Pathological Conditions, Signs and Symptoms Commons^™

A Modern Multimodal Pain Protocol Eliminates The Need For Opioids For Most Patients Following Total Knee Arthroplasty: Results From A Retrospective Comparative Cohort Study, Leland Van Deventer, Amy Bronstone, Claudia Leonardi, Matthew Bennett, Peter Yager, Vinod Dasa

School of Medicine Faculty Publications

Purpose: Modern multimodal analgesia has been shown to significantly reduce opioid use following total knee arthroplasty (TKA). This study was conducted to determine if changing TKA discharge opioid prescriptions from automatic to upon request resulted in more opioid free recoveries without compromising pain control. Methods: Between December 2019 and August 2021, an orthopedic surgeon performed 144 primary unilateral TKAs; patients received the same multimodal analgesia protocol except for postoperative opioid prescribing. The first consecutively-treated cohort automatically received an opioid prescription following discharge (automatic group) and the second cohort received opioid prescriptions only upon request (upon request group). Opioid prescription data …

Chimeric Antigen Receptor T-Cell Therapy And Hematopoiesis, Bryanna Reinhardt, Patrick Lee, Joshua P. Sasine

School of Medicine Faculty Publications

Chimeric Antigen Receptor (CAR) T-cell therapy is a promising treatment option for patients suffering from B-cell- and plasma cell-derived hematologic malignancies and is being adapted for the treatment of solid cancers. However, CAR T is associated with frequently severe toxicities such as cytokine release syndrome (CRS), immune effector cell-associated neurotoxicity syndrome (ICANS), macrophage activation syndrome (MAS), and prolonged cytopenias—a reduction in the number of mature blood cells of one or more lineage. Although we understand some drivers of these toxicities, their mechanisms remain under investigation. Since the CAR T regimen is a complex, multi-step process with frequent adverse events, ways …

Supporting Cardiac Perfusion By Preboa With Reduced Visceral Ischemia Despite Extended Occlusion, Paige Deville, John Hunt, Alan B. Marr, Lance Stuke, Patrick Greiffenstein, Jonathan Schoen, Alison Smith

School of Medicine Faculty Publications

No abstract provided.

Dissociating Statistically Determined Normal Cognitive Abilities And Mild Cognitive Impairment Subtypes With Dctclock., Emily F. Matusz, Catherine C. Price, Melissa Lamar, Rod Swenson, Rhoda Au, Sheina Emrani, Victor Wasserman, David J Libon, Louisa I. Thompson

Rowan-Virtua School of Osteopathic Medicine Departmental Research

OBJECTIVE: To determine whether the DCTclock can detect differences across groups of patients seen in the memory clinic for suspected dementia.

METHOD: Patients (n = 123) were classified into the following groups: cognitively normal (CN), subtle cognitive impairment (SbCI), amnestic cognitive impairment (aMCI), and mixed/dysexecutive cognitive impairment (mx/dysMCI). Nine outcome variables included a combined command/copy total score and four command and four copy indices measuring drawing efficiency, simple/complex motor operations, information processing speed, and spatial reasoning.

RESULTS: Total combined command/copy score distinguished between groups in all comparisons with medium to large effects. The mx/dysMCI group had the lowest total …

Eosinophils Protect Against Acetaminophen-Induced Liver Injury Through Cyclooxygenase-Mediated Il-4/Il-13 Production, Long Xu, Yang Yang, Jiali Jiang, Yankai Wen, Jong-Min Jeong, Christoph Emontzpohl, Constance L Atkins, Kangho Kim, Elizabeth A Jacobsen, Hua Wang, Cynthia Ju

Faculty, Staff and Student Publications

BACKGROUND AND AIMS: A better understanding of the underlying mechanism of acetaminophen (APAP)-induced liver injury (AILI) remains an important endeavor to develop therapeutic approaches. Eosinophils have been detected in liver biopsies of patients with APAP overdose. We recently demonstrated a profound protective role of eosinophils against AILI; however, the molecular mechanism had not been elucidated.

