Medical Specialties Commons^™

Subsets Of Inflammatory Cytokine Gene Polymorphisms Are Associated With Risk Of Carcinogenic Liver Fluke Opisthorchis Viverrini-Associated Advanced Periductal Fibrosis And Cholangiocarcinoma., Arpa Surapaitoon, Sutas Suttiprapa, Eimorn Mairiang, Narong Khuntikeo, Chawalit Pairojkul, Jeffrey Bethony, Paul J Brindley, Banchob Sripa

Microbiology, Immunology, and Tropical Medicine Faculty Publications

Opisthorchis viverrini infection induces chronic inflammation, and a minor proportion of infected individuals develop advanced periductal fibrosis (APF) and cholangiocarcinoma (CCA). Inflammatory cytokines and/or their gene polymorphisms may link to these biliary pathologies. We therefore investigated associations among cytokine gene polymorphisms and cytokine production in 510 Thai cases infected with O. viverrini who presented with APF+ or APF−, as established by abdominal ultrasonography as well as in patients diagnosed with CCA. Levels of pro-inflammatory and anti-inflammatory cytokines were determined in culture supernatants after stimulation of peripheral blood mononuclear cells (PBMCs) with O. viverrini excretory-secretory (ES) products. Pro-inflammatory cytokines, IL-1β, IL-6, …

Complete Congenital Heart Block: A Case Of Multilevel Block., Ian W Hovis, David N Schidlow, Jeffrey P Moak

Pediatrics Faculty Publications

No abstract provided.

Corneal Edema And Keratitis Following Selective Laser Trabeculoplasty, E T. Liu, L S. Seery, A Arosemena, Tania Lamba, C J. Chaya

Ophthalmology Faculty Publications

Purpose

To describe three cases of keratitis following Selective Laser Trabeculoplasty(SLT).

Observations

Three females with a history of glaucoma presented with corneal edema, keratitis (endothelial, epithelial) and decreased visual acuity shortly after SLT. There was variable resolution of symptoms after starting treatment with oral antiherpetics and topical steroids.

Conclusions and importance

With the increase in usage of SLT as a treatment for glaucoma and subsequent reports of keratitis, it is imperative for ophthalmic surgeons to be aware of herpes simplex as a possible risk factor. Prompt treatment with antivirals and steroids can potentially prevent scarring and permanent …

Exploring Overlaps Between The Genomic And Environmental Determinants Of Lvh And Stroke: A Multicenter Study In West Africa, Abiodun M. Adeoye, Bruce Ovbiagele, Philip Kolo, Lambert Appiah, Akinyemi Aje, Oladimeji Adebayo, Fred Sarfo, Joshua Akinyemi, Gregory Adekunle, Francis Agyekum, Vincent Shidali, Okechukwu Ogah, Dan Lackland, Mulugeta Gebregziabher, Donna K. Arnett, Hemant K. Tiwari, Rufus Akinyemi, Ojo Olakanmi Olagoke, Ayodipupo Sikiru Oguntade, Taiwo Olunuga, Kelechi Uwanruochi, Carolyn Jenkins, Patrick Adadey, Henry Iheonye, Lukman Owolabi, Reginald Obiako, Samuel Akinjopo, Kevin Armstrong, Albert Akpalu, Adekunle Fakunle

Epidemiology and Environmental Health Faculty Publications

Background

Whether left ventricular hypertrophy (LVH) is determined by similar genomic and environmental risk factors with stroke, or is simply an intermediate stroke marker, is unknown.

Objectives

We present a research plan and preliminary findings to explore the overlap in the genomic and environmental determinants of LVH and stroke among Africans participating in the SIREN (Stroke Investigative Research and Education Network) study.

Methods

SIREN is a transnational, multicenter study involving acute stroke patients and age-, ethnicity-, and sex-matched control subjects recruited from 9 sites in Ghana and Nigeria. Genomic and environmental risk factors and other relevant phenotypes for stroke and …

Department Of Surgery Update, June 2017, 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, and more.

