Recursos de colección

NDLTD Union Catalog (1.532.874 recursos)

The NDLTD Union Catalog is an OAICat server containing thesis and dissertation records harvested from registered NDLTD OAI repositories

Yale Medical student MD Thesis

Mostrando recursos 1 - 20 de 63

  1. Treating the Children of Bolivia Infected with Chagas Disease A Cost-Benefit Analysis

    Magee, Gregory
    The purpose of this study was to perform a cost-benefit analysis of an intervention to treat all the children in Bolivia (under 15 years of age) who are infected with Chagas disease. This research was carried out in La Paz, Bolivia where the author lived for a year collecting data in collaboration with the National Chagas Control Program, Bolivian Ministry of Health. Operational costs were based on current prices for laboratory testing and pharmaceuticals, average hourly wages for health care workers, and the number of children who would be treated. The benefit of the program was estimated as the sum...

  2. Renal Dysfunction, Cardiovascular Risk, and the Response to Ace Inhibition in Patients After Myocardial Infarction

    Jose, Powell Oliapuram
    Background: Proteinuria is a known cardiovascular risk factor in hypertensive or diabetic patients as well as the general population. Worsening renal function (WRF) has been shown to influence outcomes in the heart failure population. The prognostic value of these markers for renal dysfunction in patients after myocardial infarction is unclear. Methods: The Survival and Ventricular Enlargement trial (SAVE) randomized 2231 patients with left ventricular dysfunction between 3-16 days (average 11 days) post-MI to receive captopril or placebo; those with a serum creatinine above 2.5mg/dl were excluded from SAVE. WRF was defined as an increase in creatinine greater-than 0.3mg/dl measured from baseline...

  3. The Effects of Novel Design Strategies on the Risks and Benefits of Phase I Oncology Trials

    Koyfman, Shlomo Asher
    Considerable ethical debate surrounding the risks and benefits of Phase I oncology trials is based on older response and toxicity data that does not account for recent changes in the types of agents and trial design. This study aims to not only update these data, but to investigate the impact of novel trial designs on various clinical outcomes. We performed a review of the literature using the Medline database. Part I included nearly all phase I trials published in 2002. Part II identified phase I studies of cytotoxic agents alone, published from 2002 through 2004. 221 Phase I oncology studies, consisting of...

  4. Ethnic Differences in Intramyocellular Lipid Levels and Insulin Resistance in Obese Children and Adolescents

    Liska, David
    The prevalence of insulin resistance and type 2 diabetes mellitus (T2DM) in obese children and adolescents is growing at an alarming rate, especially in ethnic minorities. It is not clear whether young people of different ethnic backgrounds vary in their metabolic response to excessive adiposity. Differences in lipid partitioning in the abdominal fat compartments have been observed among different ethnic groups. The aim of this study was to evaluate whether there are ethnic differences in intramyocellular lipid (IMCL) levels that are related to differences in insulin sensitivity. Eighty-two obese children and adolescents underwent 1) 1H nuclear magnetic resonance (NMR) spectroscopy...

  5. Fourteen Years of Silence: An Exploration of Intimate Partner Violence in the Jewish Community

    Light, Rachel Rose
    With the background that Jewish women stay in abusive marriages twice as long as their non-Jewish American counterparts, we attempt to understand the religious and cultural factors that may inhibit Jewish women from leaving violent relationships, and examine Scriptural and Rabbinic texts as to Jewish beliefs regarding spousal violence. A variety of academic sources and primary scriptural texts were analyzed for religious and cultural attitudes towards Jewish intimate partner violence. Eight Jewish victims of spousal abuse, five Rabbis and seventeen community support workers were interviewed. Jewish women face a variety of unique issues with regard to how domestic violence is...

  6. Differentiation of Appendiceal Carcinoids By Marker Gene Expression

    Latic, Igor
    Objective: To utilize differential gene expression of candidate markers to discriminate benign APCs (APCs) from malignant and mixed cell APCs. Background Data: Considerable controversy exists in regard to the appropriate surgical management of APCs since standard clinical and immunohistochemical methods cannot reliably determine whether an APC is indolent or aggressive. We have identified five differentially expressed genes: nucleosome assembly protein 1-like 1 [NAP1L1]; melanoma antigen D2 [MAGE-D2]; metastasis-associated protein 1 [MTA1]; NAcht Leucine-rich-repeat Protein 1 [NALP1] and Chromogranin A [CgA] that define gut neuroendocrine (NE) Enterochromaffin (EC) cell behavior. We hypothesized that APC (APC) malignancy, also derived from EC cells, could...

  7. Child Abuse and Bone Fractures in Young Children: Local Trends Over Three Decades

    Larson, Ilse Anne
    The purpose of this study was to determine the patterns of fractures in children less than three years of age that are distinctive of abuse, and to examine changes in the frequency of abusive fractures in young children evaluated at a major pediatric hospital over three time periods: 1979-1983 (early), 1991-1994 (middle), and 1999-2002 (late). All children 0 to 36 months of age who were treated for bone fractures at a major medical center from 1/99 to 12/02 were selected. Medical records were abstracted for sociodemographic and clinical characteristics, and radiographs were examined. Using specific criteria, each case was rated by...

