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Evaluation Of A Social Support Measure That May Indicate Risk Of Depression During Pregnancy, Lori Spoozak
Evaluation Of A Social Support Measure That May Indicate Risk Of Depression During Pregnancy, Lori Spoozak
Yale Medicine Thesis Digital Library
The objective of this study was to evaluate the psychometric properties of the Kendler Social Support Interview modified for administration to pregnant women and to assess the relationship between social support and depression in the first trimester of pregnancy. Subjects were administered the Modified Kendler Social Support Interview (MKSSI) and the Composite International Diagnostic Index to diagnose depression. Principal components analysis was employed to construct the MKSSI score. Cronbachs coefficient alpha and principal factor analysis were run for items included in the MKSSI score. The relationship between a depressive diagnosis and the MKSSI score and subscales was assessed by logistic …
The Utility Of Plain Radiography In The Evaluation Of Degenerative Spine Disease, Andrew Simpson
The Utility Of Plain Radiography In The Evaluation Of Degenerative Spine Disease, Andrew Simpson
Yale Medicine Thesis Digital Library
Study Designs: Questionnaire, Retrospective chart review, Cadaver study, and cross-sectional study. Objectives: Assess current imaging practices; determine utility of accessory radiographic studies, including dynamic and oblique radiographs; calculate effective radiation doses of routine spine radiographs. Summary of Background Data: Plain radiography is generally considered the initial imaging modality for evaluation of degenerative spine complaints. In addition to anteroposterior (AP) and lateral views, dynamic and oblique views may also be obtained. There is currently no data on imaging practices of spine specialists, the utility of these accessory radiographic views, or the radiation exposure patients receive as a result of various spine …
Electrical Stimulation And Glutamate In The Hippocampus Of Epilepsy Patients, Gabriel Widi
Electrical Stimulation And Glutamate In The Hippocampus Of Epilepsy Patients, Gabriel Widi
Yale Medicine Thesis Digital Library
Electrical brain stimulation has been proposed as a promising treatment option for patients with medically resistant epilepsy disorder. Glutamate levels in the epileptogenic human hippocampus are elevated interictally and increase with seizures. Fifty Hz stimulation is a candidate therapeutic stimulation that is also used for clinical cortical mapping. We examined the effects of 50 Hz stimulation on glutamate efflux in the hippocampus of patients with medically refractory epilepsy. Subjects (n = 10) underwent intracranial EEG (icEEG) evaluation for possible therapeutic resection. Electrical stimulation was delivered through implanted hippocampal electrodes (n = 11) and microdialysate samples were collected every 2 mins. …
Bdnf Variants Influence Educational Attainment But Not Disease Characteristics In Alzheimers Disease, Kristina Frances Zdanys
Bdnf Variants Influence Educational Attainment But Not Disease Characteristics In Alzheimers Disease, Kristina Frances Zdanys
Yale Medicine Thesis Digital Library
This study aimed to determine whether brain-derived neurotrophic factor (BDNF) variants are related to premorbid educational attainment, progression of cognitive and functional decline, and associated neuropsychiatric symptoms in patients with Alzheimers disease (AD). A sample of n = 341 AD subjects was genotyped for the BDNF polymorphisms val66met, C270T, and G-712A. Subjects received tests of cognition and daily function at baseline and at multiple subsequent time points during their participation in a variety of research protocols. Cognition was measured by the Mini-Mental State Examination (MMSE) and Alzheimers Disease Assessment Scale (ADAS-Cog). Functional performance was assessed using the Instrumental Activities of …
Influence Of A Serotonin Transporter Promoter Polymorphism (5-Httlpr) On Corticolimbic Abnormalities In Bipolar Disorder An Integrated Genetics And Functional Mri Study, Maulik Shah
Yale Medicine Thesis Digital Library
Bipolar disorder (BD) is associated with abnormalities of the subgenual anterior cingulate cortex (sgACC) and the amygdala, components of a corticolimbic neural system that subserves emotional regulation. The short s allele - as opposed to the long l allele - of a serotonin transporter promoter (5-HTTLPR) polymorphism is associated with more severe course features of BD and impaired functional connectivity between the sgACC and amygdala in healthy control (HC) individuals. This study tests the hypothesis that the s allele influences the dysfunction in the sgACC-amygdala neural system in BD. Twenty-six euthymic BD participants (17 s carriers, 9 ll) and 43 …
Differences In The Central Neural Activation Under Emotional Stress Across The Menstrual Cycle, Nayalya Lopushnyan
Differences In The Central Neural Activation Under Emotional Stress Across The Menstrual Cycle, Nayalya Lopushnyan
Yale Medicine Thesis Digital Library
