Medicine and Health Sciences Commons^™

Outcome Of Home Mechanical Ventilation, N Salahuddin, K Haider, Sj Husain, S Siddiqui, Fazal Hameed Khan, R. Manasia

Department of Anaesthesia

OBJECTIVE: To determine the outcome of patients discharged home on portable ventilator.
DESIGN: Descriptive study.
PLACE AND DURATION OF STUDY: The Aga Khan University Hospital, Karachi from January 2000 to December 2004.
PATIENTS AND METHODS: All ventilator-dependent patients discharged home were contacted. Survivors were administered the EQ-5D Quality-of-Life instrument. SPSS version 13 was used to analyze data.
RESULTS: Eleven patients were discharged home on invasive ventilation. Mean age was 49 years (range 10-98 years). Cause of ventilatory failure were cervical spine trauma in 36%, primary neurological disease in 27%, critical illness neuropathy and respiratory failure in 18% …

Menke's Kinky Hair Syndrome--A Rare Medical Condition., Yaseer Al-Bita, Azam J. Samdani, Tania Azam

Department of Medicine

The case of a 16-month-old boy is described who had typical clinical and radiological features and was proven biochemically to be a case of Menke's disease. Clinical manifestations began in the first few months with hypothermia, hypotonia, seizures and death occurring at the age of 18 months.

El Niño Causes Dramatic Outbreak Of Paederus Dermatitis In East Africa, Ingeborg M.C.J. Van Schayk, Ruben O. Agwanda, John I. Githure, John C. Beier, Bart G.J. Knols

All Peer-Reviewed Publications

An outbreak of Paederus sabaeus rove beetles in Kenya during the 1997-1998 El Niño resulted in a dramatic increase of vesicular dermatitis in its capital Nairobi. The beetle, popularly called ‘Nairobi Fly’, contains a potent toxic fluid that causes epidermolysis and acute conjunctivitis. A cross-sectional epidemiological study involving 1,208 Nairobi residents was conducted to determine the health impact of this outbreak. The results showed that one-third of the Nairobi population were infected during this period. The majority of the respondents reported lesions on exposed body parts above the shoulders. Disfiguring, painful blisters and skin rashes in and around the facial …

Ecology, Morality And Synergism, Thomas Power

Articles

This short essay looks at the views of unorthodox members of three professions. Richard Douthwaite an anti-growth economist, James Lovelock a "mythical" scientist, and Yoneji Masuda, a Japanese guru of the Information Technology age. All three assume a re-orientation of human thinking. Douthwaite's "moral society", Lovelock's "ecological society" and Masuda's "synergistic society" have little basis in reality, despite their intrinsic appeal. Despite the "high knowledge consumption" of an information age, predicted by Masuda, history teaches us that knowledge has always been used by man to gain power and not to better the lot of mankind. There is no reason to …

International Trade Agreements: Vehicle For Better Public Health?, David P. Fidler, Jason Sapsin, Ann Marie Kimball

Articles by Maurer Faculty

No abstract provided.

An Idea Whose Time Should Never Have Come, Roger B. Dworkin

Articles by Maurer Faculty

No abstract provided.

Heartland Forgiveness Scale, Laura Yamhure Thompson, C. R. Snyder, Lesa Hoffman

Department of Psychology: Faculty Publications

Abstract from: Thompson, L. Y., Snyder, C. R., Hoffman, L., Michael, S. T., Rasmussen, H. N., Billings, L. S., Heinze, L., Neufeld, J. E., Shorey, H. S., Roberts, J. C, & Roberts, D. E. (2005). Dispositional forgiveness of self, others, and situations. Journal of Personality 73: 313-359. Six studies regarding forgiveness are presented. The Heartland Forgiveness Scale (HFS), a self-report measure of dispositional forgiveness (with subscales to assess forgiveness of self, others, and situations) was developed and demonstrated good psychometric properties. Forgiveness correlated positively with cognitive flexibility, positive affect, and distraction; it correlated negatively with rumination, vengeance, and hostility. Forgiveness …

First Documentation Of Combinatorial Song Syntax In A Suboscine Passerine Species, Daniel Leger

