Digital Commons Network^™

Treatment Choices Based On Oncotypedx In The Breast Oncology Care Setting, Teri L. Malo, Isaac Lipkus, Tobi Wilson, Hyo S. Han, Geza Acs, Susan T. Vadaparampil

Pathology and Cell Biology Faculty Publications

Introduction. This study aimed to evaluate whether OncotypeDx test results predict receipt of adjuvant chemotherapy in breast cancer patients who received an OncotypeDx recurrence score (RS). Materials and Methods. Pathology records were used to identify breast cancer patients who had OncotypeDx testing between December 2004 and January 2009 (𝑛 = 1 1 8). Patient sociodemographic information, tumor characteristics, RS, and treatment-specific data were collected via chart review. RS was classified as follows: low (R S ≤ 1 7), intermediate (RS = 18–30), or high (R S ≥ 3 1). Bivariate analyses were …

Early Outcomes Of Minimally Invasive Anterior Longitudinal Ligament Release For Correction Of Sagittal Imbalance In Patients With Adult Spinal Deformity, Armen R. Deukmedjian, Elias Dakwar, Amir Ahmadian, Donald A. Smith, Juan S. Uribe

Neurosurgery and Brain Repair Faculty Publications

The object of this study was to evaluate a novel surgical technique in the treatment of adult degenerative scoliosis and present our early experience with the minimally invasive lateral approach for anterior longitudinal ligament release to provide lumbar lordosis and examine its impact on sagittal balance. Methods. All patients with adult spinal deformity (ASD) treated with the minimally invasive lateral retroperitoneal transpsoas interbody fusion (MIS LIF) for release of the anterior longitudinal ligament were examined. Patient demographics, clinical data, spinopelvic parameters, and outcome measures were recorded. Results. Seven patients underwent release of the anterior longitudinal ligament (ALR) to …

Peripheral Nerve Repair With Cultured Schwann Cells: Getting Closer To The Clinics, Maria Carolina O. Rodrigues, Antonio Antunes Rodrigues, Loren E. Glover, Julio Voltarelli, Cesar V. Borlongan

Neurosurgery and Brain Repair Faculty Publications

Peripheral nerve injuries are a frequent and disabling condition, which affects 13 to 23 per 100.000 persons each year. Severe cases, with structural disruption of the nerve, are associated with poor functional recovery. The experimental treatment using nerve grafts to replace damaged or shortened axons is limited by technical difficulties, invasiveness, and mediocre results. Other therapeutic choices include the adjunctive application of cultured Schwann cells and nerve conduits to guide axonal growth. The bone marrow is a rich source of mesenchymal cells, which can be differentiated in vitro into Schwann cells and subsequently engrafted into the damaged nerve. Alternatively, undifferentiated …

Development And Characterization Of Anti-Nitr9 Antibodies, Radhika N. Shah, Ivan Rodriguez-Nunez, Donna D. Eason, Robert N. Haire, Julien Y. Bertrand, Valērie Wittamer, David Traver, Shila K. Nordone

Pediatrics Faculty Publications

The novel immune-type receptors (NITRs), which have been described in numerous bony fish species, are encoded by multigene families of inhibitory and activating receptors and are predicted to be functional orthologs to the mammalian natural killer cell receptors (NKRs). Within the zebrafish NITR family, nitr9 is the only gene predicted to encode an activating receptor. However, alternative RNA splicing generates three distinct nitr9 transcripts, each of which encodes a different isoform. Although nitr9 transcripts have been detected in zebrafish lymphocytes, the specific hematopoietic lineage(s) that expresses Nitr9 remains to be determined. In an effort to better understand the role of …

Retroperitoneal Lymph Node Dissection With Concomitant Ivc Thrombectomy, Caval Wall Resection, And Grafting For Metastatic Nsgt, Tariq Hakky, Timothy Kim, Alejandro R. Rodriguez, Paul Armstrong, Devanand Mangar, Philippe E. Spiess

Obstetrics & Gynecology Faculty Publications

INTRODUCTION: The management of a post-chemotherapy retroperitoneal mass secondary to testicular cancer can present a surgical challenge when involving adjacent organs or major vascular structures. We present the first video of a retroperitoneal lymph node dissection (RPLND) with IVC (inferior vena cava) thrombectomy, caval wall resection resulting from metastatic non-seminomatous germ cell testis (NSGCT) cancer.

