Medical Specialties Commons^™

Neoantigen-Specific Cd4(+) T-Cell Response Is Critical For The Therapeutic Efficacy Of Cryo-Thermal Therapy, Peng Peng, Hong-Ming Hu, Ping Liu, Lisa X Xu

Articles, Abstracts, and Reports

Background: Traditional tumor thermal ablations, such as radiofrequency ablation (RFA) and cryoablation, can result in good local control of tumor, but traditional tumor thermal ablations are limited by poor long-term survival due to the failure of control of distal metastasis. Our previous studies developed a novel cryo-thermal therapy to treat the B16F10 melanoma mouse model. Long-term survival and T-cell-mediated durable antitumor immunity were achieved after cryo-thermal therapy, but whether tumor antigen-specific T-cells were augmented by cryo-thermal therapy was not determined.

Methods: The long-term antitumor therapeutic efficacy of cryo-thermal therapy was performed in B16F10 murine melanoma models. Splenocytes derived from mice …

Guidance For Contemporary Use Of Biologics In Management Of Chronic Rhinosinusitis With Nasal Polyps: Discussion From A National Institutes Of Health-Sponsored Workshop, Lauren T Roland, Timothy L Smith, Rodney J Schlosser, Zachary M Soler, Anju T Peters, Tanya M Laidlaw, Benjamin S Bleier, Vijay Ramakrishnan, Elina Toskala, David W Kennedy, Amber U Luong

Faculty, Staff and Student Publications

BACKGROUND: Biologic medications are emerging as options for treating chronic rhinosinusitis with nasal polyps (CRSwNP). Several questions remain regarding patient selection, indications, clinical efficacy, and cost effectiveness.

METHODS: In November 2019, a group of physicians and scientists gathered to consider strategies for future studies regarding biologics. During the discussion, gaps in knowledge highlighted a need for a consensus on the present day use of biologics in polyp patients.

RESULTS: The goal of this guideline is to propose recommendations for the current use of biologics in CRSwNP as new evidence continues to emerge and inform practice.

CONCLUSION: We suggest that physicians …

What Will It Take To Implement Health And Health-Related Sustainable Development Goals?, Zulfiqar Ahmed Bhutta, Sameen Siddiqi, Wafa Aftab, Fahad Javaid Siddiqui, Luis Huicho, Roman Mogilevskii, Qamar Mahmood, Peter Friberg, Fawad Akbari

Woman and Child Health

No abstract provided.

Biomanufacturing Organized Collagen-Based Microfibers As A Tissue Engineered Device (Tend) For Tendon Regeneration, Yas Maghdouri-White, Nardos Sori, Stella Petrova, Hilary Wriggers, Nathan Kemper, Amrita Dasgupta, Kelly Coughenour, Seth Polk, Nick Thayer, Mario Rodriguez, Bill Simon, Anna Bulysheva, Kevin Bonner,, Steven Arnoczky, Samuel Adams, Michael Francis

Bioelectrics Publications

Approximately 800,000 surgical repairs are performed annually in the U.S. for debilitating injuries to ligaments and tendons of the foot, ankle, knee, wrist, elbow and shoulder, presenting a significant healthcare burden. To overcome current treatment shortcomings and advance the treatment of tendon and ligament injuries, we have developed a novel electrospun Tissue ENgineered Device (TEND), comprised of type I collagen and poly(D,L-lactide) (PDLLA) solubilized in a benign solvent, dimethyl sulfoxide (DMSO). TEND fiber alignment, diameter and porosity were engineered to enhance cell infiltration leading to promote tissue integration and functional remodeling while providing biomechanical stability. TEND rapidly adsorbs …

Survey Of Airflow Around A Heated Manikin As A Simulated Aeromedical Evacuation Patient On A Litter With Computational Fluid Dynamics Models, George P. Lemmer

