Medical Specialties Commons^™

Oscillation Phase Locking And Late Erp Components Of Intracranial Hippocampal Recordings Correlate To Patient Performance In A Working Memory Task, Jonathan K. Kleen, Markus E. Testorf, David W. Roberts, Rod C. Scott

Dartmouth Scholarship

In working memory tasks, stimulus presentation induces a resetting of intracranial temporal lobe oscillations in multiple frequency bands. To further understand the functional relevance of this phenomenon, we investigated whether working memory performance depends on the phase precision of ongoing oscillations in the hippocampus. We recorded intra-hippocampal local field potentials in individuals performing a working memory task. Two types of trials were administered. For high memory trials presentation of a list of four letters ("List") was followed by a single letter memory probe ("Test"). Low memory load trials, consisting of four identical letters (AAAA) followed by a probe with the …

Stress Granules And Rna Processing Bodies Are Novel Autoantibody Targets In Systemic Sclerosis, Michael E. Johnson, Andrew V. Grassetti, Jaclyn N. Taroni, Shawn M. Lyons, Devin Schweppe, Jessica K. Gordon, Robert F. Speira, Robert Lafyatis, Paul J. Anderson, Scott A. Gerber, Michael L. Whitfield

Dartmouth Scholarship

Autoantibody profiles represent important patient stratification markers in systemic sclerosis (SSc). Here, we performed serum-immunoprecipitations with patient antibodies followed by mass spectrometry (LC-MS/MS) to obtain an unbiased view of all possible autoantibody targets and their associated molecular complexes recognized by SSc.

Expression And Functions Of Il-24 And Socs3 In Pseudomonas Aeruginosa Keratitis In A C57bl/6 Mouse Model, Bing Xu

Wayne State University Dissertations

The aim of this study was to elucidate the expression and functions of interleukin (IL)-24 and suppressor of cytokine signaling 3 (SOCS3), and their regulatory relationship in C57BL/6 mouse corneas in response to Pseudomonas aeruginosa (PA) infection. Among IL-20R cytokines, only IL-24 was induced at both mRNA and protein levels by the infection, and this upregulation was dampened by flagellin pretreatment. Time course studies revealed that IL-24 expression was markedly elevated, followed by a subsidence and second elevation, a pattern shared with SOCS3 but not IL-1β or IL-6. Silencing of IL-24 enhanced S100A8/A9 expression, and suppressed SOCS3, IL-1β, IL-1RN, and …

Essays On Healthy Aging From The Perspective Of A Health Production Function, Nasim Baghban Ferdows

Wayne State University Dissertations

This dissertation examines the determinants of healthy aging among older adults using Grossman’s framework of a health production function. Healthy aging is produced using a variety of inputs, including some determined in early life, such as health and socioeconomic status as a child, others determined in young adulthood, such as education, others determined in mid-life, such as household wealth, and still others determined in later-life, such as current health habits. A production function for healthy aging is estimated using nationally representative data from the 2010 Health and Retirement Study on non-institutionalized seniors, and positing a simultaneous equations mediation model, recognizing …

The Role Of Oxidative Stress In The Establishment Of Resistance To Cisplatin In Epithelial Ovarian Cancer Cells, Jimmy Belotte

Wayne State University Dissertations

Epithelial ovarian cancer is the deadliest of all gynecologic cancers with an estimated 22,280 new cases and 14,240 deaths expected in 2016 in the US alone. This high mortality rate can be partially attributed to a lack of universal screening and the development of resistance to the recommended chemotherapeutics. Typically, the treatment of ovarian cancer requires both cytoreductive surgery (CRS) and platinum/taxane combination chemotherapy. Initially, 50–80% of patients with advanced disease will achieve complete clinical response. Unfortunately, most will relapse within 18 months with chemoresistant disease. Thus, understanding the mechanisms of platinum resistance is critical in order to improve the …

Whsc1l1 Regulates Estrogen Receptor Activity In Sum44 Breast Cancer Cells, Jonathan Curtis Irish

