Medical Specialties Commons^™

Bipolar I And Bipolar Ii Subtypes In Older Age: Results From The Global Aging And Geriatric Experiments In Bipolar Disorder (Gage-Bd) Project, Farren Briggs, Martha Sajatovic, Kaylee Sarna, Joy Yala

Faculty Scholarship

Objectives: The distinction between bipolar I disorder (BD-I) and bipolar II disorder (BD-II) has been a topic of long-lasting debate. This study examined differences between BD-I and BD-II in a large, global sample of OABD, focusing on general functioning, cognition and somatic burden as these domains are often affected in OABD. Methods: Cross-sectional analyses were conducted with data from the Global Aging and Geriatric Experiments in Bipolar Disorder (GAGE-BD) database. The sample included 963 participants aged ≥50 years (714 BD-I, 249 BD-II). Sociodemographic and clinical factors were compared between BD subtypes including adjustment for study cohort. Multivariable analyses were conducted …

Editorial: Perturbations In Metabolic Cues: Implications For Adverse Cardiac Function Leading To Sudden Cardiac Death, Brian P. Delisle, Ademuyiwa S. Aromolaran

Physiology Faculty Publications

No abstract provided.

Conflict, Extremism, Resilience And Peace In South Asia; Can Covid-19 Provide A Bridge For Peace And Rapprochement?, Zulfiqar Ahmed Bhutta, Arun Mitra, Afsah Salman, Fawad Akbari, Suraya Dalil, Fyezah Jehan, Mushtaque Chowdhury, Saroj Jayasinghe, Purnima Menon, Samiran Nundy

Institute for Global Health and Development

Abstract, issue, and pagination are not provided by the author/publisher

Editorial For The Genetics Of Alzheimer’S Disease Special Issue: October 2021, Laura Ibanez, Justin B. Miller

Sanders-Brown Center on Aging Faculty Publications

No abstract provided.

16th Annual Pancreatic Cancer And Related Diseases Patient Symposium, Charles Yeo, Md, Facs, Adam C. Mueller, Md, Phd, Harish Lavu, Md, Facs, Theresa Yeo, Phd, Aochp, Acnp-Bc, Faanp, Avinoam Nevler, Md, Daniel Lin, Md, Msc, Wilbur Bowne, Md, Ira Sharp, Md

Pancreatic Cancer & Related Diseases Patient Symposium

On November 13, 2021, Charles J. Yeo, MD, FACS, and the multidisciplinary team of clinicians and scientists hosted the 16th Annual Pancreatic Cancer & Related Diseases Symposium.

The video of the event is available here: vimeo.com/646517712/36786afe68.

View our Pancreatic Cancer Program 2021 Update to learn more about Dr. Yeo and the team’s great work!

PROGRAM

Welcome and Program Overview
Charles J. Yeo, MD, FACS
Samuel D. Gross Professor and Chair of Surgery

Advances in FT in Treating Pancreatic Cancer
Adam Mueller, MD, PhD
Instructor, Radiation Oncology

KRAS Mutation Allele Frequency Impacts Prognosis in Pancreatic Ductal Adenocarcinoma Using Next-Generation Sequencing …

Same Evidence, Varying Viewpoints: Three Questions Illustrating Important Differences Between United States And European Cholesterol Guideline Recommendations, David I. Feldman, Erin D. Michos, Neil J. Stone, Ty J. Gluckman, Miguel Cainzos-Achirica, Salim S. Virani, Roger S. Blumenthal

Office of the Provost

In 2018, the AHA/ACC Multisociety Guideline on the Management of Blood Cholesterol was released. Less than one year later, the 2019 ESC/EAS Dyslipidemia Guideline was published. While both provide important recommendations for managing atherosclerotic cardiovascular disease (ASCVD) risk through lipid management, differences exist. Prior to the publication of both guidelines, important randomized clinical trial data emerged on non-statin lipid lowering therapy and ASCVD risk reduction. To illustrate important differences in guideline recommendations, we use this data to help answer three key questions: 1) Are ASCVD event rates similar in high-risk primary and stable secondary prevention? 2) Does imaging evidence of …

