Translational Medical Research Commons^™

Comparison Of Ecg Features, Cardiac Biomarkers, And Clinical Outcomes In Three Waves Of Hospitalized Covid-19 Pneumonia Patients With Cardiovascular Events, Yuchen Han, Jahnavi Sunkara, Tshura S Ali, Harideep Samanapally, Vidyulata Salunkhe, Fnu Deepti, Emma C. Huang, Justin J. Huang, Maiying Kong, Jiapeng Huang

The University of Louisville Journal of Respiratory Infections

Background

Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2) is a rapidly evolving virus that can severely impact the cardiovascular system. With new variants, it is important to characterize wave-specific (defined by dominant circulating variants) clinical changes.

Methods

A multi-center retrospective cohort study of patients hospitalized with SARS-CoV-2 community acquired pneumonia at eight adult acute-care hospitals in the city of Louisville, KY was conducted. Patients hospitalized with Coronavirus Disease 2019 (COVID-19) community acquired pneumonia who experienced a cardiovascular event between March 2020 and July 2022 were included in this analysis. Variant assignment was based on temporal prevalence rather than genomic confirmation, and …

Comparing Anatomical Imaging With Functional Imaging For Coronary Artery Disease: The Limitations Of Vessel Stenosis And The Benefits Of Non-Invasive Measurement Of Fractional Flow Reserve, Zachary Zajac, Laura Aravena, Madeline Simone, David R. Allen Lll, Pranally Desai, Chanel Harvey, Nolan Tews, Nickolas Vinokurov

Clinical Research in Practice: The Journal of Team Hippocrates

A clinical decision report appraising

Neglia D, Rovai D, Caselli C, Pietila M, Teresinska A, Aguadé-Bruix S, et al. Detection of Significant Coronary Artery Disease by Noninvasive Anatomical and Functional Imaging. Circ: Cardiovascular Imaging. 2015;8(3):e002179. https://doi.org/10.1161/CIRCIMAGING.114.002179

for a stable hospitalized patient admitted for acute coronary syndrome (ACS) rule out.

When Systems Fail: The Impact Of Protocol On Physician Moral Distress, Aya Dudar

Clinical Research in Practice: The Journal of Team Hippocrates

Physicians often face the decision between following rigid hospital protocol and doing the right thing for the patient, creating moral distress and contributing to burnout. This letter describes a case in which an elderly patient with COVID-19 pneumonia and a DNI order developed worsening hypercapnia and required noninvasive ventilation. Despite clinical appropriateness, hospital policy prohibited BiPAP use in obtunded patients due to aspiration risk - even when the resident offered continuous bedside monitoring. This case highlights the ethical tension that arises when rigid hospital policies prevent physicians from making real-time exceptions in appropriate situations. Empowering physicians to make context-driven decisions …

Tadalafil Monotherapy Is A Reasonable Alternative For The Treatment Of Lower Urinary Tract Symptoms In Patients With Comorbid Benign Prostatic Hyperplasia And Erectile Dysfunction, Daniel M. Ibrahim, Anam Ahmed, Swetha Reddy, Meet S. Patel, Nabeel Sumbal, Adam Chaban, Aminah I. Fayyaz

Clinical Research in Practice: The Journal of Team Hippocrates

A clinical decision report appraising

Oelke M, Giuliano F, Mirone V, Xu L, Cox D, Viktrup L. Monotherapy with tadalafil or tamsulosin similarly improved lower urinary tract symptoms suggestive of benign prostatic hyperplasia in an international, randomized, parallel, placebo-controlled clinical trial. Eur Urol. 2012;61(5):917-925. https://doi.org/10.1016/j.eururo.2012.01.0131

for a vigorous 75-year-old man with benign prostatic hyperplasia (BPH) and erectile dysfunction (ED) who discontinued dutasteride due to intolerable sexual side effects.

Oral Pathogens Reprogram Endothelial Barrier And Angiotensin-Converting Enzyme2/Endothelial Nitric Oxide Synthase-Nitric Oxide Signaling To Promote Blood Pressure Dysregulation, Ming-Shou Hsieh, Tung-Nien Hsu, Chin-Sheng Huang, Ting-Yi Renn, Kuang-Tai Kuo, Kuo-Yao Lin, Wei Jen Chang

Journal of Dental Sciences

Background/purpose: Although periodontal disease is associated with an increased risk of hypertension, the endothelial mechanisms linking oral inflammation to vascular dysfunction remain unclear. We investigated whether Porphyromonas gingivalis lipopolysaccharide (Pg-LPS) can directly disturb endothelial homeostasis and whether macrophage–endothelial crosstalk further worsens endothelial injury.

