Medical Specialties Commons^™

Effects Of Age And Symptomatology On Cortical Thickness In Autism Spectrum Disorders, Krissy A.R. Doyle-Thomas, Emma G. Duerden, Margot J. Taylor, Jason P. Lerch, Latha V. Soorya, A. Ting Wang, Jin Fan, Eric Hollander, Evdokia Anagnostou

Paediatrics Publications

Several brain regions show structural and functional abnormalities in individuals with autism spectrum disorders (ASD), but the developmental trajectory of abnormalities in these structures and how they may relate to social and communicative impairments are still unclear. We assessed the effects of age on cortical thickness in individuals with ASD, between the ages of 7 and 39 years in comparison to typically developing controls. Additionally, we examined differences in cortical thickness in relation to symptomatology in the ASD group, and their association with age. Analyses were conducted using a general linear model, controlling for sex. Social and communication scores from …

Dietary Exposures And Allergy Prevention In High-Risk Infants, Edmond S. Chan, Carl Cummings, Mark Feldman, Ruth B. Grimes, Barbara Grueger, Larry B. Pancer, Anne Rowan Legg, Ellen P. Wood, Fabian P. Gorodzinsky, Nestor Cisneros, Janet Roberts, Adelle Atkinson, Zave Chad, Marie Josée Francoeur, Linda Kirste, Douglas Mack, Marie Noel Primeau, Timothy Vander Leek, Wade Watson

Paediatrics Publications

Allergic conditions in children are a prevalent health concern in Canada. The burden of disease and the societal costs of proper diagnosis and management are considerable, making the primary prevention of allergic conditions a desirable health care objective. This position statement reviews current evidence on dietary exposures and allergy prevention in infants at high risk for developing allergic conditions. It revisits previous dietary recommendations for pregnancy, breastfeeding and formula feeding, and provides an approach for introducing solid foods to high-risk infants. While there is no evidence that delaying the introduction of any specific food beyond six months of age helps …

Diet And Nutrition In Cancer Survivorship And Palliative Care., Anthony J Bazzan, Andrew B Newberg, William C Cho, Daniel A Monti

Marcus Institute of Integrative Health Faculty Papers

The primary goal of palliative cancer care is typically to relieve suffering and improve quality of life. Most approaches to diet in this setting have focused only on eating as many calories as possible to avoid cachexia. However, as the concept of palliative care has evolved to include all aspects of cancer survivorship and not just end of life care, there is an increasing need to thoughtfully consider diet and nutrition approaches that can impact not only quality of life but overall health outcomes and perhaps even positively affect cancer recurrence and progression. In this regard, there has been a …

B.03 Clinical Utility Of Critical Care Eeg Monitoring In A Canadian Paediatric Centre, Saptharishi Lalgudi Ganesan

Data and Test Instruments

No abstract provided.

Multi-Modality Assessment Of Language Function, Erik Carmen Brown

Wayne State University Dissertations

The work presented as part of this dissertation represents a multi-modality study of language structure and function. The primary functional modality employed is task-related electrocorticography (ECoG). This is complemented by discussion and evaluation of previously published functional magnetic resonance imaging (fMRI) data. Language-related structure is explored using diffusion-weighted magnetic resonance imaging in conjunction with ECoG data. The scientific questions pursued are broad and include reevaluation of previously proposed theories.

We start by taking the first steps in validating our naming-related ECoG approach by comparing our results from a small cohort of patients to the clinical gold-standard technique of electrical brain …

Linking Environmental Toxicant Exposure To Diabetes Susceptibility, Jannifer Beth Tyrrell

Wayne State University Dissertations

An important and unresolved question in the environmental health field is whether exposure to common environmental toxicants, such as dioxin and heavy metals like Pb, increase the risk of developing diabetes, especially in combination with other common metabolic stressors such as obesity.

Previous studies suggested that dioxin exposure increased peripheral insulin resistance but did not appear to cause fasting hyperglycemia or elevated hepatic glucose output. In concordance with those findings we observed that dioxin treatment caused a strong suppression of the expression of the key hepatic gluconeogenic genes PEPCK and G6Pase. However, this suppression was not solely mediated by the …

White Matter Integrity And Age Related Differences In Reaction Time Components, Yiqin Yang

Wayne State University Dissertations

Reduced speed in information processing is a well-documented phenomenon associated with advanced aging. Age-related deterioration in white matter integrity might play a role in age-related increase in reaction time (RT). However, the association between microstructural differences in particular white matter regions or tracts with RT is unclear. Decomposing RT into parts might be a better way to understand the relationship due to multiple processes involved in RT. In a lifespan sample of 90 healthy normotensive participants, this study examined the association between RT components derived from the Ratcliff diffusion model with age related difference in DTI indices of a wide …

Children's Mercy Hospital Annual Report 2012, Children's Mercy Hospital

Children's Mercy Annual Reports

Annual report for The Children's Mercy Hospital in Kansas City MO, a pediatric medical center.

