Medicine and Health Sciences Commons^™

Does 17 Alpha-Hydroxyprogesterone Caproate Decrease The Rate Of Preterm Birth In Women With An Ultrasound-Indicated Cerclage?, T. J. Rafael, D. Mackeen, V. Berghella

Department of Obstetrics and Gynecology Faculty Papers

Objective: To estimate whether the use of 17 alpha-hydroxyprogesterone caproate (17P) in women with an ultrasound-indicated cerclage (UIC) reduces the rate of preterm birth (PTB).

Conclusions: Among women with a prior spontaneous PTB and current UIC for CL<25mm, 17P did not reduce the rate of PTB <35 weeks.

Predictors Of Situation Awareness In Graduate Student Registered Nurse Anesthetists, Suzanne Wright

Theses and Dissertations

ABSTRACT PREDICTORS OF SITUATION AWARENESS IN GRADUATE STUDENT REGISTERED NURSE ANESTHETISTS Suzanne M. Wright, Ph.D. A dissertation submitted in partial fulfillment of the requirements for the degree of Doctor of Philosophy at Virginia Commonwealth University. Virginia Commonwealth University, 2009 Major Director: J. James Cotter, Ph.D. Situation awareness (SA) is defined as one’s perception of the elements of the environment, the comprehension of their meaning, and the projection of their status in the near future. Stated more simply, SA is knowing what is going on around you. The concept of SA is well known in the field of aviation which is …

High-Resolution Analysis Of Dna Copy Number Alterations In Patients With Primary Open-Angle Glaucoma., Khaled K Abu-Amero, Ali Hellani, Patrick Bender, George L. Spaeth, Jonathan Myers, L Jay Katz, Marlene Moster, Thomas M Bosley

Wills Eye Hospital Papers

PURPOSE: To determine whether patients with isolated primary open-angle glaucoma (POAG) have evidence of chromosomal copy number alterations.

METHODS: Twenty-seven Caucasian and African-American POAG patients and 12 ethnically matched controls were carefully screened for possible glaucoma and tested for chromosomal copy number alterations using high resolution array comparative genomic hybridization.

RESULTS: No POAG patient had evidence of chromosomal copy number alterations when compared to normal ethnically matched controls. Additionally, there was no evidence of somatic mosaicism in any tested POAG patient.

CONCLUSIONS: Chromosomal deletions and/or duplications were not detected in POAG patients as compared to controls. Other chromosomal imbalances such …

Regulation Of Survivin Gene Expression In The Human Endometrium And Endometrial Cancer, Nancy H. Nabilsi

Dissertations & Theses (Open Access)

In the United States, endometrial cancer is the leading cancer of the female reproductive tract. There are 40,100 new cases and 7,470 deaths from endometrial cancer estimated for 2008 (47). The average five year survival rate for endometrial cancer is 84% however, this figure is substantially lower in patients diagnosed with late stage, advanced disease and much higher for patients diagnosed in early stage disease (47). Endometrial cancer (EC) has been associated with several risk factors including obesity, diabetes, hypertension, previously documented occurrence of hereditary non-polyposis colorectal cancer (HNPCC), and heightened exposure to estrogen (25). As of yet, there has …

Evaluation Of The Urinary Incontinence Scales© To Measure Change After Experiential Learning: A Pilot Study, Karen A. Karlowicz

Nursing Faculty Publications

Evaluation of the effectiveness of the Urinary Incontinence Scales© to measure change after student participation in a disability-incontinence experiential learning activity was the focus of this pilot study. A comparison between pretest and posttest scores showed a significant increase in Belief and Practice subscale scores after participation in the experience. However, positive correlations between the variables measured could not be established.

Test-Retest Reliability And Minimal Detectable Change Scores For The Timed "Up & Go" Test, The Six-Minute Walk Test, And Gait Speed In People With Alzheimer Disease, Julie D. Ries, John L. Echternach, Leah Nof, Michelle Gagnon Blodgett

Rehabilitation Sciences Faculty Publications

Background. With the increasing incidence of Alzheimer disease (AD), determining the validity and reliability Of Outcome measures for people with this disease is necessary.

