Medical Specialties Commons^™

Downward Spiral, Meghan Hickey

Akesis

There are still moments when I find myself folding inwards: sinking, spiraling, struggling. I become attacked by my own intrusive thoughts. I’ve been my own monster all along.

It took me a long time to understand that progress is never linear. And I bring that idea into my PT practice. I want my patients to understand that set backs, both mental and physical, can occur throughout the healing journey. I often tell my patients expressing anxieties and concerns to observe the way they speak to themselves. Our self talk is influenced by our subconscious mind, and it reveals our thoughts, …

Deeply Rooted, Maryam Nahidian

Akesis

I captured this photo on my first solo hike, a very memorable moment for me. I was tired and questioning why I was putting myself in this position. No one would know if I turned back, but I would. Right at that moment, I stopped looking down at my feet and looked up at this scene. “Oh wow,” I said. The trees, strong and tall, but that was not what captured my attention. It was the roots. Exposed, intricate, and vulnerable and I realized at that moment that this scene portrayed me. The journey has been an uphill climb that …

Annual Hepatitis C Screening Qi: A Scoping Review, Sadiat Omowunmi Adebiyi Bsn, Rn, Sakinah Shaw Bsn, Rn, Tracy Mcclinton Dnp, Ag-Acnp-Bc, Sharon Little Dnp, Fnp-Bc, Aprn

Doctor of Nursing Practice Projects

Purpose/Background Despite the surge in HCV prevalence among pregnant women and the threat of perinatal HCV transmission, infants exposed to HCV in the United States are inadequately screened (Chappell et al., 2018). It is estimated that between 4% and 8% of babies exposed to HCV during pregnancy become infected (Watts et al., 2017). Incorporating Hep C screening with other mandated prenatal screening will play an essential role in reducing the complications associated with Hep C transmission to the newborn.

Methods Article search was done in the first three weeks of the fall 2021 semester, and a total of 63 articles …

Complex Chromosomal Rearrangement Involving 15q11-Q13 Interstitial Triplication And Duplication: A New Case Report Of Dysmorphic And Neuropsychiatric Features, Lekha Chilakamarri, Estrella Lizbeth Mellin-Sanchez

School of Medicine Publications

Our patient is the first to encompass the full spectrum of reported features related to tetrasomy of the Prader–Willi Angelman Critical Region. She has a complex chromosomal rearrangement including an interstitial triplication reported in twelve cases till date and a rare interstitial duplication reported in only four cases till date.

Concurrent P53 Mutation In Egfr Mutant Non-Small Cell Lung Cancer Is Associated With Resistance To First And Second Generation Egfr Tyrosine Kinase Inhibitors, A Meta-Analysis, Marissa Viola, Adam Kolatorowicz, Jun Wang

Research Day

Epidermal growth factor receptor (EGFR) mutant lung cancers tend to respond well to EGFR tyrosine kinase inhibitors (TKIs). However, resistance has been described. Molecular studies have revealed that concurrent mutations of tumor driver genes are associated with TKI resistance. To delineate the role of concurrent mutation of tumor suppressor gene p53 in TKI resistance, a meta-analysis was performed using published observations of EGFR mutant lung cancer patients treated with first or second generation TKIs. 31 studies are included in the analysis following a search of PubMed. Probability of TKI resistance and progress free survival (PFS) were compared in patients with …

Use Of Wastewater Surveillance For Early Detection Of Alpha And Epsilon Sars-Cov-2 Variants Of Concern And Estimation Of Overall Covid-19 Infection Burden, Van Vo, Richard L. Tillett, Katerina Papp, Shirley Shen, Richard Gu, Andrew Gorzalski, Danielle Siao, Rayma Markland, Ching-Lan Chang, Hayley Baker, Jingchun Chen, Martin Schiller, Walter Q. Betancourt, Erin Buttery, Mark Pandori, Michael A. Picker, Daniel Gerrity, Edwin C. Oh

