ERA

General Internal Medicine

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  1. Structured telephone support or telemonitoring programmes for patients with chronic heart failure [Download]

    Title: Structured telephone support or telemonitoring programmes for patients with chronic heart failure
    Creator: Inglis SC
    Subjects: Chronic Disease, Quality of Life, Telemetry, Telephone, Randomized Controlled Trials as Topic, Hospitalization, Heart Failure
    Date Created: 2010
  2. Recombinant expression of the cardiac troponin I fragment, cTnI[135-209], that controls cardiac contraction [Download]

    Title: Recombinant expression of the cardiac troponin I fragment, cTnI[135-209], that controls cardiac contraction
    Creator: Somaya Zahran
    Description: Intrinsically disordered regions (IDRs) are protein segments that lack a fixed three-dimensional structure under physiologic conditions, they are susceptible to post-translational modifications such as proteolysis. However, they are highly important in cellular signal transduction and the regulation of numerous biological processes. Cardiac Troponin I (cTnI) is a key regulatory protein in cardiac muscle contraction and relaxation being the inhibitory unit of the troponin complex. Having IDRs, makes it difficult to express. We modified methods to produce human cTnI in E.coli; using fusion partners to direct the target protein to accumulate in dense insoluble aggregates known as inclusion bodies, and protect them from proteolysis, it’s a common approach that’s been widely used to produce many clinically important peptides since the late 1970s, including insulin. CTnI, can be expressed using a PagP protein fusion system developed in our lab. PagP is superior to other fusion systems as it maintains a tandem construct of cTnI fragment in inclusion bodies, and it’s not very hydrophobic, making the inclusion bodies easier to solubilize. We produced cTnI[135-209] segment using PagP fusion system, targeted its expression in E.coli. into inclusion bodies which contained almost pure recombinant protein, solubilized it in denaturant, further purified it using nickel affinity chromatography, and then used Ni assisted hydrolysis to cleave it from PagP, it was isotopically labelled, which allowed us to study it by nuclear magnetic resonance (NMR) spectroscopy to ensure that it’s properly folded and stable. We confirmed that our cTnI[135-209] segment is structurally sound by measuring its molecular weight with MALDI-TOF mass spectrometry, and we ensured that it retained its biological activity by obtaining the chemical shift assignments by NMR before and after titrating actin as we got an evidence of their binding. We plan to use this information to gain a better understanding of heart failure, and cardiomyopathies.
    Subjects: fusion protein expression, metal ion-assisted peptide bond hydrolysis, chemical cleavage, intrinsically disordered regions
    Date Created: 2015/05/14
  3. Combining a PagP fusion protein system with nickel ion-catalyzed cleavage to produce intrinsically disordered proteins in E. coli. [Download]

    Title: Combining a PagP fusion protein system with nickel ion-catalyzed cleavage to produce intrinsically disordered proteins in E. coli.
    Creator: Zahran, Somaya
    Subjects: Nickel ion-catalyzed peptide bond hydrolysis, Inclusion bodies, Escherichia coli, Fusion protein expression, Chemical cleavage, Intrinsically disordered regions
    Date Created: 2015/08/18
  4. Long-term pharmacotherapy for obesity and overweight [Download]

    Title: Long-term pharmacotherapy for obesity and overweight
    Creator: Padwal RS
    Subjects: Randomized Controlled Trials as Topic, BodyWeight, Appetite Depressants, Anti-Obesity Agents, Weight Loss, Obesity, Cyclobutanes, Lactones
    Date Created: 2003
  5. Quality of Life (QOL) in Diabetics with Multi-Vessel Coronary Artery Disease: Real-World Experience Comparing Percutaneous Coronary Intervention (PCI) and Coronary Artery Bypass Grafting (CABG) [Download]

