Pathological Conditions, Signs and Symptoms Commons^™

Chronic Renal Failure, But Why? A Case Report., Palak Patel, Michael Rothberg M.D.

Stratford Campus Research Day

Renal failure, both acute and chronic, can present from many different etiologies and if diagnosed with diabetes mellitus, it is commonly assumed to be due to diabetic nephropathy. Monoclonal gammopathy of renal significance (MGRS) is a disorder that combines monoclonal gammopathy of undetermined significance with end stage renal disease. Monoclonal immunoglobulins are secreted by B or plasma cells leading to deposition in the kidney causing end organ damage. Several different subtypes fall under this category of renal diseases including, but not limited to, amyloidosis, C3 glomeruopathy, and light chain proximal tubulopathy, or better known as Fanconi syndrome1. Fanconi syndrome, which ...

A Case Of Atraumatic Posterior Thigh Compartment Syndrome, Nailah Mubin, Brian Katt M.D.

Stratford Campus Research Day

Compartment syndrome(CS) occurs when intra-compartmental pressures exceeds to a point where arterial, venous and lymphatic circulation of local tissues, muscles and nerves is compromised. CS is most common after a traumatic injury and usually occurs in the leg or forearm and less commonly in the thigh. Thigh compartment syndrome is rare due to its larger size and more compliant borders. We present a case of nontraumatic compartment syndrome in the posterior thigh associated with rhabdomyolysis and a sciatic nerve palsy which then required emergent fasciotomy. The patient's course was further complicated by acute renal failure due to the ...

The Correlation Between Obesity, Food Addiction, Anxiety & Depression, Ayham Khrais, Adarsh K. Gupta D.O.

Stratford Campus Research Day

Obesity is a multifaceted disease with physiological, psychological and social influences. While physiological factors, such as basal metabolic rate, can influence an individual’s BMI (Body Mass Index), obesity is primarily determined by behavior: excess food intake and a sedentary lifestyle greatly contribute to weight gain. An individual’s behavior is influenced by many factors, including their desires, perceptions, and social pressures. Therefore, psychological conditions can greatly impact an individual’s eating habits, thereby affecting that person’s BMI. This endeavor involved exploration of the potential effects of food addiction, anxiety, and depression on obesity. A survey consisting of an ...

Panniculectomy Performed In Conjunction With Gynecologic Surgery In The Morbidly Obese Patient - A Nsqip Analysis And Meta-Analysis Of The Literature, Shayoni Nag, Tirth Patel, Steven C. Bonawitz M.D.

Stratford Campus Research Day

Purpose: Panniculectomy is a common procedure in plastic surgery, often performed following massive weight loss and in morbidly obese patients. It can be performed in combination with various gynecologic procedures based on the rational that it will reduce complication rates.^{1, 2, 3} These studies fail to provide proof of these claims for reasons including study design and the lack of inclusion of both morbidly obese and non-morbidly obese patients. Recent medical practice has focused increasingly on minimizing patient morbidity and trends in reimbursement are moving towards penalizing practices which increase complications.

Methods/Results:We reviewed the NSQIP database to ...

Xanthogranulomatous Pyelonephritis: Presentation And Management, Răzvan C. Petca, Răzvan I. Popescu, Cristian Mareș, Claudia Mehedințu, Bogdan Mastalier, Dumitru Cristinel Badiu, Nicoleta Măru, Vlad D. Constantin, Aida Petca

Journal of Mind and Medical Sciences

Xanthogranulomatous pyelonephritis (XGP) is characterized by the presence of lipid-laden foamy macrophages with both acute and chronic phase inflammatory cells. The aim of the study is to present our experience about patients with Xanthogranulomatous pyelonephritis. 29 patients were evaluated through a complete anamnesis and the preoperative management included routine blood and biochemical tests, urine culture and renal ultrasound, intravenous urography and computed tomography (CT). All patients underwent open nephrectomy followed by the pathological exam. The main symptoms of these patients were fever and flank pain. Preoperative laboratory tests revealed anemia, leukocytosis and increasing levels of blood urea nitrogen (BUN) and ...

