Medical Specialties Commons^™

Integrin Α6Β4 Promotes Autocrine Epidermal Growth Factor Receptor (Egfr) Signaling To Stimulate Migration And Invasion Toward Hepatocyte Growth Factor (Hgf), Brittany L. Carpenter, Min Chen, Teresa Knifley, Kelley A. Davis, Susan M.W. Harrison, Rachel L. Stewart, Kathleen O'Connor

Markey Cancer Center Faculty Publications

Integrin α6β4 is up-regulated in pancreatic adenocarcinomas where it contributes to carcinoma cell invasion by altering the transcriptome. In this study, we found that integrin α6β4 up-regulates several genes in the epidermal growth factor receptor (EGFR) pathway, including amphiregulin (AREG), epiregulin (EREG), and ectodomain cleavage protease MMP1, which is mediated by promoter demethylation and NFAT5. The correlation of these genes with integrin α6β4 was confirmed in The Cancer Genome Atlas Pancreatic Cancer Database. Based on previous observations that integrin α6β4 cooperates with c-Met in pancreatic cancers, we examined the impact of EGFR signaling on hepatocyte growth factor (HGF)-stimulated migration and …

Vertebral Body Stapling Versus Bracing For Patients With High-Risk Moderate Idiopathic Scoliosis., Laury Cuddihy, Aina J Danielsson, Patrick J Cahill, Amer F Samdani, Harsh Grewal, John M Richmond, M J Mulcahey, John P Gaughan, M Darryl Antonacci, Randal R Betz

Department of Medicine Faculty Papers

Purpose. We report a comparison study of vertebral body stapling (VBS) versus a matched bracing cohort for immature patients with moderate (25 to 44°) idiopathic scoliosis (IS). Methods. 42 of 49 consecutive patients (86%) with IS were treated with VBS and followed for a minimum of 2 years. They were compared to 121 braced patients meeting identical inclusion criteria. 52 patients (66 curves) were matched according to age at start of treatment (10.6 years versus 11.1 years, resp. [P = 0.07]) and gender. Results. For thoracic curves 25-34°, VBS had a success rate (defined as curve progression

Active Yap Promotes Pancreatic Cancer Cell Motility, Invasion And Tumorigenesis In A Mitotic Phosphorylation-Dependent Manner Through Lpar3., Shuping Yang, Lin Zhang, Vinee Purohit, Surendra K. Shukla, Xingcheng Chen, Fang Yu, Kai Fu, Yuanhong Chen, Joyce C. Solheim, Surendra K. Shukla, Wei Song, Jixin Dong

Journal Articles: Eppley Institute

The transcriptional co-activator Yes-associated protein, YAP, is a main effector in the Hippo tumor suppressor pathway. We recently defined a mechanism for positive regulation of YAP through CDK1-mediated mitotic phosphorylation. Here, we show that active YAP promotes pancreatic cancer cell migration, invasion and anchorage-independent growth in a mitotic phosphorylation-dependent manner. Mitotic phosphorylation is essential for YAP-driven tumorigenesis in animals. YAP reduction significantly impairs cell migration and invasion. Immunohistochemistry shows significant upregulation and nuclear localization of YAP in metastases when compared with primary tumors and normal tissue in human. Mitotic phosphorylation of YAP controls a unique transcriptional program in pancreatic cells. …

Interactions Of L-3,5,3′-Triiodothyronine, Allopregnanolone, And Ivermectin With The Gabaa Receptor: Evidence For Overlapping Intersubunit Binding Modes, Thomas Westergard, Reza Salari, Joseph V. Martin, Grace Brannigan

Department of Neuroscience Faculty Papers

No abstract provided.

Sotatercept Improves Anemia, Vascular Calcification, And Bone Loss In Patients With End-Stage Kidney Disease On Hemodialysis, John Havill, Nelson Kopyt Do, Fasn, Facp, Daniel Coyne, Michael Weiswasser, William T. Smith

Department of Medicine

No abstract provided.

