Medicine and Health Sciences Commons^™

Relationship Between Maternal Methadone Dose At Delivery And Neonatal Abstinence Syndrome., Neil S., Seligman, Christopher V. Almario, Edward J. Hayes, Kevin C. Dysart, Vincenzo Berghella, Jason K. Baxter

Department of Obstetrics and Gynecology Faculty Papers

OBJECTIVE: To estimate the relationship between maternal methadone dose and the incidence of neonatal abstinence syndrome (NAS).

STUDY DESIGN: We performed a retrospective cohort study of pregnant women treated with methadone for opiate addiction who delivered live-born neonates between 1996 and 2006. Four dose groups, on the basis of total daily methadone dose, were compared (160 mg/d). The primary outcome was treatment for NAS. Symptoms of NAS were objectively measured with the Finnegan scoring system, and treatment was initiated for a score>24 during the prior 24 hours.

RESULTS: A total of 330 women treated with methadone and their 388 …

The Intellectual And Moral Integrity Of Bioethics: Response To Commentaries On "A Case Study In Unethical Transgressive Bioethics: 'Letter Of Concern From Bioethicists' About The Prenatal Administration Of Dexamethasone"., Laurence B Mccullough, Frank A Chervenak, Robert L Brent, Benjamin Hippen

Department of Pediatrics Faculty Papers

In our target article we showed that the Letter of Concern (LoC) fails to meet accepted standards for presenting empirical data for the purpose of supplementing a normative claim and for argument-based normative ethics. The LoC fails to meet the standards of evidence-based reasoning by making false claims, failing to reference data that undermine its key premises, and misrepresenting and misinterpreting the scientific publications it selectively references. The LoC fails to meet the standards of argument-based reasoning by treating as settled matters what are, instead, ongoing controversies, offering “mere opinion” as a substitute for argument, and making contradictory claims. The …

One Year Survival With Poorly Differentiated Metastatic Pancreatic Carcinoma Following Chemoembolization With Gemcitabine And Cisplatin., Daniel B Brown, Carin F Gonsalves, Charles J Yeo, Agnes K Witkiewicz, Brian I Carr

Department of Radiology Faculty Papers

While hepatic arterial chemoembolization is efficacious for a number of malignancies, there is scant data regarding treatment of pancreatic adenocarcinoma. We report a complete radiographic response at one year from diagnosis of metastatic pancreatic carcinoma. Gemcitabine/cisplatin based chemoembolization may be of potential benefit for patients with liver-dominant metastases from pancreatic carcinoma. Given the typical survival of 6 months or less in this patient group with standard therapies, further research is warranted.

One Year Outcomes Of A Pre-Hospital Myocardial Infarction Alert 3 Process, Gerald Coleman Do, Andrew C. Miller Do, David Richardson Md, David A. Cox Md, Nainesh Patel Md, J Patrick Kleaveland Md, Bruce Feldman Do, Ron Freudenberger Md, Richard S. Mackenzie Md

Department of Emergency Medicine

No abstract provided.

Examining The "Urban Advantage" In Maternal Health Care In Developing Countries, Zoe¨ Matthews, Amos Channon, Nyovani Madise, William Stones

Obstetrics and Gynaecology, East Africa

Although recent survey data make it possible to examine inequalities in maternal and newborn health care in developing countries, analyses have not tended to take into consideration the special nature of urban poverty.

Using improved methods to measure urban poverty in 30 countries, we found substantial inequalities in maternal and newborn health, and in access to health care.

The ‘‘urban advantage’’ is, for some, non-existent. The urban poor do not necessarily have better access to services than the rural poor, despite their proximity to services.

There are two main patterns of urban inequality in developing countries: (1) massive exclusion, in …

Pediatric Ophthalmology And Strabismus: Something For Everyone., Alex V. Levin

Wills Eye Hospital Papers

This issue of Current Opinion in Ophthalmology highlights the uniquely broad range of pediatric ophthalmology and strabismus. Perhaps, unlike any other area of ophthalmology, our specialty covers virtually every part of the eye and a multitude of systemic disorders. Pediatric ophthalmology offers the practitioner the opportunity to impact a patient’s visual life for many decades giving them a lifetime of good vision. This issue of the journal highlights the many ways that this is so.

