Medicine and Health Sciences Commons^™

Massively Parallel Characterization Of Insulator Activity Across The Genome, Clarice K Y Hong, Yawei Wu, Alyssa A Erickson, Jie Li, Arnold J Federico, Barak A Cohen

2020-Current year OA Pubs

A key question in regulatory genomics is whether cis-regulatory elements (CREs) are modular elements that can function anywhere in the genome, or whether they are adapted to certain genomic locations. To distinguish between these possibilities we develop MPIRE (Massively Parallel Integrated Regulatory Elements), a technology for recurrently assaying CREs at thousands of defined locations across the genome in parallel. MPIRE allows us to separate the intrinsic activity of CREs from the effects of their genomic environments. We apply MPIRE to assay three insulator sequences at thousands of genomic locations and find that each insulator functions in locations with distinguishable properties. …

The "Pros" Of Probiotics: A Review Of Probiotics Place In Therapy, Kelley Maberry, Hanh Nguyen, Connor Quinter, Justine Magalona

Transformative Medicine

As different probiotic supplements become increasingly seen in the market, questions regarding their use for gut health from patients rises as well. Because these supplements do not require FDA approval, their safety and efficacy is often unknown and limited research available poses an even greater challenge for healthcare providers when prompted with questions regarding their use. This article summarizes evidence-based recommendations provided by the American Gastroenterological Association (AGA) and the World Gastroenterology Organization (WGO). Of the conditions discussed, supportive evidence on the use of probiotics is mostly seen in the prevention of C. diff associated diarrhea, prevention of antibiotic associated …

Which Endocrine Disorder Does This Ecg Suggest?, Muhammad Mohsin Zafar, Muhammad Asad Hanif

Transformative Medicine

No abstract provided.

An Unusual Presentation Of Erythrodermic Psoriasis, Eden L. Parks, Kojo-Frimpong B. Awuah Md, Caitlin D. Couper Md

Transformative Medicine

Introduction

Erythrodermic psoriasis is a rare form of psoriasis, occurring in less than 3% of patients with psoriasis. Limited information is known regarding diagnosis and treatment for this form of psoriasis, with most studies involving small groups or single patients. This unusual case of erythrodermic psoriasis outlines the presentation, diagnosis, and treatment that occurred in a 53-year-old patient who initially presented with dyspnea and a fever.

Case Presentation

The 53-year-old patient was originally admitted for dyspnea and a fever. A maculopapular rash developed diffusely on the upper extremities, lower extremities, trunk, and face. The rash then desquamated over several days, …

Management Strategies Of Cesarean Section Ectopic Pregnancy: A Case Report, Hannah E. Daley, Ava R. Hansen, Priyanka Raju Md, Jonathan Buerger Md

Transformative Medicine

Introduction:

Cesarean scar ectopic pregnancy is a rare form of pregnancy with potential life-threatening complications such as severe hemorrhage, uterine rupture, and emergency hysterectomy Currently, there is no consensus regarding a standardized treatment algorithm for this specific variant of ectopic pregnancies.

Case Description:

This case describes a 28-year-old female with history of two prior cesarean sections who was diagnosed with cesarean section scar ectopic pregnancy. Initial management with intramuscular methotrexate was unsuccessful in the setting of inadequate decrease in β-hCG level. The patient ultimately underwent surgical management with dilation and suction evacuation under ultrasound guidance for removal of the ectopic …

The Kent-Collins Protocol For Symptom Management In Post-Radiotherapy Eustachian Tube Dysfunction: A Case Report, Matthew E. Kent, Patrick J. Collins, Ayal A. Aizer

Transformative Medicine

Introduction: Eustachian tube dysfunction is a common side effect of radiotherapy for head and neck cancers or brain tumors, although few effective treatments exist. The Kent-Collins Protocol represents a novel therapeutic option for post-radiotherapy Eustachian tube dysfunction.

