Medical Specialties Commons^™

Stress-Inducible Phosphoprotein 1 Has Unique Cochaperone Activity During Development And Regulates Cellular Response To Ischemia Via The Prion Protein., Flavio H Beraldo, Iaci N Soares, Daniela F Goncalves, Jue Fan, Anu A Thomas, Tiago G Santos, Amro H Mohammad, Martin Roffé, Michele D Calder, Simona Nikolova, Glaucia N Hajj, Andre L Guimaraes, Andre R Massensini, Ian Welch, Dean H Betts, Robert Gros, Maria Drangova, Andrew J Watson, Robert Bartha, Vania F Prado, Vilma R Martins, Marco A M Prado

Obstetrics & Gynaecology Publications

Stress-inducible phosphoprotein 1 (STI1) is part of the chaperone machinery, but it also functions as an extracellular ligand for the prion protein. However, the physiological relevance of these STI1 activities in vivo is unknown. Here, we show that in the absence of embryonic STI1, several Hsp90 client proteins are decreased by 50%, although Hsp90 levels are unaffected. Mutant STI1 mice showed increased caspase-3 activation and 50% impairment in cellular proliferation. Moreover, placental disruption and lack of cellular viability were linked to embryonic death by E10.5 in STI1-mutant mice. Rescue of embryonic lethality in these mutants, by transgenic expression of the …

Endogenous Folate Accumulation In Oocytes And Preimplantation Embryos And Its Epigenetic Implications., Mellissa R W Mann, Andrew J Watson

Obstetrics & Gynaecology Publications

No abstract provided.

Development Of Uv/Hplc Methods For Quantitative Analysis Of Benznidazole In Human Plasma And Urine For Application In Pediatric Clinical Studies, María Elena Marsón, Diego Dante Dana, Jaime Altcheh, Facundo García-Bournissen, Guido Mastrantonio

Paediatrics Publications

Objective: Chagas disease constitutes a major public health problem in Latin America. Correctly designed pharmacokinetic, safety, and bioequivalence studies are desirable in order to fill the knowledge gaps that presently exist on available drugs. It is necessary to develop accurate, simple, reproducible, and sensitive high-performance liquid chromatography (HPLC)/UV methods for the quantization of benznidazole (BNZ) in human plasma and urine for clinical applications, specially in pediatric patients. Methods: Quantization of BNZ in human plasma involved freeze-drying and re-suspension in organic solvent followed by reverse phase HPLC with UV detection. Analysis of BNZ in urine involved liquid/liquid extraction followed by reverse …

Absence Of The Genicular Arterial Anastomosis As Generally Depicted In Textbooks., Maher Sabalbal, Marjorie Johnson, Vivian Mcalister

Data and Test Instruments

This article reviews the history of anatomical research, starting with John Hunter and Astley Cooper, into the arterial anastomosis at the knee and uses dissection to determine the reality. The final draft is available below. (Ann R Coll Surg Engl. 2013 Sep;95(6):405-9) INTRODUCTION Textbook representations of the genicular arterial anastomosis show a large direct communication between the descending branch of the lateral circumflex femoral artery (DBLCFA) and a genicular branch of the popliteal artery but this is not compatible with clinical experience. The aim of this study was to determine whether the arterial anastomosis at the knee is sufficient, in …

Potential Health Impacts Of Heavy Metals On Hiv-Infected Population In Usa, Xiaohui Xu, Hui Hu, Amy B. Dailey, Greg Kearney, Evelyn O. Talbott, Robert L. Cook

Health Sciences Faculty Publications

Purpose: Noninfectious comorbidities such as cardiovascular diseases have become increasingly prevalent and occur earlier in life in persons with HIV infection. Despite the emerging body of literature linking environmental exposures to chronic disease outcomes in the general population, the impacts of environmental exposures have received little attention in HIV-infected population. The aim of this study is to investigate whether individuals living with HIV have elevated prevalence of heavy metals compared to non-HIV infected individuals in United States.