Nevada Institute of Personalized Medicine Faculty Research

A decline in diagnostic testing for SARS-CoV-2 is expected to delay the tracking of COVID-19 variants of concern and interest in the United States. We hypothesize that wastewater surveillance programs provide an effective alternative for detecting emerging variants and assessing COVID-19 incidence, particularly when clinical surveillance is limited. Here, we analyzed SARS-CoV-2 RNA in wastewater from eight locations across Southern Nevada between March 2020 and April 2021. Trends in SARS-CoV-2 RNA concentrations (ranging from 4.3 log10 gc/L to 8.7 log10 gc/L) matched trends in confirmed COVID-19 incidence, but wastewater surveillance also highlighted several limitations with the clinical data. Amplicon-based whole …

Tolerability And Feasibility Of At-Home Remotely Supervised Transcranial Direct Current Stimulation (Rs-Tdcs): Single-Center Evidence From 6,779 Sessions, Giuseppina Pilloni, Amy Vogel-Eyny, Matthew Lustberg, Pamela Best, Martin Malik, Lillian Walton-Masters, Allan George, Ibraheem Mirza, Lana Zhovtis, Abhishek Datta, Marom Bikson, Lauren Krupp, Leigh Charvet

Department of Medicine Faculty Papers

Introduction: The ability to deploy transcranial direct current stimulation (tDCS) at home is a key usability advantage to support scaling for pivotal clinical trials. We have established a home-based tDCS protocol for use in clinical trials termed remotely supervised (RS)-tDCS.

Objective: To report the tolerability and feasibility of tDCS sessions completed to date using RS-tDCS in clinical trials.

Methods: We analyzed tolerability (i.e., adverse events, AEs) reported in six Class I/II/III trials using RS-tDCS to study symptom outcomes over 10 to 60 daily applications. Across the six clinical trials, 308 participants (18-78 years old) completed an average of 23 sessions …

A Comparison Of Positive And Negative Reinforcement To Decrease Disruptive Behavior During Medical Demands, Rachel Commodario

Thesis Projects

Medical demand tolerance is imperative for improving and maintaining physical health, but a disproportionate number of intellectually disabled individuals do not readily cooperate with medical procedure demands. Research suggests that although function-based treatments can be effective, in some contexts nonfunctional interventions can also produce therapeutic results (Briggs et al., 2019; Carter, 2010; Dowdy et al., 2018; Gardner et al., 2009; Lalli et al., 1999; Piazza et al., 1997). The purpose of this study was to compare the treatment effects of using functional and nonfunctional reinforcement to decrease escape-maintained medical demand noncooperation with intellectually disabled children. A reversal design embedded within …

Mycotic Aortic Aneurysm: A Rare Etiology Of Septic Shock., Kaitlin M Bowers, Vishnu Mudrakola, Christopher M Lloyd

Heart and Vascular Articles

Mycotic aneurysm of the aorta is a rare disease with a high mortality rate due to its likelihood of aneurysmal rupture. This syndrome is predominantly seen in patients over age 65 with the most common presenting symptoms being fever and back pain. Our case illustrates a mycotic aneurysm of the aorta presenting in an elderly female with vague abdominal pain, flank pain, and generalized weakness. We review the investigative approach, diagnostic modalities, and treatment options in patient management. This case emphasizes the need for a high index of suspicion of mycotic aneurysms of the aorta in critically ill elderly patients …

Role Of Atogepant In The Treatment Of Episodic Migraines: Clinical Perspectives And Considerations, Fred Cohen, Hsiangkuo Yuan

Department of Neurology Faculty Papers

Advances in molecular biology and neuroscience have led to the discovery of calcitonin gene-related peptide (CGRP), a 37 amino-acid neuropeptide that plays a critical role in the pathogenesis of migraine. CGRP receptor antagonist, also known as gepant, is an oral medication that inhibits the CGRP-related nociceptive signaling pathway. To date, three gepants are approved by the FDA for migraine treatment. Atogepant is a 2nd-generation gepant that non-competitively antagonizes CGRP receptors inhibiting neurogenic inflammation and pain sensitization. With its long half-life and minimal cardiovascular or liver toxicity, it is the first in its class approved primarily for migraine prevention. This article …

Hand Surgery Patient Perspectives On Medical Cannabis: A Survey Of Over 600 Patients, Lilah Fones, Clay Townsend, Harry Hoyen, Frederic Liss, Mark L. Wang, Ari C. Greis, Asif M. Ilyas

Rothman Institute Papers

Purpose: Medical cannabis (MC) has been proposed as a potential addition to multimodal pain man- agement regimens in orthopedics. This study evaluates hand and upper-extremity patient perspectives of MC as a treatment for common orthopedic and musculoskeletal pain conditions. This study also aims to identify the proportion of patients already using MC, perceived barriers to MC use, and opinions on insurance coverage and legality of cannabis.

