Medical Specialties Commons^™

Novel Techniques In Imaging Congenital Heart Disease: Jacc Scientific Statement, Ritu Sachdeva, Aimee K Armstrong, Rima Arnaout, Lars Grosse-Wortmann, B Kelly Han, Luc Mertens, Ryan A Moore, Laura J Olivieri, Anitha Parthiban, Andrew J Powell

Faculty, Staff and Students Publications

Recent years have witnessed exponential growth in cardiac imaging technologies, allowing better visualization of complex cardiac anatomy and improved assessment of physiology. These advances have become increasingly important as more complex surgical and catheter-based procedures are evolving to address the needs of a growing congenital heart disease population. This state-of-the-art review presents advances in echocardiography, cardiac magnetic resonance, cardiac computed tomography, invasive angiography, 3-dimensional modeling, and digital twin technology. The paper also highlights the integration of artificial intelligence with imaging technology. While some techniques are in their infancy and need further refinement, others have found their way into clinical workflow …

Gene Regulation And Speciation In A Migratory Divide Between Songbirds, Matthew I M Louder, Hannah Justen, Abigail A Kimmitt, Koedi S Lawley, Leslie M Turner, J David Dickman, Kira E Delmore

Faculty, Staff and Students Publications

Behavioral variation abounds in nature. This variation is important for adaptation and speciation, but its molecular basis remains elusive. Here, we use a hybrid zone between two subspecies of songbirds that differ in migration - an ecologically important and taxonomically widespread behavior---to gain insight into this topic. We measure gene expression in five brain regions. Differential expression between migratory states was dominated by circadian genes in all brain regions. The remaining patterns were largely brain-region specific. For example, expression differences between the subspecies that interact with migratory state likely help maintain reproductive isolation in this system and were documented in …

Clonal Hematopoiesis Risk Score And All-Cause And Cardiovascular Mortality In Older Adults, Seyedmohammad Saadatagah, Md Mesbah Uddin, Lachelle D Weeks, Abhishek Niroula, Meng Ru, Koichi Takahashi, Lukasz Gondek, Bing Yu, Alexander G Bick, Benjamin L Ebert, Elizabeth A Platz, Pradeep Natarajan, Christie M Ballantyne

Faculty, Staff and Student Publications

IMPORTANCE: Clonal hematopoiesis (CH) with acquired pathogenic variants in myeloid leukemia driver genes is common in older adults but of unknown prognostic value.

OBJECTIVE: To investigate the prevalence of CH and the utility of the CH risk score (CHRS) in estimating all-cause and disease-specific mortality in older adults with CH.

DESIGN, SETTING, AND PARTICIPANTS: This population-based prospective cohort study involved community-dwelling older adults (aged 67-90 years) without hematologic malignant neoplasms (HMs) who were participants in the Atherosclerosis Risk in Communities Visit 5 at 4 US centers: Forsyth County, North Carolina; Jackson, Mississippi; Minneapolis, Minnesota; and Washington County, Maryland. Samples were …

Role Of Cyp3a5 In Prostate Cancer Growth, Ranjana Mitra, Jake Mclean, Ajay P. Singh, Edwin C. Oh

COM Scholarship

No abstract provided.

Is Long-Term Survival Higher In Patients Who Receive Propofol-Based Total Intravenous Anesthesia During Colorectal Cancer Surgery Compared To Volatile Anesthesia, Shad Anthony Mitchell

Theses, Dissertations and Capstones

The study reviewed several retrospective cohort studies that examined the impact of propofol-based total intravenous anesthesia (TIVA) versus volatile anesthesia (VA) on the long-term survival of colorectal cancer (CRC) surgery patients. Eight studies found no significant difference in mortality between the two anesthesia types, while three studies indicated a significant decrease in all-cause mortality favoring propofol TIVA. The studies had varying follow-up periods, with some extending to five years. Notably, two studies controlled the type of volatile anesthetic used, specifically sevoflurane and desflurane. The findings suggest a potential survival advantage for propofol TIVA, warranting further investigation.

