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The Clinical Outcome Study For Dysferlinopathy, Elizabeth Harris, Catherine Bladen, Anna Mayhew, Meredith James, Karen Bettinson, Avital Cnaan, The Jain Cos Consortium

Pediatrics Faculty Publications

Objective: To describe the baseline clinical and functional characteristics of an international cohort of 193 patients with dysferlinopathy.

Methods: The Clinical Outcome Study for dysferlinopathy (COS) is an international multicenter study of this disease, evaluating patients with genetically confirmed dysferlinopathy over 3 years. We present a cross-sectional analysis of 193 patients derived from their baseline clinical and functional assessments.

Results: There is a high degree of variability in disease onset, pattern of weakness, and rate of progression. No factor, such as mutation class, protein expression, or age at onset, accounted for this variability. Among patients with clinical diagnoses of Miyoshi …

Age-Related Effect Of Viral-Induced Wheezing In Severe Prematurity, Geovanny F. Perez, Amisha Jain, Bassem Kurdi, Rosemary Megalaa, Krishna Pancham, Shehlanoor Huseni, Natalia Isaza, Carlos E. Rodriguez-Martinez, Mary C. Rose, Dinesh Pillai, Gustavo Nino

Pediatrics Faculty Publications

Premature children are prone to severe viral respiratory infections in early life, but the age at which susceptibility peaks and disappears for each pathogen is unclear.

Methods: A retrospective analysis was performed of the age distribution and clinical features of acute viral respiratory infections in full-term and premature children, aged zero to seven years.

Results: The study comprised of a total of 630 hospitalizations (n = 580 children). Sixty-seven percent of these hospitalizations occurred in children born full-term (>37 weeks), 12% in preterm (32–37 weeks) and 21% in severely premature children (<32 weeks). The most common viruses identified were rhinovirus (RV; 60%) and respiratory syncytial virus (RSV; 17%). Age-distribution analysis of each virus identified that severely premature children had a higher relative frequency of RV and RSV in their first three years, relative to preterm or full-term children. Additionally, the probability of RV- or RSV-induced wheezing was higher overall in severely premature children less than three years old.

Conclusions: Our results indicate that the vulnerability …

Dc Beadm1™: Towards An Optimal Transcatheter Hepatic Tumour Therapy., Andrew L Lewis, Matthew R Dreher, Vincent O'Byrne, David Grey, Marcus Caine, Anthony Dunn, Yiqing Tang, Brenda Hall, Kirk D Fowers, Carmen Gacchina Johnson, Karun V. Sharma, Bradford J Wood

Pediatrics Faculty Publications

Clinical use of DC Bead™ loaded with doxorubicin (DEBDOX™) or irinotecan (DEBIRI™), for the treatment of primary and secondary tumours of the liver respectively, is showing great promise. Recently there has been a tendency to select smaller bead size ranges to treat tumours in an effort to allow more drug dose to be administered, improve tumoural penetration and resultant drug delivery and tumour coverage. Herein we describe the development and performance characterisation of a new DC Bead size range (DC BeadM1 (TM), 70-150 μm) capable of an increased bead delivery in the distal vasculature, corresponding to greater tumour coverage and …

Take The Stigma Out Of Obesity, Joseph Indelicato

The School of Health Sciences Publications and Research

The author describes Metabolic Factor as something that should be considered when public health professionals treat obese individuals. He further states that public health professional should work to take away the stigma of obesity.