Department of Psychology: Faculty Publications

Birds with songs having two or more acoustically distinct elements can arrange them either rigidly (i.e., in the same sequence) or flexibly. Flexible song syntax can be achieved either by varying the number of repetitions of elements or by combining elements in different ways. Combinatorial syntax has been documented only in the songs of oscine passerines and in one nonpasserine, but not in the suboscine passerines. Dawn and day songs of a tyrant flycatcher, the Flammulated Attila (Attila flammulatus), were recorded in Costa Rica. Flexible syntax was noted in both dawn and day song. Attilas not only varied …

Cooperative Brains: Psychological Constraints On The Evolution Of Altruism, Jeffrey R. Stevens, Marc D. Hauser

Department of Psychology: Faculty Publications

Imagine an individual called "hunter" that expends a good deal of energy to capture a gazelle. As the hunter is consuming his small prey, a second individual called "recipient" approaches and begins feeding peacefully alongside the hunter. A few weeks later the roles reverse, such that the previous recipient has now captured a gazelle, and the previous hunter is taking advantage of the recipient's hard work. Could the hunter and recipient be Maasai warriors? Is it equally likely that they are common chimpanzees, African lions, or Nile crocodiles? All of these species hunt gazelle and live in groups, so why …

Evolving The Psychological Mechanisms For Cooperation, Jeffrey R. Stevens, Fiery A. Cushman, Marc D. Hauser

Department of Psychology: Faculty Publications

Cooperation is common across nonhuman animal taxa, from the hunting of large game in lions to the harvesting of building materials in ants. Theorists have proposed a number of models to explain the evolution of cooperative behavior. These ultimate explanations, however, rarely consider the proximate constraints on the implementation of cooperative behavior. Here we review several types of cooperation and propose a suite of cognitive abilities required for each type to evolve. We propose that several types of cooperation, though theoretically possible and functionally adaptive, have not evolved in some animal species because of cognitive constraints. We argue, therefore, that …

The Interplay Of Traits And Motives On Volunteering: Agreeableness, Extraversion And Prosocial Value Motivation, Gustavo Carlo, Morris A. Okun, George Knight, Maria Rosario T. De Guzman

Department of Psychology: Faculty Publications

Social psychology and personality theorists have proposed that our understanding of prosocial behavior will be enhanced by examining the interplay of traits and motives. The present study was designed to test several pathways by which agreeableness, extraversion, and prosocial value motivation to volunteer influence volunteerism. A sample of 796 college students completed measures of the Big Five traits, prosocial value motivation to volunteer, and volunteering. Results of path analyses showed that prosocial value motivation to volunteer partially mediated the relations between agreeableness and extraversion, and volunteering. Furthermore, as agreeableness decreased, extraversion was more strongly related to prosocial value motivation to …

Replication And Encapsidation Of Papillomaviruses In Saccharomyces Cerevisiae, Peter C. Angeletti

Nebraska Center for Virology: Faculty Publications

Improvements in methodologies to recapitulate and study particular biological functions of the

papillomavirus life cycle have led to great advances in our knowledge of these viruses. Described in

this chapter are techniques that allow low-copy and high-copy replication of full-length human

papillomavirus (HPV) genomes, as well as assembly of virus-like particles, in Saccharomyces

cerevisiae (yeast). This system has several distinct advantages that make it an attractive complement

to the well-established raft-culturing system. First, yeast are inexpensive, rapid, and simple to culture

in the lab. Second, they provide an ever-widening array of genetic tools to analyze HPV functions

—most recently notable, …

Latency-Related Gene Encoded By Bovine Herpesvirus 1 Promotes Virus Growth And Reactivation From Latency In Tonsils Of Infected Calves, Sandra Perez, Melissa Inman, Alan R. Doster, Clinton J. Jones

School of Veterinary and Biomedical Sciences: Faculty Publications

Infection of calves with bovine herpesvirus 1 (BHV-1) results in transient immunosuppression that may lead to bacterium-induced pneumonia and, occasionally, death. Although sensory neurons in the trigeminal ganglia (TG) are the primary site of BHV-1 latency, viral genomes are detected in the tonsils of latently infected calves. Dexamethasone (DEX) consistently induces reactivation from latency, and viral gene expression is detected in TG and tonsils. In sensory neurons of latently infected calves, the latency-related (LR) gene is abundantly expressed and is required for reactivation from latency. In the present study, we compared the abilities of wild-type (wt) BHV-1 and a strain …