Convergence Insufficiency And Its Current Treatment., Judith B Lavrich

Wills Eye Hospital Papers

PURPOSE OF REVIEW: Considerable uncertainty and controversy has existed concerning the management of convergence insufficiency. Only recently there have been significant scientific studies published that compare the effectiveness of the commonly prescribed treatments. This paper reviews the most recent research and literature on convergence insufficiency and its treatment.

RECENT FINDINGS: The first large-scale placebo-controlled, randomized clinical trials to study the various treatments of convergence insufficiency have recently been published. Current research compares the effectiveness of base-in prism glasses, pencil push-ups, and vision therapy in reducing the signs and symptoms of convergence insufficiency and suggests that orthoptic therapy is the most …

Traumatic Dural Venous Sinus Thrombosis In High-Risk Acute Blunt Head Trauma Patients, W. Akhtar

Department of Radiology

No abstract provided.

What Is The Best Antiplatelet Agent For Prevention Of Recurrent Stroke In Pakistani Patients? Do Combinations Offer Significant Advantages In The South Asian Context?, Maria Khan, Ayeesha Kamran Kamal

Section of Neurology

No abstract provided.

Psychological Profiles In A Female Bariatric Surgery Sample, Aimee L. Donato

Loma Linda University Electronic Theses, Dissertations & Projects

Morbid obesity is an epidemic. Current literature suggests that people with morbid obesity tend to show increased levels of psychological dysfunction. This is especially pertinent to the clinicians who work with morbidly obese patients who seek bariatric surgery as the method for weight control. Surgery should be performed on patients who are psychologically ready to adjust to the stringent post-operative lifestyle.

The purpose of the present study was (1) to compare two groups of bariatric patients (a White group and a non-White group) on pre-surgery measures: specific scales on the Millon Behavioral Medicine Diagnostic (MBMD), the Beck Depression Inventory II …

The Surge Of H1n1: A Patient Safety Initiative, Charlotte Buckenmyer Ms, Rn, Cen, Constance Simpson Rn, Kristine Weitzel Rn, Sandra Sabbatini Bsn, Rn, Tara Lynne Wisniewiski Bsn, Rn

Patient Care Services / Nursing

No abstract provided.

Klebsiella Osteomyelitis Of The Right Humerus Involving The Right Shoulder Joint In An Infant, Maqbool Qadir, Syed Rehan Ali, Mumtaz Lakhani, Pervaiz Hashmi, Ahsen Amirali

Department of Paediatrics and Child Health

Osteomyelitis in newborn infants is a rare infection. Lower extremity joints are commonly affected. Most of the cases have a haematogenous spread. Aerobes are the common group of organism involved, of which Staphylococcus aureus is the commonest. Klebsiella osteomyelitis has been reported as a cause of Osteomyelitis. However, to the best of our knowledge, this is the first case report of Klebsiella pneumoniae associated osteomyelitis in an infant from Pakistan.

Pattern Of Drugs Of Abuse Identified In Chemical Samples, Farhan Javed Dar, Aysha Habib Khan, Imran Siddiqui, Farooq Ghani

Department of Pathology and Laboratory Medicine

OBJECTIVE: To determine the pattern of drugs of abuse in urine and blood samples processed at referral laboratory in Pakistan so that information on the type of drugs used can be identified and used for ready reference for future strategy. Study Design: Observational study.

PLACE AND DURATION OF STUDY: Clinical Laboratory of The Aga Khan University Hospital, Karachi, from July 2006 to March 2008. Methodology: Retrospective review of records were done for the common drugs that are used for screening at the Clinical Laboratory include alcohol, amphetamine, barbiturates, benzodiazepines, cannabinoids, cocaine and opiates. Alcohol was tested in blood and others …

Inducible Clindamycin Resistance Due To Expression Of Erm Genes In Staphylococcus Aureus: Report From A Tertiary Care Hospital Karachi, Pakistan, Naima Fasih, Seema Irfan, Afia Zafar, Erum Khan, Rumina Hasan

Department of Pathology and Laboratory Medicine

OBJECTIVE: To assess the frequency of phenotypic expression of inducible resistance of clindamycin due to expression of erm genes, in clinical isolates of Staphylococcus aureus (S. aureus), by double disk diffusion test (D-test).

