Medicine and Health Sciences Commons^™

Importance Of Proper Diagnosis For Management: Multifocal Choroiditis Mimicking Ocular Histoplasmosis Syndrome., Elham Hatef, Peykan Turkcuoglu, Mohamed Ibrahim, Yasir J. Sepah, Matthew Shulman, Jangwon Heo, Jeong H. Lee, Roomasa Channa, Afsheen Khwaja, Zubir Rentiya, Syed Mahmood Shah, Diana V. Do, Quan Dong Nguyen

Journal Articles: Ophthalmology

PURPOSE: The study aims to evaluate a series of patients with initial diagnosis of ocular histoplasmosis syndrome (OHS) with progression and response to treatments consistent with multifocal choroiditis (MFC).

METHODS: Retrospective review of nine patients referred for management of recurrent OHS lesions. Serology panel was conducted to rule out autoimmune and infectious causes.

RESULTS: Clinical examination revealed multiple small, punched-out peripheral chorioretinal scars, and peripapillary atrophy. Histoplasma antigen/antibody was negative in all patients. Fluorescein angiography and optical coherence tomography confirmed active inflammation in five patients. Immunomodulatory therapy (IMT) was initiated to control active inflammation. While on IMT, visual acuity stabilized …

The Prevalence And Factors Associated With Nonadherence With Arv Treatment And Cotrimoxazole Preventive Therapy Among Hiv Infected Adolescents Attending Out-Patient Hiv Clinics In Kenya, Reson Marima

Master of Medicine in Paediatrics and Child Health

Background: There is an increase in the burden of HIV infected adolescents, both those perinatally infected as well as those acquiring HIV during adolescence. Female adolescents continue to be at the highest risk for acquiring HIV; in many Southern African countries, they have a three fold risk of acquiring HIV compared to their male counterparts. Adherence to treatment among adolescents has been shown to range between 30-70%, which is unacceptably low for antiretroviral therapy (ART). Psychosocial wellbeing and social support have been shown to be possible contributing factors to adherence to ART. This relationship has not been previously evaluated among …

Update - June 2011, Loma Linda University Center For Christian Bioethics

Update

In this issue:

[ Clinical Bioethics and Religion: Robert Orr's Medical Ethics and the Faith Factor ]
-- Forging a Path for Christian Ethics (Review)
-- A Passionate, Faith-Inspired Physician - Ethicist (Review)
-- Excepts from Robert Orr's Medical Ethics and the Faith Factor

-- 2012 Jack W. Provonsha lecture opens the Alumni Postgraduate Convention
-- Editorial

[ Claritás - Clarity in Ethics Essay Contest - White Coats: Purple Pens ]
-- First-place 2010 essay winner, Gregory A, Lammert, School of Medicine, Loma Linda University

-- Dental Ethics at Loma Linda University
-- Non-violent Revolution: Blessed Are the Peacemakers
-- …

Recognizing Whether Sensors Are On The Same Body, Cory Cornelius, David Kotz

Dartmouth Scholarship

As personal health sensors become ubiquitous, we also expect them to become interoperable. That is, instead of closed, end-to-end personal health sensing systems, we envision standardized sensors wirelessly communicating their data to a device many people already carry today, the cellphone. In an open personal health sensing system, users will be able to seamlessly pair off-the-shelf sensors with their cellphone and expect the system to ıt just work. However, this ubiquity of sensors creates the potential for users to accidentally wear sensors that are not necessarily paired with their own cellphone. A husband, for example, might mistakenly wear a heart-rate …

Weaning Onto Solid Foods In Ireland: Some Of The Challenges, A. E. Bennett, A. O'Connor, N. J. Canning, E. M. Keaveney, Katherine Younger, M. Flynn

Conference Papers

No abstract provided.

Acute Vertebral Compression Fracture: Differentiation Of Malignant And Benign Causes By Diffusion Weighted Magnetic Resonance Imaging, Fatima Mubarak, Waseem Akhtar

Department of Radiology

OBJECTIVE: To evaluate the sensitivity, specificity and accuracy of diffusion weighted (DWI) magnetic resonance imaging (MRI) in the diagnosis and differentiation between benign (osteoporotic/infectious) and malignant vertebral compression fractures in comparison with histology findings and clinical follow up.

