Diseases Commons^™

Extracorporeal Membrane Oxygenation Rescue For Severe Aspiration Pneumonitis In Two Patients After Roux-En-Y Gastric Bypass Procedure, Melissa M Felinski, Daniyal Abbas, Peter A Walker, John A Primomo, Tanyaradzwa M Kajese, Biswajit Kar, Igor D Gregoric, Igor Banjac, Lisa Janowiak, Sriram Nathan, Rahat Hussain, Sheilendra S Mehta, Kulvinder S Bajwa, Shinil K Shah, Bindu Akkanti

Faculty, Staff and Student Publications

Roux-en-y gastric bypass (RYGB) is one of the most common weight loss surgical procedures performed in the United States. Early post-operative small bowel obstruction is a rare but potentially morbid, complication of RYGB. We report two patients who underwent RYGB and required subsequent treatment for a post-operative small bowel obstruction. Their post-operative course was complicated by severe aspiration pneumonitis leading to hypoxemic respiratory failure requiring rescue with femoral veno-venous extracorporeal membrane oxygenation (V-V ECMO). Both patients were successfully extubated, weaned off V-V ECMO support, and discharged to home. These cases highlight the potential role of V-V ECMO for patients who …

Primary Ciliary Dyskinesia: Ancestral Haplotypes Analysis Of The Rsph4a Founder Mutation In Puerto Rico, Wilfredo De Jesús-Rojas, Dalilah Reyes De Jesús, Angélica M Nieves, Ricardo A Mosquera, Juan C Martinez-Cruzado

Faculty, Staff and Student Publications

Genetic mutations in >50 genes, including RSPH4A, can lead to primary ciliary dyskinesia (PCD). RSPH4A mutations affect radial spokes, which alter the configuration of the ciliary ultrastructure and lead to chronic oto-sinopulmonary disease. The RSPH4A [c.921+3_6delAAGT] founder mutation was described as one cause of PCD without laterality defects in Puerto Rico. The average Puerto Rican genetic composition includes 64% European, 21% African ancestral, and 15% Native-American or Taino, a native tribe in the Caribbean at the start of the European colonization, genes. Due to the relatively elevated Taino ancestry on the island, it might have contributed to the endemicity of …

Primary Osteoarthritis Early Joint Degeneration Induced By Endoplasmic Reticulum Stress Is Mitigated By Resveratrol, Jacqueline T Hecht, Alka C Veerisetty, Juliana Wu, Francoise Coustry, Mohammad G Hossain, Frankie Chiu, Francis H Gannon, Karen L Posey

Faculty, Staff and Student Publications

Increasing numbers of people are living with osteoarthritis (OA) due to aging and obesity, creating an urgent need for effective treatment and preventions. Two top risk factors for OA, age and obesity, are associated with endoplasmic reticulum (ER) stress. The I-ERS mouse, an ER stress-driven model of primary OA, was developed to study the role of ER stress in primary OA susceptibility. The I-ERS mouse has the unique ability to induce ER stress in healthy adult articular chondrocytes and cartilage, driving joint degeneration that mimics early primary OA. In this study, ER stress-induced damage occurred gradually and stimulated joint degeneration …

Delirium In Frail Older Adults, Min Ji Kwak

Faculty, Staff and Student Publications

Delirium and frailty are prevalent geriatric syndromes and important public health issues among older adults. The prevalence of delirium among hospitalized older adults ranges from 15% to 75%, while that of frailty ranges from 12% to 24%. The exact pathophysiology of these two conditions has not been clearly identified, although several hypotheses have been proposed. However, these conditions are considered to be multifactorial in etiology and are associated with inflammation related to aging, alterations in vascular systems, genetics, and nutritional deficiency. Furthermore, clinically, they are significantly associated with frailty, which increases the risk of delirium by almost two- to three-fold …

Cd11c Participates In Triggering Acute Graft-Versus-Host Disease During Bone Marrow Transplantation, Qianqian Wang, Xiuhua Su, Yi He, Mei Wang, Donglin Yang, Rongli Zhang, Jialin Wei, Qiaoling Ma, Weihua Zhai, Aiming Pang, Yong Huang, Sizhou Feng, Christie M Ballantyne, Huaizhu Wu, Xiaolei Pei, Xiaoming Feng, Mingzhe Han, Erlie Jiang

