Medical Specialties Commons^™

Circadian Factors Bmal1 And Rorα Control Hif-1Α Transcriptional Activity In Nucleus Pulposus Cells: Implications In Maintenance Of Intervertebral Disc Health., Kaori Suyama, Elizabeth S Silagi, Hyowon Choi, Kou Sakabe, Joji Mochida, Irving M Shapiro, Makarand V Risbud

Department of Orthopaedic Surgery Faculty Papers

BMAL1 and RORα are major regulators of the circadian molecular oscillator. Since previous work in other cell types has shown cross talk between circadian rhythm genes and hypoxic signaling, we investigated the role of BMAL1 and RORα in controlling HIF-1-dependent transcriptional responses in NP cells that exist in the physiologically hypoxic intervertebral disc. HIF-1-dependent HRE reporter activity was further promoted by co-transfection with either BMAL1 or RORα. In addition, stable silencing of BMAL1 or inhibition of RORα activity resulted in decreased HRE activation. Inhibition of RORα also modulated HIF1α-TAD activity. Interestingly, immunoprecipitation studies showed no evidence of BMAL1, CLOCK or …

Field Cancerization With Multiple Keratoacanthomas Successfully Treated With Topical And Intralesional 5-Fluorouracil, Stephen Hemperly Do, Sean Branch Do, Stephen M. Purcell Do

Department of Medicine

No abstract provided.

Aberrant Dna Methylation: Implications In Racial Health Disparity, Xuefeng Wang, Ping Ji, Yuanhao Zhang, Joseph F. Lacomb, Xinyu Tian, Ellen Li, Jennie L. Williams

Department of Biomedical Engineering Faculty Publications

Background Incidence and mortality rates of colorectal carcinoma (CRC) are higher in African Americans (AAs) than in Caucasian Americans (CAs). Deficient micronutrient intake due to dietary restrictions in racial/ethnic populations can alter genetic and molecular profiles leading to dysregulated methylation patterns and the inheritance of somatic to germline mutations. Materials and Methods Total DNA and RNA samples of paired tumor and adjacent normal colon tissues were prepared from AA and CA CRC specimens. Reduced Representation Bisulfite Sequencing (RRBS) and RNA sequencing were employed to evaluate total genome methylation of 5’-regulatory regions and dysregulation of gene expression, respectively. Robust analysis was …

Changing The Algorithm In The Evaluation Of Pelvic Anatomy In The Infertile Patient: Is Hysterosalpingo Contrast Sonography With Saline-Air Device The Appropriate Test For Everyone?, Kathryn Coyne, Thomas C. Winter, Rose Maxwell, Steven Lindheim

Obstetrics and Gynecology Faculty Publications

The evaluation of the fallopian tubes is an essential part of the infertility workup, with abnormalities related to the fallopian tubes accounting for up to 40% of female subfertility.1 Laparoscopy is still considered the gold standard in the diagnostic evaluation of fallopian tubes, though the hysterosalpingogram (HSG) has long been recognized as complementary to laparoscopy, since tubal anatomy can be distinctly be seen.2 That said, previous investigations using laparoscopy as the gold standard demonstrate HSG has a sensitivity and specificity of 53% and 87%, respectively, for any tubal pathology and 46% and 95%, respectively, for bilateral tubal pathology.3

S100a4 Drives Non-Small Cell Lung Cancer Invasion, Associates With Poor Prognosis, And Is Effectively Targeted By The Fda-Approved Anti-Helminthic Agent Niclosamide, Rachel L. Stewart, Brittany L. Carpenter, Dava S. West, Teresa Knifley, Lili Liu, Chi Wang, Heidi L. Weiss, Tamas S. Gal, Eric B. Durbin, Susanne M. Arnold, Kathleen L. O'Connor, Min Chen

