Medical Specialties Commons^™

Ethnicity And Gender Related Differences In Extended Intraesophageal Ph Monitoring Parameters In Infants: A Retrospective Study, Dena Nazer, Ronald Thomas, Vasundhara Tolia

Wayne State University Associated BioMed Central Scholarship

Abstract

Background

Gastroesophageal reflux disease (GERD) is believed to be more common in adult males as compared to females. It also has been shown in adults to be more common in Caucasians. We wanted to determine ethnicity and gender related differences for extended pH monitoring parameters in infancy.

Methods

Extended pH monitoring data (EPM) from infants <1 year of age were reviewed. Results were classified in two groups, as control and Gastroesophageal reflux disease (GERD) group based on the reflux index (RI). The GERD group had RI of equal to or more than 5% of total monitoring period. The parameters of RI, total number of episodes of pH < 4, and the number of episodes with pH < 4 lasting more than 5 minutes were compared by genders and by ethnic groups, Caucasians and African American (AA).

Results

There were 569 infants, 388 controls, 181 with GERD (320 males, 249 females; 165 Caucasians, 375 AA). No statistical difference in EPM parameters was detected between genders in both groups. However, Caucasian infants had a significantly higher incidence of GERD than AA infants …

Epileptogenesis Causes Long-Term Plasticity Changes In Calbindin D-28k In The Rat Pilocarpine Model Of Acquired Epilepsy, Anne Johnston Harrison

Theses and Dissertations

Epilepsy is one of the most common neurological disorders, affecting more than 2% of children and 1% of adults in the U.S. Emerging research has demonstrated that calcium, as a major second messenger system, underlies many of these injury-induced plasticity changes associated with the development of epilepsy. Recent evidence has suggested that long term elevations in neuronal resting calcium levels play a role in initiating and maintaining epileptogenesis (the development of epilepsy). Collaborations between our lab and others have produced microarray data that suggests that a major calcium-binding protein, calbindin D-28k, mRNA levels are decreased in epileptic rats even up …

Evidence For Absence Of Latchbridge Formation In Phasic Saphenous Artery, Shaojie Han

Theses and Dissertations

Tonic arterial smooth muscle can produce strong contractions indefinitely by formation of slowly cycling crossbridges (latchbridges) that maintain force at a high energy economy. To fully understand the uniqueness of mechanisms regulating tonic arterial contraction, comparisons have been made to phasic visceral smooth muscles that do not sustain high forces. This study explored mechanisms of force maintenance in a phasic artery by comparing KCl-induced contractions in the tonic, femoral artery (FA) and its primary branch, the phasic saphenous artery (SA). KCl rapidly (5 N/m2) and [ca2+]i (250 nM) in FA and SA. By 10 min, [ca2+]i declined to 175 nM …

Female Athletes And Performance-Enhancer Usage, Barbara Kay Fralinger

Seton Hall University Dissertations and Theses (ETDs)

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Elevated Ex Vivo Monocyte Chemotactic Protein-1 (Ccl2) In Pulmonary As Compared With Extra-Pulmonary Tuberculosis, Zahra Hasan, Irfan Zaidi, Bushra Jamil, M Aslam Khan, Akber Kanji, Rabia Hussain

Department of Pathology and Laboratory Medicine

Background: Tuberculosis causes 3 million deaths annually. The most common site of tuberculosis is pulmonary however; extra-pulmonary forms of the disease also remain prevalent. Restriction of Mycobacterium tuberculosis depends on effective recruitment and subsequent activation of T lymphocytes, mononuclear and polymorphonuclear cells to the site of infection. Tumor necrosis factor (TNF)-α is essential for granuloma formation and is a potent activator of monocyte chemotactic protein (MCP-1, CCL2). CCL2 is essential for recruitment of monocytes and T cells and has been shown to play a role in protection against tuberculosis. Interleukin -8 (CXCL8) is a potent activator of neutrophils. Increased …

Frequency Of Irregular Red Cell Alloantibodies In Patients With Thalassemia Major: A Bicenter Study, Fareena Bilwani, Ghulam Nabi, Salman Adil, Mohammad Usman, Farrukh Hassan, Mohammad Khurshid

Department of Pathology and Laboratory Medicine

Objective: To provide frequency and distribution pattern of various types of irregular red cell alloantibodies in patients with thalassemia major.
Methods: This is a descriptive study conducted at two centers from January to December 2001. Purposive sampling was done and all patients diagnosed to have thalassemia major were included in the study. Antibody identification was carried out on serum employing commercial two-cell panel using standardized blood bank methods. If patients were found to have an irregular red cell alloantibody then the antibody identification was performed using 16 panel cells. Results: A total of ninety-seven patients were included …

