Diagnosis Commons^™

The Clinical Breast Examination: A Useful Screening Tool?, Jennifer Lo

Journal of Patient-Centered Research and Reviews

The standardization of the clinical breast examination as a screening tool for breast cancer has been a topic of controversy. Current recommendations vary significantly from organization to organization without consensus. There currently does not seem to be sufficient evidence regarding overall survival benefit of the clinical breast exam. However, as adjunct screening with mammography, it may help find earlier breast cancers and the up to 5–10% of cancers missed by mammography. The most appropriate standardized protocol may be that the clinical breast exam can be performed at the discretion of the provider and patient, with more inclination toward use in …

What Are The Recommended Timing And Screening Modalities For Women At Higher Risk Of Developing Breast Cancer? A Clin-Iq, Summer Jatala, Shawn Fitzgerald, Pamela Tietze, Kalyanakrishnan Ramakrisnan, Laine H. Mccarthy, Elizabeth Wickersham

Journal of Patient-Centered Research and Reviews

Early detection of breast cancer is desirable to prevent progression to advanced disease. This subject has been one of significant study and debate for women at normal risk, and recommendations continue to evolve. However, with regard to women at high risk, the recommendations from various health care professional organizations, including the U.S. Preventive Services Task Force, are different and also inconsistent concerning when to begin screening and which modalities should be used. We review several randomized controlled trials and consensus opinions regarding when to begin screening for breast cancer and how to best screen women at high risk. Specifically, we …

Attitudes Towards An Evidence-Based Clinical Decision Support Tool To Reduce Exposure To Ionizing Radiation, Raymond Zakhari

Faculty Publications and Presentations

Patients who suffer minor brain injuries experience unnecessary ionizing radiation in the form of a non-contrast head CT scan despite the dearth of evidence supporting standard CT scans for all brain injuries. Exposure to ionizing radiation increases the incidence of certain types of cancer. This evidence-based practice change project assesses the attitude of clinicians towards evidence-based clinical decision support tools, specifically the Canadian CT head rule. The use of highly sensitive clinical decision support tools is supported in the literature to help healthcare providers mitigate the risk associated with unnecessary use of CT scan imaging studies. The project was conducted …

Making The Leap From Research Laboratory To Clinic: Challenges And Opportunities For Next-Generation Sequencing In Infectious Disease Diagnostics., Brittany Goldberg, Heike Sichtig, Chelsie Geyer, Nathan Ledeboer, George M Weinstock

Pediatrics Faculty Publications

Next-generation DNA sequencing (NGS) has progressed enormously over the past decade, transforming genomic analysis and opening up many new opportunities for applications in clinical microbiology laboratories. The impact of NGS on microbiology has been revolutionary, with new microbial genomic sequences being generated daily, leading to the development of large databases of genomes and gene sequences. The ability to analyze microbial communities without culturing organisms has created the ever-growing field of metagenomics and microbiome analysis and has generated significant new insights into the relation between host and microbe. The medical literature contains many examples of how this new technology can be …

Noncontact Diffuse Correlation Tomography Of Breast Tumor, Lian He

Theses and Dissertations--Biomedical Engineering

Since aggressive cancers are frequently hypermetabolic with angiogenic vessels, quantification of blood flow (BF) can be vital for cancer diagnosis. Our laboratory has developed a noncontact diffuse correlation tomography (ncDCT) system for 3-D imaging of BF distribution in deep tissues (up to centimeters). The ncDCT system employs two sets of optical lenses to project source and detector fibers respectively onto the tissue surface, and applies finite element framework to model light transportation in complex tissue geometries. This thesis reports our first step to adapt the ncDCT system for 3-D imaging of BF contrasts in human breast tumors. A commercial 3-D …

The Retrospective Diagnosis Of Attention-Deficit/Hyperactivity Disorder In Adolescents: Family Physicians' Challenges, Adam M. Pechmann

Masters Theses

The primary purpose of the study was to identify current retrospective practices used by family physicians in the diagnosis of Attention-Deficit-Hyperactivity Disorder (ADHD) in adolescents and young adults. In other words, do physicians adhere to best practices and examine information from childhood in order to diagnose ADHD in adolescents and young adults? In addition, this study aimed to examine the information physicians request for ADHD diagnosis, types of treatments they recommend, the type of information they use to assess treatment outcomes, and professional attitudes regarding the nature of ADHD. Participants completed a questionnaire designed to answer the research questions. Participants …

Mirnas As Biomarkers For Prostate Cancer Progression, Gene C. Clark

Theses and Dissertations

Prostate cancer is one of the most challenging global medical issues today. In 2011, prostate cancer was the most diagnosed malignancy in the United States, making up 29% of new cancer cases. In that year it was the second leading cause of cancer related deaths among men in the USA and the second most common cause of cancer related death overall from the EU. The prostate remains, however, an under studied organ, making insights into the anatomy and biology of prostate cancer difficult to achieve. After 30 years, PSA screening of men of the appropriate age is still the first …

An Association Study Between Adult Blood Pressure And Time To First Cardiovascular Disease, Yongjia Pu

Theses and Dissertations

BACKGROUND: Several studies have demonstrated the association between the time to hypertension event and multiple baseline measurements for adults, yet other survival cardiovascular disease (CVD) outcomes such as high cholesterol and heart attack have been somewhat less considered. The Fels Longitudinal Study (FLS) provides us an opportunity to connect adult blood pressure (BP) at certain ages to the time to first CVD outcomes. The availability of long-term serial BP measurements from FLS also potentially allows us to evaluate if the trend of the measured BP biomarkers over time predicts survival outcomes in adulthood through statistical modeling.

