Medical Specialties Commons^™

Association Of Matrix Metalloproteinase-9 And Tissue Inhibitor Of Metalloproteinase-1 Levels With Diabetic Foot Ulcer In Egyptians With Type 2 Diabetes Mellitus, Ayat I. Ghanem, Ghada H. Sayed, Ghada A. Omar, Mourad I. El-Kholy, Naglaa F. Mohamed

Journal of Medicine in Scientific Research

Background The imbalance between matrix metalloproteinase-9 (MMP-9) and tissue inhibitor of metalloproteinase-1 (TIMP-1) may play an important role in impaired healing of diabetic foot ulcer. Aim of the work This study was designed to investigate the association of MMP-9 and TIMP-1 levels in diabetic foot ulcer among Egyptian patients with type 2 diabetes mellitus attending the outpatient clinic of National institute of diabetes and endocrinology. Patients and methods This study was conducted on a total number of 90 participants comprising three groups: group I included 35 type 2 diabetic patients without foot ulcer. Group II included 35 type 2 diabetic …

Improvement Of Diastolic Dysfunction After Percutaneous Coronary Intervention In Patients With Ischemic Cardiomyopathy, Amir S. M. Melika

Journal of Medicine in Scientific Research

Introduction Impaired systolic cardiac function in patients with ischemic cardiac disease is well known. Diastolic cardiac dysfunction is also found in these patients, so we aimed to show whether percutaneous coronary intervention (PCI) could improve diastolic function. Patients and methods Twenty patients with chronic ischemic cardiomyopathy (with cardiac ejection fraction <45%) were examined at baseline and at 2 weeks after PCI diastolic function was evaluated by transmitral pulsed wave Doppler. Results Before PCI 60% of patients (12 patients) showed nonrestrictive filling pattern and 40% of patients (eight patients) showed restrictive filling pattern. Following PCI, diastolic function showed an improvement in most patients with only two patients still having an restrictive filling pattern. In addition, after revascularization, most parameters of pulsed …

Effects Of Iron-Deficiency Anemia On Auditory Function In School-Aged Children, Eman Soliman Abd El-Gaffar, Gehan M. S. Abd El-Salam, Hala M. Abd El-Samad

Journal of Medicine in Scientific Research

Introduction Iron is important for proper myelination of spinal cord and white matter of cerebellar folds in brain and is a cofactor for a number of enzymes involved in neurotransmitter synthesis. Auditory brainstem evoked response (ABR) represents the progressive activation of different levels of the auditory pathway from the acoustic nerve (wave I) to the lateral lemniscuses (wave V). Otoacoustic emissions (OAEs) are sounds measured in the external ear canal that reflect movement of the outer hair cells in the cochlea. Patients and methods A total of 40 children, of both sexes, with age ranging from 6–12 years old, were …

Auditory Brainstem-Evoked Response To Chirp And Click Stimuli In Children With Moderate And Severe Sensorineural Hearing Loss, Amal El-Attar, Enass Sayed, M Hoda Abu, Sanaa Mahran

Journal of Medicine in Scientific Research

Background Auditory brainstem response (ABR) using click stimuli enables global objective estimation of hearing threshold. The application of chirp stimuli aims to produce synchronized response from large portion of hair cells in the basilar membrane. The chirp was designed to produce simultaneous displacement maxima along the cochlear partition by compensating for frequency-dependent traveling-time differences. Objectives The study aimed to compare the response characteristic of both clicks and chirps stimuli in children. Accordingly, we compared latency and amplitude of wave V at different intensity levels and waves I and III at high levels. Moreover, we correlate between pure-tone audiometry (PTA) threshold …

Association Between The Metabolic Syndrome And C-Reactive Protein In The General Population, Amir S. M. Melika

Journal of Medicine in Scientific Research

Background In the last few years, metabolic syndrome (MS) has gained much attention. The definition of the MS was established in 2005. Some studies have shown that there is an association between MS and inflammation, proven by high-sensitivity C-reactive protein (hs-CRP), but in limited population-based studies. This study tried to show the association between MS and us-CRP in the general population. Patients and methods A total of 200 persons were included in this cross-sectional study. The guidelines from the National Heart, Lung, and Blood Institute and the American Heart Association were used in the diagnosis of MS. Any three of …

