Medical Specialties Commons^™

Admission Eeg Findings In Diverse Paediatric Cerebral Malaria Populations Predict Outcomes., Douglas G Postels, Xiaoting Wu, Chenxi Li, Peter W Kaplan, Karl B Seydel, Terrie E Taylor, Youssef A Kousa, Richard Idro, Robert Opoka, Chandy C John, Gretchen L Birbeck

Pediatrics Faculty Publications

BACKGROUND: Electroencephalography at hospital presentation may offer important insights regarding prognosis that can inform understanding of cerebral malaria (CM) pathophysiology and potentially guide patient selection and risk stratification for future clinical trials. Electroencephalogram (EEG) findings in children with CM in Uganda and Malawi were compared and associations between admission EEG findings and outcome across this diverse population were assessed. Demographic, clinical and admission EEG data from Ugandan and Malawian children admitted from 2009 to 2012 with CM were gathered, and survivors assessed for neurological abnormalities at discharge.

RESULTS: 281 children were enrolled (Uganda n = 122, Malawi n = 159). …

A Rare Case Of Diffuse Alveolar Hemorrhage Secondary To Dabigatran Successfully Treated With Extracorporeal Membrane Oxygenation, C. Hutchinson, F. M. West, H. Hirose

Department of Medicine Posters

Introduction

Dabigatran, a direct thrombin inhibitor, is used for stroke risk reduction in non-valvular atrial fibrillation and for treatment and prevention of venous thromboembolism. Minor side effects include indigestion and stomach pain. Major life threatening bleeding occurs in up to 2% of patients and is largely attributed to gastrointestinal hemorrhage. Here, we describe a case of a dabigatran related diffuse alveolar hemorrhage (DAH) treated successfully with extracorporeal membrane oxygenation.

Trpv4 Mediates Hypotonic Inhibition Of Central Osmosensory Neurons Via Taurine Gliotransmission, Sorana Ciura, Masha Prager-Khoutorsky, Zahra S. Thirouin, Joshua C. Wyrosdic, James E. Olson, Wolfgang Liedtke, Charles W. Bourque

Emergency Medicine Faculty Publications

The maintenance of hydromineral homeostasis requires bidirectional detection of changes in extracellular fluid osmolality by primary osmosensory neurons (ONs) in the organum vasculosum laminae terminalis (OVLT). Hypertonicity excites ONs in part through the mechanical activation of a variant transient receptor potential vanilloid-1 channel (dn-Trpv1). However, the mechanism by which local hypotonicity inhibits ONs in the OVLT remains unknown. Here, we show that hypotonicity can reduce the basal activity of dn-Trpv1 channels and hyperpolarize acutely isolated ONs. Surprisingly, we found that mice lacking dn-Trpv1 maintain normal inhibitory responses to hypotonicity when tested in situ. In the intact setting, hypotonicity inhibits ONs …

Temporal Arteritis Presenting As An Isolated Bilateral Abducens Nerve Palsy: A Rare Case Of A 65-Year-Old Male, Abhishek Lunagariya, Chintan Rupareliya, Pradeep C. Bollu, Zabeen Mahuwala

Neurology Faculty Publications

Giant cell arteritis (GCA) or temporal arteritis (TA) is a granulomatous inflammation of medium to large-sized arteries. It may have a diverse presentation. The most common presenting symptoms of GCA are fever, malaise, unilateral headache, jaw claudication, polymyalgia rheumatica (PMR) and ophthalmoplegia. Most severe sequelae of GCA could be blindness. We report a case of a 65-year-old Caucasian male who presented for the third time with recurrent episodes of diplopia. Neurologic exam showed bilateral cranial nerve (CN) VI palsy, slightly worse on the right than the left side. Other focal neurological deficits were absent. GCA was considered and biopsy of …