Factors Associated With The Presence Of Coliforms In The Feed And Water Of Feedlot Cattle, Michael W. Sanderson, Jan M. Sargeant, David G. Renter, Dicky Dee Griffin, Robert A. Smith

School of Veterinary and Biomedical Sciences: Faculty Publications

The objective of this study was to investigate coliform counts in feedlot cattle water and feed rations and their associations with management, climate, fecal material, and water Escherichia coli O157 using a cross-sectional study design. Coliform counts were performed on feed samples from 671 pens on 70 feedlots and on water samples from 702 pens on 72 feedlots in four U.S. states collected between May and August 2001. Management and climate factors were obtained by survey and observation. Month of sampling (higher in May and June), presence of corn silage in the ration (negative association), temperature of the feed 1 …

Role Of The Hypervariable Hinge Region Of Phosphoprotein P Of Vesicular Stomatitis Virus In Viral Rna Synthesis And Assembly Of Infectious Virus Particles, Subash C. Das, Asit K. Pattnaik

School of Veterinary and Biomedical Sciences: Faculty Publications

The phosphoprotein (P protein) of vesicular stomatitis virus (VSV) is an essential subunit of the viral RNAdependent RNA polymerase and has multiple functions residing in its different domains. In the present study, we examined the role of the hypervariable hinge region of P protein in viral RNA synthesis and recovery of infectious VSV by using transposon-mediated insertion mutagenesis and deletion mutagenesis. We observed that insertions of 19-amino-acid linker sequences at various positions within this region affected replication and transcription functions of the P protein to various degrees. Interestingly, one insertion mutant was completely defective in both transcription and replication. Using …

The Evaluation Of Rectal Bleeding In Adults, Elizabeth Allen, Christina Nicolaidis, Mark Helfand

School of Social Work Faculty Publications and Presentations

Colon cancer is the third leading cause of cancer-related death in this country.5 The majority of medical societies recommend some form of colon cancer screening for asymptomatic adult patients over age 50. The evaluation of rectal bleeding is different from screening because the risk of serious disease is higher and it is unclear whether early diagnosis and treatment of serious disease results in improved mortality once gross bleeding has occurred. The optimal evaluation strategy for rectal bleeding is unknown. Neither historical information nor the presence or absence of hemorrhoids has been shown to reliably differentiate benign from serious disease.6–11 Fecal …

Development And Pathogenesis Of Parelaphostrongylus Odocoilei (Nematoda: Protostrongylidae) In Experimentally Infected Thinhorn Sheep (Ovis Dalli), Emily J. Jenkins, Eric P. Hoberg, L. Polley

Harold W. Manter Laboratory of Parasitology: Faculty Publications

Recently, the protostrongylid nematode Parelaphostrongylus odocoilei has been reported in a new host species, thinhorn sheep (Ovis dalli). For the first time, we completed the life cycle of P. odocoilei in three Stone’s sheep (O. dalli stonei) and two thinhorn hybrids (O. dalli stonei × O. dalli dalli), each infected with 200 third-stage larvae from slugs (Deroceras laeve). The prepatent period ranged from 68 days to 74 days, and shedding of first-stage larvae (L1) peaked at >10,000 L1 per gram of feces between 90 and 110 days postinfection. A total of 75, …

From International Sanitary Conventions To Global Health Security: The New International Health Regulations, David P. Fidler

Articles by Maurer Faculty

In May 2005, the World Health Organization adopted the new International Health Regulations (IHR), which constitute one of the most radical and far-reaching changes to international law on public health since the beginning of international health cooperation in the mid-nineteenth century. This article comprehensively analyses the new IHR by examining the history of international law on infectious disease control, the IHR revision process, the substantive changes contained in the new IHR and concerns regarding the future of the new IHR. The article demonstrates why the new IHR constitute a seminal event in the relationship between international law and public health …