Methods: An anonymous cross-sectional survey study was conducted of all patients at least 18 years old presenting from October 2020 to January 2021 to a hand and upper-extremity outpatient clinic. The survey collected information …

Reduction Of Mutant Atxn1 Rescues Premature Death In A Conditional Sca1 Mouse Model, James P Orengo, Larissa Nitschke, Meike E Van Der Heijden, Nicholas A Ciaburri, Harry T Orr, Huda Y Zoghbi

Duncan NRI Faculty and Staff Publications

Spinocerebellar ataxia type 1 (SCA1) is an adult-onset neurodegenerative disorder. As disease progresses, motor neurons are affected, and their dysfunction contributes toward the inability to maintain proper respiratory function, a major driving force for premature death in SCA1. To investigate the isolated role of motor neurons in SCA1, we created a conditional SCA1 (cSCA1) mouse model. This model suppresses expression of the pathogenic SCA1 allele with a floxed stop cassette. cSCA1 mice crossed to a ubiquitous Cre line recapitulate all the major features of the original SCA1 mouse model; however, they took twice as long to develop. We found that …

Genetic Susceptibility To Patient-Reported Xerostomia Among Long-Term Oropharyngeal Cancer Survivors, Puja Aggarwal, Katherine A Hutcheson, Robert Yu, Jian Wang, Clifton D Fuller, Adam S Garden, Ryan P Goepfert, Jillian Rigert, Frank E Mott, Charles Lu, Stephen Y Lai, G Brandon Gunn, Mark S Chambers, Guojun Li, Chih-Chieh Wu, Ehab Y Hanna, Erich M Sturgis, Sanjay Shete

Faculty, Staff and Students Publications

Genetic susceptibility for xerostomia, a common sequela of radiotherapy and chemoradiotherapy for head and neck cancer, is unknown. Therefore, to identify genetic variants associated with moderate to severe xerostomia, we conducted a GWAS of 359 long-term oropharyngeal cancer (OPC) survivors using 579,956 autosomal SNPs. Patient-reported cancer treatment-related xerostomia was assessed using the MD Anderson Symptom Inventory. Patient response was dichotomized as moderate to severe or none to mild symptoms. In our study, 39.2% of OPC survivors reported moderate to severe xerostomia. Our GWAS identified eight SNPs suggestively associated with higher risk of moderate to severe xerostomia in six genomic regions …

Strategic Recommendations To Bridge The Gaps In Awareness, Diagnosis And Prevention Of Heart Failure In The Middle East Region And Africa, Ahmed Bennis, Elijah N Ogola, Eric Klug, Hadi N. Skouri, Hilal Bahjet Al Saffar, Hany Ragy, Kamal Waheeb Alghalayini, Khaldoon A Alhumood, Magdy Abdelhamid, Mehmet Birhan Yilmaz, Ramzi Tabbalat, Yüksel Çavuşoğlu

Journal of the Saudi Heart Association

Abstract Objective: With the increasing burden of heart failure (HF) in the Middle East Region and Africa (MEA), it is imperative to shift the focus to prevention and early detection of cardiovascular diseases. We present a broad consensus of the real-world challenges and strategic recommendations for optimising HF care in the MEA region. Method: To bridge the gaps in awareness, prevention, and diagnosis of HF, an assembly of experts from MEA shared their collective opinions on the urgent unmet needs. Results: Lack of awareness in the community, high prevalence of risk factors, poor accessibility and affordability of care and diagnostics …

Septic Pulmonary Embolism Related To Right-Sided Infective Endocarditis, Amit Panjwani, Nooraldaem Yousif

Journal of the Saudi Heart Association

No abstract provided.

