Medical Specialties Commons^™

Identifying Mechanisms Of Resistance And Potential Therapeutic Targets For Pediatric Acute Myeloid Leukemia, John Timothy Caldwell

Wayne State University Dissertations

Acute myeloid leukemia (AML) is a potentially devastating disease that can affect people of all ages. While there are certain patient groups that typically have favorable outcomes, in the pediatric population, overall survival (OS) is approximately 70%, leaving much progress to be made. Children with Down syndrome (DS) have a substantially elevated risk for developing AML, especially of the megakaryocytic phenotype (AMKL).

Patients with DS AMKL almost universally harbor a mutation in the gene encoding the GATA1 transcription factor, resulting in the translation of a short-form protein GATA1s, which has been shown to contribute to chemotherapy sensitivity. In contrast, in …

Does The Hygiene Hypothesis Contribute To Autoimmune And Allergic Disease In Children With Focus On Type 1 Diabetes Mellitus And Asthma, Chad Briley

Physician Assistant Scholarly Project Posters

The Hygiene Hypothesis first introduced in 1989 by an epidemiologist, Dr Strachan, as he observed an increased prevalence of allergic diseases in society. Further clinical studies and research have included autoimmunity and inflammatory disease under the umbrella of the Hygiene Hypothesis. Article searches were done in the electronic medical database, Pubmed, for articles related to the Hygiene Hypothesis and autoimmunity related to Type 1 Diabetes Mellitus (T1DM) and hygiene hypothesis and childhood asthma. Articles written in the last five years were utilized for the project. The subject group is male and female children ages birth to 18 years old with …

Acute Retinal Necrosis: Early Diagnosis Is Key To Outcome, Kevin Davis

Physician Assistant Scholarly Project Posters

• Acute Retinal Necrosis (ARN) can have extremely devastating effects on the vision of both healthy and immunocompromised individuals. Many times the exact pathogen of ARN can remain a mystery due to its silent and sometimes sudden onset along with the loss of vision prior to vitreal biopsy. One of the known pathogens is the Herpes Zoster Virus (HZV).

• When Herpes Zoster Virus attack the retina, there are very devastating effects due to ARN including long term complications and blindness. A review of literature looked at the retrospective studies related to the incidence and prevalence of ARN caused by …

Comparing Scit With Slit: For Treatment Of Ige Mediated Grass-Pollen Induced Rhinoconjunctivitis, Cory Heiser

Physician Assistant Scholarly Project Posters

• The peer review literature compared the effectiveness of treating allergic rhinitis (AR) with subcutaneous immunotherapy (SCIT) versus sublingual immunotherapy (SLIT) for allergen-induced rhinoconjunctivitis.

• The findings showed that there is no clear evidence of effectiveness between SCIT and SLIT for reducing AR symptoms. SLIT has been associated with cost savings with comparison to SCIT.

• The findings indicated that SLIT may be the preferred route for immunotherapy because of its convenience, comparable efficacy, safety and cost.

Exercise As The Best Treatment Option For Nafld, Amber Kirtley-Perez

Physician Assistant Scholarly Project Posters

Nonalcoholic fatty liver disease (NAFLD) is an advancing disease in children and adults that has the potential to be reversed. This disease is emerging in the population due to an increase in processed foods in the diet, increase in glucose intake in diet or liquid form, and lack of exercise. It is a growing epidemic in children that may progress into adulthood. The purpose of the literature review is to determine if the addition of daily exercise will decrease the amount of NAFLD and reverse the disease. The review of literature explored studies that are related to increasing exercise into …

Artificial Disc Replacement As An Alternative To Lumbar Spinal Function In The Treatment Of Chronic Low Back Pain, Jennifer Polniak

Physician Assistant Scholarly Project Posters

Chronic low back pain leads to activity limitations for the patient and widespread burdens on health care systems. Lumbar fusion has been the “gold standard” surgery for severe chronic low back pain non-responsive to conservative treatment, however it has been associated with continued limitations in spinal mobility. This study was executed in order to compare an alternative surgical intervention, artificial disc replacement, with lumbar spinal fusion in the treatment of chronic low back pain in terms of long term spinal function. Literature searches of trials, guidelines and systematic reviews within the past 5 years were completed exploring surgical procedures, associated …

