Medical Specialties Commons^™

Spectrum Of Microbial Diseases And Resistance Patterns At A Private Teaching Hospital In Kenya: Implications For Clinical Practice, Daniel Maina, Geoffrey Omuse, Gunturu Revathi, Rodney Adam

Pathology, East Africa

Background: Accurate local prevalence of microbial diseases and microbial resistance data are vital for optimal treatment of patients. However, there are few reports of these data from developing countries, especially from sub-Saharan Africa. The status of Aga Khan University Hospital Nairobi as an internationally accredited hospital and a laboratory with an electronic medical record system has made it possible to analyze local prevalence and antimicrobial susceptibility data and compare it with other published data.

Methods: We have analyzed the spectrum of microbial agents and resistance patterns seen at a 300 bed tertiary private teaching hospital in Kenya using microbial identity …

The Relationship Between Aldosterone And Left Ventricular Hypertrophy In Hypertensive Patients, Tahsin M. Rahman, Phillip Levy, Aaron M. Brody

Honors College Theses

Background - Aldosterone is a pertinent hormone in naturally elevating blood pressure within the body by increasing fluid retention in the body via electrolyte reabsorption in the kidneys. Consequently, aldosterone can have an indirect effect on the incidence of LVH considering the hormone can reinforce high blood pressure. However, recent studies have suggested that aldosterone and the renin-angiotensin-aldosterone-system (RAAS) may have a direct role in leading to an increase in left ventricular mass. Patients with hyperaldosteronism, otherwise elevated circulating aldosterone, have shown high frequencies of LVH regardless of the presence of hypertension. Furthermore, cardiomyocytes have been seen to contain mineralocorticoid …

Neural Substrate Expansion For The Restoration Of Brain Function., H Isaac Chen, Dennis Jgamadze, Mijail Serruya, D Kacy Cullen, John A Wolf, Douglas H Smith

Department of Neurology Faculty Papers

Restoring neurological and cognitive function in individuals who have suffered brain damage is one of the principal objectives of modern translational neuroscience. Electrical stimulation approaches, such as deep-brain stimulation, have achieved the most clinical success, but they ultimately may be limited by the computational capacity of the residual cerebral circuitry. An alternative strategy is brain substrate expansion, in which the computational capacity of the brain is augmented through the addition of new processing units and the reconstitution of network connectivity. This latter approach has been explored to some degree using both biological and electronic means but thus far has not …

Human Polyomaviruses And Incidence Of Cutaneous Squamous Cell Carcinoma In The New Hampshire Skin Cancer Study, Anala Gossai, Tim Waterboer, Anne G. Hoen, Shohreh F. Farzan, Heather Nelson, Angelika Michel, Martina Willhauck-Fleckenstein, Brock Christensen, Ann Perry, Michael Pawlita, Margaret Karagas

Dartmouth Scholarship

Squamous cell carcinoma (SCC) of the skin is a malignancy arising from epi- thelial keratinocytes. Experimental and epidemiologic evidence raise the possibility that human polyomaviruses (PyV) may be associated with the occurrence of SCC. To investigate whether the risk for SCC was associated with PyV infection, seropositivity to 10 PyV types was assessed following diagnosis in a population- based case–control study conducted in the United States. A total of 253 SCC cases and 460 age group and gender-matched controls were included. Antibody response against each PyV was measured using a multiplex serology-based glu- tathione S-transferase capture assay of recombinantly expressed …

Development And Validation Of A Preprocedural Risk Score To Predict Access Site Complications After Peripheral Vascular Interventions Based On The Vascular Quality Initiative Database, Daniel Ortiz, Maharaj Singh, Arshad Jahangir, Suhail Allaqaband, Anjan Gupta, Tanvir Bajwa, Mark W. Mewissen

Journal of Patient-Centered Research and Reviews

Purpose

Access site complications following peripheral vascular intervention (PVI) are associated with prolonged hospitalization and increased mortality. Prediction of access site complication risk may optimize PVI care; however, there is no tool designed for this. We aimed to create a clinical scoring tool to stratify patients according to their risk of developing access site complications after PVI.

