Medicine and Health Sciences Commons^™

Cephalosporin Resistant Shigella Flexneri From A Clinical Isolate--A Rare Finding, Nasim Sabir, Afia Zafar

Department of Pathology and Laboratory Medicine

Shigellosis is an important public health problem, especially in developing countries. Antibiotic treatment of dysentery aimed at resolving diarrhea or reducing its duration, and to prevent transmission to other close contacts. Isolates with resistance to first line drugs have been reported throughout world, third generation cephalosporins and quinolones are mainstay of treatment. Shigella flexneri resistant to third generation cephalosporins in a clinical isolate is a rare finding, and this has been reported for the first time in Pakistan.

Frequency And Sensitivity Pattern Of Extended Spectrum Beta Lactamase Producing Isolates In A Tertiary Care Hospital Laboratory Of Pakistan, Kauser Jabeen, Afia Zafar, Rumina Hasan

Department of Pathology and Laboratory Medicine

Objective: To determine frequency, distribution and sensitivity pattern of Extended-Spectrum ß Lactamase (EBSL) producing organism at a tertiary care hospital in Pakistan.
Methods: All members of enterobacteriacae isolated between April and August 2002 were studied. Isolates were speciated according to standard biochemical tests. Susceptibility testing was performed by Kirby-Bauer method. ESBL was detected using double disc method using cefotaxime versus cefotaxime plus clavulanate according to NCCLS. Statistical analysis was performed by SPSS version 10. Test of significance were calculated using chi-square test.
Results: During the study period, 1137/2840 (40%) of the isolates tested were found to be ESBL producing. …

Frequency Of Isolation Of Shigella Serogroups/Serotypes And Their Antimicrobial Susceptibility Pattern In Children From Slum Areas In Karachi, Afia Zafar, Nasim Sabir, Zulfiqar Bhutta

Department of Pathology and Laboratory Medicine

Objectives: To assess the frequency of serogroups and serotypes, as well as the antimicrobial susceptibility pattern of Shigella species isolated from known cases of diarrhoea and dysentery from Karachi, Pakistan.
Methods: A cross-sectional study was conducted between January 2002 and March 2003 at Aga Khan University on stool samples received from children with diarrhoea and dysentery from four low socio-economic areas (Sultanabad, Rehri Goth, Hijrat and Sherpao colony) of Karachi. Stool samples yielding growth of Shigella species, were further identified for serotypes by slide agglutination. Antibiotics susceptibility was performed by Kirby Bauer disk diffusion method
Results: …

Vi Antigen Expression In Salmonella Enterica Serovar Typhi Clinical Isolates From Pakistan, John Wain, Deborah House, Afia Zafar, Stephen Baker, Satheesh Nair, Claire Kidgell, Zulfiqar Bhutta, Gordon Dougan, Rumina Hasan

Department of Pathology and Laboratory Medicine

The accurate identification of Salmonella enterica subsp. enterica serovar Typhi variants that fail to express the capsular polysaccharide, Vi, is an important and much discussed issue for medical microbiology. We have tested a multiplex PCR method which shows the presence or absence of the genetic locus required for Vi expression. Of 2,222 Salmonella serovar Typhi clinical isolates collected from patients' blood over a 4-year period in a region of Pakistan where typhoid is endemic, 12 tested negative for Vi expression by serological agglutination. However, only 1 of these 12 was Vi negative by the multiplex PCR method. This result was …

Solid And Cystic Epithelial Neoplasm Of Pancreas With Metastasis: Report Of A Highly Unusual Case, Zubair Ahmad, Nausheed Yaqboob, Suhail Muzaffar, Nadeem Ahmad

Department of Pathology and Laboratory Medicine

Solid and cystic papillary epithelial neoplasms of the pancreas are uncommon tumors occurring predominantly in young women. These tumors have excellent prognosis and after complete surgical resection, more that 95% patients are cured. Occasionally, they invade the surrounding pancreatic parenchyma. These tumors can recur even many years after resection, so long-term follow up is essential. Very few cases metastasize. We present a case of a middle aged woman with metastases to liver and omentum

Elevated Ex Vivo Monocyte Chemotactic Protein-1 (Ccl2) In Pulmonary As Compared With Extra-Pulmonary Tuberculosis, Zahra Hasan, Irfan Zaidi, Bushra Jamil, M Aslam Khan, Akber Kanji, Rabia Hussain

