Diseases Commons^™

Gastrointestinal Stromal Tumor Induced Hypercalcemia, Aram Barbaryan, Stefania Bailuc, Padma Poddutoori, Aida Richardson, Aibek E. Mirrakhimov

Internal Medicine Faculty Publications

Hypercalcemia in patients with cancer is a common laboratory finding affecting up to 44% of that patient population. 1,25-Dihydroxyvitamin D₃ mediated hypercalcemia is one of the rare mechanisms of this endocrine emergency in cancer patients. It is even rarer for solid organ neoplasms to present with hypercalcemia mediated through the production of 1,25-dihydroxyvitamin D₃. We report a case of a 77-year-old female who presented to the hospital with hypercalcemia and later was found to have metastatic gastrointestinal stromal tumor. There have been only 5 cases of gastrointestinal stromal tumor described in literature resulting in hypercalcemia. In our …

Plasma Cross-Gestational Sphingolipidomic Analyses Reveal Potential First Trimester Biomarkers Of Preeclampsia, Aneta Dobierzewska, Sony Soman, Sebastian E Illanes, Andrew J. Morris

Saha Cardiovascular Research Center Faculty Publications

Introduction

Preeclampsia (PE) is a gestational disorder, manifested in the second half of pregnancy by maternal hypertension, proteinuria and generalized edema. PE is a major cause of maternal and fetal morbidity and mortality, accounting for nearly 40% of all premature births worldwide. Bioactive sphingolipids are emerging as key molecules involved in etiopathogenesis of PE, characterized by maternal angiogenic imbalance and symptoms of metabolic syndrome. The aim of this study was to compare the cross-gestational profile of circulating bioactive sphingolipids in maternal plasma from preeclamptic (PE) versus normotensive control (CTL) subjects with the goal of identifying sphingolipids as candidate first trimester …

Seroprevalence Of Poliovirus Antibodies In The Kansas City Metropolitan Area, 2012-2013., Gregory S. Wallace, Barbara A. Pahud, William C. Weldon, Aaron T. Curns, M Steven Oberste, Christopher J. Harrison

Manuscripts, Articles, Book Chapters and Other Papers

No indigenous cases of poliomyelitis have occurred in the US since 1979; however the risk of importation persists until global eradication is achieved. The seropositivity rate for different age cohorts with exposures to different poliovirus vaccine types and wild virus in the US are not presently known. A convenience sample was conducted in the Kansas City metropolitan area during 2012-2103 with approximately 100 participants enrolled for each of 5 age cohorts categorized based on vaccine policy changes over time in the US. Immunization records for poliovirus vaccination were required for participants90.7%, 94.4%, and 83.3%, for types 1, 2, and 3, …

Tgfβ/Smad3 Regulates Proliferation And Apoptosis Through Irs-1 Inhibition In Colon Cancer Cells., Katie L. Bailey, Ekta Agarwal, Sanjib Chowdhury, Jiangtao Luo, Michael G. Brattain, Jennifer D. Black, J. Wang

Journal Articles: Eppley Institute

In this study, we have uncovered a novel crosstalk between TGFβ and IGF-1R signaling pathways. We show for the first time that expression and activation of IRS-1, an IGF-1R adaptor protein, is decreased by TGFβ/Smad3 signaling. Loss or attenuation of TGFβ activation leads to elevated expression and phosphorylation of IRS-1 in colon cancer cells, resulting in enhanced cell proliferation, decreased apoptosis and increased tumor growth in vitro and in vivo. Downregulation of IRS-1 expression reversed Smad3 knockdown-mediated oncogenic phenotypes, indicating that TGFβ/Smad3 signaling inhibits cell proliferation and increases apoptosis at least partially through the inhibition of IRS-1 expression and activation. …

The Rejoice Trial: A Phase 3 Randomized, Controlled Trial Evaluating The Safety And Efficacy Of A Novel Vaginal Estradiol Soft-Gel Capsule For Symptomatic Vulvar And Vaginal Atrophy., Ginger D Constantine, James A Simon, James H Pickar, David F Archer, Harvey Kushner, Brian Bernick, Gina Gasper, Shelli Graham, Sebastian Mirkin

Obstetrics and Gynecology Faculty Publications

OBJECTIVE: To evaluate the safety and efficacy of TX-004HR vaginal estradiol soft-gel capsules for moderate-to-severe dyspareunia associated with postmenopausal vulvar and vaginal atrophy.

