Medical Specialties Commons^™

Efficacy And Safety Of Bempedoic Acid For Prevention Of Cardiovascular Events And Diabetes: A Systematic Review And Meta-Analysis., Xing Wang, Yu Zhang, Huiwen Tan, Peng Wang, Xi Zha, Weelic Chong, Liangxue Zhou, Fang Fang

Department of Medicine Faculty Papers

BACKGROUND: Bempedoic acid is an oral, once-daily, first-in-class drug being developed for the treatment of hyperlipidemia. However, evidence of bempedoic acid use for the prevention of cardiovascular events and diabetes is lacking. Thus, we aim to evaluate the benefit and safety of bempedoic acid use for the prevention of cardiovascular events and diabetes.

METHODS: We searched Medline, Embase, and the Cochrane Central Register of Controlled Trials with no language restriction from inception until March 3, 2020. Pairs of reviewers independently identified randomized controlled trials comparing the use of bempedoic acid with placebo or no treatment for primary prevention of cardiovascular …

Atypical Reactivation Of Varicella Zoster Virus Associated With Pancreatitis In A Heart Transplant Patient., Christine Shieh, Ashley Barnes, Drew Johnson, Ilya Danelich, Pharmd, Bcps, Bccp, Preethi Pirlamarla, Rene Alvarez, H. Todd Massey, Md, Mahek Shah

Division of Internal Medicine Faculty Papers & Presentations

BACKGROUND Acute pancreatitis is rare following solid organ transplantation but is associated with high mortality. It has been most commonly reported following renal transplant but can occur with other solid organ transplantations. CASE REPORT A 46-year-old male who had an orthotopic heart transplant 6 months ago presented with a 3-week history of abdominal pain. The patient described it as intermittent, sharp, and stabbing, originating in the periumbilical area and radiating to the back. His lipase was elevated at 232 U/L. Given that the patient's symptoms and lipase were elevated to greater than three times the upper limit of normal, he …

Why Do Adolescents Seek Online Mental Health Information?, Daniel G. Lannin, Jeremy B. Kanter, Luke Russell, Leandra Parris, Ani Yazedjian

Journal of Adolescent and Family Health

Many adolescents avoid seeking psychological help despite the increasing prevalence of mental disorders. The current study investigated whether distress and stigma exhibit differential relationships to decisions to seek online mental health information among a sample of predominantly racial/ethnic minority U.S. adolescents. In this investigation, 174 adolescents (Age: M = 15.90, SD = 0.85, Range = 14−19) completed assessments of help-seeking stigma, psychological distress, and a question asking if they would like to view a website with mental health information. Distress was a statistically significant predictor of decisions to seek online mental health information, but stigma was not. Severely distressed boys …

Detection Of Left Ventricular Thrombi On Cardiac Magnetic Resonance Viability Studies, Donya Ahmed Alhassan, Khawaja Bilal Waheed, Muhammad Nasim Sharif, Muhammad Zia Ulhassan, Fazal Ghaffar, Khaled Saleh Saleem, Emad Fouad Mahmoud Said, Bayan Mohammed Altalaq, Zechariah Jebakumar Arulanantham, Ahmad Omar Qarmash

Journal of the Saudi Heart Association

Objective: To highlight detection of left ventricular thrombi on cardiac magnetic resonance (CMR) viability studies.

Method: This retrospective observational study was conducted in the Radiology Department at our Hospital in Dhahran, from April 2015-2019. All recently re-perfused (post-percutaneous coronary intervention/ PCI) patients with ST-segment elevation myocardial infarctions (STEMI), having low ejection fractions (

Results: Of the 125 patients, most were men (71.2%) with a mean age of 56.78 years. Eleven patients had left ventricular thrombi (8.8%), and most of these were anterior wall infarctions with low ejection fractions (

Conclusion: Left ventricular thrombi can be detected on cardiac viability studies …

Novel Use Of Fresh Frozen Plasma In Treating Hereditary Angioedema: A Success Story From Pakistan, Amber Sabeen Ahmed, Sidra Fayyaz

