Medical Specialties Commons^™

Diagnosis, Evaluation And Treatments For Dementia, John W. Margraf Md

Neurology Update for the Non-Neurologist

No abstract provided.

Acute Aortic Valve Rupture From Infective Endocarditis After Transrectal Prostate Biopsy: A Call To Revise The Aha Guidelines For Prevention Of Infective Endocarditis, Julia Ansari, Gurkaran Singh Garcha, Henry Huang, Faisal G. Bakaeen, Salim S. Virani, Hani Jneid

Office of the Provost

We describe the case of a 63-year-old man with a known murmur who presented with a 4-month history of intermittent fever and a progressive reduction in energy level after a transrectal prostate biopsy (TRPB). He subsequently presented with acute heart failure secondary to aortic valve cusp rupture caused by endocarditis and underwent urgent aortic valve surgery. The 2008 American College of Cardiology/American Heart Association Guideline update on infective endocarditis has narrowed the use of antibiotic prophylaxis before most accepted dental procedures and continues to recommend against prophylaxis before genitourinary or gastrointestinal procedures. In contrast, the American Urological Association recommends the …

Treatment Options For Seizures: Practical Points In Epilepsy Management, Soraya E. Jiménez Md

Neurology Update for the Non-Neurologist

No abstract provided.

Diagnosis, Assessment And Evaluation For Seizures, John W. Margraf Md

Neurology Update for the Non-Neurologist

No abstract provided.

Special Populations And Considerations In Migraine Therapy, Gary Clauser Md

Neurology Update for the Non-Neurologist

No abstract provided.

Migraine Diagnosis And Treatment, Vitaliy Koss Md

Neurology Update for the Non-Neurologist

No abstract provided.

Defining The Need For Specific Neurological Studies, John E. Castaldo Md

Neurology Update for the Non-Neurologist

No abstract provided.

Data Mining The Functional Characterizations Of Proteins To Predict Their Cancer-Relatedness, Peter Revesz, Christopher Assi

School of Computing: Faculty Publications

This paper considers two types of protein data. First, data about protein function described in a number of ways, such as, GO terms and PFAM families. Second, data about whether individual proteins are experimentally associated with cancer by an anomalous elevation or lowering of their expressions within cancerous cells. We combine these two types of protein data and test whether the first type of data, that is, the functional descriptors, can predict the second type of data, that is, cancer-relatedness. By using data mining and machine learning, we derive a classifier algorithm that using only GO term and PFAM family …

Low Rate Of Recurrence Of Helicobacter Pylori Infection In Spite Of High Clarithromycin Resistance In Pakistan, Javed Yakoob, Shahab Abid, Wasim Jafri, Zaigham Abbas, Khalid Mumtaz, Saeed Hamid, Rashida Ahmed

Section of Gastroenterology

Background

The aim was to investigate the reinfection rate of H. pylori during a follow-up period of 12 months in adults who had undergone eradication therapy.

Methods

One hundred-twenty patients; 116 with gastritis, 3 with duodenal ulcer and 1 gastric ulcer, were studied. Their mean age was 41 ± 13 years (range 18–77) and male: female ratio of 2:1. H. pylori were cultured and antibiotic sensitivity was determined by Epsilometer test (E-test) for clarithromycin (CLR) and amoxicillin (AMX). Primers of urease C gene of H. pylori and Sau-3 and Hha I restriction enzymes were used for polymerase chain reaction-restriction fragment …

Association Of Impaired Linear Growth And Worse Neurodevelopmental Outcome In Infants With Single Ventricle Physiology: A Report From The Pediatric Heart Network Infant Single Ventricle Trial., Chitra Ravishankar, Victor Zak, Ismee A. Williams, David C. Bellinger, J William Gaynor, Nancy S. Ghanayem, Catherine D. Krawczeski, Daniel J. Licht, Lynn Mahony, Jane W. Newburger, Victoria L. Pemberton, Richard V. Williams, Renee Sananes, Amanda L. Cook, Teresa Atz, Svetlana Khaikin, Daphne T. Hsu, Pediatric Heart Network Investigators, Girish S. Shirali

Manuscripts, Articles, Book Chapters and Other Papers

OBJECTIVES: To describe neurodevelopmental outcomes in infants with single ventricle (SV) physiology and determine factors associated with worse outcomes.

