Medical Specialties Commons^™

Enhancing Glucose Metabolism Via Gluconeogenesis Is Therapeutic In A Zebrafish Model Of Dravet Syndrome, Matthew T Dinday, Scott C Baraban, Manisha Patel

Faculty, Staff and Students Publications

Energy-producing pathways are novel therapeutic targets for the treatment of neurodevelopmental disorders. Here, we focussed on correcting metabolic defects in a catastrophic paediatric epilepsy, Dravet syndrome which is caused by mutations in sodium channel NaV1.1 gene, SCN1A. We utilized a translatable zebrafish model of Dravet syndrome (scn1lab) which exhibits key characteristics of patients with Dravet syndrome and shows metabolic deficits accompanied by down-regulation of gluconeogenesis genes, pck1 and pck2. Using a metabolism-based small library screen, we identified compounds that increased gluconeogenesis via up-regulation of pck1 gene expression in scn1lab larvae. Treatment with PK11195, a pck1 activator …

Open Problems In Extracellular Rna Data Analysis: Insights From An Ercc Online Workshop, Matthew Roth, Pieter Mestdagh, Klaas E A Max, Joel Rozowsky, Karolina Elżbieta Kaczor-Urbanowicz, Justin Chang, Leonora Balaj, Bojan Losic, Eric L Van Nostrand, Emily Laplante, Bogdan Mateescu, Brian S White, Rongshan Yu, Aleksander Milosavljevic, Gustavo Stolovitzky, Ryan M Spengler

Faculty, Staff and Students Publications

We now know RNA can survive the harsh environment of biofluids when encapsulated in vesicles or by associating with lipoproteins or RNA binding proteins. These extracellular RNA (exRNA) play a role in intercellular signaling, serve as biomarkers of disease, and form the basis of new strategies for disease treatment. The Extracellular RNA Communication Consortium (ERCC) hosted a two-day online workshop (April 19–20, 2021) on the unique challenges of exRNA data analysis. The goal was to foster an open dialog about best practices and discuss open problems in the field, focusing initially on small exRNA sequencing data. Video recordings of workshop …

Assessment Of The Impact Of Tardive Dyskinesia In Clinical Practice: Consensus Panel Recommendations, Amber R Hoberg, Stuart H Isaacson, John M Kane, Rajeev Kumar

Faculty, Staff and Students Publications

PURPOSE: Tardive dyskinesia (TD) is a hyperkinetic movement disorder in which patients experience abnormal involuntary movements that can have profound negative impacts on physical, cognitive, and psychosocial functioning. Use of measures to assess the functional impact of TD in routine clinical practice is lacking. To address this gap, an advisory panel of experts in psychiatry and movement disorder neurology was convened to develop consensus recommendations on assessment of the impact of TD on patients' functioning that can be used in clinical practice.

METHODS: An advisory panel provided recommendations using an iterative process, beginning with a narrative literature review regarding current …

Helicobacter Pylori Diagnosis And Therapy In The Era Of Antimicrobial Stewardship, David Y Graham

Faculty, Staff and Students Publications

The diagnosis and therapy of Helicobacter pylori infection have undergone major changes based on the use the principles of antimicrobial stewardship and increased availability of susceptibility profiling. H. pylori gastritis now recognized as an infectious disease, as such there is no placebo response allowing outcome to be assessed in relation to the theoretically obtainable cure rate of 100%. The recent recognition of H. pylori as an infectious disease has changed the focus to therapies optimized to reliably achieve high cure rates. Increasing antimicrobial resistance has also led to restriction of clarithromycin, levofloxacin, or metronidazole to susceptibility-based therapies. Covid-19 resulted in …

Malnutrition In Orthopaedic Sports Medicine: A Review Of The Current Literature, George F Hatch

Faculty, Staff and Students Publications

CONTEXT: Malnutrition is well-studied in various aspects of the orthopaedic literature, most commonly in relation to arthroplasty, spine surgery, and trauma. However, the management of nutritional deficiencies is commonly overlooked among orthopaedic sports medicine providers. The purpose of this article is to analyze the available sports medicine literature to review the associations between malnutrition and the management of orthopaedic sports medicine patients from a treatment and performance standpoint.

EVIDENCE ACQUISITION: PubMed was searched for relevant articles published from 1979 to 2019.

STUDY DESIGN: Clinical review.

LEVEL OF EVIDENCE: Level 4.