Markey Cancer Center Faculty Publications

S100A4 (metastasin-1), a metastasis-associated protein and marker of the epithelial to mesenchymal transition, contributes to several hallmarks of cancer and has been implicated in the progression of several types of cancer. However, the impacts of S100A4 signaling in lung cancer progression and its potential use as a target for therapy in lung cancer have not been properly explored. Using established lung cancer cell lines, we demonstrate that S100A4 knockdown reduces cell proliferation, invasion and three-dimensional invasive growth, while overexpression of S100A4 increases invasive potential. In patient-derived tissues, S100A4 is preferentially elevated in lung adenocarcinoma. This elevation is associated with lymphovascular …

Role Of Dietary Components In Modulating Hypertension, Andrew Feyh, Lucas Bracero, Hari Vishal Lakhani, Prasanna Santhanam, Joseph I. Shapiro Md, Zeid Khitan Md, Komal Sodhi

Biochemistry and Microbiology

Hypertension is a major health issue, particularly in medically underserved populations that may suffer from poor health literacy, poverty, and limited access to healthcare resources. Management of the disease reduces the risk of adverse outcomes, such as cardiovascular or cerebrovascular events, vision impairment due to retinal damage, and renal failure. In addition to pharmacological therapy, lifestyle modifications such as diet and exercise are effective in managing hypertension. Current diet guidelines include the DASH diet, a low-fat and low-sodium diet that encourages high consumption of fruits and vegetables. While the diet is effective in controlling hypertension, adherence to the diet is …

Affecting Tdap Vaccination Rates Among Women: A Multifaceted Intervention, Soneka Wynter

Evidence-Based Practice Project Reports

Despite the availability of a preventive vaccine, the incidence of pertussis in the United States has continued to increase over the past two decades and it is now considered the most common preventable infectious illness. Highly contagious in nature, it is estimated that about 50 million people are infected each year, and approximately 300,000 deaths occur worldwide (Centers for Disease Control and Prevention [CDC], 2012). In 2013, Indiana reported 616 cases (Indiana State Department of Health [ISDH], 2014). In spite of CDC recommendations on strategies that can improve vaccine delivery, rates of immunization remain low nationwide (CDC, 2014). The purpose …

Geodemographic Features Of Human Blastomycosis In Eastern Wisconsin, Megan E. Huber, Dennis J. Baumgardner, Jessica J. F. Kram, Melissa A. Lemke

Journal of Patient-Centered Research and Reviews

Purpose

Blastomycosis is an endemic fungal infection. In rural northern Wisconsin, blastomycosis cases are associated with certain environmental features including close proximity to waterways. Other studies have associated blastomycosis with particular soil chemicals. However, blastomycosis also occurs in urban and suburban regions. We explored the geodemographic associations of blastomycosis cases in the more urban/suburban landscape of eastern Wisconsin.

Methods

We conducted a retrospective study of 193 laboratory-identified blastomycosis cases in a single eastern Wisconsin health system, 2007–2015. Controls were 250 randomly selected cases of community-diagnosed pneumonia from a similar time period. Geographic features of home addresses were explored using Google …

Current Therapeutic Role And Medicinal Potential Of Scutellaria Barbata In Traditional Chinese Medicine And Western Research, Geyang Tao, Marcy J. Balunas

Honors Scholar Theses

ETHNOPHARMACOLOGICAL RELEVANCE: Scutellaria barbata is a common herb in Traditional Chinese Medicine (TCM) most often used to treat cancer. S. barbata has been found to exhibit efficacy both in vitro and in vivo on a variety of cancer types. Similarly encouraging results have been shown in patients with metastatic breast cancer from Phase Ia and Ib clinical trials. This study aims to elucidate the current use of S. barbata by TCM practitioners and in current Western research.

