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Endocarditis And Biofilm-Associated Pili Of Enterococcus Faecalis, Sreedhar R Nallapareddy, Kavindra V Singh, Jouko Sillanpää, Danielle A Garsin, Magnus Höök, Stanley L Erlandsen, Barbara E Murray

Faculty, Staff and Student Publications

Increasing multidrug resistance in Enterococcus faecalis, a nosocomial opportunist and common cause of bacterial endocarditis, emphasizes the need for alternative therapeutic approaches such as immunotherapy or immunoprophylaxis. In an earlier study, we demonstrated the presence of antibodies in E. faecalis endocarditis patient sera to recombinant forms of 9 E. faecalis cell wall-anchored proteins; of these, we have now characterized an in vivo-expressed locus of 3 genes and an associated sortase gene (encoding sortase C; SrtC). Here, using mutation analyses and complementation, we demonstrated that both the ebp (encoding endocarditis and biofilm-associated pili) operon and srtC are important for biofilm production …

Time To Renal Disease And End-Stage Renal Disease In Profile: A Multiethnic Lupus Cohort, Graciela S. Alarcón, Gerald Mcgwin, Michelle Petri, Rosalind Ramsey-Goldman, Barri J. Fessler, Luis M. Vilá, Jeffrey C. Edberg, John D. Reveille, Robert P. Kimberly

Faculty, Staff and Student Publications

BACKGROUND: Renal involvement is a serious manifestation of systemic lupus erythematosus (SLE); it may portend a poor prognosis as it may lead to end-stage renal disease (ESRD). The purpose of this study was to determine the factors predicting the development of renal involvement and its progression to ESRD in a multi-ethnic SLE cohort (PROFILE).

METHODS AND FINDINGS: PROFILE includes SLE patients from five different United States institutions. We examined at baseline the socioeconomic-demographic, clinical, and genetic variables associated with the development of renal involvement and its progression to ESRD by univariable and multivariable Cox proportional hazards regression analyses. Analyses of …

Neck Recurrence In Early Carcinoma Tongue, Mubasher Ikram, Sadaf Fatima Jafferbhoy, Maisam Abbas Shiraz Onali

Section of Otolaryngology, Head & Neck Surgery

Objective: To study the efficacy of different locoregional treatment options for tongue cancer in determining the prognosis, with reference to recurrence of disease in neck.

Methods: This is a retrospective analysis of 80 patients with early (T1/T2) carcinoma tongue who had hemiglossectomy with or without neck surgery and radiotherapy for 14 years.

Results: Eighty patients were included in this study, 49 (61.3%) men and 31 (38.8%) women; 36 (45%) patients with T1 lesion and 44 (55%) with T2 lesion. Sixty two patients (77.5%) were staged cN0 and 18 patients had a clinically palpable neck nodes (cN+). Thirty seven patients were …

To Smear Or Not To Smear? Evidence Of A Failure Of Implementation And Content Suitability Of The 2000 National Guideline On Cervical Cancer Screening Program In Kwazulu-Natal, South Africa, Lee Trope

Independent Study Project (ISP) Collection

The value of screening for cervical cancer has been proven; as such screening has resulted in a decrease in incidence and mortality of cervical cancer by over 80% in developed countries . Yet despite a screening infrastructure, cervical cancer is the most common female malignancy in South Africa , affecting 1 in ever 41 women. It is estimated that more than 3,400 South African women die of cervical cancer every year . In the year 2000, the South African Department of Health initiated its National Guideline on Cervical Cancer Screening Program. The program, based on World Health Organization (WHO) guidelines …

Treatment Evolution In High-Risk Congenital Diaphragmatic Hernia: Ten Years' Experience With Diaphragmatic Agenesis, Kevin P Lally, Pamela A Lally, Krisa P Van Meurs, Desmond J Bohn, Carl F Davis, Bradley Rodgers, Jatinder Bhatia, Golde Dudell

Faculty, Staff and Student Publications

OBJECTIVE: The objective of this study was to evaluate the impact of newer therapies on the highest risk patients with congenital diaphragmatic hernia (CDH), those with agenesis of the diaphragm.

