Digital Commons Network^™

Stem Cell Matching For Patients Of Mixed Race, Ted C. Bergstrom

Ted C Bergstrom

Patients with leukemia and other blood diseases stand a good chance of recovery and a return to normal life if they receive a stem cell transplant from a living donor. In the absence of a transplant, their survival prospects are grim. For a transplant to be successful, the human leukocyte antigens (HLA) of the donor and recipient must be a close genetic match. To facilitate non-sibling matches, the developed nations of the world have set up national volunteer registries. The larges such registry is the NMDP (National Marrow Donor Program). We estimate the distribution of HLA types for individuals of …

Corticosteroids For Pain Relief In Sore Throat: Systematic Review And Meta-Analysis, Gail Hayward, Matthew J. Thompson, Carl J. Heneghan, Rafael Perera, Paul P. Glasziou, Chris B. Del Mar

Christopher Del Mar

Objective: To evaluate whether systemic corticosteroids improve symptoms of sore throat in adults and children. Design: Systematic review and meta-analysis. Data sources: Cochrane Central, Medline, Embase, Database of Reviews of Effectiveness (DARE), NHS Health Economics Database, and bibliographies. Outcome measures: Percentage of patients with complete resolution at 24 and 48 hours, mean time to onset of pain relief, mean time to complete resolution of symptoms, days missed from work or school, recurrence, and adverse events. Results: We included eight trials, consisting of 743 patients in total (369 children, 374 adults). 348 (47%) had exudative sore throat, and 330 (44%) were …

Neuraminidase Inhibitors For Preventing And Treating Influenza In Healthy Adults: Systematic Review And Meta-Analysis, Tom Jefferson, Mark Jones, Peter Doshi, Chris Del Mar

Christopher Del Mar

Objectives: To update a 2005 Cochrane review that assessed the effects of neuraminidase inhibitors in preventing or ameliorating the symptoms of influenza, the transmission of influenza, and complications from influenza in healthy adults, and to estimate the frequency of adverse effects. Search strategy: An updated search of the Cochrane central register of controlled trials (Cochrane Library 2009, issue 2), which contains the Acute Respiratory Infections Group’s specialised register, Medline (1950-Aug 2009), Embase (1980-Aug 2009), and post-marketing pharmacovigilance data and comparative safety cohorts. Selection criteria: Randomised placebo controlled studies of neuraminidase inhibitors in otherwise healthy adults exposed to naturally occurring influenza. …

Transparent Development Of The Who Rapid Advice Guidelines, Holger J. Schunemann, Suzanne R. Hill, Meetali Kakad, Gunn E. Vist, Richard Bellamy, Lauren Stockman, Torbjorn Fosen Wisloff, Chris Del Mar, Frederick Hayden, Timothy M. Uyeki, Jeremy Farrar, Yazdan Yazdanpanah, Howard Zucker, John Beigel, Tawee Chotpitayasunondh, Tran Tinh Hien, Bulent Ozbay, Norio Sugaya, Andrew D. Oxman

Christopher Del Mar

Emerging health problems require rapid advice. We describe the development and pilot testing of a systematic, transparent approach used by the World Health Organization (WHO) to develop rapid advice guidelines in response to requests from member states confronted with uncertainty about the pharmacological management of avian influenza A (H5N1) virus infection. We first searched for systematic reviews of randomized trials of treatment and prevention of seasonal influenza and for nontrial evidence on H5N1 infection, including case reports and animal and in vitro studies. A panel of clinical experts, clinicians with experience in treating patients with H5N1, influenza researchers, and methodologists …

Possible Harms Of Oseltamivir—A Call For Urgent Action, Tom Jefferson, Mark Jones, Peter Doshi, Chris Del Mar

Christopher Del Mar

Extract: Oseltamivir is a successful drug: between July, 2004, and June, 2009, more than 11·5 million new prescriptions were issued in the USA, and nearly all influenza pandemic plans recommend antiviral drugs as a mainstay of containment on a population basis and treatment on an individual basis, with oseltamivir preferred because of ease of administration and storage. Because 75% of the world production of oseltamivir has been used in Japan,¹ this is where to look for any serious harms the drug might cause. ¹ See note in article.