Methods

The Society for Vascular Surgery’s Vascular Quality Initiative database yielded 27,997 patients who had undergone PVI at 131 North American centers. Clinically and statistically significant preprocedural risk factors associated with in-hospital, post-PVI access site complications were included in a multivariate logistic regression …

The Relationship Between Foot Arch Measurements And Walking Parameters In Children, Simone V. Gill, Sara Keimig, Damian Kelty-Stephen, Ya-Ching Hung, Jeremy M. Desilva

Publications and Research

Background: Walking mechanics are influenced by body morphology. Foot arch height is one aspect of body morphology central to walking. However, generalizations about the relationship between arch height and walking are limited due to previous methodologies used for measuring the arch and the populations that have been studied. To gain the knowledge needed to support healthy gait in children and adults, we need to understand this relationship in unimpaired, typically developing children and adults using dynamic measures. The purpose of the current study was to examine the relationship between arch height and gait in a sample of healthy children …

The Relationship Between Foot Arch Measurements And Walking Parameters In Children, Simone V. Gill, Sara Keimig, Damian Kelty-Stephen, Ya-Ching Hung, Jeremy M. Desilva

Dartmouth Scholarship

Walking mechanics are influenced by body morphology. Foot arch height is one aspect of body morphology central to walking. However, generalizations about the relationship between arch height and walking are limited due to previous methodologies used for measuring the arch and the populations that have been studied. To gain the knowledge needed to support healthy gait in children and adults, we need to understand this relationship in unimpaired, typically developing children and adults using dynamic measures. The purpose of the current study was to examine the relationship between arch height and gait in a sample of healthy children and adults …

2016 Founders' Day, Philadelphia College Of Osteopathic Medicine

Founders Day Programs

The 2016 Founders Day OJ Snyder Memorial Medal recipient was Richard Pascucci DO '75. The Philadelphia Campus Mason W. Pressly Memorial Medal Recipient was Zachary Herrman (DO '16). The Georgia campus Mason W. Pressly Memorial Medal Recipient was Jessica Mormando (DO '16).

Factors Associated With Unmet Needs Among African-American Dementia Care Providers, P. J. Desin, Allison M. Caban-Holt, Erin L. Abner, Linda J. Van Eldik, Frederick A. Schmitt

Sanders-Brown Center on Aging Faculty Publications

Racial and ethnic minorities currently comprise 20% of the U.S. population; in 2050, this figure is expected to rise to 42%. As a result, Alzheimer’s disease (AD), the 5th leading cause of death for people aged 65 and older, is likely to increase in these groups. Most dementia caregiving for these populations comes from family and friends, especially among families with lower socioeconomic status. A convenience sample of 30 African-American dementia caregivers was interviewed to determine unmet needs. Participants expressed a limited desire for formal services, such as support groups, legal advice, case management, and homemaker services. Instead, commonly expressed …

Evidence And Knowledge Gaps On The Disease Burden In Sexual And Gender Minorities: A Review Of Systematic Reviews, Karel Blondeel, Lale Say, Doris Chou, Igor Toskin, Rajat Khosla, Elisa Scolaro, Marleen Temmerman

Obstetrics and Gynaecology, East Africa

Sexual and gender minorities (SGM) include individuals with a wide range of sexual orientations, physical characteristics, and gender identities and expressions. Data suggest that people in this group face a significant and poorly understood set of additional health risks and bear a higher burden of some diseases compared to the general population. A large amount of data is available on HIV/AIDS, but far less on other health problems. In this review we aimed to synthesize the knowledge on the burden of communicable and non-communicable diseases, mental health conditions and violence experienced by SGM, based on available systematic reviews. We conducted …

Reducing Gastrointestinal Anastomotic Leak Rates: Review Of Challenges And Solutions, Benjamin Philllips

