Digital Commons Network^™

Virtual Surgical Planning In Subscapular System Free Flap Reconstruction Of Midface Defects., Brian P. Swendseid, Dylan F. Roden, Swar Vimawala, Tony Richa, Larissa Sweeny, Richard A. Goldman, Adam Luginbuhl, Ryan N. Heffelfinger, Shachika Khanna, Joseph Curry

Department of Otolaryngology - Head and Neck Surgery Faculty Papers

OBJECTIVES: Reconstruction of the midface has many inherent challenges, including orbital support, skull base reconstruction, optimizing midface projection, separation of the nasal cavity and dental rehabilitation. Subscapular system free flaps (SF) have sufficient bone stock to support complex reconstruction and the option of separate soft tissue components. This study analyzes the effect of virtual surgical planning (VSP) in SF for midface on subsite reconstruction, bone segment contact and anatomic position.

MATERIALS AND METHODS: Retrospective cohort of patients with midface defects that underwent SF reconstruction at a single tertiary care institution.

RESULTS: Nine cases with VSP were compared to fourteen cases …

Treatment Of Dental Complications In Sickle Cell Disease., Priti Mulimani, Samir K. Ballas, Adinegara Bl Abas, Laxminarayan Karanth

Cardeza Foundation for Hematologic Research

BACKGROUND: Sickle cell disease is the most common single gene disorder and the commonest haemoglobinopathy found with high prevalence in many populations across the world. Management of dental complications in people with sickle cell disease requires special consideration for three main reasons. Firstly, dental and oral tissues are affected by the blood disorder resulting in several oro-facial abnormalities. Secondly, living with a haemoglobinopathy and coping with its associated serious consequences may result in individuals neglecting their oral health care. Finally, the treatment of these oral complications must be adapted to the systemic condition and special needs of these individuals, in …

Orofacial Pain And Menstrually Related Migraine, Chisa Nishihara, Keisuke Hatori, Yung-Chu Hsu, Kana Ozasa, Andrew L. Young, Yoshiki Imamura, Noboru Noma

All Dugoni School of Dentistry Faculty Articles

PURPOSE: Migraine is a common, debilitating, primary headache disorder that can cause and be affected by odontalgia.

CASE REPORT: A 49-year-old woman(Patient 1) presented with pulsating pain in the left maxillary molar area, and a history of unsuccessful root canal treatment. She was ultimately diagnosed with menstrually related migraine without aura and zolmitriptan was prescribed, which reduced her headache and toothache together. A 45-year-old woman (Patient 2) presented with throbbing pain in the right maxillary molar and cheek area. Past repeated endodontic therapy had been unsuccessful. She was then diagnosed with menstrually related migraine without aura, and sumatriptan significantly reduced …

Ada News - 12/09/2019, American Dental Association, Publishing Division

ADA News

Established in 1970 as the official newspaper of the American Dental Association, the ADA News serves practicing dentists and others allied to the dental profession in the U.S. and internationally. It is the No. 1 source of news and information about the many benefits and services the ADA delivers to members daily as well as timely information on scientific, social, political and economic developments affecting dentistry and health care.

Assessment Of Cytotoxic Activity Of Five Common Philippine Medicinal Plants Using Brine Shrimp Lethality Assay, Lloyd O. Balinado, Merab A. Chan

Biology Faculty Publications

A wide variety of plants in the Philippines are used to address several medical ailments; however, many of which have not yet undergone thorough pharmacological studies. The problem on the possible side effects caused by these medicinal preparations has, therefore, increased the interest in validating their safety for human use. The present study was conducted to determine the cytotoxicity of five common local medicinal plants. Annona muricata L., Cymbopogon citratus DC., Graptophyllum pictum (L.) Griff, Jatropha curcas L., and Piper betle L. were selected and subjected to crude aqueous leaf extraction. Extracts were then investigated for cytotoxicity potential using brine …