A Virtual Clinic Improves Pneumococcal Vaccination For Asplenic Veterans At High Risk For Pneumococcal Disease, Robin L.P. Jump, Brigid Wilson, Rebecca Carter, Susan Phillips, Federico Perez

Faculty Scholarship

We developed a "virtual clinic" to improve pneumococcal vaccination among asplenic adults. Using an electronic medical record, we identified patients, assessed their vaccination status, entered orders, and notified patients and providers. Within 180 days, 38 of 76 patients (50%) received a pneumococcal vaccination. Avirtual clinic may optimize vaccinations among high-risk patients.

A Prospective 3-Year Follow-Up Trial Of Implantation Of Two Trabecular Microbypass Stents In Open-Angle Glaucoma, Eric D. Donnenfeld, Kerry D. Solomon, Lilit Voskanyan, David F. Chang, Thomas W. Samuelson, Iqbal Ike K. Ahmed, L. Jay Katz

Wills Eye Hospital Papers

No abstract provided.

Rewiring The Brain For Happiness: The Neuroscience Of Happiness, Part 2, Kevin Corcoran

University Faculty Publications and Creative Works

No abstract provided.

Notching Early Repolarization Pattern In Inferior Leads Increases Risk Of Ventricular Tachyarrhythmias In Patients With Acute Myocardial Infarction: A Meta-Analysis., Zhiwei Zhang, Konstantinos P Letsas, Yajuan Yang, Panagiotis Korantzopoulos, Guangping Li, Gan-Xin Yan, Tong Liu

Department of Medicine Faculty Papers

The aim of this of this meta-analysis was to examine the potential association between certain early repolarization (ER) characteristics and ventricular tachyarrhythmias (VTAs) in patients with acute myocardial infarction (AMI). We searched PubMed, Embase and Web of Science databases for records published until December 2014. Of the 658 initially identified records, 7 studies with a total of 1,565 patients (299 with ER and 1,266 without ER) were finally analyzed. Overall, patients with ER displayed a higher risk of VTAs following AMI compared to patients without ER [odds ratio (OR): 3.75, 95% CI: 2.62-5.37, p < 0.00001]. Subgroup analyses showed that the diagnosis of ER prior to AMI onset is a better predictor of VTAs (OR: 5.70, p < 0.00001) compared to those diagnosed after AMI onset (OR: 2.60, p = 0.00001). Remarkably, a notching morphology was a significant predictor of VTAs compared to slurring morphology (OR: 3.85, p = 0.002). Finally, an inferior ER location (OR: 8.85, p < 0.00001) was significantly associated with increased risk of VTAs in AMI patients. In conclusion, our meta-analysis suggests that ER pattern is associated with greater risk of VTAs in patients with AMI. A notched ER pattern located in inferior leads confers the highest risk for VTAs in AMI.

Sialylation Of Igg Fc Domain Impairs Complement-Dependent Cytotoxicity., Isaak Quast, Christian W Keller, Michael A Maurer, John P Giddens, Björn Tackenberg, Lai-Xi Wang, Christian Münz, Falk Nimmerjahn, Marinos Dalakas, Jan D Lünemann

Department of Neurology Faculty Papers

IgG molecules exert both pro- and antiinflammatory effector functions based on the composition of the fragment crystallizable (Fc) domain glycan. Sialylated IgG Fc domains have antiinflammatory properties that are attributed to their ability to increase the activation threshold of innate effector cells to immune complexes by stimulating the upregulation of the inhibitory Fcγ receptor IIB (FcγRIIB). Here, we report that IgG Fc sialylation of human monoclonal IgG1 molecules impairs their efficacy to induce complement-mediated cytotoxicity (CDC). Fc sialylation of a CD20-targeting antibody had no impact on antibody-dependent cellular cytotoxicity and did not change the affinity of the antibody for activating …

