Digital Commons Network^™

Age, Temperature, And Parasitaemia Predict Chloroquine Treatment Failure And Anaemia In Children With Uncomplicated Plasmodium Falciparum Malaria, D.H. Hamer, W.B. Macleod, E. Addo-Yobo, C.P Duggan, B. Estrella, W.W. Fawzi, J.K. Konde-Lule, V. Mwanakasale, Zul Premji, F. Sempertegui, F.P. Ssengooba, K. Yeboah-Antwi, J.L. Simon

Pathology, East Africa

The prevalence of chloroquine-resistant Plasmodium falciparum malaria has been increasing in sub-Saharan Africa and parts of South America over the last 2 decades, and has been associated with increased anaemia-associated morbidity and higher mortality rates. Prospectively collected clinical and parasitological data from a multicentre study of 788 children aged 6-59 months with uncomplicated P. falciparum malaria were analysed in order to identify risk factors for chloroquine treatment failure and to assess its impact on anaemia after therapy. The proportion of chloroquine treatment failures (combined early and late treatment failures) was higher in the central-eastern African countries (Tanzania, 53%; Uganda, 80%; …

Fall Risk Assessment : A Prospective Investigation Of Nurses' Clinical Judgement And Risk Assessment Tools In Predicting Patient Falls In An Acute Care Setting, Helen Myers

Theses: Doctorates and Masters

Falls are a significant problem in acute care, hospital settings, and can have serious consequences, especially for older patients. Fall prevention has therefore been recognised as an important area for research and intervention. In order to target interventions and use resources effectively, a major strategy of many fall prevention programmes has been the development and/or use of risk assessment tools to identify patients who are at high risk of falling. Although many tools have been developed, few have been rigorously tested, and there is currently no evidence to support the clinical utility of fall risk assessment tools. There is a …

A Comparison Between Conventional And Holistic Exercise Interventions On Physiological Function In The Elderly, Gavin R. Mccormack

Theses: Doctorates and Masters

Aging is characterised by a decline in physiological function. The rate of this decline can depend on certain lifestyle factors, genetics, and the environment. Although life expectancy is slowly increasing, there is a need to reduce the time spent in debilitated, and non-independent states by elderly individuals. Preventive measures need to be implemented to reduce dependency and improve the quality of life for elderly individuals. One such preventive and remedial measure is the use of exercise and physical activity. Because limited exercise prescription exists for the elderly population, there is a need to determine the effectiveness of exercise interventions that …

Clarifying The Lower Incidence Of Birth Defects In The Midwest Of Western Australia : A Study Using Capture Re-Capture Methodology, Donna Baker

Theses: Doctorates and Masters

In April 2000 the Western Australian Birth Defects Registry held its 20th Anniversary Scientific Symposium to signify the first 20 years of the Birth Defects Registry in Western Australia. At the Symposium, significant trends and occurrences in birth defects within Western Australia over the past 20 years were addressed. One factor highlighted in the Registry's 1980-1999 report was that birth defects were reported less frequently in rural regions compared with metropolitan areas. Data collected from the metropolitan area is considered by the Birth Defects Registry to be the most accurate. Therefore, incidence rates of birth defects in this area arc …

Febrile Seizures: Factors Affecting Risk Of Recurrence In Pakistani Children Presenting At The Aga Khan University Hospital, Z Habib, S Akram, S Ibrahim, B Hasan

Department of Paediatrics and Child Health

Objectives: To (a) describe the effect of temperature rise on seizure recurrence in the ER (b) investigate the effect of age, gender, family and developmental history, type, duration and multiple seizures, past history and number of seizures and treatment given (either late or early) on seizure recurrence in the ER and (c) explore prognostic indicators for seizure recurrence.
Methods: Data from 352 children [ages 3-84 months; 220 males (62.5%) 132 females (37.5%)] was taken using chart reviews for the years January 1998-August 2000 inclusive, from the Pediatric department of the Aga Khan University Hospital. Descriptive statistics, Chi-square, and Discriminant …

Prostate Cancer: Some Clinical And Scientific Dilemmas., Paul D. Abel, El-Nasir Lalani

Department of Pathology and Laboratory Medicine

No abstract provided.

Black Men Who Have Sex With Men And The Hiv Epidemic: Next Steps For Public Health, David J. Malebranche

David J Malebranche

No abstract provided.

