Internal Medicine Commons^™

Neonatal Abstinence Syndrome: An Update On The Cost And Length Of Stay Associated With Treatment During The Hospital Stay, Kimberly Stanfield, Kylie Day, Sarah M. Clemente, Alberto Coustasse

Management Faculty Research

Neonatal Abstinence Syndrome (NAS) has been costly for the healthcare system; every 19 minutes, a newborn was diagnosed in 2021. Medically Assisted Treatment (MAT)) for expecting mothers has been shown to decrease costs and length of stay for newborns NAS. This study utilized a literature review and a semi-structured interview. The research showed that medically assisted treatment with methadone or buprenorphine during pregnancy decreased costs, LOS, and severity of symptoms for newborns diagnosed with NAS. The findings showed a positive association between lower costs for the initial stay of infants whose mothers received MAT. MAT during pregnancy has been shown …

Gingival Transcriptomic Patterns Of Macrophage Polarization During Initiation, Progression, And Resolution Of Periodontitis, Octavio A Gonzalez, Sreenatha S Kirakodu, Linh M Nguyen, Jeffrey L Ebersole

Faculty, Staff and Student Publications

Phenotypic and functional heterogeneity of macrophages is clearly a critical component of their effective functions in innate and adaptive immunity. This investigation hypothesized that altered profiles of gene expression in gingival tissues in health, disease, and resolution would reflect changes in macrophage phenotypes occurring in these tissues. The study used a nonhuman primate model to evaluate gene expression profiles as footprints of macrophage variation using a longitudinal experimental model of ligature-induced periodontitis in animals from 3 to 23 years of age to identify aging effects on the gingival environment. Significant differences were observed in distribution of expressed gene levels for …

Cc16 Augmentation Reduces Exaggerated Copd-Like Disease In Cc16-Deficient Mice, Joselyn Rojas-Quintero, Maria Eugenia Laucho-Contreras, Xiaoyun Wang, Quynh-Anh Fucci, Patrick R Burkett, Se-Jin Kim, Duo Zhang, Yohannes Tesfaigzi, Yuhong Li, Abhiram R Bhashyam, Zhang Li, Haider Khamas, Bartolome Celli, Aprile L Pilon, Francesca Polverino, Caroline A Owen

Faculty, Staff and Students Publications

Low Club Cell 16 kDa protein (CC16) plasma levels are linked to accelerated lung function decline in patients with chronic obstructive pulmonary disease (COPD). Cigarette smoke-exposed (CS-exposed) Cc16-/- mice have exaggerated COPD-like disease associated with increased NF-κB activation in their lungs. It is unclear whether CC16 augmentation can reverse exaggerated COPD in CS-exposed Cc16-/- mice and whether increased NF-κB activation contributes to the exaggerated COPD in CS-exposed Cc16-/- lungs. CS-exposed WT and Cc16-/- mice were treated with recombinant human CC16 (rhCC16) or an NF-κB inhibitor versus vehicle beginning at the midpoint of the exposures. COPD-like disease and NF-κB activation were …

Longitudinal Associations Between Dietary Fructose And Sodium And Systolic And Diastolic Blood Pressure Among Us Black And White Adults In The Cardia Study, Rana Elhamzawy, Dragana Komnenov, Daniel Domin

Medical Student Research Symposium

Longitudinal associations between dietary fructose and sodium and systolic and diastolic blood pressure among US Black and White adults in the CARDIA study

Authors: Rana Elhamzawy, Daniel Domin, Dragana Komnenov

Hypertension is one of the leading risk factors for major adverse cardiovascular events (MACE). Likewise, suboptimal dietary habits, including high fructose and sodium intake, are major contributors to mortality. High dietary fructose alone predisposes to salt-sensitivity of blood pressure, which is an independent, significant cardiovascular risk factor. We previously showed in our rat model of fructose-salt-sensitive hypertension that even a short term (4 weeks) feeding with 20% fructose and 4% …

Gender Disparities In The Diagnosis Of Sleep Disordered Breathing, Kenna Haile, Nesrine Ibrahim, Safwan Badr, Apala Vaishnav

Medical Student Research Symposium

Introduction: Current diagnostic guidelines for sleep disordered breathing (SDB) require that apneas and hypopneas be accompanied by a 4% desaturation for it to constitute a respiratory event (AHI-Accepted). However, the American Academy of Sleep Medicine recommends expanding the diagnostic criteria to include apneas and hypopneas accompanied by a 3% desaturation or a cortical arousal for diagnosis (AHI-Recommended). We hypothesized that a clinical sample of both men and women would demonstrate that women are more likely to be misdiagnosed using the accepted criteria compared to the recommended criteria.