Changes In Beliefs Identify Unblinding In Randomized Controlled Trials: A Method To Meet Consort Guidelines, Judy R. Rees, Timothy J. Wade, Deborah A. Levy, John M. Colford, Joan F. Hilton

Journal Articles: Epidemiology

Double-blinded trials are often considered the gold standard for research, but significant bias may result from unblinding of participants and investigators. Although the CONSORT guidelines discuss the importance of reporting "evidence that blinding was successful", it is unclear what constitutes appropriate evidence. Among studies reporting methods to evaluate blinding effectiveness, many have compared groups with respect to the proportions correctly identifying their intervention at the end of the trial. Instead, we reasoned that participants' beliefs, and not their correctness, are more directly associated with potential bias, especially in relation to self-reported health outcomes. During the Water Evaluation Trial performed in …

Definition Of Target Antigens For Naturally Occurring Cd4+ Cd25+ Regulatory T Cells, Hiroyoshi Nishikawa, Takuma Kato, Isao Tawara, Kanako Saito, Hiroaki Ikeda, Kagemasa Kuribayashi, Paul M. Allen, Robert D. Schreiber, Shimon Sakaguchi, Lloyd J. Old, Hiroshi Shiku

Open Access Publications

No abstract provided.

An Evaluation Of The Metabolic Syndrome In A Large Multi-Ethnic Study: The Family Blood Pressure Program, Aldi T. Kraja, Dc Rao, Alan B. Weder, Thomas H. Mosley, Stephen T. Turner, Chao Agnes Hsiung, Thomas Quertermous, Richard Cooper, J David Curb, Michael A. Province

Open Access Publications

No abstract provided.

Genetic Analysis Of The Maximum Drinks Phenotype, Scott F. Saccone, Nancy L. Saccone, Rosalind J. Neuman, John P. Rice

Open Access Publications

No abstract provided.

Obesity And The Struggle Within Ourselves, Maxwell Gregg Bloche

Georgetown Law Faculty Publications and Other Works

The author argues that we ought to treat our eating, exercise habits, and girth as personal matters, for the most part, but that law can and should make a contribution, as an ally of our longer-term will against our immediate cravings. Law can be our ally in this fashion without command-and-control intrusion into our private lives. Such intrusion is at odds with our core beliefs and unlikely to produce public health success. It is more likely to provoke popular backlash--one reason why some who stand to gain from our unhealthy dining choices try to cast government efforts to inform these …

Mouse Cytomegalovirus M33 Is Necessary And Sufficient In Virus-Induced Vascular Smooth Muscle Cell Migration, Ryan Melnychuk, Patsy Smith, Craig N. Kreklywich, Franziska Ruchti, Jennifer Totonchy, Laurel Hall, Lambert Loh, Jay A. Nelson, Susan L. Orloff, Daniel N. Streblow

Pharmacy Faculty Articles and Research

Mouse cytomegalovirus (MCMV) encodes two potential seven-transmembrane-spanning proteins with homologies to cellular chemokine receptors, M33 and M78. While these virus-encoded chemokine receptors are necessary for the in vivo pathogenesis of MCMV, the function of these proteins is unknown. Since vascular smooth muscle cell (SMC) migration is of critical importance for the development of atherosclerosis and other vascular diseases, the ability of M33 to promote SMC motility was assessed. Similar to human CMV, MCMV induced the migration of mouse aortic SMCs but not mouse fibroblasts. To demonstrate whether M33 was required for MCMV-induced SMC migration, we employed interfering-RNA technology to specifically …

Quality Control During Aminoacyl-Trna Synthesis, M. Praetorius-Ibba, S. Ataide, C. Hausmann, J. Levengood, J. Ling, S. Wang, H. Roy, Michael Ibba

Biology, Chemistry, and Environmental Sciences Faculty Articles and Research

The fidelity of translation is determined at two major points: the accuracy of aminoacyl-tRNA selection by the ribosomes and synthesis of cognate amino acid/tRNA pairs by aminoacyl-tRNA synthetases (aaRSs) in the course of the aminoacylation reaction. The most important point in aminoacylation is the accurate recognition of cognate substrates coupled with discrimination of non-cognates. While this is generally accomplished by a single enzyme, we have recently found that discrimination against lysine analogues requires the existence of two unrelated lysyl-tRNA synthetases. For other amino acids, initial recognition is not sufficiently accurate with errors being corrected by an intrinsic editing activity. Recent …

