Laboratory Findings In Covid-19 - Alterations Of Hematological, Immunological, Biochemical, Hormonal And Other Lab Panels: A Narrative Review, Yousef Rasmi, Lucas Paulo Jacinto Saavedra, Matei-Alexandru Cozma, Heba El-Nashar, Shaza Aly, Nouran Fahmy, Omayma Eldahshan, Mohamed El-Shazly, Elena Codruța Dobrică, Hamed Kord-Varkaneh, Camelia Cristina Diaconu, Mihnea Alexandru Găman

Journal of Mind and Medical Sciences

Up to the present date, according to the official reports of the World Health Organization (WHO), 205,338,159 patients have been confirmed with the coronavirus disease (COVID-19) and 4,333,094 have died as a consequence of this infectious disorder. The majority of COVID-19 patients will develop hematological, biochemical, immunological, hormonal and other complex alterations of their laboratory data which may be diagnosed using different biomarkers. In this paper, we review the alterations of the hematology, immunology, biochemistry, hormonal and other laboratory panels discovered in the subjects diagnosed with SARS-CoV-2 infection, based on the available data in the literature.

A Proposed Treatment Of Mixed Connective Tissue Disease By Competitive Inhibition Of Autoantibodies, Thomas Russell

Senior Honors Theses

Mixed Connective Tissue Disease is an autoimmune disease characterized by Raynaud’s phenomenon and arthritis among other symptoms. It is primarily caused by antibodies that target the U1-RNP 70K peptide. The treatment proposed in this paper uses competitive inhibition to prevent the binding of the anti-U1-RNP 70K antibodies with the U1-RNP 70K peptide. A method for testing the designed treatment in silico is proposed using AutoDock Vina docking software.

Climate Change Could Make Allergy Season Longer, Odu Expert Says, Amber Kennedy

News Items

No abstract provided.

Penicillin Allergy Assessment And Medical Referral To Promote Antibiotic Stewardship, Elaine Bailey Pharmd, Mackenzie Connell, Marie Fluent Dds, Erinne Kennedy Dds, Mph, Mmsc

The Journal of the Michigan Dental Association

Antibiotic stewardship is an integral practice for the dental team to ensure a safe dental visit for patients. Now, with clinical practice guidelines and state toolkits, more dentists are aware of and actively practicing antibiotic stewardship. With the application of antibiotic stewardship practices, dentists are identifying the need for additional tools to enhance practice. For example, one need that has been identified is a tool for screening patients for true penicillin allergies. The Penicillin Allergy Assessment Tool (PAAT) is a decision-making tool that can be used chairside to screen patients who report an allergy to penicillin. After screening, dentists can …

Impact Of Social Determinants On The Burden Of Asthma And Eczema: Results From A Us Patient Survey., Don A. Bukstein, Adam Friedman, Erika Gonzalez Reyes, Mary Hart, Bridgette Jones, Tonya Winders

Manuscripts, Articles, Book Chapters and Other Papers

INTRODUCTION: Little is known about how patients with asthma and eczema perceive their medical care and burden of disease. A survey was conducted to evaluate the perceptions among the general patient population with asthma and/or eczema regarding disease and treatment burden and barriers to adequate care.

METHODS: An online survey was completed by market research panelists in the USA between March 24, 2020 and April 6, 2020. Eligible participants were at least 18 years of age and endorsed a diagnosis of asthma and/or eczema. Survey responses are described for all participants, by designated racial/ethnic groups, and by income level.

RESULTS: …

Timing Of Testing For Ige-Mediated Food Allergy After Systemic Reaction, Jordan Pitt, Paul J. Dowling, Christopher Miller, Ashley Sherman, Salman Aljubran

Posters

Rationale: A refractory period of falsely negative testing can occur following a systemic allergic reaction to Hymenoptera sting. As a result, blood specific IgE and/or skin prick tests (SPT) for other allergens are often delayed. This retrospective chart review aims to identify the proportion of patients with falsely negative test results in the 6 weeks following an allergic reaction to food, and factors that may affect it. Methods: One hundred fourteen pediatric subjects met inclusion criteria. Each had a convincing history of food allergy with a systemic allergic reaction and was tested to the culprit food within 6 weeks. The …

