Medical Specialties Commons^™

Lisinopril-Induced Angioedema In A Patient With Plasma Prekallikrein Deficiency, Swapan K Dasgupta, Stefanie Rivera, Perumal Thiagarajan

Faculty, Staff and Students Publications

Angiotensin-converting enzyme (ACE) inhibitors are extensively prescribed to treat patients with hypertension, congestive heart failure, and diabetic nephropathy. A small fraction of these patients (approximately 0.7%) develop angioedema, manifested by swelling of the lips and oropharynx. Angioedema of oropharynx is a medical emergency that can lead to asphyxiation and death. The angioedema is due to bradykinin generated from high molecular weight kininogen by kallikrein, which is derived from plasma prekallikrein by action of the factor XIIa, factor Xia, or prolylcarboxypeptidase. Bradykinin induces vasodilation and increased vascular permeability. ACE is the major degrading enzyme of bradykinin in the intravascular department. ACE …

Hypogonadism, Type-2 Diabetes Mellitus, And Bone Health: A Narrative Review, Vittoria Russo, Rui Chen, Reina Armamento-Villareal

Faculty, Staff and Students Publications

One of the complications from chronic hyperglycemia and insulin resistance due to type 2 diabetes mellitus (T2DM) on the hypothalamic-pituitary-gonadal axis in men is the high prevalence of hypogonadotropic hypogonadism (HH). Both T2DM and hypogonadism are associated with impaired bone health and increased fracture risk but whether the combination results in even worse bone disease than either one alone is not well-studied. It is possible that having both conditions predisposes men to an even greater risk for fracture than either one alone. Given the common occurrence of HH or hypogonadism in general in T2DM, a significant number of men could …

A Remarkable Response Of Granulomatous Hypophysitis To Infliximab In A Patient With A Background Of Crohn's Disease-A Case Report, Bahar K Force, Tiphanie P Vogel, Dang M Nguyen, Kent A Heck, Sherly Sebastian, Mas Takashima, Daniel Yoshor, Susan L Samson

Faculty, Staff and Students Publications

Associated Data

Chloroviruses, James L. Van Etten, Irina V. Agarkova, David D. Dunigan

Nebraska Center for Virology: Faculty Publications

Chloroviruses are large dsDNA, plaque-forming viruses that infect certain chlorella-like green algae; the algae are normally mutualistic endosymbionts of protists and metazoans and are often referred to as zoochlorellae. The viruses are ubiquitous in inland aqueous environments throughout the world and occasionally single types reach titers of thousands of plaque-forming units per ml of native water. The viruses are icosahedral in shape with a spike structure located at one of the vertices. They contain an internal membrane that is required for infectivity. The viral genomes are 290 to 370 kb in size, which encode up to 16 tRNAs and 330 …

Single-Nuclei Rna-Seq On Human Retinal Tissue Provides Improved Transcriptome Profiling, Qingnan Liang, Rachayata Dharmat, Leah Owen, Akbar Shakoor, Yumei Li, Sangbae Kim, Albert Vitale, Ivana Kim, Denise Morgan, Shaoheng Liang, Nathaniel Wu, Ken Chen, Margaret M Deangelis, Rui Chen

Faculty, Staff and Students Publications

Single-cell RNA-seq is a powerful tool in decoding the heterogeneity in complex tissues by generating transcriptomic profiles of the individual cell. Here, we report a single-nuclei RNA-seq (snRNA-seq) transcriptomic study on human retinal tissue, which is composed of multiple cell types with distinct functions. Six samples from three healthy donors are profiled and high-quality RNA-seq data is obtained for 5873 single nuclei. All major retinal cell types are observed and marker genes for each cell type are identified. The gene expression of the macular and peripheral retina is compared to each other at cell-type level. Furthermore, our dataset shows an …

Electrochemical Hydrogen Evolution Over Hydrothermally Synthesized Re-Doped Mos2 Flower-Like Microspheres, Juan Aliaga, Pablo Vera, Juan Araya, Luis Ballesteros, Julio Urzúa, Mario Farías, Francisco Paraguay-Delgado, Gabriel Alonso-Núñez, Guillermo González, Eglantina Benavente