Eight-Year-Old Girl With Hepatomegaly, Becky Biqi Chen, Chitra Prasad, Joanna C Walsh, Dhandapani Ashok

Paediatrics Publications

CASE DESCRIPTION

An 8-year-old girl was referred for abdominal pain and elevated liver transaminases. She was previously healthy and was not on any medications. There was no prior history of blood transfusions, toxin exposures or parenteral nutrition. Her parents were nonconsanguineous, and of French and Irish descent. Her family has no history of liver diseases but maternal and paternal grandparents have elevated cholesterol. Her weight was 25.5 kg (27th percentile), height 127 cm (21st percentile) and body mass index (BMI) was 15.8 kg/m2 (42nd percentile). On abdominal examination, both liver and spleen were enlarged. There was no scleral icterus or …

Inhibition Of Mt1-Mmp Proteolytic Function And Erk1/2 Signalling Influences Cell Migration And Invasion Through Changes In Mmp-2 And Mmp-9 Levels, Mario A. Cepeda, Caitlin L. Evered, Jacob J.H. Pelling, Sashko Damjanovski

Paediatrics Publications

Membrane type-1 matrix metalloproteinase (MT1-MMP, MMP-14) is a unique protease that cleaves extracellular proteins, activates proMMPs, and initiates intracellular signalling. MCF-7 cells are non-invasive and deficient in MT1-MMP, MMP-2, and MMP-9 expression. We created an MCF-7 cell line (C2) that stably produces active MT1-MMP and demonstrated increased ERK1/2 phosphorylation. MAPK inhibition in this cell line showed an inverse relationship in MMP-2 and MMP-9 transcripts where levels of these genes increased and decreased, respectively. Using invasive MDA-MB 231 cells that endogenously produce MT1-MMP and have naturally high pERK levels, we demonstrated the identical inverse relationship between MMP-2 and -9 transcript and …

The Impact Of Youth Alert! Intervention In Reducing Violence In Schools, Douglas Wain, Hatim A. Omar, Said Shahtahmasebi

Pediatrics Faculty Publications

Youth violence has long-term adverse effects on both victims and their communities. Most interventional strategies have little or no impact on reducing violence because they target supporting the victims whilst ignoring a social environment that continually facilitates exposure to violence through social and entertainment media. This paper provides some supporting evidence that interventional strategies that target changing attitudes and behaviour at a very young age through education are likely to positively change behaviour.

The Role Of The Heart Score And Clinical Decision Units In Ed Patients With Chest Pain, Gregory Jasani, Jesse M. Pines, Caitlin Carter

Center for Health Care Quality

Every year, millions of patients present to Emergency Departments across the country complaining of chest pain. Even after traditional ED testing which includes electrocardiograms, laboratory testing, and chest radiography, chest pain patients still have a small but real risk of serious illness. The HEART score is a new tool that has been validated to help risk-stratify patients. Clinical Decision Units decrease cost and length of stay without compromising patient safety, allowing for complete evaluations of these patients.

Outcome Of Judet's Quadricepsplasty For Knee Contractures And The Effect Of Local Infiltration Of Epinephrine On Reducing Blood Loss, Akber Jalil Zuberi, Haroon Rashid, Rizwan Haroon Rashid, Moiz Ali, Pervaiz Hashmi

Section of Orthopaedic Surgery

Objective: To evaluate the effectiveness of Judet's quadricepsplasty for treatment of knee contractures and to identify the effect of local infiltration of epinephrine on blood loss associated with this procedure.
Methods: A retrospective cohort study was conducted in which all cases of knee contractures managed with Judet's quadricepsplasty from 1st January 2009 to 31st December 2013 were included and were divided into two groups. The epinephrine group included patients who were infiltrated with diluted epinephrine (1:400,000) along with xylocaine, around the operative field 15 min prior to the incision time, while the control group did not receive any infiltration. Judet's …

Extent Of Resection And Timing Of Surgery In Adult Low Grade Glioma, Farhan A. Mirza, Muhammad Shahzad Shamim

Section of Neurosurgery

Low grade glioma is a group of WHO grade II tumours including diffuse astrocytoma, oligodendroglioma, and oligoastrocytoma. Strong evidence exists in literature now to support early surgery and higher extent of safe resection in improving outcomes. In this review, we are highlighting some of the important studies done in the last few years specifically addressing timing of surgery and extent of resection.

