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Pathological Conditions, Signs and Symptoms Commons

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Orbit Image Analysis Machine Learning Software Can Be Used For The Histological Quantification Of Acute Ischemic Stroke Blood Clots, Sean Fitzgerald, Shunli Wang, Daying Dai, Dennis H. Murphree Jr., Abhay Pandit, Andrew Douglas, Asim Rizvi, Ramanathan Kadirvel, Michael Gilvarry, Ray McCarthy, Manuel Stritt, Matthew J. Gounis, Waleed Brinjikji, David F. Kallmes, Karen M. Doyle 2019 National University of Ireland, Galway

Orbit Image Analysis Machine Learning Software Can Be Used For The Histological Quantification Of Acute Ischemic Stroke Blood Clots, Sean Fitzgerald, Shunli Wang, Daying Dai, Dennis H. Murphree Jr., Abhay Pandit, Andrew Douglas, Asim Rizvi, Ramanathan Kadirvel, Michael Gilvarry, Ray Mccarthy, Manuel Stritt, Matthew J. Gounis, Waleed Brinjikji, David F. Kallmes, Karen M. Doyle

Open Access Publications by UMMS Authors

Our aim was to assess the utility of a novel machine learning software (Orbit Image Analysis) in the histological quantification of acute ischemic stroke (AIS) clots. We analyzed 50 AIS blood clots retrieved using mechanical thrombectomy procedures. Following HandE staining, quantification of clot components was performed by two different methods: a pathologist using a reference standard method (Adobe Photoshop CC) and an experienced researcher using Orbit Image Analysis. Following quantification, the clots were categorized into 3 types: RBC dominant (>/=60% RBCs), Mixed and Fibrin dominant ( > /=60% Fibrin). Correlations between clot composition and Hounsfield Units density on Computed Tomography (CT) were ...


Evidence-Based Foot Care For Persons With Type 2 Diabetes, Nicole Gutierrez 2019 University of the Incarnate Word

Evidence-Based Foot Care For Persons With Type 2 Diabetes, Nicole Gutierrez

Doctor of Nursing Practice

Unmanaged Type 2 diabetes leads to macrovascular changes that affect the lower extremities, thereby damaging the sensory nerve fibers and leading to diabetic peripheral neuropathy. These patients may not be able to feel pain, heat, or cold in their lower extremities and often describe feelings of numbness and tingling. This sensory deficit may lead to the development of diabetic foot ulcers which often result in amputation. These preventable foot complications may be identified promptly with adequate diabetic foot exams. Comprehensive diabetic foot examinations reduce the occurrences of foot complications associated with uncontrolled glucose management and improves health outcomes for patients ...


In Vivo Clonal Expansion And Phenotypes Of Hypocretin-Specific Cd4(+) T Cells In Narcolepsy Patients And Controls, Wei Jiang, James R. Birtley, Grant C. Weaver, Liying Lu, Lawrence J. Stern, Elizabeth D. Mellins 2019 Stanford University

In Vivo Clonal Expansion And Phenotypes Of Hypocretin-Specific Cd4(+) T Cells In Narcolepsy Patients And Controls, Wei Jiang, James R. Birtley, Grant C. Weaver, Liying Lu, Lawrence J. Stern, Elizabeth D. Mellins

Open Access Publications by UMMS Authors

Individuals with narcolepsy suffer from abnormal sleep patterns due to loss of neurons that uniquely supply hypocretin (HCRT). Previous studies found associations of narcolepsy with the human leukocyte antigen (HLA)-DQ6 allele and T-cell receptor alpha (TRA) J24 gene segment and also suggested that in vitro-stimulated T cells can target HCRT. Here, we present evidence of in vivo expansion of DQ6-HCRT tetramer(+)/TRAJ24(+)/CD4(+) T cells in DQ6(+) individuals with and without narcolepsy. We identify related TRAJ24(+) TCRalphabeta clonotypes encoded by identical alpha/beta gene regions from two patients and two controls. TRAJ24-G allele(+) clonotypes only expand in the two ...


