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Full-Text Articles in Medicine and Health Sciences

Physicians' Experiences With Brca1/2 Testing In Community Settings., Nancy L. Keating, Kathryn A. Stoeckert, Meredith M. Regan, Lisa Digianni, Judy E. Garber Dec 2008

Physicians' Experiences With Brca1/2 Testing In Community Settings., Nancy L. Keating, Kathryn A. Stoeckert, Meredith M. Regan, Lisa Digianni, Judy E. Garber

Kathryn Sabella

PURPOSE: We surveyed a national sample of nonacademic physicians who ordered BRCA1/2 testing to understand their implementation of genetic testing and to assess recommendations for surveillance and cancer risk management of women with positive test results.

PATIENTS AND METHODS: We surveyed physicians (N = 611 of 1,050; response rate, 58.2%) practicing in nonacademic settings who ordered BRCA1/2 testing during 2004 to 2005. We described physicians' experiences with testing and used multivariable regression models to identify factors associated with more complete counseling and with recommendations for cancer risk management for a BRCA1 mutation carrier.

RESULTS: Most physicians (68.2%) usually or always …


The Differentiation Of Hepatocyte-Like Cells From Monkey Embryonic Stem Cells., Xiaocui Ma, Jian Wu, M Zern Nov 2008

The Differentiation Of Hepatocyte-Like Cells From Monkey Embryonic Stem Cells., Xiaocui Ma, Jian Wu, M Zern

jian duan wu

Embryonic stem cells (ESC) hold great potential for the treatment of liver diseases. Here, we report the differentiation of rhesus macaque ESC along a hepatocyte lineage. The undifferentiated monkey ESC line, ORMES-6, was cultured in an optimal culture condition in an effort to differentiate them into hepatocyte-like cells in vitro. The functional efficacy of the differentiated hepatic cells was evaluated using RT-PCR for the expression of hepatocyte specific genes, and Western blot analysis and immunocytochemistry for hepatic proteins such as alpha-fetoprotein (AFP), albumin and alpha1-antitrypsin (alpha1-AT). Functional assays were performed using the periodic acid schiff (PAS) reaction and ELISA. The …


New Episodes And New Onsets Of Major Depression In Borderline And Other Personality Disorders, John G. Gunderson, Robert L. Stout, Charles A. Sanislow, M. Tracie Shea, Thomas H. Mcglashan, Mary C. Zanarini, Maria T. Daversa, Carlos M. Grilo, Shirley Yen, Andrew E. Skodol Nov 2008

New Episodes And New Onsets Of Major Depression In Borderline And Other Personality Disorders, John G. Gunderson, Robert L. Stout, Charles A. Sanislow, M. Tracie Shea, Thomas H. Mcglashan, Mary C. Zanarini, Maria T. Daversa, Carlos M. Grilo, Shirley Yen, Andrew E. Skodol

Charles A. Sanislow, Ph.D.

Background: In the context of much literature and conjecture about the relationship of personality disorders (PD) and major depressive disorder (MDD), this paper uses longitudinal data to assess the frequency with which PD patients, and especially those with borderline personality disorder (BPD), have recurrences (for patients with lifetime histories), or new onsets (for patients without lifetime histories) of MDD. Methods: A sample of 478 PD patients received reliable repeated follow-up assessments over a period of 6 years. The rates of new onsets and recurrences of MDD in all PD patients, and in BPD patients compared to OPD patients were analyzed. …


Evaluation Of Scrotal Masses, Jeffrey D. Tiemstra Md, S Kapoor Oct 2008

Evaluation Of Scrotal Masses, Jeffrey D. Tiemstra Md, S Kapoor

Jeffrey Tiemstra, MD, FAAFP

Scrotal masses can represent a wide range of medical issues, from benign congenital conditions to life-threatening malignancies and acute surgical emergencies. Having a clear understanding of scrotal anatomy allows the examiner to accurately identify most lesions. Benign lesions such as hydroceles and varicoceles are often found incidentally by the patient or physician on routine examination. Epididymitis is bacterial in origin, readily diagnosed on physical examination, and treated with antibiotics. Indirect inguinal hernias usually are palpable separate from the normal scrotal contents and are a surgical emergency if strangulation is suspected based on symptoms of abdominal pain, tenderness, and nonreducibility. Testicular …


Personality Traits And Mental Health Treatment Utilization, Christopher J. Hopwood, Brian D. Quigley, Carlos M. Grilo, Charles A. Sanislow, Thomas H. Mcglashan, Shirley Yen, M. Tracie Shea, Mary C. Zanarini, John G. Gunderson, Andrew E. Skodol, John C. Markowitz, Leslie C. Morey Oct 2008

Personality Traits And Mental Health Treatment Utilization, Christopher J. Hopwood, Brian D. Quigley, Carlos M. Grilo, Charles A. Sanislow, Thomas H. Mcglashan, Shirley Yen, M. Tracie Shea, Mary C. Zanarini, John G. Gunderson, Andrew E. Skodol, John C. Markowitz, Leslie C. Morey

Charles A. Sanislow, Ph.D.

