Medicine and Health Sciences Commons^™

Variceal Bleeding From Cirrhosis: A Clinical Review Of Causes And Pharmacotherapy Options, Hillary Aphaisuwan, Ibrahim Lala, Laura Tsu

Pharmacy Faculty Articles and Research

This home-study CPE activity has been developed to educate pharmacists on the prevention and treatment of hemorrhagic esophageal varices resulting from cirrhosis.

Osteogenic And Antimicrobial Nanoparticulate Calcium Phosphate And Poly-(D, L-Lactide-Co-Glycolide) Powders For The Treatment Of Osteomyelitis, Vuk Uskoković, Charles Hoover, Marija Vukomanović, Dragan P. Uskoković, Tejal A. Dasai, Charles Hoover, Marija Vukomanović, Dragan P. Uskoković, Tejal A. Dasai

Pharmacy Faculty Articles and Research

Development of a material for simultaneous sustained and localized delivery of antibiotics and induction of spontaneous regeneration of hard tissues affected by osteomyelitis stands for an important clinical need. In this work, a comparative analysis of the bacterial and osteoblastic cell response to two different nanoparticulate carriers of clindamycin, an antibiotic commonly prescribed in the treatment of bone infection, one composed of calcium phosphate and the other comprising poly-(D,L-lactide-co-glycolide)-coated calcium phosphate, was carried out. Three different non-cytotoxic phases of calcium phosphate, exhibiting dissolution and drug release profiles in the range of one week to two months to one year, respectively, …

The Roles Of Primary Cilia In Polycystic Kidney Disease, Samred H. Kathem, Ashraf M. Mohieldin, Surya M. Nauli

Pharmacy Faculty Articles and Research

Autosomal dominant polycystic kidney disease (ADPKD) is an inherited genetic disorder that results in progressive renal cyst formation with ultimate loss of renal function and other systemic disorders. These systemic disorders include abnormalities in cardiovascular, portal, pancreatic and gastrointestinal systems. ADPKD is considered to be among the ciliopathy diseases due to the association with abnormal primary cilia function. In order to understand the full course of primary cilia and its association with ADPKD, the structure, functions and role of primary cilia have been meticulously investigated. As a result, the focus on primary cilia has emerged to support the vital roles …

Emerging Opportunities For Pharmacists To Improve Health Care For The Poor And Underserved, Lawrence M. Brown

Pharmacy Faculty Articles and Research

The changing organization, financing, and priorities of the U.S. health care system are creating new imperatives for employers, health care insurers, hospitals, and especially interprofessional health care practitioners. The Patient Protection and Affordable Care Act (ACA) of 2010 was created with the aim of decreasing overall health care cost, improving access to health care, and improving health care quality, while including provisions that support coordinated health care practitioner collaboration within the system. This coordinated collaboration among health professions has the potential to provide comprehensive, population-based, cost-effective, and high-quality patient care and a new emphasis on health promotion, wellness, and disease …

Disparity Implications Of The Medicare Medication Therapy Management Eligibility Criteria: A Literature Review, Kiraat D. Munshi, Ya-Chen Tina Shih, Lawrence M. Brown, Samuel Dagogo-Jack, Jim Y. Wan, Junling Wang

Pharmacy Faculty Articles and Research

The emphasis on eliminating racial and ethnic disparities in healthcare has received national attention, with various policy initiatives addressing this problem and proposing solutions. However, in the current economic era requiring tight monetary constraints, emphasis is increasingly being placed on economic efficiency, which often conflicts with the equality doctrine upon which many policies have been framed. The authors’ review aims to highlight the disparity implications of one such policy provision – the predominantly utilization-based eligibility criteria for medication therapy management services under Medicare Part D – by identifying studies that have documented racial and ethnic disparities in health status and …

Prolonged Sexual Abstinence After Childbirth: Gendered Norms And Perceived Family Health Risks. Focus Group Discussions In A Tanzanian Suburb, Columba Mbekenga, Andrea B. Pembe, Elisabeth Darj, Kyllike Christensson, Pia Olsson

School of Nursing & Midwifery, East Africa

Background: Prolonged sexual abstinence after childbirth is a socio-cultural practice with health implications, and is described in several African countries, including Tanzania. This study explored discourses on prolonged postpartum sexual abstinence in relation to family health after childbirth in low-income suburbs of Dar es Salaam, Tanzania.

