Medical Specialties Commons^™

Hyper-Ige Syndrome With Bullous Pemphigoid And Esophagealstricture, Laras Budiyani, Adeputri Tanesha Idayu, Ika Prasetya Wijaya, Alvina Widhani

Jurnal Penyakit Dalam Indonesia

Laras

Atypical Mycobacterial Infection Resembles Sporotrichosis In Elderly Patient, Siti Nurani Fauziah, Lili Legiawati, Sri Adi Sularsito, Shannaz Nadia Yusharyahya, Rahadi Rihatmadja, Sondang P. Sirait, Fifi Mifta Huda, Indah Widyasari

Journal of General - Procedural Dermatology and Venereology Indonesia

Atypical mycobacterial (AM) infection is caused by Mycobacterium species other than M.tuberculosis. AM skin infection has clinical manifestations that resemble M. tuberculosis infection and deep fungal infection. Laboratory workup is necessary to confirm the diagnosis.

An 83-year old female came with a painful lump and swelling on her right lower extremity since three months before admission. Physical examination revealed a plaque consisting, of multiple erythematous and hyperpigmented papules and nodules, diffuse erythematous lesion, and shallow ulcers partially covered with pus and crust. Histopathological features showed tuberculoid granuloma. Direct test and periodic acid-Schiff (PAS) staining of the skin biopsy found no …

The Role Of Dermoscopy In Non-Pigmented Skin Disorders, Hafiza Fathan, Wresti Indriatmi, Rahadi Rihatmadja, Inge Ade Krisanti

Journal of General - Procedural Dermatology and Venereology Indonesia

The use of dermoscopy in non-pigmented skin disorders includes dermoscopy as a diagnostic tool for non- pigmented skin tumors, inflammatory diseases (inflammoscopy) and/or infectious disease (entomodermoscopy), lesions on nail fold and as a tool to monitor skin reaction as a response to treatment and/or side effect. The diagnosis becomes easier, faster and less expensive with dermoscopy without the need for invasive procedures. Knowledge on vascular pattern and its architectural arrangement; which is coupled with additional dermoscopic features, can aid clinicians to the diagnosis. Dermatoscopy can also predict, monitor and evaluate therapeutical response and/or side effect of skin disorders. Nonetheless, dermoscopy …

Can Gait Signatures Provide Quantitative Measures For Aiding Clinical Decision-Making? A Systematic Meta-Analysis Of Gait Variability Behavior In Patients With Parkinson’S Disease, Niklas König Ignasiak

Physical Therapy Faculty Articles and Research

A disturbed, inconsistent walking pattern is a common feature of patients with Parkinson's disease (PwPD). Such extreme variability in both temporal and spatial parameters of gait has been associated with unstable walking and an elevated prevalence of falls. However, despite their ability to discretise healthy from pathological function, normative variability values for key gait parameters are still missing. Furthermore, an understanding of each parameter's response to pathology, as well as the inter-parameter relationships, has received little attention. The aim of this systematic literature review and meta-analysis was therefore to define threshold levels for pathological gait variability as well as to …

Cuestionario De Proceso Sensorial En Adultos: Comparación De Resultados Entre Población De Usa Y De Chile: Resultados Preliminares/Sensory Processing Questionnaire In Adults: Comparison Of Results Between Usa And Chile Population: Preliminary Results, Silvia Gómez, Megan Chang, Dianne Parham, Erna Imperatore

Faculty Research, Scholarly, and Creative Activity

Spanish: Existen escasos estudios sobre la forma de evaluar el proceso sensorial en adultos; una de estas formas es el uso de perfil sensorial desarrollado por Brown y Dunn en el año 2002, aplicable tanto para la población infantil como adulta de habla inglesa. Hasta el momento no existe una evaluación de procesamiento sensorial del adulto validada en castellano. En base a estos antecedentes, el principal objetivo de este estudio es validar la construcción interna de una escala de procesamiento sensorial en el adulto a través del Cuestionario del Proceso Sensorial del Adulto (CPSA) con una población de habla hispana, …