Microbiota, Metabolic Profiles And Immune Biomarkers In Infants Receiving Formula With Added Bovine Milk Fat Globule Membrane: A Randomized, Controlled Trial, Chloe Christensen, Car Reen Kok, Cheryl L. Harris, Nancy Moore, Jennifer L. Wampler, Weihong Zhuang, Steven S. Wu, Robert Hutkins, Jacques Izard, Jennifer M. Auchtung

Journal Articles: Internal Medicine

INTRODUCTION: Few studies have evaluated the effects of milk fat globule membrane (MFGM) on microbiota and immune markers in early infant nutrition.

METHODS: In this double-blind randomized study, infants (7-18 days of age) received either bovine milk-based infant formula (Control) or similar formula with an added source (5 g/L) of bovine MFGM (INV-MFGM) for 60 days. A reference group received mother's own human milk over the same period (HM). Oral and stool samples were collected (Baseline and Day 60) to evaluate microbiota, immune markers, and metabolites.

RESULTS: At Day 60, stool bacterial diversity and richness were higher in formula groups …

From Biliary Dilatation To Meningitis: Finding Listeria In A Patient With Advanced Cholangiocarcinoma, Molly Jain Md, Mallika Gyawali Md, Sophia Lubrin Md

Internal Medicine Residency

This presentation won 1^st prize for the 2024 ACP Indiana conference in the oral clinical vignette. Case Presentation.

A Randomized Trial Of Vaginal Antiseptic Preparation Solutions To Reduce Bacteria Colony Counts In Patients Undergoing Vaginal Surgery, James R. Saelens, Adam J. Langer, Andrew N. Boeckley, Natalie M. Castillo, Julie A. Desouza, Jennifer L. Drerup, Kelly M. Muterspaw, Hannah M. Stump, Rose A. Maxwell, Geoffrey Towers

Obstetrics and Gynecology Faculty Publications

Antiseptic preparation of surgical sites is known to reduce the rate of infective complications. However, surgical site infections (SSI) remain a leading cause of post-operative hospitalizations, increasing patient stress and cost for the healthcare system.1-7 In gynecologic surgery, preparation of the vagina is performed to reduce bacterial load prior to surgery, though it is known to remain contaminated.3 In the US, only solutions containing povidone-iodine (PI) are FDA approved for vaginal preparation; though, a 2018 ACOG Practice Bulletin lists chlorhexidine gluconate (CHG) with low (<4%) alcohol concentrations as a reasonable option for off-label use.3 Other preparations for vaginal surgery have been reported including baby shampoo (BS) and a commercially available preparation, containing PCMX (para-chloro-meta-xylenol, Techni-care®, chloroxylenol), that is marketed specifically for use with mucous membranes.8-12 There is a growing need to establish evidence-based alternatives to iodine for vaginal preparation for patients with allergies or sensitivity to iodine-containing products while minimizing postoperative irritation. One retrospective study comparing BS to PI in gynecologic surgeries showed a non-significant lower rate of surgical site infection with BS.9 One major challenge for determining effectiveness of surgical scrubs for reducing SSI is the relatively rare occurrence of postoperative infection. As an alternative proxy for infection colony counts of bacteria/fungi, before and after preparation, have been used.12,13 BS has been shown to reduce bacterial loads in non-gynecologic surgery, but there is limited data regarding its use in vaginal surgery, even though surgeons have been using BS in cases of iodine allergy or intolerance to other antiseptics.9-12CHG use in vaginal surgery has been debated due to concerns about vaginal irritation, however studies have demonstrated that alteration of the solution to 2-4% chlorhexidine with low (4%) alcohol concentration was associated with mild to no vaginal irritation. CHG showed similar reduction in post-incision bacterial counts and wound infections in cesarean delivery, and reduced colony counts during hysterectomy (when compared to PI).14-20 PCMX and CHG were shown to significantly reduce bacterial colonization of extracted root canals, and PCMX has been marketed specifically for vaginal antiseptic preparation.21 While some information on the effectiveness of these four antiseptic preparations has been documented in the literature, at this time there are no randomized controlled trials comparing these solutions in the context of vaginal surgery. Further evaluation and research of antiseptic solutions is warranted to provide evidence for best practices in minimizing infection and irritation. The purpose of this study was to compare the effectiveness of three antiseptic solutions with the standard, PI, for reducing bacterial colonies as a proxy for SSI, and to assess postoperative irritation and infection symptoms.