Faculty, Staff and Students Publications

CD11c is a canonical dendritic cell (DC) marker with poorly defined functions in the immune system. Here, we found that blocking CD11c on human peripheral blood mononuclear cell‐derived DCs (MoDCs) inhibited the proliferation of CD4+ T cells and the differentiation into IFN‐γ‐producing T helper 1 (Th1) cells, which were critical in acute graft‐versus‐host disease (aGVHD) pathogenesis. Using allogeneic bone marrow transplantation (allo‐BMT) murine models, we consistently found that CD11c‐deficient recipient mice had alleviated aGVHD symptoms for the decreased IFN‐γ‐expressing CD4+ Th1 cells and CD8+ T cells. Transcriptional analysis showed that CD11c participated in several immune regulation functions including maintaining antigen …

Mouse Experiments Demonstrate Differential Pathogenicity And Virulence Of Trypanosoma Brucei Rhodesiense Strains, Limo William Kipkorir, Thuita Kibuthu John, Orindi Benedict Owino, Oidho John, Shivairo Robert, Masiga Daniel, Adung'a Vincent Owino

All Peer-Reviewed Publications

Trypanosoma brucei rhodesiense is the causative agent for Rhodesian human African trypanosomiasis. The disease is considered acute, but varying clinical outcomes including chronic infections have been observed. The basis for these different clinical manifestations is thought to be associated with a combination of parasite and host factors. In the current study, Trypanosoma brucei rhodesiense strains responsible for varying infection outcomes were sought using mouse model. Clinical rHAT parasite isolates were subjected to PCR tests to confirm presence of the serum resistance associated (SRA) gene. Thereafter, four T. b. rhodesiense isolates were subjected to a comparative pathogenicity study using female Swiss …

Molecular Characterization Of Trypanosoma Vivax In Tsetse Flies Confirms The Presence Of The Virulent Tvv4 Genotype In Kenya: Potential Implications For The Control Of Trypanosomiasis In Shimba Hills, Faith I. Ebhodaghe, Armanda D.S. Bastos, Kevin O. Kidambasi, Shewit Kalayou, Daniel K. Masiga, Michael N. Okal

All Peer-Reviewed Publications

Trypanosoma vivax is a vector-borne protozoan parasite of livestock endemic to Africa and South America. To date, fifteen genotypes of the parasite have been described in vertebrate and insect hosts in East Africa. However, information regarding T. vivax diversity remains limited in many endemic countries in the sub-region, including Kenya. Such information could deepen insight into the local epidemiology of animal trypanosomiasis in Shimba Hills, a wildlife area in southeast Kenya where T. vivax is endemic and infects livestock. We employed two-gene conventional-PCR-sequencing and phylogenetic analysis to characterize T. vivax genotypes in tsetse flies collected between November 2018 and September …

Association Of Maternal Prenatal Selenium Concentration And Preterm Birth: A Multicountry Meta-Analysis, Nagendra Monangi, Huan Xu, Waqasuddin Khan, Furqan Kabir, Muhammad Imran Nisar, Aneeta Hotwani, Usma Mehmood, Ambreen Nizar, Javairia Khalid, Fyezah Jehan

Department of Paediatrics and Child Health

Background: Selenium (Se), an essential trace mineral, has been implicated in preterm birth (PTB). We aimed to determine the association of maternal Se concentrations during pregnancy with PTB risk and gestational duration in a large number of samples collected from diverse populations.
Methods: Gestational duration data and maternal plasma or serum samples of 9946 singleton live births were obtained from 17 geographically diverse study cohorts. Maternal Se concentrations were determined by inductively coupled plasma mass spectrometry analysis. The associations between maternal Se with PTB and gestational duration were analysed using logistic and linear regressions. The results were then combined using …

Voices From A Prison Pandemic: Lives Lost From Covid-19 At Lakeland Correctional, Kimberly Thomas

Articles

Coronavirus tore through jails and prisons like wildfire. In some states, more than half of the people incarcerated there tested positive for COVID-19; nearly 400,000 people in prison across the United States have tested positive. For people in prison, COVID-19 brought the loss of close friends, solitary confinement, loss of connection with family and programming, lack of information, and fear of contracting the virus. It has also reminded those who are incarcerated of the one-dimensional way in which people in prison are perceived. As stated by one collaborator, Cory Souders, "[s]o many men and women who come to prison are …

