Medicine and Health Sciences Commons^™

Accuracy Of Echocardiography In Diagnosing Total Anomalous Pulmonary Venous Return, Fatima Ali, Sonia Qureshi, Muneer Amanullah, Mehnaz Atiq

Department of Paediatrics and Child Health

Objective: Total anomalous pulmonary venous return is an uncommon cyanotic congenital heart defect. Echocardiography is the initial diagnostic tool. Complimentary non-invasive modalities like cardiac computerized tomographic angiography and cardiac magnetic resonance imaging have replaced the need for cardiac catheterization in difficult cases. This study aimed to determine the accuracy of echocardiography in diagnosing total anomalous pulmonary venous return, and to determine the factors that may decrease its sensitivity.
Methods: This was a cross-sectional study conducted at the Aga Khan University Hospital Karachi, Pakistan from January 2010 to August 2016. All patients who were diagnosed with Total anomalous pulmonary venous return …

Impact Of Pre-Existing Treatment With Statins On The Course And Outcome Of Tick-Borne Encephalitis, Petra Bogovic, Lara Lusa, Dasa Stupica, Tereza Rojko, Misa Korva, Gary P. Wormser, Franc Strle

NYMC Faculty Publications

OBJECTIVES: Although statins have anti-inflammatory and potentially also antimicrobial (including antiviral) activity, their therapeutic impact on infectious diseases is controversial. In this study, we evaluated whether pre-existing statin use influenced the course and outcome of tick-borne encephalitis. METHODS: To assess the influence of statin usage on the severity of acute illness and the outcome of tick-borne encephalitis, univariate and multivariable analyses were performed for 700 adult patients with tick-borne encephalitis of whom 77 (11%) were being treated with statins, and for 410 patients of whom 53 (13%) were receiving statins, respectively. RESULTS: Multivariable analyses found no statistically significant association between …

Early Detection And Management Of Massive Intraoperative Pulmonary Embolism In A Patient Undergoing Repair Of A Traumatic Acetabular Fracture, Tobechi E. Okoronkwo, Xuewei Zhang, Jessica Dworet, Matthew Wecksell

NYMC Faculty Publications

A 73-year-old male with history of hyperlipidemia and osteoarthritis was transferred from an outside hospital after a fall from a ladder at home. He sustained a severe right sided acetabular fracture involving the femoral head, requiring operative repair. Preoperative evaluation was unremarkable except for oxygen saturation < 95 %. After induction of anesthesia and surgical positioning, the patient went into cardiac arrest. After intraoperative cardiopulmonary resuscitation (CPR) and placement on extracorporeal membrane oxygenation (ECMO), the patient stabilized. Cardiac catheterization revealed a large left pulmonary embolism. Here, we discuss the etiology and management of intraoperative pulmonary embolism.

Cystamine And Cysteamine As Inhibitors Of Transglutaminases In Vivo, Thomas M. Jeitner, John T. Pinto, Arthur J. L. Cooper

NYMC Faculty Publications

Cystamine is commonly used as a transglutaminase inhibitor. This disulfide undergoes reduction in vivo to the aminothiol compound, cysteamine. Thus, the mechanism by which cystamine inhibits transglutaminase activity in vivo could be due to either cystamine or cysteamine, which depends on the local redox environment. Cystamine inactivates transglutaminases by promoting the oxidation of two vicinal cysteine residues on the enzyme to an allosteric disulfide, whereas cysteamine acts as a competitive inhibitor for transamidation reaction catalyzed by this enzyme. The latter mechanism is likely to result in the formation of a unique biomarker, N -(gamma-glutamyl)cysteamine that could serve to indicate how …

Cariprazine For Acute And Maintenance Treatment Of Adults With Schizophrenia: An Evidence-Based Review And Place In Therapy, Leslie L. Citrome

NYMC Faculty Publications

Cariprazine is an oral antipsychotic approved in the US and EU for the treatment of schizophrenia. Cariprazine differs from other antipsychotics in that it is a dopamine D3- and D2-receptor partial agonist, with tenfold higher affinity for D3 receptors than for D2 receptors. Cariprazine is metabolized in two steps by CYP3A4 to didesmethyl-cariprazine (DDCAR). DDCAR has a long half-life of 1-3 weeks and is the predominant circulating active moiety. Efficacy and safety in persons with acute schizophrenia were assessed in four similarly designed, short-term, randomized, placebo-controlled clinical trials in nonelderly adults, with three studies considered positive and yielding a number …

