Digital Commons Network^™

Real-World Comparison Of Two Molecular Methods For Detection Of Respiratory Viruses, Syed Asad Ali, James E. Gern, Tina V. Hartert, Kathryn M. Edwards, Marie R. Griffin, E Kathryn Mille, Tebeb Gebretsadik, Tressa Pappas, Wai Ming Lee, John V. Williams

Department of Paediatrics and Child Health

Background: Molecular polymerase chain reaction (PCR) based assays are increasingly used to diagnose viral respiratory infections and conduct epidemiology studies. Molecular assays have generally been evaluated by comparing them to conventional direct fluorescent antibody (DFA) or viral culture techniques, with few published direct comparisons between molecular methods or between institutions. We sought to perform a real-world comparison of two molecular respiratory viral diagnostic methods between two experienced respiratory virus research laboratories.
Methods: We tested nasal and throat swab specimens obtained from 225 infants with respiratory illness for 11 common respiratory viruses using both a multiplex assay (Respiratory MultiCode-PLx Assay [RMA]) …

Lymphomas In Sub-Saharan Africa - What Can We Learn And How Can We Help In Improving Diagnosis, Managing Patients And Fostering Translational Research?, Kikkeri N. Naresh, Martine Raphael, Leona Ayers, Nina Hurwitz, Valeria Calbi, Emily Rogena, Shahin Sayed, Omar Sherman, Hazem A.H. Ibrahim, Stefano Lazzi, Vasileios Mourmouras, Patricia Rince, Jessie Githanga, Bessie Byakika, Emma Moshi, Muheez Durosinmi, Babatunde J. Olasode, Olayiwola A. Oluwasola, Effiong E. Akang, Yetunde Akeno` Va,, Melissa Adde, Ian Magrath, Lorenzo Leoncini

Pathology, East Africa

Approximately 30 000 cases of non-Hodgkin lymphoma (NHL) occur in the equatorial belt of Africa each year. Apart from the fact that Burkitt lymphoma (BL) is very common among children and adolescents in Africa and that an epidemic of human immunodeficiency virus (HIV) infection is currently ongoing in this part of the world, very little is known about lymphomas in Africa. This review provides information regarding the current infrastructure for diagnostics in sub-Saharan Africa. The results on the diagnostic accuracy and on the distribution of different lymphoma subsets in sub-Saharan Africa were based on a review undertaken by a team …

Successful Management Of Aggressive Fibromatosis Of The Neck Using Wide Surgical Excision: A Case Report., Zain A. Sobani, Montasir Junaid, Mumtaz J Khan

Section of Otolaryngology, Head & Neck Surgery

Introduction:Aggressive fibromatosis is a benign tumor, thought to arise from deep musculoaponeurotic structures, rarely found in the head or neck. However, when it does occur in the head and neck region, it tends to be more aggressive and associated with significant morbidity, which may be attributed to the vital vascular, neurological or anatomical structures in close proximity. Case Presentation: We report the case of a 39-year-old Pakistani man who presented with a two-month history of a lump on the right side of his neck. The mass was excised and histopathological analysis revealed a case of aggressive fibromatosis.

Conclusions:

Due …

Beyond Mannequins: A Potpourri Of Enabling Technology For Healthcare Education, Rosalyn P. Scott

Department of Surgery Faculty Publications

No abstract provided.

Multilaboratory Evaluation Of Real-Time Pcr Tests For Hepatitis B Virus Dna Quantification, Angela M. Caliendo, Alexander Valsamakis, James W. Bremer, Andrea Ferreira-Gonzalez, Suzanne Granger, Linda Sabatini, Gregory J. Tsongalis