Patterns, Control And Complications Of Diabetes From A Hospital Based Registry Established In A Low Income Country., J. Akhter, Asma Ahmed, Minaz Mawani, Laila Lakhani, Ayaz Kalsekar, Shehla Tabassum, Najmul Islam

Section of Diabetes, Endocrinology and Metabolism

Background: Diabetes registry enables practitioners to measure the characteristics and patterns of diabetes across their patient population. They also provide insight into practice patterns which can be very effective in improving care and preventing complications. The aim of this study was to assess the patterns, control levels and complications at the baseline of the patients attending clinic at the large tertiary care hospital in Karachi, Pakistan with the help of the registry. This can be used as a reference to monitor the control and also for a comparison between peer groups. Methods: This was a cross sectional study with the …

Neurology Training In Pakistan: Perspectives From Physicians In A Neurology Unit Working At Different Levels, Ali Zohair Nomani, Haris Majid Rajput, Misbah Ahmed

Pakistan Journal of Neurological Sciences (PJNS)

Pakistan is a developing country of South East Asia. It stands amongst the highest in the list of high disease burden countries including that for neurological diseases. The current number of trained neurologists in the country is extremely low and the facilities not too frequently available.

Case Of A Young Girl With Hemichorea Induced By Oral Contraceptive Pills, Syeda Saba Zaidi

Pakistan Journal of Neurological Sciences (PJNS)

Chorea is an involuntary movement disorder characterized by brief, abrupt, non-repetitive, non-rhythmic movements with dance-like appearance, moving from one body part to another. When chorea involves half of the body then the term hemi-chorea is used, which usually signify structural pathology in the contralateral Basal ganglia. Use of Oral contraceptive pills, is a well-established but a rare cause of hemi-chorea. Mechanism includes either re-activation of Sydenham's chorea or drug induced lupus erythematosus. Although our case does not have any systemic manifestation of lupus but ANA positivity likely favors later mechanism. We described a case of a young girl who developed …

Is Time Of Birth A Predictor Of Adverse Perinatal Outcome? A Hospital-Based Cross-Sectional Study In A Low-Resource Setting, Tanzania, Andrew H. Mgaya, Januarius Hinju, Hussein Kidanto

Faculty of Health Sciences, East Africa

Background Inconsistent evidence of a higher risk of adverse perinatal outcomes during off-hours compared to office hours necessitated a search for clear evidence of an association between time of birth and adverse perinatal outcomes.

Methods A cross-sectional study conducted at a tertiary referral hospital compared perinatal outcomes across three working shifts over 24 h. A checklist and a questionnaire were used to record parturients’ socio-demographic and obstetric characteristics, mode of delivery and perinatal outcomes, including 5th minute Apgar score, and early neonatal mortality. Risks of adverse outcomes included maternal age, parity, referral status and mode of delivery, and were assessed …

A Whole Lot Of Shakin' Going On: Movement Disorders Caused By Brain Trauma, Jack E. Hubbard, Samuel D. Hodge, Jr.

Cleveland State Law Review

There has been a lot of publicity directed to the consequence of brain trauma, such as headaches forgetfulness, irritability, and depression. That is only part of the sequelae. A little-known but challenging result of brain trauma is the development of or aggravation of a movement disorder such as a tremor, dystonia, a tic, or Parkinson’s Disease.

A movement disorder is an all-encompassing term that refers to a constellation of neurological issues that cause involuntary or voluntary movements or abnormal positioning of a body part. Various regions of the brain interact with each other to control movements of the body. If …

Beyond The Transition Of Adolescents And Young Adults With Sickle Cell Disease To Adult Care: Role Of Geography., Nina Anderson, James R. Eckman, Samir K. Ballas

Cardeza Foundation for Hematologic Research

No abstract provided.

