Browsing by Author "Asdell, Stephanie M."
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Item Human Antibody-Dependent Cellular Cytotoxicity-Mediating Antibodies Do Not Recruit Non-Human Primate CD20+ NK Cells(2018-04) Asdell, Stephanie M.; Edwards, R. Whitney; Jha, Shalini; Ferrari, GuidoThe antibody-dependent cell-mediated cytotoxicity (ADCC) response represents one of mechanisms through which the immune system destroys tumor or infected cells. During the ADCC response to HIV-1, natural killer (NK) cells are recruited by natural infection- or vaccine-induced antibodies (Abs) bound to the HIV-1 envelope glycoproteins expressed on infected CD4+ T cells via Fc-gamma Receptor IIIA (Fc-R IIIA). The NK cells’ Ab-mediated recognition of the infected cells leads to the release of granzymes and perforin by degranulation, triggering apoptotic signal pathways in the infected cells and ultimately leading to their elimination. We have optimized an assay to investigate the degranulation of non-human primate (NHP) NK cells from five different NHP donors by measuring levels of CD107a, a marker present on the inner membranes of NK lysosomes. Using one NHP and two human monoclonal antibodies (mAbs), we compared degranulation of NK in NHP splenocytes, NHP peripheral blood mononuclear cells (PBMC), and human PBMC. We observed that both NHP and human mAbs recruited NHP and human NK effector cells. Of note, we examined the activity of CD20+ and CD20- NK cells, with the former being NK cells from a unique subset of NHP NK splenocytes. Our analysis suggests that CD20+ cells likely do not play a role in the NHP ADCC response. In conclusion, we can identify the cellular populations responsible for the Ab-mediated killing of HIV-1 infected cells, and we will be able to further analyze their full functional profile at the level of messenger RNA expression, i.e. their transcriptomic profile.Item Human Sexuality Case Based Learning: Endocrine, Reproductive, Musculoskeletal and Dermatology Course, IUSM(2020-04) Chiang, Jessica; Asdell, Stephanie M.; Haddad, Aida; Khan, IbrahimPURPOSE AND APPROACH: The goal is to help students understand the human sexual response. Students will review sexual health and risks to sexual health. SESSION OBJECTIVES: Describe the definitions of sexual health promoted by the World Health Organization and Centers for Disease Control; explain the four phases of the sexual response cycle (excitement, plateau, orgasm and resolution) in women and men; compare and contrast sexual dysfunction in men and women; list the various sexual practices engaged in by men and women; and explain the health risks associated with various sexual practices, and the interventions recommended to reduce this risk.Item Influenza Group 2 HA Stem-Only Nanoparticles Induce Heterotypic Immune Response(2017-08) Asdell, Stephanie M.; Moin, Syed M.; Corbett, Kizzmekia; Boyington, Jeffrey; Graham, Barney S.Item Knowledge and Intention to Use Long-Acting Reversible Contraception among University Students(Taylor & Francis, 2022-06-23) Asdell, Stephanie M.; Bennett, Rachel D.; Cordon, Sabrina A.; Zhao, Qiuhong; Peipert, Jeffrey F.; Obstetrics and Gynecology, School of MedicineObjective: To assess the relationship between knowledge of long-acting reversible contraception (LARC) and intention to use LARC among female students. Participants: Participants consisted of a convenience sample of 292 female undergraduate and graduate students at a large midwestern university. Methods: We conducted a cross-sectional in-person survey and multivariate analysis of LARC knowledge and intention to use LARC. Results: Total response rate was 84.9%. Among contraceptive users, 13.3% were using a LARC method. On average, respondents scored 4.8/10 (SD 2.5) on a 10-item LARC knowledge assessment. Higher levels of LARC knowledge were associated with the intent to use LARC in the future in our multivariate analysis (RR 1.7, 95% CI 1.14-2.54: p = .01). Common reasons for LARC hesitancy were a need for more information, safety concerns, and risk of undesirable side effects. Conclusions: Low LARC knowledge and students' self-identified need for further LARC information represent an opportunity for campus contraceptive interventions which empower students to make informed reproductive decisions.Item Long-Acting Reversible Contraception (LARC) Knowledge and Intent to Use among IUPUI Students(2019-08) Asdell, Stephanie M.; Bennett, Rachel D.; Cordon, Sabrina A.; Zhao, Qiuhong; Peipert, Jeffrey F.BACKGROUND AND HYPOTHESIS: More than 50% of births to women in their early 20s are unintended, and unintended pregnancies have adverse consequences on students’ education. Long-acting reversible contraceptives (LARC), including hormonal and copper intrauterine devices (IUDs) and the contraceptive implant, offer highly-effective, long-term prevention of pregnancy, yet are utilized at low rates. Thus, we sought to assess students’ LARC knowledge and intent to use LARC at Indiana University-Purdue University in Indianapolis (IUPUI) to inform a campus family planning initiative. We hypothesized that students with higher levels of LARC knowledge are more likely to intend to use LARC in the future. We also hypothesized that a lower proportion of students utilize LARC compared to the US rate of 15.8% of all contraceptive users in 2017. EXPERIMENTAL DESIGN AND PROJECT METHODS: We designed a cross-sectional survey for undergraduates, graduate students, and resident physicians assessing sexual experiences, contraceptive use, LARC knowledge, and intent to use LARC. We summarized participants’ characteristics using descriptive statistics, compared awareness of LARC methods using McNemar’s test, and evaluated association between LARC knowledge