Methods: Data for the discourse analysis were collected through focus group discussions with first-time mothers and fathers and their support people in Ilala, Dar es Salaam, Tanzania.

Results: In this setting, prolonged sexual abstinence intended at promoting child health was the dominant discourse in the period after childbirth. Sexual relations after childbirth involved the …

Prevalence And Factors Associated With Depression Among Patients With Epilepsy In A Kenyan Tertiary Care Hospital, Nduku Kiko

Master of Medicine in Internal Medicine

Aim: To determine the prevalence and factors associated with depression in patients with epilepsy at Aga Khan University Hospital Nairobi. Design: Cross-sectional Survey Background: Depression is a recognized common co-morbidity of epilepsy that often goes untreated and has great impact on quality of life of patients and management of patients with epilepsy. Patients and Setting: Patients with epilepsy on follow up at the Aga Khan University Hospital were evaluated for presence and factors associated with depression. Methodology: The study recruited eligible patients with epilepsy who were on follow up in the neurology clinic. Beck Depression Inventory was administered to evaluate …

Early Onset Type 2 Diabetes And Associated Risk Factors, Grace Nyambura Kiraka

Master of Medicine in Clinical Pathology

Background: The incidence of type 2 diabetes in patients below the age of 40 (early onset diabetes) is markedly on the rise and has been linked increased prevalence of risk factors such as the metabolic syndrome and family history of diabetes. Objective: To determine the proportion of patients with type 2 diabetes at Aga Khan University Hospital Nairobi (AKUHN) who have early onset type 2 diabetes and the association of age of onset with risk factors (family history of diabetes, obesity, waist circumference, hypertension, low HDL cholesterol and hypertriglyceridaemia) in this group of patients. Methods: This was a cross sectional …

Primary Antiretroviral Drug Resistance Profiles Among Hiv-1 Therapy Naïve Patients In Two Referral Hospitals In Kenya, Simon Onsongo Nyangena

Master of Medicine in Clinical Pathology

Objective: To characterize antiretroviral drug resistance mutations among drug naïve patients in two referral hospitals in Kenya Background: Acquired immunodeficiency syndrome (AIDS) caused by Human immunodeficiency virus (HIV) was first described in 1982. Since then the virus has spread globally to infect millions of people. HIV was first described in Kenya in the period between 1984/1985. Currently, Kenya has an estimated HIV-1 prevalence of 6.2% with a country population of about 40 million people. With the introduction of antiretroviral drugs, the survival of most HIV patients has been prolonged markedly. However this is greatly threatened by increasing rates of antiretroviral …

Acid Ceramidase Promotes Akt Activation And Nuclear Export Of Pten Through S1p Signaling, Thomas Hendrix Beckham

MUSC Theses and Dissertations

Prostate cancer is a leading cause of cancer and cancer-related mortality in males in the United States. Acid ceramidase is frequently overexpressed in prostate cancer and catalyzes the deacylation of proapoptotic ceramide into sphingosine. Sphingosine is converted by sphingosine kinases into sphingosine 1-phosphate, which promotes numerous pro-cancer phenotypes. Due to the frequent overexpression of acid ceramidase in prostate cancer and its net cancer promoting signaling effects achieved by reducing ceramide and generating sphingosine 1-phosphate, the impact of acid ceramidase, and the lipid profiles it alters, on prostate cancer cell signaling were studied. Here we report the activation of the oncogeneic …

Patients Experiences In Magnet And Non-Magnet Hospitals: Is There A Difference?, Larry Reese Kidd

MUSC Theses and Dissertations

Study Aim: To determine the relationship between hospital Magnet status designation and patient satisfaction. Data Sources: Secondary sources, the American Nurses Credentialing Center, the American Hospital Association, and Hospital Compare HCAHPS satisfaction survey data. Methods: Independent t tests were used to examine the univariate relationship between Magnet designation and 10 satisfaction survey indicators. A multivariate analysis was conducted of the 10 patient satisfaction survey indicators on Magnet designation while controlling for organization variables. It was predicted that Magnet status would be associated with 7 of the 10 measures. Results: Magnet status was found to be positively and significantly associated with …