METHODS: The study was conducted at the Radiology Department, Aga Khan University Hospital (AKUH) Karachi. It was a one year cross-sectional study from 01/01/2009 to 01/01/2010. Forty patients with sixty three vertebral compression fractures were included. Diffusion-weighted sequences and apparent diffusion coefficient (ADC) images on a 1.5 T MR scanner were obtained in all patients to identify the vertebral compression fracture along …

Chronic Disease Self-Management Programs: Relevance For Persons With Dementia, Nina M. Silverstein, Alison S. Gottlieb

Gerontology Institute Publications

The context for this study is the work of the Healthy Brain Initiative. The CDC has established a cooperative agreement with the Alzheimer’s Association to develop and implement a multifaceted approach to look at cognitive health as a public health issue. Late in 2010, the Association commissioned a review of the major chronic disease prevention programs from a systems approach to begin to understand the source of findings that Medicare beneficiaries with Alzheimer’s and related disorders are much higher cost than those simply with a single chronic disease and no AD. This led to the conclusion that Chronic Disease Self‐Management …

Control Of Reflexive Saccades Following Hemispherectomy, Patricia A. Reuter-Lorenz, Troy M. Herter, Daniel Guitton

Faculty Publications

Individuals who have undergone hemispherectomy for treatment of intractable epilepsy offer a rare and valuable opportunity to examine the ability of a single cortical hemisphere to control oculomotor performance. We used peripheral auditory events to trigger saccades, thereby circumventing dense postsurgical hemianopia. In an antisaccade task, patients generated numerous unintended short-latency saccades toward contralesional auditory events, indicating pronounced limitations in the ability of a single hemicortex to exert normal inhibitory control over ipsilateral (i.e., contralesional) reflexive saccade generation. Despite reflexive errors, patients retained an ability to generate correct antisaccades in both directions. The prosaccade task revealed numerous contralesional express saccades, …

The Role Of Protein Kinase C Epsilon In Hydrogen Peroxide And Nitric Oxide Release During Oxidative Stress Caused By Extracorporeal Shockwave Lithotripsy, Edward S. Iames

PCOM Biomedical Studies Student Scholarship

Clinical extracorporeal shock wave lithotripsy (ESWL) treatment to ablate kidney stones can cause acute damage to the renal microvasculature. Accumulation of continued treatment with shockwave therapy can lead to chronic damage to the kidney, and lead to clinical hypertension. Shockwaves have been shown to stimulate endothelial cells to release superoxide (SO), which is converted to hydrogen peroxide (H₂O₂), and reacts with nitric oxide (NO) to produce peroxynitrite anion (OONO^-), creating a powerful oxidant that increases oxidative stress while simultaneously reducing NO bioavailability. Increased oxidative stress during events such as ESWL, also uncouples NO production …

Soluble Extract From The Nematode Strongyloides Stercoralis Induces Cxcr2 Dependent/Il-17 Independent Neutrophil Recruitment., Amy E. O'Connell, Kevin Redding, Jessica A. Hess, James B. Lok, Thomas J. Nolan, David Abraham

Department of Microbiology and Immunology Faculty Papers

Neutrophil recruitment via CXCR2 is required for innate and adaptive protective immunity to the larvae of Strongyloides stercoralis in mice. The goal of the present study was to determine the mechanism of CXCR2-mediated neutrophil recruitment to S. stercoralis. Mice deficient in the receptor for IL-17A and IL-17F, upstream mediators of CXCR2 ligand production, were infected with S. stercoralis larvae; there was no difference in larval survival, neutrophil recruitment, or production of CXCR2 ligands compared with wild type mice. In vivo and in vitro stimulation of neutrophils with S. stercoralis soluble extract resulted in significant neutrophil recruitment. In vitro assays demonstrated …

Oncolog, Volume 56, Number 06, June 2011, John H. Mccool, Sunni Hoseman

OncoLog MD Anderson's Report to Physicians (All issues) Archives

• MD Anderson Celebrates 70th Anniversary: Its first clinical facility was a converted Army barracks, its first headquarters was renovated residential estate near downtown Houston, and its first cancer research was conducted by four scientists in a former horse stable
• Compass: Stage II or III Soft Tissue Sarcoma-Chemotherapy and radiation therapy before or after surgery benefit patients

Smoking During Pregnancy: Its Effects On The Prevalence Of Low Birth Weight Infants, Lynda M. Colussi

Master of Public Health Program Student Publications

Objective: The purpose of this research was to determine what impact demographic characteristics and the smoking status of mothers had on the prevalence and risk for LBW births. Methods: Birth certificate data from Montgomery County, Ohio from 2006-2009 was analyzed. Among the information collected were the infant's birth weight, the mother's age, marital status, education level, race, payer status at time of delivery, WIC status, and smoking status. The impact demographic characteristics and smoking status had on the prevalence of LBW births was determined by a logistic regression model. The effect of when women smoked during pregnancy had on the …