and future intent to use a LARC method using Fisher exact. RESULTS: Thus far, we have recruited 126 participants with a response rate of 88.7%. Mean score on the 10-question LARC assessment was 5.2/10; higher levels of LARC knowledge were positively associated with future intent to use LARC (P < 0.05). Only 7.9% of contraceptive users surveyed used LARC, compared to 15.8% of US contraceptive users in 2017. Differences in awareness of the copper IUD (61.1%), hormonal IUD (74.6%) and implant (88.9%) were statistically significant (P < 0.05). The most common reason cited for not considering LARC use was “need for more information.” CONCLUSION AND POTENTIAL IMPACT: Low LARC knowledge and use and high desire for LARC education further supports need for a campus contraceptive initiative that will empower students to make informed reproductive decisions.Item Management of Coarctation of the Aorta during Pregnancy: A Case Report.(2019-07) Patel, Pooja; Ciresi, Colette; Asdell, Stephanie M.; Hopkins, Kali; Kay, W. AaronBACKGROUND: Patients with coarctation of the aorta are increasingly reaching child-bearing age. Unrepaired coarctations and/or repaired coarctations with recurrent or residual stenosis require close monitoring for hypertension and heart failure, which can increase maternal risk for aortic rupture or dissection and neonatal risks for intrauterine growth retardation, abruptio placentae, and premature delivery. The potential for adverse outcomes may necessitate repair during pregnancy. CASE: An 18-year-old primigravida at 11 weeks gestation with history significant for unrepaired coarctation of the aorta presented with chest pain for 2-3 days and nonpalpable lower extremity pulses. She was previously diagnosed with coarctation at age 3 years, which did not require surgical repair and she was subsequently lost to follow up. Echocardiogram (ECHO) showed a dilated ascending and transverse aorta with decreased pulsatility in the descending aorta, consistent with critical coarctation. Emergent cardiac catheterization was performed and a balloon expanded stent was used to dilate the area of coarctation. Post-procedurally she had zero gradient and went on to have an uneventful pregnancy and delivery. She is now a 23-year-old G5P3. She has two living children with Shone’s complex and had two pregnancies end in miscarriages. Fetal ECHO was performed for each pregnancy and the patient received genetic counseling but declined further genetic testing. CLINICAL SIGNIFICANCE: This case illustrates a successful percutaneous repair of coarctation during pregnancy via balloon expanded stent placement. Fetal ECHO should occur from 18-22 weeks gestation in pregnant women with history of coarctation as prevalence of left-sided obstructive lesions may occur in 10–20% of first-degree relatives. As shared cardiac genetic markers exist between coarctation and Shone’s complex, this case also demonstrates the impact prenatal genetic testing can potentially have on subsequent pregnancies and neonatal outcomes.Item Management of Severe Coarctation of the Aorta During Pregnancy(Elsevier, 2020-01) Ciresi, Colette M.; Patel, Pooja R.; Asdell, Stephanie M.; Hopkins, Kali A.; Hoyer, Mark H.; Kay, W. Aaron; Pediatrics, School of MedicineAn 18-year-old primigravida woman underwent emergent percutaneous balloon stent repair of a severe coarctation of the aorta, allowing her to undergo an uneventful remaining pregnancy and the delivery of a healthy baby. Her case also demonstrates the association between maternal coarctation and fetal Shone complex. (Level of Difficulty: Beginner.)Item Myocarditis in an 18-Year-Old with Ulcerative Colitis(2021-03-27) Asdell, Stephanie M.; Prabhakar, Mira; Jones, Jenna; Frick, William; Tolliver, KevinCASE DESCRIPTION: An 18-year-old woman with recently-diagnosed ulcerative colitis (UC) on mesalamine presented with chest pain worsened by inspiration and exertion, dyspnea, and subjective fever for 6 hours. She had a self-limited dry cough 2 weeks prior. SARS-CoV-2 PCR was negative. At presentation, her hemoglobin was 7.1 g/dL. EKG showed sinus tachycardia. Peak troponin was 0.21 ng/mL. Transthoracic echocardiogram showed a possible mildly hypokinetic apex, and vasodilator stress test was normal. Due to persistent hematochezia and the possibility of mesalamine-induced myocarditis, mesalamine was changed to sulfasalazine for her UC. The patient was otherwise treated supportively and referred for outpatient cardiac MRI, but declined the study. Subsequently, Coxsackie B Virus Antibody Type 3 titer was strongly positive at > 1:640, confirming viral myocarditis. CONCLUSIONS: This case describes the work-up of an 18-year-old female patient with UC presenting with acute onset chest pain and fever. Differential diagnosis included viral myocarditis, mesalamine-induced myocarditis, pericarditis, pulmonary embolism, acute coronary syndrome (ACS), and multisystem inflammatory syndrome in children secondary to SARS-CoV-2. CLINICAL SIGNIFICANCE: Global incidence of viral myocarditis is 22 cases per 100,000 individuals annually; though significantly more common in males, female patients often present with more severe disease. Suspected myocarditis warrants an initial EKG and cardiac biomarkers followed by echocardiography, and when indicated, testing for ACS. While acute myocarditis is most commonly caused by coxsackievirus B3 and adenovirus in the U.S. and is treated supportively, several case reports of mesalamine-induced myocarditis prompted specific management for this patient with newly diagnosed UC. Thus, the acuity and incidence of myocarditis present a learning opportunity for differential diagnosis building and workup for young female patients with acute onset chest pain.