Recent theory and research suggest a relation between five-factor model personality traits and mental health treatment utilization, even after controlling for psychiatric disorders and global functioning. The current report further tests this hypothesis in a large clinical sample, using a wider array of treatment modalities than has been previously studied. Overall, results were limited and inconsistent. Although neuroticism was related to utilization across treatment modalities, many of these relationships resulted from its association with psychiatric diagnoses. Other traits showed limited and inconsistent relations to the use of psychosocial and psychiatric treatments.


Making The Donation After Cardiac Death Process Work: Inova Fairfax Hospital And Washington Regional Transplant Community, Christopher Michetti Oct 2008

Making The Donation After Cardiac Death Process Work: Inova Fairfax Hospital And Washington Regional Transplant Community, Christopher Michetti

Christopher P. Michetti, M.D., F.A.C.S.

No abstract provided.


Reuters Health: Factor Vii Curbs Bleeding In Non-Hemophiliac Trauma, Surgical Patients Aug 2008

Reuters Health: Factor Vii Curbs Bleeding In Non-Hemophiliac Trauma, Surgical Patients

Vivian C. McAlister

Use of recombinant activated factor VII (rFVIIa) reduces the need for blood transfusion in patients without hemophilia and may also reduce mortality, according to pooled data from randomized placebo-controlled trials involving more than 3000 participants, Canadian researchers report. "I had found it to be effective in some combat situations in Afghanistan," senior investigator Dr. Vivian C. McAlister told Reuters Health.


The Effect Of Medical Students' International Experiences On Attitudes Toward Serving Underserved Multicultural Populations, Michael A. Godkin, Judith A. Savageau Jun 2008

The Effect Of Medical Students' International Experiences On Attitudes Toward Serving Underserved Multicultural Populations, Michael A. Godkin, Judith A. Savageau

Judith A. Savageau

BACKGROUND: We evaluated the effect of international electives on the attitudes of preclinical and clinical-year medical students with respect to serving underserved multicultural populations. METHODS: A self-assessment instrument was used to measure attitudes of 146 students before and after participating in international electives. The same attitudinal items were also analyzed at two time intervals for 18 students who completed international electives as preclinical students and 76 class cohorts who did not. RESULTS: Analyses show that the effect of international experiences is different for preclinical students and clinical students. For both groups, however, these experiences can develop and support perceptions and …


Waiting For Liver Transplantation In Canada: Waitlist History 2000--2004 And Sensitivity Analysis For The Future., David Stanford, Elizabeth Renouf, Vivian C. Mcalister May 2008

Waiting For Liver Transplantation In Canada: Waitlist History 2000--2004 And Sensitivity Analysis For The Future., David Stanford, Elizabeth Renouf, Vivian C. Mcalister

Vivian C. McAlister

This study comprises a historical review of liver transplants performed in Canada during 2000--2004, and sensitivity analyses to assess the impact of possible changes in the operation of the waitlists. In the first part, overall statistics are reported, and the notable impact that blood type plays in affecting waiting time is discussed. Waiting times and numbers of transplants are also reported by gender, age, and geographic region (waitlist), and statistical analyses of the patient placement and cadaveric donations processes are performed. These analyses establish that the service times of an appropriate queuing model are closely approximated by an exponential distribution. …


Mira V: An Integrated System For Minimally Invasive Robot-Assisted Lung Brachytherapy, A. Trejos, A. Lin, S. Mohan, H. Bassan, C. Edirisinghe, R. Patel, C. Lewis, E. Yu, A. Fenster, R. Malthaner Apr 2008

Mira V: An Integrated System For Minimally Invasive Robot-Assisted Lung Brachytherapy, A. Trejos, A. Lin, S. Mohan, H. Bassan, C. Edirisinghe, R. Patel, C. Lewis, E. Yu, A. Fenster, R. Malthaner

Edward Yu

An integrated system for minimally invasive robot-assisted image-guided lung brachytherapy has been developed. The system incorporates an experimental setup for accurate radioactive seed placement with commercially available dosimetry planning software. The end result is a complete system that allows planning and executing a brachytherapy procedure with increased accuracy. The results of the in vitro seed placement evaluation show that seed misplacement has a significant effect on the volume receiving more than 200% of the dose (V200), and the minimum dosage received by 90% of the volume (D90).


