Medicine and Health Sciences Commons^™

E-Cadherin Expression And Blunted Interferon Response In Blastic Plasmacytoid Dendritic Cell Neoplasm, Luisa Lorenzi, Silvia Lonardi, Donatella Vairo, Andrea Bernardelli, Michela Tomaselli, Mattia Bugatti, Sara Licini, Mariachiara Arisi, Lorenzo Cerroni, Alessandra Tucci, William Vermi, Silvia Clara Giliani, Fabio Facchetti

2020-Current year OA Pubs

Blastic plasmacytoid dendritic cell neoplasm (BPDCN) is an aggressive neoplasm derived from plasmacytoid dendritic cells (pDCs). In this study, we investigated by immunohistochemical analysis the expression of E-cadherin (EC) on pDCs in reactive lymph nodes and tonsils, bone marrow, and in BPDCN. We compared the expression of EC in BPDCN to that in leukemia cutis (LC) and cutaneous lupus erythematosus (CLE), the latter typically featuring pDC activation. In BPDCN, we also assessed the immunomodulatory activity of malignant pDCs through the expression of several type I interferon (IFN-I) signaling effectors and downstream targets, PD-L1/CD274, and determined the extent of tumor infiltration …

Preparing Nursing Homes For A Second Wave Of Coronavirus Disease 2019 (Covid-19), A Rekha Murthy, Hilary Babcock, Et Al.

2020-Current year OA Pubs

No abstract provided.

The Effect Of Postpartum Depression Screening Education For Postpartum Nurses, Shecarra S. Cook

Electronic Theses and Dissertations

Depression affects about 13% of pregnant women and about 10% of women after childbirth. Some cases are so severe, the mother may even commit suicide. If left untreated, postpartum depression (PPD) affects both the mother’s and the infant’s health as well as their quality of life. The gap in clinical practice is that currently, patients only complete a postpartum depression screening tool during their 6-week follow-up appointment with their OB/GYN, leaving a gap in PPD detection and care during the immediate postpartum period. Postpartum nurses are not usually given specialized training in postpartum depression. The purpose of this study was …

Reducing Parental Stress In Neonatal And Pediatric Intensive Care Units, Nancy M. Abbene

Electronic Theses and Dissertations

Abstract

The neonatal intensive care unit (NICU) and pediatric intensive care unit (PICU) are highly operational and highly active environments. Health care workers must react quickly to care for patients and provide life-saving measures fundamental to favorable patient outcomes. Caregivers of this critical patient population are often overlooked as the healthcare team prioritizes patient’s needs. In addition, medical equipment, machines, and monitors have multiple safety alarms sounding frequently and contributing to high levels of parental stress upon their child’s admission to the NICU and PICU. Lack of giving adequate prominence to the value of caregiver support services in the hospital …

Decreasing Unintentional Pregnancies For Tennesseans, Paula M. Todd

Electronic Theses and Dissertations

In 2018, 49% of all pregnancies in the United States were unintended, with women with a lower- income status being five times more likely to experience an unplanned pregnancy. Tennessee has a high rate of unintended pregnancies, particularly among the uninsured, low-income, and rural teen populations; some 22% of these unintended pregnancies end in abortion. Oral or transdermal contraceptives that are affordable and accessible for women of childbearing age can reduce unintentional pregnancies. The addressed gap in clinical practice was that contraceptives are not currently available over the counter in Tennessee pharmacies without a prescription, which necessitates a costly medical …

Multicenter, Double-Blind, Placebo-Controlled Trial Of Seviprotimut-L Polyvalent Melanoma Vaccine In Patients With Post-Resection Melanoma At High Risk Of Recurrence, Craig L Slingluff, Leonel Hernandez-Aya, Et Al

2020-Current year OA Pubs

BACKGROUND: Most patients with advanced melanomas relapse after checkpoint blockade therapy. Thus, immunotherapies are needed that can be applied safely early, in the adjuvant setting. Seviprotimut-L is a vaccine containing human melanoma antigens, plus alum. To assess the efficacy of seviprotimut-L, the Melanoma Antigen Vaccine Immunotherapy Study (MAVIS) was initiated as a three-part multicenter, double-blind, placebo-controlled phase III trial. Results from part B1 are reported here.