Wayne State University Dissertations

Breast cancer is the most common cancer and the second leading

cause of cancer death in women. While ER-positive breast cancer subtypes are initially

well-managed by targeted therapies targeting estrogen signaling, many women are

suffering from recurrence of a more aggressive, hormone insensitive cancer 5 or more years after initial remission. Late recurrence of hormone resistant breast cancer in patients

who were previously successfully treated with anti-estrogen therapies worsens

overall long-term outcomes, and specific oncogenic mutations may be driving late recurring aggressive disease in these patients. More complete characterization of the oncogenome of

a tumor may allow for the possibility …

Structural Characterization And Therapeutic Utility Of The Proton-Coupled Folate Transporter, Michael Roy Wilson

Wayne State University Dissertations

Folate is a B9 vitamin essential to DNA synthesis. The proton-coupled folate transporter (PCFT) is a newly discovered proton/folate symporter with an acidic pH optimum and broad expression across a variety of solid tumor types, with limited expression in normal tissues. Several antifolate molecules have been developed as cancer therapeutics, although these classical antifolates display numerous off-target effects due to transport by the ubiquitous reduced folate carrier (RFC). In this dissertation, we determine the roles of multiple PCFT structure/function domains, and develop PCFT-specific antifolates to target solid tumors. We utilize substituted cysteine accessibility methods (SCAM) to identify a novel reentrant …

Inhibition Of Bacterial Growth And Prevention Of Bacterial Adhesion With Localized Nitric Oxide Delivery, Julia Osborne

Dissertations, Master's Theses and Master's Reports

Bacterial infections continue to be a problem at the site of an indwelling medical device, and over the years, various bacterial strains have become more resistant to current antibiotic treatments. Bacterial infection at an indwelling medical device can be dangerous and affect the performance of the medical device which can ultimately lead to the failure of the device due to bacterial resistance to treatment.

Nitric Oxide (NO) has been shown to possess antibacterial properties to prevent and inhibit bacterial growth. NO releasing coatings on indwelling medical devices could provide a reduction in bacterial infections that occur at the device site …

The Efficacy Of Psychosocial Services In Comprehensive Cancer Care: A Program Evaluation, Nicola B. Mucci

Antioch University Dissertations & Theses

On average, regardless of other factors, persons affected by cancer will experience some level of distress associated with the disease and its sequelae. Left untreated, psychosocial problems can, and often do, adversely affect a person's health and healthcare treatment. As a result, national initiatives have been implemented to recognize and treat psychosocial stressors to optimize a person's functioning and facilitate successful movement through the medical system. A program evaluation was conducted to examine how Providence Regional Cancer Partnership has addressed the psychosocial needs of its patient population. Specifically, the psychosocial services department, Patient Support Services, was evaluated to understand how …

Implementation Of Hiv Drug Resistance Testing In Kenya, Horacio Duarte, Ingrid Beck, James Munyao, Molly Levine, Catherine Kiptinness, Bhavna Chohan, Samah Sakr, Michael Chung, Lisa Frenkel

Internal Medicine, East Africa

Background: Testing for HIV drug resistance prior to antiretroviral therapy (ART) is standard of care in the United States but is rarely performed in Africa due to its high cost. The prevalence of HIV drug resistance is increasing in resource-limited settings (RLS). An affordable and feasible strategy is needed in RLS to identify individuals with drug resistance and prescribe effective ART. Our group developed a low-cost oligonucleotide ligation assay (OLA) that detects mutations conferring resistance. Little data exists on implementing HIV drug resistance testing in RLS. Here, we describe the implementation of OLA in one laboratory in Kenya and discuss …

794 Evaluating Disability In Adult Burn Injury Patients Treated At A Tertiary-Care Burn Unit In Karachi, Pakistan: A Longitudinal Study Using Who Disability Assessment Schedule Ii, Nukhba Zia, Asim Durrani, Safia Awan, Madiha Hashmi, Mazhar Nizam, Asad Latif

