Digital Commons Network^™

The Health Status Of Southern Children: A Neglected Regional Disparity, Jeffrey Goldhagen, Radley Remo, Thomas Bryant, Peter Wludyka, Amy B. Dailey, David Wood, Graham Watts, William Livingood

Health Sciences Faculty Publications

Purpose: Great variations exist in child health outcomes among states in the United States, with southern states consistently ranked among the lowest in the country. Investigation of the geographical distribution of children’s health status and the regional factors contributing to these outcomes has been neglected. We attempted to identify the degree to which region of residence may be linked to health outcomes for children with the specific aim of determining whether living in the southern region of the United States is adversely associated with children’s health status.

Methods: A child health index (CHI) that ranked each state in the United …

Resident Efficiency In A Pediatric Emergency Department., M Denise Dowd, Celeste Tarantino, Theodore M. Barnett, Laura Fitzmaurice, Jane F. Knapp

Manuscripts, Articles, Book Chapters and Other Papers

OBJECTIVES: To measure the hourly rate of patients evaluated and treated by resident physicians in an academic pediatric emergency department (PED) and examine differences in the rate by subspecialty and year of training.

METHODS: For all residents rotating in an academic, urban children's hospital PED, the rate of patients seen per hour over the course of their rotation was calculated using an electronic tracking system, EmSTAT, for calendar year 2000. Rates are reported as the mean number of patients seen per resident hour worked. Mean differences are reported for resident subspecialties (emergency medicine, pediatrics, and family practice) and postgraduate year …

Differential Impairment As An Indicator Of Sex Bias In Dsm-Iv Criteria For Four Personality Disorders, Christina D. Boggs, Leslie C. Morey, Andrew E. Skodol, M. Tracie Shea, Charles A. Sanislow, Carlos M. Grilo, Thomas H. Mcglashan, Mary C. Zanarini, John G. Gunderson

Charles A. Sanislow, Ph.D.

The aim of the present study was to investigate the possibility of sex bias in the diagnostic criteria for borderline, schizotypal, avoidant, and obsessive-compulsive personality disorders. A clinical sample of 668 individuals was evaluated for personality disorder criteria using a semistructured interview, and areas of functional impairment were assessed with both self-report and semistructured interview. The authors used a regression model of bias to identify bias as differences in slopes or intercepts between men and women in the relationship between each diagnostic criterion and level of impairment. The results suggest that most of the diagnostic criteria examined do not seem …

Effect Of Cytokine Gene Polymorphism On Histological Activity Index, Viral Load And Response To Treatment In Patients With Chronic Hepatitis C Genotype 3, Zaigham Abbas, Tariq Moatter, Akber Hussainy, Wasim Jafri

Section of Gastroenterology

AIM: To investigate the association between cytokine gene polymorphism and disease status in chronic hepatitis C genotype 3 by liver biopsy, ALT, HCV RNA levels and response to treatment.Methods: Patients with chronic hepatitis C genotype 3 were analyzed for single nucleotide polymorphisms of interleukin (IL)-10, IL-1 beta, interferon-gamma (IFN-gamma), tumor necrosis factor-alpha (TNF-alpha) and transforming growth factor-beta (TGF-beta) by polymerase chain reaction using sequence-specific oligonucleotide primers. Liver biopsies were assessed by modified histological activity index (HAI) scoring system using a scale of 0-18 for grading the necro-inflammatory activity and 0-6 for staging the fibrosis. HCV RNA levels were determined by …

Posterior Longitudinal Ligament Status In Cervical Spine Bilateral Facet Dislocations, John A. Carrino, Geoffrey L. Manton, William B. Morrison, Alex R. Vaccaro, Mark E. Schweitzer, Adam E. Flanders

Department of Orthopaedic Surgery Faculty Papers

Objective: It is generally accepted that cervical spine bilateral facet dislocation results in complete disruption of the posterior longitudinal ligament. The goal of this study was to evaluate the integrity of numerous spine-stabilizing structures by MRI, and to determine if any associations between injury patterns exist with respect to the posterior longitudinal ligament status.

Design: Retrospective case series.

Patients: A retrospective review was performed of 30 cervical spine injury subjects with bilateral facet dislocation. Assessment of 1.5T MRI images was carried out for: intervertebral disc disruption, facet fracture, and ligamentous disruption. Statistical analyses were performed to evaluate for associations between …

Medical Education Digest, Vol. 7 No. 6 (November/December 2005), Nova Southeastern University

Medical Education Digest

No abstract provided.

