Digital Commons Network^™

Is Mammography Useful In Screening For Local Recurrences In Patients With Tram Flap Breast Reconstruction After Mastectomy For Multifocal Dcis?, A P Salas, M A Helvie, E G Wilkins, H A Oberman, P W Possert, Alan M. Yahanda Md, Facs, A E Chang

PCI Publications and Projects

BACKGROUND: Skin-sparing mastectomy with immediate transverse rectus abdominis musculocutaneous (TRAM) flap reconstruction is being used more often for the treatment of breast cancer. Mammography is not used routinely to evaluate TRAM flaps in women who have undergone mastectomy. We have identified the potential value of its use in selected patients.

METHODS AND RESULTS: We report on four women who manifested local recurrences in TRAM flaps after initial treatment for ductal carcinoma in situ (DCIS) or DCIS with microinvasion undergoing skin-sparing mastectomy and immediate reconstruction. All four patients presented with extensive, high-grade, multifocal DCIS that precluded breast conservation. Three of four …

Eye Health Of Aboriginal And Torres Strait Islander People: Aboriginal And Torres Strait Islander Health Reviews: Number 1, Neil Thomson, Beverley Paterson

Research outputs pre 2011

As with many other aspects of health status, it is most probable that prior to the European settlement of Australia in 1788 the eye health of Australian Aborigines and Torres Strait Islanders was excellent. In fact. their eye health was almost certainly better than that of Europeans of the time. There are no definite data from early post-settlement times, but this conclusion appears reasonable from the results of a number of thorough surveys conducted as late as the 1940s and 1950s ( 1-4) Despite finding some severe preventable problems, particularly trachoma (a form of infective conjunctivitis - see Appendix l …

Terminal Sedation As Palliative Care: Revalidating A Right To A Good Death, George P. Smith Ii

Scholarly Articles

Not everyone finds a “salvific meaning” in suffering. Indeed, even those who do subscribe to this interpretation recognize the responsibility of each individual to show not only sensitivity and compassion but render assistance to those in distress. Pharmacologic hypnosis, morphine intoxication, and terminal sedation provide their own type of medical “salvation” to the terminally ill patient suffering unremitting pain. More and more states are enacting legislation that recognizes this need of the dying to receive relief through regulated administration of controlled substances. Wider legislative recognition of this need would go far toward allowing physicians, in the exercise of their reasonable …

Cardiorespiratory Fitness And Cardiovascular Disease Risk Factors In Postmenopausal Women, Bryan L. Haddock

Loma Linda University Electronic Theses, Dissertations & Projects

In spite of the reductions in cardiovascular disease mortality over the last several years, cardiovascular disease remains the number one cause of death in the U.S. Prior to menopause, women have approximately 2.5-4.5 times lower risk of cardiovascular disease than do men of a similar age. Within about 10 years following menopause, however, the rate in women becomes similar to that seen in men. Increased cardiorespiratory fitness and use of hormone replacement have been suggested as ways to improve the cardiovascular disease (CVD) risk profile. Unfortunately, very little is known about the effect of cardiorespiratory fitness on the CVD risk …

The Spectrum Of Bacterial Infections In Febrile Neutropenic Patients: Effect On Empiric Antibiotic Therapy, Ikram A. Burney, Tariq Siddiqui, Badar J. Farooqui, Mohammad Khurshid

Department of Medicine

The aim of this retrospective analysis was to look at the spectrum of bacterial isolates and their resistance patterns to the commonly used antIbiotics in the settmg of febrile neutropenia. A total of 127 bacteria were isolated from patients with acute leukemias, lymphoproliferative disorders, aplastic anaemia and various solid tumours. Fifty-four percent organisms were gram negative; while the rest were gram positive. E. coli, pseudomónas aeruginosa, staphylococcus aureus, enterococcus and streptococci were the commonly isolated organisms. Forty-eight percent organisms were isolated from blood, 16% from urine, 13% from wounds and superficial abscesses and 11% from respiratory tract. E. coli exhibited …

Identification Of Factors That Influence Physician Generated Referrals To Hospice Programs, Cheryl A. Hoerner