Department of Pathology and Laboratory Medicine

Background: Tuberculosis causes 3 million deaths annually. The most common site of tuberculosis is pulmonary however; extra-pulmonary forms of the disease also remain prevalent. Restriction of Mycobacterium tuberculosis depends on effective recruitment and subsequent activation of T lymphocytes, mononuclear and polymorphonuclear cells to the site of infection. Tumor necrosis factor (TNF)-α is essential for granuloma formation and is a potent activator of monocyte chemotactic protein (MCP-1, CCL2). CCL2 is essential for recruitment of monocytes and T cells and has been shown to play a role in protection against tuberculosis. Interleukin -8 (CXCL8) is a potent activator of neutrophils. Increased …

Frequency Of Irregular Red Cell Alloantibodies In Patients With Thalassemia Major: A Bicenter Study, Fareena Bilwani, Ghulam Nabi, Salman Adil, Mohammad Usman, Farrukh Hassan, Mohammad Khurshid

Department of Pathology and Laboratory Medicine

Objective: To provide frequency and distribution pattern of various types of irregular red cell alloantibodies in patients with thalassemia major.
Methods: This is a descriptive study conducted at two centers from January to December 2001. Purposive sampling was done and all patients diagnosed to have thalassemia major were included in the study. Antibody identification was carried out on serum employing commercial two-cell panel using standardized blood bank methods. If patients were found to have an irregular red cell alloantibody then the antibody identification was performed using 16 panel cells. Results: A total of ninety-seven patients were included …

Periplasm Organization In Treponema Denticola As Studied By Cryo-Electron Tomography, Jacques Izard, C.-E. Hsieh, C. A. Mannella, Ronald J. Limberger, M. Marko

Department of Food Science and Technology: Faculty Publications

As a spirochete, the genus Treponema is one of the few major bacterial groups whose natural phylogenic relationships are evident at the level of gross phenotypic characteristics such as their morphology. Treponema spp. are highly invasive due to their unique motility in dense media, and their ability to penetrate cell layers. This feature is associated with the helical cell body and the presence of flagellar filaments in the periplasm. Treponema denticola is an oral pathogen involved in endodontic infections and periodontal diseases. The presence and quantity of T. denticola in the subgingival biofilm is correlated with the severity of periodontal …

Ccl20/Macrophage Inflammatory Protein 3Α And Tumor Necrosis Factor Alpha Production By Primary Uterine Epithelial Cells In Response To Treatment With Lipopolysaccharide Or Pam3cys, M. A. Crane-Godreau, C. R. Wira

Dartmouth Scholarship

Having previously shown that CCL20/macrophage inflammatory protein 3 and tumor necrosis factor alpha (TNF-alpha) are released by polarized primary rat uterine epithelial cells (UEC) in response to Escherichia coli but not to Lactobacillus rhamnosus , we sought to determine if epithelial cells are responsive to pathogen-associated molecular patterns (PAMP), including lipopolysaccharide (LPS), lipoteichoic acid (LTA), and Pam 3 Cys, a bacterial lipoprotein analog. Epithelial cells were grown to confluence on Nunc cell culture inserts prior to apical treatment with PAMPs. In response to LPS, LTA, and Pam 3 Cys (EMC Microcollection GmbH, Tu ̈- bingen, Germany), CCL20 levels increased (4- …

The Challenge Of Health Care Delivery In Connecticut, Joanne M. Bortone, Michael Emery, Patricia W. Walker

Occupational Therapy Faculty Publications

The challenge of health care is explored by Jody Bortone, Michael J. Emery, and Patricia W. Walker in chapter six of Public Policy in Connecticut. They focus particularly on the shortage of health care professionals in the Connecticut workforce, the increasing difficulty Connecticut residents face with respect to accessing and receiving appropriate health care services, and the rising costs associated with the many dimensions of health care. The authors conclude their essay with a very specific set of remedial measures designed to resolve the disturbing trends in the state's health care system.

Using A Collaborative Learning Method To Enhance Mastery Of Pathophysiology Content, Margaret M. Hansen Edd, Msn, Rn, M Fonteyn

Nursing and Health Professions Faculty Research and Publications

No abstract provided.