Barnacles, Old Age Marks, Or Just Plain Seborrheic Keratoses., Lawrence Charles Parish, Joseph A. Witkowski

Department of Dermatology and Cutaneous Biology Faculty Papers

Growing older may mean more wrinkles and creaking joints, but why does it also entail an accumulation of barnacles. These brown, somewhat friable, often warty lesions are more common on senior citizens but are not necessarily limited to the chronologically challenged. Seborrheic keratoses (SKs) can be easily recognized (fig 1), but the itching and the occasional scratch-induced dermatitis make them more than a cosmetic nuisance. (fig 2)

SKs can go by a variety of names, ranging from basal cell papillomas, senile warts, and senile keratoses to seborrheic verrucae and verrucous senilis. The various terms provide no more information on their …

Giardiasis In Patients With Dyspeptic Symptoms, Javed Yakoob, Wasim Jafri, Shahab Abid, Nadim Jafri, Saeed Hamid, Hasnain Ali Shah, Lubna Rizvi, Muhammad Islam, Hizbullah Shaikh

Section of Gastroenterology

AIM:

To investigate the prevalence of giardiasis in patients with dyspeptic symptoms.

METHODS:

Clinical records of consecutive patients who attended Gastroenterology Department at Aga Khan University Hospital from January 2000 to June 2003 and had esophagogastroduodenoscopy (EGD) with duodenal biopsies and international classification of diseases 9th revision with clinical modifications (ICD-9-CM) coded with giardiasis were studied.

RESULTS:

Two hundred and twenty patients fulfilled the above criteria. There were 44% (96/220) patients who were giardiasis positive, 72% (69/96) of them were males and 28% (27/96) of them were females. There were 65% (81/124) males and 35% (43/124) females who were giardiasis …

Role Of Rapid Urease Test And Histopathology In The Diagnosis Of Helicobacter Pylori Infection In A Developing Country, Javed Yakoob, Wasim Jafri, Shahab Abid, Zaigham Abbas, Saeed Hamid, Muhammad Islam, Kashif Anis, Hasnain Ali Shah, Hizbullah Shaikh

Section of Gastroenterology

Background

The aim of this study was to determine the effect of commonly self-prescribed proton pump inhibitors (PPI) on the results of rapid urease test and histology for the diagnosis of H. pylori infection.

Methods

One hundred-nine consecutive patients with dyspeptic symptoms attending the endoscopy suite were enrolled in this study. Antrum biopsy specimens were collected at endoscopy for the rapid urease test (Pronto Dry, Medical Instrument Corp, France) and histopathology. Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and like-hood ratio of a positive and negative of Pronto Dry test were compared against histology. The gold standard …

Evaluation Of African-American And White Racial Classification In A Surveillance, Epidemiology, And End Results Cancer Registry, Diva A. Patel, Alicia Knowles, Ann G. Schwartz, Kendra Schwartz

FMPHS Faculty Publications

Objectives: This study evaluated the validity of registry-reported race for individuals who participated in research studies conducted since 1980 through the Metropolitan Detroit Cancer Surveillance System (MDCSS), a Surveillance, Epidemiology, and End Results (SEER) Program registry.

Methods: 5329 individuals who self-identified as African American or White and were classified in the MDCSS registry as African American or White were included. Self-identified and registry-reported race were compared, and associations between demographics and racial misclassification were examined.

Results: Most self-identified African Americans and Whites were correctly classified (sensitivity= 98.5%, specificity=99.7%). Males were two times more likely to be misclassified than females [odds …

The Collaborative Longitudinal Personality Disorders Study (Clps): Overview And Implications, Andrew E. Skodol, John G. Gunderson, M. Tracie Shea, Thomas H. Mcglashan, Leslie C. Morey, Charles A. Sanislow, Donna S. Bender, Carlos M. Grilo, Mary C. Zanarini, Shirley Yen, Maria E. Pagano, Robert L. Stout

Charles A. Sanislow, Ph.D.

