Digital Commons Network^™

Influences On Self-Care In Women With Heart Failure: A Pilot Study, Joy Corcione

Dissertations and Theses (Open Access)

Background: Heart Failure self-care becomes exceedingly difficult to perform as the disease progresses; therefore social support becomes important in facilitating heart failure self-care. Woman with heart failure represent a significant and growing vulnerable population. Women tend to have lower self-confidence in providing self-care, experience greater negative emotions, decreased social support, experience more adverse psychosocial factors affecting self-care and experience greater psychosocial adversity than do men. Self-care is vital in managing heart failure and social support greatly facilitates self-care behaviors.

Purpose: The purpose of this pilot study was to gain a deeper understanding about the sources of perceived social support and …

Underuse Of Oral Anticoagulants For Nonvalvular Atrial Fibrillation: Past, Present, And Future, Ramsey M Wehbe, Ajay Yadlapati

The Texas Heart Institute Journal

No abstract provided.

Defining The Functions Of Usp22 And Usp44 In Regulation Of H2bub1 Levels, Xianjiang Lan

Dissertations and Theses (Open Access)

Aberrant levels of histone ubiquitination are involved in various human diseases including neurodegenerative disorders and cancers. Particularly, Histone H2B monoubiquitination (H2Bub1) is highly associated with gene regulation in both normal cells and diseases. Many deubiquitinases (mainly USPs) are defined to regulate global H2Bub1 levels. However, how these USPs are regulated and how they contribute to diseases are not well understood.

USP22, part of the deubiquitination module (DUBm) in the SAGA complex, is a well-defined regulator of H2Bub1 levels. ATXN7, another crucial subunit of the SAGA DUBm, is involved in a neurodegenerative disease, spinocerebellar ataxia type 7 (SCA7), due to a …

Periodontitis In Chronic Heart Failure, Hanna Fröhlich, Kristina Herrmann, Jennifer Franke, Alamara Karimi, Tobias Täger, Rita Cebola, Hugo A Katus, Christian Zugck, Lutz Frankenstein

The Texas Heart Institute Journal

Periodontal disease has been associated with an increased risk of cardiovascular events. The purpose of our study was to investigate whether a correlation between periodontitis and chronic heart failure exists, as well as the nature of the underlying cause.

We enrolled 71 patients (mean age, 54 ± 13 yr; 56 men) who had stable chronic heart failure; all underwent complete cardiologic and dental evaluations. The periodontal screening index was used to quantify the degree of periodontal disease. We compared the findings to those in the general population with use of data from the 4th German Dental Health Survey.

Gingivitis, moderate …

Coronary-Cameral Fistula Caused By Guidewire Trauma And Resolved By Coil Embolization, Suvro Banerjee, Soumya Patra

The Texas Heart Institute Journal

A 57-year-old woman presented with effort angina. A coronary angiogram revealed critical 2-vessel disease, for which she subsequently underwent percutaneous coronary intervention. During angioplasty, a coronary guidewire-inadvertently passed into the right ventricle through the septal branches of the posterior descending coronary artery-caused a coronary artery-to-right ventricular fistula. This fistula was successfully closed percutaneously by coil embolization. To our knowledge, this is the first report of a case in which a coronary artery-to-right ventricular fistula caused by a guidewire was managed successfully by coil embolization.

Advanced Interventional Therapy For Radiation-Induced Cardiovascular Disease, Daisy C Nieto

The Texas Heart Institute Journal

This report describes the case of a 61-year-old woman who presented with dyspnea, aortic stenosis, and coronary artery disease-typical side effects of radiation therapy for Hodgkin lymphoma. A poor candidate for surgery, she underwent successful high-risk percutaneous coronary intervention and subsequent transcatheter aortic valve replacement. This report highlights some of the cardiovascular-specific sequelae of radiation therapy for cancer treatment; in addition, possible directions for future investigations are discussed.

