Diseases Commons^™

Use Of Do-Not-Resuscitate Orders In Patients With Kidney Disease Hospitalized With Acute Myocardial Infarction, Joline Chen, Jonathan Sosnov, Darleen Lessard, Jorge Yarzebski, Joel Gore, Robert Goldberg

Jorge L. Yarzebski

BACKGROUND: Patients with kidney disease are at increased risk for adverse health outcomes in comparison to patients without kidney disease. Therefore, patients with kidney disease may have greater use of do-not-resuscitate (DNR) orders than patients without kidney disease in the setting of an acute illness. We examined the association between advanced kidney disease and use of DNR orders in patients admitted with an acute myocardial infarction (AMI) to all greater Worcester, MA, hospitals as part of an epidemiological study.

METHODS: Use of DNR orders in 4,033 Worcester residents hospitalized with AMI at 11 greater Worcester medical centers during 1997, 1999, …

Treatment Practices And Outcomes Of Patients With Established Peripheral Arterial Disease Hospitalized With Acute Myocardial Infarction In A Community Setting, Frederick Spencer, Darleen Lessard, Chyke Doubeni, Jorge Yarzebski, Joel Gore, Robert Goldberg

Jorge L. Yarzebski

BACKGROUND: There are little contemporary data available describing the hospital and long-term outcomes of patients with peripheral arterial disease (PAD) who are hospitalized with acute myocardial infarction (AMI). The objectives of our population-based study were to examine the hospital and long-term outcomes, as well as the use of different treatment practices, among patients with established PAD who were hospitalized with AMI. METHODS: The study sample consisted of 4480 patients hospitalized with AMI at all Worcester, Mass, medical centers in 4 alternate years between 1997 and 2003. RESULTS: Among the metropolitan Worcester residents hospitalized with AMI, 13.5% had a history of …

Excess Body Weight, Clinical Profile, Management Practices, And Hospital Prognosis In Men And Women After Acute Myocardial Infarction, Robert Goldberg, Jiang Cui, Barbara Olendzki, Frederick Spencer, Jorge Yarzebski, Darleen Lessard, Joel Gore

Jorge L. Yarzebski

BACKGROUND: Excess body weight is increasingly being recognized as a major health problem in American men and women. It is unclear, however, whether body weight is associated with the demographic and clinical profile, treatment of, and hospital prognosis after acute myocardial infarction (AMI).

METHODS: Nonconcurrent prospective epidemiologic investigation of Worcester (Massachusetts) metropolitan residents hospitalized at all 11 greater Worcester medical centers with validated AMI in 1997, 1999, 2001, and 2003.

RESULTS: A total of 2008 men and 1505 women were hospitalized with confirmed AMI during the 4 study periods. Approximately 41% of men and 29% of women were classified as …

Characterizing Accuracy Of Total Hemoglobin Recovery Using Contrast-Detail Analysis In 3d Image-Guided Near Infrared Spectroscopy With The Boundary Element Method, Hamid R. Ghadyani, Subhadra Srinivasan, Brian W. Pogue, Keith D. Paulsen

Dartmouth Scholarship

The quantification of total hemoglobin concentration (HbT) obtained from multi-modality image-guided near infrared spectroscopy (IG-NIRS) was characterized using the boundary element method (BEM) for 3D image reconstruction. Multi-modality IG-NIRS systems use a priori information to guide the reconstruction process. While this has been shown to improve resolution, the effect on quantitative accuracy is unclear. Here, through systematic contrast-detail analysis, the fidelity of IG-NIRS in quantifying HbT was examined using 3D simulations. These simulations show that HbT could be recovered for medium sized (20mm in 100mm total diameter) spherical inclusions with an average error of 15%, for the physiologically …

Communities Of Cloacal Bacteria In Tree Swallow Families, Michael Lombardo, Patrick Thorpe, R. Cichewicz, M. Henshaw, C. Millard, C. Steen, T. Zeller

Michael P Lombardo

Our aim in this study was to survey the communities of bacteria found in the cloacae of adult and nestling Tree Swallows (Tachycineta bicolor), determine if there were familial patterns of prevalence, and determine if there were relationships between bacteria loads and nestling size when 12 days old and fledging success.

Perfil Dos Atendimentos Ambulatoriais Realizados Em Uma Clínica De Cirurgia Plástica No Sul Do Brasil / Outpatient Service Profile In A Plastic Surgery Clinic In Southern Brazil, Everton Fernando Alves

Everton Fernando Alves

Objetivo: Descrever o perfil dos atendimentos ambulatoriais realizados em uma clínica de cirurgia plástica no sul do Brasil. Materiais e Métodos: Foi realizado um estudo descritivo, exploratório e de caráter quantitativo com o intuito de analisar a totalidade de atendimentos ambulatoriais (consultas e cirurgias) realizadas em uma clínica privada de cirurgia plástica no período de 01 de janeiro a 31 de dezembro de 2010. Resultados: Observou-se que, das 671 (60,5%) consultas novas, apenas 205 (18,5%) cirurgias foram realizadas. Março foi o mês com mais consultas (10%) e cirurgias (11,7%). Do total de consultas novas, as reparadoras foram predominantes em 55,6% …

