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School of Medicine Faculty Publications

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Full-Text Articles in Medical Specialties

Muscle Selection And Dosing In A Phase 3, Pivotal Study Of Abobotulinumtoxina Injection In Upper Limb Muscles In Children With Cerebral Palsy, Joyce Oleszek, Ann Tilton, Jorge Carranza Del Rio, Nigar Dursun, Marcin Bonikowski, Edward Dabrowski, Simon Page, Benjamin Regnault, Catherine Thompson, Mauricio R. Delgado Oct 2021

Muscle Selection And Dosing In A Phase 3, Pivotal Study Of Abobotulinumtoxina Injection In Upper Limb Muscles In Children With Cerebral Palsy, Joyce Oleszek, Ann Tilton, Jorge Carranza Del Rio, Nigar Dursun, Marcin Bonikowski, Edward Dabrowski, Simon Page, Benjamin Regnault, Catherine Thompson, Mauricio R. Delgado

School of Medicine Faculty Publications

Background: Guidelines recommend botulinum toxin-A in pediatric upper limb spasticity as part of routine practice. Appropriate dosing is a prerequisite for treatment success and it is important that injectors have an understanding on how to tailor dosing within a safe and effective range. We report upper limb dosing data from a phase 3 study of abobotulinumtoxinA injections in children with cerebral palsy. Methods: This was a double-blind, repeat-treatment study (NCT02106351). In Cycle 1, children were randomized to abobotulinumtoxinA at 2 U/kg control dose or clinically relevant 8 U/kg or 16 U/kg doses. Doses were divided between the primary target muscle …

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A Phase Ib Dose Escalation Trial Of Ro4929097 (A Γ-Secretase Inhibitor) In Combination With Exemestane In Patients With Er + Metastatic Breast Cancer (Mbc), Julie A. Means-Powell, Ingrid A. Mayer, Roohi Ismail-Khan, Luis Del Valle, Debra Tonetti, Vandana G. Abramson, Melinda S. Sanders, Richard M. Lush, Claudia Sorrentino, Samarpan Majumder, Lucio Miele Oct 2021

A Phase Ib Dose Escalation Trial Of Ro4929097 (A Γ-Secretase Inhibitor) In Combination With Exemestane In Patients With Er + Metastatic Breast Cancer (Mbc), Julie A. Means-Powell, Ingrid A. Mayer, Roohi Ismail-Khan, Luis Del Valle, Debra Tonetti, Vandana G. Abramson, Melinda S. Sanders, Richard M. Lush, Claudia Sorrentino, Samarpan Majumder, Lucio Miele

School of Medicine Faculty Publications

Preclinical studies: have demonstrated a complex cross-talk between Notch and estrogen signaling in ERα-positive breast cancer. Gamma-secretase inhibitors (GSIs) are investigational agents that block the cleavage and activation of Notch receptors. In animal models of endocrine-resistant breast cancer, combinations of tamoxifen and GSIs produce additive or synergistic efficacy, while decreasing the intestinal toxicity of GSIs. However, results of a clinical trial of a GSI-endocrine therapy combination in the metastatic setting have not been published to date, nor had the safety of such combinations been investigated with longer term treatment. We conducted a phase 1b dose escalation trial (NCT01149356) of GSI …

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Pharmacologic And Clinical Considerations Of Nalmefene, A Long Duration Opioid Antagonist, In Opioid Overdose., Amber N. Edinoff, Catherine A. Nix, Tanner D. Reed, Elizabeth M. Bozner, Mark R. Alvarez, Mitchell C. Fuller, Fatimah Anwar, Elyse M. Cornett, Adam M. Kaye, Alan D. Kaye Oct 2021

Pharmacologic And Clinical Considerations Of Nalmefene, A Long Duration Opioid Antagonist, In Opioid Overdose., Amber N. Edinoff, Catherine A. Nix, Tanner D. Reed, Elizabeth M. Bozner, Mark R. Alvarez, Mitchell C. Fuller, Fatimah Anwar, Elyse M. Cornett, Adam M. Kaye, Alan D. Kaye

School of Medicine Faculty Publications

No abstract provided.

