Medical Specialties Commons^™

Effectiveness Of Transcutaneous Bilirubin Measurement In High-Risk Neonates And To Evaluate Validity Of Transcutaneous Bilirubin With Total Serum Bilirubin Levels In Both Low And High-Risk Neonates At A Tertiary Care Center In A Developing Country, Durre Shahwar Khan, Adnan Mirza, Areesh Bhatti, Ali Shabbir Hussain, Batha Tariq, Arjumand Rizvi

Department of Paediatrics and Child Health

Objectives: To evaluate the usefulness of transcutaneous bilirubin (TcBR) nomogram in high-risk neonates and to identify the validity of TcBR and total serum bilirubin (TsBR) in both low and high-risk neonates to guide management in under-resourced settings.
Methodology: A cross-sectional study was conducted at the well-baby nursery of a tertiary care center in Karachi, Pakistan. All neonates admitted in the well-baby nursery with jaundice were stratified into high and low-risk groups. Eighty-seven neonates were included in the low-risk group and 121 neonates in the high-risk group. The usefulness of the TcBR nomogram in high-risk neonates and the validity of TcBR …

Structural And Functional Properties Of Subsidiary Atrial Pacemakers In A Goat Model Of Sinus Node Disease, Luca Soattin, Zoltan Borbas, Jane Caldwell, Brian Prendergast, Akbar Vohra, Yawer Saeed, Andreas Hoschtitzky, Joseph Yanni, Andrew Atkinson, Sunil Jit Logantha

Section of Cardiology

Background: The sinoatrial/sinus node (SAN) is the primary pacemaker of the heart. In humans, SAN is surrounded by the paranodal area (PNA). Although the PNA function remains debated, it is thought to act as a subsidiary atrial pacemaker (SAP) tissue and become the dominant pacemaker in the setting of sinus node disease (SND). Large animal models of SND allow characterization of SAP, which might be a target for novel treatment strategies for SAN diseases.
Methods: A goat model of SND was developed (n = 10) by epicardially ablating the SAN and validated by mapping of emergent SAP locations through …

Patterns Of Left Ventricular Hypertrophy And Late Gadolinium Enhancement On Cardiac Mri In Patients With Hypertrophic Cardiomyopathy And Their Prognostic Significance - An Experience From A South Asian Country, Fateh Ali Tipoo Sultan, Sheema Saadia

Section of Cardiology

Objectives: Cardiac magnetic resonance (CMR) imaging is very pertinent in the diagnosis and risk stratification of patients with hypertrophic cardiomyopathy (HCM). We aimed to assess the patterns of left ventricular (LV) hypertrophy, late gadolinium enhancement (LGE), and their prognostic significance in HCM patients in Pakistani population, as no such data are available from Pakistan.
Material and methods: This was a retrospective, single center study. All patients who had confirmed diagnosis of HCM on CMR at Aga Khan University Hospital during the period of 2011-2019 were identified and included in the study.
Results: A total of 74 patients were included with …

Impact Of Pediatric Obesity On Diurnal Blood Pressure Assessment And Cardiovascular Risk Markers, Margaret O. Murphy, Hong Huang, John A. Bauer, Aric Schadler, Majd Makhoul, Jody L. Clasey, Aftab S. Chishti, Stefan G. Kiessling

Pediatrics Faculty Publications

Background: The prevalence of hypertension is increasing particularly among obese children and adolescents. Obese children and adolescents with hypertension are likely to remain hypertensive as they reach adulthood and hypertension is linked to an increased risk for cardiovascular disease. Twenty-four-hour ambulatory blood pressure monitoring (ABPM) has become one of the most important tools in diagnosing hypertension in children and adolescents and circadian patterns of blood pressure may be important disease-risk predictors.

