Digital Commons Network^™

Averting A Malaria Disaster In Africa - Where Does The Buck Stop?, C.J.M. Whitty, R. Allan, V. Wiseman, S. Ochola, M.V. Nakyanzi-Mugisha, B. Vonhm, M. Mwita, C. Miaka, A. Oloo, Zul Premji, C. Burgess, T.K. Mutabingwa

Pathology, East Africa

The serious threat posed by the spread of drug-resistant malaria in Africa has been widely acknowledged. Chloroquine resistance is now almost universal, and resistance to the successor drug, sulfadoxine-pyrimethamine (SP), is growing rapidly. Combination therapy has been suggested as being an available and potentially lasting solution to this impending crisis. However, the current cost of combination therapy, and especially that of artemisinin combination therapy (ACT), is potentially a serious drawback, even if a significant part of its cost is passed on to the end-user. If the question of cost is not successfully addressed this could lead to adverse results from …

Higher Il-10 Levels Are Associated With Less Effective Clearance Of Plasmodium Falciparum Parasites, E. Hugosson, S.M. Montgomery, Zul Premji, M. Troye-Blomberg, A. Bjorkman

Pathology, East Africa

The implications of high levels of the immune regulatory cytokine IL-10 in Plasmodium falciparum malaria are unclear. IL-10 may down-regulate pro-inflammatory responses and also exacerbate disease by inhibiting anti-parasitic immune functions. To study possible inhibiting effects on parasite clearance, IL-10 plasma levels were determined in 104 Tanzanian children, 1 to 4 years old, with acute uncomplicated P. falciparum malaria, and analysed for association with parasite densities during 3 days of anti-malarial treatment. Higher baseline IL-10 plasma levels were associated with statistically significantly higher parasite densities after 24, 48 and 72 h of treatment. These associations could not be explained by …

Comparison Of Pretreatment Characteristics And Treatment Outcomes For Alcohol-, Cocaine-, And Multisubstance-Dependent Patients., Ashwin A. Patkar, Charles C. Thornton, Paolo Mannelli, Kevin P. Hill, Edward Gottheil, Michael J. Vergare, Stephen P. Weinstein

Department of Psychiatry and Human Behavior Faculty Papers

We investigated whether pretreatment characteristics and measures of outcome differed for alcohol-, cocaine-, and multisubstance-dependent patients receiving outpatient substance abuse treatment. One hundred and forty substance dependent individuals (32 alcohol, 76 cocaine, and 32 multisubstance) enrolled in a 12-week outpatient treatment program were compared across measures of addiction severity, personality, and treatment-readiness at admission. In-treatment, end-of-treatment and 9-month follow-up assessments of treatment outcome were then compared across the three groups. Outcome measures included reduction in problem severity, abstinence, retention, number of sessions attended, dropout, and counselor and patient ratings of treatment benefit. At admission, the multisubstance group had a higher …

Imaging Genome Abnormalities In Cancer Research, Henry Hq Heng, Joshua B. Stevens, Guo Liu, Steven W. Bremer, Christine J. Ye

Wayne State University Associated BioMed Central Scholarship

Abstract

Increasing attention is focusing on chromosomal and genome structure in cancer research due to the fact that genomic instability plays a principal role in cancer initiation, progression and response to chemotherapeutic agents. The integrity of the genome (including structural, behavioral and functional aspects) of normal and cancer cells can be monitored with direct visualization by using a variety of cutting edge molecular cytogenetic technologies that are now available in the field of cancer research. Examples are presented in this review by grouping these methodologies into four categories visualizing different yet closely related major levels of genome structures. An integrated …

Traumatic Deep Vein Thrombosis In A Soccer Player: A Case Study, Paul S. Echlin, Ross Eg Upshur, Douglas B. Mckeag, Harsha P. Jayatilake

Wayne State University Associated BioMed Central Scholarship

Abstract

A 42 year-old male former semi-professional soccer player sustained a right lower extremity popliteal contusion during a soccer game. He was clinically diagnosed with a possible traumatic deep vein thrombosis (DVT), and sent for confirmatory tests. A duplex doppler ultrasound was positive for DVT, and the patient was admitted to hospital for anticoagulation (unfractionated heparin, warfarin). Upon discharge from hospital the patient continued oral warfarin anticoagulation (six months), and the use of compression stockings (nine months). He followed up with his family doctor at regular intervals for serial coagulation measurements, and ultrasound examinations. The patient's only identified major thrombotic …

