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Article ; Online: Seasonal variations in dermatologic and dermatopathologic diagnoses: a retrospective 15-year analysis of dermatopathologic data.

Harvell, Jeff D / Selig, Daniel J

2016 Volume 55, Issue 10, Page(s) 1115–1118

Abstract: Background: Certain dermatologic conditions are known to show seasonal variations in frequency, the reasons for which are unclear but in some cases may be attributable to changes in ambient weather conditions.: Objectives: The current study was ... ...

Abstract	Background: Certain dermatologic conditions are known to show seasonal variations in frequency, the reasons for which are unclear but in some cases may be attributable to changes in ambient weather conditions. Objectives: The current study was conducted to determine whether seasonal trends might exist for dermatologic conditions including erythema multiforme, guttate psoriasis, erythema dyschromicum perstans (ashy dermatosis), pityriasis lichenoides, and pityriasis rosea. Methods: Data were derived from a 15-year retrospective review of electronic records from a large dermatopathology laboratory located in the mid-Atlantic region of the USA. Numbers of diagnoses per month and "per season" were determined. Pairwise comparisons of seasonal data were made using two-sample t-tests with significance set at P ≤ 0.05. Results: Perniosis (chilblains) was significantly more common in winter and spring (P = 0.001). Hand, foot, and mouth disease was statistically more prevalent in summer and autumn (P = 0.028). Erythema multiforme was most common in spring and summer (P = 0.004). Grover's disease was most common in winter and spring (P = 0.000039). Guttate psoriasis was non-significantly more common in winter and spring (P = 0.076). No statistically significant seasonal variation was found for erythema dyschromicum perstans (P = 0.899), pityriasis rosea (P = 0.727), or pityriasis lichenoides (P = 0.366). Conclusions: This study found statistically significant seasonal trends for several dermatologic conditions. The study was primarily epidemiologic and was not intended to address histopathologic differences that might underlie the seasonal variations observed. However, further investigation of seasonal differences in the histopathology of erythema multiforme may prove interesting.
MeSH term(s)	Acantholysis/epidemiology ; Chilblains/epidemiology ; Erythema Multiforme/epidemiology ; Hand, Foot and Mouth Disease/epidemiology ; Humans ; Ichthyosis/epidemiology ; Mid-Atlantic Region/epidemiology ; Pityriasis Lichenoides/epidemiology ; Pityriasis Rosea/epidemiology ; Prevalence ; Psoriasis/epidemiology ; Retrospective Studies ; Seasons ; Skin Diseases/diagnosis ; Skin Diseases/epidemiology
Language	English
Publishing date	2016-10
Publishing country	England
Document type	Journal Article
ZDB-ID	412254-9
ISSN	1365-4632 ; 0011-9059 ; 1461-1244
ISSN (online)	1365-4632
ISSN	0011-9059 ; 1461-1244
DOI	10.1111/ijd.13229
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Article ; Online: Deeper habitats and cooler temperatures moderate a climate-driven seagrass disease.

Graham, Olivia J / Stephens, Tiffany / Rappazzo, Brendan / Klohmann, Corinne / Dayal, Sukanya / Adamczyk, Emily M / Olson, Angeleen / Hessing-Lewis, Margot / Eisenlord, Morgan / Yang, Bo / Burge, Colleen / Gomes, Carla P / Harvell, Drew

Philosophical transactions of the Royal Society of London. Series B, Biological sciences

2023 Volume 378, Issue 1873, Page(s) 20220016

Abstract: Eelgrass creates critical coastal habitats worldwide and fulfills essential ecosystem functions as a foundation seagrass. Climate warming and disease threaten eelgrass, causing mass mortalities and cascading ecological impacts. Subtidal meadows are ... ...