Impact Of Increasing Glp-1 On Markers Of Inflammation, Glucose Control And Cardiovascular Risk Factors In Patients With Type 2 Diabetes, Kristina Sandstedt

Physician Assistant Scholarly Project Posters

There is a strong established relationship between diabetes and cardiovascular disease. Much of the latest research studies have identified a link between the inflammatory processes and the pathogenesis of both cardiovascular disease and diabetes. Specific inflammatory markers include: Interleukins 1,6,18; C-reactive protein, Fibrinogen, Tumor Necrosis Factor-α, PAI-I and cell adhesion molecules. As a result, there has been an emphasis on identifying therapeutic approaches that would improve both markers of inflammation and glucose control. The endocrine hormones known as incretins, glucagon-like peptide-1 (GLP-1) and glucose-dependent insulinotropicpolypeptide (GIP), are produced in the gastrointestinal tract following ingestion of a meal. In individuals with …

Comparing Short Versus Long Term Antibiotics For Reducing Persistent Lyme Symptoms, Joe Webster

Physician Assistant Scholarly Project Posters

• Lyme disease is the most common tick borne illness in the United States with over 300,000 cases annually.

• Two main organizations called the Infectious Disease Society of America and the International Lyme and Associated Diseases Society differ on their opinions in the treatment duration of Lyme disease.

• A review of the literature explored studies that compared the effectiveness of short term versus long term antibiotics in the treatment of Lyme. Determining the most effective treatment method duration for reducing the long term risk of persistent symptoms of Lyme will be important for the improvement of the delivery …

"I Always Worry About What Might Happen Ahead" : Implementing Safer Conception Services In The Current Environment Of Reproductive Counseling For Hiv-Affected Men And Women In Uganda, Lynn T. Matthews, Francis Bajunirwe, Jasmine Kastner, Naomi Sanyu, Cecilia Akatukwasa, Courtney Ng, Rachel Rifkin, Cecilia Milford, Lizzie Moore, Ira B. Wilson, David Bangsberg, Jennifer A. Smit, Angela Kaida

OHSU-PSU School of Public Health Faculty Publications and Presentations

Background. We explored healthcare provider perspectives and practices regarding safer conception counseling for HIV-affected clients. Methods.We conducted semistructured interviews with 38 providers (medical and clinical officers, nurses, peer counselors, and village health workers) delivering care to HIV-infected clients across 5 healthcare centres in Mbarara District, Uganda. Interview transcripts were analyzed using content analysis. Results. Of 38 providers, 76% were women with median age 34 years (range 24–57). First, we discuss providers’ reproductive counseling practices. Emergent themes include that providers (1) assess reproductive goals of HIV-infected female clients frequently, but infrequently for male clients; (2) offer counseling focused on “family planning” …

Medical Community Distrust And The Influenza Vaccination Rates Of Black Americans, Kenyatte Irby Winston

Walden Dissertations and Doctoral Studies

Black Americans experience influenza vaccination rates that are lower than the rates of other ethnic groups. Low influenza vaccination rates among the Black community are associated with higher influenza infection rates, influenza-related hospitalizations, and higher influenza mortality rates. There is a belief within the Black American community that the medical establishment does not have the Black American patient in its best interest, leading to feelings of distrust. The purpose of this study was to determine if the distrust of the medical community is a relevant factor in the low influenza vaccination rates of Black Americans aged 18 and older in …

Trigger Point Dry Needling For Musculoskeletal Pain And Disability: A Systematic Review Of Comparative Effectiveness Research, Megan D. Jackson, Kylie Rowe, Todd E. Davenport

School of Pharmacy Faculty Articles

Background: Dry needling (DN) has been proposed to reduce pain and improve function related to myofascial trigger points (MTrPs). Several primary studies and systematic reviews have been conducted to examine the effect of DN versus placebo. However the comparative effectiveness of DN and established interventions has yet to be established.

Purpose: The purpose of this systematic review was to determine whether DN was more effective than other established therapies to treat MTrPs.

Data Sources: MEDLINE Complete, EBSCO, CINAHL, Sport Discus and Cochrane library databases were searched.

