Medical Specialties Commons^™

Solid Pseudopapillary Epithelial Neoplasm Of The Pancreas: A Case Report, Indu B. Dubey, Sajal Gupta, Shivani Paruthy, Vimal Bhandari

Journal of Medicine in Scientific Research

Solid pseudopapillary epithelial neoplasm (SPEN) of the pancreas is a rare neoplasm of the pancreas accounting for only 0.17–2.7% of all pancreatic neoplasms, often detected initially on imaging. Despite advances in imaging, pseudocysts and other cystic neoplasms feature in the differential diagnosis. We report a case of solid pseudopapillary epithelial neoplasm in a young female who presented with a progressively increasing abdominal lump in whom the diagnosis was considered based on imaging studies. She underwent exploratory laparotomy, pancreaticoduodenectomy, pancreaticojejunostomy, hepaticojejunostomy, gastrojejunostomy, and made an uneventful recovery in the postoperative period. Histopathological examination and immunohistochemistry confirmed the diagnosis. This case highlights …

Effect Of Subliminal Diode-Laser Application In Management Of Central Serous Chorioretinopathy, Mohammed S. Ahmed, Rasha Gamal-El-Din Abu-El-Goud

Journal of Medicine in Scientific Research

Background Due to the possibility of spontaneous remission, invasive treatment in central serous chorioretinopathy (CSCR) is not to be commenced sooner than 3 months after onset of the disease. The aim of this work is to evaluate the effectiveness of subliminal diode-laser (SLDL) therapy for CSCR conducted 3–6 months after diagnosis. Aim The aim of the work is to study the effectiveness of using transfoveal subliminal diode-laser application in treatment of CSCR. Patients and methods The study included CSCR cases that last up to 1–3 months after acute onset of disease. All patients had transfoveal SLDL application and these patients …

Study Of Drug Utilization Pattern In The Gynecology Outpatient Department Of A Rural Tertiary Care Teaching Hospital Of Maharashtra, Bahekar S. Eknath, Lakde P. Suresh, More P. Daulat

Journal of Medicine in Scientific Research

Context Drug utilization studies help medical practitioners and health policy makers to decide an individualized specific drug pattern for a particular disease or disease group. Aims This study was planned to study drug utilization patterns among patients visiting the Gynecology Outpatient Department (OPD) of a rural tertiary care teaching hospital. Settings and design This was a prospective, descriptive, cross-sectional, observational study conducted over 2 months in the gynecology Outpatient Department of a rural tertiary care teaching hospital in Maharashtra state. Patients and methods A total of 200 prescriptions of patients were studied. Various prescribing indicators by WHO were used for …

Clinical Profile And Outcomes Of Children With Covid-19: A Single-Center Prospective Study, Alok Raina, Pooja Bharti, Preeti Sharma, Sonam Chalotra

Journal of Medicine in Scientific Research

Objective The aim was to study the epidemiology, clinical profile, and outcomes of children with coronavirus disease-2019 (COVID-19) admitted in our hospital. Methods This prospective study was conducted at the tertiary care dedicated hospital of COVID-19 in North India between April 1, 2021 and June 30, 2021. A total of 36 children less than or equal to 18 years of age who tested positive for SARS-CoV-2 by RT-PCR from nasopharyngeal swab were enrolled. The details pertaining to age, sex, clinical symptoms, severity of the disease, radiography abnormalities, and laboratory investigations were recorded. The outcomes were mortality, discharged patients, and complications. …

A Study To Assess Dietary Pattern Among School-Going Adolescents Of Central India, Daneshwar Singh, Mahesh Gupta, Preeti Gupta, Shruti Gupta, Soumitra Sethia

Journal of Medicine in Scientific Research

Background In India, adolescents constitute 21.4% that is one-fifth of the total population and world adolescents' (10–19 years) population is more than 1.2 billion. The trend of consumption of fast food increases worldwide, and in India, fast food production and consumption is very high. The popularity of these food is because of easy preparation and more convenient to finish the meal in less time. Great taste, attractive packaging, and advertisement play a very important role in promotion of such food adolescents. Adolescents also develop the various problems related to health because of less nutritious diet, such as Chinese food, junk …

