Medicine and Health Sciences Commons^™

Vickie R. Shannon, Md, Vickie R. Shannon Md

Legends and Legacies Book Chapters Archives

No abstract provided.

Photo Spread, Staff

Legends and Legacies Book Chapters Archives

No abstract provided.

Elizabeth Shpall, Md, Elizabeth Shpall Md

Legends and Legacies Book Chapters Archives

No abstract provided.

Vivian H. Porche, Md, Vivian H. Porche Md

Legends and Legacies Book Chapters Archives

No abstract provided.

Kristen J. Price, Md, Kristen J. Price Md

Legends and Legacies Book Chapters Archives

No abstract provided.

Peggy T. Tinkey, Dvm, Peggy T. Tinkey Dvm

Legends and Legacies Book Chapters Archives

No abstract provided.

Margaret R. Spitz, Md, Margaret R. Spitz Md

Legends and Legacies Book Chapters Archives

No abstract provided.

Margaret L. Kripke, Phd, Margaret L. Kripke Phd

Legends and Legacies Book Chapters Archives

No abstract provided.

Razelle Kurzrock, Md, Razelle Kurzrock Md

Legends and Legacies Book Chapters Archives

No abstract provided.

Guillermina Lozano, Phd, Guillermina (Gigi) Lozano Phd

Legends and Legacies Book Chapters Archives

No abstract provided.

Karen H. Lu, Md, Karen H. Lu Md

Legends and Legacies Book Chapters Archives

No abstract provided.

Legends And Legacies: Personal Journeys Of Women Physicians At M.D. Anderson Cancer Center, Elizabeth L. Travis Phd

Legends and Legacies: Personal journeys of women physicians and scientists at M.D. Anderson Cancer Center Archives

No abstract provided.

Elevated Toll-Like Receptor 4 Expression And Signaling In Muscle From Insulin-Resistant Subjects, Sara M. Reyna, Sangeeta Ghosh, Puntip Tantiwong, C S. Reddy Meka, Phyllis Eagan, Christopher P. Jenkinson, Eugenio Cersosimo, Ralph A. Defronzo, Dawn K. Coletta, Apiradee Sriwijitkamol

School of Medicine Publications

OBJECTIVE— Tall-like receptor (TLR)4 has been implicated in the pathogenesis of free fatty acid (FFA)-induced insulin resistance by activating inflammatory pathways, including inhibitor of κB (IκB)/nuclear factor κB (NFκB). However, it is not known whether insulin-resistant subjects have abnormal TLR4 signaling. We examined whether insulin-resistant subjects have abnormal TLR4 expression and TLR4-driven (IκB/NFκB) signaling in skeletal muscle.

RESEARCH DESIGN AND METHODS— TLR4 gene expression and protein content were measured in muscle biopsies in 7 lean, 8 obese, and 14 type 2 diabetic subjects. A primary human myotube culture system was used to examine whether FFAs stimulate IκB/NFκB via TLR4 and …

Congenital Malaria, Emaduddin Siddiqui, Saira Lone, Seema Hashmi, Shahina Hanif

Department of Emergency Medicine

Congenital malaria is a rare disorder which is difficult to interpret as most of the clinical features are similar to other diseases e.g. neonatal sepsis. It is defined as the presence of malarial parasites in the peripheral smear of the newborn from twenty four hours to seven days of life. We report 12 days old newborn who presented with high grade fever, reluctant to take feed, increasing pallor, jaundiced, dehydrated and lethargic. He was hypotensive, hypoglycemic, convulsing with hepatospleenomegally. He had a clear history of maternal fever (intermittent) for last three weeks and increasing pallor. His MP test was positive. …

Repression Of The Sumo-Specific Protease Senp1 Induces P53-Dependent Premature Senescence In Normal Human Fibroblasts, Kristin E. Yates, Gregory A. Korbel, Michael Shtutman, Igor Roninson, Daniel Dimaio

Faculty Publications

The proliferative lifespan of normal somatic human cells in culture terminates in a permanent growth-arrested state known as replicative senescence. In this study, we show that RNA interference-mediated repression of the genes encoding the small ubiquitin-related modifier (SUMO)-specific proteases, Senp1, Senp2, and Senp7, induced low passage primary human fibroblasts to senesce rapidly. Following Senp1 repression, we observed a global increase in sumoylated proteins and in the number and size of nuclear SUMO-containing promyelocytic leukemia (PML) bodies. SUMO/PML bodies also increased during replicative senescence. p53 transcriptional activity was enhanced towards known p53 target genes following repression of Senp1, and inhibition of …

Effect Of Progressive Mandibular Advancement On Pharyngeal Airway Size In Anesthetized Adults, Samuel T Kuna, Lee C Woodson, Daneshvari R Solanki, Oliver Esch, Donald E Frantz, Mali Mathru

Faculty, Staff and Student Publications

BACKGROUND: General anesthesia in adult humans is associated with narrowing or complete closure of the pharyngeal airway. The purpose of this study was to determine the effect of progressive mandibular advancement on pharyngeal airway size in normal adults during intravenous infusion of propofol for anesthesia.

