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Search Results: 1 - 10 of 1986 matches for " Cynthia LeBron "
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Postoperative Complications after Thoracic Surgery in the Morbidly Obese Patient
Lebron Cooper
Anesthesiology Research and Practice , 2011, DOI: 10.1155/2011/865634
Abstract: Little has been recently published about specific postoperative complications following thoracic surgery in the morbidly obese patient. Greater numbers of patients who are obese, morbidly obese, or supermorbidly obese are undergoing surgical procedures. Postoperative complications after thoracic surgery in these patients that can lead to increased morbidity and mortality, prolonged hospital stay, and increased cost of care are considered. Complications include difficulties with mask ventilation and securing the airway, obstructive sleep apnea with risk of oversedation, pulmonary complications related to reduced total lung capacity, reduced functional residual capacity, and reduced vital capacity, risks of aspiration pneumonitis and ventilator-associated pneumonia, cardiomyopathies, and atrial fibrillation, inadequate diabetes management, positioning injuries, increased risk of venous thrombosis, and pulmonary embolism. The type of thoracic surgical procedure may also pose other problems to consider during the postoperative period. Obese patients undergoing thoracic surgery pose a challenge to those caring for them. Those working with these patients must understand how to recognize, prevent, and manage these postoperative complications. 1. Introduction Little has been recently published about specific postoperative complications following thoracic surgery in the morbidly obese patient. Anesthesia and postoperative management of morbidly obese patients in thoracic surgery are based on experience in these patients undergoing other types of procedures [1]. While approximately 5% of patients undergoing surgical procedures are considered morbidly obese (BMI > 40?kg/m2), another 30% of patients in the US are considered obese (BMI > 30?kg/m2) [2]. The exact number of these who require thoracic surgery is unknown. However, considering that postoperative complications are a major cause of morbidity, mortality, prolonged hospital stay, and increased cost of care, it is important that those working with these patients during the postoperative period understand how to recognize, prevent, and manage these complications [3]. 2. Airway Complications Mask ventilation and intubation may be difficult in the morbidly obese patient secondary to excessive tissue in the posterior pharyngeal wall [4]. A Mallampati score of III or IV and increased neck circumference have been found to be the best predictors of potential difficulty with tracheal intubation [5]. These considerations should be kept in mind when planning extubation following thoracic surgery in the morbidly obese
Neurofilament Heavy Polypeptide Regulates the Akt-β-Catenin Pathway in Human Esophageal Squamous Cell Carcinoma
Myoung Sook Kim,Xiaofei Chang,Cynthia LeBron,Jatin K. Nagpal,Juna Lee,Yiping Huang,Keishi Yamashita,Barry Trink,Edward A. Ratovitski,David Sidransky
PLOS ONE , 2012, DOI: 10.1371/journal.pone.0009003
Abstract: Aerobic glycolysis and mitochondrial dysfunction are common features of aggressive cancer growth. We observed promoter methylation and loss of expression in neurofilament heavy polypeptide (NEFH) in a significant proportion of primary esophageal squamous cell carcinoma (ESCC) samples that were of a high tumor grade and advanced stage. RNA interference-mediated knockdown of NEFH accelerated ESCC cell growth in culture and increased tumorigenicity in vivo, whereas forced expression of NEFH significantly inhibited cell growth and colony formation. Loss of NEFH caused up-regulation of pyruvate kinase-M2 type and down-regulation of pyruvate dehydrogenase, via activation of the Akt/β-catenin pathway, resulting in enhanced aerobic glycolysis and mitochondrial dysfunction. The acceleration of glycolysis and mitochondrial dysfunction in NEFH-knockdown cells was suppressed in the absence of β-catenin expression, and was decreased by the treatment of 2-Deoxyglucose, a glycolytic inhibitor, or API-2, an Akt inhibitor. Loss of NEFH activates the Akt/β-catenin pathway and increases glycolysis and mitochondrial dysfunction. Cancer cells with methylated NEFH can be targeted for destruction with specific inhibitors of deregulated downstream pathways.
Pheochromocytoma Presenting as Acute Heart Failure Leading to Cardiogenic Shock and Multiorgan Failure
Jochen Steppan,Julia Shields,Ralph Lebron
Case Reports in Medicine , 2011, DOI: 10.1155/2011/596354
Abstract: Pheochromocytoma is an endocrine tumor classically presenting with headache, paroxysmal hypertension, and palpitations. We discuss the case of a young male, presenting with acute heart failure and cardiogenic shock requiring stabilization with an intra-aortic balloon pump and a combination of ionotropes and vasopressors. Pheochromocytoma was diagnosed by CT scan, as well as urine and plasma metanephrines. After pretreatment with phenoxy-benzamine, the patient underwent adrenalectomy with subsequent cardiovascular stabilization and full recovery. Unfortunately, pheochromocytoma often remains undiagnosed. Given the ample diagnostic tools and good prognosis when treated suitably, the diagnosis should be entertained early in patients, presenting with unexplained cardiovascular compromise.