METHOD: This was a cross sectional study conducted in the clinical laboratory of Aga Khan University Hospital, Karachi. A total of 2432, non duplicate clinical isolates of S. aureus, consisting of 1562 methicillin sensitive S. aureus (MSSA) and 870 methicillin resistant S. aureus (MRSA), were selected from February 2007 to January 2008. One hundred and thirty eight isolates of S. aureus were selected based on discordant resistance …

Prevalences Of Giardia Lamblia And Cryptosporidium Parvum Infection In Adults Presenting With Chronic Diarrhoea, Javed Yakoob, Zaigham Abbas, M. Asim Beg, Shagufta Naz, Rustam Khan, Muhammad Islam, Wasim Jafri

Section of Gastroenterology

iardia lamblia and Cryptosporidium parvum are both waterborne pathogens associated with diarrhoea in developing countries. In a recent study based at the Aga Khan University in Karachi, 334 adults aged 16–83 years (178 patients with chronic diarrhoea and 156 diarrhoea-free volunteers who acted as controls) were checked for infection with these parasites, using stool microscopy and/or PCR. Overall, 21 (6.3%) and 29 (8.7%) of the subjects were found positive for G. lamblia by microscopy and PCR, respectively, while the corresponding values for C. parvum were 13 (3.9%) and 14 (4.2%). Although, compared with the diarrhoea-free controls, the patients with diarrhoea …

What Is The Best Antiplatelet Agent For Prevention Of Recurrent Stroke In Pakistani Patients? Do Combinations Offer Significant Advantages In The South Asian Context?, Maria Khan, Ayeesha Kamran Kamal

Department of Medicine

No abstract provided.

Identification Of A Unique Core Domain Of Par-4 Sufficient For Selective Apoptosis Induction In Cancer Cells, Vivek M. Rangnekar

Radiation Medicine Faculty Patents

The present invention relates to Par-4 mutants which cause apoptosis in cancer cells which are sensitive to Par-4 and also induce apoptosis in cancer cells which are resistant to Par-4. The present invention also relates to methods of using the Par-4 mutant to treat certain cancers, as well as to kits, vectors, and polypeptides for same.

Ranolazine Is Effective For Acute Or Chronic Ischemic Dysfunction With Heart Failure, Sudip Nanda Md, Facp, Matthew W. Martinez Md, Tanujit Dey Phd

Department of Medicine

No abstract provided.

Contrast-Induced Nephropathy In Patients Undergoing Percutaneous Coronary Intervention, Sajid H. Dhakam, Saqib A Gowani, Asif Jafferani, Sajid H Dhakam

Department of Medicine

Contrast Induced Nephropathy (CIN) is a feared complication of numerous radiological procedures that expose Patients to contrast media. The most notorious of these procedures is percutaneous coronary intervention (PCI). Not only is this a leading cause of morbidity and mortality, but it also adds to increased costs in high risk Patients undergoing PCI. It is thought to result from direct cytotoxicity and hemodynamic challenge to renal tissue. CIN is defined as an increase in serum creatinine by either ≥0.5mg/dL or by ≥25% from baseline within the first 2-3 days after contrast administration, after other causes of renal impairment have been …

Inhibition Of Allogeneic Inflammatory Responses By The Ribonucleotide Reductase Inhibitors, Didox And Trimidox, Mohammed S. Inayat, Ismail S. El-Amouri, Mohammad Bani-Ahmad, Howard L. Elford, Vincent S. Gallicchio, Oliver R. Oakley

Health and Clinical Sciences Faculty Publications

BACKGROUND: Graft-versus-host disease is the single most important obstacle facing successful allogeneic stem cell transplantation (SCT). Even with current immunosuppressive therapies, morbidity and mortality rates are high. Current therapies including cyclosporine A (CyA) and related compounds target IL-2 signaling. However, although these compounds offer great benefit, they are also associated with multiple toxicities. Therefore, new compounds with a greater efficacy and reduced toxicity are needed to enable us to overcome this hurdle.

