Medical Specialties Commons^™

Sr-Bi Protects Against Endotoxemia In Mice Through Its Roles In Glucocorticoid Production And Hepatic Clearance, Lei Cai, Ailing Ji, Frederick C. De Beer, Lisa R. Tannock, Deneys R. Van Der Westhuyzen

Internal Medicine Faculty Publications

Septic shock results from an uncontrolled inflammatory response, mediated primarily by LPS. Cholesterol transport plays an important role in the host response to LPS, as LPS is neutralized by lipoproteins and adrenal cholesterol uptake is required for antiinflammatory glucocorticoid synthesis. In this study, we show that scavenger receptor B-I (SR-BI), an HDL receptor that mediates HDL cholesterol ester uptake into cells, is required for the normal antiinflammatory response to LPS-induced endotoxic shock. Despite elevated plasma HDL levels, SR-BI–null mice displayed an uncontrollable inflammatory cytokine response and a markedly higher lethality rate than control mice in response to LPS. In addition, …

Management Of The Neck In Differentiated Thyroid Cancer, David M. Cognetti, Edmund A. Pribitkin, William M. Keane

Department of Otolaryngology - Head and Neck Surgery Faculty Papers

Differentiated thyroid cancer is characterized by an excellent long-term prognosis, which unlike other head and neck carcinomas, is not influenced definitively by regional lymph node metastasis. The relative rarity of the disease, together with its tendency for delayed metastasis and its low mortality, makes a prospective randomized trial comparing treatment outcomes difficult. As a result, the effect of cervical lymph node metastases on survival is unclear, making meaningful recommendations for their management somewhat subjective. This article discusses guidelines for the management of the neck in differentiated.

Technical Assistance For Implementing Best Practices In The Asia And Near East Region, M.E. Khan, Sohini Roychowdhury, Mary Philip Sebastian, Sitanshu Sekhar Kar, Anurag Mishra, Vivek Sharma, G. Narayana, Bhawana Sharma, Nahla G. Abdel-Tawab, Ahmed Afifi

Reproductive Health

The Population Council's Frontiers in Reproductive Health (FRONTIERS) program offered technical assistance to any Asia Near East (ANE) country mission interested in funding adaptation of USAID‟s “best practices” in family planning or reproductive health. The ANE Bureau provided funding for the costs of FRONTIERS technical assistance. The overall objective of this study was to replicate and scale up "best practices" based on findings from FRONTIERS. The specific objectives were to institutionalize the Systematic Screening Instrument in the entire state of Uttarakhand, India; to strenghten emergency contraceptive pills service provision in Uttarakhand, India; and to enhance the use of Lactational Amenorrhea …

Sexual And Reproductive Health Needs Of Adolescents Perinatally Infected With Hiv In Uganda, Harriet Birungi, John Frank Mugisha, Juliana K. Nyombi, Francis Obare, Humphres Evelia, Hannington Nyinkavu

Reproductive Health

In Uganda, HIV/AIDS treatment, care and support programs are still organized around either adult or pediatric care and fail to adequately address the needs of adolescents, specifically perinatally-infected adolescents. This study, implemented jointly by the Population Council's Frontiers in Reproductive Health (FRONTIERS) program and the AIDS Support Organization (TASO), aimed to better understand the reproductive health and sexuality of this population group, and to identify anxieties or fears they have around entering social stages of adulthood. This study confirms that wide programmatic gaps exist in addressing the sexual and reproductive health needs of young people perinatally infected with HIV who …

Situation Analysis Of The Integration Of Family Planning Services In Postpartum, Postabortion And Prevention Of Mother To Child Transmission Programs In Nicaragua, Freddy Solis, Ana Del Carmen Rojas, Gadea Adilia, M. Estela Rivero-Fuentes, Ricardo Vernon

Reproductive Health

Between September 2005 and April 2007, FRONTIERS and Alva, a Nicaraguan consulting firm, conducted a situation analysis of the provision and use of contraceptive services in postpartum, postabortion and prevention of mother-to-child transmission of HIV (PMTCT) programs. The project‘s objective was to assess the degree to which contraceptive services were linked to postpartum, postabortion and PMTCT services and if this allowed the programs to meet the contraceptive needs of their clients. The project proposes recommendations for improving the quality of these programs.