Theses and Dissertations

Aeromedical Evacuations remain the predominant method used to transport patients from forward deployed areas of operations to secure locations with more robust medical infrastructure. Transportation of chemical warfare casualties and infectious patients require additional attention to prevent cross contamination. Specific airflow characteristics paired with environmental control system settings are a gap in scholarly literature. Based on the available literature computational fluid dynamics models were created to simulate the airflow around a patient represented by human geometry using commercially available software. In order to compare simulated and experimental results a heated manikin was placed in the MURPHEE aerosol exposure chamber and …

Nonrecurrent Early Post-Transplantation Focal Segmental Glomerulosclerosis., Momina M Ahmed, Massini A Merzkani, Matthew R D'Costa, Muhannad A Leghrouz, Mary E Fidler, Haraldur Bjarnason, Patrick G Dean, Fernando C Fervenza, Sanjit Reddy, Hatem Amer

Articles, Abstracts, and Reports

No abstract provided.

Correction To: Medical Neglect As A Contributor To Poorly Controlled Asthma In Childhood., Barbara L Knox, Francois M Luyet, Debra Esernio-Jenssen

Articles, Abstracts, and Reports

[This corrects the article DOI: 10.1007/s40653-019-00290-0.].

Maternal And Perinatal Outcomes In Women With Eclampsia By Mode Of Delivery At Riley Mother Baby Hospital: A Longitudinal Case-Series Study, Philippe Amubuomombe Poli, Koech Irene, Richard Mogeni, Ann Mwangi, Andrew Cheruiyot, Elkanah Omenge

Obstetrics and Gynaecology, East Africa

Background: Eclampsia, considered a serious complication of preeclampsia, remains a life-threatening condition among pregnant women. It accounts for 12% of maternal deaths and 16–31% of perinatal deaths worldwide. Most deaths from eclampsia occurred in resource-limited settings of sub-Saharan Africa. This study was performed to determine the optimum mode of delivery, as well as factors associated with the mode of delivery, in women admitted with eclampsia at Riley Mother and Baby Hospital.

Methods: This was a hospital-based longitudinal case-series study conducted at the largest and busiest obstetric unit of the tertiary hospital of western Kenya. Maternal and perinatal variables, such as …

Literature Review On Drosophila Research In Parkinson’S Disease, Maryann Jaquith

Honors Projects

Parkinson’s disease (PD) is one of the most prevalent neurodegenerative diseases. It is characterized by its main symptom of a tremor that usually starts in one limb. The four cardinal symptoms of PD are tremor, rigidity, bradykinesia, and postural instability. While the four cardinal symptoms are all motor symptoms there are non-motor symptoms for PD which include cognitive changes, sleeping disorders, lightheadedness, early satiety, and mood disorders. PD is characterized by dopaminergic (DA) neuron loss and the accumulation of Lewy bodies (LB) which are predominantly composed of α-synuclein (α-Syn) protein.

α-Syn is a protein found abundantly in the brain. It …

Nsaids For Analgesia In The Era Of Covid-19, Daniel L Herzberg, Harry P Sukumaran, Eugene R. Viscusi

Department of Anesthesiology Faculty Papers

Globally, non-steroidal anti-inflammatory drugs (NSAIDs) are highly used to treat pain. With the rise of the COVID-19 pandemic, the safety of NSAIDs use has been called into question. These concerns are worthy of review. At present, there is no compelling data showing that NSAIDs worsen the severity of COVID-19 symptoms or increase one's likelihood of contracting the illness. For patients in pain and without symptoms that could potentially be attributed to COVID-19 (cough, fevers/chills, lethargy, myalgias, anosmia and so on), NSAIDs should continue to remain a viable option to provide analgesia to patients in need.

