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Cryptococcosis Of The Upper Genital Tract., Manish Gopal, Stacy Mccrosson, Pamela Edmonds, Thomas Klein

Department of Obstetrics and Gynecology Faculty Papers

Upper genital tract infection by Cryptococcus neoformans has not previously been reported. We describe such a case, in order to alert clinicians to the existence of this rare infection. A 34-year-old woman with AIDS presented with chronic menorrhagia, fever, anemia, and thrombocytopenia. Despite blood transfusions and hormonal therapy, her vaginal bleeding could not be controlled and she became hemodynamically unstable. Total abdominal hysterectomy and bilateral salpingo-oophorectomy were performed, at which time granulomatous peritonitis and prominent myometrial blood vessels were found. Histologic examination revealed cryptococcal infection of all upper genital organs. This case demonstrates that disseminated cryptococcosis may involve the upper …

The Role Of Nf-Κb In Pparα-Mediated Hepatocarcinogenesis, Howard P. Glauert, Karen Calfee-Mason, Yixin Li, Vani Nilakantan, Michelle L. Twaroski, Job Tharappel, Brett T. Spear

Graduate Center for Nutritional Sciences Faculty Publications

In this review, the role of NF-kappaB in the induction of hepatocarcinogenesis by peroxisome proliferators is examined. The administration of peroxisome proliferators for more than a three-day period leads to the activation of NF-kappaB in the livers of rats and mice. On the other hand, peroxisome proliferator activated receptor-alpha (PPARalpha) activation in non-hepatic tissues can lead to the inhibition of NF-kappaB activation. Several lines of evidence support the hypothesis that the activation of NF-kappaB by peroxisome proliferators in the liver is mediated by oxidative stress. The role of NF-kappaB in peroxisome proliferator-induced hepatocarcinogenesis has been examined using NF-kappaB knockout models. …

Secondary Prevention Of Heart Disease - Knowledge Among Cardiologists And Omega-3 (Omega-3) Fatty Acid Prescribing Behaviors In Karachi, Pakistan, Saqib A. Gowani, Sana Shoukat, Ather M. Taqui, Hashim M. Hanif, Wasiq F. Rawasia, Zeeshan Qadri, Sajid H. Dhakam

Section of Cardiology

Background: The use of omega-3 fatty acids is a currently proven strategy for secondary prevention of heart disease. The prescription practices for this important nutraceutical is not currently known. It is imperative to assess the knowledge of cardiologists regarding the benefits of omega-3 fatty acids and to determine the frequency of its prescription. The aim of the study was to determine the practices and associations of dietary fish prescribing among cardiologists of Karachi and to assess their knowledge of fish oil supplementation and attitudes toward dietary practices. Methods: A cross sectional survey was conducted during the period of January to …

Systems-Level Interactions Between Insulin-Egf Networks Amplify Mitogenic Signaling., Nikolay Borisov, Edita Aksamitiene, Anatoly Kiyatkin, Stefan Legewie, Jan Berkhout, Thomas Maiwald, Nikolai P Kaimachnikov, Jens Timmer, Jan B Hoek, Boris N Kholodenko

Department of Pathology, Anatomy, and Cell Biology Faculty Papers

Crosstalk mechanisms have not been studied as thoroughly as individual signaling pathways. We exploit experimental and computational approaches to reveal how a concordant interplay between the insulin and epidermal growth factor (EGF) signaling networks can potentiate mitogenic signaling. In HEK293 cells, insulin is a poor activator of the Ras/ERK (extracellular signal-regulated kinase) cascade, yet it enhances ERK activation by low EGF doses. We find that major crosstalk mechanisms that amplify ERK signaling are localized upstream of Ras and at the Ras/Raf level. Computational modeling unveils how critical network nodes, the adaptor proteins GAB1 and insulin receptor substrate (IRS), Src kinase, …