RESULTS: Few studies exist on the implications of macronutrient deficiencies …

Cardio-Pulmonary Sequelae In Recovered Covid-19 Patients: Considerations For Primary Care, Zouina Sarfraz, Azza Sarfraz, Alanna Barrios, Radhika Garimella, Asimina Dominari, Manish Kc, Krunal Pandav, Juan C. Pantoja, Varadha Retnakumar, Ivan Cherrez-Ojeda

Department of Paediatrics and Child Health

Background: Current literature lacks characterization of the post-recovery sequelae among COVID-19 patients. This review characterizes the course of clinical, laboratory, radiological findings during the primary infection period, and the complications post-recovery. Primary care findings are presented for long-COVID care.
Methods: Adhering to PRISMA guidelines, 4 databases were searched (PubMed, Embase, CINAHL Plus, Scopus) through December 5, 2020, using the keywords "COVID-19 and/or recovered and/or cardiovascular and/or long-term and/or sequelae and/or sub-acute and/or complication." We included published peer-reviewed case reports, case series, and cross-sectional studies providing the clinical course of COVID-19 infection, and cardiopulmonary complications of patients who recovered from COVID-19, …

The Influence Of Coronavirus Disease-2019 (Covid-19) On Parkinson’S Disease: An Updated Systematic Review, Vikash Jaiswal, Danah Alquraish, Zouina Sarfraz, Azza Sarfraz, Shavy Nagpal, Prakriti Singh Shrestha, Dattatreya Mukherjee, Prathima Guntipalli, Diana F. Sánchez Velazco, Arushee Bhatnagar

Department of Paediatrics and Child Health

Background: COVID-19 has affected global communities with multiple neurological complications in addition to other critical medical issues. COVID-19 binds to the host's angiotensin-converting enzyme 2 (ACE2) receptors, which are expressed in the neurons and glial cells, acting as an entry port to the central nervous system (CNS). ACE2 receptors are abundantly expressed on dopamine neurons, which may worsen the prognosis of motor symptoms in Parkinson's disease (PD). SARS-CoV-2 may lead to an indirect response via immune-mediated cytokine storms and propagate through the CNS leading to damage. In this systematic review, we aim to provide thorough analyses of associations between COVID-19 …

Covid-19 Vaccine-Associated Thrombosis With Thrombocytopenia Syndrome (Tts): A Systematic Review And Post Hoc Analysis, Muhammad Usman Hafeez, Maha Ikram, Zunaira Shafiq, Azza Sarfraz, Zouina Sarfraz, Vikash Jaiswal, Muzna Sarfraz, Ivan Chérrez-Ojeda

Department of Paediatrics and Child Health

Background: A new clinical syndrome has been recognized following the COVID-19 vaccine, termed thrombosis with thrombocytopenia syndrome (TTS). The following systematic review focuses on extrapolating thrombotic risk factors, clinical manifestations, and outcomes of patients diagnosed with TTS following the COVID-19 vaccine.
Methods: We utilized the World Health Organization's criteria for a confirmed and probable case of TTS following COVID-19 vaccination and conducted a systematic review and posthoc analysis using the PRISMA 2020 statement. Data analysis was conducted using SPSS V25 for factors associated with mortality, including age, gender, anti-PF4/heparin antibodies, platelet nadir, D-dimer peak, time to event diagnosis, arterial or …

Teleneurology Based Management Of Infantile Spasms During Covid-19 Pandemic: A Consensus Report By The South Asia Allied West Syndrome Research Group, Priyanka Madaan, Jitendra Kumar Sahu, Jithangi Wanigasinghe, Kanij Fatema, Kyaw Linn, Mimi Lhamu Mynak, Nicolás Garófalo Gómez, Pauline Samia, Prakash Poudel, Prem Chand

Department of Paediatrics and Child Health

With telehealth services rescuing patients with chronic neurological disorders during the COVID-19 pandemic, there is a need for simplified teleneurology protocols for neurological disorders in children. Infantile spasms is an epileptic encephalopathy where treatment lag is a significant predictor of outcome. It is one such condition where telemedicine can make a remarkable difference when in-person consultations are delayed or are not possible. However, the adverse effect profile of the first-line therapeutic options, the need for frequent follow-up, underdeveloped telemedicine services, lack of a rational protocol, poor awareness about infantile spasms, a lesser level of parental understanding, and scarcity of pediatric …

Hepatic Lesion Detectability On Dual Energy Computed Tomography Imaging : Phantom Study, Hataipat Jantawong

Chulalongkorn University Theses and Dissertations (Chula ETD)

The purpose of this study is to determine the hepatic lesion detectability in abdomen from various phantom sizes by dual-energy computed tomography (DECT) imaging and to investigate the factors affecting the detectability of hepatic lesion in abdomen by dual-energy CT in phantom study. The anthropomorphic liver with nodule inserted phantom with extension rings simulating the small, medium, and large patients were scanned under DECT acquisitions by varying three kVp combinations (80/-,90/-, and 100/Sn150-kVp). The series of 40-,50-,60-, and 70-keV VMI were generated from DECT data set. All images were used to assess the task-based image quality; task transfer function (TTF), …

Market Structure And Quality Of Service: Investigating Oligopolies And The Quality Of Nursing Home Care In California During The Covid-19 Pandemic, Tessa Ireton

