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Oncolog, Volume 57, Number 11-12, November - December 2012, Kathryn L. Hale, Amelia Scholtz, Luanne Jorewicz

OncoLog MD Anderson's Report to Physicians (All issues) Archives

• Research Explores Link Between Thrombocytosis and Cancer: High platelet counts can be an early indicator of cancer, In fact, about one-third of women with ovarian cancer have an abnormally high platelet count at the time of diagnosis. This paraneoplastic thrombocytosis is also seen in patients with cancers of the gastrointestinal tract, lung or breast
• Wide Range of Cancer Treatments May Produce Ocular Complications: Although most ocular side effects of cancer treatment may be transient and reversible, regular ophthalmic examinations and effective doctor-patient communication can help cancer patients avoid permanent damage
• New Software May Provide a Standardized Reporting System for Diagnostic …

A Four Factor Model Of Systems-Based Practices In Psychiatry., Jules M. Ranz, Michael Weinberg, Melissa R. Arbuckle, Joanna Fried, Anthony Carino, Hunter L. Mcquistion, Glen Davis, Donovan Wong, Sosunmolu O. Shoyinka, Benjamin Brody, Kamala D. Sethi, Anna Skiandos, Wesley Sowers, David Stern, Anne Sullivan, Michael J. Vergare

Department of Psychiatry and Human Behavior Faculty Papers

No abstract provided.

Risk Factors Associated With Death In In-Hospital Pediatric Convulsive Status Epilepticus, Tobias Loddenkemper, Tanvir U. Syed, Sriram Ramgopal, Deepak Gulati, Sikawat Thanaviratananich, Sanjeev V. Kothare, Amer Alshekhlee, Mohamad Z. Koubeissi

Neurology Faculty Publications

Objective

To evaluate in-patient mortality and predictors of death associated with convulsive status epilepticus (SE) in a large, multi-center, pediatric cohort.

Patients and Methods

We identified our cohort from the KID Inpatient Database for the years 1997, 2000, 2003 and 2006. We queried the database for convulsive SE, associated diagnoses, and for inpatient death. Univariate logistic testing was used to screen for potential risk factors. These risk factors were then entered into a stepwise backwards conditional multivariable logistic regression procedure. P-values less than 0.05 were taken as significant.

Results

We identified 12,365 (5,541 female) patients with convulsive SE aged …

Characteristics Of Children Attending Asthma Camp In Nevada, Priyank Shetty, Sheniz Moonie, Amy Beaulieu, Christopher M. Aquino

Nevada Journal of Public Health

The purpose of this study was to assess asthma trigger knowledge of camp attendees and the measure of agreement between physician and parent assessment of the children’s asthma severity. This study is based on cross-sectional data provided by the American Lung Association (ALA) and those children participating in summer asthma camps in Las Vegas and Reno, Nevada. Fifty-six children participated in the camp in August of 2008. The study results suggest a significant positive correlation between physician and parent assessment of asthma severity. With increasing asthma severity there was a relative increase in the number of school days missed among …

Reintegration Of Child Soldiers In Burundi: A Tracer Study, Mark J.D. Jordans, Ivan H. Komproe, Wietse A. Tol, Aline Ndayisaba, Theodora Nisabwe, Brandon A. Kohrt

Psychiatry and Behavioral Sciences Faculty Publications

Background

Substantial attention and resources are aimed at the reintegration of child soldiers, yet rigorous evaluations are rare.

Methods

This tracer study was conducted among former child soldiers (N=452) and never-recruited peers (N=191) who participated in an economic support program in Burundi. Socio-economic outcome indicators were measured retrospectively for the period before receiving support (T1; 2005–06); immediately afterwards (T2; 2006–07); and at present (T3; 2010). Participants also rated present functional impairment and mental health indicators.

Results

Participants reported improvement on all indicators, especially economic opportunity and social integration. At present no difference existed between both groups on any of the …

Com Outlook Fall 2012, College Of Osteopathic Medicine

COM Outlook

No abstract provided.

