Medicine and Health Sciences Commons^™

Snake Venom Cysteine-Rich Secretory Protein From Mojave Rattlesnake Venom (Css-Crisp) Induces Acute Inflammatory Responses On Different Experimental Models, Emelyn Salazar, Abcde Cirilo, Armando Reyes, Martha Barrientos, Jacob Galan, Elda E. Sánchez, Montamas Suntravat

School of Medicine Publications

Highlights

• A svCRiSP from Mojave rattlesnake triggered the release of key pro-inflammatory cytokines and chemokines in cell lines.

• Early release of pro-inflammatory mediators was observed locally and systemically in mice treated with Css-CRiSP.

• This study provides further evidence of the pro-inflammatory effects of crotalid CRiSP.

• Css-CRiSP may modulate the vascular dysfunction and persistent inflammation seen in envenomings by Mojave rattlesnakes.

Abstract

Snake venoms contain various molecules known for activating innate immunity and causing local effects associated with increased vascular permeability, such as vascular leakage and edema, common symptoms seen in snakebite envenomings. We have demonstrated that snake venom cysteine-rich secretory …

Widespread, Depth-Dependent Cortical Microstructure Alterations In Paediatric Focal Epilepsy, Chiara Casella, Katy Vecchiato, Daniel Cromb, Yourong Guo, Anderson M. Winkler, Emer Hughes, Louise Dillon, Elaine Green, Kathleen Colford, Alexia Egloff

School of Medicine Publications

Objective

Tissue abnormalities in focal epilepsy may extend beyond the presumed focus. The underlying pathophysiology of these broader changes is unclear, and it is not known whether they result from ongoing disease processes, treatment-related side-effects, or whether they emerge earlier. Few studies have focused on the period of onset for most focal epilepsies, childhood. Fewer still have utilised quantitative MRI, which may provide a more sensitive and interpretable measure of tissue microstructural change. Here, we aimed to determine common spatial modes of changes in cortical architecture in children with heterogeneous drug-resistant focal epilepsy and, secondarily, whether changes were related to …

The Internist's Post V.1 N.1, The University Of Texas Rio Grande Valley. School Of Medicine, Diana Othon Martinez, Roque Mifuji Lira, Jian Garcia Cruz, Edgar Dorsey Trevino, Eunbee Cho

School of Medicine Publications

No abstract provided.

Health-Promoting Benefits Of Lentils: Anti-Inflammatory And Anti-Microbial Effects, Rachel Alexander, Abdullah Khaja, Nicholas Debiec, Alex Fazioli, Mary Torrance, Mohammed S. Razzaque

School of Medicine Publications

This paper describes how lentils (Lens culinaris species) can positively affect health by reducing inflammation, providing antioxidants, and displaying antimicrobial properties. Lentils are rich in proteins, essential amino acids, minerals, and fibers, making them a valuable source of nutrition, particularly in low and middle-income countries. Lentils have many health benefits, including positive effects on diabetes management, support for cardiovascular health, and antioxidative properties. The antioxidative properties of lentils, attributed to their phenolic content, and their ability to inhibit inflammation-related enzymes are also discussed. We discuss the potential of lentils as a dietary tool in promoting immunity, reducing disease burdens, …

Improving Inpatient Hyperglycaemia In Non-Critically Ill Adults In Resident Wards Through Audit And Feedback, Chelsea H. Chang, Alcibiades Fleires, Alfarooq Alshaikhli, Hector Arredondo, Diana Gavilanes, Francisco J. Cabral-Amador, Jonathon Cantu, Daniela Bazan, Kathryn Oliveira Oliveira, Rene Verduzco, Lina Pedraza Sanchez

School of Medicine Publications

Inpatient hyperglycaemia is associated with an increase in morbidity and mortality, number of rehospitalisations and length of hospitalisation. Although the advantages of proper glycaemic control in hospitalised patients with diabetes are well established, a variety of barriers limit accomplishment of blood glucose targets. Our primary aim was to decrease the number of glucose values above 180 mg/dL in non-critical care hospitalised patients using an audit and feedback intervention with pharmacy and internal medicine residents. A resident-led multidisciplinary team implemented the quality improvement (QI) project including conception, literature review, educating residents, iterative development of audit and feedback tools and data analysis. …

