Digital Commons Network^™

Circulating Tumor Dna To Monitor Metastatic Breast Cancer., Massimo Cristofanilli, Paolo Fortina

Kimmel Cancer Center Faculty Papers

No abstract provided.

Horner's Syndrome Secondary To Neuroblastoma, Roberto A. Cruz, T. K. Tran, Nicky R. Holdeman, Christian Cajavilca, Rosa A. Tang

School of Medicine Publications

Horner’s syndrome is classically characterized by a triad of miosis, partial ptosis and anhidrosis. The etiology is due to an interruption in the sympathetic innervation to the eye. A prompt diagnosis is crucial, given that Horner’s syndrome could be a manifestation of a life-threatening condition. A thorough case history and clinical evaluation must be employed to arrive at the diagnosis. An important means for confirming Horner’s syndrome is pharmacological testing, which is also used to localize the level where the sympathetic chain is compromised. Following the diagnosis and localization of the lesion, an algorithm should be followed to determine the …

Trauma And Posttraumatic Stress Disorder In South Africa: Analysis From The South African Stress And Health Study, Lukoye Atwoli, Dan J. Stein, David R. Williams, Katie A. Mclaughlin, Maria Petukhova, Ronald C. Kessler, Karestan C. Koenen

Internal Medicine, East Africa

Background: South Africa’s unique history, characterised by apartheid, a form of constitutional racial segregation and exploitation, and a long period of political violence and state-sponsored oppression ending only in 1994, suggests a high level of trauma exposure in the general population. The aim of this study was to document the epidemiology of trauma and posttraumatic stress disorder (PTSD) in the South African general population.

Methods: The South African Stress and Health Study is a nationally representative survey of South African adults using the WHO’s Composite International Diagnostic Interview (CIDI) to assess exposure to trauma and presence of DSM-IV mental …

Com Outlook Summer 2013, College Of Osteopathic Medicine

COM Outlook

No abstract provided.

Medical Education Digest, Vol. 15 No. 4 (July/August 2013), Nova Southeastern University

Medical Education Digest

No abstract provided.

Racial Disparities In The Use Of Cardiac Revascularization: Does Local Hospital Capacity Matter?, Suhui Li, Arnold Chen, Katherine H. Mead

Health Policy and Management Faculty Publications

Objective: To assess the extent to which the observed racial disparities in cardiac revascularization use can be explained by the variation across counties where patients live, and how the within-county racial disparities is associated with the local hospital capacity.

Data Sources: Administrative data from Pennsylvania Health Care Cost Containment Council (PHC4) between 1995 and 2006.

Study Design: The study sample included 207,570 Medicare patients admitted to hospital for acute myocardial infarction (AMI). We identified the use of coronary artery bypass graft (CABG) and percutaneous coronary intervention (PCI) procedures within three months after the patient’s initial admission for AMI. Multi-level hierarchical …

Effect Of A Voice Recognition System On Paediatric Outpatient Medication Errors, Angela Nyangore Migowa

Master of Medicine in Paediatrics and Child Health

Background: Medication errors have potential to cause harm and death; especially children who are three times more vulnerable than adults. Risk of medication errors is higher in out- patient settings due to a stressful work environment with less familiarity of individual patients. This problem in sub-Saharan Africa is however largely undetermined. A Voice Recognition System that converts verbal messages into text and stores it in a database in a retrievable format could impact on reduction of medication errors. Objectives: The primary objective was to compare medication prescription and dispensing errors in written prescriptions with those from a Voice Recognition System. …

Frequency And Predisposing Factors Of Pharyngocutaneous Fistula After Total Laryngectomy, Asif Ali Arain, Mubasher Ikram, Shabbir Akhtar, Muhammad Shaheryar Ahmed Rajput, Mohammad Adeel, Moaz Maqbool Choudhary

Section of Otolaryngology, Head & Neck Surgery

Objective

The objective of our study was to determine the frequency and predisposing factors of pharyngocutaneous fistula in postlaryngectomy patients.