Carbonylation Modification Regulates Na/K-At Pasesignaling And Salt Sensitivity: A Review And A Hypothesis, Preeya Shah Phd, Rebecca Martin, Yanling Yan, Joseph I. Shapiro Md, Jiang Liu

Biochemistry and Microbiology

Na/K-ATPase signaling has been implicated in different physiological and pathophysiological conditions. Accumulating evidence indicates that oxidative stress not only regulates the Na/K-ATPase enzymatic activity, but also regulates its signaling and other functions. While cardiotonic steroids (CTS)-induced increase in reactive oxygen species (ROS) generation is an intermediate step in CTS-mediated Na/K-ATPase signaling, increase in ROS alone also stimulates Na/K-ATPase signaling. Based on literature and our observations, we hypothesize that ROS have biphasic effects on Na/K-ATPase signaling, transcellular sodium transport, and urinary sodium excretion. Oxidative modulation, in particular site specific carbonylation of the Na/K-ATPase α1 subunit, is a critical step in proximal …

Outcomes Of External Repair Of Heartmate Ii™ Lvad Percutaneous Leads, Jay D. Pal, Claudius Mahr, Jason W. Smith, Todd F. Dardas, Jay Pinette, David J. Farrar, Nahush A. Mokadam

The VAD Journal

Background: The HeartMate II Left Ventricular Assist Device (LVAD) receives power via a percutaneous lead connected to an external controller and batteries. At times, this lead can be damaged during normal wear, as well as by traumatic fracture, which may jeopardize the functionality of the LVAD. If there is significant internal damage, surgical replacement of the LVAD is required. However it is possible to repair externally damaged leads by replacing the distal portion of the lead to avoid pump replacement. We report the overall experience and outcomes in patients with external lead repairs.

Methods: A procedure for full …

A Rare Case Of The Upper Extremity Diffuse Large B-Cell Lymphoma Mimicking Soft Tissue Sarcoma In An Elderly Patient, Aleksandra Mamorska-Dyga, Faisal Ronny, Carmelo Puccio, Humayun Islam, Delong Liu

NYMC Faculty Publications

Diffuse large B-cell lymphoma (DLBCL) is the most common type of non-Hodgkin lymphoma, with about 30% of new cases presenting with extranodal disease. Lesions originating from soft tissues of the upper extremities are extremely rare and may mimic other malignancies like sarcoma. We present a case of an elderly patient with right upper extremity (RUE) mass which was proven to be DLBCL instead of sarcoma. We emphasize the increasing need for investigating new therapeutic options for patients of extreme age and/or with underlying heart disease.

Age- And Sex-Related Changes In Fasting Plasma Glucose And Lipoprotein In Cynomolgus Monkeys, Feng Yue, Guodong Zhang, Rongping Tang, Zhouquan Zhang, Liqiong Teng, Zhiming Zhang

Neuroscience Faculty Publications

Background: The age-related dysfunction of glucose and lipid metabolism has a long-standing relationship with cardiovascular and neurodegenerative disease. However, the effects of metabolic dysfunction on men and women are different. Reasons for these sex differences remains unclear. Cynomolgus monkeys have been used, in the past, for the study of human metabolic diseases due to their biologically proximity to humans. Nevertheless, few studies to date have focused on both age- and sex-related differences in glucose and lipid metabolism. The present study was designed to specifically address these questions by using a large cohort of cynomolgus monkeys (N = 1,399) including …

Cellular And Molecular Features Of Developmentally Programmed Genome Rearrangement In A Vertebrate (Sea Lamprey: Petromyzon Marinus), Vladimir A. Timoshevskiy, Joseph R. Herdy, Melissa C. Keinath, Jeramiah J. Smith

Markey Cancer Center Faculty Publications

The sea lamprey (Petromyzon marinus) represents one of the few vertebrate species known to undergo large-scale programmatic elimination of genomic DNA over the course of its normal development. Programmed genome rearrangements (PGRs) result in the reproducible loss of ~20% of the genome from somatic cell lineages during early embryogenesis. Studies of PGR hold the potential to provide novel insights related to the maintenance of genome stability during the cell cycle and coordination between mechanisms responsible for the accurate distribution of chromosomes into daughter cells, yet little is known regarding the mechanistic basis or cellular context of PGR in this or …

