Browsing by Subject "pathophysiology"

Now showing 1 - 5 of 5
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    Diabetes in sub-Saharan Africa – from policy to practice to progress: targeting the existing gaps for future care for diabetes
    (DovePress, 2017-06-22) Pastakia, Sonak D; Pekny, Chelsea R; Manyara, Simon M; Fischer, Lydia; Pediatrics, School of Medicine
    The global prevalence and impact of diabetes has increased dramatically, particularly in sub-Saharan Africa. This region faces unique challenges in combating the disease including lack of funding for noncommunicable diseases, lack of availability of studies and guidelines specific to the population, lack of availability of medications, differences in urban and rural patients, and inequity between public and private sector health care. Because of these challenges, diabetes has a greater impact on morbidity and mortality related to the disease in sub-Saharan Africa than any other region in the world. In order to address these unacceptably poor trends, contextualized strategies for the prevention, identification, management, and financing of diabetes care within this population must be developed. This narrative review provides insights into the policy landscape, epidemiology, pathophysiology, care protocols, medication availability, and health care systems to give readers a comprehensive summary of many factors in these domains as they pertain to diabetes in sub-Saharan Africa. In addition to providing a review of the current evidence available in these domains, potential solutions to address the major gaps in care will be proposed to reverse the negative trends seen with diabetes in sub-Saharan Africa.
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    Interaction of synchronized dynamics in cortical and subcortical circuits in Parkinson’s disease
    (Office of the Vice Chancellor for Research, 2015-04-17) Ahn, Sungwoo; Zauber, S. Elizabeth; Worth, Robert M.; Witt, Thomas; Rubchinsky, Leonid L.
    Parkinson’s disease pathophysiology is marked by increased oscillatory and synchronous activity in the beta frequency band in cortical and basal ganglia circuits. This study explores the functional connections between synchronized dynamics of cortical areas and dynamics of subcortical areas in Parkinson’s disease. We simultaneously recorded neuronal units (spikes) and local field potentials (LFP) from subthalamic nucleus (STN), and electroencephalograms (EEGs) from the scalp in parkinsonian patients and analyzed the correlation between the time-courses of the spike-LFP synchronization and inter-electrode EEG synchronization. We found the (noninvasively obtained) time-course of the synchrony strength between EEG electrodes and the (invasively obtained) time-course of the synchrony between spiking unit and LFP in STN to be weakly, but significantly correlated with each other. This correlation is largest for the bilateral motor EEG synchronization followed by bilateral frontal EEG synchronization. Our observations suggest that there may be multiple functional modes by which the cortical and basal ganglia circuits interact with each other in Parkinson’s disease: not only synchronization may be observed between some areas in cortex and the basal ganglia, but also synchronization within cortex and within basal ganglia may be related, suggesting potentially more global way of functional interaction. More coherent dynamics in one brain region may modulate or activate the dynamics of another brain region in a more powerful way causing correlations between changes in synchrony strength in both regions.
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    MicroRNAs: Clinical Relevance in Colorectal Cancer
    (MDPI, 2015) Thomas, Joe; Ohtsuka, Masahisa; Pichler, Martin; Ling, Hui
    Colorectal cancer is one of the most common cancer diagnoses and causes of mortality worldwide. MicroRNAs are a class of small, non-coding regulatory RNAs that have shown strong associations with colorectal cancer. Through the repression of target messenger RNAs, microRNAs modulate many cellular pathways, such as those involved in cell proliferation, apoptosis, and differentiation. The utilization of microRNAs has shown significant promise in the diagnosis and prognosis of colorectal cancer, owing to their unique expression profile associations with cancer types and malignancies. Moreover, microRNA therapeutics with mimics or antagonists show great promise in preclinical studies, which encourages further development of their clinical use for colorectal cancer patients. The unique ability of microRNAs to affect multiple downstream pathways represents a novel approach for cancer therapy. Although still early in its development, we believe that microRNAs can be used in the near future as biomarkers and therapeutic targets for colorectal cancer.
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    Multicenter prevalence of anaphylaxis in clinic-based oral food challenges
    (Elsevier, 2017-10-01) Akuete, Kwei; Guffey, Danielle; Israelsen, Ryan B.; Broyles, John M.; Higgins, Lori Jo; Green, Todd D.; Naimi, David R.; MacGinnitie, Andrew J.; Vitalpur, Girish; Minard, Charles G.; Davis, Carla M.; Pediatrics, School of Medicine
    Background Although previous single-center studies report the rate of anaphylaxis for oral food challenges (OFCs) as 9% to 11%, little is known regarding the epidemiology of clinical OFCs across multiple centers in the United States. Objective To examine the epidemiology, symptoms, and treatment of clinical low-risk OFCs in the nonresearch setting. Methods Data were obtained from 2008 to 2013 through a physician survey in 5 food allergy centers geographically distributed across the United States. Allergic reaction rates and the association of reaction rates with year, hospital, and demographics were determined using a linear mixed model. Meta-analysis was used to pool the proportion of reactions and anaphylaxis with inverse-variance weights using a random-effects model with exact confidence intervals (CIs). Results A total of 6,377 OFCs were performed, and the pooled estimate of anaphylaxis was 2% (95% CI, 1%-3%). The rate of allergic reactions was 14% (95% CI, 13%-16%) and was consistent during the study period (P = .40). Reaction rates ranged from 13% to 33%. Males reacted 16% more frequently than females (95% CI, 4%-37.5%; P = .04). Foods challenged in 2013 varied geographically, with peanut as the most challenged food in the Northeast, Midwest, and West and egg as the most challenged in the South. Conclusion As the largest national survey of allergic reactions of clinical open OFCs in a nonresearch setting in the United States, this study found that performing clinical nonresearch open low-risk OFCs results in few allergic reactions, with 86% of challenges resulting in no reactions and 98% without anaphylaxis.
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    A Pathophysiology Walk-Through Active Learning Strategy
    (Healio, 2020-11) Padgett, Tonja M.; Davis, Emily A.; School of Nursing