Section of Internal Medicine

Hereditary angioedema (HAE) due to a C1-esterase inhibitor(C1-INH) deficiency is a rare and potentially life-threatening disorder. It is characterized by an episodic and self-limiting increase in vascular permeability. The condition manifests itself as recurrent attacks of swelling in any part of the body. The angioedema can cause the involvement of the respiratory tract, skin, and gastrointestinal tract. Laryngeal involvement can make the condition life-threatening. It does not respond well to conventional angioedema therapy of steroids, adrenaline, and antihistamines. The targeted therapy for HAE consists of plasma-derived or recombinant C1-INH, ecallantide, and icatibant or bradykinin receptor antagonist. In the absence of …

Involuntary Treatment In Dementia Care At Home: Results From The Netherlands And Belgium, Angela M. H. J. Mengelers, Vincent R. A. Moermans, Michel H. C. Bleijlevens, Hilde Verbeek, Elizabeth Capezuti, Frans Tan, Koen Milisen, Jan P. H. Hamers

Publications and Research

Aims and objectives: To gain insight into the request, use and associated factors of involuntary treatment in people with dementia (PwD) receiving professional home care in the Netherlands and Belgium.

Background: Most of the PwD remain living at home as long as possible. Due to complex care needs, this can result in an increased risk for care provided against the wishes of the client and/or to which the client resists, referred to as involuntary treatment.

Design: Secondary data analyses of two cross-sectional surveys.

Methods: Dementia case managers and district nurses filled in a questionnaire for each PwD in their …

Management Practices For West Syndrome In South Asia: A Survey Study And Meta-Analysis, Priyanka Madaan, Prem Chand, Kyaw Linn, Jithangi Wanigasinghe, Mimi Lhamu Mynak, Prakash Poudel, Raili Riikonen, Amit Kumar, Pooja Dhir, Sandeep Negi, Jitendra Kumar Sahu

Department of Paediatrics and Child Health

Objectives: Considering the dearth of literature on West syndrome (WS) from South Asian countries, this study aimed to evaluate the management practices in South Asia by an online survey and meta-analysis.
Methods: An online questionnaire was sent to 223 pediatric neurologists/pediatricians in India, Pakistan, Myanmar, Sri Lanka, Bhutan, Nepal, and Bangladesh. Their responses were evaluated and supplemented by a meta-analysis.
Results: Of 125 responses received (response rate: 56%), around 60% of responders observed male preponderance and an approximate lead-time-to-treatment (LTTT) of 4-12 weeks. The commonest etiology observed was a static structural insult (88.6% of responders). Most commonly used first-line drug …

Fatal Case Of Newborn Lassa Fever Virus Infection Mimicking Late Onset Neonatal Sepsis: A Case Report From Northern Nigeria, Taofik Oluwaseun Ogunkunle, Surajudeen Oyeleke Bello, Chinwe Immaculata Anderson, Rashida Musa, Rasaq Olaosebikan, Abdulazeez Imam

Department of Pharmacology and Experimental Therapeutics Faculty Papers

BACKGROUND: Lassa fever is a zoonotic viral infection endemic to the West Africa countries. It is highly fatal during pregnancy and as such reports of neonatal onset Lassa fever infections are rare in scientific literature. We report a fatal case of Lassa fever in a 26-day-old neonate mimicking the diagnosis of late-onset neonatal sepsis.

CASE PRESENTATION: The patient is a 26-day-old neonate who was admitted with a day history of fever, poor feeding, pre-auricular lymphadenopathy and sudden parental death. He was initially evaluated for late onset neonatal sepsis. He later developed abnormal bleeding and multiple convulsions while on admission, prompting …

Initial Experience Using 3-Dimensional Printed Models For Head And Neck Reconstruction In Haiti., Swar Vimawala, Terry Gao, Jared Goldfarb, Dominick Gadaleta, Bon Ku, Patrick Jean-Gilles, Adam Luginbuhl, Robert Pugliese, Donald Weed, Joseph M Curry

Department of Otolaryngology - Head and Neck Surgery Faculty Papers

This report describes the first use of a novel workflow for in-house computer-aided design (CAD) for application in a resource-limited surgical outreach setting. Preoperative computed tomography imaging obtained locally in Haiti was used to produce rapid-prototyped 3-dimensional (3D) mandibular models for 2 patients with large ameloblastomas. Models were used for patient consent, surgical education, and surgical planning. Computer-aided design and 3D models have the potential to significantly aid the process of complex surgery in the outreach setting by aiding in surgical consent and education, in addition to expected surgical applications of improved anatomic reconstruction.