Department of Anaesthesia

Background: Disability after burn injury is not assessed in the context of Pakistan. This study assesses disability among adult burn injury patients presenting to a burn unit in Karachi, Pakistan.
Methods: This longitudinal study was conducted at a burn centre is Karachi, Pakistan. Adult patients(>18 years) who were discharge after 24-hour admission were enrolled from August 2014–March 2015. Baseline assessment before discharge and follow-up at 2,6 and 12 weeks after discharge via telephone was done using 12-item WHODAS 2.0 (5 -point likert-scale; 1 = none; 2 = mild; 3 = moderate; 4 = severe; and 5 = extreme) related …

Frequency, Indications And Complications Of Pulmonary Artery Catheter Insertion In Adult Open-Heart Surgery Patients Of A Tertiary Care Hospital, Syed Shabbir Ahmed, Mohammad Irfan Akhtar, Rehana Kamal

Department of Anaesthesia

Background: Patients presenting for cardiac surgery have unstable cardiovascular disease and haemodynamics with multiple coexisting diseases. Optimal monitoring in the perioperative period is very important for best perioperative outcome. The introduction of the flow-directed pulmonary artery catheter (PAC) into clinical practice is one of the most important and popular advances in the field of cardiac anaesthesia. The objective of the study was to determine the frequency, indications and complications of pulmonary artery catheter insertion in adult open-heart surgery patients.Methods: A Prospective observational study was conducted at cardiac operating rooms and Cardiac Intensive care unit (CICU) of Aga Khan University Hospital …

A Case Of Refractory Thrombotic Thrombocytopenic Purpura Treated With Plasmapheresis And Rituximab, Nicholas Kirui, Ahmed Sokwala

Internal Medicine, East Africa

Thrombotic thrombocytopenic purpura (TTP) is a rare, life-threatening disorder with no prevalence or incidence studies in sub-Saharan Africa. Acquired TTP has several causes, all of which lead to decreased activity of von Willebrand factor cleaving protease (ADAMTS13) due to autoantibodies that are directed towards ADAMTS13. We report a case of a 46-year-old man who presented with most of the classic clinical manifestations of TTP.

Short Communication: Analysis Of Minor Populations Of Human Immunodeficiency Virus By Primer Identification And Insertion-Deletion And Carry Forward Correction Pipelines, Paul Hughes, Wenjie Deng, Scott C. Olson, Robert W. Coombs, Michael Chung, Lisa M. Frenkel

Internal Medicine, East Africa

Accurate analysis of minor populations of drug-resistant HIV requires analysis of a sufficient number of viral templates. We assessed the effect of experimental conditions on the analysis of HIV pol 454 pyrosequences generated from plasma using (1) the ‘‘Insertion-deletion (indel) and Carry Forward Correction’’ (ICC) pipeline, which clusters sequence reads using a nonsubstitution approach and can correct for indels and carry forward errors, and (2) the ‘‘Primer Identification (ID)’’ method, which facilitates construction of a consensus sequence to correct for sequencing errors and allelic skewing. The Primer ID and ICC methods produced similar estimates of viral diversity, but differed in …

Symptoms In Women With Peripartum Cardiomyopathy: A Mixed Method Study, Harshida Patel, Marie Berg, Anders Barasa, Cecily Begley, Maria Schaufelberger

Internal Medicine, East Africa

Objective: Peripartum Cardiomyopathy is a form of cardiac disease often associated with cardiac failure, occurring in late pregnancy or after childbirth. The anatomical and physiological changes in the mother associated with normal pregnancy are profound, and this may result in symptoms and signs that overlap with Peripartum Cardiomyopathy, leading to missed or delayed diagnosis. Women's experiences of Peripartum Cardiomyopathy symptoms remain poorly studied. The aim of this study was to explore and descirbe women’s experiences of symptoms in Peripartum Cardiomyopathy.

Design: A triangulation of methods with individual interviews and data from medical records.