Objective. The goals of this study were to assess test-retest reliability of data for the Timed "Up & Go" Test (TUG), the Six-Minute Walk Test (6MWT), and gait speed and to calculate minimal detectable change (MDC) scores for each outcome measure. Performance differences between groups With mild to moderate AD and moderately severe to severe AD (as determined by the Functional Assessment Staging [FAST] scale) were Studied.

Design. This was a prospective, nonexperimental, descriptive methodological study. …

Examining The Relationship Of Accurate Esi© Triage Scores To Emergency Department Nursing Attitudes And Experience, Andrew Martin Bsn, Rn, Phrn, Cen, Anne Panik Ms, Rn, Nea-Bc, Courtney Vose Rn Msn Cen, Charlotte Buckenmyer Rn, Ms, Paul Delpais Rn Bsn Cen, Keith D. Micucci Rn Bsn Phrn Cen, Bryan G. Kane Md, Kimberly Badillo Rn, Michele Oritz Rn Bsn Cen, Cheryl Celia Rn Crnp, Michael Guelzow Bsn Cen, Eileen Bechtel Rn, Maria Cruz Rn, Nikki Hatmaker-Garris Rn, Bsn, Traci Dickson-Watner Rn. Bsn, Elizabeth Karoly Rrt Mba, Mae Ann Pasquale Phd, Msn, Rn, Carolyn L. Davidson Rn Ccrn Cprn Phd©

Patient Care Services / Nursing

No abstract provided.

Incomplete Kawaski Disease: Are We Missing It, Abdul Gaffar Billoo, Saira Waqar Lone, Salman Siddiqui, Huba Atiq

Department of Paediatrics and Child Health

Kawasaki disease, also known as mucocutaneous lymph node syndrome or infantile polyarteritis nodosa is an acute febrile vasculitis of unknown etiology with a predilection for coronary arteries and potential for aneurysm formation. In Incomplete Kawasaki disease, children with fever lack the sufficient number of criteria to fulfill the epidemiologic case definition and are diagnosed when coronary artery disease is detected. We present a case report of a one and a half years old girl who came with features of incomplete Kawasaki disease, high grade fever, irritability, history of conjunctivitis and cracking of lips. She was investigated and had a platelet …

Controlled Evaluation Of Bactec Peds Plus/F And Bactec Lytic/10 Anaerobic/F Media For Isolation Of Salmonella Enterica Serovars Typhi And Paratyphi A From Blood, Megan E. Reller, Anita K. M. Zaidi, Shazia Sultana, Shazia Azeem, Beenish Hanif, Shahida Qureshi, Rumina Hasan, Zulfiqar Ahmed Bhutta, Rehana Akhter, Donald A. Goldmann

Department of Paediatrics and Child Health

We compared anaerobic lytic (AL) and pediatric aerobic resin-containing (Peds Plus/F) blood culture media for the isolation of Salmonella enterica serotype Typhi or Paratyphi A from children. The yields from AL and Peds Plus/F media were the same with equal volumes of blood, but recovery was faster from AL medium than Peds Plus/F medium (10.7 and 16.4 h, respectively) (P < 0.001).

Factors Influencing Adherence To Referral Advice Following Pre-Referral Treatment With Artesunate Suppositories In Children In Rural Tanzania, Daudi Simba, Marian Warsame, Omari Kimbute, Deodatus Kakoko, Max Petzold, Goran Tomson, Zul Premji, Melba Gomes

Pathology, East Africa

Objective: WHO recommends artemisinin suppository formulations as pre-referral treatment for children who are unable to take oral medication and cannot rapidly reach a facility for parenteral treatment. We investigated factors influencing caretakers’ adherence to referral advice following pre-referral treatment of their children with rectal artesunate suppositories.