Methods: A retrospective chart review was conducted in patients aged 6–21 years who underwent 24-h ABPM at Kentucky Children's Hospital (KCH) from August 2012 through June 2017. Exclusion criteria …

Exploring Pediatric Tele-Rheumatology Practices During Covid-19: A Survey Of The Prcoin Network., Y Ingrid Goh, Danielle R. Bullock, Janalee Taylor, Rajdeep Pooni, Tzielan C. Lee, Sheetal S. Vora, Cagri Yildirim-Toruner, Esi M. Morgan, Nancy Pan, Julia G. Harris, Andrew Warmin, Kendra Wiegand, Jon M. Burnham, Fatima Barbar-Smiley

Manuscripts, Articles, Book Chapters and Other Papers

Healthcare providers were rapidly forced to modify the way they practiced medicine during the coronavirus disease 2019 (COVID-19) pandemic. Many providers transitioned from seeing their patients in person to virtually using telemedicine platforms with limited training and experience using this medium. In pediatric rheumatology, this was further complicated as musculoskeletal exams typically require hands-on assessment of patients. The objective of this study was to examine the adoption of telemedicine into pediatric rheumatology practices, to assess its benefits and challenges, and to gather opinions on its continued use. A survey was sent to the lead representatives of each Pediatric Rheumatology Care …

Presence Of Antibody-Dependent Cellular Cytotoxicity (Adcc) Against Sars-Cov-2 In Covid-19 Plasma, For Yue Tso, Salum J. Lidenge, Lisa K. Poppe, Phoebe B. Pena, Sara R. Privatt, Sydney J. Bennett, John R. Ngowi, Julius Mwaiselage, Michael Belshan, Jacob A. Siedlik, Morgan A. Raine, Juan B. Ochoa, Julia Garcia-Diaz, Bobby Nossaman, Lyndsey Buckner, W Mark Roberts, Matthew J. Dean, Augusto C. Ochoa, John T. West, Charles Wood

Nebraska Center for Virology: Faculty Publications

Background Neutralizing-antibody (nAb) is the major focus of most ongoing COVID-19 vaccine trials. However, nAb response against SARS-CoV-2, when present, decays rapidly. Given the myriad roles of antibodies in immune responses, it is possible that antibodies could also mediate protection against SARS-CoV-2 via effector mechanisms such as antibody-dependent cellular cytotoxicity (ADCC), which we sought to explore here. Methods Plasma of 3 uninfected controls and 20 subjects exposed to, or recovering from, SARS CoV-2 infection were collected from U.S. and sub-Saharan Africa. Immunofluorescence assay was used to detect the presence of SARS-CoV-2 specific IgG antibodies in the plasma samples. SARS-CoV-2 specific …

Monitoring Tissue Oxygenation Index Using Near-Infrared Spectroscopy During Pre-Hospital Resuscitation Among Out-Of-Hospital Cardiac Arrest Patients: A Pilot Study, Jumpei Tsukuda, Shigeki Fujitani, Mahbubur Rahman, Kenichiro Morisawa, Takeshi Kawaguchi, Yasuhiko Taira

Department of Emergency Medicine Faculty Papers

BACKGROUND: Tissue oxygenation index (TOI) using the near infrared spectroscopy (NIRS) has been demonstrated as a useful indicator to predict return of spontaneous circulation (ROSC) among out-of-hospital cardiac arrest (OHCA) patients in hospital setting. However, it has not been widely examined based on pre-hospital setting.

METHODS: In this prospective observational study, we measured TOI in pre-hospital setting among OHCA patients receiving cardio-pulmonary resuscitation (CPR) during ambulance transportation between 2017 and 2018. Throughout the pre-hospital CPR procedure, TOI was continuously measured. The study population was divided into two subgroups: ROSC group and non-ROSC group.

