Medical Specialties Commons^™

Determinan Diagnostik Klinis Defisiensi Vitamin D Pada Wanita Berusia Lebih Dari 50 Tahun, Vera Vera, Siti Setiati, Arya Govinda

Jurnal Penyakit Dalam Indonesia

Pendahuluan: Prevalensi deifisiensi vitamin D pada wanita 50 tahun ke atas di Indonesia cukup tinggi namun pemeriksaan kadar vitamin D serum sangat mahal. Oleh karena itu, diperlukan alat penyaring defisiensi vitamin D yang cukup ekonomis dan sederhana untuk dikerjakan di layanan kesehatan primer. Metode: Penelitian ini merupakan penelitian diagnostik, menggunakan desain potong lintang (cross-sectional) sehubungan dengan pengambilan data hanya dilakukan sewaktu saja. Penelitian ini dilakukan di Kotamadia Bandung selama Agustus–Oktober 2012. Pada 240 subjek, dilakukan pengumpulan data berupa karakteristik responden, diabetes mellitus, penyakit ginjal kronik, riwayat jatuh, riwayat fraktur setelah menopause, nyeri tulang, skor paparan sinar matahari, skor proteksi sinar …

Tatalaksana Terkini Perlemakan Hati Non Alkoholik, Randy Adiwinata, Andi Kristanto, Finna Christianty, Timoteus Richard, Daniel Edbert

Jurnal Penyakit Dalam Indonesia

Perlemakan Hati Non Alkoholik (Non Alcoholic Fatty Liver Disease/NAFLD) merupakan salah satu penyebab utama dari penyakit hati kronis di negara berkembang. NAFLD dapat berkembang menjadi menjadi penyakit hati yang lebih berat seperti Non Alcoholic Steatohepatis (NASH), sirosis hepatis, dan karsinoma hati. Tatalaksana NAFLD terus berkembang, dan saat ini klinisi dihadapkan dengan berbagai pilihan alternatif baik dari segi nonfarmakoterapi maupun farmakoterapi. Tulisan ini akan membahas berbagai pilihan terapi NAFLD terkini tersebut berdasarkan bukti terbaru.

Focused Ultrasound For Treatment Of Bone Tumours., Dario B. Rodrigues, Paul R. Stauffer, David Vrba, Mark Hurwitz, Md

Department of Radiation Oncology Faculty Papers

PURPOSE: Focused ultrasound (FUS) is a modality with rapidly expanding applications across the field of medicine. Treatment of bone lesions with FUS including both benign and malignant tumours has been an active area of investigation. Recently, as a result of a successful phase III trial, magnetic resonance-guided FUS is now a standardised option for treatment of painful bone metastases. This report reviews the clinical applications amenable to treatment with FUS and provides background on FUS and image guidance techniques, results of clinical studies, and future directions.

METHODS: A comprehensive literature search and review of abstracts presented at the recently completed …

The Emerging Role Of Ng2 In Pediatric Diffuse Intrinsic Pontine Glioma., Sridevi Yadavilli, Joseph Scafidi, Oren J. Becher, Amanda M. Saratsis, Rebecca L. Hiner, Madhuri Kambhampati, Santi Mariarita, Tobey J. Macdonald, Kari-Elise Codispoti, Suresh N. Magge, Jyoti K. Jaiswal, Roger J. Packer, Javad Nazarian

Neurology Faculty Publications

Diffuse intrinsic pontine gliomas (DIPGs) have a dismal prognosis and are poorly understood brain cancers. Receptor tyrosine kinases stabilized by neuron-glial antigen 2 (NG2) protein are known to induce gliomagenesis. Here, we investigated NG2 expression in a cohort of DIPG specimens (n= 50). We demonstrate NG2 expression in the majority of DIPG specimens tested and determine that tumors harboring histone 3.3 mutation express the highest NG2 levels. We further demonstrate that microRNA 129-2 (miR129-2) is downregulated and hypermethylated in human DIPGs, resulting in the increased expression of NG2. Treatment with 5-Azacytidine, a methyltransferase inhibitor, results in NG2 downregulation in DIPG …

