Medical Specialties Commons^™

In Vitro Three-Dimensional Skin Tissue Constructs, Tinashe Dereck Gombedza

Theses

Human skin provides fortification against peripheral threats which may compromise the integrity and health of the human body. Its presence as the largest human organ forms a protective barrier making it an effective first line of defence against pathogenic, chemical and physical damage. Tissue engineering technology has enabled the development of in vitro three-dimensional (3D) organotypic skin cultures in order to understand the skin's physiology and architecture. This advancement has enabled the use of 3D skin model platforms to study skin diseases and conditions as well as facilitate drug discovery, clinical research and cosmetic product development.

In this study, an …

Exploring The Impact Of A Training Programme On Acute Healthcare Professionals' Attitudes And Understanding Of Dementia, Orla Quirke

Theses

Acute healthcare professionals lack education and training in dementia care. This results in people with dementia having poorer outcomes when admitted to the acute healthcare setting. An overarching aim of The National Dementia Strategy (2014) is the provision of optimal care for people with dementia in all healthcare and community settings. In response to this, Dementia Elevator a national inter-professional suite of educational programmes were developed by Dublin City University and the Health Service Executive to help individuals, communities and health systems engage positively with people with dementia. This study aimed to evaluate the impact of a four-hour dementia training …

Use Of Antibiotics In Children Younger Than Two Years In Eight Countries: A Prospective Cohort Study, Elizabeth T. Rogawski, James A. Platts-Mills, Jessica C. Seidman, Sushil John, Mustafa Mahfuz, Manjeswori Ulak, Sanjaya K. Shrestha, Sajid Bashir Soofi, Zulfiqar Ahmed Bhutta, Anita K. M. Zaidi

Department of Paediatrics and Child Health

Objective: To describe the frequency and factors associated with antibiotic use in early childhood, and estimate the proportion of diarrhoea and respiratory illnesses episodes treated with antibiotics.
Methods: Between 2009 and 2014, we followed 2134 children from eight sites in Bangladesh, Brazil, India, Nepal, Pakistan, Peru, South Africa and the United Republic of Tanzania, enrolled in the MAL-ED birth cohort study. We documented all antibiotic use from mothers’ reports at twice-weekly visits over the children’s first two years of life. We estimated the incidence of antibiotic use and the associations of antibiotic use with child and household characteristics. We described …

Investigating The Practice And Capacity Of Paediatric Occupational Therapists To Promote The Physical Activity Levels Of Children In Western Australia, Sally Coombs

Theses: Doctorates and Masters

Reorientation of the Australian health care system to meet the increasing burden of disease requires health workers to develop a focus on disease prevention and health promotion. In Western Australia (WA) a priority area for the promotion of health involves increasing the physical activity levels (PAL) of children in accordance with Australia’s Physical Activity and Sedentary Behaviour Guidelines. There is substantial support in the literature for paediatric occupational therapists, who assist children to participate in a range of meaningful occupations, to incorporate the promotion of children’s PAL into their service. However, there is a dearth of research world-wide regarding occupational …

From Gd2o3suspension To Nanocomposite: Synthesis, Properties And Radiation Protection, Ly B. T. La

Theses: Doctorates and Masters

This study provides details for the design, preparation of an environmentally friendly, clinically safe and lightweight radiation protective shield made ofGd2O3/epoxy nanocomposite (Gd-nanocomposite) which is proposed as an alternative to traditional toxic lead (Pb)-based aprons for diagnostic X-ray protection. In theory, this particulate nanocomposite can possess significant features of both inorganic particles and organic polymeric matrices. However, in practice, its performance does not simply depend on the sum of the individual contributions of characteristics of the constituent phases but on the interaction of their inner interfaces and the homogeneous dispersion of inorganic particles in the polymer matrix.