METHODS: The allogeneic mixed lymphocyte reaction (MLR) is a unique ex vivo method to study a drug's action on the initial events resulting in T-cell activation and proliferation, …

Acute Lymphoblastic Leukemia Subsequent To Temozolomide Use In A 26-Year-Old Man: A Case Report., Asim Jamal Shaikh, Nehal Masood

Section of Haematology/Oncology

Introduction: We report the development of acute lymphoblastic leukemia in a Patient in whom temozolomide was used for the treatment of a brain tumor. Unlike that of other alkylating agents, the leukemogenic potential of temozolomide is considered to be very low, and very rarely are such cases reported. Case Presentation: A 26-year-old Pakistani man who was treated for glioblastoma with temozolomide in an adjuvant setting was diagnosed to have acute lymphoblastic leukemia one year after stopping temozolomide. Conclusion: Temozolomide is a highly active agent, used in the management of high-grade brain neoplasms. The agent is generally regarded to be safe, …

Survival Associated Pathway Identification With Group Lp Penalized Global Auc Maximization., Zhenqiu Liu, Laurence S Magder, Terry Hyslop, Li Mao

Department of Pharmacology and Experimental Therapeutics Faculty Papers

It has been demonstrated that genes in a cell do not act independently. They interact with one another to complete certain biological processes or to implement certain molecular functions. How to incorporate biological pathways or functional groups into the model and identify survival associated gene pathways is still a challenging problem. In this paper, we propose a novel iterative gradient based method for survival analysis with group Lp penalized global AUC summary maximization. Unlike LASSO, Lp (p < 1) (with its special implementation entitled adaptive LASSO) is asymptotic unbiased and has oracle properties 1. We first extend Lp for individual gene identification to group Lp penalty for pathway selection, and then develop a novel iterative gradient algorithm for penalized global AUC summary maximization (IGGAUCS). This method incorporates the genetic pathways into global AUC summary maximization and identifies survival associated pathways instead of individual genes. The tuning parameters are determined using 10-fold cross validation with training data only. The prediction performance is evaluated using test data. We apply the proposed method to survival outcome analysis with gene expression profile and identify multiple pathways simultaneously. Experimental results with simulation and gene expression data demonstrate that the proposed procedures can be used for identifying important biological pathways that are related to survival phenotype and for building a parsimonious model for predicting the survival times.

Cav1 Inhibits Metastatic Potential In Melanomas Through Suppression Of The Integrin/Src/Fak Signaling Pathway., Casey Trimmer, Diana Whitaker-Menezes, Gloria Bonuccelli, Janet N Milliman, Kristin M Daumer, Andrew E Aplin, Richard G Pestell, Federica Sotgia, Michael P Lisanti, Franco Capozza

Department of Stem Cell Biology and Regenerative Medicine Faculty Papers & Presentations

Caveolin-1 (CAV1) is the main structural component of Caveolae which are plasma membrane invaginations that participate in vesicular trafficking and signal transduction events. Although, evidence has recently accumulated describing the function of CAV1 in several cancer types, its role in melanoma tumor formation and progression remains poorly explored. Here, by employing B16F10 melanoma cells as an experimental system, we directly explore the function of CAV1 in melanoma tumor growth and metastasis. We first show that CAV1 expression promotes proliferation while it suppresses migration and invasion of B16F10 cells in vitro. When orthotopically implanted in the skin of mice, B16F10 cells …

The P Wave: Indicator Of Atrial Enlargement, Patrick Loftis

Physician Assistant Studies Faculty Research and Publications

No abstract provided.

Primary Human Mammary Epithelial Cells Endocytose Hiv-1 And Facilitate Viral Infection Of Cd4+ T Lymphocytes, Stephanie M. Dorosko, Ruth I. Connor

Dartmouth Scholarship

The contribution of mammary epithelial cells (MEC) to human immunodeficiency virus type 1 (HIV-1) in breast milk remains largely unknown. While breast milk contains CD4(+) cells throughout the breast-feeding period, it is not known whether MEC directly support HIV-1 infection or facilitate infection of CD4(+) cells in the breast compartment. This study evaluated primary human MEC for direct infection with HIV-1 and for indirect transfer of infection to CD4(+) target cells. Primary human MEC were isolated and assessed for expression of HIV-1 receptors. MEC were exposed to CCR5-, CXCR4- and dual-tropic strains of HIV-1 and evaluated for viral reverse transcription …

