Medicine and Health Sciences Commons^™

Body Mass Index (Bmi): A Screening Tool Analysis, Deepesh Khanna, Cadynce Peltzer, Payal Kahar, Mayur S. Parmar

HPD Articles

Body mass index (BMI), a measurement based on a person's height and weight, allows the classification of individuals into categories such as obese or overweight. With these classifications, we can assess risk for hypertension, diabetes, cancer, hypercholesterolemia, and other chronic diseases. Furthermore, childhood BMI serves as a prediction method for health and disease later in life. Along with BMI, researchers also study waist circumference and waist-to-hip ratio in correlation with the above-mentioned chronic illnesses. This brief review explores the associations between body mass index, waist circumference, and the waist-hip ratio as measurements and their capability as predictors for persistent conditions …

Febrile Infant Without Evidence Source Of Infection, Children's Mercy Kansas City

Clinical Pathways (Formally Known As Clinical Practice Guidelines)

No abstract provided.

Current Perspectives Of Oncoplastic Breast Surgery In Pakistan, Lubna Mushtaque Vohra, Dua Jabeen, Danish Ali, Syeda Sakina Abidi, Sana Zeeshan, Abida Khalil Sattar

Section of General Surgery

Oncoplastic breast surgery is based on the concept of tumour-specific immediate reconstruction. It combines both local and distant techniques to maintain breast texture, symmetry and cosmesis without compromising oncological outcome. The current narrative review was planned to highlight the current state and future of oncoplastic breast surgery in low- and middle-income countries where its utilisation in surgical practice remains insubstantial because majority of the surgeons who are treating breast cancer are either general surgeons or breast surgeons who do not have expertise in oncoplastic breast surgery or reconstructive surgery. Moreover, scarcity of financial resources, ignorance about oncoplastic breast surgery techniques, …

Diagnostic Accuracy Of Axillary Nodal Ultrasound After Neoadjuvant Chemotherapy In Node-Positive Breast Cancer Patients: A Validation Study, Syeda Sakina Abidi, Lubna Mushtaque Vohra, Asad Ali Kerawala, Imrana Masroor, Muhammad Umair Tahseen

Section of General Surgery

Objective: To determine the accuracy and false negative rate of axillary ultrasound compared to sentinel node biopsy.
Methods: The retrospective study was conducted at the Aga Khan University Hospital, Karachi, from February 1 to March 31, 2021, and comprised data of breast cancer patients who had undergone neo-adjuvant chemotherapy followed by axillary lymph node dissection or axillary disease diagnosed using lymph node biopsy or sentinel lymph node biopsy between January 1, 2016, and December 30, 2020. After receiving neoadjuvant chemotherapy, axillary ultrasound findings were compared with histopathology of lymph nodes. Data was analysed using SPSS 22.
Results: Of the 155 …

Nursing News & Views - Feburary 2022, Joanne Miller Rn

Nursing Newsletters

No abstract provided.

Ras-Mediated Tumor Stress Adaptation And The Targeting Opportunities It Presents, Alexandra Redding, A E Aplin, Elda Grabocka

Department of Cancer Biology Faculty Papers

Cellular stress is known to function in synergistic cooperation with oncogenic mutations during tumorigenesis to drive cancer progression. Oncogenic RAS is a strong inducer of a variety of pro-tumorigenic cellular stresses, and also enhances the ability of cells to tolerate these stresses through multiple mechanisms. Many of these oncogenic, RAS-driven, stress-adaptive mechanisms have also been implicated in tolerance and resistance to chemotherapy and to therapies that target the RAS pathway. Understanding how oncogenic RAS shapes cellular stress adaptation and how this functions in drug resistance is of vital importance for identifying new therapeutic targets and therapeutic combinations to treat RAS-driven …

Manual Loop In Laparoscopic Appendectomy: A Retrospective Cohort Study And Literature Review, Priyanka Ramesh, Aniqa Saeed, Muniza Nusrat, Sehrish Batool, Hina Khan, Ghulam Murtaza