Identification Of Fatty Acid Oxidation Disorder Patients With Lowered Acyl-Coa Thioesterase Activity In Human Skin Fibroblasts, Mary Hunt, Jos Ruiter, Petra Mooyer, Carlo W T Van Roermond, Rob Ofman, Lodewig Ijlst, Ronald J A Wanders

Articles

Background: Acyl-CoA thioesterases are enzymes that hydrolyze acyl-CoAs to the free fatty acid and coenzyme A (CoASH). These enzymes have been identified in several cellular compartments and are thought to regulate intracellular levels of acyl-CoAs, free fatty acids and CoASH. However, to date no patients deficient in acyl-CoA thioesterases have been identified. Design: Acyl-CoA thioesterase activity was measured in human skin fibroblasts. Western blot analysis was used to determine Type-II acyl-CoA thioesterase protein levels in patients. Results: Activity was found in human fibroblasts with all saturated acyl-CoAs from C4:0- to C18:0-CoA, with highest activity detected with lauroyl-CoA and myristoyl-CoA (C12:0 …

Gene Therapy And Targeted Toxins For Glioma, James Curtin, Gwendalyn King, Marianela Candolfi, Kurt Kroeger, Pedro Lowenstein, Maria Castro

Articles

The most common primary brain tumor in adults is glioblastoma. These tumors are highly invasive and aggressive with a mean survival time of nine to twelve months from diagnosis to death. Current treatment modalities are unable to significantly prolong survival in patients diagnosed with glioblastoma. As such, glioma is an attractive target for developing novel therapeutic approaches utilizing gene therapy. This review will examine the available preclinical models for glioma including xenographs, syngeneic and genetic models. Several promising therapeutic targets are currently being pursued in pre-clinical investigations. These targets will be reviewed by mechanism of action, i.e., conditional cytotoxic, targeted …

Combining Cytotoxic And Immune-Mediated Gene Therapy To Treat Brain Tumors, James Curtin, Gwendalyn King, Marianela Candolfi, Remy Greeno, Kurt Kroeger, Pedro Lowenstein, Maria Castro

Articles

Glioblastoma (GBM) is a type of intracranial brain tumor, for which there is no cure. In spite of advances in surgery, chemotherapy and radiotherapy, patients die within a year of diagnosis. Therefore, there is a critical need to develop novel therapeutic approaches for this disease. Gene therapy, which is the use of genes or other nucleic acids as drugs, is a powerful new treatment strategy which can be developed to treat GBM. Several treatment modalities are amenable for gene therapy implementation, e.g. conditional cytotoxic approaches, targeted delivery of toxins into the tumor mass, immune stimulatory strategies, and these will all …

Biomarkers For Placental Abnormality, Cathal Mccarthy

Doctoral

Obstetrical complications including recurrent miscarriage, pre-eclampsia and intrauterine growth restriction (IUGR) affect 1%-5% of pregnant women (Younis and Samueloff 2003). Dysfunctional trophoblasts, impaired development of spiral arteries, imbalance in systems controlling the dilation and contraction of spiral arteries, placental fibrin clots and intervillous thrombosis are all possible factors that can result in an insufficient placental circulation. The combination of the hypercoagulable state of pregnancy and presence of genetic thrombophilic markets has the potential to induce placental thrombosis and cause placental insufficiency with subsequent obstetrical complications. The initial part of the research work involved examining the relationship between four common genetic …

Applying The Information-Motivation-Behavioral Skills Model Of Hiv- Risk To Youth In Psychiatric Care, Geri R. Donenberg, Rebecca Moss Schwartz, Erin Emerson, Helen W. Wilson, Fred B. Bryant, Gloria Coleman

Psychology: Faculty Publications and Other Works

This study examined the utility of cognitive and behavioral constructs (AIDS in-formation, motivation, and behavioral skills) in explaining sexual risk taking among 172 12–20–year-old ethnically diverse urban youths in outpatient psy-chiatric care. Structural equation modeling revealed only moderate support for the model, explaining low to moderate levels of variance in global sexual risk taking. The amount of explained variance improved when age was included as a predictor in the model. Findings shed light on the contribution of AIDS informa-tion, motivation, and behavioral skills to risky sexual behavior among teens re-ceiving outpatient psychiatric care. Results suggest that cognitive and behavioral factors …

Men, Muscles, And Body Image: Comparisons Of Competitive Bodybuilders, Weight Trainers, And Athletically Active Controls, T. C. Pickett, R. J. Lewis, T. F. Cash, H. G. Pope

Psychology Faculty Publications

Objectives: To investigate body image and psychosocial adjustment among competitive bodybuilders, non-competitive weight trainers, and athletically active men.

Methods: Participants were 40 men in each of the three groups who were assessed on body composition and multiple facets of body image evaluation, investment and anxiety, eating attitudes, and social self esteem.