Black Infertility And Social Media Engagement: A Mixed Methodology Analysis, Melody Rasouli, Benette Krizel Sagun, Kajal Verma, Cindy M. Duke

Department of Obstetrics & Gynecology Faculty Research

Objective: To study social media engagement on black infertility to better understand why there is lower utilization of in vitro fertilization by black women despite higher infertility rates. Design: The online analytics module BuzzSumo was used to quantify total engagements with the search term “black infertility” across the commonly used social media platforms. The 10 article links with the highest engagement were selected from periods in 2020 and 2021. Sources cited in each article were reviewed to identify those that had citations of scientific peer-reviewed journals or national medical organizations. The contents of each article were reviewed for accuracy by …

The Challenge Of Preventing A Rare But Potentially Devastating Iatrogenic Exposure To Variant Creutzfeldt-Jakob Disease: An Ambi-Directional Observation With Policy Intervention, Ritambhara Pandey, Devesh Rai, Julie Giles, Maryrose Laguio-Vila, Emil Lesho

Advances in Clinical Medical Research and Healthcare Delivery

Although rare, patients with variant Creutzfeldt-Jakob Disease (vCJD) in their differential diagnosis of progressive dementia and movement disorder could continue to present to hospitals for care. However, U.S.-based infection control guidelines do not fully address the possibility of vCJD. After near-misses involving increasing numbers of patients with clinical findings and epidemiologic risks compatible with vCJD, or exposures to chronic wasting disease, we sought to improve recognition and prevention of iatrogenic spread of these prion-related diseases.

Improving Value (Low Cost, Optimal Clinical Outcome, Patient Satisfaction) In A Skilled Nursing Facility: A Quality Improvement (Qi) Project, Nirajan Adhikari, Joseph Mwesige, Lester Kirchner

Advances in Clinical Medical Research and Healthcare Delivery

Improving the value of care with reduced cost without compromising the quality is utmost important in the modern era of medical practice. An attempt was made in the nursing facility to observe an outcome with a plan to implement in much larger scale in the larger facility in future. In the 7-month period of this ambi- directional study, the focus was on minimizing unnecessary daily laboratory orders and to observe the reduction in the cost without adverse effect on length of stay in the nursing facility and hospitalization from the nursing facility.

The Role Of Coronary Artery Disease In Demand Mediated Myocardial Infarction: A Retrospective Study From A Community Hospital, Amr Salama, Nikhil Mehta, Abdullah Abdullah, Ruth Kouides, Jeremiah Depta, Ryan Hoefen, Richard Alweis

Advances in Clinical Medical Research and Healthcare Delivery

Type 2 Myocardial Infarction (T2MI) is an increasingly recognized clinical entity due to the availability of highly sensitive troponin assays for patients admitted due to common medical diagnoses. However, there is little epidemiological data on the significance and long-term prognosis of T2MI, which occurs secondary to an increase in myocardial oxygen demand and/or a decrease in myocardial blood flow. Arrhythmia, hypoxia, and sepsis are the major etiologies for T2MI. Therefore, sepsis was the identified area of interest for the study giving how common it is in a community hospital. We studied the cardiac workup of patients with elevated troponin in …

Emergency Medicine Journal Club, David Gibbs, Dylan Norton

Advances in Clinical Medical Research and Healthcare Delivery

In this column, we provide a brief review of important papers recently published that relate to the field of Emergency Medicine. The goal is to provide the busy clinician a bullet-like summary of the study, focusing on the research question, methods, results, limitations, and bottom line interpretation.

An Integrated Multispecialty Curriculum For Point-Of-Care Ultrasound, Carina M. Brown, Karl Fields, Duncan Vincent, Alison Rumball, Joshua Zavitz, Shane Hudnall, Caroline Iskander, Alexander Raines

Advances in Clinical Medical Research and Healthcare Delivery

Point-of-care ultrasound is increasingly recognized as a valuable tool for physicians practicing in a variety of specialties. Currently there is no standard curricula or assessment model for training primary care specialty residents in the use of ultrasound. This article presents a multispecialty experience in developing a list of 11 core Pediatric, 13 core Family Medicine and 22 core Internal Medicine ultrasound scans based on best available evidence for their clinical use.

