Medical Specialties Commons^™

Transdisciplinary Approaches To Ameliorating Racial Disparities In Prostate Cancer Outcomes, Chanita H. Halbert, Katrina Armstrong, John Holmes, David Fenstermacher, Janet Weiner, Carmen Guerra, J. S. Schwartz, Jerry C. Johnson, Edmund Weisberg, Chantal Montagnet, Benita Weathers, Charnita Zeigler-Johnson, Ernestine Delmoor, Timothy R. Rebbeck

Journal of Health Disparities Research and Practice

Though prostate cancer is the second leading cause of cause cancer deaths among men in the US, it ranks first among African American men in terms of incidence, morbidity, and mortality. To address this and other complex health issues, some researchers advocate transdisciplinary research as a framework for analysis; however, few examples exist that indicate how the framework should be applied. This report uses prostate cancer outcomes as a paradigm to describe how such a framework can be used to identify determinants of racial disparities. By integrating diverse scientific disciplines, methods, and analytic approaches from psychology, sociology, epidemiology and genetics, …

Inter-Study Reproducibility Of Cardiovascular Magnetic Resonance Myocardial Feature Tracking., Geraint Morton, Andreas Schuster, Roy Jogiya, Shelby Kutty, Philipp Beerbaum, Eike Nagel

Journal Articles: Pediatrics

BACKGROUND: Cardiovascular magnetic resonance myocardial feature tracking (CMR-FT) is a recently described method of post processing routine cine acquisitions which aims to provide quantitative measurements of circumferentially and radially directed ventricular wall strain. Inter-study reproducibility is important for serial assessments however has not been defined for CMR-FT.

METHODS: 16 healthy volunteers were imaged 3 times within a single day. The first examination was performed at 0900 after fasting and was immediately followed by the second. The third, non-fasting scan, was performed at 1400.CMR-FT measures of segmental and global strain parameters were calculated. Left ventricular (LV) circumferential and radial strain were …

What's New In Spine Surgery., Keith H Bridwell, Paul A Anderson, Scott D Boden, Alexander R Vaccaro, Jeffrey C Wang

Rothman Institute Papers

No abstract provided.

Anatomical Relationships Of The Anterior Blood Vessels To The Lower Lumbar Intervertebral Discs: Analysis Based On Magnetic Resonance Imaging Of Patients In The Prone Position., Alexander R Vaccaro, Christopher K Kepler, Jeffrey A Rihn, Hidekazu Suzuki, John K Ratliff, James S Harrop, William B Morrison, Worawat Limthongkul, Todd J Albert

Rothman Institute Papers

BACKGROUND: Intra-abdominal vascular injuries are rare during posterior lumbar spinal surgery, but they can result in major morbidity or mortality when they do occur. We are aware of no prior studies that have used prone patient positioning during magnetic resonance imaging for the purpose of characterizing the retroperitoneal iliac vasculature with respect to the intervertebral disc. The purpose of this study was to define the vascular anatomy adjacent to the lower lumbar spine with use of supine and prone magnetic resonance imaging.

METHODS: A prospective observational study included thirty patients without spinal abnormality who underwent supine and prone magnetic resonance …

Non-Typeable Haemophilus Influenzae Decreases Cilia Beating Via Protein Kinase Cε., Kristina L. Bailey, Tricia D. Levan, Daniel A. Yanov, Jacqueline A. Pavlik, Jane M. Devasure, Joseph H. Sisson, Todd A. Wyatt

Journal Articles: Pulmonary & Critical Care Med

BACKGROUND: Haemophilus influenzae infection of the nasal epithelium has long been associated with observations of decreased nasal ciliary beat frequency (CBF) and injury to the ciliated epithelium. Previously, we have reported that several agents that slow CBF also have the effect of activating protein kinase C epsilon (PKCε) activity in bronchial epithelial cells. The subsequent auto-downregulation of PKCε or the direct inhibition of PKCε leads to the specific detachment of the ciliated cells.