METHODS: Magnetic resonance imaging was performed in nine normal adults during wakefulness and during propofol anesthesia. A commercially available intraoral appliance was used to manually advance the mandible. Images were obtained during wakefulness without the appliance and during anesthesia with the participants wearing the appliance under three conditions: without mandibular advancement, advancement to 50% maximum …

Variable Judgments Of Decisional Capacity In Cognitively Impaired Research Subjects, Marion B. Patterson, Peter J. Whitehouse

Faculty Scholarship

OBJECTIVES: To compare assessments of the decisional capacity of cognitively impaired patients by research assistants (RAs) and by family caregiver/proxies and to determine whether either or both groups judge capacity differently depending on the specific (hypothetical) research enrollment decision being made. DESIGN: Cross-sectional. SETTING: Three clinics, one each in Ohio, Kentucky, and Illinois. PARTICIPANTS: One hundred forty-nine patients with established dementia diagnoses and their caregiver/proxies. MEASUREMENTS: As part of a longer interview, patients were asked about future enrollment in five hypothetical research projects with varying risks and benefits. After patients reported each decision and reasons for that decision, RAs (using …

Deletion Of Gsk-3beta In Mice Leads To Hypertrophic Cardiomyopathy Secondary To Cardiomyoblast Hyperproliferation., Risto Kerkela, Lisa Kockeritz, Katrina Macaulay, Jibin Zhou, Bradley W. Doble, Cara Beahm, Sarah Greytak, Kathleen Woulfe, Chinmay M. Trivedi, James R. Woodgett, Jonathan A. Epstein, Thomas Force, Gordon S. Huggins

Center for Translational Medicine Faculty Papers

Based on extensive preclinical data, glycogen synthase kinase-3 (GSK-3) has been proposed to be a viable drug target for a wide variety of disease states, ranging from diabetes to bipolar disorder. Since these new drugs, which will be more powerful GSK-3 inhibitors than lithium, may potentially be given to women of childbearing potential, and since it has controversially been suggested that lithium therapy might be linked to congenital cardiac defects, we asked whether GSK-3 family members are required for normal heart development in mice. We report that terminal cardiomyocyte differentiation was substantially blunted in Gsk3b(-/-) embryoid bodies. While GSK-3alpha-deficient mice …

Molecular Processes That Handle — And Mishandle — Dietary Lipids, Kevin Jon Williams

Department of Medicine Faculty Papers

Overconsumption of lipid-rich diets, in conjunction with physical inactivity, disables and kills staggering numbers of people worldwide. Recent advances in our molecular understanding of cholesterol and triglyceride transport from the small intestine to the rest of the body provide a detailed picture of the fed/fasted and active/sedentary states. Key surprises include the unexpected nature of many pivotal molecular mediators, as well as their dysregulation — but possible reversibility — in obesity, diabetes, inactivity, and related conditions. These mechanistic insights provide new opportunities to correct dyslipoproteinemia, accelerated atherosclerosis, insulin resistance, and other deadly sequelae of overnutrition and underexertion.

Minimally Invasive Papillary Carcinoma Of The Extrahepatic Bile Ducts, Samia Fatima, Zubair Ahmad, Asim Qureshi, Khurram Minhas, Inam Pal

Department of Pathology and Laboratory Medicine

Invasive papillary carcinomas of the Extrahepatic Bile Ducts (EBD) are uncommon (4-5%). The course is less aggressive than conventional adenocarcinomas of the extrahepatic bile ducts. Non-invasive and minimally invasive papillary carcinomas are even rarer, behave as in-situ carcinomas and are associated with excellent long-term prognosis. A variety of lesions of the EBD that show papillary architecture should be distinguished from papillary carcinoma. Here, we report a case of papillary carcinoma of the common bile duct showing minimal invasion. Separation of invasive from non-invasive or minimally invasive papillary carcinoma is critical in estimating the patient outcome.