A Big-Data Approach To Understanding Metabolic Rate And Response To Obesity In Laboratory Mice [Preprint], June K. Corrigan, Deepti Ramachandran, Yuchen He, Colin Palmer, Michael J. Jurczak, Bingshan Li, Randall H. Friedline, Jason K. Kim, Jon J. Ramsey, Louise Lantier, Owen P. McGuinness, Alexander S. Banks, Mouse Metabolic Phenotyping Center Energy Balance Working Group 2019 Harvard Medical School

A Big-Data Approach To Understanding Metabolic Rate And Response To Obesity In Laboratory Mice [Preprint], June K. Corrigan, Deepti Ramachandran, Yuchen He, Colin Palmer, Michael J. Jurczak, Bingshan Li, Randall H. Friedline, Jason K. Kim, Jon J. Ramsey, Louise Lantier, Owen P. Mcguinness, Alexander S. Banks, Mouse Metabolic Phenotyping Center Energy Balance Working Group

University of Massachusetts Medical School Faculty Publications

Maintaining a healthy body weight requires an exquisite balance between energy intake and energy expenditure. In humans and in laboratory mice these factors are experimentally measured by powerful and sensitive indirect calorimetry devices. To understand the genetic and environmental factors that contribute to the regulation of body weight, an important first step is to establish the normal range of metabolic values and primary sources contributing to variability in results. Here we examine indirect calorimetry results from two experimental mouse projects, the Mouse Metabolic Phenotyping Centers and International Mouse Phenotyping Consortium to develop insights into large-scale trends in mammalian metabolism. Analysis ...


Salivary Gland Choristoma: A Rare Finding At Gastroesophageal Junction, Isin Y. Comba MD, Richard Henriquez MD, Sundeep Kumar MD, Hilda Merino-Chavez MD, Maria Wallis-Crespo MD, Christopher Cooper MD, Lakhinder Bhatia MD 2019 HCA Healthcare

Salivary Gland Choristoma: A Rare Finding At Gastroesophageal Junction, Isin Y. Comba Md, Richard Henriquez Md, Sundeep Kumar Md, Hilda Merino-Chavez Md, Maria Wallis-Crespo Md, Christopher Cooper Md, Lakhinder Bhatia Md

Gastroenterology

Introduction: Choristoma is tumor-like outgrowth of heterotopic and mature tissue located at anatomically unusual sites. Heterotopic salivary gland tissue (HSGT) has been most commonly described in head and neck region but can rarely involve gastrointestinal (GI) tract with a few cases reported in the literature.

Case Description/Methods: An 87-year-old female with past medical history of gastroesophageal reflux disease (GERD), hypertension, and chronic kidney disease was admitted for an acute DVT. Due to worsening anemia, she underwent an upper endoscopy that showed a small nodularity at the GE junction (figure 1a), a large hiatal hernia, and reflux esophagitis in the ...


A Hiatal Hernia Causing Atrial Fibrillation Through Direct Mechanical Irritation, Kirolus Sourial, Zaid Yaqoob, Anthony Chahin, Saif Borgan, Ernesto S. Robalino Gonzaga, Aamir Javaid, Olga Karasik 2019 HCA Healthcare

A Hiatal Hernia Causing Atrial Fibrillation Through Direct Mechanical Irritation, Kirolus Sourial, Zaid Yaqoob, Anthony Chahin, Saif Borgan, Ernesto S. Robalino Gonzaga, Aamir Javaid, Olga Karasik

Gastroenterology

Introduction: Hiatal hernia (HH) is anatomically classified into four types according to herniated structures. Giant HH refers to a herniation of > 50% of the stomach. Atrial fibrillation (AF) is a common arrhythmia, frequently seen in association with cardiovascular diseases. We report a case of AF caused by a giant HH compressing the left atrium.

Case Description/Methods: A 90+ year-old female with a past medical history of gastroesophageal reflux disease (GERD), was admitted for surgical evaluation of symptomatic HH. During hospital stay the patient developed AF with rapid ventricular response, became hypotensive and lightheaded. EKG (Figure 1) confirmed new onset ...


Listen To Your Heart, Or At Least Theirs: Maintaining A High Index Of Suspicion For Infective Endocarditis, Mollie Powell DO, Mahesh Setty MD 2019 HCA Healthcare

Listen To Your Heart, Or At Least Theirs: Maintaining A High Index Of Suspicion For Infective Endocarditis, Mollie Powell Do, Mahesh Setty Md

Emergency Medicine

After an endothelial injury, a fibrin and platelet cap forms. This cap is typically sterile but in times of infection can become colonized by microbes leading to a vegetation. When this occurs on the endothelium of the heart, it is termed infective endocarditis (IE). IE is a difficult diagnosis to make in the ED. The symptoms are vague. Classic exam findings are often absent, murmur auscultation can be challenging and there is not a single diagnostic test. A delayed or missed diagnosis can be fatal; therefore, it is essential that ED physicians maintain a high index of suspicion in high ...