Department of Surgery Faculty Papers

Various techniques and interventions have been developed in an effort to obviate gastrointestinal anastomotic leaks. This review is intended to delineate potential modifications that can be made to reduce the risk of anastomotic leaks following gastrointestinal surgery. It may also serve to aid in identifying patients who are at increased risk of anastomotic leak. Modifiable risk factors for leak discussed include malnutrition, smoking, steroid use, bowel preparation, chemotherapy, duration of surgery, use of pressors, intravenous fluid administration, blood transfusion, and surgical anastomotic technique. Based upon literature review, operative techniques should include minimizing operative time, reducing ischemia, and utilizing stapled anastomoses. …

Models For Hsv Shedding Must Account For Two Levels Of Overdispersion, Amalia Magaret

UW Biostatistics Working Paper Series

We have frequently implemented crossover studies to evaluate new therapeutic interventions for genital herpes simplex virus infection. The outcome measured to assess the efficacy of interventions on herpes disease severity is the viral shedding rate, defined as the frequency of detection of HSV on the genital skin and mucosa. We performed a simulation study to ascertain whether our standard model, which we have used previously, was appropriately considering all the necessary features of the shedding data to provide correct inference. We simulated shedding data under our standard, validated assumptions and assessed the ability of 5 different models to reproduce the …

Hyaluronidase And Hyaluronan Oligosaccharides Promote Neurological Recovery After Intraventricular Hemorrhage, Govindaiah Vinukonda, Preeti Dohare, Arslan Arshad, Muhammad T. Zia, Sanjeet Panda, Ritesh Korumilli, Praveen Ballabh

NYMC Faculty Publications

Intraventricular hemorrhage (IVH) in premature infants results in inflammation, arrested oligodendrocyte progenitor cell (OPC) maturation, and reduced myelination of the white matter. Hyaluronan (HA) inhibits OPC maturation and complexes with the heavy chain (HC) of glycoprotein inter-α-inhibitor to form pathological HA (HC-HA complex), which exacerbates inflammation. Therefore, we hypothesized that IVH would result in accumulation of HA, and that either degradation of HA by hyaluronidase treatment or elimination of HCs from pathological HA by HA oligosaccharide administration would restore OPC maturation, myelination, and neurological function in survivors with IVH. To test these hypotheses, we used the preterm rabbit model of …

Cerebellopontine Angle Primitive Neuroectodermal Tumor Mimicking Trigeminal Schwannoma, Saad Akhtar Khan, Badar Uddin Ujjan, Adnan Salim, Muhammad Shahzad Shamim

Section of Neurosurgery

Background: Primitive neuroectodermal tumors (PNETs) comprise a group of aggressive, poorly differentiated embryonal tumors occurring in central nervous system as well as in peripheral locations. Primary cerebellopontine angle (CPA) PNET is an extremely rare entity. It is important to have knowledge of this pathology and to be able to differentiate it from other commonly occurring CPA tumors, such as vestibular and trigeminal schwannomas. This distinction is essential because of the difference in the overall treatment plan and prognosis.
Case description: This report describes a case of a young male presenting with diplopia and numbness of face; magnetic resonance imaging showed …

Harvesting Health: A Community-Based Participatory Evaluation Of The Veggie Rx Program, Natalie Royal, Kristin Brown, Fanny Rodriguez, Bianca Fernandez, Leticia Valle, Elizur Bello

Articles, Abstracts, and Reports

No abstract provided.

Pathological Tau Promotes Neuronal Damage By Impairing Ribosomal Function And Decreasing Protein Synthesis, Shelby Meier, Michelle Bell, Danielle N. Lyons, Jennifer Rodriguez-Rivera, Alexandria Ingram, Sarah N. Fontaine, Elizabeth Mechas, Jing Chen, Benjamin Wolozin, Harry Levine Iii, Haining Zhu, Jose F. Abisambra

Sanders-Brown Center on Aging Faculty Publications

One of the most common symptoms of Alzheimer's disease (AD) and related tauopathies is memory loss. The exact mechanisms leading to memory loss in tauopathies are not yet known; however, decreased translation due to ribosomal dysfunction has been implicated as a part of this process. Here we use a proteomics approach that incorporates subcellular fractionation and coimmunoprecipitation of tau from human AD and non-demented control brains to identify novel interactions between tau and the endoplasmic reticulum (ER). We show that ribosomes associate more closely with tau in AD than with tau in control brains, and that this abnormal association leads …