Antenatal Glucocorticoid Treatment Is Associated With Diurnal Cortisol Regulation In Term-Born Children, M. N. Edelmann, Curt A. Sandman, Laura M. Glynn, D. A. Wing, Elyssia Poggi Davis

Psychology Faculty Articles and Research

Due to the rapid developmental changes that occur during the fetal period, prenatal influences can affect the developing central nervous system with lifelong consequences for physical and mental health. Glucocorticoids are one of the proposed mechanisms by which fetal programing occurs. Glucocorticoids pass through the blood-brain barrier and target receptors throughout the central nervous system. Unlike endogenous glucocorticoids, synthetic glucocorticoids readily pass through the placental barrier to reach the developing fetus. The synthetic glucocorticoid, betamethasone, is routinely given prenatally to mothers at risk for preterm delivery. Over 25% of the fetuses exposed to betamethasone will be born at term. Few …

Cyclic Di-Gmp-Regulated Periplasmic Proteolysis Of A Pseudomonas Aeruginosa Type Vb Secretion System Substrate, Richard B. Cooley, T. Jarrod Smith, Wilfred Leung, Valerie Tierney, Bradley Borlee, George A. O'Toole, Holger Sondermann

Dartmouth Scholarship

We previously identified a second-messenger-regulated signaling system in the environmental bacterium Pseudomonas fluorescens which controls biofilm formation in response to levels of environmental inorganic phosphate. This system contains the transmembrane cyclic di-GMP (c-di-GMP) receptor LapD and the periplasmic protease LapG. LapD regulates LapG and controls the ability of this protease to process a large cell surface adhesin protein, LapA. While LapDG orthologs can be identified in diverse

Characterization Of The Microbiome Of Nipple Aspirate Fluid Of Breast Cancer Survivors., Alfred A Chan, Mina Bashir, Magali N Rivas, Karen Duvall, Peter A Sieling, Thomas R Pieber, Parag A Vaishampayan, Susan M Love, Delphine J Lee

Articles, Abstracts, and Reports

The microbiome impacts human health and disease. Until recently, human breast tissue and milk were presumed to be sterile. Here, we investigated the presence of microbes in the nipple aspirate fluid (NAF) and their potential association with breast cancer. We compared the NAF microbiome between women with a history of breast cancer (BC) and healthy control women (HC) using 16S rRNA gene amplicon sequencing. The NAF microbiome from BC and HC showed significant differences in community composition. Two Operational Taxonomic Units (OTUs) showed differences in relative abundances between NAF collected from BC and HC. In NAF collected from BC, there …

Compositions And Methods For Treating Ischemia, Gregory J. Bix

Sanders-Brown Center on Aging Faculty Patents

The presently-disclosed subject matter provides methods for preventing ischemia in a cell, treating ischemia in a subject, and preventing an infarction in a subject that utilize α5β1 integrin inhibitor. In some instances, α5β1 integrin inhibitor is administered to a subject prior to, during, or after the onset of ischemia to treat the ischemia and/or prevent infarction. In some instances the present methods prevent the occurrence of an infarction. In some instances the present methods restores perfusion to organs and tissues.

Direct Reprogramming To Multipotent Trophoblast Stem Cells, And Is Pluripotency Needed For Regenerative Medicine Either?, Yu Yang, Graham C. Parker, Elizabeth E. Puscheck, Daniel A. Rappolee

Department of Obstetrics and Gynecology Research Publications

No abstract provided.

