Medical Specialties Commons^™

Pediatric Obesity: Influence On Drug Dosing And Therapeutics, Barbara Ameer Pharmd, Mba, Bcps, Fcp, Michael Weintraub Md

Department of Medicine Faculty Papers

Obesity is an ongoing global health concern and has only recently been recognized as a chronic disease of energy homeostasis and fuel partitioning. Obesity afflicts 17% of US children and adolescents. Severe obesity (³120% of the 95^th percentile of BMI-for-age, or a BMI of ³35 kg/m²) is the fastest growing subgroup and now approaches 6% of all US youth. Health consequences (e.g., type 2 diabetes, coronary heart disease) are related in a dose-dependent manner to severity of obesity. Since therapeutic interventions are less effective in severe obesity, prevention is a high priority.

Treatment plans involving combinations of …

Astrocyte Activation And The Calcineurin/Nfat Pathway In Cerebrovascular Disease, Susan D. Kraner, Christopher M. Norris

Sanders-Brown Center on Aging Faculty Publications

Calcineurin (CN) is a Ca²⁺/calmodulin-dependent protein phosphatase with high abundance in nervous tissue. Though enriched in neurons, CN can become strongly induced in subsets of activated astrocytes under different pathological conditions where it interacts extensively with the nuclear factor of activated T cells (NFATs). Recent work has shown that regions of small vessel damage are associated with the upregulation of a proteolized, highly active form of CN in nearby astrocytes, suggesting a link between the CN/NFAT pathway and chronic cerebrovascular disease. In this Mini Review article, we discuss CN/NFAT signaling properties in the context of vascular disease and …

Experimental Evaluation Of The Importance Of Colonization History In Early-Life Gut Microbiota Assembly, Inés Martínez, Maria X. Maldonado-Gomez, João Carlos Gomes-Neto, Hatem Kittana, Hua Ding, Robert J. Schmaltz, Payal Joglekar, Roberto Jiménez Cardona, Nathan L Marsteller, Steven W. Kembel, Andrew K. Benson, Daniel A. Peterson, Amanda Ramer-Tait, Jens C. Walter

Department of Food Science and Technology: Faculty Publications

The factors that govern assembly of the gut microbiota are insufficiently understood. Here, we test the hypothesis that inter-individual microbiota variation can arise solely from differences in the order and timing by which the gut is colonized early in life. Experiments in which mice were inoculated in sequence either with two complex seed communities or a cocktail of four bacterial strains and a seed community revealed that colonization order influenced both the outcome of community assembly and the ecological success of individual colonizers. Historical contingency and priority effects also occurred in Rag1^-/- mice, suggesting that the adaptive immune system …

Prothrombin Complex Concentrates Or Recombinant Factor Viia Are More Effective Than Fresh-Frozen Plasma At Lowering Inr In Patients With Liver Disease, Abel J. Ignatius

Clinical Research in Practice: The Journal of Team Hippocrates

A critical appraisal and clinical application of Kwon JO, MacLaren R. Comparison of fresh-frozen plasma, four-factor prothrombin complex concentrates, and recombinant factor VIIa to facilitate procedures in critically ill patients with coagulopathy from liver disease: a retrospective cohort study. Pharmacotherapy. 2016;36(10):1047-1054. doi: 10.1002/phar.1827

Myocyte [Na+]I Dysregulation In Heart Failure And Diabetic Cardiomyopathy, Sanda Despa

Pharmacology and Nutritional Sciences Faculty Publications

By controlling the function of various sarcolemmal and mitochondrial ion transporters, intracellular Na⁺ concentration ([Na⁺]_i) regulates Ca²⁺ cycling, electrical activity, the matching of energy supply and demand, and oxidative stress in cardiac myocytes. Thus, maintenance of myocyte Na⁺ homeostasis is vital for preserving the electrical and contractile activity of the heart. [Na⁺]_i is set by the balance between the passive Na⁺ entry through numerous pathways and the pumping of Na⁺ out of the cell by the Na⁺/K⁺-ATPase. This equilibrium is perturbed in heart failure, …

Isolation Of Cerebral Capillaries From Fresh Human Brain Tissue, Anika M. S. Hartz, Julia A. Schulz, Brent S. Sokola, Stephanie E. Edelmann, Andrew N. Shen, Ralf G. Rempe, Yu Zhong, Nader El Seblani, Bjoern Bauer