Plausibility And Possible Determinants Of Sudden 'Remissions' In Borderline Patients, John G. Gunderson, Donna S. Bender, Charles A. Sanislow, Shirley Yen, Jennifer Bame Rettew, Regina Dolan-Sewell, Ingrid R. Dyck, Leslie C. Morey, Thomas H. Mcglashan, M. Tracie Shea, Andrew E. Skodol

Charles A. Sanislow, Ph.D.

THIS STUDY documents dramatic improvements in patients with borderline personality disorder (BPD) and explores their possible determinants. From a sample of the 160 carefully diagnosed borderline patients on whom prospective follow-along data was collected, a subsample of 18 was identified whose DSM-IV criteria count fell to two or fewer during the course of the first 6 months of the study and retained that improvement for the next 6 months. Follow-along data including month-by-month ratings of BPD criteria; week-by-week ratings of Axis I disorders, medication changes, and life events were then used to establish concensus ratings on four hypothesized causes: Axis …

Cancer Patterns In Quetta (1998-1999), Yasmin Bhurgri, Hadi Bhurgri, A. Ajam, Shahid Pervez, S. H. Hasan, A. Usman, J. A. Khan, Q. Kasi, I. Kasi, A. G. Rasool, A. Bhurgri, N. Faridi, J. Malik

Department of Pathology and Laboratory Medicine

Introduction: Quetta, the capital of Baluchistan, is located at latitude 30,25; longitude 67.00. It has a population of 759,245; 425,474 males (56%) and 333,771 females (44%); Census 1998. The majority of residents are Persian or Baluchi speaking Baluchs.

Methodology: The cancer cases from Quetta reported to the Karachi Cancer Registry were reviewed. The data included cases from the Aga Khan University Hospital (AKUH), Pathology Department (Quetta collection point) and health care facilities in Karachi. The residents of Baluchistan were ascertained and cancer cases residents of Quetta identified with the help of recorded addresses and retraceable telephone numbers.

Results: During a …

Subsets More Likely To Benefit From Surgery Or Prophylactic Cranial Irradiation After Chemoradiation For Localized Non-Small-Cell Lung Cancer, Bruce Keith, Mark Vincent, Larry Stitt, Anna Tomiak, Richard Malthaner, Edward Yu, Pauline Truong, Richard Inculet, Michael Lefcoe, A. Dar, Walter Kocha, Ian Craig

Edward Yu

After chemoradiation for localized non-small-cell lung cancer, surgery and prophylactic cranial irradiation (PCI) have been used as additional therapies. Less than a third of patients develop brain recurrences, or have local recurrence as their sole initial site of recurrence; these are groups that would benefit from PCI or surgery, respectively. Pretreatment identification of patients more likely to benefit from surgery or PCI would be useful. A retrospective analysis of 80 patients was performed to determine prognostic factors for such patterns of failure. Twenty-nine patients were subsequently selected for surgery in a nonrandomized manner. Seventeen patients had isolated local initial recurrence …

Leiomyosarcoma Presenting As A Spontaneously Ruptured Renal Tumor-Case Report, Mohammad Moazzam, M Hammad Ather, Akber S. Hussainy

Department of Pathology and Laboratory Medicine

Background:
Ruptured renal neoplasms can be a catastrophic clinical presentation. Angiomyolipoma is the commonest renal tumor which presents in this fashion. Renal sarcomas are rare renal neoplasms. Renal leiomyosarcomas are the most common histological subtype of renal sarcomas, accounting for approximately 50-60% of the reported cases. These tumors are usually peripherally located and appear to arise from either the renal capsule or smooth muscle tissue in the renal pelvic wall.
Case presentation:
A 70 years old male, with hypertension and ischemic disease, developed acute left flank pain. The general physician evaluated this using ultrasound, which showed a solid left renal …

Comparisons Of American, Israeli, Italian And Mexican Physicians And Nurses On The Total And Factor Scores Of The Jefferson Scale Of Attitudes Toward Physician-Nurse Collaborative Relationships, Mohammadreza Hojat, Joseph S. Gonnella, Thomas J. Nasca, Sylvia K. Fields, Americo Cicchetti, Alessandra Lo Scalzo, Francesco Taroni, Anna Maria Vincenza Amicosante, Manuela Macinati, Massimo Tangucci, Carlo Liva, Gualtiero Ricciardi, Schmuel Eidelman, Hanna Admi, Hana Geva, Tanya Mashiach, Gideon Alroy, Adelina Alcorta-Gonzalez, David Ibarra, Antonio Torres-Ruiz