METHODS: Patients with AJCC V.7 stage IIB-III cutaneous melanoma after resection were randomized 2:1, with stage stratification (IIB/C, IIIA, IIIB/C), to seviprotimut-L 40 mcg or placebo. Recurrence-free survival (RFS) was the primary endpoint. For …

Implementing An Application Programming Interface For Promis Measures At Three Medical Centers, Michael Bass, Christian Oncken, Allison W. Mcintyre, Chris Dasilva, Joshua Spuhl, Nan E. Rothrock

2020-Current year OA Pubs

BACKGROUND: There is an increasing body of literature advocating for the collection of patient-reported outcomes (PROs) in clinical care. Unfortunately, there are many barriers to integrating PRO measures, particularly computer adaptive tests (CATs), within electronic health records (EHRs), thereby limiting access to advances in PRO measures in clinical care settings.

OBJECTIVE: To address this obstacle, we created and evaluated a software integration of an Application Programming Interface (API) service for administering and scoring Patient-Reported Outcomes Measurement Information System (PROMIS) measures with the EHR system.

METHODS: We created a RESTful API and evaluated the technical feasibility and impact on clinical workflow …

Inpatient Versus Outpatient Intravenous Diuresis For The Acute Exacerbation Of Chronic Heart Failure, Ilia G Halatchev, Wen-Chin Wu, Paul A Heidenreich, Elma Djukic, Sumitra Balasubramanian, Kelly B Ohlms, Jay R Mcdonald

2020-Current year OA Pubs

BACKGROUND: We established an IV outpatient diuresis (IVOiD) clinic and conducted a quality improvement project to evaluate safety, effectiveness and costs associated with outpatient versus inpatient diuresis for patients presenting with acute decompensated heart failure (ADHF) to the emergency department (ED).

METHODS: Patients who were clinically diagnosed with ADHF in the ED, but did not have high-risk features, were either diuresed in the hospital or in the outpatient IVOiD clinic. The dose of IV diuretic was based on their home maintenance diuretic dose. The outcomes measured were the effects of diuresis (urine output, weight, hemodynamic and laboratory abnormalities), 30-90 day …

Cortical And Subcortical Brain Structure In Generalized Anxiety Disorder: Findings From 28 Research Sites In The Enigma-Anxiety Working Group, Anita Harrewijn, Elise M. Cardinale, Nynke A. Groenewold, Janna Marie Bas-Hoogendam, Moji Aghajani, Kevin Hilbert, Narcis Cardoner, Daniel Porta-Casteràs, Savannah Gosnell, Anderson M. Winkler

School of Medicine Publications

The goal of this study was to compare brain structure between individuals with generalized anxiety disorder (GAD) and healthy controls. Previous studies have generated inconsistent findings, possibly due to small sample sizes, or clinical/analytic heterogeneity. To address these concerns, we combined data from 28 research sites worldwide through the ENIGMA-Anxiety Working Group, using a single, pre-registered mega-analysis. Structural magnetic resonance imaging data from children and adults (5–90 years) were processed using FreeSurfer. The main analysis included the regional and vertex-wise cortical thickness, cortical surface area, and subcortical volume as dependent variables, and GAD, age, age-squared, sex, and their interactions as …

Real-Time Mobile Teleophthalmology For The Detection Of Eye Disease In Minorities And Low Socioeconomics At-Risk Populations, Lama A. Al-Aswad, Cansu Yuksel Elgin, Vipul Patel, Deborah Popplewell, Kalashree Gopal, Dan Gong, Zach Thomas, Devon Joiner, Cha-Kai Chu, Gladys E. Maestre

School of Medicine Publications

Purpose: To examine the benefits and feasibility of a mobile, real-time, community-based, teleophthalmology program for detecting eye diseases in the New York metro area.