Validation Of A Stroke Symptom Questionnaire For Epidemiological Surveys., Paulo A. Lotufo

Paulo A Lotufo

CONTEXT AND OBJECTIVE:Stroke is a relevant issue within public health and requires epidemiological surveillance tools. The aim here was to validate a questionnaire for evaluating individuals with stroke symptoms in the Stroke Morbidity and Mortality Study (Estudo de Mortalidade e Morbidade do Acidente Vascular Cerebral, EMMA), São Paulo, Brazil.DESIGN AND SETTING:This was a cross-sectional study performed among a sample of the inhabitants of Butantã, an area in the western zone of the city of São Paulo.METHODS:For all households in the coverage area of a primary healthcare unit, household members over the age of 35 years answered a stroke symptom questionnaire …

Breast Cancer Dna Methylation Profiles Are Associated With Tumor Size And Alcohol And Folate Intake, Brock C. Christensen, Karl T. Kelsey, Shichun Zheng, E. Andres Houseman, Carmen J. Marsit, Margaret R. Wrensch, Joseph L. Wiemels, Heather H. Nelson, Margaret R. Karagas

Dartmouth Scholarship

Although tumor size and lymph node involvement are the current cornerstones of breast cancer prognosis, they have not been extensively explored in relation to tumor methylation attributes in conjunction with other tumor and patient dietary and hormonal characteristics. Using primary breast tumors from 162 (AJCC stage I-IV) women from the Kaiser Division of Research Pathways Study and the Illumina GoldenGate methylation bead-array platform, we measured 1,413 autosomal CpG loci associated with 773 cancer-related genes and validated select CpG loci with Sequenom EpiTYPER. Tumor grade, size, estrogen and progesterone receptor status, and triple negative status were significantly (Q-values <0.05) associated with altered methylation of 209, 74, 183, 69, and 130 loci, respectively. Unsupervised clustering, using a recursively partitioned mixture model (RPMM), of all autosomal CpG loci revealed eight distinct methylation classes. Methylation class membership was significantly associated with patient race (P<0.02) and tumor size (P<0.001) in univariate tests. Using multinomial logistic regression to adjust for potential confounders, patient age and tumor size, as well as known disease risk factors of alcohol intake and total dietary folate, were all significantly (P<0.0001) associated with methylation class membership. Breast cancer prognostic characteristics and risk-related exposures appear to be associated with gene-specific tumor methylation, as well as overall methylation patterns.

Is There An Association Of Giardiasis With Beta-Thalassemia Minor?, Javed Yakoob, Wasim Jafri, Hizbullah Shaikh

Section of Gastroenterology

Beta–thalassemia minor is a symptomless carrier state of a hemoglobinopathy which predisposes to bacterial infections. We report three cases presenting with giardiasis, a parasitic infection of gastrointestinal tract caused by Giardia lamblia. Patients presented with recurrent diarrhea and abdominal pain for over a year. An esophagogastroduodenoscopy finding varied from normal to acute duodenitis. Duodenal biopsy demonstrated changes consistent with mild chronic non-specific inflammation with G. lamblia trophozoites. All three patients were diagnosed as β -thalassemia minor hemoglobin electrophoresis. They were treated with Diloxanide furoate 500 mg and Metronidazole 400mg three times daily for five days. Their symptoms resolved and a …

Hiv: Make The Diagnosis And Take The Next Step, Julie G. Stewart, Amy R. Weinberg

Nursing Faculty Publications

With the CDC urging screening for all willing patients, providers will be testing and managing a growing number of HIV-positive individuals.

The CDC estimates that with more than 40,000 new infections annually, more than 1.2 million people in the United States are living with HIV-and 24% to 27% may not be aware of their infection status.1 Studies have shown that HIV is often diagnosed late in the disease process, when the individual has already developed AIDS, which typically occurs 8 to 11 years after HIV infection.2 Research also points to missed opportunities to offer HIV testing and diagnose the infection …

Lung Carcinoma: Its Profile And Changing Trends, Saad Siddiqui, Mohammed Usman Ali, Mahrukh Ayesha Ali, Noreen Shah, Shagufta Nasreen

Section of Pulmonary & Critical Care

BACKGROUND: Lung Carcinoma is the leading causes of morbidity and mortality worldwide with an incidence of 1.3 million cases per year. This study was undertaken to determine prevalence of various histological types of lung carcinoma and to analyse their changing trends with time.

METHODS: This is a retrospective analytical study. A total of 330 cases of lung carcinoma were analysed from 2003 to 2008. Cases from Khyber Pakhtunkhwa and Federally Administered Tribal Area (FATA) were included in this study. Furthermore, only cases of lung carcinoma were considered while other malignancies were excluded.

