Medical Specialties Commons^™

Seasonality, Clinical Characteristics, And Outcomes Of Respiratory Syncytial Virus Disease By Subtype Among Children Aged <5 Years: New Vaccine Surveillance Network, United States, 2016-2020., Ariana P. Toepfer, Justin Z. Amarin, Andrew J. Spieker, Laura S. Stewart, Mary Allen Staat, Elizabeth P. Schlaudecker, Geoffrey A. Weinberg, Peter G. Szilagyi, Janet A. Englund, Eileen J. Klein, Marian G. Michaels, John V. Williams, Rangaraj Selvarangan, Christopher J. Harrison, Joana Y. Lively, Pedro A. Piedra, Vasanthi Avadhanula, Brian Rha, James Chappell, Meredith Mcmorrow, Heidi Moline, Natasha B. Halasa

Manuscripts, Articles, Book Chapters and Other Papers

BACKGROUND: Respiratory syncytial virus (RSV) is a leading cause of acute respiratory illnesses in children. RSV can be broadly categorized into 2 major subtypes: A and B. RSV subtypes have been known to cocirculate with variability in different regions of the world. Clinical associations with viral subtype have been studied among children with conflicting findings such that no conclusive relationships between RSV subtype and severity have been established.

METHODS: During 2016-2020, children aged/guardian interviews, chart reviews, and collection of midturbinate nasal plus/minus throat swabs for RSV (RSV-A, RSV-B, and untyped) using reverse transcription polymerase chain reaction.

RESULTS: Among 6398 RSV-positive …

Development Of An Online Teaching Platform To Improve Access To Postgraduate Pathology Training In Sub-Saharan Africa, Richard Byers, Anita Byers, Chibamba Mumba, Angela Mutuku, Jennifer Singer-Rupp, Michael Wilson, Kenneth Fleming, Shahin Sayed

Pathology, East Africa

Background: Resource barriers to the provision of accessible training in cancer diagnosis in lower- and middle-income countries (LMICs) limit the potential of African health systems. Long-term provision via teaching visits from senior pathologists and trainee foreign placements is unsustainable due to the prohibitive costs of travel and subsistence. Emerging eLearning methods would allow pathologists to be trained by experts in a cheaper, more efficient, and more scalable way.

Purpose: This study aimed to develop an online teaching platform, starting with hematopathology, for trainee pathologists in sub-Saharan Africa, initially in Nairobi, Kenya, and Lusaka, Zambia.

Methods: Course materials …

The Future Role Of Cytologists Regarding Telecytology And Rapid On-Site Evaluation (Rose), A Meta-Narrative Review, James Jeffery Fretwell, Liam Patrick Farley, Melissa Perez, Mary Coolbaugh Murphy Phd, Denise Juroske Short Phd

Research Methods Poster Session 2024

The use of Telecytology in conjunction with rapid on-site evaluation (ROSE) is currently at the forefront of discussion among cytologists and cytopathologists. In this meta-narrative review, the advancements of Telecytology and ROSE within the discipline of Cytology are discussed. Advancements in telecytology and ROSE enable off-site cytology slide evaluation and diagnosis through digital image transfer. ROSE allows for preliminary cytological assessment during image-guided biopsy procedures to determine specimen adequacy. The meta-narrative review concluded that the combination of these two technologies increases the efficacy of patient diagnosis without sacrificing the quality of patient care.

Improved communication between the presiding technician, the …

Considering The Histologic And Anatomic Features Of Pancreatic Heterotopia In Patient Disease Manifestation, Yeseena Alli B.S., Kelly Brenan M.D.

Tower Health Research Day

No abstract provided.

Accuracy Of Influenza Icd-10 Diagnosis Codes In Identifying Influenza Illness In Children., James W. Antoon, Tess Stopczynski, Justin Z. Amarin, Laura S. Stewart, Julie A. Boom, Leila C. Sahni, Marian G. Michaels, John V. Williams, Janet A. Englund, Eileen J. Klein, Mary A. Staat, Elizabeth P. Schlaudecker, Rangaraj Selvarangan, Jennifer E. Schuster, Geoffrey A. Weinberg, Peter G. Szilagyi, Ariana Perez, Heidi L. Moline, Andrew J. Spieker, Carlos G. Grijalva, Samantha M. Olson, Natasha B. Halasa

Manuscripts, Articles, Book Chapters and Other Papers

IMPORTANCE: Studies of influenza in children commonly rely on coded diagnoses, yet the ability of International Classification of Diseases, Ninth Revision codes to identify influenza in the emergency department (ED) and hospital is highly variable. The accuracy of newer International Statistical Classification of Diseases and Related Health Problems, Tenth Revision (ICD-10) codes to identify influenza in children is unknown.