The Effects Of Controlled Breathing And Physical Postures On Anxiety And Stress In Mental Health Patients, Kristen Killingsworth

DNP Research Projects

Objective: Anxiety and stress are debilitating disorders that have been on the rise in recent years following the COVID-19 pandemic. Medication alone has not been shown to be successful in mitigating the disorders, necessitating research into other alternatives for anxiety and stress management. The purpose of this project was to assess if a single complementary and alternative medicine (CAM) relaxation session had an impact on stress and anxiety levels. Method: A comprehensive literature review was conducted to identify strategies for reducing stress and anxiety. Guided by the Holistic Care Model of Self-Regulation, the nurse-led CAM relaxation session was developed. The …

Research Action Brief: Healthcare Experiences And Perceptions As Drivers Of Gaps In Mammography, Core (Center For Outcomes Research & Education)

Reports

No abstract provided.

Health Systems Partnership For Collaborative Anti-Racist Perinatal Care: A Case Study Of Black Community Based Perinatal Care, Roberta Hunte, Monique Gill, Kevin Cherry, Desha Reed-Holden

Reports

No abstract provided.

Impact Of Anaemia On Right And Left Ventricular Function In Dialysis Patients, Nesreen M. Zakaria, Naglaa F. Al-Mihy, Rehab M. Al-Ashry

Journal of Medicine in Scientific Research

Background A common complication in cases with end stage renal disease (ESRD) undergoing hemodialysis is anemia, contributing significantly to cardiovascular morbidity. The goal of this research is to assess anemia impact on right ventricular (RV) and left ventricular (LV) function in patients undergoing regular dialysis. Methods In this prospective study, one hundred ESRD patients on regular hemodialysis were enrolled, divided into two groups: 72 anemic patients (Group I) and 28 non-anemic patients (Group II). Anemia was characterized by hemoglobin (Hgb) levels below 120 g/L for males and below 110 g/L for women. Group I patients underwent echocardiographic evaluations at baseline, …

Seroprevalence Of Hiv Markers Among Patients Attending To Shebin El- Kom Teaching Hospital, Elham T. Awwad, Rasha G Mostafa, Asmaa M Soliman, Abdelghany Aish, Mariam A. Fouad

Journal of Medicine in Scientific Research

Objectives: to determine the prevalence of HIV infections and assess the accuracy of various testing methods among patients at Shibin El Kom teaching hospital.

Background: HIV/AIDS is a global public health challenge, with increasing prevalence in developing countries like Egypt. Stigma and limited detection methods have hindered the accurate assessment of HIV cases. Early detection is critical for effective prevention and treatment.

Methods:

A retrospective study was conducted from May 2006 to December 2022, involving 71,353 individuals who underwent routine preoperative and preadmission investigations. Blood samples were collected and tested using an immunochromatographic rapid test, ELISA, chemiluminescence, and Western blot. …

Incidence Of Peripartum Hysterectomy In Al-Galaa Teaching Hospital, Marwa R. Shahine, Sherif M. Safwat

Journal of Medicine in Scientific Research

Introduction: A hysterectomy carried out at the moment of delivery or within a day after it is known as a peripartum hysterectomy. Either a scheduled or emergency procedure can be carried out. It is a dramatic life-saving technique carried out when all other conservative management avenues have failed, made worse by the frequent emergency circumstances in which it is carried out.

Objectives: Studying the causes and patterns of peripartum hysterectomy at Al-Galaa Maternity Teaching Hospital, A tertiary referral hospital, in addition to studying the associated maternal and fetal complications.

Methodology: In order to analyze the emergency peripartum hysterectomy performed at …

Unilateral Versus Bilateral Laparoscopic Ovarian Drilling In Clomiphene Citrate Resistant Cases Of Polycystic Ovarian Syndrome: A Randomized Controlled Study, Sahar Saeed Elhalfawy, Mostafa Zein- Elabedeen Mohammed, Ayman Shehata Dawood, Mai Nabil Ageez

Journal of Medicine in Scientific Research

Background: Laparoscopic Ovarian Drilling (LOD) is superior to gonadotropins as it induces mono-ovulation, hence eliminating the potential risks linked to multiple pregnancies or ovarian hyperstimulation syndrome (OHSS).

