Medicine and Health Sciences Commons^™

A Rare Case Of Deep Vein Thrombosis Secondary To Protein S Deficiency And Antithrombin Iii Deficiency With Mthfr (C677t) Heterozygous Mutation, And Crohn’S Disease, Anusha Garg, Vanama Lakshman Sai, Ankit Singh, Aditi Rao

Digital Journal of Clinical Medicine

Deep vein thrombosis is a condition wherein a thrombus develops in the deep veins of the body, most commonly in the legs, due to increasing tendency of the blood to coagulate. One such reason is the MTHFR gene mutation, wherein an increase in homocysteine levels causes irritation of the blood vessel endothelium, causing a disturbance in Virchow’s triad, hence triggering clot formation. [1]

The MTHFR gene is responsible for instructing the body to produce an enzyme called methylene tetrahydrofolate reductase(MTHFR) [2]. MTHFR gene mutations can lead to a wide range of disorders, either as a result of the elevated levels …

Multiple System Atrophy: Case Of Atypicalparkinson With Parkinson Predominant Presentation And Progressive Cerebellar Degeneration With Extrapyramidal And Autonomic Involvement, Aayushi Sharma

Digital Journal of Clinical Medicine

ABSTRACT

BACKGROUND

Multiple System Atrophy is a rapidly progressive neurodegenerative disease. Symptoms tend to appear in 50s and advance rapidly over the course of 5-10 years with progressive loss of motor and autonomic function.

Some of the common symptoms include frequent falls with or without tremors and b/l akinetic rigidity with involvement of the axial muscles. Postural tremor, severe stridor and cranio cervical dystonia may be seen. Alpha synnuclenopathies are generally characterized by REM behavioral disorders and severe dysautonomia years before the onset of the disease.

Individuals with MSA typically do not have sustained improvement in their symptoms with levodopa. …

Association Of Physical Activity And Screen Time Usage Of Adolescents In Rural Areas Of Mysore., Aakash Pavan Kumar, Nayanabai Shabadi, Bikram Sinha Roy, Anchu R. Nath, Arun Gopi

Digital Journal of Clinical Medicine

Introduction:

In these changing times there have been increased usage of screen device due to more accessibility to both device and the internet and a greater number of children are having reduced physical activity. The purpose of the current study was to determine if screen usage among adolescents (11-17yrs) who live in supportive environments is associated with decreased levels of moderate to vigorous physical activity.

Methods & materials:

A school-based cross-sectional study was conducted in two rural schools of Mysore, Karnataka in February 2023, in 176 students between the age group of 11 – 17yrs. Physical activity and screen …

Factors That May Affect Job Satisfaction And Commitment To The Career Within The Profession Of Athletic Training., Michael Hill Jr.

Graduate Research Showcase

The primary goal of this study was to analyze factors that may affect the

longevity and commitment of a career within the profession of athletic

training. Aspects that were assessed include salary, perceived value,

scheduling, hours worked, work demands, available leisure time,

parenting, and family responsibilities.1 Previous research focused heavily

on work life balance in the athletic training profession. More specifically,

what challenges certified athletic trainers (ATs) face within their

workplace that may cause conflict in establishing as well as maintaining

work life balance and its impact on retention of ATs in the profession.

Literature supports many ATs experienced burnout …

2023 March 21 - Medical Student Education Committee Minutes, Medical Student Education Committee, East Tennessee State University

Medical Student Education Committee Minutes

No abstract provided.

2023-03-21_Michiganoverview_Covidcounts, Michigan Department Of Health & Human Services

Michigan COVID-19 Confirmed Cases by Date of Onset Data

Data was downloaded as an Excel spreadsheet which appeared in the Public Use Datasets section under the Cumulative Data link of Michigan's Coronavirus webpage, under the url https://www.michigan.gov/coronavirus/stats.

Cases are aggregated by the date of onset of COVID-19 symptoms, if known, otherwise by laboratory specimen date if known, otherwise by case referral date. Deaths are aggregated by the date of death if known, otherwise by the last date of a change to the case status.

