Medical Sciences Commons^™

Recent Conservative Management Trends In Dealing With Uterine Adnexal Torsion Will Preserve Fertility In Childbearing Women: A Review Of Literature And Case Series, Hossam H. Soliman

Journal of Medicine in Scientific Research

Introduction Uterine adnexal torsion is a rare gynecologic emergency, representing 2.5–7% of all the acute gynecologic surgical conditions. It could lead to adnexal ischemia and necrosis, putting a woman at the risk of a radical surgery, which leads her to lose a uterine adnexa, plummeting her future fertility, and possibility inducing a negative effect of her future marital and family life. Adnexal detorsion associated with cystectomy is a simple maneuver that could spare the woman of losing her ovary; this technique could successfully work even with an apparently necrosed ovary. Aim A review of literature, in addition to a retrospective …

Additive Value Of Intraoperative Hemodynamic Monitoring To Epicardial Echocardiography During Surgical Repair Of Children With Congenital Heart Disease, Ahmed A. Algebaly, Hanan Mohammed Hassan, Rania D. Eldin Abou Shokka

Journal of Medicine in Scientific Research

Aim The aim was to evaluate the additive value of intraoperative hemodynamic monitoring to epicardial echocardiography on the surgical outcome in children undergoing surgical correction of congenial heart disease. Patients and methods This study was conducted on 238 children with congenital heart disease who were enrolled for surgical correction. They were arranged in two groups: group A included 159 children in whom e-echo was used to detect intraoperative residual lesions while group B included 79 patients in whom e-echo and intraoperative hemodynamic monitoring using oxygen saturation step-up and intracardiac pressures after disconnection of cardiopulmonary bypass to detect residual shunt flow …

Surgical Outcomes Of Obstructive Mechanical Valve Thrombosis, Risk Factors, And Comorbidity Analysis, Ahmed Shafeek Ali

Journal of Medicine in Scientific Research

Background Obstructive mechanical valves thrombosis is a life-threatening complication associated with high morbidity and mortality. Although thrombolytic therapy has gained a lot of popularity in recent years, yet the treatment of choice is still controversial. Objective The aim of this study was to evaluate the outcomes of patients who underwent redo valve surgery for obstructive mechanical valve thrombosis. Patients and methods Outcomes of 380 patients who underwent emergency redo surgery for obstructive mechanical valve thrombosis at our institute during a 5-year period (January 2012 to December 2017) were reviewed retrospectively. Clinical symptoms and transthoracic echocardiography were the mainstay in diagnosis. …

A Comparison Between Monopolar Radiofrequency Ablation And Electrocautery (Diathermy) Ablations In Left Modified Maze (Short-Term Results), Waleed El-Awady

Journal of Medicine in Scientific Research

Introduction Atrial fibrillation is the most common cardiac arrhythmia and is associated with significant morbidity and mortality. The classic cut-and-sew maze procedure is successful in 85–95% of patients. However, it is technically challenging and requires prolonged cardiopulmonary bypass. The left modified maze procedure is successful in 65–85% of patients. The aim of this study was to compare the success of two different ablation sources in the left modified MAZE. Patients and methods Between June 2010 and December 2016, 40 patients underwent left modified MAZE (Cox III) procedure: 20 patients were done with monopolar radiofrequency ablation (group A) and the other …

Retrograde Transcatheter Closure Of Perimembranous Aneurysmal Ventricular Septal Defects Using Amplatzer Vascular Plug Ii, Ahmed A. Al Gebaly, Rania Diaa Abou Shokka, Wael M. Hossam

Journal of Medicine in Scientific Research

Introduction Retrograde transcatheter closure of perimembranous aneurysmal ventricular septal defects (pmVSD) can be a better option for transcatheter closure of ventricular septal defect with device placement into ventricular septal aneurysm with fewer complications. Also, a retrograde approach might decrease procedure time and radiation exposure time. Aim The purpose of this study was to report off-label experience using Amplatzer Vascular Plug II (AVPII) for the trans catheter closure of perimembranous aneurysmal VSD. Comparison of haemodynamic effects of ketamine and sevofluorane as in induction of anesthesia. Materials and methods Our series consists of a fifteen child with pmVSD. The mean age was …

One-Year Angiographic Results Of Left Anterior Descending Bypass Using Internal Mammary Artery: A Series Of 48 Consecutive Patients, Ahmed S. Mahlab

Journal of Medicine in Scientific Research

The left internal mammary artery (LIMA) has been used as a conduit for coronary artery revascularization since 1968. Here we are reporting A total of 48 consecutive patients were operated upon using double mammary arteries. All of them received a mammary graft to the left anterior descending artery (LAD). All 48 of them were controlled angiographically at 1 year postoperative to ensure satisfactory well-functioning grafts.