METHODS: In this randomized, double-blind, placebo-controlled, phase 3 study, postmenopausal women with a self-identified most bothersome symptom of dyspareunia received 4, 10, or 25 μg TX-004HR or placebo for 12 weeks. Four co-primary efficacy endpoints were change from baseline to week 12 in percentages of superficial and parabasal cells, vaginal pH, and severity of dyspareunia. Secondary endpoints included severity of vaginal dryness and vulvar and/or vaginal itching or irritation. Endometrial histology and adverse events (AEs) were included …

Angiogenesis: An Alternate Approach To Cardiovascular Disease Treatment, Scott Ouillette

Thinking Matters Symposium Archive

Up until this point research has only focused on angiogenic activators and ineffective growth factor administration Focusing on the angiogenic switch and the use of a bioresorbable stent coated with angiogenic growth factors and anti-inhibitors for prolonged local administration would solve the problems with dosage and controlled release that could push therapeutic angiogenesis over the edge as an extremely effective treatment for cardiovascular disease

Chagas, Enfermedad Olvidada: Una Perspectiva Histórica De La Prevención Y Control Del Chagas En La Provincia De Salta, Argentina (1909 – 2017) \ Chagas, A Forgotten Disease: A Historical Perspective On The Prevention And Control Of Chagas In Salta Province, Argentina (1909 – 2017), Tara Shea

Independent Study Project (ISP) Collection

El Chagas es una enfermedad vectorial más conocida en zonas rurales de América Latina y en Argentina es endémica en la región noroeste del país (MSAL, 2017). Designada una enfermedad tropical desatendida (Neglected Tropical Disease, NTD) por la OMS, la crónica del Chagas desde su “hallazgo casual” en 1909 siempre se trató de abandono (INP, 2017; MSF, 2012; OMS, 2017; Reyes López, 2009; Stamboulian, 2015; Zabala, 2009). En toda la Argentina se identifican 1.600.000 casos y 7.300.000 personas expuestas al Chagas, dando el país una de las tasas chagásicas más altas del mundo (Bär, 2015; MSAL, 2017).1

El modo de …

Abordajes De Nuevos Tratamientos Para La Enfermedad De Chagas Y Su Potencial Aplicación En Pacientes Desde Las Perspectivas De Los Profesionales En La Ciudad Autónoma De Buenos Aires, Argentina / Approaches To New Treatments For Chagas Disease And Their Potential Application In Patients From The Perspectives Of Professionals In The Autonomous City Of Buenos Aires, Argentina, Chelsea Hipwell

Independent Study Project (ISP) Collection

Más de cien años después del descubrimiento de la enfermedad de Chagas, esta enfermedad desatendida sigue afectando más de 6 millones de personas en Latinoamérica, de las cuales 1.5 millones son de Argentina. Al día de hoy, solo existen dos medicamentos para tratar esta enfermedad. El presente proyecto se basa sobre un estudio exploratorio de los desafíos de tratar la enfermedad de Chagas en sus distintas fases y los abordajes actuales para nuevos tratamientos.

Los objetivos de este trabajo fueron los siguientes: en primer lugar, estudiar el contexto socio-económico en que existe esta enfermedad y las implicaciones de este contexto …

El Acceso Y Uso De Las Pruebas Genéticas Para La Detección Precoz De Enfermedades Congénitas En Mujeres Embarazadas En La Ciudad Autónoma De Buenos Aires En El Año 2017 \ The Access And Use Of Genetic Tests For Early Detection Of Congenital Diseases In Pregnant Women In The Autonomous City Of Buenos Aires In The Year 2017, Anna Anna Bauer

Independent Study Project (ISP) Collection

Las pruebas genéticas son una herramienta útil para la prevención y el diagnóstico de defectos congénitos en las mujeres embarazadas. Esta investigación explora el acceso y uso de estas pruebas para mujeres que residen en la Ciudad Autónoma de Buenos Aires en el año 2017. Se trata de un tema amerita una investigación porque la tecnología para hacer estudios genéticos todavía es algo novedosa. Además, a través de las pruebas genéticas es posible detectar si el feto tiene un alto riesgo para desarrollar un defecto congénito, el cual es una de las causas más importantes de la mortalidad prenatal y …