Unifying Multi-State Efforts Through A Nationally Coordinated Extension Diabetes Program, Laura Balis, Shari Gallup, Heather Norman-Burgdolf, Julie Buck, Pam Daniels, Dan Remley, Lisa Graves, Margaret Jenkins, Gayle Price

Dietetics and Human Nutrition Faculty Publications

The Cooperative Extension System translates research to practice and “brings the University to the people” throughout the U.S. However, the system suffers from program duplication and is challenged to scale-out effective programs. One program, Dining with Diabetes (DWD), stands out for its dissemination to multiple states. DWD is a community-based program aimed at improving diabetes management, nutrition, and physical activity behaviors. DWD was coordinated through a national working group and implemented by state Extension systems. A pragmatic, quasi-experimental study was conducted to determine the effectiveness of the national coordination model and the overall impact of DWD. Four states reported data …

Reducing 30 Day Chf Readmission Rates: Evaluating Medication Efficacy, Jesse Bebout Msn, Rn, Ccrn, Brandon May Bsn, Rn, Tiara Richmond Bsn, Rn, Margaret Harvey Phd, Aprn, Acnp-Bc, Chfn

Doctor of Nursing Practice Projects

Purpose/Background Heart failure (HF) is a leading cause of hospital readmissions and lost revenue under the Hospital Readmission Reduction Program (HRRP). Medication management plays a crucial role in controlling HF symptoms leading to hospitalization. This scoping review examines the benefits of angiotensin receptor-neprilysin inhibitors versus beta-blockers in reducing hospital readmissions within 30 days of discharge related to heart failure with reduced ejection fraction (HFrEF) in the United States.

Methods We conducted a literature search from August 2020 to November 2021 on the Google Scholar, PubMed, and CINAHL databases using the key phrases heart failure with reduced ejection, beta-blockers, angiotensin receptor-neprilysin …

Sleep Patterns & Sleep Problems Vary By Age In Children With Autism, Charles F Reynolds, Matthew Siegel, Briana Taylor

Costas T. Lambrew Research Retreat 2022

Adolescence is a time of increased vulnerability for youth with autism spectrum disorder (ASD).1 • In non-ASD youth, sleep and circadian rhythms demonstrate marked changes during adolescence that delay the biological propensity for sleep.2 • In combination with early school start times, these agerelated changes in sleep and circadian rhythms result in insufficient sleep duration, circadian misalignment, daytime sleepiness, and numerous behavioral and psychiatric problems.3 • Age-related changes in sleep and circadian rhythms, and their relevance for behavioral and psychiatric health have not been examined in youth with ASD.

Comprehensive Analysis Of Epigenetic Clocks Reveals Associations Between Disproportionate Biological Ageing And Hippocampal Volume, Lidija Milicic, Michael Vacher, Tenielle Porter, Vincent Doré, Samantha C. Burnham, Pierrick Bourgeat, Rosita Shishegar, James Doecke, Nicola J. Armstrong, Rick Tankard, Paul Maruff, Colin L. Masters, Christopher C. Rowe, Victor L. Villemagne, Simon M. Laws, Alzheimer’S Disease Neuroimaging Initiative, Australian Imaging Biomarkers And Lifestyle (Aibl) Study

Research outputs 2022 to 2026

The concept of age acceleration, the difference between biological age and chronological age, is of growing interest, particularly with respect to age-related disorders, such as Alzheimer’s Disease (AD). Whilst studies have reported associations with AD risk and related phenotypes, there remains a lack of consensus on these associations. Here we aimed to comprehensively investigate the relationship between five recognised measures of age acceleration, based on DNA methylation patterns (DNAm age), and cross-sectional and longitudinal cognition and AD-related neuroimaging phenotypes (volumetric MRI and Amyloid-β PET) in the Australian Imaging, Biomarkers and Lifestyle (AIBL) and the Alzheimer’s Disease Neuroimaging Initiative (ADNI). Significant …

Promotion Of Covid-19 Va(X)Ccination In The Emergency Department-Procovaxed: Study Protocol For A Cluster Randomized Controlled Trial., Robert M Rodriguez, Kelli O'Laughlin, Stephanie A Eucker, Anna Marie Chang, Kristin L. Rising, Graham Nichol, Alena Pauley, Hemal Kanzaria, Alexzandra Gentsch, Cindy Li, Herbie Duber, Jonathan Butler, Vidya Eswaran, Dave Glidden

Department of Emergency Medicine Faculty Papers

Background: We conducted in-depth interviews to characterize reasons for COVID-19 vaccine hesitancy in emergency department (ED) patients and developed messaging platforms that may address their concerns. In this trial, we seek to determine whether provision of these COVID-19 vaccine messaging platforms in EDs will be associated with greater COVID-19 vaccine acceptance and uptake in unvaccinated ED patients.