Evaluation Of An Innovative Leadership Training Program For Chinese Students: Subjective Outcome Evaluation, Daniel T. L. Shek, Xiang Li

Pediatrics Faculty Publications

As a part of the Global Youth Leadership Program (GYLP), a 30-h “Service Leadership” subject was provided to 48 undergraduate students studying at The Hong Kong Polytechnic University (PolyU) or Peking University (PKU). This study evaluated the subjective outcomes of the “Service Leadership” subject, including students’ views on the course contents, lecturers, and perceived benefits from the course. A majority of students in the program showed very positive perceptions of the course content, lecturers, and course benefits, with more than 85% of the students indicating that they were very satisfied with this subject and would suggest their friends to take …

Medical Education Digest, Vol. 17 No. 6 (November-December 2015), Nova Southeastern University

Medical Education Digest

No abstract provided.

Primary Care Management Of Plantar Fasciitis, Thomas J. Melvin Pharmd, Zach J. Tankersly Dpm, Zain N. Quazi, John J. Jasko, Russell Odono Md, Franklin D. Shuler Md, Phd

Orthopaedics

Plantar fasciitis (PF) is present in 10% of the population and is the most common cause of plantar heel pain. PF is painful, can alter daily activities and presents as a sharp pain localized to the plantar foot and medial heel. The underlying etiology involves microtrauma to the plantar fascia, specifically at its insertion point on the calcaneus. Successful management of plantar fasciitis is typically achieved with the conservative therapy approaches discussed.

Engaging Older Adults To Build Social Capital, Beverly K. Lunsford, Danielle Janes

Nursing Faculty Publications

Countries are considering the healthcare implications as the proportion of older adults increases, including rising healthcare costs and resources needed as more adults want to "age in place" or continue living in the community. More in home resources and support services will be needed for older adults to continue living independently at homes. Older adults are an incredibly untapped resource with a continuing need to contribute to society and a willingness to help others. Older adults are working longer than ever before, so they have the potential to build their own social capital for meeting the needs of aging colleagues. …

Patient Satisfaction Of Surgical Treatment Of Clitoral Phimosis And Labial Adhesions Caused By Lichen Sclerosus, Anne N. Flynn, Michelle King, Mollie Rieff, Jill A. Krapf, Andrew T. Goldstein

Obstetrics and Gynecology Faculty Publications

Introduction

Lichen sclerosus (LS) is a chronic inflammatory dermatosis, usually affecting the anogenital skin in women. This chronic inflammation can cause scarring of genitalia including narrowing of the introitus and phimosis of the clitoris. These architectural changes can lead to recurrent tearing during intercourse (vulvar granuloma fissuratum) and decreased clitoral sensation. Surgical correction of vulvar granuloma fissuratum (VGF) and clitoral phimosis can be performed, but there is little data on the patient satisfaction and complications following these surgical procedures.

Aim

To evaluate patient experience and outcomes in women undergoing surgical correction of scarring caused by anogenital LS.

Methods

A retrospective …

Segmented Nitinol Guidewires With Stiffness-Matched Connectors For Cardiovascular Magnetic Resonance Catheterization: Preserved Mechanical Performance And Freedom From Heating., Burcu Basar, Toby Rogers, Kanishka Ratnayaka, Adrienne E Campbell-Washburn, Jonathan R Mazal, William H Schenke, +4 Additional Authors

Pediatrics Faculty Publications

BACKGROUND: Conventional guidewires are not suitable for use during cardiovascular magnetic resonance (CMR) catheterization. They employ metallic shafts for mechanical performance, but which are conductors subject to radiofrequency (RF) induced heating. To date, non-metallic CMR guidewire designs have provided inadequate mechanical support, trackability, and torquability. We propose a metallic guidewire for CMR that is by design intrinsically safe and that retains mechanical performance of commercial guidewires.

