Medicine and Health Sciences Commons^™

Alterations In Plasma Membrane Ion Channel Structures Stimulate Nlrp3 Inflammasome Activation In Apol1 Risk Milieu, A. Jha, V. Kumar, S. Haque, K. Ayasolla, S. Saha, X. Lan, A. Malhotra, M. A. Saleem, K. Skorecki, P. C. Singhal

Journal Articles

© 2019 Federation of European Biochemical Societies We evaluated alterations in the structural configurations of channels and activation of nucleotide-binding domain, leucine-rich-containing family, pyrin domain-containing-3 (NLRP3) inflammasome formation in apolipoprotein L1 (APOL1) risk and nonrisk milieus. APOL1G1- and APOL1G2-expressing podocytes (PD) displayed enhanced K+ efflux, induction of pyroptosis, and escalated transcription of interleukin (IL)-1β and IL-18. APOL1G1- and APOL1G2-expressing PD promoted the transcription as well as translation of proteins involved in the formation of inflammasomes. Since glyburide (a specific inhibitor of K+ efflux channels) inhibited the transcription of NLRP3, IL-1β, and IL-18, the role of K+ efflux in the activation …

The Relationship Between Medication Discrepancies And Hospitalization Risk Among Patients With Advanced Ckd, V. Sakhiya, J. James, K. D. Jhaveri, M. Zhang, J. H. Ng, C. Halinski Np, J. Tomanguillo-Chumbe, S. Fishbane

Journal Articles

No abstract provided.

'Whatsapp (R)' Ening In Nephrology Training, K. D. Jhaveri, B. Pascarelli, A. Hasan, A. Kozikowski, S. Fishbane, R. Pekmezaris

Journal Articles

No abstract provided.

Morphea (Localized Scleroderma) Presenting With Recurrent Skin And Soft Tissue Infections: A Diagnostic Dilemma., A. M. Khatri, M. Mclemore, P. Malhotra

Journal Articles

Morphea or localized scleroderma is reported to be triggered through diverse stimuli. We present a case of morphea that presented as a non-healing wound with superimposed methicillin-sensitive Staphylococcus aureus (MSSA) infection. In our case, morphea was thought to have been potentially triggered by a post-surgical infection. We discuss the potential infectious triggers and common infections that may confound the diagnosis.

Management Of Barrett's Esophagus With Dysplasia Refractory To Radiofrequency Ablation, K. L. Raphael, A. J. Trindade

Journal Articles

No abstract provided.

Bevacizumab-Induced Pneumonitis In A Patient With Metastatic Colon Cancer: A Case Report, S. Pervaiz, S. Homsy, N. Narula, S. Ngu, D. Elsayegh

Journal Articles

© The Author(s) 2020. Bevacizumab is a vascular endothelial growth factor–directed humanized monoclonal antibody used to treat many types of cancer and some eye diseases. Due to inhibition of angiogenesis, many adverse reactions such as bowel necrosis, nasal septal perforation, and renal thrombotic microangiopathy have been described. However, its association with interstitial pneumonitis is scarcely reported in the literature. We report a case of a 79-year-old woman with metastatic colon cancer who presented with cough and dyspnea on exertion the day after initiation of bevacizumab. She was found to have bilateral airspace opacities on imaging. Infectious and cardiogenic etiologies of …

Do Not Fall To The Vape Trap!, S. Acharya, S. I. Ali, S. Anwar, A. Glaser

Journal Articles

© 2020 The Author(s) Introduction: Whilst the use of combustible tobacco products continues to decline in the United States, the use of e-cigarettes has seen an explosive rise in recent years. In 2019 an outbreak on EVALI was seen across the country, highlighting the fact that e-cigarettes may not be as harmless as previously perceived. Case description: A 22-year-old male came to the emergency department complaining of vomiting and shortness of breath. Patient reported using a “pod” a day of a “JUUL” e-cigarette. Patient's oxygen requirement continued to increase and was eventually shifted to the intensive care unit and mechanically …

Isolated Pulmonary Valve Endocarditis., S. Acharya, S. Anwar, M. Iannuzzi, V. Anugu, F. Ghavami