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Obesity Modulates The Gut Microbiome In Triple-Negative Breast Cancer, Fokhrul Hossain, Samarpan Majumder, Justin David, Bruce A. Bunnell, Lucio Miele Oct 2021

Obesity Modulates The Gut Microbiome In Triple-Negative Breast Cancer, Fokhrul Hossain, Samarpan Majumder, Justin David, Bruce A. Bunnell, Lucio Miele

School of Medicine Faculty Publications

Triple-negative breast cancer (TNBC) is an aggressive, molecularly heterogeneous sub-type of breast cancer. Obesity is associated with increased incidence and worse prognosis in TNBC through various potential mechanisms. Recent evidence suggests that the gut microbiome plays a central role in the progression of cancer, and that imbalances or dysbiosis in the population of commensal microbiota can lead to inflammation and contribute to tumor progression. Obesity is characterized by low-grade inflammation, and gut dysbiosis is associated with obesity, chronic inflam-mation, and failure of cancer immunotherapy. However, the debate on what constitutes a “healthy” gut microbiome is ongoing, and the connection among …

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How I Treat Neuroendocrine Tumors, Aasems Jacob, Gaby Gabriel, Robert A. Ramirez, Yi Zarn Wang, Lowell Anthony, Aman Chauhan Oct 2021

How I Treat Neuroendocrine Tumors, Aasems Jacob, Gaby Gabriel, Robert A. Ramirez, Yi Zarn Wang, Lowell Anthony, Aman Chauhan

School of Medicine Faculty Publications

No abstract provided.

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Use, Yield, And Risk Of Device-Assisted Enteroscopy In The United States: Results From A Large Retrospective Multicenter Cohort, Michael G. Noujaim, Alice Parish, Daniel Raines, Seth A. Gross, David Cave, Iris Vance, David Beyer, Diana Liu, Benjamin Hoffman, Zoe Lawrence, Gabriel Castillo, Tanya Pavri, Donna Niedzwiecki, Daniel Wild Oct 2021

Use, Yield, And Risk Of Device-Assisted Enteroscopy In The United States: Results From A Large Retrospective Multicenter Cohort, Michael G. Noujaim, Alice Parish, Daniel Raines, Seth A. Gross, David Cave, Iris Vance, David Beyer, Diana Liu, Benjamin Hoffman, Zoe Lawrence, Gabriel Castillo, Tanya Pavri, Donna Niedzwiecki, Daniel Wild

School of Medicine Faculty Publications

Introduction: Since 2001, device-Assisted enteroscopy (DAE) has revolutionized the diagnostic and therapeutic capabilities for managing small bowel pathology. Though commonly performed, there have been no recent large studies to assess the use, yield, and risks of DAE and none that include all 3 DAE modalities. We hypothesized that DAE is safe with high diagnostic and therapeutic yields achieved within reasonable procedure duration and here we present a large retrospective multicenter US study evaluating the use, yield, and complications of DAE. Methods: After obtaining institutional review board approval, electronic records were used to identify all DAE's performed for luminal small bowel …

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Clinical Use Of Lactate Measurements: Reply, Richard M. Pino, Jaskaran Singh Oct 2021

Clinical Use Of Lactate Measurements: Reply, Richard M. Pino, Jaskaran Singh

School of Medicine Faculty Publications

No abstract provided.

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Combined Therapy With Avastin, A Paf Receptor Antagonist And A Lipid Mediator Inhibited Glioblastoma Tumor Growth, Valerie A. Cruz Flores, Hemant Menghani, Pranab K. Mukherjee, Luis Marrero, Andre Obenaus, Quan Dang, Larissa Khoutorova, Madigan M. Reid, Ludmila Belayev, Nicolas G. Bazan Sep 2021

Combined Therapy With Avastin, A Paf Receptor Antagonist And A Lipid Mediator Inhibited Glioblastoma Tumor Growth, Valerie A. Cruz Flores, Hemant Menghani, Pranab K. Mukherjee, Luis Marrero, Andre Obenaus, Quan Dang, Larissa Khoutorova, Madigan M. Reid, Ludmila Belayev, Nicolas G. Bazan

School of Medicine Faculty Publications

Glioblastoma multiforme (GBM) is an aggressive, highly proliferative, invasive brain tumor with a poor prognosis and low survival rate. The current standard of care for GBM is chemotherapy combined with radiation following surgical intervention, altogether with limited efficacy, since survival averages 18 months. Improvement in treatment outcomes for patients with GBM requires a multifaceted approach due to the dysregulation of numerous signaling pathways. Recently emerging therapies to precisely modulate tumor angiogenesis, inflammation, and oxidative stress are gaining attention as potential options to combat GBM. Using a mouse model of GBM, this study aims to investigate Avastin (suppressor of vascular endothelial …

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Atypical Osteochondroma Of The Lumbar Spine Associated With Suprasellar Pineal Germinoma: A Case Report, Patrik Suwak, Scott A. Barnett, Bryant M. Song, Michael J. Heffernan Sep 2021

Atypical Osteochondroma Of The Lumbar Spine Associated With Suprasellar Pineal Germinoma: A Case Report, Patrik Suwak, Scott A. Barnett, Bryant M. Song, Michael J. Heffernan

