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Frequency And Associated Factors For Anxiety And Depression In Pregnant Women: A Hospital-Based Cross-Sectional Study., Niloufer Sultan Ali, Iqbal Azam Syed, Badar S. Ali, Ghurnata Tabbusum, Sana S. Moin

Department of Family Medicine

Antepartum anxiety and/or depression is a major public health problem globally. The aim of this study was to estimate the frequency of antepartum anxiety and/or depression among pregnant women. This was a cross-sectional study conducted in a tertiary care hospital among pregnant women. A total of 165 pregnant women were interviewed by a clinical psychologist using HADS for assessing anxiety and/or depression and also collected information regarding sociodemographic, obstetric, family relationships, and home environment. Out of the total of 165 pregnant women about 70 percent of them were either anxious and/or depressed. The increasing age of women (P-value = 0.073), …

A Mathematical Model For Dengue Fever In A Virgin Environment, Jason K. Bowman

Senior Honors Projects

Dengue is a mosquito-borne viral infection found in tropical and subtropical regions around the world. The disease was named in 1779 and the first recorded epidemic of it occurred simultaneously on three continents within the following decade. Dengue is characterized by flu-like symptoms and, while its symptoms are generally reported as quite unpleasant, is rarely fatal. However, in some cases patients can contract a more serious form of the disease, known as Dengue Hemorrhagic Fever, which is far more dangerous. The World Health Organization estimates that today over 2.5 billion people are at risk for Dengue (over 40% of the …

High Clarithromycin Resistance And A Low Rate Of Recurrence And Reinfection Of Helicobacter Pylori Infection In Pakistan, Shahab Abid, Javed Yakoob, Wasim Jafri, Z Abbas, Khalid Mumtaz, Saeed Hamid, Rashida Ahmed

Section of Gastroenterology

No abstract provided.

Oncolog, Volume 57, Number 05, May 2012, Bryan Tutt, Sunni Hosemann

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

• Advances in Gene Mapping Technology May Accelerate Cancer Drug Development: As new technology makes DNA sequencing faster and less expensive, researchers aim to exploit these abilities to develop novel targeted cancer therapies
• Compass: Advanced Renal Cell Carcinoma: Surgery and/or systemic therapy can help manage disease
• HOUSE CALL: Do Nutritional Supplements Help Prevent Cancer ?: For many people, the risks may outweigh the benefits
• INBRIEF: Drug Provides Symptom Reduction and Survival Advantages for Myelofibrosis Patients

Effects Of Hyperthermia On Photochemical Internalization-Mediated Delivery Of Bleomycin, Christina Schlazer

UNLV Theses, Dissertations, Professional Papers, and Capstones

Standard treatment protocols for high-grade gliomas, such as glioblastoma multiforme (GBM), are highly ineffective due to their inability to eradicate infiltrating tumor cells. Improvements in overall survival are likely to be realized only with the development of more effective localized therapies capable of eradicating tumor cells in the surgical resection margin and beyond. Photochemical internalization (PCI) is a localized light-based therapeutic modality that enhances the efficacy of therapeutic macromolecules including chemotherapeutic agents such as bleomycin. A number of studies have shown that this photodynamic therapy (PDT) - based modality may prove effective in the treatment of high-grade gliomas.

Three-dimensional multicell …

Knowledge, Attitudes, And Utilization Of Brca Testing Among Obstetricians And Gynecologists, Salma Nassef

Dissertations and Theses (Open Access)

Hereditary breast and ovarian cancer (HBOC) is an inherited cancer syndrome that is associated with mutations in the BRCA1 and BRCA2 genes. Carriers of BRCA mutations, both men and women, are at an increased risk for developing certain cancers. Carriers are most notably at an increased risk to develop breast and ovarian cancers; however an increased risk for prostate cancer, melanoma, and pancreatic cancers has also been associated with these mutations. In 2009 the American Congress of Obstetricians and Gynecologists (ACOG) released a practice bulletin stating that evaluating a patient’s risk for HBOC should be a routine part of obstetric …

Progesterone And Preterm Birth Prevention: Translating Clinical Trials Data Into Clinical Practice, Vincenzo Berghella

Department of Obstetrics and Gynecology Faculty Papers

OBJECTIVE:

We sought to provide evidence-based guidelines for using progestogens for the prevention of preterm birth (PTB).