Red Blood Cell Adhesion To Icam-1 Is Mediated By Fibrinogen And Is Associated With Right-To-Left Shunts In Sickle Cell Disease, Erdem Kucukal, Yuncheng Man, Erina Quinn, Neil Tewari, Ran An, Jane A. Little, Umut A. Gurkan

Faculty Scholarship

Sickle cell disease (SCD), which afflicts 100 000 Americans, as well as millions worldwide, is associated with anemia, lifelong morbidity, and early mortality. Abnormal adhesion of sickle red blood cells (RBCs) to activated vascular endothelium may contribute acutely to the initiation of painful vaso-occlusive crises and chronically to endothelial damage in SCD. Sickle RBCs adhere to activated endothelium through several adhesion mechanisms. In this study, using whole blood from 17 people with heterozygous SCD (HbS variant) and 55 people with homozygous SCD (HbSS) analyzed in an in vitro microfluidic assay, we present evidence for the adhesion of sickle RBCs to …

Post-Exercise Sweat Loss Estimation Accuracy Of Athletes And Physically Active Adults: A Review, Eric O'Neal, Tara Boy, Brett Davis, Kelly Pritchett, Robert Pritchett, Svetlana Nepocatych, Katherine Black

All Faculty Scholarship for the College of Education and Professional Studies

The main purposes of this review were to provide a qualitative description of nine investigations in which sweat losses were estimated by participants following exercise and to perform a quantitative analysis of the collective data. Unique estimations (n = 297) were made by 127 men and 116 women after a variety of exercise modalities in moderate to hot environmental conditions. Actual sweat loss exceeded estimated sweat loss (p < 0.001) for women (1.072 ± 0.473 vs. 0.481 ± 0.372 L), men (1.778 ± 0.907 vs. 0.908 ± 0.666 L) and when all data were combined (1.428 ± 0.806 vs. 0.697 ± 0.581 L), respectively. However, estimation accuracy did not differ between women (55.2 ± 51.5%) and men (62.4 ± 54.5%). Underestimation of 50% or more of sweat losses were exhibited in 168 (54%) of estimation scenarios with heavier sweaters displaying a higher prevalence and trend of greater underestimations in general. Most modern guidelines for fluid intake during and between training bouts are based on approximate sweat loss estimation knowledge. These guidelines will likely have minimal efficacy if greater awareness of how to determine sweat losses and accurate recognition of sweat losses is not increased by coaches and athletes.

Tricyclic Antidepressant Use And Risk Of Fractures: A Meta-Analysis Of Cohort Studies Through The Use Of Both Frequentist And Bayesian Approaches, Qing Wu, Yingke Xu, Yueyang Bao, Jovan Alvarez, Mikee Lianne Gonzales

School of Medicine Faculty Research

Background: Research findings regarding the association between tricyclic antidepressant (TCA) treatment and the risk of fracture are not consistent; we aimed to assess whether people who take TCAs are at an increased fracture risk. Methods: Relevant studies published through June 2020 were identified through database searches of MEDLINE, EMBASE, Scopus, PsycINFO, ISI Web of Science, WorldCat Dissertations and Theses from each database’s inception, as well as through manual searches of relevant reference lists. Two researchers independently performed literature searches, study selection, data abstraction and study appraisal by using a standardized protocol. Frequentist and Bayesian hierarchical random-effects models were used for …

Interplay Of Trna-Derived Fragments And T Cell Activation In Breast Cancer Patient Survival, Nayang Shan, Ningshan Li, Qile Dai, Lin Hou, Xiting Yan, Amei Amei, Lingeng Lu, Zuoheng Wang