Gender Differences In The Developmental Outcomes Of Children With Congenital Cardiac Defects, Annette Majnemer, Catherine Limperopoulos, Michael Shevell, Charles Rohlicek, Bernard Rosenblatt, Chirsto Tchervenkov

Pediatrics Faculty Publications

Objective: This study compares the developmental and functional outcomes at school entry between boys and girls born with a congenital cardiac defect who required early surgical correction.

Study design: A prospective cohort of 94 children, including 49 percent boys, were followed up to 5 years of age and assessed for developmental progress. Developmental measures included Wechsler Preschool and Primary Scale of Intelligence – cognitive; Peabody Picture Vocabulary Test – receptive language; Peabody Developmental Motor Scale – motor; and Child Behaviour Checklist – behaviour. Measures of function included the Vineland Adaptive Behavior Scale and Functional Independence Measure for Children (WeeFIM).

Results: …

Real-Time Analysis Of Brain Tumor Cell Dynamics: Novel Thermoelectric Detection Of L-Glutamate And Cell Metabolism Using Microfluidics, Siva Mahesh Tangutooru

Doctoral Dissertations

This study describes the design, fabrication and applications of a novel thermoelectric microfluidic bio-sensor. The bio-sensor is used for real time detection of the L-glutamate (L-glu) dynamics and metabolism for brain tumor cells immobilized in a microfluidic device. The microfluidic device is fabricated using a polymer/glass laminating technique (Xurography). An antimony-bismuth thin-film thermopile (primary sensing element) is integrated to the microfluidic device. The brain tumor cells are immobilized over the thermopile covering measuring and reference junctions of the thermopile using a poly-l-lysine coating layer. L-glutamate oxidase (L-GLOD) is immobilized over the measuring junctions of the thermopile prior to the immobilization …

Interstage Mortality After The Norwood Procedure: Results Of The Multicenter Single Ventricle Reconstruction Trial., Nancy S. Ghanayem, Kerstin R. Allen, Sarah Tabbutt, Andrew M. Atz, Martha L. Clabby, David S. Cooper, Pirooz Eghtesady, Peter C. Frommelt, Peter J. Gruber, Kevin D. Hill, Jonathan R. Kaltman, Peter C. Laussen, Alan B. Lewis, Karen J. Lurito, L Luann Minich, Richard G. Ohye, Julie V. Schonbeck, Steven M. Schwartz, Rakesh K. Singh, Caren S. Goldberg, Pediatric Heart Network Investigators, Girish S. Shirali

Manuscripts, Articles, Book Chapters and Other Papers

OBJECTIVE: For infants with single ventricle malformations undergoing staged repair, interstage mortality is reported at 2% to 20%. The Single Ventricle Reconstruction trial randomized subjects with a single morphologic right ventricle undergoing a Norwood procedure to a modified Blalock-Taussig shunt (MBTS) or a right ventricle-to-pulmonary artery shunt (RVPAS). The aim of this analysis was to explore the associations of interstage mortality and shunt type, and demographic, anatomic, and perioperative factors.

METHODS: Participants in the Single Ventricle Reconstruction trial who survived to discharge after the Norwood procedure were included (n = 426). Interstage mortality was defined as death postdischarge after the …

Pain Assessment And Management In Different Wards Of A Tertiary Care Hospital, Anwar Ul Huda, Mohammad Hamid, Saboor Ahmed, Syed Muhammad Baqir, Aysha Almas

Department of Emergency Medicine

OBJECTIVE:

To assess the pain management by medical team, emergency room (ER) team and Acute Pain team in a tertiary care hospital.

