Digital Commons Network^™

Randomized Controlled Trial Of Interferon Gamma Versus Amantadine In Combination With Interferon Alpha And Ribavirin For Hepatitis C Genotype 3 Non-Responders And Relapsers, Z Abbas, Sajjad Raza, Saeed Hamid, Wasim Jafri

Section of Gastroenterology

OBJECTIVES: To evaluate the efficacy and safety of triple combination regimens comprising of interferon alpha-2b (IFN-alpha) and ribavirin plus either IFN-gamma or amantadine in genotype 3 patients, responders or relapsers to interferon plus ribavirin combination.

METHODS: Patients were randomized to receive IFN-alpha 3MU thrice a week, ribavirin 800-1200 mg per day with either IFN-gamma 2 MU thrice a week or amantadine 100 mg twice daily. Treatment was continued for 48 weeks in patients showing complete or partial (2 log reduction) early virological response (EVR) at 12 weeks and negative PCR at 24 weeks.

RESULTS: Total enrollments were 44; 25 were …

Sick With Fear: Popular Challenges To Scientific Authority In The Vaccine Controversies Of The 21st Century, Ellen Watkins

Annual Undergraduate Conference on Health and Society

In the 20th century, vaccines were heralded as one of the greatest medical inventions in history. In the late 1990’s, however, the myth of vaccine-caused autism caught fire. Despite mountains of evidence disproving the link, panicking Americans eschewed vaccines and turned against their physicians. Why did Americans turn their backs on doctors, scientists, and the health industry? This paper follows the vaccine controversy of the last thirty years, looking in particular at the relationship between science and the media. This paper analyzes the contrast between discussion of the hypothesized link in scientific circles and in popular news sources, seeking to …

Role Of Poly [Adp-Ribose] Polymerase 1 In Retroviral Infection, Vanessa E. Rodriguez ^, Manuel Llano *

COURI Symposium Abstracts, Spring 2012

No abstract provided.

Characterization Of Species C Human Adenovirus Serotype 6 (Ad6), Eric A. Weaver, Reeti Khare, Mathew L. Hillestad, Donna Palmer, Philip Ng, Michael A. Barry

Nebraska Center for Virology: Faculty Publications

Adenovirus serotype (Ad5) is the most studied Ad. Ad1, 2, and 6 are also members of species C Ad and are presumed to have biologies similar to Ad5. In this work, we have compared the ability of Ad1, 2, 5, and 6 to infect liver and muscle after intravenous and intramuscular injection. We found that Ad6 was surprisingly the most potent at liver gene delivery and that Ad1 and Ad2 were markedly weaker than Ad5 and 6. To understand these differences, we sequenced the Ad6 genome. This revealed that the Ad6 fiber protein is surprisingly three shaft repeats shorter than …

Heme Oxygenase-1 Regulates The Immune Response To Influenza Virus Infection And Vaccination In Aged Mice, Nathan W. Cummins, Eric A. Weaver, Shannon M. May, Anthony J. Croatt, Oded Foreman, Richard B. Kennedy, Gregory A. Poland, Michael A. Barry, Karl A. Nath, Andrew D. Badley

Nebraska Center for Virology: Faculty Publications

Underlying mechanisms of individual variation in severity of influenza infection and response to vaccination are poorly understood. We investigated the effect of reduced heme oxygenase-1 (HO-1) expression on vaccine response and outcome of influenza infection. HO-1-deficient and wild-type (WT) mice (kingdom, Animalia; phylum, Chordata; genus/species, Mus musculus) were infected with influenza virus A/PR/8/34 with or without prior vaccination with an adenoviral-based influenza vaccine. A genome-wide association study evaluated the expression of single-nucleotide polymorphisms (SNPs) in the HO-1 gene and the response to influenza vaccination in healthy humans. HO-1-deficient mice had decreased survival after influenza infection compared to WT mice (median …

Gender-Sensitive Reporting In Medical Research., Shirin Heidari, Quarraisha Abdool Karim, Judith D Auerbach, Simone E Buitendijk, Pedro Cahn, Mirjam J Curno, Catherine Hankins, Elly Katabira, Susan Kippax, Richard Marlink, Joan Marsh, Ana Marusic, Heidi M Nass, Julio Montaner, Elizabeth Pollitzer, Maria Teresa Ruiz-Cantero, Lorraine Sherr, Papa Salif Sow, Kathleen Squires, Mark A Wainberg

