Medical Specialties Commons^™

Semiparametric Receiver Operating Characteristic Analysis To Evaluate Biomarkers For Disease, Tianxi Cai, Margaret S. Pepe

UW Biostatistics Working Paper Series

The receiver operating characteristic (ROC) curve is a popular method for characterizing the accuracy of diagnostic tests when test results are not binary. Various methodologies for estimating and comparing ROC curves have been developed. One approach, due to Pepe, uses a parametric regression model with the baseline function specified up to a finite-dimensional parameter. In this article we extend the regression models by allowing arbitrary nonparametric baseline functions. We also provide asymptotic distribution theory and procedures for making statistical inference. We illustrate our approach with dataset from a prostate cancer biomarker study. Simulation studies suggest that the extra flexibility inherent …

Vinpocetine For Cognitive Impairment And Dementia, Peter J. Whitehouse

Faculty Scholarship

Background: Vinpocetine is a synthetic ethyl ester of apovincamine, a vinca alkaloid obtained from the leaves of the Lesser Periwinkle (Vinca minor) and discovered in the late 1960s. Although used in human treatment for over twenty years, it has not been approved by any regulatory body for the treatment of cognitive impairment. Basic sciences studies have been used to claim a variety of potentially important effects in the brain. However, despite these many proposed mechanisms and targets, the relevance of this basic science to clinical studies is unclear. Objectives: To assess the efficacy and safety of vinpocetine in the treatment …

Attitudes Of Developing World Physicians To Where Medical Research Is Performed And Reported, John Page, Richard F. Heller, Scott Kinlay, Lynette Lim, Wang Qian, Zheng Suping, Supornchai Kongpatanakul, Murtaza Akhtar, Salah Khedr, William Macharia

Paediatrics and Child Health, East Africa

Background: Little is known about the influence of the site of research or publication on the impact of the research findings on clinical practice, particularly in developing countries. The International Clinical Epidemiology Network (INCLEN) is dedicated to improving the quality of health research in the Developing World through institutional capacity building for evidence based medicine, and provided the opportunity to examine the likely impact of research location and journal location on physicians' practice in a number of the participating countries.

Methods: Physicians from secondary and tertiary hospitals in six cities located in China, Thailand, India, Egypt and Kenya were enrolled …

Medical Education Digest, Vol. 5 No. 1 (January 15, 2003), Nova Southeastern University

Medical Education Digest

No abstract provided.

Regulation Of Human Col9a1 Gene Expression. Activation Of The Proximal Promoter Region By Sox9., Ping Zhang, Sergio A. Jimenez, David G Stokes

Department of Medicine Faculty Papers

The COL9A1 gene contains two promoter regions, one driving expression of a long alpha1(IX) chain in cartilage (upstream) and one driving expression of a shorter chain in the cornea and vitreous (downstream). To determine how the chondrocyte-specific expression of the COL9A1 gene is regulated, we have begun to characterize the upstream chondrocyte-specific promoter region of the human COL9A1 gene. Transient-transfection analyses performed in rat chondrosarcoma (RCS) cells, human chondrosarcoma (HTB) cells, and NIH/3T3 cells showed that the COL9A1 promoter was active in RCS cells but not HTB or NIH/3T3 cells. Inclusion of the first intron had no effect on promoter …

Com Outlook Winter 2003, College Of Osteopathic Medicine

COM Outlook

No abstract provided.

Montessori-Based Activities For Dementia: A Walk Down Memory Lane, Janina C. Bognar

Case Studies from Age in Action

Educational Objectives

1. Familiarize readers with the Montessori method as used with participants who have dementia.

2. Demonstrate the role of Montessori-based activities for dementia in an adult day care setting.

The Value Of Multidisciplinary Care In Parkinson's Disease, Miriam Hirsch, Mark Baron

Case Studies from Age in Action

Educational Objectives

1. To recognize the signs and symptoms of Parkinson's disease (PD).

2. To identify key treatment and management strategies for PD.

3. To discuss the importance of multidisciplinary care and the need for individualized treatment of PD.

Abuse, Neglect, And Exploitation Of Vulnerable Elders, Sheila Crossen-Powell, Kira R. Holland, Marjorie L. Marker

Case Studies from Age in Action

Educational Objectives

1. To describe the variety and dynamics of self-neglect and abuse.

2. To illustrate cases of familial self-neglect and of financial exploitation.

3. To demonstrate the roles that Adult Protective Services (APS) plays in the investigation of adult abuse, neglect, and exploitation.