Dartmouth Scholarship

The performance characteristics of four different assays for hepatitis B virus (HBV) quantification were assessed: the Abbott RealTime HBV IUO, the Roche Cobas AmpliPrep/Cobas TaqMan HBV test, the Roche Cobas TaqMan HBV test with HighPure system, and the Qiagen artus HBV TM ASR. Limit of detection (LOD), linear range, reproducibility, and agreement were determined using a serially diluted plasma sample from a single chronically infected subject. Each assay was tested by at least three laboratories. The LOD of the RealTime and two TaqMan assays was approximately 1.0 log₁₀ IU/ml; for artus HBV (which used the lowest volume of extracted …

Effects Of Diet Type And Supplementation Of Glucosamine, Chondroitin, And Msm On Body Composition, Functional Status, And Markers Of Health In Women With Knee Osteoarthritis Initiating A Resistance-Based Exercise And Weight Loss Program, Teresa Magrans-Courtney, Colin Wilborn, Christopher Rasmussen, Maria Pontes Ferreira, Lori Greenwood, Bill Campbell, Chad M. Kerksick, Erica Nassar, Rui Li, Mike Iosia, Matt Cooke, Kristin Dugan, Darryn Willoughby, Luann Soliah, Richard B. Kreider

Nutrition and Food Science Faculty Research Publications

Background: The purpose of this study was to determine whether sedentary obese women with knee OA initiating an exercise and weight loss program may experience more beneficial changes in body composition, functional capacity, and/or markers of health following a higher protein diet compared to a higher carbohydrate diet with or without GCM supplementation.

Methods: Thirty sedentary women (54 ± 9 yrs, 163 ± 6 cm, 88.6 ± 13 kg, 46.1 ± 3% fat, 33.3 ± 5 kg/m²) with clinically diagnosed knee OA participated in a 14-week exercise and weight loss program. Participants followed an isoenergenic low fat higher …

Analyzing The Impact Of 23 Mg/Day Donepezil On Language Dysfunction In Moderate To Severe Alzheimer's Disease, Steven H. Ferris, Frederick A. Schmitt, Judith Saxton, Sharon Richardson, Joan Mackell, Yijun Sun, Yikang Xu

Sanders-Brown Center on Aging Faculty Publications

INTRODUCTION: Progressive language impairment is among the primary components of cognitive decline in Alzheimer's disease (AD). Because expressive and receptive language help to maintain emotional connections to caregivers and support the management of AD patients' functional needs, language plays a critical role in patients' emotional and physical health. Using data from a large prospective clinical trial comparing two doses of donepezil in patients with moderate to severe AD, we performed a post hoc analysis to determine whether a higher dose of donepezil was associated with greater benefits in language function.

METHODS: In the original randomized, double-blind clinical trial, 1,467 patients …

Virological And Clinical Characteristics Of Hepatitis Delta Virus In South Asia, Khalid Mumtaz, Umair S. Ahmed, Sadik Memon, Ali Khawaja, Muhammad T. Usmani, Tariq Moatter, Saeed Hamid, Wasim Jafri

Section of Gastroenterology

Background & Aims:There is a paucity of data on the impact of hepatitis D virus (HDV) in Patients with hepatitis B virus (HBV) infection from South Asia. We studied the impact of HDV co-infection on virological and clinical characteristics.

Methods: We collected data of 480 Patients with HBsAg positive and a detectable HBV DNA PCR, who presented to the Aga Khan University, Karachi and Isra University in Hyderabad, Pakistan in the last 5 years. HDV co-infection was diagnosed on the basis of anti-HDV. ALT, HBeAg, HBeAb and HBV DNA PCR quantitative levels were checked in all Patients. We divided …

Psychostimulants As Cognitive Enhancers: The Prefrontal Cortex, Catecholamines And Attention Deficit Hyperactivity Disorder, Craig Berridge, David M. Devilbiss