Design: Single site, nonrandomized, cross-sectional, teleophthalmologic study.

Methods: Participants underwent a comprehensive evaluation in a Wi-Fi-equipped teleophthalmology mobile unit. The evaluation consisted of a basic anamnesis with a questionnaire form, brief systemic evaluations and an ophthalmologic evaluation that included visual field, intraocular pressure, pachymetry, anterior segment optical coherence tomography, posterior segment optical coherence tomography, and nonmydriatic fundus photography. The results were evaluated in real-time and follow-up calls were scheduled to complete a secondary questionnaire form. Risk …

Pharmaceutical Potential Of Laboratory Grown Cultures Of Blue-Green Algae: A Comprehensive Review And Future Possibilities, Ritu Chauhan, Abhishek Chauhan, Ashutosh Tripathi, Anuj Ranjan, Subhash C. Chauhan, Tanu Jindal

School of Medicine Publications

COVID-19 pandemic has taught the world researchers the urgent need for new sources and novel pharmaceuticals not only for existing diseases but also for both seasonal epidemics and future pandemics. Pharmaceutical drug discoveries for the past fifty years depended deeply on the procedure of empirical transmission of a huge number of pure bioactive compounds to provide new leads. The screening of extracts or isolating compounds is a common way to discover novel biologically active molecules. Most of the valuable Blue-Green algal metabolites are concentrated in their biomass. For existence in nature, Blue-Green algae (BGA) secrete and contain various organic substances …

Constrained Contrastive Distribution Learning For Unsupervised Anomaly Detection And Localisation In Medical Images, Yu Tian, Guansong Pang, Fengbei Liu, Yuanhong Chen, Seon Ho Shin, Johan W. Verjans, Rajvinder Singh

Research Collection School Of Computing and Information Systems

Unsupervised anomaly detection (UAD) learns one-class classifiers exclusively with normal (i.e., healthy) images to detect any abnormal (i.e., unhealthy) samples that do not conform to the expected normal patterns. UAD has two main advantages over its fully supervised counterpart. Firstly, it is able to directly leverage large datasets available from health screening programs that contain mostly normal image samples, avoiding the costly manual labelling of abnormal samples and the subsequent issues involved in training with extremely class-imbalanced data. Further, UAD approaches can potentially detect and localise any type of lesions that deviate from the normal patterns. One significant challenge faced …

Ct Findings And Patterns Of E-Cigarette Or Vaping Product Use-Associated Lung Injury: A Multicenter Cohort Of 160 Cases, Seth J Kligerman, Constantine A Raptis, Kaitlin M Marquis, Et Al.

2020-Current year OA Pubs

BACKGROUND: e-Cigarette or vaping-induced lung injury (EVALI) causes a spectrum of CT lung injury patterns. Relative frequencies and associations with vaping behavior are unknown.

RESEARCH QUESTION: What are the frequencies of imaging findings and CT patterns in EVALI and what is the relationship to vaping behavior?

STUDY DESIGN AND METHODS: CT scans of 160 subjects with EVALI from 15 institutions were retrospectively reviewed. CT findings and patterns were defined and agreed on via consensus. The parenchymal organizing pneumonia (OP) pattern was defined as regional or diffuse ground-glass opacity (GGO) ± consolidation without centrilobular nodules (CNs). An airway-centered OP pattern was …

Clinical Trial And Postmarketing Safety Of Onasemnogene Abeparvovec Therapy, John W Day, Jerry R Mendell, Eugenio Mercuri, Richard S Finkel, Kevin A Strauss, Aaron Kleyn, Sitra Tauscher-Wisniewski, Francis Fonyuy Tukov, Sandra P Reyna, Deepa H Chand

2020-Current year OA Pubs

INTRODUCTION: This is the first description of safety data for intravenous onasemnogene abeparvovec, the only approved systemically administered gene-replacement therapy for spinal muscular atrophy.

OBJECTIVE: We comprehensively assessed the safety of intravenous onasemnogene abeparvovec from preclinical studies, clinical studies, and postmarketing data.

