Medical Specialties Commons^™

Medical Education Digest, Vol. 17 No. 4 (July-August 2015), Nova Southeastern University

Medical Education Digest

No abstract provided.

Targeting Il13ralpha2 Activates Stat6-Tp63 Pathway To Suppress Breast Cancer Lung Metastasis, Panagiotis Papageorgis, Sait Ozturk, Arthur W. Lambert, Christiana M. Neophytou, Alexandros Tzatsos, Chen K. Wong, Sam Thiagalingam, Andreas I. Constantinou

Anatomy and Regenerative Biology Faculty Publications

Introduction

Basal-like breast cancer (BLBC) is an aggressive subtype often characterized by distant metastasis, poor patient prognosis, and limited treatment options. Therefore, the discovery of alternative targets to restrain its metastatic potential is urgently needed. In this study, we aimed to identify novel genes that drive metastasis of BLBC and to elucidate the underlying mechanisms of action.

Methods

An unbiased approach using gene expression profiling of a BLBC progression model and in silicoleveraging of pre-existing tumor transcriptomes were used to uncover metastasis-promoting genes. Lentiviral-mediated knockdown of interleukin-13 receptor alpha 2 (IL13Ralpha2) coupled with whole-body in vivo bioluminescence imaging was …

Turning Up The Heat On Malignant Hyperthermia, Katie Carroll

Nursing Student Class Projects (Formerly MSN)

Surgeries are common, everyday procedures within the walls of America’s hospitals. According to Orser, Mazer, and Baker (2008), more than forty million patients in North America are given anesthetics annually. One of the major complications of anesthesia is malignant hyperthermia: a hyper-metabolic state that affects skeletal muscles. If left uncontrolled, malignant hyperthermia can cause multiple reactions within the body leading to metabolic and respiratory acidosis, cardiac dysrhythmias, kidney failure, coagulopathy, neurologic injury, and ultimately death (Seifert, Wahr, Pace, Cochrane, & Bagnola 2014). The incidence of this condition is estimated to be 1:15,000 in children and 1:20,000-50,000 in adults (Redmond, 2001). …

The Cutting Edge Summer 2015, Wright State University Department Of Surgery

The Cutting Edge Newsletter

A twelve page newsletter created by the Department of Surgery documenting current affairs of the department. This issue contains features such as faculty news, information on general surgery residencies, a list of scholarly activity, special lectures, and more.

Recognizing Guttate Psoriasis And Initiating Appropriate Treatment, Lacey Vence Md, Amanda Schmitt, Charles Meadows Md, Todd W. Gress Mph

Internal Medicine

Guttate psoriasis is a less common form of psoriasis. It manifests with numerous small, teardrop shaped, scaly plaques on the trunk and extremities. The etiology includes both environmental and genetic factors. It commonly arises 3-4 weeks following a beta hemolytic streptococcal infection. In some cases, it may be misdiagnosed as an allergy to the antibiotics being used to treat the streptococcal infection. The treatment of guttate psoriasis can vary by severity, but the mainstay treatment includes photo therapy and topical steroids. This case report presents the etiology, clinical findings and current treatment options of guttate psoriasis. It also discusses importance …

Severe Pneumomediastinum Complicating Ebus-Tbna, Yousef Shweihat, James D. Perry Iii, Nancy Munn

Internal Medicine

Pneumomediastinum infrequently complicates diagnostic bronchoscopy. Increased airway or alveolar pressure results in air leaks to the mediastinum through existing or induced defects. Excessive cough, recurrent episodes of increased abdominal pressure, vomiting, or sneezing can all induce spontaneous pneumomediastinum. Less commonly it has been documented with lung or neck infections, esophageal or tracheal tears, and rapid increases in altitude such as during plane flights or scuba diving, with mechanical ventilation, substance abuse, and after bronchoscopy. Pneumomediastinum may be, but is not always, associated with pneumothorax.

Department Of Surgery Update, July 2015, Wright State University Department Of Surgery

Department of Surgery Updates

A three page newsletter created by the Department of Surgery documenting changes to the department. This issue contains a message from the chair, a list of important dates, committee meetings, scholarly activity and more.

