Medical Specialties Commons^™

Advances And Future Challenges In Adenoviral Vector Pharmacology And Targeting, Reeti Khare, Christopher Y. Chen, Eric A. Weaver, Michael A. Barry

Nebraska Center for Virology: Faculty Publications

Adenovirus is a robust vector for therapeutic applications, but its use is limited by our understanding of its complex in vivo pharmacology. In this review we describe the necessity of identifying its natural, widespread, and multi-faceted interactions with the host since this information will be crucial for efficiently redirecting virus into target cells. In the rational design of vectors, the notion of overcoming a sequence of viral “sinks” must be combined with re-targeting to target populations with capsid as well as shielding the vectors from pre-existing or toxic immune responses. It must also be noted that most known adenoviral pharmacology …

Species D Adenoviruses As Oncolytics Against B-Cell Cancers, Christopher Y. Chen, Julien S. Senac, Eric A. Weaver, Shannon M. May, Diane F. Jelinek, Philip Greipp, Thomas Witzig, Michael A. Barry

Nebraska Center for Virology: Faculty Publications

Purpose: Oncolytic viruses are self-amplifying anticancer agents that make use of the natural ability of viruses to kill cells. Adenovirus serotype 5 (Ad5) has been extensively tested against solid cancers, but less so against B-cell cancers because these cells do not generally express the coxsackie and adenoviral receptor (CAR). To determine whether other adenoviruses might have better potency, we "mined" the adenovirus virome of 55 serotypes for viruses that could kill B-cell cancers.

Experimental Design: Fifteen adenoviruses selected to represent Ad species B, C, D, E, and F were tested in vitro against cell lines and primary patient B-cell cancers …

Evaluation And Comparison Of The Species-Specificity Of 3 Antiparvalbumin Igg Antibodies, Poi-Wah Lee, Julie A. Nordlee, Stef J. Koppelman, Joseph L. Baumert, Steve L. Taylor

Department of Food Science and Technology: Faculty Publications

Parvalbumin is a pan-allergen in fish and frogs that triggers IgE-mediated reactions in fish-allergic individuals. Previous studies demonstrated that antibodies raised against fish and frog parvalbumins displayed varying specificity for different fish species, and thus, the applicability of these antibodies for potential use in immunoassays to detect fish residues were limited. We aimed to determine the specificity of 3 IgG antibodies for various fish species. Indirect enzyme-linked immunosorbent assay (ELISA) and IgG-immunoblotting were used to compare the reactivity of the polyclonal anticod parvalbumin antibody and the commercially available, monoclonal antifrog and monoclonal anticarp parvalbumin antibodies against raw muscle extracts of …

Efficacy And Safety Of Artemether-Lumefantrine In The Treatment Of Acute, Uncomplicated Plasmodium Falciparum Malaria: A Pooled Analysis, M. Makanga, Q. Bassat, C.O. Falade, Zul Premji, S. Krudsood, P. Hunt, V. Walter, H.-P. Beck, A.-C. Marrast, M. Cousin, P.J. Rosenthal

Pathology, East Africa

Randomized trials have confirmed the efficacy and safety of artemether-lumefantrine (AL) for treatment of uncomplicated Plasmodium falciparum malaria. Data from seven studies supported by Novartis (1996-2007), including 647 adults (> 16 years of age, 83.3% completed the study) and 1,332 children (≤ 16 years of age, 89.3% completed the study) with microscopically confirmed uncomplicated P. falciparum malaria and treated with the recommended regimen of AL, were pooled. The 28-day polymerase chain reaction-corrected parasitologic cure rate (primary efficacy endpoint) was 97.1% (495 of 510) in adults and 97.3% (792 of 814) in children (evaluable population). Gametocytemia prevalence after day was 4.2% …

Population Health Metrics Research Consortium Gold Standard Verbal Autopsy Validation Study: Design, Implementation, And Development Of Analysis Datasets, C.J.L. Murray, A.D. Lopez, R. Black, R. Ahuja, S.M. Ali, A. Baqui, L. Dandona, E. Dantzer, Vinita Das, U. Dhingra, A. Dutta, W. Fawzi, A.D. Flaxman, S. Gomez, B. Hernandez, R. Joshi, H. Kalter, A. Kumar, V. Kumar, R. Lozano, M. Lucero, S. Mehta, B. Neal, S.L. Ohno, R. Prasad, D. Praveen, Zul Premji, D. Ramirez-Villalobos, H. Remolador, I. Riley, M. Romero, M. Said, D. Sanvictores

Pathology, East Africa

Background: Verbal autopsy methods are critically important for evaluating the leading causes of death in populations without adequate vital registration systems. With a myriad of analytical and data collection approaches, it is essential to create a high quality validation dataset from different populations to evaluate comparative method performance and make recommendations for future verbal autopsy implementation. This study was undertaken to compile a set of strictly defined gold standard deaths for which verbal autopsies were collected to validate the accuracy of different methods of verbal autopsy cause of death assignment.