METHODS: In this surgical video, we highlight important surgical considerations in the management of a post-chemotherapy retroperitoneal mass with direct IVC wall invasion and level 2 thrombus in such a patient.

RESULTS: A 34 year old man underwent a right inguinal orchiectomy for a mixed …

Uchunguzi (Journal Watch/Montre De Journal) June 2012, Benjamin Wachira

Family Medicine, East Africa

Uchunguzi means investigation in Swahili and provides a summary of some of the most recent international literature as presented in other leading journals, but with an emphasis on what is relevant to our continent.

Research Annual Report 2012, Children's Mercy Hospital

Research Annual Reports

Annual report of the research at Children's Mercy Hospital in Kansas City MO, a pediatric medical center.

5q Minus Myelodysplasia Associated With Multiple Epithelioid Granulomas Within Conventional Renal Cell Carcinoma, Rahul G. Matnani, Roshan K Patel, Stephen E Strup, Rouzan Karabakhtsian

Pathology and Laboratory Medicine Faculty Publications

A 69-year-old Caucasian female, with a previous diagnosis of 5q minus myelodysplastic syndrome, presented with conventional renal cell carcinoma (RCC) associated with multiple-epithelioid nonnecrotizing granulomas. Two previous reports of sarcoidosis, primarily involving the lung and skin, have been described in patients with 5q minus myelodysplasia. A cluster of closely linked genes encoding for cytokines such as IL-4, IL-5, and IL-3 are present on chromosome 5q. Hence, in sarcoidosis, cytokine imbalances associated with the deletion of these cytokine genes have been postulated. However, an occurrence of epithelioid granulomas within a carcinoma, in preexisting clonal myelodysplastic syndrome, has not been described. The …

Gene Therapy In The Cornea: 2005--Present, Rajiv R. Mohan, Jonathan C. K. Tovey, Ajay Sharma, Ashish Tandon

Pharmacy Faculty Articles and Research

Successful restoration of vision in human patients with gene therapy affirmed its promise to cure ocular diseases and disorders. The efficacy of gene therapy is contingent upon vector and mode of therapeutic DNA introduction into targeted cells/tissues. The cornea is an ideal tissue for gene therapy due to its ease of access and relative immune-privilege. Considerable progress has been made in the field of corneal gene therapy in last 5 years. Several new gene transfer vectors, techniques and approaches have evolved. Although corneal gene therapy is still in its early stages of development, the potential of gene-based interventions to treat …

Sleep Strategies: Sleep In Women A Changing Perspective, Misha Peter, Md, Ritu G. Grewal, Md

Jefferson Sleep Disorders Center in the News

As with many other specialties, sleep medicine has been shifting toward helping clinicians obtain a better understanding of gender-specific issues in disorders and disturbances. It is easier today to appreciate the complex dynamics of biological, psychosocial, and cultural factors that define sleep patterns and problems in women. Sleep in women changes across their life spans, with three major shifts likely due to hormonal differences: at the onset of the menstrual cycle, during pregnancy, and during the perimenopausal period.

Contraception In Adolescents, Donald E. Greydanus, Carolyn M. Lentzsch-Parcells, Hatim A. Omar

Pediatrics Faculty Publications

The age of adolescence is the time when most adolescents in the world begin to be sexually active with resultant millions of pregnancies and sexually transmitted diseases (STDs). This chapter considers methods of contraception for these adolescents, including oral contraceptives, transdermal contraception, minipills, intra-vaginal ring, injectable contraception, intrauterine devices (IUDs), barrier contraceptives, implants, and others. It is important for clinicians caring for sexually active youth to provide information regarding contraception and appropriate contraceptive prescriptions.