Community Acquired Pneumonia Project, Patricia Heaney

Doctor of Nursing Practice Projects

There is an increasing number of microorganisms that are becoming resistant to antimicrobial medications. This growing number of resistant organism poses a serious health threat, not only in this nation, but throughout the world. The Center for Disease Control and Prevention (CDC) estimates that there are greater than 2 million people who acquire serious infections that are resistant to one or more antimicrobial agents that were made to treat those organisms (CDC, 2013). Streptococcus pneumonia (S. pneumoniae or pneumococcus) is one such organism that has been identified by the CDC (2013) as becoming increasingly resistant to drugs that were once …

Management Of Charcot–Marie–Tooth Disease: Improving Long-Term Care With A Multidisciplinary Approach, Donald Mccorquodale, Evan M. Pucillo, Nicholas E. Johnson

Physical Therapy Collection

Charcot–Marie–Tooth (CMT) disease is the most common inherited neuropathy and one of the most common inherited diseases in humans. The diagnosis of CMT is traditionally made by the neurologic specialist, yet the optimal management of CMT patients includes genetic counselors, physical and occupational therapists, physiatrists, orthotists, mental health providers, and community resources. Rapidly developing genetic discoveries and novel gene discovery techniques continue to add a growing number of genetic subtypes of CMT. The first large clinical natural history and therapeutic trials have added to our knowledge of each CMT subtype and revealed how CMT impacts patient quality of life. In …

Socioecological Factors Influencing Women’S Hiv Risk In The United States: Qualitative Findings From The Women’S Hiv Seroincidence Study (Hptn 064), Paula M. Frew, Kimberly Parker, Linda Vo, Danielle Haley, Ann O'Leary, Dazon Dixon Diallo, Carol E. Golin, Irene Kuo, Lydia Soto-Torres, Jing Wang, Adaora A. Adimora, Laura A. Randall, Carlos Del Rio, Sally Hodder

Faculty & Staff Scholarship

Background: We sought to understand the multilevel syndemic factors that are concurrently contributing to the HIV epidemic among women living in the US. We specifically examined community, network, dyadic, and individual factors to explain HIV vulnerability within a socioecological framework. Methods: We gathered qualitative data (120 interviews and 31 focus groups) from a subset of women ages 18–44 years (N = 2,099) enrolled in the HPTN 064 HIV seroincidence estimation study across 10 US communities. We analyzed data from 4 diverse locations: Atlanta, New York City (the Bronx), Raleigh, and Washington, DC. Data were thematically coded using grounded theory methodology. …

Clinical Assessment Of Fatigability In Multiple Sclerosis: A Shift From Perception To Performance., Bryant A Seamon, Michael O. Harris-Love

Exercise and Nutrition Sciences Faculty Publications

No abstract provided.

Phage Therapy As A Mrsa Treatment, Miriam Sussman

The Science Journal of the Lander College of Arts and Sciences

This paper seeks to review how previous research on bacteriophage therapy can be utilized to improve the treatment of MRSA infections. Due to the growing phenomenon of antibiotic resistance, scientists are looking to utilize the natural antibacterial qualities of bacterial viruses called phages to fight MRSA infections. In order to improve the therapeutic methods of combatting MRSA, one must first understand the mechanics of how phages infect bacterial cells and lyse them with their proteins. The narrow host range of bacteriophages causes the infection of only the pathogenic bacteria and maintains the state of the normal flora. Research suggests that …

Crispr/Cas9 As A Therapeutic Approach To Duchenne Muscular Dystrophy, Abraham Daniel Levitman

The Science Journal of the Lander College of Arts and Sciences

Transhumanism, designer babies, gene therapy, and super-soldiers are founded upon the same concept—genetic engineering. Clustered Regularly-Interspersed Short Palindromic Repeats (CRISPR) is a natural bacterial immune response method that takes advantage of gene manipulation to prevent an infection from mobile genetic elements. Since Mojica et al. (2005) first suggested the relationship between the CRISPR/Cas system and prokaryotic immunity, significant advancements have been made in understanding the mechanism and subsequent applications of CRISPR. CRISPR, has three main subtypes based on unique proteins and interference pathways and serves as an accurate and effective method for gene editing. Its mechanism consists of spacer acquisition, …