Aim: To contrast the efficiency of unilateral laparoscopic ovarian drilling (ULOD) and bilateral ovarian drilling (BLOD) in treating clomiphene citrate (CC) resistant instances of polycystic ovarian syndrome (PCOS) according to clinical responses, change in biochemical parameters, follicle stimulating hormone (FSH), anti-mullerian hormone (AMH), luteinizing hormone (LH), ovulation rate over six months.

Methods: This Randomized Controlled Work was performed on 140 participants aged from 25 to 35 years old, with PCOS, infertile …

Association Between Urolithiasis And Non-Alcoholic Fatty Liver Disease ; A Comprehensive Study In National Institute Of Urology And Nephrology, Jehan Ibrahim M. Altohamy, Basma Aref Eltaweel, Ahmed Mostafa Elgamal, Salwa Mohammed Ahmed Dahesh, Ghadir Mohamed Elsawy

Journal of Medicine in Scientific Research

Background: Numerous studies have documented an important association between non-alcoholic fatty liver disease (NAFLD) and urolithiasis. NAFLD is described as 5% fat or more of the liver contents in other liver diseases absence including those related to alcohol consumption, chronic viral hepatitis, other chronic liver diseases as autoimmune hepatitis, and drug-induced hepatic diseases (1). Liver tru-cut biopsy is considered the gold standard yet invasive NAFLD diagnostic technique and carries potential complications (2). On the other hand, Computed Tomography (CT) is considered a non-invasive convenient tool that allows for measurable assessment of NAFLD allowing for quantitative diagnosis. Consequently, CT has proven …

The Changes In The Coefficient Of Variation Of The Corneal Endothelial Cell Size (Cv) In Specular Microscopy Following Cataract Surgery, Tarek Ibrahim Badr

Journal of Medicine in Scientific Research

Background Phacoemulsification surgery is the most widely used technique for cataract surgery worldwide. Phacoemulsification comes in two flavors: torsional and longitudinal. Our research compares The changes in the Coefficient of Variation of endothelial cell size(CV) in specular microscopy following longitudinal and torsional phacoemulsification. Patients and Methods In this prospective randomized study, we want to assess the impact of torsional versus longitudinal phacoemulsification on the variations in the Coefficient of Variation of endothelial cell size (CV) in specular microscopy. Our study will comprise 50 eyes with cataract of nuclear type, grades 1, 2 or 3. Results Upon comparing the two groups' …

Obstetrics Emergency Labor And Delivery Case Simulations With Normal Vaginal Delivery Demonstration: A Hands-On Simulation For Clerkship Students, Emily A. Young, William A. Winter, Robyn N. D'Agostino, Rose A. Maxwell, Sheela Barhan, Marilyn Kindig

Obstetrics and Gynecology Faculty Publications

Introduction: Simulation is rarely used for medical student education in the field of obstetrics. This method is an effective model of learning for topics that are encountered in clinical situations and for topics that pose significant risk to patients when an untrained individual is involved. Methods: A 2-hour obstetric delivery simulation session was developed and incorporated into the third-year obstetrics and gynecology clerkship rotation at Wright State University Boonshoft School of Medicine. Medical students completed self-guided content reviews with resources provided prior to the session. During the session, each medical student conducted a normal vaginal delivery and one of the …

Immunotherapy Serum Mixing: 2023 Best Practice Changes, Eyas Abla Md, Paul Faybusovich Do, Matthew Lies, Mallory Mondloch

Nursing Posters

Background Story:

CentraCare - Plaza Allergy & Asthma Clinic compounds immunotherapy serum with advanced training of licensed nurses. Effective November 1, 2023, USP (797) Pharmaceutical Compounding guidelines were updated and endorsed by the American Academy of Allergy, Asthma & Immunology (AAAI). The Allergy Clinic completed a gap analysis to determine what process needed to change to comply with these latest guidelines.

Technology Decreases Treatment Decision Times, Angela Moscho

Nursing Posters

Patients who experience a stroke while hospitalized have a higher mortality rate than those who present to the emergency department. Our plan is to utilize technology to allow the stroke provider to evaluate the patient while in their hospital room, instead of waiting until the patient is in the CT scanner. Utilizing technology of an iPad for inpatient code strokes will allow for quicker assessment of the patient, resulting in faster treatment decision for this population.