Rowan-Virtua School of Osteopathic Medicine Departmental Research

Psychostimulants exert behavioral-calming and cognition-enhancing actions in the treatment of attention deficit hyperactivity disorder (ADHD). Contrary to early views, extensive research demonstrates that these actions are not unique to ADHD. Specifically, when administered at low and clinically-relevant doses, psychostimulants improve a variety of behavioral and cognitive processes dependent on the prefrontal cortex (PFC) in subjects with and without ADHD. Despite the longstanding clinical use of these drugs, the neural mechanisms underlying their cognition-enhancing/therapeutic actions have only recently begun to be examined. At behaviorally-activating doses, psychostimulants produce large and widespread increases in extracellular levels of brain catecholamines. In contrast, cognition-enhancing doses …

Traumatic Retroclival Epidural Hematoma In Pediatric Patient- Case Report And Review Of Literature, Muhammad Zubair Tahir, S. A. Quadri, Sonia Hanif, Gohar Javed

Section of Neurosurgery

Background: Retroclival epidural hematoma (REDH) is a very rare entity in the practical field of neurosurgery. Only a few cases have been reported in literature. The authors present to you case of a 12-year-old female, a victim of road traffic accident (RTA), who had presented to us with loss of consciousness and seizures.
Case description: Magnetic resonance imaging revealed retroclival hematoma. She was managed on conservative grounds and discharged with assurance of multiple follow-up visits.
Conclusion: Very few cases of REDH have been reported in pediatric population to date. It should be suspected in children with head and neck injuries …

Sonic Hedgehog Dependent Phosphorylation By Ck1Α And Grk2 Is Required For Ciliary Accumulation And Activation Of Smoothened, Yongbin Chen, Noriaki Sasai, Guoqiang Ma, Tao Yue, Jianhang Jia, James Briscoe, Jin Jiang

Markey Cancer Center Faculty Publications

Hedgehog (Hh) signaling regulates embryonic development and adult tissue homeostasis through the GPCR-like protein Smoothened (Smo), but how vertebrate Smo is activated remains poorly understood. In Drosophila, Hh dependent phosphorylation activates Smo. Whether this is also the case in vertebrates is unclear, owing to the marked sequence divergence between vertebrate and Drosophila Smo (dSmo) and the involvement of primary cilia in vertebrate Hh signaling. Here we demonstrate that mammalian Smo (mSmo) is activated through multi-site phosphorylation of its carboxyl-terminal tail by CK1α and GRK2. Phosphorylation of mSmo induces its active conformation and simultaneously promotes its ciliary accumulation. We demonstrate that …

Bapcap2-1 Does Preoperative Aspirin Improve Outcomes In Cardiac Surgery Patients?, Jian-Zhong Sun, L. Cao, H. Liu, W. Sun, S Silvestry, J. Diehl

Department of Anesthesiology Faculty Papers

Best Abstracts - Runner-up Session 2 presented at Euroanaesthesia 2011 in the Netherlands.

Background and Goal of Study: The effects of preoperative aspirin on major cardiocerebral and renal outcomes and mortality remain uncertain.

A Comparison Of Two Headless Compression Screws For Operative Treatment Of Scaphoid Fractures, Ruby Grewal, Joseph Assini, David Sauder, Louis Ferreira, Jim Johnson, Kenneth Faber

Surgery Publications

PURPOSE: The purpose of this study was to compare the interfragmentary compression force across a simulated scaphoid fracture by two commonly used compression screw systems; the Acutrak 2 Standard and the 3.0 mm Synthes headless compression screw.

METHODS: Sixteen (8 pairs; 6 female, 2 male) cadaver scaphoids were randomly assigned to receive either the Acutrak 2 or Synthes screw with the contralateral scaphoid designated to receive the opposite. Guide wires were inserted under fluoroscopic control. Following transverse osteotomy, the distal and proximal fragments were placed on either side of a custom load cell, to measure interfragmentary compression. Screws were placed …

Gynaecomastia; Management With Liposuction And Glandular Excision, Stanley Ominde Khainga, Ronald Wasike, P. K. Biribwa

