Digital Commons Network^™

Fagerstrom Test For Nicotine Dependence Vs Heavy Smoking Index In A General Population Survey, M. Pérez-Ríos, M. I. Santiago-Pérez, B. Alonso, A. Malvar, X. Hervada, Jose De Leon

Psychiatry Faculty Publications

BACKGROUND: The Fagerström Test for Nicotine Dependence (FTND) is used for assessing nicotine dependence. A shorter test derived from the FTND used for the general population is the Heavy Smoking Index (HSI) (six questions vs. two). The objective of this study is to compare the validity of the HSI versus the FTND.

METHODS: A survey of tobacco use in the general population was carried out in the northern Spanish region of Galicia using both the FTND and the HSI to study a representative sample of 1655 daily smokers. The HSI was compared with the FTND, considered the gold standard. Measures …

Guyon's Canal Syndrome Due To Tortuous Ulnar Artery With Dequervain Stenosing Tenosynovitis, Ligamentous Injuries And Dorsal Intercalated Segmental Instability Syndrome, A Rare Presentation: A Case Report., Muhammad Zeeshan, Farhan Ahmed, Darakhshan Kanwal, Qazi Saad Bin Khalid, Muhammad Nadeem Ahmed

Department of Radiology

The Guyon's canal syndrome is a well known clinical entity and may have significant impact on Patient's quality of life. We report a case of 43-year-old male who presented with complaints of pain and numbness in right hand and difficulty in writing for past one month. On imaging diagnosis of Guyon's canal syndrome because of tortuous ulnar artery was made with additional findings of DeQuervain's stenosing tenosynovitis and dorsal intercalated segmental instability syndrome with ligamentous injury and subsequently these were confirmed on surgery. Although it is a rare syndrome, early diagnosis and treatment prevents permanent neurological deficits and improve Patient's …

The Negative Images Of Nursing Portrayed On Grey’S Anatomy, House And Er And Its Effect On Public Perception And The Contemporary Nursing Shortage, Jacquelyn Bishop

Health Policy & Management Student Scholarship

No abstract provided.

A Comparison Of The Wellbeing Of Orphans And Abandoned Children Ages 6–12 In Institutional And Community-Based Care Settings In 5 Less Wealthy Nations, Kathryn Whetten, Jan Ostermann, Rachel A. Whetten, Brian W. Pence, Karen O'Donnell, Lynne C. Messer, Nathan M. Thielman, The Positive Outcomes For Orphans (Pofo) Research Team

Faculty Publications

Background

Leaders are struggling to care for the estimated 143,000,000 orphans and millions more abandoned children worldwide. Global policy makers are advocating that institution-living orphans and abandoned children (OAC) be moved as quickly as possible to a residential family setting and that institutional care be used as a last resort. This analysis tests the hypothesis that institutional care for OAC aged 6–12 is associated with worse health and wellbeing than community residential care using conservative two-tail tests.

Methodology

The Positive Outcomes for Orphans (POFO) study employed two-stage random sampling survey methodology in 6 sites across 5 countries to identify 1,357 …

Documentation Of Body Mass Index And Control Of Associated Risk Factors In A Large Primary Care Network, Stephanie A. Rose, Alexander Turchin, Richard W. Grant, James B. Meigs

Internal Medicine Faculty Publications

BACKGROUND: Body mass index (BMI) will be a reportable health measure in the United States (US) through implementation of Healthcare Effectiveness Data and Information Set (HEDIS) guidelines. We evaluated current documentation of BMI, and documentation and control of associated risk factors by BMI category, based on electronic health records from a 12-clinic primary care network.

