Medical Specialties Commons^™

Socioeconomic Differences In Penicillin Allergy Label Rates Of Children Evaluated In Pediatric Emergency Departments And Urgent Cares, Zoya Siddiqui, Brian R. Lee, Amanda Nedved, Jennifer Mckinsey, Frances Turcotte Benedict, Brandi Missel, Aarti Pandya, Rana El Feghaly

Research Days

In this retrospective study of 183,692 patients ≤19 years evaluated in urgent cares and emergency departments of a large pediatric academic center July 2022- June 2023, we found that in addition to race, socioeconomic status reflected by insurance and area deprivation index had a large association with penicillin allergy labels.

Improving Nutritional Delivery To Pediatric Patients While Using Continuous Renal Replacement Therapy, Jennifer Ruiz-Boada, Sarah Brunner, Tara Benton, Vimal Chadha

Research Days

This quality improvement guide aims to enhance early nutritional delivery to pediatric patients with renal failure who require renal replacement therapy.ng renal replacement therapy.

Understanding Inpatient Diagnostic Imaging Use In Children’S Hospitals To Prioritize Stewardship Efforts, Megan E. Collins, Matt Hall, John Stephens, Jessica L. Markham

Research Days

We utilized the Pediatric Health Information System to perform a retrospective cohort study of hospitalized children across 45 hospitals to describe diagnostic imaging studies among hospitalized children with the highest prevalence, cost, rates of repetition, and hospital variation to help inform de-implementation efforts.

Electrical Stimulation Of The Medial Pin After Insertion Is Safe And Effective In Preventing Iatrogenic Ulnar Nerve Neuropraxias In Type Iii Supracondylar Fractures. A Case Series Of 128 Consecutive Patients., Lucas Georger B.A., Mckenna Noe B.S., Richard M. Schwend M.D.

Research Days

This case series explores the safety and efficacy of using a disposable nerve stimulator for intraoperative stimulation of both medial and lateral pins in Gartland type III supracondylar humerus fractures, revealing no instances of ulnar nerve stimulation response or postoperative iatrogenic ulnar nerve injury, thereby highlighting the potential for this cost-effective approach to ensure stable medial column pin fixation without ulnar nerve complications.

Safety And Efficacy Of Intraoperative Vectored Traction With Gardner-Wells (Gw) Tongs For Pediatric Spine Deformity Surgery - A Series Of 1000 Cases, Lucas Georger B.A., Krish Sardesai B.A., Andrew Dumas B.S., Mckenna Noe B.S., Richard M. Schwend M.D.

Research Days

Conducting an ongoing exploration, this study delves into the safety and efficacy of Gardner-Wells Tongs in pediatric spinal deformity surgery, involving a series of 418 cases, revealing a 5.5% complication rate primarily associated with facial swelling and abrasions, emphasizing the need for further investigation to validate the safety and effectiveness of this intervention.

Comprehensive Peripheral Blood Immunoprofiling Reveals Five Immunotypes With Immunotherapy Response Characteristics In Patients With Cancer, Daniiar Dyikanov, Aleksandr Zaitsev, Tatiana Vasileva, Iris Wang, Arseniy Sokolov, Evgenii Bolshakov, Alena Frank, Polina Turova, Olga Golubeva, Anna Gantseva, Anna Kamysheva, Polina Shpudeiko, Ilya Krauz, Mary Abdou, Madison Chasse, Tori Conroy, Nicholas Merriam, Julia Alesse, Noel English, Boris Shpak, Anna Shchetsova, Evgenii Tikhonov, Ivan Filatov, Anastasia Radko, Anastasiia Bolshakova, Anastasia Kachalova, Nika Lugovykh, Andrey Bulahov, Anastasiia Kilina, Syimyk Asanbekov, Irina Zheleznyak, Pavel Skoptsov, Evgenia Alekseeva, Jennifer Johnson, Joseph Curry, Alban Linnenbach, Andrew South, Enjun Yang, Kirill Morozov, Anastasiya Terenteva, Lira Nigmatullina, Dmitry Fastovetz, Anatoly Bobe, Linda Balabanian, Krystle Nomie, Sheila Yong, Christopher Davitt, Alexander Ryabykh, Olga Kudryashova, Cagdas Tazearslan, Alexander Bagaev, Nathan Fowler, Adam Luginbuhl, Ravshan Ataullakhanov, Michael Goldberg

