Medical Specialties Commons^™

Determining The Natural Distribution Of 24 Hour Bilirubin Levels In Term, Exclusively Breastfed Newborns, Lauren Greenawald Do, Alexis M. Newton Md, Michael D. Schwartz Md, Gwendolyn Chung Md, Greg Floyd Mba

Department of Pediatrics

No abstract provided.

Theaflavin-3, 3'-Digallate Decreases Human Ovarian Carcinoma Ovcar-3 Cell-Induced Angiogenesis Via Akt And Notch-1 Pathways, Not Via Mapk Pathways, Ying Gao, Gary O. Rankin, Youying Tu, Yi Charlie Chen

Biochemistry and Microbiology

Theaflavin-3, 3'-digallate (TF3) is a black tea polyphenol produced from polymerization and oxidization of the green tea ployphenols epicatechin gallate and (-)-epigallocatechin-3-gallate (EGCG) during fermentation of fresh tea leaves. TF3 has been reported to have anticancer properties. However, the effect of TF3 on tumor angiogenesis and the underlying mechanisms are not clear. In the present study, TF3 was verified to inhibit tumor angiogenesis. Compared with EGCG, TF3 was more potent. TF3 inhibited human ovarian carcinoma OVCAR-3 cell-induced angiogenesis in human umbilical vein endothelial cell model and in chick chorioallantoic membrane model. TF3 reduced tumor angiogenesis by downregulating HIF-1α and VEGF. …

Hdl In Sepsis - Risk Factor And Therapeutic Approach, Emily E. Morin, Ling Guo, Anna Schwendeman, Xiang-An Li

Pediatrics Faculty Publications

High-density lipoprotein (HDL) is a key component of circulating blood and plays essential roles in regulation of vascular endothelial function and immunity. Clinical data demonstrate that HDL levels drop by 40-70% in septic patients, which is associated with a poor prognosis. Experimental studies using Apolipoprotein A-I (ApoAI) null mice showed that HDL deficient mice are susceptible to septic death, and overexpressing ApoAI in mice to increase HDL levels protects against septic death. These clinical and animal studies support our hypothesis that a decrease in HDL level is a risk factor for sepsis, and raising circulating HDL levels may provide an …

Palbociclib In Hormone-Receptor-Positive Advanced Breast Cancer., Nicholas C Turner, Cynthia Huang Bartlett, Massimo Cristofanilli

Department of Medicine Faculty Papers

No abstract provided.

Connexin26 Gap Junction Mediates Mirna Intercellular Genetic Communication In The Cochlea And Is Required For Inner Ear Development, Yan Zhu, Liang Zong, Ling Mei, Hong-Bo Zhao

Otolaryngology--Head & Neck Surgery Faculty Publications

Organ development requires well-established intercellular communication to coordinate cell proliferations and differentiations. MicroRNAs (miRNAs) are small, non-coding RNAs that can broadly regulate gene expression and play a critical role in the organ development. In this study, we found that miRNAs could pass through gap junctions between native cochlear supporting cells to play a role in the cochlear development. Connexin26 (Cx26) and Cx30 are predominant isoforms and co-express in the cochlea. Cx26 deficiency but not Cx30 deficiency can cause cochlear developmental disorders. We found that associated with Cx26 deletion induced the cochlear developmental disorders, deletion of Cx26 but not Cx30 disrupted …

High Prevalence Of Obesity And Female Gender Among Patients With Concomitant Tibialis Posterior Tendonitis And Plantar Fasciitis., Christopher W. Reb, Faith A. Schick, Homyar N. Karanjia, Joseph N. Daniel

Rothman Institute Papers

UNLABELLED: The link between increased body weight and hindfoot complaints is largely based on correlation to single foot pathology. We retrospectively reviewed 6879 patients with tibialis posterior tendonitis (TPT), plantar fasciitis (PF), or both. Among patients with either TPT or PF, 1 in 11 (9%) had both. We then compared age, gender, and body mass index among these groups. Patients with both diagnoses were neither statistically older nor more obese than patients with single diagnoses. However, they were statistically more female. Given the overall high prevalence of obesity in the study population, we feel these data support the link between …

Mortality-Related Resource Utilization In The Inpatient Care Of Hypoplastic Left Heart Syndrome., David A. Danford, Quentin Karels, Aparna Kulkarni, Aysha Hussain, Yunbin Xiao, Shelby Kutty

Journal Articles: Pediatrics

BACKGROUND: Quantifying resource utilization in the inpatient care of congenital heart diease is clinically relevant. Our purpose is to measure the investment of inpatient care resources to achieve survival in hypoplastic left heart syndrome (HLHS), and to determine how much of that investment occurs in hospitalizations that have a fatal outcome, the mortality-related resource utilization fraction (MRRUF).