Expression Of Microphthalmia Transcription Factor In Sentinel Lymph Nodes Of Patients With Melanoma, Minia Hellan, Michelle S. Gentile, Luay Ailabouni, George I. Salti

Department of Surgery Faculty Publications

Background: Sentinel lymph node biopsy is widely used in the management of melanoma patients. Multiple markers are used to stain sentinel lymph node tissue including S100, HMB-45 and melan A with different success. We investigated, for the first time, the use of Microphthalmia transcription factor (Mitf) staining in a larger series of sentinel lymph nodes. Mitf is a transcription factor essential for the development and survival of melanocytes. It has been introduced recently as a sensitive and specific marker for melanomas. Methods: Thirty patients with cutaneous melanoma were included in our study: twenty patients underwent sentinel lymph node biopsy; ten …

Commencement Program 2011, Loma Linda University

Commencement Programs

CONTENTS

1 | Message from the President

3 | 2011 Events of Commencement

4 | The Academic Procession

6 | Significance of Academic Regalia

8 | The Good Samaritan

9 | University History Highlights

11 | Loma Linda University Song - "Healing Love"

12 | The Speakers

20 | The University Honorees

32 | The School Honorees

53 | The Programs

• School of Medicine, 54
• School of Pharmacy, 74
• School of Dentistry, 80
• School of Science and Technology and School of Religion, 96
• School of Nursing, 111
• School of Allied Health Professions - Physical Therapy, 121
• School of Allied Health …

The Experience Of Forgiving In The Marital Relationship, Kathleen M. Leo

Seton Hall University Dissertations and Theses (ETDs)

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Rfid Techniques For Passive Electronics, Ryan Behr, David Cobos

Electrical Engineering

No abstract provided.

Enseñanza De La Medicina Tropical Mediante La Discusión De Casos Clínicos [Teaching Tropical Medicine Through Discussion Of Clinical Cases], Pedro Navarro, Luis Alfonso Colmenares Suárez, Albany Sosa, María Soto, Nathalie Chacon, Isabel Trebesch, María Antonia De La Parte, Amando Martin

Physician Assistant Studies Faculty Publications

Introducción: En los últimos años se han propuesto cambios en la enseñanza de la medicina tropical, basando la docencia en el estudiante. Objetivo: Utilizar la metodología de la discusión organizada y razonada de casos clínicos, con la participación activa del estudiante, a in de llegar a un diagnóstico presuntivo de las patologías presentadas.

Metodología: Se describe el proceso de discusión con los estudiantes de medicina tropical, de cinco pacientes con enfermedades infecciosas bacterianas (iebre tifoidea, brucelosis, leptospirosis, cólera y shigellosis), diagnosticados y tratados en la Consulta de Endemias Rurales del Instituto de Medicina Tropical y en los Servicios de …

Remote Positioning Optical Breast Magnetic Resonance Coil For Slice-Selection During Image-Guided Near-Infrared Spectroscopy Of Breast Cancer, Michael A. Mastanduno, Shudong Jiang, Brian W. Pogue, Keith D. Paulsen, Roberta Diflorio-Alexander

Dartmouth Scholarship

The design and testing of a pneumatic optical positioning interface produced with the goal of improving fiber positioning in magnetic resonance (MR)-guided diffuse spectral imaging of breast cancer is presented. The system was created for vertical positioning of optical fibers inside the MR bore during a patient exam to target suspicious lesions with MR scans for reference and collect multiple planes of optical data. The interface includes new fiber plates for mechanical and optical coupling to the breast, and was tested in phantoms and human imaging. Reconstructions with data taken in the new interface show acceptable linearity over different absorber …

Maternal And Infant Nutritional Supplementation Practices In Ireland: Implications For Clinicians And Policymakers, Roslyn Tarrant, Margaret Sheridan-Pereira, Roberta Mccarthy, Katherine Younger, John Kearney

Articles

This prospective Irish observational study examined maternal and infant nutritional supplement use. From an initial sample of 539 mothers recruited from the Coombe Women and Infants University Hospital in Dublin (during 2004-2006), 450 eligible mothers werefollowed up at 6 weeks and 6 months postpartum. Only 200 women (44.4%) complied with peri-conceptional folic acid at therecommended time with strong social patterning associated with its uptake. Almost 10% of the sample (n=44) consumed acombined multivitamin and mineral supplement during pregnancy. A vitamin D-containing supplement was provided to only 5 (1.1%)and 15 (3.3%) infants at 6 weeks and 6 months, respectively. A national …