The Antibiotic-Resistant Bacteria Crisis: Overcoming Methicillin-Resistant Staphylococcus Aureus (Mrsa) By Myxobacterial Predation, Basirat Olorunlambe

Symposium of Student Scholars

With the growing threat of antibiotic-resistant bacteria, the need for finding new antibiotics is at an all-time high. According to the Center for Disease Control and Prevention (CDC), there were over 2.8 million cases of antibiotic-resistant infections in the United States in 2019 and over 35,000 individuals have died from them. Methicillin-Resistant Staphylococcus Aureus (MRSA) accounts for 323,700 of these cases, with 10,600 deaths. MRSA is a common cause of nosocomial infections. Although antibiotics are available to treat MRSA, such as Vancomycin, the possibility remains that these strains are likely to develop a resistance to these compounds as it has …

Anti-Vaxxers: Parents Fighting Science, Katie West

Symposium of Student Scholars

Immunizing children helps protect the health of our community, especially those people who cannot be immunized. Yet, since 1996 after a study was released that linked autism to vaccinations, there has been a trend of parents refusing to vaccinate their children. What are the demographics of the parents who believe their children are better off without vaccines? By knowing where these parents live and what decisions they make for their children’s education, counties and medical professionals can provide education and address their concerns.

My research involves data on 116,141 kindergarten classes from 2000-2015 in California. The two vaccine exemption options …

Cervical Cancer: Are There Ways To Reduce The Risks?, Madelyn Dorn

Symposium of Student Scholars

History has shown us that when caught early, cervical cancer is curable. Past research has found that the sexually transmitted diseases (STDs), herpes and human papillomavirus (HPV), have been associated with cervical cancer. In contrast, my dataset on 859 women has many more STDs and lifestyle choices compiled on 36 variables. The diagnoses in the dataset are many: cervical condylomatosis, vaginal condylomatosis, vulvo-perineral condylomatosis, syphilis, pelvic inflammatory disease, genital herpes, molluscum contagiosum, acquired immune deficiency syndrome (AIDS), human immunodeficiency virus (HIV), hepatitis B, HPV, and cervical cancer. In addition to the demographic variable on age, there are many lifestyle choice …

Oral Minimal Model For Gestational Diabetes, Sarah Peters

Symposium of Student Scholars

Gestational diabetes is one of the most common issues that a pregnant woman encounters that could result in harm to both the woman and child. Due to this issue, the woman’s glucose and insulin levels should be carefully monitored throughout her pregnancy to assess the need for prescribed diabetic medication to help regulate those levels. In this research, the objectives is to develop a MATLAB computer program of the Oral Minimal Model, which is a model that can be used to estimate a person’s insulin sensitivity from an oral glucose tolerance test (OGTT) where plasma glucose and insulin levels are …

Utilization Of Patient-Controlled Analgesia Reduces Length Of Stay Of Sickle Cell Crisis Hospitalizations, Brett M. Prestia, Talha Ramzan, Catherine Waldron, Ameer Malik, Robert M. Pallay, Candace R. Murbach, Mike Flynn, Eric Shaw Phd, Abdullah Kutlar, Daniel Lowe

HCA Healthcare Journal of Medicine

Background

Sickle cell crisis hospitalizations are emotionally and financially burdensome to patients and healthcare systems, and processes to decrease the frequency or length of stay of these crises should be examined.

Methods

This is a multicenter retrospective hospital record review of sickle cell crisis hospitalizations as defined by ICD-10 codes (D57.1-4), from January 2016 through December 2019, examining inpatient medication administration records and length of stay among admitted adults aged 18–65 years. Patient controlled analgesia orders using morphine, hydromorphone, fentanyl and/or merperidine at any point of an admission (n=188) were compared to admissions without any patient-controlled analgesia orders (n=2,159). The …

Obesity, Race, And Covid-19 Mortality: Results From A Large Cohort Early In The Pandemic, Eric K. Shaw, Anyul Ferez-Pinzon, Micah Mabe, Mike Flynn, Christopher K. Senkowski

HCA Healthcare Journal of Medicine

Background

Obesity has increased progressively in the United States and is a known risk factor for several diseases such as type 2 diabetes, coronary artery disease, stroke and hypertension. Amid the current pandemic, concerns have been raised about obesity as a risk factor for COVID-19 positive patients. The primary goal of this study was to explore the association between obesity and hospital mortality in COVID-19 patients. Our secondary objective was to explore the relationship between obesity and race on hospital mortality in COVID-19 patients.