Mitostatin, A Putative Tumor Suppressor On Chromosome 12q24.1, Is Downregulated In Human Bladder And Breast Cancer., A Vecchione, M Fassan, V Anesti, A Morrione, S Goldoni, G Baldassarre, D Byrne, D D'Arca, J P Palazzo, J Lloyd, L Scorrano, L G Gomella, R V Iozzo, R Baffa

Department of Urology Faculty Papers

Allelic deletions on human chromosome 12q24 are frequently reported in a variety of malignant neoplasms, indicating the presence of a tumor suppressor gene(s) in this chromosomal region. However, no reasonable candidate has been identified so far. In this study, we report the cloning and functional characterization of a novel mitochondrial protein with tumor suppressor activity, henceforth designated MITOSTATIN. Human MITOSTATIN was found within a 3.2-kb transcript, which encoded a approximately 62 kDa, ubiquitously expressed protein with little homology to any known protein. We found homozygous deletions and mutations of MITOSTATIN gene in approximately 5 and approximately 11% of various cancer-derived …

Iatrogenic Bile Duct Injury Associated With Anomalies Of The Right Hepatic Sectoral Ducts: A Misunderstood And Underappreciated Problem, Nitin Babel, Sujit Vijay Sakpal, Prakash Paragi, Jason Wellen, Stephen Feldman, Ronald Scott Chamberlain

Department of Surgery

Although laparoscopic cholecystectomy (LC) has been widely accepted as the standard of care, it continues to have a higher complication rate than open cholecystectomy. Bile duct injury with LC has often been attributed to surgical inexperience, but it is also clear that aberrant bile ducts are present in a significant number of patients who sustain biliary injuries during these procedures. We present three cases of right sectoral hepatic duct injuries which occurred during LC and provide a discussion of the conditions which are likely to lead to these injuries, as part of a strategy to prevent them.

Com Outlook Winter 2009, College Of Osteopathic Medicine

COM Outlook

No abstract provided.

Medical Education Digest, Vol. 11 No. 1 (January/February 2009), Nova Southeastern University

Medical Education Digest

No abstract provided.

Blanche Dubois Geriatrics, Edward F. Ansello

Director's Editorials from Age in Action

While the numbers of older adults are growing and the leading edge of the Baby Boom is in its 60s, aging-related education, service, and practice are far from burgeoning. We look forward to continuing Virginia's Geriatric Training and Education program, which produces geriatrically or gerontologically trained physicians, nurses, pharmacists, therapists, recreators, and social workers.

My Passage To India, Edward F. Ansello

Director's Editorials from Age in Action

Different cultures select different "colors" from the curriculum palette in painting the experience of aging as they see it. Aging is a construct, experienced amid and influenced by the norms, limitations, expectations, and horizons around us.

Sold A Bill Of Goods, Edward F. Ansello

Director's Editorials from Age in Action

With regard to Boomers, elders, and all of us growing older, we have been sold a bill of goods in America. Rather than independence, assisted autonomy is a means to empowerment and inclusion. Additionally, as we grow older, we grow less like our age mates, and dissimilarity and heterogeneity increases.

Awaken The Sleeping Giant, Edward F. Ansello

Director's Editorials from Age in Action

In order to maintain our commitment to quality, we in the Aging Network need to invest in the future despite the monetary problems of the present. In Virginia, older Virginians are a remarkable resource for our future.

Virginia's Money Follows The Person Demonstration, Jason A. Rachel, Karen Lawson

Case Studies from Age in Action

Educational Objectives

1. Describe Virginia's Money Follows the Person Demonstration project, including the new services available to individuals through Virginia's Medicaid-funded home and community-based waiver program.

2. Explain how Virginia's Money Follows the Person Demonstration project, being administered by the Virginia Department of Medical Assistance Services (DMAS), would assist an individual in transitioning from a long-term care facility to the community.

3. Illustrate how someone might experience the MFP processes from pre-transition through post-transition.

The Older Inmate, Tara Livengood

Case Studies from Age in Action

Educational Objectives

1. Present a general overview of elderly inmates, including statistics, characteristics, crimes, mental and medical illnesses, and disabilities.