School of Medicine Faculty Publications

BACKGROUND Osteochondromas are the most common benign bone tumor, accounting for 36% of benign bone tumors. Often found within the appendicular skeleton, osteochondromas of the spine are rare, comprising 4% to 7% of primary benign spinal tumors. CASE SUMMARY We report a case of a solitary lumbar osteochondroma in an 18-year-old male with a history of a suprasellar pineal germinoma treated with combined chemotherapy and radiation. He underwent mass excision and partial laminectomy with the ultrasonic bone scalpel (Misonix, Farmingdale, NY, United States) at the L5 Level without the use of adjuvants. The patient returned to work and full activities …

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Facilitators And Barriers To Clinical Practice Guideline-Consistent Supportive Care At Pediatric Oncology Institutions: A Children's Oncology Group Study, Aaron J. Sugalski, Tammy Lo, Melissa Beauchemin, Allison C. Grimes, Paula D. Robinson, Alexandra M. Walsh, Nancy Santesso, Ha Dang, Brian T. Fisher, Andrea Rothfus Wrightson, Lolie C. Yu, Lillian Sung, L Lee Dupuis Sep 2021

Facilitators And Barriers To Clinical Practice Guideline-Consistent Supportive Care At Pediatric Oncology Institutions: A Children's Oncology Group Study, Aaron J. Sugalski, Tammy Lo, Melissa Beauchemin, Allison C. Grimes, Paula D. Robinson, Alexandra M. Walsh, Nancy Santesso, Ha Dang, Brian T. Fisher, Andrea Rothfus Wrightson, Lolie C. Yu, Lillian Sung, L Lee Dupuis

School of Medicine Faculty Publications

Background Clinical practice guideline (CPG)-consistent care improves patient outcomes, but CPG implementation is poor. Little is known about CPG implementation in pediatric oncology. This study aimed to understand supportive care CPG implementation facilitators and barriers at pediatric oncology National Cancer Institute (NCI) Community Oncology Research Program (NCORP) institutions. Methods Healthcare professionals at 26 pediatric, Children's Oncology Group-member, NCORP institutions were invited to participate in face-to-face focus groups. Serial focus groups were held until saturation of ideas was reached. Supportive care CPG implementation facilitators and barriers were solicited using nominal group technique (NGT), and implementation of specific supportive care CPG recommendations …

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Rupture Of A Superficial Temporal Artery Pseudoaneurysm Following Craniotomy, Jessica A. Shields, Jared M. Robichaux, Kevin Morrow, Clifford Crutcher, Gabriel Tender Sep 2021

Rupture Of A Superficial Temporal Artery Pseudoaneurysm Following Craniotomy, Jessica A. Shields, Jared M. Robichaux, Kevin Morrow, Clifford Crutcher, Gabriel Tender

School of Medicine Faculty Publications

Pseudoaneurysm of the superficial temporal artery (STA) is a rare entity that has been reported in the literature after trauma or iatrogenic injuries. We describe a unique case of STA pseudoaneurysm rupture and the clinical sequelae associated with its rupture. We report a case of pseudoaneurysm rupture of the STA that occurred 14 days after craniotomy for cerebrospinal fluid leak repair. We also review the literature, diagnosis and treatment of external carotid artery aneurysms. Rupture of a STA pseudoaneurysm is a previously unreported and serious complication that must be quickly recognized in order to control hemorrhage that may have life …

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Evaluation Of Serum Calcium Differences In Hypertensive Crises And Control Patients: A Randomly Matched Case-Control Study, Ifeanyi Chukwu O. Onor, Rose M. Duchane, Casey J. Payne, Hannah Naquin Lambert, De Maurian M. Mitchner, Robbie A. Beyl, Anh T. Nguyen, Sarah E. Bilbe, Andrea Arriaga White, Mariah W. Johnson, Amber I. Faciane, Emmanuel Kouagou, Stephanie A. Hymel, Bria M. Wates, Asia D. Sanders, Phillip C.B. Vo, Jordan D. Bates, Raven J. Spooner, Christopher J. Gillard, John I. Okogbaa, Daniel F. Sarpong, Rim M. Hadgu, Samuel C. Okpechi, Gabriel I. Onor, Michael C. Okoronkwo, Mihran V. Naljayan, Shane G. Guillory, Shane E. Sanne Sep 2021

Evaluation Of Serum Calcium Differences In Hypertensive Crises And Control Patients: A Randomly Matched Case-Control Study, Ifeanyi Chukwu O. Onor, Rose M. Duchane, Casey J. Payne, Hannah Naquin Lambert, De Maurian M. Mitchner, Robbie A. Beyl, Anh T. Nguyen, Sarah E. Bilbe, Andrea Arriaga White, Mariah W. Johnson, Amber I. Faciane, Emmanuel Kouagou, Stephanie A. Hymel, Bria M. Wates, Asia D. Sanders, Phillip C.B. Vo, Jordan D. Bates, Raven J. Spooner, Christopher J. Gillard, John I. Okogbaa, Daniel F. Sarpong, Rim M. Hadgu, Samuel C. Okpechi, Gabriel I. Onor, Michael C. Okoronkwo, Mihran V. Naljayan, Shane G. Guillory, Shane E. Sanne