The miniaturization of …

The Effect Of Sport Participation On Bone, Maggie M. Minett

Electronic Theses and Dissertations

Mechanical loading – or physical activity – is essential in the bone remodeling process as well as optimizing the densitometric and geometric properties of bone throughout the lifespan. Participation in sports is a common mode of physical activity that can enhance bone mass accrual at younger ages and facilitate bone mass maintenance at older ages. Research suggests that sport participation continued from adolescence into high school and college provides added benefits on aBMD and cortical bone measures and these benefits remain 10-15 years after retirement from sport. However, in most studies, the higher rates of bone loss after sport cessation …

Havoc In The Gut: Ipilimumab-Induced Prolonged Steroid Dependent Autoimmune Gastroenterocolitis., Abdul Aleem Md, Anam Malik Md, Eric Nellis Md, Hiral N. Shah Md

Department of Medicine

No abstract provided.

The Relationship Between Relative Strength Levels To Sprinting Performance In Collegiate 100-400m Sprinters, Philip Reuer

Electronic Theses and Dissertations

The purpose of this study was to determine the relationship between relative maximal (1RM) strength (i.e. back squat and power clean) to sprinting performance in 60-400m collegiate sprinters. A secondary purpose was to determine the distribution of athletes within the theoretical relationship between relative squat strength and performance capabilities. Fifty-six (n = 56) male and sixty-four (n = 64) female collegiate track and field sprinters were observed from DI (n = 88) and DII schools (n = 32) that participated in a year round strength and conditioning program. Maximal strength was divided by body weight to calculate relative strength and …

Effectiveness Of A Shoulder Strengthening Intervention On The Incidence Rate Of Glenohumeral Joint Instability Injuries, Michael Aderman

Electronic Theses and Dissertations

Context: Shoulder injuries are frequently sustained in American football due to the contact and collision aspect of the sport. Injuries to the shoulder account for about 10% to 20% of all musculoskeletal injuries that occur in football and the shoulder is the fourth most commonly injured joint behind the hand, knee and ankle. The effectiveness of the dynamic stabilizers of the glenohumeral joint is a factor that could affect the rate of injuries that occur at the joint. The CKCUEST has been shown to be an effective test for assessing the dynamic stability of the glenohumeral joint.
Objective: The purpose …

Speed Of Processing Training Results In Lower Risk Of Dementia, Jerri D. Edwards, Huiping Xu, Daniel O. Clark, Lin T. Guey, Lesley A. Ross, Frederick W. Unverzagt

Psychiatry & Behavioral Neurosciences Faculty Publications

Introduction: Cognitive training improves cognitive performance and delays functional impairment, but its effects on dementia are not known. We examined whether three different types of cognitive training lowered the risk of dementia across 10 years of follow-up relative to control and if greater number of training sessions attended was associated with lower dementia risk.

Methods: The Advanced Cognitive Training in Vital Elderly (NCT00298558) study was a randomized controlled trial (N = 2802) among initially healthy older adults, which examined the efficacy of three cognitive training programs (memory, reasoning, or speed of processing) relative to a no-contact control condition. …

Fdg Avid Breast Cancer Bone Metastases Silent On Ct And Scintigraphy: A Case Report With Radiologic-Pathologic Correlation, Daniel Jeong, Marilyn Bui, Daniel Peterson, Jaime Montilla-Soler, Kenneth L. Gage

Pathology and Cell Biology Faculty Publications

Bone is the one of the most common distant metastatic sites in breast cancer. Routine initial breast cancer staging evaluation typically includes computed tomography (CT) and skeletal scintigraphy while 18F fluorodeoxyglucose (FDG) positron emission tomography-computed tomography (PET-CT) is reserved for clinically high-risk cases. Since FDG PET-CT is not routinely performed during staging or surveillance evaluations, it is important for radiologists and clinicians to appreciate the limitations of bone metastasis detection on CT and scintigraphy. We present a case of bony metastases of invasive ductal carcinoma of the breast which were not detected on diagnostic CT or skeletal scintigraphy but were …

Carotid Endarterectomy In A Patient With Severe Internal Carotid Artery Stenosis With Persistent Trigeminal Artery And Ischemia Of The Anterior And Posterior Circulation, Melanie R. F. Greenway, Hussam A. Yacoub, Shweta Varade, Yevgeniy Isayev

