Medicine and Health Sciences Commons^™

Sustained Nitric Oxide-Releasing Nanoparticles Interfere With Methicillin-Resistant Staphylococcus Aureus Adhesion And Biofilm Formation In A Rat Central Venous Catheter Model., Mircea Radu Mihu, Vitor Cabral, Rodney Pattabhi, Moses T Tar, Kelvin P Davies, Adam J Friedman, Luis R Martinez, Joshua D Nosanchuk

Dermatology Faculty Publications

Staphylococcus aureus is frequently isolated in the setting of infections of indwelling medical devices, which are mediated by the microbe's ability to form biofilms on a variety of surfaces. Biofilm-embedded bacteria are more resistant to antimicrobial agents than their planktonic counterparts and often cause chronic infections and sepsis, particularly in patients with prolonged hospitalizations. In this study, we demonstrate that sustained nitric oxide-releasing nanoparticles (NO-np) interfere with S. aureus adhesion and prevent biofilm formation on a rat central venous catheter (CVC) model of infection. Confocal and scanning electron microscopy showed that NO-np-treated staphylococcal biofilms displayed considerably reduced thicknesses and bacterial …

Ptpro Represses Erbb2-Driven Breast Oncogenesis By Dephosphorylation And Endosomal Internalization Of Erbb2., H Dong, L Ma, J Gan, W Lin, Rakesh Kumar, +9 Additional Authors

Biochemistry and Molecular Medicine Faculty Publications

The plasma membrane-associated tyrosine phosphatase PTPRO is frequently transcriptionally repressed in cancers and signifies poor prognosis of breast cancer patients. In this study, deletion of Ptpro inMMTV-Erbb2 transgenic mice dramatically shortened the mammary tumor latency and accelerated tumor growth due to loss of Ptpro within the breast cancer cells but not in surrounding tissue as confirmed by hetero-transplantation studies. Both in vitro and in vivo data demonstrated that the phosphatase activity was required for the inactivation of ERBB2 and its downstream signaling. PTPRO regulated the phosphorylation status of ERBB2 at Y1248. Co-immunoprecipitation and proximity ligation assay (Duolink) indicated that …

Unmasking Of Myoclonus By Lacosamide In Generalized Epilepsy, Daniel Birnbaum, Mohamad Z. Koubeissi

Neurology Faculty Publications

Lacosamide is a new-generation antiseizure medication that is approved for use as an adjunctive treatment and monotherapy in focal epilepsy. Its use in generalized epilepsy, however, has not been adequately evaluated in controlled trials. We report a 67-year-old woman who experienced new-onset myoclonic seizures after initiation of lacosamide. We presume that she had an undiagnosed generalized epilepsy syndrome, likely juvenile myoclonic epilepsy. Myoclonic seizures were not reported before introducing lacosamide and completely resolved after lacosamide was discontinued. This suggests that lacosamide may have the potential to worsen myoclonus, similar to what has been reported with another sodium channel agent, lamotrigine, …

Neurosurgery Concepts: Key Perspectives On Endoscopic Versus Microscopic Resection For Pituitary Adenomas, Surgical Decision-Making In Tuberculum Sellae Meningiomas, Optic Nerve Mobilization During Resection Of Craniopharyngiomas, And Evaluation Of Headache And Quality Of Life After Endoscopic Transphenoidal Surgery For Pituitary Adenomas, Anand Germanwala, Ryan Hofler, Carlito Lagman, Lawrence Chang, Alexander Khaleesi, Jonathan H. Sherman, +Several Additional Authors

Neurological Surgery Faculty Publications

No abstract provided.

Medical Genetics And Genomic Medicine In The United States. Part 2: Reproductive Genetics, Newborn Screening, Genetic Counseling, Training, And Registries, Debra S. Regier, Carlos Ferreira, Suzanne Hart, Donald Hadley, Maximilian Muenke

Pediatrics Faculty Publications

eview of genetics in the United States with emphasis on the prenatal, metabolic, genetic counseling, and training aspects of the field.