Study Selection: Randomized controlled trials that used DN directed to MTrPs and used at …

Promoting Shared Decision Making Through Patient Education Of Labor Inductions, Lenora W.Y. Low

Walden Dissertations and Doctoral Studies

The induction of labor is medically indicated for many conditions in which delivering the baby outweighs the risk of continuing the pregnancy. Patients admitted for the induction of labor require adequate information to actively participate in decision making that affects their plan of care. The purpose of this quality improvement project was to improve the quality of healthcare delivery and promote patient engagement by providing consistent education using a teaching tool. The project question addressed the impact of a labor-induction teaching tool on improving patient education, participation, and overall satisfaction. The Plan-Do-Study-Act (PDSA) model was used to plan, implement, and …

Development And Evaluation Of A Peer-To-Peer Intervention To Increase Self-Management Among Adult In-Center Hemodialysis Patients, Jennifer J. St Clair Russell

Theses and Dissertations

Background: Peer-to-peer (P2P) support programs have the potential to assist ESRD patients in managing their disease and improve outcomes. Yet, there is little research examining P2P programs’ impact on psychosocial outcomes and disease management behaviors.

Methods: A 4-month P2P mentoring intervention was designed and piloted in a facility serving 249 in-center hemodialysis patients in Lynchburg, Virginia. Preceded by a social marketing effort, which included a program naming contest and participant recruitment, the intervention included: (1) mentor training, (2) pairing of mentees and mentors, (3) kick-off social mixers, (4) ongoing meetings between mentees and mentors, (5) mentor training booster, and (6) …

An Unusual Case Of Cauda Equina Secondary To Spinal Metastasis Of Thyroid Cancer, Shabbir Akhtar, Mohammad Adeel

Department of Surgery Docs

Abstract

INTRODUCTION:

Cauda equina secondary to metastatic follicular thyroid cancer of the lumbosacral area is a rare entity.

CASE REPORT:

We report an unusual case of a 52-year-old male who presented with backache, lower limb weakness, and perianal numbness. A CT-scan of the lumbosacral area showed an enhancing mass at the L4, L5 and S1 vertebrae. Histopathology after excision revealed a metastatic thyroid cancer. Hence, a CT scan of the neck and chest was performed which showed a nodule in the left lobe of the thyroid and a mass in the left chest wall. A total thyroidectomy and excision of …

Autologous Transplant In Lymphomas In Current Era Of Immunotherapy, Natasha Ali, Mohammad Khurshid

Department of Pathology and Laboratory Medicine

No abstract provided.

Clinico-Pathological Profile And Outcomes Of Patients With Polycythaemia Vera, Essential Thrombocythaemia And Idiopathic Myelofibrosis: A Tertiary Care Center Experience From Southern Pakistan, Muhammad Shariq Shaikh, Mohammad Usman Shaikh, Salman Naseem Adil, Mohammad Khurshid, Zeeshan Ansar Ahmed

Department of Pathology and Laboratory Medicine

Background: The “Philadelphia Negative Classic Myeloproliferative Neoplasms” include polycythaemia vera (PV), essential thrombocythaemia (ET) andidiopathic myelofibrosis (IMF). These three disorders share several clinical and laboratory features including JAK2 V617F mutation. Our objectives were to determine the clinicoat hological profile and outcomes of Pakistani patients with polycythaemia vera (PV), essential thrombocythaemia (ET) and idiopathic myelofibrosis (IMF) in order to have an insight regarding behaviour of these conditions.
Methods: A retrospective analysis of all the cases of PV, ET and IMF diagnosed at our institute from January 1995 to December 2013 was performed.Age, gender, clinical presentation, laboratory investigations, treatment provided and …

Agreement Of Direct Antifungal Susceptibility Testing From Positive Blood Culture Bottles With The Conventional Method For Candida Species, Kauser Jabeen, Haresh Kumar, Joveria Farooqi, Raunaq Mehboob, Mary E. Brandt, Afia Zafar

Department of Pathology and Laboratory Medicine

Early availability of antifungal susceptibilities can ensure timely institution of targeted therapy in candidemia, which can improve patient outcomes. This study prospectively determines the agreement between the results of direct testing of antifungal susceptibilities from blood culture bottles by disk diffusion and Etest and the results of standardized susceptibility testing methods; direct testing would allow susceptibility results to be available 1 to 2 days earlier. A total of 104 blood cultures with different Candida species (28% C. albicans, 27% C. parapsilosis, 26% C. tropicalis, etc.) were evaluated between January 2012 and May 2013 for agreement of fluconazole, voriconazole, and amphotericin …