APPROACH AND RESULTS: In agreement with our previous data from experiments using genetic deletion of eosinophils, we found that depletion of eosinophils in wild-type (WT) mice by an anti-IL-15 antibody resulted in exacerbated AILI. Moreover, adoptive transfer of eosinophils significantly reduced liver injury and mortality …

Recent Advances In Understanding Of Pathogenesis Of Alcohol-Associated Liver Disease, Xiaoqin Wu, Xiude Fan, Tatsunori Miyata, Adam Kim, Christina K Cajigas-Du Ross, Semanti Ray, Emily Huang, Moyinoluwa Taiwo, Rakesh Arya, Jianguo Wu, Laura E Nagy

Faculty, Staff and Student Publications

Alcohol-associated liver disease (ALD) is one of the major diseases arising from chronic alcohol consumption and is one of the most common causes of liver-related morbidity and mortality. ALD includes asymptomatic liver steatosis, fibrosis, cirrhosis, and alcohol-associated hepatitis and its complications. The progression of ALD involves complex cell-cell and organ-organ interactions. We focus on the impact of alcohol on dysregulation of homeostatic mechanisms and regulation of injury and repair in the liver. In particular, we discuss recent advances in understanding the disruption of balance between programmed cell death and prosurvival pathways, such as autophagy and membrane trafficking, in the pathogenesis …

Magnetic Resonance Imaging-Derived Microvascular Perfusion Modeling To Assess Peripheral Artery Disease, Olga A. Gimnich, Tatiana Belousova, Christina M. Short, Addison A. Taylor, Vijay Nambi, Joel D. Morrisett, Christie M. Ballantyne, Jean Bismuth, Dipan J. Shah, Gerd Brunner

School of Medicine Faculty Publications

BACKGROUND: Computational fluid dynamics has shown good agreement with contrast-enhanced magnetic resonance imaging measurements in cardiovascular disease applications. We have developed a biomechanical model of microvascular perfusion using contrast-enhanced magnetic resonance imaging signal intensities derived from skeletal calf muscles to study peripheral artery disease (PAD). METHODS AND RESULTS: The computational microvascular model was used to study skeletal calf muscle perfusion in 56 in-dividuals (36 patients with PAD, 20 matched controls). The recruited participants underwent contrast-enhanced magnetic resonance imaging and ankle-brachial index testing at rest and after 6-minute treadmill walking. We have determined associations of microvascular model parameters including the transfer …

African American And Caucasian Perceptions And Attitudes Toward Colorectal Cancer Screening: A Qualitative Study, Peter Warren, Stacie Pankow, Yvette Rother, Peggy Wagner

The Qualitative Report

This study examined the attitudes held by both African Americans and Caucasians regarding colorectal cancer screening and the reasons why they avoid screenings even when clinically indicated by their physicians. Colorectal cancer (CRC) is one of the most common and easily preventable types of cancer in the United States. If diagnosed and treated early prior to metastasis, the five-year colorectal cancer survival rate is approximately 90%. However, many patients avoid screening procedures for colorectal cancer due to a number of reasons. Qualitative data was gathered from focus groups and found four major themes that emerged in both groups: (1) reported …

Estimating Dementia Risk In An African American Population Using The Dctclock, Marissa Ciesla, Jeff Pobst, Joyce Gomes-Osman, Melissa Lamar, Lisa L Barnes, Russell Banks, Ali Jannati, David Libon, Rodney Swenson, Sean Tobyne, David Bates, John Showalter, Alvaro Pascual-Leone

Rowan-Virtua School of Osteopathic Medicine Departmental Research

The prevalence of Alzheimer's disease (AD) and related dementias (ADRD) is increasing. African Americans are twice as likely to develop dementia than other ethnic populations. Traditional cognitive screening solutions lack the sensitivity to independently identify individuals at risk for cognitive decline. The DCTclock is a 3-min AI-enabled adaptation of the well-established clock drawing test. The DCTclock can estimate dementia risk for both general cognitive impairment and the presence of AD pathology. Here we performed a retrospective analysis to assess the performance of the DCTclock to estimate future conversion to ADRD in African American participants from the Rush Alzheimer's Disease Research …

Therapeutic Approaches For Chronic Hepatitis C: A Concise Review, Allah Nawaz, Azhar Manzoor, Saeed Ahmed, Naveed Ahmed, Waseem Abbas, Mushtaq Ahmad Mir, Muhammad Bilal, Alisha Sheikh, Saleem Ahmad, Ishtiaq Jeelani, Takashi Nakagawa

School of Medicine Faculty Publications

Hepatitis C virus (HCV) infection is a significant global health concern, prompting the need for effective treatment strategies. This in-depth review critically assesses the landscape of HCV treatment, drawing parallels between traditional interferon/ribavirin therapy historically pivotal in HCV management and herbal approaches rooted in traditional and complementary medicine. Advancements in therapeutic development and enhanced clinical outcomes axis on a comprehensive understanding of the diverse HCV genome, its natural variations, pathogenesis, and the impact of dietary, social, environmental, and economic factors. A thorough analysis was conducted through reputable sources such as Science Direct, PubMed, Scopus, Web of Science, books, and dissertations. …