OBJECTIVE: To determine the accuracy of ICD-10 influenza discharge diagnosis codes in the pediatric ED and inpatient settings.

DESIGN, SETTING, AND PARTICIPANTS: Children younger than 18 years presenting to the ED or inpatient settings with fever and/or respiratory symptoms at 7 …

The Dementia Care Study (D-Care): Recruitment Strategies And Demographic Characteristics Of Participants In A Pragmatic Randomized Trial Of Dementia Care, Mia Yang, Rafael Samper-Ternent, Elena Volpi, Aval-Na'ree Green, Maya Lichtenstein, Katy Araujo, Pamela Borek, Peter Charpentier, James Dziura, Thomas M Gill, Rebecca Galloway, Erich J Greene, Kristin Lenoir, Peter Peduzzi, Can Meng, Jordan Reese, Amy Shelton, Eleni A Skokos, Jenny Summapund, Erin Unger, David B Reuben, Jeff D Williamson, Alan B Stevens

Journal Articles

INTRODUCTION: Pragmatic research studies that include diverse dyads of persons living with dementia (PLWD) and their family caregivers are rare.

METHODS: Community-dwelling dyads were recruited for a pragmatic clinical trial evaluating three approaches to dementia care. Four clinical trial sites used shared and site-specific recruitment strategies to enroll health system patients.

RESULTS: Electronic health record (EHR) queries of patients with a diagnosis of dementia and engagement of their clinicians were the main recruitment strategies. A total of 2176 dyads were enrolled, with 80% recruited after the onset of the pandemic. PLWD had a mean age of 80.6 years (SD 8.5), …

Reliability Of Popliteal Artery Flow-Mediated Dilation In The Seated Position, Taskina Akhter

Rehabilitation Sciences Theses & Dissertations

Flow-mediated dilation (FMD) is a noninvasive measurement of endothelial function, which is a useful prognostic tool for cardiovascular disease risk. Despite its widespread use since 1992, the reproducibility of FMD varies widely between studies. This variability in reproducibility is especially significant in the case of the popliteal artery due to different methodological approaches. Studies perform popliteal FMD in various body positions, with the prone and seated positions most common. However, no studies have examined the reproducibility of both the seated and prone positions of the popliteal artery FMD. Therefore, the aim of this study is to examine the test-retest and …

Development Of Solitary Keratoacanthoma From A Cutaneous Wart, Joshua M. Ninan, Veronica Salazar

Research Symposium

Background: Common cutaneous warts, referred to in medicine as verrucae vulgaris, are proliferative lesions caused by human papillomavirus. These lesions are mostly benign and usually resolve without incident, except in the case of the patient mentioned in this report. Our patient developed a solitary keratoacanthoma, currently accepted as a clinical variant of squamous cell carcinoma, as a result of several risk factors and traumatic exposure. The current literature does not have an established association of HPV with solitary keratoacanthomas. This case report explores the presentation and pathogenesis of solitary keratoacanthomas within the setting of HPV.

Case Presentation: 48-year-old Caucasian female …

Case Of Rosai Dorfman Disease In A Patient With Newly Diagnosed Hodgkin Lymphoma, Liza Salloum, Jennifer Rojas Huen, Ricardo Serna, Alisha Valdez

Research Symposium

Background: Rosai Dorfman Disease (RDD, also known as sinus histiocytosis with massive lymphadenopathy) is a rare non-Langerhans cell histiocytosis, classified into nodal (classic) and extranodal disease. Most patients present with non-tender cervical lymphadenopathy, although other sites including the inguinal and axillary regions have been reported. Extranodal disease (~43% of cases) can involve any organ system. RDD is more common in children, but cases have been reported in patients in their 70s. The prognosis of nodal RDD can correlate with the number of nodal groups involved. Many cases can be managed only with observation, although surgery, chemotherapy, corticosteroids, and immunomodulators have …