School of Medicine Faculty Publications

The role of calcium in blood pressure has been widely studied among hypertensive patients; however, no study has explored the role of calcium in hypertensive crises. The primary objective of this study is to evaluate the differences in serum calcium levels between hypertensive crises patients and a 1:1 random matched controls (age-, sex-, race-, diabetes, and body mass index matched). This study is a single-center, retrospective, chart review, case-control study of patients with hypertensive crises (case group) and patients without hypertensive crises (control group). Patients were included in the case group if they were 18 years of age or older …

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Multiprong Control Of Glioblastoma Multiforme Invasiveness: Blockade Of Pro-Inflammatory Signaling, Anti-Angiogenesis, And Homeostasis Restoration, Nicolas G. Bazan, Madigan M. Reid, Valerie A.Cruz Flores, Juan E. Gallo, William Lewis, Ludmila Belayev Sep 2021

Multiprong Control Of Glioblastoma Multiforme Invasiveness: Blockade Of Pro-Inflammatory Signaling, Anti-Angiogenesis, And Homeostasis Restoration, Nicolas G. Bazan, Madigan M. Reid, Valerie A.Cruz Flores, Juan E. Gallo, William Lewis, Ludmila Belayev

School of Medicine Faculty Publications

Glioblastoma multiforme (GBM) is the most invasive type of glial tumor with poor overall survival, despite advances in surgical resection, chemotherapy, and radiation. One of the main challenges in treating GBM is related to the tumor’s location, complex and heterogeneous biology, and high invasiveness. To meet the demand for oxygen and nutrients, growing tumors induce new blood vessels growth. Antibodies directed against vascular endothelial growth factor (VEGF), which promotes angiogenesis, have been developed to limit tumor growth. Bevacizumab (Avastin), an anti-VEGF monoclonal antibody, is the first approved angiogenesis inhibitor with therapeutic promise. However, it has limited efficacy, likely due to …

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Microrna‐146a‐5p, Neurotropic Viral Infection And Prion Disease (Prd), Aileen I. Pogue, Walter J. Lukiw Sep 2021

Microrna‐146a‐5p, Neurotropic Viral Infection And Prion Disease (Prd), Aileen I. Pogue, Walter J. Lukiw

School of Medicine Faculty Publications

The human brain and central nervous system (CNS) harbor a select sub‐group of potentially pathogenic microRNAs (miRNAs), including a well‐characterized NF‐kB‐sensitive Homo sapiens microRNA hsa‐miRNA‐146a‐5p (miRNA‐146a). miRNA‐146a is significantly over-expressed in progressive and often lethal viral‐ and prion‐mediated and related neurological syndromes associated with progressive inflammatory neurodegeneration. These include ~18 different viral‐induced encephalopathies for which data are available, at least ~10 known prion diseases (PrD) of animals and humans, Alzheimer’s disease (AD) and other sporadic and progressive age‐related neurological disorders. Despite the apparent lack of nucleic acids in prions, both DNA‐ and RNA‐containing viruses along with prions significantly induce miRNA‐146a …

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Nucleated Red Blood Cells As A Biomarker For Mortality In Neonates Following Cardiac Surgery, Kurt D. Piggott, Syeda Maqsood, Cynthia L. Warner, Timothy Pettitt, Shengping Yang, Jason Turner, Amira Soliman, Casey Norlin, Latasha Lewis, Ajay Bhatia Aug 2021

Nucleated Red Blood Cells As A Biomarker For Mortality In Neonates Following Cardiac Surgery, Kurt D. Piggott, Syeda Maqsood, Cynthia L. Warner, Timothy Pettitt, Shengping Yang, Jason Turner, Amira Soliman, Casey Norlin, Latasha Lewis, Ajay Bhatia

School of Medicine Faculty Publications

Introduction: Nucleated red blood cells (NRBCs) are immature red cells that under normal conditions are not present in the peripheral circulation. Several studies have suggested an association between elevated NRBC and poor outcome in critically ill adults and neonates. We sought to determine if elevations in NRBC value following cardiac surgery and following clinical events during the hospital stay can be used as a biomarker to monitor for mortality risk in neonates post-cardiac surgery. Materials and methods: We constructed a retrospective study of 264 neonates who underwent cardiac surgery at Children's Hospital, New Orleans between 2011 and 2020. Variables included …

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Persistent Brainstem Abscess Requiring Repeat Microsurgical Drainage: Case Report, Wesley M. Shoap, Ellery A. Hayden, George A. Crabill Aug 2021

Persistent Brainstem Abscess Requiring Repeat Microsurgical Drainage: Case Report, Wesley M. Shoap, Ellery A. Hayden, George A. Crabill

School of Medicine Faculty Publications

n this paper, we present a patient who was treated for a pontine abscess at our institution. This patient underwent sub-occipital craniotomy for microscopic abscess drainage after which cultures grew Streptococcus intermedius. She was treated with antibiotics but failed to show clinical improvement and was taken back to the operating room for repeat abscess drainage. Clinical improvement was seen after the second operation. This case report describes open surgical technique as a safe and effective way of treating brainstem abscess.