Cerebral Cavernous Malformation Presenting As Seizures, Hazim Brohi, Ayisha Farooq, Bushra Rehan, Muhammad Mairaj Khan

Pakistan Journal of Neurological Sciences (PJNS)

Cerebral cavernous malformations (CCMs) is one of the rare vascular malformation. It is diagnosed by characteristic lesions on magnetic resonance imaging (MRI). CCMs typically appears as a “popcorn-like” masses on T2-weighted images on MRI studies.And clinically can lead to headaches, seizures,focal neurological deficits or intracerebral hemorrhages. . A familial form is suggested if lesions are multiple, and a sporadic form, if single

Urdu Translation And Validation Of Premature Ejaculation Diagnostic Tool (Pedt), Muhibullah Bangash, Wajahat Aziz, Mohammad Shoaib, Hammad Ather

Section of Urology

Objective: To validate an Urdu translation of premature ejaculation diagnostic tool (PEDT) by analyzing the association of this diagnostic tool with the clinical diagnosis of premature ejaculation (PE) and intravaginal ejaculatory latency time (IELT).
Methods: This cross-sectional study was conducted at the urology section of the Aga Khan University Hospital, Karachi, for six months duration, from July 2018 to December 2018. In our study 108 subjects, aged 20 to 50 years, who were in a stable sexual relationship (heterosexual) for a minimum duration of six months, were asked to fill the Urdu version of PEDT, 61 with PE and 47 …

Pregnancy Cohorts And Biobanking In Sub-Saharan Africa: A Systematic Review, Jeffrey N. Bone, Kelly Pickerill, Mai-Lei Woo Kinshella, Marianne Vidler, Rachel Craik, Lucilla Poston, William Stones, Esperanca Sevene, Marleen Temmerman, Angela Koech

Obstetrics and Gynaecology, East Africa

Background: Technological advances and high throughput biological assays can facilitate discovery science in biobanks from population cohorts, including pregnant women. Biological pathways associated with health outcomes differ depending on geography, and high-income country data may not generalise to low-resource settings. We conducted a systematic review to identify prospective pregnancy cohorts in sub-Saharan Africa (SSA) that include biobanked samples with potential to enhance discovery science opportunity.

Methods: Inclusion criteria were prospective data collection during pregnancy, with associated biobanking in SSA. Data sources included: scientific databases (with comprehensive search terms), grey literature, hand searching applicable reference lists and expert input. Results were …

Redesigning The Landscape For Women And Leadership: Insights Gained From The Covid-19 Pandemic. On Behalf Of Women In Gastroenterology Network Asia Pacific (Wignap) And Women In Endoscopy (Wie), Lubna Kamani, Nonthalee Pausawasdi, Jeanin E Van Hooft, Amrita Sethi, Sharmila Sachithanandan

Section of Gastroenterology

No abstract provided.

Building Focused Cardiac Ultrasound Capacity In A Lower Middle-Income Country: A Single Centre Study To Assess Training Impact, Wangari Siika, Anders Barasa, Benjamin Wachira, David Nekyon, Barbara Karau, Fatimah Juma, Grace Wanjiku, Harun Otieno, Gerald S. Bloomfield, Erik Sloth

Anaesthesiology, East Africa

Background: In low- and middle-income countries (LMICs) where echocardiography experts are in short supply, training non-cardiologists to perform Focused Cardiac Ultrasound (FoCUS) could minimise diagnostic delays in time-critical emergencies. Despite advocacy for FoCUS training however, opportunities in LMICs are limited, and the impact of existing curricula uncertain. The aim of this study was to assess the impact of FoCUS training based on the Focus Assessed Transthoracic Echocardiography (FATE) curriculum. Our primary objective was to assess knowledge gain. Secondary objectives were to evaluate novice FoCUS image quality, assess inter-rater agreement between expert and novice FoCUS and identify barriers to the establishment …

To Be Or Not To Be An Obstetrician / Gynaecologist, Iffat Ahmed, Abid Ashar

Department of Obstetrics & Gynaecology

Objectives: This qualitative study aimed to explore motivational sources of physicians, at the time of selection and while pursuing ObGyn career. Secondary aim was to explore challenges and strategies adapted by these physicians to overcome these challenges.
Methods: This is qualitative study with constrictive worldview. ObGyn residents and consultants of Aga Khan University, Karachi, were interviewed from July 2017 till Jan 2019, after ethical approval, using purposeful maximum variation sampling. Analysis were conducted by identifying keywords and phrases, these unedited verbatim with no assumptions provided basis for codes, which then clustered as trends. Emerging findings were discussed among authors and …

