Medicine and Health Sciences Commons^™

Perceived Deprivation In Active Duty Military Nurse Anesthetists, Julie Ann Pearson

Theses and Dissertations

Problem: There is a shortage of military certified registered nurse anesthetists (CRNAs). The exodus from military service to civilian careers could be a result of relative deprivation (the discrepancy that one perceives between what one has and what one could or should have). Relative deprivation is a perception of unfairness dependent on feelings (subjective data) as well as facts (objective data). Purpose: The purpose of this study was to measure relative deprivation in active duty military nurse anesthetists, to explore variables which correlate with relative deprivation, and to validate or refute the theory of relative deprivation in active duty military …

Automatic Colonic Polyp Detection Using Multiobjective Evolutionary Techniques, Jiang Li, Adam Huang, Jianhua Yao, Ingmar Bitter, Nicholas Petrick, Ronald M. Summers, Perry J. Pickhardt, J. Richard Choi

Electrical & Computer Engineering Faculty Publications

Colonie polyps appear like elliptical protrusions on the inner wall of the colon. Curvature based features for colonie polyp detection have proved to be successful in several computer-aided diagnostic CT colonography (CTC) systems. Some simple thresholds are set for those features for creating initial polyp candidates, sophisticated classification scheme are then applied on these polyp candidates to reduce false positives. There are two objective functions, the number of missed polyps and false positive rate, that need to be minimized when setting those thresholds. These two objectives conflict and it is usually difficult to optimize them both by a gradient search. …

Coping Processes Of Couples Experiencing Infertility, Brennan Peterson, Christopher R. Newton, Karen H. Rosen, Robert S. Shulman

Psychology Faculty Articles and Research

This study explored the coping processes of couples experiencing infertility. Participants included 420 couples referred for advanced reproductive treatments. Couples were divided into groups based on the frequency of their use of eight coping strategies. Findings suggest that coping processes, which are beneficial to individuals, may be problematic for one's partner. Couples where men used high amounts of distancing, while their partner used low amounts of distancing, reported higher levels of distress when compared to couples in the other groups. Conversely, couples with women who used high amounts of self-controlling coping, when paired with men who used low amounts of …

The Science Of Prevention Strategies, Rachel Abrishami, Jeffery A. Goad

Pharmacy Faculty Articles and Research

"From newborn screening for Phenylkentonurea (PKU) and the birth dose of Hepatitis B vaccine to prostate and breast cancer screening and pneumococcal immunization for older adults, the science of health maintenance is multi-tiered and spans the lifetime of an individual. Primary, secondary, and tertiary prevention strategies are used in concert with each other to enable healthcare professionals and their patients to sustain and improve the quality of life."

Effect Of Prophylactic And Therapeutic Mitomycin C On Corneal Apoptosis, Cellular Proliferation, Haze, And Long-Term Keratocyte Density In Rabbits, Marcelo V. Netto, Rajiv R. Mohan, Sunilima Sinha, Ajay Sharma, Pankaj C. Gupta, Steven E. Wilson

Pharmacy Faculty Articles and Research

PURPOSE—To determine the mechanism through which topical mitomycin C prevents and treats corneal haze after photorefractive keratectomy (PRK) and to examine the effects of dosage and duration of exposure.

METHODS—In 224 New Zealand rabbits, −9.0 diopter PRK with mitomycin C or balanced salt solution was performed. Haze level was graded at the slit-lamp. Rabbits were sacrificed at 4 hours, 24 hours, 4 weeks, or 6 months after surgery and immunohistochemistry was performed with TUNEL assay, Ki67 and α-SMA.

RESULTS—TUNEL-positive apoptotic cells marginally increased in all mitomycin C groups whereas Ki67-positive mitotic cells decreased significantly following mitomycin C application. A greater …

Stromal Haze, Myofibroblasts, And Surface Irregularity After Prk, Marcelo V. Netto, Rajiv R. Mohan, Sunilima Sinha, Ajay Sharma, William Dupps, Steven E. Wilson

Pharmacy Faculty Articles and Research

The aim of this study was to investigate the relationship between the level of stromal surface irregularity after photorefractive keratectomy (PRK) and myofibroblast generation along with the development of corneal haze.

Variable levels of stromal surface irregularity were generated in rabbit corneas by positioning a fine mesh screen in the path of excimer laser during ablation for a variable percentage of the terminal pulses of the treatment for myopia that does not otherwise generate significant opacity. Ninety-six rabbits were divided into eight groups[.]