The Brain Imaging Data Structure, A Format For Organizing And Describing Outputs Of Neuroimaging Experiments, Krzysztof Gorgolewski, Tibor Auer, Vince Calhoun, R Cameron Craddock, Samir Das, Eugene Duff, Guillaume Flandin, Tristan Glatard, Yaroslav Halchenko

Dartmouth Scholarship

The development of magnetic resonance imaging (MRI) techniques has defined modern neuroimaging. Since its inception, tens of thousands of studies using techniques such as functional MRI and diffusion weighted imaging have allowed for the non-invasive study of the brain. Despite the fact that MRI is routinely used to obtain data for neuroscience research, there has been no widely adopted standard for organizing and describing the data collected in an imaging experiment. This renders sharing and reusing data (within or between labs) difficult if not impossible and unnecessarily complicates the application of automatic pipelines and quality assurance protocols. To solve this …

Cannabinoid Receptor Type-2 Modulates Nociceptive Signaling Molecules In A Model Of Post-Concussion Headache, Jarred M. Stratton, Lan Cheng, Ashley L. Tyburski, Jessica Perino, Melanie B Elliott

Department of Neurosurgery Posters

Abstract

The goal of this study was to investigate the role of the cannabinoid receptor type-2 (CB₂R) in the trigeminal pain pathway in a model of post-concussion headache. Sprague Dawley rats were randomized to receive either a repeated mild closed head injury (CHI) or served as incision controls. Changes in CGRP, nNOS, and IBA-1 were assessed in the trigeminal nucleus caudalis (TNC) and trigeminal ganglia via IHC. A subset of CHI rats received either a cannabinoid receptor type 2 (CB₂R) anti-inflammatory agonist (JWH133), an NSAID (Ketorolac), or vehicle and underwent von Frey testing for trigeminal allodynia. …

Expansion Of Myeloid-Derived Suppressor Cells Promotes Differentiation Of Regulatory T Cells In Hiv-1+ Individuals, Ling Wang, Juan Zhao, Junping P. Ren, Xiao Y. Wu, Zheng D. Morrison, Mohamed A. El Gazzar, Shunbin Ning, Jonathan P. Moorman, Zhi Q. Yao

ETSU Faculty Works

Objective: Regulatory T cells (Tregs) contribute to HIV-1 disease progression by impairing antiviral immunity; however, the precise mechanisms responsible for the development of Tregs in the setting of HIV-1 infection are incompletely understood.

Design: In this study, we provide evidence that HIV-induced expansion of monocytic myeloid-derived suppressor cells (M-MDSCs) promote the differentiation of Foxp3+ Tregs.

Methods: We measured MDSC induction and cytokine expression by flow cytometry and analyzed their functions by coculturing experiments.

Results: We observed a dramatic increase in M-MDSC frequencies in the peripheral blood of HIV-1 seropositive (HIV-1+) individuals, even in those on antiretroviral therapy with undetectable viremia, …

Severity Of Lower Urinary Tract Symptoms Among Middle Aged And Elderly Nigerian Men: Impact On Quality Of Life, Patrick Temi Adegun, Philip Adebayo, Peter Olufemi Areo

Internal Medicine, East Africa

Objectives. To compare the severity of LUTS among middle aged and elderly Nigerian men and determine the influence of LUTS severity on QoL.

Methods. This cross-sectional study was conducted among new patients presenting with LUTS attending Urology clinic between 2011 and 2015. Assessment of symptoms was based on IPSS and bother score completed by the eligible subjects on the same day of their clinic visits.

Results. Four hundred patients were studied comprising 229 middle aged and 171 elderly men. Interquartile range (IQR) of IPSS scores for men < 65 years and those ≥65 years was 14.0 (16.0) and 19 (15.0), respectively (p < 0.001). Mild LUTS was significantly associated with best, good, and poor quality of life while moderate LUTS was associated with poor QoL. Severe LUTS was significantly associated with all the categories of QoL (Best-Worst). Among the cohort of subjects with poor QoL, elderly patients had a significantly higher median IPSS score (p < 0.05).

Conclusions. There is no level of severity of LUTS in which patients’ QoL …

Increasing Hiv-1 Pretreatment Drug Resistance Among Antiretroviral-Naïve Adults Initiating Treatment Between 2006 And 2014 In Nairobi, Kenya, Michael Chung, Silverman Rachel, Beck Ingrid, Yatich Nelly, Dross Sandra, Jennifer Mckernan-Mullin, Stephen Bii, Kenneth Tapia, Joshua Stern, Chohan Bhavna, Samah R. Sakr, James N. Kiarie

Internal Medicine, East Africa

Antiretroviral-naïve adults initiating antiretroviral therapy in Nairobi, Kenya were tested for HIV-1 drug resistance at codons K103N, Y181C, G190A, M184V, and K65R using an oligonucleotide ligation assay. Prevalence of pretreatment drug resistance increased from 3.89% in 2006 to 10.93% in 2014 (P < 0.001), and 95% of those with resistance had at least one nonnucleoside reverse transcriptase inhibitor mutation. Resistance to tenofovir (K65R) was found in 2014 but not in 2006.