Efficacy Of Bilateral Erector Spinae Block For Postoperative Pain Control In Patients Of Lumbar Spine Fusion Surgery, Amr A. Soliman, Sameh Mahmoud Saleh

Journal of Medicine in Scientific Research

Background Controlling postoperative pain after posterior lumbar spine surgeries is necessary to achieve patient satisfaction and good outcome after successful surgical intervention. Preoperative erector spinae block (ESB) technique is considered a recently evolved tool to achieve these goals. Purpose The aim of this study was to evaluate the efficacy of the bilateral ESB technique in pain management after lumbar spinal fusion surgery for degenerative spine diseases. Patients and methods Patients who underwent lumbar spinal fusion surgery for degenerative pathologies in 2019and 2020 were enrolled in the study. The patients were assessed according to pain score experienced postoperatively at different times …

A Comparative Study Between Mini Versus Full Sternotomy Aortic Valve Replacement, Ahmed S. Ali, Khaled N. Leon, Reham M.S Eldin Ahmed

Journal of Medicine in Scientific Research

Background Aortic valve replacement for treatment of aortic valve diseases is quite common. Minimally invasive procedures have gained a lot of popularity in recent years with the claimed better early postoperative outcomes in comparison with conventional techniques. Objective The aim was to compare early postoperative outcomes after ministernotomy versus conventional median sternotomy aortic valve replacement. Patients and methods The authors prospectively studied 60 patients who underwent aortic valve replacement surgery at the National Heart Institute between the period of May 2020 and July 2021. A total of 30 patients had aortic valve replacement via upper ministernotomy approach, whereas the other …

Neurological And Musculoskeletal Manifestations Of Coronavirus Disease 2019: A Retrospective Study, Abeer H. Ismaiel, Wael M. El-Din Eldarandaly

Journal of Medicine in Scientific Research

Objective To study neurological and musculoskeletal (MSK) manifestations in coronavirus disease 2019 (COVID-19) patients with comorbidities compared with those without and study their association with COVID-19 disease severity. Materials and methods This is an observational, retrospective study. The data were collected from the first of January 2021 till the March 30, 2021, from electronic medical records in the ward and ICU of Mataria Teaching Hospital, and included 277 hospitalized COVID patients with examination and investigations confirming diagnosis of COVID-19 patients according to WHO interim guidance. The patients were presented with neurological and MSK manifestations. Neurological manifestations had presented in three …

Transradial-Transfistula Access For Cardiac Catheterization In Patients With Abandoned Hemodialysis Fistulas, Noah Q. Haroian, Michael P. Savage, David L. Fischman

Department of Medicine Faculty Papers

Guidelines consider radial access a relative contraindication in patients with end-stage renal disease as part of a vessel preservation strategy. Radial access distal to a hemodialysis fistula, what we term transradial-transfistula access, offers a solution to radially access this population without affecting their vessel preservation plan. (Level of Difficulty: Advanced.)

Practical Mouse Model To Investigate Therapeutics For Staphylococcus Aureus Contaminated Surgical Mesh Implants, Madison M. Collins, Brent Race, Ronald J. Messer, Chase Baune, Scott D. Kobayashi, Dan Long, Katie Williams, Aaron M. Hasenkrug, Kim Hasenkrug, Natalia Malachowa

School of Medicine Faculty Publications

Introduction: The use of prosthetic mesh in hernia repair provides a powerful tool to increase repair longevity, decrease recurrence rates, and facilitate complex abdominal wall reconstruction. Overall infection rates with mesh are low, but for those affected there is high morbidity and economic cost. The availability of a practicable small animal model would be advantageous for the preclinical testing of prophylactics, therapeutics, and new biomaterials. To this end, we have developed a novel mouse model for implantation of methicillin-resistant Staphylococcus aureus–infected surgical mesh and provide results from antibiotic and immunotherapeutic testing. Materials and Methods: Implantation of surgical mesh between fascial …

Tonsillectomy In Children With 22q11.2 Deletion Syndrome., Jill M. Arganbright, Paul Bryan Hankey, Meghan Tracy, Srivats Narayanan, Janelle R. Noel-Macdonnell Phd, David G. Ingram Md