Methods

This was a cross-sectional, retrospective analysis using data from 186 hospitals from across the United …

Classical Findings Of Infantile Hepatic Hemangiomas, Senayit Demie, Michael Bossak

HCA Healthcare Journal of Medicine

Introduction

Hemangiomas are benign vascular tumors that are common during infancy. They are most commonly noted as superficial bright red lesions on the skin but can also be found deeper as subcutaneous lesions. Patients with multifocal cutaneous hemangiomas are at risk of visceral involvement with the liver being most commonly affected. Most hemangiomas can be monitored clinically as they are self-limiting. Despite this, hepatic hemangiomas can have serious complications including large arteriovenous shunts leading to cardiac compromise as well as severe hepatomegaly which can cause abdominal compartment syndrome, impaired ventilation and renal vein compression.

Clinical Findings

A six-month-old female, born …

Coronavirus Update 8-31-21, The Coronavirus Planning Team

University Briefings & Virtual Events

Wear a Mask Indoors! As you know, we are requiring that everyone wear a mask when indoors, except in their dorm rooms with only roommates present or alone in offices for faculty and staff. Unfortunately, we have observed a significant number of students who are not adhering to this mandate. To be compliant, you need to be wearing a mask that completely covers your nose and mouth.

Covid-19 Newsletter (Vol. 87), Center For Disaster Medicine, New York Medical College

COVID-19 Newsletter

No abstract provided.

Dietary Diversity And Social Determinants Of Nutrition Among Late Adolescent Girls In Rural Pakistan, Jo-Anna B. Baxter, Yaqub Wasan, Muhammad Islam, Simon Cousens, Sajid Bashir Soofi, Imran Ahmed, Daniel W. Sellen, Zulfiqar Ahmed Bhutta

Centre of Excellence in Women and Child Health

The conditions in which adolescent girls mature shape their health, development and nutrition. Nutrient requirements increase to support growth during adolescence, but gaps between consumption and requirements exist in low- and middle-income countries. We aimed to identify and quantify the relationship between dietary intake and diverse social determinants of nutrition (SDN) among a subset of adolescent girls 15-18.9 years (n = 390) enrolled within the Matiari emPowerment and Preconception Supplementation (MaPPS) Trial. The primary outcome, dietary diversity score (DDS), was derived by applying the Minimum Dietary Diversity for Women 10-item scale to 24-h dietary recall data collected three times per …

Variation Of Igg N-Linked Glycosylation Profile In Diabetic Retinopathy, Zhiyuan Wu, Huiying Pan, Di Liu, Di Zhou, Lixin Tao, Jie Zhang, Xiaonan Wang, Xia Li, Youxin Wang, Wei Wang, Xiuhua Guo

Research outputs 2014 to 2021

Background:

The relationship of immunoglobulin G (IgG) glycosylation with diabetes and diabetic nephropathy has been reported, but its role in diabetic retinopathy (DR) remains unclear. We aimed to investigate and validate the association of IgG glycosylation with DR.

Methods:

We analyzed the IgG N-linked glycosylation profile and primarily selected candidate glycans by lasso (least absolute shrinkage and selection operator) regression analysis in the discovery population. The findings were validated in the replication population using a binary logistics model. The association between the significant glycosylation panel and clinical features was illustrated with Spearman's coefficient. The results were confirmed by sensitivity analyses. …

Higher Entropy Observed In Sars-Cov-2 Genomes From The First Covid-19 Wave In Pakistan, Najia Karim Ghanchi, Asghar Nasir, Kiran I. Masood, Syed Hani Abidi, Syed Faisal Mahmood, Akber Kanji, Safina Abdul Razzak, Waqasuddin Khan, Saba Shahid, Maliha Yameen, Ali Raza, Javaria Ashraf, Zeeshan Ansar Ahmed, Mohammad Buksh Dharejo, Nazneen Islam, Zahra Hasan, Rumina Hasan