Role Of 18F-Fdg Pet Scan In Rheumatoid Lung Nodule: Case Report And Review Of The Literature, Christine L. Chhakchhuak, Mehdi Khosravi, Kristine M. Lohr

Internal Medicine Faculty Publications

Flourine-18 fluoro-2-deoxy-glucose (¹⁸F-FDG) positron emission tomography combined with computed tomography (PET/CT) is a useful test for the management of malignant conditions. Inflammatory and infectious processes, however, can cause increased uptake on PET scanning, often causing diagnostic dilemmas. This knowledge is important to the rheumatologist not only because of the inflammatory conditions we treat but also because certain rheumatic diseases impose an increased risk of malignancy either due to the disease itself or as a consequence of medications used to treat the rheumatic diseases. There is an increasing body of evidence investigating the role of PET scans in inflammatory …

The Doctor And The Person, Charles Volk

Quill & Scope

Physicians are inundated with information, making a life of study inevitable. But where does one draw the line? It’s difficult to justify not spending every available moment studying, as one never knows when some bit of information will save someone’s life. However, living the life of a monk is just not possible for most and personal desires to have experiences outside of medicine actually make a physician more well rounded and better able to connect with the patients in their care.

A Hole In My Heart, A Hole In My Head, Anonymous Anonymous

Quill & Scope

A call for help and collaboration, told through the experiences of a medical student on his journey towards becoming a physician, in order to eradicate a nationwide trend of student alienation and disempowerment.

My White Coat, Shmuel Golfeyz

Quill & Scope

A student’s view on the responsibilities and changes inherent in donning a medical student’s white coat for the first time.

Convocation Of Thanks, Nina Beizer, Julia Cooperman, Ali-Reza Force, Matthew Garofalo, Andrew Silapaswan, Oded Tal

Quill & Scope

The text of speeches delivered at the annual Convocation of Thanks ceremony, in remembrance of those who donated their bodies to the NYMC gross anatomy program.

Behind The Man In The Suit: Interview With The Chancellor, Julia Cooperman, Bailey Fitzgerald, Eric Routen, Joanne Liu

Quill & Scope

No abstract provided.

Kalkidan ('Promise'): Addressing Marital Transmission Of Hiv In Ethiopia, Banchiamlack Dessalegn, Annabel Erulkar

Poverty, Gender, and Youth

This program brief describes a Population Council initiative in three low-income areas of Ethiopia. Kalkidan (Amharic for “Promise”) is a three-year program designed to increase discussion and information-sharing on HIV and related topics between marital partners; to promote HIV prevention and health service utilization within marriage, including prevention of mother-to-child transmission (PMTCT) of HIV; and to build husbands’ support of their wives, as well as investment in their health and that of their children. Kalkidan recruits and trains community-based mentors to lead parallel discussion groups of husbands and wives, who periodically come together for joint sessions. The Population Council is …

Prevalence Of Vitamin D Deficiency In An Ethnic African Urban Obstetric Population In An Equatorial City Hospital, Raj Hasmukh Dodia

Master of Medicine in Obstetrics and Gynecology

Introduction: Low Vitamin D levels in pregnancy have been associated with an increased risk of gestational diabetes, pre-eclampsia, bacterial vaginosis, preterm birth, disordered fetal skeletal homeostasis, and impaired offspring lung health. As a result, current public health advice in several countries is to universally supplement Vitamin D during pregnancy. Data regarding the Vitamin D levels of the ethnic obstetric population in Kenya are not available; hence recommendations for Vitamin D supplementation have no scientific basis. Objectives of study: This research was carried out to determine the prevalence of deficiency of Vitamin D in ethnic African obstetric patients who had delivered …

The Adolescent Experience In-Depth: Using Data To Identify And Reach The Most Vulnerable Young People—Rwanda 2010, Population Council