General Surgery, East Africa

Gynaecomastia is caused by an increase in ductal tissue, stroma and fat in the male breast. Frequently it occurs at the time of hormonal changes during infancy, adolescence and old age. Galen, introduced the term gynaecomastia in the second century AD and surgical excision was first described by Pauli of Aegina in the seventh AD (1,2). Ultrasound assisted liposuction and surgical excision of glandular tissue through an inferior circumareolar incision is currently the best mode of treatment. In this study seven patients varying from the ages 17-45 years were operated on using this technique at the Aga Khan University teaching …

Successful Aging And The Epidemiology Of Hiv, David E. Vance, Teena Mcguinness, Karen Musgrove, Nancy Ann Orel, Pariya L. Fazeli

Gerontology Faculty Publications

By 2015, it is estimated that nearly half of those living with HIV in the US will be 50 years of age and older. This dramatic change in the demographics of this clinical population represents unique challenges for patients, health care providers, and society-at-large. Fortunately, because of highly active antiretroviral therapy (HAART) and healthy lifestyle choices, it is now possible for many infected with HIV to age successfully with this disease; however, this depends upon one’s definition of successful aging. It is proposed that successful aging is composed of eight factors: length of life, biological health, cognitive efficiency, mental health, …

Integrin-Linked Kinase: A Scaffold Protein Unique Among Its Ilk, Lina Dagnino

Paediatrics Publications

Integrin-linked kinase (ILK) is a scaffolding protein with central roles in tissue development and homeostasis. Much debate has focused on whether ILK is a bona fide or a pseudo- kinase. This aspect of ILK function has been complicated by the large volumes of conflicting observations obtained from a wide variety of experimental approaches, from in vitro models, to analyses in invertebrates and in mammals. Key findings in support or against the notion that ILK is catalytically active are summarized. The importance of ILK as an adaptor protein is well established, and defining its role as a signaling hub will be …

Terrorist Bombings: Medical Response In A Developing Country, Hasnain Zafar, Ahmed Jawad, Muhammad Shahzad Shamim, Ayaz Ahmed Memon, Aamir Hameed Khan, Muhammad Shahrukh Effendi, Saeed Qureshi

Section of General Surgery

Objective: To evaluate the process of transport and immediate Emergency Department (ER) management of mass casualties following the recent bomb blasts in Karachi and review in detail the medical response and management of victims undertaken in these two incidents.
Methods: Eyewitness accounts of the victims, medical personnel and newspaper clippings were used to understand and identify difficulties faced during the rescue process. Data regarding presenting injuries and their outcomes was also collected from all victims presenting to the emergency department at Aga Khan University Hospital.
Results: Seventy nine individuals died and over 250 victims were injured in the two incidents. …

University Of New England’S College Of Osteopathic Medicine 2011 Dean's Research Fellowship Recipients, University Of New England College Of Osteopathic Medicine

Peter Morgane Research Fellowships

2011 recipients of the University of New England College of Osteopathic Medicine's Peter Morgane Research Fellowship (known then as the Dean’s Research Fellowship).

Triphasic Computed Tomography (Ct) Scan In Focal Tumoral Liver Lesions, Saima Hafeez, Muhammad Shahbaz Alam, Zafar Sajjad, Zahid Anwar Khan, Waseem Akhter, Fatima Mubarak

Department of Radiology

OBJECTIVE: To assess the diagnostic accuracy of triphasic spiral CT in differentiating benign from malignant focal tumoral liver lesions.

METHODS: The study was conducted in Department of Radiology of Aga Khan University Hospital and Sind Institute of Urology and Transplantation, Karachi from Feb 2006 to Feb 2007. By convenient sampling, 45 patients found to have focal tumoral liver lesions were recruited for one year period and their triphasic CT scans findings were evaluated and later correlated with histopathology. Sensitivity, specificity, positive predictive value, negative predictive value and diagnostic accuracy of triphasic CT scan were calculated.