METHODS:

The cross-sectional study was done in Medical Ward, Surgical Ward and Emergency Room of Aga Khan University, Karachi, in March-April 2010. The assigned research medical officer visited the three locations every day and selected patients by way of convenient sampling. The study comprised 75 patients; 25 each in three groups. Information was collected on patient's demographics, general characteristics, type of drugs and modalities used. Specific queries about pain were sorted out like adequacy of pain assessment done …

Rethinking Hiv-Exposure Crimes, Margo Kaplan

Indiana Law Journal

This Article challenges the current legislative and scholarly approaches to HIV-exposure crimes and proposes an alternative framework to address their flaws. Twenty-four states criminalize consensual sexual activities of people with HIV. Current statutes and the scholarship that supports them focus on HIV-positive status, sexual activity, and knowledge of HIV-positive status as proxies for risk, mental state, and consent to risk. As a result, they are dramatically over- and underinclusive and stigmatize individuals living with HIV. Criminalization should be limited to circumstances in which a defendant exposed her partner to a substantial degree of unassumed risk and did so with a …

The Effect Of Genetic Background And Dose On Non-Targeted Effects Of Radiation, Sarah Irons, Virginia Sierra, Deborah Bowler, Kim Chapman, Stefania Militi, Fiona Lyng, Munira Kadhim

Articles

Purpose: This work investigates the hypothesis that genetic background plays a significant role in the signalling mechanisms underlying induction and perpetuation of genomic instability following radiation exposure.

Materials and methods: Bone marrow from two strains of mice (CBA and C57) were exposed to a range of X-ray doses (0, 0.01, 0.1, 1 and 3 Gy). Different cellular signalling endpoints: Apoptosis, cytokine levels and calcium flux, were evaluated at 2 h, 24 h and 7 d post-irradiation to assess immediate and delayed effects.

Results: In CBA (radiosensitive) elevated apoptosis levels were observed at 24 h post X-irradiation, and …

Digest Of The Philadelphia College Of Osteopathic Medicine (Fall 2012), Philadelphia College Of Osteopathic Medicine

Digest

The Fall 2012 issue of the Digest of the Philadelphia College of Osteopathic Medicine includes the following articles:

• Message from the President
• PCOM Updates
• Development News
• Protecting Human Rights
• Relieving Suffering
• On Leaders and Legacies
• Profiles of Nine PCOM Alumni Who Influence Osteopathic Medical Education
• Pharmacists’ Changing Role: From Behind the Counter to Direct Patient Care
• PCOM School of Pharmacy Is Preparing Students to Practice as Part of the Healthcare Team
• Class Notes
• In Memoriam
• My Turn Essay
• The Fund for PCOM

The Alternative Crosstalk Between Rage And Nitrative Thioredoxin Inactivation During Diabetic Myocardial Ischemia-Reperfusion Injury., Yi Liu, Yan Qu, Rutao Wang, Yanzhuo Ma, Chenhai Xia, Chao Gao, Jingyi Liu, Kun Lian, Aibing Xu, Xiaoyan Lu, Lu Sun, Lu Yang, Wayne B. Lau, Erhe Gao, Walter Koch, Haichang Wang, Ling Tao

Department of Emergency Medicine Faculty Papers

The receptor for advanced glycation end products (RAGE) and thioredoxin (Trx) play opposing roles in diabetic myocardial ischemia-reperfusion (MI/R) injury. We recently demonstrated nitrative modification of Trx leads to its inactivation and loss of cardioprotection. The present study is to determine the relationship between augmented RAGE expression and diminished Trx activity pertaining to exacerbated MI/R injury in the diabetic heart. The diabetic state was induced in mice by multiple intraperitoneal low-dose streptozotocin injections. RAGE small-interfering RNA (siRNA) or soluble RAGE (sRAGE, a RAGE decoy) was via intramyocardial and intraperitoneal injection before MI/R, respectively. Mice were subjected to 30 min of …

Mongolian Women's Voices: A Case Study On Maternal Healthcare, Pregnancy, And Birth In Ulaanbaatar's Public Hospitals, Amelia Olmsted

