Medical Specialties Commons^™

Immunotherapy For Food Allergy: Myth Or Reality?, Gatot Soegiarto

Jurnal Penyakit Dalam Indonesia

Allergic reaction to food can have serious consequences. The only treatment option is strict allergen avoidance, but accidental ingestions happen frequently and can lead to severe and potentially life-threatening allergic reactions. Food allergy is one of the most common causes of anaphylactic reactions. Therefore self-injectable epinephrine should always be at hand in case of accidental exposure. Many food allergies may resolve over time, but most patients with persistent food allergies live with fear of anaphylactic reactions. Within the last several years, the usefulness of immunotherapy for food allergies has been investigated. Several food immunotherapies are being developed; which include oral, …

Opinions Of Academic Em Society Members On The New Acgme Common Program Requirements, Shawn M. Quinn Do, Bryan G. Kane Md, Marna R. Greenberg Do, Mph, Facep, Terrence E. Goyke, Steven Bird Md, Megan Schagrin Mba, Gavin C. Barr Jr. Md

Department of Emergency Medicine

No abstract provided.

Emergency Department Skull Trephination For Management Of Acute Epidural Hematoma, Julie A. Fritzges Do

Department of Emergency Medicine

No abstract provided.

Pediatric Erythromelalgia Treated With Epidural Ropivacaine Infusion, Caroline E. Lee, Kelly Paulk, Kristen Garvie, Elizabeth Grieshaber, Jeffrey Carter, Brian Ball

School of Medicine Faculty Publications

No abstract provided.

Tobacco Smoking And Dementia In A Kentucky Cohort: A Competing Risk Analysis, Erin L. Abner, Peter T. Nelson, Gregory A. Jicha, Gregory E. Cooper, David W. Fardo, Frederick A. Schmitt, Richard J. Kryscio

Epidemiology and Environmental Health Faculty Publications

Tobacco smoking was examined as a risk for dementia and neuropathological burden in 531 initially cognitively normal older adults followed longitudinally at the University of Kentucky’s Alzheimer’s Disease Center. The cohort was followed for an average of 11.5 years; 111 (20.9%) participants were diagnosed with dementia, while 242 (45.6%) died without dementia. At baseline, 49 (9.2%) participants reported current smoking (median pack-years = 47.3) and 231 (43.5%) former smoking (median pack-years = 24.5). The hazard ratio (HR) for dementia for former smokers versus never smokers based on the Cox model was 1.64 (95% CI: 1.09, 2.46), while the HR for …

Suppression Of Hmgb1 Released In The Glioblastoma Tumor Microenvironment Reduces Tumoral Edema., Bangxing Hong, Kamaldeen Muili, Chelsea Bolyard, Luke Russell, Tae Jin Lee, Yeshavanth Banasavadi-Siddegowda, Ji Young Yoo, Yuanqing Yan, Leomar Y Ballester, Kurt H Bockhorst, Balveen Kaur

Oncology Articles

HMGB1 is a ubiquitously expressed intracellular protein that binds DNA and transcription factors and regulates chromosomal structure and function. Under conditions of cell death or stress, it is actively or passively released by cells into the extracellular environment, where it functions as damage-associated molecular pattern (DAMP) that orchestrates pro-inflammatory cytokine release and inflammation. Our results demonstrate that HMGB1 is secreted in the tumor microenvironment after oncolytic HSV (oHSV) infection in vitro and in vivo. The impact of secreted HMGB1 on tumor growth and response to oncolytic viral therapy was evaluated by using HMGB1-blocking antibodies in vitro and in mice …

Eeg Findings In Infants With Neonatal Abstinence Syndrome Presenting With Clinical Seizures, Murali Reddy Palla, Gulam Q. Khan, Zahra M. Haghighat, Henrietta S. Bada

Pediatrics Faculty Publications

Neonatal abstinence syndrome (NAS) refers to a constellation of signs occurring in newborn infants who were exposed to opioids or opiates in utero. These manifestations include poor feeding, gastrointestinal disorders, abnormal sleep patterns, and neurological signs such as jitteriness, tremors, and seizures (1, 2). Myoclonus, jitteriness, and tremors often may be interpreted as seizures and therefore treated as epileptic seizures.

Objective: To determine whether seizure like activity observed in infants with NAS correlate with electroencephalogram (EEG) findings.