Faculty, Staff and Students Publications

In this research, we report a simple hydrothermal synthesis to prepare rhenium (Re)- doped MoS2 flower-like microspheres and the tuning of their structural, electronic, and electrocatalytic properties by modulating the insertion of Re. The obtained compounds were characterized by X-ray diffraction (XRD), scanning electron microscopy (SEM), high-resolution transmission electron microscopy (HRTEM), Raman spectroscopy, and X-ray photoelectron spectroscopy (XPS). Structural, morphological, and chemical analyses confirmed the synthesis of poorly crystalline Re-doped MoS2 flower-like microspheres composed of few stacked layers. They exhibit enhanced hydrogen evolution reaction (HER) performance with low overpotential of 210 mV at current density of 10 mA/cm2, with a …

Subanesthetic Iv Ketamine Reduces Acute Suicidal Ideation In Patients With Mood Disorders, Kimberly Jenko, Jack Anzilotti

Physician Assistant Capstones, 2016 to 2019

Background. Depression and suicide are common in the United States and present a significant problem in the healthcare landscape. Currently, there are few options that can rapidly reduce suicidal ideation in patients with depression. Ketamine, a glutamate N-methyl-D-aspartate (NMDA) receptor antagonist, has been shown to reduce acute suicidality in patients with depression. Previous studies have a reduction of suicidal ideation compared to saline placebo, but few studies have shown a significant effect compared to a similar psychoactive drug such as midazolam.

Method. A search of PubMed and PsychNET was performed in September 2018 using the terms “ketamine,” “suicide,” …

The Use Of Probiotics To Prevent Ventilator-Associated Pneumonia In Adults, Michael Roper, Paige Douthett

Physician Assistant Capstones, 2016 to 2019

Objective: To assess the efficacy and safety of preventing the acquisition of ventilator- associated pneumonia with the use of probiotic supplementation, as compared to a placebo, among hospitalized adult men and women receiving more than 24 hours of mechanical ventilation. Design: Systematic Literature Review. Methods: Systematic searches were conducted through PubMed and Scopus using the search terms “ventilator”, “probiotics”, and “prevention”. Records were excluded from the analysis if they were published before 2015, full text was not available, studies other than randomized control trial or cohort studies, and if the study population was less than 18 years old. Results: Of …

Multiple Mitochondrial Thioesterases Have Distinct Tissue And Substrate Specificity And Coa Regulation, Suggesting Unique Functional Roles., Carmen Bekeova, Lauren Anderson-Pullinger, Kevin Boye, Felix Boos, Yana Sharpadskaya, Johannes M Herrmann, Erin L. Seifert

Department of Pathology, Anatomy, and Cell Biology Faculty Papers

Acyl-CoA thioesterases (Acots) hydrolyze fatty acyl-CoA esters. Acots in the mitochondrial matrix are poised to mitigate β-oxidation overload and maintain CoA availability. Several Acots associate with mitochondria, but whether they all localize to the matrix, are redundant, or have different roles is unresolved. Here, we compared the suborganellar localization, activity, expression, and regulation among mitochondrial Acots (Acot2, -7, -9, and -13) in mitochondria from multiple mouse tissues and from a model of Acot2 depletion. Acot7, -9, and -13 localized to the matrix, joining Acot2 that was previously shown to localize there. Mitochondria from heart, skeletal muscle, brown adipose tissue, and …

Residues And Residue Pairs Of Evolutionary Importance Differentially Direct Signaling Bias Of D2 Dopamine Receptors, María E Terrón-Díaz, Sara J Wright, Melina A Agosto, Olivier Lichtarge, Theodore G Wensel

Faculty, Staff and Students Publications

The D2 dopamine receptor and the serotonin 5-hydroxytryptamine 2A receptor (5-HT2A) are closely-related G-protein–coupled receptors (GPCRs) from the class A bioamine subfamily. Despite structural similarity, they respond to distinct ligands through distinct downstream pathways, whose dysregulation is linked to depression, bipolar disorder, addiction, and psychosis. They are important drug targets, and it is important to understand how their bias toward G-protein versus β-arrestin signaling pathways is regulated. Previously, evolution-based computational approaches, difference Evolutionary Trace and Evolutionary Trace–Mutual information (ET-Mip), revealed residues and residue pairs that, when switched in the D2 receptor to the corresponding residues from 5-HT2A, altered ligand potency …

