Digital Commons Network^™

Large-Scale Genome-Wide Meta-Analysis Of Polycystic Ovary Syndrome Suggests Shared Genetic Architecture For Different Diagnosis Criteria, Felix Day, Tugce Karaderi, Michelle R. Jones, Cindy Meun, Chunyan He, Alex Drong, Peter Kraft, Nan Lin, Hongyan Huang, Linda Broer, Reedik Magi, Richa Saxena, Triin Laisk, Margrit Urbanek, M. Geoffrey Hayes, Gudmar Thorleifsson, Juan Fernandez-Tajes, Anubha Mahajan, Benjamin H. Mullin, Bronwyn G. A. Stuckey, Timothy D. Spector, Scott G. Wilson, Mark O. Goodarzi, Lea Davis, Barbara Obermayer-Pietsch, André G. Uitterlinden, Verneri Anttila, Benjamin M. Neale, Marjo-Riitta Jarvelin, Bart Fauser

Internal Medicine Faculty Publications

Polycystic ovary syndrome (PCOS) is a disorder characterized by hyperandrogenism, ovulatory dysfunction and polycystic ovarian morphology. Affected women frequently have metabolic disturbances including insulin resistance and dysregulation of glucose homeostasis. PCOS is diagnosed with two different sets of diagnostic criteria, resulting in a phenotypic spectrum of PCOS cases. The genetic similarities between cases diagnosed based on the two criteria have been largely unknown. Previous studies in Chinese and European subjects have identified 16 loci associated with risk of PCOS. We report a fixed-effect, inverse-weighted-variance meta-analysis from 10,074 PCOS cases and 103,164 controls of European ancestry and characterisation of PCOS related …

Functional And Mechanical Role Of Splice Variant Of Mucin4 (Muc4/X) And Trefoil Factors In Pancreatic Cancer Pathogenesis, Rahat Jahan

Theses & Dissertations

Pancreatic Cancer (PC) is one of the vicious cancers as it ranks third in the race of leading cause of cancer-related death. Lack of early diagnostic marker, poor understanding of molecular mechanism of the disease and failure to conventional chemotherapy makes this disease dreadful.

Mucin 4 (MUC4), a high molecular weight glycoprotein is one of the top differentially expressed molecules in PC while not expressed in normal pancreas. Accumulating evidence from our lab suggested its tumorigenic role in PC by increasing cell proliferation, invasion, chemotherapy resistance, tumor growth, and metastasis. Previously, our lab and other has identified 24 different splice …

Bronchopulmonary Dysplasia: Comparison Between The Two Most Used Diagnostic Criteria, Enrique Gomez Pomar, Vanessa A. Concina, Aaron Samide, Philip M. Westgate, Henrietta S. Bada

Pediatrics Faculty Publications

Objectives: To compare the Shennan's and the consensus definition of Bronchopulmonary Dysplasia (BPD) from the National Institutes of Health (NIH) workshop and analyze specific risk factors associated with each definition.

Study design: Retrospective analysis of records of 274 infants admitted to a level IV intensive care unit. Infants were classified as having BPD or no BPD by both definitions. Differences in incidence and risk factors were analyzed. Statistical methods included descriptive statistics, comparative tests, and marginal logistic regression modeling.

Results: The estimated difference in prevalence was 32% [95% CI: (26%, 37%), (p < 0.0001)] between both criteria. The prevalence of BPD was 80% higher based on the NIH criteria [RR = 1.80; 95% CI: (1.58, 2.06)]. Infants with no BPD by the Shennan definition were breathing room air with or without positive or continuous pressure support and were most likely to be discharged home on oxygen [OR = 4.47, 95% CI: (1.20, 16.61), p = 0.03]. Gestational age, birth weight, …

Improving Satisfaction For Patients With Diabetic Foot Ulcer Using A Diagnosis Specific Written Education Packet, Douglas W. Kozeluh

DNP Scholarly Projects

Diabetes mellitus is a significant health care concern affecting 30.2 million Americans in 2015. One of the most common, costly, and serious sequela of diabetes is diabetic foot ulceration (DFU), which may lead to lower extremity amputation. Up to 50% of DFUs and lower extremity amputations can be prevented through effective patient education (PE). PE provided through written information is one intervention designed to improve patient understanding and self-management practices in order to reduce the risks and complications of DFU. The purpose of this Doctorate in Nursing Practice (DNP) project was to determine if implementation of a DFU specific written …