Maternal Outcomes After Different Surgical Techniques In Placenta Accreta: A Prospective Study, Ashraf M. Kansouh, Esmail M. Serag Eldin

Journal of Medicine in Scientific Research

Background Placenta accreta (PA) is a potentially life-threatening obstetric condition that requires a multidisciplinary approach to management nowadays owing to increased incidence of PA in parallel with the increased cesarean section rates. With the age of the patients with PA getting younger and fertility preservation being required, until now, there is no unique approach to management of PA. Objective The purpose of this study was to describe the efficacy and safety of different surgical procedure in conservative treatment of PA to evaluate their role in minimizing major surgical intervention, especially hysterectomy with its comorbidities. Patients and methods This prospective, surgical …

Anti-Cyclic Citrullinated Peptide Antibodies In Ulcerative Colitis With And Without Joint Involvement, Aisha El-Shimy, El Saied E. Shabaan, Hala I. Mohamed, Mohamed A. Safy, Tarek A. Fouad, Wael Gomah

Journal of Medicine in Scientific Research

Background Joint affection is the most common extraintestinal manifestation of ulcerative colitis (UC). Despite the high specificity of anti-cyclic citrullinated peptide (CCP) antibodies for rheumatoid arthritis, their role in UC remains unclear. Aim The aims of this study were to assess the prevalence of anti-CCP antibodies in patients with UC and to investigate any association with joint affection. Patients and methods A total of 60 patients with UC were studied. Demographic data were collected, careful history was taken, and clinical examination including rheumatologic examination was done. A blood sample was collected for assessment of anti-CCP and other laboratory tests. Colonoscopy …

Screening And Identification Of Red Blood Cell Alloantibodies Among Hemodialysis Patients In National Institute Of Urology And Nephrology, Ahmed Hasan, Aisha M. A. Elshimy, Tarek A. Fouad

Journal of Medicine in Scientific Research

Background It is well known that alloimmunization to red blood cell antigens resulting from the genetic disparities between the donor and the recipient is one of the risks of blood transfusion. Alloimmunization can result in clinical hemolysis and difficulty in cross-matching blood. The risk of alloimmunization is higher in patients who have received multiple blood transfusions such as renal failure patients on dialysis who receive blood transfusions. The antibody-screening test (2–3 cells panel) used to detect unexpected antibodies is not a mandatory pretransfusion testing in our blood bank of National Institute of Urology and Nephrology (NIUN), and is performed routinely …

Value Of Preoperative Luteinizing Hormone Before Laparoscopic Ovarian Drilling In Polycystic Ovarian Syndrome With Clomiphene Resistance, Ayman Abd-Elhakim Abd-Elghany Ibrahim, Mahmoud Elsayed Abd-Elrazek Mohammed Donia, Wael M. Hosam El-Din

Journal of Medicine in Scientific Research

Background Polycystic ovary syndrome (PCOS) is considered the most common endocrine-metabolic disorder in women in reproductive age with decreased rates of ovulation and metabolic alterations, with resulting subfertility. Clomiphene citrate (CC) is a widely used first-line treatment for infertile women with PCOS, but approximately 20% of patients have been shown to be CC resistant. Laparoscopic ovarian drilling (LOD) is a treatment option for infertile women with CC resistant PCOS. The use of a clinical biomarker such as luteinizing hormone (LH) to identify the subgroup of patients who are sensitive to LOD may be an important and consistent way to increase …

Immersive Virtual Reality For The Management Of Pain In Community-Dwelling Older Adults., Sara Benham, Minhee Kang, Namrata Grampurohit

Department of Occupational Therapy Faculty Papers

Immersive virtual reality (VR) can provide a high level of engagement and distraction analgesia to address pain. However, community-based applications of this technology for older adults have not been studied. The objective of this study was to examine the applicability and effectiveness of an immersive VR intervention for pain, depression, and quality of life (QOL) in older adults. This pretest–posttest, mixed-methods design included senior center members (n = 12) with pain that interfered with daily functioning. The outcomes included the Numeric Pain Rating Scale, Patient-Reported Outcomes Measurement Information System (PROMIS^®) depression scale, World Health Organization Quality of Life …

The Relative Financial Cost And Benefit Of An Ophthalmology Resident Compared To An Advanced Practice Provider, Optometrist, Or Faculty Ophthalmologist, Daniel B. Moore, William Barr

Ophthalmology and Visual Science Faculty Publications

Objective The main objective of the article is to determine the relative direct financial cost and benefit of an advanced practice provider (APP), optometrist, and faculty ophthalmologist compared with an ophthalmology resident.

