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Overweight Predicts Poorer Exercise Capacity In Congenital Heart Disease Patients, Karen Kuehl, Alicia Tucker, Munziba Khan, Paula Goldberg, E. Anne Greene, Megan Smith

Pediatrics Faculty Publications

Background

Overweight (OW) and obesity (OB) are endemic in the United States and affect adolescents and adults with congenital heart disease (ACHD). Defining the burden of excess weight on the cardiovascular system in ACHD is the goal of this study. Limitation of exercise capacity due to overweight or obesity might be reversible with weight loss and improve quality of life for ACHD adults.

Methods

Exercise tests performed using a Bruce protocol and measurement of maximum oxygen consumption were retrospectively reviewed on 418 CHD patients. OW and OB were defined as the 85–95 or > 95 percentile respectively for age and gender …

Donor Platelet Plasma Components Inactivate Sensitive And Multidrug Resistant Acinetobacter Baumannii Isolates, Chelsea M. Edelblute, Olga N. Pakhomova, Fanying Li, Barbara Y. Hargrave, Loree C. Heller

Bioelectrics Publications

Acinetobacter baumannii is an environmentally resilient healthcare-associated opportunistic pathogen responsible for infections at many body sites. In the last 10 years, clinical strains resistant to many or all commonly used antibiotics have emerged globally. With few antimicrobial agents in the pharmaceutical pipeline, new and alternative agents are essential. Platelets secrete a large number of proteins, including proteins with antimicrobial activity. In a previous study, we demonstrated that donor platelet supernatants and plasma significantly inhibited the growth of a reference strain of A. baumannii in broth and on skin. This inhibition appeared to be unrelated to the platelet activation state. In …

Mechanisms By Which Dietary Ellagic Acid Attenuates Obesity And Obesity-Mediated Metabolic Complications, Inhae Kang

College of Education and Human Sciences: Dissertations, Theses, and Student Research

Ellagic acid (EA) is a polyphenol found in various fruits and plants, such as berries, pomegranates, muscadine grapes, nuts and bark of oak tree. EA has been known to exhibit anti-inflammatory and anti-proliferative effects in various types of cancer. However, little is known about the effects of EA on obesity. Herein, 1) the lipid-lowering role of EA was identified in primary human adipose stem cells (hASCs) and human hepatoma Huh7 cells; 2) the molecular mechanisms by which EA attenuates adipogenesis by epigenetic modification were identified; 3) the effects of EA on high fat and high sucrose-mediated obesity was …

The Effect Of Neurostimulation On Ischemic Pain And Methods Of Assessing Pain, Kaylee Keck

Biomedical Engineering

Peripheral arterial disease (PAD) impacts approximately eight million people in the United States [1]. Disease progression leads to chronic ischemic pain, hindering quality of life. Pharmaceuticals are a typical treatment for pain associated with PAD; but as few as 30% of patients have a significant reduction of pain (≥50%) [2].

Neurostimulation is commonly used as a treatment for various diseases and injuries, including Parkinson’s disease and sports-related back and knee injuries [2]. The objective of the study was to explore neurostimulation and its effect on pain and paresthesia for a model of acute peripheral ischemia in young college students.

Pain …

Outcomes Of Prediabetes And Diabetes Education Programs Tailored For Vulnerable Popuations, Diana Al Sayed Hassan

Dissertations

Diabetes is a debilitating disease and if not managed properly it can lead to multiple complications and even premature death. Diabetes continues to disproportionately affect vulnerable populations. The purpose of this three-paper method dissertation was to examine the implementation of a prediabetes and diabetes programs in a community setting to serve vulnerable populations in addition to understanding future diabetes-related educational needs.

The first paper is an evaluation of a shortened five-week diabetes prevention program for older adults with prediabetes or at a high risk for developing type 2 diabetes mellitus (T2DM). Chang in nutrition knowledge, eating and physical activity behaviors, …

Time Preferences Predict Mortality Among Hiv-Infected Adults Receiving Antiretroviral Therapy In Kenya, Harsha Thirumurthy, Kami Hayashi, Sebastian Linnemayr, Rachel C. Vreeman, Irwin P. Levin, David Bangsberg, Noel T. Brewer

OHSU-PSU School of Public Health Faculty Publications and Presentations

Identifying characteristics of HIV-infected adults likely to have poor treatment outcomes can be useful for targeting interventions efficiently. Research in economics and psychology suggests that individuals’ intertemporal time preferences, which indicate the extent to which they trade-off immediate vs. future cost and benefits, can influence various health behaviors. While there is empirical support for the association between time preferences and various non-HIV health behaviors and outcomes, the extent to which time preferences predict outcomes of those receiving antiretroviral therapy (ART) has not been examined previously.