Journal Articles

Infective endocarditis involving the right side of the heart is typically associated with IV drug abuse and chronic indwelling catheters which commonly involve the tricuspid valve. Isolated pulmonary valve endocarditis (PVE) is a rare clinical entity. We report a rare case of a young woman with a history of end-stage renal disease (ESRD) on hemodialysis through tunneled catheter presenting with persistent coagulase-negative staphylococcus (CoNS) epidermidis bacteremia despite being on appropriate treatment with IV vancomycin for two weeks. Because of the persistent bacteremia, a transesophageal echocardiogram was performed and it revealed a thickened pulmonary valve with 1.8 cm vegetation in the …

A Rare But Reversible Cause Of Lithium-Induced Bradycardia., B. Ataallah, R. Al-Zakhari, A. Sharma, M. Tofano, G. Haggerty

Journal Articles

Lithium is a well-known medication that has been used for many years to treat mood disorders. One of its side effects is cardiotoxicity, which usually occurs at serum lithium levels > 1.5 mEq/L but rarely occurs when therapeutic levels of lithium are used. Other causes of bradycardia should be eliminated by performing a detailed workup that includes calcium level, thyroid function, and cardiac workup, with consideration of any medication interactions. Lithium-induced bradycardia is reversible upon discontinuation of lithium, but irreversible sinus node can occur and may warrant permanent insertion of a pacemaker to maintain sinus rhythm when long-term lithium therapy is …

“Palliative Pandemic Plan,” Triage And Symptoms Algorithm As A Strategy To Decrease Providers’ Exposure, While Trying To Increase Teams Availability And Guidance For Goals Of Care (Goc) And Symptoms Control, S. Lopez, G. Decastro, K. M. Van Ogtrop, S. Weiss-Domis, S. R. Anandan, C. J. Magalee, R. Roofeh, T. A. Liberman

Journal Articles

No abstract provided.

Erratum: A Large Right Ventricle And Severe Hypoxemia. Use Of Bedside Transesophageal Echocardiography To Assess Cardiopulmonary Failure (Annals Of The American Thoracic Society (2020) 17 (112-115) Doi: 10.1513/Annalsats.201904-316cc), A. Agrawal, M. Frank, A. Tsegaye

Journal Articles

Copyright © 2020 by the American Thoracic Society. The authors would like to make a correction to the legends of Videos 1 and 3 in their article published in the January 2020 issue of AnnalsATS (1). The definition for the abbreviation TEE in these video legends should read "transesophageal echocardiogram." For the convenience of our readers, AnnalsATS is replacing the online version of the article with a corrected version; we apologize for the error.

Carbapenemase Producing Klebsiella Pneumoniae (Kpc) Meningitis From Chronic Otitis Media, S. Anwar, S. Acharya, S. Thapa, J. Rabadi, N. Mobarakai

Journal Articles

© 2020 The Authors Meningitis and brain abscess caused by carbapenemase-producing Klebsiella pneumoniae (KPC) is rarely described in the medical literature. Such infections have been described after neurosurgical medium or post-trauma. We describe an unusual case of KPC meningitis originating from with long term intravenous antibiotics.

Life Threatening Haemoptysis In Primary Lung Cancer-Signet Ring Cell Carcinoma, S. Anwar, S. Acharya, D. Elsayegh, A. Sokoloff, M. Rehan

Journal Articles

© 2020 The Author(s) Primary signet ring cell carcinoma of the lung is a rare non-small cell carcinoma of the lung with extremely aggressive features and poor prognosis. The diagnosis mainly required tissue biopsy with immunohistochemical analysis and gene mutation studies. We describe a unique case of primary signet ring cell carcinoma of the lung presenting with life threatening haemoptysis along with literature review of prognosis and management of this rare clinical entity.

A Case Of Wernicke's Encephalopathy In A Pregnant Woman With A History Of Sleeve Gastrectomy., H. Kandlakunta, D. Gurala, J. Philipose, A. Polavarapu, J. R. Abergel

Journal Articles

Wernicke's encephalopathy (WE) is a neurological complication of thiamine deficiency characterized by a triad of acute confusion, ataxia, and ophthalmoplegia. Even though it is most common in chronic alcoholism, an increase in prevalence has been reported recently due to the increased popularity of bariatric surgeries. WE is a known neurological complication after gastric bypass surgery but rarely reported after sleeve gastrectomy. We present a unique case of WE in pregnant women four months after sleeve gastrectomy.

