Loma Linda University

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Padma Uppala, PhD
Associate Professor, School of Public Health
School of Public Health
Professional Development    Classes
  • ENVH 525 W14 HLTHY PPL IN HLTHY COMM 2014

    ( 1/2014 - 3/2014 ) Link...
    This course is taken in conjunction with the LLU School of Public Health’s Healthy People in Healthy Communities 2014 Conference. The course will provide students exposure to the most recent findings and best practices relating to lifestyle medicine, preventive care, and the built environment for healthy child development and growth. Students will attend plenary lectures, symposium presentations, short oral presentations, and a poster session. Topics to be addressed include: Epigenetics, Nutrition Environment, Social Determinants of Children’s Health, Autism & Sensory Disorders, the Health Impact of Community Design, Childhood Obesity and the Built Environment, Air Quality and Asthma, and the Influence of the Media on Children’s Health. An up-to-date list of topics is available on the Program page of the Healthy People in Healthy Communities 2014 website:  www.healthypeopleconference.org
  • HPRO 553 W14 ADDICTION THEORY/PROGRAM DEVEL (30326) 
     

     

    ( 1/2014 - 3/2014 )

    This course addresses the problem of addiction in our society, both the substance related addictions such as alcohol, marijuana and smoking, and the process addictions such as sex and gambling. The course will cover the mechanisms of addictions, the consequences, main treatments and the tools to prevention. Also, there are some practical components in the course where the student has to visit a drug recovery session (Preferably an AA meeting) and to design a community based substance or process addiction prevention program. 

     

  Seminars and Conferences
    1. Padma Pauline Tadi Uppala; Loistine Herndon; Hildemar Dos Santos; Amanda Dupre; Persila Mohammadnia; Maheswari Senthil.(2013).Community-based participatory research leads to sustainable lifestyle intervention program for reducing breast cancer risk among African American and Latina women. [abstract]. In: Proceedings of the 105th Annual Meeting of the American Association for Cancer Research; 2014 Apr 5-9; San Diego, California (CA): AACR; 2014.

    ( 4/2014 )
    Minority women are underrepresented in clinical research, which impedes progress in understanding and eliminating health disparities. Reducing health disparities is an important goal of public health community. Recent data suggests that community-based participatory research (CBPR) which systematically involves the affected communities in each stage of the research process-inception, planning, recruitment, conduct and education is the key to reducing health disparities. The proposed pilot study used a CBPR method to study women’s perceptions, beliefs and attitudes towards participating in a clinical breast cancer study that involved blood. Methods: A community-based participatory mixed-methods approach, including a 6-month lifestyle intervention education program was employed. Participants were recruited using purposive convenience sampling that evaluated educational program designed to increase women’s knowledge of positive attitudes and participation in breast cancer clinical studies and simple changes in lifestyle that result in reduced risk for breast cancer.  To evaluate the effectiveness of the educational intervention, we used knowledge, attitudes, behavior, and perception-based questionnaire, and in-depth interviews to assess changes before and after the educational experience. Results: Fifty eight women that included 36 African American and 22 Latina women participated in the educational program, out of which twenty five women were recruited into the lifestyle intervention program that required providing blood to test for metabolic syndrome and risk for breast cancer. All the women in the intervention study were willing to provide blood for the study.
    1. Role of insulin-like growth factor binding protein acid labile complex in ER-PR-Her2+ breast cancer in African American women. Epidemiology, Lifestyle, and Genetics - Obesity, Metabolism, and Cancer : Poster Presentations - Proffered Abstracts: Abstract A58:Cancer Epidemiol Biomarkers Prev October 2012 21:10 Supplement A58; doi:10.1158/1055-9965.DISP12-A58

    ( 10/2012 )