Methods: The clinical sample consisted of all patients receiving a PSG at the …

The Effects Of Different Antihypertensives, Steroids, And Beta Blockers On Covid-19 Outcomes In A Ckd And Non-Ckd Cohort In Detroit, Michigan, Vidhya Nadarajan, Maham Ahmed, Katerina Furman, Zoya Gurm, Priyanka Kale, Zaina Khoury, Paul Kim, Sara Koussa, Dana Labuda, Margo Mekjian, Pooja Polamarasetti, Charlotte Thill, Sophie Wittenberg, Sorabh Dhar, Dragana Komnenov

Medical Student Research Symposium

Initial studies during the COVID-19 pandemic reported angiotensin converting enzyme 2 inhibitors (ACE2i) could be associated with worse disease course due to potential increase in ACE2 receptors which SARS-CoV2 virus uses for cellular entry. Subsequent studies refuted such concerns, reporting that continued use of ACEis and angiotensin receptor blockers (ARBs) in hypertensive individuals is protective. However, there remains a paucity of data evaluating effects of various antihypertensive medications, steroids, and beta blockers in chronic kidney disease (CKD) populations and in individuals with normal kidney function. This study was designed to evaluate the potential risks associated with antihypertensive medications and COVID-19 …

An Unusual Case Of Hemophagocytic Lymphohistiocytosis Associated With Mycobacterium Chimaera Or Large-Cell Neuroendocrine Carcinoma, Tejaswi Venigalla, Sheila Kalathil, Meena Bansal, Mark Morginstin, Vinicius Jorge, Patricia Perosio

Einstein Health Papers

Hemophagocytic lymphohistiocytosis (HLH) is a rare and very dangerous condition characterized by abnormal activation of the immune system, causing hemophagocytosis, inflammation, and potentially widespread organ damage. The primary (genetic) form, caused by mutations affecting lymphocyte cytotoxicity, is most commonly seen in children. Secondary HLH is commonly associated with infections, malignancies, and rheumatologic disorders. Most current information on diagnosis and treatment is based on pediatric populations. HLH is a disease that should be diagnosed and treated promptly, otherwise it is fatal. Treatment is directed at treating the triggering disorder, along with symptomatic treatment with dexamethasone and etoposide. We present a 56-year-old …

Acupuncture Treatment For Post-Stroke Depression: Intestinal Microbiota And Its Role, Hailun Jiang, Shizhe Deng, Jieying Zhang, Junjie Chen, Boxuan Li, Weiming Zhu, Menglong Zhang, Chao Zhang, Zhihong Meng

Faculty, Staff and Student Publications

Stroke-induced depression is a common complication and an important risk factor for disability. Besides psychiatric symptoms, depressed patients may also exhibit a variety of gastrointestinal symptoms, and even take gastrointestinal symptoms as the primary reason for medical treatment. It is well documented that stress may disrupt the balance of the gut microbiome in patients suffering from post-stroke depression (PSD), and that disruption of the gut microbiome is closely related to the severity of the condition in depressed patients. Therefore, maintaining the balance of intestinal microbiota can be the focus of research on the mechanism of acupuncture in the treatment of …

The Association Between Medication Use In Older Women With Early-Stage Operable Primary Breast Cancer And Decision Regarding Primary Treatment, Natalie Tse, Ruth M Parks, Holly M Holmes, Kwok-Leung Cheung

Faculty, Staff and Student Publications

Background: Polypharmacy is one factor contributing to increased mortality, hospitalization, and adverse drug reactions in older adults. The aim of this study was to measure the prevalence of polypharmacy in a cohort of older women with early-stage operable primary breast cancer and the relationship of polypharmacy to primary treatment decision and functional status.