Department of Otolaryngology - Head and Neck Surgery Faculty Papers

The lack of comprehensive diagnostics and consensus analytical models for evaluating the status of a patient's immune system has hindered a wider adoption of immunoprofiling for treatment monitoring and response prediction in cancer patients. To address this unmet need, we developed an immunoprofiling platform that uses multiparameter flow cytometry to characterize immune cell heterogeneity in the peripheral blood of healthy donors and patients with advanced cancers. Using unsupervised clustering, we identified five immunotypes with unique distributions of different cell types and gene expression profiles. An independent analysis of 17,800 open-source transcriptomes with the same approach corroborated these findings. Continuous immunotype-based …

Development Of An International Standard Set Of Outcomes And Measurement Methods For Routine Practice For Adults With Epilepsy: The International Consortium For Health Outcomes Measurement Consensus Recommendations, Martha Sajatovic

Faculty Scholarship

At present, there is no internationally accepted set of core outcomes or measurement methods for epilepsy clinical practice. Therefore, the International Consortium for Health Outcomes Measurement (ICHOM) convened an international working group of experts in epilepsy, people with epilepsy and their representatives to develop minimum sets of standardized outcomes and outcomes measurement methods for clinical practice that support patient–clinician decision-making and quality improvement. Consensus methods identified 20 core outcomes. Measurement tools were recommended based on their evidence of strong clinical measurement properties, feasibility, and cross-cultural applicability. The essential outcomes included many non-seizure outcomes: anxiety, depression, suicidality, memory and attention, sleep …

Mammographic Density Mediates The Protective Effect Of Early-Life Body Size On Breast Cancer Risk, Marina Vabistsevits, George Davey Smith, Tom G Richardson, Rebecca C Richmond, Weiva Sieh, Joseph H Rothstein, Laurel A Habel, Stacey E Alexeeff, Bethan Lloyd-Lewis, Eleanor Sanderson

Faculty, Staff and Student Publications

The unexplained protective effect of childhood adiposity on breast cancer risk may be mediated via mammographic density (MD). Here, we investigate a complex relationship between adiposity in childhood and adulthood, puberty onset, MD phenotypes (dense area (DA), non-dense area (NDA), percent density (PD)), and their effects on breast cancer. We use Mendelian randomization (MR) and multivariable MR to estimate the total and direct effects of adiposity and age at menarche on MD phenotypes. Childhood adiposity has a decreasing effect on DA, while adulthood adiposity increases NDA. Later menarche increases DA/PD, but when accounting for childhood adiposity, this effect is attenuated. …

High All-Cause Mortality And Increasing Proportion Of Older Adults With Tuberculosis In Texas, 2008–2020, Belinda A Medrano, Miryoung Lee, Gretchen Gemeinhardt, Lana Yamba, Blanca I Restrepo

Faculty, Staff and Student Publications

Pulmonary tuberculosis (PTB) elimination efforts must consider the global growth of the ageing population. Here we used TB surveillance data from Texas, United States (2008-2020; total n = 10656) to identify unique characteristics and outcomes in older adults (OA, ≥65 years) with PTB, compared to young adults (YA, 18-39 years) or middle-aged adults (40-64 years). We found that the proportion of OA with PTB increased from 15% in 2008 to 24% in 2020 (trend p < 0.05). Diabetes was highly prevalent in OA (32%) but not associated with adverse outcomes. Death was 13-fold higher in OA compared to YA and was 7% at the time of diagnosis which suggests diagnostic delays. However, once TB was suspected, we found no differences in culture, smear, or nucleic acid detection of mycobacteria (although less lung cavitations) in OA. During treatment, OA had less drug-resistant TB, few adverse reactions and adhered with TB treatment. We recommend training healthcare workers to 'think TB' in OA, for prompt treatment initiation to diminish deaths. Furthermore, OA should be added as a priority group to the latent TB treatment guidelines by the World Health Organization, to prevent TB disease in this highly vulnerable group.