Case Description: The Kent-Collins Protocol was employed in one patient with Eustachian tube dysfunction following fractionated stereotactic radiotherapy for cerebral metastases from HER-2 positive breast cancer. The Kent-Collins Protocol provided relief of symptoms (conductive hearing loss, aural fullness, and otalgia) for a range of 5 to 45 minutes. The protocol could be repeated when symptoms returned to provide additional relief. The patient also …

Catastrophic Spontaneous Uterine And Bladder Rupture In An Unscarred Uterus, Nathanael N. Hoskins Do, Kathryn Brandt Do, Tory Peterson Md

Transformative Medicine

Introduction:

Uterine rupture during pregnancy is a rare event which can be life-threatening for both the patient and the fetus. This case report describes a rare complication of uterine rupture which ultimately required a hysterectomy and extensive urologic reconstruction.

Case Description:

A 36-year-old patient presented to the hospital after term pre-labor rupture of membranes. The patient underwent induction of labor which ultimately resulted in a uterine rupture in an unscarred uterus. The rupture extended into the posterior bladder wall, right ureter, urethra, and anterior vaginal wall, resulting in a vesicovaginal fistula. The patient required a cesarean hysterectomy due to the …

Spontaneous Spinal Epidural Hematoma Presenting As A Stroke Alert: A Case Report, Christian Flores Do, Monisha Bindra Do, Mph, Adam Sigal Md, Michael Romeo Do

Transformative Medicine

Introduction

Spinal epidural hematoma (SEH) is a rare pathologic entity that accounts for less than 1% of all space-occupying spinal canal lesions [2,8]. Even more rare are spontaneous spinal epidural hematomas (SSEH), defined as a SEH without a known traumatic or inciting cause, with a reported incidence of 0.1 cases per 100,000 annually [1,2]. Currently, there is a paucity of literature regarding this topic [2,3]. SSEH can easily be missed or misdiagnosed if clinicians do not hold a high level of clinical suspicion.

Case Description

A 69-year-old female with no history of anticoagulation use or preceding trauma presented to the …

Same Or Different? Resolution Of Diagnostic Difficulty Of Two Mixed Cell-Type Tumors In Ovarian Pathology., Sarah Ingram, Priyanka Raju Md, Wei Shaw Do, Steve Sowers Pa, Kelly Brenan-Rothschild Md

Transformative Medicine

Introduction: When confronted by two disease processes, physicians in all disciplines are faced with the question: Are they manifestations of a common etiology, or distinct entities co-occurring? Inherent in this dilemma is whether an aberration from normal is even a disease process at all. Tissue pathology plays a key role in resolving this conundrum. Although diagnoses can be challenging, there are various methodologies used in the field of pathology to ascertain whether two tumors are of the same or different origins.

Case Description: This case report reviews two patients with large ovarian neoplasms and surgical pathology revealing histopathological features of …

Guardians Of The Genitals: The Dermatogynecologic Duo, Alexis Arza, Erin Stitzlein

Transformative Medicine

No abstract provided.

Research Integrity In The Academic Transformation Of A Community Hospital, Andrew Adorboe, Paul Hryvaniak, Carol Kriebel, Erica Klopp, Wei Du

Transformative Medicine

No abstract provided.

A Brief Review Of Zuranolone, Aubrey A. Jackson

Transformative Medicine

Zuranolone, a novel analog of allopregnanolone, has been approved by the U.S. Food and Drug Administration (FDA) as the first oral medication approved for the treatment of postpartum depression in adults. Developed by Sage Therapeutics under the brand name Zurzuvae, zuranolone was approved by the FDA on August 4^th, 2023.¹ Zuranolone is a modified version of brexanolone (sold under the brand name Zulpresso), an intravenously administered allopregnanolone formulation that was previously the only FDA-approved medication for postpartum depression. Zuranolone offers a more accessible treatment option for patients with efficacy established in clinical trials. Its approval expands the …

Belonging Through Meaningful Activity In The Transition From Unhoused To Housed, Patricia Y. Plett, Rebecca Gewurtz, Abe Oudshoorn, Cheryl Forchuk, Carrie Marshall

Occupational Therapy Publications

Background

Belonging is closely associated with well-being, yet individuals with experiences of being unhoused are likely to experience social exclusion and challenges with developing a sense of belonging. Engagement in meaningful activity has been linked to belonging; however, there are no focused studies exploring experiences of how engaging in meaningful activities influences belonging. Meaningful activities are things we do that bring value to our lives.

