Medicine and Health Sciences Commons^™

Importance Of Measuring Non-Hdl Cholesterol In Type 2 Diabetes Patients., Nanik Ram, Bilal Ahmed, Fauzan Hashmi,, Abdul Jabbar

Department of Medicine

OBJECTIVE:

To study the correlation between Non-high-density lipoprotein and low-density lipoprotein cholesterol in patients with Type 2diabetes mellitus and the proportion of patients achieving Adult Treatment Panel III recommended goals.

METHODS:

The cross sectional study was conducted at the Diabetic Clinic, Aga Khan University Hospital, Karachi. Data of Type 2 diabetesmellitus patients who attended the clinic bewteen 2007 and 2011 was reviewed. All Type 2 diabetic patients of either gender with fasting lipid profile irrespective of taking lipid lowering therapy were included.Type-1 DM, gestational diabetes, type 2 diabetes patients with pregnancy and those with incomplete data were excluded. Correlation between …

Targeting Fibroblast Activation Protein In Tumor Stroma With Chimeric Antigen Receptor T Cells Can Inhibit Tumor Growth And Augment Host Immunity Without Severe Toxicity., Liang-Chuan S. Wang, Albert Lo, John Scholler, Jing Sun, Rajrupa S. Majumdar, Veena Kapoor, Michael Antzis, Cody E. Cotner, Laura A. Johnson, Amy C. Durham, Charalambos C. Solomides, Md, Carl H. June, Ellen Puré, Steven M. Albelda

Department of Pathology, Anatomy, and Cell Biology Faculty Papers

The majority of chimeric antigen receptor (CAR) T-cell research has focused on attacking cancer cells. Here, we show that targeting the tumor-promoting, nontransformed stromal cells using CAR T cells may offer several advantages. We developed a retroviral CAR construct specific for the mouse fibroblast activation protein (FAP), comprising a single-chain Fv FAP [monoclonal antibody (mAb) 73.3] with the CD8α hinge and transmembrane regions, and the human CD3ζ and 4-1BB activation domains. The transduced muFAP-CAR mouse T cells secreted IFN-γ and killed FAP-expressing 3T3 target cells specifically. Adoptively transferred 73.3-FAP-CAR mouse T cells selectively reduced FAP(hi) stromal cells and inhibited the …

Multidisplinary Simulation In Physical Therapist Assistant Education, Betsy J. Becker, Nikki Sleddens, Ian Thompson

Posters and Presentations: Physical Therapy

Background and Purpose: Clinical simulation has been shown to be an effective method of teaching students in a controlled environment. Utilizing a realistic setting with built-in controls, allows students to practice skills, receive instructor feedback and complete self-assessments to refine performance prior to participation in terminal clinical education. Small group instructor-led debriefing is also an essential part of the process to facilitate reflection on performance. Currently there are very few published reports of multidisciplinary simulation including physical therapist assistant (PTA) students with high fidelity simulation mannequins and live standardized patients. Traditionally PTA students have very little, if any, actual …

Evidence For The Use Of Exercise In Patients With Breast Cancer To Reduce Cancer-Related Fatigue, Betsy J. Becker

Posters and Presentations: Physical Therapy

Background & Purpose:

Cancer-related fatigue is the most commonly reported side effect of cancer treatment and affects 70-100% of patients. According to the 2013 National Comprehensive Cancer Network Guidelines on Cancer-Related Fatigue, institutions should assess the quality of fatigue management in their continuous quality improvement projects. In addition, the Guidelines also state that Medicare contracts should reimburse for fatigue management and disability insurance should include coverage for the continuing effects of fatigue.

Exercise has been suggested for breast cancer survivors as an intervention to reduce cancer-related fatigue both during and after cancer treatment. However, it has been reported that only …

Retina-Simulating Phantom For Optical Coherence Tomography., Jigesh Baxi, William Calhoun, Yasir Jamal Sepah, Daniel X. Hammer, Ilko Ilev, T. Joshua Pfefer, Quan Dong Nguyen, Anant Agrawal

Journal Articles: Ophthalmology

Optical coherence tomography (OCT) is a rapidly growing imaging modality, particularly in the field of ophthalmology. Accurate early diagnosis of diseases requires consistent and validated imaging performance. In contrast to more well-established medical imaging modalities, no standardized test methods currently exist for OCT quality assurance. We developed a retinal phantom which mimics the thickness and near-infrared optical properties of each anatomical retinal layer as well as the surface topography of the foveal pit. The fabrication process involves layer-by-layer spin coating of nanoparticle-embedded silicone films followed by laser micro-etching to modify the surface topography. The thickness of each layer and dimensions …

