Medicine and Health Sciences Commons^™

Oral Nanomedicines For Sirna Delivery To Treat Inflammatory Bowel Disease, Jongyoon Shinn, Juyeon Lee, Seon Ah Lee, Seon Ju Lee, Ah Hyun Choi, Jung Seo Kim, Su Jin Kim, Hyo Jin Kim, Cherin Lee, Yejin Kim, Joohyeon Kim, Jonghee Choi, Byungchae Jung, Taeho Kim, Hyeontaek Nam, Hyungjun Kim, Yonghyun Lee

Faculty, Staff and Student Publications

RNA interference (RNAi) therapies have significant potential for the treatment of inflammatory bowel diseases (IBD). Although administering small interfering RNA (siRNA) via an oral route is desirable, various hurdles including physicochemical, mucus, and cellular uptake barriers of the gastrointestinal tract (GIT) impede both the delivery of siRNA to the target site and the action of siRNA drugs at the target site. In this review, we first discuss various physicochemical and biological barriers in the GI tract. Furthermore, we present recent strategies and the progress of oral siRNA delivery strategies to treat IBD. Finally, we consider the challenges faced in the …

Quantitative Bone Imaging Biomarkers And Joint Space Analysis Of The Articular Fossa In Temporomandibular Joint Osteoarthritis Using Artificial Intelligence Models, Tamara Mackie, Najla Al Turkestani, Jonas Bianchi, Tengfei Li, Antonio Ruellas, Marcela Gurgel, Erika Benavides, Fabiana Soki, Lucia Cevidanes

Pacific Faculty Work

Temporomandibular joint osteoarthritis (TMJ OA) is a disease with a multifactorial etiology, involving many pathophysiological processes, and requiring comprehensive assessments to characterize progressive cartilage degradation, subchondral bone remodeling, and chronic pain. This study aimed to integrate quantitative biomarkers of bone texture and morphometry of the articular fossa and joint space to advance the role of imaging phenotypes for diagnosis of Temporomandibular Joint Osteoarthritis (TMJ OA) in early to moderate stages by improving the performance of machine-learning algorithms to detect TMJ OA status. Ninety-two patients were prospectively enrolled (184 h-CBCT scans of the right and left mandibular condyles), divided into two …

Research To Accelerate Practice Change In Geriatric Emergency Medicine, Susan Hastings

Journal of Geriatric Emergency Medicine

This is the Keynote Address for the First American Geriatrics Society Geriatric Emergency Department Special Interest Group

Mucopolysaccharidoses And The Blood-Brain Barrier, Onur Sahin, Hannah P Thompson, Grant W Goodman, Jun Li, Akihiko Urayama

Faculty, Staff and Student Publications

Mucopolysaccharidoses comprise a set of genetic diseases marked by an enzymatic dysfunction in the degradation of glycosaminoglycans in lysosomes. There are eight clinically distinct types of mucopolysaccharidosis, some with various subtypes, based on which lysosomal enzyme is deficient and symptom severity. Patients with mucopolysaccharidosis can present with a variety of symptoms, including cognitive dysfunction, hepatosplenomegaly, skeletal abnormalities, and cardiopulmonary issues. Additionally, the onset and severity of symptoms can vary depending on the specific disorder, with symptoms typically arising during early childhood. While there is currently no cure for mucopolysaccharidosis, there are clinically approved therapies for the management of clinical symptoms, …

An Evaluation Of Covid-19 Vaccination Rates Of The Patients At The Kentucky Racing Health Services Center, Aditya Mehta, Dedra Hayden

The Cardinal Edge

COVID-19 vaccines have been widely available to the U.S. public since early 2021. However, vaccination rates still vary considerably across geographical areas and different populations. The objective of this study was to research overall vaccination rates against COVID-19 for Latinx patients at the Kentucky Racing Health Services Center (KRHSC). Vaccination and booster data was collected from June to December 2021 for all unique patients visiting the center. It was initially hypothesized that these rates of vaccination and booster doses for the KRHSC patients would be lower than the data reported by Kentucky and Jefferson County. After a retrospective review, the …

Evaluation Of Respiratory Function Using Blood Gas Parameters In Yucatan Minipigs Following Spinal Cord Injury, Jackson Gallagher, Monique Morgan, Chase Knibbe, Destiny Gibson, Maxwell Boakye