RESULTS: Of the 81 patients included in …

Identification Of A Ctrp9 C-Terminal Polypeptide Capable Of Enhancing Bone-Derived Mesenchymal Stem Cell Cardioprotection Through Promoting Angiogenic Exosome Production., Demin Liu, Guoqiang Gu, Lu Gan, Wenjun Yan, Zhen Zhang, Peng Yao, Di Zhu, Wayne Bond Lau, Dina Xie, Sisi Wu, Zhijun Meng, Jumpei Tsukuda, Theodore Christopher, Bernard Lopez, Jianli Zhao, Erhe Gao, Walter Koch, Xin-Liang Ma, Yajing Wang

Department of Emergency Medicine Faculty Papers

BACKGROUND: Mesenchymal stem cell therapy improves ischemic heart failure via incompletely understood mechanisms. C1q-TNFα related protein-9 (CTRP9) is a novel anti-oxidative cardiokine capable of improving the local microenvironment and cell survival by its c-terminal active globular domain (gCTRP9). The current study attempted to: 1) identify active gCTRP9 c-terminal polypeptides with stem cell protective function; 2) determine whether a lead polypeptide may enable/enhance cortical bone-derived mesenchymal stem cell (CBSC) cardioprotection against post-myocardial infarction (post-MI) remodeling; and 3) define the responsible underlying cellular/molecular mechanisms.

METHODS AND RESULTS: Utilizing I-TASSER structure prediction and 3-D active site modeling, we cloned and purified 3 gCTRP9 …

The Psychometric Properties Of The Bergen–Yale Sex Addiction Scale For The Iranian Population, Samaneh Youseflu, Shane W. Kraus, Majid Yousefi Afrashteh, Soudabeh Niroomand, Fatemeh Razavinia

Psychology Faculty Research

Background: The assessment of sex addiction among different populations requires a valid and reliable tool. Since the Bergen–Yale Sex Addiction Scale (BYSAS) was not available in Iran, this study aimed to evaluate the validity and reliability of the Persian version of the BYSAS. Methods: After translation/back-translation procedure, a total of 756 Iranian men and women completed the BYSAS. The structural validity of this tool was evaluated by exploratory and confirmatory factor analyses. An expert panel review also examined content validity of the items. Psychometric properties of the scale including validity, reliability (internal consistency [Cronbach’s alpha]) and test-retest) and factor structure …

Primary Hyperhidrosis In Children: A Review Of Therapeutics, Courtney Remington, Jennifer Ruth, Adelaide A. Hebert

School of Medicine Publications

Primary hyperhidrosis, an idiopathic disease that commonly affects the palms, soles, axillae, or craniofacial region, is characterized by perspiration in excess of what is required for physiologic cooling. This disease begins in childhood or adolescence and negatively impacts emotional, physical, and psychologic well‐being. This review explores current therapeutic options for primary hyperhidrosis in the pediatric population, including topical therapies, oral therapies, non‐surgical and procedural interventions, and adjunctive therapies. In addition, this review identifies new and emerging treatments and highlights the need for further research and therapeutic options for this impactful disease.

Capturing Initial Understanding And Impressions Of Surgical Therapy For Parkinson's Disease, Somnath Das, Caio Matias, Sunihidi Ramesh, Lohit Velagapudi, Julie Barbera, Samantha Katz, Michael Baldassari, Mohammad Rasool, Daniel Kremens, Jeffrey Ratliff, Md, Tsao-Wei Liang, Chengyuan Wu

Department of Neurosurgery Faculty Papers

Background: Deep Brain Stimulation (DBS) is an underutilized surgical therapy for Parkinson's Disease (PD). Both physician and patient hesitancies have been described as potential barriers to DBS, but the specifics of patient perceptions of DBS have not been well-characterized in the general PD population. Objective: To characterize the understanding and impressions of surgical therapy in PD patients prior to formal surgical evaluation. Methods: A 30-question survey assessing impressions of surgical therapy for PD and understanding of DBS for PD was administered to PD patients seen at an urban movement disorders clinic. Results: One hundred and two patients completed the survey. …