Setting: Mothers with Peripartum Cardiomyopathy diagnosis were …

A Global Reference For Caesarean Section Rates (C‐Model): A Multicountry Cross‐Sectional Study, J. P. Souza, A. P. Betran, A. Dumont, B De Mucio, Marleen Temmerman

Obstetrics and Gynaecology, East Africa

Objective: To generate a global reference for caesarean section (CS) rates at health facilities. Design Cross-sectional study.

Setting: Health facilities from 43 countries. Population/Sample Thirty eight thousand three hundred and twenty-four women giving birth from 22 countries for model building and 10 045 875 women giving birth from 43 countries for model testing.

Methods: We hypothesised that mathematical models could determine the relationship between clinical-obstetric characteristics and CS. These models generated probabilities of CS that could be compared with the observed CS rates. We devised a three-step approach to generate the global benchmark of CS rates at health facilities: …

Effects Of The Copper Intrauterine Device Versus Injectable Progestin Contraception On Pregnancy Rates And Method Discontinuation Among Women Attending Termination Of Pregnancy Services In South Africa: A Pragmatic Randomized Controlled Trial, G. Justus Hofmeyr, Mandisa Singata-Madliki, Theresa A. Lawrie, Eduardo Bergel, Marleen Temmerman

Obstetrics and Gynaecology, East Africa

Background: The copper intrauterine device (IUD) is under-utilised in South Africa, where injectable progestin contraception (IPC) dominates contraception usage. There is a lack of robust comparative data on these contraceptive options to inform policy, programs, clinical counseling, and women’s choices.

Methods: Within the context of a South African program to increase women’s access to the IUD, we conducted a pragmatic, open-label, parallel-arm, randomised controlled trial of the IUD versus IPC at two South African hospitals. The target sample size was 7,000 women and the randomisation ratio was 1:1. The random sequence was computer-generated and group allocation was concealed in sealed, …

Contraceptive Method Choice Among Women In Slum And Non-Slum Communities In Nairobi, Kenya, Rhoune Ochako, Chimaraoke Izugbara, Jerry Okal, Ian Askew, Marleen Temmerman

Obstetrics and Gynaecology, East Africa

Background: Understanding women’s contraceptive method choices is key to enhancing family planning services provision and programming. Currently however, very little research has addressed inter and intra-regional disparities in women’s contraceptive method choice. Using data from slum and non-slum contexts in Nairobi, Kenya, the current study investigates the prevalence of and factors associated with contraceptive method choice among women.

Methods: Data were from a cross-sectional quantitative study conducted among a random sample of 1,873 women (aged 15–49 years) in two non-slum and two slum settlement areas in Nairobi, Kenya. The study locations were purposively sampled by virtue of being part of …

Assessing Women's Satisfaction With Family Planning Services In Mozambique, Leonardo Chavane, Martinho Dgedge, Patricia Bailey, Osvaldo Loquiha, Marc Aerts, Marleen Temmerman

Obstetrics and Gynaecology, East Africa

Background: The contraceptive prevalence rate in Mozambique was estimated as 11.3% in the last Demographic and Health Survey. The impact of family planning (FP) on women’s health and on the reduction of maternal mortality is well known.

Methods: Acknowledging the importance of user satisfaction in the utilisation of health services, exit interviews were used to assess women’s satisfaction with FP services in Mozambique. The survey, conducted in 174 health facilities, was representative at the national level, covered all provinces, and both urban and rural areas.

Results: Overall, 86% of respondents were satisfied with FP services, but issues such as insufficient …

Scientific Basis For Standardization Of Fetal Head Measurements By Ultrasound: A Reproducibility Study, R. Napolitano, V. Donadono, E. O. Ohuma, C. L. Knight, Sikolia Wanyonyi, B. Kemp, T. Norris, A. T. Papageorghiou

Obstetrics and Gynaecology, East Africa

Objective: To compare the standard methods for ultrasound measurement of fetal head circumference (HC) and biparietal diameter (BPD) (outer-to-outer (BPDoo) vs outer-to-inner (BPDoi) caliper placement), and compare acquisition of these measurements in transthalamic (TT) vs transventricular (TV) planes.