4. To describe the protections available to vulnerable adults in the Commonwealth.

Aging In Place -- Can Universal Design Make It A Reality?, Helen Eltzeroth

Case Studies from Age in Action

Educational Objectives

1. Comprehend the principles of universal design

2. Understand the barriers to aging in place

3. Learn what resources are available to facilitate aging in place

Synergistic Interactions Of Chlorambucil, Dha, And Trail In Jurkat And H460 Human Cancer Cells, Jennifer Ellen Bush-O'Donnell

Theses, Dissertations and Capstones

Traditional chemotherapeutic drugs are prone to toxicity and may result in secondary cancers. In recent years much attention has been garnered by alternate methods of cancer treatment with fewer side effects, including immunotherapy and administration of ω-3 fatty acids, both of which have been shown to cause apoptosis in cancer cells. Docosahexaenoic acid (DHA), a fatty acid, is a normal component of cell membranes and is safe for systemic administration. The cytokine TRAIL (tumor necrosis factorrelated apoptosis-inducing ligand) is able to induce apoptosis in cancer cells while sparing normal tissue. In this study, the alkylating agent chlorambucil (CLB) was combined …

Utilization Of Emergency Policies And Procedures By Division I-A And Division I-Aa Intercollegiate Athletic Programs, Brandy A. Petty

Theses, Dissertations and Capstones

The need for an established emergency policy and procedures plan in the college and university setting has been confirmed by various organizations such as: National Safety Council (NSC), Federal Emergency Management Agency (FEMA), National Emergency Management Association (NEMA), National Athletic Trainers’ Association (NATA), National Collegiate Athletic Association (NCAA), and the American College of Sports Medicine (ACSM). The duty of these emergency policies and procedures is twofold. The first is to provide immediate care to student-athletes in an emergency situation. The second purpose is to avoid liability issues that may arise following an emergency situation. The premise behind the establishment and …

Health Professions Division Catalog 2003-2004, Nova Southeastern University

Health Professions Divisions Course Catalogs and Course Descriptions

No abstract provided.

Lupus Anticoagulunt Associated With Transient Severe Factor X Deficiency: A Report Of Two Patients Presenting With Major Bleeding Complications, Aneel A. Ashrani, Agnes Aysola, Hani Al-Khatib Md, William L. Nichols

Articles

Abstract

Acquired factor X (FX) deficiency is rare, but has been reported in diverse disease states, including systemic amyloidosis and respiratory infections. FX deficiency associated with lupus anticoagulant (LA) and a bleeding diathesis has not been previously reported. We report two patients both of whom presented with a severe bleeding diathesis after a preceding respiratory infection due to isolated FX deficiency associated with a LA. The FX deficiency and LA were transient. We conclude that patients with LA may rarely present with severe acquired FX deficiency. This may be another mechanism whereby patients with antiphospholipid antibodies present with bleeding complications.

The Effect Of Mirthful Laughter On Stress And Natural Killer Cell Activity, Mary P. Bennett, Janice M. Zeller, Lisa Rosenberg, Judith Mccann

Nursing Faculty Publications

No abstract provided.

Clinical Issues Surrounding Once-Daily Aminoglycoside Dosing In Children, Chad A. Knoderer, Julie A. Everett, William F. Buss

Scholarship and Professional Work – COPHS

Aminoglycoside antibiotics are first-line treatment for many infectious diseases in the pediatric population and are effective in adults. The traditional dosing interval in children is every 8–12 hours. Studies in adults reported equivalent efficacy and equal or less toxicity with once-daily regimens. Despite many studies in the adult population, this approach has yet to become standard practice in most pediatric hospitals. Reasons for lack of acceptance of this strategy in children include rapid aminoglycoside clearance, unknown duration of postantibiotic effect, safety concerns, and limited clinical and efficacy data.

Research Annual Report 2002, Children's Mercy Hospital

Research Annual Reports

Annual report of the research at Children's Mercy Hospital in Kansas City MO, a pediatric medical center.