Neurology Faculty Publications

Occurrence of cerebral ischemia in the posterior circulation as a result of severe internal carotid artery disease and persistent trigeminal artery is rare. An 81-year-old man with medical history of hypertension and ischemic stroke presented with dizziness, nausea, and mild dysarthria. Magnetic resonance imaging of the brain revealed acute infarcts in the left internal carotid artery territory. CT angiogram revealed a persistent trigeminal artery (PTA) and severe atherosclerosis. The patient developed new neurological symptoms and repeat imaging revealed new acute infarcts in the PTA distribution. After undergoing a left carotid endarterectomy with no complications, the patient was discharged to a …

Hippocampal Cholinergic Neurostimulating Peptide As A Possible Modulating Factor Against Glutamatergic Neuronal Disability By Amyloid Oligomers, Toyohiro Sato, Yoshiaki Ohi, Daisuke Kato, Masayuki Mizuno, Hiroshi Takase, Tetsuko Kanamori, Cesar V. Borlongan, Akira Haji, Noriyuki Matsukawa

Neurosurgery and Brain Repair Faculty Publications

Despite having pathological changes in the brain associated with Alzheimer's disease (AD), some patients have preserved cognitive function. A recent epidemiological study has shown that diet, exercise, cognitive training, and vascular risk monitoring interventions may reduce cognitive decline in at-risk elderly people in the general population. However, the details of molecular mechanisms underlying this cognitive function preservation are still unknown. Previous reports have demonstrated that enriched environments prevent the impairment of hippocampal long-term potentiation (LTP) through β2-adrenergic signals, when LTP is incompletely suppressed by synthetic amyloid-β (Aβ) oligomers. The cholinergic network from the medial septal nucleus (MSN) is also a …

Genetic And Histological Alterations Reveal Key Role Of Prostaglandin Synthase And Cyclooxygenase 1 And 2 In Traumatic Brain Injury–Induced Neuroinflammation In The Cerebral Cortex Of Rats Exposed To Moderate Fluid Percussion Injury, Hideki Shojo, Cesar V. Borlongan, Tadashi Mabuchi

Neurosurgery and Brain Repair Faculty Publications

After the initial insult in traumatic brain injury (TBI), secondary neurodegeneration occurs that is intimately associated with neuroinflammation. Prostaglandin (PG) synthases and cyclooxygenase (COX) 1 and 2 may contribute to inflammation in the brain. Temporal and spatial expression features of PG and COX1 and 2 following trauma may guide the development of antineuroinflammation strategies. Here, we examined PG synthase signaling and COX1 and 2 gene expression levels and COX-1- and 2-positive cell types and their temporal localization in TBI-induced brain in an effort to reveal their participation in the disease’s evolving neuroinflammation. Using brain samples from the cerebral cortex of …

Racial‐Ethnic Disparities In Acute Stroke Care In The Florida‐Puerto Rico Collaboration To Reduce Stroke Disparities Study, Ralph L. Sacco, Hannah Gardener, Kefeng Wang, Chuanhui Dong, Maria A. Ciliberti-Vargas, Carolina M. Gutierrez, Negar Asdaghi, W. Scott Burgin, Olveen Carrasquillo, Enid J. Garcia-Rivera, Ulises Nobo, Sofia Oluwole, David Z. Rose, Michael F. Waters, Juan Carlos Zevallos, Mary Robichaux, Salina P. Waddy, Jose G. Romano, Tatjana Rundek

Neurology Faculty Publications

Background: Racial‐ethnic disparities in acute stroke care can contribute to inequality in stroke outcomes. We examined race‐ethnic disparities in acute stroke performance metrics in a voluntary stroke registry among Florida and Puerto Rico Get With the Guidelines‐Stroke hospitals.

Methods and Results: Seventy‐five sites in the Florida Puerto Rico Stroke Registry (66 Florida and 9 Puerto Rico) recorded 58 864 ischemic stroke cases (2010–2014). Logistic regression models examined racial‐ethnic differences in acute stroke performance measures and defect‐free care (intravenous tissue plasminogen activator treatment, in‐hospital antithrombotic therapy, deep vein thrombosis prophylaxis, discharge antithrombotic therapy, appropriate anticoagulation therapy, statin use, smoking cessation counseling) …

Incidence Of Seizure Exacerbation And Seizures Reported As Adverse Events During Adjunctive Treatment With Eslicarbazepine Acetate: A Pooled Analysis Of Three Phase Iii Controlled Trials, Mar Carreño, Selim Benbadis, Francisco Rocha, David Blum, Hailong Cheng

Neurology Faculty Publications

No abstract provided.