Mathematical Sciences Faculty Research

Effector CD8+ T cell activation and its cytotoxic function are positively correlated with improved survival in breast cancer. tRNA-derived fragments (tRFs) have recently been found to be involved in gene regulation in cancer progression. However, it is unclear how interactions between expression of tRFs and T cell activation affect breast cancer patient survival. We used Kaplan–Meier survival and multivariate Cox regression models to evaluate the effect of interactions between expression of tRFs and T cell activation on survival in 1081 breast cancer patients. Spearman correlation analysis and weighted gene co-expression network analysis were conducted to identify genes and pathways that …

Digital Breast Tomosynthesis Versus Additional Diagnostic Mammographic Views For The Evaluation Of Asymmetric Mammographic Densities, Hira Waheed, Imrana Masroor, Shaista Afzal Saeed, Muhammad Ismail Alvi, Syed Jahanzeb

Department of Radiology

Introduction: Many young females present with an advanced stage of breast cancer, which has a negative effect on the prognosis. Digital breast tomosynthesis is a new emerging imaging technique that aids in improving the specificity of mammography with subsequent early detection of breast cancer, especially in women with radiographically dense breasts. Tomosynthesis is subjectively preferred to conventional mammography and may offer superior diagnostic accuracy for the evaluation of breast lesions.
Method: Two breast radiologists retrospectively reviewed asymmetric densities using protocols that were institutional review board-approved in 185 patients aged 18 - 70 years (mean: 48 years) who underwent diagnostic mammography …

Physical Activity For Rheumatoid Arthritis Patients: Benchmark Study, Lauren Nicholson

MSN Capstone Projects

Rheumatoid arthritis (RA) is an autoimmune inflammatory condition that affects the joints; without proper treatment and management, RA leads to the destruction of joint function. The standard of care for RA includes medications such as biologic therapy and disease-modifying anti-rheumatic drugs. An often-overlooked area of disease management is the implementation of exercise programs for patients with RA. Exercise is known to decrease systemic inflammation, symptoms of depression, and combat fatigue – all common symptoms reported by patients with RA.

Standard of care for patients with RA does not currently include lifestyle management factors such as diet, exercise, and cessation of …

Start Stop-Bang, Valerie D. Reeve

MSN Capstone Projects

Currently standard of care in the perioperative unit is not conducive when caring for patients with obstructive sleep apnea (OSA). OSA is highly prevalent and often undiagnosed. Screening patients with a STOP-Bang questionnaire is quick, effective, and cost efficient. OSA is linked to poor postoperative outcomes. Patients at high risk for OSA often encounter complications such as: additional airway management, respiratory complications, cardiovascular complications, and increased length of stay. Screening creates awareness and identification of patients at risk for postoperative complications.

Arteriovenous Malformation With Associated Multiple Flow-Related Distal Anterior Cerebral Artery Aneurysms: A Case Report With Poor Outcomes, Ummey Hani, Muhammad Ehsan Bari, Syed Sarmad Bukhari

Section of Neurosurgery

Background: Low-grade arteriovenous malformations (AVMs) associated with multiple flow-related distal anterior cerebral artery (DACA) aneurysms are rare occurrences. Here, we present a case of a frontal AVM with three associated DACA aneurysms arising from a single feeder.
Case description: A 36-year-old male presented to us in the ER with acute-onset dysphasia and altered mental status. Head computed tomography and angiogram showed a spontaneous intracerebral hemorrhage with intraventricular extension and revealed a Spetzler Martin Grade II AVM, being fed by two feeders, with the major feeder from the DACA bearing three flow-related aneurysms. As the patient awaited digital subtraction angiography, his …

Therapeutic Potential Of A Ketogenic Diet In The Treatment Of Major Depressive Disorder, Jordan A. Murrin

Masters Theses, 2020-current

Major depressive disorder (MDD) is the second most common mental health condition and a leading cause of disability in the world. It is theorized that MDD develops from a combination of biological, psychological, and social stressors. The condition is typically treated using pharmaceuticals and psychotherapy. However, not all individuals with MDD have access to or choose to use these treatments, or may prefer to incorporate therapeutic lifestyle changes such as exercise, sleep, and healthy eating. Even with treatment, MDD can alter brain structure and function, leading to the development of comorbid mental health and chronic metabolic conditions like obesity, cardiovascular …

Lgbt+ Older Adults, Lynn M. Wilson Do

Department of Family Medicine

No abstract provided.