MATERIALS AND METHODS: Semi-structured interviews were conducted with fifteen TCM practitioners in Beijing and Nanjing, China to understand their clinical use of …

The Effects Of Education On Compassion Fatigue Experienced By Oncology Nurses, Ina Wilson

Evidence-Based Practice Project Reports

Oncology nursing is widely viewed as a rewarding and emotional challenging specialty. Oncology nurses witness terminal illness, death, physical, and emotional suffering which increases their risk of developing compassion fatigue. The purpose of this evidence-based practice (EBP) project was to increase awareness of compassion fatigue among oncology nurses by providing them with knowledge, effective coping skills, and self-care management skills. The Theory of Human Caring was used as the theoretical framework to support this EBP project and the intervention was guided by The Iowa Model of Research-Based Practice to Promote Quality Care. The project used a pre-test and post-test design. …

Breastfeeding Education For Fathers: An Intervention To Increase Breastfeeding Rates, Jill Marie Frisz

Evidence-Based Practice Project Reports

If every infant were breastfed within an hour of birth, exclusively breastfed until six months, and given breastmilk up to two years, almost 800,000 lives would be saved annually (who, 2014). Nationally, breastfeeding rates drop significantly from three to six months. A search of literature yielded significant evidence as fathers for facilitators to increase breastfeeding rates. The purpose of this evidence based practice (EBP) project was to determine the effects of best practice measures to educate fathers about breastfeeding to increase anytime breastfeeding rates. The social support theory and ACE Star model guided the literature search and implementation of this …

Tgf-Β Neutralization Enhances Angii-Induced Aortic Rupture And Aneurysm In Both Thoracic And Abdominal Regions, Xiaofeng Chen, Debra L. Rateri, Deborah A. Howatt, Anju Balakrishnan, Jessica J. Moorleghen, Lisa A. Cassis, Alan Daugherty

Saha Cardiovascular Research Center Faculty Publications

AngII and TGF-β interact in development of thoracic and abdominal aortic diseases, although there are many facets of this interaction that have not been clearly defined. The aim of the present study was to determine the effects of TGF-β neutralization on AngII induced-aortic pathologies. Male C57BL/6J mice were administered with either a rabbit or mouse TGF-β neutralizing antibody and then infused with AngII. The rabbit TGF-β antibody modestly reduced serum TGF-β concentrations, with no significant enhancements to AngII-induced aneurysm or rupture. Administration of this rabbit TGF-β antibody in mice led to high serum titers against rabbit IgG that may have …

Blastomyces: Why Be Dimorphic?, Dennis J. Baumgardner

Journal of Patient-Centered Research and Reviews

In introducing the infectious disease focus for this edition of the Journal of Patient-Centered Research and Reviews, the author describes the unsolved mysteries surrounding the dimorphic fungus Blastomyces and the related pathogenesis of pulmonary blastomycosis.

Epidemiology Crucial To Cracking Elizabethkingia Crisis, Angela Tonozzi

Journal of Patient-Centered Research and Reviews

The author explains the epidemiological methods, tools and personnel required to pinpoint the source of Wisconsin’s 2016 outbreak of Elizabethkingia infections.

Clinical Approach To Nonresponsive Pneumonia In Adults Diagnosed By A Primary Care Clinician: A Retrospective Study, Kiley B. Vander Wyst, Jessica J. F. Kram, Dennis J. Baumgardner

Journal of Patient-Centered Research and Reviews

Purpose

Community-acquired pneumonia (CAP) is commonly diagnosed in the primary care setting. Management of nonresponsive pneumonia (NRP), i.e. failure to respond to CAP treatment, is not clearly understood. The purpose of this study was to describe the initial work-up and treatment of CAP in the ambulatory primary care setting and to determine relative proportion of, diagnostic approach to and treatment of NRP.

Methods

We retrospectively studied adult patients diagnosed with CAP within our large, integrated health care system from October 2006 through July 2013. Cases were defined as patients with CAP who worsened after 4 days, or did not improve …

Geographic Distribution Of Maternal Group B Streptococcus Colonization And Infant Death During Birth Hospitalization: Eastern Wisconsin, Jessica J. F. Kram, Dennis J. Baumgardner, Kiley B. Vander Wyst, Melissa A. Lemke

Journal of Patient-Centered Research and Reviews

Purpose

Maternal group B Streptococcus (GBS) can be transmitted from a colonized mother to newborn during vaginal delivery and may or may not contribute to infant death. This study aimed to explore the geographic distribution and risk factors of maternal GBS colonization and infant death during birth hospitalization.