METHODS: Primary cultures of ciliated bovine bronchial epithelial cells were exposed to filtered conditioned media supernatants from non-typeable H. influenzae (NTHi) cultures. CBF and motile points were …

A Study Of Potential Risk Factors Of Depression Among Latina Breast Cancer Survivors, Claudia Ximena Aguado Loi

USF Tampa Graduate Theses and Dissertations

Women with breast cancer commonly experience depression. However, this condition often goes unrecognized, undertreated, and understudied, especially in ethnic minorities. If left untreated, co-existing depression in women with cancer can complicate cancer treatment, lead to poor treatment adherence for both conditions, and decrease survival. These negative consequences are considerably higher among Latinas. With the growing number of Latinos and diversity within the Latino community, the literature has identified the need to disaggregate Latinos by region of origin. Unfortunately, few studies account for these differences and no study to date has examined risk factors of depression among Latinas diagnosed with breast …

Three Linked Vasculopathic Processes Characterize Kawasaki Disease: A Light And Transmission Electron Microscopic Study, Jan M. Orenstein, Stanford T. Shulman, Linda M. Fox, Susan C. Baker, Masato Takahashi, Tricia R. Bhatti, Pierre A. Russo, Gary W. Mierau, Jean Pierre De Chadarévian, Elizabeth J. Perlman, Cynthia Trevenen, Alexandre T. Rotta, Mitra B. Kalelkar, Anne H. Rowley

Pathology Faculty Publications

Background

Kawasaki disease is recognized as the most common cause of acquired heart disease in children in the developed world. Clinical, epidemiologic, and pathologic evidence supports an infectious agent, likely entering through the lung. Pathologic studies proposing an acute coronary arteritis followed by healing fail to account for the complex vasculopathy and clinical course.

Methodology/Principal Findings

Specimens from 32 autopsies, 8 cardiac transplants, and an excised coronary aneurysm were studied by light (n=41) and transmission electron microscopy (n=7). Three characteristic vasculopathic processes were identified in coronary (CA) and non-coronary arteries: acute self-limited necrotizing arteritis (NA), subacute/chronic (SA/C) vasculitis, and luminal …

Associations Between Pathological Gambling And Psychiatric Comorbidity Among Help-Seeking Populations In Hong Kong., Daniel T L Shek, Elda M L Chan, Ryan H Y Wong

Pediatrics Faculty Publications

Problem gambling is complex and often comorbid with other mental health problems. Unfortunately, gambling studies on comorbid psychiatric disorders among Chinese communities are extremely limited. The objectives of this study were to (a) determine the prevalence of comorbid psychiatric disorders among treatment-seeking pathological gamblers; (b) compare the demographic profiles and clinical features of pathological gamblers with and without comorbid psychiatric disorders; (c) explore the associations between pathological gambling and psychiatric disorders and their temporal relationship. Participants (N = 201) who sought gambling counseling were examined by making Axis-I diagnoses including mood disorders, schizophrenia spectrum disorders, substance use disorders, anxiety disorders, …

Consumption Of Pornographic Materials Among Hong Kong Early Adolescents: A Replication, Daniel T. L. Shek, Cecilia M. S. Ma

Pediatrics Faculty Publications

Consumption of pornographic materials was examined in 3,638 secondary 2 students in Hong Kong. Results showed that over 80% of the respondents had never consumed pornographic materials in the past year. Internet pornography was the most common medium that adolescents used when viewing pornographic materials. Males reported a higher level of pornography consumption than did females. Participants who were born in mainland China were more likely to consume pornographic materials than their Hong Kong counterparts. Regardless of the types of pornographic materials, the levels of pornography consumption significantly increased over time. Results also showed that higher levels of positive youth …

Internet Addiction Phenomenon In Early Adolescents In Hong Kong, Daniel T. L. Shek, Lu Yu

Pediatrics Faculty Publications

The present study investigated the prevalence and demographic correlates of Internet addiction in Hong Kong adolescents as well as the change in related behavior at two time points over a one-year interval. Two waves of data were collected from a large sample of students (Wave 1: 3,328 students, age = 12.59 ± 0.74 years; Wave 2: 3,580 students, age = 13.50 ± 0.75 years) at 28 secondary schools in Hong Kong. Comparable to findings at Wave 1 (26.4%), 26.7% of the participants met the criterion of Internet addiction at Wave 2 as measured by Young's 10-item Internet Addiction Test. The …