Language Barriers To Informed Consent For Dermatologic Interventions., Jordan Wang, Matthew Keller

Department of Dermatology and Cutaneous Biology Faculty Papers

CASE SCENARIO

A 39-year-old Spanish-speaking woman with limited English-language proficiency presents with her 13-year-old son to your private dermatology practice. Through her son, you learn the patient is worried about a mole that has significantly grown in size over the past 3 months. After examination, you recommend the nevus be biopsied to better evaluate it. However, you are barely able to communicate with the patient, and you suspect that her son is not interpreting everything you say based on his especially brief communications with her. To proceed with the biopsy, you must first obtain informed consent.

As the dermatologist, you …

Growth Of Nasal And Laryngeal Airways In Children: Implications In Breathing And Inhaled Aerosol Dynamics, Jinxiang Xi, Xiuhua Si, Yue Zhou, Jong Won Kim

University Faculty Publications and Creative Works

The human respiratory airway undergoes dramatic growth during infancy and childhood, which induces substantial variability in air flow pattern and particle deposition. However, deposition studies have typically focused on adult subjects, the results of which cannot be readily extrapolated to children. We developed models to quantify the growth of human nasallaryngeal airways at early ages, and to evaluate the impact of that growth on breathing resistance and aerosol deposition. METHODS: Four image-based nasal-laryngeal models were developed from 4 children, ages 10 days, 7 months, 3 years, and 5 years, and were compared to a nasallaryngeal model of a 53-year-old adult. …

Papillary Muscle Repositioning As A Subvalvular Apparatus Preservation Technique In Mitral Stenosis Patients With Normal Left Ventricular Systolic Function, Gokhan Lafci, Kerim Cagli, Omer Faruk Cicek, Kemal Korkmaz, Osman Turak, Alper Uzun, Adnan Yalcinkaya, Adem Diken, Eren Gunertem, Kumral Cagli

The Texas Heart Institute Journal

Subvalvular apparatus preservation is an important concept in mitral valve replacement (MVR) surgery that is performed to remedy mitral regurgitation. In this study, we sought to determine the effects of papillary muscle repositioning (PMR) on clinical outcomes and echocardiographic left ventricular function in rheumatic mitral stenosis patients who had normal left ventricular systolic function.

We prospectively assigned 115 patients who were scheduled for MVR surgery with mechanical prosthesis to either PMR or MVR-only groups. Functional class and echocardiographic variables were evaluated at baseline and at early and late postoperative follow-up examinations. All values were compared between the 2 groups.

The …

Papillary Muscle Repositioning As A Subvalvular Apparatus Preservation Technique In Mitral Stenosis Patients With Normal Left Ventricular Systolic Function, Imthiaz Manoly, Dimos Karangelis, Nicola Viola, Marcus Haw

The Texas Heart Institute Journal

Surgically repairing Bland-White-Garland syndrome (anomalous origin of the left coronary artery from the pulmonary artery) is a challenge if there are variations in the origin of the anomalous artery. We report the successful repair of this congenital abnormality in a 19-year-old woman who presented with an acute anterior myocardial infarction. The anomalous artery originated from the anterior-facing sinus of the pulmonary artery, which precluded typical repair by direct reimplantation or fashioning an intrapulmonary tunnel. We created an extrapulmonary tunnel, using a strip of pulmonary artery anteriorly and an aortic flap posteriorly. Three years postoperatively, the anastomosis was patent and the …

Systemic Effects Of Intracoronary Nitroglycerin During Coronary Angiography In Children After Heart Transplantation, Diego A Lara, Mary K Olive, James F George, Robert N Brown, Waldemar F Carlo, Edward V Colvin, Brad L Steenwyck, F Bennett Pearce

The Texas Heart Institute Journal

Coronary spasm during coronary angiography for vasculopathy in children can be prevented by the intracoronary administration of nitroglycerin. We reviewed the anesthesia and catheterization reports and charts for pediatric transplant recipients who underwent angiography from 2005 through 2010. Correlation analysis was used to study the relation of post-injection systolic blood pressure (SBP) to nitroglycerin dose. Forty-one angiographic evaluations were performed on 25 patients (13 male and 12 female). Mean age was 9.9 ± 3.2 years (range, 3.3–16.1 yr). The mean total dose of nitroglycerin was 2.93 ± 1.60 µg/kg (range, 1–8 µg/kg).