The Collaborative Longitudinal Personality Disorders Study (CLPS; Gunderson et al., 2000) was developed to fill gaps in our understanding of the nature, course, and impact of personality disorders (PDs). Here, we review published findings to date, discuss their implications for current conceptualizations of PDs, and raise questions that warrant future consideration. We have found that PDs are more stable than major depressive disorder, but that meaningful improvements are possible and not uncommon. We have confirmed also that PDs constitute a significant public health problem, with respect to associated functional impairment, extensive treatment utilization, negative prognostic impact on major depressive disorder, …

The Outcome Of Mta As A Root End Filling Material: A Long Term Evaluation, Christopher M. Sechrist

Loma Linda University Electronic Theses, Dissertations & Projects

Periradicular surgery is a viable option to save natural teeth when non-surgical treatment fails or when endodontic retreatment is not feasible or contraindicated. Laboratory and animal studies have demonstrated that MTA is biocompatible, provides an excellent seal against penetrating bacteria, and promotes hard tissue healing. The purpose of this study was to provide long term (>3 years) clinical evidence for its use as a root-end filling material in endodontics. The clinical records of 294 patients who had MTA used during endodontic treatment from 1996 to 2001 were reviewed. From these, 75 patients whose root end cavities had been filled …

Treatment Outcome Of Root Perforations Repaired With Mineral Trioxide Aggregate, Stephen H. Paik

Loma Linda University Electronic Theses, Dissertations & Projects

Root perforations during root canal therapy have a significant negative impact on long-term prognosis of teeth. Proper treatment is critical in managing these accidental procedures. Laboratory and animal studies have demonstrated that Mineral Trioxide Aggregate (MTA) is biocompatible, provides an excellent seal against penetrating bacteria, and promotes hard tissue healing. The purpose of this study was to determine the long term treatment outcome of root perforations repaired with MTA.

Ninety-nine records from the Graduate Endodontic Clinic at Loma Linda University School of Dentistry from 1996 to 2001 were reviewed. Clinical and radiographic evaluations were completed. Three independent examiners evaluated digitized …

Increased Risk Of Hiv In Women Experiencing Physical Partner Violence In Nairobi, Kenya, Karoline Fonck, Leye Els, Nancy Kidula, Jeconiah Ndinya-Achola, Marleen Temmerman

Obstetrics and Gynaecology, East Africa

As part of a study on etiology of sexually transmitted infections (STI) among 520 women presenting at the STI clinic in Nairobi, data on partner violence and its correlates were analyzed. Prevalence of lifetime physical violence was 26%, mainly by an intimate partner (74%). HIV seropositive women had an almost twofold increase in lifetime partner violence. Women with more risky sexual behavior such as early sexual debut, number of sex partners, history of condom use and of STI, experienced more partner violence. Parity and miscarriage were associated with a history of lifetime violence. We found an inverse association between schooling …

Enhancing Social Interaction Between Preschoolers And Older Adults With Dementia - Report Series # 6, Linda Chud, Rose Morrison, Pat Tretjack, Anna Baas-Anderson, Barbara Ledger, Tiziana Pelusi, Julie Sweezie, Pat Spadafora, Magda Lenartowicz

Publications and Scholarship

This qualitative intergenerational study, conducted in the spring and summer of 2005, was structured within the parameters of the High/Scope educational approach. High/Scope is guided by active learning which allows children the choice to develop their own learning priorities based on their interests and abilities. Within this model, 5 older adult clients from the Victorian Order of Nurses (VON) Seniors Day Program (Halton Branch) interacted with 5 pre-school children from the Sheridan Child Care Centre. Twelve sessions were conducted over a 6-week time period, and data was collected through both remote (web-casting) and participant observation. Although quantitative data that tracked …

Brain Neprilysin Activity And Susceptibility To Transgene-Induced Alzheimer Amyloids, Troy L. Carter, Steve Pedrini, Jorge Ghiso, Michelle E. Ehrlich, Sam Gandy

Department of Neurology Faculty Papers

Neprilysin (NEP) is a zinc metalloproteinase that degrades enkephalins, endothelins, and the Alzheimer’s disease amyloid ß (Aß) peptides. NEP-deficient mice possess increased levels of brain Aß^1-40 and Aß^1-42. The objective of this study was to determine whether tissue NEP specific activity differs according to age and/or across mouse strains, especially those strains predisposed toward formation of Aß-amyloid plaques following overexpression of the human Alzheimer amyloid precursor protein (APP). The C57Bl/6J mouse strain appears to be relatively susceptible to cerebral amyloidosis, whereas the Swiss Webster (SW) strain appears more resistant. We investigated whether NEP specific activity in brain …