2023-03-21_Michiganoverview_Isdreporting, Michigan Department Of Health & Human Services

Michigan COVID-19 Outbreak Reports

The K-12 Aged ISD Reporting page was obtained from Michigan's COVID-19 data page: https://www.michigan.gov/coronavirus/stats/k-to-12-aged-isd-reporting.

This report is created from data reported by the Michigan Disease Surveillance System (MDSS) the Michigan Department of Health and Human Services' web-based communicable disease reporting system. Data is updated every week.

The purpose of the dashboard is to report the 7 day average of COVID-19 cases in Michigan school students aged 5 through 18 at the intermediate school district and school district levels, as well as display trends over time to better illustrate the changing nature of the COVID-19 pandemic. Cases are attributed to …

2023-03-21_Michiganoverview_Covidstats, Michigan Department Of Health & Human Services

Cumulative Michigan COVID-19 Data

The COVID Overview page was obtained from Michigan's main COVID-19 page: https://www.michigan.gov/coronavirus/stats.

The State of Michigan is working around the clock to test and treat COVID-19 patients. Below is the most recent data healthcare experts across the state have compiled. COVID case and testing data will be posted once a week on Tuesdays.

This report is provisional and subject to change. City of Detroit and Wayne County are reported separately. MDHHS began tracking probable cases April 5, 2020. FCI indicates federal correctional institute. MDOC indicates Michigan Department of Corrections. Diagnostic tests, including nucleic acid amplification/real-time polymerase chain reaction (NAAT/RT-PCR) …

2023-03-21_Michiganoverview_Covidsymptoms, Michigan Department Of Health & Human Services

Michigan COVID-19 Syndromic Surveillance System Data

The Syndromic Surveillance System Data report was obtained from Michigan's COVID-19 dashboard, from under the link "​Coronavirus Symptoms": https://www.michigan.gov/coronavirus/stats/coronavirus-symptoms. Data was compiled by the Michigan Department of Health and Human Services (MDHHS). The information was updated twice a week on Mondays and Thursdays.

Syndromic Surveillance System data is obtained from approximately 216 facilities participating in syndromic surveillance (139 Emergency Departments (ED), 77 Urgent Cares) across the State of Michigan. The reporting is based on individuals who present at EDs and may not be representative of the overall population. The coronavirus-like symptoms query searches visit free-text (chief complaint, triage notes, …

Management Options For Linear Immunoglobulin A (Iga) Bullous Dermatosis: A Literature Review., Madiha Khan, Lily Park, Stanley Skopit

HPD Articles

Linear immunoglobulin A (IgA) bullous dermatosis (LABD) is an autoimmune condition with various triggers. Because of the lack of randomized controlled trials on LABD treatment, management options are mostly anecdotal. This paper provides a comprehensive review of treatment options from a literature review of reported treatments to arm clinicians with a guideline for the management of LABD in both pediatric and adult patients as well as those recalcitrant to first-line therapy (dapsone and steroids). We additionally illustrate an algorithm to use for the management of LABD to aid clinicians when faced with unique patient circumstances.

A Case Of Galeazzi Fracture Subluxation Of Left Forearm In Paediatric Age Group, Sauparna Dey

Digital Journal of Clinical Medicine

A case report of a rare form of fracture- Galeazzi fracture subluxation in paediatric age group. Showing post operative progress of the patient, with a discussion on possible methodology of approaching such fractures. Correct management of the fracture is essential for proper healing and avoiding complications.

2023-03-21_Michiganoverview_Covidlongtermcare, Michigan Department Of Health & Human Services

Michigan COVID-19 Long Term Care Data

The COVID Long Term Care Facilities page was obtained from Michigan's COVID-19 data page: https://www.michigan.gov/coronavirus/stats/data-about-places/long-term-care-data.

This report is created by the Michigan Department of Health & Human Services from data self-reported by long-term care facilities into EMResource. Data for all reporting facilities is posted weekly each Monday.