There was a significant drop between the baseline …

Repair Of Bicuspid Aortic Valve In The Presence Of Endocarditis And Leaflet Perforation, William D T Kent, Hadi D Toeg, Jehangir J Appoo

The Texas Heart Institute Journal

Aortic valve repair can be a good option in younger patients who have severe aortic regurgitation. A systematic, disease-directed approach can simplify repair. This case report describes how a simplified approach can be successfully applied to complex pathologic conditions of the aortic valve.

A 49-year-old man with a bicuspid aortic valve and a history of endocarditis presented with severe aortic regurgitation and evidence of recurrent infection. Intraoperatively, we found congenital and degenerative aortic anatomy with endocarditis and perforation. We performed aortic valve repair to enable leaflet coaptation and to adjust the coaptation height. After 24 months, the patient remained well, …

A Program For Review Of Residents On Anti-Psychotic (Ap) Medications In A County Owned Nursing Facility, Catherine M. Glew Bm, Bs, Cmd, Beth Berklite Rn, Adon, Terri Bauer Rn

Department of Medicine

No abstract provided.

Cardiac Magnetic Resonance Imaging For The Investigation Of Cardiovascular Disorders Part 1: Current Applications, Ajit H Goenka, Scott D Flamm

The Texas Heart Institute Journal

Cardiac magnetic resonance imaging is a robust noninvasive technique for investigating cardiovascular disorders. The evolution of cardiac magnetic resonance and its widening span of diagnostic and prognostic applications have generated excitement as well as uncertainty regarding its potential clinical use and its role vis-à-vis conventional imaging techniques. The purpose of this evidence-based review is to discuss some of these issues by highlighting the current (Part 1) and emerging (Part 2) applications of cardiac magnetic resonance. Familiarity with the versatility and usefulness of cardiac magnetic resonance will facilitate its wider clinical acceptance for improving the management of cardiovascular disorders.

Electrical Stimulation Technologies For Wound Healing, Luther C. Kloth

Physical Therapy Faculty Research and Publications

Objective: To discuss the physiological bases for using exogenously applied electric field (EF) energy to enhance wound healing with conductive electrical stimulation (ES) devices.

Approach: To describe the types of electrical currents that have been reported to enhance chronic wound-healing rate and closure.

Results: Commercial ES devices that generate direct current (DC), and mono and biphasic pulsed current waveforms represent the principal ES technologies which are reported to enhance wound healing.

Innovation: Wafer-thin, disposable ES technologies (wound dressings) that utilize mini or micro-batteries to deliver low-level DC for wound healing and antibacterial wound-treatment purposes are commercially available. Microfluidic wound-healing chips …

The Spectrum Of Eye Disease In Hospitalized Adults Living With Hiv, 1995-2010., Christopher Miller, William Short, Md, Mph, Lorena Perez-Povis, Josephine Lontok, Christopher Fecarotta, Mengdan Liu, Jocelyn Sendecki, Katherine Belden

Department of Medicine Faculty Papers

Eye disease is a well-documented complication of HIV infection. Opportunistic infections generally comprised the majority of pre-antiretroviral therapy (ART) eye complications. With the introduction of ART, opportunistic infections diminished. However, early ART regimens were cumbersome regarding side effects and pill burden, making patient compliance difficult. Newer ART regimens are better tolerated and consist of fewer pills, theoretically making compliance easier and therapy more effective. The aim of this chart review study is to examine eye disease epidemiology in HIV patients as ART has evolved. We reviewed 222 admissions at Thomas Jefferson University Hospitals for 188 patients. These cases were divided …

Adaptive Pair-Matching In The Search Trial And Estimation Of The Intervention Effect, Laura Balzer, Maya L. Petersen, Mark J. Van Der Laan

U.C. Berkeley Division of Biostatistics Working Paper Series

In randomized trials, pair-matching is an intuitive design strategy to protect study validity and to potentially increase study power. In a common design, candidate units are identified, and their baseline characteristics used to create the best n/2 matched pairs. Within the resulting pairs, the intervention is randomized, and the outcomes measured at the end of follow-up. We consider this design to be adaptive, because the construction of the matched pairs depends on the baseline covariates of all candidate units. As consequence, the observed data cannot be considered as n/2 independent, identically distributed (i.i.d.) pairs of units, as current practice assumes. …

Concomitant Socioeconomic, Behavioral, And Biological Factors Associated With The Disproportionate Hiv Infection Burden Among Black Men Who Have Sex With Men In 6 U.S. Cities, Kenneth H. Mayer, Lei Wang, Beryl A. Koblin, Sharon B. Mannheimer, Manya Magnus, +13 Additional Authors

Epidemiology Faculty Publications

Background

American Black men who have sex with men (MSM) are disproportionately affected by HIV, but the factors associated with this concentrated epidemic are not fully understood.