METHODS:

Relevant documents, in particular randomized trials, were identified using PubMed (US National Library of Medicine, 1983 through February 2012) publications, written in English, which evaluate the effectiveness of progestogens for prevention of PTB. Progestogens evaluated were, in particular, vaginal progesterone and 17-alpha-hydroxy-progesterone caproate. Additionally, the Cochrane Library, organizational guidelines, and studies identified through review of the above were utilized to identify relevant articles. Data were evaluated according to population studied, with separate analyses for singleton vs multiple gestations, prior PTB, or short …

Bim Mediates Imatinib-Induced Apoptosis Of Gastrointestinal Stromal Tumors: Translational Implications, David Reynoso

Dissertations and Theses (Open Access)

Gastrointestinal stromal tumors (GISTs) are oncogene-addicted cancers driven by activating mutations in the genes encoding receptor tyrosine kinases KIT and PDGFR-α. Imatinib mesylate, a specific inhibitor of KIT and PDGFR-α signaling, delays progression of GIST, but is incapable of achieving cure. Thus, most patients who initially respond to imatinib therapy eventually experience tumor progression, and have limited therapeutic options thereafter. To address imatinib-resistance and tumor progression, these studies sought to understand the molecular mechanisms that regulate apoptosis in GIST, and evaluate combination therapies that kill GISTs cells via complementary, but independent, mechanisms. BIM (Bcl-2 interacting mediator …

Early Developmental Outcome In Children With Hypoplastic Left Heart Syndrome And Related Anomalies: The Single Ventricle Reconstruction Trial., Jane W. Newburger, Lynn A. Sleeper, David C. Bellinger, Caren S. Goldberg, Sarah Tabbutt, Minmin Lu, Kathleen A. Mussatto, Ismee A. Williams, Kathryn E. Gustafson, Seema Mital, Nancy Pike, Erica Sood, William T. Mahle, David S. Cooper, Carolyn Dunbar-Masterson, Catherine Dent Krawczeski, Alan Lewis, Shaji C. Menon, Victoria L. Pemberton, Chitra Ravishankar, Teresa W. Atz, Richard G. Ohye, J William Gaynor, Pediatric Heart Network Investigators, Girish S. Shirali

Manuscripts, Articles, Book Chapters and Other Papers

BACKGROUND: Survivors of the Norwood procedure may experience neurodevelopmental impairment. Clinical trials to improve outcomes have focused primarily on methods of vital organ support during cardiopulmonary bypass.

METHODS AND RESULTS: In the Single Ventricle Reconstruction trial of the Norwood procedure with modified Blalock-Taussig shunt versus right-ventricle-to-pulmonary-artery shunt, 14-month neurodevelopmental outcome was assessed by use of the Psychomotor Development Index (PDI) and Mental Development Index (MDI) of the Bayley Scales of Infant Development-II. We used multivariable regression to identify risk factors for adverse outcome. Among 373 transplant-free survivors, 321 (86%) returned at age 14.3 ± 1.1 (mean ± SD) months. Mean …

Program Evaluation Of Stroke In Rural Nevada Hospital, Starla Cheri Ricks

UNLV Theses, Dissertations, Professional Papers, and Capstones

The overall goal of this Doctor of Nursing Practice (DNP) scholarly project is to complete a program evaluation using the Centers of Disease Control (CDC) Framework for Program Evaluation to measure the effectiveness of a stroke protocol in a rural Nevada hospital. This (DNP) scholarly project evaluates program strategies over third and fourth quarters of 2010 as well as the first, second, and third quarters of 2011, that have been initiated to reduce the burden of neurological disease with the application of a stroke protocol that complies with defined evidence-based strategies for assessment and management of stroke victims. As part …

Use Of Continuous Glucose Monitors In Type-1 Diabetes: An Analysis Of Wave Form Versus Glycemic Values In The Improvement Of Glucose Control And Fear Of Hypoglycemia, Tomas Charles Walker

UNLV Theses, Dissertations, Professional Papers, and Capstones

Type-1 diabetes is a disease of subtle complexities. Patients struggle to understand glucose patterns and their responses to insulin or food intake while maintaining hectic lifestyles. Minor misjudgments in treatments can result in disastrous consequences with significant hypo- or hyperglycemic excursions.

