When Birth Control Hurts You: An Essure Investigation, Mia A. Garchitorena

Capstones

Thousands of women report having suffered from injuries and malfunctions related to Essure permanent birth control, including chronic pain, heavy bleeding, migration, or perforation. Many of these women also claim that Essure has caused nickel allergies, hair loss, bloating, rashes, unintended pregnancies, and death. What was promised to be an easy solution has become a life-altering problem.

As patient complaints have increased, experts have gone back and studied the science behind the approval of the Essure device. Their findings are startling: There were flaws with the studies that supported the Food and Drug Administration’s approval of the device, the experts …

How N.Y.’S Biggest For-Profit Nursing Home Group Flourishes Despite A Record Of Patient Harm, Jennifer Lehman

Capstones

How N.Y.'s Biggest For-Profit Nursing Home Group Flourishes Despite a Record of Patient Harm

The state’s “character-and-competence” reviews are supposed to weed out operators with histories of violations and fines— but regulators don’t always act on the full story.

Hot Spot Mutation In Tp53 (R248q) Causes Oncogenic Gain-Of-Function Phenotypes In A Breast Cancer Cell Line Derived From An African American Patient, Nataly Shtraizent, Hiroshi Matsui, Alla Polotskaia, Jill Bargonetti

Publications and Research

African American (AA) breast cancer patients often have triple negative breast cancer (TNBC) that contains mutations in the TP53 gene. The point mutations at amino acid residues R273 and R248 both result in oncogenic gain-of-function (GOF) phenotypes. Expression of mutant p53 (mtp53) R273H associates with increased cell elasticity, survival under serum deprivation conditions, and increased Poly (ADP ribose) polymerase 1 (PARP1) on the chromatin in the AA-derived TNBC breast cancer cell line MDA-MB-468. We hypothesized that GOF mtp53 R248Q expression could stimulate a similar phenotype in the AA-derived TNBC cell line HCC70. To test this hypothesis we depleted the R248Q …

Critical Time Intervention For People Leaving Shelters In The Netherlands: Assessing Fidelity And Exploring Facilitators And Barriers, Renee De Vet, Danielle A. M. Lako, Marielle D. Beijersbergen, Linda Van Den Dries, Sarah Conover, Albert M. Van Hemert, Daniel Herman, Judith R. L. M. Wolf

Publications and Research

International dissemination of evidence-based interventions calls for rigorous evaluation. As part of an evaluation of critical time intervention (CTI) for homeless people and abused women leaving Dutch shelters, this study assessed fidelity in two service delivery systems and explored factors influencing model adherence. Data collection entailed chart review (n = 70) and two focus groups with CTI workers (n = 11). The intervention obtained an overall score of three out of five (fairly implemented) for compliance fidelity and chart quality combined. Fidelity did not differ significantly between service systems, supporting its suitability for a range of populations. The eight themes …

Cladribine Analogues Via O6-(Benzotriazolyl) Derivatives Of Guanine Nucleosides, Sakilam Satishkumar, Prasanna K. Vuram, Siva Subrahmanyam Relangi, Venkateshwarlu Gurram, Hong Zhou, Robert J. Kreitman, Michelle M. Martínez Montemayor, Lijia Yang, Muralidharan Kaliyaperumal, Somesh Sharma, Narender Pottabathini, Mahesh K. Lakshman

Publications and Research

Cladribine, 2-chloro-2′-deoxyadenosine, is a highly efficacious, clinically used nucleoside for the treatment of hairy cell leukemia. It is also being evaluated against other lymphoid malignancies and has been a molecule of interest for well over half a century. In continuation of our interest in the amide bond-activation in purine nucleosides via the use of (benzotriazol-1yl-oxy)tris(dimethylamino)phosphonium hexafluorophosphate, we have evaluated the use of O6-(benzotriazol-1-yl)-2′-deoxyguanosine as a potential precursor to cladribine and its analogues. These compounds, after appropriate deprotection, were assessed for their biological activities, and the data are presented herein. Against hairy cell leukemia (HCL), T-cell lymphoma (TCL) and chronic lymphocytic …

Communication Between Family Carers And Health Professionals About End-Of-Life Care For Older People In The Acute Hospital Setting: A Qualitative Study, Glenys Caswell, Kristian Pollock, Rowan Harwood, Davina Porock

Publications and Research

Background: This paper focuses on communication between hospital staff and family carers of patients dying on acute hospital wards, with an emphasis on the family carers’ perspective. The age at which people in the UK die is increasing and many continue to die in the acute hospital setting. Concerns have been expressed about poor quality end of life care in hospitals, in particular regarding communication between staff and relatives. This research aimed to understand the factors and processes which affect the quality of care provided to frail older people who are dying in hospital and their family carers.

