Medicine and Health Sciences Commons^™

Blood-Brain Barrier Disruption Mediated By Ffa1 Receptor-Evidence Using Miniscope, Kristen L Lindenau, Jeffrey L Barr, Christopher R Higgins, Kevin T Sporici, Eugen Brailoiu, G Cristina Brailoiu

College of Pharmacy Faculty Papers

Omega-3 polyunsaturated fatty acids (n-3 PUFAs), obtained from diet and dietary supplements, have been tested in clinical trials for the prevention or treatment of several diseases. n-3 PUFAs exert their effects by activation of free fatty acid (FFA) receptors. FFA1 receptor, expressed in the pancreas and brain, is activated by medium- to long-chain fatty acids. Despite some beneficial effects on cognition, the effects of n-3 PUFAs on the blood-brain barrier (BBB) are not clearly understood. We examined the effects of FFA1 activation on BBB permeability in vitro, using rat brain microvascular endothelial cells (RBMVEC), and in vivo, by assessing Evans …

A Theoretical Framework For Addressing Fear Of Falling Avoidance Behavior In Parkinson’S Disease, Merrill R. Landers, Maria H. Nilsson

Physical Therapy Faculty Research

Postural instability in Parkinson’s disease (PD) is associated with several downstream consequences that ultimately lead to a greater risk of falling. Among the prominent downstream consequences is fear of falling (FOF), which is both common and problematic in PD. It can lead to a vicious cycle of FOF avoidance behavior that results in more sedentary behavior, physical deconditioning, and weakening of already impaired balance systems. This, in turn, may make the person with PD more susceptible to a future fall even with benign daily tasks. While FOF activity avoidance can be adaptive (appropriate), it can also be maladaptive (inappropriate or …

Challenges And Opportunities For Immunotherapeutic Intervention Against Myeloid Immunosuppression In Glioblastoma, Mark A Exley, Samantha Garcia, Amelia Zellander, Jenny Zilberberg, David W. Andrews

Department of Neurosurgery Faculty Papers

Glioblastoma multiforme (GBM), the most common and deadly brain cancer, exemplifies the paradigm that cancers grow with help from an immunosuppressive tumor microenvironment (TME). In general, TME includes a large contribution from various myeloid lineage-derived cell types, including (in the brain) altered pathogenic microglia as well as monocyte-macrophages (Macs), myeloid-derived suppressor cells (MDSC) and dendritic cell (DC) populations. Each can have protective roles, but has, by definition, been coopted by the tumor in patients with progressive disease. However, evidence demonstrates that myeloid immunosuppressive activities can be reversed in different ways, leading to enthusiasm for this therapeutic approach, both alone and …

Developing A Sexual Health Consent Strategy For Refugees: A Qualitative Approach, Amita Tuteja, Elisha Riggs, Lena Sanci, Lester Mascarenhas, Anna Power, Di Vanvliet, Katrina Sangster, Kimberley Mcguinness, Meredith Temple-Smith

The Qualitative Report

We report the development of a strategy for obtaining a truly voluntary and informed consent for sexual and reproductive health (SRH) research with Burma-born refugees settled in Australia. Using a qualitative descriptive research design, we interviewed 29 providers of refugee services (PRS) including health care professionals (doctors, nurses, midwives), bilingual supporting staff (interpreters, social workers, settlement workers, community liaison officers) and administrative staff (practice managers, reception staff) who provide primary care services to refugees. Interviews were audio recorded, transcribed, and subjected to thematic analysis. Four themes emerged: (a) unique values of Burma-born people, (b) unfamiliarity with Western concepts of research, …

Human Milk Oligosaccharide Compositions Illustrate Global Variations In Early Nutrition, Anita Vinjamuri, Jasmine C. C. Davis, Sarah M. Totten, Lauren D. Wu, Laura D. Klein, Melanie Martin, Ea Quinn, Brooke Scelza, Alicia Breakey, Michael Gurven, Grazyna Jasienska, Hillard Kaplan, Claudia Valeggia, Katie Hinde, Jennifer T. Smilowitz, Robin M. Bernstein, Angela M. Zivkovic, Michael J. Barratt, Jeffrey I. Gordon, Mark A. Underwood, David A. Mills, J. Bruce German, Carlito B. Lebrilla

ESI Publications

Background

Human milk oligosaccharides (HMOs) are an abundant class of compounds found in human milk and have been linked to the development of the infant, and specifically the brain, immune system, and gut microbiome.