Materials and methods: Human umbilical vein endothelial cells (HUVECs) were exposed to Pg-LPS alone or co-cultured (transwell system) with Pg-LPS-primed human monocytic cells -derived macrophages. Endothelial dysfunction was assessed through nitric oxide (NO) production, endothelial nitric oxide synthase (eNOS) phosphorylation, inflammatory and adhesion molecule expression, as well as junctional and cytoskeletal changes. Macrophage …

A Study On Nutritional Status Among Regular Gym Goers In And Around Chennai, India, Ettiyappan Thirumurugan, Kalpana Devi Venkatesan, Pavithra Tamilmani, Devika Preetha, Joyce Albert Princy Mariya Selvanathan, Dhanyasree Mohandas, Ameer Basha Sathik, Santhosh Kumar Manjunathan, Ashika Kannadhas Sheeba

Makara Journal of Health Research

Background: The increasing sales of sports supplements indicate a concerning trend, as many gym-goers may misuse these products owing to misinformation and insufficient knowledge, potentially impacting their performance. This issue is further compounded by specific gym trainers who may lack comprehensive information and inadvertently influence their clients' choices. To address this concern, the present study evaluated dietary supplement practices and sports nutrition knowledge among regular gym-goers at fitness centers in Chennai, India.

Methods: A cross-sectional survey was conducted from November 2023 to May 2024 using a validated questionnaire distributed across Chennai, India. A total of 450 participants were …

A Retrospective Study Of Pulmonary Function Tests In Bronchiectasis: An Infectious Disease Of The Respiratory System, Vinod Mutkule, Mahesh Shinde, Vidya Bapmare, Sangramsingh Dixit, Atharva Sharma, Kshitij Sarwey, Yogeshwari Patil, Sanket Jethlia, Aayushi Dwivedi, Disha Pardeshi, Anmol Rai, Kunal Shah, Vidhi Kalwar

The University of Louisville Journal of Respiratory Infections

Introduction: Bronchiectasis, currently being recognized worldwide, is an abnormal dilatation of the bronchi and bronchioles brought on by recurrent cycles of inflammation and airway infection. Impaired pulmonary function has a predictive significance in bronchiectasis. When treating patients with suspected or confirmed respiratory diseases, pulmonary function tests (PFT) are useful examinations. Very few studies have been done on PFTs in bronchiectasis. The main aim of this study is to study PFTs in bronchiectasis.

Method: This is a retrospective observational study done on 50 patients over two years at the tertiary care center. The previous records of patients were collected from the …

Jeremy Bentham Will See You Now, Kevin Suiter

Clinical Research in Practice: The Journal of Team Hippocrates

A discussion of remote patient monitoring through the lens of Jeremy Bentham's Panopticon

Clinical Decision-Making And Artificial Intelligence: The Role Of Large Language Models In Medicine, Richa Bhasin, Wassim El-Sayed, Kassim Salami, Mura Abdul-Nabi, Ahmed Elashmawy, M. Ellis Jaruzel Ii

Clinical Research in Practice: The Journal of Team Hippocrates

A clinical decision report using:

Goh E, Gallo R, Hom J, et al. Large Language Model Influence on Diagnostic Reasoning: A Randomized Clinical Trial. JAMA Netw Open. 2024;7(10):e2440969. https://doi.org/10.1001/jamanetworkopen.2024.40969

to explore the role of artificial intelligence in clinical settings.

Paradigm Shifts: Efficacy Of Cabg For Diabetic Patients With Coronary Artery Disease And Prior Pci, And The Utility Of Artificial Intelligence In Clinical Decision-Making, Jacob Mallad, Kevin Suiter, Mahdi Mahmoud, Sidney Caudell, Richard Lewandowski, Hazem Alata, Bethany Lyche, Zarin Kothari

Clinical Research in Practice: The Journal of Team Hippocrates

A clinical decision report using:

Thielmann M, Neuhäuser M, Knipp S, et al. Prognostic impact of previous percutaneous coronary intervention in patients with diabetes mellitus and triple-vessel disease undergoing coronary artery bypass surgery. J Thorac Cardiovasc Surg. 2007;134(2):470-476. https://doi.org/10.1016/j.jtcvs.2007.04.019

for a patient with prior coronary artery catheterization being referred for surgical intervention, and a clinician encountering a nonexistent clinical reference hallucinated by a large language model.