Quality Of Water In Relation To Diarrheal Disease Incidence In Obunga, Tianna Herman

Independent Study Project (ISP) Collection

Kenyan cities are experiencing a serious dilemma in dealing with the large influx of people from rural parts of the country to the cities. Most people come to the city in pursuit of better opportunities and jobs. Rapid urban growth with little planning and preparation by the national and county governments has led to the development of informal settlements. These informal settlements are characterized by poor environmental conditions that predispose their residents for poor health conditions. Because of their illegal status, most residents of informal settlements in Kenya do not receive government services such as water, drainage, sewerage, and rubbish …

Cancer As A Metabolic Disease, Javaria Haseeb

Honors Senior Capstone Projects

Despite decades of intensive scientific and medical efforts to develop efficient and effective treatments for cancer, it remains one of the prime causes of death today. For example, in 2016, there will be an estimated 1,685,210 new cases of cancer and 595,690 deaths due to cancer in the United States alone (National Cancer Institute). Worldwide in 2012, there were an estimated 14 million new cases of cancer and 8.2 million deaths due to cancer. In order to come up with better methods of detection and more successful modes of treatment, it is crucial that scientists understand the depth of not …

A Review Of 57 Zone: A Social Media Network For Tb Consultation And Communication In Kunming, China, India Medaris

Independent Study Project (ISP) Collection

Yunnan, a predominantly agricultural province in southwest China, is a province with a high rate of both tuberculosis (TB) and multi-drug resistant tuberculosis (MDR TB), with nearly 25,000 cases of pulmonary TB reported each year. Former TB/MDR TB patients in Yunnan, with the support of Family Health International 360 NGO (FHI) are trying to combat this problem. They have created a social media network for TB consultation and communication, 57 Zone, where TB patients can talk about their medication, adverse drug effects, and nutrition and psychosocial concerns. The goal of this study was the look at what aspects of the …

Use Of P53-Silenced Endothelial Progenitor Cells To Treat Ischemia In Diabetic Peripheral Vascular Disease., Nabanita Kundu, Cleyton C Domingues, Cyril Chou, Neeki Ahmadi, Sara Houston, D Joseph Jerry, Sabyasachi Sen

Medicine Faculty Publications

Background Peripheral vascular disease is a major diabetes mellitus‐related complication. In this study, we noted that expressions of proapoptotic p53 gene and its downstream cascade gene such as p21 are upregulated in hyperglycemia. Therefore, we investigated whether p53‐ and p21‐silenced endothelial progenitor cells (EPCs) were able to survive in hyperglycemic milieu, and whether transplantation of either p53 knockout (KO) or p21KO or p53‐ and p21‐silenced EPCs could improve collateral vessel formation and blood flow in diabetic vaso‐occlusive peripheral vascular disease mouse models.

Methods and Results We transplanted p53 and p21KO mouse EPCs (mEPCs) into streptozotocin–induced diabetic (type 1 diabetes mellitus …

Promotion Of New Diabetes Products In The District Of Columbia, Joy Eckert, Dilpan Sundaramoorthy, Alycia Hogenmiller

GW Research Days 2016 - 2020

Background: Growth in pharmaceutical expenditures for diabetes outpaced growth in diabetes prevalence. Prescribers accepting gifts and meals from pharmaceutical companies have been linked with higher prescription rates and costs[1]. Pharmaceutical marketing to these prescribers and patients often promotes newer, more expensive drugs, such as the GLP-1 analogues and SGL-2 inhibitors. These two drug classes are more expensive but no more effective than metformin,[2] the recommended first-line treatment for diabetes, and the oldest and cheapest available treatment. We investigated how cost of diabetes treatment was affected by marketing practices in the District of Columbia.