Methods: This is a cluster-randomized controlled trial (RCT) evaluating our COVID-19 vaccine messaging platforms in seven hospital EDs (mix of academic, community, and safety-net EDs) in four US cities. Within each study site, we randomized 30 1-week periods to the intervention and 30 …

Outcomes Of Covid-19 Infection In Patients With Hematological Malignancies- A Multicenter Analysis From Pakistan, Adeeba Zaki, Salman Muhammad Soomar, Danish Hasan Khan, Hasan Shaharyar Sheikh, Raheel Iftikhar, Ayaz Mir, Zeba Aziz, Khadija Bano, Hafsa Naseer, Qamar Un-Nisa Chaudhry

Section of Haematology/Oncology

Purpose: COVID-19 infection resulting from severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) began to spread across the globe in early 2020. Patients with hematologic malignancies are supposed to have an increased risk of mortality from coronavirus disease of 2019 (COVID-19) infection. From Pakistan, we report the analysis of the outcome and interaction between patient demographics and tumor subtype and COVID-19 infection and hematological malignancy.
Patients and methods: This multicenter, retrospective study included adult patients with a history of histologically proven hematological malignancies who were tested positive for COVID-19 via PCR presented at the oncology department of 5 tertiary care hospitals …

Meal Timing, Meal Frequency And Metabolic Syndrome, Fatema Alkhulaifi, Charles Darkoh

Faculty, Staff and Student Publications

Individuals with metabolic syndrome have increased risk for developing health conditions, including cardiovascular diseases and stroke. Modifiable risk factors, such as exercise and diet, are key components in the prevention and control of metabolic syndrome. Specifically, dietary patterns and habits are extremely successful in controlling more than one of the metabolic syndrome risk factors. Meal timing and frequency have been associated with type 2 diabetes, cardiovascular diseases, and other chronic conditions. However, there is limited evidence linking metabolic syndrome to meal timing and meal frequency. This review summarizes and discusses how meal timing and frequency impact metabolic outcomes in adults.

A Combined Conduit-Bioactive Hydrogel Approach For Regeneration Of Transected Sciatic Nerves, Cheuk Sun Edwin Lai, Viridiana Leyva-Aranda, Victoria H Kong, Tania L Lopez-Silva, Adam C Farsheed, Carlo D Cristobal, Joseph W R Swain, Hyun Kyoung Lee, Jeffrey D Hartgerink

Duncan NRI Faculty and Staff Publications

Transected peripheral nerve injury (PNI) affects the quality of life of patients, which leads to socioeconomic burden. Despite the existence of autografts and commercially available nerve guidance conduits (NGCs), the complexity of peripheral nerve regeneration requires further research in bioengineered NGCs to improve surgical outcomes. In this work, we introduce multidomain peptide (MDP) hydrogels, as intraluminal fillers, into electrospun poly(ε-caprolactone) (PCL) conduits to bridge 10 mm rat sciatic nerve defects. The efficacy of treatment groups was evaluated by electromyography and gait analysis to determine their electrical and motor recovery. We then studied the samples' histomorphometry with immunofluorescence staining and automatic …

Clinical Diagnosis Of Metabolic Disorders Using Untargeted Metabolomic Profiling And Disease-Specific Networks Learned From Profiling Data, Lillian R Thistlethwaite, Xiqi Li, Lindsay C Burrage, Kevin Riehle, Joseph G Hacia, Nancy Braverman, Michael F Wangler, Marcus J Miller, Sarah H Elsea, Aleksandar Milosavljevic