Hif Expression In Clear-Cell Renal Cell Carcinoma (Ccrcc) Tumors Of Adults With And Without Obstructive Sleep Apnea (Osa), Olivia Heppell, Carlos Guerra Londono, Nilesh Gupta

Medical Student Research Symposium

Introduction: Upregulation of hypoxia-inducible factors (HIF) is an important pathological feature shared by clear cell renal cell carcinoma (ccRCC) and obstructive sleep apnea (OSA). However, it is unclear whether OSA alters the pathogenesis of ccRCC via HIF expression.

Methods: A retrospective cohort of adults undergoing nephrectomy for ccRCC was identified electronically (IRB#16040-1). The diagnosis of OSA was established with preoperative STOP-BANG scores or polysomnography. A consecutive sample of 20 individuals with and 20 without OSA was selected. Clinical characteristics and pathology results were reviewed. Resected tumor sections were immunohistochemically stained for HIF-1& HIF-2 at antibody dilutions of 1:150. Intensity and …

Primary Mucinous Carcinoma Of The Thyroid: A Case Report, Literature Review, And Immunohistochemistry Summary, Martin T. Halicek, Caleb Scott, Terence Zimmermann, Brian Watson

HCA Healthcare Journal of Medicine

Introduction

Primary mucinous carcinoma of the thyroid is an exceedingly rare malignancy that is histologically similar to mucinous carcinoma of other sites. Accurate diagnosis is a challenging yet crucial component of clinical management for both patients and our understanding of this rare disease.

Case Presentation

We report the case of a 69-year-old male patient with primary mucinous carcinoma of the thyroid. Microscopic examination of a biopsy specimen showed fibrous tissue, which was extensively and irregularly infiltrated by a cytologically malignant epithelial neoplasm showing glandular differentiation with mucin production. Immunohistochemistry demonstrated that tumor cells were positive for TTF1, thyroglobulin, CK7, and …

An Unusual Case Of Microcystic Serous Cystadenoma In A 19-Year-Old Male Patient, Jamie Lee Aldakkour, Alvin Boyd Newman-Caro, Ashley Henning

HCA Healthcare Journal of Medicine

Introduction

Microcystic serous cystadenomas are uncommon, benign neoplasms rarely known to progress to malignancy. They are typically asymptomatic and inadvertently discovered during imaging for another unrelated condition. When discovered, they are commonly found in females over 60 years of age.

Case Presentation

In this case report, we examine a unique presentation of a serous cystadenoma discovered when a 19-year-old male presented with symptoms of abdominal pain, nausea, and vomiting.

Conclusion

Previous studies on serous cystadenomas in a younger male demographic are rare. Therefore, this study will provide additional insight into the signs, symptoms, diagnosis, and management of cystadenomas in young …

Granulocytic Myeloid-Derived Suppressor Cell Activity During Biofilm Infection Is Regulated By A Glycolysis/Hif1a Axis, Christopher M. Horn, Prabhakar Arumugam, Zachary Van Roy, Cortney E. Heim, Rachel W. Fallet, Blake P. Bertrand, Dhananjay Shinde, Vinai Chittezham Thomas, Svetlana Romanova, Tatiana K. Bronich, Curtis Hartman, Kevin Garvin, Tammy Kielian

Journal Articles: Pathology and Microbiology

Staphylococcus aureus is a leading cause of biofilm-associated prosthetic joint infection (PJI). A primary contributor to infection chronicity is an expansion of granulocytic myeloid-derived suppressor cells (G-MDSCs), which are critical for orchestrating the antiinflammatory biofilm milieu. Single-cell sequencing and bioinformatic metabolic algorithms were used to explore the link between G-MDSC metabolism and S. aureus PJI outcome. Glycolysis and the hypoxia response through HIF1a were significantly enriched in G-MDSCs. Interfering with both pathways in vivo, using a 2-deoxyglucose nanopreparation and granulocyte-targeted Hif1a conditional KO mice, respectively, attenuated G-MDSC-mediated immunosuppression and reduced bacterial burden in a mouse model of S. aureus PJI. …