Maternal Characteristics And Outcomes Affected By Hypothyroidism During Pregnancy (Maternal Hypothyroidism On Pregnancy Outcomes, Mhpo-1), Zareen Kiran, Aisha Sheikh, Sarwar Malik, Areeba Meraj, Maha Masood, Safana Ismail, Owais Rashid, Quratulain Shaikh, Numan Majeed, Lumaan Sheikh, Najmul Islam

Section of Diabetes, Endocrinology and Metabolism

Background: Hypothyroidism in pregnancy is an arena of ongoing research, with international conflicts regarding screening, management, and outcomes. Various studies have described the outcomes depending on geographical and international diagnostic criteria. No study has been conducted in this regard from the region of Pakistan. Therefore, we aim to report the clinical features and maternal outcomes of hypothyroid pregnancies and compare the maternal outcomes between uncontrolled and controlled TSH levels in the preconception as well as the gestational period.
Methods: We conducted a cross-sectional retrospective study on 718 cases in the Aga Khan University Hospital after ethical approval. We collected information …

Part I: Comparative Analysis Between Natural And Ceramic Teeth, Aneeza Hussain, Ibeth Erazo

Publications and Research

Ceramics play a fundamental role in Dentistry and are used widely, due to their ability to mimic the optical characteristics of enamel and dentine, as well as for their biocompatibility and strength. Initially, dental ceramics were materials that formed part of systems, designed with the purpose of producing dental prosthetics that in turn were used to replace missing or damaged dental structures. However, due to the increased demand for esthetics, its development has gone beyond in such a way that it has led to the development of all ceramic restorations. So that, in the last few decades, there have been …

Assessing Participants' Feedback To Dental Screenings And Hygiene Care Provided By City Tech's Dental Hygiene Students, Alona Abdullaieva, Wen Wen Dong, Yujing Mei, Susan Davide, Audra Haynes

Publications and Research

No abstract provided.

Emergent Airway Management Outside Of The Operating Room - A Retrospective Review Of Patient Characteristics, Complications And Icu Stay., Uzung Yoon, Jeffrey Mojica, Matthew Wiltshire, Kara Segna, Michael Block, Anthony Pantoja, Marc Torjman, Elizabeth Wolo

Department of Anesthesiology Faculty Papers

BACKGROUND: Emergent airway management outside of the operating room is a high-risk procedure. Limited data exists about the indication and physiologic state of the patient at the time of intubation, the location in which it occurs, or patient outcomes afterward.

METHODS: We retrospectively collected data on all emergent airway management interventions performed outside of the operating room over a 6-month period. Documentation included intubation performance, and intubation related complications and mortality. Additional information including demographics, ASA-classification, comorbidities, hospital-stay, ICU-stay, and 30-day in-hospital mortality was obtained.

RESULTS: 336 intubations were performed in 275 patients during the six-month period. The majority of …

Epigenomic Dysregulation-Mediated Alterations Of Key Biological Pathways And Tumor Immune Evasion Are Hallmarks Of Gingivo-Buccal Oral Cancer, Debodipta Das, Sahana Ghosh, Arindam Maitra, Nidhan K. Biswas, Chinmay K. Panda, Bidyut Roy, Rajiv Sarin, Partha P. Majumder

Journal Articles

Background: Gingivo-buccal oral squamous cell carcinoma (OSCC-GB) is the most common cancer among men in India and is associated with high mortality. Although OSCC-GB is known to be quite different from tongue cancer in its genomic presentation and its clinical behavior, it is treated identically as tongue cancer. Predictive markers of prognosis and therapy that are specific to OSCC-GB are, therefore, required. Although genomic drivers of OSCC-GB have been identified by whole exome and whole genome sequencing, no epigenome-wide study has been conducted in OSCC-GB; our study has filled this gap, and has discovered and validated epigenomic hallmarks of gingivobuccal …

Fracture Repair Requires Trka Signaling By Skeletal Sensory Nerves., Zhu Li, Carolyn A Meyers, Leslie Chang, Seungyong Lee, Zhi Li, Ryan Tomlinson, Ahmet Hoke, Thomas L Clemens, Aaron W James