Osteopathic Medical Students’ Perceptions Of Their Medical Education Due To Covid19, Kaitlyn Thomas, Richard Terry

Advances in Clinical Medical Research and Healthcare Delivery

Objective: The SARS-CoV-2 (COVID19) pandemic has led to unprecedented changes in medical education globally. Published reports on these changes have given some insight as to both positive and negative effects for specific medical schools though none have looked at osteopathic education. Our study attempts to examine the effect of COVID19 more formally on osteopathic medical students’ perception of their medical education in the third and fourth years of medical training.

Methods: Third- and fourth-year medical students at Lake Erie College of Osteopathic Medicine (LECOM) completed electronic surveys regarding their experiences with changes in medical education due to the COVID19 …

Community And Provider Acceptability Of The Covid-19 Vaccine: A Systematic Review And Meta-Analysis, Christian Akem Dimala, Benjamin Momo Kadia, Hai Nguyen, Anthony Donato

Advances in Clinical Medical Research and Healthcare Delivery

Background:

The novel coronavirus disease (COVID-19) vaccines may help control the current pandemic but would require immunization levels that would achieve herd immunity. This study aimed to quantify current COVID-19 vaccine acceptance rates, as well as characterize the determinants, enablers and barriers to vaccine acceptability across the globe by synthesizing published evidence.

Methods:

A systematic review and meta-analysis of studies was performed on studies assessing the acceptability of a COVID-19 vaccine published between November 1^st, 2019, and November 30^th, 2020. PubMed, Embase and Cochrane central were searched for eligible studies. Data extracted from retained studies was …

Health Concerns Of Adolescents And Adults With Spina Bifida, Jessica Starowicz, Caitlin Cassidy, Laura Brunton

Paediatrics Publications

Due to advancements in medical care, people with spina bifida (SB) are surviving well into adulthood, resulting in a growing number of patients transitioning to an adult sector unequipped to care for people with chronic rehabilitative and medical needs. The Transitional and Lifelong Care (TLC) program is a multidisciplinary clinical service that compensates for this gap, providing comprehensive, coordinated care to adolescents, and adults with SB. As a relatively new clinical service, objective data about the patients using the service and their needs is scant. This study sought to identify the most common health concerns among TLC patients with SB …

Collegiate Athletes’ Symptoms Of Depression: A Systematic Review, Justin Homatas

Student Theses and Dissertations

Depression in college athletics has become a growing concern in recent years. Thus, the current review sough to provide a comprehensive overview of the research conducted up to this point on the subject of depression in college athletics, while also revealing areas in which more research is still needed. The initial search of the research databases produced 729 articles. 26 of the articles met the inclusion criteria and were accepted for the review. The results identified (a) the prevalence rate of depressive symptoms in college athletes, (b) risk factors contributing to the presence of depressive symptoms in college athletes, (c) …

The Effect Of Static Stretching On Countermovement Jump And Flexibility Performance In Collegiate Dancers, Ashlyn Raines

Student Theses and Dissertations

Dancers require a large range of motion and joint mobility in order to successfully execute certain skills. The requirements of dance make stretching in warm-ups almost a necessity to reduce risk of injury, however the volume of static stretching has not been thoroughly researched in high flexibility athletes. The Purpose of this study was to investigate the dose-response of static stretching in dance and the effect it may have on performance. Two dancers volunteered for this study. Both dancers engaged in a general warm-up and different dosage of static stretches followed by a countermovement jump test on a force plate …

Biotinylation As A Tool To Enhance The Uptake Of Small Molecules In Gram-Negative Bacteria, Ankit Pandeya, Ling Yang, Olaniyi Alegun, Chamikara Karunasena, Chad Risko, Zhenyu Li, Yinan Wei