METHODS: The NHLBI passive guidewire is a 0.035" CMR-safe, segmented-core nitinol device constructed using short nitinol rod segments. The electrical length of each segment is less than one-quarter wavelength at 1.5 Tesla, which eliminates …

Rapid Fecal Calprotectin Testing To Assess For Endoscopic Disease Activity In Inflammatory Bowel Disease: A Diagnostic Cohort Study, Lukasz Kwapisz, Mahmoud Mosli, Nilesh Chande, Brian Yan, Melanie Beaton, Jessica Micsko, Pauline W. Mennill, William Barnett, Kevin Bax, Terry Ponich, John Howard, Anthony Tirolese, Robert Lannigan, James Gregor

Paediatrics Publications

Background and Aim: With increasing numbers of patients diagnosed with inflammatory bowel disease (IBD), it is important to identify noninvasive methods of detecting disease activity. The aim of this study is to examine the diagnostic accuracy of fecal rapid calprotectin (FC) testing in the detection of endoscopically active IBD. Patients and Methods: All consecutive patients presenting to outpatient clinics with lower gastrointestinal symptoms were prospectively recruited. Patients provided FC samples. Sensitivity (Sn), specificity (Sp), positive predictive value (PPV), and negative predictive value (NPV) for FC were calculated. Receiver-operator characteristics (ROC) curve was used to identify the ideal FC cutoff that …

Renal Oncocytosis In A Pediatric Patient: Case Report And Review Of The Literature, Stacey Speer, Daniele Wiseman, Madeleine Moussa, Andreana Bütter

Surgery Publications

Renal oncocytosis is a rare condition in which the kidney develops numerous oncocytomas. We present a case of a 12-year-old female who presented with right-sided flank pain of one-year duration. Imaging revealed several masses in the right kidney. Tissue biopsy confirmed multiple benign oncocytomas. Due to the presence of multiple oncocytomas throughout the kidney, a radical nephrectomy was performed. Given the rarity of this condition, as well as its known association with von Hippel-Lindau disease and Birt-Hogg-Dube syndrome, genetic investigations were pursued but failed to identify any abnormalities. This patient remains well and disease free six years after surgery. A …

Toe-Tourniquet Syndrome: A Rare Potentially Devastating Entity, Naveed Baloch, M Atif, Rizwan Hussain Rashid, Pervaiz Mahmood Hashmi

Section of Orthopaedic Surgery

Toe-tourniquet syndrome is a rare and commonly misdiagnosed condition caused by a hair or a fiber wrapped around digits (fingers and toes). A four months baby girl who was crying and presented with redness and swelling at her 2nd and 3rd toes of right foot. Child had red and swollen 2nd and 3rd toes of right foot with hair end protruding through wounds. Constricting hairs were cut and removed. Toetourniquet syndrome is a rare entity which is caused by hair wrapped around a toe or a digit. Diagnosis is mostly clinical. In order to prevent this condition to happen, education …

Surveillance In The Service Of Safety, Rashid Jooma

Section of Neurosurgery

The World Report on Road Traffic Injury Prevention of 2004 recommended that the newly motorizing countries establish road injury surveillance to define the burden, identify highrisk groups, plan intervention and monitor their impact. Despite its stated importance in the literature, very few examples of sustained surveillance systems are reported from low income countries. This presentation shares the results of an urban RTI surveillance program that has been running for the past 8 years since 2007 in the emergency departments of five major hospitals in Karachi, Pakistan. We describe the process of establishing the road injury surveillance system incorporating a multi-institution …

Comparison Of Frequency Of Insulin Resistance In Patients With Chronic Obstructive Pulmonary Disease With Normal Controls, Zareen Kiran,, Numan Majeed, Bader Faiyaz Zuberi

Section of Diabetes, Endocrinology and Metabolism

Objective: To compare mean homeostatic model assessment of insulin resistance (HOMA-IR) in patients with and without chronicobstructive pulmonary disease (COPD).