Most Efficient Methods To Treat Breast Cancer, Esther Ehrman

The Science Journal of the Lander College of Arts and Sciences

Breast cancer is rampant in today’s world. Because there are many different cases and so many different ways to classify breast cancer, a multidisciplinary approach must be taken. Many patients undergo breast conserving surgery which creates a need for the eradication of any remaining tumor residue through radiation. Fifty Gy of radiation should be applied to the breast with an additional 16 Gy as a boost. If a mastectomy is performed to remove a large tumor and 4 or more positive lymph nodes were present, radiation should be applied as well. If the tumor expresses HER2 protein, Trastuzumab should be …

A Pilot Study For Plant The Seed: A Nutrition Education Program Using Local Food Environment To Put Theory Into Action, Yeon Bai, Shahla M. Wunderlich, Karen A. Lee

Department of Nutrition and Food Studies Scholarship and Creative Works

The purpose of this study is to implement Plant the Seed, a garden-based nutrition education program designed to reconnect children with locally grown food, food environments of the past and present, and the benefits of eating seasonal foods. The pilot study investigates the environmental context and theory variables known to influence healthy food choice behavior. Social Cognitive Theory (SCT) provided a framework for the program’s curriculum and evaluation. The target audience is middle school students. Plant the Seed is a two-part program. In Part 1 (classroom), students participate in practical, interactive activities based on specific educational objectives that target …

Hexokinase Ii Localization Is Independent Of Ampk Activation In Hela Cells, Alyssa Brown

Graduate School of Biomedical Sciences Theses and Dissertations

In order for a cancer cell to thrive, it must alter its metabolism to produce the energy needed for rapid growth. Cells accomplish this by the Warburg Effect, or switching metabolism to aerobic glycolysis, where a cell can rapidly break down sugar into ATP, lactic acid and additional byproducts. Hexokinase 2, the enzyme that catalyzes the first committed step of glycolysis, may also be upregulated in cancer cells to increase glucose breakdown. Similar proteins for metabolism are found in both S. cerevisiae and mammalian cells. S. cerevisiae regulates metabolism through glucose repression, by Snf1 (mammalian homolog: AMPK) activation, which aids …

Non-Hdl-C Or Apolipoprotein-B Versus Ldl-C Screening For Evaluation And Treatment Of Atherosclerotic Cardiovascular Disease, Grant Coauette

Physician Assistant Scholarly Project Posters

• Lowering low-density lipoprotein cholesterol (LDL-C) concentration in the population has been a goal of researchers and clinicians to prevent atherosclerotic cardiovascular disease (ASCVD).

• Controversy surrounds using [LDL-C] as the primary lipid biomarker to evaluate the risk of cardiovascular events. An article search dating back to 2005 of PubMed and The Cochran Library was conducted.

• The purpose of this investigation was to determine if LDL-C should be the primary lipid biomarker used to determine ASCVD treatment and prevention. This investigation researched other lipid biomarkers and targets to determine clinical relevance and if the level of those markers more …

Screening For Cardiovascular Disease In Children, Jesse Fladmark

Physician Assistant Scholarly Project Posters

Introduction: Cardiovascular disease is one of the leading causes of death in the world with significant burden on the health care system.

Review of Literature: The focus of this paper is to look at previous studies, mostly systematic reviews and metaanalysis, in search of various clinical screening methods in the pediatric population for determining cardiovascular disease risk. Waist to height ratio can be used to screen children for cardiovascular disease with a specificity of 96% when using 0.55 as the cut-off point. An increase in waist circumference along with increased BMI places a child at a much higher risk of …

A Multimodal Approach To Preventing And Treating Alzheimer’S Disease, Jason B. Smith

Physician Assistant Scholarly Project Posters

As of 2015 over 47 million people worldwide are diagnosed with Alzheimer’s disease (AD). The incidence of AD increases with age, and affects males and females equally. Current pharmacologic treatment includes two classes of drugs. The purpose of this study was to determine if a multimodal approach (i.e. diet, exercise, cognitive stimulation) towards the prevention and treatment of AD would be more beneficial than pharmacologic therapy alone. Research methods included reviewing peer reviewed journal articles published within the past five years obtained from PubMed, Dynamed, Cochrane, CINAHL, and Clinical Key. Ehret and Chamberlin (2015) found donepezil (Aricept) increased MMSE scores …