Sanders-Brown Center on Aging Faculty Publications

Understanding blood-brain barrier function under physiological and pathophysiological conditions is critical for the development of new therapeutic strategies that hold the promise to enhance brain drug delivery, improve brain protection, and treat brain disorders. However, studying the human blood-brain barrier function is challenging. Thus, there is a critical need for appropriate models. In this regard, brain capillaries isolated from human brain tissue represent a unique tool to study barrier function as close to the human in vivo situation as possible. Here, we describe an optimized protocol to isolate capillaries from human brain tissue at a high yield and with consistent …

In Vivo Brainstem Imaging In Alzheimer’S Disease: Potential For Biomarker Development, David J. Braun, Linda J. Van Eldik

Neuroscience Faculty Publications

The dearth of effective treatments for Alzheimer’s disease (AD) is one of the largest public health issues worldwide, costing hundreds of billions of dollars per year. From a therapeutic standpoint, research efforts to date have met with strikingly little clinical success. One major issue is that trials begin after substantial pathological change has occurred, and it is increasingly clear that the most effective treatment regimens will need to be administered earlier in the disease process. In order to identify individuals within the long preclinical phase of AD who are likely to progress to dementia, improvements are required in biomarker development. …

Susceptibility Genes To Plant Viruses, Hernan Garcia-Ruiz

Nebraska Center for Virology: Faculty Publications

Plant viruses use cellular factors and resources to replicate and move. Plants respond to viral infection by several mechanisms, including innate immunity, autophagy, and gene silencing, that viruses must evade or suppress. Thus, the establishment of infection is genetically determined by the availability of host factors necessary for virus replication and movement and by the balance between plant defense and viral suppression of defense responses. Host factors may have antiviral or proviral activities. Proviral factors condition susceptibility to viruses by participating in processes essential to the virus. Here, we review current advances in the identification and characterization of host factors …

Mir-196b Target Screen Reveals Mechanisms Maintaining Leukemia Stemness With Therapeutic Potential., Sara E. Meyer, David E. Muench, Andrew M. Rogers, Tess J. Newkold, Emily Orr, Eric O'Brien, John P. Perentesis, John G. Doench, Ashish Lal, Patrick J. Morris, Craig J. Thomas, Judy Lieberman, Edwina Mcglinn, Bruce J. Aronow, Nathan Salomonis, H. Leighton Grimes

Department of Cancer Biology Faculty Papers

We have shown that antagomiR inhibition of miRNA miR-21 and miR-196b activity is sufficient to ablate MLL-AF9 leukemia stem cells (LSC) in vivo. Here, we used an shRNA screening approach to mimic miRNA activity on experimentally verified miR-196b targets to identify functionally important and therapeutically relevant pathways downstream of oncogenic miRNA in MLL-r AML. We found Cdkn1b (p27^Kip1) is a direct miR-196b target whose repression enhanced an embryonic stem cell–like signature associated with decreased leukemia latency and increased numbers of leukemia stem cells in vivo. Conversely, elevation of p27^Kip1 significantly reduced MLL-r leukemia self-renewal, promoted monocytic differentiation …

Listeria Monocytogenes As A Vector For Cancer Immunotherapy: Current Understanding And Progress, John C. Flickinger, Ulrich Rodeck, Adam E. Snook

Department of Pharmacology and Experimental Therapeutics Faculty Papers

Listeria monocytogenes, a Gram-positive facultative anaerobic bacterium, is becoming a popular vector for cancer immunotherapy. Indeed, multiple vaccines have been developed utilizing modified Listeria as a tool for generating immune responses against a variety of cancers. Moreover, over a dozen clinical trials testing Listeria cancer vaccines are currently underway, which will help to understand the utility of Listeria vaccines in cancer immunotherapy. This review aims to summarize current views on how Listeria-based vaccines induce potent antitumor immunity and the current state of Listeria-based cancer vaccines in clinical trials. © 2018 by the authors. Licensee MDPI, Basel, Switzerland.