Gastric Pepsin In Post-Tympanostomy Tube Otorrhea, Jill N. D'Souza, Md, Erin Fields, Pa-C, Zhaoping He, Phd, Robert O' Reilly, Md

Department of Otolaryngology - Head and Neck Surgery Posters

Introduction

Otorrhea is the most common complication following tympanostomy tube placement, with an incidence commonly reported at around 20%. Topical otic antibiotic drops are typically used for relief of otorrhea in children with tympanostomy tubes. In children with recurrent otorrhea, gastroesophageal reflux and extraesophageal reflux have been postulated to be involved in the pathogenesis of otitis media with effusion¹. Middle ear inflammation is thought to be mediated by proteolytic activity of pepsin, as well as by the decrease in pH associated with reflux of gastric acid through Eustachian tube. The goal of this study is to examine the …

Barriers And Facilitators To Cervical Cancer Screening Among Iraqi Refugees Resettled In Philadelphia: A Qualitative Analysis Of Patient And Provider Perceptions, Colleen Payton, Mph, Ches, Laura Parente, Md, Dalea Al-Hawarri, Md, Philip Manasseh, Mph, Kevin Scott, Md, Marc Altshuler, Md

Department of Family & Community Medicine Presentations and Grand Rounds

Oral presentation at the 6^th Annual North American Refugee Health Conference, Niagara Falls, New York.

Research Questions:

1. What is the prevalence of cervical cancer and cervical cancer screening among recently resettled refugees seen at Jefferson's Center for Refugee Health?

2. Are patient-and provider-identified barriers to cervical cancer screening at CRH consistent with those identified in previous research efforts?

3. What are patient-and provider identified facilitators to cervical cancer screening for Iraqi refugee women?

Comprehensive Refugee Health Surveillance In Philadelphia: A Combined Resettlement And Clinical Patient Registry, Colleen Payton, Mph, Ches, Brittany Divito, Mph, Bsn, Rn, Gretchen Shanfeld, Mph, Zoe Agoos, Md, Kevin Scott, Md, Marc Altshuler, Md

Department of Family & Community Medicine Presentations and Grand Rounds

Oral presentation at the 6^th Annual North American Refugee Health Conference, Niagara Falls, New York.

Goal:

To improve the success of refugee resettlement and health outcomes in Philadelphia by establishing a multi-agency registry with social services and clinical measures.

N-Acetyl Cysteine May Support Dopamine Neurons In Parkinson's Disease: Preliminary Clinical And Cell Line Data., Daniel A. Monti, George Zabrecky, Daniel Kremens, Tsao-Wei Liang, Nancy A. Wintering, Jingli Cai, Xiatao Wei, Anthony J. Bazzan, Li Zhong, Brendan Bowen, Charles Intenzo, Lorraine Iacovitti, Andrew B. Newberg

Marcus Institute of Integrative Health Faculty Papers

BACKGOUND: The purpose of this study was to assess the biological and clinical effects of n-acetyl-cysteine (NAC) in Parkinson's disease (PD).

METHODS: The overarching goal of this pilot study was to generate additional data about potentially protective properties of NAC in PD, using an in vitro and in vivo approach. In preparation for the clinical study we performed a cell tissue culture study with human embryonic stem cell (hESC)-derived midbrain dopamine (mDA) neurons that were treated with rotenone as a model for PD. The primary outcome in the cell tissue cultures was the number of cells that survived the insult …