Rudra Interrupts Receptor Signaling Complexes To Negatively Regulate The Imd Pathway, Kamna Aggarwal, Florentina Rus, Christie Vriesema-Magnuson, Deniz Erturk Hasdemir, Nicholas Paquette, Neal S. Silverman

Neal Silverman

Insects rely primarily on innate immune responses to fight pathogens. In Drosophila, antimicrobial peptides are key contributors to host defense. Antimicrobial peptide gene expression is regulated by the IMD and Toll pathways. Bacterial peptidoglycans trigger these pathways, through recognition by peptidoglycan recognition proteins (PGRPs). DAP-type peptidoglycan triggers the IMD pathway via PGRP-LC and PGRP-LE, while lysine-type peptidoglycan is an agonist for the Toll pathway through PGRP-SA and PGRP-SD. Recent work has shown that the intensity and duration of the immune responses initiating with these receptors is tightly regulated at multiple levels, by a series of negative regulators. Through two-hybrid screening …

Consent To The Use Of Stored Dna For Genetics Research: A Survey Of Attitudes In The Jewish Population, Marc D. Schwartz, Karen H. Rothenberg, Linda Joseph, Judith Benkendorf, Caryn Lerman

Karen H. Rothenberg

No abstract provided.

Whose Duty Is It Anyway?: The Kennedy Krieger Opinion And Its Implications For Public Health Research, Diane E. Hoffmann, Karen H. Rothenberg

Karen H. Rothenberg

In this article, the authors discuss the Maryland Court of Appeals decision in the case of Grimes v. Kennedy Krieger Institute, Inc. and its implications for the tort duty owed by researchers, in particular public health researchers, to their subjects. The Opinion resulted from two lawsuits alleging lead poisoning of children enrolled in a study conducted by the Kennedy Krieger Institute, a world renown pediatric research and treatment facility. The opinion shocked the research establishment with its scathing characterization of researchers and its apparent holding that in Maryland a parent cannot consent to the participation of a child in "nontherapeutic …

Colloquium - Gender, Law And Health Care: New Perspectives For Teaching And Scholarship: The Role Of Gender In Law And Health Care, Karen H. Rothenberg

Karen H. Rothenberg

No abstract provided.

Feminism, Law, And Bioethics, Karen H. Rothenberg

Karen H. Rothenberg

Feminist legal theory provides a healthy skepticism toward legal doctrine and insists that we reexamine even formally gender-neutral rules to uncover problematic assumptions behind them. The article first outlines feminist legal theory from the perspectives of liberal, cultural, and radical feminism. Examples of how each theory influences legal practice, case law, and legislation are highlighted. Each perspective is then applied to a contemporary bioethical issue, egg donation. Following a brief discussion of the common themes shared by feminist jurisprudence, the article incorporates a narrative reflecting on the integration of the common feminist themes in the context of the passage of …

Bisphenol-A And The Great Divide: A Review Of Controversies In The Field Of Endocrine Disruption, Laura Vandenberg, Maricel V. Maffini, Carlos Sonnenschein, Beverly S. Rubin, Ana M. Soto

Laura Vandenberg

In 1991, a group of 21 scientists gathered at the Wingspread Conference Center to discuss evidence of developmental alterations observed in wildlife populations after chemical exposures. There, the term “endocrine disruptor” was agreed upon to describe a class of chemicals including those that act as agonists and antagonists of the estrogen receptors (ERs), androgen receptor, thyroid hormone receptor, and others. This definition has since evolved, and the field has grown to encompass hundreds of chemicals. Despite significant advances in the study of endocrine disruptors, several controversies have sprung up and continue, including the debate over the existence of nonmonotonic dose …