Methods: We used the National Health and Nutrition Examination Survey (NHANES) 2003-2010 to compare exposures to heavy metals including cadmium, lead, and total …

Samuel D. Gross, M.D. (1805-1884): An Innovator, Even In Death., Peter R. Bucciarelli, B.S., John C. Kairys, Md, Ernest L. Rosato, Md, Charles J. Yeo, Md, Scott W. Cowan, Md

Department of Surgery Gibbon Society Historical Profiles

Dr. Samuel Gross' contributions to the field of surgery are well known and range from numerous clinical advances to pioneering scholarship and professional activities. Dr. Gross was ceaselessly ambitious and even remarked in his autobiography that his ‘‘conviction has always been that is far better for a man to wear out than to rust out.’’1 It is through this frame of motivation that Dr. Gross lived his life.

Presence Of Virus Neutralizing Antibodies In Cerebral Spinal Fluid Correlates With Non-Lethal Rabies In Dogs., Clement W Gnanadurai, Ming Zhou, Wenqi He, Christina M Leyson, Chien-Tsun Huang, Gregory Salyards, Stephen B Harvey, Zhenhai Chen, Biao He, Yang Yang, D C Hooper, Berhnard Dietzchold, Zhen F Fu

Department of Cancer Biology Faculty Papers

BACKGROUND: Rabies is traditionally considered a uniformly fatal disease after onset of clinical manifestations. However, increasing evidence indicates that non-lethal infection as well as recovery from flaccid paralysis and encephalitis occurs in laboratory animals as well as humans.

METHODOLOGY/PRINCIPAL FINDINGS: Non-lethal rabies infection in dogs experimentally infected with wild type dog rabies virus (RABV, wt DRV-Mexico) correlates with the presence of high level of virus neutralizing antibodies (VNA) in the cerebral spinal fluid (CSF) and mild immune cell accumulation in the central nervous system (CNS). By contrast, dogs that succumbed to rabies showed only little or no VNA in the …

Impact Of Postpartum Anxiety And Depression On Child’S Mental Development From Two Peri-Urban Communities Of Karachi, Pakistan: A Quasi-Experimental Study, Niloufer Sultan Ali, Sadia Mahmud, Asia Khan, Badar Sabir Ali

Department of Family Medicine

Background

Postpartum anxiety and depression has detrimental effects on the overall mental development of children. This study aims to assess the impact of postpartum anxiety and depression on children’s mental development on all sub-scales in a Pakistani population.

Methods

A quasi-experimental study was conducted in two peri-urban communities of Karachi, a mega city of Pakistan, to assess the impact of postpartum anxiety and depression on children’s growth and mental development. A total of 420 women were enrolled, who had given consent out of 651 pregnant women identified, during February 2004 to December 2005. Data for socio-demographic, home environment and family …

My Patient Has Carotid Stenosis. Should He Get Stenting Or Endarterectomy?, Quratulain Shaikh,, Ayeesha Kamran Kamal

Department of Medicine

No abstract provided.

Successful Long-Term Extracorporeal Cardiopulmonary Membrane Oxygenation Without Anti-Coagulation, Janissa Nair, Dorothea T. Watson Do, Rita Pechulis Md, Fccp, Nicholas M. Rini Pa-C, Timothy S. Misselbeck, Kenneth Miller Rrt, James K. Wu Md

Department of Surgery

No abstract provided.

Clinical And Dosimetric Implications Of Air Gaps Between Bolus And Skin Surface During Radiation Therapy, Yousaf Khan, J Eduardo Villarreal-Barajas, Mona Udowicz, Richie Sinha, Wazir Muhammad, Ahmed N. Abbasi, Amjad Hussain

Department of Radiation Oncology

Purpose: The main objective of the study was to evaluate the effect of air gaps of 0 - 5.0 cm between bolus and skin for 1.0 cm Superflab bolus on surface dose (DSurf) and depth of maximum dose (dmax) in solid water and Rando® phantoms.