Section of Urology

Objectives: To determine the incidence of complications [Surgical site infection (SSI), intra-abdominal abscess (IAA), stump leak] related to stump ligation with manual loop of sliding extracorporeal suture knot in laparoscopic appendectomy.
Methods: This cohort study was conducted on patients who underwent laparoscopic appendectomy from June 2014 to November 2020 performed by the same surgeon with almost similar technique. Stump was ligated with manual loops, applied by the surgeon or trainee or both (one by surgeon and other by trainee). SSI and IAA were classified according to Centers for Disease Control and Prevention (CDC) criteria.
Results: Total 120 patients were included …

Prostacyclin Promotes Degenerative Pathology In A Model Of Alzheimer’S Disease, Tasha R. Womack, Craig T. Vollert, Odochi Ohia-Nwoko, Monika Schmitt, Saghi Montazari, Tina L. Beckett, David Mayerich, Michael Paul Murphy, Jason L. Eriksen

Sanders-Brown Center on Aging Faculty Publications

Alzheimer’s disease (AD) is a progressive neurodegenerative disorder that is the most common form of dementia in aged populations. A substantial amount of data demonstrates that chronic neuroinflammation can accelerate neurodegenerative pathologies. In AD, chronic neuroinflammation results in the upregulation of cyclooxygenase and increased production of prostaglandin H2, a precursor for many vasoactive prostanoids. While it is well-established that many prostaglandins can modulate the progression of neurodegenerative disorders, the role of prostacyclin (PGI2) in the brain is poorly understood. We have conducted studies to assess the effect of elevated prostacyclin biosynthesis in a mouse model of AD. Upregulated prostacyclin expression …

Catheter-Associated Urinary Tract Infections: Patient Characteristics, Treatment, And Clinical Outcomes In One South Texas Acute Care Hospital, Kimberly A. Ambrosini, Jose Campo Maldonado

MEDI 9331 Scholarly Activities Clinical Years

Background: Catheter-associated urinary tract infections (CA-UTIs) account for 40 percent of nosocomial infections worldwide. Their elimination is at the forefront of quality improvement in one South Texas acute care hospital.

Methods: Over a period of 6 months, five CA-UTIs occurred in one South Texas acute care hospital. These cases were identified via regular surveillance by Infection Prevention staff and the Laboratory Department of the hospital. This research reviews patient age, sex, length of stay, bacteria contracted, appropriate antibiotic use, patient characteristics, and overall outcomes.

Results: Between the months of July and December 2021, 5 CAUTIs were contracted. Patients …

Inhibition Of Interferon-Gamma-Stimulated Melanoma Progression By Targeting Neuronal Nitric Oxide Synthase (Nnos), Shirley Tong, Maris A. Cinelli, Naglaa Salem El-Sayed, He Huang, Anika Patel, Richard B. Silverman, Sun Yang

Pharmacy Faculty Articles and Research

Interferon-gamma (IFN-γ) is shown to stimulate melanoma development and progression. However, the underlying mechanism has not been completely defined. Our study aimed to determine the role of neuronal nitric oxide synthase (nNOS)-mediated signaling in IFN-γ-stimulated melanoma progression and the anti-melanoma effects of novel nNOS inhibitors. Our study shows that IFN-γ markedly induced the expression levels of nNOS in melanoma cells associated with increased intracellular nitric oxide (NO) levels. Co-treatment with novel nNOS inhibitors effectively alleviated IFN-γ-activated STAT1/3. Further, reverse phase protein array (RPPA) analysis demonstrated that IFN-γ induced the expression of HIF1α, c-Myc, and programmed death-ligand 1 (PD-L1), in contrast …

Regulatory T Cells Control Effector T Cell Inflammation In Human Prediabetes, Rui Liu, Gabriella H. Pugh, Erin Tevonian, Katherine Thompson, Douglas A. Lauffenburger, Philip A. Kern, Barbara S. Nikolajczyk