Strategies For Recruiting Hispanic Women Into A Prospective Cohort Study Of Modifiable Risk Factors For Gestational Diabetes Mellitus, Lisa Chasan-Taber, Renee T. Fortner, Valerie Hastings, Glenn Markenson

Lisa Chasan-Taber

Background The purpose of this article was to describe effective strategies for recruitment of Hispanic women into a prospective cohort study of modifiable risk factors for gestational diabetes mellitus (GDM). Although Hispanic women have two to four times the risk of developing GDM compared with non-Hispanic white women, few GDM prevention studies have included Hispanic women. Methods The study was conducted in the ambulatory obstetrical practices of Baystate Medical Center located in a socioeconomically and ethnically diverse city in Massachusetts. The study employed a range of strategies to recruit Hispanic women based on a review of the literature as well …

Emerging Role Of Micrornas In Liver Diseases, Shashi Bala, Miguel Marcos, Gyongyi Szabo

Gyongyi Szabo

MicroRNAs are a class of small non-coding RNAs that are found in plants, animals, and some viruses. They modulate the gene function at the post-transcriptional level and act as a fine tuner of various processes, such as development, proliferation, cell signaling, and apoptosis. They are associated with different types and stages of cancer. Recent studies have shown the involvement of microRNAs in liver diseases caused by various factors, such as Hepatitis C, Hepatitis B, metabolic disorders, and by drug abuse. This review highlights the role of microRNAs in liver diseases and their potential use as therapeutic molecules.

Livelihoods And Highly Pathogenic Avian Influenza In Cambodia, Sophal Ear, Sigfrido Burgos

Sophal Ear

Teaching-Learning Philosophy, Celia M. Pechak

Celia M Pechak

No abstract provided.

Applying Informatics To Improve Vulnerable Population Registration For Emergency Preparedness In The Gulf Coast Region Of Texas, Akom Phosuwan, Chiehwen Ed Hsu, Kim Dunn

Chiehwen Ed Hsu

The application of information technology in program evaluation has gained increased attention in recent years. This paper discusses informatics-facilitated evaluation results of a federally-supported self-registration system for vulnerable people in emergency preparedness and response (known as 2-1-1 registration system) in the Gulf Coast Region state of Texas. The purpose of this project is to assess registration system utilization and available service provision, with a special focus on how to improve enrollment for annual year for those zipcodes with low registration, and inform the enhancement of participating health providers to address the zipcodes with high registrants. This project is part of …

Anatomical Variations Of The Lumbar Plexus: A Descriptive Anatomy Study With Proposed Clinical Implications.Pdf, Philip A. Anloague

Philip A. Anloague

Trajectories Of Ptsd And Substance Use Disorders In A Longitudinal Study Of Personality Disorders, Meghan E. Mcdevitt-Murphy, Gilbert R. Parra, M. Tracie Shea, Shirley Yen, Carlos M. Grilo, Charles A. Sanislow, Thomas H. Mcglashan, John G. Gunderson, Andrew E. Skodol, John C. Markowitz

Charles A. Sanislow, Ph.D.

Detection And Molecular Characterization Of Giardia Isolated From Recreational Lake Water In Malaysia, Yvonne Lim Ai Lian

Yvonne Lim Ai Lian

Nine 50-l surface water samples from a Malaysian recreational lake were examined microscopically using an immunomagnetisable separation-immunofluorescent method. No Cryptosporidium oocysts were detected, but 77.8% of samples contained low numbers of Giardia cysts (range, 0.17-1.1 cysts/l), which were genetically characterised by SSU rRNA gene sequencing. Genotype analyses indicated the presence of Giardia duodenalis assemblage A suggesting potential risk to public health. The present study represents the first contribution to our knowledge of G. duodenalis assemblages in Malaysian recreational water.