Despite improvements in technologies available for diabetes management, including home monitoring of blood glucose, more predictable insulin therapies, and improved insulin delivery via insulin pump, the average HbA1c has remained relatively unchanged. Poor diabetes control is recognized as contributing to long-term diabetes comorbidities including neuropathy, nephropathy, retinopathy, and micro- and macrovascular disease.

Real-time continuous glucose monitors, such as the …

Population-Based Survey Of Lumbar Surgery Beliefs In The United States, Amanda Elyse Mccauley, Zachery Clark Rasmussen

UNLV Theses, Dissertations, Professional Papers, and Capstones

Purpose/Hypothesis: Studies have shown that poor lumbar surgery outcomes may be influenced by a person’s preconceived perceptions of low back surgery (LBS). However, the perceptions of the general population about issues related to lumbar surgery are not known. Therefore, the purpose of this study was to investigate the general population’s perceptions regarding LBS.

Number of Subjects: This study included 262 participants (Average age: 46.1, SD=16.9; 125 Males, 137 Females) who completed the questionnaire from the general population in the Las Vegas area.

Materials/Methods: Questionnaire development involved expert panel feedback from three physical therapists, three spine surgeons, two surgeon assistants/nurses, two …

Increasing Labor And Delivery Nurse Knowledge Of Triaging Non-Obstetrical Medical Emergencies In Pregnant Women Through The Use Of Simulation, Julie Hoffman

UNLV Theses, Dissertations, Professional Papers, and Capstones

The purpose of this study was to evaluate the effect simulation training has on an OB nurse's ability to correctly triage pregnant patients. Registered Nurses (RNs) working in OB triage must be able to correctly and expediently identify the care a pregnant patient needs. OB triage nurses are trained to recognize pregnancy related issues that commonly present during the months leading up to delivery. It is as important for these nurses to have the skills to realize when a pregnant patient is having a non-obstetrical health crisis. A group of OB triage RNs participated in simulation-training scenarios based on non- …

Exercise-Induced Neuroprotection In A Hemiparkinsonian 6-Hydroxydopamine Rat Model, Merrill Russen Landers

UNLV Theses, Dissertations, Professional Papers, and Capstones

Outside of finding a cure, one of the preeminent goals of research in Parkinson's disease (PD) is finding a neuroprotective treatment that when applied prior to the onset of the disease will decrease the risk and severity of the subsequent disease. One such treatment that has potential as a neuroprotective agent in PD is exercise. Several studies have found forced exercise to be protective of Parkinson's disease in adult rodent models; however, few of these studies have used a design wherein voluntary exercise was evaluated. Moreover, no study has used a true neuroprotective design in which exercise was applied prior …

Provider Variations In Cesarean Section (Cs) And Vaginal Birth After Cesarean (Vbac) Practice, Rita Elizabeth Marrero

UNLV Theses, Dissertations, Professional Papers, and Capstones

The Centers for Disease Control and Prevention's National Center for Health Statistics (2010) report that nearly one-third of babies were born by Cesarean section (CS) in 2007. Of interest, six states, including Nevada, experienced increases of more than 70% in the last 10 years (CDC, 2007). Based on the increased rate of CS deliveries, the National Institutes of Health (NIH) convened a consensus panel in 2010, which urged the medical community to reduce barriers to women who want to try a vaginal birth after Cesarean delivery (VBAC) in the hope this would safely decrease the total CS rate. For clinicians …

Significant Differences In Markers Of Oxidant Injury Between Idiopathic And Bronchopulmonary-Dysplasia-Associated Pulmonary Hypertension In Children, Kimberly B. Vera, Donald Moore, English Flack, Michael Liske, Marshall Summar