Does Administration Of Antipsychotic Medications Reduce The Incidence And Duration Of Delirium In Critically Ill Adult Patients?, Ellen Brateng

Theses and Graduate Projects

Background: Acute delirium is a common complication among critically ill patients. Besides the manifestation of distressing symptoms, delirium can result in negative patient outcomes. Several studies show that antipsychotics such as haloperidol are one of the most commonly used interventions for delirium despite large variability and lower quality of evidence available to advocate for their use.

Methods: A literature review was conducted to investigate current evidence on the use of antipsychotic agents for preventing and treating delirium in the intensive care unit.

Discussion: There is conflicting data concerning the prophylaxis and treatment of delirium in critically ill patients. For prophylaxis …

Complex Tissue Regeneration In Mammals Is Associated With Reduced Inflammatory Cytokines And An Influx Of T Cells, Thomas R. Gawriluk, Jennifer Simkin, Corin K. Hacker, John M. Kimani, Stephen G. Kiama, Vanessa O. Ezenwa, Ashley W. Seifert

Biology Faculty Publications

While mammals tend to repair injuries, other adult vertebrates like salamanders and fish regenerate damaged tissue. One prominent hypothesis offered to explain an inability to regenerate complex tissue in mammals is a bias during healing toward strong adaptive immunity and inflammatory responses. Here we directly test this hypothesis by characterizing part of the immune response during regeneration in spiny mice (Acomys cahirinus and Acomys percivali) vs. fibrotic repair in Mus musculus. By directly quantifying cytokines during tissue healing, we found that fibrotic repair was associated with a greater release of pro-inflammatory cytokines (i.e., IL-6, CCL2, and CXCL1) …

Bk Virus Nephropathy: Prevalence, Impact And Management Strategies, Rajeev Sharma, Mareena Zachariah

School of Medicine Faculty Research

BK virus reactivation as a result of therapeutic immunosuppression following renal transplant can result in BK polyomavirus nephropathy and renal allograft loss. This is a complex and challenging clinical problem with a range of management options and practices reported in literature. The current standard for early diagnosis and treatment is surveillance by measuring viral DNA in blood using qPCR. Immunosuppression reduction is the cornerstone of effective management but is associated with a risk of acute rejection following treatment.

Contemporary Interventional Radiology Employment: Analysis Of The American College Of Radiology And The Society Of Interventional Radiology Occupational Portals, Anthony N Hage, Vibhor Wadhwa, Eric J Monroe, David S Shin, Jeffrey Forris Beecham Chick

Department of Radiology Faculty Papers

No abstract provided.

Alport Syndrome Classification And Management., Bradley A. Warady, Rajiv Agarwal, Sripal Bangalore, Arlene Chapman, Adeera Levin, Peter Stenvinkel, Robert D. Toto, Glenn M. Chertow

Manuscripts, Articles, Book Chapters and Other Papers

Alport syndrome affects up to 60,000 people in the United States. The proposed reclassification of thin basement membrane nephropathy and some cases of focal segmental glomerulosclerosis as Alport syndrome could substantially increase the affected population. The reclassification scheme categorizes Alport syndrome as 3 distinct diseases of type IV collagen α3/4/5 based on a genetic evaluation: X-linked, autosomal, and digenic. This approach has the advantage of identifying patients at risk for progressive loss of kidney function. Furthermore, the shared molecular cause of Alport syndrome and thin basement membrane nephropathy arises from mutations in the COL4A3, COL4A4, and COL4A5 genes, …

Implementing Positive Language In Anesthesia: Utilizing The Comfort Scale, Elisabeth Prehm, Tricia Oakes

Grace Peterson Nursing Research Colloquium

Implementing Positive Language in Anesthesia: Utilizing the Comfort Scale

Tricia Oakes & Elisabeth Prehm

Faculty Sponsor: Pamela Schwartz DNP, CRNA

Background

Verbal numeric pain scales (ranking pain on a scale from zero to ten) are widely utilized and taught in medicine. Evidence-based research has shown that verbal numeric comfort scales are associated with a decrease in opioid administration, improved pain perceptions, and overall better patient satisfaction .7