Antiepileptic Drugs And Migraine, Michael Rogawski Apr 2008

Antiepileptic Drugs And Migraine, Michael Rogawski

Michael A. Rogawski

Prepared for the 16th International Headache Research Seminar, “Innovative Drug Development For Headache Disorders,” March 23–25, 2007, Copenhagen, Denmark.


Chronic Disease Medication Use In Managed Care And Indemnity Insurance Plans, Randall S. Stafford, Stephen M. Davidson, Harriet Davidson, Heidi Miracle-Mcmahill, Sybil L. Crawford, David Blumenthal Mar 2008

Chronic Disease Medication Use In Managed Care And Indemnity Insurance Plans, Randall S. Stafford, Stephen M. Davidson, Harriet Davidson, Heidi Miracle-Mcmahill, Sybil L. Crawford, David Blumenthal

Sybil L. Crawford

OBJECTIVE: To evaluate the impact of managed care on the use of chronic disease medications. DATA SOURCE: Claims data from 1997 from two indemnity and three independent practice association (IPA) model managed care insurance plans. RESEARCH DESIGN: Cross-sectional analysis of claims data. DATA COLLECTION: Adult patients with diabetes mellitus (DM, n = 26,444), congestive heart failure (CHF, n = 7,978), and asthma (n = 9,850) were identified by ICD-9 codes. Chronic disease medication use was defined through pharmacy claims for patients receiving one or more prescriptions for drugs used in treating these conditions. Using multiple logistic regression we adjusted for …


A Comparison Of Interview And Self-Report Methods For The Assessment Of Borderline Personality Disorder Criteria, Christopher J. Hopwood, Leslie C. Morey, Maria Orlando Edelen, M. Tracie Shea, Carlos M. Grilo, Charles A. Sanislow, Thomas H. Mcglashan, Maria T. Daversa, John G. Gunderson, Mary C. Zanarini, John C. Markowitz, Andrew E. Skodol Feb 2008

A Comparison Of Interview And Self-Report Methods For The Assessment Of Borderline Personality Disorder Criteria, Christopher J. Hopwood, Leslie C. Morey, Maria Orlando Edelen, M. Tracie Shea, Carlos M. Grilo, Charles A. Sanislow, Thomas H. Mcglashan, Maria T. Daversa, John G. Gunderson, Mary C. Zanarini, John C. Markowitz, Andrew E. Skodol

Charles A. Sanislow, Ph.D.

Interview methods are widely regarded as the standard for the diagnosis of borderline personality disorder (BPD), whereas self-report methods are considered a time-efficient alternative. However, the relative validity of these methods has not been sufficiently tested. The current study used data from the Collaborative Longitudinal Personality disorder Study to compare diagnostic base rates and the relative validity of interview and self-report methods for assessing functional outcome in BPD. Although self-report yielded higher base rates of criteria endorsement, results did not support the common assumption that diagnostic interviews are more valid than self-reports, but instead indicated the combined use of these …


Use Of Bioluminescent Imaging To Assay The Transplantation Of Immortalized Human Fetal Hepatocytes Into Mice., Moon Seok Choi, Andreea M Catana, Jian Wu, Young Seok Kim, Sang Jeong Yoon, Alexander D Borowsky, Sanjiv S Gambhir, Sanjeev Gupta, Mark A Zern Dec 2007

Use Of Bioluminescent Imaging To Assay The Transplantation Of Immortalized Human Fetal Hepatocytes Into Mice., Moon Seok Choi, Andreea M Catana, Jian Wu, Young Seok Kim, Sang Jeong Yoon, Alexander D Borowsky, Sanjiv S Gambhir, Sanjeev Gupta, Mark A Zern

jian duan wu

Noninvasive serial monitoring of the fate of transplanted cells would be invaluable to evaluate the potential therapeutic use of human hepatocyte transplantation. Therefore, we assessed the feasibility of bioluminescent imaging using double or triple fusion lentiviral vectors in a NOD-SCID mouse model transplanted with immortalized human fetal hepatocytes. Lentiviral vectors driven by the CMV promoter were constructed carrying reporter genes: firefly luciferase and green fluorescence protein with or without herpes simplex virus type 1 thymidine kinase. Human fetal hepatocytes immortalized by telomerase reconstitution (FH-hTERT) were successfully transduced with either of these fusion vectors. Two million stably transduced cells selected by …


Sampling-Based Approach To Determining Outcomes Of Patients Lost To Follow-Up In Antiretroviral Therapy Scale-Up Programs In Africa, Elvin H. Geng Dec 2007

Sampling-Based Approach To Determining Outcomes Of Patients Lost To Follow-Up In Antiretroviral Therapy Scale-Up Programs In Africa, Elvin H. Geng

Elvin H Geng

No abstract provided.


