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Rare Presentation Of Posterior Reversible Encephalopathy Syndrome (Pres) And Neurogenic Stunned Myocardium In A Patient After Emergency Cesarean Section, Ausaf Ahmed Khan, Khalid Samad, Kashif Munshi, Madiha Hashmi

Department of Anaesthesia

Posterior Reversible Encephalopathy Syndrome (PRES) is clinically characterized by seizures, lethargy, nausea and visual impairment. These findings are thought to be due to vasogenic edema, predominantly in the posterior cerebral hemispheres and are reversible with appropriate management. Neurogenicstunned myocardium is a syndrome of reversible left ventricular dysfunction, associated with excessive sympathetic discharge states like pheochromocytoma, high-grade subarachnoid hemorrhage (SAH), status epilepticus and significant emotional stress. Here, we report a case of PRES and Neurogenic-stunned myocardium occurring simultaneously in a 25 year old primigravida at 34 weeks of gestation with twin pregnancy who presented to the emergency department with eclampsia and …

Anesthesia For Cardiac Catheterization Procedures, A Hamid

Department of Anaesthesia

Anesthesiologist's involvement for the purpose of diagnostic and interventional procedures in cardiac catheterization laboratory has been evolving particularly since last two decades. Catheterization laboratory environment poses certain challenges for the anesthesiologist including unfamiliar remote location, exposure to radiation, limited help from colleagues and communication with cardiologists. Anesthesiologists working in catheterization laboratory are required to have adequate knowledge of the environment, personnel, fluoroscope, echocardiography and type of radio contrast dye during the procedure. Anyone who is exposed to radiation environment is expected to protect himself from the exposure and must also wear a dosimeter for cumulative exposure tracing.There is no ideal …

Cervical Cancer Histology Image Feature Extraction And Classification, Peng Guo

Masters Theses

"Cervical cancer, the second most common cancer affecting women worldwide and the most common in developing countries can be cured if detected early and treated. Expert pathologists routinely visually examine histology slides for cervix tissue abnormality assessment. In previous research, an automated, localized, fusion-based approach was investigated for classifying squamous epithelium into Normal, CIN1, CIN2, and CIN3 grades of cervical intraepithelial neoplasia (CIN) based on image analysis of 62 digitized histology images obtained through the National Library of Medicine. In this research, CIN grade assessments from two pathologists are analyzed and are used to facilitate atypical cell concentration feature development …

Survival After Pneumonectomy For Stage Iii Non-Small Cell Lung Cancer, Sibu P. Saha, Rohan J. Kalathiya, Daniel L. Davenport, Victor A. Ferraris, Timothy W. Mullett, Joseph B. Zwischenberger

Surgery Faculty Publications

OBJECTIVES: Stage III non-small cell lung cancer (NSCLC) has a poor prognosis. Reports suggest that five-year survival after current treatment is between 14 to 24 percent. The purpose of this retrospective study was to investigate the morbidity and mortality of patients diagnosed with stage III NSCLC and treated with pneumonectomy at the University of Kentucky Medical Center in Lexington, KY.

METHODS: We reviewed the medical record and tumor registry follow-up data on 100 consecutive patients who underwent pneumonectomy for lung cancer at the University of Kentucky.

RESULTS: We identified thirty-six patients in stage III who underwent pneumonectomy. Ten patients had …

International Standards For Fetal Growth Based On Serial Ultrasound Measurements: The Fetal Growth Longitudinal Study Of The Intergrowth-21st Project, Aris T. Papageorghiou, Eric O. Ohuma, Douglas G. Altman, Tullia Todros, Leila Cheikh Ismail, Ann Lambert, Yasmin A. Jaffer, Enrico Bertino, Michael G. Gravett, J Alison Noble, Ruyan Pang, Cesar G. Victora, Fernando C. Barros, Maria Carvalho, Laurent J. Salomon, Zulfiqar A. Bhutta, Stephen H. Kennedy, José Villar

Obstetrics and Gynaecology, East Africa

Background: In 2006, WHO produced international growth standards for infants and children up to age 5 years on the basis of recommendations from a WHO expert committee. Using the same methods and conceptual approach, the Fetal Growth Longitudinal Study (FGLS), part of the INTERGROWTH-21st Project, aimed to develop international growth and size standards for fetuses.