Anaphylactic Reaction After Intramuscular Injection Of Cyanocobalamin (Vitamin B12): A Case Report, Fareena Bilwani, Salman Adil, Usman Sheikh, Ayesha Humera, Mohammad Khurshid

Department of Pathology and Laboratory Medicine

We report a case of anaphylactic reaction to intramuscular injection of cyanocobalamin. This 52-year-old lady was diagnosed as a case of megaloblastic anemia secondary to dietary vitamin B12 deficiency. She had severe anaphylactic reaction after the parenteral administration of cyanocobalamine. Later she received oral vitamin B12 with no adverse effects. The purpose of this case report is to draw attention to the hypersensitive reaction to injectable vitamin B12, which is rarely seen. This could be due to sensitization to the vitamin B12 molecule itself or an IgE mediated reaction. We concluded that anaphylactic reaction to vitamin B12 is a rare …

Hairy Cell Leukemia: Clinical Presentation And Long Term Follow Up After Treatment With 2-Chlorodeoxyadenosine (2-Cda), Fareena Bilwani, Mohammad Usman, Salman Adil, Ghulam N. Kakepoto, Mohammad Khurshid

Department of Pathology and Laboratory Medicine

The aim of the study was to the clinical features and long term follow up after treatment with Cladarbine in a tertiary care hospital. Seven patients with hairy cell leukemia were diagnosed between January 1990 till December 2003. Diagnosis in all the patients was established by bone marrow aspirates and trephine biopsy along with TRAP. In two patients the diagnosis was supplemented by flowcytometry and in another two patients by splenectomy. Six patients were male while one was female. Mean age was 47.7 years (range 36-64). Most common presenting features were pallor and weakness (n=5). All patients had splenomegaly. Blood …

Frequency Of Fab Subtypes In Acute Myeloid Leukemia Patients At Aga Khan University Hospital Karachi, Mahadev Sajanmal Harani, Salman Adil, Mohammad Usman Shaikh, G N Kakepoto, Mohammad Khurshid

Department of Pathology and Laboratory Medicine

BACKGROUND: Acute myeloid leukemia (AML) is a heterogeneous disease. Therefore, various parameters are needed to classify this disease into subtypes, so that specific treatment approaches can be utilized effectively. The commonly used method for diagnosis and classification is based on FAB criteria using morphology and cytochemical stains. For some of the categories, immunophenotyping is necessary. The aim of present study is to determine the frequency of various sub types in acute myeloid leukemia using FAB criteria in our population. This will aid in the correct diagnosis of acute leukemia and hence proper management of the patients.
MATERIALS AND METHODS …

Cephalosporin Resistant Shigella Flexneri From A Clinical Isolate--A Rare Finding, Nasim Sabir, Afia Zafar

Department of Pathology and Laboratory Medicine

Shigellosis is an important public health problem, especially in developing countries. Antibiotic treatment of dysentery aimed at resolving diarrhea or reducing its duration, and to prevent transmission to other close contacts. Isolates with resistance to first line drugs have been reported throughout world, third generation cephalosporins and quinolones are mainstay of treatment. Shigella flexneri resistant to third generation cephalosporins in a clinical isolate is a rare finding, and this has been reported for the first time in Pakistan.

Frequency And Sensitivity Pattern Of Extended Spectrum Beta Lactamase Producing Isolates In A Tertiary Care Hospital Laboratory Of Pakistan, Kauser Jabeen, Afia Zafar, Rumina Hasan

Department of Pathology and Laboratory Medicine

Objective: To determine frequency, distribution and sensitivity pattern of Extended-Spectrum ß Lactamase (EBSL) producing organism at a tertiary care hospital in Pakistan.
Methods: All members of enterobacteriacae isolated between April and August 2002 were studied. Isolates were speciated according to standard biochemical tests. Susceptibility testing was performed by Kirby-Bauer method. ESBL was detected using double disc method using cefotaxime versus cefotaxime plus clavulanate according to NCCLS. Statistical analysis was performed by SPSS version 10. Test of significance were calculated using chi-square test.
Results: During the study period, 1137/2840 (40%) of the isolates tested were found to be ESBL producing. …

Frequency Of Isolation Of Shigella Serogroups/Serotypes And Their Antimicrobial Susceptibility Pattern In Children From Slum Areas In Karachi, Afia Zafar, Nasim Sabir, Zulfiqar Bhutta