Differences In Health-Related Behaviors And Attitudes Between Urban, Rural, And Isolated Households In Western West Virginia, Michael Newsome Phd, Tim Hazelett, Monika Sawhney Phd, Msw

Economics Faculty Research

This study uses data from a 2013 survey of 275 randomly sampled households across nine counties in western West Virginia to examine the significant differences between the health behaviors and attitudes of rural and isolated populations. The results show that age, education, and income are significant factors in explaining differences in health-related behaviors and attitudes for all urban, rural and isolated respondents. However, after controlling for socio-demographic differences, isolation is found to have only a few significant effects, and some of the effects run counter to stereotypes of isolated populations. Rural respondents are significantly more likely than isolated respondents to …

Development Of Hyperplastic Polyps Following Argon Plasma Coagulation Of Gastric Antral Vascular Ectasia, Nihar Shah Md, Yana Cavanagh, Dharmesh H. Kaswal, Sohail Shaikh

Gastroenterology

The etiology of gastric antral vascular ectasia (GAVE) syndrome or gastric hyperplastic polyps (HPs) is not fully understood. We report a case of gastric HP arising in a patient treated with argon plasma coagulation (APC) for GAVE syndrome. Despite unclear etiologic progression, this and previously reported cases suggest a temporal relationship between the treatment of GAVE and HP. A 68-year-old male with a history of coronary artery disease, congestive heart failure and diabetes type II who initially presented with symptomatic anemia 2 weeks after starting aspirin and clopidogrel therapy. Diagnostic esophagogastroduodenoscopy (EGD) demonstrated diffuse GAVE. He was treated with 5 …

Cecal Bascule After Colonoscopy - Case Report And Review Of Literature, Nihar Shah Md, Hiren Patel Md, Varun Patel Md, Robert Spira

Gastroenterology

Cecal bascule is a rare disease variant of a cecal volvulus. It consists of upward and anterior folding of the ascending colon, forming a flap valve, and occluding the bowel lumen resulting in proximal cecal dilatation. Herein, we present a case of a patient who developed persistent abdominal pain few hours after a colonoscopy. CT scan of the abdomen revealed an upward and anterior folding of the cecum. Subsequently the patient was taken to the operating room for a right hemi-colectomy. This case emphasizes the importance to consider cecal bascule as a differential diagnosis in patients with persistent abdominal pain …

Role Of Non-Selective Beta Blockers In Hepatocellular Carcinoma: An Analysis In Patients With Cirrhosis And Portal Hypertension, Hiren Patel, Abhishek Kumar, Nihar Shah Md, Ela Eris, Michael Maroules, Walid J. Baddoura, Vincent A. Debari

Gastroenterology

There are many different biochemical processes responsible for the hepatocelluar carcinoma (HCC) development that can be targeted for the prevention or halt progression of the HCC. Non-selective betablockers (NSBB) affects a multitude of intracellular biochemical and signaling pathways involved in carcinogenesis. Aim: To determine if NSBB may be protective for HCC in patients with cirrhosis and portal hypertension. Methods: We retrospectively enrolled 200 patients from medical records diagnosed with cirrhosis and portal hypertension between January 2001 and December 2013. Eighteen patients were excluded (taking selective beta-blocker and/or unavailable medical records). The etiology of cirrhosis, use of NSBB, demographics and the …

An Unusual Initial Presentation Of Hepatocellular Carcinoma As A Sellar Mass, Nihar Shah Md, Yana Cavanagh, Hamid Shaaban, Beth Stein, Sohail N. Shaikh, Dharmesh H. Kaswala, Walid Baddoura

Gastroenterology

Sellar masses are frequently adenomatous pituitary tumors. Metastatic disease is unusual, often mimicking the presentations of adenomas. Hepatocellular carcinoma (HCC) is the most common primary hepatic malignancy but unusual to have a pituitary metastasis (PM). A 65-year-old man presented with headache, diplopia, ptosis, decreased vision in the right eye and unintentional weight loss of 32lbs. Preliminary out-patient work-up revealed a mass in the pituitary region. Cranial imaging showed 3.1 cm × 3.2 cm × 4.4 cm lesion. Abdominal imaging (computed tomography and magnetic resonance imaging) demonstrated a lobulated, nodular and heterogeneous right lobe of the liver. Trans-sphenoidal resection of the …

Recessive Mutations In Polr1c Cause A Leukodystrophy By Impairing Biogenesis Of Rna Polymerase Iii, Isabelle Thiffault, Nicole I. Wolf, Diane Forget, Kether Guerrero, Adeline Vanderver, Cas Simons, Ryan J. Taft, +17 Additional Authors