G9a Is Essential For Emt-Mediated Metastasis And Maintenance Of Cancer Stem Cell-Like Characters In Head And Neck Squamous Cell Carcinoma, Shuli Liu, Dongxia Ye, Wenzheng Guo, Wenwen Yu, Yue He, Jingzhou Hu, Yanan Wang, Ling Zhang, Yueling Liao, Hongyong Song, Shuangshuang Zhong, Dongliang Xu, Huijing Yin, Beibei Sun, Xiaofei Wang, Jingyi Liu, Yadi Wu, Binhua P. Zhou, Zhiyuan Zhang, Jiong Deng

Markey Cancer Center Faculty Publications

Head and neck squamous cell carcinoma (HNSCC) is a particularly aggressive cancer with poor prognosis, largely due to lymph node metastasis and local recurrence. Emerging evidence suggests that epithelial-to-mesenchymal transition (EMT) is important for cancer metastasis, and correlated with increased cancer stem cells (CSCs) characteristics. However, the mechanisms underlying metastasis to lymph nodes in HNSCC is poorly defined. In this study, we show that E-cadherin repression correlates with cancer metastasis and poor prognosis in HNSCC. We found that G9a, a histone methyltransferase, interacts with Snail and mediates Snail-induced transcriptional repression of E-cadherin and EMT, through methylation of histone H3 lysine-9 …

Preliminary Analysis Of In Utero Low-Level Arsenic Exposure And Fetal Growth Using Biometric Measurements Extracted From Fetal Ultrasound Reports, Matthew A. Davis, John Higgins, Zhigang Li, Diane Gilbert-Diamond, Emily R. Baker, Amar Das, Margaret R. Karagas

Dartmouth Scholarship

Background: Early life exposure to arsenic is associated with decreased birth weight in highly exposed populations but little is known about effects of low-level arsenic exposure on growth in utero.

Methods: Using a sample of 272 pregnancies from New Hampshire we obtained biometric measurements directly from fetal ultrasound reports commonly found in electronic medical records. We used information extraction methods to develop and validate an automated approach for mining biometric measurements from the text of clinical reports. As a preliminary analysis, we examined associations between in utero low-level arsenic exposure (as measured by maternal urinary arsenic concentration) and fetal growth …

Medical Students In Microscopic Anatomy And Pathology Laboratories: Design Of An E-Learning Histology And Histopathology Atlas As An Evolving Response To Interdisciplinary Pre-Clinical Curricular Needs, Michelle S. Davis, Alexandra Mills, Gisela Butera, Donald S. Karcher, Patricia S. Latham, Janette Krum, Rosalyn A. Jurjus

Anatomy and Regenerative Biology Faculty Publications

E-learning, also known as computer-assisted learning, successfully bridges anatomical knowledge and transferrable skills, such as critical analysis, teamwork, leadership and communication. Several institutions have already integrated histology and physiology in team based laboratory approaches, but integration of histology and pathology instruction has been done to a lesser extent. Our aim was to develop an e-learning atlas that integrates microanatomy and pathology laboratory for an interdisciplinary pre-clinical medical curriculum.

A multidisciplinary team of teaching faculty and students developed an online atlas (microanatomyatlas.com) that includes a library of histology and histopathology images. Traditional laboratory manual instructions and study objectives were added onto …

Finding A Foal Amongst The Zebras: An Uncommon Presentation Of Lemierre’S Syndrome, Saisho Mangla Do, Claudia F. Busse Md, Liborio Larussa Md

Department of Pediatrics

No abstract provided.

Burden Of Periprosthetic Joint Infection And Its Treatment On Kidney Function

Rothman Institute Conference Posters

Introduction:

Patients with periprosthetic joint infection (PJI) are subjected to several potentially nephrotoxic conditions such as acute and chronic systemic inflammatory reactions, multiple surgical procedures and noxious antibiotics. This study aims to investigate 1) the incidence and severity of kidney injury in patients undergoing surgical treatment for PJI, 2) whether the number of surgeries affects renal function in PJI patients and 3) the potential risk factors for kidney injury.