Evaluation Of Intra-And Inter-Fraction Motion In Breast Radiotherapy Using Electronic Portal Imaging Cine Loops, Chrison Lee, Edward Yu, Tomas Kron

Oncology Presentations

Parallel tangent breast irradiation is commonly used postbreast conservation surgery for early breast cancer patient without lymph node involvement to improve local disease control. Intra-fractional and inter-fractional variabilities are often presented in daily treatment setup. The present pilot study used Electronic Portal Imaging (EPI) to evaluate intra-and inter-fraction motion in patients undergoing simple breast tangent radiotherapy.

Susceptibility Scoring In Family-Based Association Testing, Laila M. Poisson, Benjamin A. Rybicki, Steven W. Coon, Jill S. Barnholtz-Sloan, Gary A. Chase

Wayne State University Associated BioMed Central Scholarship

Abstract

Background

Family-based association testing is an important part of genetic epidemiology. Tests are available to include multiple siblings, unaffected offspring, and to adjust for environmental covariates. We explore a susceptibility residual method of adjustment for covariates.

Results

Through simulation, we show that environmental adjustments that down-weight persons who are "destined" to be affected decrease the power to detect genetic association. We used the residual adjusted method on the Framingham Heart Study offspring data, provided for Genetic Analysis Workshop 13, and got mixed results.

Conclusion

When the genetic effect and environmental effects are independent, a susceptibility residual method of adjustment …

Analysis Of Gene × Environment Interactions In Sibships Using Mixed Models, Jill S. Barnholtz-Sloan, Laila M. Poisson, Steven W. Coon, Gary A. Chase, Benjamin A. Rybicki

Wayne State University Associated BioMed Central Scholarship

Abstract

Background

Gene × environment models are widely used to assess genetic and environmental risks and their association with a phenotype of interest for many complex diseases. Mixed generalized linear models were used to assess gene × environment interactions with respect to systolic blood pressure on sibships adjusting for repeated measures and hierarchical nesting structures. A data set containing 410 sibships from the Framingham Heart Study offspring cohort (part of the Genetic Analysis Workshop 13 data) was used for all analyses. Three mixed gene × environment models, all adjusting for repeated measurement and varying levels of nesting, were compared for …

Educating Adolescents About Puberty: What Are We Missing?, Hatim A. Omar, Darby H. Mcelderry, Rana M. Zakharia

Pediatrics Faculty Publications

Adolescents undergo significant physical and cognitive changes during their pubertal development. These changes contribute to and impact their future development. Educating adolescents at an early age about their expected development decreases the possible anxiety associated with this period of life and also helps adolescents make better choices in regards to their sexuality. In order to assess the degree of education regarding pubertal development and sexuality, we conducted a survey of late adolescents (Median age 19 years) and parents of adolescents. A total of 409 adolescents (237 females, 172 males) and 124 parents completed the survey. 14.4% of teens (36.6% of …

The Art Of Practicing Scientific Medicine, Waris Qidwai

Department of Family Medicine

No abstract provided.

Utilization Of Services Of Homeopathic Practitioners Among Patients In Karachi, Pakistan, Waris Qidwai

Department of Family Medicine

BACKGROUND: The practice of homeopathy is becoming very popular. There is a need to study and understand as to why this is happening and to raise debate on the issue.
METHODS: The study was conducted on patients, visiting the Family Practice Centre, The Aga Khan University, Karachi. A questionnaire was used to collect information on the demographic profile, and the utilization of the services of homeopathic practitioners. The ethical requirements for conducting the study were met.
RESULTS: Three hundred and eighty-seven patients were surveyed. The study population included more women then men, with average age of 32.6 years. …

Use Of Home Remedies Among Patients Presenting To Family Physicians, Waris Qidwai, Sr Alim, Rh Dhanani, S Jehangir, A Nasrullah, A Raza

Department of Family Medicine

No abstract provided.