Methods: A Case control analytic study was conducted in medical outpatient department of Medial Unit-II of Dow University of Health Sciences from April 2013 to September 2013. All patients with the diagnosis of COPD were included as cases. Controls were age match healthy individuals with minor illnesses. Age, weight, height and forced expiratory volume in one second to forced vital capacity (FEV1/FVC) ratio were documented. Fasting blood glucose and fasting insulin levels were done. Body mass index (BMI) …

Hip Fragility Fractures: Anaemia, Calcium And Vitamin D Supplementation, Iqra Khan, Ambreen Jawaid, Khabir Ahmad, Shahryar Noordin

Department of Family Medicine

Objective: To assess the burden of anaemia and osteoporosis in hip fracture patients, to determine the rate of blood transfusion per-operatively, to assess the use of calcium and vitamin D supplements and the use of anti-osteoporotic medications postoperatively.
Methods: A retrospective study was conducted at Aga Khan University and Hospital (AKUH) between June 2009 and May 2011, and comprised record of patients treated for intertrochanteric and femur neck fractures. Patients with associated pathological, open or long bone fractures were excluded. The main study outcome measures were the use of pre-operative and post-operative calcium, vitamin D, bisphosphonates and management of anaemia …

Detection Of Genetic And Epigenetic Dna Markers In Urine For The Early Detection Of Primary And Recurrent Hepatocellular Carcinoma, Hie-Won Hann, Surbhi Jain, Ting-Tsung Chang, Chi-Tan Hu, Selena Lin, Wei Song, Ying-Hsiu Su

Division of Gastroenterology and Hepatology Posters

Poster presented at American Association of the Study of Liver Diseases (AASLD) meeting in San Francisco California.

Objective:

Develop a urine test using a panel of select genetic and epigenetic markers for the early detection of primary and recurrent HCC.

Introduction:

Hepatocellular carcinoma (HCC) or liver cancer is an aggressive disease and one of the fastest growing cancers by incidence in the United States. Early detection is the key for effective treatment of HCC as the 5-year survival rate is 26% in early stage HCC as compared to only 2% when found after spreading to distant organs. The current marker, …

Positive Allosteric Modulation Of Kv Channels By Sevoflurane: Insights Into The Structural Basis Of Inhaled Anesthetic Action., Qiansheng Liang, Warren D Anderson, Shelly T Jones, Caio S Souza, Juliana M Hosoume, Werner Treptow, Manuel Covarrubias

Department of Neuroscience Faculty Papers

Inhalational general anesthesia results from the poorly understood interactions of haloethers with multiple protein targets, which prominently includes ion channels in the nervous system. Previously, we reported that the commonly used inhaled anesthetic sevoflurane potentiates the activity of voltage-gated K+ (Kv) channels, specifically, several mammalian Kv1 channels and the Drosophila K-Shaw2 channel. Also, previous work suggested that the S4-S5 linker of K-Shaw2 plays a role in the inhibition of this Kv channel by n-alcohols and inhaled anesthetics. Here, we hypothesized that the S4-S5 linker is also a determinant of the potentiation of Kv1.2 and K-Shaw2 by sevoflurane. Following functional expression …

Results Of A Health Education Message Intervention On Hpv Knowledge And Receipt Of Follow-Up Care Among Latinas Infected With High-Risk Human Papillomavirus, Maureen Sanderson, Dineo Khabele, Claudine L. Brown, Khalil Harbi, Leah R. Alexander, Ann L. Coker, Maria E. Fernandez, Heather M. Brandt, Mary K. Fadden, Pamela C. Hull

Obstetrics and Gynecology Faculty Publications

A clinic-based intervention study was conducted among high-risk human papillomavirus (HPV)-infected Latinas aged 18-64 years between April 2006 and May 2008 on the Texas-Mexico border. Women were randomly assigned to receive a printed material intervention (n=186) or usual care (n=187) and were followed at three months, six months, and 12 months through telephone surveys and review of medical records. The HPV knowledge of nearly all women had increased greatly, but only two-thirds of women reported they had received follow-up care within one year of diagnosis regardless of additional health education messaging. Our findings suggest that, regardless of type of health …