Stimulated Hyposalivary Flow Rates In Healthcare Students In An Interprofessional Awareness Educational Program Curriculum, R Constance Wiener

Faculty & Staff Scholarship

Purpose. Hyposalivation influences quality of life and medication compliance. However, oral health knowledge (in general) and knowledge about hyposalivation (in particular) are often lacking in nondental healthcare professional’s curricula. Additionally, hyposalivation has not been adequately studied in young adults. The purpose for this study is twofold: to use an interprofessional educational curriculum to increase nondental healthcare students’ knowledge about oral health and salivary testing and determine whether hyposalivation is different between sexes in young adults. Method. First-year medical and pharmacy students () learned the process of saliva collection and provided samples in an interprofessional program. Results. There were 14.4% of …

Statin Use And Risk Of Developing Diabetes: Results From The Diabetes Prevention Program, Diabetes Prevention Program(Dpp) Research Group, Marinella G. Temprosa

GW Biostatistics Center

Objective Several clinical trials of cardiovascular disease prevention with statins have reported increased risk of type 2 diabetes (T2DM) with statin therapy. However, participants in these studies were at relatively low risk for diabetes. Further, diabetes was often based on self-report and was not the primary outcome. It is unknown whether statins similarly modify diabetes risk in higher risk populations.

Research design and methods During the Diabetes Prevention Program Outcomes Study (n=3234), the long-term follow-up to a randomized clinical trial of interventions to prevent T2DM, incident diabetes was assessed by annual 75 g oral glucose tolerance testing and semiannual fasting …

Anti-Müllerian Hormone And Its Relationships With Subclinical Cardiovascular Disease And Renal Disease In A Longitudinal Cohort Study Of Women With Type 1 Diabetes, Catherine Kim, Yuanyuan Pan, Barbara Braffett, Valerie Arends, Michael Steffes, Hunter Wessells, Aruna V. Sarma

GW Biostatistics Center

Background

Reproductive age may be a risk factor for vascular disease. Anti-Müllerian hormone (AMH) is produced by viable ovarian follicles and reflects reproductive age. We examined whether AMH concentrations were associated with markers of subclinical cardiovascular disease (CVD) and kidney disease among women with type 1 diabetes.

Methods

We performed a cross-sectional analysis of the Epidemiology of Diabetes Interventions and Complications Study. Participants included women with type 1 diabetes and ≥1 AMH measurement (n = 390). In multivariable regression models which adjusted for repeated measures, we examined the associations between AMH with CVD risk factors, estimated glomerular filtration rate, …

Himmelfarb Library Annual Report 2017, George Washington University, Himmelfarb Health Sciences Library

Himmelfarb Library Annual Report

No abstract provided.

Three Damn Letters, Katherine Ammon

Honors Program Theses

Amyotrophic lateral sclerosis (ALS) is a terminal disease that destroys a patient's motor neurons. In the play Three Damn Letters, a sarcastic woman must accept her own ALS diagnosis while also balancing her relationships with her father, husband, and son. This seriocomedic play explores themes of family roles, disability, love, and death.

The Impact Of Globalization On The Perceptions And Practices Of Menstruation Among Indigenous Women In Peru, Meghan Wallace

Honors Program Theses

The existing perceptions and practices of menstruation on the island of Taquile in Lake Titicaca, Peru provide insights into the manners in which globalization can challenge and shape perspectives in indigenous communities. Through the framework of globalization as polarization, hybridization, and homogenization, this study explores the impacts that changes in menstrual practices and perceptions can have on female health outcomes, agency in the community, and education efforts. Viewpoints of menstruation distinctly differ according to gender and age, yet ultimately point toward the concept that all three lenses of globalization provide explanations for menstruation in the community of Taquile.

