Digital Commons Network^™

Book Review: Surrogacy: A Human Rights Violation By Renate Klein, Sheela Saravanan

Dignity: A Journal of Analysis of Exploitation and Violence

No abstract provided.

Routine Antenatal Ultrasound In Low- And Middle-Income Countries: First Look - A Cluster Randomised Trial, Robert L. Goldenberg, Robert O. Nathan, David Swanson, Sarah Saleem, Waseem Mirza, Fabian Esamai, David Muyodi, Ana L. Garces, Lester Figueroa, Elwyn Chomba

Community Health Sciences

Objective: Ultrasound is widely regarded as an important adjunct to antenatal care (ANC) to guide practice and reduce perinatal mortality. We assessed the impact of ANC ultrasound use at health centers in resource-limited countries.
Design: Cluster randomized trial.
Settings: Clusters within five countries (Democratic Republic of Congo, Guatemala, Kenya, Pakistan and Zambia).
Methods: Clusters were randomized to standard ANC or standard care plus two ultrasounds and referral for complications. The study trained providers in intervention clusters to perform basic obstetric ultrasounds.
Main Outcome Measures: The primary outcome was a composite of maternal mortality, maternal near-miss mortality, stillbirth, and neonatal mortality. …

Obesity: Modern Medicine Vs. Lifestyle, Jenny Christianson

Physician Assistant Scholarly Project Papers

Obesity is a rising epidemic, and is one of the most common, costly and preventable health problems the world is experiencing today (Center for Disease Control and Prevention, [CDC], 2017). From this, it is important to establish an effective treatment plan that can be implemented across the nation for maximum patient benefit. Lifestyle changes such as diet and exercise are important to any health care plan and are equally necessary to reduce health risks. However, in certain patients, lifestyle changes are not enough due to the maladaptive biologic process in their brain. From this, additional treatment options need to be …

Invasive Trichosporonosis Treated With Voriconazole, Vaibhav Garg, Elizabeth Jones, Ben J. Friedman, Jason B. Lee, Sherry Yang

Department of Dermatology and Cutaneous Biology Faculty Papers

Introduction

Trichosporon is a genus of yeast-like fungi. It is perhaps most widely known as the cause of white piedra, a benign superficial mycosis seen in immunocompetent individuals in tropical and subtropical regions. However, the incidence of invasive trichosporonosis has increased in immunocompromised patients, most notably those with hematologic malignancies. The following case illustrates characteristic features of trichosporonosis fungemia.

The Effect Of Napping On Sleep Quality And Quantity In Healthy And Concussed Collegiate Athletes, Katie Stephenson-Brown

Graduate Theses and Dissertations

Clinicians are increasingly prescribing a regulated sleep schedule to athletes post injury; however, baseline sleep habits of collegiate athletes are unknown. Moreover, the connection between napping and sleep quality and quantity has not been studied in collegiate athletes. Therefore, the purpose of this study is to investigate napping behaviors and their effects on sleep quantity and quality in concussed and non-concussed collegiate athletes. In a sample of 233 non-concussed collegiate athletes, 74% (172/233) of participants reported napping. Napping was not significantly associated with sleep quantity (χ 2 (2) = .23, p = .64) or quality (χ 2 (1) = .42, …

A Review Of Mesenchymal Stem Cell Injections For Osteoarthritis, Ammar Qureshi, Jill Goodwin, Franklin D. Shuler, Timothy Wilson-Byrne, John J. Jasko, Charles Giangarra

Marshall Journal of Medicine

Mesenchymal stem cell (MSC) injections for osteoarthritis is reviewed.

Methods- PubMed search identifying articles in English from 2003-2018 that used intra- articular injection (IA), cartilage repair, cartilage regeneration, chondral injury, adipose stem cells, bone marrow stem cells, mesenchymal stem cells, or autologous stem cells.

Results – 388 patients receiving IA MSC injections are discussed with data obtained from 10 case reports or case series, 4 randomized clinical trials (RCT), 1 cohort study, and 3 case controlled therapeutic studies.