Heme Induces Endothelial Tissue Factor Expression: Potential Role In Hemostatic Activation In Patients With Hemolytic Anemia, Yamaja Setty, Suhita G. Betal, Jie Zhang, Marie J. Stuart

Department of Pediatrics Faculty Papers

Objectives: We explored the possibility that heme, an inflammatory mediator and a product of intravascular hemolysis in patients with hemolytic anemia including sickle cell disease, could modulate hemostasis by an effect on endothelial tissue factor (TF) expression.

Methods: Levels of TF mRNA, protein and procoagulant activity were measured in heme-treated endothelial cells. Results: Heme induces TF expression on the surface of both macrovascular and microvascular endothelial cells in a concentration-dependent manner, with 12-fold to 50-fold induction being noted (enzyme-linked immunosorbent assay) between 1 and 100 μm heme (P < 0.05). Complementary flow cytometry studies showed that the heme-mediated endothelial TF expression was quantitatively similar to that of tumor necrosis factor-alpha (TNF-α). Heme also upregulated the expression of TF mRNA (8-fold to 26-fold), protein (20-fold to 39-fold) and procoagulant activity (5-fold to 13-fold) in endothelial cells in a time-dependent manner. The time-course of heme-mediated TF antigen expression paralleled the induction of procoagulant activity, with antibody blocking studies demonstrating specificity for TF protein. Interleukin (IL)-1α, and TNF-α are not involved in mediating the heme effect, as antibodies against these cytokines and IL-1-receptor antagonist failed to block heme-induced TF expression. Inhibition of heme-induced TF mRNA expression by sulfasalazine and curcumin suggested that the transcription factor nuclear factor kappaB is involved in mediating heme-induced TF expression in endothelial cells.

Conclusions: Our results demonstrate that heme induces TF expression by directly activating …

Phosphatidylserine-Positive Erythrocytes Bind To Immobilized And Soluble Thrombospondin-1 Via Its Heparin-Binding Domain, Suhita G. Betal, Yamaja Setty

Department of Pediatrics Faculty Papers

Phosphatidylserine (PS)-dependent erythrocyte adhesion to endothelium and sub-endothelial matrix components is mediated in part via thrombospondin (TSP). While TSP exhibits multiple cell-binding domains, the PS-binding site on TSP is unknown. Since a cell-binding domain for anionic heparin is located at the amino-terminus, we hypothesized that PS-positive red cells (PS+ve-RBCs) bind to this domain. We demonstrate that both heparin and its low-molecular-weight derivative enoxaparin (0.5-50u/ml) inhibited PS+ve-RBC adhesion to immobilized TSP in a concentration-dependent manner (21-77% inhibition, P<0.05). Pre-incubation of immobilized TSP with an antibody against the heparin-binding domain blocked PS+ve-RBC adhesion to TSP. Antibodies that recognize the collagen- and the carboxy-terminal CD47-binding domain on TSP had no effect on this process. While pre-incubation of PS+ve-RBCs with TSP-peptides from the heparin-binding domain containing the specific heparin-binding motif KKTRG inhibited PS+ve-erythrocyte adhesion to matrix TSP (P<0.001), these peptides in the immobilized form supported PS-mediated erythrocyte adhesion. A TSP-peptide lacking the binding-motif neither inhibited nor supported PS+ve-RBC adhesion. Additional experiments show that soluble-TSP also interacted with PS+ve-RBCs via its heparin-binding domain. Our results demonstrate that PS-positive erythrocytes bind to both immobilized and soluble TSP via its heparin-binding domain and that both heparin and enoxaparin, at clinically relevant concentrations, block this interaction. Other studies have shown that heparin inhibited P-selectin- and soluble-TSP-mediated sickle erythrocyte adhesion to endothelial cells. Our results taken together with the previously documented findings provide a rational basis for clinical use of heparin or its low-molecular-weight derivatives as therapeutic agents in treating vaso-occlusive pain in patients with sickle cell disease.

Utility Of Liver Biopsy In Hiv-Infected Patients Presenting With Febrile Illnesses And Inconclusive Evaluation, J. Shavadia, Sitna Mwanzi, F. Rana, Majid Twahir

Pathology, East Africa

Objectives: To determine the utility of liver biopsy in providing a diagnosis in HIVinfected patients presenting with febrile illnesses and inconclusive initial investigative work up.

Design: A retrospective descriptive study.

Setting: The Aga Khan University Hospital, Nairobi.

Subjects: Twelve in-patients with HIV disease who underwent liver biopsy following inconclusive initial investigative work up for febrile illnesses between January and December 2007.