Methods: The …

Nitric Oxide-Releasing Aspirin Suppresses Nf-Κb Signaling In Estrogen Receptor Negative Breast Cancer Cells In Vitro And In Vivo, Niharika Nath, Mitali Chattopadhyay, Deborah B. Rodes, Anna Nazarenko, Ravinder Kodela, Khosrow Kashfi

Publications and Research

Estrogen receptor negative (ER(−)) breast cancer is aggressive, responds poorly to current treatments and has a poor prognosis. The NF-κB signaling pathway is implicated in ER(−) tumorigenesis. Aspirin (ASA) is chemopreventive against ER(+) but not for ER(−) breast cancers. Nitric oxide-releasing aspirin (NO-ASA) is a safer ASA where ASA is linked to an NO-releasing moiety through a spacer. In vitro, we investigated anti-proliferation effects of NO-ASA (para- and meta-isomers) against ER(−) breast cancer cells MDA-MB-231 and SK-BR-23, effects on NF-κB signaling, and reactive oxygen species by standard techniques. In vivo, effects of NO-ASA were evaluated in a mouse xenograft model …

Non-Operative Management Of Hip Osteoarthritis, Ray Marks

Publications and Research

This paper reviews several non-operative and non-pharmacologic management strategies advocated for alleviating the pain and disability experienced by people with hip osteoarthritis. It analyzes whether painful debilitating hip osteoarthritis, which has no effective cure and is often progressive, may be affected positively by non-operative interventions designed to control osteoar- thritis pain. Finally, it provides an integrated plan of management for ameliorating hip osteoar- thritis pain and disability in light of this knowledge.

Medical Crises In Older People: Cohort Study Of Older People Attending Acute Medical Units, Developmental Work And Randomised Controlled Trial Of A Specialist Geriatric Medical Intervention For High-Risk Older People; Cohort Study Of Older People With Mental Health Problems Admitted To Hospital, Developmental Work And Randomised Controlled Trial Of A Specialist Medical And Mental Health Unit For General Hospital Patients With Delirium And Dementia; And Cohort Study Of Residents Of Care Homes And Interview Study Of Health-Care Provision To Residents Of Care Homes, John Gladman, Rowan Harwood, Simon Conroy, Pip Logan, Rachel Elliot, Rob Jones, Sarah Lewis, Jane Dyas, Justine Schneider, Davina Porock, Kristian Pollock, Sarah Goldberg, Judi Edmans, Adam Gordon, Lucy Bradshaw, Matthew Franklin, Katherine Whittamore, Isabella Robbins, Aidan Dunphy, Karen Spencer, Janet Darby, Lukasz Tanajewski, Vladislav Berdunov, Georgios Gkountouras, Pippa Foster, Nadia Frowd

Publications and Research

Background: This programme of research addressed shortcomings in the care of three groups of older patients: patients discharged from acute medical units (AMUs), patients with dementia and delirium admitted to general hospitals, and care home residents.

Methods: In the AMU workstream we undertook literature reviews, performed a cohort study of older people discharged from AMU (Acute Medical Unit Outcome Study; AMOS), developed an intervention (interface geriatricians) and evaluated the intervention in a randomised controlled trial (Acute Medical Unit Comprehensive Geriatric Assessment Intervention Study; AMIGOS). In the second workstream we undertook a cohort study of older people with mental health problems …

Supporting Practices To Adopt Registry-Based Care (Sparc): Protocol For A Randomized Controlled Trial, Rebeccar S. Etz, Rosalind E. Keith, Anna M. Matemick, Karen L. Stein, Roy T. Sabo, Melissa S. Hayes, Purvi Sevak, John Holland, Jesse C. Crosson

Publications and Research

Background: Diabetes is predicted to increase in incidence by 42% from 1995 to 2025. Although most adults with diabetes seek care from primary care practices, adherence to treatment guidelines in these settings is not optimal. Many practices lack the infrastructure to monitor patient adherence to recommended treatment and are slow to implement changes critical for effective management of patients with chronic conditions. Supporting Practices to Adopt Registry-Based Care (SPARC) will evaluate effectiveness and sustainability of a low-cost intervention designed to support work process change in primary care practices and enhance focus on population-based care through implementation of a diabetes …