Manuscripts, Articles, Book Chapters and Other Papers

Tonsillectomy is one of the most common procedures performed in children, however there are currently no published studies evaluating tonsillectomy in children with 22q11.2 deletion syndrome (22q11DS). With this study, our goal was to investigate the indications, efficacy, and complications of tonsillectomy in a pediatric cohort of patients with 22q11DS. This is a retrospective chart review of patients in our 22q Center's repository. Inclusion criteria were a diagnosis of 22q11DS and a history of tonsillectomy or adenotonsillectomy. Data collected included: indications for tonsillectomy, preoperative and postoperative polysomnography (PSG) results, and surgical complications. In total, 33 patients were included. Most common …

Effects Of Substance Use Disorder On Oxidative And Antioxidative Stress Markers: A Systematic Review And Meta-Analysis, Thiago Wendt Viola, Rodrigo Orso, Luisa Fossati Florian, Miguel Gomes Garcia, Marco Giovanni Signor Gomes, Eduarda Mascarenhas Mardini, João Paulo Ottolia Niederauer, Aline Zaparte, Rodrigo Grassi-Oliveira

School of Medicine Faculty Publications

Recently, it has been suggested that central and peripheral toxicities identified in persons with substance use disorder (SUD) could be partially associated with an imbalance in reactive oxygen species and antioxidant defenses. We conducted a systematic review and meta-analysis to investigate whether SUD is associated with oxidative stress and to identify biomarkers possibly more affected by this condition. We have included studies that analysed oxidant and antioxidant markers in individuals with SUD caused by stimulants, alcohol, nicotine, opioids, and others (cannabis, inhalants, and polysubstance use). Our analysis showed that persons with SUD show higher oxidant markers and lower antioxidant markers …

Qualitative Analysis Of A Twitter-Disseminated Survey Reveals New Patient Perspectives On The Impact Of Urinary Tract Infection, Kiara Olmeda, Barbara Trautner, Sheryl Justice, Christina Ching, Larissa Grigoryan

Faculty, Staff and Students Publications

Few studies have harnessed social media to explore patients’ experiences with urinary tract infection (UTI); therefore, we captured UTI experiences and future research suggestions through a Twitter-disseminated survey. The survey posed three qualitative questions inquiring about the impact of UTIs, greatest UTI management hurdle, and research suggestions. We also asked participants to rate how seriously others perceive UTIs and the importance of UTIs in their life (scale: 1–100 (highest)). The study period spanned from January to June 2021. Coding was performed in duplicate, followed by thematic analysis. Of 466 participants from 22 countries, 128 considered their UTIs recurrent (n …

Temporal Regulation Of Notch Activation Improves Arteriovenous Fistula Maturation, Ying Qing, Luan Truong, Quan Ma, Yun Wang, Jizhong Cheng

Faculty, Staff and Students Publications

Background: Arteriovenous fistula (AVF) maturation is a process involving remodeling of venous arm of the AVFs. It is a challenge to balance adaptive AVF remodeling and neointima formation. In this study we temporally controlled Notch activation to promote AVF maturation while avoiding neointima formation.

Methods: Temporal Notch activation was controlled by regulating the expression of Notch transcription factor, RBP-Jκ, or dnMAML1 (dominant negative MAML2) in vascular smooth muscle cells (VSMCs). AVF mouse model was created and VSMC phenotype dynamic changes during AVF remodeling were determined.

Results: Activated Notch was found in the nuclei of neointimal VSMCs in AVFs from uremic …

Epigenetic Regulation In Chromium-, Nickel- And Cadmium-Induced Carcinogenesis, Lei Zhao, Ranakul Islam, Yifang Wang, Xiujuan Zhang, Ling-Zhi Liu

Department of Medical Oncology Faculty Papers

Environmental and occupational exposure to heavy metals, such as hexavalent chromium, nickel, and cadmium, are major health concerns worldwide. Some heavy metals are well-documented human carcinogens. Multiple mechanisms, including DNA damage, dysregulated gene expression, and aberrant cancer-related signaling, have been shown to contribute to metal-induced carcinogenesis. However, the molecular mechanisms accounting for heavy metal-induced carcinogenesis and angiogenesis are still not fully understood. In recent years, an increasing number of studies have indicated that in addition to genotoxicity and genetic mutations, epigenetic mechanisms play critical roles in metal-induced cancers. Epigenetics refers to the reversible modification of genomes without changing DNA sequences; …