Surgical Aspects Of Common Acute Abdominal Problems In Infants And Children, Eslam M. Abd El-Hafez, Tamer A. Sultan, Tamer F. Abd El-Aziz

Menoufia Medical Journal

Objective The aim of this study was to discuss and evaluate the best diagnostic tool (clinical, radiological, laboratory, or endoscopy) used to reach a final diagnosis and best intervention for most common presentation of surgical causes of common acute abdominal problems in infants and children. Background Acute abdominal pain is a group of acute life-threatening condition that requires emergency hospital admission and often emergency surgical intervention within 24 h of duration. Patients and methods Hundred children of both sexes aged between 1 day and 12 years who presented with surgical causes of common acute abdominal problems were divided into two …

Novel Methods To Diagnose Pulmonary Hypertension In Dogs Assessed By Thoracic Radiography, Kawinthip Chanroon, Thanat Tuntipas, Promsin Sukpanich, Pawit Punyarit, Sirilak Disatian Surachetpong

The Thai Journal of Veterinary Medicine

The objective of this retrospective study was to distinguish between dogs with pulmonary hypertension (PH) and non-PH by using parameters obtained from thoracic radiographs. Data of 72 dogs of small breeds aged more than 1 year old and weighing less than 10 kg were retrieved. Echocardiography was used as a gold standard to diagnose PH and separate the dogs into two groups: PH (n=15) and non-PH (n=57). Seven formulae were created from measurements on right lateral and ventrodorsal radiographic views. Five formulae from the ventrodorsal view provided an outcome that could differentiate PH and non-PH dogs. Two formulae are recommended …

Evaluation Of Serum Midkine As A Novel Marker In Hepatocellular Carcinomas, Doaa A. Eisaa, Gehan A. Tawfik, Mohammed A. El-Jaky, Rasha I. Noreldin, Rawhia H. Ei-Edel

Menoufia Medical Journal

Objectives To evaluate the clinical significance of serum Midkine (MDK) levels in the diagnosis of hepatocellular carcinoma (HCC) compared with alpha-fetoprotein (AFP). Background It was demonstrated that serum MDK levels are increased in cancer patients. So, it was suggested that MDK would likely be a novel marker for diagnosing tumors. In this study, we evaluated the significance of serum MDK levels in the diagnosis of HCC and early-stage HCC compared with AFP. Patients and methods The study was conducted on 90 patients who were divided into three groups: group I is the HCC group (n = 50), group II …

Pretty Peachy., Li-Anne Lim, Basil K. Williams, Carol L. Shields

Wills Eye Hospital Papers

No abstract provided.

Left Ventricular Pseudoaneurysm: An Overview Of Diagnosis And Management., Faisal Inayat, Ali Raza Ghani, Iqra Riaz, Nouman Safdar Ali, Usman Sarwar, Raphael Bonita, Hafeez Ul Hassan Virk

Abington Jefferson Health Papers

Left ventricular pseudoaneurysm is a rare but life-threatening disorder that is frequently reported secondary to myocardial infarction or cardiac surgery. In this article, we chronicle the case of a patient with no prior risk factors who presented with a 2-week history of nonexertional atypical left chest pain. Apical 2-chamber transthoracic echocardiography revealed an unexpected outpouching of basal inferoseptal wall of the left ventricle, which had a narrow neck and relatively wide apex. The patient was diagnosed with left ventricular pseudoaneurysm and medical therapy was initiated. He refused to undergo the surgical intervention and subsequently, he was discharged from the hospital …

Magnetic Resonance Imaging In The Diagnosis Of White Matter Signal Abnormalities., Ravi Datar, Asuri Narayan Prasad, Keng Yeow Tay, Charles Anthony Rupar, Pavlo Ohorodnyk, Michael Miller, Chitra Prasad

Paediatrics Publications

Background White matter abnormalities (WMAs) pose a diagnostic challenge when trying to establish etiologic diagnoses. During childhood and adult years, genetic disorders, metabolic disorders and acquired conditions are included in differential diagnoses. To assist clinicians and radiologists, a structured algorithm using cranial magnetic resonance imaging (MRI) has been recommended to aid in establishing working diagnoses that facilitate appropriate biochemical and genetic investigations. This retrospective pilot study investigated the validity and diagnostic utility of this algorithm when applied to white matter signal abnormalities (WMSAs) reported on imaging studies of patients seen in our clinics. Methods The MRI algorithm was applied to …

Multiple Myeloma, Anne Doup

Nursing Student Class Projects (Formerly MSN)

No abstract provided.