    The emergence of the obesity epidemic worldwide has been associated with increases in breast cancer and type 2 diabetes. Symptoms associated with obesity collectively known as metabolic syndrome have been associated with triple negative breast tumors that are common among premenopausal women, especially those of African American (AA) descent.  The insulin-leptin adiponectin axis has been implicated in these breast tumors that are insensitive to estrogen. It is suggested that insulin, insulin like growth factors and epidermal growth factors mediate the interactions between these hormones. Previous studies have shown that insulin like growth factor 2 (IGF-2) synergistically cross-talks with estrogen receptor (ER) alpha and ER-beta to promote estrogen independent breast cancer progression. This suggests that IGF-2 can activate insulin like growth factor I (IGF-1) receptor and insulin receptor to activate both ER alpha and ER beta in breast cancer cells leading to proliferation and tumorigenesis. The purpose of this study was to find the  the role of insulin-like growth factor binding protein acid labile complex (IGFBP-ALS) identified in our previous serum proteomic pilot study that included six AA breast cancer women and six healthy AA controls. Methods: The serum samples were processed on IgY12 (Beckman) antibody column to remove the top 12 proteins. The flow through fraction was digested using trypsin for LC/MS analysis. The protein digest serum samples were analyzed in triplicate on a high performance LTQFT (Thermo Electron) mass spectrometer coupled to an online Surveyor LC system equipped with an autosampler. Samples were loaded onto a trap column using a sample pump. An MS pump was used for eluting the peptides onto an analytical column for further separation and online nano-ESI LC/MS/MS analysis. The raw MS data files were imported into DeCyderMS (GE Healthcare) module and data were processed for peptide/protein expression analysis. Results: DeCyderMS analysis revealed significant differences in the expression of 215 peptides between the two groups (t-test: < 0.05; ave fold ratio: <0.5 or >2). Most of these peptides were mapped to 28 proteins in the Swiss-Prot database. DecyderMS analyses on all the replicates from each sample are underway to identify the peptide pattern differences between the healthy and cancer samples. Among other differentially expressed proteins IGFBP-ALS was significantly low in sera from African American women with breast cancer with tumors possessing the ER-PR-Her2+receptor status. In a previous study, 60% of the women from the same cohort experienced metabolic syndrome. Conclusions: It is suggested that IGFBP-ALS is necessary for the binding of IGF-1 or IGF-2 to the plasma IGF protein BP-53. Low levels of IGFBP-ALS subunit in the sera of ER-PR-HER2+ AA cancer patients could serve as biomarker for early-stage, breast cancer with aggressive features.   Additionally this protein could reveal an association between obesity and breast cancer. Efforts are currently underway to validate this biomarker to gain insight into the etiology of aggressive breast tumors in AA women.

    Funded by The Susan G. Komen For the Cure Breast Cancer Foundation.

    1. Yuan Yuan, Padma Tadi Uppala, Sharon S Lum,  John W. Morgan, Carlos Garberoglio Accrual of under-represented minority women to breast cancer clinical trials in Inland Empire, California. Journal of Clinical Oncology 01/2012; 30(27).

       

    ( 1/2012 )
    1. Padma P.T Uppala Health effects of environmental DDT exposure: An epidemiological and serum proteomic study. Journal of Community Medicine & Health Education. 01/2012; 2.

       

    ( 1/2012 )
    Pesticides offer a variety of benefits to the society such as increased crop production and decreased insect infestations.  However, when used improperly, pesticides have the potential for causing harm.  Approximately, 10,000-20,000 physician-diagnosed pesticide poisonings occur each year among US agricultural workers. Although banned in the US in 1973, DDT, an organochlorine pesticide finds its way into the food chain as it is used in many parts of the world. The purpose of the study was to examine the health effects of DDT in a predominantly African American population who were exposed to highest levels of DDT in the US by consumption of DDT- contaminated fish. A cross-sectional study was conducted on 234 African Americans. Logistic Regression was used to calculate risk of morbidity from consumption of DDT- contaminated fish. Serum proteomic study included 21 breast cancer cases and 29 controls. Protein expression data was obtained by 2D DIGE analysis. Differentially expressed DIGE spots were excised for protein identification. Spots were digested with trypsin and the peptides were identified by QTOF LC/MS/MS or MALDI TOF analysis. Results: A non-significant increase in risk for hypertension in those who consumed DDT contaminated fish was observed (OR 1.672; 95% CI 0.324-8.628).  Serum proteomic study yielded significantly increased levels of fibrinogen gamma in exposed individuals.  Gamma fibrinogen is associated with increased risk of coronary artery disease. Future efforts will focus on validation of gamma fibrinogen in DDT exposed individuals. Funded by Susan G. Komen for the cure.
    1. John W. Morgan, Christine Guenzi, Myung Mi Cho, Christian Jackson, Sharon L. Lum, Zuhair Natto and Padma Uppala (2010) Delayed stage colorectal adenocarcinoma diagnosis: Are we neglecting critical demographic information? Cancer Epidemiology, Biomarkers & Prevention: October 2010;Volume19,Issue10,Supplement,doi:10.1158/1055-9965.DISP-10-A47
      Abstracts: AACR International Conference on the Science of Cancer Health Disparities-- Sep 30-Oct 3, 2010; Miami, FL

    ( 9/2010 ) Link...