METHODS: Single-dose toxicity studies were performed in neonatal mice and juvenile or neonatal cynomolgus nonhuman primates (NHPs). Data presented are from a composite of preclinical studies, seven clinical trials, and postmarketing sources (clinical trials, n = 102 patients; postmarketing surveillance, n = 665 reported adverse event [AE] cases). In clinical trials, safety was assessed through AE monitoring, vital-sign …

Chyloptysis As A Delayed Sequela Of Penetrating Thoracic Trauma, Kyle G Mitchell, Hope Feldman, Bryan F Meyers, Mara B Antonoff

2020-Current year OA Pubs

No abstract provided.

Friends And Foes: Extracellular Vesicles In Aging And Rejuvenation, Brian V Lananna, Shin-Ichiro Imai

2020-Current year OA Pubs

Extracellular vesicles (EVs) are released by many different cell types throughout the body and play a role in a diverse range of biological processes. EVs circulating in blood as well as in other body fluids undergo dramatic alterations over an organism's lifespan that are only beginning to be elucidated. The exact nature of these changes is an area of active and intense investigation, but lacks clear consensus due to the substantial heterogeneity in EV subpopulations and insufficiencies in current technologies. Nonetheless, emerging evidence suggests that EVs regulate systemic aging as well as the pathophysiology of age-related diseases. Here, we review …

The Antifungal Pipeline: Fosmanogepix, Ibrexafungerp, Olorofim, Opelconazole, And Rezafungin, Martin Hoenigl, Rosanne Sprute, Matthias Egger, Amir Arastehfar, Oliver A Cornely, Robert Krause, Cornelia Lass-Flörl, Juergen Prattes, Andrej Spec, George R Thompson 3rd, Nathan Wiederhold, Jeffrey D Jenks

2020-Current year OA Pubs

The epidemiology of invasive fungal infections is changing, with new populations at risk and the emergence of resistance caused by the selective pressure from increased usage of antifungal agents in prophylaxis, empiric therapy, and agriculture. Limited antifungal therapeutic options are further challenged by drug-drug interactions, toxicity, and constraints in administration routes. Despite the need for more antifungal drug options, no new classes of antifungal drugs have become available over the last 2 decades, and only one single new agent from a known antifungal class has been approved in the last decade. Nevertheless, there is hope on the horizon, with a …

How To Screen For Monoclonal Gammopathy In Patients With A Suspected Amyloidosis, Samuel M Rubinstein, Keith Stockerl-Goldstein

2020-Current year OA Pubs

No abstract provided.

Somatic Pik3r1 Variation As A Cause Of Vascular Malformations And Overgrowth, Catherine E Cottrell, Jonathan W Heusel, Meagan Corliss, Michael J Evenson, Carrie C Coughlin, Et Al.

2020-Current year OA Pubs

PURPOSE: Somatic activating variants in the PI3K-AKT pathway cause vascular malformations with and without overgrowth. We previously reported an individual with capillary and lymphatic malformation harboring a pathogenic somatic variant in PIK3R1, which encodes three PI3K complex regulatory subunits. Here, we investigate PIK3R1 in a large cohort with vascular anomalies and identify an additional 16 individuals with somatic mosaic variants in PIK3R1.

METHODS: Affected tissue from individuals with vascular lesions and overgrowth recruited from a multisite collaborative network was studied. Next-generation sequencing targeting coding regions of cell-signaling and cancer-associated genes was performed followed by assessment of variant pathogenicity.

RESULTS: The …

Impact Of Covid-19 On Gastroenterology Fellowship Training: A Multicenter Analysis Of Endoscopy Volumes, Swathi Paleti, Anas Gremida, Et Al.

2020-Current year OA Pubs

No abstract provided.