Purpose

To explore how engaging in meaningful activities may influence experiences of belonging following homelessness through a secondary analysis of qualitative interviews.

Method

Using interviews conducted in a community-based participatory action study exploring the transition …

Medical School Watercooler Newsletter - September 26, 2024, Lindsay Hughes

Watercooler Newsletter

This is the Thursday, September 26, 2024 edition of the Frederick P. Whiddon College of Medicine's newsletter -- Watercooler.

• Infectious diseases physician-researcher joins internal medicine faculty
• Augustine to present case report at American Academy of Pediatrics National Convention
• Blueprint for Success aims to empower new academic physicians and scientists
• Lunch & Learn to focus on promotion and tenure
• Whiddon COM welcomes alumna Carly McRae to emergency medicine

Research Priorities For Childhood Apraxia Of Speech: A Long View, Patricia Mccabe, Molly Beiting, Elaine R Hitchcock, Edwin Maas, Amy Meredith, Angela T Morgan, Nancy L Potter, Jonathan L Preston, Laura Moorer, Pooja Aggarwal, Kirrie Ballard, Laura Baskall Smith, Nicole F Caballero, Kathryn Cabbage, Julie Case, Susan Caspari, Karen V Chenausky, Shina Cook, Ewa Grzelak, Maryane Gomez, Aubrie Hagopian, Chantelle Highman, Anne Hodits, Jenya Iuzzini-Seigel, Jillian Levos-Carlson, Barbara A Lewis, Patricia Mayro, Jyutika Mehta, Gabrielle Miller, Kimberly D Mory, Elizabeth Murray, Megan S Overby, Lucia Pasquel-Lefebvre, Derrick Peavy, Caitlin V Raaz, Brooke Rea, Denise Santos Ford, Lynn Smith, Michelle T. Swartz, Melissa Taberski, Hayo Terband, Donna C Thomas, Hannah Valentine, Mirjam Van Tellingen, Shelley Velleman, Emily Wang, Sarah White, Eddy C H Wong, Maria I Grigos

Department of Speech-Language Pathology Faculty Papers

This article introduces the Journal of Speech, Language, and Hearing Research Special Issue: Selected Papers From the 2022 Apraxia Kids Research Symposium. The field of childhood apraxia of speech (CAS) has developed significantly in the past 15 years, with key improvements in understanding of basic biology including genetics, neuroscience, and computational modelling; development of diagnostic tools and methods; diversity of evidence-based interventions with increasingly rigorous experimental designs; and understanding of impacts beyond impairment-level measures. Papers in this special issue not only review and synthesize the some of the substantial progress to date but also present novel findings addressing critical research …

Early Results Of An Innovative Scalable Digital Treatment For Diabetes Distress In Families Of School-Age Children With Type 1 Diabetes., Susana R. Patton, Jessica S. Pierce, Nicole Kahhan, Matthew Benson, Mark A. Clements, Larry A. Fox

Manuscripts, Articles, Book Chapters and Other Papers

OBJECTIVE: This paper reports on the initial outcomes of a new mHealth intervention to reduce diabetes distress (DD) in families of school-age children living with type 1 diabetes (T1D) entitled, 'Remedy to Diabetes Distress' (R2D2).

METHODS: We randomized 34 families (mean child age = 10 ± 1.4 years; 53% male, 85% White, mean HbA1c = 7.24 ± 0.71%) to one of three delivery arms differing only by number of telehealth visits over a 10-week period: zero visits = self-guided (SG), three visits = enhanced self-guided (ESG), or eight visits = video visits (VV). All families had 24 × 7 access …

At A Crossroads: The Crucial Role Of Pharmacists In Healthcare Teams To End The Hiv Epidemic, Jerika Lam, Jennifer M. Cocohoba

Pharmacy Faculty Articles and Research

"Therapeutic advances in treatment and prevention have slowed the human immunodeficiency virus (HIV) epidemic, yet the virus and complications related to it still claim an alarming 630,000 lives globally every year.^1,2 The United States’ goals for the Ending the HIV Epidemic (EHE) initiative include reducing new infections by 90% by the year 2030 and advancing health equity through key treatment and prevention initiatives.³ Multiple agencies, professions, and patient groups are working diligently to achieve the EHE goals. Pharmacists have long recognized that our profession is a key resource in ending the HIV epidemic. We demonstrate this in the …