Design Single center cost–benefit financial analysis.

Methods The direct total expenses, including mean salary and benefits; the cost/week, based upon calculated hours worked; and net revenue, based upon technical collections subtracted from total expenses were collected for all APPs, optometrists, faculty ophthalmologists, and ophthalmology residents at the University of Kentucky for the 2016 to 2017 academic year. Optometry and ophthalmology faculty collections were adjusted for clinical full-time equivalents. …

Implantable Biomaterials To Provide Local Immunotherapy Following Surgical Resection., Michael J Gough, Jason R Baird, R Bryan Bell

Articles, Abstracts, and Reports

No abstract provided.

Assessment Of Inequalities In Coverage Of Essential Reproductive, Maternal, Newborn, Child, And Adolescent Health Interventions In Kenya, Emily Catherine Keats, Nadia Akseer, Zaid Bhatt, William Macharia, Anthony Ngugi, Arjumand Rizvi, Zulfiqar Ahmed Bhutta

Paediatrics and Child Health, East Africa

Importance: Previous work has underscored subnational inequalities that could impede additional health gains in Kenya.

Objective: To provide a comprehensive assessment of the burden, distribution, and change in inequalities in reproductive, maternal, newborn, child, and adolescent health (RMNCAH) interventions in Kenya from 2003 to 2014.

Design, Setting, and Participants: This population-based cross-sectional study used data from the 2003, 2008, and 2014 Kenya Demographic and Health Surveys. The study included women of reproductive age (ages 15-49 years) and children younger than years, with national, regional, county, and subcounty level representation. Data analysis was conducted from April 2018 to November 2018.

Exposures: …

Checkpoint Inhibitors: What Gastroenterologists Need To Know., Monjur Ahmed

Division of Gastroenterology and Hepatology Faculty Papers

Checkpoint inhibitors are increasingly being used in clinical practice. They can cause various gastrointestinal, hepatic and pancreatic side effects. As these side effects can be serious, appropriate management is essential. The different checkpoint inhibitors with their mechanisms of action and indications, as well as evaluation and management of gastrointestinal, hepatic and pancreatic side effects, are discussed in this article.

The Addition Of Simvastatin Administration To Cold Storage Solution Of Explanted Whole Liver Grafts For Facing Ischemia/Reperfusion Injury In An Area With A Low Rate Of Deceased Donation: A Monocentric Randomized Controlled Double-Blinded Phase 2 Study., Duilio Pagano, Elisabetta Oliva, Simone Khouzam, Fabio Tuzzolino, Davide Cintorino, Sergio Li Petri, Fabrizio Di Francesco, Calogero Ricotta, Pasquale Bonsignore, Alessandro Tropea, Sergio Calamia, Federico Costanzo, Angelo Luca, Salvatore Gruttadauria

Student Papers, Posters & Projects

BACKGROUND: Liver transplantation is the best treatment for end-stage liver disease. The interruption of the blood supply to the donor liver during cold storage damages the liver, affecting how well the liver will function after transplant. The drug Simvastatin may help to protect donor livers against this damage and improve outcomes for transplant recipients. The aim of this study is to evaluate the benefits of treating the donor liver with Simvastatin compared with the standard transplant procedure.

PATIENT AND METHODS: We propose a prospective, double-blinded, randomized phase 2 study of 2 parallel groups of eligible adult patients. We will compare …

Interpersonal Violence In Peacetime Malawi., Rebecca G. Maine, Brittney Williams, Jennifer A. Kincaid, Gift Mulima, Carlos Varela, Jared R. Gallaher, Trista D. Reid, Anthony G. Charles

Department of Surgery Faculty Papers

Background: The contribution of interpersonal violence (IPV) to trauma burden varies greatly by region. The high rates of IPV in sub-Saharan Africa are thought to relate in part to the high rates of collective violence. Malawi, a country with no history of internal collective violence, provides an excellent setting to evaluate whether collective violence drives the high rates of IPV in this region.

