Translational Medical Research Commons^™

Dual-Display Laparoscopic Laser Speckle Contrast Imaging For Real-Time Surgical Assistance, Jaepyeong Cha, Corey Zheng, Lung Wai Lau

Pediatrics Faculty Publications

Laser speckle contrast imaging (LSCI) utilizes the speckle pattern of a laser to determine the blood flow in tissues. The current approaches for its use in a clinical setting require a camera system with a laser source on a separate optical axis making it unsuitable for minimally invasive surgery (MIS). With blood flow visualization, bowel viability, for example, can be determined. Thus, LSCI can be a valuable tool in gastrointestinal surgery. In this work, we develop the first-of-its-kind dual-display laparoscopic vision system integrating LSCI with a commercially available 10mm rigid laparoscope where the laser has the same optical axis as …

Direct Crystal Formation From Micronized Bone And Lactic Acid: The Writing On The Wall For Calcium-Containing Crystal Pathogenesis In Osteoarthritis?, Anna A. Bulysheva, Nardos Sori, Michael P. Francis

Bioelectrics Publications

Introduction

Pathological calcium-containing crystals accumulating in the joints, synovial fluid, and soft tissues are noted in most elderly patients, yet arthritic crystal formation remains idiopathic. Interestingly, elevated lactic acid and bone erosion are frequently among the comorbidities and clinical features of patients with highest incidence of crystal arthropathies. This work shows that bone particulates (modeling bone erosion) dissolve in lactic acid and directly generate crystals, possibly presenting a mechanism for crystal accumulation in osteoarthritis.

Methods and results

Micronized human bone (average particle size of 160 μm x 79 μm ) completely dissolved in lactic acid in 48 hours, and in …

The Anti-Cancer Effect Of Retinoic Acid Signaling In Crc Occurs Via Decreased Growth Of Aldh+ Colon Cancer Stem Cells And Increased Differentiation Of Stem Cells, Shirin R. Modarai, Anindita Gupta, Lynn M. Opdenaker, Ryan Kowash, Gabriel Masters, Vignesh Viswanathan, Tao Zhang, Jeremy Z. Fields, Bruce M. Boman

Department of Pharmacology and Experimental Therapeutics Faculty Papers

Background: Tumorigenesis is driven by stem cell (SC) overpopulation. BecauseALDH is both a marker for SCs in many tissues and a key enzyme in retinoid acid (RA)signaling, we studied RA signaling in normal and malignant colonic SCs.Hypothesis: RA signaling regulates growth and differentiation of ALDH+ colonicSCs dysregulation of RA signaling contributes to SC overpopulation and colorectalcancer (CRC) development.Methods: We analyzed normal and malignant colonic tissues and CRC cell linesto see if retinoid receptors (RXR &RAR) are exclusively expressed in ALDH+ SCs,and if RA signaling changes during CRC development. We determined whether RAsignaling regulates cancer SC (CSC) proliferation, differentiation, sphere formation,and …

Non-St-Segment Elevation Acute Coronary Syndrome: Early Versus Delayed Cardiac Catheterization, Teresa Colelli, Adrianna Clapp, Rudy Wenner, Blake J. Arthurs

Clinical Research in Practice: The Journal of Team Hippocrates

An informed consent conversation regarding early vs. delayed cardiac catheterization for patients with NSTEMI.

Editorial: Clinical Practice Can Save Evidence-Based Medicine From Itself, James Peter Meza, Nicholus Yee

Clinical Research in Practice: The Journal of Team Hippocrates

Although imperfect, the structure of this journal and its publications are demonstrations of clinicians attempting to actualize the wisdom of these foundational thinkers. We need to leave examples and guideposts to the next generation of clinicians of how to fulfill this vision of being excellent clinicians, through both formal education and role modeling.

Pneumatic Balloon Dilation Versus Myotomy For The Treatment Of Achalsia, Benjamin E. Ueberroth

Clinical Research in Practice: The Journal of Team Hippocrates

A critical appraisal and clinical application of Moonen A, Annese V, Belmans A, et al. Long-term results of the European achalasia trial: A multicentre randomised controlled trial comparing pneumatic dilation versus laparoscopic Heller myotomy. Gut. 2016 May;65(5):732-9. doi: 10.1136/gutjnl-2015-310602.

Fecal Transplant Is Superior To Oral Vancomycin For Treatment Of Recurrent Clostridium Difficile, Kassandra J. Weber

Clinical Research in Practice: The Journal of Team Hippocrates

A critical appraisal and clinical application of Van Nood E, Vrieze A, Nieuwdorp M, Fuentes S, et al. Duodenal infusion of donor feces for recurrent Clostridium difficile. N Engl J Med. 2013;368(5):407-415. doi: 10.1056/NEJMoa1205037.