  8. An Anatomy Based Health Education Curriculum Taught by Medical Students May Improve High School Students Health Knowledge

    Knight, Jason Anthony
    To date, few high school based interventions have been shown to have lasting effects on adolescents' health behaviors. The need for health interventions targeting adolescents is underscored by data showing that several health behaviors with significant short and long term adverse effects begin in early adolescence and become progressively more prevalent toward late adolescence. This project tested the efficacy of a novel anatomy based health education curriculum at increasing health knowledge. The course was taught by first year Yale medical students. The curriculum placed emphasis on nutrition, physical activity and infectious disease. Forty Juniors from Career High School visited Yale's...

  9. Cyclooxygenase-2 Expression in Post-Mastectomy Chest Wall Relapse

    Kim, Janet Heejung
    The purpose of this study was to assess the prognostic significance and clinical correlations of cyclooxgenase-2 expression (COX) in a cohort of patients treated with radiation (RT) for post-mastectomy chest wall relapse (PMCWR). Between 1975 and 1999, 113 patients were treated for isolated PMCWR. All patients were treated with biopsy and/or excision of the CWR followed by RT. Median follow-up was 10 years. All clinical data including demographics, pathology, staging, receptor status, HER-2/neu status, and adjuvant therapy were entered into a computerized database. Paraffin-embedded CWR specimens were retrieved from 42 patients, of which 38 were evaluated, created into a tissue...

  10. Histone acetylation and expression of SMN, the spinal muscular atrophy gene

    Kernochan, Lauren
    Spinal Muscular Atrophy (SMA) is an inherited neuromuscular disorder caused by mutation of the Survival Motor Neuron (SMN1) gene. Embryonic lethality is rescued by a nearly identical copy of the gene, SMN2, which exists in variable copy number and produces a small quantity of functional SMN protein. Because disease severity inversely correlates with SMN2 gene copy number and with SMN protein level, one therapeutic strategy has been to increase SMN2 expression. Previous investigators have demonstrated that SMN promoter activity, transcript, and SMN protein are increased in cells treated with histone deacetylase (HDAC) inhibitors, suggesting a role for histone acetylation in...

  11. Dysregulation of Sodium Channels in a Rat Model of Absence Epilepsy

    Khera, Davender
    Absence epilepsy is a generalized form of epilepsy where spike-wave discharges (SWDs) involve both hemispheres of the brain and thereby alter consciousness. Recent evidence by Meeren et al (2002) in the WAG/Rij rat model of absence epilepsy points to a cortical focus of SWDs before rapid generalization of the SWDs. This focus belongs in the peri-oral area of the somatosensory cortex, and it was found to consistently lead SWDs in other cortical and subcortical areas. With this recent finding, it seems plausible that a defect lies in this focal region of the cortex, leading to SWD in the WAG/Rij model....

  12. The Epidemiology and Clinical Presentation of Leprosy in the Pediatric Population of Paraguay

    Kattan, Jessica Anne
    Background: Several aspects concerning the biology and epidemiology of leprosy remain unknown. It has been recognized that the study of children with leprosy could provide important insight into unanswered questions, particularly if disease manifestations are carefully observed. Methods: A retrospective chart review of 308 cases of children aged 0-14 y/o was conducted at the Ministry of Health Leprosy Department in Asuncion, Paraguay. Data regarding age, gender, leprosy classification, transmission, detection, clinical presentation, presence and class of reaction, and disability were abstracted. Results: The study group ranged from 2 to 14 years of age. The incidence rate and the risk of having leprosy...

  13. Differential Responsiveness of Early and Late Passage Endothelial Cells to Shear Stress

    Juran, Peter
    I hypothesize that shear stress helps maintain the quiescent phenotype of vascular endothelium. I also hypothesize that changes in levels of shear stress facilitate alternations in endothelial cell activity consistent with an activated phenotype and the development of atherosclerotic vascular disease. Purpose #1: To assess the effects of aging on EC proliferation induced by SS Hypothesis: Orbital SS stimulates EC proliferation. Aged cells are less responsive to orbital SS and show less proliferation. Purpose #2: To assess the effects of aging on EC survival and apoptosis Hypothesis: Versus younger cells, aged cells have increased rates of apoptosis. Purpose #3: To assess the effects of aging...

  14. Staging, Prognosis, and Treatment of Merkel Cell Carcinoma: A Population-Based Study

    Housman, Douglas Michael
    Merkel cell carcinoma (MCC) is a rare form of skin cancer, often described as the most aggressive cutaneous malignancy. Its high propensity for dermal-lymphatic invasion, local recurrence, and rapid lymphatic and distant metastasis poses a significant treatment challenge to clinicians. Combining its highly aggressive nature with its low incidence, merkel cell carcinoma is a particularly difficult cancer to study. Two major staging criteria exist for Merkel cell carcinoma. The purpose of this study is to validate and compare the Memorial Sloan Kettering Cancer Center (MSKCC) staging criteria with the American Joint Committee on Cancer (AJCC) Tumor, Node, Metastasis (TNM) staging criteria...

