Cayuga Medical Center

Cayuga Heights, NY, United States

Cayuga Medical Center

Cayuga Heights, NY, United States
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Cherrington B.D.,University of Wyoming | Mohanan S.,JA Baker Institute for Animal Health | Diep A.N.,Cayuga Medical Center | Fleiss R.,Cayuga Medical Center | And 3 more authors.
Journal of Comparative Pathology | Year: 2012

The peptidylarginine deiminase (PAD) enzyme family converts arginine residues in proteins to citrulline. In the canine mammary gland, PAD2 expression is first detected in epithelial cells in oestrus and becomes more widely expressed during dioestrus. PAD2 appears to modify nuclear histones, suggesting a role for the enzyme in chromatin remodelling and gene regulation. Recent evidence suggests that PAD2 plays a role in gene regulation in primary human breast epithelial cells. PAD2 may therefore be involved in gene regulation as it relates to mammary development, the oestrus cycle and potentially to neoplasia. The aim of the present study was to determine whether PAD2 expression was increased or decreased in mammary carcinoma compared with normal mammary tissue. A human mammary tissue microarray and archival surgical biopsy tissues from canine and feline mammary tumours were used to demonstrate differential expression of PAD2 in mammary carcinoma that appeared to be consistent across species. Normal human and canine mammary epithelium showed strong cytoplasmic and nuclear expression of PAD2, but there was reduced PAD2 expression in mammary carcinomas from both species. Feline mammary carcinomas had complete loss of nuclear PAD2 expression. Loss of nuclear PAD2 expression may therefore represent a marker of progression towards more aggressive neoplasia. © 2012 Elsevier Ltd.


Getzin A.R.,Cayuga Medical Center | Milner C.,Cayuga Medical Center | La Face K.M.,Family Medicine
Current Sports Medicine Reports | Year: 2011

Participation in ultraendurance events has been increasing. Appropriate nutrition in training and fueling while racing within the confines of gastrointestinal tolerability is essential for optimal performance. Unfortunately, there has been a paucity of studies looking at this special population of athletes. Recent field studies have helped to clarify appropriate fluid intake and dispel the myth that moderate dehydration while racing is detrimental. Additional current nutrition research has looked at the role of carbohydrate manipulation during training and its effect on macronutrient metabolism, as well as of the benefits of the coingestion of multiple types of carbohydrates for race fueling. The use of caffeine and sodiumingestion while racing is common with ultraendurance athletes, but more research is needed on their effect on performance. This article will provide the clinician and the athlete with the latest nutritional information for the ultraendurance athlete. Copyright © 2011 by the American College of Sports Medicine.


Finkel M.L.,New York Medical College | Hays J.,New York Medical College | Hays J.,PSE Healthy Energy | Law A.,New York Medical College | Law A.,Cayuga Medical Center
Medical Journal of Australia | Year: 2015

• If unconventional gas development (UGD) continues to expand in Australia, the potential health and environmental impacts should be adequately addressed and preventive public health measures should be implemented. • The United States has embraced UGD and has decades of experience that could be beneficial to Australia as stakeholders debate the potential benefits and harms of the technique. • Additional research on the health impacts of UGD is necessary. Baseline and trend morbidity and mortality data need to be collected to assess changes in population health over time. To date, few health or epidemiological studies have been conducted, so it remains difficult to assess actual health outcomes. • In the absence of scientific consensus, there are two possible risks: failing to develop unconventional natural gas when the harms are manageable; or developing it when the harms are substantial. Many government bodies around the world have chosen to minimise the risk of the latter until the impacts of UGD are better understood. • Policies should be informed by empirical evidence based on actual experience rather than assurance of best practices. There is a strong rationale for precautionary measures based on the health and environmental risks identified in the scientific literature. © 2015 AMPCo Pty Ltd. Produced with Elsevier B.V. All rights reserved.


Finkel M.,New York Medical College | Hays J.,Physicians Scientists and Engineers for Healthy Energy | Law A.,New York Medical College | Law A.,Cayuga Medical Center
American Journal of Public Health | Year: 2013

High-volume, slick water hydraulic fracturing of shale relies on pumping millions of gallons of surface water laced with toxic chemicals and sand under high pressure to create fractures to release the flow of gas. The process, however, has the potential to cause serious and irreparable damage to the environment and the potential for harm to human and animal health. At issue is how society should form appropriate policy in the absence of well-designed epidemiological studies and health impact assessments. The issue is fraught with environmental, economic, and health implications, and federal and state governments must establish detailed safeguards and ensure regulatory oversight, both of which are presently lacking in states where hydraulic fracturing is allowed. Copyright © 2012 by the American Public Health Association®.