Statistical Analysis Plan (Sap) For The Very Early Rehabilitation In Speech (Verse) After Stroke Trial: An International 3-Arm Clinical Trial To Determine The Effectiveness Of Early, Intensive, Prescribed, Direct Aphasia Therapy, Erin Godecke, Tapan Rai, Dominique A Cadilhac, Elizabeth Armstrong, Sandy Middleton, Natalie Ciccone, Anne Whitworth, Miranda L Rose, Audrey Holland, Fiona Ellery, Graeme J Hankey, Julie Bernhardt

Research outputs 2014 to 2021

Background Limited evidence exists to support very early intensive aphasia rehabilitation after stroke. VERSE is a PROBE trial designed to determine whether two types of intensive aphasia therapy, beginning within 14 days of acute stroke, provide greater therapeutic and cost-effectiveness than usual care. Objective To publish the detailed statistical analysis plan for the VERSE trial prior to unblinding. This statistical analysis plan was based on the published and registered VERSE trial protocol and was developed by the blinded steering committee and management team, led by the trial statistician. This plan was developed using outcome measures and trial data collection forms. …

Proposing A Transactional Model Of Ehealth Literacy: Concept Analysis, Samantha R. Paige, Michael Stellefson, Janice L. Krieger, Charkarra Anderson-Lewis, Jeewon Cheong, Christine Stopka

Faculty Publications

Background: Electronic health (eHealth) literacy was conceptualized in 2006 as the ability of internet users to locate, evaluate, and act upon web-based health information. Now, advances in eHealth technology have cultivated transactional opportunities for patients to access, share, and monitor health information. However, empirical evidence shows that existing models and measures of eHealth literacy have limited theoretical underpinnings that reflect the transactional capabilities of eHealth. This paper describes a conceptual model based on the Transactional Model of Communication (TMC), in which eHealth literacy is described as an intrapersonal skillset hypothesized as being dynamic; reciprocal; and shaped by social, relational, and …

Regeneration Of Neurotransmission Transcriptome In A Model Of Epileptic Encephalopathy After Antiinflammatory Treatment, Dumitru Iacobas, Libor Velisek

NYMC Faculty Publications

Inflammation is an established etiopathogenesis factor of infantile spasms (IS), a therapy-resistant epileptic syndrome of infancy. We investigated the IS-associated transcriptomic alterations of neurotransmission in rat hypothalamic arcuate nucleus, how they are corrected by antiinflamatory treatments and whether there are sex differences. IS was triggered by repeated intraperitoneal administration of N-methyl-D-aspartic acid following anti-inflammatory treatment (adreno-cortico-tropic-hormone (ACTH) or PMX53) or normal saline vehicle to prenatally exposed to betamethasone young rats. We found that treatments with both ACTH and PMX53 resulted in substantial recovery of the genomic fabrics of all types of synaptic transmission altered by IS. While ACTH represents the …

Upregulation Of Pdl1 Expression By Resveratrol And Piceatannol In Breast And Colorectal Cancer Cells Occurs Via Hdac3/P300-Mediated Nfkappab Signaling, Justin Lucas, Tze-Chen Hsieh, Dorota Halicka, Zbigniew Darzynkiewicz, Joseph M. Wu

NYMC Faculty Publications

Programmed cell death ligand 1 (PDL1) expressed in cancer cells interacting with its receptor programmed cell death 1 (PD1) expressed in immune cells represents a regulatory axis linked to the suppression and evasion of host immune functions. The blockade of PD1/PDL1 interaction using monoclonal antibodies has emerged as an effective therapy for several solid tumors; however, durable response has been observed in a subset of patients with PDL1-positive tumors. Thus, the understanding of the mechanisms responsible for the expression of PDL1 in tumor cells may help to improve the response to PDL1 blockade therapies. In this study, we investigated whether …

Evaluation Of Bleeding Disorders In Patients With Noonan Syndrome: A Systematic Review, Diane J. Nugent, Alicia A. Romano, Shreya Sabharwal, David L. Cooper