RESULTS: Among 45 patients, 136 …

The Prevalence And Factors Associated With Nonadherence With Arv Treatment And Cotrimoxazole Preventive Therapy Among Hiv Infected Adolescents Attending Out-Patient Hiv Clinics In Kenya, Reson Marima

Master of Medicine in Paediatrics and Child Health

Background: There is an increase in the burden of HIV infected adolescents, both those perinatally infected as well as those acquiring HIV during adolescence. Female adolescents continue to be at the highest risk for acquiring HIV; in many Southern African countries, they have a three fold risk of acquiring HIV compared to their male counterparts. Adherence to treatment among adolescents has been shown to range between 30-70%, which is unacceptably low for antiretroviral therapy (ART). Psychosocial wellbeing and social support have been shown to be possible contributing factors to adherence to ART. This relationship has not been previously evaluated among …

Acute Vertebral Compression Fracture: Differentiation Of Malignant And Benign Causes By Diffusion Weighted Magnetic Resonance Imaging, Fatima Mubarak, Waseem Akhtar

Department of Radiology

OBJECTIVE: To evaluate the sensitivity, specificity and accuracy of diffusion weighted (DWI) magnetic resonance imaging (MRI) in the diagnosis and differentiation between benign (osteoporotic/infectious) and malignant vertebral compression fractures in comparison with histology findings and clinical follow up.

METHODS: The study was conducted at the Radiology Department, Aga Khan University Hospital (AKUH) Karachi. It was a one year cross-sectional study from 01/01/2009 to 01/01/2010. Forty patients with sixty three vertebral compression fractures were included. Diffusion-weighted sequences and apparent diffusion coefficient (ADC) images on a 1.5 T MR scanner were obtained in all patients to identify the vertebral compression fracture along …

Chronic Disease Self-Management Programs: Relevance For Persons With Dementia, Nina M. Silverstein, Alison S. Gottlieb

Gerontology Institute Publications

The context for this study is the work of the Healthy Brain Initiative. The CDC has established a cooperative agreement with the Alzheimer’s Association to develop and implement a multifaceted approach to look at cognitive health as a public health issue. Late in 2010, the Association commissioned a review of the major chronic disease prevention programs from a systems approach to begin to understand the source of findings that Medicare beneficiaries with Alzheimer’s and related disorders are much higher cost than those simply with a single chronic disease and no AD. This led to the conclusion that Chronic Disease Self‐Management …

The Role Of Protein Kinase C Epsilon In Hydrogen Peroxide And Nitric Oxide Release During Oxidative Stress Caused By Extracorporeal Shockwave Lithotripsy, Edward S. Iames

PCOM Biomedical Studies Student Scholarship

Clinical extracorporeal shock wave lithotripsy (ESWL) treatment to ablate kidney stones can cause acute damage to the renal microvasculature. Accumulation of continued treatment with shockwave therapy can lead to chronic damage to the kidney, and lead to clinical hypertension. Shockwaves have been shown to stimulate endothelial cells to release superoxide (SO), which is converted to hydrogen peroxide (H₂O₂), and reacts with nitric oxide (NO) to produce peroxynitrite anion (OONO^-), creating a powerful oxidant that increases oxidative stress while simultaneously reducing NO bioavailability. Increased oxidative stress during events such as ESWL, also uncouples NO production …

Oncolog, Volume 56, Number 06, June 2011, John H. Mccool, Sunni Hoseman

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

• MD Anderson Celebrates 70th Anniversary: Its first clinical facility was a converted Army barracks, its first headquarters was renovated residential estate near downtown Houston, and its first cancer research was conducted by four scientists in a former horse stable
• Compass: Stage II or III Soft Tissue Sarcoma-Chemotherapy and radiation therapy before or after surgery benefit patients

Expression Of Microphthalmia Transcription Factor In Sentinel Lymph Nodes Of Patients With Melanoma, Minia Hellan, Michelle S. Gentile, Luay Ailabouni, George I. Salti