Estimating The Effects Of Race And Social Vulnerability On Hospital Admission And Mortality From Covid-19, Joshua M Landman, Karen Steger-May, Karen E Joynt Maddox, Gmerice Hammond, Aditi Gupta, Adriana M Rauseo, Min Zhao, Randi E Foraker

2020-Current year OA Pubs

OBJECTIVE: To estimate the risk of hospital admission and mortality from COVID-19 to patients and measure the association of race and area-level social vulnerability with those outcomes.

MATERIALS AND METHODS: Using patient records collected at a multisite hospital system from April 2020 to October 2020, the risk of hospital admission and the risk of mortality were estimated for patients who tested positive for COVID-19 and were admitted to the hospital for COVID-19, respectively, using generalized estimating equations while controlling for patient race, patient area-level social vulnerability, and time course of the pandemic.

RESULTS: Black individuals were 3.57 as likely (95% …

Combined Thoracic Endovascular Aortic Repair And Endovascular Aneurysm Repair And The Long-Term Consequences Of Altered Cardiovascular Haemodynamics On Morbidity And Mortality: Case Series And Literature Review, Sherif Sultan, Yogesh Acharya, Mohiey Hazima, Hiba Salahat, Juan Carlos Parodi, Niamh Hynes

2020-Current year OA Pubs

BACKGROUND: Thoracic and abdominal aortic stent grafts are firmer and more rigid than the native aorta. Aortic implanted devices have been implicated in the development of acute systolic hypertension, elevated pulse pressure, and reduced coronary perfusion.

CASE SUMMARY: We report four cases of staged thoracic endovascular aortic repair (TEVAR) and then endovascular aneurysm repair (EVAR). All patients had TEVAR first for thoracic aortic aneurysm and later on developed infra-renal abdominal aortic aneurysm (AAA) that required EVAR. There were three males and one female with a median age of 74.5 years (range 67.5-78.5). None of the patients developed aortic-related major clinical …

Medical School Watercooler Newsletter - September 30, 2021, Lindsey Lyle

Watercooler Newsletter

This is the September 30, 2021 edition of the Frederick P. Whiddon College of Medicine's newsletter - Watercooler.

Contents include:

• Meet a Med Student: Alex Templin
• Register now: USA Health Game Day returns Oct. 14 at Hancock Whitney Stadium
• Faculty Spotlight: Jai Deep Thakur, M.D.
• Med School Café to address radiation therapy in breast cancer

In-Hospital Mortality Risk Factors Among Hospitalized Geriatric Patients: A Cohort Study On Tertiary Referral Hospital In Indonesia, Fadhil Abiyyu Yofi, Arlia Ayu Damayanti, Novira Widajanti

Jurnal Penyakit Dalam Indonesia

Introduction. Decreasing fertility rates and increasing life expectancy cause an increase in the population of the elderly, with the number of elderly in the world is estimated to increase from 9.3% in 2020 to 16.0% in 2050. 24.35% of the elderly in Indonesia experience illness, and 8.71% have been hospitalized in one year. This study aimed to determine the risk factors for the death of elderly who were hospitalized.

The Role Of Albumin And Hemoglobin As Predictors Of 28-Day Mortality In Elderly Sepsis Patients In Mohammad Hoesin Hospital Palembang, Widya Mandala Sari Gultom, Nur Riviati, Rizky Perdana, Syarif Husin

Jurnal Penyakit Dalam Indonesia

Introduction. Sepsis is defined as organ dysfunction caused by dysregulation of the host’s response to infection. The majority of sepsis are experienced by elderly patients with high mortality rates. In the condition of sepsis, there are various body mechanisms that cause a decrease in albumin and hemoglobin. This study is to determine the predictive value of albumin and hemoglobin levels on 28-day mortality of elderly sepsis patients.