Dual Targeting Of Cdk4/6 And Cmet In Metastatic Uveal Melanoma., Masahiro Ohara, Kengo Saito, Ken Kageyama, Mizue Terai, Hanyin Cheng, A E Aplin, Takami Sato

Department of Medical Oncology Faculty Papers

Uveal melanoma (UM) is the most common cancer of the eye in adults. Up to 50% of UM patients subsequently develop metastases, especially in the liver. It has been reported that the retinoblastoma (RB) pathway is deregulated in more than 90% of UM despite the rarity of mutations in the RB1 gene itself. CDK4/6 inhibition (CDK4/6i) is a rational strategy for treatment of UM. In this report, we investigated the antiproliferative activity of a selective CDK4/6 inhibitor on metastatic UM. A CDK4/6 inhibitor suppressed UM cell lines growth in in vitro and in vivo experiments. Hepatocyte growth factor (HGF) decreased …

Smoking Cessation, Julita Mitchell, Md

Department of Family & Community Medicine Presentations and Grand Rounds

Learning Objectives

● Appreciate the significance of addressing smoking cessation

● Learn a brief interventional model for cessation counseling

● How to structure a quit plan

● Understand the role/risks/benefits of

• Pharmacologic therapy
• Behavioral therapy
• Electronic cigarettes

● Learn practical tips and hear sample language

● Watch a sample intervention

Evaluating Opioid Dispensing Rates Among Pediatrics And Young Adults Based On Cures Data Reporting In California From 2015–2019, Michael T. Phan, Courtney Wong, Daniel M. Tomaszewski, Zeev N. Kain, Brooke Jenkins, Candice D. Donaldson, Michelle Fortier, Sun Yang

Pharmacy Faculty Articles and Research

Background

Receipt of opioid prescriptions in pediatric and young adult patients may be a risk factor for future opioid misuse. Data from prescription drug monitoring programs provide insight on outpatient opioid use. In our study, we analyzed the opioid dispensing rates for pediatrics and young adults in California. Methods

A secondary analysis was performed from 2015–2019 using Controlled Utilization Review and Evaluation System data. This database provides dispensing data of controlled substances in California. Patients younger than 25 years who were prescribed opiates were analyzed by county. We further divided them into two groups (children: ≤14 years; adolescents and young …

Delayed Endoscopic Assisted Percutaneous Reduction Of Anterior Table Frontal Sinus Fractures, Thomas J. Gal, Robin Pappal

Otolaryngology--Head & Neck Surgery Faculty Publications

Endoscopic approaches to the management of frontal sinus fractures continue to become more commonplace. Anterior table fractures amenable to reduction by these techniques are optimally managed within the first five to ten days to avoid fibrosis of the injury. We present a case of endoscopic transnasal reduction of an anterior table frontal sinus fracture over six weeks after the injury.

Radiopharmaceutical Validation For Clinical Use, Charles A. Kunos, Rodney Howells, Aman Chauhan, Zin W. Myint, Mark E. Bernard, Riham H. El Khouli, Jacek Capala

Internal Medicine Faculty Publications

Radiopharmaceuticals are reemerging as attractive anticancer agents, but there are no universally adopted guidelines or standardized procedures for evaluating agent validity before early-phase trial implementation. To validate a radiopharmaceutical, it is desirous for the radiopharmaceutical to be specific, selective, and deliverable against tumors of a given, molecularly defined cancer for which it is intended to treat. In this article, we discuss four levels of evidence—target antigen immunohistochemistry, in vitro and in vivo preclinical experiments, animal biodistribution and dosimetry studies, and first-in-human microdose biodistribution studies—that might be used to justify oncology therapeutic radiopharmaceuticals in a drug-development sequence involving early-phase trials. We …

Incidence And Risk Factors Of Delirium In Surgical Intensive Care Unit, Muhammad Asghar Ali, Madiha Hashmi, Waqas Ahmed, Syed Amir Raza, Muhammad Faisal Khan, Bushra Salim