Homeostatic Imbalance In Epithelial Ducts And Its Role In Carcinogenesis, Katarzyna A. Rejniak

Oncologic Sciences Faculty Publications

An epithelial duct is a well-defined multicellular structure composed of tightly packed cells separating and protecting body compartments that are used for enzyme secretion and its transport across the internal. The structural and functional integrity (homeostasis) of such ducts is vital in carrying many life functions (breathing, lactation, production of hormones). However, the processes involved in maintaining the homeostatic balance are not yet fully understood. On the other hand, the loss of epithelial tissue architecture, such as filled lumens or ductal disorganization, are among the first symptoms of the emerging epithelial tumors (carcinomas). Using the previously developed biomechanical model of …

Clinical Characteristics And Predictors Of Positive Stool Culture In Adult Patients With Acute Gastroenteritis, Muhammad Mehmood Riaz, Muhammad Junaid Patel, Muhammad Shoaib Khan, Muhammad Ali Anwar, M. Tariq, Harith Hilal, Safia Awan, Shahzad Razi

Section of Internal Medicine

OBJECTIVE: To identify the presenting features and spectrum of pathogens in adult patients with acute diarrhoea and to determine the predictors of stool culture positivity.

METHODS: A descriptive study was conducted in a tertiary care hospital from April 1, 2005 to March 31, 2006. Medical records of all consecutive adult patients with history of acute diarrhoea were reviewed between June 2006 to December 2006 for clinical characteristics and laboratory investigations.

RESULTS: A total of 454 patients were admitted from April 1, 2005 to March 31, 2006. Stool cultures were performed in 233 (50%) patients, 96 (42%) had positive results. Patients …

An Incidentally Discovered Asymptomatic Para-Aortic Paraganglioma With Peutz-Jeghers Syndrome, Nazish Butt, Mohammad Salih, Mohammad Rizwan Khan, Rashida Ahmed, Zishan Haider, Syed Hasnain Ali Shah

Section of Internal Medicine

Peutz-Jeghers syndrome (PJS) is an autosomal dominant inherited disorder characterized by mucocutaneous melanin pigmentation and gastrointestinal (GI) tract hamartomatous polyps and an increased risk of malignancy. In addition to polyposis, previous studies have reported increased risk of GI and extraGI malignancies in PJS patients, compared with that of the general population. The most common extraintestinal malignancies reported in previous studies are pancreatic, breast, ovarian and testicular cancers.We report the case of a 17-year-old boy who presented with generalized weakness, recurrent sharp abdominal pain and melena, had exploratory laparotomy and ileal resection for ileo-ileal intussusception. Pigmentation of the buccal mucosa was …

Community Based Weighing Of Newborns And Use Of Mobile Phones By Village Elders In Rural Settings In Kenya: A Decentralised Approach To Health Care Provision, Peter Gisore, Evelyn Shipala, Kevin Otieno, Betsy Rono, Irene Marete, Constance Tenge, Hillary Mabeya, Sherri Bucher, Janet Moore, Edward Liechty, Fabian Esamai

Paediatrics and Child Health, East Africa

Background: Identifying every pregnancy, regardless of home or health facility delivery, is crucial to accurately estimating maternal and neonatal mortality. Furthermore, obtaining birth weights and other anthropometric measurements in rural settings in resource limited countries is a difficult challenge. Unfortunately for the majority of infants born outside of a health care facility, pregnancies are often not recorded and birth weights are not accurately known. Data from the initial 6 months of the Maternal and Neonatal Health (MNH) Registry Study of the Global Network for Women and Children’s Health study area in Kenya revealed that up to 70% of newborns did …

Influence Of Perceived Racial Discrimination On Health And Behaviour Of Immigrant Children In British Columbia, Anne George, Cherylynn Bassani, Robert Armstrong