METHODS: We conducted a cross-sectional analysis of 79,947 active network patients greater than 18 years of age seen between 7/05 - 12/06. We defined BMI category as normal weight (NW, 18-24.9 kg/m²), overweight (OW, 25-29.9), and obese (OB, ≥ 30). We measured documentation …

Giant Synovial Cell Sarcoma Of The Thorax In A 46-Year-Old Man: A Case Report., Saulat Hasnain Fatimi, Taimur Saleem

Department of Surgery

Background:Although synovial cell sarcoma is a common tumor of the extremities, its occurrence in the thorax has been less frequently documented. Case Presentation: A 46-year-old Pakistani man presented with a 2 month history of progressively increasing cough and left lower chest pain. Initial evaluation was done using a chest x-ray, the Patient was found to have a large mass involving the lower portion of the left chest. A computed tomography scan was performed next which showed a large mass involving the left chest wall with invasion into the pericardium and left hemidiaphragm. En bloc surgical resection of the tumor …

Clinical Profile, Outcomes And Improvement In Symptoms And Productivity In Rhinitic Patients In Karachi, Pakistan., Taimur Saleem, Umair Khalid, Ubaid Ur Rehman Sherwani, Shehzad Ghaffar

Section of Otolaryngology, Head & Neck Surgery

Background:Rhinitis can cause a heavy toll on Patients because of its bothersome effects on productivity. This retrospective study was conducted to explore the clinical profile, outcomes and improvement in the symptoms and productivity resulting from treatment of allergic rhinitis in Pakistan.

Methods:

We carried out a retrospective file review of all allergic rhinitis Patients who presented to the Ear, Nose, Throat Consulting Clinic from January, 2006 to June, 2008 using a structured proforma especially designed for this Purpose. Data was entered and analyzed using SPSS v. 16.0.

Results:

The charts of 169 Patients were reviewed. The mean age of …

Comparing Perceptions Of The Nursing Profession Among Associate And Baccalaureate Nursing Students And Registered Nurses, Sherry R. Lovan

Nursing Faculty Publications

The inconsistencies between the perception of the profession of nursing and the reality of practice can lead to problems in student attrition or result in disillusionment with a career in nursing after a new graduate enters practice. With the nursing shortage reaching critical levels, it is important to examine possible discrepancies that exist and address strategies to reduce them.

For this study, a quantitative design was selected to explore how the perception of the nursing profession compared among first-semester associate degree nursing students, first-semester baccalaureate nursing students, and registered nurses. A convenience sample N = 238 included 69 ADN students, …

Common Genetic Variation And The Control Of Hiv-1 In Humans, Jacques Fellay, Dongliang Ge, Kevin V. Shianna, Sara Colombo, Bruno Ledergerber, Elizabeth T. Cirulli, Thomas J. Urban, Kunlin Zhang, Curtis Gumbs, Jason P. Smith, Antonella Castagna, Alessandro Cozzi-Lepri, Andrea De Luca, Philippa Easterbrook, Huldrych F. Gunthard, Simon Mallal, Cristina Mussini, Judith Dalmau, Javier Martinez-Picado, Jose M. Miro, Niels Obel, Steven M. Wolinsky, Jeremy J. Martinson, Roger Detels, Joseph Margolick, Lisa Jacobson, Patrick Descombes, Stylianos E. Antonarakis, Jacques S. Beckmann, Stephen J. O'Brien, Norman L. Letvin, Andrew J. Mcmichael, Barton F. Haynes, Mary Carrington, Sheng Feng, Amalio Telenti, David B. Goldstein, Niaid Center For Hiv/Aids Vaccine Immunology (Chavi)

Biology Faculty Articles

To extend the understanding of host genetic determinants of HIV-1 control, we performed a genome-wide association study in a cohort of 2,554 infected Caucasian subjects. The study was powered to detect common genetic variants explaining down to 1.3% of the variability in viral load at set point. We provide overwhelming confirmation of three associations previously reported in a genome-wide study and show further independent effects of both common and rare variants in the Major Histocompatibility Complex region (MHC). We also examined the polymorphisms reported in previous candidate gene studies and fail to support a role for any variant outside of …

A Pilot Study Of An Automated Voice Response System And Nursing Intervention To Monitor Adherence To Oral Chemotherapy Agents, Veronica Decker, Sandra L. Spoelstra, Emily Miezo, Renee Bremer, Mei You, Charles W. Given, Barbara A. Given