Methods: This is a retrospective review of a prospective trauma registry from 2009 through 2016 at Kamuzu Central Hospital in Lilongwe, Malawi. Adult (>16 years) victims of IPV were compared with non-intentional trauma victims. Log binomial …

Breast Injury During Sport Participation, Laura J. Smith, Tamara Eichelberger, Elizabeth Miller, Edward J Kane

Athletic Training Collection

A recent study found that almost half (47.9%), of female college athletes participating in basketball, soccer, volleyball and softball (n = 194) suffered a breast injury during their college career with less than 10% reporting their injury to health personnel with only 2.1% receiving treatment ^[1]. Breast injury in female athletes is under-reported and is lacking a much-needed level of awareness in sport. If there is a void in awareness of breast injuries and in reporting breast injuries, preventive measures as well as any potential sequela from the injury will not be given the necessary attention.

Targeted Therapies For Advanced Non-Small Cell Lung Cancer, Xiaojuan Ai, Xialing Guo, Jun Wang, Andreea L Stancu, Patrick M N Joslin, Dianzheng Zhang, Shudong Zhu

PCOM Scholarly Works

Lung cancer is a serious health problem and the leading cause of cancer death worldwide, due to its high incidence and mortality. 85% of lung cancers are represented by the non-small cell lung cancer (NSCLC). Traditional chemotherapy has been the main treatment option in NSCLC. However, it is often associated with limited efficacy and overall poor patient survival. In recent years, molecular targeting has achieved great progress in therapeutic treatment of cancer and plays a crucial role in the current clinical treatment of NSCLC, due to enhanced efficacy on cancer tissues and reduced toxicity for normal tissues. In this review, …

In Vitro Growth Of Human Ovarian Follicles For Fertility Preservation, Diego Marin, Min Yang, Tianren Wang

Department of Biochemistry and Molecular Biology Faculty Papers

Young female cancer survival rates significantly increased due to the great progress of cancer therapy. In fact, cryostorage and transplantation of ovarian tissue have already resulted in the birth of healthy babies. Follicle in vitro growth (IVG) has the great potential of restoring fertility by achieving functional oocytes from the most immature stages to maturation. This is suitable for a wide range of patients, from pubertal to perimenopause women. Notable achievements have been achieved in human follicle IVG in the past decade. Mature oocytes have been successfully collected from long-term sequential follicle IVG. However, it is still a major challenge …

The Current Understanding Of Microrna's Therapeutic, Diagnostic, And Prognostic Role In Chordomas: A Review Of The Literature., Paul J Choi, Rod J Oskouian, R Shane Tubbs

Articles, Abstracts, and Reports

Chordomas are primary low-grade bone tumors derived from the embryonic notochord that make up less than 5% of all osseous malignancies and commonly affect the spine at its vertebral body and at its two ends i.e., skull base and the sacrum. Although histologically defined to be low-grade, chordoma is locally destructive, metastatic, and has a serious recurrence rate, which all contribute to the dismal median survival rate of six years. Its locally destructive nature places the adjacent vital neurovascular structures at risk, making an en-bloc resection a challenge. This tumor is also known to show high resistance to currently available …

Differential Expression Of Genes Related To Innate Immune Responses In Ex Vivo Spinal Cord And Cerebellar Slice Cultures Infected With West Nile Virus, Amber M. Paul, Parminder J.S. Vig, Deyin Lu, Ram Kuwar, Maria Lopez, Dobrivoje S. Stokic, A. Arturo Leis, Michael R. Garrett, Fengwei Bai

Publications

West Nile virus (WNV) infection results in a spectrum of neurological symptoms, ranging from a benign fever to severe WNV neuroinvasive disease with high mortality. Many who recover from WNV neuroinvasive infection present with long-term deficits, including weakness, fatigue, and cognitive problems. While neurons are a main target of WNV, other cell types, especially astrocytes, play an important role in promoting WNV-mediated central nervous system (CNS) damage. Conversely, it has been shown that cultured primary astrocytes secrete high levels of interferons (IFNs) immediately after WNV exposure to protect neighboring astrocytes, as well as neurons. However, how intrinsic responses to WNV …