La Inhalers For Copd: Perceptions/Reality Of Abcd Gold Tool Use., V. Boryushkina, V. Kumar, M. Barnes, S. Nabeel, T. Le, H. Siddique, G. Haggerty, J. Ng, A. Kaell

Journal Articles

BACKGROUND:The Global Initiative for Chronic Obstructive Lung Disease (GOLD) created an ABCD tool to assess staging and severity of COPD subgroups that respond to LAMA or LABA with improved quality of life and reduced exacerbations. Our study assesses perception of physicians at five community hospitals towards LAMA use for patients admitted with COPD exacerbations according to the GOLD guidelines and describes the experience at our hospital. METHODS:Electronic survey forms regarding LAMA use and the GOLD criteria ABCD for COPD treating physicians were sent to five hospitals. A one-year chart review at our hospital determined prevalent use of a maintenance LAMA …

Glycosylated Hemoglobin, But Not Advanced Glycation End Products, Predicts Severity Of Coronary Artery Disease In Patients With Or Without Diabetes., C. Basman, S. L. Fishman, D. Avtanski, U. Rashid, A. Kodra, M. Lesser, D. Inlall, K. Ziskovich, V. Singh, L. Poretsky, +3 Additional Authors

Journal Articles

Background:The association between coronary artery disease (CAD) and diabetes mellitus (DM) is strong but the physiologic mechanisms responsible for this association remain unclear. Patients with DM exhibit high circulating levels of glycated proteins and lipoproteins called advanced glycation end products (AGEs) which have been implicated in the development of oxidative damage to vascular endothelium. We examined the relationships between the presence and extent of CAD and AGEs in patients undergoing elective coronary artery catheterization in an urban teaching hospital. Methods:Patients with possible CAD (n = 364) were recruited prior to elective cardiac catheterization (52% male, 48% diabetic). Regression and correlation …

A Case Report On Metformin-Associated Lactic Acidosis., H. K. Rai, P. Patel, K. Reddy

Journal Articles

Metformin is the first-line therapy for patients with type 2 diabetes, and its most common adverse effects are gastrointestinal. Lactic acidosis associated with metformin use is rare. Here, we report the case of a 77-year-old man with a medical history of diabetes (treated with metformin), hypertension, chronic alcohol abuse, and prostate and bladder cancer, who presented with abdominal pain, nausea, vomiting, and diarrhea for five days. He was admitted with severe metabolic acidosis due to metformin toxicity (metformin-associated lactic acidosis) with metformin level 23 mcg/mL (therapeutic range approximately 1-2 mcg/mL) in the setting of acute kidney failure due to acute …

Optimizing Telehealth Experience Design Through Usability Testing In Hispanic American And African American Patient Populations: Observational Study., D. King, S. Khan, J. Polo, J. Solomon, R. Pekmezaris, N. Hajizadeh

Journal Articles

BACKGROUND:Telehealth-delivered pulmonary rehabilitation (telePR) has been shown to be as effective as standard pulmonary rehabilitation (PR) at improving the quality of life in patients living with chronic obstructive pulmonary disease (COPD). However, it is not known how effective telePR may prove to be among low-income, urban Hispanic American and African American patient populations. To address this question, a collaborative team at Northwell Health developed a telePR intervention and assessed its efficacy among low-income Hispanic American and African American patient populations. The telePR intervention system components included an ergonomic recumbent bike, a tablet with a built-in camera, and wireless monitoring devices. …

Optimizing Tissue Use: A Step-Wise Approach To Diagnosing Squamous Cell Lung Carcinoma On Small Biopsies, C. Olazagasti, I. Preeshagul, M. Aziz, N. Seetharamu

Journal Articles

© The Author(s) 2020. Background: Histologic subtyping of lung cancer has significant implications for treatment planning. Accurate diagnosis based on cytology/small biopsy specimens is challenging and frequently determined by morphology, as material is often not sufficient for immunohistochemical studies (IHC). We investigated the concordance between the rates of diagnosis from cytology/small biopsies compared with surgical specimens in patients with squamous cell lung cancer (SCC) and the utility of IHC for diagnostic precision in lung cancer subtyping. Methods: We conducted a 5-year retrospective analysis identifying cases of SCC diagnosed on cytology/small biopsies ± IHC and compared them with subsequent surgical specimens …