2. Describe Virginia’s only geriatric correctional facility.

3. Explain the practice of release planning, focusing especially on geriatric release.

Sleep And Sleep Disorders In Later Life, Robert D. Vorona

Case Studies from Age in Action

Educational Objectives

1. Describe basic changes in sleep that occur as we age.

2. Review several important sleep disorders common in later life

3. Discuss treatment modalities for these sleep disorders and potential benefits of therapy.

Activity Engagement For Persons With Dementia, Barbara Braddock, Ellen Phipps

Case Studies from Age in Action

Educational Objectives

1. Describe a successful approach to activity engagement for persons with dementia.

2. Review three cognitive interventions useful for activity engagement for persons with dementia.

3. Discuss applications of this approach using university students in home visits.

Loss Of Ski Expression In Testicular Cancer Leads To An Enhanced Invasive Phenotype Through Both Bmp-Dependent And Bmp-Independent Pathways, Amy N. Nash

Theses, Dissertations and Capstones

The proto-oncogene SKI is a transcription factor and a co-repressor of the TGFβ superfamily, including TGF

β and BMP. However, additional data suggests that SKI may function as a tumor suppressor in some cell types. The TGFβ superfamily has been implicated in cancer progression and germ cell migration. Testicular cancer afflicts men during their peak reproductive years and is the most common cancer among men of this age group. Cisplatin-based chemotherapy is the standard treatment for testicular cancer. This treatment can lead to undesirable side effects, including infertility. We have shown that SKI expression is decreased in testicular germ cell …

Chronic Elbow Dislocation Treated With Open Reduction And Lateral Ulnar Collateral Ligament Reconstruction, Louis Joseph Rubino, Michael A. Herbenick, Ryan P. Finnan, Philip A. Anloague

Physical Therapy Faculty Publications

In the United States, chronic unreduced elbow dislocations are rare injuries. We report the successful short-term outcome of a chronic elbow dislocation treated with open reduction and lateral ulnar collateral ligament reconstruction using a split semitendinosus allograft in a figure-of-8 technique without use of hinged external fixation. The authors have obtained the patient’s written informed consent for print and electronic publication of the case report.

No Effect Of Prenatal Alcohol Exposure On Activity In Three Inbred Strains Of Mice, Chris Downing, Christina Balderrama-Durbin, Jonathan Hayes, Thomas E. Johnson, David Gilliam

SPS Faculty Publications

Aims: Prenatal exposure to alcohol can have adverse effects on the developing fetus. Two of the hallmarks of children exposed to alcohol prenatally are attention deficits and hyperactivity. While hyperactivity has been observed in rats following prenatal ethanol exposure, few studies have examined these effects in mice. The present study investigated the effects of prenatal ethanol exposure on activity in mice from three inbred strains: C57BL/6 (B6), Inbred Long Sleep (ILS) and Inbred Short Sleep (ISS).

Methods: On days 7 through 18 of gestation, mice were intragastrically intubated twice daily with either 3.0 g/kg Ethanol (E) or an isocaloric amount …

Masters Of Public Health 2009, Nova Southeastern University

Health Professions Divisions Course Catalogs and Course Descriptions

No abstract provided.

Factors Influencing Early Detection Of Breast Cancer In African American Women, Tamrah Joy Parker

Nursing Theses and Capstone Projects

Background. African American women are more likely to have breast cancer diagnosed at a later stage than Caucasian women and with a five year death rate 1.5 times greater than Caucasian women. Mammography screening detects breast cancer in its early stages and can reduce mortality.

Objective. To examine factors influencing early detection of breast cancer for African American women.