HIV-infected adults initiating ART were enrolled at a health facility in Kenya. Participants’ time preferences …

Silibinin-Mediated Metabolic Reprogramming Attenuates Pancreatic Cancer-Induced Cachexia And Tumor Growth., Surendra K. Shukla, Aneesha Dasgupta, Kamiya Mehla, Venugopal Gunda, Enza Vernucci, Joshua J. Souchek, Gennifer Goode, Ryan King, Anusha Mishra, Ibha Rai, Sangeetha Nagarajan, Nina V. Chaika, Fang Yu, Surendra K. Shukla

Journal Articles: Eppley Institute

Pancreatic ductal adenocarcinoma (PDAC) is the fourth leading cause of cancer-related deaths in the US. Cancer-associated cachexia is present in up to 80% of PDAC patients and is associated with aggressive disease and poor prognosis. In the present studies we evaluated an anti-cancer natural product silibinin for its effectiveness in targeting pancreatic cancer aggressiveness and the cachectic properties of pancreatic cancer cells and tumors. Our results demonstrate that silibinin inhibits pancreatic cancer cell growth in a dose-dependent manner and reduces glycolytic activity of cancer cells. Our LC-MS/MS based metabolomics data demonstrates that silibinin treatment induces global metabolic reprogramming in pancreatic …

Identifying Protein Kinase Tbk1 As A Novel Inhibitor Of Intestinal Tumorigenesis, Amber L. Mathews

Dissertations and Theses (Open Access)

Colorectal cancer (CRC) is the third most common cancer diagnosed in women and men， causing almost 600,000 annual deaths worldwide. There is a clear need to understand how CRC forms and progresses in order to improve the strategies of CRC prevention and therapy. A major factor that drives the development of CRC is genetic mutations that lead to activation of oncogenes and inactivation of tumor suppressor genes in intestinal epithelial cells (IECs). In addition, the initiation and progression of CRC involve environmental and immunological factors. In particular, chronic inflammatory conditions are known as an important risk factor for CRC. Intestinal …

The Role Of Dna Methylation And Hydroxymethylation In Smooth Muscle Cell Phenotypic Change During Atherogenesis, Jason Williams

Dissertations and Theses (Open Access)

Atherosclerosis is a chronic arterial disease which impacts systemically the function of organs and tissues by causing inflammation and disruption of blood supply. During atherogenesis, lipid deposits, inflammation, and cells accumulate within the walls of arteries, ultimately leading to a buildup of fatty plaques and occlusion of the arterial lumen. In a multifactorial disease like atherosclerosis there are complex interplays between environmental, genetic and epigenetic risk factors. The epigenetics of atherosclerosis involving DNA methylation has been progressing from single gene to genome wide analyses. Although these epistudies have provided evidence that DNA methylation exists within certain genes during atherogenesis, the …

Development And Evaluation Of Amphotericin B Loaded Iron Oxide Nanoparticles For Targeted Drug Delivery To Systemic Fungal Infections, Pavan Balabathula

Theses and Dissertations (ETD)

A targeted nanotheronostic drug delivery system to diagnose and treat life threatening invasive fungal infections (IFIs) such as cryptococcal meningitis was designed, developed, characterized, and evaluated. To address the development processes, first, iron oxide nanoparticles (IONP) (34-40 nm) coated with bovine serum albumin (BSA), loaded and targeted with amphotericin B (AMB) (AMB-IONP) was formulated by applying a layer by layer approach. Several designs (A, B, C, D, & E) of AMB-IONP were developed and their physicochemical properties such as drug loading with HPLC method, particle size, poly dispersity index (PDI), and ζ-potential using dynamic light scattering (DLS) technique, morphology with …

Genetic Control Of Survival And Weight Loss During Pneumonic Burkholderia Pseudomallei (Bp) Infection, Felicia D. Emery

Theses and Dissertations (ETD)

Burkholderia pseudomallei (Bp) is a saprophytic, gram-negative aerobe and the causative agent of the disease melioidosis. Melioidosis is an infectious disease that occurs in humans and animals and is prevalent in Southeast Asia, northern Australia and other tropical areas. Transmission occurs through direct contact with the organism via ingestion, inhalation, or through open wounds and skin abrasions. Clinical presentation is extremely variable and can range from acute septicemia with bacterial dissemination to distant sites, to an isolated pulmonary infection. Treatment of melioidosis can be problematic because it is often difficult to diagnose and Bp is resistant to a diverse group …

Development Of Oral Vaccines Against Lyme Disease, Rita Raquel Dos Anjos De Carvalho E Melo