Making Tough Decisions, Karen A. Karlowicz

Ellmer School of Nursing Faculty Publications

This article focuses on the aspect of critical thinking in making tough decisions in life. Advances in urology have resulted in a range of therapies for many urologic diseases and disorders. Patients need information about each treatment, and the time to fully consider the effect of a given therapy on their overall health. Keep in mind that patients who are empowered to make decisions about their health care are more likely to comply with the treatment plan. Likewise the author urges readers to use their critical thinking skills to solve the clinical problems they are confronted with daily.

Patient Expectations Of Full Body Ct Screening, Carole Tanenbaum Kolber

Seton Hall University Dissertations and Theses (ETDs)

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Increased Expression Of Hla Dr2 In Acquired Aplastic Anemia And Its Impact On Response To Immunosuppressive Therapy, M. Usman, Salman Adil, Tariq Moatter, F. Bilwani, S. Arian, Mohammad Khurshid

Department of Pathology and Laboratory Medicine

Objective: To study the frequency of HLA DR2 status of patients with aplastic anemia and their response to immunosuppressive therapy at a tertiary care hospital.
Methods: Thirty eight consecutive patients of acquired aplastic anemia were evaluated with respect to demographic features, severity of HLA DR2 status and response outcome to immunosuppressive therapy.
Results: The mean age of the patients was 24.6 years + 16.4 with a male to female ratio of 2.8:1. Positivity of HLA DR2 was markedly high in acquired aplastic anemia patients. Twenty four (65%) out of 38 patients as compared to 45 (15%) of …

Hematologic And Cytogenetic Findings In Eleven Chronic Myelogenous Leukemia Patients Treated With Imatinib Mesylate At A Tertiary Care Hospital, M. Usman, G. N. Kakepoto, Salman Adil, R. Sajid, S. Arain, Mohammad Khurshid

Department of Pathology and Laboratory Medicine

Objective: To evaluate the response of Imatinib mesylate in patients with myeloid leukemia in chronic ,accelerated and blast phase.
Methods:Eleven patients with established diagnosis of chronic myeloid leukemia were treatedwith Imatinib mesylate. Adverse events were documented with regular follow ups. Hematological and cytogeneticresponses were assessed according to established criteria. Patients with zero percent Philadelphia positivemetaphases were labeled as complete cytogenetic response while patients with 1% to 35% Philadelphia positive metaphases were termed as partial responders.
Results: Of 11 cases there were 7 males and 4 females with a mean age of 39.5 years and median age 51 years(range 21-69). …

Unenhanced Helical Ct Of Ureterolithiasis: Incidence Of Secondary Urinary Tract Findings, J Yaqoob, M U. Usman, V Bari, K Munir, F Mosharaf

Department of Radiology

Objective: To determine the incidence of secondary signs of obstruction in patients with ureteral stones on unenhanced helical CT scans.MATERIAL AND Methods: Three hundred consecutive patients with suspected renal colic referred by the emergency department for an unenhanced helical CT scan were evaluated. One hundred and thirty two patients with ureteric calculi were viewed prospectively for the secondary signs of obstruction, which include hydronephrosis, hydroureter, perinephric stranding, nephromegaly, periureteral edema and difference in attenuation between acutely obstructed kidney and unobstructed kidney.Results: In the evaluated 132 patients, calculi were present in the proximal, mid and distal ureter in 12, 18 and …

Boerhaave's Syndrome: A Diagnostic Dilemma In The Emergency Room, Ab Zubairi, I Khalid, Saulat H. Fatimi, J Hussain, N Salahuddin

Department of Medicine

Boerhaave's syndrome is a potential lethal condition which presents not only a diagnostic but also a therapeutic challenge. Errors in diagnosis are usually caused by unawareness of its varied and atypical presentations. All clinicians need to be aware of this lethal disease, its frequent unusual presentations and the importance of early diagnosis.