Nucleoside/Nucleotide Analogues For The Treatment Of Chronic Hepatitis B: A 3-Year Follow Up Study, Andri Sanityoso Sulaiman, Irsan Hasan, Cosmas Rinaldi A Lesmana, Chyntia Olivia M Jasirwan, Saut Horas H. Nababan, Kemal Fariz Kalista, Gita Aprilicia, Rino Alvani Gani

Jurnal Penyakit Dalam Indonesia

Introduction. Chronic hepatitis B (CHB) is endemic in Indonesia, where it is usually treated with pegylated interferon and nucleoside/nucleotide analogs (NA). The aim of this study was to determine the efficacy of treating CHB infection among Indonesian patients with NA (lamivudine, telbivudine, and tenofovir) for a 3-year period.Methods. We retrospectively reviewed the records of patients with CHB infection attending the Hepatology Clinic Cipto Mangunkusumo during 2010-2013 period. Subjects with inclusion criteria were all patients aged above 18 years treated with NA for at least three years. The degree of liver stiffness, hepatitis B virus deoxyribonucleic acid (HBV-DNA), alanine aminotransferase (ALT) …

Neutrophil Lymphocyte Ratio, Three Year Survival Of Locally Advanced And Advanced Nasopharyngeal Carcinoma, Rahmat Cahyanur, Hayatun Nufus, Cosphiadi Irawan

Jurnal Penyakit Dalam Indonesia

Introduction. Nasopharyngeal carcinoma (NPC) is the most prevalent head and neck malignancy in Indonesia, as NPC-related mortality in Indonesia is the second-highest in Asia after China. Inflammation has been studied to be associated with cancer progression. Neutrophil lymphocyte ratio describes the balance between the unfavorable suppression of immune response against cancer by neutrophils and the beneficial effect of adaptive immunity by lymphocytes. This study aimed to determine the relationship between NLR and the survival of locally advanced and advanced NPC patients.Methods. A retrospective cohort study was conducted using the medical records of NPC patients treated at the hematology clinic RSCM …

Perkembangan Terapi Hepatitis B Kronis Di Indonesia, Juferdy Kurniawan

Jurnal Penyakit Dalam Indonesia

Indonesia merupakan salah satu negara dengan prevalensi hepatitis B yang tinggi di Asia Tenggara (kedua setelah Vietnam). Berdasarkan Riskesdas yang dilakukan oleh Kementerian Kesehatan Republik Indonesia, pada studi yang dilakukan pada sampel darah PMI, 10 dari 100 orang Indonesia terinfeksi hepatitis B atau C. Maka dari itu, dibutuhkan penanganan yang ekstra untuk penanggulangan masalah infeksi hepatitis B

Cutaneous Anthrax In Gunung Kidul, Yogyakarta: A Case Report, Riswanto Riswanto, Dhani Redhono, Evi Nurhayatun

Jurnal Penyakit Dalam Indonesia

Bacillus anthracis is an aerobic, gram-positive, and spore-forming Bacillus species. The most common form of anthrax infection is the cutaneous form. The infection usually develops several days after exposure to products of infected animals and manifest as a black sore with severe swelling on the skin. In this report, a 60-year-old man with a black and swollen lesion on her index finger presented in Gunung Kidul in December 2019. ELISA antibody anthrax serum was performed. The patient was then treated with antibiotics after diagnosis. This patient had a history of contact with the beef of a slaughtered sheep. The patient …

Anti-Sars-Cov-2 Monoclonal Antibodies For Early Covid-19: A Real-World Experience, Katherine Belden, Md, Bryan Hess, Md, Caroline Brugger, Crnp, Rachel Carr, Pa, Todd Braun, Md, Joseph Derose, Do, John Zurlo, Md

Division of Infectious Diseases and Environmental Medicine Posters

Higher rates of COVID-19 related hospitalization and death are reported in patients with underlying health conditions and advanced age as compared to the general population.While polyclonal immunity generated by vaccines has demonstrated protection against severe disease, vaccine response takes time and may be inadequate in some high-risk populations.1 Treatment with anti-SARS-CoV-2 neutralizing monoclonal antibodies affords prompt, passive humoral immunity and has been shown in randomized, controlled trials to reduce rates of hospitalization and death from COVID-19 in high-risk ambulatory patients treated early in the course of infection.2,3 The U.S. Food and Drug Administration (FDA) has issued Emergency Use Authorization for …