Paradigm Shifts In Medicine, David Meza, James Peter Meza

Clinical Research in Practice: The Journal of Team Hippocrates

Implications for history of science, scientific revolutions and paradigm shifts in the context of rapidly developing artificial intelligence.

Life Course Analysis: How Social Needs And Family Dynamics Impact Clinical Decision-Making, Vito Agrusa, Laila N. Abdallah, Bryen Turco

Clinical Research in Practice: The Journal of Team Hippocrates

The authors explore Life Course Analysis and how social needs (including pet care), changing demographics, and loneliness affect inpatient hospitalization and clinical decision making.

Off-Label Long-Term Use Of Phentermine For Weight Management, Monique Morin, Yamini Pandey, Sarah Bdeir, Rumyah Rafique, Taim-Allah Al-Jarrah, Ali Farhat

Clinical Research in Practice: The Journal of Team Hippocrates

A clinical decision report using:

Hendricks EJ, Greenway FL, Westman EC, Gupta AK. Blood pressure and heart rate effects, weight loss and maintenance during long-term phentermine pharmacotherapy for obesity. Obesity. 2011;19(12):2351-2360 https://doi.org/10.1038/oby.2011.94

for a patient struggling at the intersection of weight loss and financial instability.

Indeterminate Benefit Of Long-Term Beta-Blocker Use After Acute Myocardial Infarction For Some Patients, Logan S. Thayer, Khush Hussain, Nicholas Apostolakis, Gretchen Swift, Arifbillah Sarowar, Mohammad Al-Hadidi, Scott Yaekle

Clinical Research in Practice: The Journal of Team Hippocrates

A clinical decision report using:

Yndigegn T, Lindahl B, Mars K, et. al., Beta-blockers after myocardial infarction and preserved ejection fraction. N Engl J Med. April 7 2024;390:1372-1381. https://doi.org/10.1056/NEJMoa2401479

for a patient showing 55% left ventricular ejection fraction after myocardial infarction.

Characteristics And Outcomes Of Adults Hospitalized With Respiratory Syncytial Virus, Brian S. Shaw, Cara Slaton, Ian P. Murphy, Michael Mcalister, Daniel Egan, Kwabena Ayesu

The University of Louisville Journal of Respiratory Infections

Background: Respiratory syncytial virus (RSV) is a negative sense single-stranded RNA virus (ssRNA) that primarily causes respiratory infections in both children and older adults. We examined clinical characteristics and outcomes of hospitalized adult patients who tested positive for RSV.

Methods: This was a multicenter, retrospective, descriptive study that examined adult patients admitted with a positive RSV test over two years across eight hospitals in Orlando, Florida.

Results: A total of 120 patients were included, of which 88 (73%) were 60 years old and older. Overall, patients with RSV infection were caucasian (62%) with a median age of 70 years and …

Pull Or Play? The Interpretation Of A Novel, Ai-Powered On-Field Decision Support Tool., Lynne Becker, Dafne Badilla, Osho Yonzon, Xiaoyu Wu, Roland Rocafort, Erik Viogan Phd, Devansh Manocha

Journal for Sports Neuroscience

The document titled "Pull or Play? The interpretation of a novel, AI-powered on-field decision support tool" explores the development and application of the Injury Impact Severity Score (IISS)™ for assessing traumatic brain injuries (TBIs), particularly in sports settings. It addresses the limitations of current assessment tools like the Glasgow Coma Scale (GCS) and proposes a more objective approach using patient-reported data and machine learning algorithms.

Key points include:

• Background: TBIs are a significant health concern with under-reported cases and a lack of effective research. Current assessment tools like the GCS have limitations in accuracy and speed, especially in dynamic …

Application Of The Theory Of Planned Behavior In Concussion Disclosure: A Systematic Review, Michelle L. Weber Rawlins, R. Curtis Bay, Tamara Valovich Mcleod

Internet Journal of Allied Health Sciences and Practice

Purpose: Many athletes do not seek care for a suspected concussion for a number of reasons. Failing to do so can lead to persisting symptoms, longer recovery, or secondary injury. The Theory of Planned Behavior (TPB), along with knowledge of concussion, has been used to examine concussion care seeking. It is theorized that TPB components including attitudes, subjective norms, and self-efficacy are associated with one’s intention to perform a health-related behavior, and their actual behavior. Many studies have used the TPB in an attempt to predict concussion disclosure, with mixed results. The purpose of this systematic review was to determine …