Department of Pathology and Laboratory Medicine

Background: We investigated the genome diversity of SARS-CoV-2 associated with the early COVID-19 period to investigate evolution of the virus in Pakistan.
Materials and methods: We studied ninety SARS-CoV-2 strains isolated between March and October 2020. Whole genome sequences from our laboratory and available genomes were used to investigate phylogeny, genetic variantion and mutation rates of SARS-CoV-2 strains in Pakistan. Site specific entropy analysis compared mutation rates between strains isolated before and after June 2020.
Results: In March, strains belonging to L, S, V and GH clades were observed but by October, only L and GH strains were present. The …

Knowledge And Awareness Of Dental Specialists, General Dentists And Dental Assistants Regarding Sars‑Cov‑2, Hafsa Qabool, Rashna Hoshang Sukhia, Mubassar Fida

Section of Dental-Oral Maxillofacial Surgery

Background: Severe acute respiratory syndrome coronavirus 2 (SARS‑CoV‑2) has had drastic effects among healthcare professionals.
Objectives: This study aimed to assess knowledge and awareness among dental specialists, general dentists and dental assistants regarding standard patient care guidelines for minimizing the spread of the infection.
Material and methods: A survey-based cross-sectional study was conducted on a sample of 84 participants. The participants were divided into groups of dental specialists, general dentists and dental assistants. A modified version of a validated questionnaire was used to evaluate knowledge and awareness regarding SARS‑CoV‑2 as per the Centers for Disease Control and Prevention (CDC) guidelines. …

Assessment Of The Working Posture Among Dental Students To Prevent Musculoskeletal Disorders, Eleena Mohd Yusof, Muhamad Amir Hazim Razli, Siti Aisyah Iman Mohd Nasir

Journal of Dentistry Indonesia

Poor working posture among dental practitioners has been known to cause musculoskeletal disorders (MSDs), which are made worse by lengthy procedures and a lack of awareness about the proper working posture.

Objectives: To assess the working posture of clinical dental students to determine if interventions were needed to reduce MSDs.

Methods: The working postures of 225 clinical dental students were recorded and assessed within 10 minutes into procedures from March-December 2019, using the Rapid Upper Limb Assessment (RULA) method. The results were then statistically analysed using chi-square and Fisher’s exact tests.

Results: Of the 225 students observed, 64 (28.4%; 95% …

Atypical Idiopathic Intracranial Hypertension Presenting As Cyclic Vomiting Syndrome: A Case Report, Nafee T Talukder, Amanda H Clorfeine, Moira K Black, Shade B Moody

Faculty, Staff and Student Publications

BACKGROUND: Idiopathic intracranial hypertension is a disorder of increased intracranial pressure in the absence of cerebrospinal outflow obstruction, mass lesion, or other underlying cause. It is a rare phenomenon in prepubertal children and is most typically found in women of childbearing age. The classic presentation consists of headaches, nausea, vomiting, and visual changes; however, children present more atypically. We report a case of idiopathic intracranial hypertension in an otherwise healthy, 4-year-old child with atypical symptoms resembling those of cyclic vomiting syndrome.

CASE PRESENTATION: A 4-year-old Caucasian, otherwise healthy, male child presented to our emergency department with episodic intermittent early-morning vomiting …

Case Report: Pheochromocytoma Presenting With Cushing’S Syndrome And Hyperglycemia, Elizabeth Garbitelli, Halla Bates, Cheryl Liechty, Robert Bing-You

Journal of Maine Medical Center

Introduction: Pheochromocytomas are catecholamine-producing neuroendocrine tumors that arise from the adrenal medulla. Pheochromocytomas typically present with uncontrollable or paroxysmal hypertension that can be accompanied by other common initial symptoms, including headache, diaphoresis, arrhythmia, and pallor. Given the morbidity and mortality associated with undiagnosed pheochromocytomas, and their potential for treatment, primary care physicians should consider this tumor type, and other endocrinological phenomena, when evaluating new onset hyperglycemia.

