Medical Specialties Commons^™

Solid-Organ Transplant Recipients And Breastfeeding While On Immunosuppression, Schweta Arakali, Faith Carlin, Lisa A. Coscia, Carolyn H. Mcgrory, Dawn Armenti, Vincent T. Armenti

Department of Surgery Faculty Papers

Conclusions:

The relatively small amount of drug transferred in breast milk and the lack of reported adverse effects along with the known benefits of breastfeeding may outweigh the risk of drug exposures in the transplant population.

The threshold for determining the level of exposure of an immunosuppressive agent that is acceptable is not known at present.

Continued study and follow-up of all breast-fed transplant recipient offspring is warranted.

Centers are encouraged to report all pregnancies in transplant recipients to the NTRR.

Pregnancy Outcomes In Female Lung Transplant Recipients, Julie Shaner, Faith Carlin, Lisa A. Coscia, Carolyn H. Mcgrory, Dawn Armenti, Vincent T. Armenti

Department of Surgery Faculty Papers

Conclusions:

Female lung recipients appear to face higher risks related to pregnancy when compared to other solid organ transplant recipients.

Although successful pregnancies have been reported in female lung recipients, analyses of larger numbers of cases may help to identify pre-pregnancy factors predictive of adverse outcomes.

Centers are encouraged to report all pregnancies in transplant recipients to the NTPR.

Pregnancy Outcomes With Exposure To The Mycophenolic Acid Products (Mpa), To Dung K. Nguyen, Faith Carlin, Lisa A. Coscia, Dawn Armenti, Vincent T. Armenti

Department of Surgery Faculty Papers

Conclusions:

Reports to NTPR to date continue to reveal an increased incidence of birth defects in transplant recipients maintained on MPA products during gestation compared to those not maintained on these agents.

Structural birth defects consisting of microtia (ear deformity) and facial defects suggest a pattern of malformations.

Evaluation of the higher incidence of non-viable outcomes requires further study in this cohort.

Centers are encouraged to report all pregnancy exposures in transplant recipients to the NTPR.

Pregnancy Outcomes In Pancreas-Kidney Vs. Kidney-Alone Diabetic Female Transplant Recipients, Lyuba Gitman, Faith Carlin, Lisa A. Coscia, Carolyn H. Mcgrory, Dawn Armenti, Vincent T. Armenti

Department of Surgery Faculty Papers

Conclusions:

The high incidences of hypertension, preeclampsia, and infection during pregnancy underscore the high-risk nature of pregnancy in both pancreas-kidney and kidney alone recipients.

Although overall offspring outcomes are similar in both PK and K groups, pregnancy in PK recipients may be associated with higher incidences of maternal infections and overall graft loss.

Centers are encouraged to report all pregnancies in transplant recipients to the NTPR.

Immunosuppressive Therapy For Autoimmune Disease And Pregnancy Outcomes, Karolina Paziana, Faith Carlin, Lisa A. Corcia, Carolyn H. Mcgrory, Dawn Armenti, Vincent T. Armenti

Department of Surgery Faculty Papers

Conclusions:

Cyclosporine exposure during pregnancy in the transplant population does appear to be associated with premature delivery and low infant birthweight.

Data from the NPR show that cyclosporine exposure during pregnancy in women with psoriasis does not appear to be associated with low gestational age or low infant birthweight.

Maternal comorbidities or other factors, such as multiple drug regimens, likely play a role in the higher rates of premature delivery and low birthweight infants in the kidney transplant population.

Further investigation is warranted to evaluate the impact of comorbidities and other factors on pregnancy outcomes of women taking Neoral®.

The Type 1 Insulin-Like Growth Factor Receptor In Hepatocellular Carcinoma Cell Lines, Zhengyu Wei, Phd, Tiziana Deangelis, M.S., Reginald Hurtt, B.S., Renato Baserga, M.D., Cataldo Doria, M.D., Ph.D

Department of Surgery Faculty Papers

Summary:

1. Human HCC cells have higher expression levels of IGF-1R, IRS1, and c-Met.

2. IRS1 interacts with c-Met. The role of IGF-1R in human HCC should be revisited.

3. Lentivirus-mediated shRNA delivery system targeting IGF-1R showed significant suppressive effects on HCC cell growth, promising a potential therapeutic treatment for human HCC.

Allred Scoring For Er Reporting And It's Impact In Clearly Distinguishing Er Negative From Er Positive Breast Cancers, Asim Qureshi, Shahid Pervez

Department of Pathology and Laboratory Medicine

Objective: To determine the scoring of Estrogen Receptor (ER) status in carcinoma breast by Allred method that is essentially bimodal and to compare the results with a conventional scoring system.
Materials and Methods: A retrospective, comparative study carried out at Aga Khan University Hospital Section of Histopathology over a period of 18 months i.e. Jan 2005 to June 2006. Anti ER antibody (clone D07) was used for all IHC stains using envision detection system. ER stains of 860 consecutive breast cancer cases were reviewed and rescored by both conventional and Allred method of ER scoring.
Results: Comparison of results showed …