The Death Debate: Penumbra Conundrum, Robert F. Johnson

Peer Reviewed Articles

Determination and declaration of death by neurologic criteria, brain death, is an established and legally accepted clinical practice with profound implications. Concerns regarding the accuracy of this diagnosis raise important clinical, ethical, and legal issues. A recent magazine article highlights these concerns by describing a poignant example of a patient meeting accepted clinical and ancillary testing criteria for brain death in the setting of post cardiac arrest hypoxic ischemic encephalopathy (CA-HIE). With continuation of ventilatory and nutritional support, this patient not only survived but over time demonstrated findings that were no longer consistent with brain death. Offered here is a …

Antimicrobial Peptide Ll-37 And Recombinant Human Mannose-Binding Lectin Express Distinct Age- And Pathogen-Specific Antimicrobial Activity In Human Newborn Cord Blood In Vitro, Annette Scheid, Ning Li, Carleen Jeffers, Francesco Borriello, Sweta Joshi, Al Ozonoff, Matthew Pettengill, Ofer Levy

Department of Pathology, Anatomy, and Cell Biology Faculty Papers

Background: There is a need to prevent and treat infection in newborns. One approach is administration of antimicrobial proteins and peptides (APPs) such as LL-37, a membrane-active cathelicidin antimicrobial peptide, and mannose-binding lectin (MBL), a pattern-recognition protein that binds to microbial surface polysaccharides resulting in opsonization and complement activation. Low plasma/serum levels of LL-37 and of MBL have been correlated with infection and exogenous administration of these agents may enhance host defense. Methods: The antimicrobial activity of LL-37 (15 µg/ml) or rMBL (0.5, 2 and 10 µg/ml) was tested in hirudin-anticoagulated preterm and term human cord blood (N = 12-14) …

Antioxidants And Cancer: Theories, Techniques, And Trials In Preventing Cancer, Gloria M. Calaf, Francisco Aguayo, Consolato M. Sergi, Angeles Juarranz, Debasish Roy

Publications and Research

No abstract provided.

Hematological Changes In Response To A Drastic Increase In Training Volume In Recreational Cyclists, Jessie Axsom

James Madison Undergraduate Research Journal (JMURJ)

Changes in blood volume contribute to improvement in oxygen utilization (VO2max) with chronic endurance exercise training. Although hematological changes resulting from long-term endurance training have been well documented, it has not been well established whether an increased volume of endurance training preferentially affects plasma volume or red blood cell volume. To answer this question, I studied seven female and four male recreational cyclists before and after exposure to drastic increases (632%) in training volume. Following the 10-week training period, the mean hematocrit (Hct) of the 11 subjects who completed the study significantly (p0.05) correlated with the change in self-reported weekly …

Iron Isomaltoside Is Superior To Iron Sucrose In Increasing Hemoglobin In Gynecological Patients With Iron Deficiency Anemia., Richard Derman, Eloy Roman, Gioi N. Smith-Nguyen, Maureen M. Achebe, Lars L. Thomsen, Michael Auerbach

Global Health Articles

No abstract provided.

Banning Abortion In Cases Of Down Syndrome: Important Lessons For Advances In Genetic Diagnosis, Rebecca Reingold, Lawrence O. Gostin

Georgetown Law Faculty Publications and Other Works

In December 2017, Ohio passed into law legislation that prohibited physicians from performing abortions if the pregnant woman’s decision was influenced by her belief that the fetus has Down syndrome. Physicians who perform abortions in these cases would face fourth-degree felony charges and revocation of their medical license. No other state bans abortion specifically for Down syndrome, but several ban abortions in cases of genetic diseases. Lower courts have struck down most such laws, holding they violate the constitutional rights of women. In February 2018, a federal district court judge blocked enforcement of Ohio’s law pending a final determination.