The Regulatory Function Of Sphingosine-1-Phosphate Signaling Axis On Regulatory T Cells In Colorectal Cancer, Andrew V. Nguyen, Yuan-Yuan Wu, Elaine Y. Lin

Publications and Research

In tumors associated with inflammation such as inflammatory bowel disease (IBD) and colorectal cancer (CRC), high numbers of regulatory T cells (Tregs) are associated with both favorable and poor prognoses. The functions of Tregs in CRC remain elusive and have yet to be clearly defined. With new evidence supporting many subsets of Tregs, the research on the development and functions of these cells has begun to come to fruition. The sphingosine 1 phosphate (S1P) pathway was recently reported to regulate the development and function of regulatory T cells. This pathway may shine new light into the pleiotropic nature of these …

Tcr Alpha Lcr And Non-Lcr Cis-Elements Contributing To Tissue Specific Expression Of The Tcr Alpha Gene In Thymic And Peripheral T Cells, Martina Kucerova-Levisohn

Dissertations, Theses, and Capstone Projects

Orchestrated expression of multiple genes residing in the complex TCRα/δ/Dad1 locus requires tight control from multiple cis-acting elements. The TCRα locus control region (LCR), is positioned between TCRα and Dad1 gene, and has been implicated in the differential expression of both genes. In this study, we focus our work on the hypersensitive site (HS)1 prime (HS1'), located 3' of the classical Eα enhancer, within the TCRα LCR. We investigated its non- redundant role in TCRα expression in thymic and peripheral T cells as assayed by in vivo and in vitro studies. Furthermore, formation of HS1' in both lymphoid and …

Heterometallic Titanium–Gold Complexes Inhibit Renal Cancer Cells In Vitro And In Vivo, Jacob Fernandez-Gallardo, Benelita T. Elie, Tanmoy Sadhukha, Swayam Prabha, Mercedes Sanau, Susan A. Rotenberg, Joe W. Ramos, Maria Contel

Publications and Research

Following recent work on heterometallic titanocene–gold complexes as potential chemotherapeutics for renal cancer, we report here on the synthesis, characterization and stability studies of new titanocene complexes containing a methyl group and a carboxylate ligand (mba ¼ S–C6H4–COO) bound to gold(I)-phosphane fragments through a thiolate group [(h-C5H5)2TiMe(m-mba)Au(PR3)]. The compounds are more stable in physiological media than those previously reported and are highly cytotoxic against human cancer renal cell lines. We describe here preliminary mechanistic data involving studies on the interaction of selected compounds with plasmid (pBR322) DNA used as a model nucleic acid, and with selected protein kinases from a …

Obesity, Food Intake And Exercise: Relationship With Ghrelin, G. Tiryaki-Sonmez, Serife Vatansever, Burcin Olcucu, Brad J. Schoenfeld

Publications and Research

Obesity, a disorder of body composition, is defined by a relative or absolute excess of body fat. In general adult population, obesity has been associated with a diverse array of adverse health outcomes, including major causes of death such as cancer, diabetes, cardiovascular disease, as well as functional impairment from problems such as osteoarthritis and sleep apnea. Ghrelin is a newly discovered peptide hormone which plays an important role in obesity. It is a powerful, endogenous orexigenic peptide and has a crucial function in appetite regulation, as well as short – and long-term energy homeostasis. In the presence of increased …

Physical, Cognitive, Social And Mental Health In Near-Centenarians And Centenarians Living In New York City: Findings From The Fordham Centenarian Study, Daniela S. Jopp, Min-Kyung S. Park, Jonathan Lehrfeld, Michelle E. Paggi

Publications and Research

Background: Despite their strong increase, the population of the very old, including near-centenarians and centenarians, represent an unstudied and underserved population. Available studies mostly concentrate on predictors of exceptional longevity, but rarely extend their focus to other areas of functioning. Also, little is known about what contributes to experiencing a quality life in very old age. The present population-based study aims at providing a comprehensive picture of key domain of functioning, including physical, cognitive, social and mental function in very old individuals and to determine predictors of mental health indicators.

Methods: A total of 119 individuals aged 95 to 107 …