Browsing by Author "Méndez, Alejandra"

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    A Man Living in the Wilderness Presents With a Unique Case of Erysipelothrix rhusiopathiae Causing Primary CNS Infection
    (Hindawi, 2025-03-19) Smith, Kevin Andrew; Méndez, Alejandra; Reese, Lindsey J.; Medicine, School of Medicine
    We report the first published case of Erysipelothrix rhusiopathiae causing subdural empyema. This 66-year-old male patient had relevant exposure history including living in a tent in the woods and having direct contact with wildlife. His main symptom which triggered his presentation was diplopia with exam findings consistent with a left partial oculomotor nerve palsy. Initial attempts at less invasive source control via burr holes alone failed. He was treated successfully with craniectomy and aqueous penicillin G with a duration of 6 weeks following surgery. CNS infection as the primary manifestation of Erysipelothrix rhusiopathiae has been reported in only one other case based on our review of the literature. This pathogen demonstrates an ability to manifest infection in many ways and remains susceptible to narrow spectrum beta-lactams.
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    Describing Hidradenitis Suppurativa Misinformation Diffusion Among Facebook Users: A Content Analysis
    (Matrix Medical Communications, 2023) Méndez, Alejandra; Rao, Megana; Rahnama-Moghadam, Sahand; Gomaa, Basma; Walsh-Buhi, Eric R.; Dermatology, School of Medicine
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    From the Cochrane Library: Interventions for Pityriasis Rosea
    (JMIR, 2023-06-05) Méndez, Alejandra; Stevens, Carly; Murina, Andrea; Dermatology, School of Medicine
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    Prospective assessment of risk biomarkers of sinusoidal obstruction syndrome after hematopoietic cell transplantation
    (The American Society for Clinical Investigation, 2023-05-22) Han, Yan; Bidgoli, Alan; DePriest, Brittany P.; Méndez, Alejandra; Bijangi-Vishehsaraei, Khadijeh; Perez-Albuerne, Evelio D.; Krance, Robert A.; Renbarger, Jamie; Skiles, Jodi L.; Choi, Sung W.; Liu, Hao; Paczesny, Sophie; Biostatistics and Health Data Science, School of Medicine
    BACKGROUND: Currently, no laboratory tests exist to stratify for the risk of developing sinusoidal obstruction syndrome (SOS), an early endothelial complication after hematopoietic cell transplantation (HCT). Risk biomarkers of SOS have not been verified in a prospective cohort accounting for differences between practices across institutions. Herein, we aimed to define risk groups for SOS occurrence using 3 proteins: L-ficolin, hyaluronic acid (HA), and stimulation 2 (ST2). METHODS: Between 2017 and 2021, we prospectively accrued 80 pediatric patients across 4 US centers. Biomarkers were tested by ELISA blind to patient groupings and associated with SOS incidence on day 35 after HCT, and overall survival (OS) on day 100 after HCT. Cutpoints were identified using retrospective cohorts and applied to the prospective cohort. RESULTS: Combination of the 3 biomarkers measured on day 3 after HCT in the prospective cohort provided 80% (95% CI 55%–100%) sensitivity and 73% (95% CI 62%–83%) specificity for risk of SOS occurrence. Patients with low L-ficolin were 9 times (95% CI 3–32) more likely to develop SOS, while patients with high HA and ST2 were 6.5 (95% CI 1.9–22.0) and 5.5 (95% CI 2.3–13.1) times more likely to develop SOS. These 3 markers also predicted worse day 100 OS — L-ficolin: HR, 10.0 (95% CI 2.2–45.1), P = 0.0002; HA: HR, 4.1 (95% CI 1.0–16.4), P = 0.031; and ST2: HR, 3.9 (95% CI 0.9–16.4), P = 0.04. CONCLUSION: L-ficolin, HA, and ST2 levels measured as early as 3 days after HCT improved risk stratification for SOS occurrence and OS and may guide risk-adapted preemptive therapy.