Faculty Scholarship

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Faculty Scholarship

The Faculty Scholarship webpage is designed to share the news of faculty accomplishments in medical education including publications, conference presentations, and grants. The webpage may also serve as a resource for faculty looking to identify collaborators with shared research interests. Entries are accepted throughout the academic year, and the page is updated monthly.

July 2021 features:

Publications

  1. Gaude, E., Nogueira, B., Ladreda Mochales, M., Graham, S., Smith, S., Shaw, L., Graziadio, S., Ladreda Mochales, G., Sloan, P., Bernstock, J.D., Shekhar, S., Gropen, I., Price, C.I.. A Novel Combination of Blood Biomarkers and Clinical Stroke Scales Facilitates Detection of Large Vessel Occlusion Ischemic Strokes. Diagnostics. 2021; 11(7):1137. https://doi.org/10.3390/diagnostics11071137

    Acute ischemic stroke caused by large vessel occlusions (LVOs) is a major contributor to stroke deaths and disabilities; however, identification for emergency treatment is challenging. We recruited two separate cohorts of suspected stroke patients and screened a panel of blood-derived protein biomarkers for LVO detection. Diagnostic performance was estimated by using blood biomarkers in combination with NIHSS-derived stroke severity scales. Multivariable analysis demonstrated that D-dimer (OR 16, 95% CI 5–60; p-value < 0.001) and GFAP (OR 0.002, 95% CI 0–0.68; p-value < 0.05) comprised the optimal panel for LVO detection. Combinations of D-dimer and GFAP with a number of stroke severity scales increased the number of true positives, while reducing false positives due to hemorrhage, as compared to stroke scales alone (p-value < 0.001). A combination of the biomarkers with FAST-ED resulted in the highest accuracy at 95% (95% CI: 87–99%), with sensitivity of 91% (95% CI: 72–99%), and specificity of 96% (95% CI: 90–99%). Diagnostic accuracy was confirmed in an independent cohort, in which accuracy was again shown to be 95% (95% CI: 87–99%), with a sensitivity of 82% (95% CI: 57–96%), and specificity of 98% (95% CI: 92–100%). Accordingly, the combination of D-dimer and GFAP with stroke scales may provide a simple and highly accurate tool for identifying LVO patients, with a potential impact on time to treatment.

  2. Jagtap, R., Garrido, M.B., Hansen, M. Osteopathia striata in the mandible with cranial sclerosis: a case report and review of the literature. Journal of the Korean Association of Oral and Maxillofacial Surgeons. 2021 Apr 30; 47(2):141-4.

    The internal carotid artery (ICA) can take multiple pathways as it extends from the carotid bifurcation to the skull base. An aberration of its normal pathway may place the ICA in a retropharyngeal position in close proximity to the posterior pharyngeal wall. Radiographic classification is based on its proximity to the pharynx and/or pathway. We present a series of three cases of retropharyngeal ICAs, our goal is to report and classify these variations.

    Case 1 - Retropharyngeal right ICA. Minimum distance to the pharyngeal wall was ~ 4.9 mm (high risk of vascular injury) with a tortuous pathway.

    Case 2 - Bilateral retropharyngeal ICA. ICAs were in contact with the posterior pharyngeal wall (very high risk of vascular injury). The left has a kinking pathway, the right tortuous.

    Case 3 - Bilateral retropharyngeal ICA. Minimum distances of the right and left ICAs to the posterior pharyngeal wall were ~ 3.5 mm and ~ 3.3 mm, respectively (high risk of vascular injury). The right has a kinking pathway, the left tortuous.

    Closeness of the vessel to the retropharyngeal wall increases the risk of surgical and non-surgical complications. Noteworthy is that the position of the artery is not constant and can change in position over periods of time.

    Conclusion Knowledge of the anatomy and variations of the ICA is important for oral and maxillofacial radiologists and surgeons to enable clinicians to take necessary precautions to decrease complications if performing any procedure in the region.

  3. Jagtap, R., Shuff, N., Bawazir, M., GARRİDO, M.B., Bhattacharyya, I., Hansen, M. A Rare Presentation of Radicular Cyst: A Case Report and Review of Literature. European Annals of Dental Sciences; 48(1).