Diagnosing Isolated Hepatosplenic Tuberculosis In An Immunocompetent Patient: A Case Report, Om Dawani, Raja Samir Khan, Mujtaba Jamal Syed, Abdul Moid Shehzad, Ahmed Alratoot, Muhammad Faizan Ahmed

Section of Pulmonary & Critical Care

For many years, tuberculosis (TB) has been endemic in Pakistan; many rare and unusual presentations have been reported. There is a myriad of non-specific symptoms which always requires a high index of clinical suspicion for TB. World Health Organization data suggest that Pakistan ranks as the fifth highest country burdened with TB and has the fourth highest prevalence of multi-drug resistant TB globally. With an annual incidence of 277 cases per 100,000, the importance of early diagnosis and treatment is self-evident. We present a case where a strong suspicion of isolated hepatosplenic TB in an immunocompetent patient justified a directed …

Uncertainty And Competing Priorities In Shared Clinical Decision-Making, Dennis J. Baumgardner

Dennis J. Baumgardner, MD

In this issue introduction, the editor-in-chief of Journal of Patient-Centered Research and Reviews observes that a connecting thread among the articles published therein is an element of uncertainty among patients and clinicians. Competing priorities for the patient also may be present. Several approaches to overcoming these prevalent conflicts to delivery of better health care have been proposed, the most important of which may be clinicians embracing a will to practice shared decision-making.

Multinational Comparative Cross-Sectional Survey Of Views Of Medical Students About Acceptable Terminology And Subgroups In Schizophrenia, Shanaya Rathod, Muhammad Irfan, Rachna Bhargava, Narsimha Pinninti, Joseph Scott, Haifa Mohammad Algahtani, Zhihua Guo, Rishab Gupta, Pallavi Nadkarni, Farooq Naeem, Fleur Howells, Katherine Sorsdahi, Kerensa Thorne, Victoria Osman-Hicks, Sasee Pallikadavath, Peter Phiri, Hannah Carr, Lizi Graves, David Kingdon

Rowan-Virtua School of Osteopathic Medicine Faculty Scholarship

AIM: The aim of this study was to inform thinking around the terminology for 'schizophrenia' in different countries.

OBJECTIVES: The objective of this study was to investigate: (1) whether medical students view alternative terminology (psychosis subgroups), derived from vulnerability-stress models of schizophrenia, as acceptable and less stigmatising than the term schizophrenia; (2) if there are differences in attitudes to the different terminology across countries with different cultures and (3) whether clinical training has an impact in reducing stigma.

DESIGN: This is a cross-sectional survey that examined the attitudes of medical students towards schizophrenia and the alternative subgroups.

SETTING: The study …

Clinical Significance Of Muc13 In Pancreatic Ductal Adenocarcinoma, Sheema Khan, Nadeem Zafar, Shabia S. Khan, Saini Setua, Stephen Behrman, Zachary E. Stiles, Murali M. Yallapu, Prabhakar Pradhan, Meena Jaggi, Subhash C. Chauhan

School of Medicine Publications and Presentations

Background—Poor prognosis of pancreatic cancer (PanCa) is associated with lack of an effective early diagnostic biomarker. This study elucidates significance of MUC13, as a diagnostic/prognostic marker of PanCa.

Methods—MUC13 was assessed in tissues using our in-house generated anti-MUC13 mouse monoclonal antibody and analyzed for clinical correlation by immunohistochemistry, immunoblotting, RT-PCR, computational and submicron scale mass-density fluctuation analyses, ROC and Kaplan Meir curve analyses.

