Scholarly Works, Virginia Tech Carilion School of Medicine (VTCSOM)
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Browsing Scholarly Works, Virginia Tech Carilion School of Medicine (VTCSOM) by Content Type "Article"
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- The Airway Alert: A Multi-Disciplinary Approach to Management of The Difficult AirwayLee, Maxine (Virginia Society of Anesthesiologists, 2021-03-01)
- The Airway Alert: Optimizing Management of the Difficult AirwayLee, Maxine (2022-01-14)
- The alleged existence of partially oxidized Mg[Pt(CN)4]Cl0.28.7H2O and the attempted preparation of the analogous beryllium(2+) and barium(2+) derivatives. A caveatKoch, Timothy R.; Gebert, E.; Williams, Jack M. (American Chemical Society, 1976-06)
- Clinical Manifestations of Severe Untreated HypothyroidismBhutada, Abhishek S.; Kodankandath, Thomas V. (Cureus, 2022-07-05)Thyroid hormones play a crucial role in maintaining homeostasis throughout the human body. Hypothyroidism is a result of insufficient circulating levels of thyroid hormone. In a hypothyroid state, not only do all metabolic processes tend to slow down but so do neurological processes. Here, we present an interesting case of a woman with a history of severe hypothyroidism that was untreated for the past 10 years.
- Complete Genome Sequence of Providencia stuartii CMC-4104, Isolated from a Human Splenic Abscess, Containing Multiple Copies of NDM-1 and PER-1 Carbapenem Resistance GenesRao, Jayasimha; Stornelli, Nicholas K.; Everson, Nathan A.; McDaniel, Lauren F.; Gomez De La Espriella, Mariana; Faulhaber, Jason R.; Todd, S. Michelle; Lahmers, Kevin K.; Jensen, Roderick V. (American Society for Microbiology, 2022-08-04)We report the complete genome sequence of a clinical isolate of Providencia stuartii strain CMC-4104, isolated from a splenic abscess. Oxford Nanopore Technologies (ONT) and Illumina sequencing reads were assembled using Geneious to generate a 4,504,925-bp circular chromosome containing multiple copies of the NDM-1 and PER-1 genes in a genomic resistance island.
- Connexin 43 peptidic medicine for glioblastoma stem cellsSheng, Zhi (Elsevier, 2021-02-01)
- Conversations in cardiology: Late career transitions-Retool, retire, refocusKern, Morton J.; Applegate, Bob; Bittl, John; Block, Peter; Butman, Sam; Dehmer, Gregory; Garratt, Kirk N.; Henry, Tim; Hirshfeld, John; Holmes, David R.; Kaplan, Aaron; King, Spencer; Klein, Lloyd W.; Krucoff, Mitchell W.; Kutcher, Michael A.; Naidu, Srihari S.; Pichard, Augusto; Ruiz, Carlos E.; Skelding, Kimberly A.; Tobis, Jonathan M.; Tommaso, Carl; Weiner, Bonnie H.; White, Christopher (Wiley, 2022-04-21)
- Current and future impact of clinical gastrointestinal research on patient care in diabetes mellitusKoch, Timothy R.; Shope, Timothy R.; Camilleri, Michael (Baishideng, 2018-11-15)The worldwide rise in the prevalence of obesity supports the need for an increased interaction between ongoing clinical research in the allied fields of gastrointestinal medicine/surgery and diabetes mellitus. There have been a number of clinically-relevant advances in diabetes, obesity, and metabolic syndrome emanating from gastroenterological research. Gastric emptying is a significant factor in the development of upper gastrointestinal symptoms. However, it is not the only mechanism whereby such symptoms occur in patients with diabetes. Disorders of intrinsic pacing are involved in the control of stomach motility in patients with gastroparesis; on the other hand, there is limited impact of glycemic control on gastric emptying in patients with established diabetic gastroparesis. Upper gastrointestinal functions related to emptying and satiations are significantly associated with weight gain in obesity. Medications used in the treatment of diabetes or metabolic syndrome, particularly those related to pancreatic hormones and incretins affect upper gastrointestinal tract function and reduce hyperglycemia and facilitate weight loss. The degree of gastric emptying delay is significantly correlated with the weight loss in response to liraglutide, a glucagon-like peptide-1 analog. Network meta-analysis shows that liraglutide is one of the two most efficacious medical treatments of obesity, the other being the combination treatment phentermine-topiramate. Interventional therapies for the joint management of obesity and diabetes mellitus include newer endoscopic procedures, which require long-term follow-up and bariatric surgical procedure for which long-term follow up shows advantages for individuals with diabetes. Newer bariatric procedures are presently undergoing clinical evaluation. On the horizon, combination therapies, in part directed at gastrointestinal functions, appear promising for these indications. Ongoing and future gastroenterological research when translated to care of individuals with diabetes mellitus should provide additional options to improve their clinical outcomes.
