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The Morbidity & Mortality Of Prevalent Heart Failure, Jennifer Kwon

Loma Linda University Electronic Theses, Dissertations & Projects

The first study population included 292 unselected consecutive patients from the LLUMC heart failure clinic who were enrolled in the study from January to July 2006 and were followed up through the end of December 2010. The treatment policy at the clinic was to uptitrate dosages of beta-adrenergic blockade (β-blockers), angiotensin-converting-enzyme inhibitors (ACEi) and angiotensin II receptor blockers (ARB) to the most tolerable levels in order to reach target dosages, as recommended by the Heart Failure Society of America (HFSA). Patients were classified into systolic heart failure (ejection fraction (EF) < 40%) or diastolic heart failure (EF≥40%). All dosages of β-blockers, ACEi and ARB were extracted through chart reviews and were used as the main predictors of the patients' survival. Results from analyses showed that reaching target dosages of β-blockers and ACEi/ARB may increase survival when compared to not reaching target among the systolic HF population (HR_{β_biockers}= 0.64, 95% CI 0.26-1.56 and HR_ACEi/ARB=0.50, …

Antiseptics And Disinfectants For The Treatment Of Bacterial Vaginosis: A Systematic Review, Hans Verstraelen Verstraelen, Rita Verhelst, Kristien Roelens, Marleen Temmerman

Obstetrics and Gynaecology, East Africa

Background: The study objective was to assess the available data on efficacy and tolerability of antiseptics and disinfectants in treating bacterial vaginosis (BV).

Methods: A systematic search was conducted by consulting PubMed (1966-2010), CINAHL (1982-2010), IPA (1970-2010), and the Cochrane CENTRAL databases. Clinical trials were searched for by the generic names of all antiseptics and disinfectants listed in the Anatomical Therapeutic Chemical (ATC) Classification System under the code D08A. Clinical trials were considered eligible if the efficacy of antiseptics and disinfectants in the treatment of BV was assessed in comparison to placebo or standard antibiotic treatment with metronidazole or clindamycin …

Characterization Of Beryllium As A Novel Agent To Study Cell Cycle Arrest And Cellular Senescence, Priyatham Gorjala

UNLV Theses, Dissertations, Professional Papers, and Capstones

Cancer cells evade senescence, apoptosis, and other constraints on proliferation, often via mutation of the p53 tumor suppressor gene (TP53). Normal human lung fibroblasts have been shown to enter premature senescence upon exposure to beryllium. In these cells, BeSO₄ stabilizes p53 protein, increases p21 gene expression, induces senescence-associated β-galactosidase activity and causes cell proliferation arrest. In the present study, we have investigated whether BeSO₄ is able to induce similar effects in cancer cells that have wildtype p53. We have demonstrated that beryllium salt at low concentration can induce molecular changes in the p53 signaling pathway leading to cell …

Correlation Of Respiratory Symptoms And Spirometric Lung Patterns In A Rural Community Setting, Sindh, Pakistan: A Cross Sectional Survey, Imran Naeem Abbasi, Adeel Ahsan, Asaad Ahmed Nafees

Community Health Sciences

Background: Symptom-based questionnaires can be a cost effective tool enabling identification and diagnosis of patients with respiratory illnesses in resource limited setting. This study aimed to determine the correlation of respiratory symptoms and spirometric lung patterns and validity of ATS respiratory questionnaire in a rural community setting.
Methods: This cross sectional survey was conducted between January - March 2009 on a sample of 200 adults selected from two villages of district Khairpur, Sindh, Pakistan. A modified version of the American thoracic society division of lung disease questionnaire was used to record the presence of respiratory symptoms. Predicted lung volumes i.e. …

Selective Screening Of Type 2 Diabetes For Washoe County’S Hispanic Population, Linda M. Dunn

Nevada Journal of Public Health

Hispanic Americans with unrecognized, asymptomatic diabetes are more likely to experience poor quality of life and diabetic complications such as heart, eye and kidney disease than non-Hispanic whites of similar age. Multiple factors, such as cultural beliefs, lack of knowledge and limited access to health care, contribute to the fact that one-third of total diabetes among Hispanic Americans is undiagnosed. For Washoe County, Nevada, the actual percentage of adult Hispanics with diabetes may be almost 12%. In 2003, the Defeat Diabetes Screening Project provided three screenings targeting the Hispanic population in Reno and Sparks. Seventy-one percent of 348 screened were …

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.