Methods: The multicentre, population-based FGLS assessed fetal growth in geographically defined urban populations in eight countries, in which most of the health and nutritional needs of mothers were met and adequate antenatal care was provided. We used ultrasound to take fetal anthropometric measurements prospectively from …

Characteristics Of Participants In An Hiv Prevention Intervention For Youth In Rwanda: Results From A Longitudinal Study, Hanne Celis, Brian A. Jingwa, Olivier Degomme, Ronan Van Rossem, Marleen Temmerman, Kristien Michielsen

Obstetrics and Gynaecology, East Africa

Introduction: This paper studies determinants of participation in a peer-led school-based HIV prevention intervention in Rwanda.

Methods: A baseline survey among 1071 students (mean age 17 years) assessed potential determinants of participation, while a follow-up six months in the intervention measured actual participation in the intervention. Statistical models were built using multivariate linear and multinomial regression analysis predicting overall participation, participation in group discussions and individual counseling.

Results: Those who recently had sex, had been tested for HIV, feel more susceptible to HIV, have a higher sexual self-concept, a more positive future perspective (only for non-sexually active), and boys, were …

Pregnancy Outcomes In Benghazi, Libya, Before And During The Armed Conflict In 2011, Z. Bodalal, K. Agnaeber, N. Nagelkerke, B. Stirling, Marleen Temmerman, O. Degomme

Obstetrics and Gynaecology, East Africa

Stressful life events experienced by pregnant women may lead to adverse obstetric outcomes. This study in Benghazi compared the rates of preterm, low-birth-weight and caesarean-section births at Al-Jamhouria hospital in the months before and during the armed conflict in Libya in 2011. Data were collected on all women admitted to the delivery ward during February to May 2011 (the months of the most active fighting in the city) (n = 7096), and October to December 2010 (the months immediately before the war) (n = 5935). Compared with the preceding months there was a significant rise during the conflict in the …

A Cross-Sectional Study On Attitudes Toward Gender Equality, Sexual Behavior, Positive Sexual Experiences, And Communication About Sex Among Sexually Active And Non-Sexually Active Adolescents In Bolivia And Ecuador, Sara De Meyer, Lina Jaruseviciene, Apolinaras Zaborskis, Peter Decat, Bernardo Vega, Kathya Cordova, Marleen Temmerman, Olivier Degomme, Kristien Michielsen

Obstetrics and Gynaecology, East Africa

Background: It is widely agreed upon that gender is a key aspect of sexuality however, questions remain on how gender exactly influences adolescents’ sexual health.

Objective: The aim of this research was to study correlations between gender equality attitudes and sexual behavior, sexual experiences and communication about sex among sexually active and non-sexually active adolescents in 2 Latin American countries.

Design: In 2011, a cross-sectional study was carried out among 5,913 adolescents aged 14–18 in 20 secondary schools in Cochabamba (Bolivia) and 6 secondary schools in Cuenca (Ecuador). Models were built using logistic regressions to assess the …

Sexual Health Is Dead In My Body: Participatory Assessment Of Sexual Health Determinants By Refugees, Asylum Seekers And Undocumented Migrants In Belgium And The Netherlands, Ines Keygnaert, Nicole Vettenburg, Kristien Roelens, Marleen Temmerman

Obstetrics and Gynaecology, East Africa

Background: Although migrants constitute an important proportion of the European population, little is known about migrant sexual health. Existing research mainly focuses on migrants’ sexual health risks and accessibility issues while recommendations on adequate sexual health promotion are rarely provided. Hence, this paper explores how refugees, asylum seekers and undocumented migrants in Belgium and the Netherlands define sexual health, search for sexual health information and perceive sexual health determinants.