Peer Reviewed Articles

This study was designed to develop and test a system to monitor adherence with non-hormonal oral chemotherapeutic agents using an automated voice response (AVR) system plus nursing intervention. Participants received the Symptom Management Toolkit then participated in an interview for symptom severity, satisfaction, and beliefs about oral agents. Patients received weekly AVR calls, which assessed adherence to oral agents and severity of 15 symptoms. Patients who reported adherence of < 100% of prescribed oral agents or symptoms of 4 or greater (0-10 scale) for three consecutive weeks, were called by a nurse for assistance with symptom management and adherence to oral chemotherapy medications. Following the 8 weekly AVR calls, patients participated in a follow up interview and medical record review. Subjects were 30 oncology patients who were ambulatory and treated at two cancer centers in Midwest USA. The results indicate 23.3% non adherence rate to oral chemotherapy medications due to symptoms and forgetting to take the medication. An association between symptom management and adherence was found. Symptom severity and beliefs about medications were not significantly different between adherent and non adherent patients. This pilot study demonstrated the ability to accrue patients for a longitudinal trial and informed intervention design, while providing guidance for future interventions and research studies.

This study was designed to develop and test a system to monitor adherence with nonhormonal oral chemotherapeutic agents using an automated voice response (AVR) system plus nursing intervention. Participants were patients …

Fuzzy Logic In Neurosurgery: Predicting Poor Outcomes After Lumbar Disk Surgery In 501 Consecutive Patients, Muhammad Shahzad Shamim, Ather Enam, Uvais Qidwai

Section of Neurosurgery

Background: Despite a lot of research into Patient selection, a significant number of Patients fail to benefit from surgery for symptomatic lumbar disk herniation. We have used Fuzzy Logic-based fuzzy inference system (FIS) for identifying Patients unlikely to improve after disk surgery and explored FIS as a tool for surgical outcome prediction.
Methods: Data of 501 Patients were retrospectively reviewed for 54 independent variables. Sixteen variables were short-listed based on heuristics and were further classified into memberships with degrees of membership within each. A set of 11 rules was formed, and the rule base used individual membership degrees and their …

Etiology, Functional Status And Short Term Outcome Of Patients With Pituitary Lesions. An Experience From A Developing Country, Osama Ishtiaq, Mansoor Ul Haq, Azra Rizwan, Mohammad Qamar Masood, Saeed Mehar, Abdul Jabbar

Section of Diabetes, Endocrinology and Metabolism

OBJECTIVE: To describe the etiology, functional status and short term outcome of patients with pituitary lesions (PL).

METHODS: Brain or pituitary MRI reports of 3753 patients were analyzed for PL over the period of 2000 to 2007, done at the Aga Khan University Hospital (AKUH), Karachi, Pakistan. MRIs with reported PL and all those ordered by Endocrinologists with or without pituitary abnormalities, were included in the analysis. This made a total of 338 (9%) MRI reports. PL were defined as pituitary tumors, cysts, haemorrhage, hypoplasia; and empty sella. Patients with these PL, were analyzed for symptoms, hormonal profile and short …

Carotid Artery Disease In Patients Undergoing Elective Coronary Artery Bypass Surgery, Waseem Akhtar, Ayan Sabih, Arif Ali, Mubashir Aslam, Nadeem Ahmad

Department of Radiology

OBJECTIVE: To determine frequency of carotid artery disease in patients undergoing elective coronary artery bypass grafting (CABG) using Doppler sonography.STUDY DESIGN: Observational study.

PLACE AND DURATION OF STUDY: Radiology Department, The Aga Khan University Hospital, Karachi, from January 2005 to September 2008.

METHODOLOGY: Patients with known cardiovascular disease waiting for CABG surgery were enrolled for carotid artery Doppler sonography. A predefined data entry form was used for data collection. Coronary angiography findings, carotid artery findings and other associated factors were noted from medical and radiological records. Frequency and pattern of carotid artery disease along with associated risk factors were evaluated. …

Comparison Of Cephalometric Norms Of Esthetically Pleasing Faces, Attiya Jawaid Shaikh, Arif R Alvi

Section of Dental-Oral Maxillofacial Surgery

OBJECTIVE: To establish cephalometric norms of a sample of aesthetically pleasing Pakistani faces and to analyze differences and similarities with accepted standards for Caucasians.

STUDY DESIGN: Analytical cross sectional study.

PLACE AND DURATION OF STUDY: Carried out at Alvi Dental Hospital, Karachi, from August 2007 to February 2008.