Objectives

Advanced analytical methods were used to obtain relative quantitation of many structures in approximately 2000 samples from over 1000 mothers in urban, semirural, and rural sites across geographically diverse countries.

Methods

LC-MS−based analytical methods were used to profile the compounds with broad structural coverage and quantitative information. The profiles revealed their structural heterogeneity and their potential biological roles. Comparisons of HMO compositions were made between …

Blood–Brain Barrier Disruption Mediated By Ffa1 Receptor—Evidence Using Miniscope, Kristen L Lindenau, Jeffrey L Barr, Christopher R Higgins, Kevin T Sporici, Eugen Brailoiu, Gabriela C Brailoiu

Faculty, Staff and Student Publications

Omega-3 polyunsaturated fatty acids (n-3 PUFAs), obtained from diet and dietary supplements, have been tested in clinical trials for the prevention or treatment of several diseases. n-3 PUFAs exert their effects by activation of free fatty acid (FFA) receptors. FFA1 receptor, expressed in the pancreas and brain, is activated by medium- to long-chain fatty acids. Despite some beneficial effects on cognition, the effects of n-3 PUFAs on the blood-brain barrier (BBB) are not clearly understood. We examined the effects of FFA1 activation on BBB permeability in vitro, using rat brain microvascular endothelial cells (RBMVEC), and in vivo, by assessing Evans …

Syndecan-2 Regulates Pad2 To Exert Antifibrotic Effects On Ra-Ild Fibroblasts, Konstantin Tsoyi, Anthony J Esposito, Bo Sun, Ryan G Bowen, Kevin Xiong, Fernando Poli, Rafael Cardenas, Sarah G Chu, Xiaoliang Liang, Stefan W Ryter, Christine Beeton, Tracy J Doyle, Matthew J Robertson, Lindsay J Celada, Freddy Romero, Souheil Y El-Chemaly, Mark A Perrella, I-Cheng Ho, Ivan O Rosas

Faculty, Staff and Students Publications

Rheumatoid arthritis (RA)-associated interstitial lung disease (RA-ILD) is the most common pulmonary complication of RA, increasing morbidity and mortality. Anti-citrullinated protein antibodies have been associated with the development and progression of both RA and fibrotic lung disease; however, the role of protein citrullination in RA-ILD remains unclear. Here, we demonstrate that the expression of peptidylarginine deiminase 2 (PAD2), an enzyme that catalyzes protein citrullination, is increased in lung homogenates from subjects with RA-ILD and their lung fibroblasts. Chemical inhibition or genetic knockdown of PAD2 in RA-ILD fibroblasts attenuated their activation, marked by decreased myofibroblast differentiation, gel contraction, and extracellular matrix …

Limited Impact Of The Protein Corona On The Cellular Uptake Of Pegylated Zein Micelles By Melanoma Cancer Cells, Jitkasem Meewan, Sukrut Somani, Partha Laskar, Craig Irving, Margaret Mullin, Stuart Woods, Craig W. Roberts, Abdullah R. Alzahrani, Valerie A. Ferro, Suzanne Mcgill

School of Medicine Publications

The formation of a protein layer "corona" on the nanoparticle surface upon entry into a biological environment was shown to strongly influence the interactions with cells, especially affecting the uptake of nanomedicines. In this work, we present the impact of the protein corona on the uptake of PEGylated zein micelles by cancer cells, macrophages, and dendritic cells. Zein was successfully conjugated with poly(ethylene glycol) (PEG) of varying chain lengths (5K and 10K) and assembled into micelles. Our results demonstrate that PEGylation conferred stealth effects to the zein micelles. The presence of human plasma did not impact the uptake levels of …

Clinical Symptoms Contributing To Zenker's Diverticulum Repair: A Retrospective Review, Jhon F. Martinez Paredes, Razan Al Fakir, Amy L. Rutt

School of Medicine Publications

Objective: Zenker's diverticulum (ZD) is usually associated with dysphagia and other symptoms due to the interrelated functions of several systems. Surgical management of ZD is effective for all sizes of diverticula, but not all patients decide to undergo surgery. The purpose of this study was to determine the relationship between clinical presentation and patients' decision to undergo surgical repair.