Methods: Data collection was implemented in six sites in four …

Malpractice Suits And Physician Apologies In Cancer Care, Eugene Chung, Jill R. Horwitz, John A.E. Pottow, Reshma Jagsi

Articles

Conside the following case: The patient is a 44-year-old woman who presents for radiation treatment of an isolated locoregional recurrence of breat cancer in her chest wall, 3 years after undergoing masectomy. At the time of diagnosis, she had T2N2M0 disease, with four of 15 lymph nodes involved with tumor. She received a masectomy with negative margins and appropriate chemotherapy, but none of her physicians talked to her about postmasectomy radiation therapy, which would clearly have been indicated to reduce her risk of locoregional failure and would have been expected to improve her likelihood of survival. She asks the radiation …

Evaluation Of An Emergency Preparedness Exercise Using Hseep Format, Kelly A. Lawall Ms, Bsn, Phrn, Michael Wargo Bsn, Mba, Phrn, Cmte

Department of Emergency Medicine

No abstract provided.

Assessment Of “Gene-Environment” Interaction In Cases Of Familial & Sporadic Pancreatic Cancer, Theresa Yeo, Ralph Hruban, Kieran Brune, Alison Klein, Shiela Fitzgerald, Charles Yeo

College of Nursing Faculty Papers & Presentations

Background: Pancreatic cancer (PC) is the fourth leading cause of cancer death in the United States. Reported risk factors for PC include: advancing age, a family history of PC, high-risk inherited syndromes, cigarette smoking, exposure to occupational and environmental carcinogens, African-American race, high fat/high cholesterol diet, obesity, chronic pancreatitis, and diabetes mellitus.

Purpose: The purpose of this study was to characterize one of the largest national registries of familial PC (FPC) and sporadic PC (SPC), focusing on demographics, clinical factors, self-reported environmental and occupational lifetime exposures and survival status.

Methods: Retrospective cross-sectional, case-only analysis of FPC cases (n …

Incivility In Healthcare Settings: Manifestations, Root Causes, And Downstream Effects On Patient Care And Productivity, Theresa P. Yeo, Anne Belcher, Charles J. Yeo

College of Nursing Faculty Papers & Presentations

PURPOSE: To investigate the prevalence and effects of incivility in healthcare and educational settings

METHODS: Review of the literature

SEARCH STRATEGY: CINAHL, PubMed, Joint Commission sites searched using terms: incivility, workplace violence, disruptive behavior, bullying

Physical Activity And Cognitive-Health Content In Top-Circulating Magazines, 2006–2008, Anna E. Greer, Sara J. Corwin, Daniela B. Friedman

All PTHMS Faculty Publications

Physical activity may promote cognitive health in older adults. Popular media play an important role in preventive health communication. This study examined articles discussing associations between physical activity and cognitive health in top-circulating magazines targeting older adults. 42,753 pages of magazines published from 2006 to 2008 were reviewed; 26 articles met inclusion criteria. Explanations regarding the link between physical activity and cognitive health were provided in 57.7% of articles. These explanations were generally consistent with empirical evidence; however, few articles included empirical evidence. Physical activity recommendations were presented in 80.8% of articles; a wide range was recommended (90–300 min of …

Reduction Of Mammoplasty Using Inferior Pedicle In Heavy Breasts (Macromastia)., Stanley Ominde Khainga, Ronald Wasike, P. K. Biribwa

General Surgery, East Africa

Symptoms associated with heavy breasts are pain in the upper part of the body; back pains, poor body posture and headache. These patients also have difficulties in finding suitable clothes and experience poor self-image and problems such as establishing sexual relationships. Reduction mammoplasty procedure provides weight and volume reduction of the breast as well as enhancement of the aesthetic appearance of the breasts. In this study, the inferior pedicle technique was used in reduction of thirty five patients over the last four years with macromastia. In all the patients except three, good results were achieved. One patient suffered nipple necrosis …

Addressing The Challenges Of Practicing Breast Cytology In A Tertiary Teaching Hospital In Kenya, Neeta Kumar, Shahin Sayed, Zahir Moloo, Rajendra Chauhan

General Surgery, East Africa

Objectives: To assess diagnostic accuracy of breast cytology through histological correlation and identify reasons for diagnostic pitfalls.