Conclusions – MSC injections may be an effective adjunct in the management of osteoarthritis and a variety of cartilage related pathologies.

The Effect Of Hepatitis C On Maternal Bile Acid Level And The Fetal Left Ventricular Tei Index, Kelly Cummings, Jesse Cottrell, Songthip Ounpraseuth, Ryan Stone, David G. Chaffin, Everett Magann

Marshall Journal of Medicine

Hepatitis C (HCV) is a common form of liver disease encountered in pregnancy. The purpose of this study is to evaluate if hepatitis C is associated with elevated maternal serum bile acids and abnormal fetal cardiac function measured by the left ventricular Tei index in the absence of intrahepatic cholestasis of pregnancy. This is a prospective cohort study on pregnant women with hepatitis C seen through Marshall University’s high-risk obstetrics clinic from 2013 to 2014. Women with hepatitis C had a laboratory evaluation and an ultrasound on the fetus to calculate the left ventricular Tei index. Demographic information and delivery …

Post-Traumatic Stress Disorder: Review Of Dsm Criteria And Functional Neuroanatomy, Cornelius W. Thomas

Marshall Journal of Medicine

The Diagnostic and Statistical Manual of Mental Disorders (DSM-5) criteria for post-traumatic stress disorder (PTSD) consist of over twenty possible symptoms that can be divided into six broad categories. These categories correlate with specific brain networks that regulate emotions, behaviors, and autonomic function. Normal functioning of these networks depends on two key regions; the prefrontal cortex and the amygdala. The prefrontal cortex provides top-down executive control over amygdala, whereas the amygdala is critical for threat detection and activation of the ‘fight or flight’ response. Events that trigger extreme and/or prolonged fear can cause persisting dysregulation within the prefrontal-amygdala circuit; resulting …

Herpes Zoster Patient Education: A Coloring Book Approach, Sophia Charuhas

Senior Honors Theses

Shingles, the disease caused by the herpes zoster virus, is a widespread and widely misunderstood illness in the United States. It is preventable, but many at-risk patients do not know what measures they may take to prevent it. Clear communication from physician to patient is crucial for patient understanding of diseases. Many patient education materials on herpes zoster currently available are often unused. It is therefore beneficial to public health to disseminate new mediums of medical communication, and one way of accomplishing this is through adult coloring books. The pathophysiology of herpes zoster virus is here explored and the idea …

A Cytotoxic Evaluation Of A Chalcone Derivative Library On A549 Cells, Mary Elaine Kuo

Undergraduate Theses

Chalcones, a precursor to flavonoids, are chemical compounds found naturally in plants. The chalcones’ structure consists of a ketone bridge attached to two aromatic rings. Varying substituents on the aromatic rings allow for different affects, including anti-cancer properties. As a Michael acceptor, chalcones interact with pathways that cause inhibition of the initiation, promotion, and progression of cancer tumors. We have screened 32 compounds for growth inhibition in lung cells that vary the flexibility and confirmation of the 3 carbon bridge between the two aromatic rings as well as the effects of electronic modifications to the aromatic ring. We have found …

Investigating The Synergistic Effects Of Two Curcuminoids And Cisplatin On Cancer Cell Migration, Blaine Patty

Mahurin Honors College Capstone Experience/Thesis Projects

Cisplatin is a common chemotherapy drug used to treat various cancers; however, it is relatively ineffective against many cancers, including several types of lung cancer. One approach that could improve cisplatin’s effect is to combine it with another drug that produces a synergistic response greater than either drug alone. Curcumin, a naturally occurring plant compound, has been investigated for synergisms in conjunction with cisplatin chemotherapy, but curcumin use is hampered by its low bioavailability. This project investigated whether two synthetic curcumin analogs, EF-24 and CLEFMA (curcuminoids), which have greater solubility than curcumin, could, when combined with cisplatin, decrease the migration …

Stress, Anxiety And Depression In Students Of A Private Medical School In Karachi, Pakistan, Noman Rehmani, Qurat Ul Ain Khan, Syeda Sadia Fatima

Department of Psychiatry

Objective: To determine frequency of stress, anxiety and depression and their coping mechanisms in undergraduate students of a private sector university.