Central, Extraventricular And Atypical Neurocytomas: A Clinicopathologic Study Of 35 Cases From Pakistan Plus A Detailed Review Of The Published Literature, Zubair Ahmad, Nasir Ud Din, Aisha Memon, Mohammad Usman Tariq, Romana Idrees, Sheema Hasan

Department of Pathology and Laboratory Medicine

Background: Central neurocytomas are rare neuronal neoplasms with a favorable prognosis. They are typically located in the lateral ventricles of the brain and mostly histologically correspond to WHO grade II with a Mib 1 labelling index of 2 % and are designated as "atypical neurocytomas.AIM: The aim of our study was to describe the common as well as unusual morphologic features and the role of various immunohistochemical stains in the diagnosis of these rare tumors.MATERIALS AND Methods: We retrieved and reviewed 35 cases diagnosed between 2001 and 2015.Results: Sixty percent of patients were males, and the mean age was 26 …

Errors In Surgical Pathology Reports: A Study From A Major Center In Pakistan, Zubair Ahmad, Romana Idrees, Nasir Uddin, Arsalan Ahmed, Saira Fatima

Department of Pathology and Laboratory Medicine

Background:
Errors in surgical pathology diagnosis can have serious consequences for the patient. Since the final product of a surgical pathology lab is the report, errors can be picked by reviewing reports of cases.AIM: To determine the frequency and types of error in surgical pathology reports of cases signed out in 2014 in a laboratory in Karachi, Pakistan.
Material and Methods:
All surgical pathology reports in which changes were made in the original report after sign out and an amended report was issued were included. Errors included: (1) misinterpretations; (2) missing critical information; (3) erroneous critical information; (4) misidentification; and …

Flaviviruses As A Cause Of Undifferentiated Fever In Sindh Province, Pakistan: A Preliminary Report, Erum Khan, Joveria Q. Farooqi, Kelli L. Barr, Dhani Prakoso, Amna Nasir, Akbar Kanji, Sadia Shakoor, Faisal Riaz Malik, Rumina Hasan, John A. Lednicky

Department of Pathology and Laboratory Medicine

Arboviral diseases are expanding worldwide, yet global surveillance is often limited due to diplomatic and cultural barriers between nations. With human encroachment into new habitats, mosquito-borne viruses are also invading new areas. The actual prevalence of expanding arboviruses is unknown in Pakistan due to inappropriate diagnosis and poor testing for arboviral diseases. The primary objective of this study was to document evidence of flavivirus infections as the cause of undifferentiated fever in Pakistan. Through a cooperative effort between the USA and Pakistan, patient exposure to dengue virus (DENV), West Nile virus (WNV), and Japanese encephalitis virus (JEV) was examined in …

Sporadic Early Onset Colorectal Cancer In Pakistan: A Case- Control Analysis Of Microsatellite Instability, Sabeehuddin Siddique, Kanwal Tariq, Sobia Rafiq, Ahmed Raheem, Rashida Ahmed, Munira Shabbir-Moosajee, Kulsoom Ghias

Department of Pathology and Laboratory Medicine

Background: Early onset sporadic colorectal cancer (CRC) is a biologically and clinically distinct entity hypothesized to exhibit differences in histological features and microsatellite instability (MSI) as compared to typical onset CRC. This study compared the MSI status, mismatch repair enzyme deficiency and clinicopathological features of early onset (aged ≤45 years) with controls (>45 years).
Materials and Methods: A total of 30 cases and 30 controls were analyzed for MSI status using the Bethesda marker panel. Using antibodies against hMLH1, hMSH2 and hMSH6, mismatch repair protein expression was assessed by immunohistochemistry. Molecular characteristics were correlated with clinicopathological features.
Results: …

Determinants Of Activity Levels In African Americans With Mild Cognitive Impairment., Barry W. Rovner, Md, Robin J. Casten, Phd, Benjamin E. Leiby, Phd

