Virginia Tech Carilion School of Medicine (VTCSOM)
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Browsing 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.
- End-of-Life Care of Persons with Alzheimer's Disease and Other DementiasJan, Darlon; Kim, Kye Y. (Sage, 2024-05-07)End-of-life (EOL) care has been a common option for patients with terminal medical conditions such as cancers. However, the utilization of EOL care in Alzheimer disease and other dementing conditions have become available relatively recently. As the end-stage dementia approaches, the clinicians and caregivers become faced with numerous clinical challenges—delirium, neuropbehavioral symptoms, the patient’s inability to communicate pain and associated discomfort, food refusal, and so on. In addition to providing quality clinical care to the EOL patients, clinicians should pay special attention to their families, assuring that their loved ones will receive supportive measures to improve quality of life (QOL).
- 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.
- Get the Facts - CarbsHeilmann, Adam (Virginia Tech, 2016-09-30)Myth: Carbs are bad. Fact: Okay this one really bugs me. With the fad diets exploding over the past few years, I have been told this statement more times than I would like to count. I think the biggest culprit of the perpetuation of this myth is the Paleo diet. Here is the logic behind the myth: I stopped eating carbohydrates from the Paleo and Atkins diet, therefor the carbs made me fat. One main problem with this is that there are a lot of other factors contributing to the weight loss that has not been accounted for. With any of the low carb diets, people end up overall eating less. This may be due to the large carbohydrate prevalence in the American diet and/or the fact that people do not know what to eat that has low carbs so they just don’t eat as much. Either way there are plenty of other reasons that may contribute to the weight loss
- Get the Facts - Counting CaloriesHeilmann, Adam (Virginia Tech, 2016-11-25)MYTH: Counting calories is: • A waste of time • For women • For people on “diets” • Not feasible • Too difficult • Not important • Confusing FACT: This week’s article will be more of a recount of my own experiences and understanding so I will not have sources at the end, please let me know if you would like some literature on this topic! Referring back to the article on calories and energy consumption, fat loss is based under the overarching principle of energy consumed/energy expended. If this ratio is <1, weight loss will occur. The variables lie in the speed of the loss and manipulation of either the numerator, denominator, or both. I will focus on the numerator (energy consumed). The first (and most important in my opinion) point I want to make it that it is extremely difficult to manipulate this variable when it is not measured. Estimates can be made based on a thorough understanding of what one is eating and how calorie dense the meals are, but this takes more time, effort, and planning than actually counting the calories you eat.
- Get the Facts - Eating Fruit...Heilmann, Adam (Virginia Tech, 2016-10-07)Myth: You need to eat fruit to be healthy. Fact: This is one of my favorites only because people automatically assume I must eat tons of fruits and veggies. On the contrary, I personally have never eaten a fruit other than apples. This is just one of those childhood myths like Santa Claus, cereal as a balanced breakfast, milk making you grow faster, cursive as necessary for your future.
- Get the Facts - Protein SupplementsHeilmann, Adam (Virginia Tech, 2016-12-09)Myth: Protein supplements will destroy my kidneys, will make me fat, will make me bulky, are only for bodybuilders, are like steroids, and will make me crazy. Fact: I have heard these statements from different people and I will try to tackle them all in this issue. First thing’s first, similar to what has been stated in previous issues, technically nothing will make you “fat” or gain weight if you consume less of it in terms of calories than you are burning in a day. That being said, I will focus on protein supplementation with calories remaining constant (isocaloric conditions).
- Get the Facts - Supplemental ProteinHeilmann, Adam (Virginia Tech, 2016-10-14)Myth: If I take supplemental protein without working out, it will make me fat. Fact: I want to start by saying if you begin eating more of anything without replacing something else with it or adding more exercise to your routine, you will gain weight (or you will stop losing as much weight). Assuming we keep the number of calories the same, protein consumption in replace of fat or carbohydrate consumption will maintain muscle mass. For example, if someone eats 1000 kcals less than needed with 45% carbs, 45% fats, and 10% protein, they will experience significantly more muscle mass loss than those who consume a protein supplement to increase the percent of protein in their daily kcal allowance.
- Get the Facts - Thanksgiving RecoveryHeilmann, Adam (Virginia Tech, 2016-12-02)Myth: Thanksgiving dinner was so bad that now I must diet and exercise for weeks to catch up. Facts: If you celebrate Thanksgiving, it can sometimes feel more like a binge eating holiday than a giving thanks holiday. Many will sit with family and friends with a plate piled as high as possible, perhaps even competing with others as to who can eat more. Even for the fitness enthusiasts, tracking food and moderation are near impossible. Trust me I understand the attempt to limit yourself on Thanksgiving only to look down at your third serving of mashed potatoes dwindling away while almost automatically reaching for your first piece of pumpkin pie. I am not here to burst your bubble and talk about how bad the food is for you (partially because I don’t want to hear that either). What I do want to talk about is how badly people feel afterwards. There is this idea of a massive debt people are now in because of badly they have eaten. The next few days may consist of extreme exercise, diet, or other ways to make up for how bad you were the Thursday before. This huge jump from the norm makes it impossible to maintain and leads to an inevitable crash of poor habits. I have also seen this give a bad impression of healthy eating and exercise.
- Get the Facts: Age and Losing WeightHeilmann, Adam (Virginia Tech, 2017-03-31)Myth: I can’t lose weight because of my age/ “oh you are fit because you are young” Fact: A statement that I hear often that really frustrates me is when older adults who are overweight or not in the best shape minimize the effort and determination of those who keep themselves physically fit. These people say things like, “Oh you have it so easy, you are still young. Just wait until you are my age.” I don’t mean to be harsh, but this statement is simply using an uncontrollable variable in one’s life to justify not taking care of themselves. As far as scientific and physiologic excuses go, this is not one of them.
- Get the Facts: Burning Fat without Losing MuscleHeilmann, Adam (Virginia Tech, 2017-02-10)Fact: In a perfect world, we could go to the gym for 30 minutes and gain massive amounts of muscle while burning away all the fat. Unfortunately, this does not happen. Similar to other areas of the body, there is a balance between muscle breakdown and muscle formation. The stress applied to us by the outside world dictates which direction these mechanics will sway. This is the fundamental concept of adaptation. For example, if an animal comes across a large meal, it will store this meal as fat as well as create muscle to allow it to hunt for another meal. If, however, it does not eat at all, the muscle may begin to atrophy and will be used as fuel reserves along with the fats.
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