Digest Of The Philadelphia College Of Osteopathic Medicine (Fall 2005), Philadelphia College Of Osteopathic Medicine

Digest

The Fall 2005 issue of the Digest of the Philadelphia College of Osteopathic Medicine includes the following articles:

• Opening Remarks
• PCOM Updates and Kudos
• Uncommon Callings
• Take a Deep Breath
• Remembering Dr. Meals
• Class Notes
• In Memoriam
• My Turn
• Andrew Taylor Still Legacy Society
• PCOM Events

Effects Of Resistance Training Volume And Variety On Dietary Intake And Mood State In Untrained Subject, Suzette K. Smith

Loma Linda University Electronic Theses, Dissertations & Projects

Background: While there is research on the effects of aerobic training on various aspects of mood state and nutrient intake, little is known of the effect of resistance training on these variables.

Purpose: To examine the effects of resistance training (RT) volume and variety on total energy (kcal) and macronutrient intake, and mood states in a healthy, untrained population.

Method:The investigation was part of a prospective experimental study examining the effects of three RT protocols on body composition and strength. An initial 102, healthy, untrained male and female participants, ages 20-40, were recruited, and randomized into one of three …

Longitudinal Comparison Of Depressive Personality Disorder And Dysthymic Disorder, John C. Markowitz, Andrew E. Skodol, Eva Petkova, Hui Xie, Jianfeng Cheng, David J. Hellerstein, John G. Gunderson, Charles A. Sanislow, Carlos M. Grilo, Thomas H. Mcglashan

Charles A. Sanislow, Ph.D.

BACKGROUND: Few studies have compared the related diagnostic constructs of depressive personality disorder (DPD) and dysthymic disorder (DD). The authors attempted to replicate findings of Klein and Shih in longitudinally followed patients with personality disorder or major depressive disorder (MDD) in the Collaborative Longitudinal Personality Disorders Study.

METHODS: Subjects (N = 665) were evaluated at baseline and over 2 years (n = 546) by reliably trained clinical interviewers using semistructured interviews and self-report personality questionnaires.

RESULTS: Only 44 subjects (24.6% of 179 DPD and 49.4% of 89 early-onset dysthymic subjects) met criteria for both disorders at baseline. Depressive personality disorder …

Ponderal Index, Jabeen Fayyaz

Department of Emergency Medicine

No abstract provided.

Psychological Stress And High Sensitivity C-Reactive Protein Levels In Overweight And Obese Men, Olivia L. Moses

Loma Linda University Electronic Theses, Dissertations & Projects

Background and Purpose. High sensitivity C-reactive protein (hs-CRP), a measure of inflammatory response, is now considered an independent marker for coronary heart disease. Psychological stress also affects the immune system and influences the inflammatory response. Ladwig, et al (2003) found a significant positive association between hs-CRP levels and depression (F=4.9, p^.008) in 726 obese males, even after adjusting for smoking, high blood pressure and age. This study investigated if there was a similar association between increased hs-CRP levels and psychological stress in overweight and obese males.

Method. Sixty-one overweight (n=28) or obese (n= 33) males, ages 20-35, were recmited …

Prevalence And Predictors Of Smoking In Pakistan: Results Of The National Health Survey Of Pakistan, Khabir Ahmed, Fahim Jafary, Imtiaz Jehan, Juanita Hatcher, Abdul Qayum Khand , Khan, Nish Chaturvedi, Tazeen Jafar

Department of Surgery

No abstract provided.

Prescription Pattern Of Benzodiazepines For Inpatients At A Tertiary Care University Hospital In Pakistan, Muhammad Rizwanulhaq Khawaja, A Majeed, F Malik, K A. Merchant, M Maqsood, R Malik, S Mazahir, H Naqvi

Department of Psychiatry

Objective: To determine the point prevalence of benzodiazepine prescriptions for inpatients at a tertiary care university hospital in Pakistan and to correlate it with prescription patterns of various specialties, indications and demographic variables of the patients.Methods: This 24-hours point prevalence study was done at The Aga Khan University Hospital, Karachi. By convenient random sampling, 208 inpatients were interviewed. Patients' files were also studied to record the drugs administered. Data was entered into questionnaires and analyzed by SPSS 10.0.Results: The point prevalence of the benzodiazepines was 21.2%. It was higher among males than females and among surgical than non-surgical patients. Midazolam …

Prevalence Of Non-Helicobacter Pylori Duodenal Ulcer In Karachi, Pakistan., Javed Yakoob, Wasim Jafri, Nadim Jafri, Muhammad Islam, Shahab Abid, Saeed Hamid, Syed H Shah, Hizbullah Shaikh

Section of Gastroenterology

AIM:

To determine the prevalence of non-Helicobacter pylori (H pylori)-related duodenal ulcer in patients with acid-peptic diseases.