Prevalence Of Paternal Postpartum Depression, Aisha Noorullah, Zehra Mohsin, Taliha Munir, Rida Nasir, Misbah Malik

Pakistan Journal of Neurological Sciences (PJNS)

Background: Postpartum Depression is a type of mood disorder associated with childbirth, which can occur in both parents. It is a major public health concern because it produces insidious effects on the well-being of new born as well as on the whole family. Objective: This study aims to determine the prevalence of postpartum depression among fathers in Karachi, Pakistan. Methods: This cross sectional survey was conducted among fathers, purposive convenient and snowball sampling was used to approach 120 participants after obtaining permission from Al-Khidmat Hospital and Combined Military Hospital (CMH).Participants were aged between 20-50 years, had a newly born child …

Referral Patterns And Diagnoses At A Single Neurophysiology Center In Quetta, Pakistan: An Audit Of 1600 Cases, Ahmad Wali, Ehtisham Khalid2, Hazar Khan, Abdul Nasir, Mr Abdullah

Pakistan Journal of Neurological Sciences (PJNS)

Neurophysiologic tests such as EEG, video EEG, Polysomnography (PSG), Nerve conduction studies (NCS) and electromyography (EMG) are the next steps after neurological examinations. These tests play a significantly important role in the decision-making and management of various neurological diseases. Data regarding the availability and frequency of these tests are not being compiled in Pakistan eventually resulting in a lack of awareness about these tests among physicians as well as patients. This motivated us to conduct a medical audit to assess frequencies, mode of referral, and final conclusion of these tests in detail. A total of 1600 tests were included. Among …

A Case Of Guillain-Barré Syndrome Presented With Abnormal Pupil Without Ophthalmoplegia, Kiran Abbas, Hassan Haroon, Noorulain Qureshi, Ritesh Pahwani, Suneel Kumar

Pakistan Journal of Neurological Sciences (PJNS)

A 50-year-old man, resident of Balochistan, Pakistan presented with acute progressive tetraparesis associated with a unilateral dilated pupil. He had normal ocular movement, but the right pupil was dilated and unresponsive to light or accommodation reflexes. This is the first case from Pakistan.

Which Internal Medicine Clerkship Characteristics Are Associated With Students' Performance On The Nbme Medicine Subject Exam? A Multi-Institutional Analysis., Matthew M. Fitz, William Adams, Steven A. Haist, Karen E. Hauer, Linette P. Ross, Amanda Raff, Gauri Agarwal, T. Robert Vu, Jonathan Appelbaum, Valerie J. Lang, Chad Miller, Cyril Grum, Mark Fagan, Jennifer Foster, Hilary F. Ryder, Bruce Houghton, Ryan Nall, Amy Shaheen, Michael Elnicki, Anna Donovan, Stuart Kiken, Cynthia Ledford, Shobhina Chheda, Doug Paauw, Blake Barker, Maureen Lowery, Nina Mingioni, Deepti Rao, William Kelly

Division of Internal Medicine Faculty Papers & Presentations

PURPOSE: To identify which internal medicine clerkship characteristics may relate to NBME Medicine Subject Examination scores, given the growing trend toward earlier clerkship start dates.

METHOD: The authors used linear mixed effects models (univariable and multivariable) to determine associations between medicine exam performance and clerkship characteristics (longitudinal status, clerkship length, academic start month, ambulatory clinical experience, presence of a study day, involvement in a combined clerkship, preclinical curriculum type, medicine exam timing). Additional covariates included number of NBME clinical subject exams used, number of didactic hours, use of a criterion score for passing the medicine exam, whether medicine exam performance …

Prognostic Factors In Patients With Salivary Gland Malignancy: A Retrospective Cohort Study, Moghira Iqbaluddin Siddiqui, Haissan Iftikhar, Umar Farooq Bhatti, Mubasher Ikram