Using Operations Research To Enhance Delivery Of Postpartum/Postabortion Family Planning Services In The Arab Region, Frontiers In Reproductive Health

Reproductive Health

The FRONTIERS program in Cairo organized a two-and-half day workshop to share programmatic experiences and lessons learned in integrating family planning with service providers from Egypt, Jordan, Sudan, and Yemen representing mid-level program managers and researchers. It was held in 2008 in tandem with a national end-of-project seminar for stakeholders in Egypt. Participants emphasized the need to capture missed opportunities in antenatal, delivery, postpartum or postabortion care by providing family planning services in all encounters between women and the health care system. They also agreed on an overarching need for operations research in assisting policy makers and program managers in …

Assessment Of Progress Of The Postabortion Care Initiative In Francophone Africa, Thierno Dieng, Mohamed Diadhiou, Nafissatou J. Diop, Youmane Niang Faye

Reproductive Health

The goals of this study were to assess the national situation concerning postabortion care (PAC) in six countries (Burkina Faso, Guinea, Mali, Niger, Senegal and Togo), including the process of introduction, integration and decentralization of PAC; the successes and obstacles in the process of introducing PAC; and recommended key steps to strengthen the introductory process. The study used two approaches: a comprehensive review of the introduction and institutionalization of PAC in the six countries, and a situation analysis of PAC services within each country.

Knowledge, Attitude And Use Of Labour Pain Relief Methods Among Women Attending Antenatal Clinic In Nairobi, Vitalis Mung’Ayi, David Nekyon, Robinson Karuga

Anaesthesiology, East Africa

Background: Labour analgesia has rapidly gained popularity in obstetric practice. Low usage in the developing world has raised concern.

Objectives: To assess the knowledge, attitude and use of labour pain relief methods in women attending antenatal clinic in Nairobi.

Design: A prospective study.

Setting: Aga Khan University Hospital, a teaching and referral hospital in Nairobi, Kenya.

Subjects: Two hundred and two consecutive expectant mothers attending antenatal clinic at the Aga Khan University Hospital, Nairobi.

Results: Fifty-six per cent of the participants had knowledge about labour pain relief methods. Friends, the antenatal clinic and books/leaflets were the major source on information. …

Constructing 'Health', Defining 'Choice': Legal And Policy Perspetives On The Post-Pgd Embryo In Four Jurisdictions, Estair Van Wagner, Roxanne Mykitiuk, Jeff Nisker

Articles & Book Chapters

Through Preimplantation Genetic Diagnosis, embryos created by IVF are selected for transfer to a woman based on particular characterisations, including the presence of genetic markers or a tissue match for a sibling. In this paper we examine the precise language used in the recent policy and regulatory documents of four jurisdictions (the United Kingdom, Australia, Canada and New Zealand) that in any way characterises the post-PGD embryo. We then explore the mutually constructed relationship between how that embryo is characterised and the purposes for which PGD is applied, as well as the types of uses to which the post-PGD embryo …

Evaluation Of Suspected Renal Colic Patients With Unenhanced Low-Dose Multidetector Computed Tomography (Mdct), Nebayosi Twahirwa

Master of Medicine in Imaging and Diagnostic Radiology

Acute renal colic is probably one of the most excruciatingly painful event a person can endure. [1]. Though this is typical of urinary tract calculi, it’s important to note that non-calculus and non-genitourinary conditions can present in a similar manner. Unenhanced helical CT (CT KUB), originally described by Smith et al [2] in 1995, is one single radiological test that has proven successful in the valuation of patients presenting with renal colic. This technique has been shown to be more accurate compared to abdominal radiography [3,4], ultrasound and has replaced excretory urography in the detection of urinary tract calculi in …

Topical Application Of Entry Inhibitors As "Virustats" To Prevent Sexual Transmission Of Hiv Infection., Michael M Lederman, Robin Jump, Heather A Pilch-Cooper, Michael Root, Scott F Sieg

Kimmel Cancer Center Faculty Papers

With the continuing march of the AIDS epidemic and little hope for an effective vaccine in the near future, work to develop a topical strategy to prevent HIV infection is increasingly important. This stated, the track record of large scale "microbicide" trials has been disappointing with nonspecific inhibitors either failing to protect women from infection or even increasing HIV acquisition. Newer strategies that target directly the elements needed for viral entry into cells have shown promise in non-human primate models of HIV transmission and as these agents have not yet been broadly introduced in regions of highest HIV prevalence, they …

Left Ventricular Pseudoaneurysm Found By Ct Scan., Hitoshi Hirose, Md, Iwao Matsunaga, Md, Michael D. Strong Iii, Md

Department of Surgery Faculty Papers

A 62-year-old male with a previous coronary artery bypass grafting underwent CT scan for evaluation of left epigastric pain. Findings showed a large left ventricular pseudoaneurysm, which was subsequently confirmed by left ventriculogram. The pseudoaneurysm was successfully repaired surgically.