METHODOLOGY: Cephalometric tracings were analyzed on a sample of 40 (20 males and 20 females) Pakistani young adults, aged 18-25 years, with full complement of permanent teeth, no previous orthodontic treatment and pleasing profile. To check the reliability of the measurements, 20 randomly selected cephalograms were retraced. None of the measurements showed …

Association Of Various Reproductive Rights, Domestic Violence And Marital Rape With Depression Among Pakistani Women, Faridah A. Ali, Syed M. Israr, Badar S. Ali, Naveed Z. Janjua

Community Health Sciences

Background: Depression among women is common in developing countries. Gender inequality can contribute to women's risk for depression. Lack of reproductive and sexual rights is an important marker of gender inequality and women do not have the freedom to express their reproductive and sexual needs in many parts of the world. Therefore we designed this study to determine the association of depression with lack of various reproductive rights and domestic violence among married women in Karachi, Pakistan. Methods: A case-control study with 152 cases and 152 controls, which included women 15-48 years, recruited from two teaching hospitals from 1(st) June …

The Burden Of Stroke And Transient Ischemic Attack In Pakistan: A Community-Based Prevalence Study, Ayeesha Kamran Kamal, Ahmed Itrat, Muhammed Murtaza, Maria Khan, Asif Rasheed, Amin Ali, Amna Akber, Zainab Akber, Naved Iqbal, Sana Shoukat, Farzin Majeed, Danish Saleheen

Section of Neurology

Background: The burden of cerebrovascular disease in developing countries is rising sharply. The prevalence of established risk factors of stroke is exceptionally high in Pakistan. However, there is limited data on the burden of stroke and transient ischemic attack (TIA) in South Asia. We report the first such study conducted in an urban slum of Karachi, Pakistan. Methods:Individuals 35 years of age or older were invited for participation in this investigation through simple random sampling. A structured face-to-face interview was conducted using a pretested stroke symptom questionnaire in each participant to screen for past stroke or TIA followed by …

A Descriptive Review Of Health Care Providers Perspective On Stigmatization Of Hiv/Aids Patients: United States And South Africa, Ana I. Fonseca

Honors Projects

Compares the issue of social stigma affecting people with HIV/AIDS in the United State and in South Africa. Posits that stigma is more of an interpersonal problem in the United States, while it is a huge barrier to access to care in South Africa. Data was compiled through personal conversations and experiences in South Africa during June 2009, interviews with health professional and community members in Rhode Island during the fall of 2009, and reading of the professional literature.

Resting State Default-Mode Network Connectivity In Early Depression Using A Seed Region-Of-Interest Analysis: Decreased Connectivity With Caudate Nucleus., Robyn Bluhm, Peter Williamson, Ruth Lanius, Jean Theberge, Maria Densmore, Robert Bartha, Richard Neufeld, Elizabeth Osuch

Department of Medicine Publications

AIM: Reports on resting brain activity in healthy controls have described a default-mode network (DMN) and important differences in DMN connectivity have emerged for several psychiatric conditions. No study to date, however, has investigated resting-state DMN in relatively early depression before years of medication treatment. The objective of the present study was, therefore, to investigate the DMN in patients seeking help from specialized mental health services for the first time for symptoms of depression.

METHODS: Fourteen depressed subjects and 15 matched controls were scanned using 4-T functional magnetic resonance imaging while resting with eyes closed. All but one subject was …

Direct Healthcare Costs Of Hip, Vertebral, And Non-Hip, Non-Vertebral Fractures., Nianwen Shi, Kathleen Foley, Gregory Lenhart, Enkhe Badamgarav

College of Population Health Faculty Papers

Limited data exist regarding the cost of non-hip, non-vertebral (NHNV) fractures. Although NHNV fractures may be less expensive than hip and vertebral fractures, they have a higher incidence rate. The objective of this study was to quantify first-year healthcare costs of hip, vertebral, and NHNV fractures. This was a claims-based retrospective analysis using a case-control design among patients with commercial insurance and Medicare employer-based supplemental coverage. Patients were > or =50 years old with a closed hip, vertebral, or NHNV fracture between 7/1/2001 and 12/31/2004, and continuous enrollment 6 months prior to and 12 months after the index fracture. Adjusted mean …

Initial Tumor Metabolic Parameters (Maximum Suv And Metabolic Volume) Predict Death From Lung Cancer And Rapid Suv Decline Is Associated With Local Control, Maria Werner-Wasik, Edward Pequignot, Terry Hyslop, Brian Shulli, Ying Xiao, Mitchell Machtay, Amy Taylor, Walter Curran, Rita Axelrod

Department of Radiation Oncology Faculty Papers

Factors associated with local failure and death from lung cancer were evaluated based on post-treatment FDG-PET imaging in patients (pts) with non-small cell lung cancer (NSCLC).