The Crosstalk Between Macrophages And Cancer Cells Potentiates Pancreatic Cancer Cachexia, Mingyang Liu, Yu Ren, Zhijun Zhou, Jingxuan Yang, Xiuhui Shi, Yang Cai, Alex X Arreola, Wenyi Luo, Kar-Ming Fung, Chao Xu, Ryan D Nipp, Michael S Bronze, Lei Zheng, Yi-Ping Li, Courtney W Houchen, Yuqing Zhang, Min Li

Faculty, Staff and Student Publications

With limited treatment options, cachexia remains a major challenge for patients with cancer. Characterizing the interplay between tumor cells and the immune microenvironment may help identify potential therapeutic targets for cancer cachexia. Herein, we investigate the critical role of macrophages in potentiating pancreatic cancer induced muscle wasting via promoting TWEAK (TNF-like weak inducer of apoptosis) secretion from the tumor. Specifically, depletion of macrophages reverses muscle degradation induced by tumor cells. Macrophages induce non-autonomous secretion of TWEAK through CCL5/TRAF6/NF-κB pathway. TWEAK promotes muscle atrophy by activating MuRF1 initiated muscle remodeling. Notably, tumor cells recruit and reprogram macrophages via the CCL2/CCR2 axis …

Impact Of Renal Cell Carcinoma Molecular Subtypes On Immunotherapy And Targeted Therapy Outcomes, Renée Maria Saliby, Chris Labaki, Tejas R Jammihal, Wanling Xie, Maxine Sun, Valisha Shah, Eddy Saad, M Harry Kane, Soki Kashima, Katherine Sadak, Talal El Zarif, Deepak Poduval, Robert J Motzer, Thomas Powles, Brian I Rini, Laurence Albiges, Sumanta K Pal, Bradley A Mcgregor, Rana R Mckay, Sabina Signoretti, Eliezer M Van Allen, Sachet A Shukla, Toni K Choueiri, David A Braun

Faculty, Staff and Student Publications

Saliby et al. show that a machine learning approach can accurately classify clear cell renal cell carcinoma (RCC) into distinct molecular subtypes using transcriptomic data. When applied to tumors biospecimens from the JAVELIN Renal 101 (JR101) trial, a benefit is observed with immune checkpoint inhibitor (ICI)-based therapy across all molecular subtypes.

Parallel Use Of Low-Complexity Automated Nucleic Acid Amplification Tests On Respiratory Samples And Stool With Or Without Lateral Flow Lipoarabinomannan Assays To Detect Pulmonary Tuberculosis Disease In Children, Laura Olbrich, Alexander W Kay, Stephanie Bjerrum, Bada Yang, Johanna Åhsberg, Ruvandhi R Nathavitharana, Andreas Lundh, Maunank Shah, Devan Jaganath

Faculty, Staff and Students Publications

This is a protocol for a Cochrane Review (diagnostic). The objectives are as follows: To compare the diagnostic accuracy of the parallel use of low-complexity automated nucleic acid amplification tests on respiratory and stool specimens in children and lateral flow urine lipoarabinomannan amongst children with HIV versus each assay alone for detecting pulmonary tuberculosis. Secondary objectives To compare the diagnostic accuracy of low-complexity automated nucleic acid amplification tests on respiratory and stool specimens in combination versus each sample type alone. To investigate the following sources of heterogeneity: clinical setting, signs and symptoms of pulmonary tuberculosis disease, screening positivity by chest …