METHODS: A collaborative administrative database, the Pediatric Health Information System (PHIS) containing data for 43 children's hospitals, was queried by primary diagnosis for HLHS admissions of patients ≤21 years old during 2004-2013. Institution, patient age, inpatient deaths, billed charges (BC) and length of …

Effect Of Mycophenolate Mofetil On The White Blood Cell Count And The Frequency Of Infection In Systemic Lupus Erythematosus., Ananta Subedi, Laurence S. Magder, Michelle Petri

Department of Medicine Faculty Papers

Leukopenia is a common manifestation of SLE. Addition of immunosuppressive therapy in a SLE patient who is already leukopenic is a clinical concern. It could worsen leukopenia, increase the risk of infection, or both. The aim of this study was to analyze the immediate effect of mycophenolate mofetil on the white blood cell count and the rate of infection in SLE patients. Two hundred and forty-four patients within the Hopkins Lupus Cohort who were newly started on mycophenolate mofetil were included in the study. The white blood cell count and interval infection history on the day mycophenolate mofetil was started …

The Role Of Quality Health Services And Discussion About Birth Spacing In Postpartum Contraceptive Use In Sindh, Pakistan: A Multilevel Analysis, Hannah Tappis, Anis Kazi, Waqas Hameed, Zaib Dahar, Anayat Ali, Sohail Agha

Community Health Sciences

Introduction: Rapid population growth, stagnant contraceptive prevalence, and high unmet need for family planning present significant challenges for meeting Pakistan's national and international development goals. Although health behaviors are shaped by multiple social and environmental factors, research on contraceptive uptake in Pakistan has focused on individual and household determinants, and little attention has been given to community characteristics that may affect access to services and reproductive behavior.
Methods: Individual and community determinants of contraceptive use were identified using multivariable multilevel logistic regression to analyze data from a 2014 cross-sectional survey of 6,200 mothers in 503 communities in Sindh, Pakistan.
Results: …

A Comparison Of Static Stretching Versus Combined Static And Ballistic Stretching In Active Knee Range Of Motion, Nathan R. Blackhurst, James C. Peterson, Valerie W. Herzog, Ericka P. Zimmerman

Internet Journal of Allied Health Sciences and Practice

Background: There is continued controversy related to flexibility gains from different stretching protocols and within single protocols. Stretching methods include static, ballistic, dynamic, and proprioceptive neuromuscular facilitation (PNF). A combination of stretching methods may be an improved way to increase active knee range of motion (ROM). This study evaluated a single program formulated with static and ballistic components. Objective: To compare active knee ROM following stretching programs which either included combined static and ballistic stretching (CSBS) or static stretching (SS) alone. It was hypothesized that CSBS would show a greater increase in active knee ROM than SS. Setting …

A Critical Role For Alpha-Synuclein In Development And Function Of T Lymphocytes, Afshin Shameli, Wenbin Xiao, Yan Zheng, Susan Shyu, John Sumodi, Howard J. Meyerson, Clifford V. Harding, Robert W. Maitta

Faculty Scholarship

Alpha-synuclein is highly expressed in the central nervous system and plays an important role in pathogenesis of neurodegenerative disorders such as Parkinson's disease and Lewy body dementia. Previous studies have demonstrated the expression of α-synuclein in hematopoietic elements and peripheral blood mononuclear cells, although its roles in hematopoiesis and adaptive immunity are not studied. Using an α-synuclein knock out (KO) mouse model, we have recently shown that α-synuclein deficiency is associated with a mild defect in late stages of hematopoiesis. More importantly, we demonstrated a marked defect in B lymphocyte development and IgG, but not IgM production in these mice. …