Theses and Dissertations (ETD)

Lyme Disease, caused by the spirochete Borrelia burgdorferi, is the most common vector-borne disease in the United States and Europe. If left untreated, it can lead to permanent damage to the nervous and musculoskeletal systems. In some cases, patients that receive the recommended antibiotic therapy develop a debilitating health condition associated with substantial health care costs. Despite current preventive measures, the incidence and the geographic distribution of Lyme Disease continues to increase. Recent estimates from CDC suggest that the true number of cases of Lyme Disease in the US is approximately 300,000 per year. Yet, there is currently no vaccine …

Tunneling A Pulmonary Artery Graft: A Simplified Way To Insert And Remove A Temporary Right Ventricular Assist Device, Pankaj Saxena, Silvana F Marasco

The Texas Heart Institute Journal

Right ventricular failure can occur early or late after left ventricular assist device implantation. Support with a right ventricular assist device is needed in patients whose right ventricular failure does not respond to conservative management. The use of a temporary right ventricular assist device can enable the recovery of right ventricular function and avoid the use of a more permanent biventricular assist device, which is associated with complications and higher costs. We present our technique of instituting temporary right ventricular assist device support in patients who have undergone left ventricular assist device implantation.

Barriers For Immunization Against Hpv In Developing Countries (India), Sandhya Ghanta

Master's Theses and Doctoral Dissertations

Cervical cancer is one of the most common cancers in women. Incidence and mortality rates of cervical cancer are high in less developed and developing countries. In some countries, the acceptance of the HPV vaccine to prevent cervical cancer is low. Previous studies revealed that lack of awareness, income, and education were major barriers for accepting the HPV vaccine. Apart from the above-mentioned barriers, some socio-cultural barriers for accepting the HPV vaccine exist in less developed and developing countries. This study surveyed 250 women in India of age groups 18 years and above. The sample population for the study was …

A Descriptive Case Study Of Individuals With Presumed Ocular Histoplasmosis Syndrome Utilizing A Facebook Support Group, Lisa Aimee Thompson

Graduate Theses and Dissertations

This dissertation describes the experiences of people diagnosed with presumed ocular histoplasmosis syndrome as they participate in an online peer-support group on Facebook. This is a descriptive case study of factors related to adjustment, treatment, emotional distress, access to services, and online peer support. Participants were interviewed and observed, and documents were collected to describe this phenomenon.

Investigations Into The Cross-Infectivity Of Nematode Parasites Of Cattle And Sheep, Eva Marie Wray

Graduate Theses and Dissertations

The existence of anthelmintic resistance is not singular in parasite species, host species or geographic region. It has become a problem of worldly stature, especially when considering sheep nematodes. Recommendations have been modified from chemical-based control to multipart, managerial intervention. Compared with nematodes of cattle, the worldwide resistance of sheep nematodes to anthelmintic remedies is much more pronounced and urgent. As the resistance to essentially all anthelmintic classes approaches a cautionary level, the implementation of non-chemical controls has grown increasingly essential. Six-6 to 8 month old Holstein steer calves, six-5 month old Katahdin ram lambs and eight-5 month old Suffolk …

Reduction Of Campylobacter Jejuni On Chicken Wingettes By Treatment With Caprylic Acid, Chitosan Or Protective Cultures Of Lactobacillus Spp., Ann Nicole Woo-Ming

Graduate Theses and Dissertations

Poultry is one of the main sources of protein in the United States and in 2014 Americans ate approximately 100 lbs per person. However, consumption of poultry products is strongly associated with foodborne illness from Campylobacter. In the first study, chitosan, caprylic acid and their combination were evaluated as a coating treatment for the reduction of Campylobacter jejuni on poultry products. For the initial screening trials, chitosan of three different molecular weights (15-50 kDa, 190-310 kDa and 400-600 kDa) was evaluated at three concentrations (0.5%, 1.0%, 2.0%) and separately, caprylic acid was tested at 0.5%, 1.0% and 2.0% using chicken …

Endometrial Stromal Sarcoma Metastatic From The Uterus To The Inferior Vena Cava And Right Atrium, Daniel Scher, William Nghiem, Salim Aziz, Rodeen Rahbar, Whitney Banks, Anthony Venbrux, Shawn Sarin

The Texas Heart Institute Journal

Endometrial stromal sarcoma metastases usually occur within the pelvis and rarely involve the great vessels or the heart. We present the case of a 55-year-old woman who was referred for endovascular therapy to treat presumed thrombosis of the inferior vena cava. The suspected thrombus was recalcitrant to endovascular removal with use of an AngioVac venous drainage device. Results of an intraprocedural transvenous biopsy revealed the mass to be the intravascular extension of an endometrial stromal sarcoma. The patient underwent surgical excision of the tumor, and, shortly thereafter, a hysterectomy and salpingo-oophorectomy. This complex case highlights both the rarity of malignancy …

Banning The Handshake From Healthcare Settings Is Not The Solution To Poor Hand Hygiene, Herbert L Fred

The Texas Heart Institute Journal

No abstract provided.