A Case Of Severe Insulin Resistance In A Diabetic Patient Being Treated For Acute Promyelocytic Leukemia With Arsenic And Glucocorticoids, Eric Shiffrin, Md, Intekhab Ahmed, Md, Serge Jabbour, Md, Facp, Face, Kevin Furlong, Do

Division of Endocrinology, Diabetes and Metabolic Diseases Posters

Objective:

To present a case of severe insulin resistance in a patient with a new diagnosis of acute promyelocytic leukemia (APML) treated with all-trans retinoic acid (ATRA), arsenic, and high-dose glucocorticoids.

Poster presented at Thomas Jefferson University House Staff Quality and Safety conference.

Stages Of Chronic Kidney Disease And Soluble Transferrin Receptor (Stfr), Ferritin, Ratio, Faiza Alam Faiza Alam, Syeda Sadia Fatima, Sabeela Noor Sabeela Noor, Ahmed Bilal, Rehana Rehman

Department of Biological & Biomedical Sciences

Objective: To assess the ratio of soluble transferrin receptor to ferritin in different stages of chronic kidney disease.
Methods: This case-control study was conducted at the Aga Khan University Hospital and the Jinnah Postgraduate Medical Centre, Karachi, from January to September 2014, and comprised chronic kidney disease patients and healthy controls. Group 1 comprised controls, whereas groups 2, 3 and 4 had patients based on their mean glomerular filtration rate. SPSS 19 was used for data analysis.
Results: Of the 170 participants, 126(74.1%) were cases and 44(25.9%) were controls. The overall mean age was 55.87±3.48 years and the mean body …

Genome-Wide Chromatin Accessibility, Dna Methylation And Gene Expression Analysis Of Histone Deacetylase Inhibition In Triple-Negative Breast Cancer., Matias A Bustos, Matthew P Salomon, Nellie Nelson, Sandy C Hsu, Maggie L Dinome, Dave S B Hoon, Diego M Marzese

Articles, Abstracts, and Reports

Triple-negative breast cancer (TNBC), especially the subset with a basal phenotype, represents the most aggressive subtype of breast cancer. Unlike other solid tumors, TNBCs harbor a low number of driver mutations. Conversely, we and others have demonstrated a significant impact of epigenetic alterations, including DNA methylation and histone post-translational modifications, affecting TNBCs. Due to the promising results in pre-clinical studies, histone deacetylase inhibitors (HDACi) are currently being tested in several clinical trials for breast cancer and other solid tumors. However, the genome-wide epigenetic and transcriptomic implications of HDAC inhibition are still poorly understood. Here, we provide detailed information about the …

Modulation Of Bax And Mtor For Cancer Therapeutics., Rui Li, Chunyong Ding, Jun Zhang, Maohua Xie, Dongkyoo Park, Ye Ding, Guo Chen, Guojing Zhang, Melissa Gilbert-Ross, Wei Zhou, Adam I Marcus, Shi-Yong Sun, Zhuo G Chen, Gabriel L Sica, Suresh S Ramalingam, Andrew T Magis, Haian Fu, Fadlo R Khuri, Walter J Curran, Taofeek K Owonikoko, Dong M Shin, Jia Zhou, Xingming Deng

Articles, Abstracts, and Reports

A rationale exists for pharmacologic manipulation of the serine (S)184 phosphorylation site of the proapoptotic Bcl2 family member Bax as an anticancer strategy. Here, we report the refinement of the Bax agonist SMBA1 to generate CYD-2-11, which has characteristics of a suitable clinical lead compound. CYD-2-11 targeted the structural pocket proximal to S184 in the C-terminal region of Bax, directly activating its proapoptotic activity by inducing a conformational change enabling formation of Bax homooligomers in mitochondrial membranes. In murine models of small-cell and non-small cell lung cancers, including patient-derived xenograft and the genetically engineered mutant KRAS-driven lung cancer models, CYD-2-11 …

The 2016 Model Of The Clinical Practice Of Emergency Medicine, Francis L. Counselman, Kavita Babu, Mary Ann Edens, Diane L. Gorgas, Cherri Hobgood, Catherine A. Marco, Eric Katz, Kevin Rodgers, Leonard A. Stallings, Michael C. Wadman