Department of Anaesthesia

Background: To evaluate the incidence and modifiable risk factors of delirium in surgical intensive care unit (SICU) of tertiary care hospital in a low-income and middle-income country.
Methods: We conducted a single cohort observational study in patients over 18 years of age who were admitted to the SICU for >24 hours in Aga Khan University Hospital from January to December 2016. Patients who had pre-existing cognitive dysfunction were excluded. Intensive Care Delirium Screening Checklist was used to assess delirium. Incidence of delirium was computed, and univariate and multivariable analyses were performed to observe the relationship between outcome and associated factors. …

Association Of Blood Pressure Variability And Diuretics With Cardiovascular Events In Patients With Chronic Kidney Disease Stages 1-5, L Parker Gregg, S Susan Hedayati, Hui Yang, Peter N Van Buren, Subhash Banerjee, Sankar D Navaneethan, Salim S Virani, Wolfgang C Winkelmayer, Carlos A Alvarez

Faculty, Staff and Students Publications

Visit-to-visit blood pressure variability (BPV) is associated with cardiovascular events in the general population. Data are scarce in chronic kidney disease (CKD). We hypothesized that BPV would be associated with cardiovascular outcomes, death, and end-stage kidney disease (ESKD) and that diuretics would modify these associations in patients with CKD.

We studied U.S. Veterans with non-dialysis CKD stages 1-5 and hypertension on non-diuretic antihypertensive monotherapy. At the time of second antihypertensive agent prescription, we propensity-matched for exposure to a loop or thiazide diuretic vs. any other antihypertensive. BPV was defined as the coefficient of variation of systolic blood pressure over …

Guideline-Directed Heart Failure Therapy In Patients After Left Ventricular Assist Device Implantation, Bailey M. Colvin, James C. Coons, Craig J. Beavers

The VAD Journal

Background: Left ventricular assist devices (LVADs) are used as an advanced therapy option for patients with stage D heart failure. These devices provide mechanical unloading of the heart as either a bridge to transplant or recovery, or as destination therapy. In patients with LVADs, there are emerging data on the use of heart failure guideline-directed medical therapy (GDMT) to improve outcomes. This review describes the current evidence available for the use of neurohormonal blocking agents in patients with LVADs.

Methods: Articles were found using PubMed and web searches for heart failure therapies/neurohormonal blockade and LVADs. Studies were included if they …

Deconstructing Patriarchy In The Healing Arts, Rebekah Harbour

Journal of Transformative Touch

Sometimes we perpetuate the very systems we want to change because it's the only way we know. Making a change in the outer world can require a shift in our inner perspective.

Sars-Cov-2 Antibodies Detected In Human Breast Milk Postvaccination, Jill K. Baird, Shawn M. Jensen, Walter Urba, Bernard A Fox, Jason R Baird

Articles, Abstracts, and Reports

Importance The SARS-CoV-2 pandemic has infected over a hundred million people worldwide, with almost 2.5 million deaths at the date of this publication. In the United States, Pfizer-BioNTech and Moderna vaccines were first administered to the public starting in December 2020, and no lactating women were included in the initial trials of safety/efficacy. Research on SARS-CoV-2 vaccination in lactating women and the potential transmission of passive immunity to the infant through breast milk is needed to guide patients, clinicians and policy makers during the worldwide effort to curb the spread of this virus.

Objective To determine whether SARS-CoV-2 specific immunoglobins …

Severe Acute Respiratory Syndrome Coronavirus 2-Induced Acute Aortic Occlusion: A Case Report, Artem Minalyan, Franklin L. Thelmo, Vincent Chan, Stephanie Tzarnas, Faizan Ahmed

Department of Medicine Faculty Papers

Background: Severe acute respiratory syndrome coronavirus 2 infection can lead to a constellation of viral and immune symptoms called coronavirus disease 2019. Emerging literature increasingly supports the premise that severe acute respiratory syndrome coronavirus 2 promotes a prothrombotic milieu. However, to date there have been no reports of acute aortic occlusion, itself a rare phenomenon. We report a case of fatal acute aortic occlusion in a patient with coronavirus disease 2019.