Methods: Applying Community-based Participatory Research as the overarching research approach, we conducted 223 in-depth interviews with refugees, asylum seekers and undocumented migrants in Belgium and the Netherlands. The Framework Analysis Technique …

Promoting Reproductive Options For Hiv-Affected Couples In Sub-Saharan Africa, Okeoma Mmeje, Craig R. Cohen, Alfred Murage, John Ong’Ech, James Kiarie, Sheryl Van Der Poel

Obstetrics and Gynaecology, East Africa

HIV-affected couples have unique challenges that require access to information and reproductive services which prevent HIV transmission to the uninfected partner and offspring while allowing couples to fulfill their reproductive goals. In high HIV prevalent regions of sub-Saharan Africa, HIV-affected couples require multipurpose prevention technologies (MPTs) to enhance their reproductive healthcare options beyond contraception and prevention of HIV/sexually transmitted infections (STIs) to include assistance in childbearing. The unique characteristics of the condom and its accepted use in conjunction with safer conception interventions allow HIV-serodiscordant couples an opportunity to maintain reproductive health, prevent HIV/STI transmission, and achieve their reproductive goals while …

Prescribing Multiple Neurostimulants During Rehabilitation For Severe Brain Injury., Amy A. Herrold, Theresa Louise-Bender Pape, Ann Guernon, Trudy Mallinson, Eileen Collins, Neil Jordan

Clinical Research and Leadership Faculty Publications

Background. Despite a lack of clear evidence, multiple neurostimulants are commonly provided after severe brain injury (BI). The purpose of this study is to determine if the number of neurostimulants received during rehabilitation was associated with recovery of full consciousness or improved neurobehavioral function after severe BI.

Method. Data from 115 participants were extracted from a neurobehavioral observational study database for this exploratory, retrospective analysis. Univariate optimal data analysis was conducted to determine if the number of neurostimulants influenced classification of four outcomes: recovery of full consciousness during rehabilitation, recovery of full consciousness within one year of injury, and meaningful …

A Potential Mechanism For Extracellular Matrix Induction Of Breast Cancer Cell Normality, Robert D. Bruno, Gilbert H. Smith

School of Medical Diagnostics & Translational Sciences Publications

Extracellular matrix proteins from embryonic mesenchyme have a normalizing effect on cancer cells in vitro and slow tumor growth in vivo. This concept is suggestive of a new method for controlling the growth and spread of existing cancer cells in situ and indicates the possibility that extracellular proteins and/or embryonic mesenchymal fibroblasts may represent a fertile subject for study of new anti-cancer treatments.

Choroidal Metastasis From Leiomyosarcoma In Two Cases, Eric Feinstein, Swathi Kaliki, Carol L Shields, Hormoz Ehya, Jerry A Shields

Wills Eye Hospital Papers

Leiomyosarcoma is a malignant tumor of mesenchymal cells and is the most common soft-tissue sarcoma. Leiomyosarcoma is a notably rare tumor in the ophthalmic region and can be of primary, secondary or metastatic origin. To the best of our knowledge, there has only been one published case of leiomyosarcoma metastasis to the choroid. In this case study, we report two cases of primary leiomyosarcoma with metastasis to the choroid of the eye. Both cases displayed systemic metastasis and showed response to high dose plaque radiotherapy. Despite its prevalence as the leading form of sarcoma, leiomyosarcoma rarely metastasizes to the ocular …

The Impact Of Prostate Cancer On Survivors' Sense Of Meaning In Life, Carol Lynn Brady

Walden Dissertations and Doctoral Studies

Research has shown that meaning in life is a universal human need, regardless of cultural identity or education. This research study investigated how the encounter with prostate cancer impacted men's sense of well-being and what they considered meaningful in life. An interpretative phenomenological research design was used because of its descriptive nature and its focus on the individual's perspective. The sample included 6 men between the ages of 18 and 65 who had been out of treatment for 1 year. Participants completed essays about their perceptions and experiences over 3 periods of time: before diagnosis, during treatment, and as survivors. …

Positive Correlation Between The Expression Of Heag1 And Hif-1Α In Breast Cancers: An Observational Study, Qingxuan Lai, Ting Wang, Qingqing Guo, Yuxiang Zhang, Youxin Wang, Li Yuan, Rui Ling, Yan He, Wei Wang