Variability In Objective And Subjective Measures Affects Baseline Values In Studies Of Patients With Copd, Wayne H. Anderson, Jae Wook Ha, David J. Couper, Wanda K. O'Neal, R. Graham Barr, Eugene R. Bleecker, Elizabeth E. Carretta, Christopher B. Cooper, Claire M. Doerschuk, M. Bradley Drummond, Meilan K. Han, Nadia N. Hansel, Victor Kim, Eric C. Kleerup, Fernando J. Martinez, Stephen I. Rennard, Donald Tashkin, Prescott G. Woodruff, Robert Paine, Jeffrey L. Curtis, Richard W. Kanner, Spiromics Research Group

Journal Articles: Pulmonary & Critical Care Med

RATIONALE: Understanding the reliability and repeatability of clinical measurements used in the diagnosis, treatment and monitoring of disease progression is of critical importance across all disciplines of clinical practice and in clinical trials to assess therapeutic efficacy and safety.

OBJECTIVES: Our goal is to understand normal variability for assessing true changes in health status and to more accurately utilize this data to differentiate disease characteristics and outcomes.

METHODS: Our study is the first study designed entirely to establish the repeatability of a large number of instruments utilized for the clinical assessment of COPD in the same subjects over the same …

Factors & Risks Associated With Adolescents Late Entry Into Prenatal Care, Shannon Almonia, Kimberly Damian, Giuliana Enea, Solveig Karlsen, Jessica Markham

Student Research Posters

Prenatal care is a type of preventative health care for pregnant women that is typically initiated in the first trimester. However, when prenatal care is inadequate, initiated past the first trimester or missed, the mother and fetus experience an increased risk for preterm delivery. Adolescents are apart of a specific subgroup of pregnant women that are at a higher risk for adverse outcomes during pregnancy due to knowledge deficits. Therefore, adolescents are especially likely to receive inadequate prenatal services. Numerous studies have been conducted to discover the result of inadequate prenatal care; however, not as many studies explore the factors …

What Is The Relationship Between Food Insecurity And College Students Aged 18-22 And Its Effects On Academic Performance And How Can Proper Nutrition Be Promoted?, Karla Ramos, John Magbanua, Daniella Flores, Janelle De Dios, Karla Bugtong, Shannon Almonia

Student Research Posters

Food insecurity is defined as the limited or uncertain availability of nutritionally adequate and safe foods. It can also be defined as the limited or uncertain ability to acquire acceptable foods in socially acceptable ways. Previous research has observed that food insecurity can disrupt optimal development throughout the life cycle. A growing body of literature has documented the effects of food insecurity on cognitive, academic, and psychosocial development among college students. These studies consistently observed that food insecurity is associated with lower academic performance, poor health, and decreased psychosocial function. Among college students, financial hardship can translate into budget demands, …

Influenza Vaccination In School-Aged Children, Isabella Jao, Chloe Mcfadin, Nica Nuguid, Dan Recinto, Kaitlin Van Ryn

Student Research Posters

Should schools in the United States require children between the ages of six months to 17 years to have flu vaccination shots? Influenza is a serious disease that can lead to hospitalization and sometimes even death. According to the Center of Disease Control (CDC), every flu season varies, and an influenza infection can affect people differently. Millions of people get the flu every year, hundreds of thousands of people are hospitalized, and thousands or tens of thousands of people die from flu-related causes every year. Everyone is at risk for influenza, but the highest risk lies within children who are …

Common Factors Related To Illicit Substance Use Among Nurses In North America, Madison Marshall, Reinelle Regala, Lucy Gray, Emma Pedlar, Samantha Naguit

Student Research Posters

The prevalence of illicit substance use among registered nurses, though not widely studied or addressed, is understood to be an essential issue facing healthcare professionals. An impaired nurse is defined as someone who has impaired functioning as a result of substance abuse and it interferes with their professional judgment and ability to deliver safe, high quality care. Registered nurses have access to many high-controlled prescription medications, with little oversight, and the opportunity for substance abuse is significant. In our research, we studied the risk factors, the prevalence, and the preventative measures involved in addressing illicit substance use among nurses.