Neurology Faculty Publications

A small proportion of 4H (Hypomyelination, Hypodontia and Hypogonadotropic Hypogonadism) or RNA polymerase III (POLR3)-related leukodystrophy cases are negative for mutations in the previously identified causative genes POLR3A and POLR3B. Here we report eight of these cases carrying recessive mutations in POLR1C, a gene encoding a shared POLR1 and POLR3 subunit, also mutated in some Treacher Collins syndrome (TCS) cases. Using shotgun proteomics and ChIP sequencing, we demonstrate that leukodystrophy-causative mutations, but not TCS mutations, in POLR1C impair assembly and nuclear import of POLR3, but not POLR1, leading to decreased binding to POLR3 target genes. This study is …

Nitrate And Nitrite Ingestion And Risk Of Ovarian Cancer Among Postmenopausal Women In Iowa, Maki Inoue-Choi, Rena R. Jones, Kristin E. Anderson, Kenneth P. Cantor, James R. Cerhan, Stuart Krasner, Kimberly Robien, Peter J. Weyer, Mary H. Ward

Epidemiology Faculty Publications

Nitrate and nitrite are precursors in the endogenous formation of N-nitroso compounds (NOC), potential human carcinogens. We evaluated the association of nitrate and nitrite ingestion with postmenopausal ovarian cancer risk in the Iowa Women's Health Study. Among 28,555 postmenopausal women, we identified 315 incident epithelial ovarian cancers from 1986 to 2010. Dietary nitrate and nitrite intakes were assessed at baseline using food frequency questionnaire data. Drinking water source at home was obtained in a 1989 follow-up survey. Nitrate-nitrogen (NO₃-N) and total trihalomethane (TTHM) levels for Iowa public water utilities were linked to residences and average levels were …

The Mouse That Trolled: The Long And Tortuous History Of A Gene Mutation Patent That Became An Expensive Impediment To Alzheimer's Research, Tania M. Bubela, Saurabh Vishnubhakat, Robert Cook-Deegan

Office of the Provost

This case study presents the tale of the academic discovery of a rare mutation for early-onset Alzheimer's disease that was patented by a sole inventor and licensed to a non-practicing entity (NPE), the Alzheimer's Institute of America (AIA). Our aims are (1) to relate this story about patents, research tools, and impediments to medical progress, and (2) to inform ongoing debates about how patents affect research, disposition of university inventions, and the distribution of benefits from publicly funded research. We present an account of the hunt for Alzheimer's genes, their patenting, assignment, and enforcement based on literature, litigation records and …

Multiple Cerebral Hydatid Cysts In 8-Year-Old Boy: A Case Report And Literature Review Of A Rare Presentation, Muhammad Baba Khan, Muhammad Riaz, Muhammad Ehsan Bari

Section of Neurosurgery

Background: Multiple cerebral hydatid cysts are very rare with only a few reports in the literature detailing diagnostic workup, medical management, surgical techniques, possible complications, and outcomes.
Case description: We present the case of an 8-year-old boy who presented with progressively worsening headaches, vomiting, and intermittent fever since 20 days. Diagnostic workup was performed, and magnetic resonance imaging revealed multiple intracranial cysts predominantly in the right frontal region with significant mass effect. A total of 19 intracranial cysts were removed surgically, and the child recovered uneventfully.
Conclusions: Neurosurgeons should keep hydatidosis in the list of differentials when evaluating patients with …

Predictors Of Orthopaedic Surgery In Ncaa Athletes, Dean Wang, Caitlin M. Rugg, Erik Mayer, Pamela Sulzicki, Jeremy Vail, Sharon L. Hame

Athletic Training Faculty Publications

Objectives: Orthopaedic injury and surgery is relatively common in National Collegiate Athletic Association (NCAA) athletes and can have devastating career consequences. However, there is a paucity of data regarding predictors of orthopaedic surgery in collegiate athletes. The purpose of this study was to analyze player-related predictors of orthopaedic surgery, including that of the shoulder, hip, and knee, in NCAA athletes. Methods: All NCAA Division I collegiate athletes at a single institution who began participation from the 2003-2004 through 2008-2009 seasons were retrospectively identified. Player-related factors, including gender, sport, and any pre-college upper or lower extremity orthopaedic surgery, were elicited through …

Clinical Utility Of Lactate Dehydrogenase In Determining The Severity Of Hemolysis In Sickle Cell Anemia., Samir K. Ballas

Cardeza Foundation for Hematologic Research

No abstract provided.