Methods: A cross sectional study was conducted at Aga Khan University recruiting students from Medical School, School of Nursing & Midwifery, and Dental Hygiene program who had attended at least six months on campus from October 2016 until August 2017. The “Aga Khan University Anxiety and Depression Scale” and “Student-Life Stress Inventory” scales were used to assess depression and anxiety, and stressors.

Results: A total of 283 students participated in this study and all of them scored higher than …

Original Parts: Aging And Reckoning With Cystic Fibrosis Related Kidney Disease, Alexandra Ch Nowakowski

Patient Experience Journal

Kidney disease increasingly impacts people with cystic fibrosis (CF) as adult patients continue to survive longer. Yet the literature on CF related kidney disease focuses little on amplifying the voices of people aging with the condition. This article presents perspectives on CF related kidney disease from a medical sociologist who is themselves managing these issues. It (1) gives an overview of relevant literature and trends in epidemiological data on kidney disease and CF, (2) details the author’s own process of adjusting to progressive changes in renal function, and (3) outlines opportunities for clinicians to make a positive impact for patients …

Investigating The Synergistic Effects Of Two Curcuminoids And Cisplatin On Cancer Cell Reactive Oxygen Species, Matthew Millay

Mahurin Honors College Capstone Experience/Thesis Projects

Cisplatin is an anticancer drug which can cause the production of reactive oxygen species (ROS) that kill cancer cells. Curcumin is a naturally occurring plant compound that can increase ROS levels in cancer cells and enhance the activity of cisplatin against cancer, but it exhibits poor bioavailability. We investigated whether two synthetic curcumin analogs (curcuminoids), EF-24 and CLEFMA, with anti-cancer activity and improved bioavailability, increased cisplatin’s effect against cancer. A spectrophotometric fluorescent ROS assay was used to determine if cisplatin, the curcuminoids or combinations of cisplatin with a curcuminoid affected the level of ROS in the A549 non-small cell lung …

Dosimetric Feasibility Of 4dct-Ventilation Imaging Guided Proton Therapy For Locally Advanced Non-Small-Cell Lung Cancer, Qijie Huang, Salma K. Jabbour, Zhiyan Xiao, Ning Yue, Xiao Wang, Hongbin Cao, Yu Kuang, Yin Zhang, Ke Nie

Health Physics and Diagnostic Sciences Faculty Research

Background The principle aim of this study is to incorporate 4DCT ventilation imaging into functional treatment planning that preserves high-functioning lung with both double scattering and scanning beam techniques in proton therapy. Methods Eight patients with locally advanced non-small-cell lung cancer were included in this study. Deformable image registration was performed for each patient on their planning 4DCTs and the resultant displacement vector field with Jacobian analysis was used to identify the high-, medium- and low-functional lung regions. Five plans were designed for each patient: a regular photon IMRT vs. anatomic proton plans without consideration of functional ventilation information using …

Evaluation Of Oxytocin And Serotonin Levels In Autism Spectrum Disorder, Amal El-Ramly, Azza Samy, Eman Soliman, Golnar Oteify

Journal of Medicine in Scientific Research

Objective Autism spectrum disorder (ASD) is a complex neurological and developmental disorder that affects how a person acts and interacts, communicates with others, and learns. Endocrine and neuropeptide factors are some among the list of possible etiologic or predisposing contenders. Abnormalities in the brain serotonin system are reported in ASD, including evidence of altered serotonin synthesis and receptor binding, as well as dystrophic serotonergic axons. Blood oxytocin levels are also a focus of ASD research. This work aimed to assess oxytocin and serotonin levels as biomarkers in individuals with ASD. Participants and methods Serotonin and oxytocin levels, as biochemical parameters …