Dissertations and Theses @ UNI

The hospice movement is just over 20 years old in this country. Hospice programs are dependent on physicians to educate and refer their terminal patients to hospice care. The purpose of this study was to identify factors which influence physicians in rural Iowa to refer terminal patients to selected hospice programs. The study involved Medicare-certified hospice programs and non-certified programs located in rural communities in Iowa. One hundred and fifty licensed physicians were randomly selected to complete a 14-item questionnaire. A total of 86 questionnaires were returned. The survey tool addressed demographic information, as well as identifying factors that influenced …

Factors Which Influence Women's Decisions For Choice Of Primary Surgery For Stage I And Stage Ii Breast Cancer, Barbara Mastaglia

Theses : Honours

A descriptive correlational study was conducted to describe the factors that Western Australian women with either Stage I or Stage II Breast Cancer, perceived to be important considerations when deciding upon either Modified Radical Mastectomy (MRM) or Breast Conserving Treatment (BCT) for surgical treatment. The Conflict Theory of Decision Making (Janis & Mann, 1977) was used as the theoretical framework to guide this study. Ward, Heidrich and Wolberg's (1989) Factor List, the Multidimensional Health Locus of Control (MHLC) Scale (Wallston, Wallston & De Vellis, 1978) and a demographic questionnaire were used to measure variables. Questionnaires were mailed to a consecutive …

Role Of Serum Angiotensin Converting Enzyme In Sarcoidosis, Aysha Habib, Farooq Ghani, Mohammad Khurshid, Amanullah Khan, M. Atta Khan

Department of Pathology and Laboratory Medicine

This study was conducted to determine the role of Serum Angiotensin Converting Enzyme (SACE) as a marker in the differential diagnosis of pulmonary diseases and prognosis of sarcoidosis, A retrospective analysis of 113 medical records of patients at The Aga Khan University Hospital, with laboratory investigation for SACE was performed. Among 113 patients, 51 cases were found to have sarcoidosis, 44 of them had SACE levels greater than 52 lU/L (mean ACE 104.44). SACE levels were also found elevated in other clinical conditions like tuberculosis (mean 58.64 lUlL), but the enzyme level were less (p0.04) than those found in sarcoidosis …

Diagnostic Evaluation Of Fine Needle Aspiration Cytology In The Management Of Palpable Breast Lesions, S. H. Shah, Naila Kayani, S. H. Hasan, I. N. Soomro, Shahid Pervez, A. S. Hussainy

Department of Pathology and Laboratory Medicine

A total of 113 fine needle aspirates of the breast masses were evaluated in which the subsequent biopsy or mastectomy specimen were also available for histological examination. The age ranged from 16 to 80 years with a mean of 42 years. In benign conditions the mean age was 34.7 years while in malignant cases it was 48 years. The cytological diagnoses were compared with the histological results which revealed that the specificity and sensitivity of fine needle aspiration cytology in the palpable breast lesions was 86.1% and 89.2% respectively with a positive predictive value of 93% and efficiency of 88.2%. …

Dyslipidemia And Its Relation With Body Mass Index Versus Waist Hip Ratio, A Jabbar, A Irfanullah, J Akhter, Y K. Mirza

Section of Pulmonary & Critical Care

To study the magnitude of dyslipidemia in asymptomatic subjects and its relation to body mass index (BMI) and waist-hip-ratio (WHR), 88 subjects attending the health analysis programme were examined and their age, sex, BMI, WHR, fasting blood glucose and lipids were measured. The distribution of the lipid levels and the frequency of dyslipidemia were noted. Forty-eight percent had a total cholesterol of > 200 mg/dl and 50% had an HDL-cholesterol of < 40 mg/dl. On comparing the means of total cholesterol to BMI and WHR, it was found that total cholesterol level was statistically significant for WHR above and below 0.9 for males and 0.8 for females, whereas not so for BMI above and below 27 kg/m2. The prevalence of dyslipidemia in asymptomatic people in this group emphasizes the need for routine health screening for early institution of preventive measures. The correlation with WHR rather than BMI points towards importance of measuring parameters of central obesity rather than body weight and height only.