Loss Of Glycosaminoglycan Receptor Binding After Mosquito Cell Passage Reduces Chikungunya Virus Infectivity, Amber M. Paul, Dhiraj Acharya, John F. Anderson, Faqing Huang, Fengwei Bai

Publications

Chikungunya virus (CHIKV) is a mosquito-transmitted alphavirus that can cause fever and chronic arthritis in humans. CHIKV that is generated in mosquito or mammalian cells differs in glycosylation patterns of viral proteins, which may affect its replication and virulence. Herein, we compare replication, pathogenicity, and receptor binding of CHIKV generated in Vero cells (mammal) or C6/36 cells (mosquito) through a single passage. We demonstrate that mosquito cell derived CHIKV (CHIKVmos) has slower replication than mammalian cell derived CHIKV (CHIKVvero), when tested in both human and murine cell lines. Consistent with this, CHIKVmos infection in both cell lines produce less cytopathic …

Post-Polypectomy Electrocoagulation Syndrome: A Rare Cause Of Acute Abdominal Pain., Asad Jehangir, Kyle M. Bennett, Andrew C. Rettew, Opeyemi Fadahunsi, Bilal Shaikh, Anthony A. Donato

Reading Hospital Internal Medicine Residency

While generally safe, the most feared complication of colonoscopy is perforation of the colon, occurring in nearly 1 in 1,000 procedures, and is more common when polypectomy is performed and electrocautery is used. Less commonly known is the post-polypectomy electrocoagulation syndrome, a transmural burn of the colon which mimics the signs and symptoms of perforation as well as the time course, but follows a benign course and can be treated conservatively.

A Rare Cause Of Obscure Occult Gastrointestinal Bleeding, Haroon Shahid, Md, Jason Korenblit, Md, Mba

Division of Gastroenterology and Hepatology Faculty Papers

BACKGROUND

• Obscure gastrointestinal (GI) bleeding is defined as persistent or recurrent GI bleeding after negative evaluations with upper endoscopy and colonoscopy.
• Accounts for approximately 5% of GI bleeding.
• Obscure GI bleeding can further be classified as being overt or occult.

-Overt GI bleeding is clinically evident, with either hematemesis, hematochezia, or melena.

-Occult GI bleeding manifests as iron deficiency anemia or a positive fecal occult blood test.

• Our case demonstrates a rare cause of obscure occult GI bleeding.

Naturally Occurring Deletion Mutants Of The Pig-Specific, Intestinal Crypt Epithelial Cell Protein Clca4b Without Apparent Phenotype., Stephanie Plog, Nikolai Klymiuk, Stefanie Binder, Matthew J. Van Hook, Wallace B. Thoreson, Achim D. Gruber, Lars Mundhenk

Journal Articles: Ophthalmology

The human CLCA4 (chloride channel regulator, calcium-activated) modulates the intestinal phenotype of cystic fibrosis (CF) patients via an as yet unknown pathway. With the generation of new porcine CF models, species-specific differences between human modifiers of CF and their porcine orthologs are considered critical for the translation of experimental data. Specifically, the porcine ortholog to the human CF modulator gene CLCA4 has recently been shown to be duplicated into two separate genes, CLCA4a and CLCA4b. Here, we characterize the duplication product, CLCA4b, in terms of its genomic structure, tissue and cellular expression patterns as well as its in vitro electrophysiological …

Pnaktide Inhibits Na/K-Atpase Reactive Oxygen Species Amplification And Attenuates Adipogenesis, Komal Sodhi, Kyle Maxwell, Yanling Yan, Jiang Liu, Muhammad Chaudhry, Morgan Getty, Zijian Xie, Nader G. Abraham, Joseph I. Shapiro Md

Biochemistry and Microbiology

Obesity has become a worldwide epidemic and is a major risk factor for metabolic syndrome. Oxidative stress is known to play a role in the generation and maintenance of an obesity phenotype in both isolated adipocytes and intact animals. Because we had identified that the Na/K-ATPase can amplify oxidant signaling, we speculated that a peptide designed to inhibit this pathway, pNaKtide, might ameliorate an obesity phenotype. To test this hypothesis, we first performed studies in isolated murine preadipocytes (3T3L1 cells) and found that pNaKtide attenuated oxidant stress and lipid accumulation in a dose-dependent manner. Complementary experiments in C57Bl6 mice fed …