Materials and methods

Charts of those patients who were treated with total laryngectomy for laryngeal carcinoma in our department from 2000 to 2008 were reviewed. Total 77 patients were included in the study. The variables studied for the development of pharyngocutaneous fistula (PCF) after total laryngectomy were: age and gender, diabetes mellitus, post-operative hemoglobin, ischemic heart disease, chronic obstructive pulmonary disease, tumor characteristics including tumor site, stage, differentiation and extension into pyriform sinus, pre-operative radiotherapy, pre-operative chemotherapy, pre-operative tracheostomy and …

Digest Of The Philadelphia College Of Osteopathic Medicine (Summer 2013), Philadelphia College Of Osteopathic Medicine

Digest

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

• Message from the President
• PCOM Updates
• Commencement 2013
• Development News
• Back in the (Founders') Day: Faculty Pioneers, 1899 to World War I
• Teach Me So I May Remember—Alumni: On Faculty Mentors and Awakeners
• My Father’s Precious Legacy: A Reflection On the Influence of Nicholas S. Nicholas, DO, upon His Sons, his Family, Philadelphia College of Osteopathic Medicine and the Osteopathic Profession
• Love and Change: A Health Crisis Compels a Longtime Physician to Reevaluate his Approach to Teaching and Practicing Preventative Patient Care
• Philosophical …

The Identification And Classification Of Flow Disruptions In The Operating Room During Laparoscopic Cholecystectomy And Open Hernia Repair Procedures, Sacha N. Duff

Doctoral Dissertations and Master's Theses

The operating room is one of the most complex work environments in healthcare; it is estimated that at least 7% of adverse events due to medical error occur in the operating room. Flow disruptions are events that cause a "break" in the primary surgical task, or the loss of any team member's situational awareness. An empirical link between flow disruptions and surgical errors in the OR has been established; therefore, identifying and classifying the specific flow disruptions present during different types of procedures should facilitate the development of evidence-based interventions. The goal of this study was to identify and classify …

Needle Stick Injuries--Risk And Preventive Factors: A Study Among Health Care Workers In Tertiary Care Hospitals In Pakistan., Asad Ali Khan Afridi, Ameet Kumar, Raza Sayani

Community Health Sciences

BACKGROUND:

Health care workers (HCWs) are at substantial risk of acquiring blood borne infections such as HIV, Hepatitis-B and Hepatitis-C through needle stick injuries (NSIs). This study aimed to assess the proportion of NSIs and their associated factors among HCWs and also to identify the areas in which preventive efforts might be directed to protect against this occupational hazard.

METHODOLOGY:

A cross-sectional study was conducted in two tertiary care hospitals of Pakistan representing both private and public health sector. A total of 497 HCWs (doctors and nurses) were interviewed using a structured questionnaire. Data was collected from January to May …

Hip Fracture Surgery: Does Type Of Anesthesia Matter?, Rizwan Haroon Rashid, Adil Aijaz Shah, Amarah Shakoor, Shahryar Noordin

Department of Surgery Docs

Background: Hip fracture surgery is a common procedure, and the geriatric population with its multiple comorbid conditions is at most at risk of developing anesthesia-related complications. Data on the impact of type anesthesia on postoperative morbidity and mortality is limited.The effects of regional and general anesthesia on postoperative outcomes need to be clearly elucidated.

Methods: In this study, all patients who underwent dynamic hip screw (DHS) fixation for intertrochanteric fractures, between January 2005 and December 2010, at the Aga Khan University Hospital, were included. Patients were divided into two groups; group A included those patients who received general anesthesia, and …

Cardiovascular Health: Associations With Race-Ethnicity, Nativity, And Education In A Diverse, Population-Based Sample Of Californians, Georgiana Bostean, Christian K. Roberts, Catherine M. Crespi, Michael Prelip, Anne Peters, Thomas R. Belin, William J. Mccarthy

Sociology Faculty Articles and Research

Purpose—This study examined how race-ethnicity, nativity, and education interact to influence disparities in cardiovascular (CV) health, a new concept defined by the American Heart Association (AHA). We assessed whether race-ethnicity and nativity disparities in CV health vary by education, and whether the foreign-born differ in CV health from their US-born race-ethnic counterparts with comparable education.

Methods—We used data from the 2009 California Health Interview Survey to determine the prevalence of optimal CV health metrics (based on selected AHA guidelines) among adults ages 25 and over (n = 42,014). We examined the interaction between education and ethnicity-nativity, comparing predicted …

Human Milk Cortisol Is Associated With Infant Temperament, Katherine R. Grey, Elyssia Poggi Davis, Curt A. Sandman, Laura M. Glynn

Psychology Faculty Articles and Research

The implications of the biologically active elements in milk for the mammalian infant are largely unknown. Animal models demonstrate that transmission of glucocorticoids through milk influences behavior and modifies brain development in offspring. The aim of this study was to determine the relation between human milk cortisol levels and temperament of the breastfed infant. Fifty-two mother and infant pairs participated when the infants were three-months old. Milk cortisol levels were assessed and each mother completed the Infant Behavior Questionnaire (IBQ), a widely used parent-report measure of infant temperament. Analyses revealed a positive association between milk cortisol and the negative affectivity …