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Segmental Absence Of Intestinal Musculature In A Child With Type Iv Ehlers-Danlos Syndrome, Nicole Zeky, Celia Short, Brent Keith, Randall Craver, Jessica A. Zagory Aug 2021

Segmental Absence Of Intestinal Musculature In A Child With Type Iv Ehlers-Danlos Syndrome, Nicole Zeky, Celia Short, Brent Keith, Randall Craver, Jessica A. Zagory

School of Medicine Faculty Publications

Patients with vascular Ehlers-Danlos syndrome (vEDS) have a defect in the formation of type III collagen. This defect puts patients at risk of vascular rupture, uterine rupture, and bowel perforations. The segmental absence of intestinal musculature is a rare histopathologic finding, wherein there is a lack of a muscularis propria layer in the intestinal wall. Although typically documented in the literature in neonates or adults, it can be seen in children of other ages. This is a case report of a patient who exhibits both rare entities, which has not been described in the literature to date.

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Surgeon Decision-Making For Individuals With Obesity When Indicating Total Joint Arthroplasty, William F. Sherman, Akshar H. Patel, Nisha N. Kale, Christina M. Freiberger, C. Lowry Barnes, Olivia C. Lee Aug 2021

Surgeon Decision-Making For Individuals With Obesity When Indicating Total Joint Arthroplasty, William F. Sherman, Akshar H. Patel, Nisha N. Kale, Christina M. Freiberger, C. Lowry Barnes, Olivia C. Lee

School of Medicine Faculty Publications

Background: Obesity is a risk factor for complications after total joint arthroplasty (TJA). This study analyzed the impact of individual surgeon demographics, financial concerns, and other factors in determining patient candidacy for TJA based on body mass index (BMI). Methods: A 21-question survey was approved by the American Association of Hip and Knee Surgeons Research Committee for distribution to its membership. Objective questions asked about surgeon or hospital BMI thresholds for offering TJA. Subjective questions asked about physician comfort discussing topics including obesity, bariatric surgery, and weight loss before TJA, as well as insurance and age considerations. Results: For TJA …

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Peripheral Nerve Stimulation: A Review Of Techniques And Clinical Efficacy, Alan D. Kaye, Sasha Ridgell, Edward S. Alpaugh, Aya Mouhaffel, Aaron J. Kaye, Elyse M. Cornett, Azam A. Chami, Rutvij Shah, Bruce M. Dixon, Omar Viswanath, Ivan Urits, Amber N. Edinoff, Richard D. Urman Jul 2021

Peripheral Nerve Stimulation: A Review Of Techniques And Clinical Efficacy, Alan D. Kaye, Sasha Ridgell, Edward S. Alpaugh, Aya Mouhaffel, Aaron J. Kaye, Elyse M. Cornett, Azam A. Chami, Rutvij Shah, Bruce M. Dixon, Omar Viswanath, Ivan Urits, Amber N. Edinoff, Richard D. Urman

School of Medicine Faculty Publications

Chronic pain is a common source of morbidity in many patient populations worldwide. There are growing concerns about the potential side effects of currently prescribed medications and a continued need for effective treatment. Related to these concerns, peripheral nerve stimulation has been regaining popularity as a potential treatment modality. Peripheral nerve stimulation components include helically coiled electrical leads, which direct an applied current to afferent neurons providing sensory innervation to the painful area. In theory, the applied current to the peripheral nerve will alter the large-diameter myelinated afferent nerve fibers, which interfere with the central processing of pain signals through …

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Assessment Of Video Capsule Endoscopy In The Management Of Acute Gastrointestinal Bleeding During The Covid-19 Pandemic, Shahrad Hakimian, Daniel Raines, George Reed, Mark Hanscom, Lilia Stefaniwsky, Matthew Petersile, Prashanth Rau, Anne Foley, David Cave Jul 2021

Assessment Of Video Capsule Endoscopy In The Management Of Acute Gastrointestinal Bleeding During The Covid-19 Pandemic, Shahrad Hakimian, Daniel Raines, George Reed, Mark Hanscom, Lilia Stefaniwsky, Matthew Petersile, Prashanth Rau, Anne Foley, David Cave

