Studying the neuronal mechanisms that govern the cortical adaptations to acute stress is critical... more Studying the neuronal mechanisms that govern the cortical adaptations to acute stress is critical for understanding the development of neuropsychiatric diseases. Homeostatic plasticity stabilizes the neural activity in which a previous synaptic event drives subsequent synaptic plasticity. In this study, we evaluated the effect of acute stress induced with the socially evaluated cold pressor test (SECPT) on cortical metaplasticity in humans using a non-invasive brain stimulation protocol. After being exposed to the SECPT and control stress conditions, 30 healthy participants were tested for cortical metaplasticity assessed with changes in the amplitude of the motor evoked potential (MEP) induced by a single-pulse transcranial magnetic stimulation (TMS). Cortical metaplasticity was induced by combining priming with cathodal tDCS (cTDCS) followed by a sub-threshold 1-Hz repetitive stimulation (rTMS) test session. Our results showed that SECPT induced cardiovascular adaptations (increase in systolic, diastolic blood pressure, and heart rate), indicating that SECPT effectively induced acute stress. Also, in our experiments stimulation of subjects with 1-Hz rTMS after they had undergone the SECPT condition induced inhibition of MEP whereas 1-Hz rTMS administered after the control condition induced a facilitatory (physiologic) response pattern. Here we observed that acute stress impairs homeostatic metaplasticity. The dysfunctional regulation of cortical plastic changes after stress could play a pivotal role in the pathogenesis of neurological and psychiatric diseases.
Bell's palsy (BP) occurs when the facial nerve (CN VII) is swollen, inflamed, or compressed, ... more Bell's palsy (BP) occurs when the facial nerve (CN VII) is swollen, inflamed, or compressed, resulting in facial weakness or paralysis; etiology is unknown. BP patients often succumb to a decreased quality of life due to the inability to make facial expressions, increased sensitivity to auditory stimuli, and dysregulation in tear and saliva production. Despite conventional examination and therapy options, the syndrome is majorly regarded as idiopathic and left unresolved for many patients. In this case of a patient with BP, treatment with osteopathic manipulative treatment (OMT) which focused on restoring a normal structure-function relationship resolved the patient’s symptoms. The osteopathic manipulative procedures utilized findings from an osteopathic structural exam and addressed those somatic dysfunctions with OMT. The authors report that the patient's symptoms improved after the application of OMT and without the use of pharmaceuticals. The results of the case study su...
Cortical blindness is a rare but frightening complication following coronary angiogram probably d... more Cortical blindness is a rare but frightening complication following coronary angiogram probably due to contrast penetration in occipital lobes in susceptible individuals [1, 2].
Les souches VIH-1 n'induisant pas la formation de syncytium (NSI) ont ete associees avec la t... more Les souches VIH-1 n'induisant pas la formation de syncytium (NSI) ont ete associees avec la transmission verticale de VIH-1 in utero, et avec l'infection de placentas humains in vitro dans une etude preliminaire utilisant trois souches virales. Pour etablir la relation existant entre le phenotype NSI et SI (induisant la formation de syncytium) de VIH-1 avec l'infection du placenta humain in vitro, nous avons utilise 21 souches differentes, en majorite de type sauvage provenant de bebes infectes in utero, intra-partum ou post-partum. Des explants placentaires villeux, de grossesses a terme non infectees, ont ete incubes durant 24 heures avec chacune des souches virales avant de subir un rincage intensif pour eliminer l'inoculum. Le tissu etait ensuite incube durant trois jours supplementaires. L'infection du tissu placentaire etait determinee par l'ADN viral amplifie par PCR (2 regions, Gag et LTR). Des 21 souches VIH-1, 38 % (8 sur 21) etaient capables d'infecter le tissu placentaire. 75 % etaient des souches NSI (6 sur 8) et 25 % des souches SI (2 sur 8). Sur le total des souches NSI, 40 % (6 sur 15) etaient infectieuses contre 33% (2 sur 6) du total des souches SI. En resume, l'infection VIH-1 du placenta humain a terme n'est pas uniquement dependante du phenotype NSI ou SI du VIH-1. De plus, toutes les souches VIH-1 isolees de bebes infectes in utero n'ont pas infecte les explants placentaires, alors que ces souches infectent les PBMC. D'autres caracteristiques de VIH-1 et du placenta lui-meme pourraient etre des elements importants de l'infectivite du placenta humain par VIH-1.