Methods: The AccessRx program …

Medical Resource Utilization Of Outpatient Care For Children With Neurofibromatosis Type 1, Rabia Idrees, Michael Fisher, Rachel Hachen, Brian Callaghan, Robert A. Avery

GW Research Days 2016 - 2020

Background:

Neurofibromatosis Type 1 (NF1) is an autosomal dominant syndrome with manifestations affecting the central nervous system, musculoskeletal system, peripheral nervous system, and cognitive/behavioral functions. Many of these manifestations persist throughout life and require medical/surgical interventions.

The resource utilization and economic burden of caring for children with NF1 is unknown. Prior research has inherent selection bias and does not accurately reflect the incidence/resource utilization of morbidities. In order to identify which disease manifestations are in the most need of improved clinical algorithms and novel therapeutics, the frequency/type of resources utilized (i.e., diagnostic imaging and specialty visits) must be determined.

The …

Fungus Amungus -- A Common Disease State That Is Commonly Missed: A Survey Based Study, Ramsin Yadgar, Adam Friedman, Neal Bhatia

GW Research Days 2016 - 2020

Background: Dermatophyte infections involving the skin, hair, or nails affect an estimated 25% of the world's population, and accounted for 51 million outpatient visits over a ten-year period (1995-2004) in the United States alone. Dermatomycosis is routinely managed by dermatologists, though given the diversity of clinical presentations, is sometimes misdiagnosed, which can result in inappropriate therapy, worsening of symptoms, and even result in additional skin and soft tissue infections.

Methods: An interactive survey of board-certified dermatologists was conducted at the 2016 Orlando Dermatology Aesthetic & Clinical Conference, during a seminar on superficial mycotic infections. The structure of the survey entailed …

Secondary Prevention At The Aswan Heart Centre, Amira Athanasios

GW Research Days 2016 - 2020

Cardiovascular disease remains the leading cause of death globally, taking the lives of almost 18 million patients around the world each year. The overwhelming majority of cardiovascular deaths take place in low- to mid-income counties, suggesting that most cardiovascular deaths are preventable. In this study, current literature on secondary prevention of coronary artery disease was analyzed. Specific emphasis was given to preventative measures and successes in low income countries. Based on a literature review, a patient questionnaire to better understand patient adherence to preventative measures was created. This questionnaire focuses on patients receiving dual antiplatelet therapy post acute myocardial infarct …

Mutations In Braf Are Associated With Higher Levels Of Immune Infiltrates In Microsatellite-Stable Colon Cancer, Jake Rubin, Eduard Porta Parto

GW Research Days 2016 - 2020

While BRAF is among the most well-established oncogenes in human cancers, more recently it has garnered attention for its role in suppressing antitumor immunity, especially in melanoma. Because tumor-infiltrating lymphocyte (TIL) density is strongly prognostic in colorectal cancer (CRC)⁷, we decided to investigate the connection between TIL density and the BRAF-activating V600E mutation in CRC.

We used ESTIMATE to quantify immune infiltrate in samples from the TCGA colon adenocarcinoma (COAD) dataset (n = 216). This is an algorithm that uses the gene-expression signature of 141 immune-related genes to infer the presence of immune cells in the tumor infiltrate. …

Healthcare Provider And Patient Knowledge, Attitudes And Practices (Kap) Regarding Zika Virus, Quinton Katler, Prachi Godiwala, Charles Macri, Beth Pineles, Aileen Chang, Homa Ahmadzia

GW Research Days 2016 - 2020

Introduction:

Zika virus emergence in the western hemisphere has prompted the critical need for tailored risk counseling. Our team created a KAP survey in order to assess provider and patient awareness of Zika virus symptoms, transmission, treatment, and current and future concerns in order to inform local risk counseling efforts.

Methods:

The cross-sectional survey was issued in Medical Faculty Associates (MFA) clinics and via online link to healthcare providers and community members. The REDCap Data Collection tool was used to capture responses with subsequent SAS data analysis.