Clinical and Translational Science Faculty Publications

A disparate array of plasma/serum markers provides evidence for chronic inflammation in human prediabetes, a condition that is most closely replicated by standard mouse models of obesity and metaflammation. These remain largely nonactionable and contrast with our rich understanding of inflammation in human type 2 diabetes. New data show that inflammatory profiles produced by CD4+ T cells define human prediabetes as a unique inflammatory state. Regulatory T cells (Treg) control mitochondrial function and cytokine production by CD4+ effector T cells (Teff) in prediabetes and type 2 diabetes by supporting T helper (Th)17 or Th1 cytokine production, respectively. These data suggest …

Dean's Update, February 2022, Jerry L. Nadler

SOM Dean's Research Newsletter

No abstract provided.

Identification Des Changements Les Plus Significatifs Sur La Communication Intergénérationnelle Et La Santé Des Jeunes En Matière De Planification Familiale Et De Santé De Reproduction : Évaluation Qualitative De La Campagne Médiatique « Merci Mon Héros » Au Niger Et En Côte D’Ivoire, Martha Silva, Sethson Kassegne, Robert-Hugues Yaovi Nagbe, Rebecca Ezouatchi, Lorimpo Babogou, Farida Moussa

Sexual and Reproductive Health, Rights, and Choices

No abstract provided.

Radial Artery Coronary Bypass Grafting: Surgical Outcomes Of An Unexplored Innovation In A Developing Country, Russell Seth Martins, Laiba Masood, Mabrooka Kazi, Mishal Gillani, Ayesha Sadiq, Hina Inam, Saulat Fatimi

Medical College Documents

Objective: To explore postoperative outcomes, particularly prolonged length of hospital stay, in radial artery coronary artery bypass graft patients in a tertiary-care setting.
Methods: The pilot prospective cohort study was conducted at the Aga Khan University Hospital, Karachi, from September 2019 to September 2020, and comprised adult patients of either gender due to undergo coronary artery bypass grafting for coronary artery disease involving two or more vessels. The subjects were approached for the use of their radial artery as a conduit. Prolonged length of hospital stay was defined as postoperative stay >9 days. Multivariable logistic regression was used to identify …

Serious Mental Illness And Mental Health Treatment Utilization Among Adults Residing In Non-Metropolitan And Metropolitan Counties, Tyrone F. Borders, Timothy Williams

Rural & Underserved Health Research Center Publications

Key Findings

The past year prevalence of serious mental illness (SMI) was significantly higher among non-metropolitan than metropolitan (5.90% vs. 5.18%, P < .03) adults.

Only 67.58% of non-metropolitan and 64.29% of metropolitan adults with SMI received any mental health (MH) treatment in the past year.

Additional analyses revealed the following non-metropolitan/metropolitan treatment differences:

• A higher percentage of non-metropolitan than metropolitan adults with SMI received only medication for MH treatment (24.50% vs. 18.53%, P < .02).
• A higher percentage of metropolitan than non-metropolitan adults with SMI received inpatient, outpatient, and medication (5.42% vs. 2.63%, P < .02).
• A significantly higher percentage of non-metropolitan than metropolitan adults with …

Global, Regional, And National Sex Differences In The Global Burden Of Tuberculosis By Hiv Status, 1990–2019: Results From The Global Burden Of Disease Study 2019, Jorge R. Ledesma, Arianna Maever L. Amit, Veincent Christian F. Pepito, Gbd 2019 Tuberculosis Collaborators

Ateneo School of Medicine and Public Health Publications

Background

Tuberculosis is a major contributor to the global burden of disease, causing more than a million deaths annually. Given an emphasis on equity in access to diagnosis and treatment of tuberculosis in global health targets, evaluations of differences in tuberculosis burden by sex are crucial. We aimed to assess the levels and trends of the global burden of tuberculosis, with an emphasis on investigating differences in sex by HIV status for 204 countries and territories from 1990 to 2019.