SUMMARY BACKGROUND DATA: CDH remains a significant cause of neonatal mortality. Many novel therapeutic interventions have been used in these infants. Those children with large defects or agenesis of the diaphragm have the highest mortality and morbidity.

METHODS: Twenty centers from 5 countries collected data prospectively on all liveborn infants with CDH over a 10-year period. The treatment and outcomes in these patients were examined. Patients were followed until death …

Subependymal Giant Cell Astrocytoma, Zubair Ahmad, Fouzia Rauf, Najamul Sahar Azad, Aamir Ahsan

Department of Pathology and Laboratory Medicine

Subependymal giant cell astrocytomas (SEGAs) are slowly growing tumours corresponding to WHO grade I. They are intraventricular and usually occur in the setting of tuberous sclerosis complex. They often result in obstructive hydrocephalus. Treatment is usually restricted to surgical resection, recurrences are rare and long term prognosis is excellent. We present a series of three cases.

Botulinum Toxin Type-A In The Management Of Cerebral Palsy: Low Or High Dose?, Alper I. Dai, Mohammad Wasay

Department of Medicine

Cerebral palsy is the most common cause of severe physical disability in childhood. Spasticity is a common and disabling symptom for many patients with cerebral palsy. Therapy for spasticity is symptomatic with the aim of increasing functional capacity and relieving discomfort. Spasticity treatment by orally administered drugs and intramuscular chemodenervation agents has become more frequent. Most oral medications to treat spasticity have been inadequately studied in children, especially those with cerebral palsy. Since its first use in pediatric patients, reported in 1993, botulinum toxin (BTX-A), a relatively recent addition to the available medical interventions for children with cerebral palsy, has …

Comparison Between Tramadol And Pethidine In Patient Controlled Intravenous Analgesia, Faisal Shamim, Muhammad Qamarul Hoda, Khalid Samad, Salman Sabir

Department of Anaesthesia

Objective: To compare the efficacy and side effects related to Tramadol with Pethidine in patient controlled intravenous analgesia (PCIA) after total abdominal hysterectomies. Methods: A total of 60 patients were randomized to receive either Tramadol or Pethidine by PCIA (30 in each group) after total abdominal hysterectomy. Pain assessments were recorded one hour after starting the PCIA and then at 6, 12, and 24 hours by using visual analogue scale (VAS). Nausea vomiting score and sedation score were also recorded. Good attempts, total attempts and total drug consumption was noted from PCIA pump at the end of the study period. …

A Survey Of Primary Care Residents Regarding Knowledge Of Hepatitis C, Joseph L. Yozviak Do, Facp, Erini Vasiliadis Do, Sharon R. Kimmel Phd, Mha, Suzanne J. Templer Do, Margaret Hoffman-Terry Md, Facp

Department of Medicine

No abstract provided.

Psychiatric Outcomes In A Resident-Run, Multidisciplinary, Hepatitis C Clinic (Poster), Nicole M. Agostino Do, Edward Norris Md, Fapm, Joseph L. Yozviak Do, Facp, Suzanne J. Templer Do, Charles M. Brooks Md, Eric J. Gertner Md, Mph, Michael Kaufmann Md

Department of Medicine

No abstract provided.

Malignant Melanoma Metastacizing To The Thyroid Gland: A Case Report And Review Of The Literature, Brian Kung, Saba Aftab, Moira Wood, David Rosen

Department of Otolaryngology - Head and Neck Surgery Faculty Papers

Oral presentation 2006 AAO-H&NS Annual Meeting

Toronto, Canada September 17-20, 2006.

Objectives: The thyroid gland is a relatively uncommon site for secondary malignancy. Even lesscommon is metastasis of malignant melanoma to the thyroid gland. We present a case of malignantmelanoma metastatic to the thyroid gland presenting as thyroid enlargement.

Study Design: This is a case report which utilizes chart review, intraoperative photographs,radiographic images, and pathology slides.