Ppm1a Regulates Antiviral Signaling By Antagonizing Tbk1-Mediated Sting Phosphorylation And Aggregation, Zexing Li, Ge Liu, Liwei Sun, Yan Teng, Xuejiang Guo, Jianhang Jia, Jiahao Sha, Xiao Yang, Dahua Chen, Qinmiao Sun

Markey Cancer Center Faculty Publications

Stimulator of interferon genes (STING, also known as MITA and ERIS) is critical in protecting the host against DNA pathogen invasion. However, the molecular mechanism underlying the regulation of STING remains unclear. Here, we show that PPM1A negatively regulates antiviral signaling by targeting STING in its phosphatase activity-dependent manner, and in a line with this, PPM1A catalytically dephosphorylates STING and TBK1 in vitro. Importantly, we provide evidence that whereas TBK1 promotes STING aggregation in a phosphorylation-dependent manner, PPM1A antagonizes STING aggregation by dephosphorylating both STING and TBK1, emphasizing that phosphorylation is crucial for the efficient activation of STING. Our …

Maternal Analgosedation And Breastfeeding: Guidance For The Pediatrician, Karel Allegaert, Johannes N. Van Den Anker

Surgery Faculty Publications

As part of analgosedative treatment modalities after delivery (e.g. caesarean related pain, birth related trauma, pre-existing pain syndromes), mothers are treated with different analgosedatives that may also affect the nursing infant. This review aims to summarize the available knowledge on commonly prescribed analgosedatives (opioids, intravenous and inhalational anesthetics, benzodiazepines, non-opioid analgesics, and local anesthetics) during breastfeeding.

We propose that the use of systemic non-opioid analgesics, local anesthetics, inhalational or intravenous anesthetics is safe when mothers are nursing. When systemic opioids are used, we recommend pediatricians to consider clinical monitoring of the infant for sedation. The duration of maternal exposure ( …

Low Dose Aspirin: An Effective Chemoprophylaxis For Preventing Venous Thromboembolic Events, Javad Parvizi, Md, Frcs, Antonia F. Chen, Md, Mba, Camilo Restrepo, Md, Ronald Huang, Md, Jenny Cal, Bs, William J. Hozack, Md, Jess H. Lonner, Md

Rothman Institute Conference Posters

The available guidelines, endorsed by Surgical Care Improvement Project (SCIP), have advocated that aspirin (ASA) is a safe and eff­ective strategy for venous thromboembolic events (VTE) prophylaxis following total joint arthroplasty (TJA). The optimal dose of aspirin for this purpose is not known. The first guidelines for prevention of VTE that were issued by the American Academy of Orthopedic Surgeons recommended 325 mg Bis in die (twice a day) (bid) for this purpose with the recommendation having a 1C grade (little evidence to support the recommendation). It is known that platelet aggregation inhibition occurs at lower doses. Traditionally, ASA 81mg …

Red Cell Distribution Width: An Unacknowledged Predictor Of Mortality And Length Of Stay Following Revision Arthroplasty, Pouya Alijanipour, Md, Snir Heller, Md, Fatih Kucukdurmaz, Md, Benjamin Zmistowski, Md, Maryam Rezapoor, Ms, Javad Parvizi, Md, Frcs

Rothman Institute Conference Posters

Introduction

Red blood cell distribution width (RDW), a measure of variability in size of circulating erythrocytes, is routinely reported in complete blood cell analysis, and together with mean cell volume (MCV) has conventionally been used to distinguish the cause of anemia. It is calculated by (Standard deviation of MCV÷ mean MCV) x 100, with normal range being 11.5%-14.5%. Several recent publications have described RDW as an independent predictor of adverse outcome and mortality in patients with different underlying medical conditions such as acute and chronic heart failure, peripheral artery disease, chronic pulmonary disease and acute kidney injury1. The purposes of …

Radiation Exposure To The Eye With Mini C-Arm Use During Hand Surgery, Mark L. Wang, Md, Phd, C. Edward Hoffler, Md, Phd, Frederick E. Liss, Md, Asif Ilyas, Md, Charles Leinberry, Md, Pedro Beredjiklian, Md

Rothman Institute Conference Posters

Introduction:

Fluoroscopic radiation exposure is a potential occupational health risk to the Hand Surgeon, given operator proximity and the relative lack of eye shielding. The association of eye radiation exposure and the early development of cataracts have been previously reported. Mini C-arm fluoroscopy is commonly utilized during routine Hand Surgery. At present, the amount of radiation exposure to the eye, associated with the routine use of mini C-arm fluoroscopy, is unknown, thus warranting further investigation. The purpose of this study is to test the hypothesis that eye radiation exposure, sustained during routine mini C-arm use, does not exceed that of …

