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Hiv-1 And Helminth Co-Infection In Adults In Kenya, Cameron Page
Hiv-1 And Helminth Co-Infection In Adults In Kenya, Cameron Page
Yale Medicine Thesis Digital Library
BACKGROUND: As part of rapidly expanding HIV-1 Care Programs in sub-Saharan Africa, many HIV-1 infected individuals are being identified who do not yet qualify for ART. These individuals may benefit from treatment of co-infections, such as soil-transmitted helminths. Treatment of helminth infection in HIV-1 infected individuals may improve health and nutrition and may slow progression to AIDS. In this setting, access to both medical care and diagnostic testing is limited. Determining correlates of helminth infection in HIV-I infected individuals may allow clinicians to better target empiric anti-helminth therapy in HIV-1 infected individuals. METHODS: To describe the prevalence and correlates of …
Evaluation Of A Social Support Measure That May Indicate Risk Of Depression During Pregnancy, Lori Spoozak
Evaluation Of A Social Support Measure That May Indicate Risk Of Depression During Pregnancy, Lori Spoozak
Yale Medicine Thesis Digital Library
The objective of this study was to evaluate the psychometric properties of the Kendler Social Support Interview modified for administration to pregnant women and to assess the relationship between social support and depression in the first trimester of pregnancy. Subjects were administered the Modified Kendler Social Support Interview (MKSSI) and the Composite International Diagnostic Index to diagnose depression. Principal components analysis was employed to construct the MKSSI score. Cronbachs coefficient alpha and principal factor analysis were run for items included in the MKSSI score. The relationship between a depressive diagnosis and the MKSSI score and subscales was assessed by logistic …
Intussusception Of The Appendix: New Trends And Comprehensive Analysis Of 140 Case Reports, Barbara Wexelman
Intussusception Of The Appendix: New Trends And Comprehensive Analysis Of 140 Case Reports, Barbara Wexelman
Yale Medicine Thesis Digital Library
INTUSSUSCEPTION OF THE APPENDIX: NEW TRENDS AND COMPREHENSIVE ANALYSIS OF 140 PUBLISHED CASE REPORTS. Barbara A. Wexelman, Cassius Ochoa Chaar, and Walter Longo. Section of Colorectal Surgery, Department of Surgery, Yale University, School of Medicine, New Haven, CT. Statement of Purpose: This paper uses 139 published case reports to understand the demographic, diagnostic, and treatment trends of intussusception of the appendix. Methods: Using the PubMed literature search engine to find all English references of intussusception and appendix, and reviewing those that contained actual case reports of intussusception of the appendix, we analyzed the demographics, presentation, diagnostic methods, surgical treatment, and …
Electrical Stimulation And Glutamate In The Hippocampus Of Epilepsy Patients, Gabriel Widi
Electrical Stimulation And Glutamate In The Hippocampus Of Epilepsy Patients, Gabriel Widi
Yale Medicine Thesis Digital Library
Electrical brain stimulation has been proposed as a promising treatment option for patients with medically resistant epilepsy disorder. Glutamate levels in the epileptogenic human hippocampus are elevated interictally and increase with seizures. Fifty Hz stimulation is a candidate therapeutic stimulation that is also used for clinical cortical mapping. We examined the effects of 50 Hz stimulation on glutamate efflux in the hippocampus of patients with medically refractory epilepsy. Subjects (n = 10) underwent intracranial EEG (icEEG) evaluation for possible therapeutic resection. Electrical stimulation was delivered through implanted hippocampal electrodes (n = 11) and microdialysate samples were collected every 2 mins. …
Influence Of A Serotonin Transporter Promoter Polymorphism (5-Httlpr) On Corticolimbic Abnormalities In Bipolar Disorder An Integrated Genetics And Functional Mri Study, Maulik Shah
Yale Medicine Thesis Digital Library
Bipolar disorder (BD) is associated with abnormalities of the subgenual anterior cingulate cortex (sgACC) and the amygdala, components of a corticolimbic neural system that subserves emotional regulation. The short s allele - as opposed to the long l allele - of a serotonin transporter promoter (5-HTTLPR) polymorphism is associated with more severe course features of BD and impaired functional connectivity between the sgACC and amygdala in healthy control (HC) individuals. This study tests the hypothesis that the s allele influences the dysfunction in the sgACC-amygdala neural system in BD. Twenty-six euthymic BD participants (17 s carriers, 9 ll) and 43 …
Outcomes In Patients With End-Stage Renal Disease And Colonic Diverticular Disease, Louis Salamone
Outcomes In Patients With End-Stage Renal Disease And Colonic Diverticular Disease, Louis Salamone
Yale Medicine Thesis Digital Library