Outcome Of Cochlear Implantation In Children With Enlarged Vestibular Aqueduct (Eva) And Mondini Dysplasia (Incomplete Partition Type Ii), Abir Omara, Amr Younes, Azza Sami, Ihab Sefein, Iman Elrouby, Soha Hamada

Journal of Medicine in Scientific Research

Background Congenital inner ear abnormality is a major cause of sensorineural hearing loss in children, about 20% of children with congenital sensorineural hearing loss (SNHL) have associated malformations of the temporal bone, and increased experience in cochlear implantation has led to more children with abnormal cochleo-vestibular anatomy submitted to this procedure. Aim To evaluate the outcome of cochlear implantation in cases with enlarged vestibular aqueduct (EVA) and Mondini deformity (incomplete partition type II) following cochlear implantation and comparing the results with cochlear implant cases without inner ear anomalies. Patients and methods 69 children all less than 6 years of age, …

Association Study Between Polymorphisms Of Dopamine Transporter Gene (Slc6a3), Dopamine D1 Receptor Gene (Drd1), And Autism, Azza Abdel Aziz Azzam, Dina Mohammad Rasheed Bahgat, Ranaih Massoud Azme Nasralla, Rasha Mohamad Hosny Shahin

Journal of Medicine in Scientific Research

Introduction Autism is an etiologically and clinically heterogeneous group of disorders, collectively referred to as 'autism spectrum disorders'. Dopamine (DA) modulates a wide variety of processes, functions, and behaviors that are abnormal in individuals with autism spectrum disorders. The DA transporter gene SLC6A3 (solute carrier family 6, member 3) is a crucial regulator of DA homeostasis and neurotransmission. SLC6A3 gene has many polymorphisms which are associated with hangs in gene expression that may affect extracellular DA levels. The rs2550936 single-nucleotide polymorphism (SNP) at SLC6A3 gene decreased SLC6A3 expression or DA transporter availability. Also, the rs4532 SNP at dopamine D1 receptors …

Contrast-Enhanced Ultrasound Identifies Early Extrahepatic Collateral Contributing To Residual Hepatocellular Tumor Viability After Transarterial Chemoembolization., Sriharsha Gummadi, Maria Stanczak, Andrej Lyshchik, Flemming Forsberg, Colette M. Shaw, John R. Eisenbrey

Department of Radiology Faculty Papers

The mainstay of treatment for unresectable hepatocellular carcinoma is locoregional therapy including percutaneous ablation and transarterial chemo- and radioembolization. While monitoring for tumor response after transarterial chemoembolization is crucial, current imaging strategies are suboptimal. The standard of care is contrast-enhanced magnetic resonance imaging or computed tomography imaging performed at least 4 to 6 weeks after therapy. We present a case in which contrast-enhanced ultrasound identified a specific extra-hepatic collateral from the gastroduodenal artery supplying residual viable tumor and assisting with directed transarterial management.

Abdominal Wall Reconstruction After Extirpation Of A 140 Pound Primary Ovarian Mucinous Adenocarcinoma: A Case Report., Mamtha Raj Md, Sean J. Wallace Md, Nathan F. Miller Md, Randolph Wojcik Md

Department of Surgery

No abstract provided.

Human Cancer And Platelet Interaction, A Potential Therapeutic Target, Shike Wang, Zhenyu Li, Ren Xu

Markey Cancer Center Faculty Publications

Cancer patients experience a four-fold increase in thrombosis risk, indicating that cancer development and progression are associated with platelet activation. Xenograft experiments and transgenic mouse models further demonstrate that platelet activation and platelet-cancer cell interaction are crucial for cancer metastasis. Direct or indirect interaction of platelets induces cancer cell plasticity and enhances survival and extravasation of circulating cancer cells during dissemination. In vivo and in vitro experiments also demonstrate that cancer cells induce platelet aggregation, suggesting that platelet-cancer interaction is bidirectional. Therefore, understanding how platelets crosstalk with cancer cells may identify potential strategies to inhibit cancer metastasis and to reduce …