Distinct Neuropsychological Profile And Associated Neurochemical Changes In Individuals With Mitochondrial Encephalomyopathy, Lactic Acidosis, And Stroke-Like Episodes (Melas), Emily B. Leaffer

Dissertations, Theses, and Capstone Projects

Background: Mitochondrial Encephalomyopathy, Lactic Acidosis, and Stroke-like Episodes (MELAS) is a maternally inherited progressive multisystemic disorder. Occurrence of seizure and/or stroke-like episode, as well as classic biomarkers (i.e., cerebral lactic acidosis, depleted N-acetylaspartate (NAA)), have been linked to neuropsychological deficit and trigger the developmental cascade of neurodegeneration affecting posterior prior to anterior brain regions. While a pattern of global deterioration has been reported, systematic examination in a large MELAS cohort has not been conducted.

Objective: First, we examined verbal and visual memory function and its relationship to brain metabolites (lactate, NAA) in individuals with MELAS. Second, we hypothesized that MELAS …

Atherosclerosis In Subjects Newly Diagnosed With Human Immunodeficiency Virus Infection., Tatiana V Kirichenko, Veronika A Myasoedova, Tatiana E Shimonova, Alexandra A Melnichenko, Dmitri Sviridov, Igor A Sobenin, Alexey I Mazus, Alexander N Orekhov, Michael I Bukrinsky

Microbiology, Immunology, and Tropical Medicine Faculty Publications

HIV infection is associated with the increased risk of cardiovascular disease (CVD), even in patients successfully treated with the combination antiretroviral therapy (cART). However, the relationship between HIV, cART, and pathogenesis of CVD remains controversial. In the present study, we evaluated the carotid intima-media thickness (CIMT), a surrogate marker of atherosclerosis, in HIV-infected subjects receiving or not receiving cART. One hundred nine newly diagnosed HIV-infected subjects and one hundred nine uninfected age-matched controls (all males) without the history of CVD, hypertension, or diabetes were recruited into the present study. Cross-sectional analysis at baseline (BL) showed significantly increased levels of triglycerides …

Coping With Chronic Fungal Rhinosinusitis: Diagnosis To Therapy, Veronica Corcino, Leslie Beavin, Shengli Lu, Ashley Ross, Carmen V. Sciortino Jr.

The University of Louisville Journal of Respiratory Infections

No abstract provided.

Evaluation Of Botulinum Toxin Therapy For Chronic Anal Fissure, Amr Abu El-Ella, Ayman Al-Khaleegy, Khaled Hassan

Journal of Medicine in Scientific Research

Background Chronic anal fissure causes severe anal pain that dramatically impairs patient's quality of life. Despite a poorly understood etiology, anal fissures are characterized by continuous spasms of the internal anal sphincter. The work aims to evaluate the efficacy of botulinum toxin (BTX) local injection in relieving symptoms and healing chronic anal fissure and its complications. We also aim to popularize this simple outpatient technique. Patients and methods Thirty patients diagnosed with chronic anal fissure were included in this study. Each patient received 40 units of BTX. All patients were evaluated for pain, bleeding, and healing of the fissure from …

Emergency Surgery For Prosthetic Mitral Valve Dysfunction: Risk Factors And Technical Consideration, Ahmed Saad, H Hafez, M H. Mazen, Mohamed Refaat Kamar, Tharwat Fakhry

Journal of Medicine in Scientific Research

Objective Prosthetic mitral valve dysfunction remains a devastating complication in heart surgery. This study aims to assess the risk factors and the technical approaches to reach the best way to deal with and improve the outcome in these patients. Patients and methods Between January 2002 and March 2005, 60 patients underwent emergency reoperation for prosthetic mitral valve dysfunction, where 36 (60%) patients were in New York Heart Association class III, and 24 (40%) patients were in New York Heart Association class IV. There were 33 (55%) male and 27 (45%) female patients. The mean age at operation was 32.4 ± …

Endovascular Repair Of Traumatic Subclavian Artery Pseudoaneurysm: A Case Report And Review Of The Literature, Mohamad M. Gouda, Mohamad Taha

Journal of Medicine in Scientific Research

Traumatic subclavian artery injury resulting in pseudoaneurysm formation is relatively uncommon. With the increasing percutaneous arterial interventions utilization worldwide, the number of pseudoaneurysm formation has increased owing to iatrogenic arterial injury. After trauma, injury of subclavian artery early appears, and many complications such as life-threatening bleeding, the creation of pseudoaneurysm, and brachial plexus compression may be caused by the arterial rupture. The presence of large hematoma and pulsatile palpable mass in the supraclavicular region should raise the suspicion of severe vascular injury. Surgical thoracotomy and direct arterial repair traditionally treated subclavian artery pseudoaneurysms. However, significant morbidity is usually associated with …