Emergency Medicine Faculty Publications

Emergency medicine (EM) has a scientifically derived and commonly accepted description of the domain of its clinical practice. That document, “The Model of the Clinical Practice of Emergency Medicine” (EM Model), was developed through the collaboration of six organizations: the American Board of Emergency Medicine (ABEM), the administrative organization for the project, the American College of Emergency Physicians (ACEP), the Council of Emergency Medicine Residency Directors (CORD), the Emergency Medicine Residents' Association (EMRA), the Residency Review Committee for Emergency Medicine (RRC-EM), and the Society for Academic Emergency Medicine (SAEM). Development of the EM Model was based on an extensive practice …

Knowledge And Trends Of Caffeine Consumption Among Medical And Non Medical Students Of Lahore Pakistan, Mubashir Ahmad, Rashk E Hinna, Ahmad Tayyab

Pakistan Journal of Neurological Sciences (PJNS)

To determine the rate of the caffeine consumption among students and to assess side effects and benefits of the caffeine among medical and non-medical students. METHODOLOGY: This cross-sectional study was included medical and non-medical students of various institutes of Lahore. The study duration was three months from May 2014 to July 2014. A predesigned structured questionnaire was used to collect data from the students, Consent was obtained on the form beforehand. RESULTS: Astonishingly 98.6%(74) of medical and 97.4%(73) of the Non-Medical students said that they consume caffeine in one form or another, the most popular caffeinated product turned out to …

Infections In Post Stroke Setting: A Study From The Neurology Section Of Aga Khan University Hospital, Karachi, Rizwana Shahid, Azra Zafar, Mohammad Wasay

Pakistan Journal of Neurological Sciences (PJNS)

Stroke is one of the commonest neurological disorders, contributing to the major burden of inpatient and outpatient neurology services. Infections after the stroke are the major factor, contributingto prolonged hospital stay and poor outcome in term of increasing morbidity and mortality. The aim of this study is to define the different types of infections in post stroke patients and their impact on the outcome of patients with stroke. METHOD: This is a descriptive, cross sectional study, that was carried out in the section of Neurology, Department of Medicine at Aga Khan University Hospital, Karachi over the span of one year. …

Pain Perception In Latino Vs. Caucasian And Male Vs. Female Patients: Is There Really A Difference?, Molly Aufiero, Holly Stankewicz, Shaila Quazi, Jeanne Jacoby, Jill Stoltzfus

Jefferson Health - Northeast Papers (formerly Aria Health Papers)

INTRODUCTION: Pain is a common emergency department (ED) complaint. It is important to understand the differences in pain perception among different ethnic and demographic populations.

METHODS: We applied a standardized painful stimulus to Caucasian and Latino adult patients to determine whether the level of pain reported differed depending on ethnicity (N=100; 50 Caucasian [C], 50 Latino [L] patients) and gender (N=100; 59 female, 41 male). Patients had an initial pain score of 0 or 1. A blood pressure cuff was inflated 20 mm HG above the patient's systolic blood pressure and held for three minutes. Pain scores, using both a …

Microalbuminuria In Type-2 Diabetes Mellitus; The Tip Of Iceberg Of Diabetic Complications., Tauseef Ahmad, Imran Ulhaq, Minaz Mawani, Najmul Islam

Section of Diabetes, Endocrinology and Metabolism

Objective: To determine the prevalence of microalbuminuria and its association with hypertension and other diabetic complications among Type-2 diabetic patients attending at Aga Khan University Hospital Karachi.

