Therapeutics Commons^™

Eculizumab In The Successful Treatment Of Postpartum Hemolytic Uremic Syndrome - A Case Report, Craig A. Mackaness Do, Frederick S. Fleszler Md

Department of Medicine

No abstract provided.

Vaccine-Preventable Diseases In Travelers, Edith Mirzaian, Jeffery A. Goad, Ani Amloian, Fady Makar

Pharmacy Faculty Articles and Research

Travel to the developing world is increasing among those from developed countries, placing them at risk for vaccine preventable and non-vaccine preventable diseases. From 2007-2011, the GeoSentinel Network reported 737 returned travelers with a vaccine preventable disease. While it is essential that clinicians use vaccines when available for a disease of risk, they should also be aware that the vast majority of diseases acquired by travelers are non-vaccine preventable. The vaccine preventable diseases can be divided into routine travel vaccines, special travel vaccines and routine vaccines used for travel. The routine travel vaccines include Hepatitis A and B, typhoid; special …

The Search For Novel Inhibitors Of The Mycobacterial Enoyl Reductase Inha, Esther Saul

The Science Journal of the Lander College of Arts and Sciences

Isoniazid (INH), one of two first-line drugs used to treat tuberculosis (TB), has been shown to be a potent inhibitor of InhA, the mycobacterial enoyl reductase. However, the increasing resistance to INH makes it imperative to find alternative drugs that are as effective as the first-line drugs, yet active against INH-resistant strains. Since InhA has been validated as an excellent target of TB, there have been attempts to find novel inhibitors of InhA. Through rational drug design, a variety of high affinity InhA inhibitors were synthesized. Triclosan itself was observed to be a suboptimal inhibitor of InhA with a K …

The Efficacy And Safety Of The Human Papillomavirus Vaccine, Gail Tessler

The Science Journal of the Lander College of Arts and Sciences

The HPV virus is said to be the cause of many infections, warts, and cancers. In addition to the fact that the treatment for HPV is not always successful, not every individual knows that s/he is infected and is very likely to infect his or her partner, too. This is one factor that explains why 14 million people each year in America alone contract HPV and makes cervical cancer so threatening to many people worldwide. In light of this and the known dangers of cervical, anal, vaginal and penile cancers, the HPV vaccine was created to prevent an infection of …

Stem Cells As A Cure For Amyotrophic Lateral Sclerosis, Chaya K. Hirsch

The Science Journal of the Lander College of Arts and Sciences

Amyotrophic Lateral Sclerosis (ALS) is a fatal motor neuron disease which affects approximately 30,000 Americans at any given time (alsa.org, 2010). The etiology of this terminal disease unfortunately remains an unsolved mystery and has therefore severely limited the ability to find a cure. The use of stem cells to regenerate neurons has been vastly studied and have produced very promising results. However, its practicality as a cure or treatment for neurodegenerative diseases, such as ALS, is greatly compromised. Three different therapies involving stem cells were examined, Embryonic Stem Cells (ESC), induced pluripotent stem cells, (iPSC) and direct reprogramming of adult …

Biomarkers In Nsclc Epidermal Growth Factor Receptor Mutations, Suzanne Freidman

The Science Journal of the Lander College of Arts and Sciences

Lung Cancer is the most common global cause of cancer related deaths in men and women (Markus, Alain, 2013). As standard radiation and chemotherapy have proved ineffective, novel target therapies are in the midst of development. This review will analyze the success of the inhibitor drugs targeting the Epidermal Growth Factor Receptor (EGFR) mutation, commonly found amongst Lung Cancer patients. Numerous studies and reviews are utilized to determine the cause of the 10% success rate currently exhibited for these drugs. The L858R and E746-A750 point mutations and deletions respectively, were found prevalent in responsive patients as well as clinical-pathological features …

Is Music Therapy Effective In Improving Emotional Health In Pediatric Cancer Patients?, Elizabeth F. Matesa

PCOM Physician Assistant Studies Student Scholarship

OBJECTIVE: The objective of this evidence based medicine review is to determine whether music therapy is effective in improving emotional health in pediatric cancer patients

STUDY DESIGN: Two randomized controlled trials and a prospective cohort study were reviewed and selected based on their relevance to the clinical question and their inclusion of patient oriented outcomes (POEMS).

DATA SOURCES: Each study was obtained by searching PubMed database.