The Relationship Between Health Locus Of Control And Health Behaviors Of Women Who Have Undergone Coronary Artery Bypass Grafting, Heather Ferrillo

Nursing Master’s Theses and Projects

Due to the increasing number of women who are diagnosed with heart disease and who are undergoing coronary artery bypass grafting, it is important to explore the psychosocial aspects involved in the recovery process of these women. This study examined the relationship between locus of control and health behaviors of women who underwent coronary artery bypass grafting.

Ossifying Fibroma Of Nasal Cavity, Abbas Zafar Abbas Zafar, Muhammad Shafi Muhammad Shafi, Shaukat Malik Shaukat Malik, Shahid Pervez

Department of Pathology and Laboratory Medicine

No abstract provided.

Comparison Of Beta-Adrenoceptor Coupled Camp Production In Cultured Human Mononuclear Leukocytes And Myometrial Cells, Yu-Li Liu

Electronic Theses and Dissertations

$\beta\sb2$-Adrenoceptor ($\beta\sb2$-AR) agonists, such as terbutaline, are used as tocolytic agents in the treatment of preterm labor. $\beta$-Adrenoceptor stimulation relaxes myometrium through specific receptors coupled through Gs to adenylyl cyclase (AC) that catalyzes the conversion of ATP to cAMP. The purpose of this study was to compare $\beta$-adrenoceptors and cAMP production in cultured human leukocytes and myometrial cells, and to determine the importance of $\beta$-adrenoceptors and cAMP production in isoproterenol-induced myometrial relaxation. $\sp{125}$I-iodopindolol was used to assess $\beta$-adrenoceptor affinity and number cAMP levels were analyzed before and after stimulation by isoproterenol, AlF$\sb4\sp-$, forskolin, and PGE$\sb1$. Isometric recording was used to …

A Dichotomous Role For Nitric Oxide During Acute Toxoplasma Gondii Infection In Mice, Imtiaz A. Khan, Joseph D. Schwartzman, Tadashi Matsuura, Lloyd H. Kasper

Dartmouth Scholarship

Production of nitric oxide by macrophages is believed to be an important microbicidal mechanism for a variety of intracellular pathogens, including Toxoplasma gondii. Mice with a targeted disruption of the inducible nitric oxide synthase gene (iNOS) were infected orally with T. gondii tissue cysts. Time to death was prolonged compared with parental controls. Histologic analysis of tissue from infected mice showed scattered small foci of inflammation with parasites in various tissues of iNOS−/− mice, whereas tissue from the parental C57BL/6 mice had more extensive tissue inflammation with few visible parasites. In particular, extensive ulceration and necrosis of distal small …

Ms211: Non-Proliferation Talk At Kazakhstan, Armin Weinberg

Works on Radiation Effects: 1990-2020

These are talking notes for my presentation at a nuclear non-proliferation conference. Interesting to see recommendations including this one, "I suggest Minister Shkolnik create a joint committee with representatives from government, academicia, public survivors and ethicists to continue the pursuit of this question." See more at Armin Weinberg, PhD Papers and its finding aid.

Ms211: Plans For Nazarbayev Visit To Houston And Tmc, Armin Weinberg

Works on Radiation Effects: 1990-2020

A list of things that Armin created in preparation for the visit by the President of Kazakhstan to Texas, Houston and the Medical Center. Very insightful with names and activities. See more at Armin Weinberg, PhD Papers and its finding aid.

Phosphorylation Of Elongation Factor 1 And Ribosomal Protein S6 By Multipotential S6 Kinase And Insulin Stimulation Of Translational Elongation, Y W Chang, J A Traugh

Faculty, Staff and Student Publications

Stimulation of protein synthesis in response to insulin is concomitant with increased phosphorylation of initiation factors 4B and 4G and ribosomal protein S6 (Morley, S. J., and Traugh, J. A. (1993) Biochimie 75, 985-989) and is due at least in part to multipotential S6 kinase. When elongation factor 1 (EF-1) from rabbit reticulocytes was examined as substrate for multipotential S6 kinase, up to 1 mol/mol of phosphate was incorporated into the alpha, beta, and delta subunits. Phosphorylation of EF-1 resulted in a 2-2. 6-fold stimulation of EF-1 activity, as measured by poly(U)-directed polyphenylalanine synthesis. The rate of elongation was also …

Ms211: By Healthcare Committee Doc, Armin Weinberg

Works on Radiation Effects: 1990-2020

Selected material about the healthcare system/status in Russia circa 1997. It looks like a series of pieces from a healthcare publication. Clearly this was a part of our trying to assess the opportunity to further our work with Dennis Sokol of the American Medical Centers that Ambassador Strauss connected us with as well as the post-Chernobyl opportunities for our colleagues in the Former USSR. See more at Armin Weinberg, PhD Papers and its finding aid.