This …

Birth History As A Predictor Of Adverse Birth Outcomes: Evidence From State Vital Statistics Data, Dejun Su, Kaeli Samson, Ashvita Garg, Corrine Hanson, Ann L. Anderson Berry, Ge Lin Kan, Ming Qu

School of Public Health Faculty Research

One of the most important predictors of preterm births (PTBs) or low-birth-weight births (LBWBs) is whether a mother has had a history of these birth outcomes. This study examined how different characterizations of birth history (e.g., any previous incidence of PTBs or LBWBs, immediate previous birth that was preterm or of low birth weight, and number of previous PTBs or LBWBs) were associated with PTBs or LBWBs. Based on birth records (n = 98,776) reported to the vital statistics electronic registration system in Nebraska from 2005 to 2014, mothers with a history of PTBs or LBWBs were more likely to …

Successful Use Of Balloon Tamponade In The Management Of Postpartum Hemorrhage In A Case Of Bicornuate Uterus, Erum Saleem, Ayesha Basharat

Department of Obstetrics & Gynaecology

Worldwide 50%–70% of all cases of maternal morbidity have been attributed to postpartum hemorrhage. This report discusses a case of bicornuate uterus in a term pregnancy. The delivery was by cesarean section, which was followed by massive postpartum hemorrhage, managed successfully with balloon tamponade. This is the second reported case of successful management of post partum hemorrhage in a bicornuate uterus with balloon tamponade. A 22-year-old primigravida at 39 weeks of gestational age presented with vaginal leaking of clear fluid. Cesarean section was done due to meconium stained liquor in early labor; with an incidental finding of bicornuate uterus followed …

Implementation Of A Surgical Safety Checklist, Nicole Stathatos

Master's Projects and Capstones

Lack of standardization in the perioperative area leads to variations in practice that can cause preventable errors. In a 200-bed hospital in Northern California with eleven operating rooms preforming approximately 11,000 procedures a year, there was an increase incidence in sentinel events such as wrong site surgery (n=1), wrong patient surgery (n=1), and retained foreign body (n=5). Safety checks observed in the operating room (OR) were preformed differently among each surgical team and sometimes did not occur at all. Through the use of a Surgical Safety Checklist (SSC), efforts were aimed to standardize safety practices in the OR. The goal …

Regular Exercise Throughout Pregnancy And Maternal Recovery Postpartum, Rachel Jenkins

Graduate Theses & Dissertations

Abstract

Introduction: The American College of Obstetricians and Gynecologists recommends that “women with uncomplicated pregnancies should be encouraged to engage in aerobic and strength-conditioning exercises before, during, and after pregnancy.”1 Many pregnant mothers seek guidance regarding exercise regimens’ safety and efficacy. This paper is a systematic review of the current literature on the topic of exercise regimens performed throughout pregnancy and maternal postpartum recovery.

Purpose: To determine if following the American College of Obstetricians and Gynecologists recommendation to engage in regular aerobic and strength-conditioning exercises throughout pregnancy contributes to easier deliveries as measured by the number of caesarean sections, time …

Placement Of Lumen-Apposing Metal Stents To Drain Pseudocysts And Walled-Off Pancreatic Necrosis Can Be Safely Performed On An Outpatient Basis: A Multicenter Study, Douglas G. Adler, Janak Shah, Jose Nieto, Kenneth Binmoeller, Yasser Bhat, Linda Jo Taylor, Ali A. Siddiqui

Division of Gastroenterology and Hepatology Faculty Papers

Backgrounds and Objectives: No study on the use of lumen-apposing fully covered self-expanding metal stent (LAMS) to drain pancreatic fluid collections (PFCs) has evaluated outcomes of patients in the outpatient setting. The objective of this multicenter study was to evaluate the clinical outcomes, success rate, and adverse events of the LAMS for endoscopic ultrasound (EUS)-guided transmural drainage of patients with symptomatic PFCs on an inpatient versus an outpatient basis.

Methods: This was a multicenter, retrospective study conducted at 4 tertiary care centers. Results: We identified eighty patients with PFCs in whom EUS-guided transmural drainage using the LAMS was performed. The …

Stress Urinary Incontinence In Collegiate Female Athletes: Prevalence And Impact, Marie Bouchard

Master's Projects and Capstones

Abstract

Introduction, definition: Urinary incontinence is the involuntary leaking of urine (a few drops to a few milliliters). It can happen while exercising with no urge to urinate (stress urinary incontinence), with a sudden urge to urinate (overactive bladder or urgency urinary incontinence), or a combination of the two (mixed urinary incontinence). This issue is very common among female athletes. However, because of the reluctance to discuss this problem, it remains underdiagnosed and undertreated.