Expression Of Ps2 In Prostate Cancer Correlates With Grade And Chromogranin A Expression But Not With Stage, Hammad Ather, Farhat Abbas, Nuzhat Faruqui, M Israr, Shahid Pervez

Department of Pathology and Laboratory Medicine

Background: The biological potential of prostate cancer is extremely variable. Particular interest is focused on markers not expressed in normal prostatic tissues. pS2 protein expression has been demonstrated in a range of malignant tissues in an oestrogen-independent pathway. Recently, it has been demonstrated that pS2, in prostate cancer, is closely associated with neuro-endocrine differentiation. In the present study, we have analyzed, the potential of Neuro-endocrine and pS2 (TFF1) expression in human prostate cancer determined by immunohistochemistry, in primary adenocarcinoma of the prostate and attempted to correlate this with the clinico-pathologic features of the patient and neuroendocrine expression.

Methods: Ninety-five malignant …

Increased Risk For Aplastic Anemia And Myelodysplastic Syndrome In Individuals Lacking Glutathione S-Transferase Genes, Joanne F. Sutton, Michael Stacey, William G. Kearns, Thomas S. Roeg, Neal S. Young, Johnson M. Liu

Bioelectrics Publications

BACKGROUND: Aplastic anemia (AA) and myelodysplastic syndrome (MDS) are marrow failure states that may be associated with chromosomal instability. An absence of the glutathione S-transferase (GST) enzyme may genetically predispose individuals to AA or MDS. PROCEDURE AND RESULTS: To test this hypothesis, we determined the GSTM1 and GSTT1 genotypes in a total of 196 patients using multiplex PCR. The GSTT1 null genotype was found to be overrepresented in Caucasian, Asian, and Hispanic patients with either AA or MDS. We confirmed a difference in the expected frequency of the GSTM1 null genotype in Caucasian MDS patients. The double null GSTM1/GSTT1 …

Molecular Functionalization Of Carbon Nanotubes And Use As Substrates For Neuronal Growth, Mark P. Mattson, Robert C. Haddon, Apparao M. Rao

Sanders-Brown Center on Aging Faculty Patents

A cell and substrate system and nerve regeneration implant are disclosed including a carbon nanotube and a neuron growing on the carbon nanotube. Both unfunctionalized carbon nanotubes and carbon nanotubes functionalized with a neuronal growth promoting agent may be utilized in the invention. A method is also disclosed for promoting neuronal growth.

Uncertainty And The Value Of Diagnostic Information With Application To Axillary Lymph Node Dissection In Breast Cancer, Giovanni Parmigiani

Johns Hopkins University, Dept. of Biostatistics Working Papers

In clinical decision making, it is common to ask whether, and how much, a diagnostic procedure is contributing to subsequent treatment decisions. Statistically, quantification of the value of the information provided by a diagnostic procedure can be carried out using decision trees with multiple decision points, representing both the diagnostic test and the subsequent treatments that may depend on the test's results. This article investigates probabilistic sensitivity analysis approaches for exploring and communicating parameter uncertainty in such decision trees. Complexities arise because uncertainty about a model's inputs determines uncertainty about optimal decisions at all decision nodes of a tree. We …

Optimization Of Breast Cancer Screening Modalities, Yu Shen, Giovanni Parmigiani

Johns Hopkins University, Dept. of Biostatistics Working Papers

Mathematical models and decision analyses based on microsimulations have been shown to be useful in evaluating relative merits of various screening strategies in terms of cost and mortality reduction. Most investigations regarding the balance between mortality reduction and costs have focused on a single modality, mammography. A systematic evaluation of the relative expenses and projected benefit of combining clinical breast examination and mammography is not at present available. The purpose of this report is to provide methodologic details including assumptions and data used in the process of modeling for complex decision analyses, when searching for optimal breast cancer screening strategies …

Linda Lê : Schizo-Positive?, Isabelle Favre

Présence Francophone: Revue internationale de langue et de littérature

In her novel entitled "Calomnies", Linda Lê depicts a "mad uncle" and a young female writer fascinated with her uncle’s marginality. In this book, Lê presents a complex view of schizophrenia. Sometimes, the actions and thoughts of the uncle are reminiscent of Deleuze and Guattari’s concepts such as le corps sans organe and la machine célibataire. Some other times however, Lê pays attention to the past of the uncle and shows how, in Vietnam, he witnessed the hypocrisy of his family during the war. These passages are then closer to Laing’s theories, since the environment and conditions in which he …

The Relationship Of Health Beliefs And Health Value In Cardiovascular Outcomes, Kimberley Schaub