METHODS: When the reference …

Low Cost Shear And Pressure Sensor, Kyle L. Rohrig, Phaethon D. Kotantoulas, Brandon J. Lloyd, Hazim H. Abualola, Tao Ruan

Williams Honors College, Honors Research Projects

Elevated pressure and shearing stresses at the foot-shoe interface are believed to play a role in diabetic foot ulceration. The main goal of this project was to design a simple insole that could distinguish between sites of high pressure and sites of excessive shearing stresses at the foot-shoe interface. Wear patterns that relate specifically to shear and pressure acting on the plantar surface of a patient’s foot also needed to be exhibited. The team used reflective tape that was applied to the surface to various types of insoles to look for visible wear patterns. These wear patterns were identified by …

Dysregulation Of Micrornas In Blood As Biomarkers For Diagnosing Prostate Cancer, Rhonda W. Daniel

Theses and Dissertations

Prostate cancer is the most common noncutaneous cancer among men, yet current diagnostic methods are insufficient and more reliable diagnostic markers need to be developed. The answer that can bridge this gap and enable more efficient diagnoses may lie in microRNAs. These small, single stranded RNA molecules impact protein expression at the translational level and regulate important cellular pathways. Dysregulation of these small RNA molecules can have tumorigenic effects on cells and lead to many types of cancers.

Currently the Prostate-Stimulating Antigen (PSA) is used as a diagnostic marker for prostate cancer. However, many factors can elevate PSA levels such …

Values In Breast Cancer Screening: An Empirical Study With Australian Experts, Lisa Parker, Lucie Rychetnik, Stacy Carter

Medical Papers and Journal Articles

Objective:

To explore what Australian experts value in breast screening, how these values are conceptualised and prioritised, and how they inform experts’ reasoning and judgement about the Australian breast-screening programme.

Design:

Qualitative study based on interviews with experts.

Participants:

33 experts, including clinicians, programme managers, policymakers, advocates and researchers selected for their recognisable influence in the Australian breast-screening setting.

Setting:

Australian breast-screening policy, practice and research settings.

Results:

Experts expressed 2 types of values: ethical values (about what was good, important or right) and epistemological values (about how evidence should be created and used). Ethical values included delivering benefit, avoiding …

Analysis Of Protein Expression For Potential Biomarkers In Human Pancreatic Tumor Cell Lines, Jade Ashley Simpson

Honors Program Theses

Pancreatic cancer is an aggressive cancer of the pancreas that has been shown to have extremely low survival rates. It can be quite lethal because of its asymptomatic early stages and inability to detect cancer at the cellular level. Once diagnosed, the cancer will have usually spread or metastasized beyond surgical resection. Thus, research is focused on finding potential biomarkers in tumor cell lines to help in earlier diagnosis of this disease leading to better treatment options. Previous work using bioinformatics data suggest several cellular genes including, CTHCR1, EPPK1, AHNAK2, and IGHG3, can be potential biomarkers for pancreatic cancer. The …

Two-Dimensional Layered Mos2 Biosensors Enable Highly Sensitive Detection Of Biomolecules, Joonhyung Lee, Piyush Dak, Yeonsung Lee, Heekyeong Park, Woong Choi, Muhammad Ashraful Alam, Sunkook Kim

Birck and NCN Publications

We present a MoS₂ biosensor to electrically detect prostate specific antigen (PSA) in a highly sensitive and label-free manner. Unlike previous MoS₂-FET-based biosensors, the device configuration of our biosensors does not require a dielectric layer such as HfO₂ due to the hydrophobicity of MoS₂. Such an oxide-free operation improves sensitivity and simplifies sensor design. For a quantitative and selective detection of PSA antigen, anti-PSA antibody was immobilized on the sensor surface. Then, introduction of PSA antigen, into the anti-PSA immobilized sensor surface resulted in a lable-free immunoassary format. Measured off-state current of the device …

A Study Into The Diagnosis Of Obesity In Infants Less Than Two Years Old In The State Of Virginia, Lindsay Ann Bruno

Senior Honors Projects, 2010-2019

In 2007, the CDC reported approximately 12.5 million children and adolescents in the U.S. were obese. Among 24-month old clinically obese children, only 23% were diagnosed as obese. The most concerning is the prevalence of obesity in 6-month olds; 16% of 6-month old infants in the U.S. are obese, of which only 14% are diagnosed as being obese. Previous research concentrates on the factors that influence infant obesity, but does not address the prevalence of diagnosing obesity in children, particularly those under two years of age. The purpose of this project was to pioneer a survey exploring the prevalence of …