NYMC Faculty Publications

Background: Noonan syndrome (NS) is an autosomal dominant genetic condition that has a number of clinical features, including bleeding diathesis and a number of hematological abnormalities including clotting factor deficiencies, von Willebrand disease and abnormal platelet count/function. Methods: We evaluated the frequency/types of bleeding disorders, and associated hematological laboratory findings, in patients with NS, using published data from 1965 to 2014. Results: Of 45 studies identified, 31 included data for 428 patients with NS. Of these patients, 43% had reported bleeding, 26% had no reported bleeding and no bleed data was reported for 31%. Most patients (90%) had bleeding-related laboratory …

Ethanol Enhances Estrogen Mediated Angiogenesis In Breast Cancer, Rachana Maniyar, Sanjukta Chakraborty, Robert Suriano

NYMC Faculty Publications

Angiogenesis, a highly regulated process, is exploited by tumors like breast cancer to ensure a constant supply of oxygen and nutrients and is key for tumor survival and progression. Estrogen and alcohol independently have been observed to contribute to angiogenesis in breast cancer but their combinatorial effects have never been evaluated. The exact mechanism by which estrogen and alcohol contribute to breast cancer angiogenesis remains to be elucidated. In this study, we defined the in vitro effects of the combination of estrogen and alcohol in breast cancer angiogenesis using the tubulogenesis and scratch wound assays. Conditioned media, generated by culturing …

Using Enamel Matrix Derivative To Improve Treatment Efficacy In Periodontal Furcation Defects, Reza Masaeli, Kavosh Zandsalimi, Zahra Lotfi, Lobat Tayebi

School of Dentistry Faculty Research and Publications

Purpose

Furcations are complicated periodontal defects. Untreated furcations lead to loss of the involved teeth and supporting tissues. It has been demonstrated that regenerative biomaterials are beneficial in reconstruction of the bone surrounding furcation‐affected teeth. These biomaterials range from bone grafts and nonresorbable/resorbable barrier membranes to biologics that are able to trigger inactive regenerative processes in periodontal tissues. Selection of appropriate material(s) to treat furcations is challenging. The aim of this article is to provide a comparative outlook on different biomaterials applicable in regeneration of furcations with a focus on enamel matrix derivative (EMD).

Methods

Scientific databases including PubMed/MEDLINE, ScienceDirect, …

Intra-Tracheal Extension Of Hilar Mass Mimicking Severe Asthma: Anesthesiologist Perspective, Khalid M Siddiqui, Muhammad Faisal Khan, Muhammad A. Asghar, Syed S. Uddin

Department of Anaesthesia

No abstract provided.

Postoperative Pain Management Practices And Their Effectiveness After Major Gynecological Surgery: An Observational Study In A Tertiary Care Hospital, Samina Ismail, Sarfraz Siddiqui, Azhar Rehman

Department of Anaesthesia

Background and Aims: Despite advances in postoperative pain management, patients continue to experience moderate to severe pain. This study was designed to assess the strategy, effectiveness, and safety of postoperative pain management in patients undergoing major gynecological surgery.
Material and Methods: This observational study included postoperative patients having major gynecological surgery from February 2016 to July 2016. Data collected on a predesigned data collection sheet included patient's demographics, postoperative analgesia modality, patient satisfaction, acute pain service assessment of numeric rating scale (NRS), number of breakthrough pains, number of rescue boluses, time required for the pain relief after rescue analgesia, and …

Epidemiology Of Moderate Alcohol Consumption And Breast Cancer: Association Or Causation?, Samir Zakhari, Jan B. Hoek

Department of Pathology, Anatomy, and Cell Biology Faculty Papers

Epidemiological studies have been used to show associations between modifiable lifestyle habits and the incidence of breast cancer. Among such factors, a history of alcohol use has been reported in multiple studies and meta-analyses over the past decades. However, associative epidemiological studies that were interpreted as evidence that even moderate alcohol consumption increases breast cancer incidence have been controversial. In this review, we consider the literature on the relationship between moderate or heavy alcohol use, both in possible biological mechanisms and in variations in susceptibility due to genetic or epigenetic factors. We argue that there is a need to incorporate …

Bath-Related Headache, Aliza Kumpinsky, Stephanie J. Nahas

Department of Neurology Faculty Papers

PURPOSE OF REVIEW: The purpose of this review is to summarize the most up-to-date literature on bath-related headache, a rare disorder.