OUTCOMES MEASURED: The outcomes measured included pain scores measured using a NRS pain scoring scale, anxiety scores were measured using the Spielberger State-Trait Anxiety Inventory (STAI)and visual analog score …

The Affects Of Music Therapy On Management Of Pain And Anxiety During Burn Dressing Changes, Kush S. Patel

PCOM Physician Assistant Studies Student Scholarship

OBJECTIVE: The objective of this selective EBM review is to determine whether or not music therapy improves pain management and anxiety during burn dressing changes.

STUDY DESIGN: Review of three English languages primary randomized controlled trial studies published from 1992-2010.

DATA SOURCES: Three randomized controlled trials studying the affects of music therapy during burn dressing changes were found using PubMed, OVID and Cochrane databases.

OUTCOMES MEASURED: Outcomes measured were level of pain and anxiety experienced by the patients. The severities of these symptoms were measured using a numeric scale system. An analyses of anxiety was measured …

Scanned Ion Beam Therapy For Thoracic Tumors, John Gordon Eley

Dissertations and Theses (Open Access)

Although frequently cured of Hodgkin lymphoma, adolescents and young adults can develop radiation induced second cancers. These patients could potentially benefit from scanned ion radiotherapy yet likely would require motion mitigation strategies. In theory, four-dimensional (4D) optimization of ion beam fields for individual motion states of respiration can enable superior sparing of healthy tissue near moving targets, compared to other motion mitigation strategies. Furthermore, carbon-ion therapy can sometimes provide greater relative biological effectiveness (RBE) for cell sterilization in a target but nearly equivalent RBE in tissue upstream of the target, compared to proton therapy. Thus, we expected that for some …

A Multidisciplinary Approach To The Prevention Of Infant Torticollis And Plagiocephaly, Anne H. Zachry, S. K. Slaughter

Faculty Presentations

Research suggests that parents are more likely to carry out positioning recommendations from a health care professional than any other source. Occupational therapy practitioners can play an important role in educating parents, caregivers, and healthcare providers about the importance of providing tummy time and limiting infant time spent in baby gear.

Vaccination Practice For Pediatric Inflammatory Disease Patients Receiving Immuno-Suppressive Therapy, Naser Tolaymat Md, Clare M. Lenhart Phd, Mph

Department of Pediatrics

No abstract provided.

The Relationship Between Vitamin D Status Of Adult Women And Diet, Sun Exposure, Skin Reflectance, Body Composition, And Insulin Sensitivity, Marisa M. Mcadler

Master's Theses

As the prevalence of vitamin D deficiency continues to grow, mounting evidence supporting its link with chronic disease strengthens suggesting vitamin D’s candidacy in the prevention and treatment of multiple disease states and their complications. Dietary guidelines, however, do not take sun exposure into account. The present study sought to explore the impact of sun exposure on vitamin D status (serum 25(OH)D), and identify other significant determinants of serum levels which may have the greatest effects on overall health. Participants (n = 34) were pre-menopausal women aged 18 to 50 years (mean age 39 ± 6 years), who had their …

Characterization Of Differentiation And Prognostic Biomarkers On Cd8+ Tumor-Infiltrating Lymphocytes In Metastatic Melanoma, Richard C. Wu

Dissertations and Theses (Open Access)

CD8⁺ cytotoxic T lymphocytes (CTL) frequently infiltrate tumors, yet most melanoma patients fail to undergo tumor regression. We studied the differentiation of the CD8⁺ tumor-infiltrating lymphocytes (TIL) from 44 metastatic melanoma patients using known T-cell differentiation markers. We also compared CD8⁺ TIL against the T cells from matched melanoma patients’ peripheral blood. We discovered a novel subset of CD8⁺ TIL co-expressing early-differentiation markers, CD27, CD28, and a late/senescent CTL differentiation marker, CD57. This CD8⁺CD57⁺ TIL expressed a cytolytic enzyme, granzyme B (GB), yet did not express another cytolytic pore-forming molecule, perforin (Perf). In …