Design/ Method: We reviewed the standard EEG or video electroencephalogram (VEEG) of infants with NAS who were admitted because of seizure-like clinical …

Current Patient Perspectives Of Vulvovaginal Candidiasis: Incidence, Symptoms, Management And Post-Treatment Outcomes., Junko Yano, Jack D. Sobel, Paul Nyirjesy, Ryan Sobel, Valerie L. Williams, Qingzhao Yu, Mairi C. Noverr, Paul L. Fidel

Department of Obstetrics and Gynecology Faculty Papers

BACKGROUND: Vulvovaginal candidiasis (VVC) is a common infection affecting women worldwide. Reports of patterns/risk factors/trends for episodic/recurrent VVC (RVVC) are largely outdated. The purpose of this study was to obtain current patient perspectives of several aspects of VVC/RVVC.

METHODS: Business cards containing on-line survey information were distributed to healthy volunteers and patients seeking standard, elective, or referral gynecologic care in university-affiliated Obstetrics/Gynecology clinics. The internet-based questionnaire was completed by 284 non-pregnant women (78% Caucasian, 14% African American, 8% Asian).

RESULTS: The majority of the participants (78%) indicated a history of VVC with 34% defined as having RVVC. The most common …

The Use Of An ‘Acclimatisation’ Heatwave Measure To Compare Temperature-Related Demand For Emergency Services In Australia, Botswana, Netherlands, Pakistan, And Usa, Naomi Van Der Linden, Thomas Longden, John R. Richards, Munawar Khursheed, Wilhelmina M. T. Goddijn, Michiel J. Van Veelen, Uzma R. Khan, M. Christien Van Der Linden

Department of Emergency Medicine

Background: Heatwaves have been linked to increased risk of mortality and morbidity and are projected to increase in frequency and intensity due to climate change. The current study uses emergency department (ED) data from Australia, Botswana, Netherlands, Pakistan, and the United States of America to evaluate the impact of heatwaves on ED attendances, admissions and mortality.
Methods: Routinely collected time series data were obtained from 18 hospitals. Two separate thresholds (≥4 and ≥7) of the acclimatisation excess heat index (EHIaccl) were used to define "hot days". Analyses included descriptive statistics, independent samples T-tests to determine differences in case mix between …

Proteomic Alterations Of Hdl In Youth With Type 1 Diabetes And Their Associations With Glycemic Control: A Case-Control Study, Evgenia Gourgari, Junfeng Ma, Martin P. Playford, Nehal N. Mehta, Radoslav Goldman, Alan T. Remaley, Scott M. Gordon

Saha Cardiovascular Research Center Faculty Publications

Background: Patients with type 1 diabetes (T1DM) typically have normal or even elevated plasma high density lipoprotein (HDL) cholesterol concentrations; however, HDL protein composition can be altered without a change in cholesterol content. Alteration of the HDL proteome can result in dysfunctional HDL particles with reduced ability to protect against cardiovascular disease (CVD). The objective of this study was to compare the HDL proteomes of youth with T1DM and healthy controls (HC) and to evaluate the influence of glycemic control on HDL protein composition.

Methods: This was a cross-sectional case–control study. Blood samples were obtained from patients with T1DM and …

Forgotten Children & Bonds That Heal: The Critical Nature Of Attachment, August Ashbaker

Lesley University Community of Scholars Day

Human attachment is one of the most critical factors in proper neurological and physiological development. Attachment is built through the mutuality of emotional impact, as well as the regular reception of physical touch. Infants and children who have been deprived of these vital necessities through the lacking initiatives of their caregivers—through neglect—display visible signs of its physiological, cognitive, emotional, and behavioral impact. Research has found neglect to be the highest risk factor for permanent damage to brain development in comparison to other forms of complex trauma (i.e. chronic caregiver interpersonal trauma in childhood); it is also the most prevalent …

Acquiring Blood Pressures On High Risk Sepsis Patients In The Ed, Mckenna Scharlau, Jacob Schneider

Nurse Presentations

Describes a project to improve use of the Sepsis Tool in the Emergency Department and to improve documentation of blood pressure measurements in high risk sepsis patients under three years of age.

Overall Survival By Clinical Risk Category For High Dose Interleukin-2 (Hd Il-2) Treated Patients With Metastatic Renal Cell Cancer (Mrcc): Data From The Proclaim, M Fishman, J P Dutcher, J I Clark, A Alva, G P Miletello, B Curti, Neeraj Agarwal, R Hauke, K M Mahoney, H Moon, J Treisman, S S Tykodi, G Daniels, M A Morse, M K K Wong, H Kaufman, N Gregory, D F Mcdermott

Articles, Abstracts, and Reports

BACKGROUND: Prognostic scoring systems are used to estimate the risk of mortality from metastatic renal cell carcinoma (mRCC). Outcomes from different therapies may vary within each risk group. These survival algorithms have been applied to assess outcomes in patients receiving T-cell checkpoint inhibitory immunotherapy and tyrosine kinase inhibitor therapy, but have not been applied extensively to patients receiving high dose interleukin-2 (HD IL-2) immunotherapy.