Archives Of Neurosurgery Volume 1 Issue 1 - Full Issue

Archives of Neurosurgery

Archives of Neurosurgery Volume 1 Issue 1 - Full Issue

Misdiagnosis Between Coccygeal Dislocation Fracture And Lumbosacral Disc Herniation, Gilberto Gardea-Loera, Gilberto Gardea-Ramírez, Ylián Ramírez-Tapia

Archives of Neurosurgery

INTRODUCTION: Coccydynia is the condition of disabling pain in the coccyx that occurs when sitting or moving to a standing position. Due to a lack of knowledge by spine specialists, many patients suffer for years without adequate treatment. We highlight the relevance of diagnosing and treating coccygodynia correctly to avoid lumbosacral pathology overestimation. METHODS: We present a series of patients with painful coccygeal segment syndrome associated with different lumbar alterations who underwent coccygectomy from 1996 to 2021 in our spine clinic. We describe VAS and MacNab scores and complication rates. We used Student-T-Test for statistical analysis. RESULTS: We included 40 …

Extraforaminal Minimally Invasive Lumbar Conjoined Nerve Root Decompression And Segment Fusion: Surgical Technique, Case Report And Literature Review, Manuel Rodríguez García, José Antonio Soriano Sánchez, Sergio Soriano Solis, Oscar Sánchez Escandón, Iris Tatiana Montes González

Archives of Neurosurgery

INTRODUCTION

Associated or conjoined nerve roots are an embryological anomaly presented primarily as bifid nerve roots arising from the dura. They are susceptible to trauma with radicular symptoms and even neurological deterioration of patients presenting them, due to space they occupy and adhesions to adjacent structures. We report a case treat with a minimally invasive technique.

CASE REPORT

A 68-year-old woman with lumbar and radicular pain in the right lower limb, with findings of L4-L5 instability and L4-L5, L5-S1 degenerative disc changes on imaging studies with bilateral L5 and S1 radiculopathy predominantly on the right side on preoperatory neurophysiological studies. …

Dr. Mauro Loyo: Mexican Icon Of World Neurosurgery. Posthumous Tribute, Ramiro Del Valle

Archives of Neurosurgery

Dr. Mauro Loyo Varela was born on November 30th, 1941, in the city of Veracruz. Not only was he an extraordinary surgeon, but he was also an unforgettable teacher. He held several academic positions in and outside the country. He taught 83 Latin American and Caribbean neurosurgeons with patience and devotion, always willing to share his knowledge without reservation. A man of singular talent, his contributions to neurosurgery were outstanding. From 1977 to 1986, he was the Chief of Neurosurgery Services at the IMSS National Medical Center. Between 1982 and 1990, he contributed to the design of numerous instruments and …

Why The Neurosurgeon Should Apply The Concepts Of Neuroethics In Their Daily Clinical Practice, Miguel Antonio Sandoval Balanzario, Lizbeth Itzel Sandoval Olivares, Noe Santiago Ramírez, Noe Santiago Rea

Archives of Neurosurgery

The human being is a community and social being, thus, he was capable to establish rules and humanize he's environment, allowed by the development of he's intelligence, as well as moral behavior. Nevertheless, morals and ethics have also evolved along the history, allowing the birth of neuroethics in 2002 with the objective to study ethical behavior of neurological research procedures and study ethics from the neuroscientific point.

Metabolism Shapes Immune Responses To Staphylococcus Aureus., Prabhakar Arumugam, Tammy Kielian

Journal Articles: Pathology and Microbiology

BACKGROUND: Staphylococcus aureus (S. aureus) is a common cause of hospital- and community-acquired infections that can result in various clinical manifestations ranging from mild to severe disease. The bacterium utilizes different combinations of virulence factors and biofilm formation to establish a successful infection, and the emergence of methicillin- and vancomycin-resistant strains introduces additional challenges for infection management and treatment.