Methods: A total of 139 patients with a new diagnosis of early-stage operable primary breast cancer proven histologically were recruited as part of a prospective study. The average age was 77 years. Assessment using a cancer-specific Comprehensive Geriatric Assessment (CGA) tool was conducted within 6 weeks of …

Impact Of End Stage Renal Disease On The Clinical Outcomes Of Diabetics Admitted For Heart Failure: Analysis Of National Inpatient Sample, Muhammad Usman Almani, Yaqi Zhang, Muhammed Hamza Arshad, Muhammad Usman, Muhammad Talha Ayub

Einstein Health Papers

Introduction: Patients with diabetes and heart failure (HF) can have varying outcomes depending on whether they also have End Stage Renal Disease (ESRD). This study aimed to compare the outcomes of patients with diabetes and HF with and without ESRD.

Methods: Data from the National Inpatient Sample (NIS) 2016-2018 was analyzed to find hospitalizations for patients with HF as the main diagnosis and diabetes as a secondary diagnosis, with and without ESRD. Multivariable logistic and linear regression analysis was used to adjust for confounding factors.

Results: In the total cohort of 12215 patients with a principal diagnosis of heart failure …

Partnering With Patients And Families Living With Chronic Conditions To Coproduce Diagnostic Safety Through Ourdx: A Previsit Online Engagement Tool, Sigall K Bell, Zhiyong J Dong, Catherine M Desroches, Nicholas Hart, Stephen Liu, Brianna Mahon, Long H Ngo, Eric J Thomas, Fabienne Bourgeois

Faculty, Staff and Student Publications

OBJECTIVE: Patients and families are key partners in diagnosis, but methods to routinely engage them in diagnostic safety are lacking. Policy mandating patient access to electronic health information presents new opportunities. We tested a new online tool ("OurDX") that was codesigned with patients and families, to determine the types and frequencies of potential safety issues identified by patients/families with chronic health conditions and whether their contributions were integrated into the visit note.

METHODS: Patients/families at 2 US healthcare sites were invited to contribute, through an online previsit survey: (1) visit priorities, (2) recent medical history/symptoms, and (3) potential diagnostic concerns. …

Disparity In Checkpoint Inhibitor Utilization Among Commercially Insured Adult Patients With Metastatic Lung Cancer, Meng Li, Kaiping Liao, Alice J Chen, Tina Cascone, Yu Shen, Qian Lu, Ya-Chen Tina Shih

Faculty, Staff and Student Publications

BACKGROUND: There is a lack of evidence from nationwide samples on the disparity of initiating immune checkpoint inhibitors (ICIs) after metastatic lung cancer diagnosis.

METHODS: We identified metastatic lung cancer patients diagnosed between 2015 and 2020 from a large, nationwide commercial claims database. We analyzed the time from metastatic lung cancer diagnosis to ICI therapy using Cox proportional hazard models. Independent variables included county-level measures (quintiles of percentage of racialized population, quintiles of percentage of population below poverty, urbanity, and density of medical oncologists) and patient characteristics (age, sex, Charlson comorbidity index, Medicare Advantage, and year of diagnosis). All tests …

Risk Of Coronary Artery Disease In Patients With Gout On Treatment With Colchicine: A Systematic Review And Meta-Analysis, Muhammad U Siddiqui, Joey Junarta, Swaminathan Sathyanarayanan, Kirpal Kochar, Waqas Ullah, D L Fischman

Division of Cardiology Faculty Papers

Background: Colchicine has anti-inflammatory properties, but its utility in improving cardiovascular outcomes has been disputed. Here, we study the impact of colchicine on cardiovascular outcomes in patients with gout with and without coronary artery disease (CAD).

Methods: Medline, Web of Science and Cochrane Central Register of Controlled Trials were systematically searched to identify relevant studies. Primary outcomes included myocardial infarction (MI), percutaneous coronary intervention (PCI), and coronary artery bypass grafting (CABG). Secondary outcomes included stroke and all-cause mortality.