Multimodal Spectral Imaging Of Cells Using A Transmission Diffraction Grating On A Light Microscope, Dragan Isailovic, Yang Xu, Tyler Copus, Suraj Saraswat, Surya M. Nauli

Pharmacy Faculty Articles and Research

A multimodal methodology for spectral imaging of cells is presented. The spectral imaging setup uses a transmission diffraction grating on a light microscope to concurrently record spectral images of cells and cellular organelles by fluorescence, darkfield, brightfield, and differential interference contrast (DIC) spectral microscopy. Initially, the setup was applied for fluorescence spectral imaging of yeast and mammalian cells labeled with multiple fluorophores. Fluorescence signals originating from fluorescently labeled biomolecules in cells were collected through triple or single filter cubes, separated by the grating, and imaged using a charge-coupled device (CCD) camera. Cellular components such as nuclei, cytoskeleton, and mitochondria were …

Effects Of Hypo And Iso - Tonic Intravenous Maintenance Fluids On Plasma Sodium Level In Hospitalized Children. A Double Blind Randomized Clinical Trial, Ismail Ahmed

Master of Medicine in Paediatrics and Child Health

Background: Hypotonic fluids are widely used in pediatrics and are the standard of care when giving maintenance fluids. However, there are several reports of risk of iatrogenic hyponatremia attributed to this practice in the literature. There is therefore uncertainty as to whether isotonic fluids would be the more appropriate fluid. Objectives: The primary objective was to compare effects of hypotonic and isotonic maintenance fluids on plasma sodium levels in children between the ages of 2 months and 15 years admitted at Aga Khan University Hospital (AKUH). The secondary objective was to compare effects of hypotonic and isotonic maintenance fluids on …

Role Of Phosphoinositide 3-Kinase – Akt Signaling Pathway In The Age-Related Cytokine Dysregulation In Splenic Macrophages Stimulated Via Tlr-2 Or Tlr-4 Receptors, Mosoka Papa Fallah, R. Lakshman Chelvarajan, Beth A. Garvy, Subbarao Bondada

Microbiology, Immunology, and Molecular Genetics Faculty Publications

Age-associated defects in both B-lymphocytes and macrophages in elderly result in a reduction in the efficacy of vaccines to many Gram positive bacteria like Streptococcus pneumoniae. Splenic macrophages from aged mice have been shown to have a defect in production of pro-inflammatory cytokines (IL-6, IL-12, IL-1β, TNF-α) but exhibit increased production of IL-10 upon TLR4 ligation. Here we showed that aged macrophages demonstrate similar cytokine dysregulation phenotype upon stimulation with TLR2 ligands, or killed S. pneumoniae. We hypothesized that an age-associated increase in activity of phosphatidyl inositol 3-kinase (PI3K)-Akt signaling pathway may be playing a causal role in …

Regular Post Dinner Walk; Can Be A Useful Lifestyle Modification For Gastroesophageal Reflux, Shahid Karim, Wasim Jafri, Afsheen Faryal, Shahid Majid, Mohammad Salih, Fatima Jafri, Saeed Hamid, Hasnain Ali Shah, Zohaib Nawaz, Usman Tariq

Section of Gastroenterology

OBJECTIVES: To evaluate the correlation of gastroesophageal reflux disease (GERD) symptoms with routine post dinner physical activity and time interval before going to bed, in multiethnic South Asian population.

METHODS: Prospective, cross sectional analytical, multicenter study was conducted from February 2009 to March 2010. Patient's relative sitting in outpatient clinics with no comorbids, nonsmoker and non alcoholic were included. They were asked to fill a validated GERD questionnaire and were also inquired about routine post dinner physical activity (lying, sitting, walking) and dinner-bed time interval. Odds Ratios (OR) and their 95% Confidence Intervals (CI) were estimated using Logistic Regression, with …

Pain Control For Uterine Fibroid Embolisation : An Initial Experience In East Africa., Gilbert Mwaka, Vitalis Mung’Ayi, Nigel Hacking, William. Stones

Anaesthesiology, East Africa

Uterine fibroid embolisation (UFE) generates moderate to severe post-procedural pain. We present a case series of 24 patients who underwent UFE during our first experience in managing the sometimes excruciating pain that accompanies embolisation of the uterine arteries. We also show the evolution of our protocol for post-procedural pain management from a first to second round of procedures.