Methods: A 68 year old patient with no prior evidence of primary skin melanoma presented witha neck mass which tested positive for melanoma. A year and a half following modified radical neckdissection, the patient …

Clinical Characteristics Of Pulmonary Tuberculosis In Adult Pakistani Patients With Co-Existing Diabetes Mellitus, A Jabbar, S F. Hussain, A A. Khan

Section of Pulmonary & Critical Care

A review was made of the records of all patients with pulmonary tuberculosis and diabetes mellitus admitted over a 5-year period to a teaching hospital in Karachi, Pakistan. Among 42358 patients, the total number with both tuberculosis and diabetes was 173. The prevalence of tuberculosis in diabetic patients was 10-times higher than in non-diabetic patients and prevalence increased with duration of diabetes. The lower lung field was most frequently involved, followed by the upper and middle. Bilateral involvement was seen in half and an associated pleural effusion in one-third of the patients. Cavitating lesions were seen in 32% of men …

Medical Education Digest, Vol. 8 No. 5 (September/October 2006), Nova Southeastern University

Medical Education Digest

No abstract provided.

Stroke-Related Complications Due To Delay In Seeking Medical Care: A Review Of 100 Cases, Asad Ali

Pakistan Journal of Neurological Sciences (PJNS)

No abstract provided.

Oncolog Volume 51, Number 09, September 2006, Dawn Chalaire, Angelique Siy, Christopher G. Wood Md

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

• Zeroing In on a Moving Target
• New Life for an Old Drug
• House Call: Managing Your Medications
• DiaLog: Adjuvant Therapy for Aggressive Kidney Cancer, by Christopher G. Wood, MD, Associate Professor of Urology and Cancer Biology

Evaluation Of Program Outcomes: Assessment In Children, Cheryl M. Romano

Loma Linda University Electronic Theses, Dissertations & Projects

In an age of increased concern for accountability and the review of services, administrators of health programs should be able to present their clinics effectiveness, and demonstrate their excellent service to the community, along with providing evidence for the continued need of such clinics. Outcome evaluation plays an integral part in providing this information, and is intended to provide information concerning the effectiveness of a particular program, thus allowing for modification, and even better outcomes.

This project addressed pre and post functioning in children referred for academic and/or behavioral difficulties, in a university of health sciences-based clinic. The aim was …

Implant Success In Distracted Bone Versus Autogenous Bone-Grafted Sites, Jeffrey Allan Elo

Loma Linda University Electronic Theses, Dissertations & Projects

Endosseous implants are the treatment of choice for restoring function and reconstructing edentulous areas of the maxilla and mandible. Alveolar defects can be reconstructed by either distraction osteogenesis or autogenous bone grafting. After alveolar reconstruction, endosseous implants are used to support and retain the prosthesis for restoration of form and function. We retrospectively analyzed the success rates of endosseous implant placement in distracted versus autogenous bone graft reconstruction sites in our patient population at Loma Linda University Medical Center, Department of Oral and Maxillofacial Surgery. 82 consecutive patients requiring alveolar augmentation prior to implant placement were evaluated. All patients were …

Surgical Correction Of Severe Bilateral Thumb Pincer-Nail Deformity, Scott T. Van Duzer, John S. Taras

Department of Orthopaedic Surgery Faculty Papers

A 53 year old woman presented to the office with complaint of severe bilateral thumb nail pain and the deformity shown (Figure 1). She denied previous trauma to her thumb nails and had no history of previous bacterial or fungal infections of her nails. Based on the curvature of her nails, which increased from proximal to distal, a diagnosis of bilateral thumb pincer nail deformity was made.

Operating On The Master Gland: 100consecutive Hypophysectomies At Aga Khan University Hospital, Karachi, Muhammad Shahzad Shamim, Faraz Khursheed, Muhammad Ehsan Bari

Pakistan Journal of Neurological Sciences (PJNS)

No abstract provided.

Mult-Slice Ct Scanning, Zafar Sajjad

Pakistan Journal of Neurological Sciences (PJNS)

No abstract provided.

Clinical Applications Of Polysomnography, Imran I. Ali

Pakistan Journal of Neurological Sciences (PJNS)

No abstract provided.

Sporadic Hemiplegic Migraine: A Challenging Diagnosis, Azra Zafar, Shahid Mustafa, Kaneez Aelia

Pakistan Journal of Neurological Sciences (PJNS)

No abstract provided.