STUDY DESIGN: Neurodevelopmental outcomes for infants with SV enrolled in a multicenter drug trial were assessed at 14 months of age using the Bayley Scales of Infant Development-II. Multivariable regression analysis was used to identify factors associated with worse outcomes.

RESULTS: Neurodevelopmental testing was performed at 14 ± 1 months in 170/185 subjects in the trial. Hypoplastic left heart syndrome was present in 59% and 75% had undergone the Norwood operation. Mean Psychomotor Developmental Index (PDI) and mental developmental index (MDI) …

Loss Of Dystrophin Staining In Cardiomyocytes: A Novel Method For Detection Early Myocardial Infarction, Satwat Hashmi, Suhail Al-Salam

Department of Biological & Biomedical Sciences

Myocardial infarction (MI) is the most frequent diagnosis made in majority of sudden death cases subjected to clinical and medicolegal autopsies. When sudden death occurs at a very early stage of MI, traditional macroscopic examination, or histological stains cannot easily detect the myocardial changes. For this reason we propose a new method for detecting MI at an early stage. Murine model of MI was used to induce MI through permanent ligation of left anterior descending branch of left coronary artery. Five groups of C57B6/J mice were used for inducing MI, which includes 20 minutes, 30 minutes, one hour, four hours …

Cardiovascular Fitness Associated With Cognitive Performance In Heart Failure Patients Enrolled In Cardiac Rehabilitation, Sarah Garcia, Michael L. Alosco, Mary Beth Spitznagel, Ronald Cohen, Naftali Raz, Lawrence Sweet, Richard Josephson, Joel Hughes, Jim Rosneck, Morgan L. Oberle, John Gunstad

Wayne State University Associated BioMed Central Scholarship

Abstract

Background

Reduced cognitive function is common in persons with heart failure (HF). Cardiovascular fitness is a known contributor to cognitive function in many patient populations, but has only been linked to cognition based on estimates of fitness in HF. The current study examined the relationship between fitness as measured by metabolic equivalents (METs) from a standardized stress test and cognition in persons with HF, as well as the validity of office-based predictors of fitness in this population.

Methods

Forty-one HF patients enrolled in cardiac rehabilitation completed a standardized exercise stress test protocol, a brief neuropsychological battery, the 2-minute step …

Loss Of Dok2 Induces Carboplatin Resistance In Ovarian Cancer Via Suppression Of Apoptosis, E. Lum, M. Vigliotti, N. Banerjee, N. Cutter, K. O. Wrzeszczynski, S. Khan, S. Kamalakaran, D. A. Levine, N. Dimitrova, R. Lucito

Journal Articles

Objective. Ovarian cancers are highly heterogeneous and while chemotherapy is the preferred treatment many patients are intrinsically resistant or quickly develop resistance. Furthermore, all tumors that recur ultimately become resistant. Recent evidence suggests that epigenetic deregulation may be a key factor in the onset and maintenance of chemoresistance. We set out to identify epigenetically silenced genes that affect chemoresistance. Methods. The epigenomes of a total of 45 ovarian samples were analyzed to identify epigenetically altered genes that segregate with platinum response, and further filtered with expression data to identify genes that were suppressed. A tissue culture carboplatin resistance screen was …

Screening Diabetic And Hypertensive Patients For Ocular Pathology Using Telemedicine Technology In Rural West Virginia: A Retrospective Chart Review, Rezwan Ahmed Md, Stephen M. Petrany, Russell Fry Ii, Michael Krasnow Do, Phd

Internal Medicine

Abstract: Purpose: There is a disparity between the number of people who need healthcare and availability of medical services in rural areas. This paper describes the experience of using telemedicine technologies for ophthalmologic evaluation in diabetic and hypertensive patients presenting to a community health center in rural West Virginia.