Collaborative Instruction For Information Retrieval And Appraisal Skills In Evidence-Based Practice Models For Dental Hygiene Students., Irene M. Lubker, Joan M. Pellegrini

VCU Libraries Faculty and Staff Presentations

Objectives:

1. Collaborate with VCU Dental Hygiene Program faculty to develop and evaluate a model of evidence-based practice (EBP) for students in didactic and clinical settings.

2. Describe how a course was modified to emphasize evidence-based practice.

3. Analyze course evaluations and student scholarly output.

Methods/Materials:

Dental educators strive to develop graduates who practice evidence-based practice and whose clinical decisions are based on current scientific research. A medical librarian was invited to assist in integrating EBP into the dentistry curriculum in 2012. To gain a better understanding of EBP in dental settings, the librarian and dental hygiene faculty attended the …

Development Of Occupational Therapy-Based Pain Management Group Program To Prevent Substance Abuse, Michelle Stotesberry

MOT Student Capstones

Substance abuse, particularly opioid abuse, has become a severe problem in America. Users typically become exposed to opioids initially for pain management, which can lead to addiction if not tapered off over time. By addressing pain management using nonopioid measures, the likelihood that individuals will get addicted and abuse this substance decreases. Occupational therapy has demonstrated effectiveness in addressing pain management for clients, and occupational therapy interventions have also been effective in substance abuse treatment. This project reviewed evidence-based practice to evaluate different approaches to pain management to help individuals become independent in self-managing their pain, thereby decreasing the chances …

Assessing Attitudinal Barriers To Health Insurance Enrollment And Facilitation In Vulnerable Populations, Christopher Brown

Health Sciences Education Symposium

Introduction: Homeless individuals bear a disproportionately high burden of disease. Lack of health insurance amongst homeless populations is a significant barrier to healthcare access.

Methods: This study explored barriers and facilitators to health insurance via a survey-format that focused predominantly on attitudes towards health insurance and enrollment assistance.

Results: Majority of respondents endorse a facilitator to guide the enrollment process at their location of healthcare. While 43.8% of participants reported they knew where to go for enrollment assistance, 43.7% did not. 100% of participants agreed that health insurance is important, while only 43.1% were insured.

Conclusion: Distrust regarding facilitation in …

Determinants Of Hiv Screening Among Adults In New Jersey After Hurricane Sandy, Nathaniel R. Geyer

2017 Program & Posters

HIV screening is recommended to destigmatize the condition, prevent partner transmission, and postpone AIDS progression. However, determinants associated with implementation of opt-out HIV screening are not well understood. In order to examine determinants that predicted HIV screening for people impacted by Hurricane Sandy, this study aims to evaluate this screening to medical care after a natural disaster.

Assessment With Children Who Need Augmentative And Alternative Communication (Aac): Clinical Decisions Of Aac Specialists, Shelley Lund, Wendy Quach, Kristy S. E. Weissling, Miechelle L. Mckelvey, Aimee R. Dietz

Department of Special Education and Communication Disorders: Faculty Publications

Purpose

The purpose of this study was to explore how speech-language pathologists (SLPs) who are augmentative and alternative communication (AAC) specialists approach the assessment process for 2 case studies, 1 child with cerebral palsy and 1 with autism spectrum disorder. The aim of the study was to answer the following questions: (a) How do clinicians with expertise approach the AAC assessment process for children with developmental disabilities? (b) Can any initial hypothesis be drawn about how SLPs approach the assessment of children with motor versus social interactive deficits?