Chemistry Faculty Publications

Antibiotic resistance is a major public health concern. The shrinking selection of effective antibiotics and lack of new development is making the situation worse. Gram-negative bacteria more specifically pose serious threat because of their double layered cell envelope and effective efflux systems, which is a challenge for drugs to penetrate. One promising approach to breach this barrier is the “Trojan horse strategy”. In this technique, an antibiotic molecule is conjugated with a nutrient molecule that helps the antibiotic to enter the cell through dedicated transporters for the nutrient. Here, we explored the approach using biotin conjugation with a florescent molecule …

Mapk6-Akt Signaling Promotes Tumor Growth And Resistance To Mtor Kinase Blockade, Qinbo Cai, Wolong Zhou, Wei Wang, Bingning Dong, Dong Han, Tao Shen, Chad J Creighton, David D Moore, Feng Yang

Faculty, Staff and Students Publications

Mitogen-activated protein kinase 6 (MAPK6) is an atypical MAPK. Its function in regulating cancer growth remains elusive. Here, we reported that MAPK6 directly activated AKT and induced oncogenic outcomes. MAPK6 interacted with AKT through its C34 region and the C-terminal tail and phosphorylated AKT at S473 independent of mTORC2, the major S473 kinase. mTOR kinase inhibitors have not made notable progress in the clinic. Our identified MAPK6-AKT axis may provide a major resistance pathway. Besides repressing growth, inhibiting MAPK6 sensitized cancer cells to mTOR kinase inhibitors. MAPK6 overexpression is associated with decreased overall survival and the survival of patients with …

Allergic Bronchopulmonary Aspergillosis Misdiagnosed As Smear Negative Pulmonary Tuberculosis; A Retrospective Study From Pakistan, Nousheen Iqbal, Muhammad Dawood Amir Sheikh, Kauser Jabeen, Safia Awan, Muhammad Irfan

Section of Pulmonary & Critical Care

Background: Undiagnosed allergic bronchopulmonary aspergillosis (ABPA) can lead to chronic persistent symptoms. In country like Pakistan where tuberculosis (TB) is endemic, a significant proportion of ABPA patients are misdiagnosed as smear negative TB before reaching a diagnosis of ABPA due to chronicity of symptoms.This lead to empiric use of ATT(Anti-tuberculous therapy) and delay in primary diagnosis. The aim of the study is to determine such proportion of ABPA patients.|
Material and methods: This retrospective study was conducted at the outpatient pulmonology clinic of a tertiary care hospital in Karachi, Pakistan from January 2017 to December 2018. Xpert MTB/Rif, TB smear …

Sedation And Acute Encephalopathy In A Pediatric Patient Following Ingestion Of Delta-8-Tetrahydrocannabinol Gummies, Peter Akpunonu, Regan A. Baum, Andrew Reckers, Blake Davidson, Ross Ellison, Matthew Riley, Jordan Trecki, Roy Gerona

Emergency Medicine Faculty Publications

BACKGROUND Delta-8 tetrahydrocannabinol (delta-8 THC) is an isomer of delta-9-tetrahydrocannabinol (delta-9 THC), the primary psychoactive cannabinoid in the marijuana plant. Typically found at lower concentrations in marijuana, delta-8 THC exhibits psychoactive properties similar to delta-9 THC. Products containing delta-8 THC are readily available across the US and currently there is a lack of available confirmatory testing specific to delta-8 THC as there is cross-reactivity to other naturally occurring cannabinoids in standard immunoassays. Pediatric exposures to this substance are on the rise.