Examining Multiple Cellular Pathways At Once Using Multiplex Hextuple Luciferase Assaying, Alejandro Sarrion-Perdigones, Lyra Chang, Yezabel Gonzalez, Tatiana Gallego-Flores, Damian W Young, Koen J T Venken

Faculty, Staff and Students Publications

Sensitive simultaneous assessment of multiple signaling pathways within the same cells requires orthogonal reporters that can assay over large dynamic ranges. Luciferases are such genetically encoded candidates due to their sensitivity, versatility, and cost-effectiveness. We expand luciferase multiplexing in post-lysis endpoint luciferase assays from two to six. Light emissions are distinguished by a combination of distinct substrates and emission spectra deconvolution. All six luciferase reporter units are stitched together into one plasmid facilitating delivery of all reporter units through a process we termed solotransfection, minimizing experimental errors. We engineer a multiplex hextuple luciferase assay to probe pathway fluxes through five …

Reattachment Of The Multifidus Tendon In Lumbar Surgery To Decrease Postoperative Back Pain: A Technical Note., Neil Klinger, Emre Yilmaz, Dia R Halalmeh, R Shane Tubbs, Marc D Moisi

Articles, Abstracts, and Reports

The posterior midline approach to the lumbar spine requires significant manipulation of the paraspinal muscles. Muscle detachment and retraction results in iatrogenic damage such as crush injury, devascularization, and denervation, all of which have been associated with postoperative pain. The muscle most directly affected by the posterior approach is the lumbar multifidus (LM), the largest and most medial of the deep lumbar paraspinal muscles. The effects of the posterior approach on the integrity of the LM is concerning, as multiple studies have demonstrated that intraoperative injuries sustained by the LM lead to postoperative muscle atrophy and potentially worsening low back …

Ultrafast Two-Photon Imaging Of A High-Gain Voltage Indicator In Awake Behaving Mice, Vincent Villette, Mariya Chavarha, Ivan K Dimov, Jonathan Bradley, Lagnajeet Pradhan, Benjamin Mathieu, Stephen W Evans, Simon Chamberland, Dongqing Shi, Renzhi Yang, Benjamin B Kim, Annick Ayon, Abdelali Jalil, François St-Pierre, Mark J Schnitzer, Guoqiang Bi, Katalin Toth, Jun Ding, Stéphane Dieudonné, Michael Z Lin

Faculty, Staff and Students Publications

Optical interrogation of voltage in deep brain locations with cellular resolution would be immensely useful for understanding how neuronal circuits process information. Here, we report ASAP3, a genetically encoded voltage indicator with 51% fluorescence modulation by physiological voltages, submillisecond activation kinetics, and full responsivity under two-photon excitation. We also introduce an ultrafast local volume excitation (ULoVE) method for kilohertz-rate two-photon sampling in vivo with increased stability and sensitivity. Combining a soma-targeted ASAP3 variant and ULoVE, we show single-trial tracking of spikes and subthreshold events for minutes in deep locations, with subcellular resolution and with repeated sampling over days. In the …

Interaction Of The Oncoprotein Transcription Factor Myc With Its Chromatin Cofactor Wdr5 Is Essential For Tumor Maintenance., Lance R. Thomas, Clare M. Adams, Jing Wang, April M. Weissmiller, Joy Creighton, Shelly L. Lorey, Qi Liu, Stephen W. Fesik, Christine M. Eischen, William P. Tansey

Department of Cancer Biology Faculty Papers

The oncoprotein transcription factor MYC is overexpressed in the majority of cancers. Key to its oncogenic activity is the ability of MYC to regulate gene expression patterns that drive and maintain the malignant state. MYC is also considered a validated anticancer target, but efforts to pharmacologically inhibit MYC have failed. The dependence of MYC on cofactors creates opportunities for therapeutic intervention, but for any cofactor this requires structural understanding of how the cofactor interacts with MYC, knowledge of the role it plays in MYC function, and demonstration that disrupting the cofactor interaction will cause existing cancers to regress. One cofactor …

Memantine: Can It Be Used To Treat Children With Autism Spectrum Disorder?, Austin Brown, Katherine Liu, Pul Lee, Rachel Muhlenkamp, Manoranjan D'Souza