Knowledge Attitude And Practices Among Urban Women Of Karachi, Pakistan, Regarding Breast Cancer, Zain-Ul-Abedeen Sobani, Zeb Saeed, Hafiza Noor-Ul-Ain Baloch, Amina Majeed, Sana Chaudry, Adil Sheikh, Jalal Umar, Hira Waseem, Murtaza Mirza, Irfan Qadir

Department of Surgery Docs

Objective: To determine the knowledge,attitudes and practices of urban women regarding breast cancer and its available screening modalities.Methods: The cross-sectional, questionnaire-based, descriptive study was conducted in the urban population of Karachi in November 2010. Female attendants (n=373) visiting a tertiary care centre and four of its urban outreach centres during the study period were administered a questionnaire. The answers were then scored with regard to their knowledge. Frequencies and percentages were computed through SPSS 17, and analysis of variance was used to confirm significance.Results: Of the 373 participants with a mean age of 32.4+/-10.9 years, 293 (78.6%) were married, and …

Regional Variation In Aortic At1b Receptor Mrna Abundance Is Associated With Contractility But Unrelated To Atherosclerosis And Aortic Aneurysms, Aruna Poduri, A. Phillip Owens, Deborah A. Howatt, Jessica J. Moorleghen, Anju Balakrishnan, Lisa A. Cassis, Alan Daugherty

Pharmacology and Nutritional Sciences Faculty Publications

BACKGROUND: Angiotensin II (AngII), the main bioactive peptide of the renin angiotensin system, exerts most of its biological actions through stimulation of AngII type 1 (AT1) receptors. This receptor is expressed as 2 structurally similar subtypes in rodents, termed AT1a and AT1b. Although AT1a receptors have been studied comprehensively, roles of AT1b receptors in the aorta have not been defined.

METHODOLOGY/RESULTS: We initially compared the regional distribution of AT1b receptor mRNA with AT1a receptor mRNA in the aorta. mRNA abundance of both subtypes increased from the proximal to the distal aorta, with the greatest abundance in the infra-renal region. Corresponding …

Inter-Individual Variation During Transcranial Direct Current Stimulation And Normalization Of Dose Using Mri-Derived Computational Models, Abhishek Datta, Dennis Quangvinh Truong, Preet Minhas, Lucas C. Parra, Marom Bikson

Publications and Research

Background: Transcranial Direct Current Stimulation (tDCS) is a non-invasive, versatile, and safe neuromodulation technology under investigation for the treatment of neuropsychiatric disorders, adjunct to rehabilitation, and cognitive enhancement in healthy adults. Despite promising results, there is variability in responsiveness. One potential source of variability is the intensity of current delivered to the brain which is a function of both the operator controlled tDCS dose (electrode montage and total applied current) and subject specific anatomy. We are interested in both the scale of this variability across anatomical typical adults and methods to normalize inter-individual variation by customizing tDCS dose. Computational FEM …

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: …

Experience Of Caregivers With The Survivors Of Hepatitis C, Noureen Shehzad Jiwani, Raisa B. Gul, Rubina Sultan

School of Nursing & Midwifery

Objectives: To assess and describe the experiences of those caring for hepatitis C patients in Karachi, Pakistan.