Subjects and methods: This is a retrospective study including 165 patients with ZD treated over the last 11 years. Data collection includes patients' chief complaints and symptoms, medical history, findings on radiologic swallow evaluations, and patients' decision to undergo surgery. Pearson …

Adrenergic Modulation Of Precursor Cells Of Ovarian Cancer, Sweta Dash

USF Tampa Graduate Theses and Dissertations

Ovarian cancer remains one of the most lethal gynecological cancer and ranks eighth in cancer-related mortality among women. The high mortality rate can be attributed to majority of the cases being diagnosed at advanced stages of the disease when the survival rate and overall prognosis are poor. There is lack of effective screening modalities to detect ovarian cancer at early stages. Hence, a better understanding of the molecular mechanisms leading to ovarian cancer initiation is required.

Epidemiological studies have reported that conditions which cause chronic behavioral stress are associated with a higher risk of developing ovarian cancer. The activation of …

Repeated Endo-Tracheal Tube Disconnection Generates Pulmonary Edema In A Model Of Volume Overload: An Experimental Study, Bhushan H Katira, Doreen Engelberts, Sheena Bouch, Jordan Fliss, Luca Bastia, Kohei Osada, Kim A Connelly, Marcelo B P Amato, Niall D Ferguson, Wolfgang M Kuebler, Brian P Kavanagh, Laurent J Brochard, Martin Post

2020-Current year OA Pubs

BACKGROUND: An abrupt lung deflation in rodents results in lung injury through vascular mechanisms. Ventilator disconnections during endo-tracheal suctioning in humans often cause cardio-respiratory instability. Whether repeated disconnections or lung deflations cause lung injury or oedema is not known and was tested here in a porcine large animal model.

METHODS: Yorkshire pigs (~ 12 weeks) were studied in three series. First, we compared PEEP abruptly deflated from 26 cmH

RESULTS: As compared to PEEP 5 cmH

CONCLUSION: Single abrupt deflation from high PEEP, and repeated short deflations from moderate PEEP cause pulmonary oedema, impaired oxygenation, and increased PVR, in this …

When “There Is” A Black: Levinas And Fanon On Ethics, Politics, And Responsibility, Leswin Laubscher

Middle Voices

This paper examines some of the ways in which the Black other, by Frantz Fanon’s articulation, complicates and challenges Emmanuel Levinas’s philosophies of ethics and justice. Additionally, it brings Levinas’s notion of the il y a, or “there is,” and Fanon’s “zone of nonbeing” into critical conversation with respect to the body and being of the Black other.

Emannuel Levinas, Fr. William Richardson, And The Return Of The Irresponsible Subject, Robert Manning

Middle Voices

This article revisits the famous encounter between Levinas and William Richardson to discuss the subject's ability to return to itself despite Levinas's arguments to the the contrary in OTB.

Ethics Of Interaction: Levinas And Enactivism On Affectivity, Responsibility, And Signification, Edward A. Lenzo

Middle Voices

In recent years, there have been a number of attempts to connect enactivism with the work of Emmanuel Levinas. This essay is such an attempt. Its major theme is the relationship between affectivity and ethics. My touchstones in enactivist thought are Giovanna Colombetti and Steve Torrances’ “Emotion and Ethics: an (inter-)enactive account” (2009) and the influential concept of participatory sense-making developed by Hanne De Jaegher and Ezequiel Di Paolo (2007). With respect to Levinas, I deploy major insights from Totality and Infinity and Otherwise than Being. I first show that enactivist thought (thus represented) and Levinas roughly agree on …

Revealing Levinas: Transcending Moral And Aesthetic Distinctions Between Form And Content Through Poetic Gamespersonship, Lori E. Koelsch, Alex Kranjec

Middle Voices

This poem was inspired by the confluence of two communications: An email regarding proposed changes to university workload policies, and a call for papers for a journal’s special issue on the work of Emmanuel Levinas. We used poetic form to reflect figuratively on academic integrity and what counts literally as good Levinas scholarship.