Results: Seven out of 12 patients had granulomatous hepatitis reported on histology with characteristic tuberculous epitheloid granulomas all having stainable acid-alcohol fast bacilli on Ziehl-Nielsen (ZN) stain. The mean alkaline phosphatase (ALP) and gamma glutamyl transpeptidase (GGT) levels in …

Does Place Explain Racial Health Disparities? Quantifying The Contribution Of Residential Context To The Black/White Health Gap In The United States, Brian K. Finch, D. Phuong Do, Ricardo Basurto-Davila, Chloe E. Bird, José J. Escarce, Nicole Lurie

Faculty Publications

The persistence of the black health disadvantage has been a puzzling component of health in the United States in spite of general declines in rates of morbidity and mortality over the past century. Studies that have focused on well-established individual-level determinants of health such as socio-economic status and health behaviors have been unable to fully explain these disparities. Recent research has begun to focus on other factors such as racism, discrimination, and segregation. Variation in neighborhood context - socio-demographic composition, social aspects, and built environment - has been postulated as an additional explanation for racial disparities, but few attempts have …

Breast Cancer Survival Among Economically Disadvantaged Women: The Influences Of Delayed Diagnosis And Treatment On Mortality, Emily Rose Smith, Swann Arp Adams, Irene Prabhu Das, Matteo Bottai, Jeanette Fulton, James R. Hébert

Faculty Publications

Breast cancer affects thousands each year in the United States, and disproportionately affects certain subgroups. For example, the incidence of breast cancer in South Carolina is lower in African American compared with European American women by ~12% to 15%, but their mortality rate is twice as high as in European American women. The purpose of the study was to assess factors associated with breast cancer mortality between African American and European American women. Participants (n = 314) in South Carolina's Breast and Cervical Cancer Early Detection Program (SCBCCEDP), which provides breast cancer screening and treatment services, during the years …

Sensitivity Of The Human Circadian System To Short Wavelength (420 Nm) Light, George C. Brainard, David Silney, John P. Hanifin, Gena Glickman, Brenda Byrne, Jeffrey M. Greeson, Samar Jasser, Edward Gerner, Mark D. Rollag

Department of Neurology Faculty Papers

The circadian and neurobehavioral effects of light are primarily mediated by a retinal ganglion cell photoreceptor in the mammalian eye containing the photopigment, melanopsin. Nine action spectrum studies using rodents, monkeys, and human for these responses indicate peak sensitivities in the blue region of the visible spectrum ranging from 459 nm to 484 nm, with some disagreement in short wavelength sensitivity of the spectrum. The aim of this work was to quantify the sensitivity of human volunteers to monochromatic 420 nm light for plasma melatonin suppression. Adult female (N=14) and male (N=12) subjects participated in two studies, each employing a …

Prenatal Education: Priorities For Perinatal Nurses, Lisa Hanson

College of Nursing Faculty Research and Publications

No abstract provided.

Loneliness: A Concept Analysis, Abir K. Bekhet, Jaclene A. Zauszniewski

College of Nursing Faculty Research and Publications

TOPIC. Loneliness is a universal human experience recognized since the dawn of time, yet it is unique for every individual. Loneliness can lead to both depression and low self‐esteem.

PURPOSE. This article explicates the concept of loneliness through the examination of its conceptual definition and uses, defining attributes, related concepts, and empirical referents.

SOURCES OF INFORMATION. Literature review using hand search and database were used as sources of information.

CONCLUSION. Because loneliness is commonly encountered in nursing situations, the information provided will serve as a framework for assessment, planning, intervention, and evaluation of clients.

Variability In The Hormonally Estimated Fertile Phase Of The Menstrual Cycle, Richard J. Fehring, Mary Schneider

College of Nursing Faculty Research and Publications

The purpose of this study was to determine the variability in length of the fertile phase of the menstrual cycle with 140 participants who produced 1,060 cycles with an electronic hormonal fertility monitor. The length of the fertile phase, as defined by the first day with a threshold level of urinary E3G and ending with a second day above a threshold of LH, varied from7 days, with the most frequent length being 3 days.

A Multidisciplinary Concept Analysis Of Empowerment : Implications For Nursing., Valerie Lander Mccarthy, Linda Holbrook Freeman

Faculty and Staff Scholarship

According to the Institute of Medicine, nursing has failed to effectively shape the health care system and to advocate successfully for patients. Empowerment may be a potent tool to fulfill these responsibilities, yet nurses have not benefited from considering application of the concept to the continuum of health care advocacy in their communities, in their relationships with clients, and in their professional roles within health care organizations. This paper uses concept analysis to examine the attributes, characteristics, and uses of empowerment within diverse disciplines to clarify its meaning and explore its potential application to nursing's challenges that cross settings, disciplines, …