Parallel Use Of Low-Complexity Automated Nucleic Acid Amplification Tests And Lateral Flow Urine Lipoarabinomannan Assays To Detect Tuberculosis Disease In Adults And Adolescents Living With Hiv, Stephanie Bjerrum, Bada Yang, Johanna Åhsberg, Ruvandhi R Nathavitharana, Laura Olbrich, Devan Jaganath, Alexander W Kay, Andreas Lundh, Maunank Shah

Faculty, Staff and Students Publications

This is a protocol for a Cochrane Review (diagnostic). The objectives are as follows: To compare the diagnostic accuracy of parallel use of lateral flow urine lipoarabinomannan on urine and low-complexity automated nucleic acid amplification tests on respiratory samples versus each test alone for detection of tuberculosis disease in adults and adolescents living with HIV who present with presumptive tuberculosis. Secondary objectives To investigate the following sources of heterogeneity: clinical setting; signs and symptoms of tuberculosis; screening positivity for tuberculosis disease by chest x-ray, C-reactive protein elevation, and molecular World Health Organization-recommended rapid diagnostics; seriously ill; advanced HIV; and CD4 …

Unveiling The Nexus Of Cellular Quality Control: Exploring The Interplay Between Ribosome-Associated Protein Quality Control And Mitochondrial Quality Control Pathways, Foozhan Tahmasebinia

Biological Sciences Theses and Dissertations

In eukaryotic cells, the intricate interplay between cellular quality control mechanisms is crucial for maintaining homeostasis and safeguarding the integrity of vital processes, spanning from macromolecule synthesis to the renewal of entire cellular organelles.

Disruption of these networks can lead to severe diseases such as metabolic disorders, underscoring the interconnected nature and feedback control mechanisms inherent in biological systems, including cellular quality control systems. This interconnectedness extends to the intricate communication between organelles, enabling coordinated functioning and adaptation to changing cellular conditions, particularly in response to stressors.

While the exact mechanisms governing these communications within cellular quality control systems remain …

Vitamin C: Is It Relevant Or Obsolete In The Modern Era?, Suruchi Ramanujan, Kadakkal Radhakrishnan

Student Scholarship

Purpose: In this review, we discuss the historic background of vitamin C, vitamin C’s physiology, its dietary sources, and how deficiency can manifest. We also discuss modern studies investigating the role of Vitamin C in immunity, in cardiovascular disease, and in chronic conditions. Summary: In the body, vitamin C acts as an essential cofactor in several enzymatic reactions including, but not limited to, neurotransmitter synthesis, hormone amidation, collagen synthesis, hypoxic transcription factor modification, and epigenetic modifications. Scurvy, caused by severe vitamin C deficiency, is an infamous disease recorded in historical documents, with patients presenting with joint ache, bleeding gums, depression, …

Parental Factors Associated With Covid-19 Vaccine Uptake For Children Over 5 Years Of Age In Texas, Paula M Cuccaro, Jihye Choi, Yordanos M Tiruneh, Journey Martinez, Jing Xie, Michelle Crum, Mark Owens, Jose-Miguel Yamal

Faculty, Staff and Student Publications

The COVID-19 vaccine is safe and effective for children, yet parental hesitancy towards vaccinating children against the virus persists. We conducted a telephone-administered weighted survey in Texas to examine parents' sociodemographic factors and medical conditions associated with COVID-19 vaccination intention for parents with unvaccinated children ages 5-17 years. We collected responses from 19,502 participants, of which 4879 were parents of children ages 5-17 years. We conducted multiple logistic regression with Lasso-selected variables to identify factors associated with children's vaccination status and parents' intention to vaccinate their children. From the unweighted sample, less than half of the parents (46.8%) had at …

Surgical Approach To Urethral Diverticulum And Urethrovaginal Fistula With Mesh Erosion, Alicia Smith, Lauren Burton, Saifuddin Mama

Einstein Health Papers

INTRODUCTION AND HYPOTHESIS: This video illustrates a rare surgical case involving a urethral diverticulum, urethrovaginal fistula, and mesh erosion.