PET-CT scans were obtained 6-8 weeks after thoracic RT and approximately every 3 months thereafter.

No Association Of Obesity And Type 2 Diabetes Mellitus Related Genetic Variants With Colon Cancer, Cheryl L. Thompson, Sarah J. Plummer, Thomas C. Tucker, Graham Casey, Li Li

Markey Cancer Center Faculty Publications

Background: Obesity and type 2 diabetes mellitus (T2D) are known risk factors for colon cancer. Recent reports from a number of genome wide association studies (GWAS) have identified several single nucleotide polymorphisms (SNPs) associated with obesity and T2D. Here we tested the hypothesis that these SNPs may also be associated with risk of colon cancer.

Methods: We genotyped nine SNPs reported in GWAS of obesity and/or T2D, including SNPs in HHEX, KCNJ11, SLC30A8, FTO, CDKN2, CDKAL1, TCF2, and the rs9300039 SNP in an intergenic region, in 561 colon cancer cases and 721 population controls.

Results: None of these SNPs were …

Effects Of Caregiver Burden And Satisfaction On Affect Of Older End-Stage Renal Disease Patients And Their Spouses, Maureen Wilson-Genderson, Rachel A Pruchno, Francine P Cartwright

Rowan-Virtua School of Osteopathic Medicine Faculty Scholarship

We examined the extent to which a 2-factor model of affect explains how the burdens and satisfactions experienced by caregivers influence their own well-being and that of the spouses for whom they provide care. Using data from 315 older patients with end-stage renal disease and their spouses, we extended tests of Lawton et al.'s (1991) 2-factor model both longitudinally and dyadically. Multilevel modeling analyses partially support the 2-factor model. Consistent with the model, mean caregiver burden has a stronger effect on both caregiver and patient negative affect than does mean caregiver satisfaction. Contrary to the model, mean caregiver satisfaction has …

Finding Solutions To Language Barriers Between Nurses And Their Clients, Tammy Poisson

Honors Projects

Explores perceptions of current registered nurses' encounters with limited English proficiency (LEP) Spanish speaking clients, negative outcomes related to LEP perceived by these nurses, and suggestions offered by these RNs for innovative interventions that would lessen language barriers. Describes an exploratory study conducted via a survey of nurses working in urban health clinics within Rhode Island and discusses microscopic and macroscopic nursing implications related to language barriers between nurses and their clients.

Parental Perceptions Of Body Mass Index Referrals And Overweight School-Age Children, Misty Schwartz

Department of Educational Administration: Dissertations, Theses, and Student Research

It is well documented that there is a worldwide epidemic of obesity in children. To address obesity in children, emphasis must be on factors within family, school, and community environments. Although most parents and school officials are aware of the problem of overweight children, there is little data available to guide decision making about the acceptability of school-based Body Mass Index (BMI) screening and referral programs. As states mandate BMI screening and referral, parental insight is essential to determine the efficiency and effectiveness of BMI notification.

The purpose of this multiple case study was to explore the perceptions of parents …

Paroxysmal Atrial Fibrillation Presenting As Anterior Wall Stemi In An Elderly Woman, Muhammad Asim Shabbir, Muhammad Hamza Saad Shaukat, Lance Sullenberge, Mikhail Torosof

Section of Internal Medicine

A 77-year-old woman without traditional risk factors for coronary artery disease (CAD) underwent coronary CT-angiography for evaluation of palpitations after negative Holter monitoring and non-diagnostic ECG exercise stress test. Coronary artery calcium score was reported zero; 1 day later, she was admitted with anterior-wall ST elevation myocardial infarction. Acute left anterior descending artery thrombus was treated with mechanical thrombectomy and Percutaneous Coronary Intervention (PCI). Interestingly, the coronary arteries were angiographically normal. During hospitalisation, paroxysmal atrial fibrillation was noted followed by initiation of anticoagulation. Echocardiogram did not show thrombus or atrial shunt. Cardioversion with Sotalol was successful. Myocardial infraction was most …