Effectiveness Of Fu's Subcutaneous Needling In Pain Management And Rehabilitation: A Narrative Review, Po-En Chiu, Chun-Chang Wu, De-Jian Lu, Zhonghua Fu, Li-Wei Chou

Rehabilitation Practice and Science

Fu’s Subcutaneous Needling (FSN) is a modern needling technique distinct from traditional acupuncture, primarily used for musculoskeletal pain, neuropathic conditions, and emerging applications in rehabilitation. FSN is also designated as a kind of dry needling focusing on deactivating myofascial trigger points. This review categorizes FSN-related studies into case reports, clinical trials, and animal studies, evaluating its therapeutic efficacy, safety, and mechanisms. Case reports suggest that FSN provides rapid pain relief and functional improvement, while clinical trials, including randomized controlled trials (RCTs), support its role in reducing pain and enhancing neuromuscular function despite limitations in sample size and protocol consistency. Animal …

Exploring Alternative Treatments For Acute Exacerbations Of Cannabis Hyperemesis Syndrome In Patients Who Plan To Continue Using Cannabis, Tabitha E H Moses

Clinical Research in Practice: The Journal of Team Hippocrates

A clinical decision report using:

Dean DJ, Sabagha N, Rose K, et al. A Pilot Trial of Topical Capsaicin Cream for Treatment of Cannabinoid Hyperemesis Syndrome. Acad Emerg Med. 2020;27(11):1166-1172. https://doi.org/10.1111/acem.14062

for a patient with cannabis hyperemesis syndrome.

Clinical Utility Of Abbreviated Eeg Monitoring In Patients Unable To Tolerate A Long-Term, Ambulatory Eeg, Jack T. Mcconnell

Clinical Research in Practice: The Journal of Team Hippocrates

A clinical decision report using:

Lee C, Lim S-N, Lien F, et al. Duration of electroencephalographic recordings in patients with epilepsy. Seizure. 2013;22(6):438-442. https://10.1016/j.seizure.2013.02.016

for a patient with an inability to tolerate a long-term, ambulatory EEG.

Breast Cancer Screening In Transgender Women With High-Risk Family History, John F. Lloyd

Clinical Research in Practice: The Journal of Team Hippocrates

A clinical decision report using:

de Blok CJM, Wiepjes CM, Nota NM, et al. Breast cancer risk in transgender people receiving hormone treatment: nationwide cohort study in the Netherlands. BMJ. 2019;365:l1652. https://doi.org/10.1136/bmj.l1652

for a transgender woman with family history of breast cancer.

The Use Of Chewing Gum To Alleviate Thirst In Chf Patients Requiring Fluid Restrictions And Oral Diuretics, Madeline B. Simone

Clinical Research in Practice: The Journal of Team Hippocrates

A clinical decision report using:

Allida SM, Shehab S, Inglis SC, Davidson PM, Hayward CS, Newton PJ. A RandomisEd ControLled TrIal of ChEwing Gum to RelieVE Thirst in Chronic Heart Failure (RELIEVE-CHF). Heart Lung Circ. 2021;30(4):516-524. https://doi.org/10.1016/j.hlc.2020.09.004

for a woman with heart failure and under fluid restriction.

Exploring Alternative Treatment Options For A Patient With Acute Disseminated Encephalomyelitis (Adem) Suffering From Iatrogenic Cushing’S Symptoms, Alejandro Ponce Sepulveda

Clinical Research in Practice: The Journal of Team Hippocrates

A clinical decision report using:

Ravaglia, S,MD, P., Piccolo G, MD, Ceroni M, MD, et al. Severe steroid-resistant post-infectious encephalomyelitis: General features and effects of IVIg. J Neurol. 2007;254(11):1518-23. https://doi.org/10.1007/s00415-007-0561-4

for a patient with ADEM and iatrogenic Cushing’s secondary to long-term high dose corticosteroid therapy.

Etanercept, Methotrexate, Or Combined Therapy For Improving Rheumatoid Arthritis Symptoms, Ajith Dupati

Clinical Research in Practice: The Journal of Team Hippocrates

A clinical decision report using:

van der Heijde D, Klareskog L, Rodriguez-Valverde V, et al. Comparison of etanercept and methotrexate, alone and combined, in the treatment of rheumatoid arthritis: two-year clinical and radiographic results from the TEMPO study, a double-blind, randomized trial. Arthritis Rheum. 2006;54(4):1063-1074. https://doi.org/10.1002/art.21655

for a patient with rheumatoid arthritis.