Abstract	Eelgrass creates critical coastal habitats worldwide and fulfills essential ecosystem functions as a foundation seagrass. Climate warming and disease threaten eelgrass, causing mass mortalities and cascading ecological impacts. Subtidal meadows are deeper than intertidal and may also provide refuge from the temperature-sensitive seagrass wasting disease. From cross-boundary surveys of 5761 eelgrass leaves from Alaska to Washington and assisted with a machine-language algorithm, we measured outbreak conditions. Across summers 2017 and 2018, disease prevalence was 16% lower for subtidal than intertidal leaves; in both tidal zones, disease risk was lower for plants in cooler conditions. Even in subtidal meadows, which are more environmentally stable and sheltered from temperature and other stressors common for intertidal eelgrass, we observed high disease levels, with half of the sites exceeding 50% prevalence. Models predicted reduced disease prevalence and severity under cooler conditions, confirming a strong interaction between disease and temperature. At both tidal zones, prevalence was lower in more dense eelgrass meadows, suggesting disease is suppressed in healthy, higher density meadows. These results underscore the value of subtidal eelgrass and meadows in cooler locations as refugia, indicate that cooling can suppress disease, and have implications for eelgrass conservation and management under future climate change scenarios. This article is part of the theme issue 'Infectious disease ecology and evolution in a changing world'.
MeSH term(s)	Ecosystem ; Zosteraceae ; Temperature ; Climate Change ; Cold Temperature
Language	English
Publishing date	2023-02-06
Publishing country	England
Document type	Journal Article ; Research Support, Non-U.S. Gov't ; Research Support, U.S. Gov't, Non-P.H.S.
ZDB-ID	208382-6
ISSN	1471-2970 ; 0080-4622 ; 0264-3839 ; 0962-8436
ISSN (online)	1471-2970
ISSN	0080-4622 ; 0264-3839 ; 0962-8436
DOI	10.1098/rstb.2022.0016
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Article: Head CT Guidelines Following Concussion among the Youngest Trauma Patients: Can We Limit Radiation Exposure Following Traumatic Brain Injury?

Harvell, Bryan J / Helmer, Stephen D / Ward, Jeanette G / Ablah, Elizabeth / Grundmeyer, Raymond / Haan, James M

Kansas journal of medicine

2018 Volume 11, Issue 2, Page(s) 1–17

Abstract: Introduction: Recent studies have provided guidelines on the use of head computed tomography (CT) scans in pediatric trauma patients. The purpose of this study was to identify the prevalence of these guidelines among concussed pediatric patients.: ... ...

Abstract	Introduction: Recent studies have provided guidelines on the use of head computed tomography (CT) scans in pediatric trauma patients. The purpose of this study was to identify the prevalence of these guidelines among concussed pediatric patients. Methods: A retrospective review was conducted of patients four years or younger with a concussion from blunt trauma. Demographics, head injury characteristics, clinical indicators for head CT scan (severe mechanism, physical exam findings of basilar skull fracture, non-frontal scalp hematoma, Glasgow Coma Scale score, loss of consciousness, neurologic deficit, altered mental status, vomiting, headache, amnesia, irritability, behavioral changes, seizures, lethargy), CT results, and hospital course were collected. Results: One-hundred thirty-three patients (78.2%) received a head CT scan, 7 (5.3%) of which demonstrated fractures and/or bleeds. All patients with skull fractures and/or bleeds had at least one clinical indicator present on arrival. Clinical indicators that were observed more commonly in patients with positive CT findings than in those with negative CT findings included severe mechanism (100% vs. 54.8%, respectively, p = 0.020) and signs of a basilar skull fracture (28.6% vs. 0.8%, respectively, p = 0.007). Severe mechanism alone was found to be sensitive, but not specific, whereas signs of a basilar skull fracture, headache, behavioral changes, and vomiting were specific, but not sensitive. No neurosurgical procedures were necessary, and there were no deaths. Conclusion: Clinical indicators were present in patients with positive and negative CT findings. However, severe mechanism of injury and signs of basilar skull fracture were more common for patients with positive CT findings.
Language	English
Publishing date	2018-05-18
Publishing country	United States
Document type	Journal Article
ISSN	1948-2035
ISSN	1948-2035
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Article: A Pigmented Subcutaneous Nodule on the Scalp.