    The radicular cyst is the most common inflammatory odontogenic cyst in the jaws. It is a periapical lesion associated with non-vital teeth in the tooth-bearing regions of the jaws with a slight male predilection. A radicular cyst is typically asymptomatic, but if large or secondarily infected may cause swelling. The usual radiographic appearance of a radicular cyst is that of a periapical radiolucent lesion. This case report documents a rare case of 61-year-old male with a mixed-density periapical lesion diagnosed as a radicular cyst. The lesion presented as a well defined, expansile, space occupying, corticated, sclerotic, hydraulic, unilocular, mixed density lesion, associated with the right mandibular second premolar that was predominantly radiolucent with scattered foci of radiopacities. Microscopic examination revealed fragments of lining epithelium along with small fragments of inflamed fibrous connective tissue, aggregates of necrotic cellular debris, and bacterial colonies intermixed with foci of dystrophic calcifications. The histopathological diagnosis was a radicular cyst with dystrophic calcification. Although rare, this entity should be considered in the differential diagnosis of mixed-density periapical lesions. Complete history and proper diagnosis is important in this type of rare cases as treatment varies between a radicular cyst and other odontogenic neoplasms.

  4. Vargas-Luna, J.L., Brown, J., Krenn, M.J., McKay, B., Mayr, W., Rothwell, J.C., Dimitrijevic, M.R. (2021). Neurophysiology of epidurally evoked spinal cord reflexes in clinically motor-complete posttraumatic spinal cord injury. Experimental Brain Research. https://doi.org/10.1007/s00221-021-06153-1

    Increased use of epidural Spinal Cord Stimulation (eSCS) for the rehabilitation of spinal cord injury (SCI) has highlighted the need for a greater understanding of the properties of reflex circuits in the isolated spinal cord, particularly in response to repetitive stimulation. Here, we investigate the frequency-dependence of modulation of short- and long-latency EMG responses of lower limb muscles in patients with SCI at rest. Single stimuli could evoke short-latency responses as well as long-latency (likely polysynaptic) responses. The short-latency component was enhanced at low frequencies and declined at higher rates. In all muscles, the effects of eSCS were more complex if polysynaptic activity was elicited, making the motor output become an active process expressed either as suppression, tonic or rhythmical activity. The polysynaptic activity threshold is not constant and might vary with different stimulation frequencies, which speaks for its temporal dependency. Polysynaptic components can be observed as direct responses, neuromodulation of monosynaptic responses or driving the muscle activity by themselves, depending on the frequency level. We suggest that the presence of polysynaptic activity could be a potential predictor for appropriate stimulation conditions. This work studies the complex behaviour of spinal circuits deprived of voluntary motor control from the brain and in the absence of any other inputs. This is done by describing the monosynaptic responses, polysynaptic activity, and its interaction through its input–output interaction with sustain stimulation that, unlike single stimuli used to study the reflex pathway, can strongly influence the interneuron circuitry and reveal a broader spectrum of connectivity.

  5. Williams, M.S., Wells, J., Duhé, R.J., Shirley, T., Lampkin, A., Murphy, M, and Allen, T.C. The College of American Pathologists Foundation's See, Test & Treat Program®: an Evaluation of a One-Day Cancer Screening Program Implemented in Mississippi. Journal of Cancer Education (2021) online ahead of print; PMID: 34164764; DOI: 10.1007/s13187-021-02060-9

    This manuscript describes the implementation and evaluation of the College of American Pathologists Foundation's See, Test & Treat Program®, a cancer screening and education program aimed at increasing access to cancer screening for underserved women in the Jackson Metropolitan Area. Quantitative and qualitative data provide evidence of the impact of this community event on the 103 women who were screened for breast, cervical, and/or oral cancers, including one woman whose follow-up diagnosis confirmed she had stage 4 oral cancer.

Presentations

  1. Jagtap, R., Amasya, H., Jadhav, A., Shumilov, E., Orhan, K. Evaluation of knowledge, attitudes, and perceptions of dentists towards artificial intelligence (AI) in dentistry: a national survey. Poster presentation, International Congress of Dento-Maxillofacial Radiology, March 2021.

  2. Jagtap, R., Bhat, M., Mehta, N., Gupta, S. Dilemma with implant placement in patient with florid cemento-osseous dysplasia: a literature review. Poster presentation, International Congress of Dento-Maxillofacial Radiology, March 2021.

  3. Jagtap, R., Kirk, P., Dellinger, T. Ectopic eruption of mandibular second molar in the coronoid process: a case report and review of literature. Poster presentation, International Congress of Dento-Maxillofacial Radiology, March 2021.