Ethics In The Breakdown: Levinas, Winnicott, And Schizoid Phenomena, Matthew J. Devine

Middle Voices

This article addresses the common concern that Emmanuel Levinas’ ethics amounts to a life-denying, moral masochism. To the contrary, I demonstrate close resonances between Levinas’ project and that of the psychoanalyst D.W. Winnicott, for whom the purpose of therapy is to feel alive. In the first section, I trace the Levinasian subject’s coming to be out of the impersonal Il y a. Exploiting the object-relations undertones, I emphasize that the Levinasian subject comes to be as fastened, riveted, or bound to existence, and thereafter seeks to loosen its bond to its existence. In the second section, I discuss Winnicott’s …

King, Levinas And The Interruption Of Love: The Alchemy Of The Fire Fable, Claire S. Lebeau, Kaleb Sinclair

Middle Voices

Levinas begins Totality and Infinity with a haunting allusion from the 19^th century French poet Arthur Rimbaud, “though the true life is absent”, we are in the world. This lamentation is a fitting beginning for his exposition of a radical reformulation of an Ethics that precedes all thought, language, or systematic attempts to cast morality as a Truth. Similarly, Martin Luther King Jr. presented a lamentation for a dream of a world where the transcendence of race, creed, or classification of any kind could allow children to grow up to be first ethical human beings in relation to one …

In Memoriam: George Kunz (1934-2019) / Levinas Issue Introduction, Claire S. Lebeau

Middle Voices

No abstract provided.

Impact Of Pulmonary Rehabilitation Stewardship Program On Copd Patients, Qi Project, Salem Thabet, Mamta S. Chhabria, Muhammad Ali Naveed, Leela Kt. Boppana, Michael N. Gurell

Journal of Community Hospital Internal Medicine Perspectives

Background: Pulmonary rehabilitation (PR) has multiple benefits in COPD patient. There are multiple barriers to utilize PR including lack of knowledge about the benefits of PR by providers. Objective: We are conducting a Quality Improvement project to improve the referral rate of patients hospitalized for acute exacerbation of COPD to PR. Methods: All patients admitted with a primary diagnosis of acute exacerbation of COPD requiring systemic steroids to Rochester General Hospital in the period between 7/1/2019 and 7/31/2019 were reviewed retrospectively. Between 7/15/2020 and 11/15/2020, we started a PR stewardship program, where we daily review patients hospitalized with acute COPD …

Discussion Of Health Care Workers Attitudes Toward Covid-19 Vaccination And Its Impact On Their Personal And Professional Life, Allie Reynolds, Brittney Riedel, Alireza Hamidian Jahromi

Journal of Community Hospital Internal Medicine Perspectives

No abstract provided.

Management Of Wolff-Parkinson-White Syndrome In A Patient With Peri-Partum Cardiomyopathy, Snigdha Bendaram, Sherif Elkattawy, Muhammad Atif Masood Noori, Hardik Fichadiya, Sarah Ayad, Parminder Kaur, Raja Pullatt, Fayez Shamoon

Journal of Community Hospital Internal Medicine Perspectives

Wolf-Parkinson-White (WPW) syndrome is a congenital heart condition in which the atrioventricular (AV) node is bypassed by an accessory pathway that connects the atria and ventricle directly. WPW syndrome in patients with a history of peripartum cardiomyopathy (pregnancy-related cardiomyopathy) is associated with a high risk of morbidity and mortality secondary to failure of the pump and the conduction system of the heart. Management of these cases deals with arrhythmia and systolic heart failure, which becomes more challenging in pregnant patients as it requires treatment methods that minimize risks to the fetus. We report a case of a young female patient …