CRMEHC Faculty Papers

This cross-cultural study was designed to compare the attitudes of physicians and nurses toward physician–nurse collaboration in the United States, Israel, Italy and Mexico. Total participants were 2522 physicians and nurses who completed the Jefferson Scale of Attitudes Toward Physician–Nurse Collaboration (15 Likert-type items, (Hojat et al., Evaluation and the Health Professions 22 (1999a) 208; Nursing Research 50 (2001) 123). They were compared on the total scores and four factors of the Jefferson Scale (shared education and team work, caring as opposed to curing, nurses, autonomy, physicians’ dominance). Results showed inter- and intra-cultural similarities and differences among the study groups …

Clinical And Demographic Characteristics Of Psychiatric Inpatients Admitted Via Emergency And Non-Emergency Routes At A University Hospital In Pakistan, E U. Syed, S Mehmud, R Atiq

Department of Psychiatry

Objective: To examine the differences in the demographic and clinical characteristics of patients admitted through emergency versus non-emergency routes and see if these two groups of patients were significantly different from each other with respect to criteria mentioned in the title.Methods: Retrospective data was analysed in all 2576 patient records were reviewed and these patients were divided in two groups with respect to their mode of admission (emergency vs non emergency). These groups were then compared with respect to sex, age, length of stay, discharge status and diagnostic categories. Statistical package for social sciences version 8.0 (SPSS 8.0) was used …

Depression In The Elderly: Primary Care Practice Fact Sheet #2, Eastern Agency On Aging, University Of Maine Center On Aging, Aroostook Area Agency On Aging, Senior Spectrum, Rosscare, Norumbega Medical, Horizons Health Services, Indian Township Tribal Health Center, Bucksport Regional Health Center

Maine Center on Aging Service and Consultation

Depression is the most common psychiatric disorder that is seen in individuals over the age of 65. The National Institute of Health Consensus Statement concluded that only ten percent of older individuals needing psychiatric treatment actually receive this service. Suicide is common in these individuals, and when recognized and treated, clinical depression can be manages in over 80 percent of cases. The primary care practitioner should ensure that the family caregivers regularly see and speak to their older relatives in order to check in on well-being and recognize possible symptoms of depression.

Ischemic Stroke In Young Adults Of South Asia, A A. Razzaq, B A. Khan, S M. Baig

Section of Neurology

Objective: To study the risk factors, etiology and management of ischemic stroke in young adults in a South Asian population.

Methods: Retrospective study conducted at a large tertiary hospital in Karachi. One hundred and eighteen patients between fifteen and forty-five years admitted over a five year period with a diagnosis of ischemic infarct constituted the study population. The study variables included the full clinical spectrum, spanning historical, laboratory, radiological and outcome parameters.

Results: Forty-three percent of patients were hypertensive and 30% were diabetic. The combination of diabetes and hypertension was found in 19.5% of patients, intra-cranial and carotid …

Physician Empathy: Definition, Components, Measurement, And Relationship To Gender And Specialty, Mohammadreza Hojat, Joseph S. Gonnella, Thomas J. Nasca, Salvatore Mangione Md, Michael Vergare, Michael Magee

CRMEHC Faculty Papers

OBJECTIVE: There is a dearth of empirical research on physician empathy despite its mediating role in patient-physician relationships and clinical outcomes. This study was designed to investigate the components of physician empathy, its measurement properties, and group differences in empathy scores.

METHOD: A revised version of the Jefferson Scale of Physician Empathy (with 20 Likert-type items) was mailed to 1,007 physicians affiliated with the Jefferson Health System in the greater Philadelphia region; 704 (70%) responded. Construct validity, reliability of the empathy scale, and the differences on mean empathy scores by physicians’ gender and specialty were examined.

RESULTS: Three meaningful factors …

Digest Of The Philadelphia College Of Osteopathic Medicine (Fall 2002), Philadelphia College Of Osteopathic Medicine

Digest

The Fall 2002 Digest of the Philadelphia College of Osteopathic Medicine includes the following articles:

• Opening Remarks
• PCOM Updates
• Alumnus Marks 100th Birthday
• Cover Story: College Moves Forward with Strategic Plan
• Aging and the Immune Response
• Class Notes
• In Memoriam
• My Turn
• 2003 Annual Fund
• PCOM Events

Co-Occurrence Of Dsm-Iv Personality Disorders With Borderline Personality Disorder, Carlos M. Grilo, Charles A. Sanislow, Thomas H. Mcglashan

Charles A. Sanislow, Ph.D.