Integrated Band Intensities of Ethylene () by Fourier Transform Infrared Spectroscopy
G. B. Lebron,T. L. Tan
International Journal of Spectroscopy , 2012, DOI: 10.1155/2012/474639
Abstract: The integrated band intensities of ethylene (12C2H4) in the 640–3260 cm−1 region were determined by Fourier transform infrared (FTIR) spectroscopy. The infrared absorbance spectra of the 7 and 10, 12, 7
The Mycobacterium tuberculosis Proteasome Active Site Threonine Is Essential for Persistence Yet Dispensable for Replication and Resistance to Nitric Oxide
Sheetal Gandotra,Maria B. Lebron,Sabine Ehrt
PLOS Pathogens , 2010, DOI: 10.1371/journal.ppat.1001040
Abstract: Previous work revealed that conditional depletion of the core proteasome subunits PrcB and PrcA impaired growth of Mycobacterium tuberculosis in vitro and in mouse lungs, caused hypersusceptibility to nitric oxide (NO) and impaired persistence of the bacilli during chronic mouse infections. Here, we show that genetic deletion of prcBA led to similar phenotypes. Surprisingly, however, an active site mutant proteasome complemented the in vitro and in vivo growth defects of the prcBA knockout (ΔprcBA) as well as its NO hypersensitivity. In contrast, long-term survival of M. tuberculosis in stationary phase and during starvation in vitro and in the chronic phase of mouse infection required a proteolytically active proteasome. Inhibition of inducible nitric oxide synthase did not rescue survival of ΔprcBA, revealing a function beyond NO defense, by which the proteasome contributes to M. tuberculosis fitness during chronic mouse infections. These findings suggest that proteasomal proteolysis facilitates mycobacterial persistence, that M. tuberculosis faces starvation during chronic mouse infections and that the proteasome serves a proteolysis-independent function.
Sex differences, gonadal hormones and the fear extinction network: implications for anxiety disorders
Kelimer Lebron-Milad, Mohammed R Milad
Biology of Mood & Anxiety Disorders , 2012, DOI: 10.1186/2045-5380-2-3
Abstract: After a brief overview of the fear extinction network, we summarize what is currently known about sex differences in fear extinction and the influence of gonadal hormones on the fear extinction network. We then go on to propose possible mechanisms by which sex hormones, such as estrogen, may influence neural plasticity within the fear extinction network. We end with a discussion of how knowledge to be gained from developing this line of research may have significant ramifications towards the etiology, epidemiology and treatment of anxiety disorders.There are now substantial data indicating that structural, cellular and molecular differences exist between the male and female brains in regions that are important for cognition, memory and affect, such as the hippocampus, amygdala and prefrontal cortex. Some of these differences may have clinical relevance, as marked disparities in disease incidence, manifestation, prognosis and treatment have been observed between the sexes. For example, men have a higher prevalence of conditions that emerge early in development, such as autism, attention deficit hyperactivity disorder and schizophrenia. Women, on the other hand, have a higher prevalence of disorders that emerge in adolescence or adulthood, such as major depression and anxiety disorders. Surprisingly, very little is known about the neural mechanisms that underlie the expression of sex differences in psychiatric disorders. A 2001 report by the Institute of Medicine highlighted the need to conduct scientific studies at the cellular, molecular and whole organism level that take into account sex as a variable to investigate the neural mechanisms that lead to epidemiological differences in psychiatric disorders.The need to examine sex differences in the network mediating fear learning and its extinction can be surmised from two different perspectives. From a clinical perspective, we need to understand what contributes to the significant epidemiological differences in psychi
Factors Predictive of Right Internal Jugular Vein Cross-Sectional Area Change in Response to Trendelenburg Positioning  [PDF]
Edward Maratea, Catalina Castillo-Pedraza, Lebron Cooper, Henry Olivera, Edward Gologorsky
World Journal of Cardiovascular Surgery (WJCS) , 2013, DOI: 10.4236/wjcs.2013.32005
Abstract: Background/Purpose: The right internal jugular vein (RIJV) is the most commonly accessed central venous site in the cardiac operating room. The Trendelenburg position is frequently used to increase the cross-sectional area (CSA) of the RIJV to facilitate its cannulation. However, the extent of change of RIJV CSA in response to Trendelenburg positioning in anesthetized patients and its predictive factors remain unknown. Methods: Thirty-seven patients presented for the cardiac surgery, and 20 ASA I and II surgical patients without a history of cardiac disease (control) were studied. After induction of anesthesia, RIJV CSA was measured both at supine level position and in 10-degree Trendelenburg using vascular ultrasonography. Central venous pressure was measured in cardiac surgery patients only, since the patients in control group did not require invasive lines placement. Results and Conclusions: Body-surface area, central venous pressure, type of surgery and ejection fraction did not show any correlation with the degree of RIJV CSA change. RIJV dilation in response to Trendelenburg was significantly less pronounced, and more variable, in female patients.
