Hemic and Lymphatic Diseases Commons^™

1,25-Dihydroxyvitamin D Mediated Hypercalcemia As An Initial Presentation In A Patient With Undiagnosed B-Cell Non-Hodgkin’S Lymphoma, Ranjit Banwait Md, Jawad Noor Md, Jing He Md, Xiaolong Liu Md, Liang Sun Md

Internal Medicine

In non-Hodgkin's lymphoma the findings of hypercalcemia as an initial presentation is extremely rare (<3% of cases). Here we report a 67 year-old man who presented with ST changes secondary to hypercalcemia in the setting of B-cell lymphoma.

Felty's Syndrome: Triad Not Always Evident, Pablo G. Dubon Md, Frederick Lim Md, Shfali Bhandari Md, Sukhmani Chauhan Md, Puja Solanki Md, Luis Silva Md

Internal Medicine

No abstract provided.

Infant With Protein C Deficiency And Stroke In The Setting Of Iron Deficiency Anemia, Tahseen Jalal Karim, Dustin J Paul, Regina M Troxell, Rajan Patel, Ian J Butler

Faculty, Staff and Student Publications

We report an 18-month-old infant with ischemic stroke, neurocognitive impairment, and psychomotor retardation in the setting of severe iron deficiency anemia. Although an uncommon outcome in anemic children, stroke is important to consider as a cause for developmental delay in children with iron deficiency anemia.

In Vitro Characterization Of Sonothrombolysis And Echocontrast Agents To Treat Ischemic Stroke, Himanshu Shekhar, Robert T Kleven, Tao Peng, Arunkumar Palaniappan, Kunal B Karani, Shaoling Huang, David D Mcpherson, Christy K Holland

Faculty, Staff and Student Publications

The development of adjuvant techniques to improve thrombolytic efficacy is important for advancing ischemic stroke therapy. We characterized octafluoropropane and recombinant tissue plasminogen activator (rt-PA)-loaded echogenic liposomes (OFP t-ELIP) using differential interference and fluorescence microscopy, attenuation spectroscopy, and electrozone sensing. The loading of rt-PA in OFP t-ELIP was assessed using spectrophotometry. Further, it was tested whether the agent shields rt-PA against degradation by plasminogen activator inhibitor-1 (PAI-1). An in vitro system was used to assess whether ultrasound (US) combined with either Definity or OFP t-ELIP enhances rt-PA thrombolysis. Human whole blood clots were mounted in a flow system and visualized …

Heavy Menstrual Bleeding In Adolescent Females With Platelet Function Disorders, Lauren Amos Md

Research Days

No abstract provided.

Initial Evaluation Of Adolescent Females Hospitalized With Heavy Menstrual Bleeding, Lauren Amos Md

Research Days

No abstract provided.

Role Of Rac1-Pak Pathway In Aggressive B-Cell Lymphoma, Tian Tian

Theses & Dissertations

Aggressive B-cell lymphomas are diverse group of neoplasms that arise at different stages of B-cell development and by various mechanisms of neoplastic transformation. Aggressive B-cell lymphomas include many types, subtypes and variants of diffuse large B-cell lymphoma (DLBCL), Burkitt lymphoma (BL), mantle cell lymphoma (MCL) and B lymphoblastic lymphoma. The treatment of patients with aggressive B-cell lymphomas remains a clinical challenge. Conventional chemotherapeutic regimens, mainly based on the CHOP (cyclophosphamide, hydroxydaunorubicin, oncovin and prednisone) combination, obtain a relatively high number of complete or partial clinical responses (20-80%), but the tumor relapses in most patients, who will die of the disease. …

The Evolving Long-Term Outcome Of Heart Transplantation In Amyloid Patients, Avish Jain, Sadia Dimbil, Ryan Levine, Michele Hamilton, Jon A. Kabashigawa

Rowan-Virtua Research Day

Background: Both amyloid light chain (AL) amyloidosis and transthyretin-related (TTR) amyloid are expanding indications for heart transplantation (HTx). In the past, AL amyloid, in particular, had been a contraindication to HTx given its systemic nature and the increased risk for mortality. Modern treatments including proteasome inhibitors have allowed amyloid patients to receive heart transplants at an increasing rate. We sought to assess long-term post-transplant outcome in amyloid patients in the current era.