Methods:An anonymous and confidential survey was distributed to the 90 University of San Francisco female student athletes from seven different varsity sports in December 2017. …

The Effect Of Diabetes Self-Management Education On Hba1c And Quality Of Life In African-Americans: A Systematic Review And Meta-Analysis., Amy T. Cunningham, Denine R. Crittendon, Neva White, Geoffrey D. Mills, Victor Diaz, Marianna Lanoue

Department of Family & Community Medicine Faculty Papers

BACKGROUND: Type 2 diabetes presents a major morbidity and mortality burden in the United States. Diabetes self-management education (DSME) is an intervention associated with improved hemoglobin A1c(HbA1c) and quality of life(QOL), and is recommended for all individuals with type 2 diabetes. African-Americans have disproportionate type 2 diabetes morbidity and mortality, yet no prior meta-analyses have examined DSME outcomes exclusively in this population. This systematic review and meta-analysis examined the impact of DSME on HbA1c and QOL in African-Americans compared to usual care.

METHODS: Randomized controlled trials, cluster-randomized trials, and quasi-experimental interventions were included. 352 citations were retrieved; 279 abstracts were …

Samhd1 Phosphorylation Coordinates The Anti-Hiv-1 Response By Diverse Interferons And Tyrosine Kinase Inhibition., Matthew A Szaniawski, Adam M Spivak, James E Cox, Jonathan L Catrow, Timothy Hanley, Elizabeth S C P Williams, Michel J Tremblay, Alberto Bosque, Vicente Planelles

Microbiology, Immunology, and Tropical Medicine Faculty Publications

Macrophages are susceptible to human immunodeficiency virus type 1 (HIV-1) infection despite abundant expression of antiviral proteins. Perhaps the most important antiviral protein is the restriction factor sterile alpha motif domain and histidine/aspartic acid domain-containing protein 1 (SAMHD1). We investigated the role of SAMHD1 and its phospho-dependent regulation in the context of HIV-1 infection in primary human monocyte-derived macrophages and the ability of various interferons (IFNs) and pharmacologic agents to modulate SAMHD1. Here we show that stimulation by type I, type II, and to a lesser degree, type III interferons share activation of SAMHD1 via dephosphorylation at threonine-592 as a …

Lgbt Senior Health Disparities: Information Resources To Bridge The Gap, Gregg A. Stevens, Tony Nguyen, Francisco J. Fajardo

Library Faculty Publications

As the senior population in the United States increases, the aging LGBT (lesbian, gay, bisexual, transgender) population should also see comparable growth rates. Health care providers and social service organizations will care for more LGBT seniors with special needs beyond the general population of older adults as they are more at risk for certain conditions. This article identifies some specific health disparities and examines several organizations that work to improve LGBT senior health by providing critical health information to LGBT older adults, caregivers, and health care professionals.

Increasing Ph In Cancer: Enabling A New Therapeutic Paradigm Using Novel Carbonate Nanoparticles, Avik Som

McKelvey School of Engineering Graduate Student Theses & Dissertations

Enormous progress has been made to treat cancer, and yet the mortality rate of cancer remains unacceptably high. High clinical resistance to molecularly targeted therapeutics has pushed interest again towards inhibiting universal biochemical hallmarks of cancer. Recent evidence suggests that malignant tumors acidify the local extracellular environment to activate proteases for degrading the tumor matrix, which facilitates metastasis, and explains why more aggressive tumors are more acidic. Current therapies have only focused on using the low pH for enhancing drug release in tumors, thereby still relying on the traditional paradigm of intracellular inhibition of pathways, a method that continues to …