Dental Treatment Under General Anesthesia In Healthy And Medically Compromised/Developmentally Disabled Children: A Comparative Study, Juan Pablo Loyola-Rodriguez, Veronica Zavala-Alonso, Cinthya L. Gonzalez-Alvarez, Lilia A. Juarez-Lopez, Nuria Patiño-Marin, Cesar D. Gonzalez

School of Dentistry Faculty Research and Publications

Aim: To compare the type, number of procedures and working time of dental treatment provided under dental general anesthesia (DGA) in healthy and medically compromised/developmentally disabled children (MCDD children). Design: This cross-sectional prospective study involved 80 children divided into two groups of 40 children each. Group 1 consisted of healthy and Group 2 consisted of MCDD children. Results: Healthy children needed more working time than MCDD children, the means being 161±7.9 and 84±5.7 minutes, respectively (P= 0.0001). Operative dentistry and endodontic treatments showed a significant statistical difference (P= 0.0001). The means of procedures were 17±5.0 for healthy children and 11±4.8 …

Admission Creatine Kinase As A Prognostic Marker In Acute Myocardial Infarction, Khawar Abbas Kazmi, Saleem Perwaiz Iqbal, Ayla Bakr, Mohammad Perwaiz Iqbal

Section of Cardiology

OBJECTIVES: To investigate the prognostic significance of creatine kinase (CK) in Pakistani patients suffering from acute myocardial infarction (AMI) and to find out if CK combined with troponin T (TnT) could be a better predictor for long-term adverse cardiac event.

METHODS: One hundred and eighty six consecutive patients with AMI who were eligible for streptokinase (SK) treatment were included in this prospective cohort study. The relationship between their serum/plasma CK and TnT levels at the time of admission and clinical outcome was investigated over a mean follow up of 24.12 +/- 3.75 months.

RESULTS: Admission CK was found to be …

Fdg Pet-Positive, Mri-Negative Patients With Temporal Lobe Epilepsy: Etiology And Outcomes Compared To Patients With Hippocampal Sclerosis, C. Lopinto Khoury, M. Sperling, C. Skidmore, M. Nei, A. Zangaladze, J. Evans, A. Sharan, S. Mintzer

Department of Neurology Faculty Papers

FDG PET hypometabolism is important for surgical planning in patients with temporal lobe epilepsy (TLE), but its significance remains unclear in patients who do not have evidence of Hippocampal Sclerosis (HS) on MRI.

Role Of N-Acetylcysteine In Adults With Non-Acetaminophen-Induced Acute Liver Failure In A Center Without The Facility Of Liver Transplantation., Khalid Mumtaz, Zahid Azam, Saeed Hamid, Shahab Abid, Sadik Memon,, Syed H Shah, Wasim Jafri

Section of Gastroenterology

PURPOSE:

We aimed to study the role of N-acetylcysteine (NAC) in non-acetaminophen-induced acute liver failure (NAI-ALF).

METHODS:

A total of 47 adult patients were prospectively enrolled with NAI-ALF (group 1 or NAC group) and oral NAC was given. The primary outcome was reduction in mortality with the use of NAC in NAI-ALF. The secondary outcomes were to evaluate safety of NAC and to assess factors predicting mortality. We compared these results with records of NAI-ALF patients admitted in our hospital from 2000 to 2003 (n = 44) who were not given NAC (group 2 or historical controls).

RESULTS:

The two …

Food For Thought: The Importance Of Nutrition For Cognitive And Physical Well-Being, Keeley M. Caviness

Senior Honors Theses

The purpose of this paper is to examine the effects of nutrition upon the physical development and health of an individual. The main focus is on proving through the examination of various literature and the effects of specific nutrients that nutrition has a great impact on mental and physical well-being. The reasons which people give for not having proper nutrition are taken into consideration as well, and an overall conclusion can be made that nutrition is very important and should be taught to all consumers.