Method

This study used a phenomenological qualitative design. The researchers conducted 2 …

An Echocardiography Training Program For Improving The Left Ventricular Function Interpretation In Emergency Department; A Brief Report, Mary Jacob, Hamid A. Shokoohi, Fabith Moideen, Amelia Pousson, Keith S. Boniface

Emergency Medicine Faculty Publications

Introduction: Focused training in transthoracic echocardiography enables emergency physicians (EPs) to accurately estimate the left ventricular function. This study aimed to evaluate the efficacy of a brief training program utilizing standardized echocardiography video clips in this regard.
Methods: A before and after design was used to determine the efficacy of a 1 hour echocardiography training program using PowerPoint presentation and standardized echocardiography video clips illustrating normal and abnormal left ventricular ejection fraction (LVEF) as well as video clips emphasizing the measurement of mitral valve E-point septal separation (EPSS). Pre- and post-test evaluation used unique video clips and asked trainees to …

Selective Autonomic Stimulation Of The Av Node Fat Pad To Control Rapid Post-Operative Atrial Arrhythmias., Marco A Mercader, Dingchao He, Aditya C Sharma, Mark C Marchitto, Gregory Trachiotis, Gene A Bornzin, Richard A. Jonas, Jeffrey P Moak

Medicine Faculty Publications

Junctional ectopic tachycardia (JET) and atrial fibrillation (AF) occur in patients recovering from open-heart surgery (OHS). Pharmacologic treatment is used for the control of post-operative atrial arrhythmias (POAA), but is associated with side effects. There is a need for a reversible, modulated solution to rate control. We propose a non-pharmacologic technique that can modulate AV nodal conduction in a selective fashion. Ten mongrel dogs underwent OHS. Stimulation of the anterior right (AR) and inferior right (IR) fat pad (FP) was done using a 7-pole electrode. The IR was more effective in slowing the ventricular rate (VR) to AF (52 +/- …

A Fashi Lymphoproliferative Phenotype Reveals Non-Apoptotic Fas Signalling In Htlv-1-Associated Neuroinflammation., Soraya Maria Menezes, Fabio E Leal, Tim Dierckx, Ricardo Khouri, Daniele Decanine, Gilvaneia Silva-Santos, +Several Additional Authors

Microbiology, Immunology, and Tropical Medicine Faculty Publications

Human T-cell lymphotropic virus (HTLV)-1 was the first human retrovirus to be associated to cancer, namely Adult T-cell Leukemia (ATL), but its pathogenesis remains enigmatic, since only a minority of infected individuals develops either ATL or the neuroinflammatory disorder HTLV-1-associated myelopathy/tropical spastic paraparesis (HAM/TSP). A functional FAS -670 polymorphism in an interferon (IFN)-regulated STAT1-binding site has been associated to both ATL and HAM/TSP susceptibility. Fashi T stem cell memory (Tscm) cells have been identified as the hierarchical apex of ATL, but have not been investigated in HAM/TSP. In addition, both FAS and STAT1 have been identified in an IFN-inducible HAM/TSP …

Nasopharyngeal Microbiome Diversity Changes Over Time In Children With Asthma, Marcos Pérez-Losada, Lamia Alamri, Keith Crandall, Robert J. Freishtat

Pediatrics Faculty Publications

Background

The nasopharynx is a reservoir for pathogens associated with respiratory illnesses such as asthma. Next-generation sequencing (NGS) has been used to characterize the nasopharyngeal microbiome of infants and adults during health and disease; less is known, however, about the composition and temporal dynamics (i.e., longitudinal variation) of microbiotas from children and adolescents. Here we use NGS technology to characterize the nasopharyngeal microbiomes of asthmatic children and adolescents (6 to 18 years) and determine their stability over time.

Methods

Two nasopharyngeal washes collected 5.5 to 6.5 months apart were taken from 40 children and adolescents with asthma living in the …

Relationship Of Common Vascular Anatomy To Cannulated Catheters., Paul Gagne, Karun Sharma

Pediatrics Faculty Publications

Superficial veins of the upper extremity are the primary location for placement of peripheral IV catheters (PIVC). It is believed that a significant portion of PIVCs placed may cross or abut valves and branching veins or occlude a significant portion of the vein, limiting the ability to aspirate blood from the PIVC. Two separate clinical investigations using ultrasound were performed to understand the potential interaction between PIVCs and the vein lumen and the venous valves and branches of the superficial veins of the upper extremity. One study with 35 adult volunteers interrogated 210 vein segments where a PIV would likely …