Autophagy Protects Against Cyp2e1/Chronic Ethanol-Induced Hepatotoxicity, Yongke Lu, Arthur I. Cederbaum

Pharmacology, Physiology and Toxicology

Autophagy is an intracellular pathway by which lysosomes degrade and recycle long-lived proteins and cellular organelles. The effects of ethanol on autophagy are complex but recent studies have shown that autophagy serves a protective function against ethanol-induced liver injury. Autophagy was found to also be protective against CYP2E1-dependent toxicity in vitro in HepG2 cells which express CYP2E1 and in vivo in an acute alcohol/CYPE1-dependent liver injury model. The goal of the current report was to extend the previous in vitro and acute in vivo experiments to a chronic ethanol model to evaluate whether autophagy is also protective against CYP2E1-dependent liver …

Attempted Salvage Therapy Through Initiation Of Vedolizumab As An Inpatient In Two Patients With Refractory Active Ulcerative Colitis, Matthew Sullivan Do, Paola Blanco Md, Shashin Shah Md, Hiral N. Shah Md

Department of Medicine

No abstract provided.

In The Groove: A Case Series Of Groove Pancreatitis, Matthew Sullivan Do, Jeffrey Brodsky Md, Shashin Shah Md, Hiral N. Shah Md

Department of Medicine

No abstract provided.

The Paradox Of The Serrated Sickle Erythrocyte: The Importance Of The Red Blood Cell Membrane Topography., Samir K. Ballas, Philippe Connes

Cardeza Foundation for Hematologic Research

Red blood cell rheology and adhesiveness play a key role in the occurrence of vaso-occlusive like events in sickle cell anemia. The present paper reviews counter-intuitive findings supporting that rigid and serrated sickle red blood cells do not initiate vaso-occlusion. Instead, the less rigid red blood cells could initiate vaso-occlusion because of their increased adhesiveness to the vascular wall. We suspect that stiffness of sickle erythrocytes and the topography of RBC membrane are factors affecting adhesion to the endothelium.

Hernias, Lauren Dudas Md

Department of Surgery

No abstract provided.

Neurofibromatosis Type 1 With Ampullary Somatostatinoma, Small Bowel Gists, And Extra-Adrenal Composite Pheochromocytoma-Ganglioneuroma, Patrick Hickey Do, Rohit Sharma Md, Shanth A. Goonewardene Md, Shashin Shah Md, Hiral N. Shah Md

Department of Medicine

No abstract provided.

Primary Esophageal Adenocarcinoma With Colon Metastases After Esophagectomy, Bonnie Patek Do, Hiral N. Shah Md, Shashin Shah Md

Department of Medicine

No abstract provided.

Medical School Partnerships: Addressing Rough Sleeping In Vulnerable Youth., Rachael Snow Ms4, Sen Lu Ms4, Rachel Fieman Ms4, Jameson Dyal Ms4, Phillip Zegelbone Ms4, Brett Feldman Pa-C, Amy E. Smith Phd, Marna R. Greenberg Do, Mph, Facep

Department of Emergency Medicine

No abstract provided.

The Trial Of Calcium And Vitamin D For The Prevention Of Colorectal Adenomas, John A. Baron, Elizabeth L. Barry, Leila A. Mott, Judy R. Rees

Dartmouth Scholarship

BACKGROUND Epidemiologic and preclinical data suggest that higher intake and serum levels of vitamin D and higher intake of calcium reduce the risk of colorectal neoplasia. To further study the chemopreventive potential of these nutrients, we conducted a randomized, double-blind, placebo-controlled trial of supplementation with vitamin D, calcium, or both for the prevention of colorectal adenomas. METHODS We recruited patients with recently diagnosed adenomas and no known colorectal polyps remaining after complete colonoscopy. We randomly assigned 2259 participants to receive daily vitamin D3 (1000 IU), calcium as carbonate (1200 mg), both, or neither in a partial 2Å~2 factorial design. Women …