Open Fractures Caused By High Velocity Missiles: The Outcome Of Treatment Of 39 Fractures Followed For 1-3 Years, M A. Khan, R Hussain, S H. Khan, M Umar

Department of Surgery Docs

Between 1993 and 1995, thirty-three patients having 39 fractures caused by missiles fired from a high velocity rifle were reviewed retrospectively between 1 and 3 years after injury and the outcome of treatment assessed. Majority (33 out of 39) were Grade III. Union was achieved in 35 out of 39 fractures, there was deep infection and delayed union in one case each. Non-union occurred in three fractures. The fractures were stabilized using different techniques, but highest complication rate was seen with the use of the static external fixator. This was related to the severe nature of the injury as well …

Non-Visualization Of Lung Markings Below Hemidiaphragm In Subtle Subpulmonic Effusion: An Old Sign Resuscitated, Y A. Husen, T R. Khalid, Z A. Khan, M Y. Sheikh

Department of Radiology

To assess the lack of visibility of vascular markings under the hemidiaphragm on a frontal chest radiograph as a sign of pleural effusion, fifteen patients were collected showing this sign. Pleural effusion was diagnosed by ultrasound, comparison with previous or subsequent chest x-ray or computed tomography. Patients in the study group exhibited this sign in the absence of the classical signs of pleural effusion. In the control group, lack of visibility of blood vessels was observed in only 4.2% cases. Non-visualization of vascular markings below the hemidiaphragm should alert the interpreter to the possible presence of pleural effusion and a …

The Association Of Hla-Drb Genes And The Shared Epitope With Rheumatoid Arthritis In Pakistan, K Hameed, S Bowman, E Kondeatis, R Vaughan, T Gibson

Section of Internal Medicine

The association of particular HLA-DR alleles and the shared epitope with rheumatoid arthritis (RA) is now well established. The strength of these links varies between races. Furthermore, the proposition that the presence of the shared epitope is indicative of severe disease has been more difficult to sustain in non-Europeans. This study examines the frequency of HLA-DR and HLA-DRB1 amongst Pakistanis for the first time. Using the polymerase chain reaction (PCR) and sequence-specific oligonucleotide probes (PCR-SSOP) and primers (PCR-SSP), HLA-DR phenotype and genotype frequencies were ascertained in 86 RA hospital out-patients and 79 healthy controls matched for age, gender and ethnicity. …

Predicting Red Blood Cell Transfusions In Very Low Birth Weight Infants Based On Clinical Risk Factors., David A. Paul, Stephen A. Pearlman, Kathleen H. Leef, John L. Stefano

Department of Pediatrics Faculty Papers

OBJECTIVE: To describe the clinical factors most predictive of red blood cell transfusion in very low birth weight (VLBW) infants.

STUDY DESIGN: Retrospective review of VLBW infants cared for at a single level III NICU during a two year period, n = 199.

RESULTS: Overall transfusion requirement was 4.6 +/- 6.2 transfusions/infant/hospital course. Length of hospital stay, days of mechanical ventilation, requirement for dopamine support, birth weight, initial hematocrit, periventricular leukomalacia and necrotizing enterocolitis all independently correlated with number of transfusions and donors. Bronchopulmonary dysplasia and patent ductus arteriosus were associated with donor but not transfusion number.

CONCLUSIONS: Our data …

An Evaluation Of The Sensitivity Of Subjects With Peanut Allergy To Very Low Doses Of Peanut Protein: A Randomized, Double-Blind, Placebo-Controlled Food Challenge Study, Jonathan O'B. Hourihane, Sally A. Kilburn, Julie A. Nordlee, Susan L. Hefle, Steve L. Taylor, John O. Warner

Department of Food Science and Technology: Faculty Publications

The minimum dose of food protein to which subjects with food allergy have reacted in double-blind, placebo-controlled food challenges is between 50 and 100 mg. However, subjects with peanut allergy often report severe reactions after minimal contact with peanuts, even through intact skin.