Necrotizing Fasciitis Secondary To Aeromonas Infection Presenting With Septic Shock, Nikhil Bhatia, Manuel Castro-Borobio, John N. Greene, Sowmya Nanjappa

Pediatrics Faculty Publications

This report describes a case of necrotizing fasciitis presenting with septic shock due to an Aeromonas infection. The patient cut his foot while mowing the lawn and then spent time in a pool with black mold. He began feeling ill and developed swelling and a quarter-sized black area on his right lower extremity. Despite being hemodynamically unstable with systolic blood pressure in the low 70s, the patient was transferred to our facility from outside hospital 100 miles away. Upon arriving to facility, the patient appeared to be septic and the infected area of skin had grown. Irrigation and debridement were …

Oncoplastic Surgery: Keeping It Simple With 5 Essential Volume Displacement Techniques For Breast Conservation In A Patient With Moderate- To Large-Sized Breasts, Abhishek Chatterjee, Deniz Dayicioglu, Nazanin Khakpour, Brian J. Czerniecki

Surgery Faculty Publications

Oncoplastic surgery is an evolving field in breast surgery combining the strengths of breast surgical oncology with plastic surgery. It provides the surgeon the ability to excise large areas of the breast in the oncologic resection without compromising, and possibly improving, its aesthetic appearance. The purpose of this review is to provide a guide that could help a breast surgeon excise breast cancer in most areas of the breast using 5 oncoplastic techniques. These techniques would be used depending primarily on the location of the cancer in the breast and also on the size of the tumor.

A Pilot Study To Measure Dynamic Elasticity Of The Bladder During Urodynamics, Andrew F. Colhoun, Adam P. Klausner, Anna S. Nagle, Ashley W. Carroll, Robert W. Barbee, Paul H. Ratz, John E. Speich

Surgery Publications

AIMS: Previous studies using isolated strips of human detrusor muscle identified adjustable preload tension, a novel mechanism that acutely regulates detrusor wall tension. The purpose of this investigation was to develop a method to identify a correlate measure of adjustable preload tension during urodynamics.

METHODS: Patients reporting urgency most or all of the time based on ICIq-OAB survey scores were prospectively enrolled in an extended repeat fill-and-empty urodynamics study designed to identify a correlate of adjustable preload tension which we now call dynamic elasticity. Cystometric capacity was determined during initial fill. Repeat fills to defined percentages of capacity with passive …

Characterization Of Lower Urinary Tract Symptoms In Patients With Idiopathic Normal Pressure Hydrocephalus, Sarah C. Krzastek, William M. Bruch, Samuel P. Robinson, Harold F. Young, Adam P. Klausner

Surgery Publications

AIMS: The purpose of this study was to evaluate lower urinary tract symptoms (LUTS) in idiopathic normal pressure hydrocephalus (iNPH).

METHODS: Patients with new-onset iNPH were prospectively evaluated for LUTS via detailed history and physical, and administration of questionnaires from the International Consultation on Incontinence to assess incontinence (ICIq-UI), overactive bladder (ICIq-OAB), and quality of life (ICIq-LUTqol), as well as the American Urological Association Symptom Score bother scale. All patients with moderate-to-severe LUTS were offered urodynamic testing. Sub-analysis was performed based on gender, medical comorbidities, and age.

RESULTS: Fifty-five consecutive patients with iNPH completed the initial evaluation and surveys. Total …

Effect Of Exercise Position On Percent Changes In Serratus Anterior Muscle Thickness, Joseph M. Day

Physical Therapy Faculty Publications

Objective: A reliable method for measuring SA thickness with ultrasound imaging has been reported, yet the ability to detect differences in levels of contractility has yet to be established. The purpose of this study was to determine if there are differences in the percent change in thickness of the SA during four different exercise positions performed by healthy individuals.