Purpose: To evaluate clinical presentation and outcomes of patients with end-stage renal disease (ESRD) or renal transplantation and symptomatic colonic diverticular disease Methods: A retrospective review of all patients with the primary diagnosis of diverticulitis or diverticulosis and end-stage renal disease treated at Yale-New Haven Hospital from January 1, 1985 to December 31, 2005 was performed. Patient factors evaluated including age, gender, comorbidities, nature of ESRD, and immunosuppression if any, along with the diagnosis of diverticulosis or diverticulitis, complicated vs. uncomplicated and outcomes including morbidity, mortality and LOS. Patients were evaluated to determine predictors of poor outcome. Simple summary statistics …
Depression And Resilience During The First Six-Months Of Internship, Rachel Laff
Depression And Resilience During The First Six-Months Of Internship, Rachel Laff
Yale Medicine Thesis Digital Library
Consistent with prior studies, the prevalence of depression in interns is significantly higher than the general population. There is a significant amount of suicidal ideation among interns during the first three-months of internship. It appears that international medical graduates are significantly less depressed than U.S. medical graduates during the first six-months of internship. A prior history of depression, longer work hours, female gender, and a lack of confidence in coping with challenges are associated with the development of depression during the first six-months of internship. Of greatest concern, very few interns with clinically significant levels of depression are seeking treatment. …
Anatomy, Physiology And Management Of Patients With Diffuse Pulmonary Arteriovenous Malformations, Tamara Lazic
Anatomy, Physiology And Management Of Patients With Diffuse Pulmonary Arteriovenous Malformations, Tamara Lazic
Yale Medicine Thesis Digital Library
Diffuse pulmonary vascular malformations (PAVMs) are a small and understudied, but nevertheless important subset of the PAVM population of patients, associated with significant mortality and morbidity. A review of literature was undertaken to investigate the current understanding of diffuse PAVMs. This review demonstrated that no additional attempts to define diffuse PAVMs and describe their natural history was made before or after the in 2000 report by Faughnan et al {{51 Faughnan,M.E. 2000; }}. To further expand the findings from 2000, we performed a retrospective review of 36 patients (21 female, 15 male) with diffuse PAVMs from a cohort of 821 …
Differences In The Central Neural Activation Under Emotional Stress Across The Menstrual Cycle, Nayalya Lopushnyan
Differences In The Central Neural Activation Under Emotional Stress Across The Menstrual Cycle, Nayalya Lopushnyan
Yale Medicine Thesis Digital Library
The present study had several goals. First, we aimed to investigate the potential differences in the activation of the corticolimbic structures during emotional stress in healthy women across the menstrual cycle using stress imagery. Second, we searched for differences in the subjective anxiety under emotional stress across the menstrual cycle and tried to correlate the perceived level of anxiety to activation of the specific corticolimbic structures. Third, we attempted to compare central neural activation of women in follicular and in luteal phases of the menstrual cycle separately to that of men during emotional stress to investigate potential differences in neural …
Localized Biliary Ischemia In Patients With Hepatic Arteriovenous Malformations, A Newly Recognized Syndrome Occurring In Hereditary Hemorrhagic Telangiectasia Diagnosis And Management, Rasha Khoury
Yale Medicine Thesis Digital Library
The clinical manifestations of hepatic arteriovenous malformations (HAVMs) were elucidated. A review of the literature was undertaken to better understand how HAVMs specifically affect the biliary system. A retrospective review of the 50 patients with HAVMs seen at the Yale University HHT Center was done, including clinical manifestation, intervention and outcome analysis. Of 50 adults with HAVM, median age was 64 (range 17-73) and 84% were female. Initially 74% were classified as Type 1, symptomatic heart failure, 16% as Type 2, portal hypertension, and 10% as Type 3, biliary abnormalities. In Type 1 conversion to Type 3 was associated with …
Efficacy Of Formal Screening For Depression In Pediatric Type 1 Diabetes Clinic, Jeffrey Winer
Efficacy Of Formal Screening For Depression In Pediatric Type 1 Diabetes Clinic, Jeffrey Winer
Yale Medicine Thesis Digital Library
This study was undertaken to examine the efficacy of screening for depression in a pediatric diabetes clinic and how the yield of such screening compares with established screening protocols aimed at identifying early microvascular complications and associated autoimmune diseases. Two-hundred-fifteen children and adolescents 8-18 years old in the Yale Pediatric Diabetes Center were screened for depression using the Children's Depression Inventory (CDI), with information including gender, age, duration of diabetes, HbA1C, and results of other screening protocols compiled. A total of 8.4% of our cohort had CDI scores ≥13 indicative of clinically-significant depressive symptoms, with a range of 0-34. Depression …
Reproductive Desires And Intentions Among Hiv-Infected Individuals In Chennai, India, Elizabeth Houle
Reproductive Desires And Intentions Among Hiv-Infected Individuals In Chennai, India, Elizabeth Houle
Yale Medicine Thesis Digital Library