Cannibalism, Kuru, And Mad Cows: Prion Disease As A "Choose-Your-Own-Experiment" Case Study To Simulate Scientific Inquiry In Large Lectures., Antonio Serrano, Jeffrey Liebner, Justin K Hines

Department of Medicine Faculty Papers

Despite significant efforts to reform undergraduate science education, students often perform worse on assessments of perceptions of science after introductory courses, demonstrating a need for new educational interventions to reverse this trend. To address this need, we created An Inexplicable Disease, an engaging, active-learning case study that is unusual because it aims to simulate scientific inquiry by allowing students to iteratively investigate the Kuru epidemic of 1957 in a choose-your-own-experiment format in large lectures. The case emphasizes the importance of specialization and communication in science and is broadly applicable to courses of any size and sub-discipline of the life sciences.

Antigen Specific Induced T Regulatory Cellular Therapy For Graft-Versus-Host Disease Following Allogeneic Bone Marrow Transplantation, Jessica Lauren Heinrichs

USF Tampa Graduate Theses and Dissertations

Allogeneic hematopoietic stem cell transplantation (allo-HCT) has been a successful cellular therapy for patients suffering from hematological malignancies for many decades; however, the beneficial effects of graft-versus-leukemia (GVL) are classically offset by graft-versus-host disease (GVHD). GVHD occurs when major and/or minor human leukocyte antigen (HLA) mismatches between donor and recipient cause rapid expansion and activation of donor effector T cells (Teffs) resulting in end organ damage to the recipient’s epithelial tissues. Given the lymphoproliferative nature of this disease, the standard treatment option is broad immunosuppression, which can result in primary disease relapse, steroid refractory GVHD, and/or opportunistic infection. A more …

The Effect Of An Educational Intervention On The Knowledge And Management Of Ponv Among Anesthesia Providers: A Pilot Study, Eleazar Comprendio, Juan E. Ruan, H. Mohammad Zayed, Julie Lamoureux, Feliciano Villalba

All Publications

No abstract provided.

Genomic Diversity Of Epec Associated With Clinical Presentations Of Differing Severity, Tracy H. Hazen, Michael S. Donnenberg, Sandra Panchalingam, Martin Antonio, Anowar Hossain, Inacio Mandomando, John Benjamin Ochieng, Shahida Qureshi, Farheen Quadri, Anita K. M. Zaidi

Department of Paediatrics and Child Health

Enteropathogenic Escherichia coli (EPEC) are diarrhoeagenic E. coli, and are a significant cause of gastrointestinal illness among young children in developing countries. Typical EPEC are identified by the presence of the bundle-forming pilus encoded by a virulence plasmid, which has been linked to an increased severity of illness, while atypical EPEC lack this feature. Comparative genomics of 70 total EPEC from lethal (LI), non-lethal symptomatic (NSI) or asymptomatic (AI) cases of diarrhoeal illness in children enrolled in the Global Enteric Multicenter Study was used to investigate the genomic differences in EPEC isolates obtained from individuals with various clinical outcomes. A …

Cloning And Transcriptional Activity Of The Mouse Omi/Htra2 Gene Promoter., Dan Liu, Xin Liu, Ye Wu, Wen Wang, Xin-Liang Ma, Huirong Liu

Department of Medicine Faculty Papers

HtrA serine peptidase 2 (HtrA2), also named Omi, is a pro-apoptotic protein that exhibits dramatic changes in expression levels in a variety of disorders, including ischemia/reperfusion injury, cancer, and neurodegeneration. In our study, Omi/HtrA2 protein levels were high in the heart, brain, kidney and liver, with elevated heart/brain expression in aging mice. A similar expression pattern was observed at the mRNA level, which suggests that the regulation of Omi/HtrA2 is predominately transcriptional. Promoter binding by transcription factors is the main influencing factor of transcription, and to identify specific promoter elements that contribute to the differential expression of mouse Omi/HtrA2, we …