Ruptured Inferior Mesenteric Artery Aneurysm: A Case Report, Assem Mohamed Herzallah

Journal of Medicine in Scientific Research

Among visceral artery aneurysms, inferior mesenteric artery aneurysm is the rarest. Although most cases are of degenerative etiology, a small fraction of these cases are caused by autoimmune diseases. We report a case of spontaneous retroperitoneal hemorrhage from a ruptured inferior mesenteric artery aneurysm in a 30-year-old patient with systemic lupus erythematosus, treated by ligation.

The Effects Of Nicotine And Cigarette Smoking On Cardiac Electrophysiology., Affan B. Irfan

Electronic Theses and Dissertations

Cigarette smoking is a leading cause of preventable disease and premature death worldwide. The adverse effects of cigarette smoking, including proarrhythmia, are related to the mixture of chemicals, including nicotine (which sustains tobacco addiction). However, it remains unclear which individual tobacco smoke constituents and biological pathways mediate this increased risk. The purpose of this research was to explore the chronic effects of cigarette smoking, as well as compare the acute effects of nicotine and cigarette smoking, and the possible role of β-adrenoreceptors, on human cardiac electrophysiology. Chapter 1 is a comprehensive literature review of (a) the ex vivo and in …

The Identification Of Long Non-Coding Rna Zfas1 Through An Exploratory Rna-Sequencing Analysis And Its Association With Epithelial-To-Mesenchymal Transition In Colon Cancer Adenocarcinoma., Stephen J. O'Brien

Electronic Theses and Dissertations

Colorectal adenocarcinoma is the fourth most common cancer diagnosed worldwide and is a significant cause of morbidity and mortality. This dissertation performed an exploratory RNA-sequencing analysis comparing gene expression between colon adenocarcinoma tissue and paired normal colon epithelium. After identification of a number of lncRNAs that were increased in expression in colon adenocarcinoma compared to normal colon epithelium, we aimed to validate the expression and investigate their function in vitro. Specifically, we focused on the lncRNA ZFAS1 and its association with epithelial-to-mesenchymal transition. These studies found the following: 1. Seven candidate lncRNAs were identified from the exploratory RNA-sequencing analysis to …

Genetic Screening For Breast Cancer In The Primary Care Setting, Michael Nick Gomez

Doctor of Nursing Practice

The purpose of this project was to increase adherence to the U.S. Preventive Services Task Force and National Comprehensive Cancer Network guidelines for breast cancer screening and genetic testing. Screening for breast cancer risk factors including genetic testing helps reduce the incidence of breast cancer. A protocol was developed based on national clinical guidelines to increase screening and genetic testing for breast cancer. Provider responsibilities included screening all patients 18 years of age and older for risks factors of breast cancer, referring patients with a significant risk based on the screening for genetic testing and providing referrals for genetic counseling …

Cannabidiol, Behavior, And Immune Biomarkers In Idiopathic Autism Spectrum Disorder., Sarah Huang Shrader

Electronic Theses and Dissertations

Autism Spectrum Disorder (ASD) is a highly heterogenous neurodevelopmental disorder currently estimated by the CDC to affect 1 in 36 children in the U.S.. This uniquely human condition is characterized by a spectrum of symptoms that feature social communication deficits and repetitive behaviors with restricted interest. Autistic individuals commonly exhibit multiple comorbidities, including attention deficit hyperactivity disorder, anxiety, and seizures, which can complicate an already multi-faceted presentation. The majority of ASD cases are idiopathic in nature. Developing a well-validated animal model of ASD for translational research comes with many challenges, but is crucial for advancing our understanding of autism and …

Gna11 Brain Somatic Pathogenic Variant In An Individual With Phacomatosis Pigmentovascularis, Joseph M Sliepka, Sarah C Mcgriff, Linda Z Rossetti, Peyman Bizargity, Haley Streff, Yi-Shan Lee, Hongzheng Dai, Satyamaanasa Polubothu, Grace Lee, Vicky Ren, Jill V Hunter, Daniel J Curry, Fernando Scaglia, Adekunle M Adesina, Irfan Ali, Veronica Kinsler, Lindsay C Burrage, Dana Marafi

Faculty, Staff and Students Publications

OBJECTIVE: To describe the findings of histopathology and genotyping studies in affected brain tissue from an individual with phacomatosis pigmentovascularis (PPV).