Research outputs 2014 to 2021

Objectives: To explore the expression patterns of Eag1 (ether á go-go 1) and HIF-1α (hypoxia-inducible factor 1α) in a cohort of patients with breast cancer. Setting: Department of general surgery in an upper first-class hospital in Xi'an, China. Participants: A total of 112 female Han Chinese patients with a diagnosis of invasive ductal carcinoma were included. Patients with main internal diseases, such as cardiovascular, endocrine, gastroenterological, haematological, infectious diseases, etc, were excluded. Primary and secondary outcome measures: Expression profiles of Eag1 and HIF-1α. Results: Eag1 and HIF-1α were overexpressed in the tumour tissues compared with the pair-matched control tissues, p=0.002 …

Pulmonary Function In Patients With Huntington's Disease, Alvaro Reyes, Travis Cruickshank, Mel Ziman, Ken Nosaka

Research outputs 2014 to 2021

Background: Huntington's disease (HD) is a neurodegenerative disorder characterized by progressive motor, cognitive and psychiatric disturbances. Chest muscle rigidity, respiratory muscle weakness, difficulty in clearing airway secretions and swallowing abnormalities have been described in patients with neurodegenerative disorders including HD. However limited information is available regarding respiratory function in HD patients. The purpose of this study was to investigate pulmonary function of patients with HD in comparison to healthy volunteers, and its association with motor severity.Methods: Pulmonary function measures were taken from 18 (11 male, 7 female) manifest HD patients (53 ± 10 years), and 18 (10 male, 8 female) …

Endovascular Embolisation Of Visceral Artery Pseudoaneurysms, Yasir Jamil Khattak, Tariq Alam, Rana Hamid Shoaib, Raza Sayani, Tanveer-Ul Haq, Muhammad Awais

Department of Radiology

Objective. To evaluate the technical success, safety, and outcome of endovascular embolization procedure in management of visceral artery pseudoaneurysms. Materials and Methods. 46 patients were treated for 53 visceral pseudoaneurysms at our institution. Preliminary diagnostic workup in all cases was performed by contrast enhanced abdominal CT scan and/or duplex ultrasound. In all patients, embolization was performed as per the standard departmental protocol. For data collection, medical records and radiology reports of all patients were retrospectively reviewed. Technical success, safety, and outcome of the procedure were analyzed. Results. Out of 46 patients, 13 were females and 33 were males. Mean patient …

Functional Genomic And Proteomic Analysis Of Highly Drug Resistant Chronic Myeloid Leukemia, Derrick Matthew Oaxaca

Open Access Theses & Dissertations

Chronic Myeloid Leukemia (CML) has served as a model for how cancer can be selectively targeted with advanced forms of chemotherapies known as kinase inhibitors. Such new therapies have significantly altered the field of oncology and have led to monumental increases in both survival rates and quality of life for cancer patients. However, approximately one-third of CML patients will go on to develop drug resistance against major kinase inhibitors. Along with this, other cancers are showing increased incidences of drug resistance. Understanding how these cancers, such as CML, overcome drug sensitivity is of major importance within the clinic. To predict …

The Symptom Experience Of Patients Receiving Epidermal Growth Factor Receptor Inhibitors, Josephine Ann Howard-Ruben

Dissertations

This study explored the symptom experience of patients receiving epidermal growth factor receptor inhibitors (EGFRIs) for breast, colon, head and neck, and colon cancer. EGFRIs are targeted therapies used at various points along the treatment continuum for these solid tumors, and may be first, second or third-line agents which can be used as single agents or in combination with other therapies. The most common side effect of these agents include dermatologic effects, such as rashes, hair, and nail changes, but they can also contribute to other side effects such as fatigue, anxiety and diarrhea. Most previous work has addressed the …

Aetiology Of Acute Febrile Episodes In Children Attending Korogwe District Hospital In North-Eastern Tanzania, C. Mahende, B. Ngasala, J. Lusingu, A. Butichi, P. Lushino, M. Lemnge, Zul Premji

Pathology, East Africa

Introduction: Although the burden of malaria in many parts of Tanzania has declined, the proportion of children with fever has not changed. This situation underscores the need to explore the possible causes of febrile episodes in patients presenting with symptoms at the Korogwe District Hospital (KDH).