American journal of obstetrics and gynecology, Jan 12, 2015
Preterm rupture of membranes (PROM) is associated with increased risk of preterm birth and neonat... more Preterm rupture of membranes (PROM) is associated with increased risk of preterm birth and neonatal morbidity. Prophylactic 17-hydroxyprogesterone caproate (17OHPc) reduces the risk of preterm birth in some women at risk for preterm birth. We sought to test whether 17OHPc would prolong pregnancy or improve perinatal outcome when given to mothers with preterm rupture of the membranes. This is a multicenter, double-blind, placebo-controlled, randomized clinical trial. The study included singleton pregnancies with gestational ages between 23(0/7) to 30(6/7) weeks at enrollment, documented PROM, and no contraindication to expectant management. Consenting women were randomly assigned to receive weekly intramuscular injections of 17OHPc (250 mg) or placebo. The primary outcome was continuation of pregnancy until a favorable gestational age, defined as either 34(0/7) weeks of gestation or documentation of fetal lung maturity at 32(0/7) to 33(6/7) weeks. The two pre-specified secondary outc...
Although current obstetric practice guidelines suggest cervical length assessment in singletons f... more Although current obstetric practice guidelines suggest cervical length assessment in singletons for preterm birth risk, transvaginal ultrasonography has availability limitations. CerviLenz is a disposable device to measure vaginal cervical length. We sought to determine the threshold CerviLenz measurement with optimal specificity and sensitivity for diagnosis of short cervix by transvaginal ultrasonography and compare the abilities of CerviLenz and transvaginal ultrasonography to predict preterm birth. Women with singleton pregnancies and no cervical anomalies or surgery or premature labor were consented, enrolled, and followed to delivery. Transvaginal ultrasonography and CerviLenz cervical length measurements were obtained by independent examiners at 17-23 weeks of gestation. A central reader certified sonographers and reviewed all transvaginal ultrasound scans. Based on 358 patients, receiver operator curves indicated optimal CerviLenz threshold of 30 mm to detect short cervix (transvaginal ultrasound cervical length at or below 25 mm). CerviLenz detected a short cervix with a negative predictive value (NPV) of 100%, sensitivity of 100%, and specificity of 46% (). Preterm birth before 37 weeks of gestation occurred in 25 (7%) patients. Area under the curve analyses for preterm birth before 28, 32, or 35 weeks of gestation revealed similar results for CerviLenz and transvaginal ultrasonography. For preterm birth before 37 weeks of gestation, CerviLenz had greater sensitivity (60%, transvaginal ultrasonography 16%) and transvaginal ultrasonography had higher specificity (97%, CerviLenz 44%).(Table is included in full-text article.) : At a 30-mm threshold, CerviLenz has high NPV, high sensitivity, and moderate specificity to detect a short cervical length in the second trimester. CerviLenz is similar to transvaginal ultrasonography in prediction of preterm birth at 28-37 weeks of gestation. Based on high NPV, CerviLenz is clinically useful in identifying women not at risk for preterm birth, having potential to substantially reduce the need for transvaginal ultrasound screening in singletons.
mations on the routine obstetric sonogram examination, it is essential that a complete basic feta... more mations on the routine obstetric sonogram examination, it is essential that a complete basic fetal cardiac evaluation is performed. Competency in the basic cardiac evaluation can be achieved through education, training, and practice. The incidence of congenital heart disease (CHD) is about 4.1/1000 to 12/1000 live births. Many cardiac malformations are incidentally found during a routine obstetric sonogram. For this reason, it is important to identify the majority of fetuses with CHD. Once an abnormality is suspected, the patient can be referred to a maternal fetal medicine specialist and/or pediatric cardiologist for a detailed fetal echocardiogram. From the OB-GYN Department, University of South Alabama, Mobile. Correspondence: Shelly Zimbelman, RT(R)(CT), RDMS, RDCS, University of South Alabama, 1720 Center Street, Suite 101, Mobile, AL 36604. E-mail: szimbelman@usouthal.edu.
... Subbarao4, Scott S. Keesling5, George R. Lee5, Joseph Caba5, Maurice Panigel5, Richard Reichm... more ... Subbarao4, Scott S. Keesling5, George R. Lee5, Joseph Caba5, Maurice Panigel5, Richard Reichman3, Andr6 J. Nahmias5 and Richard K. Miller1 ... T6th, FD, Mosborg-Petersen, P., Kiss, J., Aboagye-Mathiesen, G., Zdravkovic, M., Hager, H., Aranyosi, J., Lamp6, L. and Ebbesen ...
... ROLE OF THE PLACENTA IN THE VERTICAL TRANSMISSION OF HIV AND OTHER INFECTIOUS AGENTS-A Worksh... more ... ROLE OF THE PLACENTA IN THE VERTICAL TRANSMISSION OF HIV AND OTHER INFECTIOUS AGENTS-A Workshop Report - Richard K. Millerl's ... 75, 1461-1468.Zdravkovic, M.,Aboagye-Mathiesen, G., Toth, F., Knudsen, HJ, Hager, H. and Ebbesen, P. (1997) The influence ...