METHODS: A retrospective chart review of a 2-year 10-month-old male with a clinical diagnosis of PPV cesiomarmorata (or type V) was performed. Clinical features, brain imaging and histopathology findings, and genotyping studies in his affected brain tissue are summarized.

RESULTS: The proband had a clinically severe neurologic phenotype characterized by global developmental delay, generalized hypotonia, and recurrent episodes of cardiac asystole in the setting of status epilepticus. A somatic pathogenic variant in

CONCLUSIONS: The finding of this variant in …

Bipolar Fresh Osteochondral Allograft Transplantation And Joint Reconstruction For Patellar And Trochlear Cartilage Defects, Omid Jalali, Zachary Vredenburgh, John Prodromo, Neilen Benvegnu, George Frederick Rick Hatch

Faculty, Staff and Students Publications

Patellar instability is a debilitating condition, and trauma due to the dislocations may severely damage the articular cartilage of the patellofemoral joint. The lack of healing capacity of cartilage makes treatment of such lesions challenging. In young patients, preservation of native bone and cartilage is a priority, and therefore arthroplasty procedures should be avoided even in relatively larger lesions. Fresh osteochondral allografting has been described for these difficult and complex cases, with recent studies showing promising results. In this surgical technique, we describe the use of bipolar osteochondral allografts of the patella and trochlea and patellofemoral joint reconstruction for large …

Results Of A Phase 1 Multicentre Investigation Of Dexmedetomidine Bolus And Infusion In Corrective Infant Cardiac Surgery, Athena F Zuppa, Susan C Nicolson, Nicole S Wilder, Juan C Ibla, Erin A Gottlieb, Kristin M Burns, Mario Stylianou, Felicia Trachtenberg, Hua Ni, Tera H Skeen, Dean B Andropoulos

Faculty, Staff and Students Publications

BACKGROUND: Dexmedetomidine (DEX) is increasingly used intraoperatively in infants undergoing cardiac surgery. This phase 1 multicentre study sought to: (i) determine the safety of DEX for cardiac surgery with cardiopulmonary bypass; (ii) determine the pharmacokinetics (PK) of DEX; (iii) create a PK model and dosing for steady-state DEX plasma levels; and (iv) validate the PK model and dosing.

METHODS: We included 122 neonates and infants (0-180 days) with D-transposition of the great arteries, ventricular septal defect, or tetralogy of Fallot. Dose escalation was used to generate NONMEM® PK modelling, and then validation was performed to achieve low (200-300 pg ml …

Structural Basis Of Amino Acid Surveillance By Higher-Order Trna-Mrna Interactions, Shuang Li, Zhaoming Su, Jean Lehmann, Vassiliki Stamatopoulou, Nikoleta Giarimoglou, Frances E Henderson, Lixin Fan, Grigore D Pintilie, Kaiming Zhang, Muyuan Chen, Steven J Ludtke, Yun-Xing Wang, Constantinos Stathopoulos, Wah Chiu, Jinwei Zhang

Faculty, Staff and Students Publications

Amino acid availability in Gram-positive bacteria is monitored by T-box riboswitches. T-boxes directly bind tRNAs, assess their aminoacylation state, and regulate the transcription or translation of downstream genes to maintain nutritional homeostasis. Here, we report cocrystal and cryo-EM structures of Geobacillus kaustophilus and Bacillus subtilis T-box-tRNA complexes, detailing their multivalent, exquisitely selective interactions. The T-box forms a U-shaped molecular vise that clamps the tRNA, captures its 3' end using an elaborate 'discriminator' structure, and interrogates its aminoacylation state using a steric filter fashioned from a wobble base pair. In the absence of aminoacylation, T-boxes clutch tRNAs and form a continuously …