Neural Responses To Naturalistic Clips Of Behaving Animals Under Two Different Task Contexts, Samuel A. Nastase, Yaroslav O. Halchenko, Andrew C. Connolly, M. Ida Gobbini, James V. Haxby

Dartmouth Scholarship

The human brain rapidly deploys semantic information during perception to facilitate our interaction with the world. These semantic representations are encoded in the activity of distributed populations of neurons (Haxby et al., 2001; McClelland and Rogers, 2003; Kriegeskorte et al., 2008b) and command widespread cortical real estate (Binder et al., 2009; Huth et al., 2012). The neural representation of a stimulus can be described as a location (i.e., response vector) in a high-dimensional neural representational space (Kriegeskorte and Kievit, 2013; Haxby et al., 2014). This resonates with behavioral and theoretical work describing mental representations of objects and actions as being …

Electron Monte Carlo Dose Calculation Model Dependency On Optional Applicator Specific 1d Profiles, Ryan Sharp

UNLV Theses, Dissertations, Professional Papers, and Capstones

The accuracy of a calculated dose distribution compared to the actual dose administered to a patient undergoing electron radiation treatment is dependent upon the configured electron dose calculation algorithm in the treatment planning system (TPS). Configuration of the electron Monte Carlo (eMC) algorithm in the Eclipse TPS requires a variety of beam scan data. One of the required data sets is the inclusion of optional in air crossplane (CP) and inplane (IP) profiles. It is unknown if the inclusion of the optional profiles into the eMC algorithm greatly influences the output of the TPS. Two eMC algorithms were configured in …

Hiv Mortality Difference Between Black And White Women, Carlos O. Nesbeth, Rajiv Kandala, Syed Najeeb, Ruksana Nazneen, Banglore Murthy

Journal of Health Disparities Research and Practice

OBJECTIVE

In the United States, human immunodeficiency virus (HIV) continues to be among the top 10 leading causes of mortality for black women between the ages of 20 and 54¹, but does not rank among the top 10 leading causes of death for white women amongst all age groups^². This study describes the HIV mortality difference between black and white women and formulate hypotheses that may reduce or eliminate disparities.

METHODS

Information was accessed through public data, the US Census, and the US Compressed Mortality File.

RESULTS

In these descriptive data from 1987 through 2015, including reliable HIV …

Allatostatin C Modulates Nociception And Immunity In Drosophila., Nathaniel D Bachtel, Gary A Hovsepian, Douglas F Nixon, Ioannis Eleftherianos

Microbiology, Immunology, and Tropical Medicine Faculty Publications

Bacterial induced inflammatory responses cause pain through direct activation of nociceptive neurons, and the ablation of these neurons leads to increased immune infiltration. In this study, we investigated nociceptive-immune interactions in Drosophila and the role these interactions play during pathogenic bacterial infection. After bacterial infection, we found robust upregulation of ligand-gated ion channels and allatostatin receptors involved in nociception, which potentially leads to hyperalgesia. We further found that Allatostatin-C Receptor 2 (AstC-R2) plays a crucial role in host survival during infection with the pathogenic bacterium Photorhabdus luminescens. Upon examination of immune signaling in AstC-R2 deficient mutants, we demonstrated that Allatostatin-C …

Analysis Of The Immunological Biomarker Profile During Acute Zika Virus Infection Reveals The Overexpression Of Cxcl10, A Chemokine Linked To Neuronal Damage., Felipe Gomes Naveca, Gemilson Soares Pontes, Aileen Yu-Hen Chang, George Allan Villarouco Da Silva, Valdinete Alves Do Nascimento, Dana Cristina Da Silva Monteiro, +Several Additional Authors

Medicine Faculty Publications

BACKGROUND: Infection with Zika virus (ZIKV) manifests in a broad spectrum of disease ranging from mild illness to severe neurological complications and little is known about Zika immunopathogenesis.

OBJECTIVES: To define the immunologic biomarkers that correlate with acute ZIKV infection.