Wang, Shuwei / Harvell, Jeff D / Friedman, Kenneth J / Kirkorian, A Yasmine / Milgraum, Sandy

Skinmed

2016 Volume 14, Issue 5, Page(s) 385–388

Abstract: A 52-year-old man presented to his primary doctor with a slow-growing cystic lesion on his occipital scalp. His primary care doctor diagnosed the lesion as a pilar cyst and recommended observation because the lesion was asymptomatic at that time. The ... ...

Abstract	A 52-year-old man presented to his primary doctor with a slow-growing cystic lesion on his occipital scalp. His primary care doctor diagnosed the lesion as a pilar cyst and recommended observation because the lesion was asymptomatic at that time. The patient had no significant medical or surgical history. There was no family history of skin cancer or other malignancies.
MeSH term(s)	Asymptomatic Diseases ; Epidermal Cyst/pathology ; Humans ; Male ; Middle Aged ; Scalp Dermatoses/pathology
Language	English
Publishing date	2016-10-01
Publishing country	United States
Document type	Case Reports
ZDB-ID	2171125-2
ISSN	1540-9740
ISSN	1540-9740
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Article ; Online: Disease epidemic and a marine heat wave are associated with the continental-scale collapse of a pivotal predator (

Harvell, C D / Montecino-Latorre, D / Caldwell, J M / Burt, J M / Bosley, K / Keller, A / Heron, S F / Salomon, A K / Lee, L / Pontier, O / Pattengill-Semmens, C / Gaydos, J K

Science advances

2019 Volume 5, Issue 1, Page(s) eaau7042

Abstract: Multihost infectious disease outbreaks have endangered wildlife, causing extinction of frogs and endemic birds, and widespread declines of bats, corals, and abalone. Since 2013, a sea star wasting disease has affected >20 sea star species from Mexico to ... ...

Abstract	Multihost infectious disease outbreaks have endangered wildlife, causing extinction of frogs and endemic birds, and widespread declines of bats, corals, and abalone. Since 2013, a sea star wasting disease has affected >20 sea star species from Mexico to Alaska. The common, predatory sunflower star (
MeSH term(s)	Animals ; Ecosystem ; Epidemics ; Fisheries ; Hot Temperature/adverse effects ; Infrared Rays/adverse effects ; Oceans and Seas/epidemiology ; Pacific Ocean/epidemiology ; Predatory Behavior ; Starfish ; Wasting Syndrome/epidemiology ; Wasting Syndrome/etiology ; Wasting Syndrome/mortality
Language	English
Publishing date	2019-01-30
Publishing country	United States
Document type	Journal Article ; Research Support, Non-U.S. Gov't ; Research Support, U.S. Gov't, Non-P.H.S.
ZDB-ID	2810933-8
ISSN	2375-2548 ; 2375-2548
ISSN (online)	2375-2548
ISSN	2375-2548
DOI	10.1126/sciadv.aau7042
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Article: Telangiectasia macularis eruptiva persians presenting as island sparing.

Ragi, Jennifer / Lazzara, Danielle R / Harvell, Jeffrey D / Milgraum, Sandy S

The Journal of clinical and aesthetic dermatology

2013 Volume 6, Issue 4, Page(s) 41–42

Abstract: Mastocytosis is characterized by the proliferation and accumulation of mast cells within organs and most commonly the skin; localization accounting for the frequent presentation of skin lesions in affected individuals. The authors detail a case report ... ...

Abstract	Mastocytosis is characterized by the proliferation and accumulation of mast cells within organs and most commonly the skin; localization accounting for the frequent presentation of skin lesions in affected individuals. The authors detail a case report involving a patient with telangiectasia macularis eruptive perstans, a rare cutaneous form of mastocytosis, accompanied by an unusual clinical finding of island sparing.
Language	English
Publishing date	2013-04-22
Publishing country	United States
Document type	Journal Article
ISSN	1941-2789
ISSN	1941-2789
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Article ; Online: Comparison of QTc and Troponin Levels in ST Elevation MIs Compared with Non-ST Elevation MIs.