Department of Medicine Faculty Papers

Sex and gender differences influence the health and wellbeing of men and women. Although studies have drawn attention to observed differences between women and men across diseases, remarkably little research has been pursued to systematically investigate these underlying sex differences. Women continue to be underrepresented in clinical trials, and even in studies in which both men and women participate, systematic analysis of data to identify potential sex-based differences is lacking. Standards for reporting of clinical trials have been established to ensure provision of complete, transparent and critical information. An important step in addressing the gender imbalance would be inclusion of …

Inhibition Of Adhesion And Invasion Of Pseudomonas Aeruginosa To Lung Epithelial Cells: A Model Of Cystic Fibrosis Infection, Ayman Noreddin, Ghada Sawy, Walid Elkhatib, Ehab Noreddin, Atef Shibl

Pharmacy Faculty Books and Book Chapters

"Over their life time, CF patients experience multiple infections by various pneumoniacausing bacteria [6]. With more patients surviving to adulthood, chronic infections with Pseudomonas aeruginosa are coming to the forefront as a leading cause of death [7]. Problems presented by infected CF lung are multi-dimensional; the electrolyte balance and pH of the fluids are abnormal. The mucus is thick and of an alternative composition compared to normal lung and may contribute to colonization with Pseudomonas aeruginosa [2, 3, 5]. As such, research is multi-pronged and includes gene therapy to correct the defective protein, amelioration of inflammatory response and thinning of …

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

Digest

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

• Message from the President
• PCOM Updates
• Development News
• Tug of War
• Founders’ Day 2012
• Building Social and Emotional Competence in Preschool Children
• Pioneering Color in MRI Imaging
• Class Notes
• In Memoriam
• My Turn Essay
• The Fund for PCOM

Nutritional Status In Patients With Hepatitis C, Faisal Wasim Ismail, Rustam A. Khan, Lubna Kamani, Ashfaq A. Wadalawala, Hasnain Ali Shah, Saeed Hamid, Wasim Jafri

Section of Gastroenterology

Objective: To assess the nutritional status via the SGA (subjective global assessment) screening tool of patients at all stages of hepatitis C virus (HCV) liver disease.
Study design: Descriptive study.
Place and duration of study: Out-patient Clinics of the Aga Khan University Hospital, Karachi, conducted from October 2009 to January 2011.
Methodology: Patients with hepatitis C virus infection and their HCV-negative attendants were enrolled from the outpatient clinics, and categorized into 4 groups of 100 patients each: healthy controls (HC), those with chronic hepatitis C infection (CHC), compensated cirrhotics (CC) and decompensated cirrhotics (DC). The validated subjective global assessment (SGA) …

Advocate For Immunizations., Angela L. Myers

Manuscripts, Articles, Book Chapters and Other Papers

No abstract provided.

Puerperal Fever From Hippocrates To Pasteur, Hunter A. Hammill

Houston History of Medicine Lectures (2006-2012)

The death of a mother in childbirth leaving a newborn deserted is a sort of a desecration. This was a frequent event for early physicians. It was felt to be caused by miasmas or punishment from the gods. DaVinci felt the cause was milk stasis, Hippocrates - lochia, Virchow - weather. Then came Semmelweis, Pasteur and Lister. They started a battle with ignorance, hospital administration, budget and academic politics. Ending with the murder of Semmelweis!

Laryngeal Tuberculosis Presenting As Laryngeal Carcinoma, Anwar Suhail, Muhammad Sheharyar Ahmed, Zain-Ul-Abdeen Sobani, Shahzad Ghaffar

Section of Otolaryngology, Head & Neck Surgery

Tuberculosis (TB) accounts for the highest number of mortalities among infectious diseases worldwide. Laryngeal TB is an extremely rare presentation of TB. It has many similarities to laryngeal carcinoma, one of the three most common cancers among males in the city, with an age standardized rate of 8.6. The associated risk factors of laryngeal carcinoma i.e. smoking, paan, betel nut usage and alcohol use also tend to be concentrated in the same demographic background as that of TB, creating a diagnostic dilemma. We present a case of granulomatous laryngeal TB, in a 40 year old male, with characteristic presenting features …

The Influence Of Antiretroviral Therapy On The Qtc Interval In An African Cohort, J. Shavadia, Reena Shah, Gerald Yonga, R. Patel, J. Stebbing, M. Nelson