The Cardinal Edge

There are approximately 17,810 new spinal cord injuries (SCI) in the U.S. each year [1]. Physical damage to the spinal cord has the potential to interfere with normal motor, sensory, and/or autonomic function, such as impairment of the respiratory system. In fact, respiratory insufficiency is the number one cause of mortality and morbidity after SCI. The more rostral the injury, the more likely there will be disruption to normal ventilation (generally rostral to T6) [2]. To conduct relevant preclinical research, it has been shown that large animal models, such as the Yucatan minipig, have a better success rate of translating …

Racial Disparities In Diabetes Mellitus Prevalence In Prostate Cancer Patients On Androgen Deprivation Therapy, Sameh Gomaa, William Kelly, Do, Grace Lu-Yao, Phd, Edith Mitchell, Md, Tingting Zhan, Phd, Kuang-Yi Wen, Phd

Department of Medical Oncology Posters

Intro/Background

• Androgen deprivation therapy (ADT) is successfully used in patients with advanced prostate cancer.
• ADT has show to prolong survival.
• The use of ADT is associated with many side effects, most notably an increase in diabetes incidence for patients on ADT.
• African American men have higher prevalence and mortality rates from prostate cancer than White men.
• It is unclear how prostate cancer treatment such as ADT affects these disparities.
• This study examines racial differences in the prevalence of diabetes mellitus in prostate cancer patients based on their ADT status in the US.

Access To Health Care By Foreign Children With Special Needs In An International Border Municipality, Gabriela Dominicci De Melo Casacio, Adriana Zilly, Rosane Meire Munhak Da Silva

The Qualitative Report

This qualitative study aimed to analyze access to health by foreign children with special needs in an international border municipality. Grounded on hermeneutics-dialectics, this research was conducted through in-depth interviews with 26 professionals who treat foreign children with special health care needs and thematic analysis for data analysis was adopted. One central theme emerged: Vulnerability of foreign children and the health access in a border area Brazil-Argentina-Paraguay, organized by six sub-themes. High demand of children, overload in the health services, problems with documentation and language, insufficient articulation between the countries, and lack of funding represent restrictions for the access, especially …

Pathogenesis Of Tobacco-Associated Lung Adenocarcinoma Is Closely Coupled With Changes In The Gut And Lung Microbiomes, Casey T Finnicum, Zahraa Rahal, Maya Hassane, Warapen Treekitkarnmongkol, Ansam Sinjab, Rhiannon Morris, Yuejiang Liu, Elizabeth L Tang, Sarah Viet, Jason L Petersen, Philip L Lorenzi, Lin Tan, Joseph Petrosino, Kristi L Hoffman, Junya Fujimoto, Seyed Javad Moghaddam, Humam Kadara

Faculty, Staff and Students Publications

Microbial dysbiosis has emerged as a modulator of oncogenesis and response to therapy, particularly in lung cancer. Here, we investigate the evolution of the gut and lung microbiomes following exposure to a tobacco carcinogen. We performed 16S rRNA-Seq of fecal and lung samples collected prior to and at several timepoints following (nicotine-specific nitrosamine ketone/NNK) exposure in Gprc5a^−/− mice that were previously shown to exhibit accelerated lung adenocarcinoma (LUAD) development following NNK exposure. We found significant progressive changes in human-relevant gut and lung microbiome members (e.g., Odoribacter, Alistipes, Akkermansia, and Ruminococus) that are closely associated with …

The Effect Of Exercise Modality On Age-Related Changes Observed During Running, Brianne Borgia, Janet S. Dufek, Kara N. Radzak, Julia Freedman Silvernail

Kinesiology and Nutrition Sciences Faculty Research

Introduction: With the increase in participation by older adults in endurance events, research is needed to evaluate how exercising throughout the lifespan can afect the aging process regarding gait and mobility. The purpose of this study was to determine how the type of exercise modality one participates in will affect age-related declines observed during running.