Bone-Targeted Therapies In Metastatic Castration-Resistant Prostate Cancer: Evolving Paradigms, Joelle El-Amm, Ashley Freeman, Nihar Patel, Jeanny B. Aragon-Ching

Medicine Faculty Publications

Majority of patients with metastatic castrate resistant prostate cancer (mCRPC) develop bone metastases which results in significant morbidity and mortality as a result of skeletal-related events (SREs). Several bone-targeted agents are either in clinical use or in development for prevention of SREs. Bisphosphonates were the first class of drugs investigated for prevention of SREs and zoledronic acid is the only bisphosphonate that is FDA-approved for this indication. Another bone-targeted agent is denosumab which is a fully humanized monoclonal antibody that binds to the RANK-L thereby inhibiting RANK-L mediated bone resorption. While several radiopharmaceuticals were approved for pain palliation in mCRPC …

Biclonal Gammopathy In A Patient Taking Efalizumab For The Treatment Of Psoriasis, Antonia Fthenakis, Kurt S. Wenk, Alison Ehrlich, Jeanny B. Aragon-Ching

Dermatology Faculty Publications

We report a patient who developed biclonal gammopathy of undetermined significance during treatment with
efalizumab for psoriasis. This plasma cell disorder was found during the evaluation of the patient’s complaint of mild lower extremity paresthesia. The gammopathy spontaneously remitted following cessation of therapy and has not recurred to date. Given the increasing use and development of biological agents for the treatment of psoriasis and other disorders, this finding and the mechanisms by which it may have occurred is of clinical significance.

B Cell Acute Lymphoblastic Leukemia Associated With T(8;22)(P11.2q11.2): Role Of Additional Cytogenic Anomalies, Kate M. Serdy, Shireen R. Khoury, Louis Depalma

Pathology Faculty Publications

B lymphoblastic leukemia (B-ALL) may be associated with recurrent cytogenetic and molecular abnormalities. We describe the fourth-known case of B-ALL associated with the t(8;22)(p11.2q11.2) – a translocation seen more frequently in T lymphoblastic leukemia and acute myelogenous leukemia. This patient’s leukemia involves a combination of additional cytogenetic anomalies not yet described in the literature, including del(11)(q13q23), add(9)(p22), and monosomy 7. Given the role in B cell differentiation of genes in the affected regions, including MEN1 (11q13), ATM (11q22), ETS1(11q23), MLL (11q23), AF9 (9p22), and IKZ-F1 (7p12), this case may provide further insight into B cell leukemogenesis associated with the t(8;22). …

Whole Blood Platelet Aggregation And Release Reaction Testing In Uremic Patients, Jay Zeck, Jason Schallheim, Susie Q. Lew, Louis Depalma

Pathology Faculty Publications

Background: Platelet function analysis utilizing platelet-rich plasma and optical density based aggregometry fails to identify patients at risk for uremia associated complications.

Methods: We employed whole blood platelet aggregation analysis based on impedance as well as determination of ATP release from platelet granules detected by a chemiluminescence method. Ten chronic kidney disease (CKD) stage 4 or 5 predialysis patients underwent platelet evaluation. Our study aims to evaluate this platform in this patient population to determine if abnormalities could be detected. Results. Analysis revealed normal aggregation and ATP release to collagen, ADP, and high-dose ristocetin. ATP release had a low response …

Middle Ear Myoclonus: Two Informative Cases And A Systematic Discussion Of Myogenic Tinnitus, Aviva Ellenstein, Nadia Yusuf, Mark Hallett

Neurology Faculty Publications

Background: The term middle ear myoclonus (MEM) has been invoked to explain symptoms of tinnitus presumably caused by the dysfunctional movement of either of the two muscles that insert in the middle ear: tensor tympani and stapedius. MEM has been characterized through heterogeneous case reports in the otolaryngology literature, where clinical presentation is variable, phenomenology is scarcely described, the pathogenic muscle is usually not specified, natural history is unknown, and the presumptive definitive treatment, tensor tympani or stapedius tendon lysis, is inconsistently effective. It is not surprising that no unique acoustogenic mechanism or pathophysiologic process has been identified to explain …

Household Catastrophic Medical Expenses In Eastern China: Determinants And Policy Implications, Xiaohong Li, Jay J. Shen, Jun Lu, Mei Sun, Chengyue Li, Fengshui Chang, Mo Hao

School of Public Health Faculty Research

Background: Much of research on household catastrophic medical expenses in China has focused on less developed areas and little is known about this problem in more developed areas. This study aimed to analyse the incidence and determinants of catastrophic medical expenses in eastern China.

