Medical Specialties Commons^™

Communication About End Of Life For Patients Living With Amyotrophic Lateral Sclerosis: A Scoping Review Of The Empirical Evidence, Shelagh K. Genuis, Westerly Luth, Sandra Campbell, Tania M. Bubela, Wendy S. Johnston

Office of the Provost

Background: Communication about end of life, including advance care planning, life-sustaining therapies, palliative care, and end-of-life options, is critical for the clinical management of amyotrophic lateral sclerosis patients. The empirical evidence base for this communication has not been systematically examined.
Objective: To support evidence-based communication guidance by (1) analyzing the scope and nature of research on health communication about end of life for amyotrophic lateral sclerosis; and (2) summarizing resultant recommendations.
Methods: A scoping review of empirical literature was conducted following recommended practices. Fifteen health-related and three legal databases were searched; 296 articles were screened for inclusion/exclusion criteria; and quantitative …

Effects Of Liposome-Encapsulated Tnf-Alpha And Radiation Against Colon Cancer, Dong Won Kim

Loma Linda University Electronic Theses, Dissertations & Projects

Previous studies have shown that tumor necrosis factor-α (TNF-α) can augment the antitumor effects of radiation, inhibiting tumor progression to a greater extent than either modality alone. However, nonspecific toxicities associated with TNF-α have limited its use as an adjuvant. This limitation is potentially resolved with the encapsulation of TNF-α in sterically stabilized, PEGylated liposomes (STEALTH®). Thus, the overall hypothesis of the research was that the combination of radiation with STEALTH® liposome encapsulated TNF-α (SL-TNF-α) will have greater efficacy and fewer dose-limiting side effects in the LS174T human colorectal tumor xenograft model compared to the combination of free TNF-α and …

Arrhythmogenic Right Ventricular Cardiomyopathy, Wing-Hong Fung, Chi-Kin Chan, John E. Sanderson

Journal of the Hong Kong College of Cardiology

Arrhythmogenic right ventricular cardiomyopathy (ARVC) is a familial form of cardiomyopathy predominantly affecting the right ventricle but may progress to involve the left ventricle as well. At the late stage of the disease, it is sometimes difficult to differentiate with other forms of dilated cardiomyopathy. In most affected families, the mode of inheritance of the disease is autosomal dominant. Lately, the gene accounting for the autosomal recessive form of ARVC, which was associated with palmoplantar keratosis, was identified. ARVC can present with sudden cardiac death without any preceding symptoms in the young population. Therefore, ARVC must be included in the …

Association Of Viral Genome With Graft Loss In Children After Cardiac Transplantation., Girish S. Shirali, J Ni, R E. Chinnock, J K. Johnston, G L. Rosenthal, N E. Bowles, J A. Towbin

Manuscripts, Articles, Book Chapters and Other Papers

BACKGROUND: The survival of recipients of cardiac allografts is limited by rejection, lymphoproliferative disease, and coronary vasculopathy. The purpose of this study in children who had received heart transplants was to evaluate the cardiac allografts for myocardial viral infections and to determine whether the presence of viral genome in the myocardium correlates with rejection, coronary vasculopathy, or graft loss.

METHODS: We enrolled heart-transplant recipients 1 day to 18 years old who were undergoing evaluation for possible rejection and coronary vasculopathy. Endomyocardial-biopsy specimens were evaluated for evidence of rejection with the use of standard criteria and were analyzed for the presence …

Thrombolytic Therapy For Acute Myocardial Infarction In The Elderly, Bernard Bun-Lap Wong, Wai-Hong Chen

Journal of the Hong Kong College of Cardiology

Acute myocardial infarction (MI) is a leading cause of morbidity and mortality in developed countries. Patients ≥75 years constitute up to 30% of the acute MI population and are associated with a 50% in-hospital mortality. Thrombolytic therapy was shown in a metaanalysis of 9 largest randomized controlled trials to reduce 35-day mortality. However, the benefit was observed mainly among patients < 75 years old. For patients ≥ 75 years, the 35-day mortality was 24.3% in those treated with thrombolytic therapy and 25.3% in the placebo group, a difference not reaching statistical significance.

