Medical Specialties Commons^™

A Small, Well-Differentiated Rectal Neuroendocrine Tumor With Multiple Lymph Node Metastases: A Case Report, S. J. Nam, G. B. Chae, S. Lee, S. C. Park, C. D. Kang, S. J. Lee

Journal Articles

© 2018, Spandidos Publications. All rights reserved. The incidence of rectal neuroendocrine tumor (NET), which is often diagnosed during routine surveillance endoscopy, is increasing. The majority of these tumors are small and asymptomatic, possessing benign features with favorable prognoses. At present, small rectal NETs without high-risk factors are typically treated by local resection, including endoscopic mucosal resection, endoscopic submucosal dissection, or transanal endoscopic microsurgery, with or without additional imaging follow-up by abdominal computed tomography or magnetic resonance imaging. The present study, however, describes a case of a small rectal NET without any known risk factors, which was accompanied by substantial …

Parsing Cyclothymic Disorder And Other Specified Bipolar Spectrum Disorders In Youth, A. Van Meter, B. I. Goldstein, T. R. Goldstein, S. Yen, H. Hower, M. Strober, J. A. Merranko, M. K. Gill, R. S. Diler, B. Birmaher, +3 Additional Authors

Journal Articles

© 2018 Elsevier B.V. Objective: Most studies of pediatric bipolar disorder (BP) combine youth who have manic symptoms, but do not meet criteria for BP I/II, into one “not otherwise specified” (NOS) group. Consequently, little is known about how youth with cyclothymic disorder (CycD) differ from youth with BP NOS. The objective of this study was to determine whether youth with a research diagnosis of CycD (RDCyc) differ from youth with operationalized BP NOS. Method: Participants from the Course and Outcome of Bipolar Youth study were evaluated to determine whether they met RDCyc criteria. Characteristics of RDCyc youth and BP …

Psychopharmacological Treatment In The Raise-Etp Study: Outcomes Of A Manual And Computer Decision Support System Based Intervention, D. G. Robinson, N. R. Schooler, C. U. Correll, M. John, B. T. Kurian, P. Marcy, A. L. Miller, R. Pipes, M. H. Trivedi, J. M. Kane

Journal Articles

No abstract provided.

Reminder Duration Determines Threat Memory Modification In Humans, J. Hu, W. Wang, P. Homan, P. Wang, X. Zheng, D. Schiller

Journal Articles

© 2018 The Author(s). Memory reminders can return a memory into an unstable state such that it will decay unless actively restabilized into long-term memory through reconsolidation. Exposure to a memory reminder, however, does not always lead to destabilization. The 'trace dominance' principle posits that the extent of exposure to memory reminders governs memory susceptibility to disruption. Here, we provide a first systematic investigation of reminder duration effects on threat memory modification in humans. Reminder duration was parametrically varied across 155 participants in a three-day protocol. We found that short reminders (1 s and 4 s) made the memory prone …

Statewide Cross-Sectional Survey Of Emergency Departments’ Adoption And Implementation Of The Ohio Opioid Prescribing Guidelines And Opioid Prescribing Practices, Jonathan Penm, Neil J. Mackinnon, Rebecca Mashni, Michael S. Lyons, Edmond A. Hooker, Erin L. Winstanley, Steve Carlton-Ford, Chloe Connelly, Erica Tolle, Jill Boone, Kathleen Koechlin, Jolene Defiore-Hyrmer

Faculty & Staff Scholarship

study objective: To evaluate the implementation of the Ohio Emergency and Acute Care Facility Opioids and Other Controlled Substances Prescribing Guidelines and their perceived impact on local policies and practice.

Methods: The study design was a cross-sectional survey of emergency department (ED) medical directors, or appropriate person identified by the hospital, perception of the impact of the Ohio ED Opioid Prescribing Guidelines on their departments practice. All hospitals with an ED in Ohio were contacted throughout October and November 2016. Distribution followed Dillman’s Tailored Design Method, augmented with telephone recruitment. Hospital chief executive officers were contacted when necessary to encourage …

A Cold-Inducible Rna-Binding Protein (Cirp)-Derived Peptide Attenuates Inflammation And Organ Injury In Septic Mice, F. Zhang, M. Brenner, W. Yang, P. Wang

Journal Articles

No abstract provided.