Methods: Fifty-six individuals between the ages of 18–65 who considered running, resistance training or cycling/ swimming as their primary form of activity participated in this study. Kinematics were captured using a 10-camera motion capture system while participants ran at a controlled pace of 3.5 m/s …

Regulation Of Human Cortical Interneuron Development By The Chromatin Remodeling Protein Chd2, E M A Lewis, G Chapman, K Kaushik, J Determan, I Antony, K Meganathan, M Narasimhan, P Gontarz, B Zhang, K L Kroll

2020-Current year OA Pubs

Mutations in the chromodomain helicase DNA binding protein 2 (CHD2) gene are associated with neurodevelopmental disorders. However, mechanisms by which CHD2 regulates human brain development remain largely uncharacterized. Here, we used a human embryonic stem cell model of cortical interneuron (hcIN) development to elucidate its roles in this process. We identified genome-wide CHD2 binding profiles during hcIN differentiation, defining direct CHD2 targets related to neurogenesis in hcIN progenitors and to neuronal function in hcINs. CHD2 bound sites were frequently coenriched with histone H3 lysine 27 acetylation (H3K27ac) and associated with high gene expression, indicating roles for CHD2 in promoting gene …

Obstetric Complications And Wellbeing Among Us Surgical Residents, Ruojia Li, Joshua Eng, Darci C. Foote, Christine Wu, Julie Johnson, Sarah Easter, Karl Bilimoria, Yue-Yung Hu, Erika Rangel

Conference Presentation Abstracts

No abstract provided.

Incident Chlamydia Trachomatis Infection In A High School Population, Jacques M. Nsuami, Wato Nsa, Catherine L. Cammarata, David H. Martin, Stephanie N. Taylor

School of Medicine Faculty Publications

Prospective cohort studies of sexually transmitted infections (STIs) are logistically impractical owing to time and expenses. In schools, students are readily available for school-related follow-ups and monitoring. Capitalizing on the logistics that society already commits to ensure regular attendance of adolescents in school, a school-based STI screening in New Orleans made it possible to naturally observe the occurrence of chlamydia and to determine its incidence among 14–19-year-old adolescents. Among participants screened repeatedly, we calculated incidence rates, cumulative incidence, and incidence times. Male (n = 3820) and female (n = 3501) students were observed for 6251 and 5143 person-years, respectively, during …

An International Working Group Consensus Report For The Prioritization Of Molecular Biomarkers For Ewing Sarcoma, David S Shulman, Sarah B Whittle, Didier Surdez, Kelly M Bailey, Enrique De Álava, Jason T Yustein, Adam Shlien, Masanori Hayashi, Alexander J R Bishop, Brian D Crompton, Steven G Dubois, Neerav Shukla, Patrick J Leavey, Stephen L Lessnick, Heinrich Kovar, Olivier Delattre, Thomas G P Grünewald, Cristina R Antonescu, Ryan D Roberts, Jeffrey A Toretsky, Franck Tirode, Richard Gorlick, Katherine A Janeway, Damon Reed, Elizabeth R Lawlor, Patrick J Grohar

Faculty, Staff and Students Publications

The advent of dose intensified interval compressed therapy has improved event-free survival for patients with localized Ewing sarcoma (EwS) to 78% at 5 years. However, nearly a quarter of patients with localized tumors and 60-80% of patients with metastatic tumors suffer relapse and die of disease. In addition, those who survive are often left with debilitating late effects. Clinical features aside from stage have proven inadequate to meaningfully classify patients for risk-stratified therapy. Therefore, there is a critical need to develop approaches to risk stratify patients with EwS based on molecular features. Over the past decade, new technology has enabled …

Pulmonary Hypertension With “Normal” Pulmonary Vascular Resistance, Marwan F. Jumean, Sriram Nathan, Maria Patarroyo Aponte

Journal of Shock and Hemodynamics

Abstracts not available for Perspectives.

Role Of Veno-Arterial Extracorporeal Membrane Oxygenation In Left Ventricular Conditioning After Lung Transplantation, Emily A. Ingebretson

Journal of Shock and Hemodynamics

End-stage pulmonary hypertension alters intracardiac pressures, leading to distention and failure of the right ventricle, leftward shifting of the intraventricular septum, and, thus, underfilling of the left ventricle (LV). Following the resolution of severely elevated pulmonary vascular resistance with bilateral lung transplantation, the LV is exposed to relatively high filling pressures from a potentially hypertrophic right ventricle pushing blood through normalized pulmonary vascular resistance. Veno-arterial extracorporeal membrane oxygenation (V-A ECMO) may be a valuable tool to provide a more gradual exposure of the LV to the newly available preload in the immediate postoperative phase of transplantation, thereby reducing the likelihood …

Scai Shock Stage Classification: What Is Missing From The Latest Update?, Biykem Bozkurt