Amino Acid-Based Protein-Mimic Hydrogel Incorporating Pro-Regenerative Lipid Mediator And Microvascular Fragments Promotes The Healing Of Deep Burn Wounds, Yan Lu, Shanchun Su, Chih Chang Chu, Yuichi Kobayashi, Abdul Razak Masoud, Hongying Peng, Nathan Lien, Mingyu He, Christopher Vuong, Ryan Tran, Song Hong

School of Medicine Faculty Publications

Pro-regenerative lipid mediator 1 (PreM1) is a specialized pro-resolving lipid mediator that promotes wound healing and regenerative functions of mesenchymal stem cells (MSCs), endothelial cells, and macrophages. The healing of third-degree (3°) burns and regenerative functions of MSCs are enhanced by ACgel1, an arginine-and-chitosan-based protein-mimic hybrid hydrogel. Adipose-tissue derived microvascular fragments (MVFs) are native vascularization units and a rich source of MSCs, endothelial cells, and perivascular cells for tissue regeneration. Here we describe an innovative PreM1-MVFs-ACgel1 construct that incorporated PreM1 and MVFs into ACgel1 via optimal design and fabrication. This construct delivered PreM1 to 3°-burn wounds at least up to …

Sequencing-Based Detection Of Avian Influenza A(H5n1) Virus In Wastewater In Ten Cities, Michael J Tisza, Blake M Hanson, Justin R Clark, Li Wang, Katelyn Payne, Matthew C Ross, Kristina D Mena, Anna Gitter, Sara J Javornik Cregeen, Juwan Cormier, Vasanthi Avadhanula, Austen Terwilliger, John Balliew, Fuqing Wu, Janelle Rios, Jennifer Deegan, Pedro A Piedra, Joseph F Petrosino, Eric Boerwinkle, Anthony W Maresso

Faculty, Staff and Student Publications

No abstract provided.

Relationship Between Opioid Treatment And Nonpharmacological Chronic Pain Management Interventions And Perceived Effectiveness Of Managing Chronic Pain In African American Adults, Bona Eze

Walden Dissertations and Doctoral Studies

Chronic pain impacts all areas of life for most Americans, but the issue is particularly salient among African Americans (AAs) as they face adverse pain outcomes. There is little understanding of pain management strategies used by AAs to inform pain management recommendations. The purpose of this study, guided by the COM-B model and biopsychosocial theory, was to determine if there were a relationships between opioid treatment and perceived effectiveness of managing chronic pain in AA adults who are 18 years and older as well as between nonpharmacological interventions (physical therapy, chiropractic care, talk therapy, self-management program, yoga, massage) and perceived …

Effect Of An In-Home Palivizumab Administration Program For Children With Medical Complexity, Hina Emanuel, Aravind Yadav, Julie C Eapan, Maria Caldas-Vasquez, Tomika S Harris, Katrina Mcbeth, Fatima Boricha, Janice John, Ivan G Magana Ceballos, Giuseppe N Colasurdo, Maria E Tellez, Tina Reddy, Wilfredo De Jesús-Rojas, Ricardo A Mosquera

Faculty, Staff and Student Publications

Background: In-home palivizumab administration programs (PH) have shown promise in reducing RSV-associated infections. These programs may be particularly beneficial for children with medical complexity (CMC) by limiting their exposure to healthcare-associated infections (HAIs) from non-RSV-related pathogens during transportation and visits to medical facilities.

Methods: In this prospective study, 41 children with CMC less than 2 years of age were randomized by their health insurance to receive PH or in the clinic (PC) during the RSV season (October 2018-April 2019). Patients were stratified by home ventilation. The primary outcome was the total number of face-to-face encounters. Secondary outcomes were unscheduled clinic …

Study Protocol For Writing To Heal: A Culturally Based Brief Expressive Writing Intervention For Chinese Immigrant Breast Cancer Survivors, Qian Lu, Di Lun, Lenna Dawkins-Moultin, Yisheng Li, Minxing Chen, Sharon Hermes Giordano, James W Pennebaker, Lucy Young, Carol Wang

Faculty, Staff and Student Publications

BACKGROUND: This study uses a randomized controlled trial (RCT) to test the health benefits of expressive writing that is culturally adapted for Chinese immigrant breast cancer survivors (BCSs) and to characterize how acculturation moderates the effects of expressive writing interventions.