Notes From The Field: Reemergence Of Mycoplasma Pneumoniae Infections In Children And Adolescents After The Covid-19 Pandemic, United States, 2018-2024., Chris Edens, Benjamin R. Clopper, Jourdan Devies, Alvaro Benitez, Erin R. Mckeever, Dylan Johns, Bernard Wolff, Rangaraj Selvarangan, Jennifer E. Schuster, Geoffrey A. Weinberg, Peter G. Szilagyi, Fatimah S. Dawood, Lakshmi Radhakrishnan, Christina Quigley, Leila C. Sahni, Natasha Halasa, Laura S. Stewart, Meredith L. Mcmorrow, Brett Whitaker, Danielle M. Zerr, Vasanthi Avadhanula, John V. Williams, Marian G. Michaels, Aaron Kite-Powell, Janet A. Englund, Mary Allen Staat, Kathleen Hartnett, Heidi L. Moline, Adam L. Cohen, Maureen Diaz

Manuscripts, Articles, Book Chapters and Other Papers

No abstract provided.

Challenges In Diagnosing Hepatic Epithelioid Hemangioendothelioma: A Case Series, Aratara Nutcharoen, Elliott Beard, Anupa Thirmiya, Omar Taher, Jacob Adams, Mark Mortensen, John Pelham

Annual Research Symposium

Challenges in Diagnosing Hepatic Epithelioid Hemangioendothelioma

Assessing Adequacy: A Meta-Analysis Of Rapid Onsite Evaluation Of Thyroid Nodules, Peter P. Issa, Christina Mccarthy, Mohammad Hussein, Aaron L. Albuck, Essam Emad, Mohamed Shama, Krzysztof Moroz, Eman Toraih, Emad Kandil

School of Medicine Faculty Publications

Introduction: Fine-needle aspiration (FNA) is the standard form of preoperative evaluation of thyroid nodule cytological status. A significant number FNAs are classified as inadequate for interpretation, requiring a repeat FNA which is potentially avoidable, costly, and delays treatment. To address these concerns and maximize first-time FNA adequacy, rapid onsite evaluation (ROSE) of FNA specimens was introduced. Our study aims to determine the impact of ROSE on FNA adequacy. Methods: PubMed, Embase, and Web of Science were searched for primary articles assessing the adequacy of ROSE in thyroid nodules. Results: A total of 17 studies were included for a total of …

Child Deaths Caused By Klebsiella Pneumoniae In Sub-Saharan Africa And South Asia: A Secondary Analysis Of Child Health And Mortality Prevention Surveillance (Champs) Data., Jennifer Verani, Dianna Blau, Emily Gurley, Victor Akelo, Nega Assefa, Vicky Baillie, Quique Bassat, Mussie Berhane, James Bunn, R Gunturu

Pathology, East Africa

Background; Klebsiella pneumoniae is an important cause of nosocomial and community-acquired pneumonia and sepsis in children, and antibiotic-resistant K pneumoniae is a growing public health threat. We aimed to characterize child mortality associated with this pathogen in seven high-mortality settings.

Methods; We analysed Child Health and Mortality Prevention Surveillance (CHAMPS) data on the causes of deaths in children younger than 5 years and stillbirths in sites located in seven countries across sub-Saharan Africa (Ethiopia, Kenya, Mali, Mozambique, Sierra Leone, and South Africa) and south Asia (Bangladesh) from Dec 9, 2016, to Dec 31, 2021. CHAMPS sites conduct active surveillance for …

Targeted Repression Of Topa By Crispri Reveals A Critical Function For Balanced Dna Topoisomerase I Activity In The Chlamydia Trachomatis Developmental Cycle, Li Shen, Leiqiong Gao, Abigail R. Swoboda, Scot P. Ouellette

School of Medicine Faculty Publications

Chlamydia trachomatis is an obligate intracellular bacterium that is responsible for the most prevalent bacterial sexually transmitted infection. Changes in DNA topology in this pathogen have been linked to its pathogenicity-associated developmental cycle. Here, evidence is provided that the balanced activity of DNA topoisomerases contributes to controlling Chlamydia developmental processes. Utilizing catalytically inactivated Cas12 (dCas12)-based clustered regularly interspaced short palindromic repeats interference (CRISPRi) technology, we demonstrate targeted knockdown of chromosomal topA transcription in C. trachomatis without detected toxicity of dCas12. Repression of topA impaired the developmental cycle of C. trachomatis mostly through disruption of its differentiation from a replicative form …