Differential Effects Of Interleukin-17 Receptor Signaling On Innate And Adaptive Immunity During Central Nervous System Bacterial Infection., Debbie Vidlak, Tammy Kielian

Journal Articles: Pathology and Microbiology

Although IL-17A (commonly referred to as IL-17) has been implicated in the pathogenesis of central nervous system (CNS) autoimmune disease, its role during CNS bacterial infections remains unclear. To evaluate the broader impact of IL-17 family members in the context of CNS infection, we utilized IL-17 receptor (IL-17R) knockout (KO) mice that lack the ability to respond to IL-17, IL-17F and IL-17E (IL-25). In this article, we demonstrate that IL-17R signaling regulates bacterial clearance as well as natural killer T (NKT) cell and gamma-delta (γδ) T cell infiltrates during Staphylococcus aureus-induced brain abscess formation. Specifically, when compared with wild-type (WT) …

Trends In Mortality From Septicaemia And Pneumonia With Economic Development: An Age-Period-Cohort Analysis, Irene O.L. Wong, Benjamin J. Cowling, Gabriel M. Leung, Mary Schooling

Publications and Research

Background
Hong Kong population has experienced drastic changes in its economic development in the 1940s. Taking advantage of Hong Kong’s unique demographic and socioeconomic history, characterized by massive, punctuated migration waves from Southern China, and recent, rapid transition from a pre-industrialized society to the first ethnic Chinese community reaching ‘‘first world’’ status over the last 60 years (i.e., in two or three generations), we examined the longitudinal trends in infection related mortality including septicemia compared to trends in non-bacterial pneumonia to generate hypotheses for further testing in other recently transitioned economies and to provide generalized aetiological insights on how economic …

Quality And Severity Of Lower Urinary Tract Symptoms Among African American Elders, Daniel L. Howard, Bennett G. Edwards, Kimberly Whitehead, M. A. Amamoo, Paul A. Godley

Journal of Health Disparities Research and Practice

Lack of population-based data on lower urinary tract symptoms (LUTS) among African American men represents a significant gap in understanding. This study examined LUTS among a racially over-sampled, mixed urban/rural, elderly cohort of African Americans and whites in the South to discern whether racial differences exist in the prevalence, severity, and associated risk factors of LUTS. Longitudinal analyses using generalized estimating equations (GEE) were conducted on the 1994–1998 EPESE dataset for 5 North Carolina counties. In 1994, the analytic cohort included 482 African Americans and 407 whites; by 1998, 249 and 222, respectively. In 1994, 49.4% of African Americans reported …

African American And Non-Hispanic White Births In Enhanced Prenatal Care Programs And Wic, Monica Cain

Journal of Health Disparities Research and Practice

North Carolina uses Maternity Care Coordination (MCC), an enhanced prenatal care program, to improve birth outcomes for high risk women. The WIC program provides similar services to achieve the same goal. Women in North Carolina Medicaid can choose to participate in either, both, or neither the MCC and WIC programs. The study compares the percentages of low birth weight (LBW)—less than 2500 grams—births and maternal risk characteristics of women: (1) participating in the MCC program only, (2) participating in WIC only, or (3) participating in both programs, to those women who receive conventional Medicaid prenatal care. The analysis is further …

Seeking Cancer Information: An Appalachian Perspective, Robin C. Vanderpool, Bin Huang, Brent J. Shelton

Journal of Health Disparities Research and Practice

There are noted disparities by ethnicity, race, age, gender, and socioeconomic status in the reported use of and access to cancer information. Missing from this list of variables that predict these disparities are specific geographic locales, such as Appalachia, a region recognized as a medically underserved, “special population”. Through a secondary analysis of NCI’s 2003 HINTS dataset, we are able to describe the cancer information-seeking behaviors of Appalachians as compared to non-Appalachians with a focus on actual versus preferential information-seeking behaviors, information-seeking experiences, and demographics. In general, Appalachians and non-Appalachians do not significantly differ in their cancer information-seeking behaviors and …