Internal Medicine, East Africa

Cardiovascular disease in human immunodeficiency virus (HIV) infection encompasses a wide range of pathologic entities, including myocardial, pericardial, and endocardial disease, atherosclerosis, arrhythmias, and vasculitis. The most common manifestations of HIV-associated heart disease in sub- Saharan Africa are pericarditis, cardiomyopathy, and pulmonary hypertension [1]. Coronary artery disease, lipodystrophy, and metabolic syndrome, although common in developed countries, are traditionally thought to be less clinically significant problems in the African subcontinent [2]. It is well known that prolongation of the QTC interval can predispose patients to potentially fatal ventricular tachyarrhythmias, particularly torsades de pointes, and thus is an independent predictor of cardiovascular …

Understanding Unintentional Childhood Home Injuries: Pilot Surveillance Data From Karachi, Pakistan., Nukhba Zia, Uzma R. Khan, J. Razzak, Prasanthi Puvanachandra, Adnan A. Hyder

Department of Emergency Medicine

Background: Childhood injuries, an important public health issue, globally affects more than 95% of children living in low-and middle-income countries. The objective of this study is to describe the epidemiology of childhood unintentional injuries in Karachi, Pakistan with a specific focus on those occurring within the home environment.
Methods:This was a secondary analysis of a childhood unintentional injury surveillance database setup in the emergency department of the Aga Khan Hospital, Karachi, Pakistan for 3 months. The data was collected by interviewing caretakers of children under 12 years of age presenting with an unintentional injury to the emergency departments of …

Schools As Potential Vaccination Venue For Vaccines Outside Regular Epi Schedule: Results From A School Census In Pakistan., Sajid Bashir Soofi, Inam-Ul Haq, M. Imran Khan, Muhammad Bilal Siddiqui, Mushtaq Mirani, Rehman Tahir, Imtiaz Hussain, Mahesh K Puri, Zamir Hussain Suhag, Asif R Khowaja, Abdul Razzaq Lasi, John D Clemens, Michael Favorov, R. Leon Ochiai, Zulfiqar Ahmed Bhutta

Department of Paediatrics and Child Health

Background: Vaccines are the most effective public health intervention. Expanded Program on Immunization (EPI) provides routine vaccination in developing countries. However, vaccines that cannot be given in EPI schedule such as typhoid fever vaccine need alternative venues. In areas where school enrolment is high, schools provide a cost effective opportunity for vaccination. Prior to start of a school-based typhoid vaccination program, interviews were conducted with staff of educational institutions in two townships of Karachi, Pakistan to collect baseline information about the school system and to plan a typhoid vaccination program. Data collection teams administered a structured questionnaire to all schools …

Synapsis: Philadelphia Campus (2012), Philadelphia College Of Osteopathic Medicine

All Yearbooks

This yearbook includes American Medical Association (AMA), American Medical Student Association (AMSA), American Medical Women's Association (AMWA), Association of the American College of Osteopathic Family Physicians (ACOFP), Asian Pacific American Medical Student Association (APAMSA), Robert Berger, DO Pediatrics Society, Christian Medical Dental Association (CMDA), Kappa Sigma Phi, KSPh, (ΚΣΦ) Women's Osteopathic Society, Medical Students for Choice, Military Osteopathic Physicians and Surgeons (AMOPS), Muslim Student Medical Association, National Latino Health Organization (NLHO), Phi Sigma Gamma PSG, (ΦΣΓ) Fraternity, Physicians for Human Rights Club, Physicians for Social Responsibility Club, Sigma Sigma Phi SSPh, (ΣΣΦ) Honorary Osteopathic Service Fraternity, Student American Osteopathic Academy …

Manipulating Fate: Medical Innovations, Ethical Implications, Theatrical Illuminations, Karen H. Rothenberg, Lynn W. Bush

Faculty Scholarship

Transformative innovations in medicine and their ethical complexities create frequent confusion and misinterpretation that color the imagination. Placed in historical context, theatre provides a framework to reflect upon how the ethical, legal, and social implications of emerging technologies evolve over time and how attempts to control fate through medical science have shaped -- and been shaped by -- personal and professional relationships. The drama of these human interactions is powerful and has the potential to generate fear, create hope, transform identity, and inspire empathy -- a vivid source to observe the complex implications of translating research into clinical practice through …

Application Of Nanomedicine In Emergency Medicine: Point-Of-Care Testing And Drug Delivery In Twenty - First Century, Ali Pourmand, Mohammed Reza Pourmand, Justin Wang, Robert Shesser

Emergency Medicine Faculty Publications

The application of emerging nanotechnology to the practice of medicine represents a frontier of nanomedicine. Nanomedicine has been defined as a science which emphasizes the use of nanoscale tools in conjunction with background knowledge of the human body for medical diagnosis and treatment. Application of nanomedicine in EM may give EM providers the opportunity to diagnose and treat life-threatening diseases in a shorter period of time. These applications include diagnostic utilities, preventive medicine, targeted pharmacotherapy, and tissue regeneration.