Methods: Using a qualitative approach, the study adopted a descriptive exploratory design for which 8 caregirers were selected through snowball sampling technique from different parts of Karachi. Data was collected between May and July 2010 through semi-structured interviews from the caregivers. The interviews were recorded on tape and were transcribed verbatim. The data was manually analysed for extracting themes and categories.

Results: The analyses of data led to one theme - \'deadly, dangerous, and devastating. Two associated categories could also be noted: \'perceptions …

Oncolog, Volume 57, Number 10, October 2012, Jill Delsigne, Sunni Hosemann

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

• Treatments May Alleviate and Reverse Central Nervous System Radiation Necrosis: Although radiation therapy is effective against many tumors of the brain and spine, it also damages normal tissue
• INBRIEF: Bevacizumab With High-Dose Chemotherapy Shows Promise for Cisplatin-Refractory Germ Cell Tumors
• Compass: Early-Stage Testicular Cancer-Postsurgical treatment varies according to tumor stage and histology
• HOUSE CALL: Online Cancer Support Networks-Patients and caregivers find support online

Accuracy Of Self-Reported Sun Exposure And Sun Protection Behavior, Joel J. Hillhouse, Robert Turrisi, James Jaccard, June K. Robinson

ETSU Faculty Works

The objective of this study was to compare the accuracy of self-reported skin cancer risk outcome measures proposed as standards by prevention experts to aggregated estimates of behavior from weekly diaries. Weekly electronic diaries of ultraviolet radiation (UVR) behaviors, initially validated by comparison with daily electronic diaries, were used to assess the accuracy of commonly used end-of-summer self-reported measures among 250 adults. Results revealed low biases, and good correspondence between simple open-ended self-reported estimates of days outside, hours outside, sunbathing days and hours, and days outside when not protected by either sunscreen, long-sleeved shirts, hats, or shade. Rating scale measures …

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, …

Situation Analysis Of Child Labour In Karachi, Pakistan: A Qualitative Study, Asaad Ahmed Nafees, Kausar S. Khan, Zafar Fatmi, Mubashir Aslam

Community Health Sciences

In Karachi, large employment opportunities, burgeoning population and the availability of cheap labour might be the contributing factors for the increasing prevalence of child labour. A literature review was conducted in 2007 that included published and unpublished literature since 2000. Various organizations working in the field were also covered, while the perception of the child labourers was covered through three focus group discussions. Common health issues among the child labourers in Karachi included respiratory illnesses, fever and generalised pains, as well as drug and sexual abuse. Organisations working for child labour could be broadly categorised into those working for legal …

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

Department of Neurology Faculty Papers

No abstract provided.

Feasibility Of Implementing Pulse Oximetry Screening For Congenital Heart Disease In A Community Hospital., Elizabeth A. Bradshaw, Sandra Cuzzi, S. C. Kiernan, N. Nagel, Jeffrey A. Becker, Gerard R. Martin

Pediatrics Faculty Publications

Objective:

Pulse oximetry has been recognized as a promising screening tool for critical congenital heart disease (CCHD). The aim of this research was to study the feasibility of implementation in a community hospital setting.

Study Design:

Meetings were conducted to determine an implementation plan. Pulse oximetry was performed on the right hand and foot after 24h of age. Newborns with a saturation 95% or a 3% difference were considered to have a positive screen. Screening barriers, screening time and ability to effectively screen all eligible newborns were noted.

Result:

From January 2009 through May 2010, of 6841 eligible newborns, 6745 …

Urinary Stone Disease: Great Progress With Promise For The Future., Demetrius H. Bagley

Department of Urology Faculty Papers

Urinary calculus disease has been a scourge on mankind since ancient times. Research in the field has been hampered by lack of funds and the lack of cachet with the public such as seen with cancer or heart disease. In recent years there have been marked changes led by urologists in the diagnosis, treatment and long-term management of calculi.