Methods. A convenience sample of 39 African American women 50 years of age and older was selected from two local Baptist churches in eastern North Carolina. Eligibility criteria included ability to read and write in English with no prior or present …

Vitreo-Retinal Traction And Anastrozole Use, Alvin Eisner, Emily J. Thielman, Julie Falardeau, John T. Vetto

Community Health Faculty Publications and Presentations

Purpose—This study tested a prediction stemming from the hypothesis that anastrozole users experience heightened vitreo-retinal traction. This hypothesis was based on the knowledge that menopause increases the risk of intraocular tractional events such as posterior vitreous detachments (PVDs).

Methods—Retinal thickness was measured for 3 groups of amenorrheic women: (1) anastrozole users and (2) tamoxifen users undergoing adjuvant therapy for early-stage breast cancer, and (3) control subjects not using hormonal medication. Foveal shape indices were derived for subjects without PVDs.

Results—For anastrozole users, the distance to the temporal side of the fovea became less than the distance to …

Apd2: The Updated Antimicrobial Peptide Database And Its Application In Peptide Design., Guangshun Wang, Xia Li, Zhe Wang

Journal Articles: Pathology and Microbiology

The antimicrobial peptide database (APD, http://aps.unmc.edu/AP/main.php) has been updated and expanded. It now hosts 1228 entries with 65 anticancer, 76 antiviral (53 anti-HIV), 327 antifungal and 944 antibacterial peptides. The second version of our database (APD2) allows users to search peptide families (e.g. bacteriocins, cyclotides, or defensins), peptide sources (e.g. fish, frogs or chicken), post-translationally modified peptides (e.g. amidation, oxidation, lipidation, glycosylation or d-amino acids), and peptide binding targets (e.g. membranes, proteins, DNA/RNA, LPS or sugars). Statistical analyses reveal that the frequently used amino acid residues (>10%) are Ala and Gly in bacterial peptides, Cys and Gly in plant …

Epithelial Cell Gene Expression Induced By Intracellular Staphylococcus Aureus., Xianglu Li, William G. Fusco, Keun S. Seo, Kenneth W. Bayles, Erin E. Mosley, Mark A. Mcguire, Gregory A. Bohach

Journal Articles: Pathology and Microbiology

HEp-2 cell monolayers were cocultured with intracellular Staphylococcus aureus, and changes in gene expression were profiled using DNA microarrays. Intracellular S. aureus affected genes involved in cellular stress responses, signal transduction, inflammation, apoptosis, fibrosis, and cholesterol biosynthesis. Transcription of stress response and signal transduction-related genes including atf3, sgk, map2k1, map2k3, arhb, and arhe was increased. In addition, elevated transcription of proinflammatory genes was observed for tnfa, il1b, il6, il8, cxcl1, ccl20, cox2, and pai1. Genes involved in proapoptosis and fibrosis were also affected at transcriptional level by intracellular S. aureus. Notably, intracellular S. aureus induced strong transcriptional down-regulation of several …

Bleeding Meckel’S Diverticulum In A 4-Month-Old Infant: Treatment With Laparoscopic Diverticulectomy. A Case Report And Review Of The Literature, J. Rainer Poley, Thomas E. Thielen, Jeffrey C. Pence

Department of Surgery Faculty Publications

A bleeding Meckel’s diverticulum is presented in a 4-month-old African American infant. This event is rare at this age, and our patient is only the second 4-month-old infant reported in the English literature. The infant presented with painless frank rectal bleeding, the blood being maroon-colored, and clots were found in the diaper. There was also anemia, with an hemoglobin of less than 8 gm/dl. The color of the blood suggested a bleeding site in the ileocecal region, a Meckel’s diverticulum was suspected, which was then confirmed by an isotope scan. A typical Meckel’s diverticulum was found on laparoscopic surgery, was …

Sildenafil For The Treatment Of Pulmonary Hypertension In Pediatric Patients, Alice J. Huddleston, Chad A. Knoderer, Jennifer L. Morris, Eric S. Ebenroth