Department of Pathology and Laboratory Medicine

Objectives: To assess the frequency of serogroups and serotypes, as well as the antimicrobial susceptibility pattern of Shigella species isolated from known cases of diarrhoea and dysentery from Karachi, Pakistan.
Methods: A cross-sectional study was conducted between January 2002 and March 2003 at Aga Khan University on stool samples received from children with diarrhoea and dysentery from four low socio-economic areas (Sultanabad, Rehri Goth, Hijrat and Sherpao colony) of Karachi. Stool samples yielding growth of Shigella species, were further identified for serotypes by slide agglutination. Antibiotics susceptibility was performed by Kirby Bauer disk diffusion method
Results: …

Solid And Cystic Epithelial Neoplasm Of Pancreas With Metastasis: Report Of A Highly Unusual Case, Zubair Ahmad, Nausheed Yaqboob, Suhail Muzaffar, Nadeem Ahmad

Department of Pathology and Laboratory Medicine

Solid and cystic papillary epithelial neoplasms of the pancreas are uncommon tumors occurring predominantly in young women. These tumors have excellent prognosis and after complete surgical resection, more that 95% patients are cured. Occasionally, they invade the surrounding pancreatic parenchyma. These tumors can recur even many years after resection, so long-term follow up is essential. Very few cases metastasize. We present a case of a middle aged woman with metastases to liver and omentum

Paediatric Palliative And Supportive Care: Caring For Life: The Needs Of Children And Families In Western Australia, Leanne Monterosso, Linda Kristjanson, Marianne Phillips, Sue Rowell

Research outputs pre 2011

Palliative care is the relief of symptoms, regardless of their impact on the underlying disease process. The philosophical underpinning of current international paediatric palliative and supportive care models is that palliative and supportive care should be offered to all children with life threatening or chronic illnesses/disabilities with complex care needs. This approach allows the integration of cure-directed treatment and palliative care. allowing children to benefit from both philosophies of care. In Australia, there is increasing recognition of the need for the development of appropriate paediatric palliative care services, especially in Western Australia where supportive care services for children with life-limiting …

The Long Shadow Of Cerebral Localization, Saad Shafqat

Section of Neurology

In 1995, during my first week as a neurology resident at Massachusetts General Hospital, I had the privilege of meeting the late Raymond Adams. He was an established octogenarian by then, but the years had made no difference to his air of professionalism and academic authority. His reputation was made in the 1950s and 1960s, when he developed Boston as a major centre of clinical neurology. Among other things, he is immortalized through a famous textbook that has appeared in multiple editions. Our meeting took place at a clinical conference in which I was required to present a case. He …

Development Of A Comprehensive Epilepsy Surgery Programme In Pakistan, Mughis Sheerani

Section of Neurology

No abstract provided.

Characteristics Of Patients With Guillain Barre Syndrome At A Tertiary Care Centre In Pakistan, 1995-2003, Mohammad Yawar Yakoob, Aisha Rahman, Bushra Jamil, Nadir Ali Syed

Department of Medicine

Objective: To study the clinical presentation, hospital course and outcome of patients admitted with Guillain Barre Syndrome (GBS) to a tertiary care hospital in Karachi, Pakistan.
Methods: The charts of patients conforming to International Classification of Diseases (ICD) code 9.0, for GBS, from September 1995 to January 2003 were reviewed. Clinical data was recorded on a standardized questionnaire, which included patients' age, sex, antecedent events, neurological signs and symptoms and ventilation requirement. The hospital course was analyzed, including nosocomial infections, therapy given and the functional status of patients, using the Rankin scale (0-6). Standard SPSS 11.5 software (Windows) …

Menke's Kinky Hair Syndrome--A Rare Medical Condition., Yaseer Al-Bita, Azam J. Samdani, Tania Azam

Department of Medicine

The case of a 16-month-old boy is described who had typical clinical and radiological features and was proven biochemically to be a case of Menke's disease. Clinical manifestations began in the first few months with hypothermia, hypotonia, seizures and death occurring at the age of 18 months.