Correction: First Results On Survival From A Large Phase 3 Clinical Trial Of An Autologous Dendritic Cell Vaccine In Newly Diagnosed Glioblastoma [J Transl Med., 16, (2018) (142)] Doi: 10.1186/S12967-018-1507-6, L. M. Liau, K. Ashkan, D. D. Tran, J. L. Campian, J. E. Trusheim, C. S. Cobbs, J. A. Heth, M. Salacz, M. Schulder, M. L. Bosch, +10 Additional Authors

Journal Articles

© 2018 The Author(s). Following publication of the original article [1], the authors reported an error in the spelling of one of the author names. In this Correction the incorrect and correct author names are indicated and the author name has been updated in the original publication. The authors also reported an error in the Methods section of the original article. In this Correction the incorrect and correct versions of the affected sentence are indicated. The original article has not been updated with regards to the error in the Methods section.

From Bouveret's Syndrome To Gallstone Ileus: The Journey Of A Migrating Stone!, F. G. Haddad, W. Mansour, J. Mansour, L. Deeb

Journal Articles

Bouveret's syndrome, first described in 1896, is an unusual cause of gastric outlet obstruction secondary to large gallstone impaction in the proximal duodenum after migration through a cholecystoduodenal fistula. Stone migration has been previously described after endoscopic or surgical fragmentation. However, this is the first reported case, in our knowledge, where the stone migrated after oral contrast administration a few days after the onset of symptoms, causing a distal gallstone ileus.

Hereditary Diffuse Gastric Cancer: One Family's Story, H. M. Zylberberg, K. Sultan, S. Rubin

Journal Articles

No abstract provided.

Idiopathic Pancreatitis As A Rare Gastrointestinal Manifestation Of Myotonic Muscular Dystrophy., N. Kello

Journal Articles

Myotonic muscular dystrophy (DM) is a multi-system disorder affecting skeletal muscles as well as smooth and cardiac muscles. Patients with DM experience disturbances in gastrointestinal motility; however, pancreatobiliary manifestations have rarely been described. We report the case of a 58-year-old male with MD who presented with a sudden onset of vomiting and abdominal pain. Laboratory and radiological findings were consistent with acute pancreatitis. No identifiable cause of pancreatitis could be identified despite an extensive workup. Sphincter of Oddi dysfunction (SOD) was felt to be the most likely cause of our patient's acute pancreatitis. SOD leading to acute pancreatitis results from …

Synchronous Presence Of Egfr, Alk Driver Mutations Along With Pd L1 Overexpression In A Resected Early Stage Non-Small Cell Lung Cancer: A Case Report And Review Of Literature., N. Thumallapally, S. Parylo, A. Vennepureddy, U. Ibrahim, A. Sokoloff

Journal Articles

Treatment of lung cancer has been revolutionized with development of drugs that target key driver mutations and immune checkpoints. Until recently, it was believed that these driver mutations are mutually exclusive. However, few reports have emerged citing the presence of both mutations either synchronously or metachronously. We describe a case report of lung adenocarcinoma harboring two driver mutations in the same tumor cells as well as exhibiting high PDL1 expression. We further discuss the possible association of these driver mutations with PDL1 expression.

Targeting Dec-205(-)Dcir2(+) Dendritic Cells Promotes Immunological Tolerance In Proteolipid Protein-Induced Experimental Autoimmune Encephalomyelitis, I. Tabansky, D. B. Keskin, D. Watts, C. Petzold, M. Funaro, W. Sands, P. Wright, S. Najjar, B. Diamond, J. N. H. Stern, +4 Additional Authors

Journal Articles

No abstract provided.

The Role Of Genetics In Advancing Precision Medicine For Alzheimer's Disease-A Narrative Review., Y. Freudenberg-Hua, W. Li, P. Davies

Journal Articles

Alzheimer's disease (AD) is the most common type of dementia, which has a substantial genetic component. AD affects predominantly older people. Accordingly, the prevalence of dementia has been rising as the population ages. To date, there are no effective interventions that can cure or halt the progression of AD. The only available treatments are the management of certain symptoms and consequences of dementia. The current state-of-the-art medical care for AD comprises three simple principles: prevent the preventable, achieve early diagnosis, and manage the manageable symptoms. This review provides a summary of the current state of knowledge of risk factors for …

Farnesylation Of The Transducin G Protein Gamma Subunit Is A Prerequisite For Its Ciliary Targeting In Rod Photoreceptors, Celine Brooks, Joseph Murphy, Marycharmain Belcastro, Daniel Heller, Saravanan Kolandaivelu, Oleg Kisselev, Maxim Sokolov

Faculty & Staff Scholarship

Primary cilia are microtubule-based organelles, which protrude from the plasma membrane and receive a wide range of extracellular signals. Various cilia use G protein-coupled receptors (GPCRs) for the detection of these signals. For instance, vertebrate rod photoreceptors use their cilia (also called outer segments) as antennae detecting photons by GPCR rhodopsin. Rhodopsin recognizes incoming light and activates its G protein, transducin, which is composed of three subunits α, β, and γ. Similar to all G protein γ subunits, the transducin Gγ1 subunit undergoes C-terminal prenylation resulting in the addition of an isoprenoid farnesyl; however, the significance of this posttranslational modification …