Análisis De Las Políticas Públicas De Prevención Del Cáncer De Cuello Uterino Vinculadas Al Control Del Virus Del Papiloma Humano (Vph) En Argentina / An Analysis Of Argentina’S Public Health Prevention Strategies Of Cervical Cancer Related To The Control Of The Human Papiloma Virus (Hpv), Caroline Seman

Independent Study Project (ISP) Collection

El objetivo general de este estudio es analizar las políticas públicas de prevención del cáncer de cuello uterino (CCU) basadas en la incorporación de nuevas tecnologías como el test de VPH (Virus del Papiloma Humano) y la vacuna contra el VPH en Argentina. Los objetivos específicos son 1) describir la implementación del test de VPH y la campaña de vacunación obligatoria contra el VPH como estrategias de prevención primaria del CCU a nivel nacional: 2) identificar los factores que las facilitan y las obstaculizan. El CCU es el segundo cáncer más diagnosticado en las mujeres de Argentina. Desde el año …

Vertebral Metastasis As The Initial Manifestation Of Colon Cancer, Tushina Jain, Renee Williams, Benjamin Liechty, Lea Ann Chen

Medicine Faculty Publications

Oncology guidelines currently recommend against performing colonoscopies in the workup of adenocarcinoma of unknown primary unless colonic malignancy is otherwise suggested by clinical signs or symptoms. We present 2 cases of metastatic colonic adenocarcinoma that presented only with neurologic symptoms from vertebral metastasis. Although bony metastases are a rare presentation of colon cancer and colonoscopy is not warranted in the initial workup of adenocarcinoma of unknown primary, we describe these cases as a reminder that bony metastases do not rule out a colon cancer diagnosis.

Utility And Origin Of Blood-Based Autoantibodies For Early Detection And Diagnosis Of Neurodegenerative Diseases, Cassandra Demarshall

Graduate School of Biomedical Sciences Theses and Dissertations

Autoantibodies are self-reactive antibodies that have been widely implicated as causal agents of autoimmune diseases. They are found in the blood of all human sera, regardless of age, gender, or the presence or absence of disease. While the underlying reason for their ubiquity remains unknown, it has been hypothesized that they participate in the clearance of blood-borne cell and tissue debris generated in both healthy and diseased individuals on a daily basis. Although much evidence supports this debris clearance role, recent studies also suggest a causal role for autoantibodies in disease. My thesis work has focused on this "cause and/or …

Treatment Options For Skin And Soft Tissue Infections Caused By Methicillin-Resistant Staphylococcus Aureus, Renee Weinberg

The Science Journal of the Lander College of Arts and Sciences

Staphylococcus aureus is a pathogen responsible for common skin infections, such as impetigo, cellulitis, folliculitis, and abscess and it is the most common cause for skin and soft tissue infections (SSTI). Humans are carriers of this microorganism and are responsible for facilitating its spread around the world. Over time it has developed resistance to multiple antibiotics, such as penicillin and methicillin, which has made S. aureus a persistent problem in the healthcare world today. Its methicillin resistance has given it the more commonly known name methicillin-resistant S. aureus (MRSA). MRSA was initially discovered solely in the healthcare environment and thus …

Stem Cell Therapy And Macular Degeneration, Brenda Stern

The Science Journal of the Lander College of Arts and Sciences

Macular degeneration is the leading cause of vision loss in Americans sixty years and older. Currently, it is an incurable disease. Stem cell therapy is the idea of transplanting stem cells to replace damaged cells in the body. As the demand for transplantable organs far outweighs the supply, stem cells are an encouraging alternative to replace damaged cells. Can stem cell therapy be the first cure for macular degeneration? Many experiments have been done on transplanting stem cells into the eyes of rats with macular degeneration yielding promising results. The first transplantation of retinal pigmented epithelial stem cells into humans …