Results:

A total of 172 responses were collected. Most respondents (97%) were aware …

Development Of An Interleukin-4-Inducing Principle From Schistosoma Mansoni Eggs (Ipse)-Specific Pcr Assay As A Quantitative Predictor Of Schistosomiasis-Associated Morbidity, Dannah Farah, Evaristis Mbanefo, Michael H. Hsieh

GW Research Days 2016 - 2020

Schistosomiasis is a neglected tropical disease affecting between 200-500 million people worldwide. The two species causing most human cases of schistosomiasis are Schistosoma mansoni and Schistosoma haematobium. The gold standard for diagnosis is parasitological detection of parasite eggs in stool using the Kato-Katz method. Counting eggs shed in stool is labor-intensive and inaccurate. Interleukin-4- inducing principle from Schistosoma mansoni eggs (IPSE) is the most abundant secreted protein from schistosome eggs. We hypothesized that the mRNA transcripts of the IPSE protein may be found in the liver tissue and stool of experimentally infected animals, and that these transcripts can be specifically …

Performance Of Non-Invasive Tests To Predict Significant Liver Fibrosis In Patients With Morbid Obesity, Ahmed Bakhshwin, Patricia Latham

GW Research Days 2016 - 2020

Non-Alcoholic Fatty Liver Disease (NAFLD) affects more than 90% of patients with morbid obesity (MO) and approximately 30% have significant liver fibrosis and/or cirrhosis. Liver biopsy is the gold standard for diagnosis of significant liver fibrosis and cirrhosis; however, several non-invasive tests have been suggested to predict the presence or absence of significant liver fibrosis and to avoid liver biopsy in these patients. The aim of this study was to determine the ability of these tests to predict significant liver fibrosis, specifically in patients with MO.

Methods:

Liver biopsies from patients with MO undergoing gastric bypass surgery were studied in …

Analysis Of Hiv-1 Quasispecies Sequences Generated By High Throughput Sequencing (Hts) Using Hive, Naila Gulzar, Bhavna Hora, Konstantinos Karagiannis, Krista Smith, Feng Gao, Raja Mazumder

GW Research Days 2016 - 2020

The high level of genetic variability of Human Immunodeficiency Virus type 1 (HIV-1) is caused by the low fidelity of its replication machinery. This leads to evolution of swarm-like viral populations often described as quasispecies. High throughput sequencing (HTS) technology provides higher resolution over Sanger sequencing, enabling detection of low frequency variant genomes. However, quasispecies analysis is still a challenge due to the systematic noise, introduced by HTS technology. This leads to the increase in type I errors (also known as false positives) and the underlying genetic diversity, which can lead to mathematically insolvable type II errors (also known as …

Differential Mrna Expression In Ectopic Germinal Centers Of Myasthenia Gravis Thymus, Manjistha Sengupta, Bi-Dar Wang, Norman H. Lee, Gary Cutter, Linda L. Kusner, Henry J. Kaminski

GW Research Days 2016 - 2020

Myasthenia gravis (MG) is an autoimmune neuromuscular disorder resulting in weakness of voluntary muscles. It is caused by antibodies directed against proteins present at the post-synaptic surface of neuromuscular junction (NMJ). A characteristic pathology of patients with early onset MG is thymic hyperplasia with ectopic germinal centers (GC). However, mechanisms that trigger and maintain thymic hyperplasia are poorly characterized.

In order to determine the central mechanisms involved in the pathology, thymus samples from MG patients were assessed by histology and grouped based on appearance of GC compared to samples without them. We assessed the differential mRNA expression profiles between the …

Using Mobile Health (Mhealth) Technology In The Management Of Diabetes Mellitus, Physical Inactivity, And Smoking, Hasan Rehman, Ayeesha Kamran Kamal, Saleem Sayani, Pamela B. Morris, Anwar T. Merchant, Salim S. Virani

Department of Medicine

Purpose of Review: Cardiovascular mortality remains high due to insufficient progress made in managing cardiovascular risk factors such as diabetes mellitus, physical inactivity, and smoking. Healthy lifestyle choices play an important role in the management of these modifiable risk factors. Mobile health or mHealth is defined as the use of mobile computing and communication technologies (i.e., mobile phones, wearable sensors) for the delivery of health services and healthrelated information. In this review, we examine some recent studies that utilized mHealth tools to improve management of these risk factors, with examples from developing countries where available.
Recent Findings: The mHealth …

Autoimmune Hemolytic Anemia Associated With Babesiosis, Roshni Narurkar, Aleksandra Mamorska-Dyga, John Nelson, Delong Liu