Astrocyte-Specific Overexpression Of Insulin-Like Growth Factor-1 Protects Hippocampal Neurons And Reduces Behavioral Deficits Following Traumatic Brain Injury In Mice, Sindhu K. Madathil, Shaun W. Carlson, Jennifer M. Brelsfoard, Ping Ye, A Joseph D'Ercole, Kathryn E. Saatman

Spinal Cord and Brain Injury Research Center Faculty Publications

Traumatic brain injury (TBI) survivors often suffer from long-lasting cognitive impairment that stems from hippocampal injury. Systemic administration of insulin-like growth factor-1 (IGF-1), a polypeptide growth factor known to play vital roles in neuronal survival, has been shown to attenuate posttraumatic cognitive and motor dysfunction. However, its neuroprotective effects in TBI have not been examined. To this end, moderate or severe contusion brain injury was induced in mice with conditional (postnatal) overexpression of IGF-1 using the controlled cortical impact (CCI) injury model. CCI brain injury produces robust reactive astrocytosis in regions of neuronal damage such as the hippocampus. We exploited …

Development Of Novel In Vivo Chemical Probes To Address Cns Protein Kinase Involvement In Synaptic Dysfunction, D Martin Watterson, Valerie L. Grum-Tokars, Saktimayee M. Roy, James P. Schavocky, Brinda Desai Bradaric, Adam D. Bachstetter, Bin Xing, Edgardo Dimayuga, Faisal Saeed, Hong Zhang, Agnieszka Staniszewski, Jeffrey C. Pelletier, George Minasov, Wayne F. Anderson, Ottavio Arancio, Linda J. Van Eldik

Sanders-Brown Center on Aging Faculty Publications

Serine-threonine protein kinases are critical to CNS function, yet there is a dearth of highly selective, CNS-active kinase inhibitors for in vivo investigations. Further, prevailing assumptions raise concerns about whether single kinase inhibitors can show in vivo efficacy for CNS pathologies, and debates over viable approaches to the development of safe and efficacious kinase inhibitors are unsettled. It is critical, therefore, that these scientific challenges be addressed in order to test hypotheses about protein kinases in neuropathology progression and the potential for in vivo modulation of their catalytic activity. Identification of molecular targets whose in vivo modulation can attenuate synaptic …

Smartphone Apps For Disasters: Workshop Lesson Plan, Paul Levett

Himmelfarb Library Faculty Posters and Presentations

This instruction was designed to be delivered to a Disaster Medical Assistance Team (DMAT) or a Community Emergency Response Team (CERT).

Instructional Goal #1: Using a personal smartphone connected to the internet, learners will download medical information apps, before deployment to a disaster environment.

Instructional Goal #2: Recalling real and simulated patient care situations that required additional medical information, learners will identify and search smartphone apps for relevant, current, authoritative, medical information that could be applied to the care of individual patients in disasters.

To Bear Witness: A Journey Of Healing And Solidarity, Updated, Revised, And Expanded Edition, Kevin M. Cahill, M.D.

International Affairs

For more than fifty years, Dr. Cahill has been helping to heal the world, as a leading specialist in tropical medicine and as a driving force in humanitarian assistance and relief efforts around the globe. In this revised and expanded edition, he chronicles extraordinary achievements of compassion and commitment. Bringing together a rich selection of writings, he crafts a fascinating memoir of a life devoted to others. The book includes front-line reports from places under siege—Lebanon, Somalia, Sudan, Nicaragua, Gaza, and Ireland; there are also visionary essays from the origins of the AIDS epidemic and landmine crises, and no less …

Methods For Quantifying T Cell Receptor Binding Affinities And Thermodynamics, Kurt H. Piepenbrink, Brian E. Gloor, Kathryn M. Armstrong, Brian M. Baker

Food for Health: Publications

αβ T cell receptors (TCRs) recognize peptide antigens bound and presented by class I or class II major histocompatibility complex (MHC) proteins. Recognition of a peptide/MHC complex is required for initiation and propagation of a cellular immune response, as well as the development and maintenance of the T cell repertoire. Here we discuss methods to quantify the affinities and thermodynamics of interactions between soluble ectodomains of TCRs and their peptide/MHC ligands, focusing on titration calorimetry, surface plasmon resonance, and fluorescence anisotropy. As TCRs typically bind ligand with weak-to-moderate affinities, we focus the discussion on means to enhance the accuracy and …

Post-Prandial Upright Exercise Echocardiography In Hypertrophic Cardiomyopathy, Ellina C. Feiner Md, Milla Arabadjian Fnp, Glenda Winson Rn, Bette Kim Md, Farooq Chaudhry Md, Mark V. Sherrid Md

Department of Medicine

No abstract provided.