Current And Future Approaches To Pediatric Anxiety Disorder Treatment, André Zugman, Anderson M. Winkler, Purnima Qamar, Daniel Samuel Pine

School of Medicine Publications

This overview critically appraises the literature on the treatment of pediatric anxiety disorders. The two established treatments for these conditions comprise cognitive-behavioral therapy (CBT) and antidepressant medications. Many youths receiving these treatments fail to achieve remission, which creates a need for new treatments. After summarizing the literature on CBT and currently available medications, the authors describe research that lays a foundation for improvements in the treatment of pediatric anxiety disorders. This foundation leverages neuroscientific investigations, also described in the overview, which provide insights on mechanisms of successful treatment.

Contemplating On The End Of Integrated Care-Part Ii: Living The Questions To Foster Adaptability, Deepu George, Parinda Khatri

School of Medicine Publications

This article extends the use of the ecocycle planning framework to describe challenges ahead for the integrated care and Collaborative Family Healthcare Association (CFHA). The authors make the case that to remain agile and adaptable, there are contextual, ecological, and moral challenges that integrated care and CFHA should keep in the forefront as they navigate the future of an inequitable health care system that is morphing at a rapid pace. These influences include but are not limited to challenges of social determinants of health, artificial intelligence, generational differences in technology among older and younger populations, the moral issue of poverty, …

Worldwide Trends In Underweight And Obesity From 1990 To 2022: A Pooled Analysis Of 3663 Population- Representative Studies With 222 Million Children, Adolescents, And Adults, Ncd Risk Factor Collaboration (Ncd-Risc), Nowell H. Phelps, Rosie K . Singleton, Bin Zhou, Rachel A. Heap, Anu Mishra, James E. Bennett, Christopher J. Paciorek, Gladys Maestre, Jesus Melgarejo

School of Medicine Publications

Background: Underweight and obesity are associated with adverse health outcomes throughout the life course. We estimated the individual and combined prevalence of underweight or thinness and obesity, and their changes, from 1990 to 2022 for adults and school-aged children and adolescents in 200 countries and territories.

Methods: We used data from 3663 population-based studies with 222 million participants that measured height and weight in representative samples of the general population. We used a Bayesian hierarchical model to estimate trends in the prevalence of different BMI categories, separately for adults (age ≥20 years) and school-aged children and adolescents (age 5-19 years), …

The Covid Cohort: Pem Fellowship Training During A Pandemic, Thuy L. Ngo, Derya Caglar, Lisa Yanek, Michelle Eckerle, Jerri A. Rose, Mellisa M. Tavarez, Frances Turcotte Benedict, Melissa Langhan

Manuscripts, Articles, Book Chapters and Other Papers

Background: The COVID-19 pandemic led to training programs abruptly stopping in-person learning and redesigning curricula. Trainees had decreased patient contact. Trainee well-being became even more vital with social isolation and fears of infecting loved ones increased. Our study evaluated impacts of COVID-19 on Pediatric Emergency Medicine (PEM) fellowship programs, including effects on fellows’ clinical and didactic experiences, and effects on fellows’ well-being.

Methods: In this cross-sectional study, two surveys inquiring about the impact of COVID-19 on PEM fellowship training were developed using an iterative process: one for Program Directors (PDs) and one for fellows. Survey questions, which consisted of multiple …

The Association Between Diet Quality And Glycemic Outcomes Among People With Type 1 Diabetes., Melanie B. Gillingham, Martin Chase Marak, Michael C. Riddell, Peter Calhoun, Robin L. Gal, Susana R. Patton, Peter G. Jacobs, Jessica R. Castle, Mark A. Clements, Francis J. Doyle, Michael R. Rickels, Corby K. Martin

Manuscripts, Articles, Book Chapters and Other Papers

BACKGROUND: The amount and type of food consumed impacts the glycemic response and insulin needs of people with type 1 diabetes mellitus (T1DM). Daily variability in consumption, reflected in diet quality, may acutely impact glycemic levels and insulin needs.