Metformin Prevents Aggressive Ovarian Cancer Growth Driven By High-Energy Diet: Similarity With Calorie Restriction, Zaid Al-Wahab, Ismail Mert, Calvin Tebbe, Jasdeep Chhina, Miriana Hijaz, Robert T. Morris, Rouba Ali-Fehmi, Shailendra Giri, Adnan Munkarah, Ramandeep Rattan

Department of Obstetrics and Gynecology Research Publications

Caloric restriction (CR) was recently demonstrated by us to restrict ovarian cancer growth in vivo. CR resulted in activation of energy regulating enzymes adenosine monophosphate activated kinase (AMPK) and sirtuin 1 (SIRT1) followed by downstream inhibition of Akt-mTOR. In the present study, we investigated the effects of metformin on ovarian cancer growth in mice fed a high energy diet (HED) and regular diet (RD) and compared them to those seen with CR in an immunocompetent isogeneic mouse model of ovarian cancer. Mice either on RD or HED diet bearing ovarian tumors were treated with 200 mg/kg metformin in drinking …

Long Term Follow-Up Of A Successful Lower Limb Replantation In A 3-Year-Old Child, Akbar Jaleel Zubairi, Pervaiz Mahmood Hashmi

Section of Orthopaedic Surgery

Replantation of the lower extremity has controversial indications but nevertheless it may be considered in carefully selected patients who present early and are expected to show good functional recoveries. Here we present a successful replantation in a 3-year-old boy who has made excellent recovery with no functional deficit evident at 12 years of follow-up. He sustained a traumatic amputation at the level of distal tibia when he fell of a "Qing Qi" (motorcycle rickshaw). Replantation was attempted at 8 hours cold ischemia time with the tibia shortened 4cm and all tendons, vessels, and nerves repaired. Patient required a second procedure …

Sarcoidosis Presented As Retroperitoneal And Lung Mass, Nousheen Iqbal, Aamer Mahmood, Muhammad Irfan, Khurram Minhas

Section of Pulmonary & Critical Care

Sarcoidosis is a multisystem granulomatous disorder of unknown aetiology characterised pathologically by the presence of non-caseating granulomas in involved organs. Sarcoidosis most frequently involves the lungs followed by eye and skin. Presentation as retroperitoneal and lung mass is rare in sarcoidosis. We describe an unusual case of sarcoidosis where the patient presented with large retroperitoneal and lung masses, and was treated as tuberculosis

Rotational Alignment In Medial Unicompartmental Knee Arthroplasty: Comparison Of Anatomic Landmarks, Glenn J. Kerr, Md, Patrick O'Toole, Md, Eddie Wu, Do, Jess H. Lonner, Md

Rothman Institute Conference Posters

Introduction:

The landmarks used for tibial component rotation in total knee arthroplasty (TKA) and medial unicompartmental knee arthroplasty (UKA) may differ, utilizing the medial edge of the tibial tubercle and the medial edge of the tibial spine, respectively. However, some surgeons reference from the medial edge of the tibial tubercle in UKA. Use of the tibial tubercle to determine orientation of the sagittal cut in medial UKA can result in external rotation of the tibial component, leading to rotational mismatch between the femoral and tibial components, potential disruption of the ACL and tibial component undersizing. The purpose of this study …

The Patellar Tendon Can Cause External Tibial Component Malrotation In Lateral Unicondylar Knee Arthroplasty, Glenn J. Kerr, Md, Patrick O'Toole, Md, Eddie Wu, Do, Jess H. Lonner, Md

Rothman Institute Conference Posters

Introduction:

The optimal rotational axis of the tibial component in lateral unicompartmental knee arthroplasty (UKA) should be aligned parallel to the lateral tibial spine. However, the relatively lateral positions of the tibial tubercle and patellar tendon make the sagittal tibial cut in lateral UKA difficult and commonly predisposes to inadvertent external rotation of the tibial component. The purpose of this study was to quantify the potential rotational impact that occurs when aligning the anterior edge of the sagittal tibial cut with the lateral edge of the patellar tendon in lateral UKA.