Methods: Between 2010 and 2015, we assessed 27 patients (5 AL, 10 TTR-wildtype (wt), 12 TTR-mutant (m)) underwent heart transplant for cardiac amyloidosis at our single center. A …

A Case Of Atraumatic Posterior Thigh Compartment Syndrome, Nailah Mubin, Brian Katt

Rowan-Virtua Research Day

Compartment syndrome(CS) occurs when intra-compartmental pressures exceeds to a point where arterial, venous and lymphatic circulation of local tissues, muscles and nerves is compromised. CS is most common after a traumatic injury and usually occurs in the leg or forearm and less commonly in the thigh. Thigh compartment syndrome is rare due to its larger size and more compliant borders. We present a case of nontraumatic compartment syndrome in the posterior thigh associated with rhabdomyolysis and a sciatic nerve palsy which then required emergent fasciotomy. The patient's course was further complicated by acute renal failure due to the rhabdomyolysis and …

What Are The Ods? A Case Of Osmotic Demyelination Syndrome Associated With Hemodialysis In End-Stage Renal Disease, Ellen Colleen Bradley, Yvette Wang

Rowan-Virtua Research Day

Osmotic demyelination syndrome (ODS) is the irreversible demyelination of the central pons, among other areas of the brain, that is most often associated with rapid correction of hyponatremia. Per contra, reversible ODS is a rare state that can be seen in patients with end-stage renal disease (ESRD) on hemodialysis (HD). This clinical case offers an alternative problem representation for acute altered mental status in a patient with ESRD on HD.

Dual Therapy Treatment Of Pediatric Acute Lymphoblastic Leukemia With Blinotumomab And A Standard Chemotherapy Regimen, Tori I. Scheffler

Selected Honors Theses

Leukemia is the number one cancer affecting children in the nation, with acute lymphoblastic leukemia being the most prevalent classification.1 While new and innovative treatment protocols have greatly increased the success rate of primary cancer patients, those who face relapse receive a much more dismal prognosis. Recent studies have shown that patients who relapse quite frequently have developed drug-resistant clones of the original cancer cells, leading to a need for various secondary treatment options. The drug-resistance is due to clonal mutations that take place within the cancer cell, most often because of an outside pressure or stress within the environment …

Experiential Learning In Dietetics: Can Diabetes Camp Make A Difference?, Mallory Jean Mount

Theses, Dissertations and Capstones

This longitudinal qualitative case study explored the knowledge, perceptions, confidence, and empathy gained by dietetics students during experiential learning at a residential diabetes camp. Qualitative research methods were used to explore and understand participants’ experience of hands-on involvement with type one diabetes, and what they learned at camp that cannot be learned in a classroom. Data were collected over two years at Camp Kno-Koma, the diabetes camp of West Virginia. This study suggests that experiential learning at diabetes camp can make an important contribution to the overall education of dietetics students. One year of experiential learning was beneficial to participating …

The Right Vasopressor At The Right Time Does Early Use Of Vasopressors Decrease Morbidity And Mortality In Septic Shock, Michael Kittok

Theses and Graduate Projects

Sepsis and septic shock is a disease process that carries a high mortality rate and is responsible for a large portion of healthcare expenditures in the United States. The Surviving Sepsis Campaign has been working to decrease the mortality of sepsis since 2001. Their mission is two-fold; providing evidence based guidelines to help direct treatment, and raising awareness to healthcare providers and patients about sepsis. A main goal in treating sepsis is to reverse the hypoperfused state by giving crystalloid fluids and administering vasopressors, specifically norepinephrine, after patients have received adequate fluids. Would modifying this treatment by giving a combination …

Barriers That Prevent Initial Prescription Of Hydroxyurea In Sickle Cell Disease, Harini Halaharvi