Methods: This study utilized ultrasound images acquired from women participating in the Oxford arm of the INTERGROWTH-21st Project. In the first phase of the study, BPDoo and BPDoi were measured on stored images. In the second phase, real-time measurements of BPD, occipitofrontal diameter (OFD) and HC in TT and TV planes were obtained by pairs of sonographers. Reproducibility of measurements made by …

Near Real-Time Early Cancer Detection Using A Graphics Processing Unit, Jason Helms

EWU Masters Thesis Collection

"Automatically detecting early cancer using medical images is challenging, yet very crucial to help save millions of lives in the early stages of cancer. In this work, we improved a method that was originally developed by Yamaguchi et al. from the Saga University in Saga Japan. The original method would first decompose the endoscopic image into four color elements: red, green, blue and luminance (RGBL). Next each component is again decomposed to non-overlapping blocks of smaller images. Each smaller image undergoes two phases of DWT(s) and finally the Fractal Dimension (FD) is calculated per smaller image and abnormal regions are …

Parallel Profiles Of Inflammatory And Effector Memory T Cells In Visceral Fat And Liver Of Obesity-Associated Cancer Patients, Melissa Conroy, Karen Galvin, Suzanne Doyle, Maria Kavanagh, Ann-Marie Mongan, Aoife Cannon, Gillian Moore, John Reynolds, Joanne Lysaght

Articles

In the midst of a worsening obesity epidemic, the incidence of obesity-associated morbidities, including cancer, diabetes, cardiac and liver disease is increasing. Insights into mechanisms underlying pathological obesity-associated inflammation are lacking. Both the omentum, the principal component of visceral fat, and liver of obese individuals are sites of excessive inflammation, but to date the T cell profiles of both compartments have not been assessed or compared in a patient cohort with obesity-associated disease. We have previously identified that omentum is enriched with inflammatory cytokines, chemokines and T cells. Here, we compared the inflammatory profile of T cells in the omentum …

Methodologies And Considerations For Bladder Cancer Detection With Raman Based Urine Cytology, Laura T. Kerr, Thérése M. Lynn, Ivor M. Cullen, Padraig J. Daly, Nigam Shah, Shirley O'Dea, Alison Malkin, Bryan M. Hennelly

Articles

Bladder cancer has the highest recurrence rate of any cancer. The American Urological Association recommends cystoscopic surveillance every 3–6 months for 3 years, and at least once a year thereafter, particularly for high-risk patients; however, cystoscopy is invasive, expensive, and is not without insignificant morbidity for the patient. Urine cytology is often used as an adjunct to cystoscopy; however, it has a low sensitivity in detecting low grade bladder cancers. Recent studies have investigated the application of Raman micro-spectroscopy for the detection of bladder cancer via urine cytology, and it has been demonstrated to significantly improve the diagnostic sensitivity of …

Breastfeeding Education For Women With Diabetes, Pregnancy-Induced Hypertension And Multiple Gestations, Oluwapelumi Adefunmike Adeboyejo

Walden Dissertations and Doctoral Studies

Breastfeeding is considered a public health concern due to increased maternal/infant mortality and morbidity rates associated with persistent low rates in breastfeeding. Providing early breastfeeding education for women with diabetic, pregnancy-induced hypertension and multiple gestations can result in higher persistence rates and a decrease in maternal and infant mortality and morbidity rates. This quality improvement project provided early prenatal breastfeeding education for women with diabetes, pregnancy-induce hypertension and multiple gestations at a private clinic in Long Beach, Southern California. Evidence-based literature reviews were conducted through CINAHL and Medline (2009-2014). The descriptive study used for the project was made up questionnaires …

Improving Communication Between Cancer Patients And Providers During A 15-Minute Office Visit: A Systematic Review Of The Literature, Dr. Tammy Elizabeth Manganelli

