Medical Specialties Commons^™

Skin To Skin In The Operating Room For Cesareans, Marietta Sperry

Books, Presentations, Posters, Etc.

Is there a difference in outcomes with both mothers & babies in mothers that deliver by Cesarean Section who experience Skin to Skin Contact (SSC) in the Operating Room (OR) compared to those who do not have SSC after a Cesarean Delivery?

E3 Ligase Identified By Differential Display (Edd) Enhances Cell Survival And Cisplatin Resistance In Epithelial Ovarian Cancer And Oral Squamous Cell Carcinoma, Amber Thompson Bradley

MUSC Theses and Dissertations

EDD (E3-ubiquitin ligase identified by Differential Display) is an E3 ubiquitin ligase that is overexpressed in ovarian cancer, but is rare in benign and borderline tumors. EDD is also overexpressed in recurrent, platinum-resistant ovarian cancers and is associated with a two-fold increased risk of disease recurrence and death in ovarian cancer patients, suggesting a role in tumor survival and/or platinum resistance. EDD knockdown by siRNA induced apoptosis in A2780ip2, OVCAR5, and ES-2 ovarian cancer cells, correlating with a loss of the anti-apoptotic protein Mcl-1 through a GSK-3β-independent mechanism. Transient knockdown of EDD or Mcl-1 induced comparable levels of apoptosis in …

Discovery Of Pharmacological Compounds That Stimulate Renal Mitochondrial Biogenesis And Restore Kidney Function, Sean Robert Jesinkey

MUSC Theses and Dissertations

Dysfunctional mitochondria are a primary pathological consequence of acute kidney injury (AKI). Mitochondrial homeostasis is disrupted up to 144 h after ischemia-reperfusion (I/R) induced-AKI in the renal cortical tissue of mice. Stimulation of mitochondrial biogenesis in renal cells after oxidant injury restores mitochondrial function. The primary goals of this project were to identify novel pharmacological compounds capable of inducing mitochondrial biogenesis in the renal proximal tubule and evaluate if this induction would promote the recovery of mitochondrial and/or renal function after in vivo AKI. The secondary goal was to employ our mitochondrial approach for drug discovery towards identifying a novel …

Prevalence And Clinical Characteristics Of Venous Thromboembolism At The Aga Khan University Hospital, Nairobi, Felix Mutuma Riunga

Master of Medicine in Internal Medicine

Aim: To determine the prevalence of venous thromboembolism in patients presenting to the Aga Khan University Hospital, Radiology Department for lower limb compression ultrasonography with doppler and CT pulmonary angiography. In those found to have venous thromboembolism, the distribution of risk factors as described by Wells, the pattern of clinical presentation, the pattern of initial therapy, the length of hospital stay, major bleeding episodes and in hospital mortality were described. Design: Prospective survey Background: Venous Thromboembolism is a major cause of morbidity and mortality worldwide and its occurrence locally, as well as its clinical characteristics needs to be described in …

The Utility Of A Tablet Computer Device In Comparison To A Standard High Resolution Monitor For Reporting Ct Kub Images, Kenneth Kiriinya Ibeere

Master of Medicine in Imaging and Diagnostic Radiology

Background: The latest technological developments in the field of digital medical imaging have facilitated the transfer of the power and utility of the personal computer to mobile computing devices. One of these that have been used in diagnostic imaging is a tablet computer. Mobile tele-radiology using a tablet computer device is an apt extension of imaging services, for after-office-hours consultation. It is crucial to determine the diagnostic accuracy of these portable computer devices in order to determine safety for use in diagnostic image interpretation without compromising patient care. Objective: To find out the diagnostic accuracy of urolithiasis (urinary tract calculi) …

Prediction Of Breast Tumor Size By Ultrasound: A Comparison With Pathology, David Toyis Wanyonyi