Primary Drug Resistance To Antituberculous Drugs In Nwfp Pakistan, Arshad Javaid, Abdul Ghafoor, Abdul Rab, Anila Basit, Zia Ullah, Shaukat Ali, Afia Zafar, Rumina Hasan

Department of Pathology and Laboratory Medicine

Objective: To assess the prevalence of Primary drug resistance to Antituberculous drugs in NWFP
Method: A cross-sectional prevalence study was undertaken to evaluate the prevalence of drug resistance among new TB patients, using a non-probability convenience sampling methodology. Sample size was calculated according to the population and WHO's estimated incidence of smear positive tuberculosis in the province/country. Sputum samples were obtained from 122 newly diagnosed patients of pulmonary tuberculosis from centres in Peshawar and Abbotabad in NWFP.
Results: Sensitivities were performed by proportion method which showed the following resistance values in 118 eligible patients: 15 (12.7 %) …

Hepatic Angiosarcoma With Metastasis To Small Intestine, Zubair Ahmad, Azizun Nisa, Romana Idrees, Khurram Minhas, Shahid Pervez, Khalid Mumtaz

Department of Pathology and Laboratory Medicine

Hepatic angiosarcomas are rare tumours with poor prognosis, with patients usually dying within 6 months. Metastases mainly occur in lymph nodes, spleen, lungs, bones and adrenals. Metastasis to small intestine is even rarer. Similarly, primary or metastatic angiosarcomas in small intestine are extremely rare, often present with recurrent gastrointestinal bleeding and anemia, and have an extremely poor prognosis. Both primary or metastatic intestinal angiosarcomas may exhibit epithelioid morphology. It may be very difficult to differentiate between primary and secondary cases in intestine and especially when the tumour exhibits epithelioid morphology.

Pediatric Emergency Medicine--An Evolving Sub-Speciality In Pakistan, Emaduddin Siddiqui, Junaid Razzak

Department of Emergency Medicine

No abstract provided.

Understanding The Relationship Between The Diligence Inventory-Higher Education Edition And The Myers-Briggs Type Indicator In The Admission Of College Students To An Orthopaedics-Based Honors Program, Michael A. Harstine

Dissertations

Problem. The Orthopaedic Scholar Institute (OSI) Team realized its need for a more objective selection and admission process that, as much as possible, quantified the characteristics desired in OSI students rather than relying solely on referral perception, intuition, and an interview, but it did not have a clear method or approach to do so. Administering standardized inventories that highlighted these desired characteristics and aided in the selection and admission process seemed to be an objective approach to obtain more quantifiable data. The problem for my study was, therefore, whether the Myers- Briggs Type Inventory (MBTI) alone could measure a student’s …

Continuous Source Of Care Among Young Underserved Children: Associated Characteristics And Use Of Recommended Parenting Practices., Esther K Chung, Leny Mathew, Kelly F Mccollum, Irma T Elo, Jennifer F Culhane

Department of Pediatrics Faculty Papers

OBJECTIVES: The aim of this study was to 1) assess sociodemographic and health characteristics associated with having a continuous source of care (CSOC) among young children and 2) determine the relationship between having a CSOC and use of parenting practices.

METHODS: We conducted a prospective, community-based survey of women receiving prenatal care at Philadelphia community health centers. We conducted surveys at the first prenatal visit and at a mean age +/- standard deviation of 3 +/-1, 11 +/- 1, and 24 +/- 2 months postpartum, obtaining information on sociodemographic and health characteristics, child's health care provider, and 6 parenting practices. …

Obesity, Hypertension, And Mental Health Evaluation In Adolescents: A Comprehensive Approach, Stefan G. Kiessling, Kimberly K. Mcclanahan, Hatim A. Omar

Pediatrics Faculty Publications

The global epidemic of childhood and adolescent obesity in developing and developed countries has become a major public health concern. Given the relation between obesity and hypertension as documented in several landmark studies, it is no surprise that as the prevalence of obesity has increased in the pediatric population, the rates of hypertension have also increased substantially. Hypertension is one of the most important risk factors for cardiovascular diseases and stroke; therefore, evaluation and initiation of appropriate treatment are extremely important in the pediatric population. Evaluation for secondary causes of hypertension, including renovascular, renoparenchymal, and endocrine disease is the approach …

Hirsutism, Shibani Kanungo, Hatim A. Omar

Pediatrics Faculty Publications

No abstract provided.