METHODS: Survival of 810 mRCC patients treated from 2006 to 2017 with high dose IL-2 (aldesleukin) and enrolled in the PROCLAIM

RESULTS: Among the 810 patients, 721 were treatment-naïve (89%) and 59% were intermediate risk. Overall, …

Six-Month Outcome Of Transient Ischemic Attack And Its Mimics, Alireza Sadighi, Vida Abedi, Alia C. Stanciu, Nada El Andary, Mihai Banciu, Neil Holland, Ramin Zand

Faculty Journal Articles

Background and Objective: Although the risk of recurrent cerebral ischemia is higher after a transient ischemic attack (TIA), there is limited data on the outcome of TIA mimics. The goal of this study is to compare the 6-month outcome of patients with negative and positive diffusion-weighted imaging (DWI) TIAs (DWI-neg TIA vs. DWI-pos TIA) and also TIA mimics.

Methods: We prospectively studied consecutive patients with an initial diagnosis of TIA in our tertiary stroke centers in a 2-year period. Every included patient had an initial magnetic resonance (MR) with DWI and one-, three-, and six-month follow-up visits. The primary outcome …

Kinase Suppressor Of Ras 1 And Exo70 Promote Fatty Acid-Stimulated Neurotensin Secretion Through Erk1/2 Signaling, Stephanie Rock, Xian Li, Jun Song, Courtney M. Townsend, Heidi L. Weiss, Piotr G. Rychahou, Tianyan Gao, Jing Li, B. Mark Evers

Markey Cancer Center Faculty Publications

Neurotensin is a peptide hormone released from enteroendocrine cells in the small intestine in response to fat ingestion. Although the mechanisms regulating neurotensin secretion are still incompletely understood, our recent findings implicate a role for extracellular signal–regulated kinase 1 and 2 as positive regulators of free fatty acid-stimulated neurotensin secretion. Previous studies have shown that kinase suppressor of Ras 1 acts as a molecular scaffold of the Raf/MEK/extracellular signal–regulated kinase 1 and 2 kinase cascade and regulates intensity and duration of extracellular signal–regulated kinase 1 and 2 signaling. Here, we demonstrate that inhibition of kinase suppressor of Ras 1 attenuates …

Effects Of Altered Gravity On The Central Nervous System Of Drosophila Melanogaster, Amber M. Paul, Siddhita Mhatre, Janani Iyer, Jhony A. Zavaleta, Ravikumar Hosamani

Publications

A comprehensive understanding of the effects of spaceflight and altered gravity on human physiology is necessary for continued human space exploration and long-term space habitation. Spaceflight includes multiple factors such as microgravity, hyper gravity, ionizing radiation, physiological stress, and disrupted circadian rhythms and these have been shown to contribute to pathophysiological responses that target immunity, bone and muscle integrity, cardiovascular and nervous systems. In terrestrial conditions, some of these factors can lead to cancer and neuroimmunological disorders. In this study, we used a well-established spaceflight model organism, Drosophila melanogaster, to assess spaceflight-associated changes in the nervous system. We hypothesize that …

The Role Of Inhibition Of Apoptosis In Acute Leukemias And Myelodysplastic Syndrome., Amanda Mcbride, Sarah Houtmann, Lindsay Wilde, Carlos Vigil, Christine M. Eischen, Margaret Kasner, Neil Palmisiano

Department of Medical Oncology Faculty Papers

Avoidance of apoptosis is a key mechanism that malignancies, including acute leukemias and MDS, utilize in order to proliferate and resist chemotherapy. Recently, venetoclax, an inhibitor of the anti-apoptotic protein BCL-2, has been approved for the treatment of upfront AML in an unfit, elderly population. This paper reviews the pre-clinical and clinical data for apoptosis inhibitors currently in development for the treatment of AML, ALL, and MDS.

Safety Oriented, Low-Cost Peritonsillar Abscess Needle Aspiration Model For Emergency Medicine Simulation, Anne Mai Bs, Julie A. Fritzges Do, Gavin C. Barr Jr. Md, Marna R. Greenberg Do, Mph, Facep, Smeet Bhimani Do

Department of Emergency Medicine

No abstract provided.