Caloric Restriction Augments Radiation Efficacy In Breast Cancer., Anthony D Saleh, Brittany A Simone, Juan Palazzo, Jason E Savage, Yuri Sano, Tu Dan, Lianjin Jin, Colin E Champ, Shuping Zhao, Meng Lim, Frederica Sotgia, Kevin Camphausen, Richard G Pestell, James B Mitchell, Michael P Lisanti, Nicole L Simone

Kimmel Cancer Center Faculty Papers

Dietary modification such as caloric restriction (CR) has been shown to decrease tumor initiation and progression. We sought to determine if nutrient restriction could be used as a novel therapeutic intervention to enhance cytotoxic therapies such as radiation (IR) and alter the molecular profile of triple-negative breast cancer (TNBC), which displays a poor prognosis. In two murine models of TNBC, significant tumor regression is noted with IR or diet modification, and a greater regression is observed combining diet modification with IR. Two methods of diet modification were compared, and it was found that a daily 30% reduction in total calories …

A Preliminary Report Of Percutaneous Craniofacial Osteoplasty In A Rat Calvarium, William J. Parkes, Md, Jewel Greywoode, Md, Brian J. O'Hara, Md, Ryan N. Heffelfinger, Md, Howard Krein, Md, Phd

Department of Otolaryngology - Head and Neck Surgery Presentations and Grand Rounds

Objective: To evaluate the potential for injectable, permanent bone augmentation by assessing the biocompatibility and bioactivity of subperiosteal hydroxylapatite (Radiesse) deposition in a rat model.

Methods: Fourteen adult Sprague Dawley rats were injected in the parietal skull with hydroxylapatite (n=10) or a carrier gel control (n=4), using a subperiosteal injection technique on the right and a subcutaneous injection technique on the left. At 1, 3, and 6 months, 3 rats (1 negative control, 2 variables) were sacrificed. At 12 months, the remaining 5 rats were sacrificed. After each harvest, the calvaria were examined under both light and polarized microscopy.

Results: …

Dynamic Functions Of Rhoa In Tumor Cell Migration And Invasion, Kathleen L. O'Connor, Min Chen

Markey Cancer Center Faculty Publications

RhoA is one of the more extensively studied members of the Rho family of small GTPase where it is most readily recognized for its contributions to actin-myosin contractility and stress fiber formation. Accordingly, RhoA function during cell migration has been relegated to the rear of the cell where it mediates retraction of the trailing edge. However, RhoA can also mediate membrane ruffling, lamellae formation and membrane blebbing, thus suggesting an active role in membrane protrusions at the leading edge. With the advent of fluorescence resonance energy transfer (FRET)-based Rho activity reporters, RhoA has been shown to be active at the …

Relationship Between Serum And Brain Carotenoids, Α-Tocopherol, And Retinol Concentrations And Cognitive Performance In The Oldest Old From The Georgia Centenarian Study, Elizabeth J. Johnson, Rohini Vishwanathan, Mary Ann Johnson, Dorothy B. Hausman, Adam Davey, Tammy M. Scott, Robert C. Green, L. Stephen Miller, Marla Gearing, John Woodard, Peter T. Nelson, Hae-Yun Chung, Wolfgang Schalch, Jonas Wittwer, Leonard W. Poon

Sanders-Brown Center on Aging Faculty Publications

Oxidative stress is involved in age-related cognitive decline. The dietary antioxidants, carotenoids, tocopherols, and vitamin A may play a role in the prevention or delay in cognitive decline. In this study, sera were obtained from 78 octogenarians and 220 centenarians from the Georgia Centenarian Study. Brain tissues were obtained from 47 centenarian decedents. Samples were analyzed for carotenoids, α-tocopherol, and retinol using HPLC. Analyte concentrations were compared with cognitive tests designed to evaluate global cognition, dementia, depression and cognitive domains (memory, processing speed, attention, and executive functioning). Serum lutein, zeaxanthin, and β-carotene concentrations were most consistently related to better cognition …

Ectopic Cushing's Syndrome From Acth-Producing Pheochromocytoma, Susan Gerber, Md, Lawrence C. Kenyon, Md, Phd, Mary Kate Mccullen, Serge Jabbour, Md, Facp, Face

Department of Medicine Faculty Papers

ACTH-dependent Cushing’s syndrome results from excessive ACTH secretion from a pituitary gland adenoma (Cushing’s disease) in 80% of cases. Much less commonly, ectopic ACTH production occurs outside the pituitary gland, with the majority of those cases caused by bronchial carcinoids. A small number are due to excessive ACTH secretion by a pheochromocytoma.