Obesity: A Lesson From The Venus Of Willendorf, Donald E. Greydanus, Dilip R. Patel, Hatim A. Omar, Joav Merrick

Pediatrics Faculty Publications

No abstract provided.

Beta-Hemolytic Streptococcus Group A Endocarditis: A Rare Clinical Presentation, Aysha Almas, M. Tariq

Section of Internal Medicine

A case report of an elderly gentleman is reported herein, who presented with one week history of fever, drowsiness and left lower limb weakness. Examination revealed left lower limb weakness with power of grade 3/5. His workup showed evidence of infection and multiple cerebral infarcts on the right side. Blood culture grew Streptococcus pyogens. Echocardiogram showed two vegetations on the aortic valve. Fever was the main presenting feature in this case but it was the presentation of patient with multiple cerebral infarcts that lead to the diagnosis of infective endocarditis. The organism causing Infective Endocarditis (IE) in this patient was …

Longitudinal Association Of Sleep-Disordered Breathing And Nondipping Of Nocturnal Blood Pressure In The Wisconsin Sleep Cohort Study, Khin Mae Hla, Terry Young, Laurel Finn, Paul E. Peppard, Mariana Szklo-Coxe, Maryan Stubbs

Community & Environmental Health Faculty Publications

Study objectives: The association of sleep-disordered breathing (SDB) and blunting of normal nocturnal lowering of blood pressure (BP) (nondipping) has only been examined cross-sectionally. The purpose of this study is to investigate whether SDB is prospectively associated with nondipping.

Methods: The longitudinal association between SDB and incident nondipping was examined in a subsample of 328 adults enrolled in the Wisconsin Sleep Cohort Study who completed 2 or more 24-hour ambulatory BP studies over an average of 7.2 years of follow-up. SDB identified by baseline in-laboratory polysomnography was defined by apnea-hypopnea index (AHI) categories. Systolic and diastolic nondipping was defined by …

Continence Care: The Need For Creativity And Innovation, Karen A. Karlowicz

Ellmer School of Nursing Faculty Publications

(First paragraph) In April 2007, I attended a conference quite different from anything I had previously experienced. The conference, Innovating for Continence: The Engineering Challenge, was hosted by the Simon Foundation for Continence. As the title implies, this was not your usual conference about the diagnosis, treatment, and management of urinary incontinence. Rather, it was a conference dedicated to exploring technological advances in continence care. The central question throughout this two-and-a-half day event was, "What can be done to simulate continence technology to ensure the most effective management for persons who suffer with this problem?"

Developmental Dysplasia Of Hip--Where Do We Stand?, Masood Umer, Haq Nawaz

Department of Surgery Docs

No abstract provided.

Comparison Of Long-Term Care Residents' Food Intake, Body Weight, And Food Costs Between Two Meal Service Styles, Dee Murphy

Master's Theses and Doctoral Dissertations

The purpose of this study was to determine if residents (n = 26) living in an Iowa long-term care facility had differences in food intake at their noon meal and body weight when served traditional tray meal service for 10 weeks compared to being served restaurant-style meal service for 10 weeks. The study also evaluated the facility’s raw food costs of the two meal service styles.

Mean meal intake scale scores improved when residents were served restaurant-style meal service (0.4±0.3) compared to traditional tray meal service. Residents did not show a significant percent weight (1.1%±3.7%) change or percent BMI (0.9%±3.7%) …

Antibiotic Susceptibility Of Pathogens Isolated From Patients With Community-Acquired Respiratory Tract Infections In Pakistan--The Active Study, Afia Zafar, Zahid Hussain, Eale Lomama, Sophie Sibille, Seema Irfan, Erum Khan

Department of Pathology and Laboratory Medicine

BACKGROUND: Respiratory tract infections (RTIs) are amongst the most wide spread and serious infections, accounting for over 50 million deaths globally each year. In developing countries, infants under 4 years of age are at greatest risk of lower RTIs, whereas in developed countries the severity of infection and rate of mortality are greater in elderly. The objective of the survey was to determine the in vitro susceptibility of antibiotics commonly prescribed RTIs against Streptococcus pneumoniae (SP), Haemophilus influenzae (HI) and Streptococcus pyogenes, isolated from patients with community-acquired RTIs globally. This survey involved 9 countries. In this study we present the …