Building Research Capacity In Low- And Middle-Income Countries And Pandemic Preparedness: Lessons Learned And Future Directions, Peter H. Kilmarx, Karen A. Goralesk, Erum Khan, John F. Lindo, Nancy Gore Saravia

Department of Pathology and Laboratory Medicine

Research capacity is a critical component of pandemic preparedness, as highlighted by the challenges faced during the Ebola outbreak in West Africa. Recent global initiatives, such as the Research & Development Task Force of the Global Health Security Agenda and the World Health Assembly's resolution on strengthening clinical trials, emphasize the need for robust research capabilities. This Perspective discusses the experiences of leaders in infectious disease research and capacity building in low- and middle-income countries, focusing on Colombia, Jamaica, and Pakistan. These case studies underscore the importance of collaborative efforts, interdisciplinary training, and global partnerships in pandemic response. The experiences …

Metabolism Shapes Immune Responses To Staphylococcus Aureus., Prabhakar Arumugam, Tammy Kielian

Journal Articles: Pathology and Microbiology

BACKGROUND: Staphylococcus aureus (S. aureus) is a common cause of hospital- and community-acquired infections that can result in various clinical manifestations ranging from mild to severe disease. The bacterium utilizes different combinations of virulence factors and biofilm formation to establish a successful infection, and the emergence of methicillin- and vancomycin-resistant strains introduces additional challenges for infection management and treatment.

SUMMARY: Metabolic programming of immune cells regulates the balance of energy requirements for activation and dictates pro- versus anti-inflammatory function. Recent investigations into metabolic adaptations of leukocytes and S. aureus during infection indicate that metabolic crosstalk plays a crucial role in …

Evaluation And Modeling Of Factors Associated With Urine Drug Testing Appointment Absences, Rui Xu

Graduate College Dissertations and Theses

Why doesn’t a patient show up for their appointment? Is it too far? Are there too many appointments? Or something else? Urine drug testing clinics often observe patient scheduled visit absenteeism, and this can be used as a data source to answer our questions and explore other potential correlations between factors. With a well-developed electronic health data system, a retrospective study was performed on a large data set collected between January 2019 and December 2021 across the U.S. and more than half a million patient encounters; it contained nearly a year of quarantine, and pandemic status was also analyzed as …

Evaluation And Modeling Of Factors Associated With Urine Drug Testing Appointment Absences, Rui Xu

Graduate College Dissertations and Theses

Why doesn’t a patient show up for their appointment? Is it too far? Are there too many appointments? Or something else? Urine drug testing clinics often observe patient scheduled visit absenteeism, and this can be used as a data source to answer our questions and explore other potential correlations between factors. With a well-developed electronic health data system, a retrospective study was performed on a large data set collected between January 2019 and December 2021 across the U.S. and more than half a million patient encounters; it contained nearly a year of quarantine, and pandemic status was also analyzed as …

Evaluation And Modeling Of Factors Associated With Urine Drug Testing Appointment Absences, Sherry Xu

Graduate College Dissertations and Theses

Why doesn’t a patient show up for their appointment? Is it too far? Are there too many appointments? Or something else? Urine drug testing clinics often observe patient scheduled visit absenteeism, and this can be used as a data source to answer our questions and explore other potential correlations between factors. With a well-developed electronic health data system, a retrospective study was performed on a large data set collected between January 2019 and December 2021 across the U.S. and more than half a million patient encounters; it contained nearly a year of quarantine, and pandemic status was also analyzed as …

A Rare Case Of Breast Carcinoma Metastasis Into A Meningioma In A 64-Year-Old Female Patient, Edwin Mogere, Miriam Mutebi, Allan Njau, Manel Haj Mansour

General Surgery, East Africa

This report discusses the occurrence of tumor-to-tumor metastasis—an atypical phenomenon in oncology where a secondary malignancy develops within an existing primary tumor. The case of a 64-year-old woman is presented, who, with a history of stage II invasive ductal carcinoma of the breast treated with mastectomy and chemoradiotherapy, developed neurological symptoms indicative of a secondary brain tumor. MRI and subsequent histopathological analysis post-craniotomy confirmed a meningioma with a metastatic breast carcinoma, demonstrating the clinical importance of considering tumor-to-tumor metastasis in similar patient histories.