Pik3ca-Associated Developmental Disorders Exhibit Distinct Classes Of Mutations With Variable Expression And Tissue Distribution, Ghayda Mirzaa, Andrew E Timms, Valerio Conti, Evan August Boyle, Katta M Girisha, Beth Martin, Martin Kircher, Carissa Olds, Jane Juusola, Sarah Collins, Kaylee Park, Melissa Carter, Ian Glass, Inge Krägeloh-Mann, David Chitayat, Aditi Shah Parikh, Rachael Bradshaw, Erin Torti, Stephen Braddock, Leah Burke, Sondhya Ghedia, Mark Stephan, Fiona Stewart, Chitra Prasad, Melanie Napier, Sulagna Saitta, Rachel Straussberg, Michael Gabbett, Bridget C O'Connor, Catherine E Keegan, Lim Jiin Yin, Angeline Hwei Meeng Lai, Nicole Martin, Margaret Mckinnon, Marie-Claude Addor, Luigi Boccuto, Charles E Schwartz, Agustina Lanoel, Robert L Conway, Koenraad Devriendt, Katrina Tatton-Brown, Mary Ella Pierpont, Michael Painter, Lisa Worgan, James Reggin, Raoul Hennekam, Karen Tsuchiya, Colin C Pritchard, Mariana Aracena, Karen W Gripp, Maria Cordisco, Hilde Van Esch, Livia Garavelli, Cynthia Curry, Anne Goriely, Hulya Kayserilli, Jay Shendure, John Graham, Renzo Guerrini, William B Dobyns

Articles, Abstracts, and Reports

Mosaicism is increasingly recognized as a cause of developmental disorders with the advent of next-generation sequencing (NGS). Mosaic mutations of PIK3CA have been associated with the widest spectrum of phenotypes associated with overgrowth and vascular malformations. We performed targeted NGS using 2 independent deep-coverage methods that utilize molecular inversion probes and amplicon sequencing in a cohort of 241 samples from 181 individuals with brain and/or body overgrowth. We identified PIK3CA mutations in 60 individuals. Several other individuals (n = 12) were identified separately to have mutations in PIK3CA by clinical targeted-panel testing (n = 6), whole-exome sequencing ( …

Development And Implementation Of Intensive Behavioral Therapy For Obesity In The Primary Care Setting, Kathleen Mcfadden, Meera Ramsooksingh, Steven Baltic, Vartika Bhardwaj, Glenn Deangelis, Thomas Kwarcinski Ms, Victoria Psomiadis, Adison Weseloh, Robin S. Schroeder Md

Department of Family Medicine

No abstract provided.

Duplication And Remolding Of Trna Genes In The Mitochondrial Genome Of Reduvius Tenebrosus (Hemiptera: Reduviidae), Pei Jiang, Hu Li, Fan Song, Yao Cai, Jianyun Wang, Jinpeng Liu, Wanzhi Cai

Markey Cancer Center Faculty Publications

Most assassin bugs are predators that act as important natural enemies of insect pests. Mitochondrial (mt) genomes of these insects are double-strand circular DNAs that encode 37 genes. In the present study, we explore the duplication and rearrangement of tRNA genes in the mt genome of Reduvius tenebrosus, the first mt genome from the subfamily Reduviinae. The gene order rearranges from CR (control region)-trnI-trnQ-trnM-ND2 to CR-trnQ-trnI2-trnI1-trnM-ND2. We identified 23 tRNA genes, including 22 tRNAs commonly found in insects and an additional trnI (trnI2), which has high sequence similarity to trnM. We found several …

Lifting Others, Kevin G. Budziszewski

Akesis

Medicine is full of paradoxes. As a species, we often need to take care of ourselves before we can take care of others. As humans, we become more energetic by the energy-intensive process of exercise. As physicians, we elevate ourselves by lifting others. Through all of the unexpected worries and complications that crop up in life – finances, illness, and indeed an understanding of our own mortality – it is through these three paradoxes of self-care that we survive the complications that life throws at us.

During my first year of medical school, I have grown to understand how important …

Making A Mountain Of A Mole Hill, Nihit N. Mehta

Akesis

There are times when students develop a certain amount of tunnel vision, which focuses their vision at the problem in front, making the proverbial "mountain out of a molehill.”

(Least) Complicated, Masina G. Wright

Akesis

The personal has always been a microcosm of the political.