Primary Drug Resistance To Anti-Tuberculous Drugs In Karachi, Arshad Javaid, Nadim Rizvi, Mosavir Ansari, Ashraf Sadiq, Iqbal Sher Burki, Nadeem Ur Rehman, Rumina Hasan, Afia Zafar

Department of Pathology and Laboratory Medicine

Objective: To assess the frequency of primary drug resistance among newly diagnosed tuberculosis cases in Karachi.
Study Design: Cross-sectional study.
Place and Duration of Study: Multicentric study involving various TB clinics and treatment centres of Karachi between April to December 2005.
Methodology: The frequency of drug resistance among new TB patients was evaluated using a non-probability convenient sampling methodology. Sputum sample was obtained from 140 newly diagnosed sputum smear-positive patients of pulmonary tuberculosis from various centres of Karachi. Sensitivities were performed by proportion method.
Results: Fifteen (11.5%) samples in 130 eligible patients showed primary resistance to one …

Development Of An Immunofluorescence Assay Using Recombinant Proteins Expressed In Insect Cells To Screen And Confirm Presence Of Human Herpesvirus 8-Specific Antibodies, Veenu Minhas, Lynsey N. Crosby, Kay L. Crabtree, Saul Phiri, Tendai J. M'Soka, Chipepo Kankasa, William J. Harrington, Charles D. Mitchell, Charles Wood

Nebraska Center for Virology: Faculty Publications

Human herpesvirus 8 (HHV-8), or Kaposi’s sarcoma (KS)-associated herpesvirus, has been linked to all forms of KS. The results of most current serological assays for the detection of HHV-8-specific antibodies have low levels of concordance among themselves. To establish a sensitive and specific testing strategy that can be used to screen for HHV-8-specific antibodies, three HHV-8 proteins, ORF65, ORF73, and K8.1A, were expressed by using baculoviral vectors in insect cells and incorporated into a monoclonal antibodyenhanced immunofluorescence assay (mIFA) termed the Sf9 three-antigen mIFA. The results obtained by this mIFA were compared to those obtained by a standard mIFA with …

Small-Molecule Cd4 Mimics Interact With A Highly Conserved Pocket On Hiv-1 Gp120, Navid Madani, Arne Schön, Amy M. Princiotto, Judith M. Lalonde, Joel R. Cpurter, Takahiro Soeta, Danny Ng, Liping Wang, Evan T. Brower, Shi-Hua Xiang, Young Do Kwon, Chih-Chin Huang, Richard Wyatt, Peter D. Kwong, Ernesto Freire, Amos B. Smith Iii, Joseph Sodroski

Nebraska Center for Virology: Faculty Publications

Human immunodeficiency virus (HIV-1) interaction with the primary receptor, CD4, induces conformational changes in the viral envelope glycoproteins that allow binding to the CCR5 second receptor and virus entry into the host cell. The small molecule NBD-556 mimics CD4 by binding the gp120 exterior envelope glycoprotein, moderately inhibiting virus entry into CD4-expressing target cells, and enhancing CCR5 binding and virus entry into CCR5-expressing cells lacking CD4. Studies of NBD-556 analogues and gp120 mutants suggest that: 1) NBD-556 binds within the Phe 43 cavity, a highly conserved, functionally important pocket formed as gp120 assumes the CD4- bound conformation; 2) the NBD-556 …

The Human Immunodeficiency Virus Type 1 Envelope Confers Higher Rates Of Replicative Fitness To Perinatally Transmitted Viruses Than To Nontransmitted Viruses, Xiaohong Kong, John T. West, Hong Zhang, Danielle M. Shea, Tendai J. M’Soka, Charles Wood

Nebraska Center for Virology: Faculty Publications

Selection of a minor viral genotype during perinatal transmission of human Immunodeficiency virus type 1

(HIV-1) has been observed, but there is a lack of information on the correlation of the restrictive transmission

with biological properties of the virus, such as replicative fitness. Recombinant viruses expressing the enhanced

green fluorescent protein or the Discosoma sp. red fluorescent (DsRed2) protein carrying the V1 to V5

regions of env from seven mother-infant pairs (MIPs) infected by subtype C HIV-1 were constructed, and

competition assays were carried out to compare the fitness between the transmitted and nontransmitted

viruses. Flow cytometry was used to …