- Filtration evaluation and clinical use of expired elastomeric P-100 filter cartridges during the COVID-19 pandemicPatolia, Harsh H.; Pan, Jin; Harb, Charbel; Marr, Linsey C.; Baffoe-Bonnie, Anthony W. (Cambridge University Press, 2020-05-27)To the Editor—The limited supply of more conventional disposable personal protective equipment (PPE), namely single-use N95 filtering facepiece respirators (FFRs), among hospital systems in the United States during the COVID-19 pandemic has been alleviated with the adoption of extended use and reuse policies by the Centers for Disease Control and Prevention (CDC).1 These measures, along with a variety of implemented decontamination methodologies (eg, ultraviolet germicidal irradiation, vaporized hydrogen peroxide, etc), have prolonged PPE supplies during pressing times. Another strategy adopted by the CDC and health systems to protect healthcare providers caring for COVID-19 patients and patients under investigation in limited resource settings includes the use of elastomeric FFRs with reusable cartridges. Although elastomeric respirators have not been approved by the Food and Drug Administration for fluid resistance, they have been endorsed by the CDC as reasonable alternatives for N95 FFRs during the COVID-19 pandemic due to their filtration approval by the National Institutes for Occupational and Safety Health (NIOSH).2 Subsequently, elastomeric respirators have formed a major arm of the COVID-19 pandemic response strategy in many hospital systems...
- Gastric Outlet Obstruction Secondary to Metastatic Breast Carcinoma 25 Years After Initial Diagnosis: A Mimic of Primary Gastric CarcinomaAbel, William; Ganjineh, Brandon; Reddy, Shravani; Gohil, Vishal V.; Yeaton, Paul; Grider, Douglas J. (Lippincott, Williams & Wilkins, 2022-12-26)Although breast cancer is the most common form of cancer in women, metastasis to the stomach is incredibly rare. Gastric metastasis of breast cancer has been described in the literature, with an estimated median of 6 years from the initial diagnosis of primary breast cancer to metastasis and multiple instances greater than 10 years. In this case, a patient presented with gastric outlet obstruction in the setting of breast cancer metastasis to the pylorus 25 years after the original diagnosis.
- A Genetic System for Methanocaldococcus jannaschii: An Evolutionary Deeply Rooted Hyperthermophilic MethanarchaeonSusanti, Dwi; Frazier, Mary C.; Mukhopadhyay, Biswarup (Frontiers, 2019-07-03)Phylogenetically deeply rooted methanogens belonging to the genus of Methanocaldococcus living in deep-sea hydrothermal vents derive energy exclusively from hydrogenotrophic methanogenesis, one of the oldest respiratory metabolisms on Earth. These hyperthermophilic, autotrophic archaea synthesize their biomolecules from inorganic substrates and perform high temperature biocatalysis producing methane, a valuable fuel and potent greenhouse gas. The information processing and stress response systems of archaea are highly homologous to those of the eukaryotes. For this broad relevance, Methanocaldococcus jannaschii, the first hyperthermophilic chemolithotrophic organism that was isolated from a deep-sea hydrothermal vent, was also the first archaeon and third organism for which the whole genome sequence was determined. The research that followed uncovered numerous novel information in multiple fields, including those described above. M. jannaschii was found to carry ancient redox control systems, precursors of dissimilatory sulfate reduction enzymes, and a eukaryotic-like protein translocation system. It provided a platform for structural genomics and tools for incorporating unnatural amino acids into proteins. However, the assignments of in vivo relevance to these findings or interrogations of unknown aspects of M. jannaschii through genetic manipulations remained out of reach, as the organism was genetically intractable. This report presents tools and methods that remove this block. It is now possible to knockout or modify a gene in M. jannaschii and genetically fuse a gene with an affinity tag sequence, thereby allowing facile isolation of a protein with M. jannaschii-specific attributes. These tools have helped to genetically validate the role of a novel coenzyme F420-dependent sulfite reductase in conferring resistance to sulfite in M. jannaschii and to demonstrate that the organism possesses a deazaflavin-dependent system for neutralizing oxygen.