NYMC Faculty Publications

BACKGROUND: Babesiosis is endemic in selected areas in North America. Babesia infection is commonly associated with anemia, thrombocytopenia, hyponatremia and elevated liver enzymes. Autoimmune hemolytic anemia (AIHA) is known to be caused by parasitic and viral infections but has not been well characterized. CASE PRESENTATION: We describe two cases diagnosed with babesiosis triggering severe AIHA. One case had history of splenectomy, and the other was an elderly patient. Older, immunocompromised and asplenic patients may be particularly at risk for post-babesiosis AIHA (PB-AIHA). CONCLUSIONS: The pathogenesis for conventional AIHA and PB-AIHA appears to be different, since splenectomy is a treatment for …

Hla-B*57:01 Allele Prevalence In Hiv-Infected North American Subjects And The Impact Of Allele Testing On The Incidence Of Abacavir-Associated Hypersensitivity Reaction In Hla-B*57:01-Negative Subjects, Catherine Small, D Margolis, M Shaefer, L Ross

NYMC Faculty Publications

BACKGROUND: The presence of the HLA-B*57:01 allele in HIV-infected subjects is associated with a higher risk of abacavir-associated hypersensitivity reaction (ABC HSR). HLA-B*57:01 allele prevalence varies in different populations, but HLA-B*57:01 testing with immunological confirmation has had a negative predictive value for ABC HSR between 97 and 100%. METHODS: In the ASSURE study (EPZ113734), the HLA-B*57:01 prevalence in virologically suppressed, antiretroviral treatment-experienced, HIV-infected subjects from the United States, including Puerto Rico, was assessed. RESULTS: Three hundred eighty-five subjects were screened; 13 were HLA-B*57:01 positive and 372 were negative. Only HLA-B*57:01-negative, abacavir-naive subjects were eligible to enroll into the ASSURE trial. …

Understanding The Patterns Of Distribution And Abundance Of Lyme Disease Carrying Ticks And Their Hosts, Julio Ruiz

Honors Theses

Lyme disease is caused by the bacteria Borrelia burgodorferi and spreads to their hosts by the bites of infected Ixodes scapularis ticks. In the United States, Lyme disease is typically found in the northeast but in recent years the disease has begun to be found further south and west than previously before. Yet, today, little information can be found about the patters of distribution and abundance of ticks and their host. The main goal of this research work was to expand the knowledge of the abundance and distribution of ticks and host. Based on tick collection data obtained from Maikis …

Creation Of A Novel Human Wound Model To Test Novel Wound Healing Approaches, Nathan Northern

The University Honors Program

In the US there is a growing prevalence of chronic wounds such as such as leg ulcers, diabetic foot ulcers, and pressure ulcers. These wounds persist for long periods of time and are expensive to manage. Improved human-based model systems that emulate the wound healing process in humans would accelerate the identification of novel healing strategies that are directly translatable to humans. The goal of this study was to develop a novel wound model able to imitate the human wound healing process. To do this, 8mm punch biopsies were taken from human abdominoplasty samples and 2mm wounds were created in …

Variables Associated With Overweight/Obesity Among African-American Women With Hypertension And/Or Diabetes, Monica A. Hamilton, Dnp, Rn, Acns-Bc

Doctor of Nursing Practice Projects

BACKGROUND

Obesity is the second leading cause of preventable death next to tobacco use. Although it is prevalent in all populations, it disproportionately affects AA women. Overweight/obesity increases AA women’s chances of developing chronic illnesses such as diabetes, hypertension, heart disease, and decreases their life expectancy. The purpose of this study was to explore variables associated with overweight/obese AA women with hypertension and/or diabetes.

METHODS

A secondary data analysis was conducted using a descriptive-correlational design to analyze cross-sectional data obtained from the 2013 Behavioral Risk Factor Surveillance System (BRFSS). The sample consisted of AA women (n =1823). The dependent variable …

Dupuytren's Disease, Leah C. Pinckney

Student Publications

Dupuytren's disease (DD) is a chronic condition in which fibrosis of tissue beneath the palm of the hand occurs. Causes and mechanisms of this disease's development are still not entirely understood. However, symptoms and the negative impact on individuals' quality of life are evident. While existing therapies for DD have been established to prevent and slow its progression, further research is needed to effectively address it on a wider scale.