Special Report On Children Born To Hiv Positive Parents In Nevada, 1991-1999, Drew Mather, Mary Guinan, Richard Whitley, Wei Yang

School of Public Health Faculty Research

Background:

This report encompasses an effort to look at the number of children born to HIV (Human Immunodeficiency Virus) and/or AIDS (Acquired Immunodeficiency Syndrome) infected parents during the years 1991 to 1999 in Nevada.

According to the Healthy People 2000 (HP 2000) Review for the years 1998- 1999, infants of untreated or undetected HIV positive women have been identified as a distinct population at risk for contracting the virus that causes AIDS.

The State of Nevada’s Bureau of Disease Control and Intervention Services in collaboration with the Bureau of Health Planning and Statistics has taken the initial step to “cross …

Hormonal And Barrier Methods Of Contraception, Oncogenic Human Papillomaviruses, And Cervical Squamous Intraepithelial Lesion Development, Ann L. Coker, Laura C. Sanders, Sharon M. Bond, Tsilya Gerasimova, Lucia Pirisi

CRVAW Faculty Journal Articles

We assessed the influence of hormonal (oral, injectable, or levonorgestrel [Norplant, Wyeth-Ayerst, Philadelphia, PA]) and barrier methods of contraception on the risk of cervical squamous intraepithelial lesions (SIL), while adjusting for high-risk (HR) HPV infection. Subjects were women receiving family planning services through the state health department clinics from 1995 to 1998. We selected 60 cases with high-grade cervical/SIL (HSIL) and 316 with low-grade cervical/SIL (LSIL) and controls (427 women with normal cervical cytology) and analyzed cervical DNA for HR-HPV, using Hybrid Capture I (Digene; Gaithersburg, MD).When assessing ever use, duration, recency, latency, and age at first use, neither oral …

Cerumen Composition By Flash Pyrolysis-Gas Chromatography/Mass Spectrometry, Craig N. Burkhart, Michael A. Kruge, Craig G. Burkhart, Curtis Black

Department of Earth and Environmental Studies Faculty Scholarship and Creative Works

Objective: To assess the chemical composition of cerumen by flash pyrolysis-gas chromatography/mass spectrometry.

Study Design: Collected earwax specimens were fractionated into residue and supernatant by means of deoxycholate. This natural bile acid produces significantly better disintegration of earwax in vitro than do presently available ceruminolytic preparations, and also has demonstrated excellent clinical results in vivo to date.

Patients: The sample for analysis was obtained from a patient with clinical earwax impaction.

Results: The supernatant is composed of simple aromatic hydrocarbons, C₅-C_{l 7} straight-chain hydrocarbons, a complex mixture of compounds tentatively identified as diterpenoids, …

Epstein-Barr Virus Serology In The Diagnosis Of Nasopharyngeal Carcinoma From Sarawak, Madeline Wong Mei Fong

Student Works (2000-2009)

The Epstein-Barr virus (EBV) is closely associated with nasopharyngcal carcinoma (NPC). The role(s) of EBV in NPC remains unclear but antibodies to two EBV proteins namely the viral capsid antigen (VCA) and early antigen (EA), are clinically useful diagnostic markers of NPC. The NPC scenario in Malaysia has been based on studies done on West Malaysian patients but not much has been described for NPC in Sarawak, East Malaysia. In this study, 164 NPC sera from newly histologically confirmed NPC patients were collected from the Radiotherapy Unit of Kuching General Hospital, Sarawak prior to radiotherapy. One hundred and forty seven …

Retinoblastoma Tells The Story Of Our Health Care System, Irshad Soomro, Muhammad Nadeem Khan, Suhail Muzaffar, Naila Kayani, Shahid Pervez, Akbar Shah Hussainy, Rashida Ahmed, Sheema H. Hasan

Department of Pathology and Laboratory Medicine

Objective:

To review cases of retinoblastoma.

Setting:

Department of Pathology Aga Khan University Hospital Karachi.

Method:

Twenty three specimens from cases of retinoblastoma received over a period of eight years were routinely processes and stained with haematoxylin and Eosin stain Other stains were used for tuberculosis and melanin. Immunochemistry was resorted to in undifferentiated tumors.

Results:

Over 60% cases of retinoblastoma were diagnosed after 5 years and nine cases showed involvement of opti-nerve.

Conclusion:

Late diagnosis of retinoblastoma effects the stage of the tumors and the prognisis.