Microaxial Flow Left Ventricular Assist Device As A Bridge To Transplantation After Lvad Malfunction, Heidi J Reich, Aamir Shah, Babak Azarbal, Jon Kobashigawa, Jaime Moriguchi, Lawrence Czer, Fardad Esmailian

The Texas Heart Institute Journal

Evolving technology and improvements in the design of modern, continuous-flow left ventricular assist devices have substantially reduced the rate of device malfunction. As the number of implanted devices increases and as survival prospects for patients with a device continue to improve, device malfunction is an increasingly common clinical challenge. Here, we present our initial experience with an endovascular microaxial flow left ventricular assist device as a successful bridge to transplantation in a 54-year-old man who experienced left ventricular assist device malfunction.

Multivariate Criteria Most Accurately Distinguish Cardiac From Noncardiac Causes Of Dyspnea, Mirza Nubair Ahmad, Syed Hasan Yusuf, Rafath Ullah, Mirza Mujadil Ahmad, Mary K Ellis, Haroon Yousaf, Timothy E Paterick, Khawaja Afzal Ammar

The Texas Heart Institute Journal

Cardiopulmonary exercise testing provides oxygen pulse as a continuous measure of stroke volume, which is superior to other stress-testing methods in which systolic function is measured at baseline and at peak stress. However, the optimal peak oxygen pulse criterion for distinguishing cardiac from noncardiac causes of exercise limitation is unknown.

In comparing several peak oxygen pulse criteria against the clinical standard of cardiopulmonary exercise testing, we retrospectively studied 54 consecutive patients referred for cardiopulmonary exercise testing. These exercise tests included measurement of oxygen consumption, carbon dioxide production, breathing reserve, arterial blood gases at baseline and at peak stress, exercise electrocardiogram, …

Concussions Related To Football, Jerry Stephen

University Honors Program

Concussions are a major problem in football. They cause short and long term problems. Much is known about the causes of concussions in football, little is yet known about how to truly really decrease the amount of concussions and the effects a concussion really has on an individual, I propose to look at efforts being put in remaking helmets, physiological effects on the brain, and the long term behavioral and emotional effects of concussions. There is an ongoing research to solve the concussion in football. Scientists are learning about the physiological effects on the brain and the long term emotion …

Cyclin-Dependent Kinase Inhibitor P1446a Induces Apoptosis In A Jnk/P38 Mapk-Dependent Manner In Chronic Lymphocytic Leukemia B-Cells, Cody Paiva, J. Claire Godbersen, Ryan S. Soderquist, Taylor Rowland, Sumner Kilmarx

Dartmouth Scholarship

CDK (cyclin-dependent kinase) inhibitors have shown remarkable activity in CLL, where its efficacy has been linked to inhibition of the transcriptional CDKs (7 and 9) and deregulation of RNA polymerase and short-lived pro-survival proteins such as MCL1. Furthermore, ER (endoplasmic reticulum) stress has been implicated in CDK inhibition in CLL. Here we conducted a pre-clinical study of a novel orally active kinase inhibitor P1446A in CLL B-cells. P1446A inhibited CDKs at nanomolar concentrations and induced rapid apoptosis of CLL cells in vitro, irrespective of chromosomal abnormalities or IGHV mutational status. Apoptosis preceded inactivation of RNA polymerase, and was accompanied by …

With More Huntington’S Disease Clinical Trials, Volunteers Need Help With Comparison Shopping, Kenneth P. Serbin

At Risk for Huntington's Disease

No abstract provided.

Score Big For Decreasing Mortality: Icd Risk Score Model, Linda Francaviglia, Rachel Petersen, Maria Stone, M. Eyman Mortada

Journal of Patient-Centered Research and Reviews

Background: Aurora Health Care, a system of 14 acute care hospitals in eastern Wisconsin, has been a long-time participant in the American College of Cardiology’s National Cardiovascular Data Registries, submitting data to its ICD Registry™ since 2005. Our system’s implantable cardioverter-defibrillator (ICD) procedure volume averages 930 cases annually. During 2012 we experienced an increase in in-hospital mortality/morbidity for ICD cases.