Master of Medicine in Imaging and Diagnostic Radiology

Background: Tumor size is one of the most important prognostic factors in breast cancer and its accurate assessment is critical in planning appropriate treatment. Although histology is often regarded as the definitive way of establishing tumor size, radiological techniques, particularly ultrasonography, are usually relied upon to give an estimate of the tumor size for prognostication and treatment planning. Correlations between mammography, ultrasonography, magnetic resonance imaging (MRI) and pathology size have been performed in different populations with varying results however no prospective study has been done to establish the agreement between sonographic tumor size and histopathological tumor size in our population. …

The Prevalence Of Malaria And Assessment Of The Uptake Of Malaria Prevention Measures In Blood Donors In Two Regional Blood Transfusion Centres In Kenya, Valerie Magutu

Master of Medicine in Clinical Pathology

Transfusion transmitted malaria is one of the most common transfusion transmissible infections and is a threat to blood safety and malaria control in Sub-Saharan African countries where malaria is endemic. The majority of healthy adults living in malaria endemic areas have some degree of immunity to the disease and an asymptomatic low-level parasitaemia is known to exist in a subset of this population. Blood donors recruited from the population are screened using a donor-selection criteria that includes age, weight, self-declared well-being and measurement of vital signs but not history of recent malaria infection or treatment. The Kenya National Blood Transfusion …

Beta-Alanine Suppresses Malignant Breast Epithelial Cell Aggressiveness Through Alterations In Metabolism And Cellular Acidity In Vitro, Roger A. Vaughan, Nicholas P. Gannon, Randi Garcia-Smith, Yamhilette Licon-Munoz, Miguel A. Barberena, Marco Bisoffi, Kristina A. Trujillo

Biology, Chemistry, and Environmental Sciences Faculty Articles and Research

Background: Deregulated energetics is a property of most cancer cells. This phenomenon, known as the Warburg Effect or aerobic glycolysis, is characterized by increased glucose uptake, lactate export and extracellular acidification, even in the presence of oxygen. beta-alanine is a non-essential amino acid that has previously been shown to be metabolized into carnosine, which functions as an intracellular buffer. Because of this buffering capacity, we investigated the effects of beta-alanine on the metabolic cancerous phenotype.

Methods: Non-malignant MCF-10a and malignant MCF-7 breast epithelial cells were treated with beta-alanine at 100 mM for 24 hours. Aerobic glycolysis was quantified …

18 F-Fluorothymidine Uptake In Follicular Lymphoma And Error-Prone Dna Repair, Marielle J. Wondergem, Ken Herrmann, Sergei Syrbu, Josee M. Zijlstra, Nikie Hoetjes, Otto S. Hoekstra, Saskia Agm Cillessen, Laura M. Mosenbergen, Andreas K. Buck, Julie M. Vose, Malik E. Juweid

Journal Articles: Oncology and Hematology

BACKGROUND:

We observed a disproportional 18 F-fluorothymidine (F-FLT) uptake in follicular lymphoma (FL) relative to its low cell proliferation. We tested the hypothesis that the 'excess' uptake of 18 F-FLT in FL is related to error-prone DNA repair and investigated whether this also contributes to 18 F-FLT uptake in diffuse large B cell lymphoma (DLBCL).

METHODS:

We performed immunohistochemical stainings to assess the pure DNA replication marker MIB-1 as well as markers of both DNA replication and repair like PCNA, TK-1 and RPA1 on lymph node biopsies of 27 FLs and 35 DLBCLs. In 7 FL and 15 DLBCL patients, …

Psychosocial Factors Associated With Exclusive Breastfeeding Among Pregnant Women On Follow Up In A Tertiary Maternity Hospital, Cornelia Akinyi Ochola

Master of Medicine in Paediatrics and Child Health

Introduction: Exclusive breastfeeding during the first six months of life is the ideal form of infant feeding. Health benefits of exclusive breastfeeding to infant and mother are well documented in literature. Despite this, the rate of exclusive breastfeeding in the first six months of infants‘ life in Kenya remains low. National nutrition strategy for maternal, infant and young child has set its 2017 target for exclusive breastfeeding at 80% from 32%. To achieve this target, new strategies are needed to complement current exclusive breastfeeding initiatives. Application of theory of planned behaviour model was used to determine the psychosocial factors associated …