Neurology, Mohammad Wasay

Pakistan Journal of Neurological Sciences (PJNS)

No abstract provided.

Psychiatry, Syed Ahmer

Pakistan Journal of Neurological Sciences (PJNS)

No abstract provided.

Central Nervous System Involvement Indengue Viral Infection, Romasa Channa, Mohammad Wasay

Pakistan Journal of Neurological Sciences (PJNS)

No abstract provided.

Neurosurgery, S. Ather Enam

Pakistan Journal of Neurological Sciences (PJNS)

No abstract provided.

Open Versus Laparoscopic Pyloromyotomy For Pyloric Stenosis: A Prospective, Randomized Trial., Shawn D. St Peter, G W. Holcomb Iii, Casey M. Calkins, J Patrick Murphy, Walter S. Andrews, Ronald J. Sharp, Charles L. Snyder, Daniel J. Ostlie

Manuscripts, Articles, Book Chapters and Other Papers

BACKGROUND: Pyloric stenosis, the most common surgical condition of infants, is treated by longitudinal myotomy of the pylorus. Comparative studies to date between open and laparoscopic pyloromyotomy have been retrospective and report conflicting results. To scientifically compare the 2 techniques, we conducted the first large prospective, randomized trial between the 2 approaches.

METHODS: After obtaining IRB approval, subjects with ultrasound-proven pyloric stenosis were randomized to either open or laparoscopic pyloromyotomy. Postoperative pain management, feeding schedule, and discharge criteria were identical for both groups. Operating time, postoperative emesis, analgesia requirements, time to full feeding, length of hospitalization after operation, and complications …

Cd80 And Cd86 Control Antiviral Cd8+ T-Cell Function And Immune Surveillance Of Murine Gammaherpesvirus 68, Shinichiro Fuse, Joshua J. Obar, Sarah Bellfy, Erica K. Leung, Weijun Zhang, Edward J. Usherwood

Dartmouth Scholarship

The interactions between CD80 and CD86 on antigen-presenting cells and CD28 on T cells serve as an important costimulatory signal in the activation of T cells. Although the simplistic two-signal hypothesis has been challenged in recent years by the identification of different costimulators, this classical pathway has been shown to significantly impact antiviral humoral and cellular immune responses. How the CD80/CD86-CD28 pathway affects the control of chronic or latent infections has been less well characterized. In this study, we investigated its role in antiviral immune responses against murine gammaherpesvirus 68 (MHV-68) and immune surveillance using CD80/CD86^−/− mice. In the …

Ligand-Signaled Upregulation Of Enterococcus Faecalis Ace Transcription, A Mechanism For Modulating Host-E Faecalis Interaction, Sreedhar R Nallapareddy, Barbara E Murray

Faculty, Staff and Student Publications

Enterococcus faecalis, the third most frequent cause of bacterial endocarditis, appears to be equipped with diverse surface-associated proteins showing structural-fold similarity to the immunoglobulin-fold family of staphylococcal adhesins. Among the putative E. faecalis surface proteins, the previously characterized adhesin Ace, which shows specific binding to collagen and laminin, was detectable in surface protein preparations only after growth at 46 degrees C, mirroring the finding that adherence was observed in 46 degrees C, but not 37 degrees C, grown E. faecalis cultures. To elucidate the influence of different growth and host parameters on ace expression, we investigated ace expression using E. …

Incorporating Endoscope In Middle Ear Surgery, Shehzad Ghaffar, Mubasher Ikram, Ahsan Raza

Section of Otolaryngology, Head & Neck Surgery

We conducted a study to evaluate the use of a pediatric rigid otoendoscope for determining the extent of middle ear disease and for assessing ossicular integrity and mobility during tympanoplasty. Our study population was made up of 132 patients who were undergoing surgery for the treatment of chronic suppurative otitis media; of this group, 41 patients underwent otoendoscopy and 91 underwent scutum lowering for purposes of visualization. In the otoendoscopy group, the ossicles were successfully visualized and their mobility assessed in 34 patients; the remaining 7 patients subsequently underwent scutum lowering. A 30° endoscope allowed for complete visualization of the …