Methods: In this work, the effects of bolus to surface distance on DSurf and variation in dmax were analyzed in a solid water phantom and in an anthropomorphic Rando® phantom for different field sizes, using Gafchromic® EBT films and farmer chamber.

Results: For field sizes of 5 × 5 cm2 the DSurf …

Longitudinal Spectral Domain Optical Coherence Tomography Changes In Eyes With Intraocular Lymphoma, Hyun Soo Jang, Yasir J. Sepah, Raafay Sophie, Millena G. Bittencourt, Daniel Ferraz, Mostafa Hanout, Hongting Liu, Diana V. Do, Quan Dong Nguyen

Journal Articles: Ophthalmology

BACKGROUND:

Cases of patients with primary intraocular lymphoma (PIOL) were retrospectively analyzed to describe the longitudinal intra-retinal morphological changes in PIOL as visualized on images obtained by spectral domain optical coherence tomography (SD-OCT).

RESULTS:

In a retrospective case series, Heidelberg Spectralis SD-OCT images obtained in the longitudinal evaluation of patients with biopsy-proven PIOL were analyzed and assessed. The images were graded for the presence of macular edema (ME), pigment epithelial detachment (PED), subretinal fluid (SRF), and hyperreflective signals. SD-OCT scans of five eyes from five patients were assessed. Patients showed signs of inflammation, such as ME and SRF, which were …

Labrad : Vol 39, Issue 1 - September 2013, Aga Khan University Hospital, Karachi

LABRAD - Departments of Pathology & Laboratory Medicine and Radiology Archives

• Immunophenotyping by Flowcytometry
• Chronic Lymphocytic Leukaemia: Diagnosis and Prognostic Factors
• Tumour Markers
• Role of Chemical Pathology in Screening and Diagnosis of Multiple Myeloma
• 1p/19q Deletion: Favourable Prognostic Marker for Oligodendroglioma
• EGFR Mutation Screening Test for Lung Cancer Patients
• Clinical Utility of BCR-ABL1 Kinase Domain Mutational Analysis
• Molecular Cytogenetic Testing for Acute Myeloid Leukaemia
• Diffuse Large B-Cell Lymphoma (DLBCL) Subgroups have Different Phenotype

Therapeutic Ultrasound: Osteoarthritis Symptom-Modification And Potential For Disease Modification, Daniel J. Leong, Huagang Zhang, Lin Xu, Justin Tang, David M. Hirsh, John A. Hardin, Luis Cardoso, Chandan Guha, Neil J. Cobelli, Hui B. Sun

Publications and Research

Osteoarthritis (OA) is a degenerative joint disease and a leading cause of adult disability. While joint replacement surgery is a common treatment option for end-stage disease, non-surgical management is critical for preventing disability and maintaining quality of life. Although therapeutic ultrasound, which applies mechanical and may also apply thermal energy in the form of sound waves, is widely used to treat various musculoskeletal disorders such as bone fractures, tendinopathy, and muscle contusions, its symptom- and disease-modifying effects on osteoarthritis have not been clearly demonstrated. Recent clinical evidence indicates therapeutic ultrasound is capable of relieving OAassociated pain and improving function of …

Oncolog, Volume 58, Number 09, September 2013, Jill Delsigne, Markeda Wade

OncoLog MD Anderson's Report to Physicians (All issues) Archives

• Advances in Neuroimaging Help Unveil the Mechanisms of Chemobrain: Chemobrain, a catchall term for the cognitive dysfunction and neurophysiological changes produced bt chemotherapy toxicity, is an important quality-of-life issue for cancer survivors
• Opioid Rotation Can Improve Pain Control and Reduce Neurotoxicity for Cancer Patients: Opioids are a main stay in the relief of pain-especially the chronic cancer-related pain often encountered in the palliative care setting. However, extended opioid use can result in tolerance, dependence, and opioid-induced neurotoxicity
• INBRIEF: Researchers Identity Inhibitor of Cancer-Promoting Protein SKp2/ Change in CA-125 Level Over Time Shows Promise for Ovarian cancer Screening
• HOUSE CALL: Myths …