Health Bills: What's At The Core, Robert B. Leflar

Robert B Leflar

Column 2 (of 5) on the health reform debate: explanation of the legislation.

Family Sources Of Educational Gender Inequality In Rural China: A Critical Assessment, Emily C. Hannum, Peggy A. Kong, Yuping Zhang

Emily C. Hannum

In this paper, we investigate the gender gap in education in rural northwest China. We first discuss parental perceptions of abilities and appropriate roles for girls and boys; parental concerns about old-age support; and parental perceptions of different labor market outcomes for girls' and boys' education. We then investigate gender disparities in investments in children, children's performance at school, and children's subsequent attainment. We analyze a survey of nine to twelve year-old children and their families conducted in rural Gansu Province in the year 2000, along with follow-up information about subsequent educational attainment collected seven years later. We complement our …

Reliability Of Measuring Abductor Hallucis Muscle Parameters Using Two Different Diagnostic Ultrasound Machines, Wayne A. Hing, Keith Rome, Alyse F. M. Cameron

Wayne Hing

Background: Diagnostic ultrasound provides a method of analysing soft tissue structures of the musculoskeletal system effectively and reliably. The aim of this study was to evaluate within and between session reliability of measuring muscle dorso-plantar thickness, medio-lateral length and cross-sectional area, of the abductor hallucis muscle using two different ultrasound machines, a higher end Philips HD11 Ultrasound machine and clinically orientated Chison 8300 Deluxe Digital Portable Ultrasound System.

Methods: The abductor hallucis muscle of both the left and right feet of thirty asymptomatic participants was imaged and then measured using both ultrasound machines. Interclass correlation coefficients (ICC) with 95% confidence …

Health Care: Yellow Lights, Red Flags, Robert B. Leflar

Robert B Leflar

Column 1 (of 5) on the health reform debate

Is Extended Volume Of External Beam Irradiation Beneficial In Post-Esophagectomy High Risk Patients Receiving Combined Chemoradiation Therapy?, E. Yu, A. R. Dar, R. Ash, G. Videtic, P. Truong, L. Stitt, A. Tomiak, M. Vincent, R. Malthaner, I. Craig, E. Brecevic, W. Kocha, R. Inculet, M. Lefcoe

Edward Yu

OBJECTIVE: To assess the value of extended volume irradiation with anastomotic coverage in high risk resected esophageal cancer patients. METHOD: A retrospective study was undertaken at LRCC from 1989-1999 for high risk resected esophageal cancer patients. Adjuvant treatments consisted of 4 cycles of chemotherapy (epirubicin/fluorouracil/cisplatin or cisplatin/fluorouracil), and local regional irradiation with or without coverage of the anastomotic site. Radiation dose ranged from 45-60Gy at 1.8-2.0 Gy/fraction given with initial anterior-posterior/posterior-anterior arrangement with either extended (with anastomotic coverage) or small (without anastomotic coverage) field followed by oblique fields for boost. RESULT: One hundred eighty-eight charts were reviewed. Seventy-two patients were …

Robot Assisted Ultrasound Imaged Guided Interstitial Lung Brachytherapy In A Porcine Model, Richard A. Malthaner, Edward Yu, Jerry J. Battista, Chris Blake, Donal Downey, Aaron Fenster

Edward Yu

We set out to see if permanent interstitial brachytherapy seeds could be safely and reproducibly inserted thoracoscopicaly with the ZEUS Robotic system and intraoperative ultrasound into in-vivo porcine lungs.