2017-2018 Pediatric Subspecialty Trainees, Children's Mercy Hospital

Residents and Fellows Portraits

Photo composites of the graduate pediatric trainees in allergy/immunology, child abuse pediatrics, child neurology, clinical child psychology, clinical pharmacology, developmental-behavioral pediatrics, hospice & palliative care, laboratory genetics & genomics, neonatal-perinatal medicine, pediatric adolescent gynecology, pediatric anesthesiology, pediatric bioethics, pediatric cardiology, pediatric critical care medicine, pediatric dentistry, pediatric emergency medicine, pediatric endocrinology, pediatric gastroenterology, pediatric hematology/oncology, pediatric hospital medicine, pediatric infectious diseases, pediatric nephrology, pediatric optometry, pediatric ophthalmology, pediatric otolaryngology, pediatric pulmonology, pediatric radiology, pediatric rehabilitation, pediatric sports medicine, pediatric surgery, pediatric residency and med/peds residency.

Intermediate-Risk Meningioma: Initial Outcomes From Nrg Oncology Rtog 0539, L. Rogers, P. Zhang, M. A. Vogelbaum, A. Perry, L. S. Ashby, J. M. Modi, A. M. Alleman, J. Galvin, J. P. S. Knisely, M. P. Mehta, +5 Additional Authors

Journal Articles

No abstract provided.

Insulin-Like Growth Factor 2: A Poor Prognostic Biomarker Linked To Racial Disparity In Women With Uterine Carcinosarcoma, A. R. Van Arsdale, R. C. Arend, M. J. Cossio, B. K. Erickson, Y. Wang, D. W. Doo, C. A. Leath, G. L. Goldberg, G. S. Huang

Journal Articles

© 2018 The Authors. Cancer Medicine published by John Wiley & Sons Ltd. The objective of this study was to investigate the relationship of insulin-like growth factor 2 (IGF2) expression and survival in women with uterine carcinosarcoma (UCS). Insulin-like growth factor 2 protein expression was determined by immunohistochemical staining of tumor tissues from 103 patients with UCS. The H-score (product of staining intensity and percentage positive cells) was quantified for the epithelial cytoplasmic (EC), epithelial nuclear (EN), and malignant stromal compartments. Multivariable Cox proportional hazard regression models were used to examine the relationship of IGF2 levels with progression-free survival (PFS) …

Implementation And Utilization Of Hypofractionation For Breast Cancer, P. Gilbo, L. Potters, L. Lee

Journal Articles

© 2018 The Authors Purpose: Hypofractionation (HF) of whole breast irradiation has become a standard treatment regimen because randomized trials continue to demonstrate equivalence in survival and local control compared with conventional fractionation. In 2011, the American Society for Radiation Oncology (ASTRO) adopted clinical guidelines on the proper selection of HF. Nevertheless, utilization remains lower than predicted. We evaluate the effects of clinical directives that serve as default treatment decisions and prospective contouring rounds on the implementation of HF in a large, multicenter radiation oncology department. Methods and materials: In 2010, we implemented consensus-driven and evidence-based clinical directives to guide …

January 2018, New England Osteopathic Heritage Center

New England Osteopathic Heritage Center Newsletter

New England Osteopathic Heritage Center's annual newsletter for January 2018

Developing Racial Literacy And Cultural Fluency In The Pediatric Healthcare Setting: The Use Of Staff Focus Groups To Address Implicit Bias And Cultural Competence When Working With A Culturally Diverse Patient Population, Natalie Kinsky

Graduate Student Independent Studies

Developing Racial Literacy and Cultural Fluency in the Pediatric Healthcare Setting: The use of staff focus groups to address implicit bias and cultural competence when working with a culturally diverse patient population by Natalie Kinsky.

The purpose of this evidence-based practice (EBP), quality improvement project was to explore how targeted education and discussion, delivered through healthcare staff focus groups pertaining to race, culture, and bias, affect staff members’ knowledge and awareness of how these issues and experiences affect pediatric patients/families.