Methods: Data were obtained from a health care utilization and expense survey of 11,577 households conducted in eastern China in 2008. The incidence of household catastrophic medical expenses was calculated using the method introduced by the World Health Organization. A multi-level logistic regression model was used to identify the determinants.

Results: The incidence of household catastrophic …

Alloreactivity-Based Medical Conditions, Stanislav Vukmanovic, Margaret G. Petroff, Anne M. Stevens, Daniel Rukavina

Pediatrics Faculty Publications

No abstract provided.

Microenvironment Generated During Egfr Targeted Killing Of Pancreatic Tumor Cells By Atc Inhibits Myeloid-Derived Suppressor Cells Through Cox2 And Pge2 Dependent Pathway, Archana Thakur, Dana Schalk, Elyse Tomaszewski, Sri Kondadasula, Hiroshi Yano, Fazlul H. Sarkar, Lawrence G. Lum

Wayne State University Associated BioMed Central Scholarship

Abstract

Background

Myeloid-derived suppressor cells (MDSCs) are one of the major components of the immune-suppressive network, play key roles in tumor progression and limit therapeutic responses. Recently, we reported that tumor spheres formed by breast cancer cell lines were visibly smaller in a Th₁ enriched microenvironment with significantly reduced differentiation of MDSC populations in 3D culture. In this study, we investigated the mechanism(s) of bispecific antibody armed ATC mediated inhibition of MDSC in the presence or absence of Th₁ microenvironment.

Methods

We used 3D co-culture model of peripheral blood mononuclear cells (PBMC) with pancreatic cancer cells MiaPaCa-2 [MiaE] …

Inhibition Of Hedgehog Signaling Sensitizes Nsclc Cells To Standard Therapies Through Modulation Of Emt-Regulating Mirnas, Aamir Ahmad, Ma'in Y. Maitah, Kevin R. Ginnebaugh, Yiwei Li, Bin Bao, Shirish M. Gadgeel, Fazlul H. Sarkar

Wayne State University Associated BioMed Central Scholarship

Abstract

Background

Epidermal growth factor receptor- tyrosine kinase inhibitors (EGFR-TKIs) benefit Non-small cell lung cancer (NSCLC) patients, and an EGFR-TKIi erlotinib, is approved for patients with recurrent NSCLC. However, resistance to erlotinib is a major clinical problem. Earlier we have demonstrated the role of Hedgehog (Hh) signaling in Epithelial-to-Mesenchymal transition (EMT) of NSCLC cells, leading to increased proliferation and invasion. Here, we investigated the role of Hh signaling in erlotinib resistance of TGF-β1-induced NSCLC cells that are reminiscent of EMT cells.

Methods

Hh signaling was inhibited by specific siRNA and by GDC-0449, a small molecule antagonist of G protein coupled …

Patient-Family Centered Advisory Council For The Emergency Department, Kelly Sanocki

Theses and Graduate Projects

Issues such as overcrowding and long wait times in the ED cause an increase in patient frustration and dissatisfaction, which may lower hospital satisfaction scores,, and reimbursement. This project proposes the implementation of a Patient-Family Advisory Council (PFAC) in the Emergency Department (ED) setting in a large urban hospital. The addition of a PFAC will offer patients and family members a voice in their care, as they work collaboratively with various healthcare providers to improve patient care, patient safety, and overall satisfaction. The addition of Watson's Caring theory will serve as the theoretical framework for the PFAC since it is …

Complex Biological Reconstruction After Wide Excision Of Osteogenic Sarcoma In Lower Extremities, Kashif Abbas, Masood Umer, Haroon Ur Rashid

Section of Orthopaedic Surgery

Wide margin resection of extremity tumor sometimes leaves a huge soft tissue and bony defects in limb salvage surgery. Adequate management of these defects is an absolute requirement when aiming for functional limb. Multidisciplinary management in such cases is an answer when complex biologic reconstruction is desired. We aim to present cases of osteogenic sarcoma of lower extremity requiring combined surgical approach to achieve effective musculoskeletal reconstruction. Patients and Methods. From 2006 to 2010 ten patients were operated on for osteogenic sarcoma of lower extremity requiring complex musculoskeletal reconstruction. Results. Six patients had pathology around knee joint, whereas one each …