Department of Neurology Faculty Papers

Engaging in cognitive, social, and physical activities may prevent cognitive decline. In a sample of older African Americans with mild cognitive impairment (MCI; N=221), we investigated the cross-sectional relationships between activity levels and participants' demographic, clinical, and neuropsychological characteristics. The average age of participants was 75.4 years (SD, 7.0); 177 (80.1%) were women. Participation in cognitive/social activities was positively associated with education, depression, literacy, mobility, instrumental activities of daily living (IADL), verbal learning, and subcomponents of executive function. A linear regression identified IADLs, education, depression, and verbal learning as independent predictors. Participation in physical activities was positively associated with sex, …

Depression And Anxiety: A Snapshot Of The Situation In Pakistan, Bilaal Ahmed, Syed Faaiz Enam, Zafar Iqbal, Ghulam Murtaza, Shahid Bashir

Medical College Documents

Background: Depression is a great cause of morbidity around the world. Not one person seems to escape the hollow dread that the disease can bring forth.
Aims: Although living in a large extended family which serves as a social support is common in Pakistan, why we still suffer from anxiety and depression just as often if not more than those in other countries?
Method: We checked studies conducted in different localities of Pakistan over the past 10 years to find prevalence values of anxiety and depression. Results: The values of anxiety and depression ranging from 22% to as high as …

International Consortium On Mammographic Density: Methodology And Population Diversity Captured Across 22 Countries, Valerie A. Mccormacka, Anya Burton, Isabel Dos-Santos-Silva, John H. Hipwell, Caroline Dickens, Dorria Salem, Rasha Kama, Mikael Hartman, Charmaine Pei Ling Lee, Kee-Seng Chia, Vahit Ozmen, Mustafa Erkin Aribal, Anath Arzee Flugelman, Martín Lajous, Ruy Lopez-Riduara, Megan Rice, Isabelle Romieu, Giske Ursin, Samera Qureshi, Huiyan Ma, Eunjung Lee, Carla H. Van Gils, Johanna O.P. Wanders, Sudhir Vinayak, Rose Ndumia, Steve Allen, Sarah Vinnicombe, Sue Moss, Jong Won Lee, Jisun Kim, Ana Pereira, Maria Luisa Garmendia, Reza Sirous, Mehri Sirous, Beata Peplonska, Agnieszka Bukowska, Rulla M. Tamimi, Kimberly Bertrand, Chisato Nagata, Ava Kwong, Celine Vachon, Christopher Scott, Beatriz Perez-Gomez, Marina Pollan, Gertraud Maskarinec, Graham Giles, John Hopper, Jennifer Stone, Nadia Rajaram, Soo-Hwang Teo, Shivaani Mariapun, Martin J. Yaffe, Joachim Schüz, Anna M. Chiarelli, Linda Linton, Norman F. Boyd

Imaging & Diagnostic Radiology, East Africa

Mammographic density (MD) is a quantitative trait, measurable in all women, and is among the strongest markers of breast cancer risk. The population-based epidemiology of MD has revealed genetic, lifestyle and societal/environmental determinants, but studies have largely been conducted in women with similar westernized lifestyles living in countries with high breast cancer incidence rates. To benefit from the heterogeneity in risk factors and their combinations worldwide, we created an International Consortium on Mammographic Density (ICMD) to pool individual-level epidemiological and MD data from general population studies worldwide. ICMD aims to characterize determinants of MD more precisely, and to evaluate whether …

Conformational Stability Of Digestion-Resistant Peptides Of Peanut Conglutins Reveals The Molecular Basis Of Their Allergenicity, Danijela Apostolovic, Dragana Stanic-Vucinic, Harmen H.J. De Jongh, Govardus A.H. De Jong, Jelena Radosavljevic, Milica Radibratovic, Julie A. Nordlee, Joseph L. Baumert, Milos Milcic, Steve L. Taylor, Nuria Garrido Clua, Tanja Cirkovic Velickovic, Stef J. Koppelman

Department of Food Science and Technology: Faculty Publications

Conglutins represent the major peanut allergens and are renowned for their resistance to gastrointestinal digestion. Our aim was to characterize the digestion-resistant peptides (DRPs) of conglutins by biochemical and biophysical methods followed by a molecular dynamics simulation in order to better understand the molecular basis of food protein allergenicity. We have mapped proteolysis sites at the N- and C-termini and at a limited internal segment, while other potential proteolysis sites remained unaffected. Molecular dynamics simulation showed that proteolysis only occurred in the vibrant regions of the proteins. DRPs appeared to be conformationally stable as intact conglutins. Also, the overall secondary …