Despite the personal and cultural importance of childbearing in India, limited information exists on the extent of childbearing desires and intentions among HIV-infected individuals in this setting. The purpose of this study was to measure the extent of childbearing desires among HIV-infected individuals in Chennai, India, thereby testing the hypothesis that HIV significantly influences the desire to have children. Three hundred HIV-infected individuals were interviewed about childbearing desires and intentions during routine visits for HIV care at an HIV specialty care clinic in Chennai, South India. Sixteen percent of participants expressed desire for childbearing, and 9% expressed intention to have …
The Association Between Pediatric Overweight And Ankle Injuries: A Case-Control Analysis, Ellen Margaret House
The Association Between Pediatric Overweight And Ankle Injuries: A Case-Control Analysis, Ellen Margaret House
Yale Medicine Thesis Digital Library
Pediatric obesity has become a worldwide pandemic and trauma is the leading cause of pediatric morbidity and mortality. Our hypothesis is that being overweight increases the likelihood of acute ankle injuries in children. Our study consisted of a case-control analysis in an urban pediatric emergency department with subjects between 5-19 years of age. Cases consisted of children presenting with acute ankle injury; controls had chief complaints of fever, headache, or sore throat. Demographic information, physical activity score, heights, and weights were obtained on all participants; injury severity was calculated for the cases. Age and gender specific body mass index percentiles …
Clinical And Demographic Predictors Of Short-Term Recovery From Arthroscopic Partial Meniscectomy, Peter Fabricant
Clinical And Demographic Predictors Of Short-Term Recovery From Arthroscopic Partial Meniscectomy, Peter Fabricant
Yale Medicine Thesis Digital Library
Patients undergoing orthopaedic surgery are concerned with returning to activities of daily living (recovery) in addition to the long-term result of their surgery (end result). As evidence of predictors of rate of short-term recovery is limited to date, this study seeks to determine which patient clinical and demographic factors can serve as prognostic indicators for rate of short-term recovery from arthroscopic partial meniscectomy in the year following surgery and how they may differ from previously published associations with long-term outcome. Clinical (depth of meniscal excision, involvement of one or both menisci, extent of meniscal tear, extent of osteoarthritis) and demographic …
The Use And Safety Of Vascular Occlusion Techniques: A Survey Of Practicing Surgeons, Ryan Kelly
The Use And Safety Of Vascular Occlusion Techniques: A Survey Of Practicing Surgeons, Ryan Kelly
Yale Medicine Thesis Digital Library
Vascular occlusion techniques can be divided into two categories ¡V transfixion and non-transfixion. Transfixion techniques are defined by the passage of suture material or staples through the vascular tissue. Non-transfixion techniques are defined as suture, metal, or polymer material placed solely around the vascular tissue. The purpose of this study was to survey surgeons in various specialties to determine which vascular control technique they believe is safest and most appropriate to manage medium-sized arteries 6-10mm in diameter. A survey was distributed to surgeons in the following specialties: general surgery, urology, thoracic surgery, vascular surgery, obstetrics and gynecology, and colon and …
Community Based Epidemiological Study Of Chagas Disease In Rural Peru, Paul Walker
Community Based Epidemiological Study Of Chagas Disease In Rural Peru, Paul Walker
Yale Medicine Thesis Digital Library
The purpose of this study was to evaluate the epidemiology of Trypanosoma cruzi infection, to valuate the TESA blot, and to characterize cardiac findings of patients with Chagas disease in a rural setting near Arequipa, Peru. The study site was the town of Quequeña, Peru with a population of 774 with 236 inhabitants under the age of 18 according to the 2005 census conducted by Peru. A fumigation/insect collection campaign was done in December of 2006 to quantify household infestation levels, document housing characteristics, and GPS household locations. Of the 602 people surveyed to be living in Quequeña, blood samples …
The Effect Of Teleradiology On Interpretation Times For Ct Pulmonary Angiography Studies, Scott Thomas Olcott Kennedy
The Effect Of Teleradiology On Interpretation Times For Ct Pulmonary Angiography Studies, Scott Thomas Olcott Kennedy
Yale Medicine Thesis Digital Library
The purpose of this study was to evaluate the impact of a teleradiology service on the timely interpretation of computed tomography (CT) pulmonary angiography studies. A survey of clinical and imaging physicians was performed to develop achievable goals for interpretation of CT pulmonary angiography studies. Percentages of studies given preliminary written reports within these thresholds were compared for 1,102 pulmonary angiography CT studies from three months before teleradiology was implemented to three months after. Identical control data were matched over the same periods for 1,638 CT brain studies. Data are reported as averages and percentages. Statistical significance was evaluated with …