Studying the neuronal mechanisms that govern the cortical adaptations to acute stress is critical... more Studying the neuronal mechanisms that govern the cortical adaptations to acute stress is critical for understanding the development of neuropsychiatric diseases. Homeostatic plasticity stabilizes the neural activity in which a previous synaptic event drives subsequent synaptic plasticity. In this study, we evaluated the effect of acute stress induced with the socially evaluated cold pressor test (SECPT) on cortical metaplasticity in humans using a non-invasive brain stimulation protocol. After being exposed to the SECPT and control stress conditions, 30 healthy participants were tested for cortical metaplasticity assessed with changes in the amplitude of the motor evoked potential (MEP) induced by a single-pulse transcranial magnetic stimulation (TMS). Cortical metaplasticity was induced by combining priming with cathodal tDCS (cTDCS) followed by a sub-threshold 1-Hz repetitive stimulation (rTMS) test session. Our results showed that SECPT induced cardiovascular adaptations (increase in systolic, diastolic blood pressure, and heart rate), indicating that SECPT effectively induced acute stress. Also, in our experiments stimulation of subjects with 1-Hz rTMS after they had undergone the SECPT condition induced inhibition of MEP whereas 1-Hz rTMS administered after the control condition induced a facilitatory (physiologic) response pattern. Here we observed that acute stress impairs homeostatic metaplasticity. The dysfunctional regulation of cortical plastic changes after stress could play a pivotal role in the pathogenesis of neurological and psychiatric diseases.
Bell's palsy (BP) occurs when the facial nerve (CN VII) is swollen, inflamed, or compressed, ... more Bell's palsy (BP) occurs when the facial nerve (CN VII) is swollen, inflamed, or compressed, resulting in facial weakness or paralysis; etiology is unknown. BP patients often succumb to a decreased quality of life due to the inability to make facial expressions, increased sensitivity to auditory stimuli, and dysregulation in tear and saliva production. Despite conventional examination and therapy options, the syndrome is majorly regarded as idiopathic and left unresolved for many patients. In this case of a patient with BP, treatment with osteopathic manipulative treatment (OMT) which focused on restoring a normal structure-function relationship resolved the patient’s symptoms. The osteopathic manipulative procedures utilized findings from an osteopathic structural exam and addressed those somatic dysfunctions with OMT. The authors report that the patient's symptoms improved after the application of OMT and without the use of pharmaceuticals. The results of the case study su...
Cortical blindness is a rare but frightening complication following coronary angiogram probably d... more Cortical blindness is a rare but frightening complication following coronary angiogram probably due to contrast penetration in occipital lobes in susceptible individuals [1, 2].
Les souches VIH-1 n'induisant pas la formation de syncytium (NSI) ont ete associees avec la t... more Les souches VIH-1 n'induisant pas la formation de syncytium (NSI) ont ete associees avec la transmission verticale de VIH-1 in utero, et avec l'infection de placentas humains in vitro dans une etude preliminaire utilisant trois souches virales. Pour etablir la relation existant entre le phenotype NSI et SI (induisant la formation de syncytium) de VIH-1 avec l'infection du placenta humain in vitro, nous avons utilise 21 souches differentes, en majorite de type sauvage provenant de bebes infectes in utero, intra-partum ou post-partum. Des explants placentaires villeux, de grossesses a terme non infectees, ont ete incubes durant 24 heures avec chacune des souches virales avant de subir un rincage intensif pour eliminer l'inoculum. Le tissu etait ensuite incube durant trois jours supplementaires. L'infection du tissu placentaire etait determinee par l'ADN viral amplifie par PCR (2 regions, Gag et LTR). Des 21 souches VIH-1, 38 % (8 sur 21) etaient capables d'infecter le tissu placentaire. 75 % etaient des souches NSI (6 sur 8) et 25 % des souches SI (2 sur 8). Sur le total des souches NSI, 40 % (6 sur 15) etaient infectieuses contre 33% (2 sur 6) du total des souches SI. En resume, l'infection VIH-1 du placenta humain a terme n'est pas uniquement dependante du phenotype NSI ou SI du VIH-1. De plus, toutes les souches VIH-1 isolees de bebes infectes in utero n'ont pas infecte les explants placentaires, alors que ces souches infectent les PBMC. D'autres caracteristiques de VIH-1 et du placenta lui-meme pourraient etre des elements importants de l'infectivite du placenta humain par VIH-1.