Results: We included 4 observational studies comprising 10,026 patients with gout on treatment with colchicine. There was no significant difference in the …

Health Disparities Experienced By Hispanic Americans With Multiple Myeloma: A Systematic Review, Andrea Anampa-Guzmán, Sara Taveras Alam, Inas Abuali, Samer Al Hadidi

Faculty, Staff and Student Publications

Health disparities in multiple myeloma (MM) disproportionately affect minorities. Characterization of health disparities encountered by Hispanic Americans with MM is necessary to identify gaps and inform future strategies to eliminate them. We performed a systematic review of publications that described health disparities relevant to Hispanic Americans with MM through December 2021. We included all original studies which compared incidence, treatment, and/or outcomes of Hispanic Americans with other ethnic groups. Eight hundred and sixty-eight articles were identified of which 22 original study articles were included in our systematic review. The number of publications varied over time with the highest number of …

Ideal Cardiovascular Health, Biomarkers, And Coronary Artery Disease In Persons With Hiv, Pamela S Douglas, Sara Mccallum, Michael T Lu, Triin Umbleja, Kathleen V Fitch, Borek Foldyna, Markella V Zanni, Evelynne S Fulda, Gerald S Bloomfield, Carl J Fichtenbaum, Edgar T Overton, Judith A Aberg, Carlos D Malvestutto, Tricia H Burdo, Roberto C Arduino, Ken S Ho, Michael T Yin, Heather J Ribaudo, Steven K Grinspoon

Faculty, Staff and Student Publications

OBJECTIVE: To investigate relationships between Life's Simple 7 (LS7), an assessment of cardiovascular health (CVH), and coronary plaque among people with HIV (PWH).

DESIGN: Cross-sectional.

METHODS: Coronary computed tomography angiography, immune/inflammatory biomarkers, and characterization of LS7 were collected among a subset of ART-treated PWH enrolled in REPRIEVE, a primary prevention trial. Analyses adjusted for cardiovascular disease risk (ASCVD score).

RESULTS: Median age of the 735 participants was 51(±6) years, 16% female, and median (Q1-Q3) CVD risk was 4.5% (2.6-6.9). Forty percent had poor (≤2 ideal components), 51% had intermediate (three or four ideal components), and only 9% had ideal CVH …

Antihypertensive Medication Regimens Used In The Systolic Blood Pressure Intervention Trial, Catherine G Derington, Adam P Bress, Andrew E Moran, William S Weintraub, Jennifer S Herrick, William C Cushman, Ian M Kronish, Barry Stults, Daichi Shimbo, Paul Muntner, Tom Greene, Jeffrey T Bates, Tara I Chang, Lois Anne Katz, Shakaib U Rehman, Christianne L Roumie, Leonardo Tamariz, Jordan B King

Faculty, Staff and Students Publications

BACKGROUND: Describing the antihypertensive medication regimens used in the SPRINT (Systolic Blood Pressure Intervention Trial) would contextualize the standard and intensive systolic blood pressure (SBP) interventions and may inform future implementation efforts to achieve population-wide intensive SBP goals.

METHODS: We included SPRINT participants with complete medication data at the prerandomization and 12-month visits. Regimens were categorized by antihypertensive medication class. Analyses were stratified by treatment group (standard goal SBPHg).

RESULTS: Among 7860 participants (83.7% of 9361 randomized), the median number of classes used at the prerandomization visit was 2.0 and 2.0 in the standard and intensive groups (

CONCLUSIONS: SPRINT …

Building The Foundation For A Community-Generated National Research Blueprint For Inherited Bleeding Disorders: Research Priorities To Transform The Care Of People With Hemophilia, Duc Q Tran, Craig C Benson, Judith A Boice, Meera Chitlur, Amy L Dunn, Miguel A Escobar, Kalpna Gupta, Jill M Johnsen, James Jorgenson, Scott D Martin, Suzanne Martin, Shannon L Meeks, Alfredo A Narvaez, Doris V Quon, Mark T Reding, Ulrike M Reiss, Brittany Savage, Kim Schafer, Bruno Steiner, Courtney Thornburg, Lena M Volland, Annette Von Drygalski

Faculty, Staff and Student Publications

BACKGROUND: Decades of research have transformed hemophilia from severely limiting children's lives to a manageable disorder compatible with a full, active life, for many in high-income countries. The direction of future research will determine whether exciting developments truly advance health equity for all people with hemophilia (PWH). National Hemophilia Foundation (NHF) and American Thrombosis and Hemostasis Network conducted extensive inclusive all-stakeholder consultations to identify the priorities of people with inherited bleeding disorders and those who care for them.