Methods: A registered nurse at a community health center in McDowell County, WV was trained to use a retinal camera to capture high-resolution digital images of the retina. Patients with diabetes or hypertension were screened during their routine primary care visits. Retinal photos were transmitted to an ophthalmologist for review and …

Effect Of Budesonide On Fibroblast-Mediated Collagen Gel Contraction And Degradation, Qiuhong Fang, Nancy A. Schulte, Huijung Kim, Tetsu Kobayashi, Xingqi Wang, Anna Miller-Larsson, Elisabet Wieslander, Myron L. Toews, Xiangde Liu, Stephen I. Rennard

Journal Articles: Pulmonary & Critical Care Med

BACKGROUND: The balance between production and degradation of extracellular matrix is crucial in maintaining normal tissue structure. This study was designed to investigate the effect of budesonide on fibroblast-mediated tissue repair and remodeling.

METHODS: Using human fetal lung fibroblasts in a three-dimensional collagen gel culture system, we investigated the effect of budesonide (1-1000 nM) on collagen gel contraction and degradation in the presence or absence of Inflammatory cytokines (interleukin-1β and tumor necrosis factor α; 5 ng/mL each) and, in order to activate latent proteases, serine protease trypsin 0.25 μg/mL. The effects of budesonide on metalloproteinase production and activation were also …

Pge 2 Desensitizes Β -Agonist Effect On Human Lung Fibroblast-Mediated Collagen Gel Contraction Through Opregulating Pde4, Qiuhong Fang, Yingmin Ma, Jing Wang, Joel Michalski, Stephen I. Rennard, Xiangde Liu

Journal Articles: Pulmonary & Critical Care Med

In the current study, we investigated the effect of a long-acting β -agonist (salmeterol) and a phosphodiesterase 4 (PDE4) inhibitor (cilomilast) on human lung fibroblast-mediated collagen gel contraction. Higher concentrations of salmeterol (10(-7) and 10(-6) M) inhibited fibroblast-mediated collagen gel contraction. No effect was observed with cilomilast alone (up to 10(-5) M). In the presence of 10(-8) M salmeterol, however, cilomilast could significantly inhibit fibroblast-mediated collagen gel contraction in a concentration-dependent manner (10(-7) ~10(-5) M). Blockade of endogenous PGE2 by indomethacin further potentiated the inhibitory effect of salmeterol on fibroblast-mediated collagen gel contraction, but it did not affect cilomilast's effect. …

Factors Associated Within 28 Days In-Hospital Mortality Of Patients With Acute Respiratory Distress Syndrome, Nadia Sharif, Muhammad Irfan, Javaid Hussain, Javaid Khan

Section of Pulmonary & Critical Care

Objective. To determine the factors leading to in-hospital mortality within 28 days in hospitalized patients with ARDS. It was a prospective observational cohort study conducted in Intensive Care Unit of Aga Khan University Hospital Karachi from March to August 2011. Methodology. Data was collected from patients admitted in the intensive care unit on the basis of inclusion and exclusion criteria. The patients were followed daily for 28 days to record any in-hospital complications and the outcome of patients. Results. Total of 46 patients were included during this period out of which 56% (26) were males and 43% (20) were females. …

Bronchial Carcinoid Presenting As Multiple Lung Abscesses, Zeeshan Waheed, Muhammad Irfan, Saulat Fatimi, Ruqaiya Shahid

Section of Pulmonary & Critical Care

Bronchial carcinoid tumours is a rare group of pulmonary malignant neoplasm that is derived from neuroendocrine system. Bronchial carcinoid usually present with hilar masses, atelactasis, bronchiectasis, or post-obstructive pneumonia. This case describes a very unusual presentation of bronchial carcinoid tumour with multiple lung abscesses involving the whole lung. This report is of an adult lady who presented with multiple lung abscesses involving her whole of the right lung. She was found to have an endo-bronchial lesion in her right main bronchus which eventually turned out to be carcinoid tumour. She responded to resection and antibiotic therapy.