Slit lamp analysis and haze grading were performed in all groups. Rabbits were sacrificed at 4 hr …

Giant Multiple Intra-Abdominal Hydatid Cysts, Naila Nadeem, Hassan Khan, Saulat H. Fatimi, Mohammad Nadeemd Ahmad

Section of Cardiothoracic Surgery

No abstract provided.

M. Leprae Inhibits Apoptosis In Thp-1 Cells By Downregulation Of Bad And Bak And Upregulation Of Mcl-1 Gene Expression, Zahra Hasan, Mussarat Ashraf, Ali Tayyebi, Rabia Hussain

Department of Pathology and Laboratory Medicine

Background: Virulent Mycobacterium leprae interfere with host defense mechanisms such as cytokine activation and apoptosis. The mitochondrial pathway of apoptosis is regulated by the Bcl-2 family of proteins. Expression of Fas ligand and apoptotic proteins is found in leprosy lesions and M. leprae has been shown to activate pro-apoptotic Bcl-2 genes, Bak and Bax. However, the mechanism by which M. leprae modulates apoptosis is as yet unclear. We investigated expression of apoptotic genes in THP-1 monocytes in response to infection by M. leprae and non-pathogenic M. bovis BCG.
Results: M. leprae did not induce apoptosis in THP-1 cells, while BCG …

Role Of Ict Malaria Immunochromatographic Test For Rapid Diagnosis Of Malaria, Mahadev S. Harani, M.Asim Beg, Lubna Khaleeq,, Salman Adil, Ghulam Nabi Kakepoto, Mohammad Khurshid

Department of Pathology and Laboratory Medicine

Objective: To evaluate the sensitivity and specificity of immunochromatographic test (ICT) malaria p.f/p.v using microscopy as the gold standard diagnosis. Methods: Five hundred and sixty patients of both sexes and all age groups with clinical suspicion of malaria were studied. Venous blood was collected for microscopy and ICT. Thick and thin films prepared and stained with Leishman's stain were examined. ICT malaria test was performed and interpreted according to manufacturer's instructions. Data was analyzed using Epi-6.
Results: A total of 560 cases were studied, 339 males and 221 females with age ranges between 2 to 73 years. …

Clinico-Pathologic Features Of Chronic Myeloid Leukemia And Risk Stratification According To Sokal Score, Naveen Naz Syed, Mikal Usman, Gulnaz Khaliq, Salman Adil, Mohammad Khurshid

Department of Pathology and Laboratory Medicine

To compile the clinical and haematological parameters of chronic myeloid leukemia (CML) and risk stratification according to Sokal score in our population. A descriptive analysis. The Aga Khan University Hospital, during the period from August 1997 to August 2005. All patients with diagnosis of chronic myeloid leukemia treated as outpatient in haematology clinic, or admitted in haem-oncology wards in The Aga Khan University Hospital were included. Records were retrospectively analyzed for clinicopathologic features. Risk groups were assigned as per Sokal scoring. During the 8 years study period, 245 patients with chronic myeloid leukemia were analyzed, the median age of presentation …

The Use Of Proteomic Technologies To Identify Serum Glycoproteins For The Early Detection Of Liver And Prostate Cancers, Elizabeth Ellen Schwegler

Theses and Dissertations in Biomedical Sciences

The application of proteomic technologies to identify serum glycoproteins is an emerging technique to identify new biomarkers indicative of disease severity. Many of these newly evolving protein-profiling methodologies have evolved from previous global protein expression profiling studies such as those involving SELDI-TOF-MS technologies. Though the SELDI approach could distinguish disease from normal by utilizing protein patterns as shown herein with the HCC study of chapter II, it was unable to offer sequence information on the selected peaks, and did not have the ability to analyze the entire dynamic range of the serum/plasma proteome. To address these deficiencies, new strategies that …

Understanding The Nature Of Surgical Excellence Using A Competency Modeling Approach, Hope S. Hanner-Bailey

Psychology Theses & Dissertations

Currently, a thorough description of the knowledge, skills, abilities, and other personal characteristics (KSAOs) that distinguish an exceptional surgeon does not exist. This knowledge is pertinent to the development of selection, training, and performance assessment methods that can be used to develop high performing surgeons. Expert surgeons from around the country were recruited to participate in an interview to discuss the KSAOs (i.e., the competencies) needed to be exceptional in the field. A smaller number of novice surgeons were also interviewed. The expert interview data were distilled into a competency model that consists of ten competencies and patterns within the …

Chronic Exposure To Mdma (Ecstasy) Elicits Behavioral Sensitization In Rats But Fails To Induce Cross-Sensitization To Other Psychostimulants, Gunjan M Modi, Pamela B Yang, Alan C Swann, Nachum Dafny

Journal Articles

BACKGROUND: The recreational use of 3,4-methylenedioxymethamphetamine (MDMA, ecstasy) among adolescents and young adults has become increasingly prevalent in recent years. While evidence suggests that the long-term consequences of MDMA use include neurodegeneration to serotonergic and, possibly, dopaminergic pathways, little is known about susceptibility, such as behavioral sensitization, to MDMA.