Association Between High Endocardial Unipolar Voltage And Improved Left Ventricular Function In Patients With Ischemic Cardiomyopathy, Ki Park, Dejian Lai, Eileen M Handberg, Lem Moyé, Emerson C Perin, Carl J Pepine, R David Anderson

The Texas Heart Institute Journal

We know that endocardial mapping reports left ventricular electrical activity (voltage) and that these data can predict outcomes in patients undergoing traditional revascularization. Because the mapping data from experimental models have also been linked with myocardial viability, we hypothesized an association between increased unipolar voltage in patients undergoing intramyocardial injections and their subsequent improvement in left ventricular performance.

For this exploratory analysis, we evaluated 86 patients with left ventricular dysfunction, heart-failure symptoms, possible angina, and no revascularization options, who were undergoing endocardial mapping. Fifty-seven patients received bone marrow mononuclear cell (BMC) injections and 29 patients received cell-free injections of a …

Precision Medicine Informatics, Lewis J Frey, Elmer V Bernstam, Joshua C Denny

Faculty, Staff and Student Publications

No abstract provided.

The Strengths Of Recent Latino Immigrant Parents Raising Young Children: An Application Of The Concepts Of Human Agency, Angel L. Gullón-Rivera Dr.

Journal of Family Strengths

Grounded in the family strengths perspective, this study focuses on the experience of first-generation immigrant parents in an effort to highlight the role of human agency in relation to family adjustment. Using a qualitative approach, this study examined the experience of 20 first-generation immigrant Latino parents of young children (ages 0-7), before and after migration, and their perceived adjustment. This approach created a holistic story of the migration process, relevant to promote civic and social participation. Several themes emerged within three cultural domains in relation to the concept of human agency: (1) pre-migration: intentionality and forethought, (2) settlement process: planning …

Does Myocardial Necrosis Occur In Rhabdomyolysis?, Gabriel M Aisenberg, Herbert L Fred

Faculty, Staff and Student Publications

No abstract provided.

Fresh Autologous Pericardium To Reconstruct The Pulmonary Valve At The Annulus When Tetralogy Of Fallot Requires A Transannular Patch At Midterm, Shantanu Pande, Jugal K Sharma, C R Siddartha, Anubhav Bansal, Surendra K Agarwal, Prabhat Tewari, Aditya Kapoor

The Texas Heart Institute Journal

Tetralogy of Fallot often requires reconstruction of the right ventricular outflow tract with a transannular patch (TAP), but this renders the pulmonary valve incompetent and eventually leads to right ventricular dysfunction.

We retrospectively evaluated the efficacy of a reconstructed pulmonary valve and annulus in 70 patients who underwent, from December 2006 through December 2010, complete correction of tetralogy of Fallot. We divided the 70 patients into 2 groups in accordance with whether they required (n=50) or did not require (n=20) a TAP. We used autologous untreated pericardium to fashion the TAP and to create both an annulus of the correct …

Skepticism, The Trained Eye, And The Telltale Clue, Ethan A Natelson

The Texas Heart Institute Journal

No abstract provided.

Emergency Coronary Artery Bypass Grafting: Indications And Outcomes From 2003 Through 2013, Erin M Schumer, John H Chaney, Jaimin R Trivedi, Paul L Linsky, Matthew L Williams, Mark S Slaughter

The Texas Heart Institute Journal

Emergency coronary artery bypass grafting (CABG) is associated with increased in-hospital mortality rates and adverse events. This study retrospectively evaluated indications and outcomes in patients who underwent emergency CABG.

The Society of Thoracic Surgeons database for a single center (Jewish Hospital) was queried to identify patients undergoing isolated CABG. Univariate analysis was performed.

From January 2003 through December 2013, 5,940 patients underwent CABG; 212 presented with emergency status. A high proportion of female patients (28.2%) underwent emergency surgery. Emergency CABG patients experienced high rates of intra-aortic balloon pump support, bleeding, dialysis, in-hospital death, and prolonged length of stay. The proportion …

Endocarditis And Incomplete Endothelialization 12 Years After Amplatzer Septal Occluder Deployment, Allan K Nguyen, Brian A Palafox, Joanne P Starr, Richard N Gates, Farbouch Berdjis