Methods

We used a Bayesian hierarchical Cause of Death Ensemble model (CODEm) platform to analyse 21 505 site-years of vital …

Surgical Training In Ophthalmology: Role Of Eyesi In The Era Of Simulation-Based Learning, Sehrish Nizar Ali Momin, Abdul Sami Memon, Muhammad Bilal Malik, Pir Salim Meher

Section of Ophthalmology

Recent advancements in surgical training methods have escalated the need for simulators. The EyeSi simulation has played a major role in Ophthalmology training by providing opportunity to the novice residents to grasp the surgical steps of the procedure and master the skill by repeated attempts. Participants were assessed on single level of cataract module and their consecutive scores were assessed with each attempt. It was found that repetitive practice on simulator can help develop proficiency in the desired steps that can ultimately prepare the surgical trainees for real life surgery.

Reducing Post-Operative Emergency Department Visits And Readmissions After Nephrectomy: An Initial Evaluation Of The Music-Kidney Registry, M Butaney, A Johnson, A Bulusu, D Gandham, J Qi, M Jamil, A Patel, S Noyes, J Anema, Michael Levin, Bradley Rosenberg

Conference Presentation Abstracts

Introduction & Objectives: Emergency department (ED) visits and readmissions are often used metrics of quality care provided to surgical patients and important contributors to healthcare costs and utilization. We evaluate post-operative ED visits and readmissions after partial (PN) and radical (RN) nephrectomy in the MUSIC-KIDNEY registry to identify potentially preventable events and develop prevention strategies. Materials & Methods: Data abstractors recorded clinical, radiographic, pathologic, and follow-up data for patients with newly diagnosed clinical T1 renal masses (cT1RM) at 16 MUSIC practices with >90 physicians. All charts associated with 30-day ED visits and readmissions since the inception of MUSIC-KIDNEY (6/2017) were …

Analytics Monthly, Lehigh Valley Health Network

LVHN documents

No abstract provided.

Examining The Job Satisfaction Of Direct Care Workers During Covid-19: A Quantitative Descriptive Study, Sonja A. Stewart

All Theses And Dissertations

This quantitative descriptive study examined the job satisfaction of 39 Direct Care Workers (DCWs) who worked during the COVID-19 pandemic from March 2020-December 2021 in the United States. This was done not to determine cause and effect between the pandemic and job satisfaction of DCWs: the pandemic was simply used as a timeframe. A REDCap survey was posted to two DCWs groups on Facebook which contained information on the study, an electronic version of the Job Satisfaction Survey (JSS) by Paul Spector (2021) and general demographics questions. Snowball sampling was also encouraged for particpants to share the survey with other …

A Bayesian Phase I/Ii Biomarker-Based Design For Identifying Subgroup-Specific Optimal Dose For Immunotherapy, Beibei Guo, Yong Zang

Faculty Publications

Immunotherapy is an innovative treatment that enlists the patient's immune system to battle tumors. The optimal dose for treating patients with an immunotherapeutic agent may differ according to their biomarker status. In this article, we propose a biomarker-based phase I/II dose-finding design for identifying subgroup-specific optimal dose for immunotherapy (BSOI) that jointly models the immune response, toxicity, and efficacy outcomes. We propose parsimonious yet flexible models to borrow information across different types of outcomes and subgroups. We quantify the desirability of the dose using a utility function and adopt a two-stage dose-finding algorithm to find the optimal dose for each …

Increased Condom Use Among Key Populations Using Oral Prep In Kenya: Results From Large Scale Programmatic Surveillance, Griffins O. Manguro, Abednego M. Musau, Daniel K. Were, Soud Tengah, Brian Wakhutu, Jason Reed, Marya Plotkin, Stanley Luchters, Peter Gichangi, Marleen Temmerman

Institute for Human Development, East Africa

Background: Female sex workers (FSW) and men having sex with men (MSM) in Kenya have high rates of HIV infection. Following a 2015 WHO recommendation, Kenya initiated national scale-up of pre-exposure prophylaxis (PrEP) for all persons at high-risk. Concerns have been raised about PrEP users’ potential changes in sexual behaviors such adopting condomless sex and multiple partners as a result of perceived reduction in HIV risk, a phenomenon known as risk compensation. Increased condomless sex may lead to unintended pregnancies and sexually transmitted infections and has been described in research contexts but not in the programmatic setting. This study …

