19043 research outputs found
Sort by
A Novel Single-Tier Serologic Test to Diagnose All Stages of Lyme Disease
No full textLyme disease, a bacterial zoonosis, is the most commonly reported vector-borne disease in the United States. Laboratory diagnosis has relied on a two-tier serologic approach, originally comprising an ELISA, or another first-tier assay, followed by separate IgG and IgM immunoblots to confirm a positive first-tier result. This standard two-tier testing (STTT) approach provides high specificity, but at the cost of low sensitivity in early Lyme disease. Recent studies have shown that a modified two-tier (MTTT) testing approach, in which a second ELISA replaces the immunoblot, can provide an increase in test sensitivity without a loss of specificity. Nevertheless, neither STTT nor MTTT is considered sensitive enough for diagnosing patients with erythema migrans, the most common clinical manifestation of early Lyme disease. We have developed a novel ELISA methodology termed Hybrid Lyme ELISA for single-tier Lyme antibody detection, which relies on the simultaneous binding of individual antibody molecules to the Borrelia burgdorferi surface protein VlsE and to the C6 peptide derived from it. This dual binding requirement builds exceptionally high specificity into the assay, eliminating the majority of non-specific antibody interactions. In this study, the single-tier Hybrid Lyme ELISA was shown to provide greater sensitivity, but with equivalent specificity, to both STTT and MTTT. In addition, given the \u3e90% sensitivity of the Hybrid Lyme ELISA in patients with erythema migrans, this assay may not only transform serologic testing from two-step to single-step testing, but may also provide a means for the first time to diagnose patients with erythema migrans.IMPORTANCEThe diagnosis of Lyme disease, a tick-borne spirochetal infection caused by Borrelia burgdorferi sensu lato, is subject to two major limitations: the need for a two-tier serologic testing algorithm to provide adequate specificity, and the low sensitivity of this algorithm in practice for detection of early Lyme disease manifesting with the erythema migrans skin lesion, the most common clinical manifestation. This study presents the first description of a new assay, the Hybrid Lyme ELISA, which demonstrates sensitivity high enough to potentially diagnose over 90% of patients with erythema migrans, and specificity high enough to preclude the need for a second-tier test. These test characteristics suggest the potential for the Hybrid Lyme ELISA to be the first single-tier serologic test suitable for laboratory diagnosis of all stages of Lyme disease
Autologous Pericardial Reconstruction of the Pulmonary Valve: The Case for the Pulmonary Ozaki Procedure
No full textPulmonary valve pathology is the most common entity encountered in adults with congenital heart disease. Most of these patients have undergone a previous interventional cardiac catheterization procedure or were operated upon during childhood and later on had persistent or recurrent pulmonary valve pathology that warrants re-interventions. The majority of these adulthood re-interventions are in the form of pulmonary valve replacement, and while there are currently several options for replacement of the pulmonary valve, none is satisfactory and will create a need for future procedures considering the young age of these patients. In this video tutorial, we present another option for these patients, which is pulmonary valve reconstruction using the patient\u27s own autologous pericardium
First Light, First Steps
No full texthttps://touroscholar.touro.edu/quill_and_scope_images/1226/thumbnail.jp
The Chironian 2025
No full textThe Chironian is distributed to a readership of 16,000 faculty, alumni and employees of New York Medical College, government and community leaders, affiliated hospitals and selected media. Each issue is carefully crafted to provide a balance of articles on cutting-edge research, personality profiles, student accomplishments and alumni news from all five schools on the NYMC campus. Inquiries can be sent to [email protected]://touroscholar.touro.edu/nymc_arch_journals/1188/thumbnail.jp
Strategies to Address the Growing Impact of the Antibiotic Resistance Crisis
No full textAs time progresses, more bacterial strains are becoming resistant to the antibiotics developed to treat them. Impeding such intractable infections should be a major clinical priority, as previously treatable diseases have begun to incur a fatality rate that will escalate catastrophically unless it is halted. This research paper explores relevant information regarding the advances in developing alternative strategies to antibiotics to combat antimicrobial resistant (AMR) bacteria, within the context of clinical application. Recognizing the profound impact antimicrobial resistance (AMR) will have on patient health enables the implementation of proactive measures to curb the expanding prevalence of multidrug-resistant (MDR) pathogens. This would primarily include the implementation of antimicrobial stewardship to oversee that antibiotics are appropriately prescribed. Bacteria’s intertwined relationship with body processes and the immune system is not yet fully understood, but its role in upkeeping homeostatic function is crucial. The overconsumption of antibiotics can selectively promote AMR bacterial