The Texas Heart Institute Journal

A 4-year-old boy had a 15-mm atrial septal defect repaired percutaneously with use of an Amplatzer Septal Occluder. At age 16 years, he presented with a week's history of fever, chills, dyspnea, fatigue, and malaise. Cultures grew methicillin-sensitive Staphylococcus aureus. A transesophageal echocardiogram showed a 1.25 × 1.5-cm pedunculated mass on the left aspect of the atrial septum just superior to the mitral valve, and a smaller vegetation on the right inferior medial aspect of the septum. At surgery, visual examination of both sides of the septum revealed granulation tissue, the pedunculated mass, the small vegetation, and exposed metal …

Two Cases Of Transcatheter Closure Of Central Aortopulmonary Shunts: One With An Amplatzer Duct Occluder Ii And One With An Amplatzer Vascular Plug I, Ahmet Celebi, Ilker Kemal Yucel, Sevket Balli, Mehmet Kucuk

The Texas Heart Institute Journal

When total correction is not possible in infants who have a cyanotic congenital heart disease, creation of a palliative aortopulmonary shunt is essential. A central aortopulmonary shunt is preferable, because of its technical and hemodynamic advantages. Overcirculation, thrombosis, and stenosis of the shunt are the main postoperative sequelae that necessitate urgent reintervention. Percutaneous transcatheter closure of aortopulmonary shunts can eliminate the need for reoperation and substantially decrease postoperative morbidity and mortality rates. We report our successful transcatheter closures of central aortopulmonary shunts in a 3-month-old infant and a 15-year-old girl, with use of an Amplatzer Duct Occluder II and an …

Ms 210 Guide To The Judson L. Taylor, Md Papers (1940-1951), Judson L. Taylor (1881-1949)

Manuscript Finding Aids

The Judson L. Taylor, MD papers consists of one oversize photograph portrait, two full sheet newspapers, and other newspapers clippings related to Judson Taylor and his brother, Dr. Martin Junius Taylor. The collection is in good condition, and all materials are stored in one oversize box. See more at MS 210.

Information Processing Speed Impairment After Stroke, A Descriptive Study, Susan Alderman

Dissertations and Theses (Open Access)

Background Information processing speed (IPS) is an elemental cognitive function impacting multiple other functions including memory, attention, and executive function, and academic skills like arithmetic, reading and writing. However, little research has been done on IPS impairment in acute stroke. This article compares the frequency and severity of IPS impairment in mild and moderate stroke and its impact on quality of life.

Methods The longitudinal study of patients with mild stroke (NIHSS

Results Using linear mixed model regression, similar frequency and severity of IPS and memory impairments were noted, regardless of stroke severity, in the sample of 30 patients (60% …

Psychometric Performance Of The Arabic Versions Of The Cancer Behavior Inventory‐Brief And The Functional Assessment Of Cancer Therapy‐Breast In Saudi Arabia, Maaidah M. Algamdi Msn

Dissertations and Theses (Open Access)

Background: Arabic is the mother tongue of 26 countries, including Saudi Arabia where cancer is the fourth leading cause of death. Cancer is a sensitive issue in the Arabic population and a clear understanding of patients’ perceptions of self-efficacy for coping with cancer and quality of life helps assess interventions designed to facilitate optimal patient outcomes. In preliminary studies, the Cancer Behavior Inventory-Brief (CBI-B) was translated and back translated between English and Arabic, and reviewed for translational validity by an expert panel. The Arabic version of the CBI-B (CBI-BA) had acceptable evidence of translational validity with an overall translational validity …

Ethnic Identity And Teratogenic Risk Perceptions, Katie M. Chan

Dissertations and Theses (Open Access)

Elevated perceptions of teratogenic risk can cause anxiety and confusion among pregnant women. To assess whether ethnic identity and demographic factors can influence teratogenic risk perceptions, 194 pregnant women in Houston were surveyed using the Multigroup Ethnic Identity Measure (MEIM) and visual analog scales to quantify perceptions of teratogenic risk for common exposures during pregnancy. Overall, participants estimated an elevated baseline risk of 25% for birth defects among the general population. In addition, participants overestimated birth defect risks for specific exposures, such as alcohol and marijuana. Based on the MEIM scores, ethnic identity was not significantly associated with teratogenic risk …