Pharmacy and Wellness Review

Autism spectrum disorder (ASD) is a neurodevelopmental disorder characterized by impairment in social, behavior and communicative skills. The current therapy for ASD only targets the associated symptoms such as aggression, self-harming acts or temper tantrums but not the core symptoms of social dysfunction. The pathology of ASD is not fully understood. Interestingly, imaging studies in ASD patients have reported abnormal high levels of glutamate in certain brain regions that play an important role in social interaction and communication. Thus, it has been hypothesized that medications attenuating glutamate transmission may be used as treatment for some of the core symptoms of …

Alzheimer's And Amyloid Beta: Amyloidogenicity And Tauopathy Via Dyshomeostatic Interactions Of Amyloid Beta, Jordan Tillinghast

Senior Honors Theses

This paper reviews functions of Amyloid-β (Aβ) in healthy individuals compared to the consequences of aberrant Aβ in Alzheimer’s disease (AD). As extraneuronal Aβ accumulation and plaque formation are characteristics of AD, it is reasonable to infer a pivotal role for Aβ in AD pathogenesis. Establishing progress of the disease as well as the mechanism of neurodegeneration from AD have proven difficult (Selkoe, 1994). This thesis provides evidence suggesting the pathogenesis of AD is due to dysfunctional neuronal processes involving Aβ’s synaptic malfunction, abnormal interaction with tau, and disruption of neuronal homeostasis. Significant evidence demonstrates that AD symptoms are partially …

Implementation Of Ventilator Bundle For Prevention Of Ventilator-Associated Pneumonia In Pediatric Intensive Care Unit, Abd-Elaleem Elgendy, Ahmed Y. Alsawah, Mahmoud M. Al-Shahat, Mohamed F. Alsoda, Mohammad A. M. Abboud, Sherif M. K. Reda

Journal of Medicine in Scientific Research

Background Ventilator-associated pneumonia (VAP) is associated with increased morbidity and mortality in pediatric intensive care unit (PICU) patients. Objective The aim was to examine the effect of adherence to VAP prevention bundle on the incidence of VAP in PICU. Patients and methods A prospective comparative study was conducted in Al-Hussein University Hospital on all patients admitted and ventilated in PICU in a year from September 2017 until September 2018. They were divided into two groups: the first group included patients admitted to PICU after implementation of the study, comprising 43 patients as cases, and the second group included patients admitted …

The Use Of Gonadotropin-Releasing Hormone Antagonist In Women Undergoing Intrauterine Insemination, Bassem Sobhy, M Yousef Elsemary

Journal of Medicine in Scientific Research

Background Intrauterine insemination (IUI) is considered to be a very popular treatment procedure that is used for many infertile women worldwide. Aim The aim was to evaluate whether the addition of gonadotropin-releasing hormone antagonist would improve the clinical pregnancy rate in women undergoing IUI. Materials and methods A prospective study was performed at El-Galaa Maternity Teaching Hospital where 124 women with primary or secondary infertility were subjected to controlled ovarian stimulation with human menopausal gonadotropin (74–150 IU/day) only (control group, n=62) or to human menopausal gonadotropin (75–150 IU/day) plus Cetrorelix (0.25 mg/day, starting when the leading follicle was ≥16 mm; …

Determinants Of Infarction Patterns In Posterior Cerebral Circulation, Ahmed H. T Badr Ahmed, Mohamed M. Fouad, Ramez R. Moustafa, Taha K. Alloush

Journal of Medicine in Scientific Research

Background Ischemic stroke is defined as focal or global neurological dysfunction lasting longer than 24 h or leading to death that is caused by vascular insult, either stricture or occlusion of a specific vascular territory. Aim of the study This study aimed to determine the relationship between different risk factors and different infarction patterns in posterior circulation such single small lacunar lesion, single large lesion, and multiple scattered lesions. Patients and methods This study included 60 patients recruited from the stroke unit of Ain Shams University and El Sahel Teaching Hospitals during the period from April to October 2018 with …

Omental Flap Harvested Through Transdiaphragmatic Approach At The Same Sternotomy Incision For Poststernotomy Mediastinitis: A New Approach, Waleed El-Awady