Multi-Institution Analysis Of Racial Disparity Among African- American Men Eligible For Prostate Cancer Active Surveillance, Michael Dinizo, Weichung Shih, Young Suk Kwon, Daniel Eun, Adam Reese, Laura Giusto, Edouard J. Trabulsi, Bertram Yuh, Nora Ruel, Daniel Marchalik, Jonathan Hwang, Shilajit D. Kundu, Scott Eggener, Isaac Yi Kim

Department of Urology Faculty Papers

There is a significant controversy on whether race should be a factor in considering active surveillance for low-risk prostate cancer. To address this question, we analyzed a multi-institution database to assess racial disparity between African-American and White-American men with low risk prostate cancer who were eligible for active surveillance but underwent radical prostatectomy. A retrospective analysis of prospectively collected clinical, pathologic and oncologic outcomes of men with low-risk prostate cancer from seven tertiary care institutions that underwent radical prostatectomy from 2003–2014 were used to assess potential racial disparity. Of the 333 (14.8%) African-American and 1923 (85.2%) White-American men meeting active …

Mechanisms Of Sleep And The Brain, Doungbagai Leo

Honors Theses

One of the most important homeostatic functions of the brain and body is sleep. This literary review analyzes the genes that are involved in sleep: Clock, Bmal1, Period, and Cryptochrome. It also explains the role of melatonin, GABA, orexin, and melanopsin during sleep regulation. The genes and neurotransmitters influence the suprachiasmatic nuclei and the circadian rhythm that our brain, and every cell of our bodies, have connections to. These connection help to ensure the homeostatic function of our bodies. The analysis of sleep-like states in other animals may show an evolutionary connection of sleep from non-mammals to mammals, but may …

Out Of The Shell: Exploring The Phagocytic Capabilities Of The B Cell And Isolated Lymphoid Follicle-Lie Structures In The Red-Eared Slider, Trachemys Scripta, Marc A. Ashford Jr.

Theses and Dissertations

Management of immunity is crucial for survival in all living organisms. While there is a large amount of research for established model organisms, such as the mouse model, much less is known about reptiles. When compared to immunity in mammals, we discover many differences such as susceptibility to certain pathogens, alteration of immune processes due to environmental temperature, the total absence of certain lymphoid organs contained in mammals, among many others. Despite this, the reptile has shown in many studies that they are worthy systems to study immunity in an evolutionary perspective and recent studies may show that they may …

Do Global Diets Affect The Rate Of Type 2 Diabetes?, Demetria Meyer

Honors Theses

The purpose of this study is to determine whether different global diets correlate with the increase in type 2 diabetes rates. Type 2 diabetes is the main diabetes type being looked at due to it being the one that can be maintained primarily by glycemic control, which is controlled by a good diet. Five different countries from different regions will be examined: Brazil, China, Micronesia, Nigeria, and the United States. The diets of these countries will be broken down into smaller pieces, like calories consumed each day and the percentage of macronutrients that make up the calories. Eleven food groups …

Preclinical Comparison Of Proteasome And Ubiquitin E1 Enzyme Inhibitors In Cutaneous Squamous Cell Carcinoma: The Identification Of Mechanisms Of Differential Sensitivity, Angela Mchugh, Kenneth Fernandes, Andrew P. South, Jemima E. Mellerio, Julio C. Salas-Alanis, Charlotte M. Proby, Irene M. Leigh, Mark K. Saville

Department of Dermatology and Cutaneous Biology Faculty Papers

Proteasome inhibitors have distinct properties and the biochemical consequences of suppressing ubiquitin E1 enzymes and the proteasome differ. We compared the effects of the proteasome inhibitors bortezomib, ixazomib and carfilzomib and the ubiquitin E1 enzyme inhibitor MLN7243/TAK-243 on cell viability and cell death in normal keratinocytes and cutaneous squamous cell carcinoma (cSCC) cell lines. The effects of both a pulse of treatment and more extended incubation were investigated. This is relevant to directly-delivered therapy (topical treatment/intratumoral injection) where the time of exposure can be controlled and a short exposure may better reflect systemically-delivered inhibitor pharmacokinetics. These agents can selectively kill …