Ureteroscopic Treatment Of Larger Renal Calculi (>2 Cm)., Demetrius H. Bagley, Kelly A. Healy, Nir Kleinmann

Department of Urology Faculty Papers

OBJECTIVES: To evaluate the current status of ureteroscopic lithotripsy (UL) for treating renal calculi of >2 cm, as advances in flexible ureteroscope design, accessory instrumentation and lithotrites have revolutionised the treatment of urinary calculi. While previously reserved for ureteric and small renal calculi, UL has gained an increasing role in the selective management of larger renal stone burdens.

METHODS: We searched the available databases, including PubMed, Google Scholar, and Scopus, for relevant reports in English, and the article bibliographies to identify additional relevant articles. Keywords included ureteroscopy, lithotripsy, renal calculi, and calculi >2 cm. Retrieved articles were reviewed to consider …

Non Fatal Injuries Among Infants: A Pilot Study, Seema Zainulabdin Lasi, Ghazala Rafique, Habib Peermohammad

Human Development Programme

Objective: To determine the incidence, nature and the extent of infant injuries in two suburban and rural communities of Pakistan.
Methods: The cross-sectional study was conducted on a cohort of 310 infants in suburban and rural communities of Pakistan in September 2007. The information was collected from primary care-givers based on any injury that had occurred to their infants during the preceding 3 months that required treatment at home or in a hospital.
Result: The incidence of non-fatal injury for infants up to 1-year-old was found to be 19 injuries per 100 person (child) years of exposure (95% CI 9.90 …

Herpes Simplex Virus 34.5 Interferes With Autophagosome Maturation And Antigen Presentation In Dendritic Cells, Philipe A. M. Gobeil, David A. Leib

Dartmouth Scholarship

The cellular autophagy response induced by herpes simplex virus 1 (HSV-1) is countered by the viral γ34.5 protein. γ34.5 modulates autophagy by binding to the host autophagy protein Beclin-1 and through this binding inhibits the formation of autophagosomes in fibroblasts and neurons. In contrast, in this study dendritic cells (DCs) infected with HSV-1 showed an accumulation of autophagosomes and of the long-lived protein p62. No such accumulations were observed in DCs infected with a γ34.5-null virus or a virus lacking the Beclin-binding domain (BBD) of γ34.5. To explore this further, we established stably transduced DC lines to show that γ34.5 …

Psychometrics Of The Scale Of Attitudes Toward Physician-Pharmacist Collaboration: A Study With Medical Students., Mohammadreza Hojat, John Spandorfer, Gerald A. Isenberg, Michael J. Vergare, Reza Fassihi, Joseph S. Gonnella

Department of Psychiatry and Human Behavior Faculty Papers

BACKGROUND: Despite the emphasis placed on interdisciplinary education and interprofessional collaboration between physicians and pharmacologists, no psychometrically sound instrument is available to measure attitudes toward collaborative relationships.

AIM: This study was designed to examine psychometrics of an instrument for measuring attitudes toward physician-pharmacist collaborative relationships for administration to students in medical and pharmacy schools and to physicians and pharmacists.

METHODS: The Scale of Attitudes Toward Physician-Pharmacist Collaboration was completed by 210 students at Jefferson Medical College. Factor analysis and correlational methods were used to examine psychometrics of the instrument.

RESULTS: Consistent with the conceptual framework of interprofessional collaboration, three underlying …

Carrs Surveillance Study: Design And Methods To Assess Burdens From Multiple Perspectives, Manisha Nair, Mohammed K. Ali, Vamadevan S. Ajay, Roopa Shivashankar, Viswanathan Mohan, Rajendra Pradeepa, Hassan Mehmood Khan, Muhammad Masood Kadir, Zafar Fatmi, K Srinath Reddy, Nikhil Tandon, Km Venkat Narayan, Dorairaj Prabhakaran