Methods: A total of 2700 cases were reported in cytology during the study period of 14 months, of which 1100 (40%) were from breast lesions. Only 96 (9%) cases had histological follow up in the form of core biopsy, lumpectomy and/or mastectomy. The cases in which cytology diagnosis did not match with histology diagnosis were reviewed by two pathologists and reasons for the diagnostic pitfalls in cytology were recorded. Sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of cytology were …

Microsurgical Reconstruction Of Large, Locally Advanced Cutaneous Malignancy Of The Head And Neck, Joseph L. Hill, Brian Rinker

Surgery Faculty Publications

Large, locally advanced cutaneous malignancy of the head and neck region is rare. However, when present, they impart a significant reconstructive challenge. These cancers have a tendency to invade peripheral tissues covering a large surface area as well as expose deeper structures such as skull, dura, orbit, and sinus after resection. Complicating the reconstructive dilemma is the high incidence of individuals who have undergone previous surgery in the region as well as adjuvant radiation therapy, which may preclude the use of local flaps or skin graft. Free tissue transfer provides a reconstructive surgeon the ability to provide well-vascularized tissue with …

Bacterial Vaginosis Is Associated With Uterine Cervical Human Papillomavirus Infection: A Meta-Analysis, Evy Gillet, Joris Fa Meys, Hans Verstraelen, Carolyne Bosire, Philippe De Sutter, Marleen Temmerman, Davy Vanden Broeck

Obstetrics and Gynaecology, East Africa

Background: Bacterial vaginosis (BV), an alteration of vaginal flora involving a decrease in Lactobacilli and predominance of anaerobic bacteria, is among the most common cause of vaginal complaints for women of childbearing age. It is well known that BV has an influence in acquisition of certain genital infections. However, association between BV and cervical human papillomavirus (HPV) infection has been inconsistent among studies. The objective of this meta-analysis of published studies is to clarify and summarize published literature on the extent to which BV is associated with cervical HPV infection.

Methods: Medline and Web of Science were systematically searched for …

Eltrombopag For Management Of Chronic Immune Thrombocytopenia (Raise): A 6-Month, Randomised, Phase 3 Study, Gregory Cheng, Mansoor Saleh, Claus Marcher, Sandra Vasey, Bhabita Mayer, Manuel Aivado, Michael Arning, Nicole Stone, James Bussel

Haematology and Oncology, East Africa

Background: Eltrombopag is an oral thrombopoietin receptor agonist for the treatment of thrombocytopenia. We aimed to compare the response to once daily eltrombopag versus placebo in patients with chronic immune thrombocytopenia during a 6-month period.

Methods: We undertook a phase 3, double-blind, placebo-controlled study in adults with previously treated immune thrombocytopenia of more than 6 months’ duration who had baseline platelet counts lower than 30 000 per μL. Patients were randomly allocated (in a 2:1 ratio) treatment with local standard of care plus 50 mg eltrombopag or matching placebo once daily for 6 months. Randomisation was done centrally with a …

Examining The Relationship Of Inflammatory Mediators Among Fetal Compartments, Daniel G. Kiefer Md, Sean M. Keeler Md, Jolene C. Muscat Md, Michael Demishev Md, Nazeeh Hanna Md

Department of Obstetrics & Gynecology

No abstract provided.

Can Non-Invasive Sampling Determine The Inflammatory Status Of The Intra-Uterine Environment?, Daniel G. Kiefer Md, Sean M. Keeler Md, Jolene C. Muscat Md, Michael Demishev Md, Anthony M. Vintzileos Md, Nazeeh Hanna Md

Department of Obstetrics & Gynecology

No abstract provided.

Midtrimester Dilation And Evacuation (D&E) Versus Prostaglandin Induction: A Comparison Of Composite Outcomes (Poster), Kari A. Whitley Md, Meredith L. Rochon Md, Kevin Trinchere, Wendy Prutsman Msn, Crnp

Department of Obstetrics & Gynecology

No abstract provided.

Preterm Labor: Can The Initial Cervical Dilation Predict Gestational Age At Delivery?, Olga E. Jackson Md, Mph, Joanne N. Quiñones Md, Msce

Department of Obstetrics & Gynecology

No abstract provided.