Outcome Of Home Mechanical Ventilation, N Salahuddin, K Haider, Sj Husain, S Siddiqui, Fazal Hameed Khan, R. Manasia

Department of Anaesthesia

OBJECTIVE: To determine the outcome of patients discharged home on portable ventilator.
DESIGN: Descriptive study.
PLACE AND DURATION OF STUDY: The Aga Khan University Hospital, Karachi from January 2000 to December 2004.
PATIENTS AND METHODS: All ventilator-dependent patients discharged home were contacted. Survivors were administered the EQ-5D Quality-of-Life instrument. SPSS version 13 was used to analyze data.
RESULTS: Eleven patients were discharged home on invasive ventilation. Mean age was 49 years (range 10-98 years). Cause of ventilatory failure were cervical spine trauma in 36%, primary neurological disease in 27%, critical illness neuropathy and respiratory failure in 18% …

Drug Related Critical Incidents, F A. Khan, M Q. Hoda

Department of Anaesthesia

Drug related incidents are a common form of reported medical errors. This paper reviews the critical incidents related to drug errors reported from the main operating theatre suite in a teaching hospital in a developing country from January 1997 to December 2002. Each report was evaluated individually by two reviewers using a structured process. During this period, 44 874 anaesthetics were administered; 768 critical incidents were reported, 165 (21%) of which were related to drug errors. Underdosage, side-effect/drug reaction and syringe swap were the most common. A total of 76% were classified as preventable; 56% due to human error and …

Symptoms Of Gastro-Oesophageal Reflux Disease And The Severity Of Obstructive Sleep Apnoea Syndrome Are Not Related In Sleep Disorders Center Patients, H.-N. Kim, R. D. Vorona, M. P. Winn, M. Doviak, D. A. Johnson, J. Catesby Ware

Mathematics & Statistics Faculty Publications

Background: Studies suggest obstructive sleep apnea syndrome (OSAS) frequently manifests in patients with gastroesophageal reflux disease (GERD) and that there may be a causal relationship.

Aim: To determine the relationship between OSAS and symptoms of GERD.

Methods: Consecutive patients referred to the Sleep Disorders Center (SDC) 18 years and older with polysomnographically defined OSAS were evaluated prospectively for GERD using a validated symptoms questionnaire. The GERD and OSAS relationship was assessed by 1) determining frequency of GERD in patients with and without OSAS; 2) ascertaining the relationship between OSAS severity categories and presence of GERD; 3) examining GERD score in …

Biomarkers For Placental Abnormality, Cathal Mccarthy

Doctoral

Obstetrical complications including recurrent miscarriage, pre-eclampsia and intrauterine growth restriction (IUGR) affect 1%-5% of pregnant women (Younis and Samueloff 2003). Dysfunctional trophoblasts, impaired development of spiral arteries, imbalance in systems controlling the dilation and contraction of spiral arteries, placental fibrin clots and intervillous thrombosis are all possible factors that can result in an insufficient placental circulation. The combination of the hypercoagulable state of pregnancy and presence of genetic thrombophilic markets has the potential to induce placental thrombosis and cause placental insufficiency with subsequent obstetrical complications. The initial part of the research work involved examining the relationship between four common genetic …

Regulatory Role Of Glycogen Synthase Kinase 3 For Transcriptional Activity Of Add1/Srebp1c, Kang Ho Kim, Min Jeong Song, Eung Jae Yoo, Sung Sik Choe, Sang Dai Park, Jae Bum Kim

Faculty, Staff and Student Publications

Adipocyte determination- and differentiation-dependent factor 1 (ADD1) plays important roles in lipid metabolism and insulin-dependent gene expression. Because insulin stimulates carbohydrate and lipid synthesis, it would be important to decipher how the transcriptional activity of ADD1/SREBP1c is regulated in the insulin signaling pathway. In this study, we demonstrated that glycogen synthase kinase (GSK)-3 negatively regulates the transcriptional activity of ADD1/SREBP1c. GSK3 inhibitors enhanced a transcriptional activity of ADD1/SREBP1c and expression of ADD1/SREBP1c target genes including fatty acid synthase (FAS), acetyl-CoA carboxylase 1 (ACC1), and steroyl-CoA desaturase 1 (SCD1) in adipocytes and hepatocytes. In contrast, overexpression of GSK3beta down-regulated the transcriptional …

Chloride Equilibrium Potential In Salamander Cones., Wallace B. Thoreson, Eric J. Bryson

Journal Articles: Ophthalmology

BACKGROUND: GABAergic inhibition and effects of intracellular chloride ions on calcium channel activity have been proposed to regulate neurotransmission from photoreceptors. To assess the impact of these and other chloride-dependent mechanisms on release from cones, the chloride equilibrium potential (ECl) was determined in red-sensitive, large single cones from the tiger salamander retinal slice.