Pain Scores Among Ed Patients: Correlation With Desire For Pain Medication, Catherine A. Marco, Megan Mcgervey, Joan Gekonde, Caitlin Martin

Emergency Medicine Faculty Publications

Introduction: Pain has been identified as the most common reason for Emergency Department (ED) visits. The verbal numeric rating pain scale (VNRS) is commonly used to assess pain in the ED. This study was undertaken to determine whether VNRS pain scores correlate with desire for pain medication among ED patients.

Methods: In this prospective survey study, eligible patients included Emergency Department patients over 18 with painful conditions. The primary outcome measures included self-reported VNRS, ED diagnosis, number of ED visits and number of ED admissions within the past year, and the self-reported desire for pain medication.

Results: Among 482 participants …

One Year Symptom Severity And Health-Related Quality Of Life Changes Among Patients Undergoing Uterine Fibroid Embolisation, Charles Muriuki Mariara

Master of Medicine in Obstetrics and Gynecology

Background: The main aim of treatment of symptomatic fibroids by various modalities including uterine fibroid embolisation is to alleviate symptoms and ultimately improve the quality of life. The efficacy of this modality of treatment in women with significant fibroid burden and large uterine volumes is not clear. Objective: To determine the change in symptom severity and health-related quality of life among patients who have undergone uterine fibroid embolisation for treatment of symptomatic uterine fibroids. Setting: Aga Khan University Hospital, Nairobi Methods: A prospective before and after study (observational) of patients undergoing uterine fibroid embolisation. Prior to embolisation, study participants underwent …

The Incidence Of Early Upper Extremity Disability After Axillary Surgery In Patients With Early Breast Cancer, Karen Mbaabu

Master of Medicine in General Surgery

Background: The treatment of early breast cancer includes surgical removal of the tumor as well as evaluation of the axillary lymph node status. Axillary lymph node surgery, both sentinel lymph node biopsy and axillary lymph node dissection, is associated with upper arm morbidity that has been relatively understudied. The impact of this upper arm limitation has a direct effect on the patients’ quality of life. Determining the degree to which our patients experience this disability will enable the breast cancer unit to develop a prospective surveillance rehabilitative program. Objectives: The objectives of the study were to determine the occurrence of …

Frequency Of Dentofacial Asymmetries: A Cross-Sectional Study On Orthodontic Patients, Nita Kumari Bhateja, Mubassar Fida, Attiya Shaikh

Section of Dental-Oral Maxillofacial Surgery

Background: Correction of orthodontic asymmetries is crucial to achieve functional occlusion, aesthetics and stability of post orthodontic treatment results. To date valid frequency data of dentofacial asymmetries in Pakistani orthodontic patients do not exist to document orthodontic treatment need. The objectives of this study were to determine frequency of dento-facial asymmetries, severity of dental asymmetries and to determine difference in frequency of dentofacial asymmetries in mixed and permanent dentition.
Methods: The sample of this cross-sectional study comprised of 280 patients (177 females and 103 males) with no history of previous orthodontic treatment having no craniofacial anomalies. Dento-facial asymmetries were assessed …

Reducing Unsafe Menstrual Regulation Through Medication In Bangladesh, Ubaidur Rob, Ismat Ara Hena, Nargis Sultana, Md. Irfan Hossain, Reena Yasmin, Tapash Ranjan Das, Farid Uddin Ahmed

Reproductive Health

The Population Council and Marie Stopes Bangladesh, in collaboration with the Directorate General of Family Planning and with funding from the World Health Organization, tested the feasibility of introducing menstrual regulation with medication (MRM) in Bangladesh and assessed the acceptability of providing MRM using the combination drug regimen mifepristone and misoprostol in urban and rural public health facilities. As reported in this policy brief, the study demonstrates that it is feasible and safe to introduce MRM in rural and urban public health facilities. Given the choice, almost two-thirds of women preferred MRM to manual vacuum aspiration and women receiving MRM …