Department of Orthopaedic Surgery Faculty Papers

Bone is richly innervated by nerve growth factor-responsive (NGF-responsive) tropomyosin receptor kinase A-expressing (TrKa-expressing) sensory nerve fibers, which are required for osteochondral progenitor expansion during mammalian skeletal development. Aside from pain sensation, little is known regarding the role of sensory innervation in bone repair. Here, we characterized the reinnervation of tissue following experimental ulnar stress fracture and assessed the impact of loss of TrkA signaling in this process. Sequential histological data obtained in reporter mice subjected to fracture demonstrated a marked upregulation of NGF expression in periosteal stromal progenitors and fracture-associated macrophages. Sprouting and arborization of CGRP+TrkA+ sensory nerve fibers …

Growth Differentiation Factor 11 Locally Controls Anterior-Posterior Patterning Of The Axial Skeleton., Joonho Suh, Je-Hyun Eom, Na-Kyung Kim, Kyung Mi Woo, Jeong-Hwa Baek, Hyun-Mo Ryoo, Se-Jin Lee, Yun-Sil Lee

Faculty Research 2019

Growth and differentiation factor 11 (GDF11) is a transforming growth factor β family member that has been identified as the central player of anterior-posterior (A-P) axial skeletal patterning. Mice homozygous for Gdf11 deletion exhibit severe anterior homeotic transformations of the vertebrae and craniofacial defects. During early embryogenesis, Gdf11 is expressed predominantly in the primitive streak and tail bud regions, where new mesodermal cells arise. On the basis of this expression pattern of Gdf11 and the phenotype of Gdf11 mutant mice, it has been suggested that GDF11 acts to specify positional identity along the A-P axis either by local changes in …

Intravenous Dexamethasone Along With Caudal Block Improves Analgesic Efficacy Following Day-Case Inguinal Hernia Repair In Children: A Randomized Controlled Trial, Amjad Nadeem, Aliya Ahmed

Department of Anaesthesia

Objective: To assess the effectiveness of intravenous dexamethasone along with caudal block in improving analgesia following inguinal hernia repair in children.
Methods: The double-blind randomised controlled trial was conducted over a 6-month period from June 01, 2016 to November 30, 2016 at the Aga Khan University Hospital, Karachi, and comprised patients aged 1-5 years, scheduled for elective inguinal hernia repair. The subjects were randomised into two groups using the sealed envelope technique. Group D patients received 0.5mg/kg dexamethasone intravenous in 5ml, and group P was given placebo (5ml 0.9% saline). Assessment of postoperative pain was made through the faces, legs, …

Phase Iib, Randomized, Double-Blind Trial Of Gc4419 Versus Placebo To Reduce Severe Oral Mucositis Due To Concurrent Radiotherapy And Cisplatin For Head And Neck Cancer., Carryn M. Anderson, Christopher M Lee, Deborah P. Saunders, Amarinthia Curtis, Neal Dunlap, Chaitali Nangia, Arielle S. Lee, Sharon M. Gordon, Philip Kovoor, Roberto Arevalo-Araujo, Voichita Bar-Ad, Abhinand Peddada, Kyle Colvett, Douglas Miller, Anshu K. Jain, James Wheeler, Dukagjin Blakaj, Marcelo Bonomi, Sanjiv S. Agarwala, Madhur Garg, Francis Worden, Jon Holmlund, Jeffrey M. Brill, Matt Downs, Stephen T. Sonis, Sanford Katz, John M. Buatti

Department of Radiation Oncology Faculty Papers

PURPOSE: Oral mucositis (OM) remains a common, debilitating toxicity of radiation therapy (RT) for head and neck cancer. The goal of this phase IIb, multi-institutional, randomized, double-blind trial was to compare the efficacy and safety of GC4419, a superoxide dismutase mimetic, with placebo to reduce the duration, incidence, and severity of severe OM (SOM).