January 2020, New England Osteopathic Heritage Center

New England Osteopathic Heritage Center Newsletter

New England Osteopathic Heritage Center's annual newsletter for January 2020

The Effect Of Rugby World Cup 2019 On Residents’ Psychological Well-Being: A Mediating Role Of Psychological Capital, Shintaro Sato, Keita Kinoshita, Minjung Kim, Daichi Oshimi, Munehiko Harada

Faculty and Student Publications

© 2020 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group. The current study aimed to examine the relationships among residents’ impact perception of 2019 Rugby World Cup (i.e. economic impact, cultural interests and new opportunity, community pride, and environmental impact), psychological capital (i.e. hope, self-efficacy, optimism, and resilience), and psychological well-being. The two-wave time-lagged data were collected from residents in the host cities (a following week of the event and eight weeks after the event; N = 206). The results indicated that residents’ perceptions of event impacts were positively associated with psychological capital, which influenced …

Nanoscale Interaction Of Recg With Mobile Fork Dna, Zhiqiang Sun, Yaqing Wang, Piero R. Bianco, Yuri L. Lyubchenko

Journal Articles: Pharmaceutical Sciences

RecG DNA helicase is a guardian of the bacterial genome where it dominates stalled DNA replication fork rescue. The single-stranded DNA binding protein (SSB) is involved in this process and promotes the binding of RecG to stalled replication forks. Atomic force microscopy (AFM) was used to investigate the interaction of RecG and SSB on a mobile fork substrate capable of being regressed. In the absence of proteins, the fork undergoes spontaneous dynamics between two states, defined by the length of the DNA complementarity at the fork. The binding of SSB does not affect these dynamics as it binds to single-stranded …

Neuronal-Derived Extracellular Vesicles Are Enriched In The Brain And Serum Of Hiv-1 Transgenic Rats, Raghubendra S. Dagur, Ke Liao, Susmita Sil, Fang Niu, Zhiqiang Sun, Yuri L. Lyubchenko, Eric S. Peebles, Guoku Hu, Shilpa Buch

Journal Articles: Pharmaceutical Sciences

Despite the efficacy of combination antiretroviral therapy (ART) in controlling human immunodeficiency virus (HIV-1) replication, cytotoxic viral proteins such as HIV-1 transactivator of transcription (Tat) persist in tissues such as the brain. Although HIV-1 does not infect neuronal cells, it is susceptible to viral Tat protein-mediated toxicity, leading to neuroinflammation that underlies HIV-associated neurocognitive disorders (HAND). Given the role of extracellular vesicles (EVs) in both cellular homoeostasis and under pathological conditions, we sought to investigate the alterations in the quantity of neuronal-derived EVs in the brain–as defined by the presence of cell adhesion molecule L1 (L1CAM) and to evaluate the …

The Current State Of Drug Repurposing And Rare Diseases: An Interview With Paul Trippier, Paul C. Trippier

Journal Articles: Pharmaceutical Sciences

Paul Tripper is an Associate Professor of Medicinal Chemistry at the University of Nebraska Medical Center (UNMC, NE, USA) and an Editorial Board member of Future Drug Discovery. Here, he speaks to Managing Editor Francesca Lake about drug repurposing, focusing on the key challenges, its application to rare diseases and what we can look forward to in the future.

Robotically Steered Needles: A Survey Of Neurosurgical Applications And Technical Innovations, Michel A. Audette, Stéphane P.A. Bordas, Jason E. Blatt

Computational Modeling & Simulation Engineering Faculty Publications

This paper surveys both the clinical applications and main technical innovations related to steered needles, with an emphasis on neurosurgery. Technical innovations generally center on curvilinear robots that can adopt a complex path that circumvents critical structures and eloquent brain tissue. These advances include several needle-steering approaches, which consist of tip-based, lengthwise, base motion-driven, and tissue-centered steering strategies. This paper also describes foundational mathematical models for steering, where potential fields, nonholonomic bicycle-like models, spring models, and stochastic approaches are cited. In addition, practical path planning systems are also addressed, where we cite uncertainty modeling in path planning, intraoperative soft tissue …