Uric Acid-Induced Adipocyte Dysfunction Is Attenuated By Ho-1 Upregulation: Potential Role Of Antioxidant Therapy To Target Obesity, Komal Sodhi, Jordan Hilgefort, George Banks, Chelsea Gilliam, Sarah Stevens, Hayden A. Ansinelli, Morghan Getty, Nader G. Abraham, Joseph I. Shapiro, Zeid J. Khitan

Internal Medicine

Increased uric acid levels have been implicated in the pathogenesis of metabolic syndrome. To examine the mechanisms by which this occurs, we hypothesized that an increase in heme oxygenase 1, a potent antioxidant gene, will decrease uric acid levels and adipocyte dysfunction via suppression of ROS and xanthine oxidase (XO) levels.We examined the effect of uric acid on adipogenesis in human mesenchymal stem cells (MSCs) in the presence and absence of cobalt protoporphyrin (CoPP), an HO-1 inducer, and tin mesoporphyrin (SnMP), an HO activity inhibitor. Uric acid increased adipogenesis by increasing NADPH oxidase expression and elevation in the adipogenesis markers …

Serum Biomarkers Compared To Neural Imaging In The Differentiation Of Stroke Etiologies, Kevin Conboy

Physician Assistant Scholarly Project Posters

• Stroke is a leading cause of disability and morbidity and the fourth leading cause of death in the United States, and the second leading cause of death worldwide.

• Early restoration of blood flow is the most effective treatment of ischemic stroke by intravenous thrombolytic therapy within 3-4.5hrs of symptom onset.

• Patient outcomes have been shown to improve with earlier thrombolytics, each 15 minute increment increases survival by 3.0-4.0%.

• Non-contrast CT is the current standard for differentiation of stroke. It is beneficial due to speed of acquisition and its high sensitivity in ruling out hemorrhagic stroke.

• …

Patient Self-Management: Impact Of Racism-Related Vigilance In The Management Of Hypertension In African-Americans, Rackelle N. Wilkinson-Alston

Writing Across the Curriculum

It is important to understand the role that discrimination plays in health disparities. This paper will discuss racism-related vigilance, and its role in health outcomes in hypertensive African-Americans (AAs). This paper will also attempt to provide insight on how the absence of a culturally competent health care system may predispose AAs to developing stress-induced hypertension due to racism-related vigilance. This paper will explore how community partnership programs may be beneficial interventions for building resilience and promoting positive health behaviors among hypertensive AAs in the face of discrimination-related vigilance.

Identification Of The Effects Of Diabetes Mellitus On The Brain, Tryphina A. Mikhail

Honors Undergraduate Theses

As more studies accumulate on the impact of diabetes mellitus on the central nervous system, they resound with the same conclusion - diabetes has a detrimental effect on cognition regardless of the presence of comorbidities. Less consistent however, are the specific mental processes wherein these declines are noticeable, and the structural changes that accompany these reductions in mental capacity. From global atrophy to changes in the volume of gray and white matter, to conflicting results regarding the effects of hypo- and hyperglycemic states on the development of the hippocampus, the studies display a variety of results. The goal of this …

Differential Rna Expression Profile Of Skeletal Muscle Induced By Experimental Autoimmune Myasthenia Gravis In Rats, Henry J. Kaminski, Keiichi Himuro, Jumana Alshaikh, Bendi Gong, Georgiama Cheng, Linda L. Kusner

Neurology Faculty Publications

The differential susceptibility of skeletal muscle by myasthenia gravis (MG) is not well understood. We utilized RNA expression profiling of extraocular muscle (EOM), diaphragm (DIA), and extensor digitorum (EDL) of rats with experimental autoimmune MG (EAMG) to evaluate the hypothesis that muscles respond differentially to injury produced by EAMG. EAMG was induced in female Lewis rats by immunization with acetylcholine receptor purified from the electric organ of the Torpedo. Six weeks later after rats had developed weakness and serum antibodies directed against the AChR, animals underwent euthanasia and RNA profiling performed on DIA, EDL, and EOM. Profiling results were validated …