    Background: Colorectal cancer (CRC) is the second leading cause of cancer deaths in the United States. Poor survival for CRC is associated with delayed diagnosis. To remedy this problem, race and ethnicity are routinely used to target intensified CRC screening when information about health insurance is not available. We sought to distinguish roles of demographic variables and bowel segments as predictors of delayed (AJCC stage II-IV) vs. early (in situ and stage I) diagnosis of colorectal adenocarcinoma in the diverse California population.

    Methods: Demographic variables and right (C18.0-C18.4) vs. left (C18.5-C18.7, C19.9 & C20.9) bowel origin for 66,806 CRC cases diagnosed in 2004-2008 were extracted from the California Cancer Registry and analyzed by logistic regression as delayed vs. early stage.

    Results: Of the CRC cases, 65% were non-Hispanic (NH) white, 15% Hispanic, 13% Asian/Other and 7% NH black. Logistic regression showed increased odds of delayed vs. early diagnosis (OR, 95% confidence limits) for age <40 (2.58,2.26-2.94), 40-49 (1.71,1.60-1.83) and 75+ (1.05,1.02-1.09) relative to 50-74 years. Contrast with NH whites, odds ratios for delayed vs. early stage were: 1.05,0.99-1.13 (NH blacks); 1.08,1.02-1.13 (Hispanics) and 1.05,1.00-1.11 (Asian/Others). Females had higher odds of delayed CRC diagnosis (1.09,1.06-1.13) than males. Lower odds ratios for delayed stage diagnosis were seen for successively lower to highest SES quintiles (OR4:5=1.08,1.03-1.14; OR3:5=1.13,1.08-1.19; OR2:5=1.18,1.12-1.24; and OR15=1.21,1.14-1.28; Trend p <0.0001). Origin in the right bowel vs. left showed higher odds of delayed vs. early diagnosis (1.68,1.63-1.74). No significant product interactions between race/ethnicity and SES were detected (p=0.47).

    Discussion: Our findings identify younger and older than age 50-74 at diagnosis, female gender, Hispanic ethnicity, right or proximal bowel, and lower SES as independent predictors of delayed CRC diagnosis. Low SES persists as the most robust predictor of delayed diagnosis, independent of race/ethnicity and other covariates. Consistent with other studies, females showed higher odds of delayed stage CRC than males. More than 70% of CRC (76% of delayed stage) cases were in race/ethnic groups not routinely classified as underserved that are neglected in many intensified screening recommendations. Findings for higher odds of delayed CRC diagnosis in the right bowel challenge current screening practices that favor FOBT over colonoscopy in underserved populations. Delayed stage diagnosis among persons younger than 50 can be partly remedied by screening that targets familial adenomatous polyposis (FAP) and hereditary nonpolyposis colorectal cancer (HNPCC) syndromes. Our findings show the value of including SES, together with Hispanic ethnicity, FAP and HNPCC syndromes, and female gender when targeting intensified and egalitarian CRC screening in the diverse California population where health insurance information is not available.

    Citation Information: Cancer Epidemiol Biomarkers Prev 2010;19(10 Suppl):A47.

  • June 22, 2009-Invited speaker at World Cancer Congress, Beijing China. Topic: Biomarkers for cancer predisposition, screening and prognosis “ Shotgun LC/MS proteomics of breast cancer sera from African American women.” ( 6/2009 ) Link...
  Special Projects
  • SB Community Lifestytle Intervention Research Project 101 - P Uppala

    ( 10/2013 - 10/2014 ) Link...

     

    The purpose of this course is to help San Bernardino community women reduce risk for breast cancer through simple changes in diet and exercise.