METHODS: The objectives of this study were to examine the dose-response characteristics of acute and chronic MDMA administration in rats and to determine whether MDMA elicits behavioral sensitization and whether it cross-sensitizes with amphetamine and methylphenidate. Adult male Sprague-Dawley rats were randomly divided into three MDMA dosage groups (2.5 mg/kg, 5.0 …

Fludarabine Induced Autoimmune Haemolytic Anaemia In A Patient With Chronic Lymphocytic Leukaemia, Naveen Naz Syed, Mohammad Khurshid

Department of Pathology and Laboratory Medicine

Autoimmune haemolytic anaemia following fludarabine is an uncommon complication and previously treated patients are at higher risk. We describe a case of 57- year old lady with chronic lymphocytic leukaemia; she received intermittent courses of alkylating agents and purine analogue, fludarabine. Reintroduction of fludarabine for her relapsing disease induced autoimmune haemolytic anaemia. Numbers of cases have been reported regarding autoimmune haemolytic anaemia following fludarabine administration, but none have been published from our part of the world. Normally T-cell suppresses autoreactive lymphocytes that can produce autoantibodies. Suppression of T-cells by fludarabine, in addition to the underlying disease process appears to be …

Significance Of Cytogenetic Abnormalities In Acute Myeloid Leukaemia, Mahadev S. Harani, Salman Adil, Ghulam Nabi Kakepoto, Zahida Khilji, Usman Shaikh, Mohammad Khurshid

Department of Pathology and Laboratory Medicine

Objective: To evaluate the role of karyotype in acute myeloid leukaemia (AML) as a predictor of response to induction chemotherapy.
Methods: A cross-sectional study was carried out at the department of Pathology and Oncology, Aga Khan University Karachi from January 2003 to January 2005. Newly diagnosed patients with denovo AML admitted to the hospital were included in the study. Diagnosis of AML was based on FAB criteria, immunophenotyping and cytogenetic studies. They were treated according to standard protocols (combination of anthracycline and cytarabine -3+7) and those who had acute promyelocytic leukaemia additionally received all- trans retinoic acid (ATRA). …

Extra Pulmonary Uptake Of Tc-99m-Maa Perfusion Lung Scan As A Result Of Right To Left Intra Cardiac Shunt, Riffat Hussain, Maseeh-Uz-Zaman, Sohail Abrar Khan, M Nadeem Ahmad

Department of Pathology and Laboratory Medicine

Extra pulmonary accumulation of Tc-99m-macroaggregate of albumin (MAA) is rarely seen on perfusion lung scan, and has been reported in less than 4% of a study population of nearly 380 patients1. It occurs when the agent bypasses the lungs due to a right to left (R-L) cardiac or pulmonary shunt, when it is shunted to the portal vein before reaching the right atrium and ventricle of the heart, and when the agent is degraded to a submicron particle size.2 When a pharmaceutical problem is excluded, extra-pulmonary uptake implies unusual hemodynamics with a shunt.

Contemporary Analysis Of Thoracic Aortic Injury: Importance Of Screening Based On Crash Characteristics, Christopher Michetti, R Hanna, J Crandall, S Fakhry

Christopher P. Michetti, M.D., F.A.C.S.

No abstract provided.

The Role Of Radiation Therapy On Medically Inoperable Clinically Localized Non-Small Cell Lung Patients: London Regional Cancer Program (Lrcp) Clinical Experience, Michael Lee, Edward Yu, Robert Ash, Patricia Tai, Larry Stitt, George Rodrigues, Rashid Dar, Mark Vincent, Richard Inculet, Richard Malthaner

Edward Yu

Lung cancer is the most frequent cause of cancer death in both men and women in North America. In 2006, an estimated 22,700 Canadians will be diagnosed with lung cancer and 19,300 will die of it (Canadian Cancer Statistics 2006). Approximately 15-20% of NSCLC patients present with early or localized disease. Surgical resection of T1-2N0 NSCLC remains the treatment of choice for this population, and results in a 5-year survival rate of 50-70%. Patients deemed medically inoperable have been treated with non-surgical therapies, such as radiation therapy(RT), while some patients have simply been observed without any tumor therapy because of …