PATIENTS AND METHODS: A total of 223 patients (from 44 institutions) with locally advanced oral cavity or oropharynx cancer planned to be treated with definitive or postoperative intensity-modulated RT (IMRT; 60 to 72 Gy [≥ 50 Gy to two or more oral sites]) plus cisplatin (weekly …

Phase Iib, Randomized, Double-Blind Trial Of Gc4419 Versus Placebo To Reduce Severe Oral Mucositis Due To Concurrent Radiotherapy And Cisplatin For Head And Neck Cancer., Carryn M Anderson, Christopher M Lee, Deborah P Saunders, Amarinthia Curtis, Neal Dunlap, Chaitali Nangia, Arielle S Lee, Sharon M Gordon, Philip Kovoor, Roberto Arevalo-Araujo, Voichita Bar-Ad, Abhinand Peddada, Kyle Colvett, Douglas Miller, Anshu K Jain, James Wheeler, Dukagjin Blakaj, Marcelo Bonomi, Sanjiv S Agarwala, Madhur Garg, Francis Worden, Jon Holmlund, Jeffrey M Brill, Matt Downs, Stephen T Sonis, Sanford Katz, John M Buatti

Articles, Abstracts, and Reports

PURPOSE: Oral mucositis (OM) remains a common, debilitating toxicity of radiation therapy (RT) for head and neck cancer. The goal of this phase IIb, multi-institutional, randomized, double-blind trial was to compare the efficacy and safety of GC4419, a superoxide dismutase mimetic, with placebo to reduce the duration, incidence, and severity of severe OM (SOM).

PATIENTS AND METHODS: A total of 223 patients (from 44 institutions) with locally advanced oral cavity or oropharynx cancer planned to be treated with definitive or postoperative intensity-modulated RT (IMRT; 60 to 72 Gy [≥ 50 Gy to two or more oral sites]) plus cisplatin (weekly …

Ada News - 11/18/2019, American Dental Association, Publishing Division

ADA News

Established in 1970 as the official newspaper of the American Dental Association, the ADA News serves practicing dentists and others allied to the dental profession in the U.S. and internationally. It is the No. 1 source of news and information about the many benefits and services the ADA delivers to members daily as well as timely information on scientific, social, political and economic developments affecting dentistry and health care.

Pink Tooth Of Mummery In The Maxillary Left Canine After Fixed Partial Denture (Fpd) Preparation, Eger V. Korolevsky, Takashi Komabayashi, Denise Foran

Dental Medicine Faculty Publications

Pink tooth of Mummery is typically found after trauma. However, this case report describes an unusual occurrence of pink tooth in a 67-year-old Caucasian male after fixed partial denture (FPD) tooth preparation. Pink tooth in this case may be due to one or more factors: tooth reduction and heat generation during tooth preparation; heat generation during polymerization of provisional material; and hyperocclusion of a provisional FPD. This case highlights the importance of choosing the appropriate materials and techniques to avoid pulpal complications after dental prosthesis work.

Functional Localization Of The Frontal Eye Fields In The Common Marmoset Using Microstimulation, Janahan Selvanayagam, Kevin D. Johnston, David J. Schaeffer, Lauren K. Hayrynen, Stefan Everling

Brain and Mind Institute Researchers' Publications

Copyright © 2019 the authors. The frontal eye field (FEF) is a critical region for the deployment of overt and covert spatial attention. Although investigations in the macaque continue to provide insight into the neural underpinnings of the FEF, due to its location within a sulcus, the macaque FEF is virtually inaccessible to electrophysiological techniques such as high-density and laminar recordings. With a largely lissencephalic cortex, the common marmoset (Callithrix jacchus) is a promising alternative primate model for studying FEF microcircuitry. Putative homologies have been established with the macaque FEF on the basis of cytoarchitecture and connectivity; however, physiological investigation …

Induction Techniques That Reduce Redistribution Hypothermia: A Prospective, Randomized, Controlled, Single Blind Effectiveness Study., Jonathan V. Roth, Leonard E. Braitman, Lacy H. Hunt

Student Papers, Posters & Projects

BACKGROUND: While much effort has been devoted to correcting intraoperative hypothermia, less attention has been directed to preventing redistribution hypothermia. In this study, we compared three different anesthetic induction techniques to standard IV propofol inductions (control) in their effect on reducing redistribution hypothermia.