Coordination Of Airway Protective Behaviors And Swallow: Effects Of Afferent Feedback And Sex., Alyssa D. Huff

Electronic Theses and Dissertations

This dissertation represents a series of studies describing mechanisms related to breathing, upper airway behaviors and their coordination in man and animal. Chapter two transformed the cough swallow aspiration protocol from the cat (previous work) to the human introducing a new strategy, volume targeting, in swallow breathing coordination. Chapter three evaluated swallow breathing coordination at increasing altitudes. As respiratory drive altered due to hypoxia and hypocapnia, swallow breathing coordination shifted toward inspiration occurring during the transition from inspiration and expiration. The collection of the two previous studies led to development of an animal model to evaluate volume targeting and …

Identification And Molecular Analysis Of Dna In Exosomes, Jena Tavormina

Dissertations and Theses (Open Access)

Exosomes are heterogeneous nanoparticles 50-150nm in diameter. Exosomes contain many functional cargo components, such as protein, DNA, and RNA. While protein and RNA exosome content has been extensively studied, very little work has been done to characterize exosomal DNA. Here, we demonstrate that exosomal DNA is heterogeneous and its packaging into exosomes is dependent on the cell of origin. Furthermore, through a rigorous assessment of various isolation methods, we identify Size Exclusion Chromatography (SEC) as the best method for the isolation of exosomal DNA for downstream applications. Additionally, we evaluate the methylation status of exosomal DNA and demonstrate that exosomal …

The Acute Effect Of Water Intake On Glucose Regulation In Low Drinkers, Adam David Seal

Graduate Theses and Dissertations

Previous evidence suggests the hormone arginine vasopressin (AVP) may be a modifiable factor contributing to hyperglycemia. Significant differences in urine concentration and copeptin, a marker for AVP, have been observed between low and high water drinkers. Purpose: The purpose was to investigate the acute effect of adequate water intake on glucose regulation in low drinkers. Methods: 7 healthy (5 males, 2 female) low drinkers were recruited using a water frequency questionnaire (WFQ), spot and 24-h urine sample (age 43±6 y, BMI 30.9±3, WFQ volume 823±403 mL∙d-1, 24 h Uosm 961±105 mmol∙kg-1, copeptin 8.17±3.05 pmol∙L-1). During two experimental protocols, participants remained …

Quantitative Study Of The Antimicrobial Effects Of Silver On The Motility Of Escherichia Coli, Benjamin Russell

Graduate Theses and Dissertations

In recent decades, the number of antibiotic-resistant bacterial infections has grown to become a serious global threat. This rise can be attributed to the widespread misuse of antibiotics and the lack of newly developed drugs to fight resistant organisms. Novel bactericidal substances have, therefore, garnered significant research interest. Silver, due to its powerful antimicrobial effects, is one such substance. Silver is typically most effective in cationic form; however, advancements in nanotechnology have paved the way for the controlled fabrication of nano-silver. Silver nanoparticles have been shown to have increased antibacterial potency for a variety of reasons, including the release of …

The Dynamic Impacts Of Online Healthcare Community On Physician Altruism: A Hidden Markov Model, Kai Luo, Qiu-Hong Wang, Hock Hai Teo

Research Collection School Of Computing and Information Systems

Physician altruism is not only a key foundation of modern medical professionalism, but also a critical component in the theoretical health economics study. There is considerable interest in understanding the impacts of contemporary healthcare technology on physician altruism. In this paper, we investigate the dynamic influence of multiple incentive mechanisms developed by an online healthcare community (OHC) on physician altruism. We model physician altruism as the degree of tendency to benefit the patients at the cost of oneself and focus on the incentive mechanisms that give physicians social and economic returns. The dynamics of physician altruism is characterized via a …

Examining The Theoretical Mechanisms Underlying Health Information Exchange Impact On Healthcare Outcomes: A Physician Agency Perspective, Fang Zhou, Qiu-Hong Wang, Hock Hai Teo

Research Collection School Of Computing and Information Systems

Health information exchange (HIE) is presumed to reduce medical costs by facilitating information sharing across healthcare providers. Existing studies focused on different medical costs or one set of costs, and resulted in mixed findings. We examine the effects of patient access to HIE on two of the most important medical costs of a hospitalization episode - test costs and medication costs - through a natural experiment and the discharge data of a hospital. Besides the negative direct effect of access to HIT on tests costs, we also find its positive spillover effect on medication costs, such that more patients having …