Radiotherapy For Merkel Cell Carcinoma Of The Skin, Patricia Tai, Edward Yu, Juan Pacella

Edward Yu

We examine the impact of radiotherapy in the treatment of Merkel cell carcinoma (MCC) of the skin. Data at two Canadian institutions (Allan Blair Cancer Centre and London Regional Cancer Program) were collected and charts were retrieved from the registry of 1987 to 2005. A total of 79 patients with definite MCC were studied. All except three had a primary skin lesion. Six patients presented with nodal metastases and three patients with distant metastases. Fourteen patients were referred to the cancer centers at the time of recurrence: 2/14 with local recurrence, 8/14 with nodal recurrence, 2/14 with both local and …

Depressed Contractile Responses To Neurokinin A In Idiopathic But Not Neurogenic Overactive Human Detrusor Muscle, Donna Sellers, Christopher Chapple, Douglas Hay, Russell Chess-Williams

Donna Sellers

Objective: The role of tachykinins such as neurokinin A in regulating bladder function is unclear, but NK2 receptors seem to mediate contraction in the human bladder and it has been suggested that these peptides may have a role in the pathophysiology of bladder dysfunction. The present study investigates neurokinin receptor-mediated contractility of detrusor muscle in the idiopathic overactive and neurogenic overactive bladder and investigates the neurokinin receptor subtypes involved.

Methods: Human bladder was obtained from patients undergoing cystectomy (normal) or clam cystoplasty (idiopathic overactive) and from patients with spinal injuries (neurogenic overactive). Strips of isolated detrusor muscle were mounted in …

Non-Pharmacological Management Of Hypokinetic Dysarthria In Parkinson’S Disease, Andrew Johnson, S. Adams

Andrew M. Johnson

No abstract provided.

An Ethnographic Study Of The Social Context Of Migrant Health In The United States, Seth M. Holmes Phd, Md

Seth M. Holmes PhD, MD

Background

Migrant workers in the United States have extremely poor health. This paper aims to identify ways in which the social context of migrant farm workers affects their health and health care.

Methods and Findings

This qualitative study employs participant observation and interviews on farms and in clinics throughout 15 months of migration with a group of indigenous Triqui Mexicans in the western US and Mexico. Study participants include more than 130 farm workers and 30 clinicians. Data are analyzed utilizing grounded theory, accompanied by theories of structural violence, symbolic violence, and the clinical gaze. The study reveals that farm …

Eye Of The Needle, David J. Malebranche

David J Malebranche

No abstract provided.

Additional Cardiovascular Risk Factors Associated With Excess Weigth In Children And Adolescents. The Belo Horizonte Heart Study, Paulo A. Lotufo

Paulo A Lotufo

OBJECTIVE: To examine the association of overweight and obesity with physical activity, blood pressure (BP) and serum lipid profiles. METHODS Epidemiologic investigation of 1,450 students, between the ages of 6 and 18, in the city of Belo Horizonte, MG. Data: weight, height, BP, skinfold thickness, waist circumference, physical activity, total cholesterol (TC), LDL-c, HDL-c, and dietary habits. RESULTS The prevalence rates for overweight and obesity were 8.4% and 3.1%, respectively. In relation to the students in the lower quartile (Q1) of the distribution of subscapular skinfold, the students in the upper quartile (Q4) presented a 3.7 times higher risk (odds …

In Search Of The Anglophone Doctor In Jacques Ferron’S Story “Le Petit William”, Vivian C. Mcalister, Christiane I. Mcalister

Vivian C. McAlister

"Body Contouring After Massive Weight Loss," Edited By A. Aly., Vivian C. Mcalister

Vivian C. McAlister

Nowhere is the failure of the health care system, as currently managed, more evident than in the surgical care of obesity. A marked contrast has emerged between surgery in the United States and Canada for these patients. It is not clear whether the reluctance to supply surgical services in Canada is due to a bias in favour of “more deserving” patients or whether the considerably higher rate of obesity surgery in the US is due to the excesses of private enterprise. Governments have acknowledged that an element of the former proposition is true by referring obese patients to centres in …

“You’Re Awfully Old To Have This Disease”: Experiences Of Stigma And Ageism In Adults 50 Years An Older Living With Hiv/Aids., Charles A. Emlet

Charles Emlet

No abstract provided.