Validity Of Dual-Energy X-Ray Absorptiometry Scan In Evaluation Of Trunk Fat In Non-Obese Patients With Polycystic Ovary Syndrome, Amir S. M. Melika, Ikram I. Alyan, Osama S. El-Dein

Journal of Medicine in Scientific Research

To detect trunk obesity, which was claimed to be a major cause of insulin resistance, in nonobese patients with polycystic ovary syndrome (PCOS) by using dual-energy X-ray absorptiometry (DEXA) scan. A total of 60 normal weight, with BMI less than 25 kg/m², patients with PCOS were included in the study. DEXA scan was used to assess the body composition of all patients. Metabolic and hormone measurements and cardiovascular risk were determined. All data were collected and compared with 60 healthy controls. Normal-weight patients with PCOS had a higher ratio of total and trunk fat than non-PCOS controls. Moreover, …

Role Of Ankle Peak Systolic Velocity In Predicting Healing Of Diabetic Foot Lesions In Patients With Critical Lower Limb Ischemia, Assem M. Herzallah

Journal of Medicine in Scientific Research

Aim We designed the study for determining if ankle peak systolic velocity (APSV) has value in prediction of healing in diabetic foot lesions in patients with critical lower limb ischemia. APSV is the mean of the peak systolic velocities estimated at the ankle level over the distal tibial arteries. Patient and Methods Patients were included if they had diabetes foot lesions. Such lesions were ulcers, gangrene, or tissue necrosis. In addition, they had nonpalpable pedal pulses. Endpoints were healed or healing foot lesions, revascularization, major amputation, or death. Fifty diabetic limbs were included. Results Twenty-five (50%) limbs with diabetic foot …

Estimation Of Insulin-Like Growth Factor-1 As A Biomarker In Nonalcoholic Fatty Liver Disease In Patients With Metabolic Syndrome, Amal E. El-Maghraby, Eman A. Aissa, Hoda El H. Ahmed

Journal of Medicine in Scientific Research

Background Nonalcoholic fatty liver disease (NAFLD) is becoming the most common chronic liver pathology especially in developed countries, ranging from simple liver steatosis to nonalcoholic steatohepatitis. Patients with NAFLD having metabolic syndrome have abnormal liver enzymes that positively correlate with the number of metabolic syndrome components. Abdominal ultrasonography is frequently used in epidemiological studies to detect NAFLD. Insulin-like growth factor (IGF-1) is the critical hormone in the pathophysiology of metabolic syndrome and is associated with cardiovascular disease, diabetes mellitus, and abnormal lipid metabolism. Participants and methods A total of 70 patients, 50 patients having NAFLD by ultrasonography and 20 individuals …

The Relation Between Sarcopenia, Associated Factors, And Disease Activity In Patients With Rheumatoid Arthritis, Ikram I. Alyan

Journal of Medicine in Scientific Research

Aim The aim of this study was to detect the incidence of sarcopenia in patients with rheumatoid arthritis (RA) and study associated factors. Patients and methods Dual-energy X-ray absorptiometry was used to assess the body composition of 80 patients with RA and 80 healthy controls. Sarcopenia was defined as a relative skeletal muscle index of less than 5.5 kg/m² in male and less than 7.26 kg/m² in female patients. BMI, waist circumference, and disease activity score 28 erythrocyte sedimentation rate were used to assess disease activity. Functional disability was measured using Health Assessment Questionnaire, and 4-m gait speed …

Assessment Of Evaluated Pulmonary Vascular Resistance By Isoproterenol Infusion In Patients With Atrial Septal Defects, Amir S. Michael

Journal of Medicine in Scientific Research

Aim and Background Congenital heart diseases constitute a major category of disorders associated with pulmonary hypertension in atrial septal defect there is tendency to repair essentially all large defect except some of those with severe obstructive pulmonary vascular diseases. in this study the isoproterenol is used for assessment of patients with atrial septal defect, with elevated pulmonary / systemic vascular resistance ratio. Methods and Results 100 cases with atrial septal defect, with pulmonary hypertension received isoproterenol infusion. Haemodynamic findings found among all patients with atrial septal defect before and after isoproterenol infusion. There is a significant in pulmonary blood flow …