CASE REPORT We present a case with laboratory confirmation of a previously healthy 2-year-old girl ingesting approximately 15 mg/kg …

Examining Eating Attitudes And Behaviors In Collegiate Athletes, The Association Between Orthorexia Nervosa And Eating Disorders, Nancy A. Uriegas, Zachary K. Winkelmann, Kelly Pritchett, Toni M. Torres-Mcgehee

All Faculty Scholarship for the College of Education and Professional Studies

Purpose: Orthorexia nervosa (Orthorexia) is an eating attitude and behavior associated with a fixation on healthy eating, while eating disorders (EDs) are clinically diagnosed psychiatric disorders associated with marked disturbances in eating that may cause impairment to psychosocial and physical health. The purpose of this study was to examine risk for Orthorexia and EDs in student-athletes across sex and sport type and determine the association between the two.

Methods: Student-athletes (n = 1,090; age: 19.6 ± 1.4 years; females = 756; males = 334) completed a survey including demographics, the ORTO-15 test (values), the Eating Attitudes Test-26 (EAT-26; >20 …

Surgical Treatment Of Femoroacetabular Impingement: Minimum 10-Year Outcome And Risk Factors For Failure, Hamed Vahedi, Steven Yacovelli, Claudio Diaz, Javad Parvizi

Rothman Institute Papers

Background: Femoroacetabular impingement (FAI) is a well-known cause of hip pain and dysfunction in young adults. Surgical treatment has been widely popularized during the past decade. However, most reported results have been limited to short-term and intermediate-term follow-up. The long-term success rate and risk factors for failure are largely unknown. This study aimed to report the long-term (minimum, 10 years) clinical outcomes of surgical treatment of FAI and to describe the clinical and radiographic parameters associated with the failure of treatment involving femoroacetabular osteoplasty (FAO) and labral repair.

Methods: Using our prospective hip preservation database, 164 patients (178 hips) who …

The Fate Of Periprosthetic Joint Infection Following Megaprosthesis Reconstruction, Kamolsak Sukhonthamarn, Timothy L Tan, John Strony, Scot A. Brown, David Nazarian, Javad Parvizi

Rothman Institute Papers

Background: A megaprosthesis may be used for reconstruction in patients with massive bone loss or a periprosthetic fracture. Periprosthetic joint infection (PJI) may occur after a megaprosthesis reconstruction and may pose a major challenge. The outcomes of managing PJI in patients with a megaprosthesis is relatively unclear. The aim of this study was to investigate the clinical course and outcomes of PJI in patients with a megaprosthesis in place.

Methods: From a total of 219 patients who underwent megaprosthesis replacement for non-oncologic conditions, 38 (17.4%) developed subsequent PJI. A retrospective review of the medical record was performed to ascertain the …

Microbial Profile Of Lacrimal System Dacryolith In Midwest Patient Population, Peter Kally, Olivia Cheng, Thai Do, Dianne Schachter, Francesca Nesi-Eloff

Conference Presentation Abstracts

Introduction: Dacryoliths of the lacrimal excretory system are found in patients undergoing surgical treatment of primary canaliculitis and nasolacrimal duct obstruction.1,2 Dacryoliths of the canalicular pathway are classically attributed to Actinomyces species, yet a growing body of literature throughout Asia and the Middle East supports a shift towards Streptococcus and Staphylococcus species being the most common cultured organism.1–4 The Midwest microbial profile in 2009 was reported to maintain Actinomyces as the most common organism.1 The objective of this paper is to update the American Midwest demographic and microbial profile of lacrimal system dacryoliths to direct tailored regional approaches to treatment. …

Alterations In Functional Connectivity Measured By Functional Magnetic Resonance Imaging And The Relationship With Heart Rate Variability In Subjects After Performing Orgasmic Meditation: An Exploratory Study, Andrew B. Newberg, Nancy Wintering, Chloe Hriso, Faezeh Vedaei, Marie Stoner, Reneita Ross

Department of Radiology Faculty Papers

Background: We measured changes in resting brain functional connectivity, with blood oxygen level dependent (BOLD) functional magnetic resonance imaging (fMRI), associated with a creative meditation practice that is augmented by clitoral stimulation and is designed to not only achieve a spiritual experience but to help individuals manage their most intimate personal relationships. Briefly, the meditative state is attained by both the male and female participants while the male stimulates the woman's clitoris. The goal of this practice, called orgasmic meditation (OM), according to the practitioners is not sexual, but to use the focus on clitoral stimulation to facilitate a meditative …