strains and can disturb the gut microbiome. Numerous studies have demonstrated how the current burden of AMR-associated infections and fatalities will continue to exponentiate, highlighting the need for novel therapies. Investigating the mechanisms through which bacteria can become resistant to antibiotics allows researchers to extrapolate and develop new treatments to address these developments. AMR in bacteria often emerges as the result of genetic factors, whether through inherent physiological structures, by genetic mutation, or by the acquisition of foreign genetic material. Biofilms, an aggregation of bacteria with conferred survival mechanisms, pose a significant challenge as they are particularly adept at resisting antibiotic threats. Strategies like quorum sensing inhibitors attempt to disrupt biofilm formation, while efflux pump inhibitors focus on preventing the bacteria’s expulsion of the antibiotic. Additionally, phage therapy, which utilizes viruses that target specific bacterial strains, has demonstrated promising results in eradicating MDR pathogens during clinical trials. Another avenue under exploration is the development of synthetic antimicrobial peptides as a novel anti-inflammatory adjuvant. The studies in this paper serve to provide a contextualized picture of the current fight against antibiotic resistance and identify alternative treatments to traditional antibiotics
Rise in Deaths From Drug Overdose and Firearm Injury During Coronavirus Disease 2019 Pandemic and Its Impact on Organ Transplantation
No full textBACKGROUND The coronavirus disease 2019 (COVID-19) pandemic had a profound societal impact in the United States which was associated with a decrease in overall life expectancy and an increase in substance abuse and firearm injury. Our understanding of changes in mortality trends during the pandemic and its effect on organ availability for transplantation is limited. AIM To examine the trends of substance abuse and firearm injury fatalities during COVID-19 and a potential correlation with organ transplantation. METHODS Crude rates of population-based deaths among adults (18-75 years) from firearm injury and substance abuse from the period of 2014-2021 were obtained from centers of disease control wide-ranging online data for epidemiologic research database. Crude rates of causes of donor (18-75 years) deaths from 2014-2021 were obtained from the united network for organ sharing database. RESULTS Average annual percentage change (AAPC) deaths among the United States population were 16.4% from substance abuse and 3.4% from firearm injury. AAPC in cause of death among organ donors was 10.9% from drug intoxication and 2.1% from firearm injury. There was a significant (P \u3c 0.001) and progressive increase in mortality from both causes during the pandemic (2020-2021) and significant correlation (P \u3c 0.001) between population and donor causes of death. COVID-19 exacerbated trends in substance abuse and firearm mortality with a consequent increase in organ donation from donors who died from these two causes. CONCLUSION Identifying the socioeconomic and regional disparities associated with increase in deaths from substance abuse and firearms can help guide post-pandemic healthcare policies and mitigate their impact on organ transplantation
Differences in Observed Outcomes and Toxicities for Adolescent and Young Adult Patients With Aggressive Mature B-Cell Lymphomas Treated at an Adult versus Pediatric Cancer Center
No full textBackground: Treatments for adolescent and young adult (AYA) patients with mature B-cell lymphomas (MBCL) differ between adult versus pediatric centers, and data are scarce regarding comparative toxicities and outcomes. Procedures: We identified AYA patients (age 12–39) with MBCL seen between 2011 and 2021 at an adult (AC) and pediatric (PC) tertiary cancer center. Data regarding baseline characteristics, adverse events, and long-term outcomes were collected. Results: A total of 173 AYA patients with MBCL were identified, 20 in the PC and 153 in the AC. During treatment, more unplanned hospitalizations (80% vs. 49%, p = 0.008), febrile neutropenia (70% vs. 42%, p = 0.04), Grade ≥3 mucositis (35% vs. 12%, p = 0.014), and fungal infections (15% vs. 3%, p = 0.040) were observed at PC versus AC, while neuropathy was less common (0% vs. 23%, p = 0.015). Two-year overall survival (OS) and progression-free survival (PFS) for those with Burkitt lymphoma were 92%, whereas those with diffuse large B-cell lymphoma (DLBCL) had 2-year OS and PFS of 92% and 76%, respectively. Conclusions: Among patients with DLBCL, pediatric-inspired or more intensive therapies were associated with improved PFS compared with R-CHOP, hazard ratio of 0.33 (95% confidence interval: 0.11–0.98). Greater short-term toxicity and lower incidence of peripheral neuropathy were observed in AYA MBCL patients treated at a pediatric versus adult center
InTouch Week of August 11, 2025
No full textNew Chief Development Officer Joins NYMC GSBMS Welcomes a New Cohort of Students 20 Years of Revolutionizing Emergency Preparedness Study Calls for Nuanced Approach to Stroke Care in Sexual and Gender Diverse Patients NYMC and TU Host “Ninety Minutes: The Medical Magazine of the Web” Back-to-School Savings TCDM Announces its First Alumni Association Executive Boardhttps://touroscholar.touro.edu/in_touch/1371/thumbnail.jp