Methods: 1280 Type-2 diabetes patients who visited the outpatient department of Aga Khan University Hospital from September 2014 to August 2016 were included in the study. Microalbuminuria was diagnosed if spot urinary microalbumin excretion was confirmed to be more than 20mg/l. Hypertension was diagnosed if BP >140/90 or already on antihypertensive medications. Other demographic, clinical and laboratory data were also recorded. Results: Microalbuminuria was diagnosed in 404(31.56%) patients and among these albuminuric patients …

Vitamin-D Toxicity And Other Non-Malignant Causes Of Hypercalcemia: A Retrospective Study At A Tertiary Care Hospital In Pakistan, Muhammad Naeem Khan, Qamar Masood, Mohammad Arsalan Siddiqui, Sabahat Naz, Najmul Islam

Section of Diabetes, Endocrinology and Metabolism

Background: Hypercalcemia is a common clinical problem; primary hyperparathyroidism and malignancy is commonest causes of hypercalcemia. Aetiology of hypercalcemia are changing, causes that were diseases of the past like Vitamin-D toxicity and milk alkali syndrome are observed more often. Vitamin-D deficiency is an important problem and overzealous replacement of Vitamin-D has been observed, suspected to cause toxicity.

Methods: This was a retrospective review of patients admitted at the Aga Khan University Hospital from January 2008 to December 2013 with hypercalcemia. We reviewed the electronic health records for laboratory and radiological studies, and discharge summaries to establish the cause of hypercalcemia. …

Myalgic Encephalomyelitis/Chronic Fatigue Syndrome Diagnosis And Management In Young People: A Primer, P Rowe, R Underhill, K Friedman, A Gurwitt, Marvin Medow, M Schwartz, N Speight, Julian Stewart, R Vallings, K Rowe

NYMC Faculty Publications

Myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) is a complex disease that affects children and adolescents as well as adults. The etiology has not been established. While many pediatricians and other health-care providers are aware of ME/CFS, they often lack essential knowledge that is necessary for diagnosis and treatment. Many young patients experience symptoms for years before receiving a diagnosis. This primer, written by the International Writing Group for Pediatric ME/CFS, provides information necessary to understand, diagnose, and manage the symptoms of ME/CFS in children and adolescents. ME/CFS is characterized by overwhelming fatigue with a substantial loss of physical and mental stamina. …

Comparison Of Online 6 Degree-Of-Freedom Image Registration Of Varian Truebeam Cone-Beam Ct And Brainlab Exactrac X-Ray For Intracranial Radiosurgery., Jun Li, Wenyin Shi, David W. Andrews, Maria Werner-Wasik, Bo Lu, Yan Yu, Adam Dicker Md, Phd, Haisong Lui

Department of Radiation Oncology Faculty Papers

PURPOSE: The study was aimed to compare online 6 degree-of-freedom image registrations of TrueBeam cone-beam computed tomography and BrainLab ExacTrac X-ray imaging systems for intracranial radiosurgery.

METHODS: Phantom and patient studies were performed on a Varian TrueBeam STx linear accelerator (version 2.5), which is integrated with a BrainLab ExacTrac imaging system (version 6.1.1). The phantom study was based on a Rando head phantom and was designed to evaluate isocenter location dependence of the image registrations. Ten isocenters at various locations representing clinical treatment sites were selected in the phantom. Cone-beam computed tomography and ExacTrac X-ray images were taken when the …

Zinc Transporters Ybtx And Znuabc Are Required For The Virulence Of Yersinia Pestis In Bubonic And Pneumonic Plague In Mice, Alexander G. Bobrov, Olga Kirillina, Marina Y. Fosso, Jacqueline D. Fetherston, M. Clarke Miller, Tiva T. Vancleave, Joseph A. Burlison, William K. Arnold, Matthew B. Lawrenz, Sylvie Garneau-Tsodikova, Robert D. Perry

Microbiology, Immunology, and Molecular Genetics Faculty Publications

A number of bacterial pathogens require the ZnuABC Zinc (Zn²⁺) transporter and/or a second Zn²⁺ transport system to overcome Zn²⁺ sequestration by mammalian hosts. Previously we have shown that in addition to ZnuABC, Yersinia pestis possesses a second Zn²⁺ transporter that involves components of the yersiniabactin (Ybt), siderophore-dependent iron transport system. Synthesis of the Ybt siderophore and YbtX, a member of the major facilitator superfamily, are both critical components of the second Zn²⁺ transport system. Here we demonstrate that a ybtX znu double mutant is essentially avirulent in mouse models of bubonic and pneumonic …