Methods: A hospital based cross-sectional study was conducted at KDH, north-eastern Tanzania. Patients aged 2 to 59 months presenting at the outpatient department with an acute medical condition and fever (measured axillary temperature ≥37.5°C) were enrolled. Blood samples were examined for malaria parasites, human immunodeficiency virus (HIV) and bacterial infections. A urine culture was …

Using Verbal Autopsy To Measure Causes Of Death: The Comparative Performance Of Existing Methods, C.J.L. Mahende, R. Lozano, A.D. Flaxman, P. Serina, D. Phillips, A. Stewart, S.L. James, A. Vahdatpour, C. Atkinson, M.K. Freeman, S.L. Ohno, R. Black, S.M. Ali, A.H. Baqui, L. Dandona, E. Dantzer, G.L. Darmstadt, V. Das, U. Dhingra, A. Dutta, W. Fawzi, S. Gomez, B. Hernandez, R. Joshi, H.D. Kalter, A. Kumar, V. Kumar, M. Lucero, S. Mehta, Zul Premji, D. Ramirez-Villalobos, H. Remolador, I. Riley, M. Romero, M. Said, D. Sanvictores, S. Sazawal, V. Tallo, A. D. Lopez

Pathology, East Africa

Background: Monitoring progress with disease and injury reduction in many populations will require widespread use of verbal autopsy (VA). Multiple methods have been developed for assigning cause of death from a VA but their application is restricted by uncertainty about their reliability.

Methods: We investigated the validity of five automated VA methods for assigning cause of death: InterVA-4, Random Forest (RF), Simplified Symptom Pattern (SSP), Tariff method (Tariff), and King-Lu (KL), in addition to physician review of VA forms (PCVA), based on 12,535 cases from diverse populations for which the true cause of death had been reliably established. For adults, …

A Review Of 74 Patients With Newly Diagnosed Multiple Myeloma At A Tertiary Referral Hospital In Nairobi, Kenya, G. Kiraka, Mbayah Etabale, Riyat Malkit

Pathology, East Africa

Introduction: Multiple myeloma is a neoplastic disorder characterized by clonal proliferation of plasma cells. We aimed to carry out a retrospective audit to describe clinical and laboratory features of patients newly diagnosed with multiple myeloma.

Materials and Methods: Records of all patients initially diagnosed with multiple myeloma at the haematology clinic of Aga Khan University Hospital, Nairobi, from January 1, 1999 to December 31, 2011 were reviewed. Diagnosis of multiple myeloma was based on (1) increased numbers of abnormal, atypical or immature plasma cells in a bone marrow aspirate or trephine, (2) presence of monoclonal protein or free light chains …

Applying Consensus Criteria To The Evaluation Of Patients With Suspected Chronic Lymphocytic Leukemia/Small Lymphocytic Lymphoma, E. Mulwa-Babu, Riyat Malkit, D. Parech

Pathology, East Africa

We describe a series of 5 patients in whom the application of consensus criteria for the diagnosis of chronic lymphocytic leukemia (CLL) led to a revised diagnosis. These patients had been recruited in a wider study describing the occurrence of CLL in Kenya. This case series highlights some of the pitfalls of making a diagnosis of CLL without incorporating all criteria.

Harnessing Microbiome And Probiotic Research In Sub-Saharan Africa: Recommendations From An African Workshop, Gregor Reid, Nicholas Nduti, Wilbert Sybesma, Remco Kort, Tobias R. Kollmann, Rodney Adam, Hamadi Boga, Eric M. Brown, Alexandra Einerhand, Hani El-Nezami, Gregory B. Gloor, Irene I. Kavere, Johanna Lindahl, Amee Manges, Wondu Mamo, Rocio Martin, Amy Mcmillan, Jael Obiero, Pamela A. Ochieng’, Arnold Onyango, Stephen Rulisa, Eeva Salminen, Seppo Salminen, Antony Sije, Jonathan R. Swann, William Van Treuren, Daniel Waweru, Steve J. Kemp

Pathology, East Africa

To augment capacity-building for microbiome and probiotic research in Africa, a workshop was held in Nairobi, Kenya, at which researchers discussed human, animal, insect, and agricultural microbiome and probiotics/prebiotics topics. Five recommendations were made to promote future basic and translational research that benefits Africans.