Objective

The purpose of this study is to assess the impact of a video-based educational tool demonstrating the use of a comfort scale in the perioperative setting among Nurse Anesthesia Trainees (NATs), and …

Crnas And Sugammadex Use: A Qualitative Analysis, Natalia Izquierdo Bsn, Rn, Emily Mancewicz Bsn, Rn

Grace Peterson Nursing Research Colloquium

Background: The availability of Sugammadex has increased options for Certified Registered Nurse Anesthetists’ (CRNAs) and their choice of neuromuscular reversal agents, however administration is impacted by a variety of provider and institutional factors.

Objectives: The purpose of this study was to examine and describe the personal and institutional factors impacting the use of Sugammadex in Illinois by CRNAs.

Method: A qualitative study design using an open-ended survey yielded 209 responses. The three main themes that emerged were 1) Why CRNAs choose to use or avoid Sugammadex 2) How CRNAs dose Sugammadex and 3) Practice variations existing within the clinical setting. …

Optimal Time Repair Of Ventricular Septal Rupture Post Myocardial Infarction, Ibrahim Shafiei, Fatemeh Jannati, Mansour Jannati

Journal of the Saudi Heart Association

Ventricular septal rupture (VSR) is an uncommon complication of myocardial infarction (MI). The mortality rate of VSR is high. The management of VSR is including the stabilization of the hemodynamic status and surgical closure of the rupture. In spite of the agreement of experts on the necessity of surgical repair, the timing of VSR repair management remains unclear. In this review article, we evaluate the optimal time repair of VSR. To collect the data, Pubmed, EMBASE, and Cochrane Central Registry databases were searched for potentially suitable studies. Search terms were including “Ventricular Septal Rupture”, “Myocardial Infarction”, “Timing”, and “MI”. According …

Recent Advances In The Management Of Gastrointestinal Stromal Tumor., Monjur Ahmed

Division of Gastroenterology and Hepatology Faculty Papers

Gastrointestinal stromal tumor (GIST) is a rare but an important clinical entity seen in our clinical practice. It is the most common mesenchymal tumor of the gastrointestinal tract and most common malignancy of the small intestine. Although the exact prevalence of GIST is not known, the incidence of GIST has been increasing. GISTs arise from interstitial cells of Cajal. Most of the GISTs occur due to mutation in c-kit gene or platelet derived growth factor receptor alpha gene. 15% of GISTs do not have these mutations and they are called wild-type GISTs. Almost all GISTs express KIT receptor tyrosine kinase. …

Oral Cancer: Clinicopathological Features And Associated Risk Factors In A High Risk Population Presenting To A Major Tertiary Care Center In Pakistan, Namrah Anwar, Shahid Pervez, Qurratulain Chundriger, Mohammad Sohail Awan, Tariq Moatter, Tazeen Saeed Ali

Department of Pathology and Laboratory Medicine

Oral squamous cell carcinoma (OSCC) has the highest prevalence in head and neck cancers and is the first and second most common cancer in males and females of Pakistan respectively. Major risk factors include peculiar chewing habits like areca nut, betel quid, and tobacco. The majority of OSCC presents at an advanced stage with poor prognosis. On the face of such a high burden of this preventable cancer, there is a relative lack of recent robust data and its association with known risk factors from Pakistan. The aim of this study was to identify the socioeconomic factors and clinicopathological features …

Depression In Primary Care: With A Focus On First-Line Medications, Michael Danielewicz, Md

Department of Family & Community Medicine Presentations and Grand Rounds

This Lecture Will Cover:

• An overview of selective serotonin reuptake inhibitors (SSRIs), serotonin-norepinephrine reuptake inhibitors (SNRIs), bupropion and mirtazapine
• Appropriate selection and dose adjustments of first-line agents for depressive disorders in a primary care setting
• Monitoring and tapering first-line antidepressants
• Special considerations in treatment
• Future directions for antidepressant treatment