The Effect Of Malnutrition On Patients Undergoing Elective Joint Arthroplasty., Ronald Huang, Md, Max Greenky, Bs, Glenn J. Kerr, Md, Mathew S. Austin, Md, Javad Parvizi, Md, Frcs

Rothman Institute Papers

Malnutrition has been linked to serious complications in patients undergoing elective total joint arthroplasty (TJA). This study prospectively evaluated 2,161 patients undergoing elective TJA for malnutrition as defined by either an abnormal serum albumin or transferrin. The overall incidence of malnutrition was 8.5% (184 of 2,161) and the rate of overall complications in the malnourished group was 12% as compared to 2.9% in patients with normal parameters (P55years-old undergoing TJA and is associated with a significant increase in post-operative complications.

Sequential Sectioning Of The Ulnar Collateral Ligament Of The Elbow In Cadaveric Arms With Ulnohumeral Laxity Assessed By Dynamic Ultrasonography, Christopher C. Dodson, Levon N. Nazarian, Michael G. Ciccotti, Steven B. Cohen, Sommer Hammoud, Michael C. Ciccotti

Rothman Institute Papers

Objectives: Injury of the ulnar collateral ligament (UCL), whether acute or chronic, is potentially career-threatening for elite overhead throwing athletes. Dynamic ultrasound (DUS) allows for rapid, cost-effective, non-invasive, and non-radiating evaluation of the UCL and elbow joint both at rest and with applied stress. The purpose of this study was to determine the amount of cadaveric elbow valgus laxity with sequential UCL sectioning using DUS. Our objective was to quantify which portions of the UCL must be injured to cause the varying levels of laxity seen clinically on DUS testing. No prior study has used DUS to quantify valgus joint …

Reactive Hyperemia Occurs Via Activation Of Inwardly Rectifying Potassium Channels And Na+/K+-Atpase In Humans, Anne R. Crecelius, Jennifer C. Richards, Gary J. Luckasen, Dennis G. Larson, Frank A. Dinenno

Health and Sport Science Faculty Publications

Rationale: Reactive hyperemia (RH) in the forearm circulation is an important marker of cardiovascular health, yet the underlying vasodilator signaling pathways are controversial and thus remain unclear.

Objective: We hypothesized that RH occurs via activation of inwardly rectifying potassium (K_IR) channels and Na⁺/K⁺-ATPase and is largely independent of the combined production of the endothelial autocoids nitric oxide (NO) and prostaglandins in young healthy humans.

Methods and Results: In 24 (23±1 years) subjects, we performed RH trials by measuring forearm blood flow (FBF; venous occlusion plethysmography) after 5 minutes of arterial occlusion. In protocol 1, …

Association Between Elevated Third Trimester Maternal Haemoglobin And Neonatal Gestational Age Adjusted Birth Weight, Bob Otieno Achila

Master of Medicine in Obstetrics and Gynecology

Background: Women tend to have lower haemoglobin compared to men due to menstrual blood losses. This is often compounded by nutritional deficiencies. There is a further drop in haemoglobin during pregnancy due to red cell dilution. Pregnancy itself places a huge demand on maternal iron stores. High haemoglobin may reflect haemoconcentration due to a failure of the normal physiological expansion in plasma volume. Iron excess has also been associated with free-radical damage. In current practice, high maternal haemoglobin in pregnancy is often not given as much attention as anaemia. This study examines the association between high maternal haemoglobin in the …

Taking Family Centered Care To A Whole New Level: Babycam, Cathy L. Bailey Rn, Ms, Crnp

Patient Care Services / Nursing

No abstract provided.