Henrie, Nathan / Harvell, Bryan / Ernst, Amy A / Weiss, Steven J / Oglesbee, Scott / Sarangarm, Dusadee / Hernandez, Lorenzo

Southern medical journal

2017 Volume 110, Issue 3, Page(s) 210–216

Abstract: Objectives: ST elevation myocardial infarctions (STEMIs) and non-ST elevation myocardial infarctions (NSTEMIs) have differences that can be important to differentiate. Our primary hypothesis was that corrected QT (QTc) duration and troponin I levels ... ...

Abstract	Objectives: ST elevation myocardial infarctions (STEMIs) and non-ST elevation myocardial infarctions (NSTEMIs) have differences that can be important to differentiate. Our primary hypothesis was that corrected QT (QTc) duration and troponin I levels were higher in STEMIs compared with NSTEMIs. The objective of our study was to compare STEMIs with NSTEMIs for QTc duration and troponin levels. Methods: This was a retrospective case-control study of all STEMIs and a random sample of NSTEMIs during a 1-year period. STEMIs were retrieved by searching our electrocardiogram database for all of the cardiology-diagnosed STEMIs. NSTEMIs were found by selecting a randomized sample of all of the patients with a final discharge diagnosis of NSTEMI. Records and electrocardiograms were reviewed for initial troponin I levels and QTc duration. Data extractors were educated formally and a 5% sample was reevaluated by the other extractor as a reliability measure. Data analysis included χ Results: A total of 92 STEMIs and 111 NSTEMIs were evaluated, and interrater reliability showed 90% agreement. Patients with NSTEMIs had significantly longer QTc. Troponin I did not differ on univariate analysis. In a logistic model, Hispanics were more likely than whites to have a STEMI (adjusted odds ratio [AOR] 2.2, 95% confidence interval [CI] 1.09-4.5). An increase in troponin I of 1 was associated with a 7% increase in the AOR of a STEMI (AOR 1.7, 95% CI 1.03-1.12) and an increase in QTc by 10 was associated with a 13% decrease in the AOR of a STEMI (AOR 0.87, 95% CI 0.78-0.93). Conclusions: Patients with NSTEMIs had longer QTc intervals and lower troponin I levels than those with STEMIs.
MeSH term(s)	Cardiac Catheterization/statistics & numerical data ; Case-Control Studies ; Continental Population Groups ; Coronary Artery Bypass/statistics & numerical data ; Electrocardiography ; Female ; Humans ; Male ; Middle Aged ; Non-ST Elevated Myocardial Infarction/blood ; Non-ST Elevated Myocardial Infarction/epidemiology ; Non-ST Elevated Myocardial Infarction/therapy ; Retrospective Studies ; ST Elevation Myocardial Infarction/blood ; ST Elevation Myocardial Infarction/epidemiology ; ST Elevation Myocardial Infarction/therapy ; Stents ; Troponin I/blood
Chemical Substances	Troponin I
Language	English
Publishing date	2017-03
Publishing country	United States
Document type	Journal Article
ZDB-ID	185329-6
ISSN	1541-8243 ; 0038-4348
ISSN (online)	1541-8243
ISSN	0038-4348
DOI	10.14423/SMJ.0000000000000623
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Article ; Online: The meaning of elevated troponin I levels: not always acute coronary syndromes.

Harvell, Bryan / Henrie, Nathan / Ernst, Amy A / Weiss, Steven J / Oglesbee, Scott / Sarangarm, Dusadee / Hernandez, Lorenzo

The American journal of emergency medicine

2016 Volume 34, Issue 2, Page(s) 145–148

Abstract: Background: Troponin elevation can be caused by etiologies other than acute coronary syndromes (ACS). Our hypothesis was that elevated troponins occur more frequently in non-ACS cases but that ACS cases (type 1 ST-elevation myocardial infarction [STEMI] ...