Sarcoidosis Presenting With Massive Splenomegaly And Severe Epistaxis, Austen Stoelting MD, Shawn B. Esperti DO, Andrew Mangano DO, Nino Balanchivadze MD 2019 HCA Healthcare

Sarcoidosis Presenting With Massive Splenomegaly And Severe Epistaxis, Austen Stoelting Md, Shawn B. Esperti Do, Andrew Mangano Do, Nino Balanchivadze Md

Internal Medicine

No abstract provided.


Spinal Cord Stimulator For Treating Pudendal Neuralgia, Bruce Dixon DO, Stephen Pyles MD, Ettore Crimi MD 2019 HCA Healthcare

Spinal Cord Stimulator For Treating Pudendal Neuralgia, Bruce Dixon Do, Stephen Pyles Md, Ettore Crimi Md

Anesthesiology

No abstract provided.


Peripheral Nerve Stimulator For Treating Nummular Headaches And Occipital Neuralgia, Bruce Dixon DO, Stephen Pyles MD, Ettore Crimi MD 2019 HCA Healthcare

Peripheral Nerve Stimulator For Treating Nummular Headaches And Occipital Neuralgia, Bruce Dixon Do, Stephen Pyles Md, Ettore Crimi Md

Anesthesiology

No abstract provided.


Implications Of Frailty In Copd Exacerbations, Aimee Almanzar, Armando Cabrera, Felix Hernandez, Hector Y. Vazquez, Asma Jafri, Miriam Zylberglait Lisigurski, Livasky Concepcion, Gustavo Ferrer 2019 HCA Healthcare

Implications Of Frailty In Copd Exacerbations, Aimee Almanzar, Armando Cabrera, Felix Hernandez, Hector Y. Vazquez, Asma Jafri, Miriam Zylberglait Lisigurski, Livasky Concepcion, Gustavo Ferrer

Pulmonary Disease

Introduction The extrapulmonary manifestations of chronic obstructive pulmonary disease (COPD) patients are similar to symptoms of frailty, a geriatric syndrome. This study was designed to identify the relation between frailty and patient outcomes during a COPD exacerbation. Methods This retrospective study identified 10,235 patients hospitalized for COPD exacerbation, as well as 16 laboratory tests included in a frailty index that have been linked to frailty. Patients were divided into less frail (0-8 positive laboratory values) and more frail (9-16 positive laboratory values) groups. The primary composite endpoints were mechanical ventilation, ICU length of stay, readmission, and discharge status. Results ...


Coronary Disease Is Not Associated With Robust Alterations In Inflammatory Gene Expression In Human Epicardial Fat, Timothy P. Fitzgibbons, Nancy Lee, Khanh-Van T. Tran, Sarah M. Nicoloro, Mark Kelly, Stanley Kc Tam, Michael P. Czech 2019 University of Massachusetts Medical School

Coronary Disease Is Not Associated With Robust Alterations In Inflammatory Gene Expression In Human Epicardial Fat, Timothy P. Fitzgibbons, Nancy Lee, Khanh-Van T. Tran, Sarah M. Nicoloro, Mark Kelly, Stanley Kc Tam, Michael P. Czech

Open Access Publications by UMMS Authors

Epicardial adipose tissue (EAT) is the visceral fat depot of the heart. Inflammation of EAT is thought to contribute to coronary artery disease (CAD). Therefore, we hypothesized that the EAT of patients with CAD would have increased inflammatory gene expression compared with controls without CAD. Cardiac surgery patients with (n = 13) or without CAD (n = 13) were consented, and samples of EAT and subcutaneous adipose tissue (SAT) were obtained. Transcriptomic analysis was performed using Affymetrix Human Gene 1.0 ST arrays. Differential expression was defined as a 1.5-fold change (ANOVA P < 0.05). Six hundred ninety-three genes were differentially expressed between SAT and EAT in controls and 805 in cases. Expression of 326 genes was different between EAT of cases and controls; expression of 14 genes was increased in cases, while 312 were increased in controls. Quantitative reverse transcription PCR confirmed that there was no difference in expression of CCL2, CCR2, TNF-alpha, IL-6, IL-8, and PAI1 between groups. Immunohistochemistry showed more macrophages in EAT than SAT, but there was no difference in their number or activation state between groups. In contrast to prior studies, we did not find increased inflammatory gene expression in the EAT of patients with CAD. We conclude that the specific adipose tissue depot, rather than CAD status, is responsible for the majority of differential gene expression.