Results—MUC13 expression was detected in 100% pancreatic intraepithelial neoplasia (PanIN) lesions (Mean composite score: MCS=5.8; AUC >0.8, P<0.0001), 94.6% of pancreatic ductal adenocarcinoma (PDAC) samples (MCS=9.7, P<0.0001) as compared to low expression in tumor adjacent tissues (MCS=4, P<0.001) along with faint or no expression in normal pancreatic tissues (MCS=0.8; AUC >0.8; P<0.0001). Nuclear MUC13 expression positively correlated with nodal metastasis (P<0.05), invasion of cancer to peripheral tissues (P<0.5) and poor patient survival (P<0.05; prognostic AUC=0.9). Submicron scale mass density and artificial intelligence based algorithm analyses also elucidated association of MUC13 with greater morphological disorder (P<0.001) and nuclear MUC13 as strong predictor for cancer aggressiveness and poor patient survival.

Conclusion—This study provides significant information regarding MUC13 expression/ subcellular localization in PanCa samples …

Developmental Language Disorder (Dld): A Persistent Language Disorder Of Unknown Aetiology, Lisa Archibald

Communication Sciences and Disorders Presentations

Speech-language pathologists (SLPs) often see children on their caseload who exhibit a persistent delay in language development for no discernable reason. Historically, there has been no consistency in the term used to describe this disorder, which has made it difficult for families to both understand and help with the problem. Recently, an international consensus agreed on the term Developmental Language Disorder (DLD) to describe this difficulty. The release of the consensus statement was paired with an international campaign aimed at raising awareness of DLD (RADLD). Canadian SLPs are invited to join discussion on the use of the term DLD.

Uncertainty And Competing Priorities In Shared Clinical Decision-Making, Dennis J. Baumgardner

Journal of Patient-Centered Research and Reviews

In this issue introduction, the editor-in-chief of Journal of Patient-Centered Research and Reviews observes that a connecting thread among the articles published therein is an element of uncertainty among patients and clinicians. Competing priorities for the patient also may be present. Several approaches to overcoming these prevalent conflicts to delivery of better health care have been proposed, the most important of which may be clinicians embracing a will to practice shared decision-making.

Bilateral Facial Spasm Following Guillain-Barré Syndrome, Zain Guduru, John Morgan, Kapil Sethi

Neurology Faculty Publications

Background: We report a patient who developed lower facial muscle spasm at rest and bilateral facial synkinesis several months after treatment of Guillain–Barré syndrome (GBS); this finding, to our knowledge, is hitherto unreported.

Phenomenology Shown: Bilateral synkinesis, facial muscles spasm at rest, bilateral postparalytic facial syndrome.

Educational Value: Aberrant regeneration of nerve fibers post GBS, resulting in facial muscles spasm at rest, bilateral synkinesis.

Spontaneous Coronary Artery Dissection: A Case Series Of 9 Patients With Literature Review., Ali Raza Ghani, Md, Faisal Inayat, Nouman Safdar Ali, Reema Anjum, Michael Viray, Arsalan Talib Hashmi, Iqra Riaz, Bruce D. Klugherz, Hafeez Ul Hassan Virk

Abington Jefferson Health Papers

Spontaneous coronary artery dissection is an increasingly recognized nonatherosclerotic cause of acute coronary syndrome. Reports regarding the prognosis and natural history of this disease are limited. In addition to the diagnostic difficulty, this condition poses a significant therapeutic challenge due to the lack of specific management guidelines. We present here a case series of 9 patients with spontaneous coronary artery dissection. Additionally, this article reviews the incidence, clinical characteristics, risk factors, diagnostic modalities, therapeutic approaches, and patterns of recurrence in patients with spontaneous coronary artery dissection.

An International Delphi Survey For The Definition Of The Variables For The Development Of New Classification Criteria For Periodic Fever Aphtous Stomatitis Pharingitis Cervical Adenitis (Pfapa)., Federica Vanoni, Silvia Federici, Jordi Antón, Karyl S Barron, Paul Brogan, Fabrizio De Benedetti, Fatma Dedeoglu, Erkan Demirkaya, Veronique Hentgen, Tilmann Kallinich, Ronald Laxer, Ricardo Russo, Natasa Toplak, Yosef Uziel, Alberto Martini, Nicolino Ruperto, Marco Gattorno, Michael Hofer

Paediatrics Publications

Background

Diagnosis of Periodic fever, aphthous stomatitis, pharyngitis and cervical adenitis (PFAPA) is currently based on a set of criteria proposed in 1999 modified from Marshall's criteria. Nevertheless no validated evidence based set of classification criteria for PFAPA has been established so far. The aim of this study was to identify candidate classification criteria PFAPA syndrome using international consensus formation through a Delphi questionnaire survey.