Abstract	Background: Troponin elevation can be caused by etiologies other than acute coronary syndromes (ACS). Our hypothesis was that elevated troponins occur more frequently in non-ACS cases but that ACS cases (type 1 ST-elevation myocardial infarction [STEMI] and type 1 non-STEMI [NSTEMI]) have significantly higher troponin elevations. Methods: This was a cross-sectional cohort analysis of a random subset of all patients with elevated troponins (defined as ≥0.06 ng/mL) over a 1-year period from July 2013 to June 2014. The first positive troponin I and the peak were used in this study. All included patients had medical record reviews looking for whether our cardiologists or hospitalists attributed the elevated troponin to an ACS (NSTEMI or STEMI) or non-ACS cause. Non-ACS causes were categorized as infection, cancer, renal diseases, cardiovascular disease, pulmonary disease, trauma, cardiac arrest, neurologic disease, hypertension, or other. Data were extracted by 2 investigators on the cause of the elevated troponin. Three sessions to educate data extractors were arranged and methods of data extraction discussed, then a 5% sample was reevaluated by the other extractor to determine interrater agreement measures. Parametric data were evaluated with t test and analysis of variance. Dichotomous variables were compared using χ(2) test. Troponin data were evaluated using nonparametric Kruskal-Wallis or Mann-Whitney U. A logistic regression model was created with variables selected a priori to evaluate the predictive ability of these variables in differentiating ACS vs non-ACS causes of elevated troponin. Results: We evaluated 458 randomly selected patients from 1317 unique cases of all patients with initial elevated troponins at least 0.06 mg/mL during the study period. There was 84% interrater agreement in the 5% sampling. Seventy-nine percent had a non-ACS cause of elevated troponin, and the average initial positive troponin I level was significantly lower in the non-ACS cases (0.14; 95% confidence interval [CI], 0.08-0.37) than those with documented STEMI (10.2; 95% CI, 0.75-20.1) or NSTEMIs (0.4; 95% CI, 0.13-1.7). In the non-ACS group, the median initial troponin was 0.14 ng/mL (0.08-0.37 ng/mL). Peak troponin levels were highest in STEMI, next NSTEMI, and lowest in non ACS causes. The most frequent subgroups in the non-ACS group were non-ACS cardiovascular, infectious, renal, or hypertensive causes. In a linear regression model adjusting for age and sex, higher troponin levels had higher odds of being related to ACS causes (adjusted odds ratio, 1.4; 95% CI, 1.2-1.6) than non-ACS causes. Conclusion: The etiology for most initial elevated troponin I levels in a randomly selected population is the result of non-ACS causes. As initial + troponin levels increased, they were more likely associated with ACS causes than with non-ACS causes. Average initial + and peak troponin values were highest in STEMIs, next highest in NSTEMIs, and lowest overall in non-ACS causes.
MeSH term(s)	Acute Coronary Syndrome/blood ; Biomarkers/blood ; Brain Diseases/blood ; Cardiovascular Diseases/blood ; Cross-Sectional Studies ; Female ; Humans ; Infection/blood ; Kidney Diseases/blood ; Lung Diseases/blood ; Male ; Middle Aged ; Neoplasms/blood ; Risk Factors ; Troponin I/blood ; Wounds and Injuries/blood
Chemical Substances	Biomarkers ; Troponin I
Language	English
Publishing date	2016-02
Publishing country	United States
Document type	Journal Article
ZDB-ID	605890-5
ISSN	1532-8171 ; 0735-6757
ISSN (online)	1532-8171
ISSN	0735-6757
DOI	10.1016/j.ajem.2015.09.037
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Article ; Online: (with research data) Plastic waste associated with disease on coral reefs.

Lamb, Joleah B / Willis, Bette L / Fiorenza, Evan A / Couch, Courtney S / Howard, Robert / Rader, Douglas N / True, James D / Kelly, Lisa A / Ahmad, Awaludinnoer / Jompa, Jamaluddin / Harvell, C Drew

Science (New York, N.Y.)

2018 Volume 359, Issue 6374, Page(s) 460–462

Abstract: Plastic waste can promote microbial colonization by pathogens implicated in outbreaks of disease in the ocean. We assessed the influence of plastic waste on disease risk in 124,000 reef-building corals from 159 reefs in the Asia-Pacific region. The ... ...