Clinical Findings: Patient G was a 76-year-old female who presented in her primary care office with newly uncontrollable hyperglycemia. During initial evaluation, her clinical condition deteriorated rapidly. Her laboratory studies revealed markedly elevated cortisol, …

Factors That Influence Perception Of Hiv Risk And Willingness To Use Pre-Exposure Prophylaxis In People Who Inject Drugs, Daria Egorova, Anny Fenton, Kinna Thakarar

Journal of Maine Medical Center

Introduction: Sexual and injection behaviors increase the risk of HIV transmission in people who inject drugs (PWID). We aimed to determine the prevalence of sexual and drug behaviors that increase HIV risk in PWID hospitalized for infections related to injection drug use in Maine. We also examined factors that influenced their perception of HIV risk and willingness to take pre-exposure prophylaxis (PrEP).

Methods: We surveyed 101 PWID with infections related to injection drug use who were hospitalized at 4 hospitals in Maine. T-tests assessed differences in means of bacterial infection risk scores and willingness to take PrEP based on different …

Comparative Trends In Ischemic Heart Disease Admissions, Presentation And Outcomes Due To The Covid-19 Pandemic: First Insights From A Tertiary Medical Center In Pakistan, Ali Aahil Noorali, Humza Thobani, Shiraz Hashmi, Sara Iqbal, Asma A H. Merchant, Mian Arsam Haroon, Sardar Shahmir Babar Chauhan, Saad Mallick, Nida Zahid, Yasir Khan, Osman Faheem, Saulat Fatimi

Department of Medicine

Introduction: COVID-19 has manifested a striking disarray in healthcare access and provision, particularly amongst patients presenting with life-threatening ischemic heart disease (IHD). The paucity of data from low-middle income countries has limited our understanding of the consequential burden in the developing world. We aim to compare volumes, presentations, management strategies, and outcomes of IHD amongst patients presenting in the same calendar months before and during the COVID-19 pandemic.
Methods: We conducted a retrospective cross-sectional analysis at the Aga Khan University Hospital, one of the premier tertiary care centres in Pakistan. Data were collected on all adult patients (>18 years) …

Hepatitis E: Genotypes, Strategies To Prevent And Manage, And The Existing Knowledge Gaps, Lubna Kamani, Zahra Ali Padhani, Jai K. Das

Section of Gastroenterology

Hepatitis E virus (HEV) is considered an emergent source of viral hepatitis worldwide, with an increasing burden of jaundice, liver failure, extrahepatic illnesses, and deaths in developed countries. With the scarcity of data from efficient animal models, there are still open-ended questions about designing new models to study pathogenesis, types, virology, and evolution of these viruses. With an emphasis on available data and updates, there is still enough information to understand the HEV life cycle, pathogen interaction with the host, and the valuation of the role of vaccine and new anti-HEV therapies. However, the World Health Organization (WHO) and the …

Urinary Proteomics Combined With Home Blood Pressure Telemonitoring For Health Care Reform Trial: Rational And Protocol, Lutgarde Thijs, Kei Asayama, Gladys E. Maestre, Tine W. Hansen, Luk Buyse, Dong-Mei Wei, Jesus D. Melgarejo, Jana Brguljan-Hitij, Hao-Min Cheng, Fabio De Souza

School of Medicine Publications

Background: Hypertension and diabetes cause chronic kidney disease (CKD) and diastolic left ventricular dysfunction (DVD) as forerunners of disability and death. Home blood pressure telemonitoring (HTM) and urinary peptidomic profiling (UPP) are technologies enabling prevention.

Methods: UPRIGHT-HTM (Urinary Proteomics Combined with Home Blood Pressure Telemonitoring for Health Care Reform [NCT04299529]) is an investigator-initiated 5-year clinical trial with patient-centred design, which will randomise 1148 patients to be recruited in Europe, sub-Saharan Africa and South America. During the whole study, HTM data will be collected and freely accessible for patients and caregivers. The UPP, measured at enrolment only, will be …

Coronavirus Update 8-27-21, The Coronavirus Planning Team

University Briefings & Virtual Events

We want to say welcome to the Class of 2025 who have been moving in yesterday and today. We just have a few quick reminders for you as we get ready for the start of the fall semester.