Endothelial Cells Expressing Endothelial And Mesenchymal Cell Gene Products In Lung Tissue From Patients With Systemic Sclerosis-Associated Interstitial Lung Disease., Fabian A. Mendoza, Sonsoles Piera-Velazquez, John L. Farber, Carol Feghali-Bostwick, Sergio A. Jimenez

Department of Dermatology and Cutaneous Biology Faculty Papers

OBJECTIVE: To examine whether lung endothelial cells (ECs) from patients with systemic sclerosis (SSc)-associated interstitial lung disease (ILD) express mesenchymal cell-specific proteins and gene transcripts, indicative of the occurrence of endothelial-to-mesenchymal phenotypic transition (EndoMT).

METHODS: Lung tissue from 6 patients with SSc-associated pulmonary fibrosis was examined by histopathology and immunohistochemistry. Confocal laser microscopy was utilized to assess the simultaneous expression of EC and myofibroblast molecular markers. CD31+CD102+ ECs were isolated from the lung tissue of 2 patients with SSc-associated ILD and 2 normal control subjects, and the expression of EC and mesenchymal cell markers and other relevant genes was analyzed …

Complete Genome Sequence Of Highly Virulent Porcine Reproductive And Respiratory Syndrome Virus Variants That Recently Emerged In The United States, Aspen M. Workman, Timothy P.L. Smith, Fernando A. Osorio, Hiep L.X. Vu

Nebraska Center for Virology: Faculty Publications

A recent outbreak of particularly virulent disease caused by porcine reproductive and respiratory syndrome virus has occurred in swine herds across the United States. We report here the complete genome sequence of eight viral isolates from four Nebraska herds experiencing an outbreak of severe disease in 2016.

Domain I Of The 5′ Non-Translated Genomic Region In Coxsackievirus B3 Rna Is Not Required For Productive Replication, L. Jaramillo, S. Smithee, S. Tracy, N. M. Chapman

Nebraska Center for Virology: Faculty Publications

Domain I is a cloverleaf-like secondary structure at the 5′ termini of all enterovirus genomes, comprising part of a cis-acting replication element essential for efficient enteroviral replication. 5′ genomic terminal deletions up to as much as 55% of domain I can occur without lethality following coxsackie B virus infections. We report here that the entire CVB structural domain I can be deleted without lethality.

Reversion To Wildtype Of A Mutated And Nonfunctional Coxsackievirus B3cre(2c), Shane Smithee, Steven Tracy, Nora M. Chapman

Nebraska Center for Virology: Faculty Publications

The cis-acting replication element (CRE) in the 2C protein coding region [CRE(2C)] of enteroviruses (EV) facilitates the addition of two uridine residues (uridylylation) onto the virus-encoded protein VPg inorder for it to serve as the RNA replication primer. We demonstrated that coxsackievirus B3 (CVB3) is replication competent in the absence of a native (uridylylating) CRE(2C) and also demonstrated that lackof a functional CRE(2C) led to generation of 5’ terminal genomic deletions in the CVB3 CRE-knock-out (CVB3-CKO) population. We asked whether reversion of the mutated CRE(2C) occurred, thus permitting sustained replication, and when were 5’ terminal deletions generated during replication. Virions …

Replicating Single-Cycle Adenovirus Vectors Generate Amplified Influenza Vaccine Responses, Catherine M. Crosby, William E. Matchett, Stephanie S. Anguiano-Zarate, Christopher A. Parks, Eric A. Weaver, Larry R. Pease, Richard J. Webby, Michael A. Barry

Nebraska Center for Virology: Faculty Publications

Head-to-head comparisons of conventional influenza vaccines with ade- novirus (Ad) gene-based vaccines demonstrated that these viral vectors can mediate more potent protection against influenza virus infection in animal models. In most cases, Ad vaccines are engineered to be replication-defective (RD-Ad) vectors. In contrast, replication-competent Ad (RC-Ad) vaccines are markedly more potent but risk causing adenovirus diseases in vaccine recipients and health care workers. To harness antigen gene replication but avoid production of infectious virions, we de- veloped “single-cycle” adenovirus (SC-Ad) vectors. Previous work demonstrated that SC-Ads amplify transgene expression 100-fold and produce markedly stronger and more persistent immune responses than …