Generation And Characterization Of Peptide Fusion Proteins, Brianna L. Probasco

Graduate School of Biomedical Sciences Theses and Dissertations

Pathogenic Th17 cells drive progression of many autoimmune diseases. Th17 cells develop from naïve T cells in the immune system after antigen-driven stimulation in a specific cytokine environment. Normally, T cells act to fight off infection, but when not properly controlled, they can cause disease. The cytokine interleukin-23 (IL-23) plays an essential role in the expansion of pathogenic Th17 cells. IL-23 is a heterodimeric protein, composed of a p19 alpha chain and a p40 beta chain. The p40 is also part of IL-12 and binds to the IL-12 receptor beta 1 (IL-12Rβ1) subunit. Thus, it follows that the IL-23 receptor …

Are Oncolytic Viruses A Cure For Cancer? A Look At Reovirus, Adenovirus, And Hsv-1 In Cancer Treatment, Yehuda Rosenberg

The Science Journal of the Lander College of Arts and Sciences

This paper aims to evaluate the option of utilizing Oncolytic Viruses as a viable treatment in fighting cancer. However, due to the broad nature of the subject, a more limited purview is necessary. With that in mind, the focus will be on a few of the more researched ones: Reovirus, Adenovirus, and HSV-1. In each case, we will examine what makes each of these potential options. This will include an examination of each one's tumor-specificity. Cancer and viral physiology will be discussed as necessary to examine the distinct protein expressions in tumor cells, so that the virus's method of battling …

Efficacy Of Probiotics Lactobacillus Rhamnosus Gg And Saccharomyces Boulardii In The Treatment Of Antibiotic-Associated Diarrhea And Clostridium Diffiicile-Associated Disease, Estie Klugmann

The Science Journal of the Lander College of Arts and Sciences

Antibiotic therapy may cause serious side effects. Two disturbing effects of antibiotic administration are antibiotic-associated diarrhea and Clostridium difficile-associated disorder. Antibiotic-associated diarrhea occurs as a direct result of the normal flora destruction due to the antibiotics - which do not discriminate against pathogens or healthy forms of bacteria. C. diff disorder also occurs as an indirect result of antibiotic administration, because the destruction of the normal flora prevents people from having healthy bacteria to prevent disease. There have been studies conducted to determine if replacing the destroyed normal flora with probiotics, or beneficial microorganisms will prevent or treat these conditions. …

What Is The Role Of Incretin Mimetics In The Treatment Of Type 2 Diabetes?, Isaac Silberstein

The Science Journal of the Lander College of Arts and Sciences

Type 2 diabetes mellitus (DM) is an intricate disorder defined by insulin resistance, impaired insulin secretion, hyperglycemia, and both microvascular and macrovascular complications. Standard antidiabetic agents like metformin, insulin, sulfonylureas and thiazolidinediones are often insufficient at glucoregulation and do not address the decline in beta cell function that characterizes type 2 diabetes. Moreover, the adverse effects of some of these pharmaceuticals, such as hypoglycemia and weight gain, are disappointing and further limit their clinical utility. Research demonstrates that the actions of two potent incretins. Glucagon-like peptide 1 (GLP-1) and gastric inhibitory polypeptide (GIP), address these concerns as they stimulate beta …

Is Modafinil (Provigil®) Effective In Improving Cognitive Function In Adults With Narcolepsy?, Stephanie V. Bui

PCOM Physician Assistant Studies Student Scholarship

OBJECTIVE: The objective of this selective EBM review is to determine whether or not modafinil (Provigil®) is effective in improving cognitive function in adults with narcolepsy.

STUDY DESIGN: Review of all English language primary randomized controlled trials from 1996 to 2010.

DATA SOURCES: Double-blind, randomized controlled trials that compared modafinil (Provigil®) to a visually matched placebo were found using OVID, MEDLINE, and Cochrane Databases.

OUTCOME(S) MEASURED: Each of the three trials assessed the effect of modafinil on cognitive and executive function by Low-Resolution Brain Electromagnetic Tomography (LORETA), and the following assessment tools: Epworth Sleepiness Scale (ESS), Multiple Sleep …

What Is The Effectiveness Of Onabotulinumtoxina (Botox®) In Reducing The Number Of Chronic Migraines (Cm) In Patients 18-65 Years Old?, Kristin A. Beddingfield

PCOM Physician Assistant Studies Student Scholarship

OBJECTIVE: The objective of this selective EBM review is to determine whether or not onabotulinumtoxinA (Botox®) is effective in reducing the number of chronic migraines (CM) in patients 18-65 years old? Study Design: Review of three published, double blind randomized controlled trials were used for this review, which were found on PubMed; were selected based on their relevance to the clinical question and if they included patient oriented outcomes.