Community Health Sciences

Background: Cardio-metabolic diseases (CMDs) are a growing public health problem, but data on incidence, trends, and costs in developing countries is scarce. Comprehensive and standardised surveillance for non-communicable diseases was recommended at the United Nations High-level meeting in 2011.
Aims: To develop a model surveillance system for CMDs and risk factors that could be adopted for continued assessment of burdens from multiple perspectives in South-Asian countries.
Design: Hybrid model with two cross-sectional serial surveys three years apart to monitor trend, with a three-year prospective follow-up of the first cohort.Sites: Three urban settings (Chennai and New Delhi in India; Karachi in …

Reflective Journals Of Students Taking A Positive Youth-Development Course In A University Context In Hong Kong, Daniel T. L. Shek, Florence K. Y. Wu

Pediatrics Faculty Publications

To promote the holistic development of university students, a course entitled "Tomorrow's Leaders" was developed and offered at The Hong Kong Polytechnic University. Based on a case study approach, reflective journals of five outstanding students of the course are presented and analyzed (i.e., thick description), with several themes emerging from the reflection. First, the students liked the course, and they identified many positive attributes. Second, the students appreciated the instructors. Third, the students viewed that the course contributed to different aspects of their development. Fourth, some areas of improvements were proposed. In conjunction with other evaluation mechanisms, the present findings …

Coronary Heart Disease In Primary Care: Accuracy Of Medical History And Physical Findings In Patients With Chest Pain – A Study Protocol For A Systematic Review With Individual Patient Data, Jörg Haasenritter, Marc Aerts, Stefan Bösner, Frank Buntinx, Bernard Burnand, Lilli Herzig, J André Knottnerus, Girma Minalu, Staffan Nilsson, Walter Renier, Carol Sox, Carol Sox, Harold Sox, Norbert Donner-Banzhoff

Dartmouth Scholarship

Chest pain is a common complaint in primary care, with coronary heart disease (CHD) being the most concerning of many potential causes. Systematic reviews on the sensitivity and specificity of symptoms and signs summarize the evidence about which of them are most useful in making a diagnosis. Previous meta-analyses are dominated by studies of patients referred to specialists. Moreover, as the analysis is typically based on study-level data, the statistical analyses in these reviews are limited while meta-analyses based on individual patient data can provide additional information. Our patient-level meta-analysis has three unique aims. First, we strive to determine the …

Parent-Clinician Communication Intervention During End-Of-Life Decision Making For Children With Incurable Cancer., Pamela S. Hinds, Linda L. Oakes, Judy Hicks, Brent Powell, Deo K. Srivastava, Justin N. Baker, Sheri L. Spunt, Nancy K. West, Wayne L. Furman

Pediatrics Faculty Publications

Background: In this single-site study, we evaluated the feasibility of a parent-clinician communication intervention designed to: identify parents' rationale for the phase I, do-not-resuscitate (DNR), or terminal care decision made on behalf of their child with incurable cancer; identify their definition of being a good parent to their ill child; and provide this information to the child's clinicians in time to be of use in the family's care.

Methods: Sixty-two parents of 58 children and 126 clinicians participated. Within 72 hours after the treatment decision, parents responded to 6 open-ended interview questions and completed a 10-item questionnaire about the end-of-life …

Oncolog, Volume 57, Number 08, August 2012, Amelia Scholtz, Dawn Chalaire

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

• Preoperative Chemotherapy Offers Best Outcomes for Patients with Rare Bladder Cancer: A combination of neoadjuvant chemotherapy and surgery provides patients who have small-cell urothelial cancer (SCUC) with much longer survival times than does initial surgery, the previous standard treatment
• Addressing Psychological Concerns for Cancer Patients: Despite advances in cancer treatment over the past several years, for many people, a diagnosis of cancer can still feel like a death sentence. The added stress leads to psychological problems for many patterns
• INBRIEF: New Antibody Treatment Produces Responses in Patient with Advanced Cancer/Accelerated Partial-Breast Brachytherapy Associated with Decreased Long-Term Breast Preservation and Increased …