Speech Interactions With Linguistic, Cognitive, And Visuomotor Tasks, Christopher Dromey, Emily Bates

Faculty Publications

Lip movements were examined across several repetitive speaking conditions (speech alone and speaking concurrently with a linguistic, cognitive, or visuomotor challenge task) in 20 young adults. Performance in these nonspeech activities was also compared between isolated tasks and concurrent speech conditions. Linguistic challenges resulted in increased spatiotemporal variability of lip displacement across repetitions. Motor challenges led to more rapid speech with smaller lip displacement. These qualitatively different changes suggest that different aspects of attention are required for linguistic versus manual visuomotor activity. Vocal intensity increased for all concurrent task conditions compared with speech alone, suggesting increased effort compared to the …

Inhibition Modifies The Effects Of Slow Calcium-Activated Potassium Channels On Epileptiform Activity In A Neuronal Network Model, Keun-Hang Susan Yang, Piotr J. Franaszczuk, Gregory K. Bergey

Mathematics, Physics, and Computer Science Faculty Articles and Research

Generation of epileptiform activity typically results from a change in the balance between network excitation and inhibition. Experimental evidence indicates that alterations of either synaptic activity or intrinsic membrane properties can produce increased network excitation. The slow Ca2+-activated K+ currents (sI AHP) are important modulators of neuronal firing rate and excitability and have important established and potential roles in epileptogenesis. While the effects of changes in sI AHP on individual neuronal excitability are readily studied and well established, the effects of such changes on network behavior are less well known. The experiments here utilize a defined small network model of …

Human Rights And Bioethics: Formulating A Universal Right To Health, Health Care, Or Health Protection?, George P. Smith Ii

Scholarly Articles

Codifying, and then implementing, an international right to health, health care, or protection is beset with serious roadblocks - foremost among them being contentious issues of indeterminacy, justiciability, and progressive realization. Although advanced - and to some degree recognized under the rubric of a social or cultural entitlement within the law of human rights and, more particularly, the U.S. Declaration on Human Rights, together with International Covenant on Economic, Social and Cultural Rights (ICESCR), the International Covenant on Civil and Political Rights, the European Convention on Human Rights, and presently UNESCO's Draft Declaration on Universal Norms on Bioethics - attainment …

Autonomic Nervous System Dysfunction Predicts Poor Prognosis In Patients With Mild To Moderate Tetanus, Mohammad Wasay, Bhojo A. Khealani, Naasha Talati, Rohmah Shamsi, Nadir Ali Syed, Naseem Salahuddin

Department of Medicine

Background

Autonomic nervous system (ANS) dysfunction is present in up to one third of patients with tetanus. The prognostic value of ANS dysfunction is known in severe tetanus but its value is not well established in mild to moderate tetanus.

Methods

Medical records of all patients admitted with tetanus at two academic tertiary care centers in Karachi, Pakistan were reviewed. The demographic, clinical and laboratory data was recorded and analyzed. ANS dysfunction was defined as presence of labile or persistent hypertension or hypotension and sinus tachycardia, tachyarrythmia or bradycardia on EKG. Patients were divided into two groups based on presence …

Management Outcome Of Residual Common Bile Duct Stones At Aga Khan University Hospital, Muhammad Rizwan Khan, Sameera Naureen, Dildar Hussain, Rizwan Azami

Department of Surgery Docs

Background: The frequency of residual common bile duct (CBD) stones in patients with previous cholecystectomy ranges from 2-10%, and a minimally invasive approach is generally recommended for these patients. This study reviews the experience in the management of residual CBD stones at the Aga Khan University Hospital.Methods: All adult patients diagnosed to have residual CBD stones, from 1993 to 2001, were identified and analyzed in terms of the treatment modality utilized and its associated complications. The role of endoscopic sphincterotomy was particularly analyzed in our set-up.Results: The study population consisted of 66 patients. The mean age was 52 (range:18-84 years) …