Sarcoidosis Presenting As Acute Respiratory Distress Syndrome., Bilal Lashari, Ahmad Raza, Vincent Chan, William Ward

Abington Jefferson Health Papers

Sarcoidosis is a multisystem granulomatous disease of unknown origin. It typically involves the lungs and mediastinal lymph nodes in a chronic fashion. However, acute syndrome has been reported possibly in response to systemic release of proinflammatory cytokines. Acute pulmonary manifestations, especially acute respiratory failure or acute respiratory distress syndrome, remain extremely uncommon in individuals without a prior diagnosis. We present the case of a 41-year-old African American female, who presented with ARDS. An extensive workup into the cause of her illness remained negative, and she subsequently succumbed to her illness. A diagnosis of sarcoidosis was made upon autopsy, after exclusion …

Non-Pharmacological Solutions To Sleep And Circadian Rhythm Disruption: Voiced Bedside Experiences Of Hospice And End-Oflife Staff Caregivers, Rana Sagha Zadeh, Elizabeth Capezuti, Paul Eshelman, Nicole Woody, Jennifer Tiffany, Ana C. Krieger

Publications and Research

Background: Sleep disturbance is a significant issue, particularly for patients with advanced terminal illness. Currently, there are no practice-based recommended approaches for managing sleep and circadian disruptions in this population. To address this gap, a cross-sectional focus group study was performed engaging 32 staff members at four hospices/end-of-life programs in three demographically diverse counties in New York State.

Methods: Participants responded to structured open-ended questions. Responses were transcribed and subjected to qualitative content analysis. The themes and recommendations for improved practice that emerged were tabulated using Atlas TI qualitative software.

Results: This report details the experiences of hospice and end-of-life …

Prognostic Relevance Of Ccdc88c (Daple) Transcripts In The Peripheral Blood Of Patients With Cutaneous Melanoma, Ying Dunkel, Anna L. Reid, Jason Ear, Nicolas Aznar, Michael Millward, Elin Gray, Robert Pearce, Melanie Ziman, Pradipta Ghosh

Research outputs 2014 to 2021

A loss of balance between G protein activation and deactivation has been implicated in the initiation of melanomas, and non-canonical Wnt signaling via the Wnt5A/Frizzled (FZD) pathway has been shown to be critical for the switch to an invasive phenotype. Daple [CCDC88C], a cytosolic guanine nucleotide exchange modulator (GEM) which enhances non-canonical Wnt5A/FZD signaling via activation of trimeric G protein, Gαi, has been shown to serve opposing roles-as an inducer of EMT and invasiveness and a potent tumor suppressor-via two isoforms, V1 (full-length) and V2 (short spliced isoform), respectively. Here we report that the relative abundance of these isoforms in …

Oculomotor Nerve Palsy After Influenza Vaccine In Inflammatory Bowel Disease., Rajesh Essrani Md, Rajesh K Essrani, Shehriyar Mehershahi, Arjun K Lohana, Anuraj Sudhakaran

Department of Medicine

Influenza and pneumococcal vaccines are recommended in inflammatory bowel disease patients. Several neurologic complications have been reported after influenza vaccines, such as Guillain-Barre syndrome, chronic inflammatory demyelinating polyneuropathy, and acute disseminated encephalomyelitis; however, rarely, oculomotor palsy will occur. We report the case of a 23-year-old male with a past medical history of ulcerative colitis on sulfasalazine who presented to the hospital with a complaint of blurry vision five days after an influenza vaccine. Most of the possible causes of oculomotor nerve palsy, such as stroke, intracranial space-occupying lesions, aneurysms, and infections, were ruled out by history, physical exam, blood work, …

Monitoring Postoperative Opioid Use Following Simple Arthroscopic Meniscectomy: A Performance-Improvement Strategy For Prescribing Recommendations And Community Safety., Vance Gardner, David Gazzaniga, Michael Shepard, Robert Grumet, Benjamin Rubin, Michael Dempewolf, Camille Bray, Carlos Prietto

Articles, Abstracts, and Reports

Background: Orthopaedic surgeons are confronted with a difficult dilemma: managing acute pain postoperatively and balancing the risk of prescription opioid use. To our knowledge, a prospective performance-improvement project providing opioid-prescription recommendations based on the actual amounts of usual and customary medication consumed following simple knee meniscectomy has not been described.