Understanding The Pincer - The Importance Of Reference Plane Orientation On Acetabular Rim Evaluation, Anil K. Gupta, Nozomu Inoue, Michael D. Hellman, Joshua D. Harris, Frank M. Mccormick, Shane Nho

Rothman Institute Papers

Objectives: Femoroacetabular impingement (FAI) is a common cause of young adult hip pain. FAI can result from an acetabular-sided bony lesion, or “pincer” lesion. A pincer lesion is defined as an area of linear contact between the acetabular rim and the femoral head-neck junction due to general or focal acetabular overcoverage. Three dimensional (3D) analysis of the acetabular rim morphology is essential to understand etiology and aciculate diagnosis of the of the pincer type FAI. A few studies have measured 3D geometry of the acetabular rim; in which the acetabular rim is described as a deviation from a reference plane. …

Human Resource Inequalities At The Base Of India's Public Health Care System, Saseendran Pallikadavath, Abhishek Singh, Reuben Ogollah, Tara Dean, William Stones

Obstetrics and Gynaecology, East Africa

This paper examines the extent of inequalities in human resource provision at India's Heath Sub-Centres (HSC)—first level of service provision in the public health system. ‘Within state’ inequality explained about 71% and ‘between state’ inequality explained the remaining 29% of the overall inter-HSC inequality. The Northern states had a lower health worker share relative to the extent of their HSC provision. Contextual factors that contributed to ‘between’ and ‘within’ district inequalities were the percentages of villages connected with all-weather roads and having primary schools. Analysis demonstrates a policy and programming need to address ‘within State’ inequalities as a priority.

Managing Data For The International, Multicentre Intergrowth-21st Project, E O. Ohuma, L Hoch, C Cosgrove, H E. Knight, L Cheikh Ismail, L Juodvirsiene, A T. Papageorghiou, H Al-Jabri, M Domingues, P Gilli, N Kunnawar, N Musee, F Roseman, A Carter, M Wu, D G. Altman

Obstetrics and Gynaecology, East Africa

The INTERGROWTH-21st Project data management was structured incorporating both a centralised and decentralised system for the eight study centres, which all used the same database and standardised data collection instruments, manuals and processes. Each centre was responsible for the entry and validation of their country-specific data, which were entered onto a centralised system maintained by the Data Coordinating Unit in Oxford. A comprehensive data management system was designed to handle the very large volumes of data. It contained internal validations to prevent incorrect and inconsistent values being captured, and allowed online data entry by local Data Management Units, as well …

The Prevalence Of Postoperative Pain In The First 48 Hours Following Day Surgery At A Tertiary Hospital In Nairobi, Gilbert Mwaka, Shariff Thikra, Vitalis Mung’Ayi

Anaesthesiology, East Africa

Background: Day case surgery services are increasing all over the world. The prevalence of postoperative pain after day surgery is found to be high. Little is known about the prevalence of postoperative pain, in Kenya, after day case surgeries.

Objective: To investigate the prevalence of postoperative pain after day surgery at Aga Khan University Hospital (AKUH), Nairobi, to determine the severity/intensity of postoperative pain following day case surgery

Methods: Consecutive sampling was carried out until sample size of one hundred and fifty patients was achieved. The purpose and nature of the study was explained to patients before informed consent was …

Identifying Barriers To Patient Acceptance Of Active Surveillance: Content Analysis Of Online Patient Communications., Mark V Mishra, Michele Bennett, Armon Vincent, Olivia T Lee, Costas D Lallas, Edouard J Trabulsi, Leonard G Gomella, Adam P Dicker, Timothy N Showalter

Department of Urology Faculty Papers

OBJECTIVES: Qualitative research aimed at identifying patient acceptance of active surveillance (AS) has been identified as a public health research priority. The primary objective of this study was to determine if analysis of a large-sample of anonymous internet conversations (ICs) could be utilized to identify unmet public needs regarding AS.