Methods

We retrospectively studied mothers with live birth(s) in a large eastern Wisconsin hospital system from 2007 through 2013. Associations between maternal and neonatal variables, GBS colonization and infant death were examined using chi-squared, Mann-Whitney U and t-tests. Multivariable logistic regression models also were developed.

Results

Study population (N = 99,305) had …

Is 13-Valent Pneumococcal Conjugate Vaccine (Pcv13) Combined With 23-Valent Pneumococcal Polysaccharide Vaccine (Ppsv23) Superior To Ppsv23 Alone For Reducing Incidence Or Severity Of Pneumonia In Older Adults? A Clin-Iq, Starla Hayward, Lou Ann Thompson, Andrea Mceachern

Journal of Patient-Centered Research and Reviews

Pneumonia infection is a significant cause of morbidity and mortality worldwide. In addition to the public health concerns, pneumonia also accounts for a significant cost to the health care system. Currently there are two leading vaccines targeted against Streptococcus pneumoniae: 23-valent pneumococcal polysaccharide vaccine (PPSV23) and 13-valent pneumococcal conjugate vaccine (PCV13). Until recently, the recommendation for adult pneumonia vaccination has been a single dose of PPSV23 for all adults aged 65 years or older. However, concerns were raised regarding the vaccine’s efficacy due to the persistent burden of pneumococcal disease in the elderly population. This paper focuses on two …

Treatment Of Dental Complications In Sickle Cell Disease., Priti Mulimani, Samir K. Ballas, Adinegara B L Abas, Laxminarayan Karanth

Cardeza Foundation for Hematologic Research

BACKGROUND: Sickle cell disease is the most common single gene disorder and the commonest haemoglobinopathy found with high prevalence in many populations across the world. Management of dental complications in people with sickle cell disease requires special consideration for three main reasons. Firstly, dental and oral tissues are affected by the blood disorder resulting in several oro-facial abnormalities. Secondly, living with a haemoglobinopathy and coping with its associated serious consequences may result in individuals neglecting their oral health care. Finally, the treatment of these oral complications must be adapted to the systemic condition and special needs of these individuals, in …

Interventions For Improving Pregnancy Outcomes In Antenatally Diagnosed Or Suspected Morbidly Adherent Placenta, Rinku Sengupta, Alexis C. Gimovsky, Shuqin Wei, Anthony Akinloye Bamigboye, Vincenzo Berghella, Amanda R. Amorim Adegboye, William Donald Fraser

Department of Obstetrics and Gynecology Faculty Papers

This is the protocol for a review and there is no abstract. The objectives are as follows:

To assess the benefits and harms associated with clinical interventions for improving outcomes in women with antenatally diagnosed or suspected MAP. We will compare conventional caesarean hysterectomy with uterine conservation treatments (together with adjunct measures) in women who have been diagnosed antenatally with, or suspected to have, MAP.

Disease-Causing Fungi In Homes And Yards In The Midwestern United States, Dennis J. Baumgardner

Journal of Patient-Centered Research and Reviews

A number of fungal pathogens that may result in a variety of human diseases are found in residential homes and yards. The growth of these microscopic fungi is often favored by particular characteristics of the dwelling and nearby outdoor environment. Evolved virulence factors or increased ability of specific fungi to grow in diverse, and sometimes harsh, microenvironments presented by the domestic environment may promote growth and pathogenesis. Infection may occur by inhalation or direct inoculation and include endemic fungi in addition to opportunistic or emerging species. Systemic or locally aggressive fungal infections are particularly likely and may be life-threatening in …

Coronary-Artery Bypass Surgery In Patients With Ischemic Cardiomyopathy, Eric J. Velazquez, Julio A. Panza, Torsten Doenst, Patrice Desvigne-Nickens, George Sopko, Stiches Investigators

NYMC Faculty Publications

BACKGROUND: The survival benefit of a strategy of coronary-artery bypass grafting (CABG) added to guideline-directed medical therapy, as compared with medical therapy alone, in patients with coronary artery disease, heart failure, and severe left ventricular systolic dysfunction remains unclear.