Msto1 Mutations Cause Mtdna Depletion, Manifesting As Muscular Dystrophy With Cerebellar Involvement., S Donkervoort, R Sabouny, P Yun, L Gauquelin, K R Chao, Y Hu, I Al Khatib, A Töpf, P Mohassel, B B Cummings, R Kaur, D Saade, S A Moore, L B Waddell, M A Farrar, J K Goodrich, P Uapinyoying, S H S Chan, A Javed, M E Leach, P Karachunski, J Dalton, L Medne, A Harper, C Thompson, Isabelle Thiffault, S Specht, R E Lamont, Carol J. Saunders, H Racher, F P Bernier, D Mowat, N Witting, J Vissing, R Hanson, Keith A. Coffman, Meagan K. Hainlen, J S Parboosingh, A Carnevale, G Yoon, R E Schnur, Care4rare Canada Consortium, K M Boycott, J K Mah, V Straub, A Reghan Foley, A M Innes, C G Bönnemann, T E Shutt

Manuscripts, Articles, Book Chapters and Other Papers

MSTO1 encodes a cytosolic mitochondrial fusion protein, misato homolog 1 or MSTO1. While the full genotype-phenotype spectrum remains to be explored, pathogenic variants in MSTO1 have recently been reported in a small number of patients presenting with a phenotype of cerebellar ataxia, congenital muscle involvement with histologic findings ranging from myopathic to dystrophic and pigmentary retinopathy. The proposed underlying pathogenic mechanism of MSTO1-related disease is suggestive of impaired mitochondrial fusion secondary to a loss of function of MSTO1. Disorders of mitochondrial fusion and fission have been shown to also lead to mitochondrial DNA (mtDNA) depletion, linking them to the mtDNA …

Identification Of The Kaposi's Sarcoma-Associated Herpesvirus (Kshv) Surface Glycoprotein Targets Of Human Kshv-Specific Neutralizing Antibody Responses, Yasaman Mortazavi

School of Biological Sciences: Dissertations, Theses, and Student Research

Kaposi’s sarcoma-associated herpesvirus (KSHV), also known as human herpesvirus 8 (HHV-8), is the etiological agent of Kaposi’s sarcoma (KS), and is also associated with two B cell malignancies, primary effusion lymphoma and multicentric Castleman's disease. The distribution of KSHV varies globally with high prevalence in some areas of sub-Saharan Africa (SSA), where seroprevalence can be as high as 80%. It is estimated that nearly 44,000 new cases of KS emerge annually globally, with the highest incidents occurring in Africa, where KSHV is endemic. Currently, there is no prophylactic vaccine against KSHV, and efforts to develop prophylactic vaccines have been limited. …

A Rewiring Model Of Intratumoral Interaction Networks., Mengmeng Sang, Shawn Rice, Libo Jiang, Xin Liu, Claudia Gragnoli, Chandra P. Belani, Rongling Wu

Division of Endocrinology, Diabetes and Metabolic Diseases Faculty Papers

Intratumoral heterogeneity (ITH) has been regarded as a key cause of the failure and resistance of cancer therapy, but how it behaves and functions remains unclear. Advances in single-cell analysis have facilitated the collection of a massive amount of data about genetic and molecular states of individual cancer cells, providing a fuel to dissect the mechanistic organization of ITH at the molecular, metabolic and positional level. Taking advantage of these data, we propose a computational model to rewire up a topological network of cell-cell interdependences and interactions that operate within a tumor mass. The model is grounded on the premise …

Tamoxifen Activity Against Plasmodium In Vitro And In Mice, Ada Weinstock, Julio Gallego-Delgado, Cláudia Gomes, Julian Sherman, Cyrus Nikain, Sandra Gonzalez, Edward Fisher, Ana Rodriguez

Publications and Research

Background: Tamoxifen is an oestrogen receptor modulator that is widely used for the treatment of early stage breast cancer and reduction of recurrences. Tamoxifen is also used as a powerful research tool for controlling gene expression in the context of the Cre/loxP site-specific recombination system in conditional mutant mice.