Methods

A first open-ended questionnaire was sent to adult and pediatric clinicians/researchers, asking to identify the variables thought most likely to be helpful and relevant for the diagnosis of PFAPA. In a second survey, respondents …

Practice Standards For Initial Adhd Assessment: A Review, Lauren Spencer

Masters Theses & Specialist Projects

There are many challenges that come with diagnosing attentiondeficit/ hyperactivity disorder (ADHD), including shared symptoms with many similar disorders, high comorbidity of other mental disorders, and subjective bias from informant reports. Three clinical guidelines for diagnosing ADHD currently exist, published by the American Academy of Pediatrics (AAP), the National Institute for Health and Care Excellence (NICE), and the American Academy of Child and Adolescent Psychiatry (AACAP). However, these guidelines are outdated as they are based on the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) and do not include more recent research. This project was intended to update …

Central Nervous System Histoplasmosis: Multicenter Retrospective Study On Clinical Features, Diagnostic Approach And Outcome Of Treatment, Joseph Wheat, Thein Myint, Ying Guo, Phebe Kemmer, Chadi A. Hage, Colin Terry, Marwan M. Azar, James Riddell, Peter Ender, Sharon Chen, Kareem Shehab, Kerry Cleveland, Eden Esguerra, James Johnson, Patty Wright, Vanja Douglas, Pascalis Vergidis, Winnie Ooi, John Baddley, David Bamberger, Raed N. Khairy, Holenarasipur R. Vikram, Elizabeth Jenny-Avital, Geetha Sivasubramanian, Karen Bowlware, Barbara Pahud, Juan Sarria, Townson Tsai, Maha Assi, Satish Mocherla

Internal Medicine Faculty Publications

Central nervous system (CNS) involvement occurs in 5 to 10% of individuals with disseminated histoplasmosis. Most experience has been derived from small single center case series, or case report literature reviews. Therefore, a larger study of central nervous system (CNS) histoplasmosis is needed in order to guide the approach to diagnosis, and treatment.

A convenience sample of 77 patients with histoplasmosis infection of the CNS was evaluated. Data was collected that focused on recognition of infection, diagnostic techniques, and outcomes of treatment.

Twenty nine percent of patients were not immunosuppressed. Histoplasma antigen, or anti-Histoplasma antibodies were detected in the …

The Time Has Come For Dimensional Personality Disorder Diagnosis, Christopher J Hopwood, Roman Kotov, Robert F. Krueger, David Watson, Thomas A. Widiger, Robert R. Althoff, Emily B. Ansell, Bo Bach, R. Michael Bagby, Mark A. Blais, Marina A. Bornovalova, Michael Chmielewski, David C. Cicero, Christopher Conway, Barbara De Clercq, Filip De Fruyt, Anna R. Docherty, Nicholas R. Eaton, John R. Edens, Miriam K. Forbes, Kelsie T. Forbush, Michael P. Hengartner, Masha Y. Ivanova, Daniel Leising, W. John Livesley, Mark R. Lukowitsky, Donald R. Lynam, Kristian E. Markon, Joshua D. Miller, Leslie C. Morey

Psychology Faculty Publications

No abstract provided.

Female Autistic Perspectives: Limits In Diagnosis And Understanding, Alexandra Helmers

Dissertations, Theses, and Capstone Projects

The diagnosis of autism spectrum disorder has increased dramatically within the last two decades, with males being diagnosed, on average, four to five times more than females. Although researchers in the medical community have searched for a biological explanation for this discrepancy, no definitive cause has been found. I argue that our understanding of autism is primarily a social and cultural construction, in addition to a diagnosable medical disorder. The gender disparity in diagnosis reflects cultural narratives surrounding social interaction and the widespread belief in two distinct gender roles. Furthermore, narratives surrounding the topic of autism tend to unintentionally highlight …

Understanding Older Women's Experience Of Being Diagnosed With Breast Cancer, Molly Wilhelm

The Pegasus Review: UCF Undergraduate Research Journal

This study describes the experience of being diagnosed with early stage breast cancer for women age 65 and older. This qualitative study used content analysis to analyze twenty interviews of older women with early stage breast cancer. A variety of positive and negative factors influence the experience of being diagnosed with breast cancer. These factors include: their initial reactions, interactions with their respective medical teams, family support, religion, education, and misinformation. Nurses can use the information from this study to help make diagnosis more positive by educating older women about breast cancer and treatment, encouraging them to develop an optimistic …