Measurement Characteristics And Correlates Of Hiv-Related Stigma Among Adults Living With Hiv: A Cross-Sectional Study From Coastal Kenya, Stanley W. Wanjala, Moses Nyongesa, Paul Mwangi, Agnes M. Mutua, Stanley Luchters, Charles R J C Newton, Amina Abubakar

Institute for Human Development, East Africa

Objective We studied the psychometric properties of the 12-item short version of the Berger HIV stigma scale and assessed the correlates of HIV-related stigma among adults living with HIV on the Kenyan coast.

Design Cross-sectional study.

Setting Comprehensive Care and Research Centre in the Kilifi County Hospital.

Participants Adults living with HIV on combination antiretroviral therapy were recruited and interviewed between February and April 2018 (n=450).

Main outcome measures HIV-related stigma.

Results 450 participants with a median age of 43 years (IQR=36–50) took part in the study. Of these, 356 (79.1%) were female. Scale reliability and validity were high (alpha=0.80, …

Clinical Feasibility Of A Contactless Multiparameter Continuous Monitoring Technology For Neonates In A Large Public Maternity Hospital In Nairobi, Kenya, Amy Sarah Ginsburg, Sahar Zandi Nia, Dorothy Chomba, Dustin Dunsmuir, Mary Waiyego, Jesse Coleman, Roseline Ochieng, Sichen Liu, Guohai Zhou, J. Mark Ansermino, William Macharia

Paediatrics and Child Health, East Africa

Multiparameter continuous physiological monitoring (MCPM) technologies are critical in the clinical management of high-risk neonates; yet, these technologies are frequently unavailable in many African healthcare facilities. We conducted a prospective clinical feasibility study of EarlySense’s novel under-mattress MCPM technology in neonates at Pumwani Maternity Hospital in Nairobi, Kenya. To assess feasibility, we compared the performance of EarlySense’s technology to Masimo’s Rad-97 pulse CO-oximeter with capnography technology for heart rate (HR) and respiratory rate (RR) measurements using up-time, clinical event detection performance, and accuracy. Between September 15 and December 15, 2020, we collected and analyzed 470 hours of EarlySense data from …

Frequency And Types Of Healthcare Encounters In The Week Preceding A Sepsis Hospitalization: A Systematic Review, Alexander H. Flannery, Chad M. Venn, Amanda Gusovsky, Stephanie Henderson, Adam S. Kiser, Hallie C. Prescott, Chanu Rhee, Chris Delcher, Peter E. Morris

Pharmacy Practice and Science Faculty Publications

OBJECTIVES: Early recognition and treatment are critical to improving sepsis outcomes. We sought to identify the frequency and types of encounters that patients have with the healthcare system in the week prior to a sepsis hospitalization.

DATA SOURCES: PubMed, Cumulative Index to Nursing and Allied Health Literature, Scopus, and the Cochrane Library.

STUDY SELECTION: Observational cohort studies of patients hospitalized with sepsis or septic shock that were assessed for an outpatient or emergency department encounter with the healthcare system in the week prior to hospital admission.

DATA EXTRACTION: The primary outcome was the proportion of patients with a healthcare encounter …

Nevirapine Hair And Plasma Concentrations And Hiv-1 Viral Suppression Among Hiv Infected Ante-Partum And Post-Partum Women Attended In A Mother And Child Prevention Program In Maputo City, Mozambique, Rosa Marlene Cuco, Osvaldo Loquiha, Adelino Juga, Aleny Couto, Bindiya Meggi, Adolfo Vubil, Esperança Sevene, Nafissa Osman, Marleen Temmerman, Olivier Degomme

Obstetrics and Gynaecology, East Africa

Introduction: Prevention of mother to child transmission of HIV (PMTCT) is frequently challenged by irregular access to more effective anti-retroviral therapy. Nevirapine single dose (sdNVP), sdNVP+AZT+3TC for MTCT prophylaxis and NVP+ AZT+3TC for treatment and PMTCT were withdrawn due to low genetic resistance barrier and low efficacy. However current PMTCT lines in Mozambique include DTG+3TC+TDF, TDF+3TC+EFV, DTG +ABC+3TC, and AZT + NVP syrup prophylaxis for exposed babies. We assessed NVP hair and plasma concentrations and association with HIV-1RNA suppression among HIV+ ante-partum and post-partum women under PMTCT in Maputo, Mozambique.