METHODS: Elective, afebrile patients, age 18 to 55 years, were randomly assigned to one of four groups (n = 50 each). Group "INH/100" was induced with 8% sevoflurane in 100% oxygen, Group "INH/50" with 8% sevoflurane in 50% oxygen and 50% nitrous oxide, Group "PROP" with 2.2 mg/kg propofol, and Group "Phnl/PROP" with 2.2 mg/kg propofol immediately …

Ada News - 11/04/2019, American Dental Association, Publishing Division

ADA News

Established in 1970 as the official newspaper of the American Dental Association, the ADA News serves practicing dentists and others allied to the dental profession in the U.S. and internationally. It is the No. 1 source of news and information about the many benefits and services the ADA delivers to members daily as well as timely information on scientific, social, political and economic developments affecting dentistry and health care.

Jcph Presentations At The American Public Health Association Annual Conference 2019

JCPH at APHA 2019

No abstract provided.

Design Of A New 3d‐Printed Joint Plug, Lobat Tayebi, Zhanfeng Cui, Hua Ye

School of Dentistry Faculty Research and Publications

This paper introduces a kit of parts as a novel three‐dimensional (3D)–printed joint plug, in which each of the parts function cooperatively to treat cartilage damage in joints of the human body (e.g., hips, wrists, elbow, knee, and ankle). Three required and one optional parts are involved in this plug. The first part is a 3D‐printed hard scaffold (bone portion) to accommodate bone cells, and the second is a 3D‐printed soft scaffold (cartilage portion) overlying the bone portion to accommodate chondrocytes. The third part of joint plug is a permeable membrane, termed film, to cover the entire plug to provide …

“Real World” Research Using Practice Based Research Networks (Pbrn): A Systematic Review, Elmon Oliver Iii, Robert Brown

Transactions of the International Conference on Health Information Technology Advancement

Objective: While the randomized control clinical trial (RCT) has long been viewed as the “gold standard” for evidence based medicine, researchers and clinicians have also recognized limitations of RCTs when applied to clinical practice. These limitations arise from the fact that the results of interventions and procedures of RCTs conducted in controlled institutional settings often differ significantly from results obtained when the same interventions are applied in clinical practice. Consequently, there are increasing calls for more research to be carried out in the “real world” setting of clinical practices treating heterogeneous groups of patients. Studies conducted in clinical practices are …

Current State Of Knowledge Of Basic Life Support In Health Professionals Of The Largest City In Pakistan: A Cross-Sectional Study, Babar Irfan, Ibrahim Zahid, Muhammad Sharjeel Khan, Omar Abdul Aziz Khan, Shayan Zaidi, Safia Awan, Sobia Bilal, Omar Irfan

Section of Neurology

Background: Basic Life Support (BLS) is the recognition of sudden cardiac arrest and activation of the emergency response system, followed by resuscitation, and rapid defibrillation. According to WHO, Pakistan has one of the highest mortality rates from accidental deaths therefore assessment and comparison of BLS knowledge in health professionals is crucial. We thereby aim to assess and compare the knowledge of BLS in doctors, dentists and nurses.

Methods: A multi-centric cross-sectional survey was conducted in Karachi at different institutions belonging to the private as well as government sector from January to March 2018. We used a structured questionnaire which was …

Case-Based Asynchronous Interactive Modules In Undergraduate Medical Education., Tatiana Villatoro, Katherine Lackritz, Joanna S Y Chan