Abstract	Plastic waste can promote microbial colonization by pathogens implicated in outbreaks of disease in the ocean. We assessed the influence of plastic waste on disease risk in 124,000 reef-building corals from 159 reefs in the Asia-Pacific region. The likelihood of disease increases from 4% to 89% when corals are in contact with plastic. Structurally complex corals are eight times more likely to be affected by plastic, suggesting that microhabitats for reef-associated organisms and valuable fisheries will be disproportionately affected. Plastic levels on coral reefs correspond to estimates of terrestrial mismanaged plastic waste entering the ocean. We estimate that 11.1 billion plastic items are entangled on coral reefs across the Asia-Pacific and project this number to increase 40% by 2025. Plastic waste management is critical for reducing diseases that threaten ecosystem health and human livelihoods.
MeSH term(s)	Coral Reefs ; Plastics ; Refuse Disposal
Chemical Substances	Plastics
Language	English
Publishing date	2018-01-26
Publishing country	United States
Document type	Journal Article
ZDB-ID	128410-1
ISSN	1095-9203 ; 0036-8075
ISSN (online)	1095-9203
ISSN	0036-8075
DOI	10.1126/science.aar3320
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Article: Persistent and recurrent blue nevi.

Harvell, J D / White, W L

The American Journal of dermatopathology

1999 Volume 21, Issue 6, Page(s) 506–517

Abstract: Persistence of common melanocytic nevi has been fairly well characterized, clinically and histologically. In contrast, persistence of blue nevi has been reported infrequently. To define this entity better, nine cases of biologically persistent and ... ...

Abstract	Persistence of common melanocytic nevi has been fairly well characterized, clinically and histologically. In contrast, persistence of blue nevi has been reported infrequently. To define this entity better, nine cases of biologically persistent and clinically recurrent blue nevi are described. The persistent lesions in four cases were spindle-fascicular blue nevi; one showed senescent or "ancient" change and one had additional deep penetrating/epithelioid blue nevus features with atypical changes worrisome for malignancy. These changes included increased cellularity, cellular pleomorphism, mitotic figures, and a lymphocytic infiltrate. Three were biphasic dendritic-sclerotic/spindle-fascicular blue nevi, one of which had atypical changes. One case was a dendritic-sclerotic ("common") blue nevus. The original histology in one case was unavailable, but the recurrence was a combined blue nevus. The interval from initial biopsy to biopsy of the recurrent lesion was often longer (mean 2.7 years) for recurrent blue nevi than for recurrent common compound or intradermal melanocytic nevi. In addition, in contrast to recurrent common melanocytic nevi, the recurrence, in at least one case, extended beyond the scar of the original excision. These cases demonstrated that blue nevi of all histiotypes and combinations are capable of persistence with clinical recurrence. The persistence usually was histologically similar to the original, but in some cases was more "cellular" because, for the most part, the excisions of the persistent lesion revealed a deeper spindle-fascicular ("cellular") component not evident in the original superficial biopsy. In two cases, the original blue nevus appeared completely banal, but the persistent/recurrent lesions were histologically distinct and demonstrated atypical histologic features. Yet, follow-up (average 3.7 years) supports benign biology. Clinical recurrence is often associated with malignant transformation in blue nevus, but this series demonstrates that malignant tumor progression is not necessarily the case. In the absence of necrosis en mass, marked cytologic atypia, and frequent mitotic figures, the described atypical morphologic parameters in previously biopsied small blue nevi are probably reactive and "pseudomalignant." Awareness of this potential change may avoid diagnostic and prognostic errors.
MeSH term(s)	Adolescent ; Adult ; Aged ; Biopsy ; Child, Preschool ; Female ; Follow-Up Studies ; Humans ; Male ; Neoplasm Recurrence, Local ; Nevus, Blue/pathology ; Skin/pathology ; Skin Neoplasms/pathology
Language	English
Publishing date	1999-12
Publishing country	United States
Document type	Case Reports ; Journal Article
ZDB-ID	448469-1
ISSN	1533-0311 ; 0193-1091
ISSN (online)	1533-0311
ISSN	0193-1091
DOI	10.1097/00000372-199912000-00002
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