Excretory/Secretory Proteome Of Females And Males Of The Hookworm Ancylostoma Ceylanicum, Samuel C Uzoechi, Bruce A Rosa, Kumar Sachin Singh, Young-Jun Choi, Bethany K Bracken, Paul J Brindley, R Reid Townsend, Robert Sprung, Bin Zhan, Maria-Elena Bottazzi, John M Hawdon, Yide Wong, Alex Loukas, Sergej Djuranovic, Makedonka Mitreva

Faculty, Staff and Students Publications

The dynamic host-parasite mechanisms underlying hookworm infection establishment and maintenance in mammalian hosts remain poorly understood but are primarily mediated by hookworm’s excretory/secretory products (ESPs), which have a wide spectrum of biological functions. We used ultra-high performance mass spectrometry to comprehensively profile and compare female and male ESPs from the zoonotic human hookworm Ancylostoma ceylanicum, which is a natural parasite of dogs, cats, and humans. We improved the genome annotation, decreasing the number of protein-coding genes by 49% while improving completeness from 92 to 96%. Compared to the previous genome annotation, we detected 11% and 10% more spectra in …

Community Risks For Sars-Cov-2 Infection Among Fully Vaccinated Us Adults By Rurality: A Retrospective Cohort Study From The National Covid Cohort Collaborative, Alfred Jerrod Anzalone, Jing Sun, Amanda J. Vinson, William H. Beasley, William B. Hillegass, Kimberly Murray, Brian M. Hendricks, Melissa Haendel, Carol Reynolds Geary, Kristina L. Bailey, Corrine K. Hanson, Lucio Miele, Ronald Horswell, Julie A. Mcmurry, J. Zachary Porterfield, Michael T. Vest, H. Timothy Bunnell, Jeremy R. Harper, Bradley S. Price

School of Medicine Faculty Publications

Background While COVID-19 vaccines reduce adverse outcomes, post-vaccination SARS-CoV-2 infection remains problematic. We sought to identify community factors impacting risk for breakthrough infections (BTI) among fully vaccinated persons by rurality. Methods We conducted a retrospective cohort study of US adults sampled between January 1 and December 20, 2021, from the National COVID Cohort Collaborative (N3C). Using Kaplan-Meier and Cox-Proportional Hazards models adjusted for demographic differences and comorbid conditions, we assessed impact of rurality, county vaccine hesitancy, and county vaccination rates on risk of BTI over 180 days following two mRNA COVID-19 vaccinations between January 1 and September 21, 2021. Additionally, …

Perforated Sigmoid Diverticulitis Within A Strangulated Inguinal Hernia, Christen E. Chaconas, Patrick D. Melmer, Aaron D. Pinnola, Isabella C. Moncada

South Atlantic Division GME Research Day 2023

No abstract provided.

Case Report Of Hemarthrosis In Patient With Alcohol Related Cirrhotic Liver Disease, Benjamin Haight

Far West Division GME Research Day 2023

No abstract provided.

Urinary Ascites In A Newborn Male, Amanda Stragnell, Querube Santana-Holcombe, Annette Santiago

East Florida Division GME Research Day 2023

Please see supplemental content for full abstract with references.

Neonatal ascites is a condition characterized by abdominal distention resulting from the accumulation of fluid within the peritoneal cavity and is life-threatening if not treated appropriately. Genitourinary abnormalities and urinary ascites are important to consider as part of the differential for newborns presenting with abdominal distention and ascites. In male infants with urinary ascites, presence of a posterior ureteral valve is a common etiology, accounting for up to 70% of cases. In this setting, early identification and management of urinary outlet obstruction is essential to prevent progression to autodialysis and uremia. …

Spontaneous Intercostal Artery Bleeding With Hemothorax, Raafia Sajjad, Legesse Tebeje

Central & West Texas GME Research Day 2023

No abstract provided.

Novel Esophageal Perforation, Alexandra Moran, Bhavesh Shukla, Jeffrey Ramsey, Gregory Hicks

Continental, MidAmerica, & Mountain Divisions GME Research Day 2023

No abstract provided.

Examining Nationwide Disparities In Managing Critical Limb Threatening Ischemia Among Individuals With Diabetes Mellitus Or End-Stage Kidney Disease By Race And Ethnicity, Daniel Dominguez, Waseem Wahood

East Florida Division GME Research Day 2023

Please see supplemental content for full abstract with tables.