Evaluation Of The Outcomes Of Oral Challenges To Azithromycin, Cephalexin And Trimethoprim-Sulfamethoxazole In Pediatrics, Hannah N. Neuhaus, Jordan Heath Md, Salman Aljubran

Posters

Rationale: Antibiotic hypersensitivity complicates treatment for various infections and leads to long-term healthcare costs and antibiotic resistance. Data regarding the outcomes of oral challenges to trimethoprim-sulfamethoxazole, azithromycin and cephalexin are limited in Pediatrics.  The goal of this study was to characterize the outcomes and safety of oral challenges to these antibiotics in Pediatrics.

Methods: A retrospective chart review was performed of pediatric patients who underwent oral challenges to cephalexin, azithromycin and trimethoprim-sulfamethoxazole in Allergy Clinic over the last 12 years.

Results: Ten patients underwent oral challenge to trimethoprim-sulfamethoxazole and all were successful. Thirteen patients underwent oral challenge to azithromycin and …

The Emergence Of Covid-19 Associated Mucormycosis: A Review Of Cases From 18 Countries, Martin Hoenigl, Danila Seidel, Agostinho Carvalho, Shivaprakash M. Rudramurthy, Amir Arastehfar, Jean-Pierre Gangneux, Nosheen Nasir, Alexandro Bonifaz, Javier Araiza, Nikolai Klimko

Department of Medicine

Reports of COVID-19-associated mucormycosis have been increasing in frequency since early 2021, particularly among patients with uncontrolled diabetes. Patients with diabetes and hyperglycaemia often have an inflammatory state that could be potentiated by the activation of antiviral immunity to SARS-CoV2, which might favour secondary infections. In this Review, we analysed 80 published and unpublished cases of COVID-19-associated mucormycosis. Uncontrolled diabetes, as well as systemic corticosteroid treatment, were present in most patients with COVID-19-associated mucormycosis, and rhino-orbital cerebral mucormycosis was the most frequent disease. Mortality was high at 49%, which was particularly due to patients with pulmonary or disseminated mucormycosis or …

The Effects Of Celiac Disease On Oral Health In Children And Adults, Marissa Balducci, Katarina Jones

Dental Hygiene Student Scholarship

Objectives: Celiac disease (CD) is an autoimmune disorder characterized by intolerance to dietary gluten in genetically predisposed subjects. To ensure affected patients receive optimal dental care, it is necessary for dental professionals to recognize the oral manifestations of celiac disease in both children and adults. Upon associating oral conditions with celiac disease, the dental provider should be able to present recommendations to the patient, contributing to an improvement in their oral health.

Methods: This review of the literature used PubMed to identify relevant professional research articles with publication after 2017. MesH terms utilized in the search process were …

Inflammatory Response To Sleep Fragmentation In Skeletal, Cardiac, And Smooth Muscle Tissues In Female Mice, Patton Allen

Mahurin Honors College Capstone Experience/Thesis Projects

Sleep is a critical process that the body undergoes. When sleep is interrupted, so that an individual is awakened for some period before going back into sleep, the sleep can be described as fragmented. Studies in the past have shown that sleep fragmentation (SF) promotes an inflammatory environment, especially in the brain and peripheral tissue. However, studies have not been conducted to observe inflammatory responses in muscle. To examine this, C57BL/6J female mice were subjected to either a control group (no SF) or a SF group which involved using an automated SF chamber to disrupt sleep every 2 min over …

Relationships Of Serum Cc16 Levels With Smoking Status And Lung Function In Copd, Kelli C. Gribben, Jill A. Poole, Amy J. Nelson, Paraskevi A. Farazi, Christopher S. Wichman, Art J. Heires, Debra J. Romberger, Tricia D. Levan

Journal Articles: Pulmonary & Critical Care Med

Background: The club cell secretory protein (CC16) has anti-inflammatory and antioxidant effects, and low CC16 serum levels have been associated with both risk and progression of COPD, yet the interaction between smoking and CC16 on lung function outcomes remains unknown.