Methods: One hundred and two patients undergoing arthroscopic knee meniscectomy prospectively recorded postoperative pain medications in a pain journal. Arthroscopic procedures were performed at 2 centers by 9 fellowship-trained senior surgeons. Various usual and customary prescribing protocols were observed, and the amount of medication consumed was recorded. Prescription and over-the-counter …

Spio Enhance The Cross-Presentation And Migration Of Dcs And Anionic Spio Influence The Nanoadjuvant Effects Related To Interleukin-1Β., Hui Liu, Heng Dong, Na Zhou, Shiling Dong, Lin Chen, Yanxiang Zhu, Hong-Ming Hu, Yongbin Mou

Articles, Abstracts, and Reports

Superparamagnetic iron oxide nanoparticles (SPIO) have been synthesized and explored for use as carriers of various nanoadjuvants via loading into dendritic cells (DCs). In our study, homogeneous and superparamagnetic nanoparticles are susceptible to internalization by DCs and SPIO-pulsed DCs showed excellent biocompatibility and capacity for ovalbumin (OVA) cross-presentation. Herein, we found that SPIO-loaded DCs can promote the maturation and migration of DCs in vitro. SPIO coated with 3-aminopropyltrimethoxysilane (APTS) and meso-2,3-dimercaptosuccinic acid (DMSA), which present positive and negative charges, respectively, were prepared. We aimed to investigate whether the surface charge of SPIO can affect the antigen cross-presentation of the DCs. …

Efficacy Of A T Cell-Biased Adenovirus Vector As A Zika Virus Vaccine, Brianna L. Bullard, Brigette N. Corder, Matthew J. Gorman, Michael S. Diamond, Eric A. Weaver

Nebraska Center for Virology: Faculty Publications

Zika virus (ZIKV) is a major public health concern due to the risk of congenital Zika syndrome in developing fetuses and Guillain-Barre syndrome in adults. Currently, there are no approved vaccines available to protect against infection. Adenoviruses are safe and highly immunogenic vaccine vectors capable of inducing lasting humoral and cellular immune responses. Here, we developed two Adenovirus (Ad) vectored Zika virus vaccines by inserting a ZIKV prM-E gene expression cassette into human Ad types 4 (Ad4-prM-E) and 5 (Ad5-prM-E). Immune correlates indicate that Ad5-prM-E vaccination induces both an anti-ZIKV antibody and T-cell responses whereas Ad4-prM-E vaccination only induces a …

The Role Of An Advanced Practice Provider (App) And Its Relation To Physician Shortages And Rural Healthcare Survival: A State-By-State Analysis, Allen Anderson

Dissertations, Theses, and Projects

The extent that Advanced Practice Providers (APPs) are able to practice independently with a full scope of practice varies state-by-state. The purpose of this paper was to review how APPs could help in a number of different areas of healthcare. This analysis examines the state of rural healthcare and reviews physician shortage statistics and hospital closures by state. In the examination, it also evaluates which states have full scope, reduced scope, and restricted scope of practice laws and cross-references that with states that have experienced a hospital closure. Through case studies, this research finds that APPs can be an alternative …

Regulators Of Oncogenic Mutant Tp53 Gain Of Function., Satomi Yamamoto, Tomoo Iwakuma

Manuscripts, Articles, Book Chapters and Other Papers

The tumor suppressor p53 (TP53) is the most frequently mutated human gene. Mutations in TP53 not only disrupt its tumor suppressor function, but also endow oncogenic gain-of-function (GOF) activities in a manner independent of wild-type TP53 (wtp53). Mutant TP53 (mutp53) GOF is mainly mediated by its binding with other tumor suppressive or oncogenic proteins. Increasing evidence indicates that stabilization of mutp53 is crucial for its GOF activity. However, little is known about factors that alter mutp53 stability and its oncogenic GOF activities. In this review article, we primarily summarize key regulators of mutp53 stability/activities, including genotoxic stress, post-translational modifications, ubiquitin …