SUMMARY: Metabolic programming of immune cells regulates the balance of energy requirements for activation and dictates pro- versus anti-inflammatory function. Recent investigations into metabolic adaptations of leukocytes and S. aureus during infection indicate that metabolic crosstalk plays a crucial role in …

Elucidating Granulocytic Myeloid-Derived Suppressor Cell Heterogeneity During Staphylococcus Aureus Biofilm Infection, Blake P. Bertrand, Cortney E. Heim, Scott A. Koepsell, Tammy Kielian

Journal Articles: Pathology and Microbiology

Myeloid-derived suppressor cells (MDSCs) are pathologically activated immature myeloid cells with immunosuppressive activity that expand during chronic inflammation, such as cancer and prosthetic joint infection (PJI). Myeloid-derived suppressor cells can be broadly separated into 2 populations based on surface marker expression and function: monocytic myeloid-derived suppressor cells (M-MDSCs) and granulocytic myeloid-derived suppressor cells (G-MDSCs). Granulocytic myeloid-derived suppressor cells are the most abundant leukocyte infiltrate during PJI; however, how this population is maintained in vivo and cellular heterogeneity is currently unknown. In this study, we identified a previously unknown population of Ly6G+Ly6C+F4/80+MHCII+ MDSCs during PJI that displayed immunosuppressive properties ex vivo. …

C1q Is Elevated During Chronic Staphylococcus Epidermidis Central Nervous System Catheter Infection, Matthew K. Beaver, Lara Bergdolt, Anna Dunaevsky, Tammy Kielian, Gwenn Skar

Journal Articles: Pathology and Microbiology

INTRODUCTION: Significant neurologic morbidity is caused by pediatric cerebrospinal fluid (CSF) shunt infections. The underlying mechanisms leading to impaired school performance and increased risk of seizures are unknown, however, a better understanding of these mechanisms may allow us to temper their consequences. Recent evidence has demonstrated important roles for complement proteins in neurodevelopment and neuroinflammation.

METHODS: We examined complement activation throughout

RESULTS: We found that MASP2 predominated early in catheter infection, but that Factor B was elevated at intermediate time points. Unexpectedly C1q was elevated at late timepoints when bacterial burdens were low or undetectable. Based on these findings and …

Antimicrobial Activity Of Gallium(Iii) Compounds: Pathogen-Dependent Targeting Of Multiple Iron/Heme-Dependent Biological Processes, Seoung-Ryoung Choi, Mohammed A. Hassan, Bradley E. Britigan, Prabagaran Narayanasamy

Journal Articles: Pathology and Microbiology

Metals play vital roles in biological systems, with iron/heme being essential for cellular and metabolic functions necessary for survival and/or virulence in many bacterial pathogens. Given the rise of bacterial resistance to current antibiotics, there is an urgent need for the development of non-toxic and novel antibiotics that do not contribute to resistance to other antibiotics. Gallium, which mimics iron, has emerged as a promising antimicrobial agent, offering a novel approach to combat bacterial infections. Gallium does not have any known functions in biological systems. Gallium exerts its effects primarily by replacing iron in redox enzymes, effectively inhibiting bacterial growth …

Aconitate Decarboxylase 1 Mediates The Acute Airway Inflammatory Response To Environmental Exposures, Aaron Schwab, Amy J. Nelson, Angela Gleason, Oliver Schanze, Todd A. Wyatt, Dhananjay Shinde, Peng Xiao, Vinai Chittezham Thomas, Chittibabu Guda, Kristina L. Bailey, Tammy Kielian, Geoffrey M. Thiele, Jill A. Poole

Journal Articles: Pathology and Microbiology

Background: Environmental lipopolysaccharide (LPS) and microbial component-enriched organic dusts cause significant lung disease. These environmental exposures induce the recruitment and activation of distinct lung monocyte/macrophage subpopulations involved in disease pathogenesis. Aconitate decarboxylase 1 (Acod1) was one of the most upregulated genes following LPS (vs. saline)exposure of murine whole lungs with transcriptomic profiling of sorted lung monocyte/macrophage subpopulations also highlighting its significance. Given monocyte/macrophage activation can be tightly linked to metabolism, the objective of these studies was to determine the role of the immunometabolic regulator ACOD1 inenvironmentalexposure-induced lung inflammation.

Methods: Wild-type (WT) mice were intratracheally (i.t.) instilled with 10 …