Methods

Black MSM were enrolled in 6 US cities to evaluate a multi-component prevention intervention, with the current analysis focusing on the correlates of being newly diagnosed with HIV compared to being HIV-uninfected or previously diagnosed with HIV.

Results

HPTN 061 enrolled 1553 Black MSM whose median age was 40; 30% self-identified exclusively as gay or homosexual, 29% exclusively as bisexual, and 3% as transgender. About 1/6th(16.2%) were previously diagnosed with HIV (PD); …

Hpv Vaccine Use Among African American Girls: Qualitative Formative Research Using A Participatory Social Marketing Approach, Pamela C. Hull, Elizabeth A. Williams, Dineo Khabele, Candace Dean, Brea Bond, Maureen Sanderson

Public Health, Health Administration, and Health Sciences Faculty Research

Objective

To generate recommendations for framing messages to promote HPV vaccination, specifically for African American adolescents and their parents who have not yet made a decision about the vaccine (the “Undecided” market segment).

Methods

Focus groups and interviews were conducted with African American girls ages 11–18 (N = 34) and their mothers (N = 31), broken into market segments based on daughter's vaccination status and mother's intent to vaccinate.

Results

Findings suggested that the HPV vaccine should be presented to “Undecided” mothers and adolescents as a routine vaccine (just like other vaccines) that helps prevent cancer. Within the “Undecided” segment, …

Heart Attack And Kidney Attack: Evolution Of Lay And Clinical Terms For Spontaneous, Acute Organ Injury Syndromes, Claudio Ronco, Peter A. Mccullough, Pupulan Iyngkaran, Lakhmir S. Chawla

Anesthesiology and Critical Care Medicine Faculty Publications

No abstract provided.

Galectin-1 In Early Acute Myocardial Infarction, Suhail Al-Salam, Satwat Hashmi

Department of Biological & Biomedical Sciences

Myocardial infarction (MI) is the most serious manifestation of coronary artery disease and the cause of significant mortality and morbidity worldwide. Galectin-1(GAL-1), a divalent 14.5-kDa protein, is present both inside and outside cells, and has both intracellular and extracellular functions. Hypoxia inducible factor-1 alpha (HIF-1α) is a transcription factor mediating early and late responses to myocardial ischemia. Identification of the pattern of expression of GAL-1 and HIF-1α in the heart during the first 24 hours following acute MI will help in understanding early molecular changes in this event and may provide methods to overcome serious complications. Mouse model of MI …

Examining Factors That Contribute To The Application Of Improved Nutritional Practices In Guatemala, Kim Proffit, Ashley Jensen, Dr. Vickie Johnsen

Journal of Undergraduate Research

Malnutrition is a significant problem in Guatemala. Malnutrition, and its related diseases, are part of most diagnoses of children in the hospital regardless of the reason for admission. Ruel, Habicht, Rasmussen & Martorell (1996, p. 671) report the severity of the problem, “Guatemala has one of the highest prevalences of stunting in the world.” In 2001 UNICEF reported that 29% of Guatemalan children under 5 years of age were underweight, 46% were stunted and 3% were wasting. Even in countries suffering with severe malnutrition, Zeitlin, Ghassemi, and Mansour, (1990) suggest that some children who live in poverty and have severely …

College Of Public Health News, Georgia Southern University

College of Public Health: News & Publications

• Analysis of Subgroup Data of Clinical Trials

Cost-Effectiveness Of Alternative Strategies For Annual Influenza Vaccination Among Children Aged 6 Months To 14 Years In Four Provinces In China, Lei Zhou, Sujian Situ, Zijian Feng, Charisma Y. Atkins, Isaac Chun-Hai Fung, Zhen Xu, Ting Huang, Shixiong Hu, Xianjun Wang

Epidemiology: Faculty Publications (2002-2018)

Background: To support policy making, we developed an initial model to assess the cost-effectiveness of potential strategies to increase influenza vaccination rates among children in China.