Journal of Shock and Hemodynamics

The revised Society for Cardiovascular Angiography and Interventions classifications reflect graduation of severity within each stage and pathway by which patients progress or recover. However, they are limited regarding the following: their predictive role to guide therapy; escalation of therapy or referral; variability in diagnostic criteria and interpretation; presence of other disease modifiers and confounders; variability of etiology and reversibility of cause; response to therapy and trajectory to be taken into risk stratification; magnitude and phenotypes of end-organ damage. Thus, we need a modified risk score to predict the necessity to escalate therapy and consider advanced therapies, such as mechanical …

Should All Shock Centers Offer Ecpr? Balancing Futility, Cost Effectiveness, And Hope, Michael Mooney

Journal of Shock and Hemodynamics

There are over 400,000 out-of-hospital cardiac arrests (OHCA) in the United States annually. Of those, 50% are refractory cardiac arrest, defined as the lack of return of spontaneous circulation (ROSC) after 30 minutes of appropriate cardiopulmonary resuscitation (CPR) in the absence of hypothermia. Extracorporeal cardiopulmonary resuscitation (ECPR) has been increasingly used given its potential to improve survival and offer improved neurological outcomes.

Systemic Inflammatory Response Syndrome And Mechanical Circulatory Support Devices, Mircea R. Mihu, Aly El-Banayosy

Journal of Shock and Hemodynamics

Systemic inflammatory response syndrome is an increased inflammatory state affecting the whole body. Mechanical circulatory support (MCS) is a temporary or permanent form of extracorporeal support that may have an associated complication of an exacerbated inflammatory response to the extracorporeal circuit. This brief review will focus on understanding the complex pathophysiology of inflammatory response to MCS, factors that influence the extent of the inflammatory response, the inflammatory response and outcomes as well as potential therapeutic strategies.

Role Of Hypothermia In Cardiogenic Shock, Filio Billia

Journal of Shock and Hemodynamics

While patient management in the intensive care unit has undoubtedly improved over the last 20 years, many questions remain. Neurological prognostication has become very important and aided in improving survival outcomes over time. The limited number of randomized control trials and limitations from currently completed studies leave the field with little certainty regarding targeted temperature management. In addition, implementing hypothermia can use multiple methods and protocols that impact the interpretation and comparison of results.

Management Of Severe Aortic Stenosis In Cardiogenic Shock: Early Percutaneous Mechanical Circulatory Support Or Emergent Transcatheter Aortic Valve Replacement?, Sandeep Nathan

Journal of Shock and Hemodynamics

Aortic stenosis (AS) affects an estimated 1.5 million patients in the United States, with 250,000 patients or more suffering severe, symptomatic aortic stenosis. A subset of these patients also have unrevascularized coronary artery disease and left ventricular dysfunction, representing an extreme risk population of AS patients. Cardiogenic shock (CS) complicates a small minority of AS presentations and/or patients referred for transcatheter aortic valve replacement (TAVR) but is responsible in these cases for a disproportionately high rate of morbidity and mortality. Indeed, CS results in a 4-fold increase in TAVR mortality, proportional to shock severity and largely independent of procedural complications. …

A Case Of Inferior Myocardial Infarction Complicated By Ventricular Septal Rupture Leading To Cardiogenic Shock: Tandem Heart To The Rescue!, Shehab Al-Ansari, Sachin Kumar, Angelo Nascimbene, Manish K. Patel, Igor D. Gregoric

Journal of Shock and Hemodynamics

Ventricular septal rupture (VSR) is a rare but life-threatening complication of acute myocardial infarction. We present a case of VSR-related refractory cardiogenic shock that was successfully managed with TandemHeart® followed by surgical repair.

Early Unloading In Venoarterial Extracorporeal Membrane Oxygenation Shock: When, How, Where, And Why?, Benedikt Schrage

Journal of Shock and Hemodynamics

As extracorporeal membrane oxygenation increases the left ventricular afterload, a successful treatment plan should include strategies to address this issue. One promising approach to do so is the addition of a second device for active left ventricular unloading. However, this relatively new approach is currently only based on retrospective data. This article summarizes the current perspectives on this approach, provides recommendations for its application, and highlights the need for randomized data on this topic.

Microcirculation Versus Macrocirculation In Cardiogenic Shock, Christian Jung

Journal of Shock and Hemodynamics

Macro- and microcirculation are important parameters in cardiogenic shock. Microcirculation is relevant for monitoring organ function and prognosis. Serum lactate might be the best daily life parameter to assess microcirculation, and the crude 8-hour value can be used for outcome prediction. Any treatment should consider the consequences of microcirculation and macrocirculation.