All-Inclusive List of Electronic Theses and Dissertations

Despite extensive theoretical information regarding Schwarzer's Health Action Process Approach the utility of the model pas yet to be explored within a chronic illness population. Using Schwarzer's Health Action Process Approach (Schwarzer, 1992), the purpose of this study was to investigate cardiovascular outcomes based on health beliefs and health value. Participants were eighty-one adults ages 42-87 with cardiovascular disease recruited from a cardiac rehabilitation program in Central Indiana. Participants completed instruments that assessed (a) health beliefs, (b) health value and, (c), quality of life. Measurements of physiological outcome (resting heart rate, distance walked, and metabolic equivalent) were also obtained. A …

Determination Of The Optimal Form Of A Dna Vaccine To Induce An Effective Immune Response Against A Murine B-Cell Lymphoma, Deepti Aurora

All-Inclusive List of Electronic Theses and Dissertations

Tumor vaccines are a promising alternative to chemotherapy for the treatment of cancer. To be effective and safe, a cancer vaccine should specifically target antigens expressed only on tumor cells. The B-cell tumor-derived Ig receptor may be considered a model tumor antigen for cancer vaccine development. Specifically the immunoglobulin idiotype (ld) encoded by the variable region genes (VH and VL) provides a target antigen. Promising results have been obtained in clinical studies of ld vaccination using ld proteins. However, ld protein is laborious and time-consuming to produce. Gene-based vaccines, on the other hand, are inexpensive and offer ease of manipulation …

Determinants Of Satisfaction With An Automated Alcohol Evaluation Program., Daniel Z Lieberman

Psychiatry and Behavioral Sciences Faculty Publications

High rates of untreated mental illness cause serious health problems in the United States and worldwide. The use of computer-administered therapy has the potential to increase access to mental health care for certain patient populations. An online version of an alcohol check-up was developed that guided subjects through a series of standardized questionnaires, and provided them with feedback designed to enhance their appreciation of the negative aspects of their alcohol use. Ratings of the helpfulness of the questionnaires were evaluated in order to determine the characteristics of individuals who would potentially benefit from an automated substance abuse intervention, and to …

Oncolog, Volume 48, Number 12, December 2003, Karen Stuyck, Dawn Chalaire, Martha A. Askins, Martha Aschenbrenner

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

• On the Move: Efforts Under Way to Improve Outcomes for Patients with Renal Cancer
• Protocols: Studies Examine Treatments for Renal Cell Carcinoma
• Art Therapy Helps Children Affected by Cancer Express Their Emotions
• Children's Art Project Has Been Improving the Lives of Children with Cancer for 30 Years
• DiaLog: When a Parent Is Sick: Talking to Children about Cancer, by Martha A. Askins, PhD, Division of Pediatrics, and Martha Aschenbrenner, Director, Child Life Services

Status Epilepticus In Children: A Five-Year Experience At Aga Khan University Hospital, S H. Ibrahim, M A. Yezdan, S Q. Nizami

Department of Paediatrics and Child Health

Objective: Status epilepticus is an under diagnosed entity in Pakistan. It is a potentially reversible condition but has a high mortality, if it is not recognized and managed on time. The purpose of this study was to determine the clinical profile and the relationship of mortality of status epilepticus with its known risk factors.
Methods: This was a retrospective study. Medical records of all the patients admitted in the last five years (1998-2002) with a diagnosis of status epilepticus (ICDcode 345.30, 345.31) were reviewed. Data was recorded on a Performa and analyzed by using the statistical programme SPSS, chi square …

Measured Effects Of Rapid Palatal Expansion On Nasal Cavity Volume Utilizing Cbct, Jon Neal Robinson

Loma Linda University Electronic Theses, Dissertations & Projects

The purpose of this study was to evaluate and predict the expected changes that occur in the nasal cavity volume following rapid palatal expansion. Eighteen subjects (11 female, 7 male), ages 9 to 18, requiring rapid palatal expansion in conjunction with comprehensive orthodontic treatment, were selected for the study. Rapid palatal expansion was accomplished using the standard, banded hyrax appliance. Three-dimensional cone beam computed tomograms using the NewTom 9000™ were acquired before and after expansion. Serial coronal slices of the nasal cavity were made using the QV9000™ software program. The resultant serial images were imported into 3-D Doctor™ for analysis …

The Histological Effects Of Mandibular Distraction Osteogenesis On Rabbit Condyles, Eunice Jungmin Hong

Loma Linda University Electronic Theses, Dissertations & Projects

The present study is a histological evaluation of condyles taken from rabbits that underwent either a midline or paramedian distraction osteogenesis procedure on the mandibles. Fifteen rabbits were originally operated on and eight of these fifteen successfully made it through both the distraction osteogenesis procedure and the 1 month holding period that followed. There was one control animal.