OBJECTIVE: Type 1 Diabetes Exercise Initiative (T1DEXI) data were examined to evaluate the impact of daily diet quality on near-term glycemic control and interaction with exercise.

METHODS: Using the Remote Food Photography Method, ≤8 d of dietary intake data were analyzed per participant. Diet quality was quantified with the Healthy Eating Index-2015 (HEI), where a score of 100 indicates the highest-quality …

Special Insert: Guideline For Delegation Of Duties For Allied Dental Personnel In Michigan, David Foe Ma

The Journal of the Michigan Dental Association

Dental assistants, registered dental assistants, and registered dental hygienists have specific duties they can perform for patients as outlined by the Michigan Public Health Code and the Michigan Board of Dentistry General Rules. Permitted delegated services vary based on a team member’s level of training, licensure, and available supervision by a licensed dentist.

The Journal of Michigan Dental Association provides this pullout insert to guide the dental team. This easy-to-read chart quickly identifies recent changes to the duties each dental auxiliary can legally perform.

People With Degenerative Cervical Myelopathy Have Impaired Reactive Balance During Walking, Timothy F. Boerger, Learon Mcginn, Megan Bellman, Marjorie C. Wang, Brian D. Schmit, Allison S. Hyngstrom

Physical Therapy Faculty Research and Publications

Background

People with degenerative cervical myelopathy are known to have impaired standing balance and walking abilities, but less is known about balance responses during walking.

Research question

The aim of this project was to assess reactive balance impairments during walking in people with degenerative cervical myelopothy (PwDCM). We hypothesized that center of mass motion following perturbations would be larger in PwDCM and gluteus medius electromyographic amplitude responses would be decreased in PwDCM.

Methods

Reactive balance responses were quantified during unanticipated lateral pulls to the waist while treadmill walking. Walking biomechanics data were collected from 10 PwDCM (F=6) and 10 non-myelopathic …

Overview Of The Zoonotic Potential And Coinfection Of Sars-Cov-2 In Indonesia, Muhammad Khaliim Jati Kusala, Ni Luh Putu Indi Dharmayanti

Karbala International Journal of Modern Science

In the ASEAN region, Indonesia has the highest overall COVID-19 infection score. The SARS-CoV-2 pandemic first emerged in China and then transmitted sporadically throughout the world. Animals and humans can be infected with the corona virus, so this disease is classified as a zoonotic disease. This review aims to gather information regarding the potential of SARS-CoV-2 as a zoonotic disease and coinfections with several other pathogens in Indonesia. This study collected data demonstrating the potential for COVID-19 to be transmitted from humans to animals, as an evidenced by positive test results for the Bat Coronavirus Antigen in bats. Cats have …

Socio-Economic Integration Strategies Of “Former Rwandan Refugees” In Yaoundé, Cameroon., Michèle Mc Signé

Journal of Critical Global Issues

This research is entitled The Socio-economic Integration Strategies of “former Rwandan refugees” in Yaoundé, Cameroon. This is an analysis of immigrants who were once under international protection. The presence of former Rwandan refugees in the city of Yaoundé dates back to the time of the 1994 Rwandan genocide. With the advent of the cessation clause in 2018, we are faced with individuals who must find ways of coping with the new realities. Based on the assimilation and integration of immigrant, this study analyzes the integration strategies of former Rwandan refugees. This integration is facilitated by a social context described as …

Prioritizing Indigenous Participation And Compensation In Research, Amanda Sabin

Journal of Critical Global Issues

Throughout history, the dynamic between colonial entities and indigenous groups has been characterized by exploitation and power imbalance. Indigenous knowledge has the potential to positively impact the world, through medicinal breakthroughs, radical approaches to sustainability, cultural heritage, systems of learning and adaptation, and more. Particularly in the context of research, fields like anthropology, botany and pharmacology serve to benefit from indigenous knowledge, but these interactions cannot continue to be based on extraction at the cost of indigenous communities. This work will discuss the future of relationships between researchers and indigenous communities; how this power dynamic must be transformed into an …

Covid-19 Prevalence And Trends Among Pregnant And Postpartum Persons In Maine By Rurality And Pregnancy Conditions, Charlie O. Grantham, Christina M. Ackerman-Banks Md, Heather S. Lipkind Md, Ms, Kristin Palmsten Scd, Katherine A. Ahrens Mph, Phd

Journal of Maine Medical Center

No abstract provided.

