of history and literature, and The Odyssey by Homer is one of his favorite books. In Triumph Over Tragedy, he details his own personal odyssey, and relays his experiences, through text and photos, as a son, student, …

Stability Of Metabolic Factor Before And After Bariatric Surgery, Brandon Davis, Joseph Indelicato

The School of Health Sciences Publications and Research

No abstract provided.

Obesity Is Associated With More Disability At Presentation And After Treatment In Low Back Pain But Not In Neck Pain: Findings From The Oioc Registry, Maria M. Wertli, Ulrike Held, Marco Campello, Shira Schecter Weiner

The School of Health Sciences Publications and Research

Background: The influence on the treatment response in patients with low back pain (LBP) and neck pain (NP) is unknown. The aim of the study was to investigate the influence of body weight in patients with low back pain (LBP) and neck pain (NP) on baseline and end of treatment disability.

Methods: Cross-sectional analysis of baseline factors. Longitudinal analysis of prospectively collected patient information at an outpatient physical therapy registry (data from June 2010 to December 2012). WHO-BMI classification was used: underweight, lean, overweight, obesity class I, obesity class II and III. The influence of body weight and …

Take The Stigma Out Of Obesity, Joseph Indelicato

The School of Health Sciences Publications and Research

The author describes Metabolic Factor as something that should be considered when public health professionals treat obese individuals. He further states that public health professional should work to take away the stigma of obesity.

Zika Virus, Abigail Hanneken

Nursing Student Class Projects (Formerly MSN)

Zika virus (ZIKV) is a member of the Spondweni serocomplex within the genus Flavivovirus, family flaviviridae (Weaver et. al, 2012). ZIKV is related to dengue, West Nile, and yellow fever viruses (Lazear et. al, 2016). ZIKV was first discovered in Uganda, but since then outbreaks have been reported in Africa and Southeast Asia. In May 2015, the Pan American Health Organization (PAHO) issued an alert regarding the first confirmed Zika virus infection in Brazil, where it began to rapidly spread throughout the region (CDC, 2016). Recently, the World Health Organization (WHO) declared the ongoing outbreak of Zika virus and associated …

Sepsis In The Intensive Care Setting, Katie Mojzisik

Nursing Student Class Projects (Formerly MSN)

Sepsis is a complex systemic illness. According to Kruse et al. (2016), neutropenic sepsis is a frequent complication in cancer patients. Although the underlying disease is curable, once transferred to the ICU with sepsis these patients have poor outcomes. • Patients who develop sepsis are commonly admitted to an Intensive Care Unit. Working on the Medical Intensive Care Unit (JMICU) at the James Cancer Hospital, one sees septic cancer patients often. This cancer diagnosis places patients at a higher risk of developing sepsis. Some patients also have a high risk due to decreased immunity from chemotherapy treatments. Oncology patients can …

Pathophysiology Of Sepsis Associated Acute Kidney Injury, Amanda M. Urban

Nursing Student Class Projects (Formerly MSN)

Sepsis is a common cause of AKI. The research shows that AKI associated sepsis has high morbidity and mortality rates. According to Bonventre and Yang (2011) even if a patient survives the acute phase of kidney injury there are many chronic consequences that can occur as a result. These can include chronic kidney disease and end-stage renal disease (p. 4210). This makes keeping up with further research and developments related to AKI all the more important to nurses. Many factors contribute to the occurrence of sepsis associated AKI. Sepsis is a major cause of AKI due to the alterations in …

The Effect Of Step Frequency Training On A Male Runner With Patellofemoral Pain, Shelley Payne Dr., Katelyn Barrett, Joe Wilkins

Health and Sport Sciences Faculty Scholarship

Running is a very popular form of exercise. The most common site of injury for runners is the knee with patellofemoral pain being the most common complaint. Patellofemoral pain is described as pain around the patella that is worse with activities such as running, squatting, ascending or descending stairs, or sitting for long periods. Much of the recent work with the treatment of patellofemoral pain has involved strengthening of the hip musculature to reduce pain about the knee. However, the ability of these strengthening programs to change lower extremity mechanics or sustain long-term pain reduction has been unproven. More recently, …

Risk Factors Associated With Noncontact Time-Loss Lower-Quadrant Injury In Male Collegiate Soccer Players, Jason Brumitt, Amy Engilis, Amber Eubanks, Alma Mattocks, Jennifer Peet, Nathanael Bush

Faculty Publications - College of Physical Therapy

Introduction: The incidence of time-loss injury in male collegiate soccer players in the United States (US) is 6.4 per 1000 athletic exposures. With thousands of male athletes competing in soccer at the US collegiate level each year, there is the potential for numerous time-loss injuries that may ultimately impact team success. Thus, identifying risk factors for injury is warranted.

Purpose: The primary purpose of this study was to determine if preseason functional performance test (FPT) measures (the standing long jump [SLJ] and single-leg hop [SLH] for distance tests) were associated with an increased risk of a noncontact time-loss lower-quadrant (LQ) …

Functional Performance Deficits Exist In Female Naia Collegiate Athletes With History Of Anterior Cruciate Ligament Reconstruction, Jason Brumitt, Amy Engilis

Faculty Publications - College of Physical Therapy

This study compared preseason measures of standing long jump (SLJ) and single-leg hop (SLH) distances between female collegiate athletes with or without history of anterior cruciate ligament reconstruction (ACLR). The data from 45 female collegiate athletes (mean age: 20.6 +- 2.2 years) competing at the National Association of Intercollegiate Athletes (NAIA) level in three team sports (volleyball, soccer, and basketball) were collected as a subanalysis of measures for a prospective cohort study. There were no differences in SLJ or SLH distances between athletes with or without prior history of low back and/or lower extremity sports injuries. However, female athletes with …

Current And Desired Practice Patterns Of Trauma And Acute Care Surgeons (T/Acs), Nathan M. Droz, Melissa L. Whitmill, Priti Parikh, Kimberly M. Hendershot

Department of Surgery Faculty Publications

Resident hour restrictions and the addition of emergency general surgery (EGS) have changed how the T/ACS team functions and their work patterns. The purpose of our study is to report current practice patterns of T/ACS and compare those to desired practice patterns of the future workforce in the field (residents/fellows).

Developing A Global Health Assessment Collaboration: Ancillary Report, Daniel Edwards, Jacob Pearce, David Wilkinson

Higher education research

This document reports on a project designed to develop an assessment collaboration between medical schools in both Australia and the United Kingdom. The project was funded by the Office for Learning and Teaching (OLT), utilising surplus funding from a broader assessment collaboration project – the Australian Medical Assessment Collaboration (OLT ID12-2482). The Global Health Assessment Collaboration (GHAC) involved five universities in Australia and the United Kingdom (UK). It developed an assessment framework and item specifications, undertook assessment item drafting workshops, built in a process of review and resulted in the development of a focused suite of assessment items. This report …