Theses and Graduate Projects

Sickle cell disease (SCD) is one of the most common inherited red blood cell disorders, affecting millions of people worldwide. According to CDC, SCD affects approximately 100,000 Americans and is most prominent in people with ancestry from sub-Saharan Africa, Spanish- speaking regions in the Western Hemisphere (South America, the Caribbean, and Central America), Saudi Arabia, India, and Mediterranean countries such as Turkey, Greece, and Italy. 1 out of every 365 black or African-American and 1 out of every 16,300 Hispanic-American children are born with SCD.1 Approximately 6,000 Latin Americans are born with SCD annually in both US and Latin American …

Physical Activity Guidelines In Patients With Hemophilia: Benefits, Barriers, And Recommendations, Chelsea Johnson

Theses and Graduate Projects

Hemophilia describes a group of genetic disorders that lead to the dysfunction of proteins involved in the clotting cascade.1 These proteins, also known as coagulation factors, are required to form clots and ultimately cessate bleeding. Although there are three distinct forms of congenital hemophilia (hemophilia A, hemophilia B, and hemophilia C), the affected proteins (factor VIII, factor IX, and factor XI, respectively), are within the same pathway leading to the formation of a clot. In condensed terms, each of these factors play a role in the ultimate activation of thrombin, which activates fibrinogen to form a fibrin clot and solidify …

Clinical Pharmacology Of Tisagenlecleucel In B-Cell Acute Lymphoblastic Leukemia., Karen Thudium Mueller, Edward Waldron, Stephan A. Grupp, John E. Levine, Theodore W. Laetsch, Michael A. Pulsipher, Michael W. Boyer, Keith August, Jason Hamilton, Rakesh Awasthi, Andrew M. Stein, Denise Sickert, Abhijit Chakraborty, Bruce L. Levine, Carl H. June, Lori Tomassian, Sweta S. Shah, Mimi Leung, Tetiana Taran, Patricia A. Wood, Shannon L. Maude

Manuscripts, Articles, Book Chapters and Other Papers

PURPOSE: Tisagenlecleucel is an anti-CD19 chimeric antigen receptor (CAR19) T-cell therapy approved for the treatment of children and young adults with relapsed/refractory (r/r) B-cell acute lymphoblastic leukemia (B-ALL).

PATIENTS AND METHODS: We evaluated the cellular kinetics of tisagenlecleucel, the effect of patient factors, humoral immunogenicity, and manufacturing attributes on its kinetics, and exposure-response analysis for efficacy, safety and pharmacodynamic endpoints in 79 patients across two studies in pediatric B-ALL (ELIANA and ENSIGN).

RESULTS: Using quantitative polymerase chain reaction to quantify levels of tisagenlecleucel transgene, responders (N = 62) had ≈2-fold higher tisagenlecleucel expansion in peripheral blood than nonresponders ( …

Retrospective Review Of Patients Treated With Argatroban For Heparin Induced Thrombocytopenia, Jessica Justiz, Jessica Greenwood, Heidi Clarke, Radhan Gopalani

All Publications

No abstract provided.

Hyperhomocysteinemia As A Risk Factor For Vascular Contributions To Cognitive Impairment And Dementia, Brittani R. Price, Donna M. Wilcock, Erica M. Weekman

Physiology Faculty Publications

Behind only Alzheimer’s disease, vascular contributions to cognitive impairment and dementia (VCID) is the second most common cause of dementia, affecting roughly 10–40% of dementia patients. While there is no cure for VCID, several risk factors for VCID, such as diabetes, hypertension, and stroke, have been identified. Elevated plasma levels of homocysteine, termed hyperhomocysteinemia (HHcy), are a major, yet underrecognized, risk factor for VCID. B vitamin deficiency, which is the most common cause of HHcy, is common in the elderly. With B vitamin supplementation being a relatively safe and inexpensive therapeutic, the treatment of HHcy-induced VCID would seem straightforward; however, …