RESEARCH DESIGN AND METHODS: Working group (WG) 1 of the NHF State of the Science Research Summit distilled the community-identified priorities for …

Transabdominal Cerclage During Pregnancy: A Retrospective Single Operator Series Over A Quarter Century, David R Hall, Mari Van De Vyver

Faculty, Staff and Student Publications

OBJECTIVE: To describe the pregnancy outcomes and complications observed in a series of cases of transabdominal cerclage (TAC), which is reserved for highly selected women with recurrent mid-trimester pregnancy loss, due to cervical insufficiency.

METHODS: A retrospective audit covering 25 years (January 1, 1997 to December 31, 2021) was performed at the Obstetric Special Care division, Tygerberg Academic Hospital in Cape Town, South Africa. All 118 pregnancies from 94 procedures, operated and managed by the principal author were included for descriptive analysis.

RESULTS: Eighty-four (91.3%) of the 92 first pregnancies after first insertion had successful outcomes. All second and third …

Epstein-Barr Virus-Associated Lymphoepithelial Carcinoma Arising In The Parotid Gland: A Case Report And Literature Review, Akinobu Kubota, Nobuyuki Bandoh, Takashi Goto, Ken-Ichi Matsumoto, Tomomi Yamaguchi-Ishochi, Yasutaka Kato, Hiroshi Nishihara, Hidehiro Takei

Faculty, Staff and Student Publications

A 60-year-old woman presented with a 3-year history of a slow-growing, painless mass in their left parotid gland. Ultrasonography revealed a well-circumscribed, lobulated, hypoechoic mass measuring 19x12x10 mm in the left parotid gland. Computed tomography revealed a well-circumscribed, solid mass with homogeneous enhancement. Fluorodeoxyglucose-positron emission tomography revealed uptake by the tumor but no uptake in other organs, including the nasopharynx. The patient underwent superficial parotidectomy with adequate safety margins and selective neck dissection followed by radiotherapy. No facial paralysis or recurrence of the tumor had been observed as of 20 months post-operation. Histologically, the tumor was composed of sheets of …

Crk2 Controls Cytoskeleton Morphogenesis In Trypanosoma Brucei By Phosphorylating Β-Tubulin To Regulate Microtubule Dynamics, Kyu Joon Lee, Qing Zhou, Ziyin Li

Faculty, Staff and Student Publications

Microtubules constitute a vital part of the cytoskeleton in eukaryotes by mediating cell morphogenesis, cell motility, cell division, and intracellular transport. The cytoskeleton of the parasite Trypanosoma brucei contains an array of subpellicular microtubules with their plus-ends positioned toward the posterior cell tip, where extensive microtubule growth and cytoskeleton remodeling take place during early cell cycle stages. However, the control mechanism underlying microtubule dynamics at the posterior cell tip remains elusive. Here, we report that the S-phase cyclin-dependent kinase-cyclin complex CRK2-CYC13 in T. brucei regulates microtubule dynamics by phosphorylating β-tubulin on multiple evolutionarily conserved serine and threonine residues to inhibit …

Eczema Monkeypoxicum In A Female Patient With Atopic Dermatitis, Emma Napoli, Madeline Frizzell, Clark Gravell, Sergio Vallejo, Shasta Theodore, Karen Chen, Huma Siddiqui, Justin Dunn, Dora Marrufo, Jose Cadena, Patrick J Danaher

Faculty, Staff and Student Publications

A female patient with atopic dermatitis who had recently received a tattoo presented with severe right ear pain and several vesiculopustular lesions. Over 1 week, she developed approximately 80 widely distributed lesions. Laboratory testing confirmed mpox (previously monkeypox) virus, and no further lesions developed after initiation of oral tecovirimat.

Invasive Mold Infections Following Hurricane Harvey-Houston, Texas, Mitsuru Toda, Samantha Williams, Brendan R Jackson, Sebastian Wurster, Jose A Serpa, Masayuki Nigo, Carolyn Z Grimes, Robert L Atmar, Tom M Chiller, Luis Ostrosky-Zeichner, Dimitrios P Kontoyiannis

Faculty, Staff and Student Publications

BACKGROUND: Characterizing invasive mold infection (IMI) epidemiology in the context of large flooding events is important for public health planning and clinical decision making.