OUTCOMES MEASURED: The outcomes measured were headache/migraine free days measured by >50% responder rate analysis, the Treatment Responder Rate based on Physician Global Assessment, and total adverse events reported by …

Pharmacokinetics And Brain Uptake In The Rhesus Monkey Of A Fusion Protein Of Arylsulfatase A And A Monoclonal Antibody Against The Human Insulin Receptor, Ruben J. Boado, Jeff Zhiqiang Lu, Eric Ka-Wai Hui, Rachita K. Sumbria, William M. Pardridge

Pharmacy Faculty Articles and Research

Metachromatic leukodystrophy (MLD) is a lysosomal storage disorder of the brain caused by mutations in the gene encoding the lysosomal sulfatase, arylsulfatase A (ASA). It is not possible to treat the brain in MLD with recombinant ASA, because the enzyme does not cross the blood-brain barrier (BBB). In the present investigation, a BBB-penetrating IgG-ASA fusion protein is engineered and expressed, where the ASA monomer is fused to the carboxyl terminus of each heavy chain of an engineered monoclonal antibody (MAb) against the human insulin receptor (HIR). The HIRMAb crosses the BBB via receptor-mediated transport on the endogenous BBB insulin receptor, …

Novel Use Of Dual Anti-Inflammatory Therapy To Overcome Drug Resistance And Improve Functional Recovery Following Spinal Cord Injury, Jennifer Dulin

Dissertations and Theses (Open Access)

Over 1.2 million Americans are currently living with a traumatic spinal cord injury (SCI). Despite the need for effective therapies, there are currently no proven effective treatments that can improve recovery of function in SCI patients. Many therapeutic compounds have shown promise in preclinical models of SCI, but all of these have fallen short in clinical trials.

P-glycoprotein (Pgp) is an active transporter expressed on capillary endothelial cell membranes at the blood-spinal cord barrier (BSCB). Pgp limits passive diffusion of blood-borne drugs into the CNS, by actively extruding drugs from the endothelial cell membrane. Pgp can become pathologically up-regulated, thus …

Ginkgo Extract Egb761 Confers Neuroprotection By Reduction Of Glutamate Release In Ischemic Brain, Alexander Mdzinarishvili, Rachita K. Sumbria, Dorothee Lang, Jochen Klein

Pharmacy Faculty Articles and Research

Purpose - Ginkgo extract EGb761 has shown anti-edema and anti-ischemic effects in various experimental models. In the present study, we demonstrate neuroprotective effects of EGb761 in experimental stroke while monitoring brain metabolism by microdialysis. Methods - We have used oxygen-glucose deprivation in brain slices in vitro and middle cerebral artery occlusion (MCAO) in vivo to induce ischemia in mouse brain. We used microdialysis in mouse striatum to monitor extracellular concentrations of glucose and glutamate. Results - In vitro, EGb761 reduced ischemia-induced cell swelling in hippocampal slices by 60%. In vivo, administration of EGb761 (300 mg/kg) reduced cell degeneration and edema …

Post Gastric Bypass Hypoglycemia: Four Cases Treated Successfully With Alphaglucosidase Inhibitor Therapy, Shavon S. Frankhouser Do, Aakif N. Ahmad Do, Gretchen A. Perilli Md, Benjamin J. Quintana Md, Marc A. Vengrove Do, Facp

Department of Medicine

No abstract provided.

Treatment Options For Parkinson’S Disease, Sara Russ

The Science Journal of the Lander College of Arts and Sciences

The following is an excerpt from this article: Parkinson’s disease was first described and named Paralysis Agitans in 1817 by British physician James Parkinson (Lieberman 2004). Later on, it took on its current name after Dr. Parkinson. Parkinson’s disease (PD) is a neurological disorder for which the cause is yet to be discovered. Like many other diseases, PD has numerous facets. Throughout all of its different stages, it presents with motor, as well as nonmotor, symptoms (Simuni et al. 2009). Though estimates of people affected by PD are constantly being made, it is difficult to determine a precise and accurate …

Imatinib Resistance In Philadelphia Chromosome-Positive Chronic Myeloid Leukemia, Rivky Kops