Hiv-1 Resistant Cdk2-Knockdown Macrophage-Like Cells Generated From 293t Cell-Derived Human Induced Pluripotent Stem Cells, Marina Jerebtsova, Namita Kumari, Min Xu, Gustavo Brito Alvim De Melo, Xiaomei Niu, Kuan-Teh Jeang, Sergei Nekhai

Pediatrics Faculty Publications

A major challenge in studies of human diseases involving macrophages is low yield and heterogeneity of the primary cells and limited ability of these cells for transfections and genetic manipulations. To address this issue, we developed a simple and efficient three steps method for somatic 293T cells reprogramming into monocytes and macrophage-like cells. First, 293T cells were reprogrammed into induced pluripotent stem cells (iPSCs) through a transfection-mediated expression of two factors, Oct-4 and Sox2, resulting in a high yield of iPSC. Second, the obtained iPSC were differentiated into monocytes using IL-3 and M-CSF treatment. And third, monocytes were differentiated into …

Reasons For Low Pandemic H1n1 2009 Vaccine Acceptance Within A College Sample, Russell D. Ravert, Linda Y. Fu

Pediatrics Faculty Publications

This study examined health beliefs associated with novel influenza A (H1N1) immunization among US college undergraduates during the 2009-2010 pandemic. Undergraduates (ages 18–24 years) from a large Midwestern University were invited to complete an online survey during March, 2010, five months after H1N1 vaccines became available. Survey items measured H1N1 vaccine history and H1N1-related attitudes based on the health belief literature. Logistic regression was used to identify attitudes associated with having received an H1N1 vaccine, and thematic analysis of student comments was conducted to further understand influences on vaccine decisions. Among the 296 students who participated in the survey, 15.2% …

Tetanus Toxoid, Reduced Diphtheria Toxoid And Acellular Pertussis Vaccination And Influenza Vaccination Of Pregnant And Postpartum Women, Colleen M. Mccormick

Master of Public Health Program Student Publications

Introduction: Infants ≤2 months are at greatest risk for morbidity/mortality from pertussis. Tdap vaccines given in late pregnancy or postpartum can protect infants from pertussis. Pregnancy increases risks for maternal and perinatal complications. Influenza vaccine (FLUV) given in pregnancy can protect women and newborns.

Objectives: To determine Tdap and FLUV rates in pregnant and postpartum patients and identify factors associated with vaccination.

Methods: Miami Valley Hospital delivery records from 01/2009-12/2011 were retrospectively reviewed. Data reviewed included age, insurance, race/ethnicity, and county of residence. Descriptive statistics analyzed prevalence of immunization, timing, and demographics. Chi-square and odds ratios detected differences between characteristics. …

Neurotechnology And Psychiatric Biomarkers, William Bosl

Nursing and Health Professions Faculty Research and Publications

No abstract provided.

Graduate Medical Education 2011-2012 Annual Report, Children's Mercy Hospital

GME Annual Reports

Annual report of the Children's Mercy Hospital Graduate Medical Education department, including pediatric residency, internal medicine/pediatrics residency, fellowship programs, medical students, continuing medical education, and library services.

Patient- And Population-Level Health Consequences Of Discontinuing Antiretroviral Therapy In Settings With Inadequate Hiv Treatment Availability, April D. Kimmel, Stephen C. Resch, Xavier Anglaret, Norman Daniels, Sue J. Goldie, Christine Daniel, Angela Y. Wong, Kenneth A. Freedberg, Milton C. Weinstein

Health Policy Publications

Background

In resource-limited settings, HIV budgets are flattening or decreasing. A policy of discontinuing antiretroviral therapy (ART) after HIV treatment failure was modeled to highlight trade-offs among competing policy goals of optimizing individual and population health outcomes.

Methods

In settings with two available ART regimens, we assessed two strategies: (1) continue ART after second-line failure (Status Quo) and (2) discontinue ART after second-line failure (Alternative). A computer model simulated outcomes for a single cohort of newly detected, HIV-infected individuals. Projections were fed into a population-level model allowing multiple cohorts to compete for ART with constraints on treatment capacity. In the …

Children's Mercy Hospital Annual Report 2011, Children's Mercy Hospital

Children's Mercy Annual Reports

Annual report for The Children's Mercy Hospital in Kansas City MO, a pediatric medical center.