Correcting Glucose-6-Phosphate Dehydrogenase Deficiency With A Small-Molecule Activator, Sunhee Hwang, Karen Mruk, Simin Rahighi, Andrew G. Raub, Che-Hong Chen, Lisa E. Dorn, Naoki Horikoshi, Soichi Wakatsuki, James K. Chen, Daria Mochly-Rosen

Pharmacy Faculty Articles and Research

Glucose-6-phosphate dehydrogenase (G6PD) deficiency, one of the most common human genetic enzymopathies, is caused by over 160 different point mutations and contributes to the severity of many acute and chronic diseases associated with oxidative stress, including hemolytic anemia and bilirubin-induced neurological damage particularly in newborns. As no medications are available to treat G6PD deficiency, here we seek to identify a small molecule that corrects it. Crystallographic study and mutagenesis analysis identify the structural and functional defect of one common mutant (Canton, R459L). Using high-throughput screening, we subsequently identify AG1, a small molecule that increases the activity of the wild-type, the …

Multiple Myeloma, Anne Doup

Nursing Student Class Projects (Formerly MSN)

No abstract provided.

Fatal Case Of Ttp In Patient With Underlying Pulmonary Aspergillosis, Shimool A. Rabbani, Ankit Shah, Joan Wiley, Jay Kirkham

Rowan-Virtua Research Day

A 70-year- old Caucasian male with history of renal transplant on tacrolimus presented with 5-days of fevers, productive cough, and confusion. Patient was initially diagnosed with pneumonia, presumed bacterial, but soon noted to have worsening neurologic status, renal failure, and respiratory failure requiring mechanical ventilation. He further developed thrombotic microangiopathy (TMA); TMA along with the other clinical findings led to diagnosis of Thrombotic Thrombocytopenic Purpura (TTP). Despite aggressive treatment of TTP with plasmapheresis, patient expired on day five of his hospitalization. Fungal cultures from a bronchoscope performed on day three of hospitalization that resulted postmortem grew many aspergillus flavus and …

Within Season Hematological Changes In College Athletes With Sickle Cell Trait, Michael E. Owens

LSU Master's Theses

ABSTRACT

PURPOSE: To explore the hematological differences in African-American athletes with sickle cell trait (SCT) and healthy controls (CON) before preseason camp and the changes that occur after a full season. METHODS: Sixteen (n=8 SCT; n=8 position matched, CON) NCAA Division 1 athletes (12 football, 2 each women’s soccer and volleyball) had blood drawn before preseason camp, after and at the end of the season, and analyzed for Hb electrophoresis (Hb-A, Hb-A2, Hb-S, and Hb-F), complete blood count with differential, chemistry panel 26, and prothrombin time, activity and international normalized ratio (INR). RESULTS: Baseline total Hb was …

Designing A Social Norms-Based Intervention To Reduce Anemia In India: A Formative Research Protocol, Aika Aluc, Erica Sedlander, Rajiv N. Rimal, Sameera A. Talegawkar, Hagere Yilma, Wolfgang Munar

GW Research Days 2016 - 2020

Background: Economic and gender inequalities are important determinants of anemia in low and middle income countries. Gender dimensions of food security contribute to the undernutrition among women. More than half of women of reproductive age in India are anemic. Anemia causes increased risk of preterm delivery, higher maternal mortality and contributes to fatigue, which influences women’s work productivity. The World Health Organization (WHO) recommends daily oral iron and folic acid (IFA) supplements during pregnancy and weekly supplements for women of reproductive age. Despite the efforts of government programs and global donors to reduce anemia in India, both initial uptake and …

Evaluating The Impact Of A Standardized Education Class On A Person Diagnosed With Chronic Kidney Disease, Stage Iv, Nancy K. Uhland, Dnp, Msn, Rn, Fnp-C

Doctor of Nursing Practice Projects

Background: Chronic kidney disease (CKD) is a complex, progressive, and costly disease impacting more than 26 million Americans. Providing effective education is necessary so the patient may actively participate in managing the disease process, but the effectiveness of the delivery of education to the patient with CKD is not well-known.