Independent Study Project (ISP) Collection

Mongolia is a country undergoing an incredible amount of change. Last year, in 2011, they had the fastest growing economy in the world, with a 17.2% increase in their GDP, according to the World Bank. A mere 22 years ago, Mongolia was a communist country, and today they are a parliamentary democracy. The country has opened itself up to the rest of the world and a free market economy, and experienced a very drastic shift in this direction in the early 1990's. Many Mongolians will tell you that the mindset of Mongolia's citizens has made a drastic shift since communism …

Awareness Of Type Ii Diabetes In The Developing World: Case Study In Binh Du’O’Ng, Vietnam, Anna Hong Le

Independent Study Project (ISP) Collection

Vietnam’s rapid economic development after 1986 forever changed the lifestyle of the Vietnamese. Economic development has highly impacted behavior, “changing from a traditional lifestyle to an industrial lifestyle [increasing] noncommunicable diseases (NCDs) : diabetes, overweight, high blood pressure, and high cholesterol disorders” (Danh, Personal Interview). With the increase of NCDs within the country, it is important to focus on awareness education that motivates the population especially those living in the urban sector to practice healthy behaviors. This study project focuses on the evaluating the reach and effectiveness of current diabetes awareness educational materials. One week was spent in Ha Noi, …

Orientation-Invariant Ecg-Based Virtual Pathology Stethoscope Tracking For Standardized Patient Heart Auscultation, Nahom B. Kidane

Computational Modeling & Simulation Engineering Theses & Dissertations

Cardiac auscultation (CA), the act of listening to the heart sounds, is a critical physician's skill that provides substantial information for diagnosing many cardiovascular disorders; therefore, competent training can be a key for accurate and reliable diagnosis. The teaching of CA has been an area of recognized importance since the inception of the stethoscope. However, recent changes in health-care, such as limited student access to patients and higher reliance on competing technologies have made it challenging to teach bedside CA techniques.

Over the past few decades, standardized patients (SPs), individuals trained to portray real patients, have been widely used for …

Pulmonary Complications In Patients With Severe Brain Injury., Kiwon Lee, Fred Rincon

Department of Neurology Faculty Papers

Pulmonary complications are prevalent in the critically ill neurological population. Respiratory failure, pneumonia, acute lung injury and the acute respiratory distress syndrome (ALI/ARDS), pulmonary edema, pulmonary contusions and pneumo/hemothorax, and pulmonary embolism are frequently encountered in the setting of severe brain injury. Direct brain injury, depressed level of consciousness and inability to protect the airway, disruption of natural defense barriers, decreased mobility, and secondary neurological insults inherent to severe brain injury are the main cause of pulmonary complications in critically ill neurological patients. Prevention strategies and current and future therapies need to be implemented to avoid and treat the development …

Neurosteroid-Mediated Regulation Of Brain Innate Immunity In Hiv/Aids: Dhea-S Suppresses Neurovirulence, Amber Paul, Ferdinand G. Maingat, Maria J. Polyak, Pornpun Vivithanaporn, Farshid Noorbakhsh, Samir Ahboucha, Glen B. Baker, Keir Pearson, Christopher Power

Publications

Neurosteroids are cholesterol-derived molecules synthesized within the brain, which exert trophic and protective actions. Infection by human and feline immunodeficiency viruses (HIV and FIV, respectively) causes neuroinflammation and neurodegeneration, leading to neurological deficits. Secretion of neuroinflammatory host and viral factors by glia and infiltrating leukocytes mediates the principal neuropathogenic mechanisms during, although the effect of neurosteroids on these processes is unknown. We investigated the interactions between neurosteroid mediated effects and lentivirus infection outcomes. Analyses of HIV-infected uninfected human brains disclosed a reduction in neurosteroid synthesis enzyme expression. Human neurons exposed to supernatants from HIV macrophages exhibited suppressed enzyme expression without …

Phase Ii Evaluation Of Dasatinib In The Treatment Of Recurrent Or Persistent Epithelial Ovarian Or Primary Peritoneal Carcinoma: A Gynecologic Oncology Group Study., Russell J Schilder, William E Brady, Heather A Lankes, James V Fiorica, Mark S Shahin, Xun C Zhou, Robert S Mannel, Harsh B Pathak, Wei Hu, R Katherine Alpaugh, Anil K Sood, Andrew K Godwin