Integrating Cannabis Education Into The Athletic Training Curriculum, Jeff G. Konin, Jimmy Onate

Journal of Sports Medicine and Allied Health Sciences: Official Journal of the Ohio Athletic Trainers Association

Context. Cannabis has become more prevalent in society and requires greater knowledge on the part of the athletic trainer. Objective. The purpose of this paper is to provide a framework for recognizing how cannabis education can be integrated into the athletic training curriculum utilizing the existing accreditation standards. Background. For decades the use of cannabis has been illegal. Athletes who were caught with cannabis in their system were penalized by their respective e sport organization body. During the past decade in the United States the federal government has moved toward decriminalization and expungement for those found with and …

Breaking Barriers And Building Confidence: Interprofessional Education's Impact On Allied Health Students' Competence And Self-Efficacy In Addressing Exercise Accessibility For People With Disabilities, Elizabeth A. Starns, Rebecca Wehler, Lindsay A. Church, Stephanie Kubiak

Journal of Sports Medicine and Allied Health Sciences: Official Journal of the Ohio Athletic Trainers Association

Purpose: The researchers’ objective was to evaluate the effectiveness of an interprofessional educational (IPE) program on student learning while addressing exercise accessibility barriers experienced by people living with disabilities (PLWD), including allied health professionals’ lack of practical experience, knowledge, and perceived competence and comfort working with PLWD in a fitness setting. Method: A qualitative explanatory single case study approach utilizing individual interviews was used. The individual interviews that explored how a collaboration between allied health students influenced learning, perceived comfort, and perceived competence working with PLWD were audio-recorded, transcribed verbatim and thematically analyzed. Results: Four major themes emerged: collaboration, comfort, …

Effects Of Three Different Recovery Methods In Decreasing Blood Lactate In Collegiate Baseball Pitchers Post Pitching., Joseph Volpi, Harrison Ndetan, S. Andrew Cage, Brandon Warner, Alan Cook, Lynzi Warner, Carly Wadle

Journal of Sports Medicine and Allied Health Sciences: Official Journal of the Ohio Athletic Trainers Association

Purpose: The purpose of this study was to determine the effectiveness of active recovery, electrical stimulation, cupping therapy, and sequential compression for decreasing blood lactate in collegiate pitchers after pitching. Methods: 20 healthy collegiate baseball pitchers consented to participate in this study as a convenience sample (age 21.6 ± 1.90 years; height 175.61 ± 21.41 cm; mass 80.33 ± 8.07 kg). A total of 17 participants completed the study. Subjects were randomly assigned to one of the four interventions and rotated between interventions in one-week increments. The interventions used were active recovery, electrical stimulation, cupping therapy, and sequential compression. The …

Athletic Trainers’ Stress, Support, And External Pressures When Making Clinical Decisions, Stephanie Carr, Meredith Madden, Meredith Kneavel, Tom Bowman

Journal of Sports Medicine and Allied Health Sciences: Official Journal of the Ohio Athletic Trainers Association

Context: Athletic trainers (ATs) work in various settings with very different work environments and patient populations. How stress, social and organizational support, and external pressures alter athletic training decision-making remains unknown. Objective: Determine the relationship between workplace stress, social support, and organizational support for ATs who are providing healthcare. Design: Concurrent mixed methods. Setting: Online survey. Patients or Other Participants: 275 (7% response rate; 76 females, 44 males, 1 third gender/self-identify, 154 wished not to disclose; age=36.80±11.9 years, experience =13.65±12.55 years) athletic trainers. Interventions: The size (SSQ-N) and quality (SSQ-Q) components of the social support scale (SSQ) and the …

Structured Textbook Review And Individualized Learning Plans Successfully Remediate Underperforming Residents And Improve General Surgery Program Performance On The Absite, Aaron Pinnola, Christoph Kaufmann

HCA Healthcare Journal of Medicine

Background

We endeavored to create an evidence-based curriculum to improve general surgery resident fund of knowledge. Global and resident-specific interventions were employed to this end. These interventions were monitored via multiple choice question results on a weekly basis and American Board of Surgery In-Training Examination (ABSITE) performance.