METHODS: We characterized the levels of circulating cytokines, chemokines, and growth factors in 54 infected patients of both genders at five different time points after symptom onset using microbeads multiplex immunoassay; comparison to 100 age-matched controls was performed for statistical analysis and data mining.

FINDINGS: ZIKV-infected patients present a striking systemic inflammatory response with high levels of pro-inflammatory mediators. Despite …

Ice-Man Down: Using Simulation To Practice The Safe Extrication Of Collapsed Hockey Players In A Confined Space., Meryl Abrams, Dimitrios Papanagnou, Carlos Rodriguez, Joshua Rudner, Hyunjoo Lee, Simran Buttar, Ronald V Hall, Xiao Chi Zhang

Department of Emergency Medicine Faculty Papers

Sporting event emergencies are common among both spectators and players, with unique sets of challenges associated with patient extrication in unfamiliar and chaotic environments. It is critical for sports physicians and trainers to deliberately train and prepare for emergent situations with limited resources during athletic events. One of the most difficult, yet commonly encountered challenges is determining when and how to safely remove an injured player's helmet and sporting equipment, particularly if a spinal injury is highly suspected. We created a high-fidelity simulation case to practice the safe extrication of a hockey player who collapses on the bench in the …

Intense Exercise For Survival Among Men With Metastatic Castrate-Resistant Prostate Cancer (Interval-Gap4): A Multicentre, Randomised, Controlled Phase Iii Study Protocol, Robert Newton, Stacey A Kenfield, Nicolas H. Hart, June M Chan, Kerry S. Courneya, James Catto, Stephen P Finn, Rosemary Greenwood, Daniel C Hughes, Lorelei Mucci, Stephen R Plymate, Stephan F E Praet, Emer M Guinan, Erin L Van Blarigan, Orla Casey, Mark Buzza, Sam Gledhill, Li Zhang, Daniel A. Galvao, Charles J Ryan, Fred Saad

Research outputs 2014 to 2021

INTRODUCTION: Preliminary evidence supports the beneficial role of physical activity on prostate cancer outcomes. This phase III randomised controlled trial (RCT) is designed to determine if supervised high-intensity aerobic and resistance exercise increases overall survival (OS) in patients with metastatic castrate-resistant prostate cancer (mCRPC).

METHODS AND ANALYSIS: Participants (n=866) must have histologically documented metastatic prostate cancer with evidence of progressive disease on androgen deprivation therapy (defined as mCRPC). Patients can be treatment-naïve for mCRPC or on first-line androgen receptor-targeted therapy for mCRPC (ie, abiraterone or enzalutamide) without evidence of progression at enrolment, and with no prior chemotherapy for mCRPC. Patients …

A Letter From The President, Siobahn E. Fagan

Journal of Sports Medicine and Allied Health Sciences: Official Journal of the Ohio Athletic Trainers Association

Thank you for viewing this Special Edition of the Journal of Sports Medicine and Allied Health Sciences. As we continue to grow and continue to provide a platform for excellent scholarship your continued support is greatly appreciated.

Nfl Wide Receiver With Paroxysmal Dystonia/Dyskinesia, Chad Rairdon, Brian Dykuhuizen, Paul Sparling, Erika Smith-Goodwin

Journal of Sports Medicine and Allied Health Sciences: Official Journal of the Ohio Athletic Trainers Association

In volume 4, Issue 1 of the JSMAHS you will find Professional Research Abstracts, as well as Bachelor Student Research Abstracts and Case Reports.

Thank you for viewing this 4^th Annual OATA Special Edition

Chronic Subluxation And Relocation Of The Shoulder In A Collegiate Dodgeball Player, Victoria Stupecki, Nathan Doles

Journal of Sports Medicine and Allied Health Sciences: Official Journal of the Ohio Athletic Trainers Association

In volume 4, Issue 1 of the JSMAHS you will find Professional Research Abstracts, as well as Bachelor Student Research Abstracts and Case Reports.

Thank you for viewing this 4^th Annual OATA Special Edition