Objective: We sought to determine whether adults previously proven by challenge to be allergic to peanut react to very low doses of peanut protein.

Methods: We used a randomized, double-blind, placebo-controlled food challenge of 14 subjects allergic to peanuts with doses of peanut ranging from 10 μg to 50 mg, administered in the form of …

Permeable, Non-Irritating Prodrugs Of Nonsteroidal And Steroidal Agents, Paul Ashton, Thomas J. Smith, Peter G. Glavinos, John D. Conklin, Peter A. Crooks, Robert M. Riggs, Tadeusz Cynkowski, Grazyna Cynkowska

Ophthalmology and Visual Science Faculty Patents

Prodrugs containing an active drug molecule linked to a polyethylene glycol group, and a method of use thereof are described. Exemplary soluble ester prodrugs contain naproxen, triamcinolone acetonide, gancyclovir, taxol, cyclosporin, dideoxyinosine, trihydroxy steroids, and flurbiprofen molecules linked to polyethylene glycol (PEG) groups. Pharmaceutical compositions containing these prodrugs, and a method of using these esters for treating disease states or symptoms are also described.

Detection And Characterization Of Sp1 Binding Activity In Human Chondrocytes And Its Alterations During Chondrocyte Dedifferentiation., Rita M. Dharmavaram, Gang Liu, Sheryl D. Mowers, Sergio A. Jimenez

Department of Medicine Faculty Papers

We have detected DNA binding activity for a synthetic oligonucleotide containing an Sp1 consensus sequence in nuclear extracts from human chondrocytes. Changes in the levels of Sp1 oligonucleotide binding activity were examined in nuclear extracts from freshly isolated human chondrocytes, from chondrocytes that had been cultured under conditions that allowed the maintenance of a chondrocyte-specific phenotype on plastic dishes coated with the hydrogel poly(2-hydroxyethyl methacrylate), and from chondrocytes induced to dedifferentiate into fibroblast-like cells by passage in monolayer culture on plastic substrata. It was observed that Sp1 binding was 2-3-fold greater in nuclear extracts from dedifferentiated chondrocytes than in nuclear …

Foundation News: Fall 1997, University Of Health Sciences Foundation

Foundation News (1997)

Contents: UHS LiFE Challenge -- Foundation Faces -- Foundation Grants -- UHS Scholarships -- Gift Opportunities -- Foundation Activities -- UHS Foundation Board.

Renal Tubular Acidosis With Muscle Paralysis, A M. Nagaria, A Jabbar, J A. Khan

Section of Pulmonary & Critical Care

No abstract provided.

Vital Signs, Fall 1997, Boonshoft School Of Medicine

Vital Signs

A twenty four page newsletter created by the Boonshoft School of Medicine to document the current affairs of the school. This issue includes a variety of feature articles, alumni profiles, class notes, and more.

The Optimal Fontan Connection: A Growing Extracardiac Lateral Tunnel With Pedicled Pericardium., S R. Gundry, A J. Razzouk, M J. Del Rio, Girish S. Shirali, L L. Bailey

Manuscripts, Articles, Book Chapters and Other Papers

OBJECTIVE: The concept of a lateral tunnel for the Fontan operation is now widely accepted. Most lateral tunnels are constructed intraatrially with the use of aortic crossclamping. Construction of extracardiac lateral tunnels with the use of homografts or other nonviable tubes eliminates aortic crossclamping but lacks growth potential in length or width. The native pericardium, which is "sealed" posteriorly along the pulmonary artery, atrium, and inferior vena cava, could be turned down onto the right atrium to form a viable extracardiac lateral tunnel.

METHODS: We designed and successfully constructed extracardiac lateral tunnels using viable autologous pericardium, pedicled on its lateral …

Mucinous Cystadenoma Of The Urinary Bladder, I N. Soomro, A T. Rashid

Department of Pathology and Laboratory Medicine

No abstract provided.