Post-Operative Extended Volume External Beam Radiation Therapy Is Safe For High Risk Esophageal Cancer Patients, Edward Yu, Patricia Tai, Jawaid Younus, Richard Malthaner, Larry Stitt, Pauline Truong, George Rodrigues, Robert Ash, Rashid Dar, Anna Tomiak, Mark Vincent, Walter Kocha, Brian Dingle, Richard Inculet

Edward Yu

Post-operative radiation therapy (RT) (1) and post-operative chemoradiation (2) have been used for esophageal cancer patients deemed high risk for recurrence after esophagectomy. Defining opitmal RT target volume after esophagectomy is difficult due to significant changes in patient anatomy and function. Some radiationon cologists advocated the inclusion of the anastomotic site within the irradiation volume due to concerns for potential increased relapse risk, while others did not subscribe to this practice due to concerns for increased treatment related toxicity. We have previously reported patient outcome benefit using extended volume RT In management with high risk esophageal cancer patients underwent esopagectomy(3). …

Extended Vs. Small Field Irradiation In High Risk Post Esophagectomy Patients Receiving Combined Chemoradiation Therapy: A Decade Experience In Treatment Of Esophageal Cancer, Edward Yu, Patricia Tai, George Rodrigues, Robert Ash, Larry Stitt, Rashid A. Dar, Pauline Truong, Gregory M. Videtic, Richard Malthaner, Richard Inculet, Anna Tomiak, Jawaid Younus, Brian Dingle, Walter Kocha, Mark Vincent

Edward Yu

OBJECTIVE: To assess the impact of extended field irradiation with anastomotic coverage on local recurrence in high risk resected esophageal cancerpatients. METHODS: From 1989-1999, high risk resected esophageal cancer cases receiving post-resection chemoradiation were reviewed. Adjuvant chemotherapy consisted of four cycles of fluorouracil-based regimens. Loco-regional irradiation with or without coverage of anastomotic site had radiation a dose range from 45-60 Gyat 1.8-2.0 Gy/fraction given with initial anterior-posterior/posterior-anterior arrangement with either extended (with anastomotic coverage), or small (without anastomotic coverage) field followed by oblique fields for boost. RESULTS: One hundred eighty-eight charts were reviewed. Seventy-two patients were eligible for post-resection chemoradiation. …

Evaluation Of Intra-And Inter-Fraction Motion In Breast Radiotherapy Using Electronic Portal Imaging Cine Loops, Chrison Lee, Edward Yu, Tomas Kron

Edward Yu

Parallel tangent breast irradiation is commonly used postbreast conservation surgery for early breast cancer patient without lymph node involvement to improve local disease control. Intra-fractional and inter-fractional variabilities are often presented in daily treatment setup. The present pilot study used Electronic Portal Imaging (EPI) to evaluate intra-and inter-fraction motion in patients undergoing simple breast tangent radiotherapy.

Diagnosis In General Practice: Using Probabilistic Reasoning, Jenny Doust

Jenny Doust

Diagnostic tests—whether clinical signs, imaging, or laboratory tests—are imperfect: there is always a possibility that test results are inaccurate and our diagnosis is wrong. However, we need to make decisions about whether to treat or not to treat patients, and so we need to feel confident that our diagnosis is above a certain threshold before we decide to treat a patient and below a certain threshold if we decide to withhold treatment. The threshold depends on the disease and the potential harms and benefits of treating or not treating patients. Unless we have clear strategies to cope with the uncertainties …

The Black, African And Caribbean Canadian Health (Blacch) Study: Phase I Preliminary Findings, Shamara Baidoobonso, Roxanne Longman, Greta Bauer, Mercy Nleya-Ncube, Daniel Pugh, Erica Lawson, Monica Abdelkader, Jan Jasnos, Sherin Hussien

Shamara M Baidoobonso, PhD

The Challenge: Most studies of HIV and health in African, Caribbean and Black (ACB) communities have taken place in large urban centres and rarely examine how the interactions between racism, gender, HIV-related stigma and multiple forms of oppression affect health and HIV vulnerability. This lack of information negatively impacts HIV prevention and health promotion efforts for ACB communities. Our Approach: The BLACCH Study uses a community-based approach to collect extensive information about the health of ACB communities in Middlesex County, Ontario. The first stage of the project consists of semi-structured interviews to collect information about the breadth of health-related experiences …