Expression Of M. Tuberculosis-Induced Suppressor Of Cytokine Signaling (Socs) 1, Socs3, Foxp3 And Secretion Of Il-6 Associates With Differing Clinical Severity Of Tuberculosis, Kiran I. Masood, Martin E. Rottenberg, Naseem Salahuddin, Muhammad Irfan, Nisar Rao, Berit Carow, Muniba Islam, Rabia Hussain, Zahra Hasan

Section of Pulmonary & Critical Care

Background

Appropriate immune activation of T cells and macrophages is central for the control of Mycobacterium tuberculosis infections. IFN-γ stimulated responses are lowered in tuberculosis (TB), while expression of Suppressor of Cytokine Signaling (SOCS) molecules – 1 and 3 and CD4⁺CD25⁺FoxP3⁺T regulatory cells is increased. Here we investigated the association of these molecules in regard to clinical severity of TB.

Methods

Peripheral blood mononuclear cells (PBMCs) were isolated from patients with pulmonary TB (PTB, n = 33), extra-pulmonary TB (ETB, n = 33) and healthy endemic controls (EC, n = 15). Cases were classified …

Merkel Cell Carcinoma, Cynthia L. Bartus Md, Steven Oberlender Md, Phd, Christian W. Oram Do

Department of Medicine

No abstract provided.

Comparing Margin Diameter And Margin Index In Predicting Residual Disease Following Partial Mastectomy, P85, Daniel F. Barnas Md, Aaron D. Bleznak Md, Facs, Anna Widmyer Md, Elizabeth Dellers Md, Heiwon Chung Md, Facs

Department of Surgery

No abstract provided.

Aβ Alters The Dna Methylation Status Of Cell-Fate Genes In An Alzheimer’S Disease Model, Gary D. Isaacs, Noor Taher, Courtney Mckenzie, Rebecca Garrett, Matthew Baker, Nena Fox

Faculty Publications and Presentations

Alzheimer’s disease (AD) is characterized by neurofibrillary tangles and extracellular amyloid-β plaques (Aβ). Despite ongoing research, some ambiguity remains surrounding the role of Aβ in the pathogenesis of this neurodegenerative disease. While several studies have focused on the mutations associated with AD, our understanding of the epigenetic contributions to the disease remains less clear. To that end, we determined the changes in DNA methylation in differentiated human neurons with and without Aβ treatment. We isolated the DNA from neurons treated with Aβ or vehicle, and digested the two samples with either a methylation-sensitive (HpaII) or a methylation-insensitive (MspI) restriction endonuclease. …

Anti-Inflammatory Effects Of Budesonide In Human Lung Fibroblast Are Independent Of Histone Deacetylase 2, Xingqi Wang, Amy J. Nelson, Zachary M. Weiler, Amol Patil, Tadashi Sato, Nobuhiro Kanaji, Masanori Nakanishi, Joel Michalski, Maha Farid, Hesham Basma, Tricia D. Levan, Anna Miller-Larsson, Elisabet Wieslander, Kai-Christian Muller, Olaf Holz, Helgo Magnussen, Klaus F. Rabe, Xiangde Liu, Stephen I. Rennard

Journal Articles: Pulmonary & Critical Care Med

OBJECTIVE AND DESIGN: Reduced expression of histone deacetylase 2 (HDAC2) in alveolar macrophages and epithelial cells may account for reduced response of chronic obstructive pulmonary disease (COPD) patients to glucocorticoids. HDAC2 expression and its role in mediating glucocorticoid effects on fibroblast functions, however, has not been fully studied. This study was designed to investigate whether HDAC2 mediates glucocorticoid effects on release of inflammatory cytokines and matrix metalloproteinases (MMPs) from human lung fibroblasts.

METHODS: Human lung fibroblasts (HFL-1 cells) were stimulated with interleukin (IL)-1 β plus tumor necrosis factor (TNF)-α in the presence or absence of the glucocorticoid budesonide. Cytokines (IL-6 …

Analysis Of Autophagy And Inflammasome Regulation In Neuronal Cells And Monocytes Infected With Chlamydia Pneumoniae: Implications For Alzheimer’S Disease, Brian J. Balin, Christine J. Hammond, Juliana Zoga, Ahmad B. Cader, Annette K. Slutter, Jonathan M. Anzman, Ian Kohler, Susan T. Hingley, Denah M. Appelt