Trigger Finger Release Performed Wide Awake: Prospective Comparison Of Local Anesthetics, Constantinos Ketonis, Md, Phd, Nayoung Kim, Bs, Frederic Liss, Md, Benjamin Zmistowski, Md, Jonas L. Matzon, Md, Charles Leinberry, Md, Mark L. Wang, Md, Phd, Christopher Jones, Md, William Kirkpatrick, Md, Asif M Ilyas, Md

Rothman Institute Conference Posters

Introduction:

Trigger fi­nger (TF) is one of the most common conditions treated by hand surgeons with a lifetime risk up to 10% in patients with diabetes. If conservative management fails, surgical treatment is undertaken, with or without sedation and a tourniquet, via a small incision to release the A1 pulley. A number of local anesthetics are readily available including Lidocaine, Ropivacaine and Marcaine as well as encapsulated formulations thereof such as Exparel. Since it’s approval in 2011, there have been numerous reports of successfully achieving prolonged pain relief with locally injected Exparel after various procedures, but to the best of …

Cystic Multiglandular Maternal Hyperparathyroidism Diagnosed By Neonatal Hypocalcemic Seizures, Kristin Long, Tessa Cartwright, David A. Sloan, Cortney Y. Lee

Surgery Faculty Publications

A 7-day-old male infant born to a healthy 33-year-old female at 37 weeks of gestation was brought to the local emergency department (ED) with sudden-onset tonic-clonic seizures. Laboratory testing revealed extreme hypocalcemia (ionized calcium of 3.2 mg/dl) and undetectable parathyroid hormone (PTH/ml). Concomitant evaluation of the mother revealed both elevated ionized calcium (5.9 mg/dl) and PTH (116 pg/ml). The mother underwent preoperative ultrasound localization and sestamibi scan, followed promptly by parathyroidectomy. Given the cystic appearance and presence of multiglandular disease, evaluation for familial cystic parathyroid adenomatosis (hyperparathyroidism-jaw bone-tumor syndrome) and MEN 1 were undertaken. The infant was stabilized and discharged …

When Is It Safe For Patients To Drive After Right Total Hip Arthroplasty?, Victor H. Hernandez, Md, Alvin C. Ong, Md, Fabio Orozco, Md, Anne Marie Madden, Zachary D. Post, Md

Rothman Institute Conference Posters

Introduction:

• Driving restrictions after total hip arthroplasty (THA) can be inconvenient and burdensome for patients.
• When patients may safely be allowed to drive remains controversial.
• Most studies recommend 6 weeks but recent advances in surgical approach, pain management and rapid recovery may have changed this time frame.
• The purpose of this study was to prospectively evaluate driving safety after THA through brake reaction time.

Aspirin May Be Adequate For Venous Thromboembolic Event Prophylaxis After Revision Hip And Knee Arthroplasty, Greg K. Deirmengian, Md, Snir Heller, Md, Eric B. Smith, Md, Mitchell Maltenfort, Phd, Javad Parvizi, Md, Frcs

Rothman Institute Conference Posters

Introduction:

The optimal prophylaxis for prevention of venous thromboembolic events (VTE) after total hip arthroplasty (THA) and total knee arthroplasty (TKA) remains unknown.(1) Current studies focus on primary arthroplasty and there are little to no data on the ideal prophylaxis for VTE following revision arthroplasty.(2) Revision surgery, due to its complexity, longer operative time, higher risk of bleeding and infection diff­ers from primary arthroplasty.(3) The objective of this study was to evaluate whether aspirin, known to be e­ffective for prevention of VTE after primary arthroplasty, is also e­ffective against such events following revision THA and TKA.

Antimicrobial Peptides In 2014., Guangshun Wang, Biswajit Mishra, Kyle Lau, Tamara Lushnikova, Radha Golla, Xiuqing Wang

Journal Articles: Pathology and Microbiology

This article highlights new members, novel mechanisms of action, new functions, and interesting applications of antimicrobial peptides reported in 2014. As of December 2014, over 100 new peptides were registered into the Antimicrobial Peptide Database, increasing the total number of entries to 2493. Unique antimicrobial peptides have been identified from marine bacteria, fungi, and plants. Environmental conditions clearly influence peptide activity or function. Human α-defensin HD-6 is only antimicrobial under reduced conditions. The pH-dependent oligomerization of human cathelicidin LL-37 is linked to double-stranded RNA delivery to endosomes, where the acidic pH triggers the dissociation of the peptide aggregate to release …

Ocular Complications Of Inflammatory Bowel Disease, Rana Mady, Will Grover, Salim Butrus

Ophthalmology Faculty Publications

No abstract provided.