Spatially Aware Dimension Reduction For Spatial Transcriptomics, Lulu Shang, Xiang Zhou

Faculty, Staff and Student Publications

Spatial transcriptomics are a collection of genomic technologies that have enabled transcriptomic profiling on tissues with spatial localization information. Analyzing spatial transcriptomic data is computationally challenging, as the data collected from various spatial transcriptomic technologies are often noisy and display substantial spatial correlation across tissue locations. Here, we develop a spatially-aware dimension reduction method, SpatialPCA, that can extract a low dimensional representation of the spatial transcriptomics data with biological signal and preserved spatial correlation structure, thus unlocking many existing computational tools previously developed in single-cell RNAseq studies for tailored analysis of spatial transcriptomics. We illustrate the benefits of SpatialPCA for …

Acafinder: Genome Mining For Anti-Crispr-Associated Genes, Bowen Yang, Jinfang Zheng, Yanbin Yin

Food for Health: Publications

Anti-CRISPR (Acr) proteins are encoded by (pro)viruses to inhibit their host’s CRISPR-Cas systems. Genes encoding Acr and Aca (Acr associated) proteins often colocalize to form acr-aca operons. Here, we present AcaFinder as the first Aca genome mining tool. AcaFinder can (i) predict Acas and their associated acr-aca operons using guilt-by-association (GBA); (ii) identify homologs of known Acas using an HMM (Hidden Markov model) database; (iii) take input genomes for potential prophages, CRISPR-Cas systems, and self-targeting spacers (STSs); and (iv) provide a standalone program (https://github.com/boweny920/AcaFinder) and a web server (http://aca .unl.edu/Aca). AcaFinder was applied to mining over …

Covid-19 Newsletter (Vol. 146), Center For Disaster Medicine, New York Medical College

COVID-19 Newsletter

No abstract provided.

Strategies For Expanding Iohexol Supply During A Shortage, Anupam Sinha, Theodore Conliffe

Rothman Institute Papers

No abstract provided.

Effect Of Pharmacist Intervention On Emergency Department Geriatric Patients With Polypharmacy, Rachael Sheehan, Ashley Stajkowski, Lee Hraby, Melanie Mommaerts, Tyler Nichols, Marisa Nichols, Alex Beuning, Victor Warne

Journal of Geriatric Emergency Medicine

Background: Polypharmacy is common within the geriatric population due to the commonality of multiple comorbidities and use of multiple providers. The emergency department (ED) is a prime location to capture these patients, especially when they present with chief complaints which may be medication related. Much of this population is prescribed potentially inappropriate medications which increases their risk for adverse drug reactions. Pharmacist review of patient home medication lists has been shown to decrease the number of potentially inappropriate medications, as well as medication-related problems, such as therapeutic duplications and drug interactions. These reductions can increase patient safety.

Objective: The goal …

Using A Human-Centered, Mixed Methods Approach To Understand The Patient Waiting Experience And Its Impact On Medically Underserved Populations, Elizabeth N. Liao, Lara Z. Chehab, Kathryn Neville, Jennifer Liao, Devika Patel, Amanda Sammann

Department of Emergency Medicine Faculty Papers

Purpose: To use a mixed methods approach to investigate the patient waiting experience for a medically underserved population at an outpatient surgical clinic.

Methods: We used lean methodology to perform 96 time-tracked observations of the patient journey in clinic, documenting the duration of activities from arrival to departure. We also used human-centered design (HCD) to perform and analyze 43 semi-structured interviews to understand patients’ unmet needs.