METHODS: We assessed IMI incidence (per 10 000 healthcare encounters) 1 year before and after Hurricane Harvey at 4 hospitals in Houston, Texas. Potential IMI cases were assigned as proven or probable cases using established definitions, and surveillance cases using a novel definition. We used rate ratios to describe IMI incidence and multivariable logistic regression to examine patient characteristics associated with IMI case status.

RESULTS: IMI incidence was significantly higher posthurricane (3.69 cases) than prehurricane (2.50 …

Trigeminal Trophic Syndrome In A Pediatric Patient With Diffuse Intrinsic Pontine Glioma., Ezra Hoover, Ryan Jay, Patricia Witman

Ambulatory and Primary Care Articles

A 13-year-old girl with a history of diffuse intrinsic pontine glioma (DIPG) suffered from progressively worsening facial ulcerations secondary to paresthesia-induced self-excoriation. She was diagnosed with trigeminal trophic syndrome (TTS) induced by DIPG and struggled to heal her lesions in the background of this excoriation disorder. A multidisciplinary approach that included mood disorder management with sertraline and amitriptyline helped diminish paresthesia, improve her quality of life, and promote healing of the ulcers despite the progression of her DIPG. This case highlights the multifactorial complexity of TTS in pediatric patients and the need for successful management strategies.

The Increased Clinical And Economic Burden Of Hyperkalemia In Medicare Patients Admitted To Long-Term Care Settings., James F Neuenschwander, Alison R Silverstein, Christie L Teigland, Shambhavi Kumar, Edric Y Zeng, Abiy T Agiro, William J Pottorf, W Frank Peacock

Ambulatory and Primary Care Articles

INTRODUCTION: Older patients are at increased risk for hyperkalemia (HK). This study describes the prevalence, recurrence, and clinical and economic burden of HK in Medicare patients admitted to a long-term care (LTC) setting.

METHODS: Retrospective cohort study using 100% Medicare Fee-for-Service (FFS) claims identified patients aged ≥ 65 years with index admission between 2017 and 2019 to a LTC setting (skilled nursing, home health, inpatient rehabilitation, or long-term acute care). Beneficiaries were required to have 12 months continuous medical and pharmacy coverage prior to index LTC admission and ≥ 30 days after LTC discharge (follow-up). Patient characteristics, healthcare resource utilization, …

Blood Neutrophil Count And Neutrophil-To-Lymphocyte Ratio For Prediction Of Disease Progression And Mortality In Two Independent Systemic Sclerosis Cohorts, Nancy Wareing, Vishnu Mohan, Rana Taherian, Elizabeth R Volkmann, Marka A Lyons, Holly Wilhalme, Michael D Roth, Rosa M Estrada-Y-Martin, Brian Skaug, Maureen D Mayes, Donald P Tashkin, Shervin Assassi

Faculty, Staff and Student Publications

OBJECTIVE: To assess the predictive significance of blood neutrophil count and the ratio between neutrophil and lymphocyte count (neutrophil-to-lymphocyte ratio [NLR]) for disease severity and mortality in systemic sclerosis (SSc).

METHODS: Neutrophil and lymphocyte counts were prospectively measured in the Genetics versus Environment in Scleroderma Outcome Study (GENISOS) and the Scleroderma Lung Study II (SLS II). Forced vital capacity percent predicted (FVC%) and modified Rodnan skin thickness score (MRSS) were used as surrogate measures for disease severity. Longitudinal analyses were performed using generalized linear mixed models. Cox proportional hazards models evaluated the predictive significance of these cell counts for mortality. …

An Echogenic Clot Method For Thrombolysis Monitoring In Thrombotic Stroke Models, Dalton E Carter, Tao Peng, Melanie R Moody, Shao-Ling Huang, David D Mcpherson, Melvin E Klegerman

Faculty, Staff and Student Publications

To demonstrate thrombolytic efficacy of a tissue plasminogen activator (tPA)-loaded echogenic liposome (TELIP) formulation in a rabbit thrombotic stroke model (the most relevant animal model for evaluation of directed thrombolytic therapy for ischemic stroke), we sought to develop a means of monitoring thrombus dissolution quantitatively by ultrasound imaging methods. We hypothesized that a gas-free ultrasound contrast agent can be incorporated into blood clots at a concentration that does not affect the tPA-mediated clot dissolution rate, while enabling quantitative assessment of the clot dissolution rate. Clots were formed from a mixture of whole rabbit blood, 1 M calcium chloride, human thrombin …

Bacteremia, Liver Injury, And Pneumonitis: Strongyloides Unleashed By A Supplement, Emily Y Xiao, Robert L Pecha, Zaven Sargsyan

Faculty, Staff and Students Publications

No abstract provided.