Bridging The Gap On Schistosomiasis: A Cross-Sectional Study Examining The Knowledge Gap And Common Attitudes And Practices Regarding S. Mansoni Infections Among Varying Education Levels In Luanda K’Otieno, Western Kenya, Kathy Zhang 2019 SIT Study Abroad

Bridging The Gap On Schistosomiasis: A Cross-Sectional Study Examining The Knowledge Gap And Common Attitudes And Practices Regarding S. Mansoni Infections Among Varying Education Levels In Luanda K’Otieno, Western Kenya, Kathy Zhang

Independent Study Project (ISP) Collection

Background: Schistosomiasis is considered one of the most prevalent neglected tropical diseases in the world. According to the World Health Organization (WHO), the most effective strategy for schistosomiasis control is through preventive chemotherapy with praziquantel (PZQ). In order to successfully control morbidity rates, the WHO recommends mass treatment targeting high risk groups, such as school-age children and adults considered to be at risk.

Methods: This cross-sectional study examined the effects of the National School-Based Deworming Programme (NSBDP) on knowledge of schistosomiasis and subsequent prevalence rates and intensity. A total of 43 residents in Luanda K’Otieno were interviewed, and 34 ...


Felty's Syndrome: Triad Not Always Evident, Pablo G. Dubon MD, Frederick Lim MD, Shfali Bhandari MD, Sukhmani Chauhan MD, Puja Solanki MD, Luis Silva MD 2019 HCA Healthcare

Felty's Syndrome: Triad Not Always Evident, Pablo G. Dubon Md, Frederick Lim Md, Shfali Bhandari Md, Sukhmani Chauhan Md, Puja Solanki Md, Luis Silva Md

Internal Medicine

No abstract provided.


Post-Dural Puncture Headache Complicated By Subdural Hematomas - A Case Report, Mark Cohen MD, Mays Alani MD, Amir Touray MD, Saif Ullah MD 2019 HCA Healthcare

Post-Dural Puncture Headache Complicated By Subdural Hematomas - A Case Report, Mark Cohen Md, Mays Alani Md, Amir Touray Md, Saif Ullah Md

Neurology

Post-dural puncture headache (PDPH) is a potential iatrogenic complication of procedures which disrupt meningeal integrity, particularly in obstetric patients, which are perhaps the highest-risk group. Common clinical manifestations include severe diffuse headache, neck stiffness, and nausea and vomiting; these symptoms, however, are non-specific and PDPH remains a diagnosis of exclusion that can be ascertained with a thorough history and proper consideration of other etiologies.


Case 28-2019: A 22-Year-Old Woman With Dyspnea And Chest Pain, Ted M. Kremer, Mark E. Lindsay, T Bernard. Kinane, Megan H. Hawley, Brent P. Little, Mari Mino-Kenudson 2019 University of Massachusetts Medical School

Case 28-2019: A 22-Year-Old Woman With Dyspnea And Chest Pain, Ted M. Kremer, Mark E. Lindsay, T Bernard. Kinane, Megan H. Hawley, Brent P. Little, Mari Mino-Kenudson

Pediatric Publications

Case report on a 22-year-old woman who was seen in the pediatric pulmonary clinic of this hospital because of chest pain, cough, and dyspnea on exertion.