Methods: From December 2013 to November 2014, prospectively …

Maintain The Sharp Cutting Edge Of Periodontal Instruments, Khrystyna Vyprynyuk, Annie Chitlall

Publications and Research

No abstract provided.

Early Morphological Changes Of The Rectus Femoris Muscle And Deep Fascia In Ullrich Congenital Muscular Dystrophy, Patrizia Sabatelli, Luciano Merlini, Alberto Di Martino, Vittoria Cenni, Cesare Faldini

Department of Medicine Faculty Papers

Ullrich congenital muscular dystrophy (UCMD) is a severe form of muscular dystrophy caused by the loss of function of collagen VI, a critical component of the muscle-tendon matrix. Magnetic resonance imaging of UCMD patients’ muscles shows a peculiar rim of abnormal signal at the periphery of each muscle, and a relative sparing of the internal part. The mechanism/s involved in the early fat substitution of muscle fiber at the periphery of muscles remain elusive. We studied a muscle biopsy of the rectus femoris/deep fascia (DF) of a 3-year-old UCMD patient, with a homozygous mutation in the COL6A2 gene. By immunohistochemical …

Study Protocol: Randomised Controlled Hybrid Type 2 Trial Evaluating The Scale-Up Of Two Arts Interventions For Postnatal Depression And Parkinson’S Disease, Tayana Soukup, Rachel Davis, Maria Baldellou Lopez, Andy Healey, Carolina Estevao, Daisy Fancourt, Paola Dazzan, Carmine Pariante, Hannah Dye, Tim Osborn, Rebecca Bind, Kristi Sawyer, Lavinia Rebecchini, Katie Hazelgrove, Alexandra Burton, Manonmani Manoharan, Rosie Perkins, Aleksandra Podlewska, Ray Chaudhuri, Fleur Derbyshire-Fox, Alison Hartley, Anthony Woods, Nikki Crane

Faculty Publications

INTRODUCTION: Research on the benefits of 'arts' interventions to improve individuals' physical, social and psychological well-being is growing, but evidence on implementation and scale-up into health and social care systems is lacking. This protocol reports the SHAPER-Implement programme (Scale-up of Health-Arts Programmes Effectiveness-Implementation Research), aimed at studying the impact, implementation and scale-up of: Melodies for Mums (M4M), a singing intervention for postnatal depression; and Dance for Parkinson's (PD-Ballet) a dance intervention for Parkinson's disease. We examine how they could be embedded in clinical pathways to ensure their longer-term sustainability. METHODS AND ANALYSIS: A randomised two-arm effectiveness-implementation hybrid type 2 trial …

Targeting Gastrointestinal Cancers With Chimeric Antigen Receptor (Car)-T Cell Therapy, Ross E Staudt, Robert D Carlson, Adam E. Snook

Department of Pharmacology and Experimental Therapeutics Faculty Papers

The immune system is capable of remarkably potent and specific efficacy against infectious diseases. For decades, investigators sought to leverage those characteristics to create immune-based therapies (immunotherapy) that might be far more effective and less toxic than conventional chemotherapy and radiation therapy for cancer. Those studies revealed many factors and mechanisms underlying the success or failure of cancer immunotherapy, leading to synthetic biology approaches, including CAR-T cell therapy. In this approach, patient T cells are genetically modified to express a chimeric antigen receptor (CAR) that converts T cells of any specificity into tumor-specific T cells that can be expanded to …