Acute Esophageal Necrosis: An In-Depth Review Of Pathogenesis, Diagnosis And Management, Abu Baker Sheikh, Samir Mirza, Ramsha Abbas, Nismat Javed, Anthony Nguyen, Hamza Hanif, Asif Farooq

Journal of Community Hospital Internal Medicine Perspectives

Introduction: Acute esophageal necrosis (AEN) is an uncommon but fatal cause of upper gastrointestinal bleeding. The complex pathophysiology of the disorder provides multiple points for intervention. Therefore, it is important to discuss the many multifaceted aspects of the disease. Methods: A scoping review was performed using PubMed, Google Scholar, and ClinicalTrials.gov. We reviewed literature from 1990 to 2021. The keywords used were ‘acute esophageal necrosis’, ‘upper GI bleed’, ‘pathogenesis’, ‘EGD’, ‘prognosis’. Results and conclusions: The review summarized findings of 46 studies. AEN usually targets older males who have underlying cardiovascular disease. The middle part of the esophagus is commonly involved. …

A Case Of Chest Jolts: Pulmonary Vein Thrombus Extending Into The Left Atrium, Shaikh Iqbal, Shiavax J. Rao, Nicholas Bedard, Christopher J. Haas

Journal of Community Hospital Internal Medicine Perspectives

Pulmonary vein thrombosis (PVT) is a rare but life-threatening clinical condition, often found incidentally on imaging. In this report, we present an interesting case of PVT of the left inferior pulmonary vein with extension into the left atrium in a 78-year-old woman presenting with “jolts” in the chest. Initial imaging with plain chest film radiograph showed findings consistent with COPD and no acute intrathoracic process. A CT angiogram of the chest revealed a filling defect consistent with thrombus within the left inferior pulmonary vein extending into the left atrium. A transthoracic echocardiogram was remarkable for a severely enlarged right ventricular …

Heart And Kidney Transplant In A Patient On Total Artificial Heart Bridge Therapy For 318 Days, Sunny S. Cai, Heather L. Andrews, Christopher A. Molini

Journal of Community Hospital Internal Medicine Perspectives

There are few cases in the current literature that describe simultaneous heart and kidney transplant (HKTx) while on total artificial heart (TAH) bridge therapy. We present a case of successful HKTx after 318 days on TAH bridge therapy and renal replacement therapy. This case demonstrates that TAH placement is a unique and up-and-coming option for bridging patients with heart and kidney failure to HKTx. TAH is a promising bridging option for patients who do not qualify for left ventricular assist device placement. The survival rates to heart transplant and long-term outcomes after heart transplant on TAH bridge therapy are encouraging …

Rare Case Of High Grade Neuroendocrine Carcinoma Found On Bone Marrow Biopsy: A Case Report, Alexander Belkin, Sara Velayati, Yordan Jimenez-Perez, Zubin Tharayil, Ravi Gupta, Kenneth Lidonnici, Samir Patel

Journal of Community Hospital Internal Medicine Perspectives

Background: Neuroendocrine neoplasms (NENs) comprise a wide-ranging group of abnormal neoplasms with atypical presentations, from primary localized disease to extensive metastasis, reaching the bone and brain. The NENs are divided into two major groups: neuroendocrine tumors (NETs), which are well-differentiated tumors of any grade, and neuroendocrine carcinomas (NECs), which are poorly differentiated, high-grade cancers with a high risk of morbidity and mortality. The challenge of diagnosing NENs early, particularly prior to metastasis, highlights the importance of further studying these diseases. We present a case of aggressive metastatic neuroendocrine carcinoma of a gastrointestinal/pancreaticobiliary origin. Case Report: A 54-year-old male with a …

Seeking Opportunity In Crisis: Redesigning Care For High-Risk Diabetics During The Pandemic, Kelly Le, Susan Arnold, Fatoumatta Sissoho, Hmu Minn, Eugene Obah, Patricia Nicholls, Allison Hicks, Mary Stumbroski