Design: Observational study

Setting: Laboratory

Participants: Twenty-eight healthy participants, mean age 26 (SD 4, 57% female, 100% right handed)

Methods: Volunteers were positioned in a standardized sitting posture and anatomical landmarks were marked for ultrasound probe positioning. Two resting and two …

Tuberous Sclerosis Complex In The Western Cape, South Africa: The Clinical Presentation Features, E. Kija, B. Schlegel, Pauline Samia, M. Wessels, J. M. Wilmshurst

Paediatrics and Child Health, East Africa

Tuberous sclerosis complex (TSC) is a genetic neurocutaneous condition, which affects multiple organ systems. This study aimed to determine the presenting features of children with TSC in Cape Town, South Africa. A cross-sectional study was conducted at a TSC clinic, and clinical features at presentation were prospectively collected. Thirty-nine children (23 boys; median age 10 (range 1 - 26) years; median diagnosis age 16 (0 - 153) months) were recruited. Twenty-one (54%) children presented with focal seizures. Seven (18%) children had epileptic spasms. Skin manifestations led to a diagnosis in 13 (33%) and neuroimaging in 22 (56%) children. Antenatal screening …

The 17th International Congress On Infectious Diseases Workshop On Developing Infection Prevention And Control Resources For Low- And Middle-Income Countries, Sangeeta Sastry, Nadia Masroor, Gonzalo Bearman, Rana Hajjeh, Alison Holmes, Ziad Memish, Britta Lassmann, Didier Pittet, Fiona Macnab, Rachel Kamau, Evelyn Wesangula, Paras Pokharel, Paul Brown, Frances Daily, Fatma Amer, Jaime Torres, Miguel O’Ryan, Gunturu Revathi, Andre Bulabula, Shaheen Mehtar

Pathology, East Africa

Hospital-acquired infections (HAIs) are a major concern to healthcare systems around the world. They are associated with significant morbidity and mortality, in addition to increased hospitalization costs. Recent outbreaks, including those caused by the Middle East respiratory syndrome coronavirus and Ebola virus, have highlighted the importance of infection control. Moreover, HAIs, especially those caused by multidrug-resistant Gram-negative rods, have become a top global priority. Although adequate approaches and guidelines have been in existence for many years and have often proven effective in some countries, the implementation of such approaches in low- and middle-income countries (LMICs) is often restricted due to …

Babesiosis-Associated Immune Thrombocytopenia, Roshni Narurkar, Aleksandra Mamorska-Dyga, A Agarwal, John Nelson, Delong Liu

NYMC Faculty Publications

Thrombocytopenia is a common feature of babesiosis. The mechanism for thrombocytopenia in babesiosis remains elusive. We report a case of babesiosis with severe new onset immune thrombocytopenia (ITP). In addition to antibiotics treatment for babesiosis, ITP therapy was administered. ITP in the present case was most likely triggered by the babesia infection. The severity of ITP in this case was not proportional to the severity of parasitemia. The neoantigen triggering the autoimmune response in babesiosis requires further characterization.

Alcohol Use And Immune Reconstitution Among Hiv-Infected Patients On Antiretroviral Therapy In Nairobi, Kenya, Anthony Cagle, Christine Mcgrath, Barbra A. Richardson, Dennis Donovan, Sameh Sakr, Nelly Yatich, Richard Ngomoa, Agnes Chepngeno Langat, Grace John-Stewart, Michael Chung

Internal Medicine, East Africa

Studies on the effects of alcohol use on HIV disease progression have been contradictory, with at least one study finding a positive effect of low alcohol consumption on CD4 count. In addition, most such studies have taken place in the developed West. We investigated the association between alcohol use and immune reconstitution through CD4 count response among HIV-infected individuals on antiretroviral therapy (ART) at an urban sub-Saharan African clinic. This was a retrospective cohort study of treatment-naïve HIV-infected adults initiating ART in Nairobi, Kenya and followed for 12 months between January 2009 and December 2012. At enrollment, a standardized questionnaire …

Mhealth In Palliative Care For Cancer Patients & Care Givers, Newton Andebe, Peter Waiganjo, John Weru