No abstract provided.

Mexican-Descent Latinas’ Compliance With Cervical Cancer Screening Guidelines, Evelinn A. Borrayo, Awilda Reyes

University Libraries Faculty Publications

No abstract provided.

Predictors Of Mortality In Brain Abscess, H U. Qureshi, A A. Habib, A A. Siddiqui, T Mozaffar, A R. Sarwari

Section of Neurosurgery

Objective: Brain abscess carries significant morbidity and mortality. Our objective was to elucidate the clinical presentation of brain abscess and to assess predictors of mortality in these patients.
Methods: All patients with a brain abscess presenting to the Aga Khan University Hospital, a tertiary care referral center in Karachi, Pakistan, were studied retrospectively. Statistical analysis involved univariate analysis and a logistic regression model.
Results: Among the 66 patients analyzed, a distant metastatic focus of infection was the most commonly identified predisposing factor (29%). Otogenic infection was the commonest contiguous source and sinusitis was noticeably absent. Multiple abscesses were frequent (35%). …

Typical Symptoms Are Predictive Of Acute Coronary Syndromes In Women, Kerry A. Milner, Marjorie Funk, Amy L. Arnold, Viola Vaccarino

Nursing Faculty Publications

Background: Previous research suggests that the presentation of acute coronary syndromes (ACS) may differ in women and men. No study has prospectively evaluated the role of a comprehensive set of typical and atypical symptoms and whether different symptoms on presentation predict ACS diagnosis in women and men. Methods and Results: We directly observed 246 women and 276 men seen in the emergency department with symptoms suggestive of ACS and documented their symptoms verbatim. ACS was eventually diagnosed in 89 (36%) women and 124 (45%) men on the basis of standard electrocardiogram and cardiac enzyme criteria. Presence of typical symptoms (chest …

Functional Impairment In Patients With Schizotypal, Borderline, Avoidant, And Obsessive-Compulsive Personality Disorder, Andrew E. Skodol, John G. Gunderson, Thomas H. Mcglashan, Ingrid R. Dyck, Robert L. Stout, Donna S. Bender, Carlos M. Grilo, M. Tracie Shea, Mary C. Zanarini, Leslie C. Morey, Charles A. Sanislow, John M. Oldham

Charles A. Sanislow, Ph.D.

Objective: The purpose of this study was to compare psychosocial functioning in patients with schizotypal, borderline, avoidant, or obsessive-compulsive personality disorder and patients with major depressive disorder and no personality disorder.

Method: Patients (N=668) were recruited by the four clinical sites of the Collaborative Longitudinal Personality Disorders Study. The carefully diagnosed study groups were compared on an array of domains of psychosocial functioning, as measured by the Longitudinal Interval Follow-Up Evaluation—Baseline Version and the Social Adjustment Scale.

Results: Patients with schizotypal personality disorder and borderline personality disorder were found to have significantly more impairment at work, in social relationships, and …

Retrospective Analysis Of Youth Evaluated For Suicide Attempt Or Suicidal Ideation In An Emergency Room Setting, Julie Hagedorn, Hatim A. Omar

Pediatrics Faculty Publications

Suicide is the third leading cause of death in adolescents and a major contributor to morbidity in this age group. The objective of this study was to look at the demographics, major stressors and factors leading to attempting suicide as well as the methods of attempted suicide in adolescents admitted to two hospitals in a medium size city. Medical records were reviewed of adolescents admitted to two area hospitals for attempted suicide between 7/1/97-12/31/99. Coroner's data on completed suicide were also reviewed. In the study period a total of 287 persons aged 21 years or under were admitted for attempted …

Factors Influencing Immunization Status In Primary Care Clinics, David Page, Jan Meires, Amy B. Dailey

Health Sciences Faculty Publications

Background and Objectives: National standards and goals for childhood immunization rates are well established. Yet, despite clear standards and goals, physicians do not achieve the desired rate (90%) for immunization coverage. This study examined factors related to immunization status for 2-year-old children in pediatric and family practice settings.

Methods: Specially trained personnel used computer software to audit 2,552 records from 42 practices in Northeast Florida throughout 1997–1999. Immunization records were judged as either complete or incomplete, and factors related to immunization status were studied. Clinic type and 18 immunization practice standards were reviewed for effect on immunization status.