Attachment Of Toxoplasma Gondii To A Specific Membrane Fraction Of Cho Cells, Chaitali Dutta, Jane Grimwood, Lloyd H. Kasper

Dartmouth Scholarship

We have observed previously that attachment of Toxoplasma gondii to synchronized host cells is considerably increased at the mid-S phase (4 h postrelease). Synchronized CHO host cells at the mid-S phase were fractionated by molecular weight, and the antigens were used to produce a panel of polyclonal mouse antisera. The polyclonal antisera raised against fraction 4 with molecular mass ranging approximately from 18 to 40 kDa significantly reduced attachment to mid-S-phase host cells. Immunofluorescence assays demonstrated strong reactivity to mid-S-phase host cells and identified a number of potential receptors on Western blots. These data indicate that there is a specific …

Lack Of Cd4+ T Cells Does Not Affect Induction Of Cd8+ T-Cell Immunity Against Encephalitozoon Cuniculi Infection, Magali Moretto, Lori Casciotti, Brigit Durell, Imtiaz A. Khan

Dartmouth Scholarship

Cell-mediated immunity has been reported to play an important role in defense against Encephalitozoon cuniculi infection. Previous studies from our laboratory have underlined the importance of cytotoxic CD8⁺ T lymphocytes (CTL) in survival of mice infected with E. cuniculi. In the present study, immune response against E. cuniculi infection in CD4⁺T-cell-deficient mice was evaluated. Similar to resistant wild-type animals, CD4^−/− mice were able to resolve E. cuniculi infection even at a very high challenge dose (5 × 10⁷ spores/mouse). Tissues from infected CD4^−/−mice did not exhibit higher parasite loads in comparison to …

Recognition Of Left Atrial Aneurysm By Fetal Echocardiography., R R. Fountain-Dommer, H B. Wiles, C O. Shuler, S M. Bradley, Girish S. Shirali

Manuscripts, Articles, Book Chapters and Other Papers

No abstract provided.

Brachytherapy In The New Millennium Abstracts, Jilin Chen, Runlin Gao, Qiangjun Cai, Yuejin Yang

Journal of the Hong Kong College of Cardiology

In order to examine long-term efficacy of percutaneous transluminal coronary angioplasty (PTCA), coronary stenting and to assess the factors affecting its efficacy, 790 patients who underwent successful PTCA and PTCS+Stent in this Hospital were followed by direct interview or letter.

Structured Treatment Interrupion (Sti) With Nevirapine (Nvp) And Two Nucleoside Reverse Transciptase Inhibitors (Nsrti): Is Re-Suppression Achieved Following Treatment Interruption?, Joseph L. Yozviak Do, Facp, R Eric Doerfler Np, Cch, William C. Woodward Do

Department of Medicine

No abstract provided.

The Cardiac Correlates Of Attention In The Denervated Heart: A Study Of Infant Heart Transplant Recipients, Stephanie Dianne Griffone

Loma Linda University Electronic Theses, Dissertations & Projects

The cardiac correlate of attention is a deceleration in heart rate, controlled by the parasympathetic division of the autonomic nervous system. This has been extensively studied in infants; the findings indicate that this deceleration is affected by a number of factors, several mediated by the vagus nerve. However, the effects of denervation on this response are not known. Studies with adult heart transplant recipients have shown attenuated acceleration in response to stressful mental tasks. This study investigated the cardiac response to attention in infants who had received a heart transplant, using a habituation paradigm. The hypothesis that they would show …

Antiretroviral Therapy (Art) In Clinical Practice: Effectiveness And Tolerability Of Necvirapine (Nvp), Stavudine (D4t) And Lamivudine (3tc), Joseph L. Yozviak Do, Facp, R Eric Doerfler Np, Cch, William C. Woodward Do

Department of Medicine

No abstract provided.

Differential Infectivity And Division Of Toxoplasma Gondii In Human Peripheral Blood Leukocytes, Jacqueline Y. Channon, Rosanne M. Seguin, Lloyd H. Kasper

Dartmouth Scholarship

When tachyzoites were incubated with human peripheral blood leukocytes in vitro, more monocytes and dendritic cells than neutrophils or lymphocytes were infected. Although tachyzoites were able to divide in each of these cell types, monocytes and dendritic cells were more permissive to rapid tachyzoite division than neutrophils or lymphocytes.