Image-Based Multiplex Immune Profiling Of Cancer Tissues: Translational Implications. A Report Of The International Immuno-Oncology Biomarker Working Group On Breast Cancer., Shahin Sayed, Chowdhury Arif Jahangir, David Page, Glenn Broeckx, Claudia Gonzalez, Caoimbhe Burke, Clodagh Murphy, Jorge Reis-Filho, Amy Ly, Paul Harms

Pathology, East Africa

Recent advances in thefield of immuno-oncology have brought transformative changes in the management ofcancer patients. The immune profile of tumours has been found to have key value in predicting disease prognosis andtreatment response in various cancers. Multiplex immunohistochemistry and immunofluorescence have emerged aspotent tools for the simultaneous detection of multiple protein biomarkers in a single tissue section, therebyexpanding opportunities for molecular and immune profiling while preserving tissue samples. By establishing thephenotype of individual tumour cells when distributed within a mixed cell population, the identification of clinicallyrelevant biomarkers with high-throughput multiplex immunophenotyping of tumour samples has great potential toguide appropriate treatment …

Elucidating Granulocytic Myeloid-Derived Suppressor Cell Heterogeneity During Staphylococcus Aureus Biofilm Infection, Blake P. Bertrand, Cortney E. Heim, Scott A. Koepsell, Tammy Kielian

Journal Articles: Pathology and Microbiology

Myeloid-derived suppressor cells (MDSCs) are pathologically activated immature myeloid cells with immunosuppressive activity that expand during chronic inflammation, such as cancer and prosthetic joint infection (PJI). Myeloid-derived suppressor cells can be broadly separated into 2 populations based on surface marker expression and function: monocytic myeloid-derived suppressor cells (M-MDSCs) and granulocytic myeloid-derived suppressor cells (G-MDSCs). Granulocytic myeloid-derived suppressor cells are the most abundant leukocyte infiltrate during PJI; however, how this population is maintained in vivo and cellular heterogeneity is currently unknown. In this study, we identified a previously unknown population of Ly6G+Ly6C+F4/80+MHCII+ MDSCs during PJI that displayed immunosuppressive properties ex vivo. …

Dual Gallium Drug Treatment Against Carbapenem-Resistant Klebsiella Pneumoniae: Efficacy And Potential Mechanism(S) Of Action And Resistance, Zachary Scott, Seoung-Ryoung Choi, Bradley E. Britigan, Prabagaran Narayanasamy

Journal Articles: Pathology and Microbiology

Klebsiella pneumoniae (KLP) is a Gram-negative pathogen that can be highly antibiotic-resistant. Our group has worked with gallium-based compounds as a means of treating bacterial infections. Here the possible mechanism is investigated for dual therapy comprised of gallium nitrate (Ga(NO₃)₃) and gallium protoporphyrin (GaPP) on KLP. It is found that in vitro the combination of Ga(NO₃)₃ and GaPP is synergistic against KLP. The in vivo efficacy is of the dual therapy is additionally tested by treating pulmonary KLP infections in mice. Much greater effectiveness are observed in bacterial clearance and survival of mice …

Metabolic Diversity Of Human Macrophages: Potential Influence On Staphylococcus Aureus Intracellular Survival, Blake P. Bertrand, Dhananjay Shinde, Vinai C. Thomas, Marvin Whiteley, Carolyn B. Ibberson, Tammy Kielian

Journal Articles: Pathology and Microbiology

Staphylococcus aureus is a leading cause of medical device-associated biofilm infections. This is influenced by the ability of S. aureus biofilm to evade the host immune response, which is partially driven by the anti-inflammatory cytokine interleukin-10 (IL-10). Here, we show that treatment of human monocyte-derived macrophages (HMDMs) with IL-10 enhanced biofilm formation, suggesting that macrophage anti-inflammatory programming likely plays an important role during the transition from planktonic to biofilm growth. To identify S. aureus genes that were important for intracellular survival in HMDMs and how this was affected by IL-10, transposon sequencing was performed. The size of the S. aureus …