Evolving Workforce Roles In Medicare Next Generation Acos, Clese E Erikson

Health Workforce Research Center Publications

The purpose of this study was to explore key workforce strategies in Next Generation Accountable Care Organizations (Next Gen ACOs), the latest evolution in Medicare ACOs. We conducted semi-structured interviews with leaders from seven of the initial 18 Next Gen ACOs to better understand their perceptions regarding how workforce roles are changing to support the Next Gen ACO model. Key Questions:

1. What new and expanded roles for existing health workforce members are reported by Next Generation ACO leaders?
2. Has use of the health workforce changed as a result of Next Gen waivers for telehealth, home visits, and use of SNFs? …

Biomarkers Of Tubulointerstitial Damage And Function In Type 1 Diabetes, Ian De Boer, Xiaoyu Gao, Ionut Bebu, Andrew Hoofnagle, John Lachin, Diabetes Control And Complications Trial/Epidemiology Of Diabetes Interventions And Complications (Dcct/Edic) Research Group.

Epidemiology Faculty Publications

Objective To evaluate biomarkers of renal tubulointerstitial damage and function in type 1 diabetes with and without diabetic kidney disease.

Research design and methods Cross-sectional case-control study of Diabetes Control and Complications Trial/Epidemiology of Diabetes Interventions and Complications Study participants. Cases (N=43) had incident persistent estimated glomerular filtration rate (eGFR) <60 mL/min/1.73 m2 with urinary albumin excretion >300 mg/24 hour. Controls (N=43) had persistent eGFR >90 mL/min/1.73 m2 and urinary albumin excretion <30 mg/24 hour. Urinary and plasma biomarkers reflecting tubular injury, inflammation, fibrosis, secretion, and synthetic function were measured from stored specimens collected at the first study visit with reduced eGFR (for case participants) or the corresponding study year (for control participants).

Results Mean (SD) age was 51 (9) and 50 (8) years for case and control participants, and mean (SD) duration of diabetes was 30 (6) and 30 (5) years, respectively. Mean (SD) eGFR was 39 …

Press-Pulse: A Novel Therapeutic Strategy For The Metabolic Management Of Cancer, Thomas Seyfried, George Yu, Joseph Maroon, Dominic D'Agostino

Urology Faculty Publications

Background

A shift from respiration to fermentation is a common metabolic hallmark of cancer cells. As a result, glucose and glutamine become the prime fuels for driving the dysregulated growth of tumors. The simultaneous occurrence of “Press-Pulse” disturbances was considered the mechanism responsible for reduction of organic populations during prior evolutionary epochs. Press disturbances produce chronic stress, while pulse disturbances produce acute stress on populations. It was only when both disturbances coincide that population reduction occurred.

Methods

This general concept can be applied to the management of cancer by creating chronic metabolic stresses on tumor cell energy metabolism (press disturbance) …

The World Health Organization Fetal Growth Charts: A Multinational Longitudinal Study Of Ultrasound Biometric Measurements And Estimated Fetal Weight., Torvid Kiserud, Gilda Piaggio, Guillermo Carroli, Mariana Widmer, José Carvalho, Lisa Neerup Jensen, Sameera A Talegawkar, +Several Additional Authors

Exercise and Nutrition Sciences Faculty Publications

BACKGROUND: Perinatal mortality and morbidity continue to be major global health challenges strongly associated with prematurity and reduced fetal growth, an issue of further interest given the mounting evidence that fetal growth in general is linked to degrees of risk of common noncommunicable diseases in adulthood. Against this background, WHO made it a high priority to provide the present fetal growth charts for estimated fetal weight (EFW) and common ultrasound biometric measurements intended for worldwide use.

METHODS AND FINDINGS: We conducted a multinational prospective observational longitudinal study of fetal growth in low-risk singleton pregnancies of women of high or middle …