Use Of Empagliflozin As An Adjuvant Treatment For Obstructive Sleep Apnea For A Patient Who Has Not Seen A Physician In Over 40 Years, Andrew Demko

Clinical Research in Practice: The Journal of Team Hippocrates

A clinical decision report using:

Neeland IJ, Eliasson B, Kasai T, et al. The Impact of Empagliflozin on Obstructive Sleep Apnea and Cardiovascular and Renal Outcomes: An Exploratory Analysis of the EMPA-REG OUTCOME Trial. Diabetes Care. 2020;43(12):3007-3015. https://doi.org/10.2337/dc20-1096

for a patient with obstructive sleep apnea who has not seen a physician in over 40 years.

Mirabegron Does Not Adversely Impact Cognitive Function In Older Adults With Overactive Bladder Compared To Placebo, Sanjna Ghanshani, Abbie R. Bauer

Clinical Research in Practice: The Journal of Team Hippocrates

A clinical decision report using:

Griebling TL, Campbell NL, Mangel J, et al. Effect of mirabegron on cognitive function in elderly patients with overactive bladder: MoCA results from a phase 4, randomized, placebo-controlled study (PILLAR). BMC Geriatr. 2020;20(1):109. https://doi.org/10.1186/s12877-020-1474-7

for a patient with a history of lacunar infarctions who is experiencing urge incontinence.

Predictors And Diagnosis Of Adjustment Disorder In A Middle-Aged Patient With Cholangiocarcinoma, Zoya Gurm, Abbie R. Bauer

Clinical Research in Practice: The Journal of Team Hippocrates

A clinical decision report using:

Hund B, Reuter K, Härter M, et al. Stressors, Symptom Profile, and Predictors of Adjustment Disorder in Cancer Patients. Results from an Epidemiological Study with the Composite International Diagnostic Interview, Adaptation for Oncology (CIDI-O). Depression and Anxiety. 2016;33(2):153. https://doi.org/10.1002/da.22441

for a patient with recently diagnosed solid tumor malignancy.

Safety Of Ipsilateral Intravenous Access In Breast Cancer Surgery Patients, Austin J. Piontkowski, Abbie R. Bauer

Clinical Research in Practice: The Journal of Team Hippocrates

A clinical decision report appraising

Naranjo J, Portner ER, Jakub JW, Cheville AL, Nuttall GA. Ipsilateral Intravenous Catheter Placement in Breast Cancer Surgery Patients. Anesth Analg. 2021 Sep 1;133(3):707-712. https://doi.org/10.1213/ANE.0000000000005597

for a post-lumpectomy patient requiring ipsilateral peripherally inserted central catheter.

Avaren-Fc, A Novel Immunotherapeutic, Recruits Nk Cells In B16f10 Melanoma Tumor Tissue, Sreevatsa Vemuri, Katarina L Mayer, Nobuyuki Matoba

The Cardinal Edge

Melanoma is the fifth most common cancer in the US, with limited effective immunotherapeutic options available for patients. Avaren-Fc (AvFc) is a novel experimental immunotherapeutic agent with a unique “lectibody” property. It is capable of targeting cancer cells through the selective recognition of high mannose glycans, which are aberrantly overrepresented on the surface of malignant cells. Upon binding to cancer cells, AvFc can interact with circulating effector immune cells equipped with Fc receptors, such as natural killer (NK) cells to induce antibody-dependent cell-mediated cytotoxicity (ADCC) and kill the cancer cells. Previous work has shown that AvFc effectively induces ADCC activity …

Exercise Is A Vital Sign, Megan Dannemiller, Anthony Shadiack, Marvin Sineath Jr, Andrew Baird, Marc Poirier, Kevin Thomas, Michael G. Flynn

HCA Healthcare Journal of Medicine

In this review, we argue that exercise (physical activity) be monitored as a vital sign since no other basic sign or symptom provides as much information about a patient's health status. The influence of regular exercise on patient health is indisputable, with strong evidence to show the power of exercise to mitigate chronic disease and improve overall health. Several simple tools, such as Physical Activity as a Vital Sign and Exercise as a Vital Sign are available to assess patient physical activity. When properly applied, there is evidence to support the efficacy of these tools, but there are barriers that …