How Patients' Self-Disclosure About Sickle Cell Pain Episodes To Significant Others Relates To Living With Sickle Cell Disease, Valerian J. Derlega, Louis H. Janda, Jeannie Miranda, Ian A. Chen, B. Mitchell Goodman Iii, Wally Smith

Psychology Faculty Publications

Objectives: This cross-sectional study examines to whom and how fully sickle cell disease (SCD) patients talk to others about sickle cell pain, how helpful it is to talk with others about these pain episodes, and the association between talking to others about sickle cell pain episodes and patients' psychological adjustment and coping strategies in managing the disease.

Methods: A convenience sample of 73 African American patients with SCD (30 men and 43 women), were recruited from two SCD clinics at the time of routine medical visits. Most participants had been diagnosed with hemoglobin SS, and they reported an average number …

Profiles Of Binge Eating: The Interaction Of Depressive Symptoms, Eating Styles, And Body Mass Index, Tyler B. Mason, Robin J. Lewis

Psychology Faculty Publications

Binge eating is associated with depressive symptoms, eating styles, and obesity. However, less is known about interactions between these variables and binge eating. This study examined the relationship between depressive symptoms, eating styles, body mass index, and binge eating. Individuals with a higher body mass index, who reported more depressive symptoms and more external eating, reported the greatest binge eating. Similarly, individuals with a higher body mass index who reported more depressive symptoms and more emotional eating reported the greatest binge eating. These findings demonstrate possible profiles of individuals most at risk for binge eating and associated eating disorders. Copyright …

Evaluation Of Tissue-Engineered Tendon Enthesis Polymer Constructs, Joshua A. Bundy Bs, Mary Beth Wade Phd, Hitomi Nakao Md, Phillip Mcclellan Phd, Qing Yu Phd, Robin Jacquet-Childs Ms, William J. Landis Phd

Williams Honors College, Honors Research Projects

Both scientists and clinicians have proposed tissue engineering as the future of medicine. The possibilities for tissue engineering, that is, fabrication of tissues and organs in the laboratory and their translation to patients, appear to be endless, and many believe that this new approach in medicine will result in abolishing many common ailments, injuries, and congenital defects. Injuries to a tendon enthesis, the normal tissue connection between tendon and bone, are of particular concern to clinicians because of their frequency and failure to repair as a result of surgery. While these injuries may not be life threatening, they can certainly …

The Effect Of An Educational Intervention On The Knowledge And Management Of Ponv Among Anesthesia Providers: A Pilot Study, Eleazar Comprendio, Juan E. Ruan, Mohammad Zyed, Julie Lamoureux, Feliciano Villalba

All Publications

No abstract provided.

Differential Effects Of Fatigue On Movement Variability, N. Cortes, J. Onate, S. Morrison

Rehabilitation Sciences Faculty Publications

When individuals perform purposeful actions to fatigue, there is typically a general decline in their movement performance. This study was designed to investigate the effects exercise-induced fatigue has on lower limb kinetics and kinematics during a side-step cutting task. In particular, it was of interest to determine what changes could be seen in mean amplitude and all metrics of signal variability with fatigue. The results of the study revealed that post-fatigue there was an overall decrease in absolute force production as reflected by a decline in mean amplitude and variability (SD) of the ground reaction forces (GRF_V and GRF …

Reevaluation Of The Aapm Tg-43 Brachytherapy Dosimetry Parameters For An 125I Seed, And The Influence Of Eye Plaque Design On Dose Distributions And Dose-Volume Histograms, Prakash Aryal

Theses and Dissertations--Physics and Astronomy

The TG-43 dosimetry parameters of the Advantage^{TM 125}I model IAI-125A brachytherapy seed were studied. An investigation using modern MCNP radiation transport code with updated cross-section libraries was performed. Twelve different simulation conditions were studied for a single seed by varying the coating thickness, mass density, photon energy spectrum and cross-section library. The dose rate was found to be 6.3% lower at 1 cm in comparison to published results. New TG-43 dosimetry parameters are proposed.

The dose distribution for a brachytherapy eye plaque, model EP917, was investigated, including the effects of collimation from high-Z slots. Dose distributions for …