Poverty, Gender, and Youth

“The Adolescent Experience In-Depth: Using Data to Identify and Reach the Most Vulnerable Young People: Rwanda 2010” is part of a series of Population Council guides that draw principally on data from the Demographic and Health Surveys to provide decisionmakers at all levels—from governments, nongovernmental organizations, and advocacy groups—with evidence on the situation of adolescent girls and boys and young women aged 10–24 years. The data are presented in graphs, tables, and maps (wherever possible), providing multiple formats to make the information accessible to a range of audiences. Section I is the Foreword. Section II offers brief technical notes specific …

Growing Up In Rural India: An Exploration Into The Lives Of Younger And Older Adolescents In Madhya Pradesh And Uttar Pradesh, K.G. Santhya, Shireen J. Jejeebhoy, Iram Saeed, Archana Sarkar

Poverty, Gender, and Youth

This technical report describes the situation of adolescents according to a baseline assessment conducted in selected villages in India. The objectives of the assessment were to explore the attitudes, practices, and behaviors of adolescent girls, their adolescent brothers and if married, their husbands, with regard to sexual and reproductive matters, including HIV; their perspectives on adolescent girls’ and boys’ vulnerability to HIV and ways in which it can be mitigated; and the perspectives of parents and other critical adults in the community on the vulnerability of adolescent girls and boys to HIV. Results will be used to: (1) enhance adolescent …

Financial Inclusion Of Female Garment Workers, Sigma Ainul, Md. Irfan Hossain, Sajeda Amin, Ubaidur Rob

Poverty, Gender, and Youth

Since the 1980s rapid growth in the manufacturing of ready-made garments for export has created new opportunities for women industrial workers in Bangladesh. This study explores ways of improving the financial capabilities of these young, inexperienced wage earners through a targeted program of financial education. It also aims to identify scalable financing models that can be replicated to increase the opportunities of garment workers. The project culminated in a workshop to share results from the research study and to elicit discussions and recommendations based on the findings of the study. Recommendations include a preference for in-factory training in peri-urban areas, …

Evaluation Of Filles Eveillees ("Girls Awakened"): A Pilot Program For Migrant Adolescent Girls In Domestic Service, Sarah Engebretsen

Poverty, Gender, and Youth

The Filles Éveillées (Girls Awakened) program was designed to increase social networks and skill building among migrant adolescent girls in domestic service in urban Burkina Faso. The program was piloted over two cycles: 2011–2012 in Bobo Dioulasso, and 2012–2013 in Ouagadougou and Bobo Dioulasso. According to this evaluation report, process evaluation was conducted between the two cycles to assess program effectiveness and suggest improvements for program structure, implementation, and content before launching the second cohort. Changes resulting from this process evaluation included simplifying the sexual and reproductive health program content; reordering the modules and introducing financial capabilities earlier so that …

The Ishraq Program For Out-Of-School Girls: From Pilot To Scale-Up, Mona Selim, Nahla G. Abdel-Tawab, Khaled El Sayed, Asmaa Elbadawy, Heba El Kalaawy

Poverty, Gender, and Youth

In response to the needs of adolescent girls in Egypt for improved schooling, health, and livelihood prospects, Ishraq (sunrise)—a multidimensional program for 12–15-year-old out-of-school girls—was launched in 2001 by the Population Council in collaboration with CEDPA, Save the Children, Caritas, and local nongovernmental organizations. The program combined traditional tested program elements (literacy, life skills, nutrition) with more innovative ones (sports, financial education). It focused on building a multilayered platform to support and institutionalize the program by educating and mobilizing communities around issues of importance to adolescent girls; forging partnerships between international NGOs, government institutions, and local NGOs; and building capacities …

Girls On The Move: Adolescent Girls & Migration In The Developing World, Miriam Temin, Mark R. Montgomery, Sarah Engebretsen, Kathryn M. Barker

Poverty, Gender, and Youth

Adolescent girls in developing countries are migrating to urban areas in ever greater numbers. While migration can be risky, for the majority of girls, migration can increase opportunities and economic stability and provide them with the autonomy to make decisions about their lives. Preventing the worst outcomes and helping girls succeed are essential to unlocking the benefits of migration. When migrant girls can take advantage of the benefits, they can be a powerful force for change in the developing world—improving lives and reducing poverty in their communities and countries. This Girls Count report examines the social and economic determinants of …