Assessment Of Value Of Adding Low Dose Of Intermediate-Acting Nondepolarizing Muscle Relaxant To Local Anesthesia And Hyaluronidase Mixture Percaruncular And Peribulbar Anesthesia For High Myopes In Ophthalmic Surgery, Alaa A. Ibrahim, Ashraf A. M. Soliman

Journal of Medicine in Scientific Research

Objective The purpose of this study was to assess thevalue of adding low-dose intermediate-acting nondepolarizing muscle relaxant to local anesthesia and hyaluronidase mixture percaruncular and peribulbar anesthesia for high myopes in ophthalmic surgery. Patients and methods A total of 82 patients with American Society of Anesthesiologists I–III planned for elective ophthalmic surgery with high myopes enrolled in a double-blind comparative study. The atients were randomized into one of the two groups: group A (n = 42) patients received lidocaine, bupivacaine (local anesthesia), hyaluronidase, and atracurium (intermediate-acting nondepolarizing muscle relaxant) percaruncular and peribulbar. Group B patients received local anesthesia, hyaluronidase …

Assessment Of Value Of Epidural Magnesium Sulfate In Postoperative Analgesia After Lower Limb Vascular Surgery, Ashraf A. M. Soliman

Journal of Medicine in Scientific Research

Objective The aim of the study was to assess the value of epidural magnesium sulfate in postoperative analgesia after lower limb vascular surgery. Patients and methods A total of 80 patients planned for elective lower limb vascular surgery were enrolled in a double-blind comparative study. Their ages were between 30 and 60 years and were of ASA physical status I–III. Patients were randomly distributed into two group: group A (n = 40) included patients who received 100-mg magnesium sulfate in 6 ml normal saline 0.9% plus 4 mg morphine epidurally, and group B (n = 40) had patients …

Femoral Tunneled Hemodialysis Catheter As A Permanent Access For Hemodialysis Patients, Ahmed A. Morsi, Assem M. Herzallah, Mohamed T. Y. Madkour, Tarek S. Elshanshoury

Journal of Medicine in Scientific Research

Background Vascular access (VA) remains the cornerstone in HD patients. The survival of the patients becomes risky if approaches like arteriovenous fistulae, grafts, and thoracic tunneled central catheters are used with no benefits. The options become limited to transplantation, dialysis through the peritoneum, and catheter insertion translumbarally or femorally, which in some cases is the only available approach. Methods We are discussing our experience from Mataria Teaching Hospital with 17 patients; in those patients, all the vascular procedures were used with no benefits. We could not perform other options like transplantation or peritoneal dialysis. Hence, we chose femoral tunneled catheters …

A Surprising Incidence Of Mammary Duct Ectasia In Egyptian Female Individuals: A 20-Year Experience, Adel K. Barsoum

Journal of Medicine in Scientific Research

The vast majority of breast pathology is benign. Much attention is given to malignant lesions because breast cancer is the most common malignancy in women. Duct ectasia is one of the benign breast diseases; Haagenson was the first to use the term. It is a widening of the ducts of the breast, a condition that occurs most frequently in women in their fourth and fifth decade of life. American Cancer Society states that mammary duct ectasia does not increase the risk for developing breast cancer, as duct ectasia is considered a nonproliferative disease (cells that have changed but are not …

Laparoscopic Omental Patch Repair For Perforated Peptic Ulcer: An Early Experience From Al-Sahel Teaching Hospital, Amr M. Abulfadle, Ashraf M. Habeeb, Ayman A. Al-Khaleegy, Khaled M. Hassan

Journal of Medicine in Scientific Research

Background Peptic ulceration is a common condition. The most common etiologic factors are drugs use like NSAIDs and infection by Helicobacter pylori. The perforated duodenal ulceration is not an uncommon surgical emergency, ur aim was to show our experience with Laparoscopic omental patch repair for perforated peptic ulcer. Patient and Method In this study, we included 16 patients who underwent laparoscopic repair of perforated duodenal ulcer at our department. The patients were urgently admitted to the emergency department. Result In our study, we have neither morbidity nor mortality. The recorded time for the operation was 72–90 min, and the …

