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Articles 1 - 13 of 13
Full-Text Articles in Medicine and Health Sciences
Balancing Safety And Availability: A Historical Perspective On The Pace Of Drug Approval, 1950s-2009., Fabienne C. Meier-Abt
Balancing Safety And Availability: A Historical Perspective On The Pace Of Drug Approval, 1950s-2009., Fabienne C. Meier-Abt
Yale Medicine Thesis Digital Library
BALANCING SAFETY AND AVAILABILITY: A HISTORICAL PERSPECTIVE ON THE PACE OF DRUG APPROVAL, 1950s-2009. Fabienne C. Meier-Abt and Bruno J. Strasser. Department of History of Medicine, Yale University, School of Medicine, New Haven, CT. Over the course of the past 50 years, drug approval processes have ranged from 42 days to more than 10 years. What are the consequences of slow or rapid drug approvals on drug safety and drug availability? How slow is too slow? How fast is too fast? These questions have engaged the public, the government, physicians and the pharmaceutical industry for decades. This essay adopts a …
Forehead Laser Doppler And Transcranial Doppler During Simulated Hypovolemia, Kathleen Samuels
Forehead Laser Doppler And Transcranial Doppler During Simulated Hypovolemia, Kathleen Samuels
Yale Medicine Thesis Digital Library
The present study employed lower body negative pressure (LBNP), a rapidly titratable, safe and reversible means of inducing simulated hypovolemia, for a comparison of transcranial Doppler (TCD) ultrasound of the middle cerebral artery and laser Doppler (LD) flowmetry of the forehead microvasculature. With IRB approval, 9 healthy volunteers (26.3±2.7 years) were monitored continuously with EKG, noninvasive finger arterial blood pressure (BP), and TCD positioned at the transtemporal window. After a baseline (Base) period, subjects underwent rapid onset of LBNP to -70 mmHg over the course of 1 minute, followed by progressive declines of ~10 mmHg until lightheadedness or had a …
Development And Localization Of Spike-Wave Seizures In Animal Models, Damien Jon Ellens
Development And Localization Of Spike-Wave Seizures In Animal Models, Damien Jon Ellens
Yale Medicine Thesis Digital Library
Animal models allow for detailed investigation of neuronal function, particularly invasive localization and developmental studies not possible in humans. This thesis will review the technical challenges of simultaneous EEG-fMRI, and epileptogenesis studies in animal models, including issues related to anesthesia, movement, signal artifact, physiology, electrode compatibility, data acquisition, and data analysis, and review recent findings from simultaneous EEG-fMRI studies in epilepsy and other fields. Original research will be presented on the localization of neuronal networks involved during spike-and-wave seizures in the WAG/Rij rat, a model of human absence epilepsy. Simultaneous EEG-fMRI at 9 Tesla, complimented by parallel electrophysiology, including Multiple …
Hemangiomas Of Infancy: Mesenchymal Stem Cell Tumors Of Perivascular Origin, Christopher Spock
Hemangiomas Of Infancy: Mesenchymal Stem Cell Tumors Of Perivascular Origin, Christopher Spock
Yale Medicine Thesis Digital Library
Introduction: Hemangiomas of infancy (HOI) are the most common benign tumor of childhood. Initially thought to be composed entirely of endothelial cells, it has recently been shown that mesenchymal stem cells reside within these tumors. We propose that hemangiomas represent mesenchymal stem cell tumors of pericyte origin, as demonstrated by expression of pericytic markers (NG2, PDGFR-β, and DLK), neural crest origin (expression of nestin and sox10), expression of factors that play a role in the maintenance of stem cell pluripotency (Oct4, Sox2, Nanog, C-myc, and piRNAs), and a microRNA expression profile suggestive of mesenchymal stem cells. Methods: Quantitative RT-PCR was …
Comparison Of Four Different Embolic Materials For Uterine Artery Embolization In Post-Procedure Mri Enhancement, Steven David Abramowitz
Comparison Of Four Different Embolic Materials For Uterine Artery Embolization In Post-Procedure Mri Enhancement, Steven David Abramowitz
Yale Medicine Thesis Digital Library
The aim of this study was to assess embolic agent equivalency in uterine artery embolization (UAE) using post-procedure MRI enhancement of uterine fibroids in patients embolized using Embosphere Microspheres, (EM) Contour SE spheres (CSE), Poly-Vinyl Alcohol particles (PVA) and Bead Block spheres (BB). A total of 84 women with 6-month MRI follow-up constituted this retrospective study. Within this group, 25 women were treated with PVA, 23 were treated with CSE, 19 were treated with EM and 17 were treated with BB. Pre- and post-procedure MRI exams were analyzed for the total number of fibroids present in the uterus of each …
Polymorphisms And Biologic Effects Of Acidic Mammalian Chitinase In Asthma, Heather Wachtel
Polymorphisms And Biologic Effects Of Acidic Mammalian Chitinase In Asthma, Heather Wachtel
Yale Medicine Thesis Digital Library
In this study, we hypothesize that human acidic mammalian chitinase (AMCase) binds and is regulated by the epidermal growth factor receptor (EGFR), and that AMCase interacts with Galectin-3 (Gal-3) to mediate anti-apoptotic functions. We further hypothesize that asthma-associated polymorphisms of AMCase alter chitinase activity and modulate anti-apoptotic effects. We investigated the interactions between AMCase, Gal-3 and EGFR by establishing binding and co-expression in vitro; apoptotic effects were evaluated via Annexin V/Propidium Iodide staining. Molecular cloning was performed to generate single nucleotide polymorphisms (SNPs) of AMCase associated with asthma. Our data showed that co-expression of AMCase and EGFR induces chitinase activity; …
The Rate And Time Course Of Complications In Catheter-Dependent Hemodialysis Patients, Shreya Sood
The Rate And Time Course Of Complications In Catheter-Dependent Hemodialysis Patients, Shreya Sood
Yale Medicine Thesis Digital Library