Paediatrics and Child Health, East Africa

This study examines the influence of perceived discrimination on the health and behaviour of ethnic minority immigrant children in British Columbia, Canada. Using data from the New Canadian Children and Youth Study, we examine perceived discrimination experienced by the parent, family, and cultural group in Canada to test the influence of micro-, meso-, and macrolevels of discrimination on children. Families from 6 ethnic backgrounds participated in the study. Parents’ perceptions of the child’s health and six behavioral scales (hyperactivity, prosocial behaviour, emotional problems, aggression, indirect aggression, and a general combined behaviour scale) were examined as outcome variables. After controlling for …

Reminder Systems For Self Uterine Massage In The Prevention Of Postpartum Blood Loss, S. K. Ngichabe, B. W. Gatinu, M. A. Nyangore, R. Karuga, Sikolia Wanyonyi, Jn Kiarie

Obstetrics and Gynaecology, East Africa

Background: Uterine massage may significantly reduce post partum blood loss and could be patient-driven.

Objective: To assess the effectiveness of an alarm reminder system for self uterine massage in the prevention of post partum blood loss.

Design: A random controlled trial.

Setting: Meru District Hospital, Kenya.

Subjects: One hundred and twenty seven (127) women were randomly assigned to a 15 minute alarm reminder system (71) and non-alarm (56) control arm during the fourth stage of labour.

Results: Uterine massage compliance was better in the alarm group compared to the non-alarm group ( Average massage …

Modulation Of Anti-Tumor Immune Response By Tgf-Β-Inducible Early Gene 1 (Tieg1), Andi Cani

Wayne State University Theses

Cancer immunotherapy has had limited clinical efficacy partly because regulatory T cells (Treg) suppress the immune response to tumor-associated antigens. Inducible regulatory T cells (iTreg), which are converted from naïve CD4 T cells by TGF-β, an abundant cytokine in the tumor microenvironment, may contribute to this immune suppression. Induction of Foxp3 by TGF-β is mediated by the transcription factor TIEG1 and abrogation of this protein prevents Foxp3 expression. We are testing the hypothesis that blockade of TIEG1 to prevent iTreg conversion will enhance immune response in DNA vaccination to the tumor associated antigen Her-2. Wild type and TIEG1 knockout mice …

Neuroangiogenesis: A Vascular Basis For Alzheimer's Disease And Cognitive Decline During Aging, Charles T. Ambrose

Microbiology, Immunology, and Molecular Genetics Faculty Publications

Angiogenesis directs development of the brain's microcirculation during antenatal and postnatal development, but its role later in life is less well recognized. I contend that during senescence a reduced cerebral capillary density accounts in part for the vascular cognitive impairment observed in many older persons and possibly for some forms of Alzheimer's disease. I propose that neuroangiogenesis is essential throughout adult life for maintaining the microcirculation of the cerebral cortex and elsewhere in the brain and that it commonly declines with old age. To support this hypothesis I have examined the neurological literature for relevant studies on cerebral capillary density …

Evaluating The Impact Of Prior Hospital Mortality Versus Surgical Volume On Length Of Stay Following Pediatric Congenital Cardiac Surgery In New York State, Ming Liu

Legacy Theses & Dissertations (2009 - 2024)

Objective: To examine the relationship of prior hospital surgical volume and risk-adjusted mortality rate with future length of stay for children undergoing congenital cardiac surgery in New York State.

Bcr-Abl-Mediated Regulation Of Sphingomyelin Synthase, Tara Ann Burns

MUSC Theses and Dissertations

SMS is an enzyme belonging to the sphingolipid metabolic pathway. Since the discovery and initial characterizations of sphingolipids (SLs) in 1884, extensive research has established that these molecules not only are structural components of eukaryotic membranes but they are also critical bioactive lipids involved in fundamental cellular processes such as proliferation, differentiation, apoptosis, inflammation, migration, and autophagy. In particular, SMS produces sphingomyelin (SM) in mammalian cells by transfering the phosphorylcholine moiety from phosphatidylcholine (PC) onto ceramide forming SM and diacylglycerol (DAG). Both ceramide and DAG are bioactive lipids with opposing functions, and SMS produces sphingomyelin (SM) while consuming ceramide (negative …