Senior Independent Study Theses

Quality-of-service outcomes in nursing homes are of great social and human importance. However, especially during the COVID-19 pandemic, consistently maintaining markets with high quality care has been a pervading issue in the American nursing home industry. Furthermore, the industry is strongly characterized by oligopolies, a market structure that literature indicates may be less compatible with quality service than competitive markets. With this paper, I aim to investigate the possible intersection of oligopolist market structures and the quality of nursing home care during the COVID-19 pandemic. I start by describing quality of care in nursing homes, particularly during the COVID-19 pandemic, …

Dosimetric Comparison Of Rapidplan And Manually Optimized Plans For Hippocampus Avoidance Whole Brain Radiation Therapy, Laksamon Phimolasawakun

Chulalongkorn University Theses and Dissertations (Chula ETD)

Nowadays, whole-brain radiation therapy (WBRT) is a good method to cure brain metastases. However, it has been noted that whole-brain radiation therapy could be a cause to neurological toxicity which could damage the hippocampus that is an important part of forming long-term memories. The HA-WBRT is a complicated plan depending on planner skills, the researcher would like to simplify this problem using knowledge-based planning called RapidPlan. The objective of this study was to compare the dosimetric difference of RapidPlan and manually optimized plans for the treatment of HA-WBRT. The RapidPlan model was created for HA-WBRT. The PTV and OARs constraints …

Determination Of Field Output Correction Factors In Elongated Small Field Photon Beams, Mananchaya Vimolnoch

Chulalongkorn University Theses and Dissertations (Chula ETD)

IAEA along with AAPM have published a code of practice TRS 483 for small field dosimetry. The field correction output factors of various detectors were introduced to correct detector response changes in relative dosimetry. However, the publication of TRS 483 has focused on symmetry field sizes, the correction factors for elongated small fields are not included in the protocol. The overall objective of this work is to determine the field output correction factor in elongated small field. The correction factors of IBA CC01, Sun nuclear EDGE, and Exradin W2 PSD for 6 MV photon beam were determined using Monte Carlo …

Evaluation Of Integral Depth-Dose Curves In Proton Pencil Beam Scanning Using Plane-Parallel Ionization Chambers, Phatthraporn Thasasi

Chulalongkorn University Theses and Dissertations (Chula ETD)

Proton therapy is an advanced form of radiation therapy treatment that can potentially decrease side effects and increase tumor control probability. The integral depth-dose curve is an essential parameter that has to be determined and introduced into the proton treatment planning system for the dose calculation. Besides the halo, the integral depth-dose curve measurements should be performed with a large-diameter plane-parallel ionization chamber. The purpose of this research is to determine the integral depth-dose curves and assess the geometrical collection efficiency at intermediate depths of different detector diameters in proton pencil beam scanning. The integral depth-dose curves with a proton …

Baselines Of Daily Quality Assurance For Proton Pencil Beam Scanning Using The Sphinx Compact, Tanapat Tiajaroen

Chulalongkorn University Theses and Dissertations (Chula ETD)

Quality assurance (QA) is a systematic process used to determine whether the product meets specified requirements. The American Association of Physicists in Medicine (AAPM) published a comprehensive proton therapy machine QA in TG-224 to provide confidence in use. King Chulalongkorn Memorial Hospital (KCMH) recently operated the first proton therapy center in Thailand, and the data of daily QA are not available or established. This study aims to apply the control chart for establishing the baselines of daily QA for the proton pencil beam scanning system using the Sphinx Compact detector. The Sphinx Compact was used to perform the proton daily …

Moderated Neutron Detector For Accumulated Ambient Dose Equivalent In Proton Therapy, Tanawat Tawonwong

Chulalongkorn University Theses and Dissertations (Chula ETD)

The Varian ProBeam compact was installed at Her Royal Highness Princess Maha Chakri Sirindhorn Proton Center. Since 2017, the project has started at the King Chulalongkorn Memorial Hospital and after 4 years, during Covid19 pandemic, the 1st patient treatment received proton therapy on August, 2021. The radiation safety of the center was accomplished through firstly, the shielding calculation and secondary, the radiation survey at the milestone points such as cyclotron installation and 1st Beam ON at the treatment room. The only one WENDI-II dosimeter was used in radiation survey. The main purpose of this study is to validate the in-house …

Dosimetric Impact Of Interplay Effects Instereotactic Body Radiation Therapy (Sbrt) Lung Cancer, Vanida Poolnapol

Chulalongkorn University Theses and Dissertations (Chula ETD)

Lung cancer patient breathing induced interplay effects in the volumetric modulated arc therapy (VMAT) together with stereotactic body radiation therapy (SBRT), which lead to non-uniform doses within the target volume and unwanted dose to the surrounding tissues. The purpose of this study was to investigate the dosimetric impact of interplay effects in 6 MV FFF of photon beams for lung cancer and to calculate the novel interplay effects factor (IEF) for VMAT-SBRT lung cancer. This study performed the static and dynamic measurements using two dimensions (2D) robotic platform and diode array for 3D-conformal radiation therapy (3D-CRT) plans, while using three …