The present study had several goals. First, we aimed to investigate the potential differences in the activation of the corticolimbic structures during emotional stress in healthy women across the menstrual cycle using stress imagery. Second, we searched for differences in the subjective anxiety under emotional stress across the menstrual cycle and tried to correlate the perceived level of anxiety to activation of the specific corticolimbic structures. Third, we attempted to compare central neural activation of women in follicular and in luteal phases of the menstrual cycle separately to that of men during emotional stress to investigate potential differences in neural …
Reproductive Desires And Intentions Among Hiv-Infected Individuals In Chennai, India, Elizabeth Houle
Reproductive Desires And Intentions Among Hiv-Infected Individuals In Chennai, India, Elizabeth Houle
Yale Medicine Thesis Digital Library
Despite the personal and cultural importance of childbearing in India, limited information exists on the extent of childbearing desires and intentions among HIV-infected individuals in this setting. The purpose of this study was to measure the extent of childbearing desires among HIV-infected individuals in Chennai, India, thereby testing the hypothesis that HIV significantly influences the desire to have children. Three hundred HIV-infected individuals were interviewed about childbearing desires and intentions during routine visits for HIV care at an HIV specialty care clinic in Chennai, South India. Sixteen percent of participants expressed desire for childbearing, and 9% expressed intention to have …
Chronic Villus Sampling And The Risk Of Hypertensive Disorders Of Pregnancy: A Case Control Study, Sanaz Ghazal
Chronic Villus Sampling And The Risk Of Hypertensive Disorders Of Pregnancy: A Case Control Study, Sanaz Ghazal
Yale Medicine Thesis Digital Library
The purpose of this study was to determine whether there is an association between chorionic villus sampling for prenatal diagnosis and the development of hypertensive disorders of pregnancy. This study is a single-site retrospective case control study using medical records of patients seen at Yale-New Haven Hospital. A total of 448 patients in three groups (first trimester aneuploidy screening with nuchal translucency assessment, genetic amniocentesis, and chorionic villus sampling) were included and data on maternal characteristics, delivery outcomes, risk factors, and hypertensive outcomes were recorded. Unadjusted odds ratios and odds ratios adjusted for maternal age and race were calculated to …
Genotypic Confirmation Of Transimmunization-Induced Dendritic Cell Maturation, Kristin Elizabeth Hoffmann
Genotypic Confirmation Of Transimmunization-Induced Dendritic Cell Maturation, Kristin Elizabeth Hoffmann
Yale Medicine Thesis Digital Library
Transimmunization (TI), a novel modification of the widely used immunotherapy extracorporeal photopheresis (ECP), induces conversion of processed monocytes into cells expressing phenotypic and functional features of dendritic antigen presenting cells (DC). To further characterize TI-induced DC, we analyzed differential gene expression in the monocyte/DC population after TI treatment. Because ECP, the therapy upon which TI is based, has the unique capacity to induce both anti-cancer immune responses in cutaneous T cell lymphoma (CTCL) patients and tolerogenic responses in graft-versus-host disease (GVHD), we studied TI-induced gene expression changes in both of these patient populations as well as in healthy normal control …
Clinical And Demographic Predictors Of Short-Term Recovery From Arthroscopic Partial Meniscectomy, Peter Fabricant
Clinical And Demographic Predictors Of Short-Term Recovery From Arthroscopic Partial Meniscectomy, Peter Fabricant
Yale Medicine Thesis Digital Library
Patients undergoing orthopaedic surgery are concerned with returning to activities of daily living (recovery) in addition to the long-term result of their surgery (end result). As evidence of predictors of rate of short-term recovery is limited to date, this study seeks to determine which patient clinical and demographic factors can serve as prognostic indicators for rate of short-term recovery from arthroscopic partial meniscectomy in the year following surgery and how they may differ from previously published associations with long-term outcome. Clinical (depth of meniscal excision, involvement of one or both menisci, extent of meniscal tear, extent of osteoarthritis) and demographic …
Physiologic Effect Of Relaxation Therapies On Autonomic Tone Early After Acute Coronary Syndromes, Rachel Summer Claire Friedman
Physiologic Effect Of Relaxation Therapies On Autonomic Tone Early After Acute Coronary Syndromes, Rachel Summer Claire Friedman
Yale Medicine Thesis Digital Library
Post-MI patients are at increased risk of arrhythmic sudden death. Stress and sympathetic activation are known to influence arrhythmogenesis. While relaxation therapies improve psychological well-being in multiple medical illnesses, whether these therapies can positively influence sympathovagal balance in the post-MI population is unknown. We explored the physiologic effects of Reiki, a light-touch relaxation therapy, and music on post-acute coronary syndrome (ACS) inpatients, using heart rate variability (HRV) to assess changes in cardiac autonomic function during treatment. Forty-eight patients with ACS within the last 72 hours were randomized to received a single 20-minute session of either Reiki, classical music, or a …
Serum Proteomic Profiles In Inflammatory And Non-Inflammatory Cardiomyopathies: A Novel Approach For Diagnostic Biomarker Discovery, Oyere Onuma