Paracrine Effect Of Nrg1 And Hgf Drives Resistance To Mek Inhibitors In Metastatic Uveal Melanoma., Hanyin Cheng, Mizue Terai, Ken Kageyama, Shinji Ozaki, Peter Mccue, Takami Sato, Andrew E. Aplin

Department of Cancer Biology Faculty Papers

Uveal melanoma patients with metastatic disease usually die within one year, emphasizing an urgent need to develop new treatment strategies for this cancer. MEK inhibitors improve survival in cutaneous melanoma patients but show only modest efficacy in metastatic uveal melanoma patients. In this study, we screened for growth factors that elicited resistance in newly characterized metastatic uveal melanoma cell lines to clinical-grade MEK inhibitors, trametinib and selumetinib. We show that neuregulin 1 (NRG1) and hepatocyte growth factor (HGF) provide resistance to MEK inhibition. Mechanistically, trametinib enhances the responsiveness to NRG1 and sustained HGF-mediated activation of AKT. Individually targeting ERBB3 and …

Setting Up Triage Services In The Emergency Department: Experience From A Tertiary Care Institute Of Pakistan. A Journey Toward Excellence., Munawar Khursheed, Jabeen Fayyaz, Ahsan Jamil

Department of Emergency Medicine

The history of triage started from the French battle field for prioritizing patients. Emergency triage was started in early 1950's in USA in order to treat the sickest first. It has now become an integral component of all emergency departments (ED). The basic aim of triage is not only to sort out patients according to the criticality of their illness, but it also serves to streamline the patient flow. This will ultimately enable the ED physician to provide right management at the right time to the right patient in the available resources. In turn has a positive impact in reducing …

‘What About The Mother?’ Women׳S And Caregivers׳ Perspectives On Caesarean Birth In A Low-Resource Setting With Rising Caesarean Section Rates, Helena Litorp, Andrew Mgaya, Hussein Kidanto, Sara Johnsdotter, Birgitta Essén

Faculty of Health Sciences, East Africa

Objective in light of the rising caesarean section rates in many developing countries, we sought to explore women׳s and caregivers׳ experiences, perceptions, attitudes, and beliefs in relation to caesarean section.

Design qualitative study using semi-structured individual in-depth interviews, focus group discussions, and participant observations. The study relied on a framework of naturalistic inquiry and data were analysed using thematic analysis.

Setting a public university hospital in Dar es Salaam, Tanzania.

Participants we conducted a total of 29 individual interviews, 13 with women and 16 with caregivers, and two focus group discussions comprising five to six caregivers each. Women had undergone …

Radiobiological Evaluation Of Intensity Modulated Radiation Therapy Treatments Of Patients With Head And Neck Cancer: A Dual-Institutional Study, G. Narayanasamy, A. P. Pyakuryal, S. Pandit, J. Vincent, C. Lee, P. Mavroidis, N. Papanikolaou, Mahesh Kudrimoti, T. T. Sio

Radiation Medicine Faculty Publications

In clinical practice, evaluation of clinical efficacy of treatment planning stems from the radiation oncologist's experience in accurately targeting tumors, while keeping minimal toxicity to various organs at risk (OAR) involved. A more objective, quantitative method may be raised by using radiobiological models. The purpose of this work is to evaluate the potential correlation of OAR-related toxicities to its radiobiologically estimated parameters in simultaneously integrated boost (SIB) intensity modulated radiation therapy (IMRT) plans of patients with head and neck tumors at two institutions. Lyman model for normal tissue complication probability (NTCP) and the Poisson model for tumor control probability (TCP) …

Pregnancy Apps: A Closer Look At The Implications For Childbirth Educators, Christine Frazer, Leslie Hussey, Emily Bosch, Michelle Squire

Walden Faculty and Staff Publications

Most pregnant women download an average of three pregnancy apps during their gestational period. There are no set standards in place for what needs to be included in an app’s description leaving consumers to decide for themselves when it comes to selecting the right app to download. The childbirth educator must be knowledgeable about pregnancy apps, in-tune as to what apps their clientele download, and how to analyze them for credibility. This article presents characteristics associated with women of childbearing age (i.e. Millennial/Net generation); the reasons why pregnant women are turning to apps; the limitations of apps, and the childbirth …

Laparoscopic Cholecystectomy: Outcome Of First 202 Cases In A District Hospital In Gilgit, Ghulam H, Dildar Hussain, Seema Waheed, Rehman Shah, Ali Ahmad Khan, Mumtaz Ibrahim, Syed Mahboob Ali Shah

Department of Medicine

BACKGROUND:

The incidence of gall stone disease is on the rise in Gilgit Baltistan. The objectives of the study were to assess the outcome of laparoscopic cholecystectomy in terms of conversion rate and postoperative morbidity, in The Aga Khan Medical Centre Gilgit.