METHODS: We present a 58-year-old patient attending a tertiary care center with a suspected urethrovaginal fistula. Her concerns included stress urinary incontinence (SUI), recurrent urinary tract infection, and vaginal pain. The surgical history was notable for the placement of two different mesh slings during the same procedure to treat SUI. Preoperative evaluation and findings are illustrated in detail. The video uses a high-definition surgical camera to emphasize the initial intraoperative evaluation with localization of the fistula and diverticulum. We then demonstrate …

Regulation Of Cerebral Blood Flow Boosts Precise Brain Targeting Of Vinpocetine-Derived Ionizable-Lipidoid Nanoparticles, Xufei Bian, Ling Yang, Dingxi Jiang, Adam J Grippin, Yifan Ma, Shuang Wu, Linchong Wu, Xiaoyou Wang, Zhongjie Tang, Kaicheng Tang, Weidong Pan, Shiyan Dong, Betty Y S Kim, Wen Jiang, Zhaogang Yang, Chong Li

Faculty, Staff and Student Publications

Despite advances in active drug targeting for blood-brain barrier penetration, two key challenges persist: first, attachment of a targeting ligand to the drug or drug carrier does not enhance its brain biodistribution; and second, many brain diseases are intricately linked to microcirculation disorders that significantly impede drug accumulation within brain lesions even after they cross the barrier. Inspired by the neuroprotective properties of vinpocetine, which regulates cerebral blood flow, we propose a molecular library design centered on this class of cyclic tertiary amine compounds and develop a self-enhanced brain-targeted nucleic acid delivery system. Our findings reveal that: (i) vinpocetine-derived ionizable-lipidoid …

Dataset Of Weekly Intra-Treatment Diffusion Weighted Imaging In Head And Neck Cancer Patients Treated With Mr-Linac, Dina M El-Habashy, Kareem A Wahid, Renjie He, Brigid Mcdonald, Samuel J Mulder, Yao Ding, Travis Salzillo, Stephen Y Lai, John Christodouleas, Alex Dresner, Jihong Wang, Mohamed A Naser, Clifton D Fuller, Abdallah Sherif Radwan Mohamed, Joint Head And Neck Radiation Therapy-Mri Development Cooperative

Faculty, Staff and Student Publications

Radiation therapy (RT) is a crucial treatment for head and neck squamous cell carcinoma (HNSCC); however, it can have adverse effects on patients' long-term function and quality of life. Biomarkers that can predict tumor response to RT are being explored to personalize treatment and improve outcomes. While tissue and blood biomarkers have limitations, imaging biomarkers derived from magnetic resonance imaging (MRI) offer detailed information. The integration of MRI and a linear accelerator in the MR-Linac system allows for MR-guided radiation therapy (MRgRT), offering precise visualization and treatment delivery. This data descriptor offers a valuable repository for weekly intra-treatment diffusion-weighted imaging …

Inotuzumab Ozogamicin For The Treatment Of Adult Acute Lymphoblastic Leukemia: Past Progress, Current Research And Future Directions, Nicholas J Short, Elias Jabbour, Nitin Jain, Hagop Kantarjian

Faculty, Staff and Student Publications

Inotuzumab ozogamicin (INO) is an anti-CD22 antibody-drug conjugate that was first evaluated in B-cell lymphomas but was subsequently shown to be highly effective in acute lymphoblastic leukemia (ALL). INO improved response rates and survival in a randomized study in adults with relapsed/refractory B-cell ALL, leading to its regulatory approval in the United States in 2017. While the formal approval for INO is as monotherapy in relapsed/refractory ALL, subsequent studies with INO administered in combination with chemotherapy and/or blinatumomab both in the frontline and salvage settings have yielded promising results. In this review, we discuss the clinical development of INO in …