Cross Talk Between O-Glcnacylation And Phosphorylation: Roles In Signaling, Transcription, And Chronic Disease, Gerald W. Hart, Chad Slawson, Genaro A. Ramirez-Correa, Olof Lagerlof

School of Medicine Publications

O-GlcNAcylation is the addition of β-D-N-acetylglucosamine to serine or threonine residues of nuclear and cytoplasmic proteins. O-linked N-acetylglucosamine (O-GlcNAc) was not discovered until the early 1980s and still remains difficult to detect and quantify. Nonetheless, O-GlcNAc is highly abundant and cycles on proteins with a timescale similar to protein phosphorylation. O-GlcNAc occurs in organisms ranging from some bacteria to protozoans and metazoans, including plants and nematodes up the evolutionary tree to man. O-GlcNAcylation is mostly on nuclear proteins, but it occurs in all intracellular compartments, including mitochondria. Recent glycomic analyses have shown that O-GlcNAcylation has surprisingly extensive …

Chronic Diseases: The Emerging Pandemic., Andre Terzic, Scott A. Waldman

Department of Pharmacology and Experimental Therapeutics Faculty Papers

According to the 2011 World Health Organization Global Status Report, of the 57 million annual global deaths – a staggering 36 million or over 63% are due to chronic diseases.¹ Four noncommunicable diseases - namely cardiovascular, cancer, diabetes, and chronic respiratory diseases - emerge as the leading cause of mortality in the world, accounting respectively for 17, 7.6, 4.2, and 1.3 million deaths based on the latest available global epidemiology data. By 2020, global deaths due to chronic diseases are projected to worsen by at least 15 to 20%. It is estimated that the four major noncommunicable diseases will …

Congenital Diaphragmatic Hernia Presenting In The Sixth Decade Mimicking Pneumonia, Saulat H. Fatimi, Nida Sajjad, Marium Muzaffar, Hashim Muhammad Hanif

Section of Cardiothoracic Surgery

Congenital diaphragmatic hernia presentation in adults is extremely rare. Patients who present with late diaphragmatic hernias complain of a wide variety of symptoms and diagnosis can be difficult. We report a case of a 64 year old male who presented with a six month history of cough, shortness of breath and weight loss. The most common strategy to treat a Bochdalek hernia is via a thoracotomy or laparotomy or both. In our patient the repair was performed with a thoracotomy.

Dynamic Contrast-Enhanced Mri Of Pancreatic Islet Transplants, Nathaniel K. Chan

Loma Linda University Electronic Theses, Dissertations & Projects

Since its discovery in 1922, insulin has been the life-saving treatment for type 1 diabetes mellitus. As the disease is caused by the loss of insulin-producing pancreatic islets, transplantation of donor islets has the potential to not only supplement insulin replacement therapy but to cure type 1 diabetes. However, long-term insulin independence (> 2 years post-transplant) remains a challenge partly due to low islet blood flow immediately following transplantation leading to hypoxic stress on islets. The goal of our studies is to improve islet engraftment by monitoring and promoting the regrowth and maturation of new islet blood vessels in a …

Dna Repair Of 8-Oxo-7,8-Dihydroguanine Lesions In Porphyromonas Gingivalis, Leroy G. Henry Jr.

Loma Linda University Electronic Theses, Dissertations & Projects

The persistence of Porphyromonas gingivalis in the inflammatory environment of the periodontal pocket requires an ability to overcome oxidative stress. DNA damage is a major consequence of oxidative stress. Unlike other organisms, a non-base excision repair mechanism for the removal of 8-oxo-7,8-dihydroguanine (8-oxoG) in P. gingivalis was suggested. Because the uvrB gene is known to be important in nucleotide excision repair, the role of this gene in the repair of oxidative stress-induced DNA damage was investigated. A 3.1 kb fragment containing the uvrB gene was PCR-amplified from the chromosomal DNA of P. gingivalis W83. This gene was insertionally inactivated using …

Novel Molecules That Regulate Bone Formation And Bone Resorption, Gabriel Robert Linares

Loma Linda University Electronic Theses, Dissertations & Projects

Osteoporosis is a disease characterized by decreased bone mass and microarchitectural deterioration of bone. Bone loss occurs when the increased bone resorption that occurs with age is not compensated by a corresponding increase in bone formation. Therefore, understanding the mechanisms which regulate bone formation and bone resorption is important for developing diagnostic and treatment strategies for osteoporosis. In my dissertation, we investigated the role of Glutaredoxin 5 (Grx5), Diabetes and Obesity Related protein (DOR), and Claudin 18 (Cldn-18), novel molecules involved in regulating bone formation and bone resorption. We demonstrated that Grx5 protects osteoblasts from oxidative stress induced apoptosis via …