Yale Medicine Thesis Digital Library
The aim of this project is to develop a noninvasive serum test that predicts histologic forms of myocarditis (inflammatory) and dilated (non-inflammatory) cardiomyopathy using proteomic techniques to analyze serum proteins. Idiopathic dilated cardiomyopathy (DCM) and myocarditis (myocardial inflammation) represent a spectrum of heart muscle disease of various etiologies that usually present with progressive heart failure. Together, they constitute the leading cause of heart transplantation in the United States. Currently, the gold standard of diagnosis of myocarditis is by endomyocardial biopsy (EMB) and histopathological classification according to the Dallas Criteria ; however this diagnostic technique is severely limited by its invasiveness, …
Platelet-Derived Growth Factor Enables Direct Derivation Of Oligodendrocyte Progenitors From Cns Stem Cells, Rajesh Rao
Platelet-Derived Growth Factor Enables Direct Derivation Of Oligodendrocyte Progenitors From Cns Stem Cells, Rajesh Rao
Yale Medicine Thesis Digital Library
Oligodendrocytes derived in the laboratory from stem cells have been proposed as a treatment for acute and chronic injury to the central nervous system (CNS). Platelet-derived growth factor-receptor alpha (PDGFRα) signaling is known to play an important role for regulation of oligodendrocyte progenitor cell numbers both during development and adulthood. Here, we analyze the effect of PDGFRα signaling on CNS stem cells derived from embryonic day 13.5 murine cortex and cultured in monolayer. Fetal and adult CNS stem cells express PDGFRα, and PDGF-AA treatment increases viability and proliferation of these cells. In the absence of insulin, this effect of PDGF-AA …
Surrogate Markers Of Success In The Bariatric Surgery Population, Alain Ramirez
Surrogate Markers Of Success In The Bariatric Surgery Population, Alain Ramirez
Yale Medicine Thesis Digital Library
Purpose: The purpose of this study was to examine the associations between pre-operative weight loss, weight loss programs, and clinic attendance relative to the success of gastric bypass in class II and III obese patients. Background: The increasing number of obese children and adults in the United States poses an extensive social problem in the era of managed care. Notwithstanding the stigmatization associated with obesity, the considerable health implications along with the financial burden it imposes create a formidable adversary. Surgical procedures have proved to be superior to conservative and pharmacotherapeutic interventions in the morbidly obese. Despite the overall success …
The Uses Of Rickets: Race, Technology, And The Politics Of Preventive Medicine In The Early Twentieth Century, M. Allison Arwady
The Uses Of Rickets: Race, Technology, And The Politics Of Preventive Medicine In The Early Twentieth Century, M. Allison Arwady
Yale Medicine Thesis Digital Library
Rickets, the bone disease classically caused by Vitamin D deficiency, was one of the most common diseases of children 100 years ago. It has been recognized as a disease of urban living and linked to issues of race and culture for generations. This paper uses unpublished patient records from 1904 to 1909 and archival and published materials from multiple community-based trials, including the New Haven Rickets Study (1923-1926), to explore how the definition, diagnosis, and treatment of rickets shifted in the first decades of the twentieth century in the United States. Before 1910, as evidenced by patient records, neither the …
Community Based Epidemiological Study Of Chagas Disease In Rural Peru, Paul Walker
Community Based Epidemiological Study Of Chagas Disease In Rural Peru, Paul Walker
Yale Medicine Thesis Digital Library
The purpose of this study was to evaluate the epidemiology of Trypanosoma cruzi infection, to valuate the TESA blot, and to characterize cardiac findings of patients with Chagas disease in a rural setting near Arequipa, Peru. The study site was the town of Quequeña, Peru with a population of 774 with 236 inhabitants under the age of 18 according to the 2005 census conducted by Peru. A fumigation/insect collection campaign was done in December of 2006 to quantify household infestation levels, document housing characteristics, and GPS household locations. Of the 602 people surveyed to be living in Quequeña, blood samples …
The Effect Of Teleradiology On Interpretation Times For Ct Pulmonary Angiography Studies, Scott Thomas Olcott Kennedy
The Effect Of Teleradiology On Interpretation Times For Ct Pulmonary Angiography Studies, Scott Thomas Olcott Kennedy
Yale Medicine Thesis Digital Library
The purpose of this study was to evaluate the impact of a teleradiology service on the timely interpretation of computed tomography (CT) pulmonary angiography studies. A survey of clinical and imaging physicians was performed to develop achievable goals for interpretation of CT pulmonary angiography studies. Percentages of studies given preliminary written reports within these thresholds were compared for 1,102 pulmonary angiography CT studies from three months before teleradiology was implemented to three months after. Identical control data were matched over the same periods for 1,638 CT brain studies. Data are reported as averages and percentages. Statistical significance was evaluated with …