METHODS: From July 2002 to May 2007, a total of 1212 patients with an ejection fraction of 35% or less and coronary artery disease amenable to CABG were randomly assigned to undergo CABG plus medical therapy (CABG group, 610 patients) or medical therapy alone (medical-therapy group, 602 patients). The primary outcome was death from any cause. Major secondary outcomes included death …

Use Of Surface-Enhanced Laser Desorption/Ionization With Time Of Flight (Seldi-Tof) Of The Urine In The Assessment Of Acute Kidney Injury (Aki), David J. Kennedy, Phd, Joseph M. Chan, Dinkar Kaw, Md, Anand M. Ravindaran, Md, Shobha Ratnam, Md, Phd, Deepak Malhotra, Md, Phd, Joseph I. Shapiro Md

Marshall Journal of Medicine

Background: Urinalysis is an important component in the assessment of acute kidney injury (AKI). Proteonomics is a rapidly developing approach in the analysis of physiological states. Several techniques have been developed to screen for protein populations. In this regard SELDI-TOF is a technique based on mass spectroscopy that is being utilized in proteonomics research.

Methods:For this study, clean catch or catheterized urine was collected from normals (n=18) and patients referred to the renal service with AKI. Based upon urine and serum chemistries, clinical parameters, and microscopic urinalysis, the urines were separated into those consistent with prerenal azotemia (n=17) and acute …

An Unusual Migration Of A Stent: A Case Report, Fikadu G. Tekleyes Md, Melissa D. Lester Md, Mark A. Studeny Md, Ellen A. Thompson Md, Steven Craig Md

Marshall Journal of Medicine

Stent dislodgment and embolization is a rare complication of coronary stenting.

There are reports of intra-coronary stent entrapment, stripping, and dislodgement

during percutaneous coronary interventions causing potentially life threatening

complications, including intra-coronary or systemic embolization. Reports of

dislodgment and migration of previously placed drug eluting intra-coronary stent

several months after deployment are very limited in the literature. We describe a

drug eluting stent dislodgment and migration in an 88 year-old male 10 months after

its deployment.

Management Of Co-Existing Lung Cancer And Endobronchal Hamartomas, Mark H. Cooper, Md

Marshall Journal of Medicine

Abstract:

The coexistence of lung cancer with an endobronchial hamartoma is infrequent, and requires accurate oncologic evaluation of the endobronchial lesion prior to potential surgical treatment of the lung cancer. We describe a patient who presented with an undiagnosed endobronchial mass and and a biopsy-proven lung cancer which were successfully managed by a staged approach using initial bronchoscopic resection of the endobronchial lesion and subsequent lobectomy for squamous cell lung cancer.

Modern Evaluation Of Abdominal Trauma, Errington C. Thompson, Md, Chadwick J. Knight, Md

Marshall Journal of Medicine

Abdominal trauma can be mysterious to some physicians. If patients are evaluated for being stable or unstable, then abdominal trauma can be easily managed. Using a combination of physical examination, ultrasound and CT scans, patients can be quickly and efficiently evaluated.

Performance Of Sentinel Lymph Node Biopsy In High-Risk Endometrial Cancer., Jessie Ehrisman, Angeles Alvarez Secord, Andrew Berchuck, Paula S Lee, Nicola Di Santo, Micael Lopez-Acevedo, Gloria Broadwater, Fidel A Valea, Laura J Havrilesky

Obstetrics and Gynecology Faculty Publications

OBJECTIVE: To determine the rate and performance of sentinel lymph node (SLN) mapping among women with high-risk endometrial cancers.