Developing And Using Methyl-Specific Antibodies To Study The Biological Roles Of Arginine Methylation, Vidyasiri Vemulapalli

Dissertations and Theses (Open Access)

Arginine residues can be modified in three different ways to produce asymmetric dimethylarginine (ADMA), symmetric dimethylarginine (SDMA), and monomethylarginine (MMA). These modifications are catalyzed by a family of nine protein arginine methyltransferases (PRMT1-9), which are of three types (I, II, and III). The majority of Type I enzymes asymmetrically dimethylate Glycine- and Arginine-rich (GAR) motifs, except for PRMT4, which methylates Proline-, Glycine-, and Methionine-rich (PGM) motifs. The same substrates (GAR or PGM motifs) can also be dimethylated by PRMT5 in a symmetric fashion. However, it is not clear whether there are dedicated residues within these motifs for ADMA and SDMA, …

Network Dynamics Of Visual Object Recognition, Mehmet C. Kadipasaoglu

Dissertations and Theses (Open Access)

Visual object recognition is the principal mechanism by which humans and many animals interpret their surroundings. Despite the complexity of neural computation required, object recognition is achieved with such rapidity and accuracy that it appears to us almost effortless. Extensive human and non-human primate research has identified putative category-selective regions within higher-level visual cortex, which are thought to mediate object recognition. Despite decades of study, however, the functional organization and network dynamics within these regions remain poorly understood, due to a lack of appropriate animal models as well as the spatiotemporal limitations of current non-invasive human neuroimaging techniques (e.g. fMRI, …

Mechanisms Of Regulation Of Tau Ires Mediated Translation, Niza Nemkul

Dissertations and Theses (Open Access)

The translation of most eukaryotic mRNAs occurs in a cap-dependent manner. However, a subset of mRNAs are capable of initiating translation in a cap-independent manner by utilizing sequences in their 5’ UTR called IRES. It was previously shown that the 5’ UTR of the tau mRNA contains an IRES. In this study I show that IRES dependent translation of tau IRES is regulated at multiple levels in order to regulate the expression of the tau protein.

Tau protein is ubiquitously expressed but is concentrated in the brain. In this study, I utilized neural and non-neural cell lines to show that …

Characterization Of Stem Cell Turnover In A Living Epithelial Bilayer, Elizabeth Sumner

Dissertations and Theses (Open Access)

Homeostatic maintenance of epithelia requires the renewal and replacement of old or dying cells while sustaining a functional barrier. Imbalance between cell production and elimination are hypothesized to underlie many pathological conditions. However, our knowledge of cell turnover within living tissues remains largely restricted to static images due to the limited ability to study epithelia in their native context. Here we report that clearance of damaged basal stem cells promotes compensatory proliferation of neighboring stem cells to maintain overall population numbers in a bilayered epithelium. Time-lapse imaging and electron microscopy experiments reveal that dying cells are rapidly cleared as nearby …

Factors Influencing Uptake Of Risk-Reducing Salpingo-Oophorectomy By Brca1 And Brca2 Mutation Carriers, Victoria E. Breen

Dissertations and Theses (Open Access)

Germline mutations in the BRCA1 and BRCA2 genes are associated with significantly increased risks for ovarian cancer. The National Comprehensive Cancer Network (NCCN) currently recommends that female BRCA mutation carriers undergo risk-reducing salpingo-oophorectomy (RRSO) after age 35; however, not all women elect this option. The purpose of this study was to prospectively survey women with BRCA mutations currently undergoing ovarian cancer screening about their intention to have an RRSO and the various factors influencing their decision. Of the 26 women who completed our survey, 26 (100%, CI: 86.8-100) plan to undergo an RRSO in their lifetime. The average woman reported …

The Psychosocial Effects Of The Li-Fraumeni Education And Early Detection (Lead) Program On Indivdiuals With Li-Fraumeni Syndrome, Jessica L. Ross

Dissertations and Theses (Open Access)