Equal Efficacy Of Clopidogrel Versus Ticagrelor As Monotherapy In Peripheral Artery Disease, Aimee L. Vos

Clinical Research in Practice: The Journal of Team Hippocrates

A critical appraisal and clinical application of Hiatt H, Fowkes G, Heizer G, et al. Ticagrelor versus clopidogrel in symptomatic peripheral artery disease. N Engl J Med. 2017;376:32-40. doi: 10.1056/NEJMoa1611688.

Lurasidone Is Not Associated With Risk Of Qtc Prolongation, Halimah Y. Oral

Clinical Research in Practice: The Journal of Team Hippocrates

A critical appraisal and clinical application of Meltzer HY, Cucchiaro J, Silva R, Ogasa M, Phillips D, Xu J, Kalali AH, Scheizer E, Pikalov A, Loebel A. Lurasidone in the treatment of schizophrenia: a randomized, double-blind, placebo- and olanzapine-controlled study. Am J Psychiatry. 2011 Sep;168(9):957-67. doi: https://doi.org/10.1176/appi.ajp.2011.10060907.

Long-Term Antibiotic Therapy Is Just As Effective As Amputation For Foot Osteomyelitis In Diabetics Without Peripheral Arterial Disease, Christopher Hopper

Clinical Research in Practice: The Journal of Team Hippocrates

A critical appraisal and clinical application of Lázaro-Martínez JL, Aragón-Sánchez J, García-Morales E. Antibiotics versus conservative surgery for treating diabetic foot osteomyelitis: a randomized comparative trial. Diabetes Care. 2014;37(3):789-95. doi: 10.2337/dc13-1526.

Ssri Maintenance Therapy Reduces Rate Of Recurrence For Elderly Patients With First Episode Of Major Depression, Blake J. Arthurs

Clinical Research in Practice: The Journal of Team Hippocrates

A critical appraisal and clinical application of Reynolds CF 3rd, Dew MA, Pollock BG, et al. Maintenance treatment of major depression in old age. N Engl J Med. 2006 Mar 16;354(11):1130-8. doi: 10.1056/NEJMoa052619. Based on the appraisal, long term SSRI maintenance therapy is recommended for elderly patients suffering from first episode of major depression.

My Patient Chose To Not Use Daily Azithromycin To Prevent Exacerbation Of Copd, Jacob Oblak

Clinical Research in Practice: The Journal of Team Hippocrates

A critical appraisal and clinical application of Albert RK, Connett J, Bailey WC, et al. Azithromycin for prevention of exacerbations of COPD. New Eng J Med. 2011;365:689-698. doi: 10.1056/NEJMoa1104623.

Abstinence From Alcohol Improves Survival In Decompensated Cirrhotic Patients, Perry Zong

Clinical Research in Practice: The Journal of Team Hippocrates

A critical appraisal and clinical application of Alvarez MA, Cirera I, Solà R, Bargalló A, Morillas RM, Planas R. Long-term clinical course of decompensated alcoholic cirrhosis. Journal of Clinical Gastroenterology. 2011;45(10):906-911. doi: 10.1097/mcg.0b013e3182284e13.

Therapeutic Hypothermia For Children After In-Hospital Cardiac Arrest Not Helpful, Bradley Kolb

Clinical Research in Practice: The Journal of Team Hippocrates

An informed consent discussion regarding the merits of therapeutic hypothermia in a comatose pediatric patient following in-hospital cardiac arrest and return of spontaneous circulation.

Institutional Protocols Can Improve Ivc Filter Retrieval Rates, Madeline Ross, Gong He, Veronica Santana-Ufret, Anjali Sundar

Clinical Research in Practice: The Journal of Team Hippocrates

A critical appraisal and clinical application of Lynch FC. A method for following patients with retrievable inferior vena cava filters: results and lessons learned from the first 1100 patients. J Vasc Interv Radiol. 2011;22:1507–1512. doi: 10.1016/j.jvir.2011.07.019

Pepducin-Mediated Cardioprotection Via Β-Arrestin-Biased Β2-Adrenergic Receptor-Specific Signaling, Laurel A. Grisanti, Toby P. Thomas, Rhonda L. Carter, Claudio De Lucia, Erhe Gao, Walter J. Koch, Jeffrey L. Benovic, Douglas G. Tilley