Differences Between Blacks And Whites With Coronary Heart Disease In Initial Symptoms And In Delay In Seeking Care, Sally B. Richards, Marjorie Funk, Kerry A. Milner

Nursing Faculty Publications

BACKGROUND: Mortality rates for coronary heart disease are higher in blacks than in whites. OBJECTIVES: To examine differences between blacks and whites in the manifestation of symptoms of coronary heart disease and in delay in seeking treatment. METHODS: Patients were directly observed as they came to an emergency department with symptoms suggestive of coronary heart disease. The sample included 40 blacks and 191 whites with a final diagnosis of angina or acute myocardial infarction. RESULTS: After controlling for pertinent demographic and clinical characteristics, logistic regression analysis revealed that blacks were more likely than whites to have shortness of breath (odds …

Antiretroviral Therapy (Art) In Clinical Practice: Ethnic Variability In Effectiveness And Tolerability Of Nelfinavir And Two Nucleoside Reverse Transcriptase Inhibitors, Joseph L. Yozviak Do, Facp, B Moran, R Eric Doerfler Np, Cch, William C. Woodward Do

Department of Medicine

No abstract provided.

Locus Of Control, Coping, And Anticipatory Nausea In Women With Breast Cancer, Melinda L. Nielsen

Loma Linda University Electronic Theses, Dissertations & Projects

Many cancer patients experience adverse chemotherapy-related side effects. The present study examined whether the perception that one can control and effectively cope with her treatment for breast cancer mitigate against any nausea and vomiting that she may experience in anticipation of chemotherapy treatments. Seventy-five women with breast cancer completed the Multidimensional Health Locus of Control Scale - Form C, the Krantz Health Opinion Survey, the Ways of Coping Scale - Revised, and the Morrow Assessment of Nausea and Emesis. As hypothesized, internal health locus of control was significantly positively related to positive reappraisal coping strategies. This relationship was moderated by …

The Relationship Between Health Attitudes, Beliefs, Health Locus Of Control And Use Of Breast Cancer Screening Modalities In Elderly Hispanic Women, Debra Kay Gillett, Rosamaria Ortiz

Theses and Dissertations - UTB/UTPA

A non-experimental design was used to examine the relationship between health attitudes, beliefs, locus of control and the use of breast cancer screening modalities in elderly Hispanic women in this pilot study. Leininger's Theory of Culture Care Diversity and Universality and the Health Belief Model were the supporting theoretical frameworks. Research was conducted at the Amigos del Valle senior centers in Hidalgo County and included 52 English-speaking elderly Hispanic volunteer participants. Instruments used for data collection were the Health Care Attitudes and Beliefs Scale and the Multidimensional Health Locus of Control Scale. Results of this study revealed that there appears …

The Pediatric Breathing Survey, Linda J. Galloway

Health Services Research Dissertations

To ensure culturally-sensitive assessments, the researcher designed a Pediatric Breathing Survey (PBS) to measure quality of life for African-American children. The purpose of this study was to test whether the PBS is a reliable and valid instrument. Comparisons of group differences on race, income and parent's level of education based on parent responses to the questionnaires were conducted. More specifically, differences in Health Related Quality of Life (HRQOL) between Caucasian and African-American children were examined. The researcher-designed instrument was compared to Juniper's Pediatric Asthma Quality of Life Questionnaire. The sample consisted of parents of 84 school-aged children diagnosed with asthma. …

Intimate Partner Violence And Cervical Neoplasia, Ann L. Coker, Maureen Sanderson, Mary Kay Fadden, Lucia Pirisi

CRVAW Faculty Journal Articles

Intimate partner violence (IPV) is associated with a range of adverse physical health outcomes, including chronic and infectious diseases. An emerging literature suggests that partner violence and specifically sexual violence may be associated with an increased risk of cervical neoplasia. To assess the risk of preinvasive and invasive cervical cancer in a cross-sectional study of women screened for IPV by type, frequency and duration, 1152 women ages 18–65 were recruited from family practice clinics in 1997–1998. They were screened for IPV during a brief in-clinic interview, and health history and current status were assessed in a follow-up interview. Of 1152 …

Relationship Between Intestinal Parasitosis With The Basic Services, And The Nutritional State Of Children Under The Age Of Five Of Black, Native, And Mestizo Ethnicities In The Rural Area Of The Province Of Imbabura 1998-1999, Carlos Rosero