Exercise Rescues Gene Pathways Involved In Vascular Expansion And Promotes Functional Angiogenesis In Subcutaneous White Adipose Tissue, So Yun Min, Heather Learnard, Shashi Kant, Olga Gaelikman, Raziel Rojas-Rodriguez, Tiffany Desouza, Anand Desai, John F. Keaney Jr., Silvia Corvera, Siobhan M. Craige

Open Access Publications by UMMS Authors

Exercise mitigates chronic diseases such as diabetes, cardiovascular diseases, and obesity; however, the molecular mechanisms governing protection from these diseases are not completely understood. Here we demonstrate that exercise rescues metabolically compromised high fat diet (HFD) fed mice, and reprograms subcutaneous white adipose tissue (scWAT). Using transcriptomic profiling, scWAT was analyzed for HFD gene expression changes that were rescued by exercise. Gene networks involved in vascularization were identified as prominent targets of exercise, which led us to investigate the vasculature architecture and endothelial phenotype. Vascular density in scWAT was found to be compromised in HFD, and exercise rescued this defect ...

Uhthoff Phenomenon, Sreelakshmi Panginikkod, Lokesh A.. Rukmangadachar

Open Access Publications by UMMS Authors

Uhthoff's phenomenon (also known as Uhthoff sign or Uhthoff syndrome) is described as temporary, short-lived (less than 24 hours) and stereotyped worsening of neurological function among multiple sclerosis patients in response to increases in core body temperature. This phenomenon is named after Wilhelm Uhthoff, a German ophthalmologist who described it. In 1890, Uhthoff first described exercise-induced amblyopia in multiple sclerosis patients. In 1961, this phenomenon was given his surname, Uhthoff's Phenomenon (UP), by G. Ricklefs[1]. In four out of 100 MS patients, Uhthoff observed the appearance of reversible optic symptoms induced by an increase in body temperature ...

Inhibition Of Triggering Receptor Expressed On Myeloid Cells 1 Ameliorates Inflammation And Macrophage And Neutrophil Activation In Alcoholic Liver Disease In Mice, David Tornai, Istvan Furi, Zu T. Shen, Alexander B. Sigalov, Sahin Coban, Gyongyi Szabo

Gyongyi Szabo

Alcoholic liver disease (ALD) is characterized by macrophage and neutrophil leukocyte recruitment and activation in the liver. Damage- and pathogen-associated molecular patterns contribute to a self-perpetuating proinflammatory state in ALD. Triggering receptor expressed on myeloid cells 1 (TREM-1) is a surface receptor that amplifies inflammation induced by toll-like receptors (TLRs) and is expressed on neutrophils and monocytes/macrophages. We hypothesized that TREM-1 signaling contributes to proinflammatory pathway activation in ALD. Using an in vivo ALD model in mice, we tested the effects of ligand-independent TREM-1 inhibitory peptides that were formulated into human high-density lipoprotein (HDL)-mimicking complexes GF9-HDL and GA ...

Sepsis: Identification & Recognition, Shelbi Ethington, Lakisha Irwin, Jodi Cramer, Victoria Roell, Mindy Von Elling

Nurse Presentations

Describes educational interventions to increase confidence of pediatric nurses on a medical/surgical unit in their recognition and treatment of sepsis.

Low Back Pain, A Comprehensive Review: Pathophysiology, Diagnosis, And Treatment (Poster), Ivan Urits, Aaron Burshtein, Medha Sharma, Lauren Testa, Peter A. Gold, Vwaire Orhurhu, Omar Viswanath, Mark R. Jones, Moises A. Sidransky, Alan D. Kaye

Senior Scholars Program

Purpose of Review: Low back pain encompasses three distinct sources: axial lumbosacral, radicular, and referred pain. Annually, the prevalence of low back pain in the general U.S. adult population is 10-30%, and the lifetime prevalence of U.S. adults is as high as 65-80%.