Department of Biochemistry and Molecular Biology Faculty Papers

Reperfusion as a therapeutic intervention for acute myocardial infarction-induced cardiac injury itself induces further cardiomyocyte death. β-arrestin (βarr)-biased β-adrenergic receptor (βAR) activation promotes survival signaling responses in vitro; thus, we hypothesize that this pathway can mitigate cardiomyocyte death at the time of reperfusion to better preserve function. However, a lack of efficacious βarr-biased orthosteric small molecules has prevented investigation into whether this pathway relays protection against ischemic injury in vivo. We recently demonstrated that the pepducin ICL1-9, a small lipidated peptide fragment designed from the first intracellular loop of β2AR, allosterically engaged pro-survival signaling cascades in a βarr-dependent manner in …

Autologous Blood Patch After Ct-Guided Lung Biopsy Might Reduce Pneumothorax Requiring Chest Tube Placement, Tiffani Strickland

Clinical Research in Practice: The Journal of Team Hippocrates

A critical appraisal and clinical application of Malone LJ, Stanfill RM, Wang H, Fahey KM, Bertino RE. Effect of intraparenchymal blood patch on rates of pneumothorax and pneumothorax requiring chest tube placement after percutaneous lung biopsy. American Journal of Roentgenology. 2013;200(6):1238-1243. doi: 10.2214/ajr.12.8980.

Icatibant Is Not An Appropriate Treatment Option For Ace-Inhibitor Induced Angioedema Of The Head And Neck, Faiz Khaja

Clinical Research in Practice: The Journal of Team Hippocrates

A critical appraisal and clinical application of Sinert T, Levy P, Bernstein JA, et al. Randomized trial of icatibant for angiotensin-converting enzyme inhibitor-induced upper airway angioedema. J Allergy Clin Immunol Pract. 2017;5(5):1402-9. doi: 10.1016/j.jaip.2017.03.003

Transcriptional Up-Regulation Of Relaxin-3 By Nur77 Attenuates Β-Adrenergic Agonist-Induced Apoptosis In Cardiomyocytes., Xiaohua You, Zhifu Guo, Fang Cheng, Bing Yi, Fan Yang, Xinzhu Liu, Ni Zhu, Xianxian Zhao, Guijun Yan, Xin-Liang Ma, Jianxin Sun

Center for Translational Medicine Faculty Papers

The relaxin family peptides have been shown to exert several beneficial effects on the heart, including anti-apoptosis, anti-fibrosis, and anti-hypertrophy activity. Understanding their regulation might provide new opportunities for therapeutic interventions, but the molecular mechanism(s) coordinating relaxin expression in the heart remain largely obscured. Previous work demonstrated a role for the orphan nuclear receptor Nur77 in regulating cardiomyocyte apoptosis. We therefore investigated Nur77 in the hopes of identifying novel relaxin regulators. Quantitative real-time PCR (qRT-PCR) and enzyme-linked immunosorbent assay (ELISA) data indicated that ectopic expression of orphan nuclear receptor Nur77 markedly increased the expression of latexin-3 (RLN3), but not relaxin-1 …

Anidulafungin: A Noninferior Alternative To Fluconazole For Treatment Of Esophageal Candidiasis, Blake S. Sanford

Clinical Research in Practice: The Journal of Team Hippocrates

A critical appraisal and clinical application of Krause DS, Simjee AE, van Rensburg C, et al. A randomized, double-blind trial of anidulafungin versus fluconazole for the treatment of esophageal candidiasis. Clin Infect Dis. 2004;39(6):770-775. doi: 10.1086/423378.

Sertraline Is An Effective Management Option For Cholestatic Pruritus, Rudy W. Wenner

Clinical Research in Practice: The Journal of Team Hippocrates

A critical appraisal and clinical application of Mayo MJ, Handem I, Saldana S, Jacobe H, Getachew Y, Rush AJ. Sertraline as a first-line treatment for cholestatic pruritus. Hepatology. 2007 Mar;45(3):666-74. doi: 10.1002/hep.21553

Intravenous Glucocorticoids Provide No Additional Benefit Over Oral Glucocorticoids In Chronic Obstructive Pulmonary Disease Exacerbation, Alexander C. Waselewski

Clinical Research in Practice: The Journal of Team Hippocrates

A critical appraisal and clinical application of de Jong YP, Uil SM, Grotjohan HP, Postma DS, Kerstjens HA, van den Berg JW. Oral or IV prednisolone in the treatment of COPD exacerbations: a randomized, controlled, double-blind study. Chest. 2007;132(6):1741-1747. doi: 10.1378/chest.07-0208

Characteristics And Clinical Outcomes Of Hospitalized Patients With Community-Acquired Pneumonia Who Are Active Intravenous Drug Users, Vidyulata Salunkhe, Paula Peyrani, Leslie A. Beavin, Stephen P. Furmanek, Julio A. Ramirez

The University of Louisville Journal of Respiratory Infections

Background: Intravenous drug users (IVDU) have a 10-fold increased risk of community-acquired pneumonia (CAP) compared to the general population. There is scarce data available evaluating the clinical outcomes of IVDU hospitalized patients with CAP and that data mostly focuses on mortality. The objective of this study was to evaluate the clinical characteristics, incidence and outcomes of hospitalized patients with CAP in active intravenous drug users in Louisville, Kentucky.