Process Evaluation In Action: Lessons Learned From Alabama Reach 2010, M. C. Nagy, Rhoda E. Johnson, Robin C. Vanderpool, Mona N. Fouad, Mark Dignan, Theresa A. Wynn, Edward E. Patridge, Isabel Scarinci, Cheryl Holt, Sharina D. Person

Journal of Health Disparities Research and Practice

The CDC-funded Alabama Racial and Ethnic Approaches to Community Health (REACH 2010) project is designed to reduce and eliminate disparities in breast and cervical cancer between African American and white women in six rural and three urban counties in Alabama. In this manuscript, we report on the development, implementation, results, and lessons learned from a process evaluation plan initiated during the Phase I planning period of the Alabama REACH 2010 program. The process evaluation plan for Alabama REACH 2010 focused on four main areas of activity that coincided with program objectives: assessing coalition development, building community capacity, conducting a needs …

Transforming Growth Factor-Β Suppresses Metastasis In A Subset Of Human Colon Carcinoma Cells., Neka A.K. Simms, Ashwani Rajput, Elizabeth A. Sharratt, Melanie Ongchin, Carol A. Teggart, J. Wang, Michael G. Brattain

Journal Articles: Eppley Institute

BACKGROUND: TGFβ signaling has typically been associated with suppression of tumor initiation while the role it plays in metastasis is generally associated with progression of malignancy. However, we present evidence here for an anti-metastatic role of TGFβ signaling.

METHODS: To test the importance of TGFβ signaling to cell survival and metastasis we compared human colon carcinoma cell lines that are either non-tumorigenic with TGFβ response (FET), or tumorigenic with TGFβ response (FETα) or tumorigenic with abrogated TGFβ response via introduction of dominant negative TGFβRII (FETα/DN) and their ability to metastasize. Metastatic competency was assessed by orthotopic transplantation. Metastatic colony formation …

Sudden Cardiac Death With Clozapine And Lorazepam Combination, Sriram Ramaswamy, Susan J. Boust, Prizada S. Sattar, Subhash C. Bhatia, Frederick Petty

Jefferson Journal of Psychiatry

Objective: To report a case of sudden cardiac death in a patient taking a combination of clozapine and lorazepam.

Case summary: A 31-year-old white man with schizophrenia was found dead at his apartment. His medication regimen included clozapine 500 mg at bed time, lorazepam 0.5 mg three times daily and levothyroxine 75 mcg once a day. Autopsy studies revealed cardiac hypertrophy, pulmonary congestion and edema.

Discussion: Clozapine therapy may cause cardiomyopathy and reduction in heart rate variability (HRV) indices. Benzodiazepines can reduce vagal tone and increase sympathetic activity. This combination can have an enhanced potential for sudden cardiac death.

Conclusions: …

Using Transcranial Magnetic Stimulation (Tms) To Compare Cortical Excitability Among Depressed Patients, Sleep-Deprived Controls, And Rested Controls, Rajani Rajan, Paul A. Zarkowski, Pedro L. Delgado

Jefferson Journal of Psychiatry

Objective: To compare cortical excitability among sleep-deprived and rested controls, and depressed subjects.

Methods: 3 controls and 4 depressed patients (average HAM-D 19) wererecruited. Sleep-deprived controls were instructed to sleep <=4 hours the previous night. TMS-produced motor evoked potentials (MEPs) were measured before and after subjects engaged in sets of non-fatiguing manual exercise.

Results: Post-exercise MEP increased 71+1-19% for rested controls, 28+1-32% for sleep deprived controls, and 8+1-15% for depressed patients. This increase, "facilitation," was significantly greater in rested controls than in depressed patients (p=0.011). No significant difference in facilitation was found between sleep-deprived controls and depressed patients.

Conclusion: Sleep-deprivation may partially account for reduced cortical excitability in depressed patients.