Childhood Sexual Abuse In Black Men Who Have Sex With Men: Results From Three Qualitative Studies, Sheldon D. Fields, David J. Malebranche, Sonja Feist-Price Dec 2007

Childhood Sexual Abuse In Black Men Who Have Sex With Men: Results From Three Qualitative Studies, Sheldon D. Fields, David J. Malebranche, Sonja Feist-Price

David J Malebranche

This report describes the high prevalence and context of childhood sexual abuse (CSA) among Black men who have sex with men (MSM) across 3 independent qualitative studies. Semistructured one-on-one interviews were conducted with 87 Black MSM across 3 cities (Rochester, NY, n=28; Lexington, KY/Atlanta, GA, n=30; and Atlanta, GA, n =29). A combined CSA prevalence of 32% (28/87) was found among the 3 samples, despite variation in geographic location, mean age, and sexual identification. Common themes emerging across the 3 samples included prolonged and repeated abuse by a close male relative; blaming of same-sex desire on CSA; and descriptions of …


Bisexually Active Black Men In The United States And Hiv: Acknowledging More Than The "Down Low", David J. Malebranche Dec 2007

Bisexually Active Black Men In The United States And Hiv: Acknowledging More Than The "Down Low", David J. Malebranche

David J Malebranche

HIV is disproportionately impacting Black men who have sex with men and heterosexual women in theUnited States. Current speculation posits a ‘‘bisexual bridge’’ of HIV transmission connecting these two subpopulations of the Black community. Specifically, bisexually active Black men who identify as heterosexual but do not disclose their same-sex behavior, or ‘‘down low’’ (DL) men, have received the most attention and blame as the primary group fueling this epidemic. This essay explores the current knowledge and limitations of public health research on bisexually active Black men. Implications for future research initiatives are discussed.


Escalating Levels Of Access To In-Hospital Care And Stroke Mortality., Gustavo Saposnik Dec 2007

Escalating Levels Of Access To In-Hospital Care And Stroke Mortality., Gustavo Saposnik

Gustavo Saposnik

No abstract provided.


Stroke Outcome In Those Over 80: A Multicenter Cohort Study Across Canada., Gustavo Saposnik Dec 2007

Stroke Outcome In Those Over 80: A Multicenter Cohort Study Across Canada., Gustavo Saposnik

Gustavo Saposnik

No abstract provided.


Report Of The Global Health Task Force, Vivian C. Mcalister Dec 2007

Report Of The Global Health Task Force, Vivian C. Mcalister

Vivian C. McAlister

The mandate of the Global Health Task Force was to advise the Dean regarding the development of Global Health at SSMD by broadly analyzing Global and international Health activities, within SSMD at The University of Western Ontario and in other Canadian universities, in order to make recommendations with respect to scope, coordinating structure, required administrative support, existing and potential academic activity and placement within the formal undergraduate curriculum for medical and dental students, as well as elective offerings and volunteer opportunities that may also involve students from professional programs within the Faculty of Health Sciences. The Task Force reviewed structures …


Dosimetric Evaluation Of Helical Tomotherapy Treatment Planning For Non-Small Cell Lung Cancer, Karen Chu, George Rodrigues, Slav Yartsev, A. Rashid Dar, Edward Yu, Robert Ash, Brian Yaremko, Marc Mackenzie, Harvey Quon, Glenn Bauman, Wilson Roa Dec 2007

Dosimetric Evaluation Of Helical Tomotherapy Treatment Planning For Non-Small Cell Lung Cancer, Karen Chu, George Rodrigues, Slav Yartsev, A. Rashid Dar, Edward Yu, Robert Ash, Brian Yaremko, Marc Mackenzie, Harvey Quon, Glenn Bauman, Wilson Roa

Edward Yu

Helical tomotherapy (HT) is a novel technique to deliver intensity modulated radiation therapy guided by 3D megavoltage CT imaging. The purpose of our study is to assess the dosimetric parameters related to HT and 3DCRT in advanced non-small cell lung cancer (NSCLC). Eleven patients from the London Regional Cancer Centre and the Cross Cancer Institute with NSCLC underwent individualized treatment planning on both HT and 3DCRT. Corresponding HT and 3DCRT plans for each patient were analyzed using dose-volume histograms for GTV, PTV (median dose 60Gy/30 fractions), and critical structures (lung V5-30, esophageal V50-60, and spinal cord D1). Observed differences in …