Section of Otolaryngology, Head & Neck Surgery

Our objective was to determine the factors affecting the prognosis in patients with major salivary gland malignancy presenting to Aga Khan University Hospital in Karachi. Retrospective cohort study was carried out at our center on patients diagnosed and treated for salivary gland cancers. Presentation and treatment offered was reviewed from medical charts. Telephonic interviews were conducted to assess the survival of patients who were lost to follow-up. Log rank test was used to compare the mean survival times. A total of 36 patients were included in the study. The mean age was 45.1 +/- 14.6 years. Majority were male 21 …

A Multi-Institutional Analysis Of Sternoclavicular Joint Coverage Following Osteomyelitis, Sammy Othman, Omar Elfanagely, Saïd C Azoury, Geoffrey M Kozak, Jessica Cunning, Arturo J Rios-Diaz, Prashanth Palvannan, Patrick J. Greaney, Matthew Jenkins, Doraid Jarrar, Stephen J Kovach, John P Fischer

Department of Surgery Faculty Papers

BACKGROUND: Sternoclavicular joint (SCJ) osteomyelitis is a rare pathology requiring urgent intervention. Several operative approaches have been described with conflicting reports. Here, we present a multi-institutional study utilizing multiple surgical pathways for SCJ reconstruction.

METHODS: A multi-institutional retrospective cohort study was conducted to identify patients who underwent surgical repair for sternoclavicular osteomyelitis between 2008 and 2019. Patients were stratified according to reconstruction approach: single-stage reconstruction with advancement flap and delayed-reconstruction with flap following initial debridement. Demographics, operative approach, type of reconstruction, and postoperative outcomes were analyzed.

RESULTS: Thirty-two patients were identified. Mean patient age was 56.2±13.8 years and 68.8% were …

A Rare Presentation Of Acute Flaccid Myelitis In Covid-19 Patient: A Case Report, Liaquat Ali, Adnan Khan, Osama Elalamy, Beatriz Canibano, Mohammad Al Hatou, Ghulam Adeli, Islam Ahmed, Ambreen Iqrar, Ahmed Abdussalam, A Saif Ibrahim, Sundus Sardar

Pakistan Journal of Neurological Sciences (PJNS)

SARS-CoV-2 virus enters human cells via ACE-2 receptors and causes multiple organs dysfunction. These ACE-2 receptors are in cells surface of human lung, liver, heart, kidney and blood vessels. The expression of ACE2 receptors in cortical neurons, glial cells and spinal cord cells create nervous system susceptible to SARS-CoV-2 attack and may be a source of different neurological deficits including myelitis in COVID-19 patients.

Parkinson's Disease- "Move Together To End": Theme For World Brain Day 2020, Abdul Malik

Pakistan Journal of Neurological Sciences (PJNS)

World Federation of Neurology (WFN) promoting brain health through its educational, skills development & advocacy activities. Since 2014 WFN had been focused to organized dedicated awareness drive in all the WFN members countries round the globe.

Dramatic Outcomes In Epilepsy: Depression, Suicide, Injuries, And Mortality, Boulenouar Mesraoua, Dirk Deleu, Al Hail Hassan, Melykian Gayane, Alsheikh Lubna, Musab Abdalhalim Ali, Torbjorn Tomson, Bassel Abou Khalil, J Helen Cross, Ali A Asadi-Pooya

Department of Neurology Faculty Papers

In this narrative review, we will discuss some of the significant risks and dramatic consequences that are associated with epilepsy: depression, suicide, seizure-related injuries, and mortality, both in adults and in children. Considering the high prevalence of depression among people with epilepsy (PWE), routine and periodic screening of all PWE for early detection and appropriate management of depression is recommended. PWE should be screened for suicidal ideation regularly and when needed, patients should be referred for a psychiatric evaluation and treatment. When starting an antiepileptic drug (AED) or switching from one to another AED, patients should be advised to report …

Outcomes Of Cancer Patients Undergoing Transcatheter Aortic Valve Replacement., Vardhmaan Jain, Anas M Saad, Mohamed M Gad, Agam Bansal, Omar Abdelfattah, Medhat Farwati, Keerat R. Ahuja, James Yun, Amar Krishnaswamy, Samir R Kapadia

Reading Hospital Cardiovascular Medicine Fellowship

No abstract provided.