Internal Medicine, East Africa

Patients and caregivers in palliative care experience multidimensional pain. In current practice, information about a cancer patient progress is known when they visit a clinic or make a distress call when their conditions worsen. This strategy is not efficient for systematic monitoring of symptoms, which is key in improving palliative care. Mobile phones have helped to transform healthcare through diagnosis, health education and symptoms management of chronic illnesses. In this study, a mobile phone assessment tool was implemented at an outpatient palliative care clinic for cancer patients in Aga Khan University Hospital, Nairobi. The usefulness of the mobile phone application …

Electrosensitization Increases Antitumor Effectiveness Of Nanosecond Pulsed Electric Fields In Vivo, Claudia Muratori, Andrei G. Pakhomov, Loree Heller, Maura Casciola, Elena Gianulis, Sergey Grigoryev, Shu Xiao, Olga N. Pakhomova

Bioelectrics Publications

Nanosecond pulsed electric fields are emerging as a new modality for tissue and tumor ablation. We previously reported that cells exposed to pulsed electric fields develop hypersensitivity to subsequent pulsed electric field applications. This phenomenon, named electrosensitization, is evoked by splitting the pulsed electric field treatment in fractions (split-dose treatments) and causes in vitro a 2- to 3-fold increase in cytotoxicity. The aim of this study was to show the benefit of split-dose treatments for in vivo tumor ablation by nanosecond pulsed electric field. KLN 205 squamous carcinoma cells were embedded in an agarose gel or grown subcutaneously as tumors …

Hla-Bw4-I-80 Isoform Differentially Influences Clinical Outcome As Compared To Hla-Bw4-T-80 And Hla-A-Bw4 Isoforms In Rituximab Or Dinutuximab-Based Cancer Immunotherapy, Amy Erbe, Wei Wang, Patrick Reville, Lakeesha Carmichael, Kyungmann Kim, Mehmet F. Ozkaynak, Paul Sondel

NYMC Faculty Publications

Killer-cell immunoglobulin-like receptors (KIRs) are a family of glycoproteins expressed primarily on natural killer cells that can regulate their function. Inhibitory KIRs recognize MHC class I molecules (KIR-ligands) as ligands. We have reported associations of KIRs and KIR-ligands for patients in two monoclonal antibody (mAb)-based trials: (1) A Children's Oncology Group (COG) trial for children with high-risk neuroblastoma randomized to immunotherapy treatment with dinutuximab (anti-GD2 mAb) + GM-CSF + IL-2 + isotretinion or to treatment with isotretinoin alone and (2) An Eastern Cooperative Oncology Group (ECOG) trial for adults with low-tumor burden follicular lymphoma responding to an induction course of …

Mechanisms Of Vasovagal Syncope In The Young: Reduced Systemic Vascular Resistance Versus Reduced Cardiac Output, Julian Stewart, Marvin Medow, R Sutton, Paul Visintainer, D Jardine, W Wieling

NYMC Faculty Publications

BACKGROUND: Syncope is a sudden transient loss of consciousness and postural tone caused by cerebral hypoperfusion. The most common form is vasovagal syncope (VVS). Presyncopal progressive early hypotension in older VVS patients is caused by reduced cardiac output (CO); younger patients have reduced systemic vascular resistance (SVR). Using a priori criteria for reduced CO ( downward arrowCO) and SVR ( downward arrowSVR), we studied 48 recurrent young fainters comparing subgroups of VVS with VVS- downward arrowCO, VVS- downward arrowSVR, and both VVS- downward arrowCO& downward arrowSVR. METHODS AND RESULTS: Subjects were studied supine and during 70-degrere upright tilt with a …

Role Of Dual Energy Computed Tomography Imaging In The Diagnosis Of Gout, Divya Jayakumar, S Sehra, S Anand, Gary Stallings, A Danve

NYMC Faculty Publications

Gout is a well-known inflammatory arthritis and affects four percent of the United States population. It results from the deposition of uric acid crystals in joints, tendons, bursae, and other surrounding tissues. Prevalence of gout has increased in the recent decade. Gout is usually seen in conjunction with other chronic comorbid conditions like cardiac disease, metabolic syndrome, and renal disease. The diagnosis of this inflammatory arthritis is confirmed by visualization of monosodium urate (MSU) crystals in the synovial fluid. Though synovial fluid aspiration is the standard of care, it is often deferred because of inaccessibility of small joints, patient assessment …