Antidepressant Pharmacotherapy: Prescription Practices In Psychiatric Resident Care, Rachel Dew, W. Vaughn Mccall

Jefferson Journal of Psychiatry

Background: Research on treatment of depression has raised concerns regarding adequacy of medication trials and rationality of drug choice. Little data exists regarding pharmacotherapy by psychiatric residents. As practice habits begun in training will likely persist after graduation, examination of residents' antidepressant use may ultimately improve treatment by psychiatrists.

Methods: Charts of new patients presenting to the Wake Forest University Psychiatry Resident Clinic were reviewed. Survey was made of medications prescribed to 112 patients diagnosed with major depression, dysthymia, depressive disorder NOS, adjustment disorder with depressed mood, or bipolar disorder with a documented depression during the studied period. Drug choice …

The Duty To Warn/Protect Doctrine And Its Application In Pennsylvania, Clarence Watson

Jefferson Journal of Psychiatry

Despite the almost universal familiarity of mental health professionals with the Tarasoff case, many questions regarding its associated legal requirements often arise when evaluating potentially dangerous patients. The principles of the duty to warn/protect, while appearing nebulous at times, contain key concepts that the clinician must consider in the face of potential danger to third parties. This article reviews the landmark decision of the Tarasoff case and outlines its key concepts. In addition, given that state jurisdictions vary in treatment of Tarasoff-like cases, this article explores the Pennsylvania Supreme Court decision, Emerich v. Philadelphia Center for Human Development, Inc.

Editor's Note, Anika Vaughn-Cooke

Jefferson Journal of Psychiatry

No abstract provided.

Electroconvulsive Therapy: A Review Of Its Current Status, Tyler Kenning, Ranjnish Mago, Steven Huege, Kenneth Certa, Rodney Pelchat

Jefferson Journal of Psychiatry

This article presents an overview of the current knowledge and practice of ECT. It provides a brief history of the development of ECT followed by a discussion of the accepted indications for ECT in psychiatric practice, including major depression, bipolar disorder (mania and depression), and schizophrenia. Moreover, a description of the technique of performing ECT is given. Also examined are the use of ECT in medically ill patients and the risks associated with ECT. In conclusion, with the aid of advances in anesthesia and the delivery of ECT, electroconvulsive therapy is a safe and effective treatment of mood and psychotic …

Effectiveness Of The Project P.A.T.H.S. In Hong Kong: Evaluation Based On Different Strategies And Different Studies Over Time, Daniel T. L. Shek, Hing Keung Ma, Joav Merrick

Pediatrics Faculty Publications

No abstract.

Participants' Evaluation Of The Project P.A.T.H.S.: Are Findings Based On Different Datasets Consistent?, Daniel T. L. Shek, Rachel C. F. Sun

Pediatrics Faculty Publications

Subjective outcome evaluation findings based on the perspective of the participants of the Project P.A.T.H.S. (Positive Adolescent Training through Holistic Social Programmes) in nine datasets collected from 2005 to 2009 (n = 206, 313 program participants) were examined in this paper. Based on the consolidated data with schools as units, results showed that the participants generally had positive perceptions of the program, implementers, and benefits of the program. More than four-fifths of the participants regarded the program as beneficial to their holistic development. Multiple regression analysis revealed that the perceived qualities of the program and the program implementers predicted perceived …

Selective Impact Of Hiv Disease Progression On The Innate Immune System In The Human Female Reproductive Tract, Timothy Lahey, Mimi Ghosh, John V. Fahey, Zheng Shen, Lucy R. Mukura, Yan Song, Susan Cu-Uvin, Kenneth H. Mayer, Peter F. Wright, John C. Kappes, Christina Ochsenbauer, Charles R. Wira

Dartmouth Scholarship

Background: We have previously demonstrated intrinsic anti-HIV activity in cervicovaginal lavage (CVL) from HIV-infected women with high CD4 counts and not on antiretroviral therapy. However, the impact of HIV disease progression on CVL innate immune responses has not been delineated.