Walden Dissertations and Doctoral Studies

Patients undergoing chemotherapy treatments for cancer often experience adverse side effects, including cognitive deficits. These deficits impact the patient's ability to communicate effectively with their oncology provider. Ineffective communication can adversely affect patient outcomes and decrease patient-provider satisfaction. The resulting poor communication can contribute to poor patient outcomes. This systematic literature review focused on assistive communication tools that could be used in an outpatient oncology setting to improve patient-provider communication. The literature review findings led to the development of a resource for providers that includes 15 communication tools that can be used to assess and improve communication in cancer care. …

Incidence And Factors Associated With Nonalcoholic Fatty Liver Disease Among Patients With Rheumatoid Arthritis, Ani K. John

Walden Dissertations and Doctoral Studies

Nonalcoholic fatty liver disease (NAFLD) has become one of the most common hepatic diseases worldwide, making the diagnosis and management of NAFLD an emerging public health issue. Theories associated with NAFLD surmise that inflammation may be the root cause, along with the complex interplay of other chronic conditions such as obesity, metabolic syndrome, diabetes, dyslipidemia, and cardiovascular disease (CVD). It is unknown if other inflammatory conditions such as rheumatoid arthritis (RA), along with the use of methotrexate (MTX), might confer increased risk for NAFLD. Longitudinal data collected from a retrospective cohort of 17,481 adult RA patients in the United States …

Complexity Of Prostate Cancer Diagnosis In African American Men In The United States, Adam B. Sumlin

Walden Dissertations and Doctoral Studies

Researchers have identified higher incidence rates and mortality rates among African American men (AAM) diagnosed with prostate cancer than they have among urban African American men. This quantitative descriptive study was conducted to measure the association between advanced stage and grade of prostate cancer, demographic location, and prostate specific antigen (PSA) levels over a 5-year period in AAM and European American men (EAM) in rural versus urban communities. This study addressed 4 research questions concerning cancer grade, cancer stage, age, geographic location, PSA level, and the impact that each of these variables had on prostate cancer diagnosis in AAM in …

The Association Of Cancer Development In Patients With Systemic Lupus Erythematosus, Rose Michelle Coley

Walden Dissertations and Doctoral Studies

The Association of Cancer Development in Patients with Systemic Lupus Erythematosus by

Rose Michelle Coley

MPH, Walden University, 2011

BS, University of Mount Olive, 2008

Dissertation Submitted in Partial Fulfillment

of the Requirements for the Degree of

Doctor of Philosophy

Public Health

Walden University

March 2016

Both cancer and autoimmune diseases have been associated with numerous factors that may independently lead to the development of either disease. When these factors overlap the difficulty in assessing association is compounded. The numerous factors that are thought to cause systemic lupus erythematosus (SLE), which leads to the development of cancer, makes the study …

Barriers To Exclusive Breastfeeding Among Mothers During The First Four Weeks Postpartum, Jessy V. Thomas

Walden Dissertations and Doctoral Studies

According to the World Health Organization, breastfeeding is natural and the most effective way of nourishment to feed infants and young children to ensure child health and survival. Currently, the World Health Organization, the American Academy of Pediatrics, and other health organizations recommend exclusive breastfeeding during the first 6 months of life. Although exclusive breastfeeding has been shown to reduce the occurrence of adverse health outcomes to the infant and mother, the duration of exclusive breastfeeding remains relatively low in the United States. The theory of planned behavior was used as a theoretical framework for this study. The purpose of …

A Plan For The Implementation And Evaluation Of Diet Education In Type 2 Diabetes, Soy Ramsumeer

Walden Dissertations and Doctoral Studies

Abstract

Type 2 Diabetes Mellitus (T2DM) is the seventh leading cause of death in the United States with a projected increase of 552 million people worldwide who will be affected with this illness by 2030. The need to address this issue is vital to prevent complications and reduce healthcare spending. The DNP project is aimed at planning and designing a nutritional education program tailored toward specific ethnic groups in order to increase knowledge in making healthy food choices. This project is intended to educate Registered Nurses (RNs) on nutrition so that they can offer dietary knowledge to T2DM patients. Additional …