Journal of Medicine in Scientific Research

Background The surgical treatment of poststernotomy mediastinitis is still a challenge and associated with high mortality. Conservative treatment and various surgical procedures are sometimes inadequate and need more aggressive treatment. Omental flap improves control of infection and prognosis, but harvesting is an additional procedure with its associated morbidity and trauma. Patients and methods A total of 14 patients had omental flap, which was harvested through a diaphragmatic opening at the lower part of the same sternotomy incision, without additional laparotomy incision or extension of sternotomy incision into the upper abdomen or even laparoscopically. The mean age of the patients was …

Cardiovascular Risk In Patients With Rheumatoid Arthritis: The Role Of Cholesterylester Transfer Protein, Ali M. Mursi, Emad M. Elshebiny, Lobna Y. Ebrahim, Sahar H. Quashwa, Sherry K. Abdelrahman, Taghreed F. Mohammed Mostafa

Journal of Medicine in Scientific Research

Aim To detect serum level of cholesterylester transfer protein (CETP) (the enzyme involved in reverse cholesterol transport) in patients with rheumatoid arthritis (RA) and to evaluate its relation to various clinical parameters of the disease, lipid profile, and carotid intima-media thickness (CIMT) as a marker of atherosclerosis and cardiovascular disease risk. Patients and methods This study involved a total of 80 participants, comprising 50 patients with RA and 30 age-matched and sex-matched healthy controls. Detailed medical history and thorough clinical examination (general and musculoskeletal) as well as laboratory investigations including lipid profile were performed for all patients with RA. Serum …

Role Of Arginine And/Or Taurine In Protection Against Gentamicin-Induced Nephrotoxicity In Male And Female Rats, Amal H. Emara, Wafaa M. Ismaeil

Journal of Medicine in Scientific Research

Background As a highly effective antibiotic, gentamicin is used in the treatment of serious and life-threatening gram-negative infections. L-arginine (2-amino-5-guanidino-pentanoic acid) has a protective role on renal failure that induced by gentamicin administration and it may decrease the tubular reabsorption of another cationic substance, gentamicin due to its cationic structure. The aim of this study is to determine the influence of gender on nephroprotective effects of L-arginine (Arg) and/or taurine (Tau) on gentamicin (G) induced nephrotoxicity. Methods Adult Sprague-Dawley albino rats of both sexes (150-200 g, 48 male and 48 female), were bred from the animal unit of National Nutrition …

Glutamic Acid Decarboxylase Auto-Antibodies Prevalence Among Patients With Type 2 Diabetes Mellitus And Their Clinical Characteristics In A Sample Of The Egyptian Population, Atef A. Bassyounia, Ayat I. Ghanem, Ghada A. Omar

Journal of Medicine in Scientific Research

Background Patients with latent autoimmune diabetes in adults may develop early loss of β-cell mass. They are often misdiagnosed as having type 2 diabetes mellitus (T2DM). This is because latent autoimmune diabetes in adults condition does share characteristics of both type 1 and T2DM. Aim To estimate the prevalence of unrecognized cases with glutamic acid decarboxylase auto-antibodies (GADA) among patients with T2DM in a sample of the Egyptian population, describing their clinical and laboratory features, and investigating the relationship with chronic complications of diabetes. Settings and design A total of 1515 Egyptian patients previously diagnosed as having T2DM were divided …

Recent Conservative Management Trends In Dealing With Uterine Adnexal Torsion Will Preserve Fertility In Childbearing Women: A Review Of Literature And Case Series, Hossam H. Soliman

Journal of Medicine in Scientific Research

Introduction Uterine adnexal torsion is a rare gynecologic emergency, representing 2.5–7% of all the acute gynecologic surgical conditions. It could lead to adnexal ischemia and necrosis, putting a woman at the risk of a radical surgery, which leads her to lose a uterine adnexa, plummeting her future fertility, and possibility inducing a negative effect of her future marital and family life. Adnexal detorsion associated with cystectomy is a simple maneuver that could spare the woman of losing her ovary; this technique could successfully work even with an apparently necrosed ovary. Aim A review of literature, in addition to a retrospective …

Additive Value Of Intraoperative Hemodynamic Monitoring To Epicardial Echocardiography During Surgical Repair Of Children With Congenital Heart Disease, Ahmed A. Algebaly, Hanan Mohammed Hassan, Rania D. Eldin Abou Shokka