School of Medicine Faculty Publications

Importance: Evaluation of acute gastrointestinal (GI) bleeding using invasive endoscopic procedures comprising the standard of care (SOC) - upper endoscopy and colonoscopy - can expose the endoscopy staff to SARS-CoV-2. Video capsule endoscopy (VCE) does not generate aerosols and only requires 1 person to manage the procedure. Objective: To examine the safety of VCE for the initial evaluation of GI bleeding at the peak of the COVID-19 pandemic to identify signs of active bleeding while minimizing patient and personnel exposure, saving personal protective equipment, and avoiding invasive or unnecessary procedures. Design, Setting, and Participants: A multicenter (UMass Memorial Medical Center …

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Precision Medicine And Triple-Negative Breast Cancer: Current Landscape And Future Directions, Fokhrul Hossain, Samarpan Majumder, Justin David, Lucio Miele Jul 2021

Precision Medicine And Triple-Negative Breast Cancer: Current Landscape And Future Directions, Fokhrul Hossain, Samarpan Majumder, Justin David, Lucio Miele

School of Medicine Faculty Publications

Triple-negative breast cancer (TNBC) is an aggressive and heterogeneous subtype of breast cancer associated with a high recurrence and metastasis rate that affects African-American women disproportionately. The recent approval of targeted therapies for small subgroups of TNBC patients by the US ‘Food and Drug Administration’ is a promising development. The advancement of next-generation sequencing, particularly somatic exome panels, has raised hopes for more individualized treatment plans. However, the use of precision medicine for TNBC is a work in progress. This review will discuss the potential benefits and challenges of precision medicine for TNBC. A recent clinical trial designed to target …

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Preoperative, Multidisciplinary Clinical Optimization Of Patients With Severely Depressed Left Ventricular Ejection Fraction Who Are Undergoing Coronary Artery Bypass Grafting, Islam Mohammad Shehata, Tiffany D. Odell, Amir Elhassan, Maxim Spektor, Ivan Urits, Omar Viswanath, George M. Jeha, Elyse M. Cornett, Alan D. Kaye Jul 2021

Preoperative, Multidisciplinary Clinical Optimization Of Patients With Severely Depressed Left Ventricular Ejection Fraction Who Are Undergoing Coronary Artery Bypass Grafting, Islam Mohammad Shehata, Tiffany D. Odell, Amir Elhassan, Maxim Spektor, Ivan Urits, Omar Viswanath, George M. Jeha, Elyse M. Cornett, Alan D. Kaye

School of Medicine Faculty Publications

Coronary artery bypass grafting (CABG) remains a routine operation despite major advancements in angioplastic procedures. Around 200,000 CABG procedures are performed annually in the U.S. Patients who are not candidates for angioplasty intervention often have advanced coronary disease and comorbidities that raise the risk of heart failure with decreased ejection fraction to around 25%. Over the years, significant developments in various preoperative interventions have occurred; in this paper, we suggest a multidisciplinary preoperative algorithm that can be included in a regularly scheduled multidisciplinary care plan.

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Severe Covid-19 Is Characterized By An Impaired Type I Interferon Response And Elevated Levels Of Arginase Producing Granulocytic Myeloid Derived Suppressor Cells, Matthew J. Dean, Juan B. Ochoa, Maria Dulfary Sanchez-Pino, Jovanny Zabaleta, Jone Garai, Luis Del Valle, Dorota Wyczechowska, Lyndsey Buckner Baiamonte, Phaethon Philbrook, Rinku Majumder, Richard S. Vander Heide, Logan Dunkenberger, Ramesh Puttalingaiah Thylur, Bobby Nossaman, W. Mark Roberts, Andrew G. Chapple, Jiande Wu, Chindo Hicks, Jack Collins, Brian Luke Jul 2021

Severe Covid-19 Is Characterized By An Impaired Type I Interferon Response And Elevated Levels Of Arginase Producing Granulocytic Myeloid Derived Suppressor Cells, Matthew J. Dean, Juan B. Ochoa, Maria Dulfary Sanchez-Pino, Jovanny Zabaleta, Jone Garai, Luis Del Valle, Dorota Wyczechowska, Lyndsey Buckner Baiamonte, Phaethon Philbrook, Rinku Majumder, Richard S. Vander Heide, Logan Dunkenberger, Ramesh Puttalingaiah Thylur, Bobby Nossaman, W. Mark Roberts, Andrew G. Chapple, Jiande Wu, Chindo Hicks, Jack Collins, Brian Luke