Scholarship and Professional Work – COPHS

Sildenafil is a phosphodiesterase 5 inhibitor widely used for the treatment of pulmonary hypertension in children. Despite limited available safety and efficacy evidence, use of sildenafil continues to increase. To date, sildenafil use for pediatric pulmonary hypertension has been characterized for 193 children through 16 studies and 28 case series and reports. The primary efficacy data suggest that sildenafil is beneficial for facilitating the weaning of inhaled nitric oxide in children after cardiac surgery. Compiled safety data suggest that sildenafil is well tolerated among children with idiopathic pulmonary arterial hypertension and pulmonary arterial hypertension associated with congenital heart disease. This …

Administrators’ Perceptions Of Medication Management In Assisted Living Facilities: Results From Focus Groups, Priscilla T. Ryder, Melanie Joseph, Marnie Zuckermann, Ilene H. Zuckermann

Scholarship and Professional Work – COPHS

Objective: Assisted living (AL) residents are vulnerable to adverse events as a result of using numerous medications and frequently need assistance in administering medications. Very little is known, however, about the ways in which medications are managed within this level of care. Design: AL administrators from the metropolitan Baltimore, Maryland area were invited to participate in focus groups to explore issues involved in medication management.

Setting and Participants: Four administrators from smaller (15 beds or fewer) and six larger (more than 15 beds) certified AL facilities serving primarily older residents participated. Administrators must have served in their position at least …

Association Of Antipsychotic Use With Hospital Events And Mortality Among Medicare Beneficiaries Residing In Long-Term Care Facilities, Linda Simoni-Wastila, Priscilla T. Ryder, Jingjing Qian, Ilene H. Zuckermann, Thomas Shaffer, Lirong Zhao

Scholarship and Professional Work – COPHS

Objective—Antipsychotic (AP) utilization has grown significantly in long-term care (LTC) settings. Although a growing literature associates AP use with higher mortality in elderly with dementia, the association of APs with hospital events is unclear. The authors examine prevalence and trends in AP use by Medicare beneficiaries residing in LTC and the association of APs and other drug use variables with hospital events and mortality.

Design—Retrospective analysis using sequential multivariate Cox proportional hazards models.

Setting—Medicare Current Beneficiary Survey linked to Institutional Drug Administration and Minimum Data Set files.

Participants—A total of 2,363 LTC Medicare beneficiaries, 1999–2002. Measurements—Trends in LTC AP use …

Treatment Of Metastatic Renal Cell Carcinoma, David J. Reeves, Chin Y. Liu

Scholarship and Professional Work – COPHS

Purpose

To review the treatment of metastatic renal cell carcinoma (RCC), including the use of new targeted therapies.

Methods

A search of MEDLINE (1966 to August 2008) and American Society of Clinical Oncology Meeting abstracts (2005 to May 2008) was preformed using the search terms bevacizumab, everolimus, interferon-alfa (IFN-α), interleukin-2 (IL-2), sorafenib, sunitinib, temsirolimus, and RCC. Articles most pertinent to the treatment of metastatic RCC are reviewed.

Results

The treatment of metastatic RCC has undergone a paradigm shift over the past 5 years from biologic response modifiers to new targeted therapies. Historically, response rates for the biological response modifiers, aldesleukin …

Retrospective Evaluation Of Venous Thromboembolism Prophylaxis In The Adult Cancer Population, David J. Reeves, Chin Y. Liu

Scholarship and Professional Work – COPHS

Study objectives. Hospitalized cancer patients are at an increased risk for venous thromboembolism (VTE) and it is recommended they receive pharmacologic prophylaxis unless otherwise contraindicated. The majority of data supporting this recommendation comes from sub-group analyses and extrapolation of data gathered in general medical/surgical patients. This study seeks to assess the safety and efficacy of VTE prophylaxis in cancer patients admitted to our institution.

Methods. Charts of patients 18—89 years of age receiving VTE prophylaxis with unfractionated heparin, low molecular weigh heparin, or fondaparinux while admitted to Karmanos Cancer Center between September and October 2007 were retrospectively reviewed. Risk factors …