Autoclaved Tumor Bone For Skeletal Reconstruction In Paediatric Patients: A Low Cost Alternative In Developing Countries, Masood Umer, Hafiz Muhammad Umer, Irfan Qadir, Haroon Rashid, Rabia Awan, Raza Askari, Shamvil Ashraf

Section of Orthopaedic Surgery

We reviewed in this series forty patients of pediatric age who underwent resection for malignant tumors of musculoskeletal system followed by biological reconstruction. Our surgical procedure for reconstruction included (1) wide en bloc resection of the tumor; (2) curettage of tumor from the resected bone; (3) autoclaving for 8 minutes (4) bone grafting from the fibula (both vascularized and nonvascularized fibular grafts used); (5) reimplantation of the autoclaved bone into the host bone defect and fixation with plates. Functional evaluation was done using MSTS scoring system. At final followup of at least 18 months (mean 29.2 months), 31 patients had …

Traumatic Pancreatic Injury: An Elusive Diagnosis: Experience From A Developing Country Urban Trauma Referral Centre, Ayaz Ahmed Memon, Hasnain Zafar, Rushna Raza, Ghulam Murtaza

Section of General Surgery

Objective: To determine the frequency of pancreatic injury in patients presenting with trauma and to review the mechanism of injury, management, subsequent complications and in-hospital mortality rate associated with these patients.
Methods: The retrospective study included all patients over 18 years of age presenting with pancreatic injury due to trauma at the Aga Khan University Hospital, Karachi, between January 1990 and December 2009. Patients with iatrogenic pancreatic injury were excluded. The severity of the injury was assessed using the Injury Severity Score, while it was graded according to the scale defined by the American Association for the Surgery of Trauma. …

Scientific Rationale For Study Design Of Community-Based Simplified Antibiotic Therapy Trials In Newborns And Young Infants With Clinically Diagnosed Severe Infections Or Fast Breathing In South Asia And Sub-Saharan Africa., Anita K. M. Zaidi, Abdullah H. Baqui, Shamim Ahmad Qazi, Rajiv Bahl, Samir Saha, Adejumoke I. Ayede, Ebunoluwa A. Adejuyigbe, Cyril Engmann, Fabian Esamai, Antoinette Kitoto Tshefu, Robinson D. Wammanda, Adegoke G. Falade, Adetanwa Odebiyi, Peter Gisore, Adrien Lokangaka Longombe, William N. Ogala, Shiyam Sundar Tikmani, A. S. M. Nawshad Uddin Ahmed, Steve Wall, Neal Brandes, Daniel E. Roth, Gary L. Darmstadt

Paediatrics and Child Health, East Africa

Background: Newborns and young infants suffer high rates of infections in South Asia and sub-Saharan Africa. Timely access to appropriate antibiotic therapy is essential for reducing mortality. In an effort to develop community case management guidelines for young infants, 0–59 days old, with clinically diagnosed severe infections, or with fast breathing, 4 trials of simplified antibiotic therapy delivered in primary care clinics (Pakistan, Democratic Republic of Congo, Kenya and Nigeria) or at home (Bangladesh and Nigeria) are being conducted.

Methods: This article describes the scientific rationale for these trials, which share major elements of trial design. All the trials are …

Risk Of Childhood Asthma In A Tropical African Urban Setting: A Case - Control Study At The Aga Khan Hospital, Dar-Es-Salaam, Tanzania, Lynda C. Koech

Master of Medicine in Family Medicine

Objective: To determine the modifiable and non-modifiable risk factors for childhood asthma in children aged between two and 15years in a tropical urban East-African setting. Methods: Hospital based case-control study matched for age + two months and sex. Data were obtained from parents of cases and controls using a structured interviewer-administered questionnaire. The study sample consisted of 226 cases of two to 15years old, with physician-confirmed asthma, who met a set of defined clinical criteria and 226 controls with no previous diagnosis or symptoms of asthma matched by sex and age (+two months). The Risk Factors included in this study …

Perception Of Final Year Undergraduate Medical Students Towards Family Medicine In Dar Es Salaam, Tanzania, Eric Luggar Aghan