Results: Patients spent an average of 68.5% of their total clinic visit waiting to be seen. While the average visit was 95.8minutes, over a quarter of visits (27%) were over 2hours. Patients waited an …

Emergency Medicine Clinician Experiences Addressing Uncertainty In First-Trimester Bleeding., Garrison Nord, Amanda Doty, Andrew J Monick, Danielle M Mccarthy, Robin J Casten, Amer Z Aldeen, Philip S Nawrocki, Kristin L. Rising

Department of Emergency Medicine Faculty Papers

The purpose of this work is to understand Emergency Department (ED) clinicians' experiences in communicating uncertainty about first-trimester bleeding (FTB) and their need for training on this topic. This cross-sectional study surveyed a national sample of attending physicians and advanced practice providers (APPs). The survey included quantitative and qualitative questions about communicating with patients presenting with FTB. These questions assessed clinicians' frequency encountering challenges, comfort, training, prior experience, and interest in training on the topic. Of 402 respondents, 54% reported that they encountered challenges at least sometimes when discussing FTB with patients where the pregnancy outcome is uncertain. While the …

Oleuropein Suppresses Endometriosis Progression And Improves The Fertility Of Mice With Endometriosis, Mi Jin Park, Xiaoming Guan, William E Gibbons, Bert W O'Malley, Sang Jun Han

Faculty, Staff and Students Publications

BACKGROUND: Endometriosis is an estrogen-dependent inflammatory reproductive disease. Therefore, systematic estrogen depletion and anti-inflammatory drugs are the current treatment for endometriosis. However, current endometriosis treatments have low efficacy and cause adverse effects in endometriosis patients. Consequently, alternative endometriosis treatments targeting endometriosis-specific factors are in demand. In this context, ERβ was selected as a druggable target for endometriosis due to its critical role in progression. Therefore, selective targeting of ERβ without inhibiting ERα activity would be a new paradigm for endometriosis treatment to overcome the low efficacy and adverse effects of hormonal endometriosis therapy.

METHODS: Cell-based ERβ and ERα activity assay …

Pathogenicity And Impact Of Hla Class I Alleles In Aplastic Anemia Patients Of Different Ethnicities, Timothy S Olson, Benjamin F Frost, Jamie L Duke, Marian Dribus, Hongbo M Xie, Zachary D Prudowsky, Elissa Furutani, Jonas Gudera, Yash B Shah, Deborah Ferriola, Amalia Dinou, Ioanna Pagkrati, Soyoung Kim, Yixi Xu, Meilun He, Shannon Zheng, Sally Nijim, Ping Lin, Chong Xu, Taizo A Nakano, Joseph H Oved, Beatriz M Carreno, Yung-Tsi Bolon, Shahinaz M Gadalla, Steven Ge Marsh, Sophie Paczesny, Stephanie J Lee, Dimitrios S Monos, Akiko Shimamura, Alison A Bertuch, Loren Gragert, Stephen R Spellman, Daria V Babushok

Department of Medicine Faculty Papers

Acquired aplastic anemia (AA) is caused by autoreactive T cell-mediated destruction of early hematopoietic cells. Somatic loss of human leukocyte antigen (HLA) class I alleles was identified as a mechanism of immune escape in surviving hematopoietic cells of some patients with AA. However, pathogenicity, structural characteristics, and clinical impact of specific HLA alleles in AA remain poorly understood. Here, we evaluated somatic HLA loss in 505 patients with AA from 2 multi-institutional cohorts. Using a combination of HLA mutation frequencies, peptide-binding structures, and association with AA in an independent cohort of 6,323 patients from the National Marrow Donor Program, we …

Association Between Sacubitril/Valsartan Initiation And Mitral Regurgitation Severity In Heart Failure With Reduced Ejection Fraction: The Prove-Hf Study, James L Januzzi, Alaa Mabrouk Salem Omar, Yuxi Liu, Sean Murphy, Javed Butler, G Michael Felker, Iliana L Piña, Jonathan Ward, Scott Solomon, Johanna Contreras

Division of Cardiology Faculty Papers

No abstract provided.

Predicting Left Ventricular Assist Device Outcomes Utilizing The Stanford Integrated Psychosocial Assessment For Transplant Measure, Nicholas Chesher, Kristina L. Greenwood, Candace Fanale, Cody Gustaveson, Brian Jaski, Hirsch S. Mehta, Peter Hoagland, Kristine Ortiz, Marc Verlasky, Robert Adamson, Walter Dembitsky

The VAD Journal

Objective: Durable mechanical circulatory support is a proven therapy to extend survival for patients with end-stage heart failure (HF). The International Society for Heart and Lung Transplantation guidelines recommend a detailed psychosocial assessment when selecting candidates for durable mechanical circulatory support. Currently, there are no formally validated psychosocial evaluation tools for left ventricular assist device (LVAD) candidacy. The Stanford Integrated Psychosocial Assessment for Transplantation (SIPAT) uses a multidisciplinary algorithm to evaluate the impact of pre-transplant risk factors on post-transplant outcomes. Emerging literature suggests that the SIPAT might be useful for assessing psychosocial risk factors for LVAD outcomes.