- Kikuchi-Fujimoto Disease: A Differential for When It is Not Systemic Lupus ErythematosusKazmi, Taskeen R.; Greear, Emma L.; Lavallee, Catherine A.; Stump, Michael S.; Bankole, Adegbenga A. (Hindawi, 2022-08-09)Kikuchi-Fujimoto disease (KFD) is a rare and benign disease process that is characterized by fever and lymphadenopathy that was first described in young Japanese women in the early 1970s. Knowledge of KFD is important as it can often mimic other causes of lymphadenopathy including systemic lupus erythematosus (SLE) or malignancies, and this can lead to invasive diagnostic testing and even treatments that can be avoided. The etiology and exact mechanism by which KFD develops is not fully understood at this time, but is thought to be an immune response of T cells and histiocytes to viral or bacterial infections. We present a 35-year-old African-American woman who was referred to the rheumatology clinic by our colleagues in the breast clinic with new onset right axillary lymphadenopathy and abnormal serologic testing with the suspicion of SLE after a malignancy had been ruled out.
- Methemoglobinemia Secondary to Babesia Microti Infection: A Novel Case ReportColeman, Keel; Brown, Andrew J. (2023)Background Tick-borne illnesses and methemoglobinemia have not been traditionally associated with each other or known to occur together in humans. Few cases have been documented in various animals of methemoglobinemia secondary to tick-borne infections. Case Report A 49-year-old male with no significant past medical history presented to the emergency department from an urgent care with hypoxia saturating in the mid 80’s. He also complained of a pruritic rash on his back and right shoulder as well as both of his lower extremities. The rash had been present for 4 days. The patient was tachycardic and hypoxic at 90% but denied shortness of breath. He had cyanosis of the lips and fingertips and multiple erythematous, raised, ovoid lesions on the right shoulder, left thigh and left lower extremity. Methemoglobin levels were elevated at 26%. He was treated with methylene blue, supplemental oxygen, and empiric doxycycline with improvement in his oxygenation. A tick-borne illness panel resulted two days later positive for Babesia microti infection. His skin lesions resolved with the above described treatment. Why should an emergency physician be aware of this? Both tick-borne illnesses and methemoglobinemia are typically easily treatable with proper antimicrobial coverage and methylene blue, respectively. The current literature is bare regarding concurrent tick-borne illnesses, specifically babesiosis, and methemoglobinemia. Without knowledge and documentation of a potential link between the two conditions, hypoxia, if found to be due to methemoglobinemia, may be treated adequately, while a potentially life-threatening tick-borne illness may continue to cause damage and disease to the patient if not tested for, identified and treated.
- Organization of future training in bariatric gastroenterologyKoch, Timothy R.; Shope, Timothy R.; Gostout, Christopher J. (Baishideng, 2017-09-21)A world-wide rise in the prevalence of obesity continues. This rise increases the occurrence of, risks of, and costs of treating obesity-related medical conditions. Diet and activity programs are largely inadequate for the long-term treatment of medically-complicated obesity. Physicians who deliver gastrointestinal care after completing traditional training programs, including gastroenterologists and general surgeons, are not uniformly trained in or familiar with available bariatric care. It is certain that gastrointestinal physicians will incorporate new endoscopic methods into their practice for the treatment of individuals with medically-complicated obesity, although the longterm impact of these endoscopic techniques remains under investigation. It is presently unclear whether gastrointestinal physicians will be able to provide or coordinate important allied services in bariatric surgery, endocrinology, nutrition, psychological evaluation and support, and social work. Obtaining longitudinal results examining the effectiveness of this ad hoc approach will likely be difficult, based on prior experience with other endoscopic measures, such as the adenoma detection rates from screening colonoscopy. As a longterm approach, development of a specific curriculum incorporating one year of subspecialty training in bariatrics to the present training of gastrointestinal fellows needs to be reconsidered. This approach should be facilitated by gastrointestinal trainees' prior residency training in subspecialties that provide care for individuals with medical complications of obesity, including endocrinology, cardiology, nephrology, and neurology. Such training could incorporate additional rotations with collaborating providers in bariatric surgery, nutrition, and psychiatry. Since such training would be provided in accredited programs, longitudinal studies could be developed to examine the potential impact on accepted measures of care, such as complication rates, outcomes, and costs, in individuals with medically-complicated obesity.