The Staphylococcus-Specific Gene Rsr Represses Agr And Virulence In Staphylococcus Aureus, Sandeep Tamber, Dindo Reyes, Niles P. Donegan, Joseph D. Schwartzman, Ambrose L. Cheung, Guido Memmi

Dartmouth Scholarship

The expression of virulence factors in Staphylococcus aureus is tightly coordinated by a vast network of regulatory molecules. In this report, we characterize a genetic locus unique to staphylococci called rsr that has a role in repressing two key virulence regulators, sarR and agr. Using strain SH1000, we showed that the transcription of virulence effectors, such as hla, sspA, and spa, is altered in an rsr mutant in a way consistent with agr upregulation. Analysis of RNAIII expression of the agr locus in rsr and rsr-sarR mutants indicated that rsr likely contributes to agr expression independently …

Mononucleosis And Antigen-Driven T Cell Responses Have Different Requirements For Interleukin-2 Signaling In Murine Gammaherpesvirus Infection, Michael Molloy, Weijun Zhang, Edward Usherwood

Dartmouth Scholarship

Interleukin-2 (IL-2) has been implicated as being necessary for the optimal formation of primary CD8⁺ T cell responses against various pathogens. Here we have examined the role that IL-2 signaling plays in several aspects of a CD8⁺ T cell response against murine gammaherpesvirus 68 (MHV-68). Exposure to MHV-68 causes a persistent infection, along with infectious mononucleosis, providing a model for studying these processes in mice. Our study indicates that CD25 is necessary for optimal expansion of the antigen-specific CD8⁺ T cell response but not for the long-term memory response. Contrastingly, IL-2 signaling through CD25 is absolutely required …

Synthesis Of Novel Aromatic Quinols For Colon And Renal Cancers, Bradley J. Davey, Tae Soo Jo, Pradip K. Bhowmik

Undergraduate Research Opportunities Program (UROP)

Colon Cancer: The third most common cancer in USA. More than 1 million Americans currently living with colon cancer. 148,810 new cases expected in 2010. 50,000 deaths annually.

Renal Cancer: Approximately 58,000 people diagnosed in USA annually. Seventh most common cancer and tenth most common cause of cancer related death in men.

Aromatic quinols have demonstrated in vitro antitumor activity. Three heteroaromatic quinols show antitumor activity.

Y-Aminobutyric Acid Inhibits Synergistic Interleukin-6 Release And Increases Intracellular Cytokine Content In C6 Astrocytoma Cells In Vitro, Daniella Sandoval, Becky M. Hess, Bryan L. Spangelo

Undergraduate Research Opportunities Program (UROP)

Alzheimer’s disease (AD) is a neurodegenerative disorder that is characterized by memory loss and is the most common cause of dementia. It is has been hypothesized that pro-inflammatory cytokines induce the inflammation that is believed to be the cause of the neuronal death that is associated with AD. γ-aminobutyric acid (GABA) is a major inhibitory neurotransmitter in the Central Nervous System possessing membrane hyperpolarization or depolarization activities. A decline in GABA may enhance cytokine release in Alzheimer’s disease resulting in neuroinflammation. Therefore, we investigated the GABA-mediated suppression of the synergistic release of interleukin-6 (IL-6) induced by interleukin 1- (IL-1) and …

Polymorphisms In The Macrophage Migration Inhibitory Factor Gene And Bone Loss In Postmenopausal Women, George A. Kuchel, Anne M. Kenny

UCHC Articles - Research

Osteoporosis is a severe condition in postmenopausal women and a common cause of fracture. Osteoporosis is a complex disease with a strong genetic impact, but susceptibility is determined by many genes with modest effects and environmental factors. Only a handful of genes consistently associated with osteoporosis have been identified so far. Inflammation affects bone metabolism by interfering with the interplay between bone resorption and formation, and many inflammatory mediators are involved in natural bone remodeling. The cytokine macrophage migration inhibitory factor (MIF) has been shown to affect bone density in rodents, and polymorphisms in the human MIF promoter are associated …