Case report: A 59-year-old Caucasian male with past medical history of peripheral vascular disease presented to the emergency department for evaluation of shortness of breath, fevers, and dry cough. …

Tuberculosis And Non-Communicable Disease Multimorbidity: An Analysis Of The World Health Survey In 48 Low- And Middle-Income Countries, Brendon Stubbs, Kamran Siddiqi, Helen Elsey, Najma Siddiqi, Ruimin Ma, Eugenia Romano, Sameen Siddiqi, Ai Koyanagi

Community Health Sciences

Tuberculosis (TB) is a leading cause of mortality in low- and middle-income countries (LMICs). TB multimorbidity [TB and ≥1 non-communicable diseases (NCDs)] is common, but studies are sparse. Cross-sectional, community-based data including adults from 21 low-income countries and 27 middle-income countries were utilized from the World Health Survey. Associations between 9 NCDs and TB were assessed with multivariable logistic regression analysis. Years lived with disability (YLDs) were calculated using disability weights provided by the 2017 Global Burden of Disease Study. Eight out of 9 NCDs (all except visual impairment) were associated with TB (odds ratio (OR) ranging from 1.38-4.0). Prevalence …

Using Carrots Not Sticks To Cultivate A Culture Of Safeguarding In Sport, Judith L. Komaki, Yetsa A. Tuakli-Wosornu

Publications and Research

The power-driven, win-at-all-costs milieu of many sport settings can create fertile ground for athlete victimization and abuse (Roberts et al., 2020). Victory can in fact be so sovereign that abusive coaches and staff are enabled and “even rewarded. . . in the name of winning” (Armour, 2020). Athlete abuse prevention therefore requires systemic cultural change (Letourneau et al., 2014; Rhind and Owusu-Sekyere, 2017). Thus far, however, enacting this idea has eluded organizations in sport (Mountjoy et al., 2016; Harris and Terry, 2019; Kerr et al., 2019; Rhind and Owusu-Sekyere, 2020) as well as in other settings (National Academies of Sciences, …

Smartphone-Based Prediction Model For Postoperative Cardiac Surgery Outcomes Using Preoperative Gait And Posture Measures, Rahul Soangra, Thurmon Lockhart

Physical Therapy Faculty Articles and Research

Gait speed assessment increases the predictive value of mortality and morbidity following older adults’ cardiac surgery. The purpose of this study was to improve clinical assessment and prediction of mortality and morbidity among older patients undergoing cardiac surgery through the identification of the relationships between preoperative gait and postural stability characteristics utilizing a noninvasive-wearable mobile phone device and postoperative cardiac surgical outcomes. This research was a prospective study of ambulatory patients aged over 70 years undergoing non-emergent cardiac surgery. Sixteen older adults with cardiovascular disease (Age 76.1 ± 3.6 years) scheduled for cardiac surgery within the next 24 h were …

Prediction Of Obstructive Sleep Apnea Using Fast Fourier Transform Of Overnight Breath Recordings, Nicole L. Molin, Clifford Molin, Rohan J. Dalpatadu, Ashok K. Singh

Mathematical Sciences Faculty Research

The objective of this study is to address the problem of predicting the risk of obstructive sleep apnea (OSA) from overnight breath recordings collected by a subject using a smartphone or an iPhone. The dataset used in this study was collected at a health care facility and consists of breathing amplitudes of 42 subjects using the smart phone App ZeeAppnea. A total of four data mining multi-level classifiers are used on the Fast Fourier Transform (FFT) of each time series, and prediction accuracies are computed. The Random Forest (RF) and the Support Vector Machine (SVM) classifiers yielded the best results, …

Brucella Melitensis-Induced Transaminitis., Rajesh Essrani Md, Anastasia Shnitser Md