Results: Relative to the other two groups, competitive bodybuilders had greater body mass due to fat-free body mass. Although groups did not differ in their situational body image discomfort, competitive bodybuilders and weight trainers had a more positive global appearance evaluation and were more psychologically invested in their physical …

Cancer Information Seeking Preferences Among Health Professionals Serving American Indians In Minnesota, North Dakota, And Wisconsin, K. Knutsen, R. Strickland, J. Matloub, P. Remington, J. Kaur

Native Health Database Full Text

This article identifies cancer information resources used by health professionals in tribal health departments or Indian Health Service clinics serving American Indian communities in Wisconsin, Minnesota and North Dakota.

2005 Navajo Middle And High School Youth Risk Behavior Survey Report, Primary Navajo Yrsb Team

Native Health Database Full Text

From 1997 to 2005, the Navajo Youth Risk Behavior Surveilance System (YRBS) was implemented to be used to monitor health-risk behaviors among youth in middle and high schools. Unhealthy risk behaviors can lead to unhealthy health conditions or injuries, and could enventually lead to health or social problems as chronic diseases, disability and drug or alcohol addictions.

The Pedagogical Significance Of The Bush Stem Cell Policy: A Window Into Bioethical Regulation In The United States (President George W. Bush, Fifth Anniversary Essay Collection), O. Carter Snead

Journal Articles

The enormous significance of the Bush stem cell funding policy has been evident since its inception. The announcement of the policy on August 9, 2001 marked the first time a U.S. president had ever taken up a matter of bioethical import as the sole subject of a major national policy address. Indeed, the August 9th speech was the President's first nationally televised policy address of any kind. Since then, the policy has been a constant focus of attention and discussion by political commentators, the print and broadcast media, advocacy organizations, scientists, elected officials, and candidates for all levels of office …

Medical Symptoms Associated With Tobacco Smoking With And Without Marijuana Abuse Among Crack Cocaine-Dependent Patients., Ashwin A. Patkar, Vikas Batra, Paolo Mannelli, Sarah Evers-Casey, Michael J. Vergare, Frank T. Leone

Department of Psychiatry and Human Behavior Faculty Papers

Despite the widespread use of tobacco and marijuana by cocaine abusers, it remains unclear whether combined tobacco and marijuana smoking is more harmful than tobacco smoking alone in cocaine abusers. We investigated the differences in medical symptoms reported among 34 crack cocaine abusers who did not smoke tobacco or marijuana (C), 86 crack cocaine abusers who also smoked tobacco (C + T), and 48 crack abusers who smoked both tobacco and marijuana (C + T + M). Medical symptoms were recorded using a 134-item self-report instrument (MILCOM), and drug use was assessed using the Addiction Severity Index (ASI). After controlling …

Ethnicity And Gender Related Differences In Extended Intraesophageal Ph Monitoring Parameters In Infants: A Retrospective Study, Dena Nazer, Ronald Thomas, Vasundhara Tolia

Wayne State University Associated BioMed Central Scholarship

Abstract

Background

Gastroesophageal reflux disease (GERD) is believed to be more common in adult males as compared to females. It also has been shown in adults to be more common in Caucasians. We wanted to determine ethnicity and gender related differences for extended pH monitoring parameters in infancy.

Methods

Extended pH monitoring data (EPM) from infants <1 year of age were reviewed. Results were classified in two groups, as control and Gastroesophageal reflux disease (GERD) group based on the reflux index (RI). The GERD group had RI of equal to or more than 5% of total monitoring period. The parameters of RI, total number of episodes of pH < 4, and the number of episodes with pH < 4 lasting more than 5 minutes were compared by genders and by ethnic groups, Caucasians and African American (AA).

Results

There were 569 infants, 388 controls, 181 with GERD (320 males, 249 females; 165 Caucasians, 375 AA). No statistical difference in EPM parameters was detected between genders in both groups. However, Caucasian infants had a significantly higher incidence of GERD than AA infants …

Correlation Of Same-Visit Hba1c Test With Laboratory-Based Measurements: A Metronet Study, Kendra L. Schwartz, Joseph C. Monsur, Monina G. Bartoces, Patricia A. West, Anne Neale

Wayne State University Associated BioMed Central Scholarship

Abstract

Background

Glycated hemoglobin (HbA1c) results vary by analytical method. Use of same-visit HbA1c testing methodology holds the promise of more efficient patient care, and improved diabetes management. Our objective was to test the feasibility of introducing a same-visit HbA1c methodology into busy family practice centers (FPC) and to calculate the correlation between the same-visit HbA1c test and the laboratory method that the clinical site was currently using for HbA1c testing.