Chronically Implanted Intracranial Electrodes: Tissue Reaction And Electrical Changes., Andrew Campbell, Chengyuan Wu

Department of Neurosurgery Faculty Papers

The brain-electrode interface is arguably one of the most important areas of study in neuroscience today. A stronger foundation in this topic will allow us to probe the architecture of the brain in unprecedented functional detail and augment our ability to intervene in disease states. Over many years, significant progress has been made in this field, but some obstacles have remained elusive-notably preventing glial encapsulation and electrode degradation. In this review, we discuss the tissue response to electrode implantation on acute and chronic timescales, the electrical changes that occur in electrode systems over time, and strategies that are being investigated …

Lafora Disease Masquerading As Hepatic Dysfunction, Faisal Inayat, Waqas Ullah, Hanan T. Lodhi, Zarak H. Khan, Ghulam Ilyas, Nouman Safdar Ali, Hafez Mohammad A. Abdullah

Abington Jefferson Health Papers

Lafora disease is fatal intractable progressive myoclonic epilepsy. It is frequently characterized by epileptic seizures, difficulty walking, muscle spasms, and dementia in late childhood or adolescence. We chronicle here an unusual case of an asymptomatic young male soccer player who presented with elevated liver enzymes. Neurological examination was unremarkable. The diagnostic workup for hepatitis, infectious etiologies, autoimmune disorders, hemochromatosis, Wilson's disease, alpha-1 antitrypsin deficiency, and other related diseases was inconclusive. He subsequently underwent an uneventful percutaneous liver biopsy. Based on the pathognomonic histopathological findings, Lafora disease was considered the likely etiology. The present study is a unique illustration of this …

Considerations For Best Practices In Studies Of Fiber Or Other Dietary Components And The Intestinal Microbiome, David M. Klurfeld, Cindy D. Davis, Robert W. Karp, Emma Allen-Vercoe, Eugene B. Chang, Benoit Chassaing, George C. Fahey Jr, Bruce R. Hamaker, Hannah D. Holscher, Johanna W. Lampe, Andre Marette, Eric Martens, Stephen J. O'Keefe, Devin J. Rose, Maria Saarela, Barbara O. Schneeman, Joanne L. Slavin, Justin L. Sonnenburg, Kelly S. Swanson, Gary D. Wu, Christopher J. Lynch

Food for Health: Publications

Considerations for best practices in studies of fiber or other dietary components and the intestinal microbiome. Am J Physiol Endocrinol Metab 315: E1087–E1097, 2018. First published August 21, 2018; doi:10.1152/ajpendo.00058.2018.—A 2-day workshop organized by the National Institutes of Health and U.S. Department of Agriculture included 16 presentations focused on the role of diet in alterations of the gastrointestinal microbiome, primarily that of the colon. Although thousands of research projects have been funded by U.S. federal agencies to study the intestinal microbiome of humans and a variety of animal models, only a minority addresses dietary effects, and a small subset is …

Intestinal Carriage Of Third-Generation Cephalosporin-Resistant And Extended-Spectrum Β-Lactamase-Producing Enterobacteriaceae In Healthy Us Children., Shamim Islam, Rangaraj Selvarangan, Neena Kanwar, Rendie Mchenry, James D. Chappell, Natasha Halasa, Mary E. Wikswo, Daniel C. Payne, Parvin H. Azimi, L Clifford Mcdonald, Oscar G. Gomez-Duarte

Manuscripts, Articles, Book Chapters and Other Papers

Background: The epidemiology of antibiotic-resistant Enterobacteriaceae intestinal carriage in healthy US children has not been well characterized.

Methods: Children between 14 days and 14 years of age were enrolled during well-child visits in Oakland, California, Kansas City, Kansas, and Nashville, Tennessee, between December 2013 and March 2015. Data on recent antibiotic use by the child and travel and hospitalization history of all members of each child's household were obtained with a risk-factor survey. Stool specimens collected from the subjects were screened for extended-spectrum β-lactamase-producing (ESBL-P) bacteria using CHROMagar ESBL medium. Putative ESBL-P Escherichia coli and Klebsiella colonies underwent phenotypic confirmation …