    Title: Quality of Life (QOL) in Diabetics with Multi-Vessel Coronary Artery Disease: Real-World Experience Comparing Percutaneous Coronary Intervention (PCI) and Coronary Artery Bypass Grafting (CABG)
    Creator: McGrath, Brent M.
    Description: Introduction Studies demonstrate mortality benefit supporting CABG over PCI in diabetics with multi-vessel CAD. However, CABG is associated with longer recovery and higher stroke rates. Thus, while CABG prolongs life it’s impact on QOL warrants study. This study utilizes comprehensive real-world data from the Alberta Provincial Project for Outcomes Assessment in Coronary Heart Disease (APPROACH) to compare the baseline, 1, 3 and 5 year QOL of diabetes with multi-vessel CAD by revascularization technique (CABG versus PCI). Methods APPROACH is an outcomes initiative capturing all patients undergoing cardiac revascularization in Alberta since 1995. Health status was measured using the Seattle Angina Questionnaire, a 19-item disease-specific questionnaire measuring five domains of health status: anginal stability, anginal frequency, exertional capacity, QOL and treatment satisfaction. Also captured within APPROACH is detailed information on demographics, comorbidites, first treatment designation (medical, PCI or CABG) and subsequent intervention. The present analysis included diabetics with multi-vessel CAD who had at least 1-year of QOL data. This primary crude analysis compared patient-reported QOL by first revascularization technique (PCI or CABG) among diabetics across baseline, 1, 3 and 5 years. Results At baseline, diabetics undergoing CABG reported worse health status across all domains when compared to PCI(p<0.05). One-year following revascularization, CABG-treated patients reported significantly better levels of angina stability and frequency, treatment satisfaction and QOL(p<0.05) compared to PCI, but did not differ in terms of exertional capacity(p>0.05). At three years, groups differed significantly only in angina stability, favouring CABG-treated patients(p<0.05) with a trend toward better QOL with CABG(p=0.07). There where no significant differences between groups at five years but the trend toward better QOL with CABG persisted(p=0.06). Conclusion Results suggest that diabetics undergoing CABG score significantly worse on health status domains at baseline. Following revascularization they do better than those undergoing PCI with the trend in improved QOL extending out 5-years.
    Subjects: Cardiology
  6. Incidence of Catheter-Related VTE in Acute Leukemia Patients Requiring Peripherally-Inserted Central Catheter [Download]

    Title: Incidence of Catheter-Related VTE in Acute Leukemia Patients Requiring Peripherally-Inserted Central Catheter
    Creator: Refaei, Mohammad R.
    Description: Resident research day for Core Internal Medicine. Background- Central venous catheters (CVCs) are a leading cause of upper extremity deep vein thrombosis (UE DVT). Long term CVCs are required for chemotherapy in acute leukemia (AL), who can be thrombocytopenic which makes anticoagulation for CVC related thrombosis a challenge. Incidence of UE DVT has been reported to be increased in those with peripherally inserted (PICC) vs centrally inserted lines. Aims- To identify leukemia inpatients with a PICC line and report the incidence of VTE. Methods- AL inpatients admitted to Hematology at the University of Alberta Hospital between 2003-2013 and who required PICC insertion were identified, and their charts reviewed retrospectively. Baseline patient characteristics were recorded. All VTE were objectively confirmed on imaging studies. Incidence of catheter associated thrombosis was calculated. Results- 420 patients with AL were identified. 83 patients were excluded for not undergoing a PICC insertion. The remaining 337 patients had at least one PICC line insertion. Overall, there were 634 PICC line insertions, with the 5FR dual lumen being the most commonly used PICC line (80%). Out of the 634 insertions, there were 65 (10%) new upper extremity DVTs, 54 (83%) of which developed acutely (<1month). Conclusions- The incidence rate of DVT in our AL patients is higher than predicted for a general cancer patient population.
    Subjects: Venous Thromboembolism Event, Acute Leukemia, Thrombosis, Catheter related thrombosis in leukaemia patients, Central Venous Catheter
    Date Created: 2015/05/21