Anticipated And Unanticipated Complications Of Severe Dengue In A Primigravida, Madiha Hashmi, Ghulam Zainab, Farah Khan

Department of Obstetrics & Gynaecology

As the incidence of dengue is rising among adults more cases of dengue fever are being reported during pregnancy. Physiological changes of pregnancy mask the pathognomonic features of severe dengue such as increased hematocrit, thrombocytopenia, and leukopenia and a high index of suspicion are required in endemic areas. Massive hemorrhage may complicate operative deliveries in unsuspected patients. World Health Organization recommends that all patients with severe dengue should be admitted to a hospital with access to intensive care facilities and blood transfusion. We present the successful management of hemorrhage and unanticipated complications of severe dengue in a young primigravida admitted …

Use Of Modeling And Simulation In The Design And Conduct Of Pediatric Clinical Trials And The Optimization Of Individualized Dosing Regimens, Chris Stockmann, J. S. Barrett, Jessica K. Roberts, Catherine M.T. Sherwin

Pediatrics Faculty Publications

Mathematical models of drug action and disease progression can inform pediatric pharmacotherapy. In this tutorial, we explore the key issues that differentiate pediatric from adult pharmacokinetic (PK) / pharmacodynamic (PD) studies, describe methods to calculate the number of participants to be enrolled and the optimal times at which blood samples should be collected, and therapeutic drug monitoring methods for individualizing pharmacotherapy. The development of pediatric‐specific drug dosing dashboards is also highlighted, with an emphasis on clinical‐relevance and ease of use.

Endogenous Endophthalmitis: Diagnosis, Management, And Prognosis., Mohammad Ali Sadiq, Muhammad Hassan, Aniruddha Agarwal, Salman Sarwar, Shafak Toufeeq, Mohamed K. Soliman, Mostafa Hanout, Yasir Jamal Sepah, Diana V. Do, Quan Dong Nguyen

Journal Articles: Ophthalmology

Endogenous endophthalmitis is an ophthalmic emergency that can have severe sight-threatening complications. It is often a diagnostic challenge because it can manifest at any age and is associated with a number of underlying predisposing factors. Microorganisms associated with this condition vary along a broad spectrum. Depending upon the severity of the disease, both medical and surgical interventions may be employed. Due to rarity of the disease, there are no guidelines in literature for optimal management of these patients. In this review, treatment guidelines based on clinical data and microorganism profile have been proposed.

The Role Of Self-Leadership In Service Leadership, Daniel T. L. Shek, Cecilia M. S. Ma, Ting Ting Liu, Andrew M. H. Siu

Pediatrics Faculty Publications

One of the core beliefs of the service leadership curriculum proposed by the Hong Kong Institute of Service Leadership and Management is that ‘Every day, every human occupies a position of leadership and possesses the potential to improve his leadership quality and effectiveness’. This core belief is in sharp contrast to some of the mainstream leadership theories that only a few people and elites can be leaders. In this paper, a lecture plan regarding the nature of self-leadership with reference to service leadership is presented. The topics include definitions and concepts of self-leadership, relationships between self-leadership and service leadership, ways …

Role Of Acute Pain Service In Optimizing Postoperative Pain Relief In A Tertiary Care Teaching Hospital, Aliya Ahmed, Muhammad Yasir

Department of Anaesthesia

Objective: To assess the frequency and types of adjustments that acute pain service makes to postoperative analgesic regimes to improve pain relief or treat side effects.Methods: The prospective observational study was conducted at the Aga Khan University Hospital, Karachi, from December 1, 2012, to March 31, 2013. Data was collected from Acute Pain Service register four hours after the pain rounds by a Service member not involved in rounds. Data was collected on a standardised form and analysed using SPSS 19.Results: Of the 323 patients, 209(65%) were receiving epidural infusions and 114(35%) were receiving intravenous patient-controlled analgesia. Overall, 114(35%) required …