Patterns Of Acetaminophen Use At A Tertiary Care Center: Exposures Exceeding 4 Grams Daily, Jesse Civan, Victor Navarro, Jeffrey Riggio, Paul Adams, Steven Herrine, Simona Rossi

Jefferson Hospital Staff Papers and Presentations

Unintentional hepatotoxicity due to acetaminophen use at the recommended daily dose of up to four grams daily has increasingly been recognized as a significant problem. The phrase "therapeutic misadventure" has been coined in the literature, in reference to biochemical evidence of hepatocellular injury associated with acetaminophen use at recommended doses. Previous studies have documented a 25% to 40% incidence of two- to three-fold alanie aminotransferase (ALT) elevation, in healty volunteers administered one gram of acetaminophen every six hours.

The recognition of this problem is reflected in part by recent changes in FDA recommendations, including more stringent controls on the amount …

Oncolog, Volume 57, Number 01, January 2012, Joe Munch, Sunni Hosemann

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

• Meeting Needs of Cancer Survivors: Thanks to new treatments and early detection, many types of cancer can be cured or managed, and more cancer patients are surviving than in the past. These long-term survivors have unique health care needs that are just beginning to be understood.
• Compass: Locally Advanced Squamous Cell carcinoma of the Tonsil- Advances in surgical techniques may broaden treatment options for some patients.
• HOUSE CALL: Sex after Cancer Treatment- Many cancer-related sexual problems can be solved

Preoperative Fdg-Pet/Ct Is An Important Tool In The Management Of Patients With Thick (T4) Melanoma., Rodrigo Arrangoiz, Pavlos Papavasiliou, Carrie A Stransky, Jian Q Yu, Li Tianyu, Elin R Sigurdson, Adam C Berger, Jeffrey M Farma

Department of Surgery Faculty Papers

The yield of preoperative PET/CT (PET/CT) for regional and distant metastases for thin/intermediate thickness melanoma is low. Objective of this study is to determine if PET/CT performed for T4 melanomas helps guide management and alter treatment plans. Methods. Retrospective cohort of 216 patients with T4 melanomas treated at two tertiary institutions. Fifty-six patients met our inclusion criteria (T4 lesion, PET/CT and no clinical evidence of metastatic disease). Results. Fifty-six patients (M: 32, F: 24) with median tumor thickness of 6 mm were identified. PET/CT recognized twelve with regional and four patients with metastatic disease. Melanoma-related treatment plan was altered in …

Insulin Pump School: Back To The Basics Of Pump Therapy, Sara Wilson Reece, Cheryl Williams

Scholarly Posters

The Longstreet Clinic (TLC), P.C. is a regional multidisciplinary physician practice. The Internal Medicine (IM) and Family Medicine (FM) departments are located in Gainesville and Oakwood (Hall County), Georgia. • Hall County is located in Northeast Georgia 50 miles northeast of Atlanta. It lies at the southern edge of the Chattahoochee National Forest and the foothills of the Blue Ridge Mountains. The population of Hall County is approximately 187,700. • Diabetes Education and Medical Nutritional Therapy department provides diabetes education and management services for IM and FM patients with diabetes. • Team of CDEs: RN, RD, PharmD • RN and …

Dynamics Of Envelope Evolution In Clade C Shiv-Infected Pig-Tailed Macaques During Disease Progression Analyzed By Ultra-Deep Pyrosequencing, For Yue Tso, Damien C. Tully, Sandra Gonzalez, Christopher Quince, On Ho, Patricia Polacino, Ruth M. Ruprecht, Shiu-Lok Hu, Charles Wood

Nebraska Center for Virology: Faculty Publications

Understanding the evolution of the human immunodeficiency virus type 1 (HIV-1) envelope during disease progression can provide tremendous insights for vaccine development, and simian-human immunodeficiency virus (SHIV) infection of nonhuman primate provides an ideal platform for such studies. A newly developed clade C SHIV, SHIV-1157ipd3N4, which was able to infect rhesus macaques, closely resembled primary HIV-1 in transmission and pathogenesis, was used to infect several pig-tailed macaques. One of the infected animals subsequently progressed to AIDS, whereas one remained a nonprogressor. The viral envelope evolution in the infected animals during disease progression was analyzed by a bioinformatics approach using ultra-deep …