Master of Medicine in Family Medicine

Primary health care was identified as the ideal model of health care delivery during the Alma Atta conference in USSR in 1978. The World Health Organization urged member countries to adopt it as a model of health care service delivery to their people. Since then many countries have adopted a primary health care model including Tanzania. In countries such as Cuba and Costa Rica where primary health care has successfully been implemented, access to affordable and quality health care service to all has resulted in lowered morbidity, mortality, improved quality and longevity of life. The success story behind primary health …

Generalized Anxiety Disorder: Can We Rest Now?, Aamir Abbas, Haider A. Naqvi

Pakistan Journal of Neurological Sciences (PJNS)

Generalized anxiety disorder is a complex psychiatric syndrome. Current understanding on the epidemiological risk factors, genetic vulnerability and neurobiology of the GAD is beginning to unfold the complexities behind this disorder. This narrative review has attempted to put together the recent advances in the area of GAD research with intent to identify the gaps requiring further research.

Novel Use Of An Ultrasonic Bone-Cutting Device For Endoscopic-Assisted Craniosynostosis Surgery, Chaichana Kl, Jallo Gi, Dorafshar Ah, Ahn Es

Pakistan Journal of Neurological Sciences (PJNS)

Endoscopic-assisted craniosynostosis surgery is associated with less blood loss and shorter operative times as compared to open surgery. However, in infants who have low circulating blood volumes, the endoscopic approach is still associated with significant blood loss. A major source of blood loss is the bone that is cut during surgery. We discuss the novel use of an ultrasonic bone-cutting device for craniosynostosis surgery, which decreases bone bleeding. This device, which has primarily only been used for spine and skull base surgery, may help reduce blood loss in these infants.

20th Annual Meeting Of Pakistan Society Of Neurology Bhurban, Islamabad April 2013, Aftab Leghari, Hazim Brohi

Pakistan Journal of Neurological Sciences (PJNS)

: Stroke is a major preventable public health challenge. Diabetic patients constitute a fair percentage of patients with stroke. Numerous epidemiological studies in the United States and Europe suggest that one fifth of stroke patients have diabetes.We evaluate the risk factors leading to stroke in Diabetic patients

Gut Modulator Effects Of Conyza Bonariensis Explain Its Traditional Use In Constipation And Diarrhea, I A. Bukhari, A J. Shah, R A. Khan, S A. Meo, A Khan, A H. Gilani

Department of Biological & Biomedical Sciences

BACKGROUND AND OBJECTIVES:

The current investigation was carried out to explore the pharmacological basis of the crude extract of Conyza bonariensis (Cb.Cr) for its use in constipation and diarrhea.

MATERIALS AND METHODS:

The plant extract of Conyza bonariensis (C. bonariensis) was prepared, isolated guinea-pig ileum and rabbit jejunum preparations were used to evaluate its gut modulator effects.

RESULTS:

The Cb.Cr (0.3-10 mg/mL) exhibited spasmogenic effect in isolated guinea-pig ileum preparation, which was about 19-84% of the acetylcholine maximum. Pretreatment of the tissues with atropine (0.1 µM) abolished the contractile effect, similar to acetylcholine. Among the fractions, only the butanol fraction …

Prevalence Of Acute Kidney Injury Using Urine Neutrophil Gelatinase Associated Lipocalin As An Early Biomarker In Neonates With Perinatal Asphyxia, Farida Essajee

Master of Medicine in Paediatrics and Child Health

Introduction: Perinatal asphyxia is a major cause of neonatal morbidity and mortality. Acute kidney injury (AKI) is a common complication of perinatal asphyxia occurring in up to 61% of the neonates. Currently the diagnosis of AKI is based on serum creatinine levels and clinically by oliguria, however these are late markers of the disease. More novel biomarkers are emerging that predict the diagnosis early. Current research indicates urine NGAL as an early marker for AKI, yet there is paucity of data about its use in term neonates with perinatal asphyxia. Objectives: This study aimed to investigate the prevalence of acute …

Gently Into The Good Night: Toward A Compassionate Response To End-Stage Illness, George P. Smith Ii

Scholarly Articles

End-of-life decision making by health care providers must respect individual patient values. Indeed, these values must always be viewed as the baseline for developing and pursuing patient-centered palliative care for those with terminal illness. Co-ordinate with this fundamental bioethics principle is that of beneficence or, in other words, respect for conduct which benefits the dying patient by alleviating end-stage suffering — be it physical or existential. Compassion, charity, agape and/or just common sense, should be a part of setting normative standards and of legislative and judicial responses to the task of managing death. Aided by the principles of medical futility, …