Methods: We studied on children aged 6 months to 14 years in four provinces (Shandong, Henan, Hunan, and Sichuan), with a health care system perspective. We used data from 2005/6 to 2010/11, excluding 2009/10. Costs are reported in 2010 U.S. dollars.

Results: In comparison with no vaccination, the mean (range) of Medically Attended Cases averted by the current self-payment policy for the two age groups (6 to 59 months and 60 …

Research Brief: "Caregiving Experiences And Health Conditions Of Women Veteran And Non-Veteran Caregivers", Institute For Veterans And Military Families At Syracuse University

Institute for Veterans and Military Families

This brief is a summary of women veteran caregivers experiencing health concerns, including sleeplessness, poor mental health, and some chronic conditions.

Giving Birth: Voices Of Chinese Women, Robin Kartchner, Dr. Lynn Clark Callister

Journal of Undergraduate Research

Women’s perceptions of the childbirth experience vary widely depending on the cultural context. The quality of care a childbearing woman receives is deeply influenced by the cultural understanding the nurse brings to their health care interaction. The purpose of this study was to examine the childbirth experiences of Chinese women living in Utah. It builds on a previous study with Chinese women living in China conducted by the researcher last year.

Nursing Curricula Changes: Reflections Of Shifts In Health Care Delivery, Chloe Allen Maycock, Dr. Cynthia O'Neill Conger

Journal of Undergraduate Research

My ORCA grant resulted in a 50 page thesis that I submitted for graduation with University Honors. The thesis was completed between April 1997 and August 1998. The focus of my thesis was change in nursing curricula. The convergence of change and nursing curricula are inevitable. In order to understand the underlying forces of change relating to nursing curricula, change, curricula, and the cumulative implications for nursing practice and education were reported. These concepts provided the foundation and significance for research questions aimed at determining why and how nursing curricula are changing. Research questions included: (a) are nursing curricula changing …

Novel Pharmacologic Targeting Of Tight Junctions And Focal Adhesions In Prostate Cancer Cells, Patrick J. Hensley, Andreas Desiniotis, Chi Wang, Arnold J. Stromberg, Ching-Shih Chen, Natasha Kyprianou

Surgery Faculty Publications

Cancer cell resistance to anoikis driven by aberrant signaling sustained by the tumor microenvironment confers high invasive potential and therapeutic resistance. We recently generated a novel lead quinazoline-based Doxazosin® derivative, DZ-50, which impairs tumor growth and metastasis via anoikis. Genome-wide analysis in the human prostate cancer cell line DU-145 identified primary downregulated targets of DZ-50, including genes involved in focal adhesion integrity (fibronectin, integrin-α6 and talin), tight junction formation (claudin-11) as well as insulin growth factor binding protein 3 (IGFBP-3) and the angiogenesis modulator thrombospondin 1 (TSP-1). Confocal microscopy demonstrated structural disruption of both focal adhesions and tight junctions by …

Electrophoretic Particle Guidance Significantly Enhances Olfactory Drug Delivery: A Feasibility Study, Jinxiang Xi, Xiuhua A. Si, Rachel Gaide

University Faculty Publications and Creative Works

Intranasal olfactory drug delivery provides a non-invasive method that bypasses the Blood-Brain-Barrier and directly delivers medication to the brain and spinal cord. However, a device designed specifically for olfactory delivery has not yet been found. Methods: In this study, a new delivery method was proposed that utilized electrophoretic forces to guide drug particles to the olfactory region. The feasibility of this method was numerically evaluated in both idealized 2-D and anatomically accurate 3-D nose models. The influence of nasal airflow, electrode strength, and drug release position were also studied on the olfactory delivery efficiency. Findings: Results showed that by applying …

The Santa Clara, 2014-01-30, Santa Clara University

The Santa Clara

No abstract provided.

Measuring Patient Satisfaction In Multidisciplinary Cancer Centers: Optimize Use Of Results To Effect Change And Improve Processes, Mary-Kate Cellmer, Bs

Kimmel Cancer Center Papers, Presentations, and Grand Rounds

Jefferson¹s Kimmel Cancer Center¹s multidisciplinary centers were established in 1994. The centers are a collaborative effort among radiation oncologists, medical oncologists, surgeons and other specialists involved in leading-edge cancer treatments.

The multidisciplinary center sees patients on the following days:

• Monday: Brain and Metastatic Uveal Melanoma
• Tuesday: Thoracic/Aerodigestive and Senior Adult Oncology
• Wednesday: Genitourinary and Liver
• Thursday: Small Renal Mass
• Friday: Senior Adult Oncology