Methods: Utilizing cross-sectional data on United States veterans, CC16 serum concentrations were measured by ELISA and log transformed for analyses. Spirometry was conducted and COPD status was defined by post-bronchodilator FEV₁/FVC ratio < 0.7. Smoking measures were self-reported on questionnaire. Multivariable logistic and linear regression were employed to examine associations between CC16 levels and COPD, and lung function with adjustment for covariates. Unadjusted Pearson correlations described relationships between CC16 level and lung function measures, pack-years smoked, and years since smoking cessation.

Results: The study population (N = 351) was mostly male, white, with an average age over 60 years. An interaction between CC16 and smoking status on …

Identifying Individual Medications Affecting Pulmonary Outcomes When Multiple Medications Are Present, Yisha Li, Ran Dai, Yeongjin Gwon, Stephen I. Rennard, Barry J. Make, Dinah Foer, Matthew J. Strand, Erin Austin, Kendra A. Young, John E. Hokanson, Katherine A. Pratte, Rebecca Conway, Gregory L. Kinney, Copdgene Investigators

Journal Articles: Pulmonary & Critical Care Med

No abstract provided.

Updated Perspectives On The Role Of Biomechanics In Copd: Considerations For The Clinician, Jennifer M. Yentes, Wai-Yan Liu, Kuan Zhang, Eric Markvicka, Stephen I. Rennard

Journal Articles: Pulmonary & Critical Care Med

Patients with chronic obstructive pulmonary disease (COPD) demonstrate extra-pulmonary functional decline such as an increased prevalence of falls. Biomechanics offers insight into functional decline by examining mechanics of abnormal movement patterns. This review discusses biomechanics of functional outcomes, muscle mechanics, and breathing mechanics in patients with COPD as well as future directions and clinical perspectives. Patients with COPD demonstrate changes in their postural sway during quiet standing compared to controls, and these deficits are exacerbated when sensory information (eg, eyes closed) is manipulated. If standing balance is disrupted with a perturbation, patients with COPD are slower to return to baseline …

Brain Antigens Stimulate Proliferation Of T Lymphocytes With A Pathogenic Phenotype In Multiple Sclerosis Patients, Assaf Gottlieb, Hoai Phuong T Pham, John William Lindsey

Faculty, Staff and Student Publications

A method to stimulate T lymphocytes with a broad range of brain antigens would facilitate identification of the autoantigens for multiple sclerosis and enable definition of the pathogenic mechanisms important for multiple sclerosis. In a previous work, we found that the obvious approach of culturing leukocytes with homogenized brain tissue does not work because the brain homogenate suppresses antigen-specific lymphocyte proliferation. We now report a method that substantially reduces the suppressive activity. We used this non-suppressive brain homogenate to stimulate leukocytes from multiple sclerosis patients and controls. We also stimulated with common viruses for comparison. We measured proliferation, selected the …

Addressing The Inpatient Penicillin Allergy: Implementing A Nurse-Driven Allergy Assessment Tool To Enhance Antimicrobial Stewardship., Shelby Ryan Bliss

DNP Projects

Background: In an acute care setting, more than half the inpatient population receives antibiotics. Approximately 10% of the general population reports an allergy to penicillin. It has been replicated in the literature with data that of those who report a penicillin allergy, up to 95% are incorrectly identified. When a patient is admitted to the hospital with a penicillin allergy on their electronic health record, they are at higher risk for adverse events such as a hospital acquired infection, the occurrence of an antibiotic resistant bacteria related to receiving broader therapy and increased healthcare utilization.

Purpose: The purpose of this …

Defective Dna Polymerase Beta Invoke A Cytosolic Dna Mediated Inflammatory Response, Shengyuan Zhao, Julia A Goewey Ruiz, Manu Sebastian, Dawit Kidane

Faculty, Staff and Student Publications

Base excision repair (BER) has evolved to maintain the genomic integrity of DNA following endogenous and exogenous agent induced DNA base damage. In contrast, aberrant BER induces genomic instability, promotes malignant transformation and can even trigger cancer development. Previously, we have shown that deoxyribo-5'-phosphate (dRP) lyase deficient DNA polymerase beta (POLB) causes replication associated genomic instability and sensitivity to both endogenous and exogenous DNA damaging agents. Specifically, it has been established that this loss of dRP lyase function promotes inflammation associated gastric cancer. However, the way that aberrant POLB impacts the immune signaling and inflammatory responses is still unknown. Here …