Molecular Insights Into Prostate Field Cancerization: Telomere Length, Egr-­‐1 Expression, And Regulation Of Mic-­‐1, Pdgf-­‐A, And Fas, Emily Frisch, Kristin Gabriel, Marco Bisoffi

Student Scholar Symposium Abstracts and Posters

The diagnosis of prostate cancer (adenocarcinoma) relies on screening for elevated prostate-specific antigen (PSA) in blood samples and on digital rectal examination (DRE). With high PSA levels and/or abnormal DRE, physicians recommend a biopsy, which often misses the location of the adenocarcinoma and results in false negatives. Previous studies have shown expression of the key transcription factor early growth response 1 (EGR-1), the pro-survival factor macrophage inhibitor cytokine 1 (MIC-1), and the growth stimulatory platelet derived growth factor A (PDGF-A) to be up-regulated in histologically normal tissues 1 centimeter adjacent to prostate adenocarcinomas. We hypothesize that tumors emerge from “field …

Prostate Field Cancerization -- Thinking Outside The Tumor, Dor Shoshan, Marco Bisoffi

Student Scholar Symposium Abstracts and Posters

Prostate field cancerization (or field effect) is characterized by the presence of molecular alterations in histologically normal tissues adjacent to adenocarcinomas. Accordingly, our research indicates deregulated expression of several proteins that define this type of molecular pathology. The scope of the present study was to determine the expression of the key transcription factor and potential marker of field cancerization early growth response 1 (EGR-1) in human prostate tissues derived from prostatectomies and biopsy cores.

EGR-1 was detected by immunofluorescence using a polyclonal anti-human EGR-1 and Alexa Fluor 488-conjugated secondary antibodies. EGR-1 expression was quantitated by determining the pixel count per …

Selective Indicators For Optical Determination Of Disease Biomarkers, Lovemore Hakuna

Dissertations and Theses

The most abundant biological thiols, homocysteine (Hcy), cysteine (Cys) and glutathione (GSH) have been the subject of intense research due to their association with a wide range of diseases. They play a key role in maintaining the redox status of biological systems. Selective detection methods for these thiols are challenging due to their similar structures and properties. Current commercially available detection methods use separations, fragile and expensive enzymatic or immunogenic materials and complex instrumentation. This has led to a global effort towards developing simple and inexpensive optical probes and indicators selective for specific biological thiols.

Highly selective chemical probes and …

Raman Microspectroscopy For The Early Detection Of Pre-Malignant Changes In Cervical Tissue, Nosheen Rashid, Haq Nawaz, Kelvin W. Poon, Franck Bonnier, Salih Bakhiet, Cara Martin, John O'Leary, Hugh Byrne, Fiona Lyng

Articles

Cervical cancer is the third most common cancer affecting women worldwide. The mortality associated with cervical cancer can, however, be significantly reduced if the disease is detected at the pre-malignant stage. The aim of this study was to evaluate the potential of Raman microspectroscopy for elucidation of the biochemical changes associated with the pre-malignant stages of cervical cancer. Formalin fixed paraffin preserved tissue sections from cervical biopsies classified as negative for intraepithelial lesion and malignancy (NILM), low grade squamous intraepithelial lesion (LSIL) or high grade squamous intraepithelial lesion (HSIL) were analysed by Raman spectral mapping. Raman mapping, with K-Means Cluster …

What Is Pfapa And Why Does It Matter?, Dennis J. Baumgardner

Journal of Patient-Centered Research and Reviews

PFAPA, the syndrome of periodic fever, aphthous stomatitis, pharyngitis and cervical lymphadentitis, is an uncommon disease of episodic immune dysregulation that usually begins in early childhood. Symptoms occur at regular, predictable intervals, with healthy periods in between, and generally include the namesake signs and various other constitutional symptoms such as fever and fatigue. The etiology is unknown and there is no definitive diagnostic test or treatment. Uncertainty during the period of searching for a diagnosis may be disconcerting to the family and the clinician. Single-dose prednisone is effective for resolving the fever of PFAPA episodes within just a few hours, …

Sorting Reality From What We Think We Know About Breast Cancer In Africa, Sulma I. Mohammed, Joe B. Harford

Department of Comparative Pathobiology Faculty Publications

Much attention has been paid to the features of breast cancer in Africa and the parallels between breast cancer in indigenous Africans and in African American women, including a shift toward earlier onset; a tendency toward poorer outcomes; and an increased likelihood for the tumors to be negative for the estrogen receptor (ER), the progesterone receptor (PR), and/or the human epidermal growth factor receptor-2 (HER2) [1,2]. One of the more aggressive forms of breast cancer is termed ‘‘triple negative,’’ i.e., ER2, PR2, HER22 [3]. Patients with triple negative breast cancer tend to be younger than patients with other forms of …