Recent Findings: Patient history, physical exam, and diagnostic testing are important components to accurate diagnosis and identification of patient pathophysiology. Etiologies of low back pain include myofascial pain, facet joint pain, sacroiliac joint pain, discogenic pain, and spinal stenosis, and failed back surgery. In chronic back pain patients, a multidisciplinary, logical approach to treatment is ...

Pharmacological Inhibition Of The Nlrp3 Inflammasome Reduces Blood Pressure, Renal Damage, And Dysfunction In Salt-Sensitive Hypertension, Shalini M. Krishnan, Eicke Latz, Grant R. Drummond

Open Access Publications by UMMS Authors

AIMS: Renal inflammation, leading to fibrosis and impaired function is a major contributor to the development of hypertension. The NLRP3 inflammasome mediates inflammation in several chronic diseases by processing the cytokines pro-interleukin (IL)-1beta and pro-IL-18. In this study, we investigated whether MCC950, a recently-identified inhibitor of NLRP3 activity, reduces blood pressure (BP), renal inflammation, fibrosis and dysfunction in mice with established hypertension.

METHODS AND RESULTS: C57BL6/J mice were made hypertensive by uninephrectomy and treatment with deoxycorticosterone acetate (2.4 mg/day, s.c.) and 0.9% NaCl in the drinking water (1K/DOCA/salt). Normotensive controls were uninephrectomized ...

Gait Mechanics Contribute To Exercise Induced Pain Flares In Knee Osteoarthritis, Katherine A. Boyer, Jocelyn F. Hafer

Open Access Publications by UMMS Authors

BACKGROUND: Exercise-induced pain flares represent a significant barrier for individuals with knee osteoarthritis to meet physical activity recommendations. There is a need to understand factors that contribute to pain flares and the potential for the motor system to adapt and reduce joint loading should a flare occur. The study aim was to examine the impact of a bout of exercise on self-reported pain, walking mechanics and muscle co-contraction for participants with knee osteoarthritis.

METHODS: Thirty-six adults (17 healthy older and 19 knee osteoarthritis) participated in this study. Self-reported pain, joint mechanics and muscle co-activation during gait at two self-selected speeds ...

A National Study Of Veterans With Major Upper Limb Amputation: Survey Methods, Participants, And Summary Findings, Linda Resnik, Sarah Ekerholm, Matthew Borgia, Melissa A. Clark

Open Access Publications by UMMS Authors

INTRODUCTION: A comprehensive study to assess quality and outcomes of care for Veterans with upper limb amputation is needed. This paper presents methods and summary findings from a national survey of Veterans with upper limb amputation.

METHODS: After completion of a pilot study to develop and refine methods, computer-assisted telephone interviews were conducted with 808 Veterans with upper limb amputation (response rate = 47.7%; cooperation rate = 63.3%).

RESULTS: Respondents were 776 unilateral and 32 bilateral amputees, 97.5% male, mean age 63.3 (sd 14.1). Prostheses were used by 60% unilateral and 91% bilateral, the majority used body ...

No Woman Is An Island -- Access To Care And Extreme Measures For Cancer Pain And Lymphedema: A Case Report, Lauren M. Hall, Julia Reilly, Mathew J. Most, Jennifer Baima

Orthopedics and Physical Rehabilitation Publications

Background: Cancer rehabilitation is a rapidly growing diverse field in physiatry. This case provides an example where rehabilitation physiatrists played a crucial role in the pain management, education, and rehabilitation before and after a palliative amputation. Due to her limited resources, both in her home country and in her local community, she could not access appropriate care that may have prevented the need for amputation. Though amputation is not generally accepted as the first line of treatment for pain, there have been several reports of palliative amputation in metastatic cancer patients. In particular, fore quarter amputations have been reported in ...

Diabetic Neuropathic Foot Without Neuropathy: Could It Be Cancer? - A Case Report, Jennifer Baima, Felix Santiago, Mathew J. Most

Orthopedics and Physical Rehabilitation Publications

We present a case of a 64 year-old diabetic male who presented with months of progressively worsening foot pain and swelling, who was initially diagnosed with Charcot joint disease.(CJD) He was ultimately found to have a very rare tumor.