Pediatrics Faculty Publications

While oxidant stress is elevated in adult forms of pulmonary hypertension (PH), levels of oxidant stress in pediatric PH are unknown. The objective of this study is to measure F₂-isoprostanes, a marker of oxidant stress, in children with idiopathic pulmonary hypertension (IPH) and PH due to bronchopulmonary dysplasia (BPD). We hypothesized that F₂-isoprostanes in pediatric IPH and PH associated with BPD will be higher than in controls. Plasma F₂-isoprostanes were measured in pediatric PH patients during clinically indicated cardiac catheterization and compared with controls. F₂-Isoprostane levels were compared between IPH, PH due …

Electrical & Magnetic Stimulation And Health, Yiyan Li

College of Engineering: Graduate Celebration Programs

1, Introduction Most of the patients with neural diseases such as Parkinson’s disease, Stroke and Depression, cannot be cured by taking pills or conducting surgery. In contrast to the conventional therapies, physical therapies such as TMS (transcranial magnetic stimulation) (Fig. 1) and tDCS (transcranial direct current stimulation) (Fig. 2) are the most popular methods in treating neural disorders with a non-invasive way. TMS employs electromagnetic (1-3 Tesla) induction generates an Electric field suitable for neural stimulation; tDCS employs a weak current (1-2 mA) to modulate neuronal excitabilities.

Colorectal Cancer Brochure Development For African Americans, Kim L. Freeman, Lina Jandorf, Hayley Thompson, Katherine N. Duhamel

Journal of Health Disparities Research and Practice

Introduction: African Americans are more likely to die from colorectal cancer (CRC) than any other racial/ethnic group in the United States. Unfortunately, African Americans are also less likely to undergo screening for CRC than their White counterparts. Focus groups methodology was used to refine educational brochures designed to increase CRC screening among African Americans.

Methods: Two series of focus groups were completed, with a total of seven groups and 39 participants. Six different brochures (stage-matched and culturally sensitive) designed to promote CRC screening among African Americans were evaluated.

Results: All participants thought that the brochures motivated them …

Obstructive Sleep Apnea Syndrome And Perioperative Complications: A Systematic Review Of The Literature., Tajender S. Vasu, Md, Ms, Ritu G. Grewal, Md, Karl Doghramji, Md

Department of Sleep Medicine Faculty Papers

Obstructive sleep apnea syndrome (OSAS) is a common sleep related breathing disorder. Its prevalence is estimated to be between 2% and 25% in the general population. However, the prevalence of sleep apnea is much higher in patients undergoing elective surgery. Sedation and anesthesia have been shown to increase the upper airway collapsibility and therefore increasing the risk of having postoperative complications in these patients. Furthermore, the majority of patients with sleep apnea are undiagnosed and therefore are at risk during the perioperative period. It is important to identify these patients so that appropriate actions can be taken in a timely …

Enhancing The Immune Response Through Ikkbeta-Induced Activation Of Nf-Kappab, Emily Hopewell

USF Tampa Graduate Theses and Dissertations

Nuclear factor-κB (NF-κB) is one of the main regulators of inflammatory and immune responses. It is a family of transcription factors composed of five members: RelA, RelB, cRel, NF-κB1 (p105/p50), and NF-κB2 (p100/p52). Homo- and hetero-dimers of family members are inhibited by inhibitor of &klappaB (IκB) family members and activated by IκB kinase (IKK) family members. The IKK family is comprised of IKKα, IKKΒ, and IKKγ. The focus of my dissertation delves into the role of NF-κB activation by IKKΒ in both an immunotherapy setting and its role in T cell mediated anti-tumor immune responses.

A central focus of immunotherapy …

Regulation Of Natural Killer Cells: Ship-1, 2b4, And Immunomodulation By Lenalidomide, Nicole Renee Fortenbery

USF Tampa Graduate Theses and Dissertations

Natural Killer cells (NK) are critical components of the innate immune system. Often referred to by their morphology, these large granular lymphocytes (LGLs) are bone marrow-derived lymphocytes and can be found throughout the body. NK cells reside in the liver, lymph nodes, spleen, thymus, and mucosal-associated lymphoid tissues (MALT). Importantly, NK cells also circulate throughout the blood where they function as surveyors of the body and are armed to eliminate malignant, infected, damaged, or foreign cells.