Psychosocial, Psychiatric And Work-Related Risk Factors Associated With Suicide In Ireland: Optimised Methodological Approach Of A Case-Control Psychological Autopsy Study, E. Arensman, Celine Larkin 2019 University College Cork

Psychosocial, Psychiatric And Work-Related Risk Factors Associated With Suicide In Ireland: Optimised Methodological Approach Of A Case-Control Psychological Autopsy Study, E. Arensman, Celine Larkin

Open Access Publications by UMMS Authors

BACKGROUND: Suicide has profound effects on families and communities, but is a statistically rare event. Psychological autopsies using a case-control design allow researchers to examine risk factors for suicide, using a variety of sources to detail the psychological and social characteristics of decedents and to compare them to controls. The Suicide Support and Information System Case Control study (SSIS-ACE) aimed to compare psychosocial, psychiatric and work-related risk factors across three groups of subjects: suicide decedents, patients presenting to hospital with a high-risk self-harm episode, and general practice controls.

METHODS: The study design includes two inter-related studies; one main case-control study ...


Micro-Rnas Are Related To Epicardial Adipose Tissue In Participants With Atrial Fibrillation: Data From The Mirhythm Study, Khanh-Van T. Tran, Jordan Majka, Saket Sanghai, Mayank Sardana, Darleen M. Lessard, Zachary J. Milstone, Kahraman Tanriverdi, Jane E. Freedman, Timothy P. Fitzgibbons, David D. McManus 2019 University of Massachusetts Medical School

Micro-Rnas Are Related To Epicardial Adipose Tissue In Participants With Atrial Fibrillation: Data From The Mirhythm Study, Khanh-Van T. Tran, Jordan Majka, Saket Sanghai, Mayank Sardana, Darleen M. Lessard, Zachary J. Milstone, Kahraman Tanriverdi, Jane E. Freedman, Timothy P. Fitzgibbons, David D. Mcmanus

Open Access Publications by UMMS Authors

Introduction: Epicardial adipose tissue (EAT) has been linked to incidence and recurrence of atrial fibrillation (AF), but the underlying mechanisms that mediate this association remain unclear. Circulating microRNAs (miRNAs) contribute to the regulation of gene expression in cardiovascular diseases, including AF. Thus, we sought to test the hypothesis that circulating miRNAs relate to burden of EAT.

Methods: We examined the plasma miRNA profiles of 91 participants from the miRhythm study, an ongoing study examining associations between miRNA and AF. We quantified plasma expression of 86 unique miRNAs commonly expressed in cardiomyocytes using quantitative reverse transcriptase polymerase chain reaction (qPCR). From ...


Memory Cd4 T Cell-Derived Il-2 Synergizes With Viral Infection To Exacerbate Lung Inflammation, K. Kai McKinstry, Fahmida Alam, Valeria Flores-Malavet, Mate Z. Nagy, Stewart Sell, Andrea M. Cooper, Susan L. Swain, Tara M. Strutt 2019 University of Central Florida

Memory Cd4 T Cell-Derived Il-2 Synergizes With Viral Infection To Exacerbate Lung Inflammation, K. Kai Mckinstry, Fahmida Alam, Valeria Flores-Malavet, Mate Z. Nagy, Stewart Sell, Andrea M. Cooper, Susan L. Swain, Tara M. Strutt

Open Access Publications by UMMS Authors

Defining the most penetrating correlates of protective memory T cells is key for designing improved vaccines and T cell therapies. Here, we evaluate how interleukin (IL-2) production by memory CD4 T cells, a widely held indicator of their protective potential, impacts immune responses against murine influenza A virus (IAV). Unexpectedly, we show that IL-2-deficient memory CD4 T cells are more effective on a per cell basis at combating IAV than wild-type memory cells that produce IL-2. Improved outcomes orchestrated by IL-2-deficient cells include reduced weight loss and improved respiratory function that correlate with reduced levels of a broad array of ...


Overview On Percutaneous Therapies Of Disc Diseases, Salvatore Masala, Fabio Salimei, Adriano Lacche, Stefano Marcia, Francesco Massari 2019 University of Rome

Overview On Percutaneous Therapies Of Disc Diseases, Salvatore Masala, Fabio Salimei, Adriano Lacche, Stefano Marcia, Francesco Massari

Radiology Publications

Low back pain is an extremely common pathology affecting a great share of the population, in particular, young adults. Many structures can be responsible for pain such as intervertebral discs, facet joints, nerve roots, and sacroiliac joints. This review paper focuses on disc pathology and the percutaneous procedures available to date for its treatment. For each option, we will assess the indications, technical aspects, advantages, and complications, as well as outcomes reported in the literature and new emerging trends in the field.


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