METHODS: English-language ICs regarding prostate cancer (PC) treatment with AS from 2002-12 were identified using a novel internet search methodology. Web spiders were developed to mine, aggregate, and analyze content from the world-wide-web for ICs centered on AS. Collection of ICs was not restricted to any specific geographic region of …

Grant Application: Maine Partners For Health In Africa, Lindsay Katona, William Douglas, Sean Lena, Daniel Crothers

Maine Partners For Health In Africa

IPEC Mini-grant application for funding of UNE student project Maine Partners for Health in Africa: Clinical and Public Health Initiatives. The team organized a day long conference in February 2014, "The Maine Africa Connection," to bring together UNE community, Maine organizations, members of the public, and practitioners to discuss best practices, challenges, and begin new collaborations for future health projects. Goals of the conference were to gather experts on interdisciplinary approaches to health care for African refugees and immigrants in Maine, educate health providers, administrators, educators, and community members on best practices for refugee health care, and set a …

Improvement In Access And Equity For Maternal And Neonatal Health Services: Comparative Advantages Of Contracted-Out Versus Non-Contracted-Out Facilities, Shehla Zaidi, Fauziah Rabbani, Iqbal Azam Syed, Atif Riaz, Peter Hatcher, Gul Nawaz Khan Nawaz Khan, Nousheen Pradhan, Hassan Fazli, Shiraz Shaikh, Yasmeen Khan, Syeda Nida Naim, Unaib Rabbani

Community Health Sciences

No abstract provided.

Strengthening Paediatric Emergency Medicine In Pakistan Is Our Need To Reach Millennium Development Goal 4., Emaduddin Siddiqui, Kiran Ejaz

Department of Emergency Medicine

No abstract provided.

Long-Term Outcome Of Primary External Dacryocystorhinostomy, Rashid Baig, Qazi Assad Khan, Khabir Ahmad

Department of Surgery Docs

bstract

OBJECTIVE:

To assess the long-term functional outcome of external dacryocystorhinostomy (DCR) in terms of epiphora.

STUDY DESIGN:

Single-group cohort study.

PLACE AND DURATION OF STUDY:

Section of Ophthalmology, The Aga Khan University Hospital, Karachi, from January 2000 to June 2010.

METHODOLOGY:

This study included adults who underwent external DCR surgery at the AKUH during January 2000 to June 2010. The main outcome measure was the proportion of patients reporting to have developed epiphora after surgery. During the telephonic interviews participants were asked if they had a recurrence (symptoms such as watering or discharge) after surgery. Individuals answering in affirmative …

Occupational Exposure To Hepatitis C Virus: Early T-Cell Responses In The Absence Of Seroconversion In A Longitudinal Cohort Study., Theo Heller, Jens Martin Werner, Fareed Rahman, Eishiro Mizukoshi, Yuji Sobao, Ann Marie Gordon, Arlene Sheets, Averell H. Sherker, Ellen Kessler, Kathleen S. Bean, Steven K. Herrine, M'Lou Stevens, James Schmitt, Barbara Rehermann

Division of Gastroenterology and Hepatology Faculty Papers

BACKGROUND: T-cell responses have been described in seronegative patients who test negative for hepatitis C virus (HCV) RNA despite frequent HCV exposure. However, the cross-sectional design of those studies did not clarify whether T cells were indeed induced by low-level HCV exposure without seroconversion or whether they resulted from regular acute infection with subsequent antibody loss.

METHODS: Over a 10-year period, our longitudinal study recruited 72 healthcare workers with documented HCV exposure. We studied viremia and antibody and T-cell responses longitudinally for 6 months.

RESULTS: All healthcare workers remained negative for HCV RNA and antibodies. However, 48% developed proliferative T-cell …