Sport Participation And Specialization Characteristics Among Pediatric Soccer Athletes, Tamara Valovich Mcleod, Michael Israel, Melissa A. Christino, Jane S. Chung, Scott D. Mckay, Pamela J. Lang, David R. Bell, Charles M. Chan, Allison Crepeau, Elizabeth Davis, Amanda L. Fletcher, Jessica Laniak, Kelsie Mccaffrey, Donna M. Pacicca, Mark Riederer, Katherine Rizzone, Jeremy K. Rush, Tracy Zaslow

Manuscripts, Articles, Book Chapters and Other Papers

© The Author(s) 2019.

Background: Soccer is an increasingly popular sport for children and adolescents in the United States. Little is known about participation patterns related to sport specialization.

Purpose: To investigate soccer participation levels and sport specialization characteristics among youth soccer athletes.

Study Design: Cross-sectional study. Methods: Adolescent athletes aged between 12 and 18 years completed an online survey addressing participant demographics, sports and soccer participation history, and level of specialization. Descriptive analyses characterized participation, while chi-square and Kruskal-Wallis tests assessed the influence of specialization, sex, and grade on survey variables.

Results: Overall, 83.7% of 746 respondents participated in …

Evidence Doesn’T Change Prescribing Patterns…So What Does?, Ali Rida, Anthony Brooks

Clinical Research in Practice: The Journal of Team Hippocrates

The authors write in support of critical analysis of clinical research, as a corrective to the physician's urge to "do something" even when no evidence of benefit exists.

Temporary Fracture Stabilization Device, Steven J. Lawrence

Orthopaedic Surgery and Sports Medicine Faculty Patents

A temporary fracture stabilization device includes a first intramedullary fixation rod, a second intramedullary fixation rod, a first extramedullary connector, a second extramedullary connector and a fastener. A field kit for temporary fracture stabilization is also disclosed.

Endovascular Coiling Versus Neurosurgical Clipping For Aneurysmal Subarachnoid Hemorrhage: A Systematic Review And Meta-Analysis, Syed Ijlal Ahmed, Gohar Javed, Syeda Beenish Bareeqa, Syeda Sana Samar, Ali Shah, Arwa Giani, Zainab Azam, Abeer Tasleem, Syed Hasham Humayun

Section of Neurosurgery

Background: Aneurysmal subarachnoid hemorrhage is a frequently devastating condition with a reported incidence of between 10 and 15 people per 100,000 in the United States. Currently, according to the best of our knowledge, there are not enough meta-analyses available in the medical literature of the last five years which compare the risks and benefits of endovascular coiling with neurosurgical clipping.
Methods: Twenty-two studies were selected out of the short-listed studies. The studies were selected on the basis of relevance to the topic, sample size, sampling technique, and randomization. Data were analyzed on Revman software.
Results: Mortality was found to be …

Lifestyle, Cardiovascular Risk Knowledge And Patient Counselling Among Selected Sub-Saharan African Family Physicians And Trainees. African Journal Of Primary Health Care & Family Medicine, Pius O. Ameh, Kenneth Yakubu, Miriam Miima, Olugbemi Popoola, Gulnaz Mohamoud, Klaus B. Von Pressentin

Family Medicine, East Africa

Background: Cardiovascular disease (CVD)-related deaths in sub-Saharan Africa (SSA) are on the rise, and primary care physicians could facilitate the reversal of this trend through treatment and prevention strategies.

Aim: The aim of this study was to determine the relationship between physician lifestyle practices, CVD prevention knowledge and patient CVD counselling practices among family physicians (FPs) and family medicine (FM) trainees affiliated to FM colleges and organisations in SSA.

Setting: FPs and FM trainees affiliated to FM colleges and organisations in Anglophone SSA.

Methods: A web-based cross-sectional analytical study was conducted using validated, self-administered questionnaires. Following …

The Flavonoid Metabolite 2,4,6-Trihydroxybenzoic Acid Is A Cdk Inhibitor And An Anti-Proliferative Agent: A Potential Role In Cancer Prevention, Ranjini Sankaranarayanan, Chaitanya K. Valiveti, Ramesh Kumar Dhandapani, Severine Van Slambrouck, Siddharth S. Kesharwani, Teresa Seefeldt, Joy Scaria, Hemachand Tummala, G. Jayarama Bhat

Entomology Faculty Publications

Flavonoids have emerged as promising compounds capable of preventing colorectal cancer (CRC) due to their anti-oxidant and anti-inflammatory properties. It is hypothesized that the metabolites of flavonoids are primarily responsible for the observed anti-cancer effects owing to the unstable nature of the parent compounds and their degradation by colonic microflora. In this study, we investigated the ability of one metabolite, 2,4,6-trihydroxybenzoic acid (2,4,6-THBA) to inhibit Cyclin Dependent Kinase (CDK) activity and cancer cell proliferation. Using in vitro kinase assays, we demonstrated that 2,4,6-THBA dose-dependently inhibited CDKs 1, 2 and 4 and in silico studies identified key amino acids involved in …