Breast Cancer Antiestrogen Resistance 3 (Bcar3) Promotes Cell Motility By Regulating Actin Cytoskeletal And Adhesion Remodeling In Invasive Breast Cancer Cells., Ashley L Wilson, Randy S Schrecengost, Michael S Guerrero, Keena S Thomas, Amy H Bouton

Department of Cancer Biology Faculty Papers

Metastatic breast cancer is incurable. In order to improve patient survival, it is critical to develop a better understanding of the molecular mechanisms that regulate metastasis and the underlying process of cell motility. Here, we focus on the role of the adaptor molecule Breast Cancer Antiestrogen Resistance 3 (BCAR3) in cellular processes that contribute to cell motility, including protrusion, adhesion remodeling, and contractility. Previous work from our group showed that elevated BCAR3 protein levels enhance cell migration, while depletion of BCAR3 reduces the migratory and invasive capacities of breast cancer cells. In the current study, we show that BCAR3 is …

A Comparison Of Who Guidelines Issued In 1997 And 2009 For Dengue Fever - Single Centre Experience., Munawar Khursheed, Uzma R. Khan, Kiran Ejaz, Jabeen Fayyaz, Irum Qamar, J. Razzak

Department of Emergency Medicine

Objective: To compare the original (1997) and revised (2009) versions of World Health Organization guidelines for dengue patients
Methods: Adult patients with a positive dengue Immunoglobulin M serology, and a diagnosis of dengue were included in the study at Aga Khan University Hospital during a three-year period from January 2005 to December 2007. Data related to these dengue patients was collected from their medical records. Guidelines were then applied by the research assistant and correlation among these guidelines was computed. SPSS 19 was used for statistical analysis.
Results: A total of 612 patients were found with a diagnosis of dengue, …

An Examination Of Executive Function, Mild Cognitive Impairment And Fall Risk In Community Dwelling Older Adults, Jennifer A. Blackwood

Dissertations

The aim of this three-paper dissertation was to examine the relationship between fall risk, executive function (EF) and mild cognitive impairment (MCI) in community dwelling older adults. Papers one and two describe how mild changes in cognition influence performance on four measures of fall risk, the Five Times Sit to Stand Test (FTSTS), usual gait speed, the Timed Up and Go (TUG) test, and the Activities Specific Balance Confidence Scale (ABC) in a group of community dwelling older adults. The third paper describes if participation in a progressively challenging domain specific computerized cognitive training intervention influenced performance on measures of …

Increased Expression Of Pigment Epithelium-Derived Factor In Aged Mesenchymal Stem Cells Impairs Their Therapeutic Efficacy For Attenuating Myocardial Infarction Injury., Hongliang Liang, Huiyuan Hou, Wei Yi, Guodong Yang, Chunhu Gu, Wayne Bond Lau, Erhe Gao, Xinliang Ma, Zifan Lu, Xufeng Wei, Jianming Pei, Dinghua Yi

Department of Emergency Medicine Faculty Papers

AIMS: Mesenchymal stem cells (MSCs) can ameliorate myocardial infarction (MI) injury. However, older-donor MSCs seem less efficacious than those from younger donors, and the contributing underlying mechanisms remain unknown. Here, we determine how age-related expression of pigment epithelium-derived factor (PEDF) affects MSC therapeutic efficacy for MI.

METHODS AND RESULTS: Reverse transcriptase-polymerized chain reaction and enzyme-linked immunosorbent assay analyses revealed dramatically increased PEDF expression in MSCs from old mice compared to young mice. Morphological and functional experiments demonstrated significantly impaired old MSC therapeutic efficacy compared with young MSCs in treatment of mice subjected to MI. Immunofluorescent staining demonstrated that administration of …

Visual Outcome Of Cataract Surgery, Farzeen Khalid Hashmi, Qazi Assad Khan, Tanveer Anjum Chaudhry, Khabir Ahmad

Department of Surgery Docs

The aim of this study was to assess whether the visual outcome of cataract surgery in the institution was in accordance with the World Health Organization recommendations. In this retrospective case series, all patients who underwent cataract surgery by a single surgeon from January 2009 till June 2011 were included. Date were collected from medical records on age, gender, visual acuity and causes of sub-optimal outcome. The main outcome was best-corrected visual acuity in the operated eye, measured 4 – 6 weeks after surgery. Data on visual outcome was grouped using WHO's classification. Of the 495 eyes that underwent cataract …