Methods

This study was performed in a prospective manner over a 2-year period. A structured textbook review with testing was implemented for all residents. A focused textbook question-writing assignment and a Surgical Council on Resident Education (SCORE)-based individualized learning plan (ILP) were implemented for residents scoring below the 35th percentile on the ABSITE. …

Presentations Of Cutaneous Disease In Various Skin Pigmentations: Acne Vulgaris - Comedonal Acne, Christopher M. Wong, Christina Guo, Christian J. Scheufele, Daniel A. Nguyen, Jean Elizze M. Charles, Michael Carletti, Stephen E. Weis

HCA Healthcare Journal of Medicine

Acne vulgaris is a common inflammatory skin condition of the pilosebaceous unit in adolescents and young adults and is primarily characterized by the presence of open and closed comedones. In patients of various skin pigmentations, skin-colored comedones may be difficult to appreciate and lead to incorrect or delayed diagnosis of acne. To aid in the identification of acne vulgaris in patients of various skin pigmentations, we present comedonal acne in different skin types and commonly encountered differential diagnoses. With its significant volume and burden of disease, acne vulgaris should be correctly identified in various skin pigmentations by primary care clinicians …

Percutaneous Endoscopic Gastrostomy: A Possible Trigger For Dieulafoy's Lesion, Ali Tariq Alvi, Elsa Tchouambou, Murali Shankar

HCA Healthcare Journal of Medicine

Introduction

Upper gastrointestinal (GI) bleeding is a medical condition commonly seen in clinical practice due to variable etiologies and a multitude of presentations. The patients can present with hematemesis, melena, or hematochezia in case of severe bleeding. The initial evaluation should involve assessing the hemodynamic status with adequate resuscitation followed by diagnostic tests to identify the source and potentially treat it. Dieulafoy's lesion, sometimes referred to as Dieulafoy's disease, is a rare cause of upper GI bleeding with no clear risk factors, which makes it a diagnostic conundrum. Here we describe an unusual case of Dieulafoy's lesion developing following percutaneous …

Primary Mucinous Carcinoma Of The Thyroid: A Case Report, Literature Review, And Immunohistochemistry Summary, Martin T. Halicek, Caleb Scott, Terence Zimmermann, Brian Watson

HCA Healthcare Journal of Medicine

Introduction

Primary mucinous carcinoma of the thyroid is an exceedingly rare malignancy that is histologically similar to mucinous carcinoma of other sites. Accurate diagnosis is a challenging yet crucial component of clinical management for both patients and our understanding of this rare disease.

Case Presentation

We report the case of a 69-year-old male patient with primary mucinous carcinoma of the thyroid. Microscopic examination of a biopsy specimen showed fibrous tissue, which was extensively and irregularly infiltrated by a cytologically malignant epithelial neoplasm showing glandular differentiation with mucin production. Immunohistochemistry demonstrated that tumor cells were positive for TTF1, thyroglobulin, CK7, and …

An Unusual Case Of Microcystic Serous Cystadenoma In A 19-Year-Old Male Patient, Jamie Lee Aldakkour, Alvin Boyd Newman-Caro, Ashley Henning

HCA Healthcare Journal of Medicine

Introduction

Microcystic serous cystadenomas are uncommon, benign neoplasms rarely known to progress to malignancy. They are typically asymptomatic and inadvertently discovered during imaging for another unrelated condition. When discovered, they are commonly found in females over 60 years of age.

Case Presentation

In this case report, we examine a unique presentation of a serous cystadenoma discovered when a 19-year-old male presented with symptoms of abdominal pain, nausea, and vomiting.