Prehospital Troponin Testing Protocol For Accelerated Diagnosis And Early Intervention In Chest Pain Patients, Ronald D. Meador

DNP Final Reports

Non-ST elevation acute coronary syndromes (NSTE-ACS) have significant morbidity and mortality rates despite the progress made in diagnosis and management and represent a significant public health burden in the United States. Lengthy diagnostic algorithms contribute to emergency department over-crowding, increased health care costs, and adverse patient outcomes. A troponin assay instituted earlier in the diagnostic pathway of patients with chest pain suspected of NSTE-ACS will reduce time to definitive diagnosis and medical intervention. This will improve patient outcomes, decrease emergency department crowding through improved ED workflow, and reduce the economic burden. The Star Model of Knowledge Transformation was used to …

The Influence Of Stressful Life Events On The Development Of Type 2 Diabetes, Joshua Minks

Dissertations

This study examined the relationship between distress and the development of Type 2 diabetes mellitus (T2DM) in the presence of established risk factors. Distress secondary to mental health disparities, stressful life events, and work conditions has been shown to promote insulin resistance and the development of T2DM.

Subjects (N=79) diagnosed with T2DM within the previous six months were recruited from SSM Health Centers and VA Medical Centers in the greater St. Louis area. They completed the Recent Life Changes Questionnaire, ENRICHD Social Support Instrument, and a demographic survey and analyses were conducted to determine differences between the veteran …

A Mixed Method Multi-Country Assessment Of Barriers To Implementing Pediatric Inpatient Care Guidelines, Kirkby D. Tickell, Dorothy I. Mangale, Stephanie N. Tornberg-Belanger, Celine Bourdon, Johnstone Thitiri, Molline Timbwa, Jenala Njirammadzi, Wieger Voskuijl, Ali Faisal Saleem, Zaubina Kazi

Department of Paediatrics and Child Health

Introduction: Accelerating progress in reducing child deaths is needed in order to achieve the Sustainable Development Goal child mortality target. This will require a focus on vulnerable children-including young children, those who are undernourished or with acute illnesses requiring hospitalization. Improving adherence to inpatient guidelines may be an important strategy to reduce child mortality, including among the most vulnerable. The aim of our assessment of nine sub-Saharan African and South Asian hospitals was to determine adherence to pediatric inpatient care recommendations, in addition to capacity for and barriers to implementation of guideline-adherent care prior to commencing the Childhood Acute Illness …

Continuous Quality Improvement Methodology: A Case Study On Multidisciplinary Collaboration To Improve Chlamydia Screening, Allison Ursu, Grant M. Greenberg M.D., M.H.S.A., M.A., Michael Mckee

Department of Family Medicine

This article illustrates quality improvement (QI) methodology using an example intended to improve chlamydia screening in women. QI projects in healthcare provide great opportunities to improve patient quality and safety in a real-world healthcare setting, yet many academic centres lack training programmes on how to conduct QI projects. The choice of chlamydia screening was based on the significant health burden chlamydia poses despite simple ways to screen and treat. At the University of Michigan, we implemented a multidepartment process to improve the chlamydia screening rates using the plan-do-check-act model. Steps to guide QI projects include the following: (1) assemble a …

The Time Is Now For Mandatory Liver-Focused Clinical Experiences In Medical School., Alexander Y. Pan, Lauren D. Feld, Jeanne M. Farnan, Steven K. Herrine, Adam E. Mikolajczyk

Division of Gastroenterology and Hepatology Faculty Papers

The national burden of chronic liver disease is steadily increasing and is only expected to worsen with the ongoing obesity and opioid epidemics fueling growth in the prevalence of nonalcoholic fatty liver disease and a resurgence of new hepatitis C infections. Our letter highlights the disparity between the rising prevalence of chronic liver disease and the proportion of medical students who receive exposure to patients with liver disease as part of their medical education. A more comprehensive survey of clerkship directors is needed to further corroborate this data, which may lead to reforms in medical school curricula to better address …

Adult-Onset Hypophosphatasia: Before And After Treatment With Asfotase Alfa, Angela Magdaleno Do, Sonum Singh Md, Sandhya Venkataraman Do, Ya-Yu Lee Md

Department of Medicine

No abstract provided.