Comprendre Les Grossesses Non Désirées Au Sénégal: Rapport Du Profil Pays, Kaila Clarke, Mohamadou Sall, Babacar Mane, Nafissatou Diop, Bocar Mamadou Daff

Reproductive Health

Dans le cadre du programme de recherche « Strengthening Evidence for Programming on Unintended Pregnancy (STEP UP) », le Population Council a élaboré un Rapport du Profil Pays pour comprendre les grossesses non désirées au Sénégal. Ils ont mené une revue de la littérature, analysé des données d'enquêtes disponibles, et a mené des entretiens pour discuter plus en détail de certains aspects avec quelques parties prenantes clés. Le Profil Pays a été discuté lors d’un atelier de deux jours à Dakar regroupant les principaux acteurs du gouvernement aux niveaux central et régional, des organisations non-gouvernementales, et des acteurs de la …

Understanding Unintended Pregnancy In Senegal: Country Profile Report, Kaila Clarke, Mohamadou Sall, Babacar Mane, Nafissatou Diop, Bocar Mamadou Daff

Reproductive Health

As part of the Strengthening Evidence for Programming on Unintended Pregnancy (STEP UP) research program, the Population Council has developed a Country Profile Report to understand unwanted pregnancies in Senegal. The Population Council conducted a literature review, analyzed available survey data, and conducted interviews to discuss some aspects in more detail with a number of key stakeholders. The Country Profile was discussed at a two-day workshop in Dakar bringing together key government actors at the central and regional levels, nongovernmental organizations, and civil society actors. The report is composed of six chapters, summarized in this evidence brief.

La Planification Familiale Postpartum Au Burkina Faso - Résumé En Français, Step Up Research Programme Consortium

Reproductive Health

Ce résumé décrit une étude sur la planification familiale post-partum (PFPP) au Burkina Faso. L’étude avait pour but: de donner un aperçu de la disponibilité et la qualité des services prénatals, du post-partum, et de planification familiale au niveau des soins primaires, et d’évaluer la mesure dans laquelle ils fournissent des services efficaces de PFPP; d’évaluer l'accessibilité des services PFPP; d’explorer l’effet de facteurs sociaux, économiques, et culturels sur la demande et l'adoption de la PFPP; d’estimer l’impact, la pertinence, et la mise en œuvre de la politique nationale et des protocoles cliniques par rapport à la PFPP; et d’identifier …

International Seminar On Promoting Postpartum And Post-Abortion Family Planning: Challenges And Opportunities, Iussp Scientific Panel On Reproductive Health

Reproductive Health

The IUSSP Scientific Panel on Reproductive Health, in collaboration with the Population Council, India, and the Department of Reproductive Health and Research, World Health Organization held a seminar on “Promoting postpartum and post-abortion family planning: Challenges and opportunities” in Cochin, India, November 2014. The seminar brought together 24 scientists, policymakers, and program managers to present and discuss a range of issues relating to postpartum and post-abortion family planning. This report summarizes the papers presented at the seminar which sought to answer several key questions pertaining to postpartum and post-abortion contraception. Several conclusions drawn from the evidence are presented and research …

Unintended Pregnancy And Abortion In India: Country Profile Report, Mary Philip Sebastian, M.E. Khan, Daliya Sebastian

Reproductive Health

A review of literature and analysis of large surveys were carried out with funding from the STEP UP consortium led by Population Council to build a coherent body of robust research-based evidence on the situation in India in the context of unmet need for family planning (FP) and safe abortion services. The study found that there is insufficient training of different cadres of health staff in the public health system on abortion provision, post-abortion care, FP counseling of young couples, emergency contraception, and IUD insertion/removal. Despite service delivery guidelines in India expecting providers to provide FP counseling during antenatal visits, …