Methods: To determine whether the administration of tamoxifen affects Plasmodium growth and/or disease outcome in malaria, in vitro studies assessing the effect of tamoxifen and its active metabolite 4-hydroxytamoxifen on Plasmodium falciparum blood stages were performed. Tamoxifen effects were also evaluated in vivo treating C57/B6 mice infected with Plasmodium berghei (ANKA …

Burnout, Job Dissatisfaction, And Mental Health Outcomes Among Medical Students And Health Care Professionals At A Tertiary Care Hospital In Pakistan: Protocol For A Multi-Center Cross-Sectional Study, Syed Hamza Mufarrih, Aeman Naseer, Nada Qaisar Qureshi, Zohaib Anwar, Nida Zahid, Riaz Hussain Lakdawala, Shahryar Noordin

Department of Biological & Biomedical Sciences

Burnout, a state of vital exhaustion, has frequently been related to work-related stress and job dissatisfaction. Given the emotionally and physically challenging nature of their work, high rates of burnout have been reported among health care professionals. This may put them at a higher risk for of suffering from adverse mental health outcomes, including depression, anxiety and stress. In our study, we aim to assess the prevalence i of and associations among burnout and job dissatisfaction and adverse mental health outcomes in a developing country, where the challenges faced by the health care system are unique. Facilities are over-burdened and …

Accelerated 129xe Mri Morphometry Of Terminal Airspace Enlargement: Feasibility In Volunteers And Those With Alpha-1 Antitrypsin Deficiency, Alexei Ouriadov, Fumin Guo, David G Mccormack, Grace Parraga

Medical Biophysics Publications

PURPOSE: Multi-b diffusion-weighted hyperpolarized inhaled-gas MRI provides imaging biomarkers of terminal airspace enlargement including ADC and mean linear intercept (L

METHODS: We evaluated multi-b (0, 12, 20, 30, and 45.5 s/cm

RESULTS: For the HV subgroup, mean differences of 5%, 2%, and 8% were observed between fully sampled and undersampled k-space for ADC, L

CONCLUSIONS: Accelerated multi-b diffusion-weighted

Cardiac Dysfunction In Patients With Community-Acquired Pneumonia, Ehab Elmelegy, El-Saied Shaheen, Wael Hossam El Din

Journal of Medicine in Scientific Research

Background Community-acquired pneumonia (CAP) is still an important cause of morbidity and mortality worldwide especially in the elderly. Evidence shows a high correlation between acute respiratory infections and increased risk of cardiovascular events (CVEs). The occurrence of CVE in hospitalized patients with CAP may significantly affect the clinical status, and a severe CVE could be the primary cause of clinical failure. Aim To study the incidence of cardiac complications in patients with CAP. Patients and methods This clinical study was carried out on 120 patients (63 males and 57 females) hospitalized with a primary diagnosis of CAP. Patients with the …

Using Ondansetron As An Oral Premedication Drug For Prevention Of Postanesthesia Shivering, Ashraf A. M. Soliman

Journal of Medicine in Scientific Research

Introduction Postanesthesia shivering (PAS) is one of the most common complications after surgeries. There are two methods to reduce the shivering, including pharmacological and nonpharmacological methods. Aim This study compared the efficacy and safety of 4-mg oral ondansetron premedication on preventing PAS, perioperative core body temperature changes, and hemodynamic stability. Patients and methods This prospective, observational study consisted of 100 adult patients scheduled for general surgery or interventional structural heart disease. The patients were randomized into two groups of 50 patients each. Group I received 4 mg of oral ondansetron, and group II received an oral placebo 60–90 min before …

Rare Presentation Of Typhoid Fever In An Immunocompetent Patient, Kumar Priyanka, Rajnish Kumar

Journal of Medicine in Scientific Research

Typhoid fever, caused by Salmonella enterica serovar Typhi, is the most common cause of enteric fever, and presents classically with fever and other gastrointestinal symptoms. We report an interesting case of a 27-year-old Indian man who lives in a semiurban area of Haryana (northern India) and presented with a 3-day-long history of intermittent fever, chills, and rigor. He was misdiagnosed previously as having mumps fever in view of the clinical presentation, but later, with proper workup, it was found to be an atypical presentation of typhoid fever. He responded well to intravenous antibiotics and recovered completely from typhoid infection.