Li-Fraumeni syndrome (LFS) is a hereditary cancer syndrome that leads to an increased risk of multiple cancers. In the past five years new screening protocols have been developed that provide improved screening options for individuals with LFS. However, very little has been published on the psychosocial impact of these screening protocols. The goals of this study were to determine how participation in screening impacts individuals psychosocially, to examine the benefits and drawbacks of screening, and to evaluate possible barriers to continued screening. This qualitative study consisted of phone interviews with 20 individuals that took part in an LFS screening program …

Attitudes To Wards Prenatal Genetics Among Southeast And East Asian Women: A Qualitative Pilot Study, Ginger J. Tsai

Dissertations and Theses (Open Access)

From 2000-2010, the Asian population in the United States grew five times faster than the overall US population. As Asians become incorporated into the US health care system, it is important to recognize cultural differences that may arise between Asian patients and their health care providers. Prior studies show that cultural values influence genetic perceptions within Asian populations. The reputation of the family unit factors into decisions such as pregnancy termination and disclosure of family medical history, and the non-directive model of American genetic counseling conflicts with the historical Asian model of paternalistic health care. Previous studies also provide conflicting …

Patient Perception Of Negative Non-Invasive Prenatal Testing Results, Ann Theresa Wittman

Dissertations and Theses (Open Access)

Non-invasive prenatal testing (NIPT) uses cell-free fetal DNA to assess for fetal aneuploidy during pregnancy. NIPT has higher detection rates and positive predictive values than previous methods; however, NIPT is not diagnostic. Studies suggest patients may underestimate the limitations of prenatal screening. Therefore, we conducted a prospective cross-sectional study of ninety-four women from genetic counseling clinics in Houston, Texas to assess patient understanding of the residual risk for aneuploidy after receiving a negative NIPT. The majority of participants (66%) understood the residual risk for Down syndrome following negative NIPT; however, 34% of participants indicated that negative NIPT completely eliminated the …

Rerouting Pre-Existing Host Vaccine-Induced Immunity To Wards Breast Cancer, Bharat Kumar Reddy Chaganty

Dissertations and Theses (Open Access)

For decades, investigators have attempted to activate the immune system to prevent cancer metastasis or recurrence; however, owing to host immune tolerance to cancer antigens and the immunosuppressive environment at tumor sites, many such attempts have failed. The recent success of anti-CTLA4, PD-L1 and PD-1 antibodies targeting immune checkpoint pathways and HPV vaccines has renewed hope that patient survival can be increased through enhancing T-cell responses. We propose to test a novel approach that may bypass host immune tolerance to cancer cells. We hypothesize that host T-cell immunity acquired through vaccination against or natural infection with infectious diseases—e.g., influenza—can be …

Nipt Results Indicative Of Maternal Neoplasms: Genetic Counselors' Preferences And Attitudes, Meagan E. Giles

Dissertations and Theses (Open Access)

Performing non-invasive prenatal testing (NIPT) on a pregnant woman with a chromosomally abnormal neoplasm may incidentally lead to the diagnosis of cancer due to the coexistence of circulating tumor and placental DNA. Published information regarding NIPT’s accuracy for neoplasm screening is limited, and guidance for patient management is currently lacking. This challenges clinicians’ ability to counsel patients regarding the implications of these results, which often is the responsibility of a genetic counselor. Over three hundred board-eligible/certified genetic counselors were surveyed regarding their awareness, preferences, and attitudes towards NIPT’s ability to indicate maternal neoplasms. Despite 95% of this cohort being aware …

In Vivo Kinome Screen Reveals Non-Canonical Cdk-Driven Metabolic Adaptation In Brain Metastasis, Frank J. Lowery Iii

Dissertations and Theses (Open Access)

Brain metastasis, which frequently arises from breast cancer, lung cancer, melanoma, and colorectal cancer, remains a severely unmet medical need and its incidence continues to rise while treatment options remain palliative. To better understand the biology underlying its aggressive, incurable nature, I performed an unbiased in vivo kinome screen to identify potential driver kinases of experimental brain metastasis in a nude xenograft model using the human breast cancer cell line MDA-MB-231. Several of the kinase pools led to decreased brain metastasis-specific survival in nude mice, shortening survival time by up to 50% relative to controls. Targeted next-generation sequencing (NGS) was …