RESULTS: Squamous Cell carcinoma was found in 42.7% …

Small Molecule Inhibition Of Macrophage Tnf-A Release, Razwana Wahdat

Seton Hall University Dissertations and Theses (ETDs)

Tumor Necrosis Factor Alpha (TNF-a) is a vital pro-inflammatory cytokine produced in response to the activation ofthe innate immune response via the Toll-like receptor signal transduction pathway. This thesis explores the release and inhibition of TNF-a from RAW 264.7 mouse macrophages and human U937 cells that have been exposed to a potent activator of innate immunity. Using lipopolysaccharide (LPS), a Gram negative bacterial endotoxin, in the presence or absence of proinflammatory cytokine interferon 'Y (IFN-y) as activators ofthe TLR-4 pathway, a robust release ofTNF­ a was observed. Co-incubation of stimulated macrophages with the tyrosine phosphatase inhibitor, sodium vanadate, resulted in …

Anti-Hiv Activity In Cervical-Vaginal Secretions From Hiv-Positive And -Negative Women Correlate With Innate Antimicrobial Levels And Igg Antibodies, Mimi Ghosh, John V. Fahey, Zheng Shen, Timothy Lahey, Susan Cu-Uvin, Zhijin Wu, Kenneth Mayer, Peter F. Wright, John C. Kappes, Christina Ochsenbauer, Charles R. Wira

Dartmouth Scholarship

Background: We investigated the impact of antimicrobials in cervicovaginal lavage (CVL) from HIV(+) and HIV(2) women on target cell infection with HIV. Since female reproductive tract (FRT) secretions contain a spectrum of antimicrobials, we hypothesized that CVL from healthy HIV(+) and (2) women inhibit HIV infection.

Methodology/Principal Findings: CVL from 32 HIV(+) healthy women with high CD4 counts and 15 healthy HIV(2) women were collected by gently washing the cervicovaginal area with 10 ml of sterile normal saline. Following centrifugation, anti- HIV activity in CVL was determined by incubating CVL with HIV prior to addition to TZM-bl cells. Antimicrobials and …

Probiotic Therapy - Recruiting Old Friends To Fight New Foes, Roy D. Sleator

Department of Biological Sciences Publications

Against a backdrop of increasing antibiotic resistance, and the emergence of new and evolving pathogens, clinicians are increasingly forced to consider alternative therapies - probiotics are one such alternative.

The Efficacy And Safety Of Insulin-Sensitizing Drugs In Hiv-Associated Lipodystrophy Syndrome: A Meta-Analysis Of Randomized Trials, Siddharth H. Sheth, Robin J. Larson

Dartmouth Scholarship

HIV-associated lipodystrophy syndrome (HALS) is characterized by insulin resistance, abnormal lipid metabolism and redistribution of body fat. To date, there has been no quantitative summary of the effects of insulin sensitizing-agents for the treatment of this challenging problem. We searched MEDLINE, the Cochrane Library, clinical trial registries, conference proceedings and references for randomized trials evaluating rosiglitazone, pioglitazone or metformin in patients with evidence of HALS (last update December 2009). Two reviewers independently abstracted data and assessed quality using a standard form. We contacted authors for missing data and calculated weighted mean differences (WMD) and 95% confidence intervals (CI) for each …

Charting New Territory: Going Public About Hd, Kenneth P. Serbin

At Risk for Huntington's Disease

No abstract provided.

God, Huntington's Disease And The Meaning Of Life, Kenneth P. Serbin

At Risk for Huntington's Disease

No abstract provided.

Naïve T Cells Re-Distribute To The Lungs Of Selectin Ligand Deficient Mice, Thandi M. Onami, John R. Harp

Microbiology Publications and Other Works

BACKGROUND: Selectin mediated tethering represents one of the earliest steps in T cell extravasation into lymph nodes via high endothelial venules and is dependent on the biosynthesis of sialyl Lewis X (sLe(x)) ligands by several glycosyltransferases, including two fucosyltransferases, fucosyltransferase-IV and -VII. Selectin mediated binding also plays a key role in T cell entry to inflamed organs.

METHODOLOGY/PRINCIPAL FINDINGS: To understand how loss of selectin ligands (sLe(x)) influences T cell migration to the lung, we examined fucosyltransferase-IV and -VII double knockout (FtDKO) mice. We discovered that FtDKO mice showed significant increases (approximately 5-fold) in numbers of naïve T cells in …

Socioeconomic Status And Coronary Heart Disease Mortality In The City Of Sao Paulo, Brazil (1996 To 2007), Paulo A. Lotufo

Paulo A Lotufo

No abstract provided.

Naı¨Ve T Cells Re-Distribute To The Lungs Of Selectin Ligand Deficient Mice, Thandi M. Onami, John R. Harp

Thandi M. Onami

BACKGROUND: Selectin mediated tethering represents one of the earliest steps in T cell extravasation into lymph nodes via high endothelial venules and is dependent on the biosynthesis of sialyl Lewis X (sLe(x)) ligands by several glycosyltransferases, including two fucosyltransferases, fucosyltransferase-IV and -VII. Selectin mediated binding also plays a key role in T cell entry to inflamed organs. METHODOLOGY/PRINCIPAL FINDINGS: To understand how loss of selectin ligands (sLe(x)) influences T cell migration to the lung, we examined fucosyltransferase-IV and -VII double knockout (FtDKO) mice. We discovered that FtDKO mice showed significant increases (approximately 5-fold) in numbers of naïve T cells in …