METHODS:

Medical records of patients who attended the Gastroenterology Department at Aga Khan University Hospital from 1999 to 2001 and had endoscopic diagnosis of duodenal ulcers were reviewed. Duodenal ulcer associated with H pylori was diagnosed on the basis of endoscopy, rapid urease test and histopathology whereas histories of aspirin or other non-steroidal anti-inflammatory drugs (NSAIDs) related duodenal ulcers. Non-H pylori, non-NSAID duodenal ulcers were those without H pylori infection and history of NSAID intake. Co-morbid conditions associated were noted.

RESULTS:

Of 2 …

Unanticipated Hospital Admission After Ambulatory Surgery, Mueenullah Khan, Aliya Ahmed, Laila Abdullah, Azmeena Nizar, Aslam Fareed, Fauzia Anis Khan

Department of Anaesthesia

The unplanned admission rate is considered to be an important measure of the quality of ambulatory surgical units. The objective of our study was to evaluate the unanticipated hospital admission rate from the Surgical Day Care (SDC) unit of our university affiliated teaching hospital and to analyze the reasons for admission. A review of all unanticipated admissions over a one-year period was done. The admission rate was calculated and the reasons for admission were analysed. The overall admission rate was 4.93%. Most of the admissions were ordered by the surgeons (97%). The main reasons for admission were patient observation indicated …

Serum Creatinine As Marker Of Kidney Function In South Asians: A Study Of Reduced Gfr In Adults In Pakistan, Tazeen H. Jafar, Christopher H. Schmid, Andrew S. Levey

Section of Nephrology

Migrant populations of South Asian origin have a higher risk for chronic kidney disease than the native whites. Several formulas have been developed to estimate kidney function from serum creatinine concentration. However, none of these has been validated in the South Asian population, which generally has different muscle mass composition than whites. A population-based cross-sectional study was performed on 262 individuals who were aged > or = 40 yr in Karachi, Pakistan. Reduced GFR was defined as creatinine clearance (Ccr) measured in 24-h urine collection of /min per 1.73 m2. Creatinine excretion was compared with age- and gender-matched white individuals by …

Developing A Valid Screening Tool For Assessing Nutritional Adequacy And Osteoporosis Risk Among Vegans In The United States, Patricia Adelle Dyett

Loma Linda University Electronic Theses, Dissertations & Projects

The vegetarian lifestyle in the United States has increased significantly over recent decades. With this growth trend, it has become necessary to assess the pros and cons of vegetarian diet patterns, particularly with respect to nutrition adequacy and chronic disease concerns.

The vegan diet engenders more concern than other common vegetarian lifestyles because it seeks to replace all nutrient-rich animal food products with only plant foods. Consequently, there are concerns of compromised protein, calcium. vitamin D, vitamin B₁₂, n-3 fatty acid, zinc, and iron status. Moreover, because of typical vegan diet phenomena such as low BMI, low protein …

Self-Rated Health In Pakistan: Results Of A National Health Survey, Khabir Ahmed, Tazeen Jafar, Nish Chaturvedi

Department of Surgery

Abstract Background: Self-rated health (SRH) is a robust predictor of mortality. In UK, migrants of South Asian descent, compared to native Caucasian populations, have substantially poorer SRH. Despite its validation among migrant South Asian populations and its popularity in developed countries as a useful public health tool, the SRH scale has not been used at a population level in countries in South Asia. We determined the prevalence of and risk factors for poor/fair SRH among individuals aged ≥15 years in Pakistan (n = 9442). Methods: The National Health Survey of Pakistan was a cross-sectional population-based survey, conducted between 1990 and …

Implementing Infant Hearing Screening At Maternal And Child Health Clinics: Context And Interactional Processes, De Wet Swanepoel, René Hugo, Brenda Louw

Brenda Louw

Medical Education Digest, Vol. 7 No. 2 (March/April 2005), Nova Southeastern University

Medical Education Digest

No abstract provided.