  15. Onset and Exacerbation of Obsessive-Compulsive Disorder in Pregnancy and the Postpartum Period

    Focseneanu, Mariel Aida
    The overarching goal of this study was two-fold; to determine the prevalence of perinatal onset or worsening of OCD symptoms in women attending a university-based research program, and to determine whether there is a continuity between perinatal onset or worsening of OCD and premenstrual exacerbation of such symptoms. Women ages 18 to 69 years old that were enrolled in the Yale OCD Research Program between 1990 and 1995 were interviewed by phone or in person regarding demographics, onset and course of OCD, types of primary OCD symptoms, treatment history, comorbid diagnoses including substance use/abuse, and the impact of pregnancy and menstruation...

  16. Effect of Pyridostigmine on Heart Rate Recovery After Exercise in Trained Athletes and Sedentary Adults

    Dewland, Thomas Andrew
    Acetylcholinesterase inhibition with pyridostigmine has been previously studied in patients with congestive heart failure (CHF), but the effects of this medication on heart rate recovery after exercise and other indices of parasympathetic activity in populations with greater baseline vagal tone has not been fully characterized. Ten healthy, sedentary adults and ten aerobically trained athletes were enrolled in a prospective, double blind, randomized placebo controlled crossover trial. All study subjects were treated with a single dose of oral pyridostigmine 30 mg and matching placebo on separate days. Heart rate variability (HRV) at rest and heart rate recovery (HRR) at one minute...

  17. Increase in Peripheral Arterial Tone Predicts Myocardial Ischemia Induced by Mental Stress

    Graeber, Brendon Lewis
    Mental stress ischemia (MSI) is associated with poor prognosis for coronary artery disease (CAD) and is amenable to treatment, yet no easily administered test exists to diagnose it. Given the known increase in systemic vascular tone in response to stress, we studied the ability of peripheral arterial tonometry (PAT), a noninvasive functional measure of arterial tone, to predict those vulnerable to MSI. Seventy-seven patients with chronic stable CAD were subjected to mental stress with concomitant assessment of myocardial perfusion and pulse wave amplitude. Nuclear perfusion imaging was used to document MSI, and PAT was used to measure pulse wave and...

  18. T Cell Integrin Dependent, MKK3/p38 Mapk-Mediated Stabilization of Labile Cytokine mRNAs

    DeGregorio, Scott David
    The goal of this project is to elucidate the signaling pathway involved in the T cell integrin lymphocyte function-associated antigen 1 (LFA-1) engagement-mediated, HuR nuclear-to-cytoplasmic translocation and subsequent mRNA stabilization. To examine the pathway transducing LFA-1 engagement-mediated mRNA stabilization, we employed quantitative, real time RT-PCR in the presence of a transcriptional inhibitor to examine the half-life of interferon gamma (IFN-ã) mRNA, a labile cytokine transcript. We used immunofluorescence to observe the nuclear-to-cytoplasmic tranlocation of HuR, an mRNA-binding and stabilizing protein. We also used Western blot analysis to analyze the activity levels of specific mitogen activated protein kinases (MAPKs) upon LFA-1 engagement....

  19. What is the Optimal Management of Late Presenting Survivors of Acute Type A Aortic Dissection?

    Coe, Marcus Philip
    Type A aortic dissections represent a surgical emergency, yet there are those patients who do not receive immediate surgical treatment after the onset of their symptoms. The natural history of these patients, their reasons for delay in presentation or surgical correction, and their comparative clinical courses are not well defined. Data on 195 patients with type A dissections followed at Yale New Haven Hospital between 1985 and 2005 have been collected prospectively and retrospectively. Ninety-two (47.2%) patients received surgical treatment ¡Ý 48 hours after the initial onset of pain or did not receive any surgical treatment (Group A); the remaining 103...

  20. The Ventilatory Response to Normoxic Hypercapnia in Male Pet-1 Knockout Mice and the Influence of Female Sex Hormones

    Best, Simon Roderick Alfred
    Purpose: To determine if the deficiency in the hypercapnic ventilatory response as a result of 70% loss of serotonergic neurons in male Pet-1 knockout mice and the sparing of the female Pet-1 knockout mice can been accounted for and corrected by supplementation with estrogen and progesterone. Methods: Using whole-body flow-through plethysmography, 5 male Pet-1 -/- mice and 5 wild type mice were exposed to room air, 3%, 5%, 7%, and 10% CO2 and VE measured. All mice were then treated with oral 17â-estradiol (2500 nM) for 48 hours followed by a SC injection of progesterone (2 mg/kg). One hour after injection...

Aviso de cookies: Usamos cookies propias y de terceros para mejorar nuestros servicios, para análisis estadístico y para mostrarle publicidad. Si continua navegando consideramos que acepta su uso en los términos establecidos en la Política de cookies.