Department of Medical Oncology Faculty Papers

OBJECTIVES: Preclinical data suggest an important role for the sarcoma proto-oncogene tyrosine kinase (SRC) in the oncogenesis of epithelial ovarian cancer (EOC) or primary peritoneal carcinoma (PPC). The Gynecologic Oncology Group (GOG) conducted a Phase II trial to evaluate the efficacy and safety of dasatinib, an oral SRC-family inhibitor in EOC/PPC, and explored biomarkers for possible association with clinical outcome.

METHODS: Eligible women had measurable, recurrent or persistent EOC/PPC and had received one or two prior regimens which must have contained a platinum and a taxane. Patients were treated with 100mg orally daily of dasatinib continuously until progression of disease …

Non-Compaction Of The Left Ventricle And Associated Ventricular Septal Defect., Abid Laghari, Javed Tai, Sumaira Saleem

Department of Medicine

A case report of a 28-year-old patient, who presented with symptoms and signs of congestive heart failure and had clinical signs of ventricular septal defect as well. On further work-up echocardiogram showed non-compaction of the left ventricle with severe left ventricular systolic dysfunction and a ventricular septal defect. He was treated with standard treatment of heart failure and is doing well.

Determining The Absolute Requirement Of G Protein-Coupled Receptor Kinase 5 For Pathological Cardiac Hypertrophy: Short Communication., Jessica I Gold, Erhe Gao, Xiying Shang, Richard T Premont, Walter J Koch

Center for Translational Medicine Faculty Papers

RATIONALE: Heart failure (HF) is often the end phase of maladaptive cardiac hypertrophy. A contributing factor is activation of a hypertrophic gene expression program controlled by decreased class II histone deacetylase (HDAC) transcriptional repression via HDAC phosphorylation. Cardiac-specific overexpression of G proteinen-coupled receptor kinase-5 (GRK5) has previously been shown to possess nuclear activity as a HDAC5 kinase, promoting an intolerance to in vivo ventricular pressure overload; however, its endogenous requirement in adaptive and maladaptive hypertrophy remains unknown.

OBJECTIVE: We used mouse models with global or cardiomyocyte-specific GRK5 gene deletion to determine the absolute requirement of endogenous GRK5 for cardiac hypertrophy …

Life History Theory And Social Psychology., Donald F Sacco, Karol Osipowicz

Department of Neurology Faculty Papers

No abstract provided.

The Causes, Treatment, And Outcome Of Acute Heart Failure In 1006 Africans From 9 Countries, Albertino Damasceno, Bongani M. Mayosi, Mahmoud Sani, Okechukwu S. Ogah, Charles Mondo, Dike Ojji, Anastase Dzudie, Charles Kouam Kouam, Ahmed Suliman, Neshaad Schrueder, Gerald Yonga, Serigne Abdou Ba, Fikru Maru, Bekele Alemayehu, Christopher Edwards, Beth A. Davison, Gad Cotter, Karen Sliwa

Internal Medicine, East Africa

Background: Acute heart failure (AHF) in sub-Saharan Africa has not been well characterized. Therefore,wesought to describe the characteristics, treatment, and outcomes of patients admitted with AHF in sub-Saharan Africa.

Methods: The Sub-Saharan Africa Survey of Heart Failure (THESUS–HF) was a prospective, multicenter, observational survey of patients with AHF admitted to 12 university hospitals in 9 countries. Among patients presenting with AHF, we determined the causes, treatment, and outcomes during 6 months of follow-up.

Results: From July 1, 2007, to June 30, 2010, we enrolled 1006 patients presenting with AHF. Mean (SD) age was 52.3 (18.3) years, 511 (50.8%) were women, …

Medical Education Digest, Vol. 14 No. 5 (September/October 2012), Nova Southeastern University

Medical Education Digest

No abstract provided.