The information below represents COVID-19 data reported directly to MDHHS by licensed and operating Skilled Nursing, Home for the Aged and Adult Foster Care facilities (licensed to serve 13 or more individuals) in Michigan from January 1, 2020. All long-term care facilities additionally have an obligation to report COVID-positive residents and/or staff …

Acute Traumatic Spondyloptosis: A Case Report., Johann Braithwaite, Joshua Gruber, Jordan Fakhoury, Gus Katsigiorigis, Kanwarpaul Grewal

HPD Articles

Acute traumatic spondyloptosis (ATS) is a rare condition in the orthopedic literature, with few cases reported. We present a case of ATS in a 35-year-old Hispanic male with multilevel injury, without neurological deficits at the time of injury. The patient was treated in a two-stage method consisting of combined anterior and posterior spinal decompression and fusion. At the six-month follow-up, the patient had no motor/sensory deficits, he remained stable during the one-year period. Conclusion: ATS is rarely seen in patients without neurological deficits on presentation. Although surgical intervention presents significant risks of iatrogenic neurologic compromise, surgical fixation is warranted.

Acute Traumatic Spondyloptosis: A Case Report., Johann Braithwaite, Joshua Gruber, Jordan Fakhoury, Gus Katsigiorigis, Kanwarpaul Grewal

HPD Articles

Acute traumatic spondyloptosis (ATS) is a rare condition in the orthopedic literature, with few cases reported. We present a case of ATS in a 35-year-old Hispanic male with multilevel injury, without neurological deficits at the time of injury. The patient was treated in a two-stage method consisting of combined anterior and posterior spinal decompression and fusion. At the six-month follow-up, the patient had no motor/sensory deficits, he remained stable during the one-year period. Conclusion: ATS is rarely seen in patients without neurological deficits on presentation. Although surgical intervention presents significant risks of iatrogenic neurologic compromise, surgical fixation is warranted.

Deciphering The N-Glycomic And Collagen Proteomic Molecular Signatures Towards Breast Cancer Control And Prevention, Denys Rujchanarong

MUSC Theses and Dissertations

Breast cancer is the most diagnosed cancer among women worldwide and the incidence rates are rising annually. The rates of metastatic breast cancer are projected to increase by 54.3% from 2015 to 2030. Breast stroma plays a significant role in breast cancer risk and progression yet remains poorly understood. In breast stroma, regulation of post-translational modifications (PMTs) is representative of the health state of the local microenvironment. Two abundant PTMs in the extracellular matrix include hydroxylation of prolines (HYP) and N-glycosylation in collagen and non-collagen proteins, respectively. Here, mass spectrometry imaging (MSI) was used to investigate the spatial N-glycomic and …

What Is The Effect Of Opioid Use During Pregnancy On Infant Health And Wellbeing At Birth?, Jessica Pac, Christine Durrance, Lawrence Berger, Deborah Ehrenthal

Population Health Research Brief Series

The opioid epidemic has severe consequences for pregnant women and their infants. Opioid use during pregnancy increases the risk of numerous poor outcomes at birth, including Neonatal Abstinence Syndrome (NAS), preterm birth, and low birth weight. Opioid use during pregnancy can also lead to child protective services reports and foster care entry. This brief summarizes the findings from a recent study that used linked administrative data from Wisconsin from 2010-2019 and child protective service reports to evaluate the effects of exposure to prescription and illicit opioids during pregnancy on infant health and wellbeing at birth.

How Has The Opioid Overdose Crisis Affected Child Maltreatment In The U.S.?, Alexander Chapman

Population Health Research Brief Series

This brief summarizes results from a study examining the association between U.S. county-level opioid mortality rates and child maltreatment rates from 2007 to 2017. Places with higher opioid overdose mortality rates have higher rates of child maltreatment. Poverty makes this problem worse - where the proportion of families in poverty increases, the association between fatal opioid overdose rates and child maltreatment also increases. Findings suggest that intervening in opioid use by reducing poverty has the potential to markedly decrease the incidence of child maltreatment.