Still Disease, Juhi Bhargava, Sreelakshmi Panginikkod

Open Access Publications by UMMS Authors

Adult Onset Still's Disease (AOSD) is a rare systemic inflammatory disorder characterized by daily fever, inflammatory polyarthritis, and a transient salmon-pink maculopapular rash. AOSD is alternatively known as systemic onset juvenile idiopathic arthritis. Even though there is no specific diagnostic test, a serum ferritin level more than 1000ng/ml is common in AOSD.

The Neutrophil-To-Lymphocyte And Monocyte-To-Lymphocyte Ratios Are Independently Associated With Neurological Disability And Brain Atrophy In Multiple Sclerosis, Christopher C. Hemond, Bonnie I. Glanz, Rohit Bakshi, Tanuja Chitnis, Brian C. Healy

Open Access Publications by UMMS Authors

BACKGROUND: Serum hematological indices such as the neutrophil-lymphocyte ratio (NLR) or monocyte-lymphocyte ratio (MLR) have been used as biomarkers of pathogenic inflammation and prognostication in multiple areas of medicine; recent evidence shows correlation with psychological parameters as well.

OBJECTIVES/AIMS: To characterize clinical, neuroimaging, and psycho-neuro-immunological associations with NLR and MLR in persons with multiple sclerosis (MS).

METHODS: We identified a large cohort of clinically well-defined patients from our longitudinal database that included MS-related outcomes, disease-modifying therapy, patient-reported outcome (PRO) measures, and quantified cerebral MRI at 1.5 T. We queried hospital records for complete blood counts within 2 months ...

Sepsis: Triage Triggers, Outcomes Quicker, Rylee Ainge, Mackenzie Flaws, Natalie Heim, Emily Herndon, Hayley Norris, Amy L. Scott

Posters

No abstract provided.

Detection Of Bleeding Events In Electronic Health Record Notes Using Convolutional Neural Network Models Enhanced With Recurrent Neural Network Autoencoders: Deep Learning Approach, Rumeng Li, Baotian Hu, Feifan Liu, Weisong Liu, Francesca Cunningham, David D. Mcmanus, Hong Yu

Open Access Publications by UMMS Authors

BACKGROUND: Bleeding events are common and critical and may cause significant morbidity and mortality. High incidences of bleeding events are associated with cardiovascular disease in patients on anticoagulant therapy. Prompt and accurate detection of bleeding events is essential to prevent serious consequences. As bleeding events are often described in clinical notes, automatic detection of bleeding events from electronic health record (EHR) notes may improve drug-safety surveillance and pharmacovigilance.

OBJECTIVE: We aimed to develop a natural language processing (NLP) system to automatically classify whether an EHR note sentence contains a bleeding event.

METHODS: We expert annotated 878 EHR notes (76,577 ...

Compartmentalization Of Immune Response And Microbial Translocation In Decompensated Cirrhosis, Camila Alvarez-Silva, Robert Schierwagen, Alessandra Pohlmann, Fernando Magdaleno, Frank E. Uschner, Patrick Ryan, Maria J.G.T. Vehreschild, Joan Claria, Eicke Latz, Benjamin Lelouvier, Manimozhiyan Arumugam, Jonel Trebicka

Open Access Publications by UMMS Authors

Background: Acquired dysfunctional immunity in cirrhosis predisposes patients to frequent bacterial infections, especially spontaneous bacterial peritonitis (SBP), leading to systemic inflammation that is associated with poor outcome. But systemic inflammation can also be found in the absence of a confirmed infection. Detection of bacterial DNA has been investigated as a marker of SBP and as a predictor of prognosis. Data is, however, contradictory. Here we investigated whether levels of IL-6 and IL-8 putatively produced by myeloid cells in ascites are associated with systemic inflammation and whether inflammation depends on the presence of specific bacterial DNA.

Methods and Materials: We enrolled ...