School of Medicine Faculty Publications

COVID-19 ranges from asymptomatic in 35% of cases to severe in 20% of patients. Differences in the type and degree of inflammation appear to determine the severity of the disease. Recent reports show an increase in circulating monocytic-myeloid-derived suppressor cells (M-MDSC) in severe COVID 19 that deplete arginine but are not associated with respiratory complications. Our data shows that differences in the type, function and transcriptome of granulocytic-MDSC (G-MDSC) may in part explain the severity COVID-19, in particular the association with pulmonary complications. Large infiltrates by Arginase 1+ G-MDSC (Arg+G-MDSC), expressing NOX-1 and NOX-2 (important for production of reactive oxygen …

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Regulation Of Microrna Expression In Sleep Disorders In Patients With Epilepsy, Edyta Dziadkowiak, Justyna Chojdak-Łukasiewicz, Piotr Olejniczak, Bogusław Paradowski Jul 2021

Regulation Of Microrna Expression In Sleep Disorders In Patients With Epilepsy, Edyta Dziadkowiak, Justyna Chojdak-Łukasiewicz, Piotr Olejniczak, Bogusław Paradowski

School of Medicine Faculty Publications

The effects of epilepsy on sleep and the activating effects of sleep on seizures are well documented in the literature. To date, many sleep-related and awake-associated epilepsy syndromes have been described. The relationship between sleep and epilepsy has led to the recognition of polysomnographic testing as an important diagnostic tool in the diagnosis of epilepsy. The authors analyzed the available medical database in search of other markers that assess correlations between epilepsy and sleep. Studies pointing to microRNAs, whose abnormal expression may be common to epilepsy and sleep disorders, are promising. In recent years, the role of microRNAs in the …

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Endoscopic Proximal Median Nerve Decompression: An Alternative Treatment For Pronator Syndrome, Scott A. Barnett, Sagar A. Shah, Rasheed I. Ahmad Jul 2021

Endoscopic Proximal Median Nerve Decompression: An Alternative Treatment For Pronator Syndrome, Scott A. Barnett, Sagar A. Shah, Rasheed I. Ahmad

School of Medicine Faculty Publications

Proximal forearm median nerve compressive neuropathy, termed as pronator syndrome, is difficult to diagnose and often overlooked. Its symptoms include vague proximal volar forearm pain that may be associated with paresthesia and numbness in the median nerve distribution. Weakness is typically not present. The treatment of pronator syndrome is largely nonsurgical, consisting of activity modification, anti-inflammatory medication, corticosteroid injections, stretching, and periods of splinting. Surgery is indicated when conservative therapy fails; however, there is no consensus on the treatment approach or technique. Most decompressions are performed using an open technique through a variety of incisions. Recently, endoscopic approaches have drawn …

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Diagnosis-To-Surgery Interval And Survival For Different Histologies Of Stage I-Iia Lung Cancer, Lu Zhang, Mei Chin Hsieh, Lior Rennert, Paige Neroda, Xiao Cheng Wu, Chindo Hicks, Jiande Wu, Ronald Gimbel Jul 2021

Diagnosis-To-Surgery Interval And Survival For Different Histologies Of Stage I-Iia Lung Cancer, Lu Zhang, Mei Chin Hsieh, Lior Rennert, Paige Neroda, Xiao Cheng Wu, Chindo Hicks, Jiande Wu, Ronald Gimbel

School of Medicine Faculty Publications

Background: Guidelines on timeliness of lung cancer surgery are inconsistent. Lung cancer histologic subtypes have different prognosis and treatment. It is important to understand the consequences of delayed surgery for each lung cancer histologic subtype. This study aimed to examine the association between diagnosis-to-surgery time interval and survival for early stage lung cancer and selected histologic subtypes. Methods: Patients diagnosed with stage I-IIA lung cancer between 2004 and 2015 receiving definitive surgery and being followed up until Dec. 31, 2018, were identified from Surveillance, Epidemiology, and End Results database. Histologic subtypes included adenocarcinoma, squamous or epidermoid carcinoma, bronchioloalveolar carcinoma, large …

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Oridonin And Its Derivatives For Cancer Treatment And Overcoming Therapeutic Resistance, Xi Liu, Jimin Xu, Jia Zhou, Qiang Shen Jul 2021

Oridonin And Its Derivatives For Cancer Treatment And Overcoming Therapeutic Resistance, Xi Liu, Jimin Xu, Jia Zhou, Qiang Shen

School of Medicine Faculty Publications

Cancer is one of the diseases with high morbidity and mortality on a global scale. Chemotherapy remains the primary treatment option for most cancer patients, including patients with progressive, metastatic, and recurrent diseases. To date, hundreds of chemotherapy drugs are used to treat various cancers, however, the anti-cancer efficacy and outcomes are largely hampered by chemotherapy-associated toxicity and acquired therapeutic resistance. The natural product (NP) oridonin has been extensively studied for its anti-cancer efficacy. More recently, oridonin has been shown to overcome drug resistance through multiple mechanisms, with yet-to-be-defined bona fide targets. Hundreds of oridonin derivative analogs (oridonalogs) have been …