The EBP project consisted of pediatric healthcare staff focus groups to discuss topics of race, bias, and culture. The self-selected …

Photoluminescence Mechanism And Applications Of Zn-Doped Carbon Dots, Quan Xu, Wei Cai, Miaoran Zhang, Yingchun Ye, Yeqing Li, Lipeng Zhang, Yongjian Guo, Zhiqiang Yu, Siyu Li, Xun Lin, Yusheng Chen, Yan Lou, Jason Street, Meng Xu

Faculty & Staff Scholarship

Heteroatom-doped carbon dots (CDs) with excellent optical characteristics and negligible toxicity have emerged in many applications including bioimaging, biosensing, photocatalysis, and photothermal therapy. The metal-doping of CDs using various heteroatoms results in an enhancement of the photophysics but also imparts them with multifunctionality. However, unlike nonmetal doping, typical metal doping results in low fluorescence quantum yields (QYs), and an unclear photoluminescence mechanism. In this contribution, we detail results concerning zinc doped CDs (Zn-CDs) with QYs of up to 35%. The zinc ion charges serve as a surface passivating agent and prevent the aggregation of graphene p–p stacking, leading to an …

Acute Effects Of Diets Rich In Almonds And Walnuts On Endothelial Function, Ravindra Bhardwaj, Harvinder Dod, Manjinder S. Sandhu, Rohil Bedi, Sachin Dod, Gregory Konat, H.K. Chopra, Rakesh Sharma, Abnash C. Jain, Navin Nanda

Faculty & Staff Scholarship

Objective: Omega-3 fatty acids, especially alpha-linolenic acid (ALA), which are present in nuts may reduce cardiovascular disease (CVD) risk, by changing vascular inflammation and improving endothelial dysfunction. The objective of the study was to evaluate the acute effects of two different diets, one containing walnuts and the other almonds on endothelial function.

Methods: Twenty-seven overweight volunteers underwent a randomized 2-period, crossover, controlled intervention study. The subjects were given either walnut or almond diets which varied in monounsaturated fatty acid (MUFA) and polyunsaturated fatty acid (PUFA) content. The walnut diet provided 23.1% energy from PUFA and the almond diet provided 7.6% …

Spontaneous Dna Damage To The Nuclear Genome Promotes Senescence, T Redox Imbalance And Aging, Andria R. Robinson, Matthew J. Yousefzadeh, Tania A. Rozgaja, Jin Wang, Xuesen Li, Jeremy S. Tilstra, Chelsea H. Feldman, Siobhan Q. Gregg, Caroline H. Johnson, Erin M. Skoda, Marie-Celine Frantz, Harris Bell-Temin, Hannah Pope-Varsalona, Aditi U. Gurkar, Luigi A. Nasto, Rena A.S. Robinson, Heike Fuhrmann-Stroissnigg, Jolanta Czerwinska, Sara J. Mcgowan, Nadiezhda Cantu-Madellin, Jamie B. Harris, Salony Maniar, Mark A. Ross, Christy E. Trussoni, Nicholas F. Larusso, Eugenia Cifuentes-Pagano, Patrick J. Pagano, Barbara Tudek, Nam V. Vo, Lora H. Rigatti, Patricia L. Opresko, Donna B. Stolz, Simon C. Watkins, Christin E. Burd, Claudette M. St, Croix, Gary Siuzdak, Nathan A. Yates, Paul D. Robbins, Yinsheng Wang, Peter Wipf, Eric E. Kelley, Laura J. Neidernhofer

Faculty & Staff Scholarship

Accumulation of senescent cells over time contributes to aging and age-related diseases. However, what drives senescence in vivo is not clear. Here we used a genetic approach to determine if spontaneous nuclear DNA damage is sufficient to initiate senescence in mammals. Ercc1-/Δ mice with reduced expression of ERCC1-XPF endonuclease have impaired capacity to repair the nuclear genome. Ercc1-/Δ mice accumulated spontaneous, oxidative DNA damage more rapidly than wild-type (WT) mice. As a consequence, senescent cells accumulated more rapidly in Ercc1-/Δ mice compared to repair-competent animals. However, the levels of DNA damage and senescent cells in Ercc1-/Δ mice never exceeded that …

Risk Perceptions Of Cellphone Use While Driving: Results From A Delphi Survey, Motao Zhu, Toni M. Rudisill, Kimberly J. Rauscher, Danielle M. Davidov, Jing Feng

Faculty & Staff Scholarship

Cellphone use while driving has been recognized as a growing and important public health issue by the World Health Organization and U.S. Center for Disease Control and Prevention. Surveys typically collect data on overall texting while driving, but do not differentiate between various forms of cellphone use. This study sought to improve the survey indicators when monitoring cellphone use among young drivers. Experts and young drivers were recruited to propose behavioral indicators (cellphone use while driving behaviors) and consequential indicators (safety consequences of cellphone use while driving) in 2016. Subsequently, experts and young drivers selected the top indicators using the …