Use Of Folk Remedies Among Patients In Karachi, Pakistan, Waris Qidwai, Sr Alim, Rh Dhanani, S Jehangir, A Nasrullah, A Raza

Department of Family Medicine

BACKGROUND: The concept that food is medicine is being practiced in certain parts of the world, with positive outcomes on health of the population. We have such practice in Pakistan but it needs to be brought in line with the available scientific evidence.
METHODS: The study was conducted on 270 patients, visiting the Family Practice Center, the Aga Khan University, Karachi. A questionnaire was used to collect information on the demographic profile, and the use of folk remedies for medicinal uses.
RESULTS: Substantial use of folk remedies for different medical conditions has been documented. The remedies included cinnamon, ginger, …

The Role Of Ap-1 Transcription Complex In Retinoic Acid-Dependent B16 Melanoma Cell Growth Arrest And Differentiation, Ying Huang

Theses, Dissertations and Capstones

Our laboratory has been studying the effects of all-trans retinoic acid (atRA) on the growth and differentiation of the B16 mouse melanoma cells. RA inhibits both anchorage-dependent and –independent growth and stimulates melanin production in B16 cells, which are accompanied by an increase in AP-1 activity. To further investigate the RA-induced AP-1 activity, I established clones of B16 stably expressing an AP-1-luciferase reporter gene. Treatment of these clones with phorbol dibutyrate (PDB), a known activator of AP-1, rapidly increased AP-1 activity which reached its maximum level at 2-4 h and returned to baseline level by 24 h. In contrast, RA …

Selective Expression Of Beta Tubulin Isotypes In Gerbil Vestibular Sensory Epithelia And Neurons, Brian Perry, Heather Jensen Smith, Richard F. Ludueña, Richard Hallworth

Journal Articles: Eppley Institute

The seven mammalian isotypes of beta tubulin are strikingly similar in amino acid sequence. The differences in isotypic sequence, although small, are nonetheless conserved in evolution, which suggests that they may confer distinct functional roles. If so, such roles should be reflected in the selective expression of isotypes by cell type, or even in the sorting of isotypes to within-cell pools. Hair cells of the vestibular sensory epithelia each possess a kinocilium, a microtubule-based organelle that could represent a distinct microtubule compartment, separate from the extensive microtubule network in the soma. The afferent neurons that innervate the vestibular sensory epithelia …

Cell Type-Specific Reduction Of Beta Tubulin Isotypes Synthesized In The Developing Gerbil Organ Of Corti, Heather Jensen Smith, Jonquille Eley, Peter S. Steyger, Richard F. Ludueña, Richard Hallworth

Journal Articles: Eppley Institute

There are seven isotypic forms of the microtubule protein beta tubulin in mammals, but not all isotypes are synthesized in every cell type. In the adult organ of Corti, each of the five major cell types synthesizes a different subset of isotypes. Inner hair cells synthesize only betaI and betaII tubulin, while outer hair cells make betaI and betaIV tubulin. Only betaII and betaIV tubulin are found in inner and outer pillar cells, while betaI, betaII, and betaIV tubulin are present in Deiters cells, and betaI, betaII and betaIII tubulin are found in organ of Corti dendrites. During post-natal organ …

Platelets Stimulate Fibroblast-Mediated Contraction Of Collagen Gels, Ulrika Zagai, Karin Fredriksson, Stephen I. Rennard, Joachim Lundahl, C. Magnus Sköld

Journal Articles: Pulmonary & Critical Care Med

BACKGROUND: Platelets are thought to play a role in a variety of inflammatory conditions in the lung, some of which may lead to fibrosis. In the current study we tested the hypothesis that whole platelets and platelet lysate can mediate remodelling of extracellular matrix in vitro by affecting fibroblast-mediated contraction of a collagen gel. We also sought to determine to what extent platelet-derived growth factor (PDGF) and transforming growth factor-beta (TGF-beta) contribute to this effect.

METHODS: Washed platelets, isolated from healthy blood donors, and platelet lysate (freezing and thawing), were cast together with human lung fibroblasts in three-dimensional collagen gels. …

Renovascular Hypertension: Factors Affecting The Outcome Following Surgical Revascularisation, Malik Anas Rabbani, Alia Zaidi, Syed Sohail Ali, Bushra Anas, Asmooni Younus, Syed Mansoor Shah

Section of Nephrology

This study was conducted at the Aga Khan University Hospital, Karachi, Pakistan to evaluate factors that affect outcome following revascularisation in patients with renovascular hypertension. We included all the patients diagnosed to have renovascular hypertension, confirmed by renal angiography, between July 1997 and September 2000. Of the total 15 patients, nine were males and six were females. Eleven patients received venous grafts, three received polytetraflouroethyline (PTFE) grafts while one patient underwent angioplasty and stenting. All were followed-up for a period of nine months (median) with the range from 2 to 84 months. A total of 33.3% of the study patients …