A Cost Analysis Of Postoperative Pain Management In Endometrial Cancer Patients: Robotic Department Of Surgery Vs. Laparoscopy Department Of Surgery, Martin A. Martino Md, Jocelyn Shubella, Rachel Miller Pa-C, Joycelyn C. Schindler Md, Sharon R. Kimmel Phd, Mha, Shamol Williams Msii, Richard Boulay Md, M Bijoy Thomas Md

Department of Obstetrics & Gynecology

No abstract provided.

A Survey Of Georgia Adult Protective Services Staff: Implications For Older Adult Injury Prevention And Policy, Sheryl M. Stasser, Judith Kerr, Patricia S. King, Brian Payne, Sarah Beddington, Danielle Pendrick, Elizabeth Leyda, Frances Mccarty

Sociology & Criminal Justice Faculty Publications

Introduction:

The aging population is a rapidly growing demographic. Isolation and limited autonomy render many of the elderly vulnerable to abuse, neglect and exploitation. As the population grows, so does the need for Adult Protective Services (APS). This study was conducted to examine current knowledge of older adult protection laws in Georgia among APS staff and to identify training opportunities to better prepare the APS workforce in case detection and intervention.

Methods:

The Georgia State University Institute of Public Health faculty developed a primary survey in partnership with the Georgia Division of Aging Services’ leadership to identify key training priority …

Using Lean Principals To Improve Patient Flow, Keith Weinhold Mha, Fache, Eliot L. Friedman Md, Darlene Matthias Rn, Ms, Ocn, Mary R. Greenberg, Amy E. Levan Rn, Bsn, Ocn, Jill Korn Rn, Bsn, Ocn, Melissa Kratz Rn, Msn, Aocn, Mandy Melocheck Rn, Msn, Ocn, Cindy J. Fenton Rn, Ocn, Janine Barnaby Rph, Bcop, Jeanne Kenna Rn, Ocn, Jennifer Mesker Pharmad, Kyle Sabatino Rn, Msn, Aocn, Lori Turnbach, Maura Price Rn, Bsn, Ocn, Pamela Tobias Ms, Rhia, Patricia Shearburn Rn, Msn, Aocn, Ramona E. Chase Crnp, Stephanie Thomas, Pamela Repetz, Barbara Versage Rn, Mba, Cphq

Administration & Leadership

No abstract provided.

Gastric Malt Lymphoma: A Rarity, Shahid Pervez, Naureen Ali, Hina Aaqil, Khalid Mumtaz, Syed Siddiq Ullah

Department of Pathology and Laboratory Medicine

Association of Helicobacter pylori (H. Pylori) infection with gastric ‘Mucosa Associated Lymphoid Tissue’ (MALT) lymphomas (MALTomas) is well established. In this study the frequency and characteristics of gastric MALToma over a period of 18 years was evaluated. During this period 24 patients with gastric MALToma were diagnosed; out of them, 13 (54.2%) had active H. Pylori infection. The mean and median age was 49.7 and 53.5 years. The male: female ratio was 17:7. The common presenting complaints were epigastric pain (n=10) and dyspepsia (n=9). Endoscopic findings revealed mild gastric hyperemia (n=16), superficial erosions (n=4) and superficial ulcers (n=4). It was …

Interposition Grafting Of Large Extracranial Carotid Aneurysm, Marlous Huyzer, Michel M P J Reijnen, Johannes E M Sybrandy, Jacob Buth, Clark J Zeebregts

The Texas Heart Institute Journal

Extracranial carotid aneurysms are a rare entity and carry an inherent risk of thromboembolic complications. Treatment options consist of endovascular and conventional surgical techniques. We describe the cases of 3 patients who were treated with an interposition graft for a large extracranial carotid aneurysm.

The patients had presented with an extracranial carotid aneurysm with a diameter of 30 to 43 mm. In all cases, the aneurysm was excluded by means of an interposition graft, without major perioperative complications. There was 1 case of temporary paresis of the facial nerve and another of temporary paresis of the vocal cord. After a …

Paclitaxel Induces Thrombomodulin Downregulation In Human Aortic Endothelial Cells, Huang-Joe Wang, Te-Ling Lu, Haimei Huang, Huey-Chun Huang

The Texas Heart Institute Journal

Patients with paclitaxel-eluting stents are at risk of developing stent thrombosis upon premature discontinuation of dual antiplatelet therapy. In this study, we set out to clarify whether paclitaxel can modulate thrombomodulin expression in human aortic endothelial cells. Human aortic endothelial cells were stimulated with paclitaxel. Methoxyphenyl tetrazolium inner salt cell viability assay, Western blot analysis, real-time polymerase chain reaction, and immunohistochemical assay were performed. In human aortic endothelial cells, paclitaxel (10(-5) to 10(-9) mol/L) treatment for 13 hours caused significant cytotoxicity at drug concentrations greater than 10(-7) mol/L. Paclitaxel (10(-5) to 10(-9) mol/L) treatment for 5 hours downregulated thrombomodulin expression …