Jiang X.,Cornell University | Bar H.Y.,Cornell University | Yan J.,Cornell University | Jones S.,Cornell University | And 9 more authors.
FASEB Journal | Year: 2013

This study investigated the influence of maternal choline intake on the human placental transcriptome, with a special interest in its role in modulating placental vascular function. Healthy pregnant women (n=26, wk 26-29 gestation) were randomized to 480 mg choline/d, an intake level approximating the adequate intake of 450 mg/d, or 930 mg/d for 12 wk. Maternal blood and placental samples were retrieved at delivery. Whole genome expression microarrays were used to identify placental genes and biological processes impacted by maternal choline intake. Maternal choline intake influenced a wide array of genes (n=166) and biological processes (n=197), including those related to vascular function. Of special interest was the 30% down-regulation (P=0.05) of the antiangiogenic factor and preeclampsia risk marker fms-like tyrosine kinase-1 (sFLT1) in the placenta tissues obtained from the 930 vs. 480 mg/d choline intake group. Similar decreases (P=0.04) were detected in maternal blood sFLT1 protein concentrations. The down-regulation of sFLT1 by choline treatment was confirmed in a human trophoblast cell culture model and may be related to enhanced acetylcholine signaling. These findings indicate that supplementing the maternal diet with extra choline may improve placental angiogenesis and mitigate some of the pathological antecedents of preeclampsia © FASEB.


Lewis G.K.,Zetroz Inc. | Langer M.D.,Zetroz Inc. | Henderson C.R.,Cornell University | Ortiz R.,Cayuga Medical Center
Ultrasound in Medicine and Biology | Year: 2013

Ultrasound therapy for pain and healing is a versatile treatment modality for musculoskeletal conditions that is used daily in rehabilitation clinics around the world. Our group designed and constructed a wearable, battery-operated, low-intensity therapeutic ultrasound (LITUS) device that patients could self-apply and operate during daily activity for up to 6 h. Thirty patients with chronic trapezius myofascial pain evaluated the LITUS system in a double-blind, placebo-controlled, 10-d study under institutional review board approval. While continuing their prescribed medication regimen, patients with the active device reported on average 1.94× reduction in pain and 1.58× improvement in health relative to placebo devices after 1 h of treatment. Both of these results were statistically significant (p < 0.05) for the first 2 d of the study. Male patients reported the majority of benefit, and there is a sex-treatment confound in the sample. The study indicates that wearable, long-duration LITUS technology improves mobile access to drug-free pain relief. © 2013 World Federation for Ultrasound in Medicine & Biology.


Yan J.,Cornell University | West A.A.,Cornell University | Perry C.A.,Cornell University | Malysheva O.V.,Cornell University | And 6 more authors.
American Journal of Clinical Nutrition | Year: 2012

Background: In 1998 choline Adequate Intakes of 425 and 450 mg/d were established for nonpregnant and pregnant women, respectively. However, to our knowledge, no dose-response studies have been conducted to evaluate the effects of pregnancy or maternal choline intake on biomarkers of choline metabolism. Objective: We sought to quantify the effects of pregnancy and maternal choline intake on maternal and fetal indicators of choline metabolism. Design: Healthy pregnant (n = 26; 27 wk gestation) and nonpregnant (n = 21) women were randomly assigned to receive 480 or 930 mg choline/d for 12 wk. Fasting blood samples and placental tissue and umbilical cord venous blood were collected and analyzed for choline and its metabolites. Results: Regardless of the choline intake, pregnant women had higher circulating concentrations of choline (30%; P < 0.001) but lower concentrations of betaine, dimethylglycine, sarcosine, and methionine (13-55%; P < 0.001). Obligatory losses of urinary choline and betaine in pregnant women were ∼2-4 times as high (P ≤ 0.02) as those in nonpregnant women. A higher choline intake yielded higher concentrations of choline, betaine, dimethylglycine, and sarcosine (12-46%; P ≤ 0.08) in both pregnant and nonpregnant women without affecting urinary choline excretion. The higher maternal choline intake also led to a doubling of dimethylglycine in cord plasma (P = 0.002). Conclusion: These data suggest that an increment of 25 mg choline/d to meet the demands of pregnancy is insufficient and show that a higher maternal choline intake increases the use of choline as a methyl donor in both maternal and fetal compartments. This trial was registered at clinicaltrials.gov as NCT01127022. © 2012 American Society for Nutrition.