Hemodynamics Of Prolonged Percutaneous Mechanical Circulatory Support – When Vasodilatation Sets, Holger Thiele

Journal of Shock and Hemodynamics

Hemodynamics play an important role in cardiogenic shock assessment for prognosis estimation and for phenotyping cardiogenic shock. This is best done by pulmonary artery catheters. In general, at the beginning of cardiogenic shock, patients have vasoconstriction, which over time may lead to vasodilation. This is often triggered by percutaneous mechanical circulatory support. This review will elucidate the hemodynamics and the factors that possibly lead to vasodilation in patients with mechanical circulatory support.

Society For Improving Medical Professional Learning Collaborative: What’S It All About?, Joseph B. Zwischenberger, Katherine Breetz, Daniel Cooper

Journal of Shock and Hemodynamics

The Society for Improving Medical Professional Learning (SIMPL) Collaborative is a non-profit, educational, quality improvement consortium focused on developing tools, curricula, and policies to improve physician training. The goal is to provide educators and learners with convenient, reliable, and valid evaluation tools for frequent, real-time workplace assessment and feedback. The SIMPL Operating Room application provides this platform. It was developed to provide high-quality, time-sensitive, procedural feedback. Its objective is to facilitate intra-rotation corrections.

SIMPL is available to all residency programs and has matured to include over 175 residency programs, involving 19 different specialties, 4000 trainees, 5000 attendings, and 354,800 evaluations …

Houston Shock: A Practical Scoring System Incorporating Cardiogenic Shock Dynamic Changes, Marwan F. Jumean, Sriram Nathan, Igor D. Gregoric, Biswajit Kar

Journal of Shock and Hemodynamics

Cardiogenic shock has an unacceptably high mortality rate and additional tools are needed to improve outcomes. The Society of Cardiovascular Angiography and Interventions (SCAI) shock severity classification has provided a unified definition of shock severity that has proven to be reproducible and predictive of survival. However, cardiogenic shock assessment goes beyond standardizing its severity, and a uniform and practical approach to comprehensive assessment that may guide therapy in a dynamic state is currently lacking.

Since cardiogenic shock is a rapidly evolving pathophysiological catastrophe, we propose a new assessment tool – the Houston SHOCK Score – which incorporates dynamic changes. The …

Medical School Watercooler Newsletter - September 16, 2022, Lindsey Lyle

Watercooler Newsletter

This is the September 16, 2022 edition of the Frederick P. Whiddon College of Medicine's newsletter - Watercooler.

Contents include:

• New neonatology division chief joins Children’s &Women’s Hospital
• USA Center for Lung Biology announces Murray Bander Faculty Development Award recipients
• Med students invited to attend GME virtual open house
• Borchert receives $1 million from National Science Foundation to study Salmonella survival
• Menger wins Young Neurosurgeon Award from Congress of Neurological Surgeons

Engaging Stakeholders As Advisors On The Design Of A Large-Scale Calibration Study Of The Spinal Cord Injury Movement Index (Sci-Mi) Item Pools, Olivia M. Biller, Otdc, Jason Biundo, Bs, Edward S.-L. Mitchell, Mba, Ernest Ofori, Mb Chb, Lmcc, Bonnie Richardson, Rachel Y. Kim, Otd, Otrl/L, Nicole Gerhardt, Ms, Otr/L, Cbis, M.J. Mulcahey, Phd, Otr/L, Fasia

Department of Occupational Therapy Posters and Presentations

Introduction

• People living with spinal cord injury (SCI) in North America are involved in the following as stake holders in research: identifying priorities for research; planning interventions; and implementing rehabilitation or peer-support interventions.
• The best practice is for partnerships to span the continuum of research.
• Project purpose: to collaborate with an advisory board of individuals living with SCI, to make recommendations for the methods of a large-scale calibration study of the Spinal Cord Injury Movement Index )SCI-MI).
• The SCI-MI is being developed as a SCI clinical trial outcome assessment to evaluate the construct of movement in the context of function …

Coronavirus Update—Tests Available And Other Reminders 9/16, The Coronavirus Planning Team

University Briefings & Virtual Events

We want to remind everyone that the University has home tests and masks available to anyone who needs them.