NK cells function by a dual receptor system. That is, NK receptors are broadly categorized as inhibitory or activating. It is a fine balance, …

Sir William Osler, M.D., C.M., Jonathan Sarik, B.S., Charles J. Yeo, Md, Pinckney J. Maxwell, Iv, Md

Department of Surgery Gibbon Society Historical Profiles

Sir William Osler impacted medical education and the practice of medicine like few other physicians. As a writer, he authored nearly 1500 publications and lent his name to numerous eponyms. As a teacher he educated vast numbers of students and through his legacy impacted countless more. Sir William Osler (Fig. 1) epitomized what a physician should be throughout his professional life.

Relationship Between Vitamin B12, Folate And Homocysteine Levels And H. Pylori Infection In Patients With Functional Dyspepsia: A Cross-Section Study, Shahid Rasool, Shahab Abid, Mohammad Perwaiz Iqbal, Naseema Mehboobali, Ghulam Haider, Wasim Jafri

Section of Gastroenterology

Background

H. pylori infection has been associated with many micronutrient deficiencies. There is a dearth of data from communities with nutritional deficiencies and high prevalence of H. pylori infection. The aim of this study was to determine the impact of H. pylori infection on serum levels of vitamin B₁₂, folate and homocysteine in patients with functional dyspepsia (FD).

Methods

One hundred and thirty-two patients with FD undergoing gastroscopy were enrolled. The serum was analyzed for B₁₂, folate and homocysteine levels before gastroscopy. H. pylori infection was diagnosed by histopathological examination of gastric biopsies and urea breath …

A Progressive Postresection Walking Program Significantly Improves Fatigue And Health-Related Quality Of Life In Pancreas And Periampullary Cancer Patients., Theresa Yeo, Sherry A Burrell, Patricia K Sauter, Eugene P Kennedy, Harish Lavu, Benjamin E Leiby, Charles Yeo

College of Nursing Faculty Papers & Presentations

BACKGROUND: As patients with pancreas and periampullary cancer (PPC) experience improved survival rates and longevity, the focus shifts toward living life while surviving cancer. Fatigue is the most commonly reported symptom in all cancer patients. Exercise has been found to effectively decrease fatigue levels and improve physical functioning in cancer patients.

STUDY DESIGN: One hundred two patients with resected PPC consented to participate in this study and were randomized to either an intervention group (IG) or a usual care group (UCG). Subjects completed visual analog scales, the FACIT-Fatigue Scale and the Short Form-36v2 after surgery and again 3 to 6 …

Comparison Of Conventional Cervical Cytology Versus Visual Inspection With Acetic Acid (Via) Among Hiv-Infected Women In Western Kenya, Hillary Mabeya, Kareem Khozaim, Tao Liu, Elkanah Omenge, David Chumba, Latha Pisharodi, J. Carter, Susan Cu-Uvin

Obstetrics and Gynaecology, East Africa

Objective: To determine the accuracy of visual inspection with Acetic Acid (VIA) versus conventional Pap smear as a screening tool for cervical intraepithelial neoplasia (CIN)/cancer among HIV-infected women.

Materials and Methods: 150 HIV-infected women attending the Moi Teaching and Referral Hospital HIV clinic in Eldoret underwent conventional Pap smear, VIA, colposcopy and biopsy. VIA and Pap smears were done by nurses while colposcopy and biopsy were done by a physician. Receiver Operating Characteristic (ROC) analysis was conducted to compare the accuracies between VIA and Pap smear in sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV).

Results: Among …

Knowledge And Attitudes About Tetanus And Rabies: A Population-Based Survey From Karachi, Pakistan, Mohammad Wasay, Abdul Malik, Ammad Fahim, Adnan Yousuf, Rajesh Chawla, Haroon Daniel, Muhammad Rafay, Iqbal Azam, Junaid Razzak

Section of Neurology

OBJECTIVE: To evaluate public knowledge regarding predisposing factors, fatality and prevention of Tetanus and Rabies and attitudes toward vaccination and post-exposure prophylaxis.