Obesity-Induced Colorectal Cancer Is Driven By Caloric Silencing Of The Guanylin-Gucy2c Paracrine Signaling Axis., Jieru E. Lin, Francheska Colon-Gonzalez, Erik S. Blomain, Gilbert W. Kim, Amanda Aing, Brian Stoecker, Justin Rock, Adam E. Snook, Tingting Zhan, Terry M. Hyslop, Michal Tomczak, Richard S. Blumberg, Scott A. Waldman

Department of Pharmacology and Experimental Therapeutics Faculty Papers

Obesity is a well-known risk factor for colorectal cancer but precisely how it influences risks of malignancy remains unclear. During colon cancer development in humans or animals, attenuation of the colonic cell surface receptor guanylyl cyclase C (GUCY2C) that occurs due to loss of its paracrine hormone ligand guanylin contributes universally to malignant progression. In this study, we explored a link between obesity and GUCY2C silencing in colorectal cancer. Using genetically engineered mice on different diets, we found that diet-induced obesity caused a loss of guanylin expression in the colon with subsequent GUCY2C silencing, epithelial dysfunction, and tumorigenesis. Mechanistic investigations …

Targeting Wnt/Β-Catenin Pathway In Hepatocellular Carcinoma Treatment, Valery Vilchez, Lilia M. Turcios, Francesc Marti, Roberto Gedaly

Surgery Faculty Publications

Hepatocellular carcinoma (HCC) is one of the most common causes of cancer-related death worldwide. Liver cancer is generally related to hepatitis B or C infection and cirrhosis. Usually, patients with HCC are asymptomatic and are diagnosed at late stages when surgical treatment is no longer suitable. Limited treatment options for patients with advanced HCC are a major concern. Therefore, there is an urge for finding novel therapies to treat HCC. Liver cancer is highly heterogeneous and involved deregulation of several signaling pathways. Wnt/β-catenin pathway is frequently upregulated in HCC and it is implicated in maintenance of tumor initiating cells, drug …

Metastatic Mantle Cell Lymphoma To The Pituitary Gland: Case Report And Literature Review, Arthur Wang, Nathan Carberry, Elena Solli, George Kleinman, Adesh Tandon

NYMC Faculty Publications

We present an unusual case of a metastatic mantle cell lymphoma (MCL) to the pituitary gland. The patient had a known history of MCL for which she previously received chemotherapy. She presented with new-onset diplopia and confusion, and reported a history of progressive vision blurriness associated with headache, nausea, and vomiting. MRI of the brain showed an enhancing lesion within the sella turcica involving the cavernous sinuses bilaterally, extending into Meckel's cave on the left, and abutting the optic nerves bilaterally. Following surgical excision, histopathology revealed the tumor to be a MCL. Metastatic pituitary tumors are rare and have been …

Drug Eluding Stents For Malignant Airway Obstruction: A Critical Review Of The Literature, Wolfgang Hohenforst-Schmidt, Paul Zarogoulidis, Georgia Pitsiou, Bernd Linsmeier, Drosos Tsavlis, Ioannis Kioumis, Eleni Papadaki, Lutz Freitag, Theodora Tsiouda, J. Francis Turner, Robert Browning, Michael Simoff, Nikolaos Sachpekidis, Kosmas Tsakiridis, Bojan Zaric, Lonny Yarmus, Sofia Baka, Grigoris Stratakos, Harald Rittger

Internal Medicine Faculty Publications

Lung cancer being the most prevalent malignancy in men and the 3rd most frequent in women is still associated with dismal prognosis due to advanced disease at the time of diagnosis. Novel targeted therapies are already on the market and several others are under investigation. However non-specific cytotoxic agents still remain the cornerstone of treatment for many patients. Central airways stenosis or obstruction may often complicate and decrease quality of life and survival of these patients. Interventional pulmonology modalities (mainly debulking and stent placement) can alleviate symptoms related to airways stenosis and improve the quality of life of patients. Mitomycin …