- Percutaneous Coronary Intervention Without On-Site Surgical Backup—The Times They Are A-Changin’Dehmer, Gregory J. (Elsevier, 2023-01)
- Rare Occurrence of Extradigital Glomangioma in the Prepatellar Bursa of a 40-Year-Old: A Case StudyCrawford, Dylan C.; O'Malley, Michael; Samuel, Linsen T. (Indian Orthopaedic Research Group, 2022-07)INTRODUCTION: A solitary subcutaneous mass can be a common clinical finding for patients symptomatic for knee pain, especially when direct pressure by kneeling on the anterior aspect of the knee causes pain. CASE REPORT: We present a 40-year-old who noticed a small fluid filled mass that has become progressively larger and more painful over the past 7 years. The patient's primary complaint was sharp pain with direct contact. Ultimately, a surgical excision was performed to remove the mass. The histopathological report came back as a glomangioma, a subtype of a glomus tumor. To the best of our knowledge, this is the youngest reported case of a glomangioma of the knee. CONCLUSION: Glomus tumors found on the digital and subungual regions of patients are a common clinical finding. An extradigital occurrence of a glomangioma, a subtype of a glomus tumor, is rarely found, especially in younger patients. Therefore, a histopathological examination must be done after the removal of any subcutaneous mass.
- Selecting A Medical School AdvisorLareau, Stephanie; Blumstein, Howard; Hopson, Laura; Keller, Barbara L.; Haydel, Micelle J.; Cheaito, Mohamad Ali; Hitti, Eveline A.; Epter, Michael; Kazzi, Amin (2019-05)Having an advisor offers medical students many advantages, including increased likelihood of matching into their top choices. Interestingly, students who choose emergency medicine (EM) as a specialty are more likely to seek advising. However, finding and optimally utilizing an EM faculty advisor is often challenging for the medical student. In this article, we tackle the different ways to seek advising, including the 'virtual advisor program' implemented by the Society for Academic Emergency Medicine, the 'e-Advisor Program' instigated by the Clerkship Director in EM Group, the 'member exclusive mentorship program' of the Emergency Medicine Residency Association, as well as peer-based mentoring. More so, we discuss the consensus recommendations developed by the Student Advising Task Force to guide both students planning to apply to EM and their advisors to ensure high-caliber advising. (C) 2019 The Author(s). Published by Elsevier Inc. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
- START NOW: An Effective Mental Health InterventionTrestman, Robert L.; Truong, Albert Y.; Kablinger, Anita S.; Hartman, David W.; McNamara, Robert S.; Seidel, Richard W.; Hartman, Cheri W.; Sylvester-Johnson, Anders (Scientia, 2021-10-28)Dr. Robert Trestman, at the Carilion Clinic and Virginia Tech Carilion School of Medicine, has co-developed START NOW, a successful group psychotherapy intervention specifically targeting mental health issues in prisoners. It combines elements of cognitive behavioral therapy to form skills-based learning. Furthermore, START NOW is easily accessible, cost-effective, and designed for use in settings with limited resources. Due to its success within correctional institutions, START NOW is being adapted for use in fields such as adolescent conduct issues and opioid misuse.
- Stevens-Johnson Syndrome and Stroke Related to MycoplasmaYadava, Sanjay K.; Adhikari, Soumya; Ojha, Niranjan; Zaidi, Syed Hammad; Hanish, Jain; Fazili, Tasaduq (SAGE, 2022-01)Mycoplasma pneumonia usually causes asymptomatic to mild respiratory tract infection. However, nonrespiratory manifestations are not rare with involvement of various organ including skin, cardiovascular, central nervous system. We are presenting a 43-year-old male who presented with diffuse rash, sever mucositis, confusion, and complicated by ischemic stroke; also, review of mycoplasma related stroke and Stevens-Johnson syndrome.
- Time to Reconsider Hepatitis A Vaccination in Food Handlers: Are We Seeing More Outbreaks and Severe Disease?Kim, Hyun Sue; Torres, Jordan Lydia; Baffoe-Bonnie, Anthony (Oxford University Press, 2022-04-12)The risk for secondary infection from hepatitis A-infected food handlers to patrons is deemed as low. Thus, hepatitis A vaccination is not specifically recommended for persons who handle food in the absence of other risk factors in the United States. We describe an ongoing food handler-associated hepatitis A outbreak in southwest Virginia and recommend policy changes that will incentivize food industry employers to embrace broader food handler hepatitis A vaccination.