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Covid-19 Vaccines And Thrombosis—Roadblock Or Dead-End Street?, Kenneth Lundstrom, Debmalya Barh, Bruce D. Uhal, Kazuo Takayama, Alaa A.A. Aljabali, Tarek Mohamed Abd El-Aziz, Amos Lal, Elrashdy M. Redwan, Parise Adadi, Gaurav Chauhan, Samendra P. Sherchan, Gajendra Kumar Azad, Nima Rezaei, Ángel Serrano-Aroca, Nicolas G. Bazan, Sk Sarif Hassan, Pritam Kumar Panda, Pabitra Pal Choudhury, Damiano Pizzol, Ramesh Kandimalla Jul 2021

Covid-19 Vaccines And Thrombosis—Roadblock Or Dead-End Street?, Kenneth Lundstrom, Debmalya Barh, Bruce D. Uhal, Kazuo Takayama, Alaa A.A. Aljabali, Tarek Mohamed Abd El-Aziz, Amos Lal, Elrashdy M. Redwan, Parise Adadi, Gaurav Chauhan, Samendra P. Sherchan, Gajendra Kumar Azad, Nima Rezaei, Ángel Serrano-Aroca, Nicolas G. Bazan, Sk Sarif Hassan, Pritam Kumar Panda, Pabitra Pal Choudhury, Damiano Pizzol, Ramesh Kandimalla

School of Medicine Faculty Publications

Two adenovirus-based vaccines, ChAdOx1 nCoV-19 and Ad26.COV2.S, and two mRNA-based vaccines, BNT162b2 and mRNA.1273, have been approved by the European Medicines Agency (EMA), and are invaluable in preventing and reducing the incidence of coronavirus disease-2019 (COVID-19). Recent reports have pointed to thrombosis with associated thrombocytopenia as an adverse effect occurring at a low frequency in some individuals after vaccination. The causes of such events may be related to SARS-CoV-2 spike protein interactions with different C-type lectin receptors, heparan sulfate proteoglycans (HSPGs) and the CD147 receptor, or to different soluble splice variants of the spike protein, adenovirus vector interactions with the …

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Efficiency Of Prolonged Prone Positioning For Mechanically Ventilated Patients Infected With Covid-19, Elizabeth M. Parker, Edward A. Bittner, Lorenzo Berra, Richard M. Pino Jul 2021

Efficiency Of Prolonged Prone Positioning For Mechanically Ventilated Patients Infected With Covid-19, Elizabeth M. Parker, Edward A. Bittner, Lorenzo Berra, Richard M. Pino

School of Medicine Faculty Publications

Hypoxemia of the acute respiratory distress syndrome can be reduced by turning patients prone. Prone positioning (PP) is labor intensive, risks unplanned tracheal extubation, and can result in facial tissue injury. We retrospectively examined prolonged, repeated, and early versus later PP for 20 patients with COVID-19 respiratory failure. Blood gases and ventilator settings were collected before PP, at 1, 7, 12, 24, 32, and 39 h after PP, and 7 h after completion of PP. Analysis of variance was used for comparisons with baseline values at supine positions before turning prone. PP for >39 h maintained PaO2/FiO2 (P/F) ratios when …

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Upregulation Of Endogenous Trail-Elicited Apoptosis Is Essential For Metformin-Mediated Antitumor Activity Against Tnbc And Nsclc, Shuang Liu, Erik V. Polsdofer, Lukun Zhou, Sanbao Ruan, Hui Lyu, Defu Hou, Hao Liu, Ann D. Thor, Zhimin He, Bolin Liu Jun 2021

Upregulation Of Endogenous Trail-Elicited Apoptosis Is Essential For Metformin-Mediated Antitumor Activity Against Tnbc And Nsclc, Shuang Liu, Erik V. Polsdofer, Lukun Zhou, Sanbao Ruan, Hui Lyu, Defu Hou, Hao Liu, Ann D. Thor, Zhimin He, Bolin Liu

School of Medicine Faculty Publications

Tumor necrosis factor-related apoptosis-inducing ligand (TRAIL) shows promising antitumor activity in preclinical studies. However, the efficacy of recombinant TRAIL in clinical trials is compromised by its short serum half-life and low in vivo stability. Induction of endogenous TRAIL may overcome the limitations and become a new strategy for cancer treatment. Here, we discovered that metformin increased TRAIL expression and induced apoptosis in triple-negative breast cancer (TNBC) and non-small cell lung cancer (NSCLC) cells. Metformin did not alter the expression of TRAIL receptors (TRAIL-R1/DR4 and TRAIL-R2/DR5). Metformin-upregulated TRAIL was secreted into conditioned medium (CM) and found to be functional, since the …

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