Methods: This was a secondary data analysis of the University of Louisville Pneumonia study. IVDU patients were propensity score matched to a non-IVDU group. Study outcomes were time to clinical stability (TCS), …

Pulmonary Histoplasmosis In A Patient With Cough, Dyspnea, Pulmonary Nodule And Rheumatologic Manifestations: Case Report And Review, Johnson Britto

The University of Louisville Journal of Respiratory Infections

In this case report we describe a case of pulmonary histoplasmosis in a healthy adult female living in Kentucky. The patient presented with two months history of poly-arthralgia and myalgia, intermittent dry cough, chest tightness, exertional dyspnea, malaise, fatigue and one week history of skin rash. She did not respond to broad-spectrum antibiotic therapy and she also had extensive endocrine and rheumatologic work up that was negative. A diagnosis of histoplasmosis was established based on radiological findings as well as endobronchial ultrasound-guided transbronchial needle aspiration cytology (EBUS-TBNA) of mediastinal lymph nodes demonstrating necrotizing granuloma with fungal stains positive for Histoplasma. …

A Continuum Of Disease From Community-Acquired Pneumonia To Multiple Organ Dysfunction Syndrome, Julio A. Ramirez

The University of Louisville Journal of Respiratory Infections

No abstract provided.

Pulmonary Aspergillosis: A Review On Diagnosis And Management, Bilal A. Jalil, Juan M. Galvis, Karim A. El Kersh, Mohamed Saad, Mostafa M. Fraig, Juan J. Guardiola Ii

The University of Louisville Journal of Respiratory Infections

Aspergillosis is acquired by inhalation of spores of Aspergillus, a ubiquitous species in the environment. In normal hosts, spore inhalation rarely causes lung disease.

Pulmonary aspergillosis covers a wide spectrum of clinical syndromes depending on the interaction between Aspergillus and the host (immune-status, prior bronchopulmonary disease). It runs the gamut from invasive aspergillosis to Aspergillus bronchitis and colonization.

Invasive aspergillosis occurs in severely immunocompromised patients, typically with neutropenia. Chronic pulmonary aspergillosis affects patients with chronic structural lung disease such as chronic obstructive pulmonary disease, mycobacterial lung disease, but without significant immunocompromise. Aspergillus bronchitis affects patients with bronchial disease such …

Coping With Chronic Fungal Rhinosinusitis: Diagnosis To Therapy, Veronica Corcino, Leslie Beavin, Shengli Lu, Ashley Ross, Carmen V. Sciortino Jr.

The University of Louisville Journal of Respiratory Infections

No abstract provided.

Continuous Infusion Of Epoprostenol As Salvage Therapy For Severe Pulmonary Arterial Hypertension, Jenna Rousseau, Jie Chi

Clinical Research in Practice: The Journal of Team Hippocrates

A critical appraisal and clinical application of Barst RJ, Rubin LJ, Long WA, McGoon MD, Rich S. A comparison of continuous intravenous epoprostenol (prostacyclin) with conventional therapy for primary pulmonary hypertension. New Eng J Med. 1996;334(5):296-301. doi: 10.1056/nejm199602013340504

The Transfusion Threshold For Upper Gastrointestinal Bleeding Is A Hemoglobin Of 7.0 G/Dl Or Less, Matthew J. Ouellette , D.O., Katherine S. Lee , M.D., Daniel P. Noack, Aaron Simpson , M.D., Rana K. Zaban , D.O., Chelsea Gonzalez , D.O., Racha El-Ladki , D.O.

Clinical Research in Practice: The Journal of Team Hippocrates

A critical appraisal and clinical application of Villanueva C, Colomo A, Bosch A, Concepcion M, Hernandez-Gea V, Aracil C. Transfusion strategies for acute upper gastrointestinal bleeding. New Eng J Med. 2013;368(1):11-21. doi: 10.1056/NEJMoa1211801

Correction Of Abnormal Coagulation Parameters As Prophylaxis For Post-Procedural Bleeding Is Unnecessary Prior To Ultrasound-Guided Thoracentesis, Eric Walton

Clinical Research in Practice: The Journal of Team Hippocrates

A critical appraisal and clinical application of Hibbert RM, Atwell TD, Lekah A, et al. Safety of ultrasound-guided thoracentesis in patients with abnormal preprocedural coagulation parameters. Chest. 2013;144(2):456-463. doi: 10.1378/chest.12-2374.