Surgical Gps Proof Of Concept For Scoliosis Surgery, Austin Tapp, Michel Audette

Computational Modeling & Simulation Engineering Faculty Publications

Scoliotic deformities may be addressed with either anterior or posterior approaches for scoliosis correction procedures. While typically quite invasive, the impact of these operations may be reduced through the use of computer-assisted surgery. A combination of physician-designated anatomical landmarks and surgical ontologies allows for real-time intraoperative guidance during computer-assisted surgical interventions. Predetermined landmarks are labeled on an identical patient model, which seeks to encompass vertebrae, intervertebral disks, ligaments, and other soft tissues. The inclusion of this anatomy permits the consideration of hypothetical forces that are previously not well characterized in a patient-specific manner. Updated ontologies then suggest procedural directions throughout …

Deformable Multisurface Segmentation Of The Spine For Orthopedic Surgery Planning And Simulation, Rabia Haq, Jérôme Schmid, Roderick Borgie, Joshua Cates, Michel Audette

Computational Modeling & Simulation Engineering Faculty Publications

Purpose: We describe a shape-aware multisurface simplex deformable model for the segmentation of healthy as well as pathological lumbar spine in medical image data.

Approach: This model provides an accurate and robust segmentation scheme for the identification of intervertebral disc pathologies to enable the minimally supervised planning and patient-specific simulation of spine surgery, in a manner that combines multisurface and shape statistics-based variants of the deformable simplex model. Statistical shape variation within the dataset has been captured by application of principal component analysis and incorporated during the segmentation process to refine results. In the case where shape statistics hinder detection …

Sweat And Saliva Cortisol Response To Stress And Nutrition Factors, Peter Pearlmutter, Gia Derose, Cheyenne Samson, Nicholas Linehan, Yuqiao Cen, Lina Begdache, Daehan Won, Ahyeon Koh

Health & Wellness Studies Faculty Scholarship

Cortisol is a biomarker for stress monitoring; however, the biomedical and clinical relevance is still controversial due to the complexity of cortisol secretion mechanisms and their circadian cycles as well as environmental factors that afect physiological cortisol level, which include individual mood and dietary intake. To further investigate this multifaceted relationship, a human pilot study examined cortisol concentration in sweat and saliva samples collected from 48 college-aged participants during aerobic exercise sessions along with mental distress and nutrition surveys. Enzyme-linked immunosorbent assays determined highly signifcant diferences between apocrine-dominant sweat (AP), saliva before exercise (SBE), and saliva after exercise (SAE) cortisol …

Massive Pulmonary Embolism In A Recent Intracranial Hemorrhage: Case Report Of Inhaled Nitric Oxide To Improve Outcomes, Abhinav Mittal, Anne P. Mittal, Edward Rojas, Hatim Al-Jaroushi

Faculty & Staff Scholarship

Acute massive pulmonary embolism (PE) has a high mortality if left untreated. The mainstay of treatment is systemic thrombolysis which has some absolute contraindications like intracranial hemorrhage (ICH). Inhaled nitric oxide (iNO) is a selective pulmonary vasodilator that decreases pulmonary artery pressure (PAP) and allows the right ventricle of the heart to pump against less resistance. We present a case of iNO use to improve hemodynamics in a patient with a recent ICH. We believe this to be the first such case reported.

A 70-year-old female with a history of PE on Eliquis initially presented for weakness and was found …

Opening Large-Conductance Potassium Channels Selectively Induced Cell Death Of Triple-Negative Breast Cancer, Gina Sizemore, Sarah Mclaughlin, Mackenzie Newman, Kathleen Brundage, Amanda Ammer, Karen Martin, Elena Pugacheva, James Coad, Malcolm D. Mattes, Han-Gang Yu

Faculty & Staff Scholarship

Background

Unlike other breast cancer subtypes that may be treated with a variety of hormonal or targeted therapies, there is a need to identify new, effective targets for triple-negative breast cancer (TNBC). It has recently been recognized that membrane potential is depolarized in breast cancer cells. The primary objective of the study is to explore whether hyperpolarization induced by opening potassium channels may provide a new strategy for treatment of TNBC.

Methods

Breast cancer datasets in cBioPortal for cancer genomics was used to search for ion channel gene expression. Immunoblots and immunohistochemistry were used for protein expression in culture cells …