Department of Pathology, Anatomy, and Cell Biology Faculty Papers

Undergraduate medical education traditionally consists of 2 years of lecture-based courses followed by 2 years of clinical clerkships. However, over the past couple decades, undergraduate medical education has been evolving toward non-lecture-based integrated curriculums, requiring a collaborative curriculum. Additionally, e-learning platforms have become efficacious and essential to delivering education asynchronously to students. At Thomas Jefferson University, the Pathology and Obstetrics and Gynecology departments collaborated to create a pilot series of case-based asynchronous interactive modules to teach gynecologic pathology in a clinical context, while interweaving other educational components, such as evidence-based medicine, clinical skills, and basic sciences. The case-based asynchronous interactive …

Integrating Primary Care Into Community Mental Health Centres In Texas, Usa: Results Of A Case Study Investigation, Rebecca Wells, Ellen D Breckenridge, Sasha Ajaz, Aman Narayan, Daniel Brossart, James H Zahniser, Jolene Rasmussen

Journal Articles

INTRODUCTION: Despite evidence that people with serious mental illness benefit from receiving primary care within mental health care settings, there is little research on this type of integration. The objective of this study was to characterize how providers and patients experienced implementation of primary care into specialty mental health services.

METHODS: During site visits, study team members interviewed staff and conducted focus groups with patients at 10 United States community mental health centres then beginning to integrate primary into their practices. One year later, follow up phone interviews with key centre staff informants validated and updated findings. Data analysis included …

Amoxicillin-Clavulanate Related Liver Injury, Devin Vaishnani Md, Pratikkumar Vekaria Md, Ravish Patel Md, Megan White Md, Marvin Vaishnani Md

Gastroenterology

Introduction: Recognition of Drug-induced Liver Injury (DILI) may be challenging as it is often diagnosis of exclusion, unavailability of diagnostic test and variability in presentation. Many antibiotics can cause DILI but Amoxicillin-Clavulanate has rare adverse reaction causing mixed cholestatic-hepatocellular injury. Since amoxicillin alone does not induce liver injury, combination of amoxicillin and clavulanic acid could be responsible for this adverse reaction. It can be due to metabolic idiosyncrasy or hypersensitivity mechanism. Case Report: 64-year-old female with no pertinent PMH presented to ER with abdominal pain and jaundice. She had abdominal pain for 4-5 days. Abdominal pain was constant and located …

Rare Infective Endocarditis Caused By Dental Source Due To Streptococcus Bovis Masquerading As Cardiac Failure, Ravish Patel, Pratikkumar Vekaria, Devin Vaishnani, Johnnie Mao, Asif Shah

Internal Medicine

No abstract provided.

Physical Mobility Impairment And Risk For Cardiovascular Disease, Mary Wilby

School of Nursing and Health Sciences Faculty Work

Background: People with disabilities (PWD) often self-report reduced access to preventive health services and poorer health than people without disability. Risk factors for chronic disease are more prevalent in PWD, increasing risk for secondary conditions including cardiovascular disease (CVD).

Methods: Logistic regression was used to analyze data from the 2016 Behavioral Risk Factor Surveillance Survey to explore the relationship between disability with mobility impairment and CVD.

Results: Difficulty walking and climbing stairs significantly predicted concomitant CVD and diabetes in logistic regression models.

Conclusion: Information from this study may be useful in addressing CVD risk for adults with mobility impairments.

Identifying Emergency Department Symptom-Based Diagnoses With The Unified Medical Language System., Benjamin H. Slovis, Danielle M. Mccarthy, Garrison Nord, Amanda Doty, Katherine Piserchia, Kristin L. Rising

Department of Emergency Medicine Faculty Papers

INTRODUCTION: Many patients who are discharged from the emergency department (ED) with a symptom-based discharge diagnosis (SBD) have post-discharge challenges related to lack of a definitive discharge diagnosis and follow-up plan. There is no well-defined method for identifying patients with a SBD without individual chart review. We describe a method for automated identification of SBDs from ICD-10 codes using the Unified Medical Language System (UMLS) Metathesaurus.

METHODS: We mapped discharge diagnosis, with use of ICD-10 codes from a one-month period of ED discharges at an urban, academic ED to UMLS concepts and semantic types. Two physician reviewers independently manually identified …