Extraskeletal Osteosarcoma: Clinico-Pathologic Features And Results Of Multimodal Management, Nicola Fabbri, Akshay Tiwari, Masood Umer

Department of Radiology

. Extraskeletal Osteosarcoma: Clinico-pathologic Features and Results of Multimodal
Management N. Fabbri, A. Tiwari, M. Umer, D. Vanel, M. Alberghini, P. Ruggieri, S. Ferrari, P.
Picci, M. Mercuri Department of Musculoskeletal Oncology Istituto Ortopedico Rizzoli, Bologna,
Italy 23rd EMSOS Meeting Birmingham, UK 5th-7th May 2010 Page 2. Extraskeletal Osteosarcoma
Background .About 1% of all soft tissue sarcomas .First described by Wilson in 1941 .Few large
series then reported .Older individuals & usually worse survival

Surgical Interventions For Malignant Middle Cerebral Infarction--Saving Lives And Functionality Or Increasing Disabled Survivors?, Maria Khan, Ayeesha Kamran Kamal

Section of Neurology

No abstract provided.

Effect Of Indomethacin On Bile Acid-Phospholipid Interactions: Implication For Small Intestinal Injury Induced By Nonsteroidal Anti-Inflammatory Drugs, Yong Zhou, Elizabeth J Dial, Rand Doyen, Lenard M Lichtenberger

Faculty, Staff and Student Publications

The injurious effect of nonsteroidal anti-inflammatory drugs (NSAIDs) in the small intestine was not appreciated until the widespread use of capsule endoscopy. Animal studies found that NSAID-induced small intestinal injury depends on the ability of these drugs to be secreted into the bile. Because the individual toxicity of amphiphilic bile acids and NSAIDs directly correlates with their interactions with phospholipid membranes, we propose that the presence of both NSAIDs and bile acids alters their individual physicochemical properties and enhances the disruptive effect on cell membranes and overall cytotoxicity. We utilized in vitro gastric AGS and intestinal IEC-6 cells and found …

Turf Or Grass? Comparison Of Rates And Causes Of Anterior Cruciate Ligament (Acl) And Medial Collateral Ligament (Mcl) Injuries On Field Turf And Natural Grass Football Fields Of A Division Iii School, Thomas Michael Mcknight

Undergraduate University Honors Capstones

The mixed methods study will compare the rates and causes of anterior cruciate ligament and medial collateral ligament injuries on Field Turf and natural grass football fields of a NCAA Division III school. This study offers evidence for the safety of the different playing surfaces and risk to the players. This pilot study finds also evidence that there is no statistical significance between knee injuries and the playing fields. The qualitative and quantitative data are inconclusive and require further study to reach a conclusion.

Brain Research To Ameliorate Impaired Neurodevelopment - Home-Based Intervention Trial (Brain-Hit), Jan L. Wallander, Elizabeth Mcclure, Fred Biasini, Shivaprasad S. Goudar, Omrana Pasha, Elwyn Chomba, Darlene Shearer, Linda Wright, Vanessa Thorsten, Hrishikesh Chakraborty, Sangappa M. Dhaded, Niranjana S. Mahantshetti, Roopa M. Bellad, Zahid Abbasi, Waldemar Carlo

Community Health Sciences

Background: This randomized controlled trial aims to evaluate the effects of an early developmental intervention program on the development of young children in low-and low-middle-income countries who are at risk for neurodevelopmental disability because of birth asphyxia. A group of children without perinatal complications are evaluated in the same protocol to compare the effects of early developmental intervention in healthy infants in the same communities. Birth asphyxia is the leading specific cause of neonatal mortality in low-and low-middle-income countries and is also the main cause of neonatal and long-term morbidity including mental retardation, cerebral palsy, and other neurodevelopmental disorders. Mortality …

Download The Full Pdf Of Jefferson Surgical Solutions Spring 2010, Volume 5, Number 1

Jefferson Surgical Solutions

No abstract provided.

Designing For An Aging Population, Allison Shives

Undergraduate Research Conference

Aging starts at birth and continues throughout life. As people age, they need to continue to live a happy life. A designer’s job is to design a facility that will encourage an independent lifestyle while providing the help and community involvement aging requires. The design solution should meet the aging population’s desire to age in place. An assisted living facility allows older adults to live independently while being surrounded by a support group and events that promote an active lifestyle which is conducive to physical and mental wellbeing.

Increase In Isolation Of Extended Spectrum Beta Lactamase Producing Multidrug Resistant Non Typhoidal Salmonellae In Pakistan., Kauser Jabeen, Afia Zafar, Seema Irfan, Erum Khan, Vikram Mehraj, Rumina Hasan

Department of Pathology and Laboratory Medicine

Background:Increasing resistance to quinolones and ceftriaxone in non typhoidal Salmonellae is a global concern. Resistance to quinolone and 3rd generation cephalosporin amongst non typhoidal Salmonellae (NTS) from Pakistan has been reported in this study.