Inhibition Of Insulin‐Like Growth Factor 1 Receptor Enhances The Efficacy Of Sorafenib In Inhibiting Hepatocellular Carcinoma Cell Growth And Survival, Fang Wang, Thomas Bank, George Malnassy, Maribel Arteaga, Na Shang, Annika Dalheim, Xianzhong Ding, Scott J. Cotler, Mitchell F. Denning, Michael I. Nishimura, Peter Breslin, Wei Qiu

Biology: Faculty Publications and Other Works

Hepatocellular carcinoma (HCC) is the fifth most common primary cancer and second largest cause of cancer‐related death worldwide. The first‐line oral chemotherapeutic agent sorafenib only increases survival in patients with advanced HCC by less than 3 months. Most patients with advanced HCC have shown limited response rates and survival benefits with sorafenib. Although sorafenib is an inhibitor of multiple kinases, including serine/threonine‐protein kinase c‐Raf, serine/threonine‐protein kinase B‐Raf, vascular endothelial growth factor receptor (VEGFR)‐1, VEGFR‐2, VEGFR‐3, and platelet‐derived growth factor receptor β, HCC cells are able to escape from sorafenib treatment using other pathways that the drug insufficiently inhibits. The aim …

Sorafenib-Induced Tumor Lysis Syndrome In A Patient With Metastatic Hepatocellular Carcinoma., Sardar Zakariya Imam, Mohammad Faizan Zahid, Muhammad Asad Maqbool

Medical College Documents

Tumor lysis syndrome is a potentially lethal complication of chemotherapy, usually associated with aggressive hematologic malignancies. We describe the case of a young patient with meta-static hepatocellular cancer who developed rapid and fatal tumor lysis syndrome following ini-tiation of sorafenib therapy. Although rare with sorafenib therapy for hepatocellular carcinoma, tumor lysis syndrome is serious complication. Patients with a high burden of disease at therapy initiation should have their metabolic parameters measured prior to starting therapy and closely followed for the first 1–2 weeks while being treated

Loss Of Inter-Cellular Cooperation By Complete Epithelial-Mesenchymal Transition Supports Favorable Outcomes In Basal Breast Cancer Patients., Anne Grosse-Wilde, Rolf E Kuestner, Stephanie M Skelton, Ellie Macintosh, Aymeric Fouquier D'Hérouël, Gökhan Ertaylan, Antonio Del Sol, Alexander Skupin, Sui Huang

Articles, Abstracts, and Reports

According to the sequential metastasis model, aggressive mesenchymal (M) metastasis-initiating cells (MICs) are generated by an epithelial-mesenchymal transition (EMT) which eventually is reversed by a mesenchymal-epithelial transition (MET) and outgrowth of life-threatening epithelial (E) macrometastases. Paradoxically, in breast cancer M signatures are linked with more favorable outcomes than E signatures, and M cells are often dispensable for metastasis in mouse models. Here we present evidence at the cellular and patient level for the cooperation metastasis model, according to which E cells are MICs, while M cells merely support E cell persistence through cooperation. We tracked the fates of co-cultured E …

Bilateral Carotid Artery Stenosis Causes Unexpected Early Changes In Brain Extracellular Matrix And Blood-Brain Barrier Integrity In Mice, Jill M. Roberts, Michael E. Maniskas, Gregory J. Bix

Neuroscience Faculty Publications

Bilateral carotid artery stenosis (BCAS) is one experimental model of vascular dementia thought to preferentially impact brain white matter. Indeed, few studies report hippocampal and cortical pathology prior to 30 days post-stenosis; though it is unclear whether those studies examined regions outside the white matter. Since changes in the blood-brain barrier (BBB) permeability precede more overt brain pathology in various diseases, we hypothesized that changes within the BBB and/or BBB-associated extracellular matrix (ECM) could occur earlier after BCAS in the hippocampus, cortex and striatum and be a precursor of longer term pathology. Here, C57Bl/6 mice underwent BCAS or sham surgeries …