Gender Differences In Study Enrollment For A Mechanical Fall Prevention Study, Kaley J. Miller Bs, Pa-S, Bryan G. Kane Md, Jeanne L. Jacoby Md, Robert D. Barraco Md, Mph, Vartika Bhardwaj Ms, Michael Goodwin Ms, Cameron Paterson Ms, Kara Mia V. Villaneuva Msii, Phillip Zegelbone Ms, Bernadette Glenn-Porter Bs, Marna R. Greenberg Do, Mph, Facep, Samantha L. Myles Bs

Department of Emergency Medicine

No abstract provided.

Invariant Characteristics Of Carcinogenesis., Simon Sherman, Nirosha Rathnayake, Tengiz Mdzinarishvili

Journal Articles: Eppley Institute

Carcinogenic modeling is aimed at mathematical descriptions of cancer development in aging. In this work, we assumed that a small fraction of individuals in the population is susceptible to cancer, while the rest of the population is resistant to cancer. For individuals susceptible to cancer we adopted methods of conditional survival analyses. We performed computational experiments using data on pancreatic, stomach, gallbladder, colon and rectum, liver, and esophagus cancers from the gastrointestinal system collected for men and women in the SEER registries during 1975-2009. In these experiments, we estimated the time period effects, the birth cohort effects, the age effects …

A Randomized 2x2 Factorial Clinical Trial Of Renal Transplantation: Steroid-Free Maintenance Immunosuppression With Calcineurin Inhibitor Withdrawal After Six Months Associates With Improved Renal Function And Reduced Chronic Histopathology, R. Brian Stevens, Kirk W. Foster, Clifford D. Miles, Andre C. Kalil, Diana F. Florescu, John P. Sandoz, Theodore H. Rigley, Tamer Malik, Lucile E. Wrenshall

Department of Surgery Faculty Publications

Introduction

The two most significant impediments to renal allograft survival are rejection and the direct nephrotoxicity of the immunosuppressant drugs required to prevent it. Calcineurin inhibitors (CNI), a mainstay of most immunosuppression regimens, are particularly nephrotoxic. Until less toxic antirejection agents become available, the only option is to optimize our use of those at hand.

Aim

To determine whether intensive rabbit anti-thymocyte globulin (rATG) induction followed by CNI withdrawal would individually or combined improve graft function and reduce graft chronic histopathology–surrogates for graft and, therefore, patient survival. As previously reported, a single large rATG dose over 24 hours was well-tolerated …

Racial Disparities In Intravenous Recombinant Tissue Plasminogen Activator Use Persist At Primary Stroke Centers., Hugo J. Aparicio, Brendan G. Carr, Scott E. Kasner, Michael J. Kallan, Karen C. Albright, Dawn O. Kleindorfer, Michael T. Mullen

Department of Emergency Medicine Faculty Papers

BACKGROUND: Primary stroke centers (PSCs) utilize more recombinant tissue plasminogen activator (rt-PA) than non-PSCs. The impact of PSCs on racial disparities in rt-PA use is unknown.

METHODS AND RESULTS: We used data from the Nationwide Inpatient Sample from 2004 to 2010, limited to states that publicly reported hospital identity and race. Hospitals certified as PSCs by The Joint Commission were identified. Adults with a diagnosis of ischemic stroke were analyzed. Rt-PA use was defined by the International Classification of Diseases, 9th Revision procedure code 99.10. Discharges (304 152 patients) from 26 states met eligibility criteria, and of these 71.5% were …

Bicompartmental Decompressive Craniectomy: Report Of Two Cases, Saad Akhtar, Badar Uddin Ujjan, Muhammad Waqas, Muhammad Waqas Khan Waqas Khan, Gohar Javed

Section of Neurosurgery

A recent study of randomized controlled trials showed favorable outcomes with use of decompressive craniectomy in managing and treating uncontrolled intracranial pressures accompanied with cerebral edema due to trauma. We present the details of bicompartmental decompressive craniectomy on two patients who presented with severe head trauma of supra- and infratentorial pathologies. The surgical management techniques and long-term follow-up are discussed in detail.