RESULTS: Whole cell recordings were done using gramicidin perforated patch techniques to maintain endogenous Cl- levels. Membrane potentials were corrected for liquid junction potentials. Cone resting potentials were found to average -46 mV. To measure ECl, we applied long depolarizing steps to activate the calcium-activated chloride current …

Childhood Traumatic Brain Injury: Recovery Of Working Memory Function And Behavioral Adjustment, Gayle L. Crahen

All-Inclusive List of Electronic Theses and Dissertations

Children and adolescents with a traumatic brain injury (TBI) were the focus of this investigation using an extant data set. The 3 7 participants were between the ages of 5 and 15 years at the time of injury, and the majority had a severe TBI. Participants were evaluated soon after injury for a Baseline description of functioning on measures of cognition and memory and re-evaluated at one and/or two year return appointments. Parents provided estimates of adaptive, internalizing, and externalizing behaviors at Baseline and at follow-up appointments on the V ABS and CBCL. It was expected that parents' descriptions of …

Édouard Glissant : Du Dé-Lire Verbal Au Discours Maîtrisé, Katell Colin-Thébaudeau

Présence Francophone: Revue internationale de langue et de littérature

This article questions the experience of delirium of the character of Marie Celat and places it in relation to the violence of identity and cultural alienation linked to the history of the West Indies. Using the word “Odono” as a pretext, which was transmitted to the character by a family tale, the text tackles the problem of the identity and origin of the subject. In Marie Celat’s delirium, the reference to “Odono” opens the way for diverse positions on the subject of enunciation, stretching the historical truth into an a-temporal, a-spatial, “out of chronology” event. The words juxtapose each other …

Folie De L'Écriture, Écriture De La Folie Dans La Littératureféminine Des Antilles Françaises, Pascale De Souza

Présence Francophone: Revue internationale de langue et de littérature

There are many female characters with sick/mutilated bodies in Guadeloupe and Martinique’s female literature. Madness, anorexia, self-mutilation, even the suicide of these female characters not only denounce a repressive social order inherited from the history of slavery, but also represent means to affect a social environment that is not responsive to the female quest for identity. Madness, crisis or acts of self-mutilation allow them to escape (“marronnage”) a system, which tries to negate their very existence.

Separate And Concomitant Use Of Lamotrigine, Lithium, And Divalproex In Bipolar Disorders., Daniel Z Lieberman, Frederick K Goodwin

Psychiatry and Behavioral Sciences Faculty Publications

Expert consensus emphasizes the need for better recognition and accurate diagnosis of bipolar disorder. Current research on lithium, divalproex, and lamotrigine provides new insight into the effective management of this illness. Advances in identifying the mechanism of action of mood stabilization has focused on signaling pathways within the cell that are associated with neurotrophic effects. Clinical research has led to confirmatory evidence of the efficacy of lithium in all phases of bipolar disorder, with the greatest effects seen in the treatment and prevention of mania. Compared to divalproex, lithium also has been found to have greater efficacy in the prevention …

Bronchial Airway Epithelial Cell Denudation In The Pathogenesis Of Asthma: The Role Of Il-4 And Il-13, Gail Ramirez-Icaza

All-Inclusive List of Electronic Theses and Dissertations

Asthma is characterized by infiltration and shedding of the bronchial epithelium. The Th2 cytokines IL-4 and IL-13 are involved in the cellular recruitment and infiltration seen in asthma. The effects ofIL-4 and IL-13 on cell-matrix interactions, gap formation, increased monolayer permeability and epithelial shedding are unknown. Experiments described in this report test the hypothesis that bronchial airway epithelial cells (BAEC) express paxillin, a structural focal adhesion protein, and down-regulation of paxillin by Th2 cytokines lead to BAEC hyperpermeability. Furthermore, the hypothesis that the Th2 cytokines IL-4 and IL-13 could down-regulate the adherens junction proteins Pcatenin and E-cadherin in BAEC, and …

Cbct Panoramic Images Vs. Traditional Panoramic Radiographs, Sunny Young Hutchinson

Loma Linda University Electronic Theses, Dissertations & Projects

The purpose of this research was to compare the accuracy of angular measurements of the panoramic image of the Newtom 9000™ Cone Beam Computed Tomography (CBCT) with the Sirona™ Orthophos panoramic unit. The study was separated into three parts: phantom study, patient study, and archform study. The phantom study used fabricated phantom typodonts to compare angular measurements between the Newtom 9000™ panoramic image and the Sirona™ panoramic radiograph. Accuracies of the measurements were then determined by comparing the values to the actual phantom typodont. No marked differences in angular measurements were recorded for the phantom typodont using either of the …