Interpreting Patient-Reported Outcomes From Clinical Trials In Copd: A Discussion, Paul W. Jones, Stephen I. Rennard, Maggie Tabberer, John H. Riley, Mitra Vahdati-Bolouri, Neil C. Barnes

Journal Articles: Pulmonary & Critical Care Med

One of the challenges faced by the practising physician is the interpretation of patient-reported outcomes (PROs) in clinical trials and the relevance of such data to their patients. This is especially true when caring for patients with progressive diseases such as COPD. In an attempt to incorporate the patient perspective, many clinical trials now include assessments of PROs. These are formalized methods of capturing patient-centered information. Given the importance of PROs in evaluating the potential utility of an intervention for a patient with COPD, it is important that physicians are able to critically interpret (and critique) the results derived from …

Upregulation Of Rgs2: A New Mechanism For Pirfenidone Amelioration Of Pulmonary Fibrosis, Yan Xie, Haihong Jiang, Qian Zhang, Suneet Mehrotra, Peter W. Abel, Myron L. Toews, Dennis W. Wolff, Stephen I. Rennard, Reynold A. Panettieri, Thomas B. Casale, Yaping Tu

Journal Articles: Pulmonary & Critical Care Med

BACKGROUND: Pirfenidone was recently approved for treatment of idiopathic pulmonary fibrosis. However, the therapeutic dose of pirfenidone is very high, causing side effects that limit its doses and therapeutic effectiveness. Understanding the molecular mechanisms of action of pirfenidone could improve its safety and efficacy. Because activated fibroblasts are critical effector cells associated with the progression of fibrosis, this study investigated the genes that change expression rapidly in response to pirfenidone treatment of pulmonary fibroblasts and explored their contributions to the anti-fibrotic effects of pirfenidone.

METHODS: We used the GeneChip microarray to screen for genes that were rapidly up-regulated upon exposure …

Effects Of Roflumilast In Copd Patients Receiving Inhaled Corticosteroid/Long-Acting Β2-Agonist Fixed-Dose Combination: Re(2)Spond Rationale And Study Design, Stephen I. Rennard, Fernando J. Martinez, Klaus F. Rabe, Sanjay Sethi, Emilio Pizzichini, Andrew Mcivor, Shahid Siddiqui, Antonio Anzueto, Haiyuan Zhu

Journal Articles: Pulmonary & Critical Care Med

BACKGROUND: Roflumilast, a once-daily, selective phosphodiesterase-4 inhibitor, reduces the risk of COPD exacerbations in patients with severe COPD associated with chronic bronchitis and a history of exacerbations. The RE(2)SPOND study is examining whether roflumilast, when added to an inhaled corticosteroid/long-acting β2-agonist (ICS/LABA) fixed-dose combination (FDC), further reduces exacerbations. The methodology is described herein.

METHODS: In this Phase IV, multicenter, double-blind, placebo-controlled, parallel-group trial, participants were randomized 1:1 (stratified by long-acting muscarinic antagonist use) to receive roflumilast or placebo, plus ICS/LABA FDC, for 52 weeks. Eligible participants had severe COPD associated with chronic bronchitis, had two or more moderate-severe exacerbations within …

Is Deep Brain Stimulation A Viable Treatment For Parkinson’S Disease?, Brocha Gold

The Science Journal of the Lander College of Arts and Sciences

Treatment options for those suffering from Parkinson’s Disease are as diverse as its symptoms. With the advent of modern technology there are new and innovative treatments that are becoming available, such as Deep Brain Stimulation (DBS). Prior to exploring treatment options one must understand the various causes of the disease. Treatment of the various motor and non-motor symptoms can include a combination of medication and surgical therapies. Among surgical interventions DBS is the treatment of choice. It has the fewest side effects and provides the greatest symptomatic relief.