The Oxycontin® Reformulation In 2010 Increased States’ Food Insecurity Rates, Colleen Heflin, Xiaohan Sun

Population Health Research Brief Series

The massive surge in opioid misuse and overdose over the past three decades has led to major family, economic, and social disruptions in the United States. OxyContin® - a highly potent, extended-release opioid was among the most commonly-abused narcotics throughout the 2000s. After reformulating OxyContin® to make it more difficult to inhale or inject, many people with opioid use disorders switched to using street drugs. The reformulation had many other unanticipated consequences. This brief shows that states with higher initial OxyContin® misuse rates had an increase in food insecurity after OxyContin® reformulation. The authors argue that public policies must consider …

Federal Medication-Assisted Treatment Expansion Grants Do Not Reduce Homelessness, Andrew Sullivan, Changwe Park

Population Health Research Brief Series

Medication-assisted treatment (MAT) is an evidence-based intervention that, combined with counseling and behavioral therapies, can effectively treat opioid use disorders. However, MAT is underused due to multiple barriers. To increase access to MAT, the U.S. government awarded grants to local governments and nonprofit organizations to increase and retain the number of people receiving MAT. This brief examined differences in homelessness and employment outcomes between places that received a MAT grant and those that did not. They found that these grants did not reduce homelessness or unemployment rates in the places that received funding and concluded that their effectiveness may have …

How Has The Opioid Crisis Affected Health, Health Care Use, And Crime In The United States?, Johanna Catherine Maclean, Justine Mallatt, Christopher J. Ruhm, Kosali Simon

Population Health Research Brief Series

The U.S. opioid crisis is the deadliest drug crisis in the nation’s history and is not abating. This brief summarizes what is known about the relationships between opioid misuse, health, healthcare use, and crime. The authors show that the opioid crisis has led to worsening health, increased mortality, increased healthcare use, and modest increases in crime. In addition, the policies designed to curb opioid misuse and its associated harms have had only limited success.

Which Demographic Groups And Which Places Have The Highest Drug Overdose Rates In The U.S.?, Shannon M. Monnat

Population Health Research Brief Series

Although the drug overdose crisis has affected all demographic groups and places in the United States, overdose rates are much higher in some sub-populations and places than others. This brief describes demographic and geographic differences in fatal drug overdose rates from 1999-2020. Throughout most of this period, fatal drug overdose rates were highest among young and middle-aged adult White and Native American males and middle-aged and older Black males. Rates have been consistently highest in Appalachia, but in recent years have spread throughout several regions in urban and rural areas alike. Although opioids have been the main contributor, cocaine- and …

Opioid Treatment Programs Can Reduce Opioid-Related Emergency Department Visits And Foster Care Placements, Lindsey Rose Bullinger, Vivian Wang, Kenneth A. Feder

Population Health Research Brief Series

The U.S. opioid epidemic has led not only to unprecedented increases in opioid overdoses, functional impairment, and deaths among adults but also harmed children. After lifting a long-standing moratorium on drug treatment programs and increasing the number of medication-assisted opioid treatment programs (OTPs), Indiana saw a decrease in emergency overdose treatments and foster care placements. This brief explores the positive effects of medication-assisted treatments on children and their caregivers and the cost savings for foster care agencies.

The Opioid Epidemic Has Disrupted Children’S Living Arrangements, Mónica L. Caudillo, Andres Villarreal, Philip N. Cohen

Population Health Research Brief Series

The contemporary drug overdose crisis has had profound impacts on children and families in the United States. This brief summarizes how children’s living arrangements have changed during the opioid epidemic. The authors find that opioid overdose deaths are associated with decreasing shares of children living with two married parents and increases in shares of children living with unmarried but cohabiting parents, single fathers, and adults other than their parents. These changes have been most pronounced among White children.

U.S. Counties With Higher Drug Overdose Rates Have Lower School Test Scores, Rajeev Darolia, Sam Owens, John Tyler

Population Health Research Brief Series

The impacts of the contemporary U.S. drug overdose crisis on child and family wellbeing have been profound. This brief describes the link between county-level opioid overdose rates and children’s test scores, finding that counties with higher overdose rates have lower average 3^rd and 8th-grade test scores than counties with lower overdose rates. The relationship between higher overdose rates and lower test scores is particularly strong in rural counties. The places with the highest overdose rates and lowest test scores tend to be economically-disadvantaged, suggesting that economic investments may be needed to address the issue.