Line Intensity Measurements of the Band of Ethylene ( 12 C 2 H 4 )
G. B. Lebron,T. L. Tan
International Journal of Spectroscopy , 2013, DOI: 10.1155/2013/492092
Abstract: From the four high-resolution FTIR absorbance spectra recorded at a spectral resolution of 0.0063?cm?1, 123 line intensities belonging to the band of 12C2H4 were measured and fit. The upper state rovibrational constants up to sextic terms determined using a Watson's -reduced Hamiltonian model in representation were used to calculate the line intensities of the band. Results of the experimental fit of the line intensities agree well with those obtained by calculations. 1. Introduction Spectroscopists take special interest in ethylene (12C2H4) for its atmospheric and astrophysical importance. Ethylene is naturally present in the atmosphere and is one of several precursors for the formation of tropospheric ozone, a pollutant that has adverse effects on human health. It also has been detected in the atmospheres of the Jovian planets Jupiter, Saturn, Neptune [1–4] and the satellite Titan [5]. Since accurate rotation-vibration parameters and knowledge of line positions and intensities are needed in the detection and monitoring of ethylene in the atmosphere, there have been a number of ethylene studies on the subject in the literature (e.g., [6–10]). As part of our ongoing FTIR investigation of ethylene and its isotopic variants [11–21], determination of the upper state rovibrational constants and line intensity measurements of the -type band of 12C2H4 in the 1820–1950?cm?1 region were performed. The present study aims to contribute to the limited but growing body of knowledge on ethylene line positions and intensities. Previous studies on the band of 12C2H4 include [22–25] which all considered the Coriolis interactions between the band and the and states. Ben Hassen and coworkers [6] measured the absolute line intensities of ethylene in the 1800–2350?cm?1 region. According to a previous paper [25], 39 of the 264 line intensities they measured belonged to the band. In the present study, the upper state rovibrational constants up to sextic centrifugal distortion terms were determined first using a standard Watson’s Hamiltonian model. The derived parameters were then used to calculate line intensities and positions of the band of 12C2H4. From the high-resolution FTIR spectra collected in the laboratory, 123 ethylene line positions and intensities were measured using a peak fitting analysis that implemented the Levenberg-Marquardt algorithm. We found the fit to be satisfactory falling within 6% error when compared to the calculated line intensities. 2. Experimental Details A Bruker 125HR Fourier transform spectrometer located at the FTIR laboratory of the
A Case Report: Calciphylaxis Presenting as Digital Ischemia in Patient with End Stage Kidney Disease on Peritoneal Dialysis  [PDF]
Hatoon Abbas, Manal Alotaibi, Ralph J. Lebron
Open Journal of Nephrology (OJNeph) , 2019, DOI: 10.4236/ojneph.2019.92006
Abstract: Calciphylaxis also known as Calcific uremic arteriolopathy (CUA), is a fatal disease with high mortality that mostly affects patients with end stage kidney disease (ESKD) on dialysis. In recent years the incidence of CUA has been increasing among patients on peritoneal dialysis (PD). The exact mechanism and risk factors are not well described.
“It’s a Wild Ride”: A Phenomenological Exploration of High Maternal, Gestational Weight Gain  [PDF]
Cynthia L. Murray
Health (Health) , 2014, DOI: 10.4236/health.2014.618293
Abstract: High maternal, gestational weight gain is associated with high birthweight, large-for-gestational-age birthweights, cesarean delivery, child overweight, and short- and long-term postpartum weight retention. In this phenomenological study, the meaning and experiences of weight gain for pregnant women with high gestational weight gain were investigated. Data were collected through interviews with pregnant women from Atlantic Canada. van Manen’s method of phenomenology was utilized. The data analysis revealed four patterns or major themes: being caught off guard; losing your bearings; hanging on for dear life; and hoping for health. The participants experienced their gestational weight gain as an unexpected “wild ride” that they could not control. The findings highlight the need for health care professionals to provide pregnant women with more support concerning gestational weight gain.
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