Objective: To evaluate the effectiveness of a standardized education class on the basic kidney knowledge of persons diagnosed with CKD, stage IV.

Method: This pilot study, using a one-group pre and post-test design, was conducted in an outpatient nephrology clinic located in Washington, D.C. The study participants, recruited using census …

Designing A Socio-Normative Intervention To Reduce Anemia In Odisha India: A Formative Research Protocol [Version 1; Referees: 2 Approved], Erica Sedlander, Rajiv N Rimal, Sameera A Talegawkar, Hagere Yilma, Wolfgang Munar

Prevention and Community Health Faculty Publications

Background: More than half of women of reproductive age in India are anemic. Anemia is associated with increased risk of preterm delivery, higher maternal mortality and contributes to fatigue, which affects women’s work productivity. The World Health Organization (WHO) recommends daily oral iron and folic acid (IFA) supplements during pregnancy and weekly supplements for women of reproductive age. Government programs and global donors have distributed and promoted IFA supplements in India for over four decades. However, initial intake and compliance remain inadequate.
Objectives: This protocol describes the formative research phase of a larger study, which will test, through a randomized …

A Healthcare Improvement Initiative To Increase Multidisciplinary Pain Management Referrals Of Youth With Sickle Cell Disease, Rae Ann Kingsley, Gail Robertson, Lynne Covitz, Areli Ramphal

Posters

No abstract provided.

Understanding Ttp, Alexis L. Koester

Natural Sciences Student Research Presentations

This poster for the Natural Sciences Poster Session summarizes Thrombotic thrombocytopenic purpura (TTP), a rare autoimmune disorder, either inherited or acquired, that produces antibodies affecting the gene ADAMTS13, which causes bleeding and inhibits blood clotting. Symptoms include purple bruising (purpura) and small red dots on the skin, called petechiae. Untreated TTP can lead to damage in the brain, heart and kidneys.

Medication Timeliness In Emergency Department In Pediatric Sickle Cell Disease Population Presenting With Vaso-Occlusive Episode, Derrick Goubeaux, Kaitlyn Hoch, Gerald Woods, Julie Routhieaux, Maureen Guignon, Valerie Mcdougall Kestner

Posters

No abstract provided.

The Evaluation Of Mefloquine Drug Repurposing On Acute Myeloid Leukemia, Jessica L. Phan, Bhavuk Garg, Hrishikesh Mehta, Seth Corey

Undergraduate Research Posters

The aim of this study is to observe cell proliferation, cell viability, apoptosis, and autophagy on acute myeloid leukemia (AML) cell lines, NB4 and U937, with the drug repurposing of mefloquine (MQ). Methods such as the 3-(4,5-Dimethylthiazol-2-Yl)-2,5-Diphenyltetrazolium Bromide (MTT) assay and trypan blue staining have shown a decrease in live cells with high concentrations of mefloquine. Using their average perspective IC50 values of MQ concentration, Western blotting was applied by means of apoptosis and autophagy markers to determine if the induction of apoptosis and inhibition of autophagy was present in MQ-treated AML cells. The experiment will be continued with more …

Robustness Of A Newly Proposed Risk Schema For Lymphatic Dissemination In Endometrioid Endometrial Cancer, Danielle M. Greer, Jessica J.F. Kram, Callie M. Cox Bauer, Scott A. Kamelle

Journal of Patient-Centered Research and Reviews

Background: Surgical management for endometrioid endometrial cancer (EEC) includes complete lymph node dissection for all patients at risk of lymphatic dissemination. The standard risk schema, defined by Mayo Clinic, identifies low-risk patients as those with grade 1/2 EEC, myometrial invasion (MI) ≤ 50%, and tumor diameter (TD) ≤ 2 cm. We recently proposed (and published) a risk schema containing modified forms of grade, MI and TD that suggests a significant decrease in false-negative rate and need for lymphadenectomy in low-risk women.

Purpose: Evaluate robustness of our proposed schema for lymphatic dissemination risk stratification in a subsequent EEC patient cohort.

Methods: …