Anterior Cruciate Ligament Reconstruction With Bone-Patellar Tendon-Bone Autograft Versus Allograft In Young Patients, Alfred W. Atanda, Daniel F. O'Brien, Matthew J. Kraeutler, Russell R. Flato, Matthew R. Salminen, Kevin Henrichsen, Patrick Kane, Christopher Dodson, Steven B. Cohen, Michael G. Ciccotti

Rothman Institute Papers

Objectives: Traditionally, bone-patella tendon-bone (BTB) autograft has been the gold standard graft choice for younger, athletic patients requiring ACL reconstruction. However, donor site morbidity, post-operative patella fracture, and increased operative time have led many surgeons to choose BTB allograft for their reconstructions. Opponents of allografts feel that slower healing time, higher rate of graft failure, and potential for disease transmission makes them undesirable graft choices in athletic patients. The purpose of this study is to evaluate the clinical outcomes, both subjective and objective, of young patients that who have undergone either BTB autograft or allograft reconstructions with a minimum of …

The Flavonoid Nobiletin Inhibits Tumor Growth And Angiogenesis Of Ovarian Cancers Via The Akt Pathway, Jianchu Chen, Allen Y. Chen, Haizhi Huang, Xingqian Ye, William D. Rollyson, Haley E. Perry, Kathleen C. Brown, Yon Rojanasakul, Gary O. Rankin, Piyali Dasgupta, Yi Charlie Chen

Pharmaceutical Science and Research

Despite its importance, the death rate of ovarian cancer has remained unchanged over the past five decades, demanding an improvement in prevention and treatment of this malignancy. With no known carcinogens, targeted prevention is currently unavailable, and efforts in early detection of this malignancy by screening biomarkers have failed. The inhibition of angiogenesis, also known as angioprevention, is a promising strategy to limit the growth of solid tumors, including ovarian cancers. Nobiletin, a polymethoxy flavonoid compound isolated from the tiansheng plant, has been shown to inhibit the growth of multiple types of human cancers. However, there are no reports involving …

Female Gender In Esophageal Intramucosal Adenocarcinoma Treated With Endoscopic Mucosal Resection: A Case Series, Patrick Hickey Do, Shashin Shah Md, Hiral N. Shah Md

Department of Medicine

No abstract provided.

Surgical Considerations Of Lvad Implantation In Patients With Prosthetic Valves, Igor D. Gregoric

The VAD Journal

No abstract provided.

Assessment Of Changes In Quality Of Life Among Patients In The Save Study - Sirolimus As Therapeutic Approach To Uveitis: A Randomized Study To Assess The Safety And Bioactivity Of Intravitreal And Subconjunctival Injections Of Sirolimus In Patients With Non-Infectious Uveitis., Erin M. Vigil, Yasir J. Sepah, Anthony L. Watters, Mohammad A. Sadiq, Mehreen Ansari, Millena G. Bittencourt, Mohamed A. Ibrahim, Diana V. Do, Quan Dong Nguyen

Journal Articles: Ophthalmology

BACKGROUND: The National Eye Institute 39-Question Visual Function Questionnaire (NEI VFQ-39) is an indicator of vision-related quality of life (QoL). The NEI VFQ-39 is used to assess the QoL in patients with non-infectious posterior uveitis, intermediate uveitis, or panuveitis, treated with subconjunctival (SCJ) or intravitreal (IVT) sirolimus as an immunomodulatory therapeutic (IMT) agent, delivered subconjunctivally (SCJ) or intravitreally (IVT) (the SAVE Study). Thirty subjects with non-infectious uveitis were randomized (SCJ:IVT, 1:1) for a prospective clinical trial. The 39-Question Visual Function Questionnaire (VFQ-39) was administered at baseline (BL), month 6 (M6), and month 12 (M12) visits. The survey measures self-reported vision …