Shared Decision Making And Patient Reported Outcomes Among Adults With Atherosclerotic Cardiovascular Disease, Medical Expenditure Panel Survey 2006-2015, Victor Okunrintemi, Javier Valero-Elizondo, Neil J. Stone, Ron Blankstein, Michael J. Blaha, Martha Gulati, Salim S. Virani, William A. Zoghbi, Erin D. Michos, Khurram Nasir

Office of the Provost

Importance: Shared decision-making (SDM), one of the pillars of patient centered care is strongly encouraged and has been incorporated into the management of atherosclerotic cardiovascular disease (ASCVD) but the expansion of its use has been limited.
Objective: To determine the association of SDM on patient-reported health status, measures of quality of care, healthcare resource utilization, and healthcare spending among US adults with ASCVD.
Method: This is a retrospective cohort study in an ambulatory setting, utilizing the Medical Expenditure Panel Survey (MEPS) 2006-2015. Analysis completed in December 2020. Participants included were adults 18 years and over with a diagnosis of ASCVD. …

Perspectives On Extended-Release Naltrexone Induction Among Patients Living With Hiv And Opioid Use Disorder: A Qualitative Analysis, Kim A. Hoffman, Robin Baker, Laura C. Fanucchi, Paula J. Lum, Lynn E. Kunkel, Javier Ponce Terashima, Dennis Mccarty, Petra Jacobs, P. Todd Korthuis

Internal Medicine Faculty Publications

BACKGROUND: The CHOICES study randomized participants with HIV and opioid use disorder (OUD) to HIV clinic-based extended-release naltrexone (XR-NTX), which requires complete cessation of opioid use, versus treatment-as-usual (i.e., buprenorphine, methadone). Study participants randomized to XR-NTX were interviewed to assess their experiences with successful and unsuccessful XR-NTX induction.

METHODS: Semi-structured qualitative interviews were completed with a convenience sample of study participants with HIV and OUD (n = 37) randomized to XR-NTX in five HIV clinics between 2018 and 2019. All participants approached agreed to be interviewed. Interviews were digitally recorded, professionally transcribed, and analyzed using thematic analysis.

RESULTS: Participants …

Verrucous Carcinoma Of The Vulva: Patterns Of Care And Treatment Outcomes., Sara M. Dryden, Leonid B. Reshko, Jeremy T. Gaskins, Scott R. Silva

Faculty and Staff Scholarship

Background: Verrucous vulvar carcinoma (VC) is an uncommon and distinct histologic subtype of squamous cell carcinoma (SCC). The available literature on VC is currently limited to case reports and small single institution studies. Aims: The goals of this study were to analyze data from the National Cancer Database (NCDB) to quantitate the incidence of VC and to investigate the effects of patient demographics, tumor characteristics, and treatment regimens on overall survival (OS) in women with verrucous vulvar carcinoma. Methods and results: Patients diagnosed with vulvar SCC or VC between the years of 2004 and 2016 were identified in the NCDB. …

Thrombotic Microangiopathy, An Unusual Form Of Monoclonal Gammopathy Of Renal Significance: Report Of 3 Cases And Literature Review., Edward J. Filippone, Eric D. Newman, Li Li, Rakesh Gulati, John L. Farber

Department of Medicine Faculty Papers

Monoclonal gammopathies result from neoplastic clones of the B-cell lineage and may cause kidney disease by various mechanisms. When the underlying clone does not meet criteria for a malignancy requiring treatment, the paraprotein is called a monoclonal gammopathy of renal significance (MGRS). One rarely reported kidney lesion associated with benign paraproteins is thrombotic microangiopathy (TMA), provisionally considered as a combination signifying MGRS. Such cases may lack systemic features of TMA, such as a microangiopathic hemolytic anemia, and the disease may be kidney limited. There is no direct deposition of the paraprotein in the kidney, and the presumed mechanism is disordered …