Epigenetic Repression Of Pdz-Lim Domain-Containing Protein 2 Promotes Ovarian Cancer Via Nos2-Derived Nitric Oxide Signaling., Linjie Zhao, Chuan Yu, Shengtao Zhou, Wayne Bond Lau, Bonnie Lau, Zhongyue Luo, Qiao Lin, Huiliang Yang, Yu Xuan, Tao Yi, Xia Zhao, Yuquan Wei

Department of Emergency Medicine Faculty Papers

Ovarian cancer constitutes one of the most lethal gynaecological malignancies worldwide and currently no satisfactory therapeutic approaches have been established. Therefore, elucidation of molecular mechanisms to develop targeted therapy of ovarian cancer is crucial. PDLIM2 is critical to promote ubiquitination of nuclear p65 and thus its role in inflammation has been highlighted recently. We demonstrate that PDLIM2 is decreased in both ovarian high-grade serous carcinoma and in various human ovarian cancer cell lines compared with normal ovary tissues and human ovarian surface epithelial cells (HOSE). Further functional analysis revealed that PDLIM2 is epigenetically repressed in ovarian cancer development and inhibition …

Multiplatform Molecular Profiling Identifies Potentially Targetable Biomarkers In Malignant Phyllodes Tumors Of The Breast., Zoran Gatalica, Semir Vranic, Anatole Ghazalpour, Joanne Xiu, Idris Tolgay Ocal, John Mcgill, Ryan P Bender, Erin Discianno, Aaron Schlum, Souzan Sanati, Juan P. Palazzo, Sandeep Reddy, Barbara Pockaj

Department of Pathology, Anatomy, and Cell Biology Faculty Papers

Malignant phyllodes tumor is a rare breast malignancy with sarcomatous overgrowth and with limited effective treatment options for recurrent and metastatic cases. Recent clinical trials indicated a potential for anti-angiogenic, anti-EGFR and immunotherapeutic approaches for patients with sarcomas, which led us to investigate these and other targetable pathways in malignant phyllodes tumor of the breast. Thirty-six malignant phyllodes tumors (including 8 metastatic tumors with two cases having matched primary and metastatic tumors) were profiled using gene sequencing, gene copy number analysis, whole genome expression, and protein expression. Whole genome expression analysis demonstrated consistent over-expression of genes involved in angiogenesis including …

Membranoproliferative Glomerulonephritis Recurrence After Kidney Transplantation: Using The New Classification., Sami Alasfar, Naima Carter-Monroe, Avi Z Rosenberg, Robert A Montgomery, Nada Alachkar

Pathology Faculty Publications

BACKGROUND: Membranoproliferative glomerulonephritis (MPGN) is an uncommon glomerular disorder that may lead to end stage renal disease (ESRD). With new understanding of the disease pathogenesis, the classical classification as MPGN types I, II, III has changed. Data on post-transplant MPGN, in particular with the newly refined classification, is limited. We present our center's experience of MPGN after kidney transplantation using the new classification.

METHODS: This is a retrospective study of 34 patients with ESRD due to MPGN who received 40 kidney transplants between 1994 and 2014. We reviewed the available biopsies' data using the new classification. We assessed post transplantation …

Simplified Paper Format For Detecting Hiv Drug Resistance In Clinical Specimens By Oligonucleotide Ligation, Nuttada Panpradist, Ingrid A. Beck, Michael Chung, James N. Kiarie, Lisa M. Frenkel, Barry R. Lutz

Internal Medicine, East Africa

Human immunodeficiency virus (HIV) is a chronic infection that can be managed by antiretroviral treatment (ART). However, periods of suboptimal viral suppression during lifelong ART can select for HIV drug resistant (DR) variants. Transmission of drug resistant virus can lessen or abrogate ART efficacy. Therefore, testing of individuals for drug resistance prior to initiation of treatment is recommended to ensure effective ART. Sensitive and inexpensive HIV genotyping methods are needed in low-resource settings where most HIV infections occur. The oligonucleotide ligation assay (OLA) is a sensitive point mutation assay for detection of drug resistance mutations in HIV pol. The current …

Unbalanced But Satisfied?, Asha N. Shenoi

Pediatrics Faculty Publications

No abstract provided.