Life Expectancy And Active Life Expectancy By Disability Status In Older U.S. Adults, Haomiao Jia, Erica I. Lubetkin

Publications and Research

Objectives

The Medicare Health Outcome Survey (HOS) is the largest longitudinal survey of the U.S. community-dwelling elderly population. This study estimated total life expectancy, active life expectancy (ALE), and disability-free life expectancy (DFLE) by disability status among HOS participants.

Methods

Data were from the Medicare HOS Cohort 15 (baseline 2012, follow-up 2014). We included respondents aged ≥ 65 years (n = 164,597). Participants’ disability status was assessed based on the following six activities of daily living (ADL): bathing, dressing, eating, getting in or out of chairs, walking, and using the toilet. The multi-state models were used to estimate life expectancy, …

Integrating Affect Perception Tasks From The New York Emotion Battery Into A Comprehensive Measure Of Neuropsychological Change Across The Lifespan, Melinda A. Cornwell

Dissertations, Theses, and Capstone Projects

Background: The ability to perceive others’ emotions is a vital skill for social competency, impacting the success of personal and professional relationships (Brinton & Fujiki, 2011; Cassidy et al., 1992; Côté & Miners, 2006). According to Socioemotional Selectivity Theory (SST; Carstensen, 1991), human motivation develops to become more discerning in choosing milieus that yield the most gratifying return on the investment of personal resources (e.g., time, attention, and effort), perhaps explaining why some research findings indicate that older adults may demonstrate an affect perception (AP) bias described as a positivity effect (Reed et al., 2014). Moreover, AP predicts cognitive and …

Long Noncoding Rna H19x Is A Key Mediator Of Tgf-Β-Driven Fibrosi, Elena Pachera, Shervin Assassi, Gloria A Salazar, Mara Stellato, Florian Renoux, Adam Wunderlin, Przemyslaw Blyszczuk, Robert Lafyatis, Fina Kurreeman, Jeska De Vries-Bouwstra, Tobias Messemaker, Carol A Feghali-Bostwick, Gerhard Rogler, Wouter T Van Haaften, Gerard Dijkstra, Fiona Oakley, Maurizio Calcagni, Janine Schniering, Britta Maurer, Jörg Hw Distler, Gabriela Kania, Mojca Frank-Bertoncelj, Oliver Distler

Faculty, Staff and Student Publications

TGF-β is a master regulator of fibrosis, driving the differentiation of fibroblasts into apoptosis-resistant myofibroblasts and sustaining the production of extracellular matrix (ECM) components. Here, we identified the nuclear long noncoding RNA (lncRNA) H19X as a master regulator of TGF-β-driven tissue fibrosis. H19X was consistently upregulated in a wide variety of human fibrotic tissues and diseases and was strongly induced by TGF-β, particularly in fibroblasts and fibroblast-related cells. Functional experiments following H19X silencing revealed that H19X was an obligatory factor for TGF-β-induced ECM synthesis as well as differentiation and survival of ECM-producing myofibroblasts. We showed that H19X regulates DDIT4L gene …

Machine Learning Can Identify Abnormal Chromosomes To Facilitate Initial Screening In The Cytogenomics Laboratory, Mark Micale, Zhenhong Qu, Blake Martin

Conference Presentation Abstracts

Context: Artificial intelligence/machine learning (AI-ML) has made great strides in recent years with applications in diagnostic medicine. We tested the hypothesis that AI-ML can permit initial screening for structural chromosome abnormalities at various band levels of resolution. Such technology could markedly reduce the downstream laboratory workload and increase turnaround time in cases positive for a clinically significant chromosome abnormality.

Design: We utilized partial karyotypes of normal chromosomes 4, 5, 7, 9, 13, 21, and 22 and abnormal derivative chromosomes 9 and 22 from the t(9;22)(q34;q11.2) associated with chronic myeloid leukemia to train our AI-ML system to identify normal from abnormal …