METHODS: A population-based, cross-sectional survey was conducted in all the 18 towns of Karachi, the largest metropolitan city of Pakistan, from December 2007 to January 2008. Men and women of more than 18 years of age were included in the study which used a self-reporting questionarre as its tool.

RESULTS: There were 1201 people interviewed by the study. The majority of respondents had known or heard about Tetanus (n = 973; 81%) and rabies (n = 699; 58%). …

Rates Of Iucd Discontinuation And Its Associated Factors Among The Clients Of A Social Franchising Network In Pakistan, Syed Khurram Azmat, Babar Tasneem Shaikh, Waqas Hameed, Mohsina Bilgrami, Ghulam Mustafa, Muhammad Ali, Muhammad Ishaque, Wajahat Hussain, Aftab Ahmed

Community Health Sciences

Background: Modern Intrauterine contraceptive device (IUCD) is very safe, highly effective reversible and inexpensive family planning method which offers 5-10 years of protection against pregnancy. The contraceptive use in Pakistan has been merely 30% for over a decade with IUCD being the least used method. Higher discontinuation rates are documented in developing countries; however no such data is available for Pakistan. Marie Stopes Society (MSS) established a social franchise outlets network branded as 'SURAJ' (Sun) in Pakistan to provide quality family planning services. This study attempts to determine IUCD discontinuation rates and its associated risk factors. Using a semi-structured questionnaire, …

Advances In Ultrafast Time Resolved Fluorescence Physics For Cancer Detection In Optical Biopsy, R. R. Alfano

Publications and Research

We discuss the use of time resolved fluorescence spectroscopy to extract fundamental kinetic information on molecular species in tissues. The temporal profiles reveal the lifetime and amplitudes associated with key active molecules distinguishing the local spectral environment of tissues. The femtosecond laser pulses at 310 nm excite the tissue. The emission profile at 340 nm from tryptophan is non-exponential due to the micro-environment. The slow and fast amplitudes and lifetimes of emission profiles reveal that cancer and normal states can be distinguished. Time resolved optical methods offer a new cancer diagnostic modality for the medical community.

Patient Safety In Developing Countries: Retrospective Estimation Of Scale And Nature Of Harm To Patients In Hospital, R. M. Wilson, P. Michel, S. Olsen, R. W. Gibberd, C. Vincent, R. El-Assady, O. Rasslan, S. Qsous, William Macharia, A. Sahel, S. Whittaker, M. Abdo-Ali, M. Letaief, N. A. Ahmed, A. Abdellatif, I. Larizgoitia

Paediatrics and Child Health, East Africa

Objective: To assess the frequency and nature of adverse events to patients in selected hospitals in developing or transitional economies.

Design: Retrospective medical record review of hospital admissions during 2005 in eight countries.

Setting: Ministries of Health of Egypt, Jordan, Kenya, Morocco, Tunisia, Sudan, South Africa and Yemen; the World Health Organisation (WHO) Eastern Mediterranean and African Regions (EMRO and AFRO), and WHO Patient Safety.

Participants: Convenience sample of 26 hospitals from which 15 548 patient records were randomly sampled.

Main outcome measures: Two stage screening. Initial screening based on 18 explicit criteria. Records that screened positive were then reviewed …

Robotic Surgery Training With Commercially Available Simulation Systems In 2011: A Current Review And Practice Pattern Survey From The Society Of Urologic Robotic Surgeons., Costas D Lallas, John W Davis And Members Of The Society Of Urologic Robotic Surgeons

Department of Urology Faculty Papers

Abstract Objectives: Virtual reality (VR) simulation has the potential to standardize surgical training for robotic surgery. We sought to evaluate all commercially available VR robotic simulators. Materials and Methods: A MEDLINE(®) literature search was performed of all applicable keywords. Available VR simulators were evaluated with regard to face, content, and construct validation. Additionally, a survey was e-mailed to all members of the Endourological Society, querying the pervasiveness of VR simulators in robotic surgical training. Finally, each company was e-mailed to ask for a price quote for their respective system. Results: There are four VR robotic surgical simulators currently available: RoSS™, …