RECENT FINDINGS: Initially described in middle-aged Asian women, it is now reported in a wider demographic. More information is available about the pathophysiology of bath-related headache, including its classification as a subtype of reversible cerebral vasoconstriction syndrome (RCVS). Nimodipine can be effective in patients both with and without vasospasm. Bath-related headache is a rare form of thunderclap headache. Although its mechanism is still unclear, it is associated with vasospasm and RCVS. Controlled trials investigating the use of nimodipine and …

None Shall Pass: Migrated Surgical Mesh Causing Gastric Outlet Obstruction With Endoscopic Extraction, Matthew J. Sullivan Do, Shashin Shah Md, Paola Blanco Md

Department of Medicine

No abstract provided.

A Perf-Ect Diagnosis: Ileocolonic Crohn Disease Presenting As Acute Appendicitis, Matthew J. Sullivan Do, Michael C. Engels Md

Department of Medicine

No abstract provided.

An Emancipatory Approach To Cultural Competency: The Application Of Critical Race, Postcolonial, And Intersectionality Theories, Linda M. Wesp, Victoria Scheer, Ashley Ruiz, Kimberly Walker, Jennifer Weitzel, Leslie Shaw, Peninnah M. Kako, Lucy Mkandawire-Valhmu

College of Nursing Faculty Research and Publications

Nurses teach, work, and conduct research in an increasingly hostile sociopolitical climate where health inequities persist among marginalized communities. Current approaches to cultural competency do not adequately equip nurses to address these complex factors and risk perpetuating stereotypes and discrimination. A theory-driven emancipatory approach to cultural competency will instead lead to lasting change and uphold the core nursing value of commitment to social justice. This article explicates key tenets of critical race, postcolonial feminist, and intersectionality theories and then applies them, using an emancipatory approach to cultural competency that can reshape nursing education, research, and practice.

In Vitro Transport Of Methotrexate By Drosophila Multidrug Resistance-Associated Protein., Agnes Karasik, András Váradi, Flóra Szeri

Department of Dermatology and Cutaneous Biology Faculty Papers

Methotrexate (MTX) is a widely used chemotherapeutic agent, immune suppressant and antimalarial drug. It is a substrate of several human ABC proteins that confer multidrug resistance to cancer cells and determine compartmentalization of a wide range of physiological metabolites and endo or xenobiotics, by their primary active transport across biological membranes. The substrate specificity and tissue distribution of these promiscuous human ABC transporters show a high degree of redundancy, providing robustness to these key physiological and pharmacological processes, such as the elimination of toxins, e.g. methotrexate from the body. A similar network of proteins capable of transporting methotrexate has been …

Medical School Watercooler Newsletter - September 30, 2018, Lindsey Lyle

Watercooler Newsletter

This is the September 30, 2018 edition of the Frederick P. Whiddon College of Medicine's newsletter - Watercooler.

Contents Include:

• Mark Your Calendar: College of Medicine Research Forum
• USA Welcomes Pediatric Surgeon Dr. Hanna Alemayehu
• Dr. Elizabeth Minto Named Director of Clinical Skills atUSA College of Medicine
• Game Day 2018: Free Football Tickets, Tailgate for USA Health Employees and Medical Students

The Association Between D-Dimer Concentration And Laboratory Parameters For Plasma Leakage In Dengue Infection, Suhendro Suwarto, Riyanti Astrid Diahtantri, Elian Hudiya

Jurnal Penyakit Dalam Indonesia

Introduction. Plasma leakage and activation of the coagulation system are the pathological hallmark of dengue hemorrhagic fever (DHF) that causes an increase in D-dimer concentration due to the degradation of fibrin clots. This study was conducted to determine the association between of D-dimer and laboratory parameters of plasma leakage, namely: thrombocytopenia, hypoalbuminemia, hemoconcentration and concentration serum glutamic oxaloacetic transaminase (SGOT) in dengue infected patients. Methods. A retrospective study was conducted at private hospitals in Jakarta, from December 2016 to March 2018. Patients >14 years with dengue infection and positive NS-1 were included in this study, and were classified into dengue …

Comparison Of Renal Safety Of Tenofovir And Telbivudine In Chronic Hepatitis B Patients: A Real World Study In Indonesia, Rino Alvani Gani