The Science Journal of the Lander College of Arts and Sciences

Chronic myeloid leukemia (CML) is a disorder of blood stem cells in bone marrow, which leads to a rapid production of white blood cells. Of the patients diagnosed with CML, 95% have the Philadelphia (Ph) chromosome, which means that chromosome 22 is smaller than regular (22 q-). Historically, the median survival time for chronic phase CML patients was four to five years, while the accelerated and blast (profusion of immature red blood cells in circulation) phases had a much shorter survival time. Recently, due to the revolutionary new drug imatinib, CML patients diagnosed early have a higher survival rate. Nevertheless, …

Does Whole Body Vibration (Wbv) Therapy Positively Affect The Motor Skills Of Patients Who Have Been Diagnosed With Parkinson’S Disease?, Courtney Forsyth

PCOM Physician Assistant Studies Student Scholarship

OBJECTIVE: The objective of this systematic review is to determine whether Whole Body Vibration (WBV) therapy positively affects the motor skills of patients who have been diagnosed with Parkinson’s disease.

STUDY DESIGN: Review of 3 English language primary studies. All three were randomized control trials; one was rater blinded and one double blinded with a placebo.

DATA SOURCES: All of the articles were Randomized Control Trials found using the PubMed database.

OUTCOMES MEASURED: Each of the three studies looked at the symptoms of Parkinson’s disease patients before and after Whole Body Vibration Therapy. Each study used the Unified Parkinson’s Disease …

Does Pre-Hospital Therapeutic Hypothermia Improve The Functional And Survival Status Of Patients Post Cardiac Arrest?, Stephanie Corsi

PCOM Physician Assistant Studies Student Scholarship

OBJECTIVE: The objective of this selective EBM review is to determine whether or not prehospital therapeutic hypothermia improves the functional and survival status of post cardiac arrest patients.

STUDY DESIGN: Review of three English language primary studies, two of which were published in 2007 and one in 2010.

DATA SOURCES: Two randomized, controlled, clinical trials and one cohort study comparing pre-hospital therapeutic hypothermia to induction of therapeutic hypothermia upon hospital admission, and to standard normothermic post cardiac arrest care. All were found using Medline, OVID, and Cochrane Systematic databases.

OUTCOMES MEASURED: An outcome measured was functional status at hospital discharge, …

Examining Cancer-Related Pain And Quality Of Life In Lehigh Valley Home Care Patients, Linda G. Alley Phd, Rn, Hannah D. Paxton Rn, Mph, Michelle D. Flores Bsn, Rn, Carol A. Foltz Phd, Jen Wike Mph, Mba, Vickie Cunningham Bsn, Rn, Jeffrey Etchason Md

Administration & Leadership

No abstract provided.

Lymphotoxin-Beta Receptor Blockade Reduces Cxcl13 In Lacrimal Glands And Improves Corneal Integrity In The Nod Model Of Sjögren's Syndrome, Roy A. Fava, Susan M. Kennedy, Sheryl G. Wood, Anne I. Bolstad, Jadwiga Bienkowska, Adrian Papandile, John A. Kelly

Dartmouth Scholarship

In Sjögren's syndrome, keratoconjunctivitis sicca (dry eye) is associated with infiltration of lacrimal glands by leukocytes and consequent losses of tear-fluid production and the integrity of the ocular surface. We investigated the effect of blockade of the lymphotoxin-beta receptor (LTBR) pathway on lacrimal-gland pathology in the NOD mouse model of Sjögren's syndrome.

Neuroprotective Effects Of Bilobalide Are Accompanied By A Reduction Of Ischemia-Induced Glutamate Release In Vivo, Dorothee Lang, Cornelia Kiewert, Alexander Mdzinarishvili, Tina Maria Schwarzkopf, Rachita K. Sumbria, Joachim Hartmann, Jochen Klein

Pharmacy Faculty Articles and Research

Neuroprotective properties of bilobalide, a specific constituent of Ginkgo extracts, were tested in a mouse model of stroke. After 24 h of middle cerebral artery occlusion (MCAO), bilobalide reduced infarct areas in the core region (striatum) by 40–50% when given at 10 mg/kg 1 h prior to MCAO. Neuroprotection was also observed at lower doses, or when the drug was given 1 h past stroke induction. Sensorimotor function in mice was improved by bilobalide as shown by corner and chimney tests. When brain metabolism in situ was monitored by microdialysis, MCAO caused a rapid disappearance of extracellular glucose in the …