Journal of Medicine in Scientific Research

Aim The aim was to evaluate the additive value of intraoperative hemodynamic monitoring to epicardial echocardiography on the surgical outcome in children undergoing surgical correction of congenial heart disease. Patients and methods This study was conducted on 238 children with congenital heart disease who were enrolled for surgical correction. They were arranged in two groups: group A included 159 children in whom e-echo was used to detect intraoperative residual lesions while group B included 79 patients in whom e-echo and intraoperative hemodynamic monitoring using oxygen saturation step-up and intracardiac pressures after disconnection of cardiopulmonary bypass to detect residual shunt flow …

Surgical Outcomes Of Obstructive Mechanical Valve Thrombosis, Risk Factors, And Comorbidity Analysis, Ahmed Shafeek Ali

Journal of Medicine in Scientific Research

Background Obstructive mechanical valves thrombosis is a life-threatening complication associated with high morbidity and mortality. Although thrombolytic therapy has gained a lot of popularity in recent years, yet the treatment of choice is still controversial. Objective The aim of this study was to evaluate the outcomes of patients who underwent redo valve surgery for obstructive mechanical valve thrombosis. Patients and methods Outcomes of 380 patients who underwent emergency redo surgery for obstructive mechanical valve thrombosis at our institute during a 5-year period (January 2012 to December 2017) were reviewed retrospectively. Clinical symptoms and transthoracic echocardiography were the mainstay in diagnosis. …

A Comparison Between Monopolar Radiofrequency Ablation And Electrocautery (Diathermy) Ablations In Left Modified Maze (Short-Term Results), Waleed El-Awady

Journal of Medicine in Scientific Research

Introduction Atrial fibrillation is the most common cardiac arrhythmia and is associated with significant morbidity and mortality. The classic cut-and-sew maze procedure is successful in 85–95% of patients. However, it is technically challenging and requires prolonged cardiopulmonary bypass. The left modified maze procedure is successful in 65–85% of patients. The aim of this study was to compare the success of two different ablation sources in the left modified MAZE. Patients and methods Between June 2010 and December 2016, 40 patients underwent left modified MAZE (Cox III) procedure: 20 patients were done with monopolar radiofrequency ablation (group A) and the other …

Retrograde Transcatheter Closure Of Perimembranous Aneurysmal Ventricular Septal Defects Using Amplatzer Vascular Plug Ii, Ahmed A. Al Gebaly, Rania Diaa Abou Shokka, Wael M. Hossam

Journal of Medicine in Scientific Research

Introduction Retrograde transcatheter closure of perimembranous aneurysmal ventricular septal defects (pmVSD) can be a better option for transcatheter closure of ventricular septal defect with device placement into ventricular septal aneurysm with fewer complications. Also, a retrograde approach might decrease procedure time and radiation exposure time. Aim The purpose of this study was to report off-label experience using Amplatzer Vascular Plug II (AVPII) for the trans catheter closure of perimembranous aneurysmal VSD. Comparison of haemodynamic effects of ketamine and sevofluorane as in induction of anesthesia. Materials and methods Our series consists of a fifteen child with pmVSD. The mean age was …

One-Year Angiographic Results Of Left Anterior Descending Bypass Using Internal Mammary Artery: A Series Of 48 Consecutive Patients, Ahmed S. Mahlab

Journal of Medicine in Scientific Research

The left internal mammary artery (LIMA) has been used as a conduit for coronary artery revascularization since 1968. Here we are reporting A total of 48 consecutive patients were operated upon using double mammary arteries. All of them received a mammary graft to the left anterior descending artery (LAD). All 48 of them were controlled angiographically at 1 year postoperative to ensure satisfactory well-functioning grafts.

Ruptured Inferior Mesenteric Artery Aneurysm: A Case Report, Assem Mohamed Herzallah

Journal of Medicine in Scientific Research

Among visceral artery aneurysms, inferior mesenteric artery aneurysm is the rarest. Although most cases are of degenerative etiology, a small fraction of these cases are caused by autoimmune diseases. We report a case of spontaneous retroperitoneal hemorrhage from a ruptured inferior mesenteric artery aneurysm in a 30-year-old patient with systemic lupus erythematosus, treated by ligation.