METHODS:

It was descriptive case series. All patients that underwent laparoscopic cholecystectomy between June 2009 to May 2014 were included. The data was collected prospectively. Demographic features, operative time, and hospital stay were studied. Postoperative complications were documented and evaluated according to outcome measures (bile duct injuries, morbidity, mortality, conversion rates, wound infections).

RESULTS:

A total of 202 …

Clinical Characteristics And Risk Factors Of Candidemia In Tertiary Care Hospital, Iffat Khanum, Syed Faisal Mahmood, Farheen Ali, Hafsa Waqar, Safia Awan

Department of Medicine

Introduction: During the past two decades, the incidence of candidemia has doubled and Candida spp. currently ranks in top blood stream pathogen in developed countries. Given the need to ensure appropriate and timely antifungal therapy, there is need to identify these patients as early as possible and therefore a risk stratification for candidemia is imperative. We aim to identify the risk factors of candidemia in patients admitted at our tertiary care center.

Methods: A retrospective case control study were conducted on adult patients (15 years. or more) admitted to Aga Khan University Hospital between 2009 and 2013 who developed candidemia …

Role Of Mitochondria In Regulating Microrna Activity And Its Relevance To The Central Nervous System, Wang-Xia Wang, Joe E. Springer

Physical Medicine and Rehabilitation Faculty Publications

No abstract provided.

New Approach To Develop Ultra-High Inhibitory Drug Using The Power Function Of The Stoichiometry Of The Targeted Nanomachine Or Biocomplex, Dan Shu, Fengmei Pi, Chi Wang, Peng Zhang, Peixuan Guo

Pharmaceutical Sciences Faculty Publications

AIMS: To find methods for potent drug development by targeting to biocomplex with high copy number.

METHODS: Phi29 DNA packaging motor components with different stoichiometries were used as model to assay virion assembly with Yang Hui's Triangle [Formula: see text], where Z = stoichiometry, M = drugged subunits per biocomplex, p and q are the fraction of drugged and undrugged subunits in the population.

RESULTS: Inhibition efficiency follows a power function. When number of drugged subunits to block the function of the complex K = 1, the uninhibited biocomplex equals q(z), demonstrating the multiplicative effect of stoichiometry on inhibition with …

Glanzmann's Thrombasthenia: Pathogenesis, Diagnosis, And Current And Emerging Treatment Options, Tia Solh, Ashley Botsford, Melhem Solh

PCOM Scholarly Works

Glanzmann’s thrombasthenia (GT) is a genetic platelet surface receptor disorder of GPIIb/IIIa (ITG αIIbβ3), either qualitative or quantitative, which results in faulty platelet aggregation and diminished clot retraction. Spontaneous mucocutaneous bleeding is common and can lead to fatal bleeding episodes. Control and prevention of bleeding among patients with GT is imperative, and remains challenging. Local measures, including anti-fibrinolytic therapy, with or without platelet transfusions, used to be the mainstay of therapy. However, in recent years the use of recombinant factor VIIa (rFVIIa) has increased significantly, with excellent response rates in treating and preventing hemorrhage among GT patients. Gene therapy and …

Oncolog, Volume 60, Number 07, July 2015, Kathryn L. Hale, Bryan Tutt, K. Stuyck

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

• Emergency Care for Cancer Patients: Medical problems that may seem routine in patients without cancer often mean something different or have a different cause in cancer patients and may be much more serious, requiring urgent treatment. Managing these problems promptly and effectively is a challenge faced by all cancer centers.
• Immunotherapy Trials Offer Hope to Patients with High-Risk or Metastatic Cancer: Although the cure rate for the breast cancer has risen steadily in recent decades, recurrent or metastatic disease remains difficult to control. To fight metastatic breast cancer and forestall the recurrence of high-risk primary disease, researchers at The University …

Surgeon Radiation Exposure In Hip Arthroscopy: A Prospective Analysis, John P. Salvo, Jake Zarah

Rothman Institute Papers

Objectives: Hip arthroscopy is an established field within orthopaedic surgery. The majority of the procedures involve repairs of the acetabular labrum and arthroscopic treatment of femoroacetabular impingement (FAI). The procedures are being performed with increasing frequency annually. Fluoroscopic guidance is recommended during these procedures, and radiation exposure to the surgeon, staff, and patient remains a valid concern. The purpose of this study is to measure radiation exposure to the surgeon during hip arthroscopy and determine if this exposure remains below recommended annual occupational radiation exposure thresholds recommended by the International Committee on Radiological Protection (IRCP). Methods: Prospectively, radiation exposure was …