Duncan NRI Faculty and Staff Publications

Untargeted metabolomics is a global molecular profiling technology that can be used to screen for inborn errors of metabolism (IEMs). Metabolite perturbations are evaluated based on current knowledge of specific metabolic pathway deficiencies, a manual diagnostic process that is qualitative, has limited scalability, and is not equipped to learn from accumulating clinical data. Our purpose was to improve upon manual diagnosis of IEMs in the clinic by developing novel computational methods for analyzing untargeted metabolomics data. We employed CTD, an automated computational diagnostic method that "connects the dots" between metabolite perturbations observed in individual metabolomics profiling data and modules identified …

The Effects Of Paclitaxel On Cellular Migration And The Cytoskeleton, Ashley Salguero-Gonzalez

Thinking Matters Symposium

In a clinical setting, some patients are exposed to an anti-cancer chemotherapy agent, paclitaxel. Cancerous cells undergo rapid, continuous cell division without control. Chemotherapy treatments try to slow and stop the uncontrollable cell division cycles and eliminate cancerous cells in the process. Paclitaxel serves as a treatment for some types of cancers, including lung, melanoma, bladder, and esophageal. Because it targets the cytoskeleton, paclitaxel can also influence cell migration. This project utilizes a cellular migration assay and an immunohistochemistry assay to analyze the effects of paclitaxel on the movement of cells and on the cytoskeleton of neuroglia rat cells with …

Sotrovimab: Neutralizing Antibody To Combat Covid-19, Aya Allam, Steven Lippmann

The University of Louisville Journal of Respiratory Infections

No abstract provided.

Are Antipyretic Medications Compatible With Sars-Cov-2 Vaccines?, Sharanya S E Santhi, Niguma Rayamajhi, Steven B Lippmann

The University of Louisville Journal of Respiratory Infections

No abstract provided.

Advancements In Left Ventricular Assist Devices To Prevent Pump Thrombosis And Blood Coagulopathy, Grainne Malone, Gerges Abdelsayed, Fianait Bligh, Fatma Al Qattan, Saifullah Syed, Prateepan Varatharajullu, Augustin Msellati, Daniela Mwipatayi, Maimoona Azhar, Saulat Hasnain Fatimi

Section of Cardiothoracic Surgery

Mechanical circulatory support (MCS) devices, such as left ventricular assist devices (LVADs) are very useful in improving outcomes in patients with advanced-stage heart failure. Despite recent advances in LVAD development, pump thrombosis is one of the most severe adverse events caused by LVADs. The contact of blood with artificial materials of LVAD pumps and cannulas triggers the coagulation cascade. Heat spots, for example, produced by mechanical bearings are often subjected to thrombus build-up when low-flow situations impair washout and thus the necessary cooling does not happen. The formation of thrombus in an LVAD may compromise its function, causing a drop …

Impact Of Social Determinants Of Health On Adherence To Urinary Tract Infection Treatment Recommendations: A Scoping Review, Charles W. Stewart Cpnp, Diana Dedmon Dnp, Aprn, Fnp-Bc

Doctor of Nursing Practice Projects

Purpose/Background: Pediatric health is significantly affected by social determinants of health. Screening for and addressing social determinants of health helps to decrease negative effect on health outcomes. The purpose of this project is to determine if there is an association between addressing or not addressing social determinants of health by the healthcare provider and parents’ adherence to treatment recommendations in children with urinary tract infections.

Methods: Between October 2020 and November 2021, a literature review was performed to obtain data from studies regarding urinary tract infections, social determinants of health and adherence to treatment recommendations. The University of Tennessee Health …

Targeted Therapy In The Management Of Modern Craniopharyngiomas, Maikerly Reyes, Mohammad Taghvaei, Siyuan Yu, Anish Sathe, Sarah Collopy, Giyarpuram Prashant, James J. Evans, Michael Karsy

Department of Neurosurgery Faculty Papers

Background: The proximity of craniopharyngiomas (CPs) to critical neurovascular structures can lead to a host of neurologic and endocrine complications that lead to difficulty with surgical management. In this review, we examine the molecular and genetic markers implicated in CP, their involvement in tumorigenic pathways, and their impact on CP prognosis and treatment.

Methods: We undertook a focused review of relevant articles, clinical trials, and molecular summaries regarding CP.

Results: Genetic and immunological markers show variable expression in different types of CP. BRAF is implicated in tumorigenesis in papillary CP (pCP), whereas CTNNB1 and EGFR are often overexpressed in adamantinomatous …