Jurnal Penyakit Dalam Indonesia

Introduction. Tenofovir disoproxil fumarate (tenofovir) and telbivudine are two available nucleos(t)ide analogue (NA) for the treatment of chronic hepatitis B (CHB) patients. Tenofovir has been known as a nephrotoxic agent in HIV patients, but still controversy in CHB patients. On the other hand, telbivudine had a renal protective effect and increased estimated glomerular filtration rate (eGFR). This studi aimed to address the renal safety of tenofovir and telbivudine in Indonesian patients. Method. A retrospective cohort study design was conducted in CHB patients who prescribed with tenofovir or telbivudine from January 2013 to December 2016. Patients who hade baseline eGFR

The Differences Of Marital Satisfaction Of Odha Couples With And Without Depression Symptoms, Muhammad Ismail Salahudin, Alifiati Fitrikasari, Muchlis Achsan Udji Sofro, Hari Peni Julianti

Jurnal Penyakit Dalam Indonesia

Introduction. HIV/AIDS disease has caused physical, social, and emotional problems to infected individuals and their spouses. ODHA couples have a prevalence of depression symptoms with physical complaints, which amounted to 12.7%. There is a relationship between love, communication, and physical intimacy to satisfaction in marriage. Depression in ODHA couples is correlated with marital satisfaction. This study aimed to analyze the differences of marital satisfaction of ODHA HIV negative couples who experience depression symptoms with ODHA who do not experience depression symptoms Methods. The research design was cross-sectional. The samples were 52 official couples of ODHA aged 18-60 years who had …

Cedera Hati Hipoksik Pada Infark Miokard Akut, Chyntia Olivia Maurine Jasirwan

Jurnal Penyakit Dalam Indonesia

No abstract provided.

Composite Lymphoma: Hodgkin And Non-Hodgkin Lymphoma A Case Report, Noorwati Soetandyo, Ruth Vonky Rebecca, Maria Yunti, Arry Harryanto Reksodiputro

Jurnal Penyakit Dalam Indonesia

Composite lymphoma (CL) is a rare disease. Composite lymphoma is two or more different type of lymphoma that sequentially or simultaneously occur in one anatomical site. Making a diagnosis of CL is a challenge and there is still no guidelines about the treatment. This case report is about a 36 y.o female with CL, sequentially consisted of Hodgkin and non-Hodgkin lymphoma.

Efficacy And Safety Of Oral Antidiabetic Drugs In Type 2 Diabetes Mellitus With Chronic Kidney Disease, Retta C. Sihotang, Rizka Ramadhani, Dicky L. Tahapary

Jurnal Penyakit Dalam Indonesia

No abstract provided.

Antibiotic Treatment Based On Guidelines For Reducing Length Of Stay (Los) In Patients With Community Acquired Pneumonia (Cap), Fetri Charya Munarsih, Ronald Irwanto Natadidjadja, Syamsudin Syamsudin

Jurnal Penyakit Dalam Indonesia

Introduction. Community acquired pneumonia (CAP) now is known as the most common infection presented. Empiric antibiotic administered followed by observing parameters. This study aimed to know how far the American Thoracic Society/ Infectious Disease Society of America (ATS/IDSA) antibiotic guidelines 2007 based treatment influenced the length of stay (LOS) of CAP subject in a private hospital ward between January 2014-August 2015 Methods. A retrospective cohort was conducted with bivariate analysis and multivariate analysis for reducing the confounding factor. Sample taken with proportional sampling formula at ward in a hospital in Jakarta. Results. The result showed that subjects with unproper empiric …

Hypoxic Liver Injury As Predictor Of Major Adverse Cardiac Events In Acute Myocardial Infarction Patients Admitted To Intensive Coroner Care Unit Of Cipto Mangunkusumo National General Hospital, Muhadi Muhadi, Nurhayati Adnan Prihartono

Jurnal Penyakit Dalam Indonesia

Introduction. Major adverse cardiac events (MACE) is a complicating myocard infarct which consist of acute heart failure, cardiogenic shock, and fatal arrhytmia. An accurate, easy and cost-effective biomarker is needed to predict MACE and mortality in patients with myocard infarct. Hypoxic liver injury (HLI) is a potential biomarker using serum glutamic-oxaloacetic transaminase (SGOT) level as the parameter. This study is aimed to discover HLI’s role in predicting MACE in non ST elevation myocard infarct (NSTEMI). Methods. This study was designed as cross sectional to predict MACE and prospective cohort for survival analysis. Study population was all NSTEMI patients admitted to …

Efficacy Of Pharmacotherapy And Psychotherapy In Treating Depression And Anxiety Disorders, Tolu Okuneye

Nursing Capstones

No abstract provided.