American journal of obstetrics and gynecology, Jan 12, 2015
Preterm rupture of membranes (PROM) is associated with increased risk of preterm birth and neonat... more Preterm rupture of membranes (PROM) is associated with increased risk of preterm birth and neonatal morbidity. Prophylactic 17-hydroxyprogesterone caproate (17OHPc) reduces the risk of preterm birth in some women at risk for preterm birth. We sought to test whether 17OHPc would prolong pregnancy or improve perinatal outcome when given to mothers with preterm rupture of the membranes. This is a multicenter, double-blind, placebo-controlled, randomized clinical trial. The study included singleton pregnancies with gestational ages between 23(0/7) to 30(6/7) weeks at enrollment, documented PROM, and no contraindication to expectant management. Consenting women were randomly assigned to receive weekly intramuscular injections of 17OHPc (250 mg) or placebo. The primary outcome was continuation of pregnancy until a favorable gestational age, defined as either 34(0/7) weeks of gestation or documentation of fetal lung maturity at 32(0/7) to 33(6/7) weeks. The two pre-specified secondary outc...
Although current obstetric practice guidelines suggest cervical length assessment in singletons f... more Although current obstetric practice guidelines suggest cervical length assessment in singletons for preterm birth risk, transvaginal ultrasonography has availability limitations. CerviLenz is a disposable device to measure vaginal cervical length. We sought to determine the threshold CerviLenz measurement with optimal specificity and sensitivity for diagnosis of short cervix by transvaginal ultrasonography and compare the abilities of CerviLenz and transvaginal ultrasonography to predict preterm birth. Women with singleton pregnancies and no cervical anomalies or surgery or premature labor were consented, enrolled, and followed to delivery. Transvaginal ultrasonography and CerviLenz cervical length measurements were obtained by independent examiners at 17-23 weeks of gestation. A central reader certified sonographers and reviewed all transvaginal ultrasound scans. Based on 358 patients, receiver operator curves indicated optimal CerviLenz threshold of 30 mm to detect short cervix (transvaginal ultrasound cervical length at or below 25 mm). CerviLenz detected a short cervix with a negative predictive value (NPV) of 100%, sensitivity of 100%, and specificity of 46% (). Preterm birth before 37 weeks of gestation occurred in 25 (7%) patients. Area under the curve analyses for preterm birth before 28, 32, or 35 weeks of gestation revealed similar results for CerviLenz and transvaginal ultrasonography. For preterm birth before 37 weeks of gestation, CerviLenz had greater sensitivity (60%, transvaginal ultrasonography 16%) and transvaginal ultrasonography had higher specificity (97%, CerviLenz 44%).(Table is included in full-text article.) : At a 30-mm threshold, CerviLenz has high NPV, high sensitivity, and moderate specificity to detect a short cervical length in the second trimester. CerviLenz is similar to transvaginal ultrasonography in prediction of preterm birth at 28-37 weeks of gestation. Based on high NPV, CerviLenz is clinically useful in identifying women not at risk for preterm birth, having potential to substantially reduce the need for transvaginal ultrasound screening in singletons.
mations on the routine obstetric sonogram examination, it is essential that a complete basic feta... more mations on the routine obstetric sonogram examination, it is essential that a complete basic fetal cardiac evaluation is performed. Competency in the basic cardiac evaluation can be achieved through education, training, and practice. The incidence of congenital heart disease (CHD) is about 4.1/1000 to 12/1000 live births. Many cardiac malformations are incidentally found during a routine obstetric sonogram. For this reason, it is important to identify the majority of fetuses with CHD. Once an abnormality is suspected, the patient can be referred to a maternal fetal medicine specialist and/or pediatric cardiologist for a detailed fetal echocardiogram. From the OB-GYN Department, University of South Alabama, Mobile. Correspondence: Shelly Zimbelman, RT(R)(CT), RDMS, RDCS, University of South Alabama, 1720 Center Street, Suite 101, Mobile, AL 36604. E-mail: szimbelman@usouthal.edu.
... Subbarao4, Scott S. Keesling5, George R. Lee5, Joseph Caba5, Maurice Panigel5, Richard Reichm... more ... Subbarao4, Scott S. Keesling5, George R. Lee5, Joseph Caba5, Maurice Panigel5, Richard Reichman3, Andr6 J. Nahmias5 and Richard K. Miller1 ... T6th, FD, Mosborg-Petersen, P., Kiss, J., Aboagye-Mathiesen, G., Zdravkovic, M., Hager, H., Aranyosi, J., Lamp6, L. and Ebbesen ...
... ROLE OF THE PLACENTA IN THE VERTICAL TRANSMISSION OF HIV AND OTHER INFECTIOUS AGENTS-A Worksh... more ... ROLE OF THE PLACENTA IN THE VERTICAL TRANSMISSION OF HIV AND OTHER INFECTIOUS AGENTS-A Workshop Report - Richard K. Millerl's ... 75, 1461-1468.Zdravkovic, M.,Aboagye-Mathiesen, G., Toth, F., Knudsen, HJ, Hager, H. and Ebbesen, P. (1997) The influence ...
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