Counties With Higher Prescription Opioid Presence Have Slower Student Learning Rates, Jessica Drescher, Carrie Townley-Flores

Population Health Research Brief Series

The adverse impacts of the U.S. opioid crisis have been documented in many domains, but surprisingly little attention has been directed to understanding how the opioid crisis has affected children’s educational outcomes. This brief shows that students in counties with high levels of opioid prescribing are learning more slowly over time than their peers in counties with low levels of opioid prescribing. In addition to directing more support to schools, the authors advocate for policies that address the underlying social conditions that lead to prescription opioid misuse.

Over Two-Thirds Of Opioid Overdose Victims In Canada Were Employed Before They Died, Alexander Cheung, Joseph Marchand, Patricia Mark

Population Health Research Brief Series

As in the United States, drug overdose is the leading cause of unnatural death in Canada, with most overdoses involving opioids. The authors of this brief quantify the lost labor productivity from opioid overdoses in Canada. They show that from 2016 to 2019, over two-thirds of opioid overdose victims were working and contributing to the economy before they died, with those employed in construction, trades, and transportation having the highest opioid overdose rates. The authors argue that destigmatizing drug use, ensuring a safe supply, and improving access to medical care and take-home Naloxone kits are critical for reducing overdose deaths.

Effect Of Ligase I Deficiency On Replication Fork And Chromatin, Seema Khattri Bhandari

Biomedical Sciences ETDs

Half of all the eukaryotic nuclear genome is synthesized as Okazaki fragments on the lagging strand at the replication fork. Okazaki fragment synthesis begins with repeated production of short RNA-DNA primers synthesized by the DNA Polymerase α (Pol α)-primase complex. The primer terminus is recognized by Replication Factor C (RFC) which then loads the sliding clamp protein, proliferating cell nuclear antigen (PCNA), resulting in the recruitment of DNA Polymerase δ (Pol δ) which carries out the gap filling DNA synthesis displacing the 5’ end of the preceding Okazaki fragment which is cleaved by Flap Endonuclease 1 (FEN-1), and ultimately the …

Trauma-Informed And Family-Centered Paediatric Resuscitation: Defining Domains And Practices, Nancy Kassam-Adams, Lucas Butler, Julia Price, Marcie Gawel, Leila Graham, Sage Myers, Marc Auerbach

Department of Pediatrics Faculty Papers

Aim

For paediatric patients and families, resuscitation can be an extremely stressful experience with significant medical and psychological consequences. Psychological sequelae may be reduced when healthcare teams apply patient- and family-centered care and trauma-informed care, yet there are few specific instructions for effective family-centered or trauma-informed behaviours that are observable and teachable. We aimed to develop a framework and tools to address this gap.

Methods

We reviewed relevant policy statements, guidelines, and research to define core domains of family-centered and trauma-informed care, and identified observable evidence-based practices in each domain. We refined this list of practices via review of provider/team …

Systematic Assessment Of The Quality And Comprehensibility Of Youtube Content On Ulnar Collateral Ligament Injury And Management, Sohil S. Desai, Matthew J. Anderson, Connor R. Crutchfield, Anastasia Gazgalis, Frank J. Alexander, Charles A. Popkin, Christopher S. Ahmad

Department of Orthopaedic Surgery Faculty Papers

Background:

Purpose:

Study Design:

Methods:

An Unusual Case Of Hemophagocytic Lymphohistiocytosis Associated With Mycobacterium Chimaera Or Large-Cell Neuroendocrine Carcinoma, Tejaswi Venigalla, Sheila Kalathil, Meena Bansal, Mark Morginstin, Vinicius Jorge, Patricia Perosio

Einstein Health Papers

Hemophagocytic lymphohistiocytosis (HLH) is a rare and very dangerous condition characterized by abnormal activation of the immune system, causing hemophagocytosis, inflammation, and potentially widespread organ damage. The primary (genetic) form, caused by mutations affecting lymphocyte cytotoxicity, is most commonly seen in children. Secondary HLH is commonly associated with infections, malignancies, and rheumatologic disorders. Most current information on diagnosis and treatment is based on pediatric populations. HLH is a disease that should be diagnosed and treated promptly, otherwise it is fatal. Treatment is directed at treating the triggering disorder, along with symptomatic treatment with dexamethasone and etoposide. We present a 56-year-old …