Results: The …

Are You My Parent? Are You My Child? The Role Of Genetics And Race In Defining Relationships After Reproductive Technological Mistakes, 5 Depaul J. Health Care L. 15 (2002), Raizel Liebler

UIC Law Open Access Faculty Scholarship

Imagine that you are a married woman who wants to have a genetically related child with your husband. Your doctor tells you that you are infertile, and therefore you and your husband go to XYZ fertility clinic to receive in vitro treatment. You have your eggs harvested, your husband supplies sperm, and ten embryos are created. Five embryos are implanted in your uterus and five are frozen and kept by the fertility clinic for your later use. You successfully conceive and give birth to twins. You notice that the children you give birth to are of a different race than …

Psychological Impact Of Comprehensive Tumor Genomic Profiling Results For Advances Cancer Patients, Phyllis N. Butow, Megan Best, Grace Davies, Timothy Schlub, Christine Napier, Nicci Bartley, Mandy Ballinger, Ilona Juraskova, Bettina Meiser, David Goldstein, Barbara Biesecker, David Thomas

IES Papers and Journal Articles

Objective

Comprehensive tumor genomic profiling (CTGP) is increasingly used to personalize treatments, providing hope, but potentially disappointment, for patients. We explored psychological outcomes in patients with advanced, incurable cancer, after receiving CTGP results.

Methods

Participants with advanced, incurable cancer (n = 560, mean age 56, 43% university educated) in this longitudinal substudy of the Molecular Screening and Therapeutics Program (MoST), completed questionnaires before and after receiving CGP results. MoST participants, recruited from Australian oncology clinics, undergo CTGP, and if there are actionable findings, are offered treatment in a related therapeutic trial if available.

Results

Patients who received actionable results, (n …

Using Operations Research To Strengthen Programmes For Encouraging Abandonment Of Female Genital Cutting. Report Of A Consultative Meeting On Methodological Issues For Fgc Research, Frontiers In Reproductive Health

Reproductive Health

The Population Council’s Frontiers in Reproductive Health program, with funding from USAID, organized a consultative meeting on the practice of female genital cutting (FGC) in Nairobi, Kenya in April 2002. The meeting brought together a small group of researchers and program managers who are actively undertaking operations research and systematic program evaluations to review the state of the art concerning intervention research design and measurement issues. The deliberations at this workshop should stimulate interest both in undertaking operations research more routinely when programming anti-FGC activities and in furthering the development and application of research methods appropriate for this subject. Several …

Long-Term Outcomes Of Acute Myeloid Leukemia In Adults In Pakistan, G. N. Kakepoto, S. N. Adil, Mohammad Khurshid, I. A. Bumey, S. Zaki

Department of Pathology and Laboratory Medicine

Objective: To describe the long-term outcomes of Acute Myeloid Leukemia (AML) and to study clinico­pathological features at presentation, morphological subtypesand remission rates.
Methods: Demographic information, response to therapy and survival of patients (>14 years of age) admitted between January 1988 to August 1996 with acute myeloid leukaemia was retrieved and analysed.
Results: Seventy-four patients were admitted with a diagnosis of AML during the study period. There were 43 males and 31 females. Age ranged between 15 and 70 years with a mean age of 38 years. The most common presenting feature was fever (67.5%) and the …

Developing And Testing A Pain Management Program For Family Caregivers Of Advanced Cancer Patients, Lynn Oldham

Theses: Doctorates and Masters

Increasingly, advanced cancer patients are receiving care in the community supported by families and hospice home care services. However, little or no preparation is provided to family caregivers who assume this supportive role, often 24 hours per day. Pain management is consistently identified by family caregivers as their primary concern related to care and support of a relative with cancer. This project involved a three-phase program of research to develop and test a pain management program (PMP) that would provide family caregivers of advanced cancer patients with information and skills to manage the patient's pain.

Beta-Adrenergic, Arachidonic Acid And Potassium Channel Associated-Regulation Of Human Breast Cancer Cell Lines, Yavuz Cakir

Doctoral Dissertations

During the late stages of breast cancer progression, breast cancer cell growth switches from steroid hormone to growth factor dependence, and it is assumed that invasive breast cancers are growth factor receptor positive and estrogen hormone resistant. The cellular arachidonic acid (AA) pathway is upregulated in a variety of cancer types, and it may play an important role in the growth regulation of breast cancer cells.

Recent evidence suggests that beta-adrenergic receptors (β-ARs) are expressed in some estrogen receptor (ER) negative breast cancers and that beta agonists not only can trigger AA release via the activation of cytosolic PLA2 or …