Jiang X.,Cornell University | Yan J.,Cornell University | West A.A.,Cornell University | Perry C.A.,Cornell University | And 5 more authors.
FASEB Journal | Year: 2012

The in utero availability of methyl donors, such as choline, may modify fetal epigenetic marks and lead to sustainable functional alterations throughout the life course. The hypothalamic-pituitary-adrenal (HPA) axis regulates cortisol production and is sensitive to perinatal epigenetic programming. As an extension of a 12-wk dose-response choline feeding study conducted in third-trimester pregnant women, we investigated the effect of maternal choline intake (930 vs. 480 mg/d) on the epigenetic state of cortisol-regulating genes, and their expression, in placenta and cord venous blood. The higher maternal choline intake yielded higher placental promoter methylation of the cortisol-regulating genes, corticotropin releasing hormone (CRH; P=0.05) and glucocorticoid receptor (NR3C1; P=0.002); lower placental CRH transcript abundance (P=0.04); lower cord blood leukocyte promoter methylation of CRH (P=0.05) and NR3C1 (P=0.04); and 33% lower (P=0.07) cord plasma cortisol. In addition, placental global DNA methylation and dimethylated histone H3 at lysine 9 (H3K9me2) were higher (P=0.02) in the 930 mg choline/d group, as was the expression of select placental methyltransferases. These data collectively suggest that maternal choline intake in humans modulates the epigenetic state of genes that regulate fetal HPA axis reactivity as well as the epigenomic status of fetal derived tissues. © FASEB.


PubMed | University of Nevada, Reno, Cayuga Medical Center, Franklin Pierce University and Ithaca College
Type: Journal Article | Journal: The Journal of manual & manipulative therapy | Year: 2016

Randomized clinical trial.To investigate the immediate effects of soft tissue mobilization (STM) versus therapeutic ultrasound (US) in patients with neck and arm pain who demonstrate neural mechanical sensitivity.While experts have suggested that individuals with neck and arm pain associated with neural tissue mechanical sensitivity may benefit from STM, there has been little research to investigate this hypothesis.Twenty-three patients with neck and arm pain and a positive upper limb neurodynamic test (ULNT) were randomly assigned to receive STM or therapeutic US during a single session. Outcome measures were collected immediately before and after treatment, and at 2-4 day follow-up. Primary outcomes were the Global Rating of Change (GROC), range of motion (ROM) during the ULNT, and pain rating during the ULNT. Secondary measures included the Neck Disability Index (NDI), Patient-Specific Functional Scale (PSFS), Numeric Pain Rating Scale (NPRS), and active range of shoulder abduction motion combined with the wrist neutral or wrist extension.A greater proportion of patients in the STM group reported a significant improvement on the GROC immediately after treatment (P=0003, STM=75%, US=9%), and at 2-4 day follow-up (P=0027, STM=58%, US=9%). Patients who received STM demonstrated greater improvements in ROM during ULNT (P=0026), PSFS (P=0007), and shoulder active ROM combined with wrist extension (P=0028). Improvements in Numeric Pain Rating Scale and pain during the ULNT were observed only in the STM group. There was no difference between groups for the NDI or shoulder abduction ROM with wrist neutral.Patients with neck and arm pain demonstrated greater improvements in ULNT ROM, GROC, and PSFS, and pain following STM than after receiving therapeutic US.Therapy, level 1b.


Patel D.N.,New York University | Young B.,Cayuga Medical Center | Onyekwelu I.,New York University | Zuckerman J.D.,New York University | Kwon Y.W.,New York University
Journal of Shoulder and Elbow Surgery | Year: 2012

Introduction: Shoulder arthroplasty provides excellent outcomes for most patients; however, a subset of these patients with a failed arthroplasty will require revision. Recently, the reverse total shoulder arthroplasty (rTSA) has been used in these difficult clinical situations. Therefore, we sought to examine our initial experience using rTSA as a treatment for failed shoulder arthroplasty. Methods: During a 5-year period, 31 patients (mean age, 68.7 years) underwent rTSA for treatment of a failed shoulder arthroplasty and their presurgical and operative data were analyzed. Of the 31 patients, 28 were available for an average follow-up of 40.7 months. Their outcomes were assessed with American Shoulder and Elbow Surgeons (ASES), University of California-Los Angeles (UCLA), and Simple Shoulder Test (SST) scores, and the visual analog scale (VAS) for pain. Results: Compared with preoperative status, there were statistically significant improvements in all outcome measurements, including the ASES (24.0 to 66.2), UCLA (7.4 to 23.5), SST (1.5 to 7.6), and VAS (7.0 to 2.6). Active forward elevation improved from 44° preoperatively to 108° postoperatively (P < .001). Results were rated as good or excellent by 19 patients (67.9%), satisfactory by 4 (14.3%), and unsatisfactory by 5 (17.8%). Among the types of failed arthroplasty, patients with failed TSA noted the greatest improvement in their outcome, but this improvement was not statistically significant. Conclusions: The data suggest that patients can expect improved functional outcome and decreased pain after revision of previous arthroplasty to rTSA and that this procedure can provide a reliable salvage option for a challenging clinical problem. © 2012.

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