Conclusion

Previous studies on serous cystadenomas in a younger male demographic are rare. Therefore, this study will provide additional insight into the signs, symptoms, diagnosis, and management of cystadenomas in young …

Bowel-Associated Dermatosis-Arthritis Syndrome: A Case Report, Christian J. Scheufele, Leisa Hodges, Aya Hasan, Ashleigh E. Workman, Peter Malouf, Stephen E. Weis

HCA Healthcare Journal of Medicine

Introduction

Gastric bypass surgery is an effective surgical intervention for morbid obesity. However, it is not without risk. Gastric bypass surgery may produce malabsorptive or surgical complications, which can result in nutritional deficiencies as well as syndromes related to bacterial overgrowth in the blind loops of the bowel.

Case Presentation

Severe nutritional deficiencies may occur due to patient noncompliance with the prescribed regimen, or arise secondary to malabsorptive or mechanical surgical complications. We describe a case of a 37-year-old female who underwent gastric bypass surgery and experienced a recalcitrant eczematous eruption with sporadic subcutaneous, purulent nodules which completely resolved after …

Characteristics And Hospital Outcomes Of 1403 Patients Hospitalized At Community Hospitals With Ankylosing Spondylitis, Se Won Lee, Carol Elsakr, Jonathan Holt, Napatkamon Ayutyanont

HCA Healthcare Journal of Medicine

Background

In this study, we aimed to assess the hospital course, outcomes after hospitalization, and predictors of outcomes in patients with ankylosing spondylitis (AS).

Methods

We included 1403 patients with AS between 2016 and 2021 who were identified using International Classification of Disease (ICD) codes from a large for-profit healthcare system database. Demographics and clinical characteristics were compared between those who had a favorable outcome, defined as being discharged to home without readmission within 3 months of discharge, versus those who had an unfavorable outcome. A stepwise logistic regression was used to identify demographic and clinical characteristics associated with home …

Variation In Transcript Reports Among Residency Applicants: An Anesthesia Program’S Perspective, Alex M. Hendon, Imani Thornton

HCA Healthcare Journal of Medicine

Background

With recent changes made to move USMLE Step 1 and COMLEX Level 1 scores to Pass/Fail, it becomes necessary to find other metrics to evaluate residency candidates. One conserved metric included in all residency applications is medical school transcripts. This study aims to highlight the highly varied transcript reporting in a new era of holistic applicant review.

Methods

Medical school transcripts were extracted from the Electronic Residency Application Service applications to our anesthesiology residency program for the 2021-2022 application cycle. All personally identifiable information was removed. Results were categorized and tallied by 2 independent reviewers. Overall, we assessed transcript …

An Acknowledgement To The Hca Healthcare Journal Of Medicine's Reviewers And Editors For The Second Half Of 2023, Bruce Deighton, Hossein Akhondi, Barbara L. Gracious, Graig Donini

HCA Healthcare Journal of Medicine

The HCA Healthcare Journal of Medicine would like to thank those behind the scenes who make this publication possible. Our journal would not be possible without the assistance of our peer reviewers, authors, and board members. We also share a special message for our resident and fellow board members.

Granulocytic Myeloid-Derived Suppressor Cell Activity During Biofilm Infection Is Regulated By A Glycolysis/Hif1a Axis, Christopher M. Horn, Prabhakar Arumugam, Zachary Van Roy, Cortney E. Heim, Rachel W. Fallet, Blake P. Bertrand, Dhananjay Shinde, Vinai Chittezham Thomas, Svetlana Romanova, Tatiana K. Bronich, Curtis Hartman, Kevin Garvin, Tammy Kielian

Journal Articles: Pathology and Microbiology

Staphylococcus aureus is a leading cause of biofilm-associated prosthetic joint infection (PJI). A primary contributor to infection chronicity is an expansion of granulocytic myeloid-derived suppressor cells (G-MDSCs), which are critical for orchestrating the antiinflammatory biofilm milieu. Single-cell sequencing and bioinformatic metabolic algorithms were used to explore the link between G-MDSC metabolism and S. aureus PJI outcome. Glycolysis and the hypoxia response through HIF1a were significantly enriched in G-MDSCs. Interfering with both pathways in vivo, using a 2-deoxyglucose nanopreparation and granulocyte-targeted Hif1a conditional KO mice, respectively, attenuated G-MDSC-mediated immunosuppression and reduced bacterial burden in a mouse model of S. aureus PJI. …