Unintended Pregnancies In Kenya: A Country Profile, Joyce Mumah, Caroline W. Kabiru, Carol Mukiira, Jessica Brinton, Michael Mutua, Chimaraoke O. Izugbara, Harriet Birungi, Ian Askew

Reproductive Health

This research report presents a country profile of Kenya, and looks at differential access to and quality of family planning (FP) and abortion/post-abortion services to assess their current situation, as well the various financing and delivery mechanisms for these crucial services. Since 2000, Kenya has passed several new sexual and reproductive health (SRH) and population-related policies, including a new population and development policy that addresses rapid population growth. Results of this country profile highlight the need for further research on: 1) innovative ways through which SRH information can be brought to schools; 2) FP/SRH indicators in people living with disabilities; …

Postpartum Family Planning In Burkina Faso, Marina Daniele

Reproductive Health

This is a formative study aiming to identify the main barriers to the provision and uptake of quality postpartum family planning (PPFP) services at the supply, access, demand, and policy levels in Burkina Faso. This study reveals that there are substantial shortfalls in the availability of quality PPFP at all these levels. Most of the difficulties observed in the provision of PPFP services are due to the failure to translate largely sound policies and guidelines into practice. This study contributes to identifying priority areas and makes recommendations for improvement in order to respond to unmet need for family planning in …

Breast Cancer Survivorship In African American Women, Michelle Arda Mollica

MUSC Theses and Dissertations

With advances in screening, diagnostic capabilities, and treatments, the amount of breast cancer survivors continues to grow. African American (AA) breast cancer survivors (BCS) are a particularly vulnerable group, who experience persistent disparities in outcomes, information, and support post primary cancer treatment. Peer navigation (PN) in AA BCS could be one strategy to increase quality of life and follow-up care after treatment, though research on quality of life and PN in this population is limited. This dissertation first examines factors contributing to quality of life in AA BCS, utilizing the Quality of Life Model Applied to Cancer Survivors. Next, the …

Enhancing The Efficacy Of Enzalutamide By Inhibition Of Sphingosine Kinase 2 To Target Inflammation And Tumor Proliferation, Heather Venant

MUSC Theses and Dissertations

Prostate cancer is the second leading cause of cancer death in American men. The interaction of androgen with its receptor (AR) is one of the major pathways that contributes to the progression of prostate cancer. As a result, hormone deprivation is a major strategy for prostate cancer treatment, but the emergence of castration resistant prostate cancer (CRPC) is a major clinical problem. Recently, the novel AR inhibitor, enzalutamide, demonstrated improved survival in men with metastatic CRPC by 4.8 months (13.8 vs 18.4 months in placebo vs treated groups) (18). While these results are encouraging, they also indicate that there is …

Serotonergic Stimulation Of Mitochondrial Biogenesis And Their Cheminformatic Models, Richard Edwin Trager Iii

MUSC Theses and Dissertations

Kidney disease and toxicity is increasingly being tied to mitochondrial dysfunction. Cheminformatic modeling and high-throughput phenotypic screens can discover discrete subsets of selective ligands that correlate with mitochondrial biogenesis (MB) and accelerate recovery from acute kidney injury (AKI). Serotonergic (5-HT) stimulation has been shown to cause MB. Subtype specific ligands for 5-HT1F and 5-HTA/C receptors show increased uncoupled oxygen consumption rate (OCR). Our overall goal, in a screening assay, is to discover small molecules that increase MB to be used as drugs in the treatment of diseases that exhibit mitochondrial dysfunction. To achieve this goal we created pharmacophore models of …

Dual-Specificity Phosphatase-1 Regulates The Inflammatory Milieu In Head And Neck Squamous Cell Carcinoma, Xiaoyi Zhang