In the present study, the condyles from these nine rabbits (1 control, 2 midline distraction osteogenesis, 6 paramedian distraction osteogenesis) were prepared for histological evaluation (18 total). Step serial sections were cut along the coronal plane and the sections from the anterior …

Interleukin-10 And Pathogenesis Of Murine Ocular Toxoplasmosis, Fangli Lu, Shiguang Huang, Lloyd H. Kasper

Dartmouth Scholarship

To understand the role of interleukin-10 (IL-10) in ocular toxoplasmosis, we compared C57BL/6 (B6) and BALB/c background mice lacking a functional IL-10 gene (IL-10(-/-)) and B6 transgenic mice expressing IL-10 under the control of the IL-2 promoter. Increased cellular infiltration and necrosis were observed in the eye tissue of IL-10(-/-) mice of both the B6 and BALB/c backgrounds with associated changes in the levels of cytokines in serum. In contrast, there was no evidence of necrosis in the eye tissue from IL-10 transgenic mice following parasite exposure. Our results demonstrate that IL-10 is important in the regulation of inflammation during …

Determinants Of Balance Confidence In Community-Dwelling Elderly People, Janine Hatch, Kathleen M. Gill-Body, Leslie G. Portney

All PTHMS Faculty Publications

Background and Purpose. The fear of falling can have detrimental effects on physical function in the elderly population, but the relationship between a persons' confidence in the ability to maintain balance and actual balance ability and functional mobility is not known. The extent to which balance confidence can be explained by balance performance, functional mobility, and sociodemographic, psychosocial, and health-related factors was the focus of this study.

Subjects. The subjects were 50 community-dwelling elderly people, aged 65 to 95 years (X̄=81.7, SD=6.7).

Methods. Balance was measured using the Berg Balance Scale. Functional mobility was measured using the Timed Up & …

Socio-Economic And Diagnostic Aspects Of Tuberculosis In Pakistan, Saba Sohail

Department of Radiology

No abstract provided.

Neurological Care In Pakistan: Actions Are Needed, M. Wasay

Department of Medicine

No abstract provided.

Ischemic Stroke Subtypes In Pakistan: The Aga Khan University Stroke Data Bank, N. A. Syed, B. A. Khealani, S. Ali, A. Hasan, H. Brohi, T. Mozaffar, N. Ahmed, A. Hameed, S. M. Baig, M. Wasay

Department of Medicine

Objective: Frequency of ischemic stroke subtypes is influenced by ethnic and geographic variables. Our objective was to identify various stroke subtypes and its determinants at a tertiary care hospital.

Methods: We prospectively collected data on ischemic stroke subtypes admitted to The Aga Khan University Hospital in Karachi.

Results: A total of 596 patients were enrolled in 22 months in the Aga Khan Universtiy Stroke Registry. These included 393 patients with Ischemic stroke, 126 patients with intracerebral hemorrhage, 50 patients with subarachnoid hemorrhage and others. The ischemic stroke group was classified according to the TOAST criteria and comprised of lacunar 168/393 …

Spectrum Of Complications And Mortality Of Bacterial Meningitis: An Experience From A Developing Country, M. A. Rabbani, A. A. Khan, S. S. Ali, B. Ahmad, Mohammad Asim Beg, M. A. Khan, Mohammad Wasay

Department of Medicine

Objective:

The aim of this study was to obtain data on predisposing factors, causative organisms and their associated mortality and complications related to acute bacterial meningitis.

Methods:

The chart review of all patients in whom acute bacterial meningitis was diagnosed at The Aga Khan University Hospital from January 1995 through December 2001.

Results:

One hundred ninety-four patients were included in study. There were 146 males and 48 females. The mean age of our study population was 41±12.3 years. One hundred and ninety (97.9%) patients had community acquired meningitis; only 4 (2.0%) patients developed meningitis nosocomially. The two most common predisposing …