The Effectiveness Of Oral Non-Steroidal Anti-Inflammatories Versus Steroid Injections In Patients With Shoulder Pain, Darren Scott Pledger

Physician Assistant Scholarly Project Papers

Shoulder pain is the third most common musculoskeletal complaint in primary care. Therefore, it is important that we have quality evidenced based treatments to guide clinicians in treating shoulder pain. I examined in this review whether corticosteroid injection into the glenohumeral joint or oral NSAIDs was more effective in reducing shoulder pain as well as the side effects associated with each treatment modality. Search methods included the PubMed and Cochrane databases. Only studies comparing corticosteroid injection and oral NSAIDs were included and not each treatment individually. In conclusion, corticosteroid injections into the glenohumeral joint accelerate pain relief but have equal …

Pre-Participation Physical Exams: Are We Doing Enough?, Steven Jacob Pietrusza

Physician Assistant Scholarly Project Posters

•Inclusion of screening electrocardiograms (EKGs) during pre-participation physical examination has been a topic of debate for some time. There is unquestioned usefulness in the ability of a well-trained health care provider in using EKG to identify cardiac abnormalities.

•Further, there have been several contemporary EKG criteria published that increase specificity and sensitivity of detection of disease. However, these criteria do not account for athletes less than 14 years of age, and that demographic represents a large portion of patients seeking pre-participation screenings in the United States.

•The lack of research into pediatric cardiac remodeling secondary to activity, coupled with the …

Antibiotic Therapy In Preventing Exacerbations Of Severe Chronic Obstructive Pulmonary Disease, Jamie Trautner

Physician Assistant Scholarly Project Posters

• Chronic obstructive pulmonary disease (COPD) is a progressive disease that has no cure but is treatable. The treatment goal is to have adequate symptom control, decreased exacerbations, prevent hospitalizations and maintain an independent quality of life.

• The review of literature is to determine if the benefits of long-term antimicrobial therapy outweigh the risks in the treatment of severe COPD.

• The gold standard for pharmacotherapy consists of inhaled corticosteroids and bronchodilators (long-acting beta2agonist (LABA).

• Adding azithromycin to standard therapy for patients with frequent exacerbations showed a 27% reduction in exacerbation frequency.

• With prolonged use of antimicrobials …

Patient-Specific Quantification Of The Relationship Between The Left Atrium Pressure And The Ostial Diameter Of The Left Atrial Appendage, Sky Tianqi Gao

Electronic Theses and Dissertations

The left atrial appendage has been a historically understudied region of the heart until fairly recently with the new understanding of its role in the stroke pathway of patients with atrial fibrillation. The goal of this study is to take a look at the biomechanical behavior of the left atrium and left atrial appendage under normal physiological loading conditions using material properties taken from biaxial stretch tests. Several different options for material properties models were tested and biaxial stretch test data of cadaveric human tissue samples for the left atrium and appendage were fit to a Fung-type strain-energy function for …

Future Implications Of Using Registered Dietitians In Multidisciplinary Polycystic Ovary Syndrome Treatment, Wendy M. Wolf, Rachel A. Wattick, Pamela J. Murray, Melanie Clemmer, Melissa D. Olfert

Faculty & Staff Scholarship

Polycystic ovary syndrome (PCOS) is the most common reproductive endocrine disorder in females with insulin resistance playing a key role in pathogenesis. The objective of this study was to investigate current trends and future implications of multidisciplinary PCOS clinics with inclusion of dietitians. A two-phase, formative investigation on practitioners was conducted through an anonymous survey followed by focus groups. Survey respondents included 261 health care providers from around the world; the majority (59%) representing multidisciplinary teams. Focus group participants included four dietitians, three physicians, a health psychologist and a licensed nutritionist. Primary barriers for future multidisciplinary clinics included: money/resources, insurance …

Glycemic Control And Type 1 Diabetes Mellitus: Current Standard Treatment Vs. Closed-Loop Insulin Pumps, Kelsey Daley

Physician Assistant Scholarly Project Posters

As of 2015, 9.4% of the US population had a diagnosis of Diabetes Mellitus (DM). Although most of the data sets studied encompass type 1 (T1) and type 2 (T2) DM data in all ages of patients, the focus of this project will be primarily on T1DM.

There are effective methods currently available for the management of T1DM patients. These methods include: closed-loop insulin pumps that integrate a continuous glucose monitor (CGM) and insulin pump into one effective system that calculates the needed insulin doses through complicated algorithms, CGM with self-blood glucose monitoring calibrations (SBGM) and insulin administration, and SBGM …