METHODS: We will recruit Chinese immigrant BCSs (N = 240) diagnosed with stage 0-III breast cancer and within 5 years of completion of primary treatment. Recruitment will occur primarily through community-based organizations and cancer registries. Participants will be randomly assigned either to a control condition to write about neutral topics or to one of two intervention conditions, self-regulation or self-cultivation, …

Sequencing-Based Detection Of Avian Influenza A(H5n1) Virus In Wastewater In Ten Cities, Michael J Tisza, Blake M Hanson, Justin R Clark, Li Wang, Katelyn Payne, Matthew C Ross, Kristina D Mena, Anna Gitter, Sara J Javornik Cregeen, Juwan Cormier, Vasanthi Avadhanula, Austen Terwilliger, John Balliew, Fuqing Wu, Janelle Rios, Jennifer Deegan, Pedro A Piedra, Joseph F Petrosino, Eric Boerwinkle, Anthony W Maresso

Faculty, Staff and Students Publications

No abstract provided.

Using Syndromic Surveillance For Unintentional And Undetermined Intent Drowning Surveillance In A Large Metropolitan Area, Rohit P Shenoi, Briana Moreland, Jennifer L Jones, Nicholas Peoples, Elizabeth A Camp, Ned Levine

Faculty, Staff and Students Publications

INTRODUCTION: A drowning definition is available for use with National Syndromic Surveillance Program (NSSP) data. However, its accuracy in capturing drowning emergency department and urgent care visits at the regional level is unknown. We tested the ability of the syndromic surveillance (SS) definition in capturing unintentional and undetermined intent drowning (UUID) and describe UUID SS visit trends in a large metropolitan area.

METHODS: We applied the drowning definition to NSSP data from 2016 to 2022 for the 8-county metropolitan Houston region. We queried the dataset for UUID ICD-10-CM codes and manually reviewed the chief complaint (CC) and discharge diagnosis (DD) …

Durations Of Antibiotic Treatment For Acute Otitis Media And Variability In Prescribed Durations Across Two Large Academic Health Systems, Sophie E Katz, Timothy C Jenkins, Amy B Stein, Gale Thomas, Nancy Koenig, Gary Lucas Starnes, Jason G Newland, Ritu Banerjee, Holly M Frost

2020-Current year OA Pubs

BACKGROUND: Acute otitis media (AOM) accounts for roughly 25% of antibiotics prescribed to children annually. Despite national guidelines that recommend short (5-7 days) durations of antibiotics for children 2 years and older with AOM, most receive long (10 day) courses. This study aims to evaluate antibiotic durations prescribed for children aged 2-17 years with uncomplicated AOM across two pediatric academic health systems, and to assess the variability in prescribed durations between and within each system.

METHODS: Electronic medical record data from 135 care locations at two health systems were retrospectively analyzed. Outpatient encounters for children aged 2-17 years with a …

Untargeted Metabolomic Biomarker Discovery For The Detection Of Ectopic Pregnancy, Onur Turkoglu, Ayse Citil, Ceren Katar, Ismail Mert, Robert A Quinn, Ray O Bahado-Singh, Stewart F Graham

Faculty, Staff and Students Publications

Ectopic pregnancy (EP) is the leading cause of maternal morbidity and mortality in the first trimester. Using an untargeted metabolomic approach, we sought to identify putative plasma biomarkers using tandem liquid chromatography-mass spectrometry for the detection of tubal EP. This case-control study included the prospective recruitment of 50 tubal EP cases and 50 early intrauterine pregnancy controls. To avoid over-fitting, logistic regression models were developed in a randomly selected discovery group (30 cases vs. 30 controls) and validated in the test group (20 cases vs. 20 controls). In total, 585 mass spectral features were detected, of which 221 molecular features …