Oncolog, Volume 57, Number 09, September 2012, Zach Bohannan, Sunita Patterson

OncoLog MD Anderson's Report to Physicians (All issues) Archives

• Stereotactic Body Radiation Therapy Achieves High Control Rates in Lung Cancer: Stereotactic body radiation (SBRT), a relatively new treatment modality, has recently become a very successful treatment-and may even exceeded the effectiveness of surgery-for early-stage lung cancer
• Inflammatory Breast Cancer: Clinical Challenge, Research Enigma- Inflammatory breast cancer (IBC) stands apart from other cancers of the breast in its unusual clinical presentation, its aggressiveness, and its poor prognosis. Researchers and clinicians are working to clarify what distinguishes IBC from other breast cancers and to discover treatments that improve patient outcomes
• HOUSE CALL: Reducing Cancer-Causing Chemicals in Outdoor Cooking: Tips for healthy …

Dermatofibroma: A Curious Tumor., Lawrence Parish, Shideh Yazdanian, W Clark Lambert, Peter C Lambert

Department of Dermatology and Cutaneous Biology Faculty Papers

A tumor, such as a dermatofibroma, causes consternation among many patients, but it rarely creates problems on its own. Also called a histiocytoma, it remains one of the most common mesenchymal growths. Its etiology is unknown with the previous theory that it is a dermal response to injury, such as an insect bite, being challenged. As much as patients like to blame spiders or other arthropods for traumatizing an arm or leg, no definitive explanation is available for its etiology.

Faculty And Patient Evaluations Of Radiology Residents' Communication And Interpersonal Skills, Naila Nadeem, Abdul Mueed Zafar, Muhammad Nadeem Ahmad, Rukhsana Wamiq Zuberi

Department for Educational Development

Objective: To assess communication and interpersonal skills (CIS) of radiology residents through faculty and standardised patients (SP).

Methods: In this day-long objective structured clinical examination (OSCE) in January 2009, 42 radiology residents took part at six stations in Karachi, each with a standardised patient and a faculty evaluator. Each encounter lasted 15 minutes followed by independent assessments of the residents by both the evaluators.

Results: Based on rating-scale evaluations, all cases had satisfactory internal consistency (Cronbach\'s alpha 0.6 to 0.9). The alpha values were comparatively diminutive against the checklist scores. Correlation among faculty was 0.6 (p

Conclusion: Both checklists and …

Tension Pneumothorax On Extracorporeal Membrane Oxygenation Leading To Significant Pneumoperitoneum., Hitoshi Hirose, Nicholas C. Cavarocchi, Kathleen Holoyda

Department of Surgery Faculty Papers

Veno-venous and veno-arterial extracorporeal membrane oxygenation (ECMO) therapy is used to support the cardiac and pulmonary systems in the setting of acute failure. Maintaining adequate ECMO flow is crucial for the success of the therapy. Sudden decrease in venous return on ECMO has multiple etiologies, such as intravascular hypovolemia, malposition or kink of the venous cannula, suction occlusion of a cannula, and venous or arterial thrombi. Pathology within the chest, including pneumothorax, tension hemothorax and pericardial tamponade, may also decrease the ECMO flow because of compression of the cannula and decreased atrial volume. Air from a tension pneumothorax may be …

Migration Of Health Workers: A Challenge For Health Care System, Shaista Afzal, Imrana Masroor, Gulnaz Shafqat

Department of Radiology

The migration of health workers has resulted in a growing apprehension universally because of its impact on health system of the developing countries. Although the choice to migrate is basically a personal one, however, the overall social and economic circumstances have important impact on the decision to migrate. The "push and pull" factors for migration are disparity in working conditions, pay, lack of promotion opportunities, poor living conditions, desire to gain experience, professional development, family background and family wealth. A strategic approach by the government and other agencies is mandatory for regulating the flow of health workers between countries. A …