Department of Surgery Faculty Publications

Background: Sentinel lymph node biopsy is widely used in the management of melanoma patients. Multiple markers are used to stain sentinel lymph node tissue including S100, HMB-45 and melan A with different success. We investigated, for the first time, the use of Microphthalmia transcription factor (Mitf) staining in a larger series of sentinel lymph nodes. Mitf is a transcription factor essential for the development and survival of melanocytes. It has been introduced recently as a sensitive and specific marker for melanomas. Methods: Thirty patients with cutaneous melanoma were included in our study: twenty patients underwent sentinel lymph node biopsy; ten …

Femoroacetabular Impingement: Saving The Joint, Ronald Huang, Javad Parvizi

Department of Orthopaedic Surgery Faculty Papers

Many factors have been linked to the development of osteoarthritis (OA) of the hip, but often, cases are still considered “idiopathic.” Femoroacetabular impingement (FAI) has been suggested as a possible etiologic factor for the otherwise “idiopathic” cases. It is theorized that the subtle morphologic abnormalities seen at the head-neck junction and acetabulum in FAI may lead to labral tears, chondral damage, and subsequent progression of OA. Prevalence of FAI has been suggested to be as high as 14% in the general population. It often presents in young active patients that subject their hip joint to repetitive micro trauma associated with …

Use Of Geocoding And Us Census Data To Assess Determinants Of Outcome In Trauma Patients, Krista M. Goodman Md, John J. Hong Md, Sherrine Eid Mph, Leslie Baga Bsn, Ccrc, Michael M. Badellino Md, Mph, Facs, Michael D. Pasquale Md, Facs

Department of Surgery

No abstract provided.

Effects Of Hypo And Iso - Tonic Intravenous Maintenance Fluids On Plasma Sodium Level In Hospitalized Children. A Double Blind Randomized Clinical Trial, Ismail Ahmed

Master of Medicine in Paediatrics and Child Health

Background: Hypotonic fluids are widely used in pediatrics and are the standard of care when giving maintenance fluids. However, there are several reports of risk of iatrogenic hyponatremia attributed to this practice in the literature. There is therefore uncertainty as to whether isotonic fluids would be the more appropriate fluid. Objectives: The primary objective was to compare effects of hypotonic and isotonic maintenance fluids on plasma sodium levels in children between the ages of 2 months and 15 years admitted at Aga Khan University Hospital (AKUH). The secondary objective was to compare effects of hypotonic and isotonic maintenance fluids on …

Pain Control For Uterine Fibroid Embolisation : An Initial Experience In East Africa., Gilbert Mwaka, Vitalis Mung’Ayi, Nigel Hacking, William. Stones

Anaesthesiology, East Africa

Uterine fibroid embolisation (UFE) generates moderate to severe post-procedural pain. We present a case series of 24 patients who underwent UFE during our first experience in managing the sometimes excruciating pain that accompanies embolisation of the uterine arteries. We also show the evolution of our protocol for post-procedural pain management from a first to second round of procedures.

Surgical Management Of Complete Atrioventricular Septal Defect: Associations With Surgical Technique, Age, And Trisomy 21., Andrew M. Atz, John A. Hawkins, Minmin Lu, Meryl S. Cohen, Steven D. Colan, James Jaggers, Ronald V. Lacro, Brian W. Mccrindle, Renee Margossian, Ralph S. Mosca, Lynn A. Sleeper, L Luann Minich, Pediatric Heart Network Investigators, Girish S. Shirali

Manuscripts, Articles, Book Chapters and Other Papers

OBJECTIVES: We sought to evaluate the contemporary results after repair of a complete atrioventricular septal defect and to determine the factors associated with suboptimal outcomes.

METHODS: The demographic, procedural, and outcome data were obtained within 1 and 6 months after repair of a complete atrioventricular septal defect in 120 children in a multicenter observational study from June 2004 to 2006.

RESULTS: The median age at surgery was 3.7 months (range, 9 days to 1.1 years). The type of surgical repair was a single patch (18%), double patch (72%), and a single atrial septal defect patch with primary ventricular septal defect …