2022 American College Of Rheumatology Guideline For Vaccinations In Patients With Rheumatic And Musculoskeletal Diseases, Anne R Bass, Eliza Chakravarty, Elie A Akl, Clifton O Bingham, Leonard Calabrese, Laura C Cappelli, Sindhu R Johnson, Lisa F Imundo, Kevin L Winthrop, Reuben J Arasaratnam, Lindsey R Baden, Roberta Berard, S Louis Bridges, Jonathan T L Cheah, Jeffrey R Curtis, Polly J Ferguson, Ida Hakkarinen, Karen B Onel, Grayson Schultz, Vidya Sivaraman, Benjamin J Smith, Jeffrey A Sparks, Tiphanie P Vogel, Eleanor Anderson Williams, Cassandra Calabrese, Joanne S Cunha, Joann Fontanarosa, Miriah C Gillispie-Taylor, Elena Gkrouzman, Priyanka Iyer, Kimberly S Lakin, Alexandra Legge, Mindy S Lo, Megan M Lockwood, Rebecca E Sadun, Namrata Singh, Nancy Sullivan, Herman Tam, Marat Turgunbaev, Amy S Turner, James Reston

Faculty, Staff and Students Publications

OBJECTIVE: To provide evidence-based recommendations on the use of vaccinations in children and adults with rheumatic and musculoskeletal diseases (RMDs).

METHODS: This guideline follows American College of Rheumatology (ACR) policy guiding management of conflicts of interest and disclosures and the ACR guideline development process, which includes the Grading of Recommendations Assessment, Development and Evaluation (GRADE) methodology. It also adheres to the Appraisal of Guidelines for Research and Evaluation (AGREE) criteria. A core leadership team consisting of adult and pediatric rheumatologists and a guideline methodologist drafted clinical population, intervention, comparator, outcomes (PICO) questions. A review team performed a systematic literature review …

Electronic Health Records' Support For Primary Care Physicians' Situation Awareness: A Metanarrative Review, April Savoy, Himalaya Patel, Daniel R Murphy, Ashley N D Meyer, Jennifer Herout, Hardeep Singh

Faculty, Staff and Students Publications

OBJECTIVE: Situation awareness (SA) refers to people's perception and understanding of their dynamic environment. In primary care, reduced SA among physicians increases errors in clinical decision-making and, correspondingly, patients' risk of experiencing adverse outcomes. Our objective was to understand the extent to which electronic health records (EHRs) support primary care physicians (PCPs)' SA during clinical decision-making.

METHOD: We conducted a metanarrative review of papers in selected academic databases, including CINAHL and MEDLINE. Eligible studies included original peer-reviewed research published between January 2012 and August 2020 on PCP-EHR interactions. We iteratively queried, screened, and summarized literature focused on EHRs supporting PCPs' …

Tubular-Specific Expression Of Hiv Protein Vpr Leads To Severe Tubulointerstitial Damage Accompanied By Progressive Fibrosis And Cystic Development, Yuqiang Chen, Ya Chen, Jia Fu, Zeguo Sun, Huilin Li, Wenzhen Xiao, Jing E, Benjamin Y Lo, Niansong Wang, Weijia Zhang, Mary E Klotman, Paul E Klotman, Jeffrey B Kopp, Vivette D D'Agati, John Cijiang He, Kyung Lee

Faculty, Staff and Students Publications

Chronic kidney disease (CKD) is a common cause of morbidity in human immunodeficiency virus (HIV)-positive individuals. HIV infection leads to a wide spectrum of kidney cell damage, including tubular epithelial cell (TEC) injury. Among the HIV-1 proteins, the pathologic effects of viral protein R (Vpr) are well established and include DNA damage response, cell cycle arrest, and cell death. Several in vitro studies have unraveled the molecular pathways driving the cytopathic effects of Vpr in tubular epithelial cells. However, the in vivo effects of Vpr on tubular injury and CKD pathogenesis have not been thoroughly investigated. Here, we use a …