Methods: CVL from 57 HIV-infected women not on antiretroviral therapy were collected by washing the cervicovaginal area with 10 ml of sterile normal saline. We characterized subject HIV disease progression by CD4 count strata: >500 cells/µl, 200-500 cells/µl, or <200 cells/µl of blood. To assess CVL anti-HIV activity, we incubated TZM-bl cells with HIV plus or minus CVL. Antimicrobials, cytokines, chemokines and anti-gp160 HIV IgG antibodies were measured by ELISA and Luminex.

Lung Cancer Screening For The Poor And Underserved: Should Routine Screening Be Performed?, Vaibhav Verma, Vladimir K. Gotlieb, Joshua Fogel, Alan S. Multz, Geeti Sharma

Publications and Research

Background: Lung cancer is a leading cause of death in United States. A recent study using low dose CT scans for screening long term smokers for lung cancer has, for the first time, demonstrated reduction in mortality, although it is not a standard of care in the community yet.

Methods: We analyzed lung cancer data for stages 0 through 4 for 1,412 individuals from, a public hospital, Nassau University Medical Center (NUMC) with patients of lower income, two private hospitals, North Shore University Hospital (NSUH) and Long Island Jewish Hospital (LIJ), with patients of higher income, with average household income …

Melanoma Induction By Ultraviolet A But Not Ultraviolet B Radiation Requires Melanin Pigment, Frances P. Noonan, M. Raza Zaidi, Agnieszka Wolnicka-Glubisz, Miriam R. Anver, Jesse Bahn, Anastas Popratiloff, +9 Additional Authors

Anatomy and Regenerative Biology Faculty Publications

Malignant melanoma of the skin (CMM) is associated with ultraviolet radiation exposure, but the mechanisms and even the wavelengths responsible are unclear. Here we use a mammalian model to investigate melanoma formed in response to precise spectrally defined ultraviolet wavelengths and biologically relevant doses. We show that melanoma induction by ultraviolet A (320–400 nm) requires the presence of melanin pigment and is associated with oxidative DNA damage within melanocytes. In contrast, ultraviolet B radiation (280–320 nm) initiates melanoma in a pigment-independent manner associated with direct ultraviolet B DNA damage. Thus, we identified two ultraviolet wavelength-dependent pathways for the induction of …

Molecular Genetic Studies And Delineation Of The Oculocutaneous Albinism Phenotype In The Pakistani Population, Thomas J. Jaworek, Tasleem Kausar, Shannon M. Bell, Nabeela Tariq, Muhammad I. Maqsood, Asma Sohail, Muhammad Ali, Furhan Iqbal, Shafqat Rasool, Saima Riazuddin, Rehan S. Shaikh, Zubair M. Ahmed

Obstetrics and Gynecology Faculty Publications

Background: Oculocutaneous albinism (OCA) is caused by a group of genetically heterogeneous inherited defects that result in the loss of pigmentation in the eyes, skin and hair. Mutations in the TYR, OCA2, TYRP1 and SLC45A2 genes have been shown to cause isolated OCA. No comprehensive analysis has been conducted to study the spectrum of OCA alleles prevailing in Pakistani albino populations.

Methods: We enrolled 40 large Pakistani families and screened them for OCA genes and a candidate gene, SLC24A5. Protein function effects were evaluated using in silico prediction algorithms and ex vivo studies in human melanocytes. The effects of splice-site …

Foodborne Illness Outbreak Response: A Snapshot Of Ohio, Calen Wherry

Master of Public Health Program Student Publications

Biosurveillance is one of the primary roles of local Public health offices. As the all-hazards (biological, chemical, and radiation emergencies) approach adds to the responsibilities already performed in foodborne illness outbreak response, it is crucial to assess the capabilities and robustness of the local public health Foodborne Illness (FBI) response. By surveying the most populated counties in Ohio with a checklist based on the 2009 Council for Improvement of Foodborne Outbreak Response (CIFOR) guidelines, it was possible to obtain a snapshot of the current outbreak response capabilities. Though only one county reported 100% compliance with the checklist, the overall average …