Early Events In Herpes Simplex Virus Lifecycle With Implications For An Infection Of Lifetime, Sarah Salameh '12, Urmi Sheth '12, Deepak Shukla

Student Publications & Research

Affecting a large percentage of human population herpes simplex virus (HSV) types -1 and -2 mainly cause oral, ocular, and genital diseases. Infection begins with viral entry into a host cell, which may be preceded by viral “surfing” along filopodia. Viral glycoproteins then bind to one or more of several cell surface receptors, such as herpesvirus entry mediator (HVEM), nectin-1, 3-O sulfated heparan sulfate (3-OS HS), paired immunoglobulin-like receptor, and non-muscle myosin-IIA. At least five viral envelope glycoproteins participate in entry and these include gB, gC, gD and gH-gL. Post-entry, these glycoproteins may also facilitate cell-to-cell spread of the virus, …

Community Perspectives On Research Consent Involving Vulnerable Children In Western Kenya, Rachel Vreeman, Eunice Kamaara, Allan Kamanda, David Ayuku, Winstone Nyandiko, Lukoye Atwoli, Samuel Ayaya, Peter Gisore, Michael Scanlon, Paula Braitstein

Paediatrics and Child Health, East Africa

Involving vulnerable pediatric populations in international research requires culturally appropriate ethical protections. We sought to use mabaraza, traditional East African community assemblies, to understand how a community in western Kenya viewed participation of children in health research and informed consent and assent processes. Results from 108 participants revealed generally positive attitudes towards involving vulnerable children in research, largely because they assumed children would directly benefit. Consent from parents or guardians was understood as necessary for participation while gaining child assent was not. They felt other caregivers,community leaders, and even community assemblies could participate in the consent process. Community members believed …

Newer Agents In Antiplatelet Therapy: A Review., Jennifer Yeung, Michael Holinstat

Cardeza Foundation for Hematologic Research

Antiplatelet therapy remains the mainstay in preventing aberrant platelet activation in pathophysiological conditions such as myocardial infarction, ischemia, and stroke. Although there has been significant advancement in antiplatelet therapeutic approaches, aspirin still remains the gold standard treatment in the clinical setting. Limitations in safety, efficacy, and tolerability have precluded many of the antiplatelet inhibitors from use in patients. Unforeseen incidences of increased bleeding risk and recurrent arterial thrombosis observed in patients have hampered the development of superior next generation antiplatelet therapies. The pharmacokinetic and pharmacodynamic profiles have also limited the effectiveness of a number of antiplatelet inhibitors currently in use …

Childhood Unintentional Injuries: Need For A Community-Based Home Injury Risk Assessments In Pakistan., Adnan A. Hyder, Aruna Chandran, Uzma R. Khan, Nukhba Zia, Cheng-Ming Huang, Sarah Stewart De Ramirez, Junaid Razzak

Department of Emergency Medicine

Background. A substantial proportion of the annual 875,000 childhood unintentional injury deaths occur in the home. Very few printed tools are available in South Asia for disseminating home injury prevention information. Methods. Three tools were planned: an injury hazard assessment tool appropriate for a developing country setting, an educational pamphlet highlighting strategies for reducing home injury hazards, and an in-home safety tutorial program to be delivered by a trained community health worker. Results. The three tools were successfully developed. Two intervention neighborhoods in Karachi, Pakistan, were mapped. The tools were pretested in this local setting and are now ready for …

Nitric Oxide Metabolites As Biomarkers For Influenza-Like Acute Respiratory Infections Presenting To The Emergency Room, Asad Mian, Federico R Laham, Andrea T Cruz, Harsha Garg, Charles G Macias, A. Chantal Caviness, Pedro A Piedra

Department of Emergency Medicine

Aims: Nitric oxide (NO) is increased in the respiratory tract in pulmonary infections. The aim was to determine whether nasal wash NO metabolites could serve as biomarkers of viral pathogen and disease severity in children with influenza-like illness (ILI) presenting to the emergency department (ED) during the 2009 influenza A H1N1 pandemic.
Methods: Children ≤18 years old presenting to the ED with ILI were eligible. Nasal wash specimens were tested for NO metabolites, nitrate and nitrite, by HPLC and for respiratory viruses by real-time PCR.
Results: Eighty-nine patients with ILI were prospectively enrolled during Oct-Dec, 2009. In the …