Optical Coherence Tomography Application To Alopecia In The Scalp, Elizabeth Melcher

Research Opportunities for Engineering Undergraduates (ROEU) Program 2017-18

Alopecia is the loss of hair, whether it be from the scalp or other regions of the body. Current techniques used to best diagnose and track alopecia are often invasive, requiring a biopsy for results. The use of the OCT, or optical coherence tomography, could drastically improve a patient’s experience in undergoing a diagnosis while proving accurate results. The objective of this study is to develop diagnostic algorithms for the rapid, non-invasive diagnosis of alopecia with OCT. The first step is collecting OCT images of a healthy scalp to understand the anatomical structures with the imaging technique.

Shoulder Symptom Irritability: Development And Testing Of A New Construct, Stephen Michael Kareha

Department of Physical Therapy Student Theses, Dissertations and Capstones

Background: Physical therapists regularly make decisions regarding intervention intensity based upon pathoanatomy and symptom irritability, but the reliability and validity of classifying patients by symptom irritability are unknown. Purpose: Examine the reliability and construct validity of the shoulder symptom irritability classification (SSIC) system for the purposes of determining an appropriate treatment intensity. Design: Prospective repeated-measures cross-sectional single-blinded design. Methods: 101 consecutive subjects with primary complaints of shoulder pain were assessed by a pair of blinded raters. Raters recorded the SSIC level and selected the appropriate intervention intensities for the subjects. Data Analysis: Prevalence-adjusted, bias-adjusted Kappa for ordinal scales (PABAK-OS) and …

Improvement In Diagnosis Of Histoplasma Meningitis By Combined Testing For Histoplasma Antigen And Immunoglobulin G And Immunoglobulin M Anti-Histoplasma Antibody In Cerebrospinal Fluid, Karen C. Bloch, Thein Myint, Luke Raymond-Guillen, Chadi A. Hage, Thomas E. Davis, Patty W. Wright, Felicia C. Chow, Laila Woc-Colburn, Raed N. Khairy, Alan C. Street, Tomotaka Yamamoto, Amanda Albers, L Joseph Wheat

Internal Medicine Faculty Publications

Background. Central nervous system (CNS) histoplasmosis is a life-threatening condition and represents a diagnostic and therapeutic challenge. Isolation of Histoplasma capsulatum from cerebrospinal fluid (CSF) or brain tissue is diagnostic; however, culture is insensitive and slow growth may result in significant treatment delay. We performed a retrospective multicenter study to evaluate the sensitivity and specificity of a new anti-Histoplasma antibody enzyme immunoassay (EIA) for the detection of IgG and IgM antibody in the CSF for diagnosis of CNS histoplasmosis, the primary objective of the study. The secondary objective was to determine the effect of improvements in the Histoplasma galactomannan …

Guinea : Malaria, Madeleine Jacobson

Global Public Health

This brief analyzes malaria in Guinea and its impacts on individuals and the society. It consists of a geographic and demographic presentation of Guinea which includes information about its location, climate, natural resources, ethnic groups, politics and social internal and external challenges where human trafficking, lack of healthcare and refugees are discussed. The brief analyzes malaria´s transmission, diagnosis, preventions and a suggestion for an intervention.

Malaria is a vector-borne disease, which means that living organisms that can transmit infectious diseases between humans or from animals to humans, spread malaria. 70 percent of all malaria deaths occur in age years, but …

The Effectiveness Of Screening For Comorbid Depression Among Outpatients With Chronic Diseases In Maryland, Linda Hasssan Allibalogun

Walden Dissertations and Doctoral Studies

Depression is a pervasive mental health disorder worldwide. Although being diagnosed with chronic illness exacerbates susceptibility to depression, detection and subsequent treatment of comorbid depression in primary care settings remain suboptimal because patients with chronic medical disorders are not commonly screened for depression. There is a need to initiate proactive measures by implementing routine screening in primary care settings. The plan-do-study-act (PDSA) model guided an intervention to establish a depression screening practice. This study aimed to determine if the implementation of evidence-based screening for depression using the Patient Health Questionnaire-9 (PHQ-9) tool could increase diagnosis of comorbid depression among patients …