Scholarly Posters

Objectives: Our laboratory has been studying the role of infection with the obligate intracellular bacterium Chlamydia pneumoniae in sporadic late-onset Alzheimer disease (LOAD). This infection may be a trigger for the pathology observed in LOAD as a function of initiating changes in gene regulation following entry of the organism into the brain. As such, we are analyzing how this infection can promote changes in autophagy and inflammasome gene regulation as both have been shown to be altered in LOAD. Methods: Human SKNMC neuronal cells and THP1 monocytes were infected in vitro for 24-72 hrs with a laboratory strain of Chlamydia …

Relevance Of Molecular Mimicry In The Mediation Of Infectious Myocarditis, Chandirasegaran Massilamany, Sally A. Huber, Madeleine W. Cunningham, Jay Reddy

Jay Reddy Publications

Heart disease, the leading cause of death in humans, is estimated to affect one in four American adults in some form. One predominant cause of heart failure in young adults is myocarditis, which can lead to the development of dilated cardiomyopathy, a major indication for heart transplantation. Environmental microbes, including viruses, bacteria, and fungi that are otherwise innocuous, have the potential to induce inflammatory heart disease. As the list is growing, it is critical to determine the mechanisms by which microbes can trigger heart autoimmunity and, importantly, to identify their target antigens. This is especially true as microbes showing structural …

Winning The Battle Against Surgical Site Infections, Lisa Farthing Msn, Rn, Cnor, Michelle Reigard Rn, Cnor

Patient Care Services / Nursing

No abstract provided.

A Review Of Comparison Of Complications Of Vaginal Hysterectomy With And Without Concomitant Surgery For Sui: A 5 Years’ Experience At A Tertiary Care Hospital Of Pakistan, Raheela Mohsin Rizvi, Munnazza Akhtar, Nadeem F. Zuberi

Department of Obstetrics & Gynaecology

Objective. The study was performed to review the complications of surgery for POP with or without surgery for SUI. This included the need for second procedure two years after the primary surgery. Study Design. We conducted a retrospective cross-sectional comparative study at the Aga Khan University, Karachi, Pakistan. International Classification of Diseases, 9th revision, Clinical Modification (ICD-9-CM) was used to identify women who underwent vaginal hysterectomy with anterior/posterior repair alone and those with concomitant tension-free vaginal tape surgery for urodynamic stress incontinence. Results. The 28 cases of VH/repair combined with TVT were compared for complications with 430 cases of VH …

Psychiatric Nursing Care For Patients With Cardiac Disease, Gail Stern Msn, Donna Petruccelli Msn, Crnp, Np-C, Jeanne Manavizadeh Bsn, Rn, Pccn

Patient Care Services / Nursing

No abstract provided.

Is The Use Of Intestinal Helminths Safe And Effective In The Treatment Of Allergic Rhinitis?, Tanner Mccalley

PCOM Physician Assistant Studies Student Scholarship

OBJECTIVE: The objective of this EBM review is to determine whether the use of intestinal helminths is safe and effective in the treatment of allergic rhinitis.

STUDY DESIGN: Review of three English language, blinded randomized controlled trials from 2009, 2010, and 2010.

DATA SOURCE: Randomized, controlled, blinded trials comparing the use of intestinal helminths versus visually matched placebo as a treatment for allergic rhinitis found using PubMed and Ovid databases.

OUTCOMES MEASURED: Several different systems were used to evaluate the symptoms or occurrence of AR. Bager et al.2010 uses symptom scores of AR scale of 0 …

Is Dapsone Gel Safe And Effective For The Treatment Of Acne Vulgaris?, Amy Patel

PCOM Physician Assistant Studies Student Scholarship

OBJECTIVE: The objective of this selective EBM review is to determine whether or not dapsone gel is safe and effective for the treatment of acne vulgaris.

STUDY DESIGN: A review of three English language studies published in 2007. Includes two randomized, double-blind, controlled trials and one open label, noncomparative study. DATA SOURCES: Randomized, controlled trials comparing dapsone gel to vehicle gel control were found using PubMed and Cochrane database.

OUTCOMES MEASURED: Success on the Global Acne Assessment Score (GAAS) and reduction in acne lesion counts

RESULTS: The two randomized, controlled trials and the open-label noncomparative study …