The Adolescent Girls Vulnerability Index: Guiding Strategic Investment In Uganda, Sajeda Amin, Karen Austrian, Michelle Chau, Kimberly Glazer, Eric P. Green, David Stewart, Marie Stoner

Poverty, Gender, and Youth

Adolescence (from the ages of 10 to 19 years) is a critical stage of human development during which children experience rapid social, physical, psychological, and emotional changes on the path from childhood to adulthood. The decisions that are made during this period of life affect not only the individual well-being of young people, but also the well-being of the entire society. The Adolescent Girls Multilevel Vulnerability Index (AGI) was developed based on a growing recognition of the need to channel resources to vital—yet highly vulnerable and vastly underserved—populations of adolescent girls in Uganda specifically, and the East and Southern Africa …

Étude De Suivi Des Adolescentes Migrantes Employées De Maison Ayant Participé À La Première Cohorte Du Programme Filles Éveillées, Sarah Engebretsen

Poverty, Gender, and Youth

La migration circulaire (du milieu rural au milieu urbain et retour), est courante parmi les adolescents et adolescentes d'Afrique occidentale, la principale motivation étant la quête de débouchés économiques, y compris le travail domestique. Les données d’efficacité programmatique disponibles s’interrompent généralement au moment de la conclusion des programmes, sans suivi des adolescents à plus longue échéance. Cette étude suit un sous-échantillon d'adolescentes migrantes employées de maison au Burkina Faso après leur participation à la première cohorte du programme pilote Filles Éveillées. Ce programme a été conçu pour offrir aux filles migrantes employées de maison l’occasion de renforcer leurs réseaux sociaux …

Breaking The Silence: Learning About Youth Sexual And Reproductive Health In Egypt [Arabic], Nahla G. Abdel-Tawab, Sally Saher, Nora El Nawawi

Poverty, Gender, and Youth

This collection of research (supported by the Ford Foundation office in Cairo) documents the Population Council’s efforts to build the capacity of young Egyptian researchers to study youth sexual and reproductive health. Understanding the needs of young Egyptians, including their sexual and reproductive health needs, is crucial for developing policies and programs that can help bring about desired changes and improve their health and well-being. Young people must be given accurate information and access to services to protect their sexual and reproductive health and to prepare them for taking on family responsibilities as they get older. This report sets the …

Discovery Of Novel Prognostic Biomarkers Of Acute Kidney Injury, Joseph Lee Alge

MUSC Theses and Dissertations

Background: Acute kidney injury is a cause of significant morbidity and mortality in hospitalized patients. Prognostic biomarkers that predict at the time of diagnosis which patients will develop severe AKI and its complications would facilitate timely intervention and could lead to improved outcomes. The urinary proteome is a logical source of candidate biomarkers of kidney injury. Methods: Urine was collected from rodents and human subjects with AKI secondary to diverse etiologies, including cardiac surgery, ischemic/hypoxic injury, and nephrotoxicity. Shotgun proteomics was used to identify candidate biomarkers in four separate discovery phase experiments. These candidates were then verified in a larger …

Synthesis And Biochemical Activities Of Antiproliferative Amino Acid And Phosphate Derivatives Of Microtubule-Disrupting Beta-Lactam Combretastatins, Niamh M. O'Boyle, Lisa M. Greene, Niall O. Keely, Shu Wang, Tadhg S. Cotter, Daniela M. Zisterer, Mary J. Meegan

Articles

The synthesis and biochemical activities of novel water-soluble β-lactam analogues of combretastatin A-4 are described. The first series of compounds investigated, β-lactam phosphate esters 7a, 8a and 9a, exhibited potent antiproliferative activity and caused microtubule disruption in human breast carcinoma-derived MCF-7 cells. They did not inhibit tubulin polymerisation in vitro, indicating that biotransformation was necessary for their antiproliferative and tubulin binding effects in MCF-7 cells. The second series of compounds, β-lactam amino acid amides (including 10k and 11l) displayed potent antiproliferative activity in MCF-7 cells, disrupted microtubules in MCF-7 cells and also inhibited the polymerisation of …