Engineered Cord Blood Megakaryocytes Evade Killing By Allogeneic T-Cells For Refractory Thrombocytopenia, Bijender Kumar, Vahid Afshar-Kharghan, Mayela Mendt, Robert Sackstein, Mark R Tanner, Uday Popat, Jeremy Ramdial, May Daher, Juan Jimenez, Rafet Basar, Luciana Melo Garcia, Mayra Shanley, Mecit Kaplan, Xinhai Wan, Vandana Nandivada, Francia Reyes Silva, Vernikka Woods, April Gilbert, Ricardo Gonzalez-Delgado, Sunil Acharya, Paul Lin, Hind Rafei, Pinaki Prosad Banerjee, Elizabeth J Shpall

Faculty, Staff and Student Publications

The current global platelet supply is often insufficient to meet all the transfusion needs of patients, in particular for those with alloimmune thrombocytopenia. To address this issue, we have developed a strategy employing a combination of approaches to achieve more efficient production of functional megakaryocytes (MKs) and platelets collected from cord blood (CB)-derived CD34+ hematopoietic cells. This strategy is based on ex-vivo expansion and differentiation of MKs in the presence of bone marrow niche-mimicking mesenchymal stem cells (MSCs), together with two other key components: (1) To enhance MK polyploidization, we used the potent pharmacological Rho-associated coiled-coil kinase (ROCK) inhibitor, KD045, …

Symmetrical Drug-Related Intertriginous And Flexural Exanthema Induced By Cellulitis Prophylaxis, Tiffany Truong, Jonathan H. Ryder, Erica Lee, Clayton Mowrer, Ashley Wysong, Jasmine R. Marcelin

Graduate Medical Education Research Journal

Penicillin VK and hydroxyzine are typically well-tolerated antipruritic agents that are indicated in the prophylaxis of cellulitis. We herein report a case of a unique rash occurring during penicillin VK and hydroxyzine treatment in combination with the ingestion of cashews.

A 77-year-old male presented with new onset rash. Eleven days after the administration of penicillin VK and hydroxyzine for cellulitis prophylaxis, he developed a symmetric, erythematous, scaling rash on his buttocks and perineal region with associated pruritus and bleeding without fevers, chills, adenopathy, night sweats, or any other symptoms. He was diagnosed with symmetrical drug-related intertriginous and flexural exanthema (SDRIFE) …

Gender Differences In Urothelial Bladder Cancer: Effects Of Natural Killer Lymphocyte Immunity, Charles T. Lutz, Lydia Livas, Steven R. Presnell, Morgan Sexton, Peng Wang

Pathology and Laboratory Medicine Faculty Publications

Men are more likely to develop cancer than women. In fact, male predominance is one of the most consistent cancer epidemiology findings. Additionally, men have a poorer prognosis and an increased risk of secondary malignancies compared to women. These differences have been investigated in order to better understand cancer and to better treat both men and women. In this review, we discuss factors that may cause this gender difference, focusing on urothelial bladder cancer (UBC) pathogenesis. We consider physiological factors that may cause higher male cancer rates, including differences in X chromosome gene expression. We discuss how androgens may promote …

Evaluation Of The Outcomes Of Trimethoprim-Sulfamethoxazole Oral Challenges In The Pediatric Population, Hannah N. Neuhaus, Salman Aljubran

Posters

Introduction: Trimethoprim-sulfamethoxazole allergy can complicate treatment for various infections. While trimethoprim-sulfamethoxazole hypersensitivity, desensitization/oral challenges are frequently reported in adults, data is limited on the outcomes/safety of oral challenges to trimethoprim-sulfamethoxazole in Pediatrics. The goal of this study was to characterize the outcomes and safety of trimethoprim-sulfamethoxazole oral challenges in Pediatrics.

Methods: An IRB-exempt retrospective chart review was performed of pediatric patients who underwent oral challenge to trimethoprim-sulfamethoxazole in Allergy Clinic over the last 12 years. We assessed characteristics including age, sex, reaction (IgE-mediated/non-IgE-mediated/indeterminate), skin testing, challenge outcome and complications to draw a conclusion regarding the overall safety of the procedure …