Methods:

Retrospective analysis of laboratory data was conducted (1990-2006). NTS were isolated and identified from clinical samples using standard microbiological techniques. Antimicrobial susceptibility testing was performed by Kirby Bauer. Extended spectrum beta lactamase production (ESBL) was detected using combined disc method. Ciprofloxacin sensitivity was detected by nalidixic acid screening method. Minimum inhibitory concentration (MIC) of ciprofloxacin was determined by agar dilution method. Statistical analysis was …

Optimal Bone Strength And Mineralization Requires The Type 2 Iodothyronine Deiodinase In Osteoblasts, J. H. D. Bassett, Alan Boyde, Peter G. T. Howell, Richard H. Bassett, Thomas M. Galliford, Marta Archanco, Holly Evans, Michelle A. Lawson, Peter Croucher, Donald L. St. Germain, Valerie A. Galton, Graham R. Williams

Dartmouth Scholarship

Hypothyroidism and thyrotoxicosis are each associated with an increased risk of fracture. Although thyroxine (T4) is the predominant circulating thyroid hormone, target cell responses are determined by local intracellular availability of the active hormone 3,5,3'-L-triiodothyronine (T3), which is generated from T4 by the type 2 deiodinase enzyme (D2). To investigate the role of locally produced T3 in bone, we characterized mice deficient in D2 (D2KO) in which the serum T3 level is normal. Bones from adult D2KO mice have reduced toughness and are brittle, displaying an increased susceptibility to fracture. This phenotype is characterized by a 50% reduction in bone …

News In Brief

Jefferson Surgical Solutions

No abstract provided.

Jefferson Awards Gala Celebrates A Dedicated Faculty Member

Jefferson Surgical Solutions

No abstract provided.

On The Job-Katie Ashburn, Crnp, And Shawn Pierce, Cnrp

Jefferson Surgical Solutions

No abstract provided.

Brody Recognized For Promising Pancreatic Cancer Research

Jefferson Surgical Solutions

No abstract provided.

Please Welcome-Joyce Hartmann, Physician Liaison For Liver Transplant Program

Jefferson Surgical Solutions

No abstract provided.

The New Breast Care Center: Truly “Managed Care” For Women

Jefferson Surgical Solutions

No abstract provided.

Overview-Charles J. Yeo, Md Samuel D. Gross Professor And Chair, Department Of Surgery

Jefferson Surgical Solutions

No abstract provided.

The Surgeon Speaks-Carlo Ramirez, Md, Facs

Jefferson Surgical Solutions

No abstract provided.

Kidney Transplant Program Offers Many Options And Encourages Living Donors

Jefferson Surgical Solutions

No abstract provided.

Impact Of Insurance Status On Migraine Care In The United States, Andrew Wilper, Steffie Woolhandler, David U. Himmelstein, Rachel Nardin

Publications and Research

Objective
To determine whether insurance status is associated with differential outpatient treatment of migraine in the United States.

Methods
We analyzed 11 years of data from the National Ambulatory Medical Care Survey and National Hospital Ambulatory Medical Care Survey (1997–2007), which survey patient visits to doctors’ offices, hospital outpatient departments, and emergency departments (EDs) in the United States. We used logistic regression to determine whether insurance status was associated with the prescription of standard migraine therapy, defined as 1) a triptan or dihydroergotamine and 2) a prophylactic agent.

Results
We identified 6,814 individual patient visits for migraine, representing 68.6 million …

Preoperative Drainage In Pancreatic Cancer., Eugene P Kennedy, Ernest L Rosato, Charles J Yeo

Department of Surgery Faculty Papers

Van der Gaag et al. conclude that preoperative biliary drainage in patients undergoing surgery for cancer of the head of the pancreas increases complications. Previous studies have shown that stenting is associated with a doubling in the risk of wound infection and an overall slightly increased risk of any complication.

Rituximab In The Treatment Of B-Cell Non-Hodgkin Lymphoma, Focus On Outcomes And Comparative Effectiveness, Firas Badin, John Hayslip

Markey Cancer Center Faculty Publications

Rituximab is an important and well established component in the treatment of many patients with B-cell non-Hodgkin lymphoma. In this paper we review recent clinical trials investigating the addition of rituximab to standard chemotherapy regimens for treatment of patients with diffuse large B cell lymphoma and follicular lymphoma. This report focuses upon treatment efficacy, quality of life, and safety of rituximab or rituximab-containing regimens. More uniquely, we review economic aspects of lymphoma treatments, including the cost of standard chemotherapy regimens with or without rituximab, cost effectiveness of rituximab in both induction and maintenance treatment, and lymphoma's impacts on patient's productivity …

Standardized Performance Measurement And Reporting In Emergency Departments (Eds), Gw Urgent Matters Learning Network Ii

Health Workforce Research Center Publications

The drive to maximize emergency department (ED) efficiency while also ensuring the quality of care they deliver has been the focus of experts in the United States for decades. Access to patient-centered and equitable emergency care is critical to a community, and EDs are the safety net that must provide that care whenever it is needed, to whomever needs it. A wellmanaged ED increases the quality and safety of patient care and strengthens the health care infrastructure.

Com Outlook Spring 2010, College Of Osteopathic Medicine

COM Outlook

No abstract provided.