Journal of Community Hospital Internal Medicine Perspectives

Management of uncontrolled diabetic (DM) patients has always been a challenge across healthcare settings, but recently we noticed a surge in the number of uncontrolled DM patient in our clinic patients’ population during the COVID19 pandemic. This in part a combination of disruptions to care, delayed or inaccessible care, and poor diet and physical activity. To address this issue, we formed a multidisciplinary Diabetes Initiative Team consisting of attending physicians, residents, clinical pharmacist, nurse manager, care manager, and coordinator, along with supportive staffs in our Internal Medicine Residency clinic. Our aim was to reengage diabetic patients in the outpatient setting …

Tetrad Of Dka, Hypertriglyceridemia Induced Pancreatitis And Splenic Vein Thrombosis, Beenish Faheem, Balraj Singh, Hamdallah Ashkar, Parminder Kaur, Sachin Gupta, Michael Maroules

Journal of Community Hospital Internal Medicine Perspectives

Patients with diabetes mellitus have diabetic dyslipidemia that occurs due to disturbances in glucose metabolism and can lead to hypertriglyceridemia (HPTG). Severe HPTG is associated with significantly increased risk of developing acute pancreatitis (AP). Acute pancreatitis (AP) is characterized as an inflammatory condition where inactive digestive enzymes become activated causing pancreatic tissue destruction. Hypertriglyceridemia and the inflammatory state that ensues therein also gives rise to a hypercoagulable state in patients with AP. Splenic vein thrombosis (SVT) is a rare complication of both AP and chronic pancreatitis (CP). We report a case of 55-year-old Filipino male with past medical history of …

Ruptured Sinus Of Valsalva Aneurysm In Apert Syndrome: Case Report, Louay Aldabain, Metri Haddaden, Sumanth Bandaru, Lyn Camire, David S. Weisman

Journal of Community Hospital Internal Medicine Perspectives

Background Sinus of Valsalva aneurysm (SOVA) is a rare anomaly of the aorta that can be congenital or acquired. It can be associated with syndromes such as Marfan syndrome and Ehlers-Danlos syndrome. However, to our knowledge, it has never been described in a patient with Apert syndrome. Although it often presents as an incidental finding on imaging, SOVA is associated with the risk of serious complications, including rupture. A possible connection between the conditions might be the FGFR2 gene mutation in Apert syndrome and the influence of a mutation in fibroblast growth factor 2 (FGF2) on heart development. Here we …

Brevibacterium Casei Induced Peritonitis In A Patient Undergoing Continuous Cycler Peritoneal Dialysis: Case Report And Literature Review, Sasmit Roy, Amarinder Singh Garcha, Sumit Patel, Ebad Ur Rahman, Sreedhar Adapa

Journal of Community Hospital Internal Medicine Perspectives

Brevibacterium casei is an extremely rare organism that can lead to peritonitis in End stage renal disease patients of peritoneal dialysis. Out of only five overall Brevibacterium species peritonitis reported worldwide, only two of them had Brevibacterium casei subspecies peritonitis detected, with both needing peritoneal dialysis catheter removal and change in dialysis modality to hemodialysis. Our patient, an elderly 63-year-old Hispanic male, was on peritoneal dialysis at home and presented with features suggestive of peritonitis. He was diagnosed subsequently with Brevibacterium casei and started on broad spectrum intraperitoneal antibiotics. However, he did not need dialysis modality change and recovered fully …

Teriparatide-Associated Late Hypercalcemia: A Report Of Two Cases And Literature Review, Jovan Milosavljevic, Asha Mary Thomas

Journal of Community Hospital Internal Medicine Perspectives

Introduction: Teriparatide, recombinant human parathyroid hormone (1-34), is a safe and usually well-tolerated medication. We describe two cases of late-onset hypercalcemia associated with teriparatide use and report current evidence of hypercalcemia during the treatment with PTH analogs. Case report: Case 1 is a 54-year-old man with a history of osteoporosis, previously treated with 6 months of teriparatide, but had not been consistent in taking the medication. Before restarting teriparatide, his serum calcium, PTH and vitamin D were normal. Six months into the treatment, he developed asymptomatic hypercalcemia of 11.2 mg/dL 24 hours after the last dose. Repeat serum calcium was …