Methods: A total …

Triple Blockade Of Ido-1, Pd-L1 And Mek As A Potential Therapeutic Strategy In Nsclc, Carminia Maria Della Corte, Vincenza Ciaramella, Kavya Ramkumar, Giovanni Vicidomini, Alfonso Fiorelli, Salvatore Cappabianca, Federica Zito Marino, Gaetano Di Guida, Qi Wang, Robert Cardnell, Carl Michael Gay, Davide Ciardiello, Erika Martinelli, Teresa Troiani, Giulia Martini, Stefania Napolitano, Jing Wang, Lauren Averett Byers, Fortunato Ciardiello, Floriana Morgillo

Faculty, Staff and Student Publications

BACKGROUND: Despite the recent progress in the treatment and outcome of Non Small Cell Lung Cancer (NSCLC), immunotherapy has still significant limitations reporting a significant proportion of patients not benefiting from therapy, even in patients with high PD-L1 expression. We have previously demonstrated that the combined inhibition of MEK and PD-L1 in NSCLC patients derived three dimensional cultures exerted significant synergistic effect in terms of immune-dependent cancer cell death. However, subsequent experiments analyzing the expression of Indoleamine 2,3-dioxygenase-1 (Ido-1) gene expression demonstrated that Ido-1 resulted unaffected by the MEK inhibition and even increased after the combined inhibition of MEK and …

Low Rates Of Structured Advance Care Planning Documentation In Electronic Health Records: Results Of A Single-Center Observational Study, Adela Wu, Robert J Huang, Gabriela Ruiz Colón, Chris Zembrzuski, Chirag B Patel

Faculty, Staff and Student Publications

BACKGROUND: Proper advance care planning (ACP) documentation both improves patient care and is increasingly seen as a marker of high quality by governmental payers. The transition of most medical documentation to electronic health records (EHR) allows for ACP documents to be rapidly disseminated across diverse ambulatory practice settings. At the same time, the complexity and heterogeneity of the EHR, as well as the multiple potential storage locations for documentation, may lead to confusion and inaccessibility. There has been movement to promote structured ACP (S-ACP) documentation within the EHR.

METHODS: We performed a retrospective cohort study at a single, large university …

Clinical Impact Of Number Of Lymph Nodes Dissected On Postoperative Survival In Node-Negative Small Cell Lung Cancer, Shinkichi Takamori, Takefumi Komiya Md, Emily Powell Phd

PCI Publications and Projects

Objectives: Small cell lung cancer (SCLC) is a lethal histologic subtype of lung cancer. Although the Commission on Cancer recommends pathological examination of at least 10 lymph nodes dissected (LNDs) for resected early-stage non-small cell lung cancer, its survival benefit of LNDs in patients with early-stage SCLC is unknown.

Methods: The National Cancer Database was queried for SCLC patients with clinical stage I-II and clinical N0, NX disease per AJCC 7th edition who had undergone lobectomy between 2004 and 2017. Overall survival of SCLC patients by the number of LNDs was compared using Log-rank tests. Univariate and multivariable Cox proportional …

Mechanisms Of Recovery: Community Perceptions Of Change And Growth Following Multiple Disasters, Howard Osofsky, Joy Osofsky, Leia Y. Saltzman, Estilla Lightfoot, Jule De King, Tonya C. Hansel

School of Medicine Faculty Publications

Introduction and purpose: The geographic location of the Gulf South leaves communities in continuous threat, response, and recovery disaster cycles. Hurricane Katrina in 2005 provided an opportunity to study disaster mental health. Less than 5 years after the storm, many Hurricane Katrina survivors were impacted again by the Deepwater Horizon Gulf oil spill. Despite adversities impacting Gulf communities, over 90% of participants reported they were resilient. The purpose of this study was to improve the understanding of the mechanisms that contribute to strengths following adversity in communities affected by repeated disasters. Specifically, we focused on survivor perceptions of personal, spiritual, …