The Evaluation And Management Of Electrical Storm, Michael Eifling, Mehdi Razavi, Ali Massumi

The Texas Heart Institute Journal

Electrical storm is an increasingly common and life-threatening syndrome that is defined by 3 or more sustained episodes of ventricular tachycardia, ventricular fibrillation, or appropriate shocks from an implantable cardioverter-defibrillator within 24 hours. The clinical presentation can be dramatic. Electrical storm can manifest itself during acute myocardial infarction and in patients who have structural heart disease, an implantable cardioverter-defibrillator, or an inherited arrhythmic syndrome. The presence or absence of structural heart disease and the electrocardiographic morphology of the presenting arrhythmia can provide important diagnostic clues into the mechanism of electrical storm. Electrical storm typically has a poor outcome.

The effective …

Left Atrial Ablation For Atrial Fibrillation: Creating The “Box Lesion” With A Bipolar Radiofrequency Device, Leonid Sternik, Hartzel V Schaff, David Luria, Michael Glikson, Alexander Kogan, Ateret Malachy, Maya First, Ehud Raanani

The Texas Heart Institute Journal

The maze procedure is the gold standard for the ablation of atrial fibrillation, and the “box lesion” around the pulmonary veins is the most important part of this procedure. We have created this lesion with a bipolar radiofrequency ablator, abandoning the usual use of this device (to achieve bilateral epicardial isolation of the pulmonary veins).

From March 2004 through the end of May 2010, we performed surgical ablation of atrial fibrillation in 240 patients. Of this number, 205 underwent operation by a hybrid maze technique and the remaining 35 (our study cohort) underwent the creation of a box lesion around …

Cd34-Positive Stem Cells In The Treatment Of Heart And Vascular Disease In Human Beings, Alexander R Mackie, Douglas W Losordo

The Texas Heart Institute Journal

Bone marrow-derived CD34(+) cells are a well-characterized population of stem cells that have traditionally been used clinically to reconstitute the hematopoietic system after radiation or chemotherapy. More recently, CD34(+) cells have also been shown to induce therapeutic angiogenesis in animal models of myocardial, peripheral, and cerebral ischemia. The mechanism by which CD34(+) cells promote therapeutic angiogenesis is not completely understood, although evidence supports both direct incorporation of the cells into the expanding vasculature and paracrine secretion of angiogenic growth factors that support the developing microvasculature. Phase I and phase II clinical trials have explored the usefulness of CD34(+) cells in …

Sirolimus-Eluting Stents Versus Bare-Metal Stents In Routine Clinical Use, Muhammad Munir, Jonathan Aliota, Amany Ahmed, Anwarullah Mohammed, Vei Vei Lee, Macarthur A Elayda, James M Wilson

The Texas Heart Institute Journal

Conflicting patient outcomes have been reported after the use of sirolimus-eluting stents or bare-metal stents. In this nonrandomized study, we examine the outcomes after placement of sirolimus-eluting versus bare-metal stents in an unselected population of patients who underwent percutaneous coronary revascularization.

We used THIRD-base, a longitudinal data registry of patients who underwent revascularization at our institution, to compare demographics and outcomes in patients treated with a sirolimus-eluting or bare-metal stent from January 2001 through June 2006. Outcome measures included major acute coronary and cerebral events at 30 days, target-vessel failure at 9 months and at 3 years, and stent thrombosis. …

Endovascular Repair Of Aortoesophageal And Aortobronchial Fistulae, Roberto Chiesa, Andrea Kahlberg, Yamume Tshomba, Enrico M Marone, Massimiliano M Marrocco-Trischitta, Germano Melissano

The Texas Heart Institute Journal

Aortoesophageal fistulae (AEF) and aortobronchial fistulae (ABF) are uncommon, but are in general fatal if left untreated. Conventional treatment requires surgical replacement of the thoracic aorta, along with several adjunctive procedures to repair the esophageal or tracheobronchial lesion.The mortality rates associated with open surgery reach 61% in cases of primary fistula and 78% in secondary fistula.

Thoracic endovascular aortic repair (TEVAR) has been proposed as an alternative strategy to surgical management.Although less invasive, this technique has important limitations in treating AEF and ABF, the chief of which is the high risk of graft contamination. Moreover, we still lack sufficient data …