METHODS: Patients diagnosed between 2012 and 2015 with uterine cancer of grade 3 endometrioid, clear cell, serous or carcinosarcoma histology and who underwent SLN mapping prior to full pelvic lymph node dissection were included. Subjects underwent methylene blue or ICG injection for laparoscopic (N = 16) or robotic-assisted laparoscopic (N = 20) staging. Outcomes included SLN mapping rates, SLN and non-SLN positive rates, false negative SLN algorithm rate, and the negative predictive value (NPV) of the SLN algorithm. Fisher's exact test …

A Direct Quantification Method For Measuring Plasma Micrornas Identified Potential Biomarkers For Detecting Metastatic Breast Cancer., Qian Zhao, Shengqiong Deng, Guangxue Wang, Cuicui Liu, Lingyu Meng, Shanshan Qiao, Lei Shen, Yue Zhang, Jinhui Lü, Yuzhen Zhang, Min Wang, Richard Pestell, Chunli Liang, Zuoren Yu, Wenshu Li

Department of Cancer Biology Faculty Papers

Circulating miRNAs are protected from ribonuclease degradation by assembly into microvesicles and exosomes. Releasing miRNAs completely from these particles is the key step to quantify the circulating miRNAs. Currently purified RNA-based quantitative analysis is widely used while it is time and cost consuming with high risk for those circulating miRNAs with low abundance due to partial loss of RNA during the steps of total RNA extraction and small RNA enrichment. Herein, we optimized a simple, effective and time-saving method to directly measure plasma miRNAs without RNA isolation. It is based on complete miRNA release from the protein complexes, followed by …

Ictal Asystole In A Patient With Posterior Reversible Encephalopathy Syndrome (Pres) And Seizures: A Case Report, Joanna Suski, Md, Reginald T. Ho, Md, Maromi Nei, Md

Department of Neurology Posters

BACKGROUND

• Ictal asystole is rare, seen in less than 1% of patients with epilepsy, and typically seen in patients with temporal or frontal lobe seizures, rarely in occipital lobe seizures, and has never been described in a patient with PRES .
• PRES is a clinical-radiologic diagnosis in which there is a breakdown of the blood brain barrier caused by abrupt changes of blood pressure, or cytokines causing endothelial damage and this creates brain edema.
• The typical neurological symptoms of PRES include encephalopathy (50-80%), seizure (60-75%), headache (50%), and visual disturbance (35%).
• Brain imaging in PRES usually reveals vasogenic edema in …

Sonographic Findings Of A Semi-Professional Football Player With 1st Mtp Joint Pain: Gout Or Turf Toe?, David Jeong, Md, Caqsm, Cep, Rmsk, Danielle Snyderman, Md, Lauren Hersh, Md, Jeremy Close, Md

Department of Family & Community Medicine Posters

Purpose

Aim : To review the applications and indications of sonography for forefoot disorders, especially gout and plantar plate injury of 1^st MTP joint.

Introduction

• Forefoot disorders are common but forefoot ultrasound is underutilized.
• Point-of-Care Ultrasound was utilized in initial workup evaluating acute on chronic 1^st MTP joint pain in our case study.

Composite Split Cord Malformation Associated With A Dermal Sinus Tract, Dermoid Cyst, And Epidural Abscess: A Case Report And Review Of Literature, Saad Akhtar, Abdul Azeem, Muhammad Shahzad Shamim, Muhammad Zubair Tahir

Section of Neurosurgery

Background: Split cord malformation (SCM) is typically present at a single level but rarely, may be present at multiple levels in the spinal cord and can be associated with a wide array of lesions such as myelomeningoceles, lipomas, teratomas, and dermal sinus tracts (DSTs).
Case description: We describe a case of a 15-month-old female child who presented with high-grade fever and progressive motor weakness in the lower limbs. Magnetic resonance imaging revealed the presence of SCM along with an epidural abscess, DST, and dermoid cyst. The child underwent surgery for excision of DST along with removal of the dermoid cyst …