The Use Of Preoperative Epoetin-Α In Revision Hip Arthroplasty., Lawrence A Delasotta, Ashwin Rangavajjula, Michael L Frank, Jamie Blair, Fabio Orozco, Alvin Ong

Rothman Institute Papers

PURPOSE: To evaluate the efficacy of preoperative epoetin-α on the revision hip arthroplasty patient. We hypothesized that epoetin-α will reduce blood transfusion. A pertinent review of the literature is provided.

METHODS: Forty-six patients were retrospectively reviewed. Sixteen patients received epoetin-α. Patients were case matched by age, preoperative hemoglobin, surgery, gender, and BMI. The clinical triggers for blood transfusion during or after the procedure were determined based on peri- and postoperative hemoglobin levels, ASA score, and/or clinical symptoms consistent with anemia. Blood salvage was not used.

RESULTS: Blood transfusion and length of stay were decreased in the epoetin-α group. Hemoglobin in …

Does Cerclage Improve Neonatal Outcomes In A Molar Pregnancy And A Coexistent Fetus? A Case Report, Eduardo Aguin, Victor Aguin, Ligia Cisneros, Tina Aguin, Cosmas Van De Ven, Ray Bahado-Singh

Wayne State University Associated BioMed Central Scholarship

Abstract

Background

Complete hydatiform mole and coexistent viable fetus is very rare. The use of a cervical cerclage for cervical indications in the presence of this condition has never been reported. Although the diagnosis was made postnatal, the objective is to present a case with good neonatal outcome.

Case presentation

A patient presented with vaginal spotting around 23 weeks. She has a history of four preterm deliveries. Her cervix was dilated and a cerclage was placed. She presented again with PPROM around 25 weeks. She went into spontaneous preterm labor and delivered a viable fetus that is a healthy girl …

Evaluation Of Age-Related Changes In Translocator Protein (Tspo) In Human Brain Using 11C-[R]-Pk11195 Pet, Ajay Kumar, Otto Muzik, Varun Shandal, Diane Chugani, Pulak Chakraborty, Harry T. Chugani

Wayne State University Associated BioMed Central Scholarship

Abstract

Background

We studied the distribution and expression of translocator protein in the human brain using ¹¹C-[R]-PK-11195 positron emission tomography (PK11195 PET) and evaluated age-related changes.

Methods

A dynamic PK11195 PET scan was performed in 15 normal healthy adults (mean age: 29 ±8.5 years (range: 20 to 49); 7 males) and 10 children (mean age: 8.8 ±5.2 years (range: 1.2 to 17); 5 males), who were studied for potential neuroinflammation but showed no focally increased PK11195 binding. The PET images were evaluated by calculating standard uptake values and regional binding potential, based on a simplified reference region model, as …

Bickerstaff’S Brainstem Encephalitis, Miller Fisher Syndrome And Guillain-Barré Syndrome Overlap In An Asthma Patient With Negative Anti-Ganglioside Antibodies, Chongyu Han, Yuan Wang, Jianping Jia, Xunming Ji, Vance Fredrickson, Yuchuan Ding, Wei Sun, Jia Xu, Yong-Xin Sun

Wayne State University Associated BioMed Central Scholarship

Abstract

Background

Bickerstaff’s brainstem encephalitis (BBE), together with Miller Fisher syndrome (MFS) and Guillain-Barré syndrome (GBS) were considered to form a continuous clinical spectrum. An anti-GQ1b antibody syndrome has been proposed to underlie the common pathophysiology for the three disorders; however, other studies have found a positive anti-GM1 instead of anti-GQ1b antibody.

Case presentation

Here we report a 20-year-old male patient with overlapping BBE, MFS and GBS. The patient had a positive family history of bronchial asthma and had suffered from the condition for over 15 years. He developed BBE symptoms nine days after an asthma exacerbation. During the course …