An Analysis Of Professional Education For Future Physicians To Address Implicit Racial Bias In Black Maternal Health, Jasmine Butler

Honors Theses

The history of medicine in the United States is littered with incidences of racism and exploitation of Black Americans. The extensive history of medical racism has continued to be perpetuated in healthcare today. Within the field of maternal health, the dark history of medicine shows its face with the treatment of black mothers. Black maternal health is a current public health crisis currently being exacerbated through discrimination in the form of implicit bias. Implicit bias is a current issue in our healthcare system that needs to be addressed through adequate training of both medical students and physicians. This qualitative research …

The Greenbeard Gene Tgrb1 Regulates Altruism And Cheating In Dictyostelium Discoideum, Mariko Katoh-Kurasawa, Peter Lehmann, Gad Shaulsky

Faculty, Staff and Students Publications

Greenbeard genetic elements encode rare perceptible signals, signal recognition ability, and altruism towards others that display the same signal. Putative greenbeards have been described in various organisms but direct evidence for all the properties in one system is scarce. The tgrB1-tgrC1 allorecognition system of Dictyostelium discoideum encodes two polymorphic membrane proteins which protect cells from chimerism-associated perils. During development, TgrC1 functions as a ligand-signal and TgrB1 as its receptor, but evidence for altruism has been indirect. Here, we show that mixing wild-type and activated tgrB1 cells increases wild-type spore production and relegates the mutants to the altruistic stalk, whereas mixing …

Long Acting Reversible Contraceptive Removal After Immediate Postpartum Insertion, Andrea Dousdebes Md

Dept. of Obstetrics & Gynecology Resident Research Day

No abstract provided.

Postoperative Telemedicine Use: Safety And Satisfaction After Benign Gynecologic Surgery, Chloe Smith Md

Dept. of Obstetrics & Gynecology Resident Research Day

No abstract provided.

Use Of Clomiphene Citrate As An Inhibitor Of Ovulation In An Oocyte Cryopreservation Cycle, Shelby Howard Md

Dept. of Obstetrics & Gynecology Resident Research Day

No abstract provided.

Genetic Testing After Abnormal Prenatal Ultrasound, Eleanor Germano Md

Dept. of Obstetrics & Gynecology Resident Research Day

No abstract provided.

Effect Of Residential Geographic Location On Adverse Pregnancy Outcomes In South-Central Louisiana, Aaliyah Keels Md

Dept. of Obstetrics & Gynecology Resident Research Day

No abstract provided.

Trends In Postpartum Birth Control Uptake Following Dobbs Decision, Deanna Dawson Md

Dept. of Obstetrics & Gynecology Resident Research Day

No abstract provided.

Agenda (Pdf), Department Of Obstetrics & Gynecology

Dept. of Obstetrics & Gynecology Resident Research Day

Agenda for the 36th Annual Dept. of Obstetrics & Gynecology Residents Research Day held Friday, May 10, 2024.

In Football Players With Scaphoid Fractures, How Does Surgical Intervention Compare To A Conservative Intervention For The Outcomes Of Repair? A Critically Appraised Topic, Kaitlin Brun, Meggan Bartok, Caitlin Craig, Ally Smith

Journal of Sports Medicine and Allied Health Sciences: Official Journal of the Ohio Athletic Trainers Association

CLINICAL SCENARIO

Scaphoid injuries are common in high impact or high collision sports with 11% of all hand injuries and 60%-70% of all carpal injuries being attributed to the scaphoid bone. Athletes at the highest risk include males ages 20-24 years of age and those who participate in football, basketball, or ice hockey. Fracture of the scaphoid are often misdiagnosed which increase the chance of a nonunion fracture. Currently most scaphoid fractures are treated either conservatively or with surgical interventions. The increasing knowledge of this injury leads us to question the best treatment options for future football athletes.