Introduction: Critical Limb Threatening Ischemia (CLTI) presents a significant challenge, particularly for individuals with diabetes mellitus (DM) or End-Stage Kidney Disease (ESKD). Healthcare disparities related to race and ethnicity are a pressing concern. This study aims to examine a 16-year trend to assess whether the disparities in managing critical limb-threatening ischemia (CLTI) are diminishing among individuals with diabetes mellitus (DM) or End-Stage Kidney Disease (ESKD).

Methods: The analysis involved an examination of the National Inpatient Sample data from 2005 to 2020, with a focus on hospitalizations related to CLI. Identification of …

An Intersting Presentation Of Angina Due To Left Posterolateral To Right Posterolateral Coronary Artery Fistula, Vivek Nadipalli, Ahmed Mahmood, Muhammad Uzair Lodhi, Bilal Hussain, Sohail Khan, Christel Cuevas, Thomas Alexander

Gulf Coast Division GME Research Day 2023

No abstract provided.

An Incisional Hernia Containing A Gangrenous Gallbladder: A Case Report, Timbre Backen, William Tyler Crawley, Travis Bouchard, Glenda Quan

Continental, MidAmerica, & Mountain Divisions GME Research Day 2023

No abstract provided.

Rare Case Of Obturator Hernia: Surgical Anatomy, Planning And Considerations, Adam Delgado, Sidra Bhuller, Peter Phan, John Weaver

Continental, MidAmerica, & Mountain Divisions GME Research Day 2023

No abstract provided.

Acute Colonic Perforation With Septic Shock Secondary To Disseminated Histoplasmosis In A Autologous Bone Marrow Transplant Recipient, Harsimrandeep Bhatti, Srijisnu De, Enkhbileg Batbileg, Glen Friedman

Central & West Texas GME Research Day 2023

No abstract provided.

Hyperbilirubinemia Due To Klatskin Tumor, Srijisnu De, Ammar Mahmood, Akash Hazari, Blane Alost, Aasia Khan

Central & West Texas GME Research Day 2023

No abstract provided.

Empyema Necessitans Due To Actinomycetes Odontolyticus, Alexandra E. Thomson, Jean Toffrey, Jessica Thomas, Jana Byrd, Chad Martins

South Atlantic Division GME Research Day 2023

No abstract provided.

Congenital Mesenteric Defect Results In Internal Hernia In An Adult With Obstructed Small Bowel, Tameem Jamal, Adina Mcnair, Saptarshi Biswas

South Atlantic Division GME Research Day 2023

No abstract provided.

Opioid-Induced Intrathecal Catheter Tip Granuloma Via Pain Pump In A Patient With Chronic Pain Syndrome: A Case Report, Katherine David, R Blake Kline, Jon Halling

South Atlantic Division GME Research Day 2023

No abstract provided.

The Utility Of Using Ivig In Setting Of Septic Shock, Nikhilesh Srinivasan, Amanda Brodeur, Deren Goker, Sarah Fraser, Noah Risner, Gregory Hicks

Continental, MidAmerica, & Mountain Divisions GME Research Day 2023

No abstract provided.

A Case Of A Rare Posterior Rectus Sheath Hernia, Emily Sherwood, Jacquelyn Glenn, Ryan Spilman, Natasha Fazel

Continental, MidAmerica, & Mountain Divisions GME Research Day 2023

No abstract provided.

Evaluating The Effectiveness Of A Delirium Protocol Order Set At Hca Florida Osceola Hospital, Sarah Alam, Derek Lanuto, Mabit Gonzalez, Manojna Kintada, Harsh Patel, Michael Hale

North Florida Division GME Research Day 2023

No abstract provided.

Community Socioeconomic And Urban-Rural Differences In Emergency Medical Services Times For Suspected Stroke In North Carolina, Srihari V Chari, Eric R Cui, Haylie E Fehl, Antonio R Fernandez, Jane H Brice, Mehul D Patel

Faculty, Staff and Student Publications

OBJECTIVE: Our objectives were to describe time intervals of EMS encounters for suspected stroke patients in North Carolina (NC) and evaluate differences in EMS time intervals by community socioeconomic status (SES) and rurality.

METHODS: This cross-sectional study used statewide data on EMS encounters of suspected stroke in NC in 2019. Eligible patients were adults requiring EMS transport to a hospital following a 9-1-1 call for stroke-like symptoms. Incident street addresses were geocoded to census tracts and linked to American Community Survey SES data and to rural-urban commuting area (RUCA) codes. Community SES was defined as high, medium, or low based …