Methods

Consecutive diabetic patients 18 years of age and older having blood samples drawn for routine laboratory analysis of HbA1c were asked to provide a capillary blood sample for …

Helicobacter Pylori Infection In Havana, Cuba. Prevalence And Caga Status Of The Strains, Beatriz Gutiérrez, Teresita Vidal, Carlos Ernesto Valmaña, Christine Camou-Juncas, Adriana Santos, Françis Mégraud, Nery González, Ibrahim Leonard, Rolando Martínez, Osvaldo Díaz-Canel, Manuel Paniagua, María Del Pilar Escobar, George L. Mendz

Medical Papers and Journal Articles

There is a great paucity of information about Helicobacter pylori infection in the countries of the Caribbean basin. Almost no studies have been performed to determine the prevalence, antibiotic resistance or virulence factors of the bacterium. To measure the prevalence of H. pylori infection among patients attending endoscopy in three clinics in Havana, Cuba, to evaluate clarithromycin resistance, and to determine the cagA status of the strains obtained. Endoscopy was performed and biopsies were obtained from 117 successive patients attending the Institute of Oncology, the Institute of Gastroenterology, and the Calixto Garcia Hospital in Havana, Cuba. Biopsies were maintained at …

Hinderin, A Five-Domains Protein Including Coiled-Coil Motifs That Binds To Smc3., Chirag A Patel, Giancarlo Ghiselli

Department of Pathology, Anatomy, and Cell Biology Faculty Papers

BACKGROUND: The structural maintenance of chromosome proteins SMC1 and SMC3 play an important role in the maintenance of chromosomal integrity by preventing the premature separation of the sister chromatids at the onset of anaphase. The two proteins are constitutive components of the multimeric complex cohesin and form dimers by interacting at their central globular regions. RESULTS: In order to identify proteins that by binding to SMC3 may interfere with the protein dimerization process, a human cDNA library was screened by the yeast two-hybrid system by using the hinge region of SMC3 as bait. This has lead to the identification of …

Palm Is Expressed In Both Developing And Adult Mouse Lens And Retina., Meryl Castellini, Louise V Wolf, Bharesh K Chauhan, Deni S Galileo, Manfred W Kilimann, Ales Cvekl, Melinda K Duncan

Department of Pathology, Anatomy, and Cell Biology Faculty Papers

BACKGROUND: Paralemmin (Palm) is a prenyl-palmitoyl anchored membrane protein that can drive membrane and process formation in neurons. Earlier studies have shown brain preferred Palm expression, although this protein is a major water insoluble protein in chicken lens fiber cells and the Palm gene may be regulated by Pax6. METHODS: The expression profile of Palm protein in the embryonic, newborn and adult mouse eye as well as dissociated retinal neurons was determined by confocal immunofluorescence. The relative mRNA levels of Palm, Palmdelphin (PalmD) and paralemmin2 (Palm2) in the lens and retina were determined by real time rt-PCR. RESULTS: In the …

Prophylactic Defibrillator Implantation—Toward An Evidence-Based Approach, Alan H. Kadish

Office of the President Publications and Research

The author discusses research on using implantable cardioverter-defibrillators for the primary prevention of sudden death.

Nanosecond Pulsed Electric Fields: A New Stimulus To Activate Intracellular Signaling, Stephen J. Beebe, Karl H. Schoenbach

Bioelectrics Publications

When new technologies are introduced into the scientific community, controversy is expected and both excitement and disappointment enrich the lives of those who initiate the new ideas. It becomes the mission of the “inventors” to embrace the burden of proof to establish their ideas and convince the skeptics and disbelievers who will undoubtedly temper their enthusiasm and test their patience. While open mindedness is generally a scientific motto, those who review patents, manuscripts, and grants do not always readily practice it, even when the evidence is convincingly presented; old ideas and concepts often die hard. So it has been and …

The Long Shadow Of Cerebral Localization, Saad Shafqat

Section of Neurology

In 1995, during my first week as a neurology resident at Massachusetts General Hospital, I had the privilege of meeting the late Raymond Adams. He was an established octogenarian by then, but the years had made no difference to his air of professionalism and academic authority. His reputation was made in the 1950s and 1960s, when he developed Boston as a major centre of clinical neurology. Among other things, he is immortalized through a famous textbook that has appeared in multiple editions. Our meeting took place at a clinical conference in which I was required to present a case. He …

Development Of A Comprehensive Epilepsy Surgery Programme In Pakistan, Mughis Sheerani

Section of Neurology

No abstract provided.