Many patients with end-stage renal disease come to rely on catheters as their only means of hemodialysis when other options are no longer viable. These patients have a very poor quality of life due to their chronic illness as well as many long-term complications related to the use of tunneled catheters. Many prior attempts have been made to understand these catheter-related problems. Yet, they continue to be a major cause of morbidity and mortality in chronic catheter-reliant patients. We hope to examine the rate as well as long term time course of these complications such that in future, we may …
A Survey Of Radiology Practices' Use Of After-Hours Services, Adam Harris Kaye
A Survey Of Radiology Practices' Use Of After-Hours Services, Adam Harris Kaye
Yale Medicine Thesis Digital Library
Purpose: To identify the characteristics of and the motives behind radiologists use, or lack thereof, of after-hours services. Methods: From August 2005 to June 2006, 300 non-specialty hospitals randomly selected from the 2005 American Hospital Association Directory of Hospitals were contacted by phone, email, and mail, with an attempt made to speak to the chief of radiology. We obtained 115 responses, a 38.3% response rate, including 64 from practices that used an external after-hours service. Responses were analyzed using descriptive statistical analyses. Results Practices gave convenience as the most important reason they use an after-hours services, with value for recruiting …
The Role Of Frizzled-1 And Frizzled-3 In Olfactory Sensory Neuronal Targeting, Mina Safain
The Role Of Frizzled-1 And Frizzled-3 In Olfactory Sensory Neuronal Targeting, Mina Safain
Yale Medicine Thesis Digital Library
THE ROLE OF FRIZZLED-1 AND FRIZZLED-3 IN OLFACTORY SENSORY NEURONAL TARGETING. Mina G. Safain. Department of Neurosurgery, Yale University School of Medicine, New Haven, CT. While most areas of the brain do not exhibit profound neurogenesis or continuing synaptogenesis in the adult, there are notable exceptions which include the olfactory and hippocampal regions of the nervous system. In the olfactory system the olfactory sensory neurons continually turn over and extend their axons into the olfactory bulb in a highly precise manner. Some preliminary data exists that suggests the presence of Wnt and Frizzled (Fz) family members in the primary olfactory …
Psychiatric Illness In The Next-Of-Kin Of Intensive Care Unit Patients, Janelle Katie Moulder
Psychiatric Illness In The Next-Of-Kin Of Intensive Care Unit Patients, Janelle Katie Moulder
Yale Medicine Thesis Digital Library
The prevalence of psychiatric symptoms in next-of-kin (NOK) of intensive care unit (ICU) patients has been reported at higher than 70% when screening is performed using the Hospital Anxiety and Depression Scale (HADS). The primary purpose of this study was to assess the ability of the HADS to predict psychiatric illness, diagnosed with the aide of a validated tool, the Structured Clinical Interview for DSM-IV (SCID). In addition, we asked NOK to rate aspects of the ICU experience to determine possible associations with psychiatric diagnosis. Thirty-four NOK were enrolled in this study from July 2006 to November 2006. Subjects were …
Chest X-Ray Clues To Osteoporosis : Criteria, Correlations, And Consistency, Natalie Renee Simmons
Chest X-Ray Clues To Osteoporosis : Criteria, Correlations, And Consistency, Natalie Renee Simmons
Yale Medicine Thesis Digital Library
The purpose of this study was to determine whether radiologists could accurately assess osteopenia on chest plain films. Two chest radiologists evaluated lateral chest films from 100 patients (80 female and 20 male), ranging in age from 16 to 86 years, for osteopenia and its associated findings. Intra- and interobserver agreement was determined using weighted kappa statistics, and accuracy was assessed by making comparisons to bone mineral density as measured by the non-invasive gold standard of dual-energy x-ray absorptiometry (DXA). Overall, radiologists were good at identifying signs of late, but not early, disease. Intraobserver consistency was substantial for fish vertebrae …
Autologous Stem Cell Transplantation In Elderly Patients With Non-Hodgkin's Lymphoma, Joel Robert Green
Autologous Stem Cell Transplantation In Elderly Patients With Non-Hodgkin's Lymphoma, Joel Robert Green
Yale Medicine Thesis Digital Library
Clinical trials investigating autologous stem cell transplantation (ASCT) have historically excluded elderly patients due to the risk of treatment-related morbidity related to the administration of high dose chemotherapy. While the availability of this procedure continues to expand, the elderly still represent a population for which the role of ASCT needs to be fully defined. 201 patients who underwent autologous stem cell transplantation (ASCT) for Non Hodgkins lymphoma (NHL) at a single institution following BEAM conditioning between January 1, 2000 and December 31, 2007 were retrospectively identified from the Yale University School of Medicine Bone Marrow Transplant Database. 67 patients were …
Creating A Path For High Quality Care: Implementation Of The Mini-Cex In A Student-Run Clinic, Paul Daniel Di Capua
Creating A Path For High Quality Care: Implementation Of The Mini-Cex In A Student-Run Clinic, Paul Daniel Di Capua
Yale Medicine Thesis Digital Library
Purpose: This study examines the utility of implementing the mini-CEX at a student-run primary care clinic. The mini-CEX is a validated tool for clinical skills feedback and evaluation. The implementation of the mini-CEX sought to improve quality standards in providers clinical skills, and therefore to set a model for continuous quality improvement in medical education. Hypothesis: The primary hypothesis tested is that a minimum of three mini-CEXs per week will produce a positive utility for both students and faculty. Methods: A needs-based analysis focus group solicited opinions on the mission and function of the clinic from the student-providers. The mini-CEX …