Department of Medicine

Brucellosis is infrequently reported in the United States and is mostly an occupational hazard among workers engaged in livestock raising and processing. It is a systemic infectious disease and can involve the liver in varying ways, ranging from benign subclinical increases in serum aminotransferase levels to ominous chronic suppurative disease. It is endemic in many countries, primarily those of the Mediterranean region. It is usually treated with antibiotics. We present a case of a 37-year-old female who developed

Discovery And Characterization Of Bromodomain 2-Specific Inhibitors Of Brdt, Zhifeng Yu, Angela F Ku, Justin L Anglin, Rajesh Sharma, Melek Nihan Ucisik, John C Faver, Feng Li, Pranavanand Nyshadham, Nicholas Simmons, Kiran L Sharma, Sureshbabu Nagarajan, Kevin Riehle, Gundeep Kaur, Banumathi Sankaran, Marta Storl-Desmond, Stephen S Palmer, Damian W Young, Choel Kim, Martin M Matzuk

Faculty, Staff and Students Publications

Bromodomain testis (BRDT), a member of the bromodomain and extraterminal (BET) subfamily that includes the cancer targets BRD2, BRD3, and BRD4, is a validated contraceptive target. All BET subfamily members have two tandem bromodomains (BD1 and BD2). Knockout mice lacking BRDT-BD1 or both bromodomains are infertile. Treatment of mice with JQ1, a BET BD1/BD2 nonselective inhibitor with the highest affinity for BRD4, disrupts spermatogenesis and reduces sperm number and motility. To assess the contribution of each BRDT bromodomain, we screened our collection of DNA-encoded chemical libraries for BRDT-BD1 and BRDT-BD2 binders. High-enrichment hits were identified and resynthesized off-DNA and examined …

Glucagon Blockade Restores Functional Β-Cell Mass In Type 1 Diabetic Mice And Enhances Function Of Human Islets, May-Yun Wang, E Danielle Dean, Ezekiel Quittner-Strom, Yi Zhu, Kamrul H Chowdhury, Zhuzhen Zhang, Shangang Zhao, Na Li, Reshing Ye, Young Lee, Yiyi Zhang, Shiuhwei Chen, Xinxin Yu, Derek C Leonard, Greg Poffenberger, Alison Von Deylen, S Kay Mccorkle, Amnon Schlegel, Kyle W Sloop, Alexander M Efanov, Ruth E Gimeno, Philipp E Scherer, Alvin C Powers, Roger H Unger, William L Holland

Faculty, Staff and Students Publications

We evaluated the potential for a monoclonal antibody antagonist of the glucagon receptor (Ab-4) to maintain glucose homeostasis in type 1 diabetic rodents. We noted durable and sustained improvements in glycemia which persist long after treatment withdrawal. Ab-4 promoted β-cell survival and enhanced the recovery of insulin+ islet mass with concomitant increases in circulating insulin and C peptide. In PANIC-ATTAC mice, an inducible model of β-cell apoptosis which allows for robust assessment of β-cell regeneration following caspase-8–induced diabetes, Ab-4 drove a 6.7-fold increase in β-cell mass. Lineage tracing suggests that this restoration of functional insulin-producing cells was at least partially …

Dexmedetomidine As An Adjunct To Regional And Neuraxial Anesthesia, Tobin Tollett

Nurse Anesthesia Student Capstones

Regional and neuraxial anesthetic techniques are ever-expanding, and an understanding of the tools, medications, and adjuncts associated with these techniques is prudent for anesthesia providers. One goal of these techniques is to extend pain management beyond the initial surgical phase by using long-acting local anesthetics with or without adjunct medications. The purpose of this review is to detail the clinical utility, benefits, and risks of dexmedetomidine as an adjunct to regional and neuraxial anesthetic techniques. This review includes an analysis of literature of over 20 randomized controlled trials comparing the use of dexmedetomidine to other adjuncts in common regional and …