Purpose: A single-center study examining in-hospital mortality/morbidity post-ICD implant before and after changes in practice and patient selection.

Methods: ICD implants and generator changes discharged from January 1, 2009, to December 31, 2012, were included in developing a risk model …

Coronary Aorta Systolic And Diastolic Pressure Indices: Two Novel Indicators For Predicting Significant Coronary Stenosis –– A Validation Against Fractional Flow Reserve, Mirza Mujadil Ahmad, Khawaja Afzal Ammar, Mirza Nubair Ahmad, Arsalan Riaz, Fatima A. Husain, Syed Shahab Kazmi, Imran Husain, Anjan Gupta

Journal of Patient-Centered Research and Reviews

Background: Since most of the coronary flow occurs in diastole, either mean Pd/Pa or iFR has been used to measure the hemodynamic significance of a coronary stenosis. We have observed that a significant pressure gradient exists in coronary stenosis even in systole, which is contrary to general understanding but similar to ankle brachial index. Furthermore, prior studies have evaluated baseline Pd/Pa (mean coronary artery/mean aorta pressure) ratio as well as iFR (instantaneous wave-free ratio obtained during entire period of diastole) to predict fractional flow reserve (FFR) ≤ 0.80. We hypothesized a simple end-systolic and -diastolic pressure measurement in the coronary …

Essentials Of Herb-Drug Interactions In The Elderly With Cardiovascular Disease, Sulaiman Sultan, Maria Viqar, Rabaiya Ali, A. Jamil Tajik, Arshad Jahangir

Journal of Patient-Centered Research and Reviews

As the number of individuals, particularly the elderly, using herbal products with prescription drugs continues to grow, the risk for adverse interactions increases but remains poorly recognized. The true incidence and nature of adverse herb reactions or herb-drug interactions remains unknown since no postmarketing surveillance mechanism exists. Adverse events are greatly underreported, and information regarding safety mainly comes from case reports and suboptimally conducted studies in a limited number of healthy young volunteers or patients with limited comorbidities. Therefore, convincing evidence for the safety of herbal products in the elderly is lacking, and the true magnitude of problems that herb-drug …

Reducing Readmission Rates In Acute Pancreatitis Through Patient Education And Risk Assessment, Jordan T. Vulcano

Journal of Patient-Centered Research and Reviews

Background: Early hospital readmissions are a direct burden on both our patients’ well-being and health care system as a whole. Acute pancreatitis is a top offender, with countless 30-day readmissions. Studies have showed a consistently higher than average 30-day readmission rates in acute pancreatitis, around 19%. This is significantly higher than the average all-cause readmission rate at Aurora Health Care hospitals. This quality improvement project aimed to reduce the rate of acute pancreatitis 30-day readmission rates at several Aurora hospitals through patient education and a readmission risk assessment tool.

Purpose: To clarify some of the risk factors associated with acute …

Does The Expression Of Ki-67, P16 And Cox-2 At Initial Diagnosis Of Breast Atypia Or Usual Ductal Hyperplasia Predict A Second Clinically Significant Event?, Judy A. Tjoe, Philippe Gascard, Jianxin Zhao, Gary F. Neitzel, Maharaj Singh, Brittany Last, James Marx, Thea Tlsty, Sanjay Kansra

Journal of Patient-Centered Research and Reviews

Background: Women diagnosed with atypical ductal hyperplasia (ADH) or atypical lobular hyperplasia (ALH) have a fivefold increased risk of developing breast cancer. Because ADH/ALH can be precursors or predictive markers of a subsequent clinically significant event (SCSE), i.e. atypia, in situ or invasive carcinoma, the clinical outcome for these patients ranges anywhere from remission to invasive malignancy. Currently we cannot predict which atypical breast lesion is likely to be associated with future cancer, resulting in aggressive management and, possibly, overtreatment. Kerlikowske et al. reported that a combination of three biomarkers (cell cycle regulator p16INK4a, proliferation antigen Ki-67 and stress response …

Should Primary Care Physicians Address Sleep To Improve Weight Loss In Obese Patients? A Clin-Iq, Kjersti E. Knox

Journal of Patient-Centered Research and Reviews

Obesity is a commonly encountered problem in the primary care setting. Simultaneously, sleep is seen to hold an increasingly important role in many components of health and wellness. A review of the literature was performed to determine if improving sleep positively impacts weight loss in obese adults. The evidence reviewed suggests that improving patients’ sleep may initially improve patient weight loss; however, current studies do not show a sustained statistically significant impact. Until higher powered and higher quality studies are completed, there are no clear evidence-based guidelines for primary care physicians to follow regarding sleep and obesity.