Molecular Testing Of Environmental Samples As A Potential Source To Estimate Parasite Infection, Rojelio Mejia, Barton Slatko, Cristina Almazan, Ruben Cimino, Alejandro Krolewiecki, Natalia Montellano Duran, Jacob Edwin Valera Aspetty, Paola Andrea Vargas, Chiara Cássia Oliveira Amorim, Stefan Michael Geiger, Ricardo Toshio Fujiwara, Juan David Ramirez, Luz Marina Llangarí-Arizo, Irene Guadalupe, Liliana E Villanueva-Lizama, Julio Vladimir Cruz-Chan, María Leticia Ojeda, Eva Mereles Aranda, Sandra Ocampos Benedetti, Maritza Dalí Camones Rivera, Eddyson Montalvo Sabino, Carlos Pineda, Eric J Wetzel, Philip J Cooper

Faculty, Staff and Students Publications

We discuss the potential usefulness of molecular testing of soil, dust, and water samples to detect medically important parasites, and where such testing could be used to supplement stool sampling in humans. A wide variety of parasites including protozoa and helminths, many of which are zoonotic, have an important infection reservoir in the environment. In some cases, this environmental period is essential for further parasite development. We describe the progress in implementing methods for the molecular detection of these parasites in soil across eight collaborating centers in Latin America and represent a variety of potential applications in improving our understanding …

Longitudinal Development Of Resting-State Functional Connectivity In Adolescents With And Without Internalizing Disorders, Eline F. Roelofs, Janna Marie Bas-Hoogendam, Anderson M. Winkler, Nic J.A. Van Der Wee, Robert R.J. M. Vermeiren

School of Medicine Publications

Longitudinal studies using resting-state functional magnetic resonance imaging (rs-fMRI) focused on adolescent internalizing psychopathology are scarce and have mostly investigated standardized treatment effects on functional connectivity (FC) of the full amygdala. The role of amygdala subregions and large resting-state networks had yet to be elucidated, and treatment is in practice often personalized. Here, longitudinal FC development of amygdala subregions and whole-brain networks are investigated in a clinically representative sample. Treatment-naïve adolescents with clinical depression and comorbid anxiety who started care-as-usual (n = 23; INT) and healthy controls (n = 24; HC) participated in rs-fMRI scans and questionnaires at baseline (before …

Chronic Graft-Versus-Host Disease: Unresolved Complication Or Ancient History?, Joseph A Pidala, Ted A Gooley, Leo Luznik, Bruce R Blazar

Faculty, Staff and Students Publications

Chronic graft-versus-host disease (cGVHD) is associated with morbidity, mortality, impaired quality of life, prolonged immunosuppressive therapy, and infection risk after allogeneic hematopoietic cell transplantation (HCT). Major strides have occurred in the understanding of cGVHD biology; National Institutes of Health Consensus meetings have refined rigorous approaches to diagnosis, staging, and response criteria; major interventional trials have established standard benchmarks for treatment outcome; and 3 agents to date have been US Food and Drug Administration approved for treating corticosteroid-refractory cGVHD. Promising results from several recent trials have led some, but not others, to conclude that the risk of developing cGVHD is sufficiently …

Treatment Outcomes Among Patients With A Positive Candida Culture Close To Randomization Receiving Rezafungin Or Caspofungin In The Restore Study, Alex Soriano, Marin Kollef, Et Al.

2020-Current year OA Pubs

BACKGROUND: Rezafungin, a novel, once-weekly echinocandin for the treatment of candidemia and/or invasive candidiasis (IC) was noninferior to caspofungin for day 30 all-cause mortality (ACM) and day 14 global cure in the phase 3 ReSTORE trial (NCT03667690). We conducted preplanned subgroup analyses for patients with a positive culture close to randomization in ReSTORE.

METHODS: ReSTORE was a multicenter, double-blind, double-dummy, randomized trial in patients aged ≥18 years with candidemia and/or IC treated with once-weekly intravenous rezafungin (400 mg/200 mg) or once-daily intravenous caspofungin (70 mg/50 mg). This analysis comprised patients with a positive blood culture drawn between 12 hours before …