MUSC Theses and Dissertations

Head and neck cancer accounts for approximately 6% of diagnosed malignancies in the United States, with an estimated 35,000 incidences and over 7,000 deaths every year. Head and neck squamous cell carcinoma (HNSCC) comprises the majority of head and neck cancers, with a worldwide incidence of more than 500,000 cases. Head and neck cancer patients often present in advanced stages of disease, and despite ongoing research, survival rates remain lower than other more common malignancies. Cytokines and pro-inflammatory factors have been shown to have a critical role in the various steps of malignant transformation, including tumor growth, survival, invasion, angiogenesis, …

The Role Of Gamma-Secretase Impairment And Amyloid Beta Degradation In Alzheimer's Disease Pathogenesis, Robert J. Baranello Jr.

MUSC Theses and Dissertations

Accumulation of the amyloid β (Aβ) protein in the brain as senile plaques is a signature lesion of Alzheimer's disease (AD). The mechanisms of Aβγ accumulation that foster its deposition is a subject of intense study and represent the primary targets for most drug development efforts in the field. As one of the most important neurodegenerative diseases in the world, it is imperative that we continue to move toward efficacious treatment strategies. A number of y-secretase inhibitors (GSIs), such as N-[N-(3,5-Difluorophenacetyl-L-alanyl)]-S-phenylglycine t-butyl ester (DAPT), have been developed with the goal of reducing Aβ to treat AD. Although most studies show …

Survivorship Analysis For Osteosarcoma And Ewing’S Sarcoma In Children And Adolescents At A Single Pediatric Institution: Comparison To Seer Data, Chittalsinh M. Raulji, Hope Pritchett, Matthew Stark, Kenneth Ward, Velasco Cruz, Jaime Morales

Journal Articles: Pediatrics

Primary malignant bone tumors account for approximately 6% of all childhood malignancies. Osteosarcoma (OS) and Ewing’s sarcoma (ES) are the most common and have an annual incidence of 8.7 per million under the age of 20 years. The mean 5-year survival for OS and ES has been 61% and 60% respectively. The survival for OS and ES has not significantly improved for past 20 years.

We examined the cases of OS and ES, treated at Children’s Hospital of New Orleans (CHNOLA) from 1999-2012. Comparison to national survival data from the Survival, Epidemiological and End Results (SEER) study was done. The …

Effects Of Hyperbaric Oxygen On Eye Tracking Abnormalities In Males After Mild Traumatic Brain Injury, Joanna R. Wares, David X. Cifu, Kathy W. Hoke, Paul A. Wetzel, George Gitchel, William Carne

Department of Math & Statistics Faculty Publications

The effects of hyperbaric oxygen (HBO2) on eye movement abnormalities in 60 military servicemembers with at least one mild traumatic brain injury (mTBI) from combat were examined in a single-center, randomized, double-blind, sham-controlled, prospective study at the Naval Medicine Operational Training Center. During the 10 wk of the study, each subject was delivered a series of 40, once a day, hyperbaric chamber compressions at a pressure of 2.0 atmospheres absolute (ATA). At each session, subjects breathed one of three preassigned oxygen fractions (10.5%, 75%, or 100%) for 1 h, resulting in an oxygen exposure equivalent to breathing either surface air, …

Prevalence Of Significant Liver Fibrosis In Patients With Hiv Monoinfection Compared To Those With Hiv-Hepatitis B Coinfection As Assessed By Shear Wave Elastography, Samuel Nguku

Master of Medicine in Imaging and Diagnostic Radiology

Background: Liver disease is an emerging management problem in human immunodeficiency virus (HIV) infected patients. The incidence of chronic Hepatitis B infection, which accelerates the progression of chronic liver disease and development of liver fibrosis, is ten times higher in patients with HIV than the general population. Staging of liver fibrosis provides essential information in management of these patients. Objective: To determine the prevalence of significant liver fibrosis in patients with HIV mono-infection versus those with HIV-HBV co-infection as assessed with shear wave elastography (SWE). Methods: This was a cross-sectional study whereby HIV infected patients attending the HIV clinic at …