Theses and Dissertations

The parasitosis in the tropical countries like Ecuador, are found in the different population groups of all ages, sexes, social conditions, ethnic groups, especially in those without hygienic conditions, pertaining to different geographic zones and the prevalence varies in agreement with the ecology, the human factors and the social economic characteristics. The fecal contamination on land and water where an adequate disposition of excretes, the surrounding conditions, the deficient living conditions, the rural life, the absence of bathrooms, the custom to not use shoes and to have contact with the water. The deficiency of hygienic education, contamination of foods and …

A Preclinical Model Of Ionizing Radiation And Tnf-Alpha Gene Therapy For Cancer, Jun Li

Loma Linda University Electronic Theses, Dissertations & Projects

Long term control of high-grade brain tumors is rarely achieved with current therapeutic regimens. This study sought to determine if pretreatment with plasmid DNA expressing Tumor Necrosis Factor-α (TNF-α) could enhance the effect of ionizing radiation in an aggressive, rapidly growing glioma tumor (C6) model. Plasmid DNA is an attractive vector system for delivery of foreign genes into eukaryotic cells due to its advantages including low immunogenicity in vivo, lesser toxicity and relatively low cost. We have constructed a plasmid-based mammalian expression vector (pGL1-TNF) to secrete human TNF-α from cancer cells. Plasmid DNA was successfully transfected into C6 cells …

Gastric Carcinoma With Lymphoid Stroma: Association With Epstein Virus Genome Demonstrated By Pcr, Irshad N. Soomro, Samina Noorali, Syed Abdul Aziz, Suhail Muzaffar, Shahid Pervez, Akbar S. Hussainy, Tariq Moatter

Department of Pathology and Laboratory Medicine

No abstract provided.

Immune Responses Induced By Gene Gun Or Intramuscular Injection Of Dna Vaccines That Express Immunogenic Regions Of The Serine Repeat Antigen From Plasmodium Falciparum, Alexia A. Belperron, David Feltquate, Barbara A. Fox, Toshihiro Horii, David J. Bzik

Dartmouth Scholarship

The liver- and blood-stage-expressed serine repeat antigen (SERA) of Plasmodium falciparum is a candidate protein for a human malaria vaccine. We compared the immune responses induced in mice immunized with SERA-expressing plasmid DNA vaccines delivered by intramuscular (i.m.) injection or delivered intradermally by Gene Gun immunization. Mice were immunized with a pcdna3 plasmid encoding the entire 47-kDa domain of SERA (amino acids 17 to 382) or the N-terminal domain (amino acids 17 to 110) of SERA. Minimal antibody responses were detected following DNA vaccination with the N-terminal domain of SERA, suggesting that the N-terminal domain alone is not highly immunogenic …

A Study On The Effects Of The N-Terminal Amino Acid Sequence On The Activation Of Human T-Cell Leukemia Virus Type 1 Protease, Hidayah Muhammad Kendall

Chemistry & Biochemistry Theses & Dissertations

Human T-cell leukemia virus type 1 (HTL V-1) is dependent upon the enzymatic activity of its protease for maturation. Maturation of the protease is facilitated by cleavage of specific amino acid residues, followed by dimerization. The effects of the amino acid sequence located N-terminally to the cleavage site on the ability of the protease to become active were the focus of the current study. These amino acid sequences were contributed by the plasmid vector into which the protease gene was inserted.

Surface probability analyses (SPAs) of the vectors, as well as for native sequences which produce the mature protease and …

Spectrum Of Hodgkin's Disease In Children And Adults: Impact Of Combined Morphologic And Phenotypic Approach For Exclusion Of Look-Alikes, Tanya Siddiqui, Shahid Pervez

Department of Pathology and Laboratory Medicine

Objective:

To determine the prevalence of Hodgkin’s disease (HD) and its various subtypes in children and adults and assess the use of immunohistochemical (IHC) studies in confirming HD cases and excluding its close mimicries/look-alikes.

Material and Methods:

All 265 Hodgkin’s disease cases diagnosed at The Aga Khan University Hospital, Karachi over the last 6 years (July 1991 - July 1997) were included. Of these 219 were diagnosed on routine H&E examination while in the remaining 46 cases, diagnosis was made after a thorough IHC workup. (This group initially included 161 cases labelled as lymphoproliferative disorder with HD as one of …