Methods: The study was nested within an intervention study that involved pre-referral treatment of all children who came to a community dispenser for treatment because they were unable to take oral medications because of repeated vomiting, lethargy, convulsions or altered consciousness. All patients who did not comply with referral advice were stratified by actions …

In Vivo Selection Of Plasmodium Falciparum Parasites Carrying The Chloroquine-Susceptible Pfcrt K76 Allele After Treatment With Artemether-Lumefantrine In Africa, C. Sisowath, I. Petersen, M.I. Veiga, A. Martensson, Zul Premji, A. Bjorkman, D.A. Fidock, J.P. Gil

Pathology, East Africa

Background: Artemether-lumefantrine (AL) is a major and highly effective artemisinin-based combination therapy that is becoming increasingly important as a new first-line therapy against Plasmodium falciparum malaria. However, recrudescences occurring after AL treatment have been reported. Identification of drug-specific parasite determinants that contribute to treatment failures will provide important tools for the detection and surveillance of AL resistance.

Methods: The findings from a 42-day follow-up efficacy trial in Tanzania that compared AL with sulfadoxinepyrimethamine (SP) were analyzed to identify candidate markers for lumefantrine tolerance/resistance in the chloroquine resistance transporter gene (pfcrt) and multidrug resistance gene 1 (pfmdr1). The findings were corroborated …

Automatic Diagnosis For Prostate Cancer Using Run-Length Matrix Method, Xiaoyan Sun, Shao-Hui Chuang, Jiang Li, Frederic Mckenzie, Nico Karssemeijer (Ed.), Maryellen L. Giger (Ed.)

Electrical & Computer Engineering Faculty Publications

Prostate cancer is the most common type of cancer and the second leading cause of cancer death among men in US¹. Quantitative assessment of prostate histology provides potential automatic classification of prostate lesions and prediction of response to therapy. Traditionally, prostate cancer diagnosis is made by the analysis of prostate-specific antigen (PSA) levels and histopathological images of biopsy samples under microscopes. In this application, we utilize a texture analysis method based on the run-length matrix for identifying tissue abnormalities in prostate histology. A tissue sample was collected from a radical prostatectomy, H&E fixed, and assessed by a pathologist …

Thoracoscopic Decortication Vs Tube Thoracostomy With Fibrinolysis For Empyema In Children: A Prospective, Randomized Trial., Shawn D. St Peter, Kuojen Tsao, Troy L. Spilde, Scott J. Keckler, Christopher J. Harrison, Mary Anne Jackson, Susan W. Sharp, Walter S. Andrews, Douglas C. Rivard, Frank P. Morello, G W. Holcomb Iii, Daniel J. Ostlie

Manuscripts, Articles, Book Chapters and Other Papers

PURPOSE: Management of empyema has been debated in the literature for decades. Although both primary video-assisted thoracoscopic surgery (VATS) and tube thoracostomy with pleural instillation of fibrinolytics have been shown to result in early resolution when compared to tube thoracostomy alone, there is a lack of comparative data between these modes of management. Therefore, we conducted a prospective, randomized trial comparing VATS to fibrinolytic therapy in children with empyema.

METHODS: After Institutional Review Board approval, children defined as having empyema by either loculation on imaging or more than 10,000 white blood cells/microL were treated with VATS or fibrinolysis. Based on …

Socioeconomic Disparity In Healthcare-Seeking Behavior Among Chinese Women With Genitourinary Symptoms, Qi Zhang, Diane Lauderdale, Shanshan Mou, William I. Parish, Edward O. Laumann, John Schneider

Community & Environmental Health Faculty Publications

Background: Sexually transmitted infections (STIs) are of growing concern in China. Understanding the relationship between socioeconomic status (SES) and healthcare-seeking (HCS) behavior will help design effective policies to contain the epidemic of STIs across SES.

Methods: We used the Chinese Health and Family Life Survey, a nationally representative survey of 3813 adults from 48 Chinese cities and counties during 1999-2000. We studied the 730 women with at least one genito-urinary (GU) symptom. HCS was measured by whether respondents visited a hospital or an unrecognized clinic, self-treatment, or doing nothing. Formal treatment was defined as visiting a hospital. SES was measured …

Training New Mothers In Infant Cardiopulmonary Resuscitation (Cpr), Gavin C. Barr Jr. Md, Marna R. Greenberg Do, Mph, Facep, Valerie Rupp Rn, Bsn, Charles C. Worrilow Md, Katie Fredericks, Anne Marie Crown, John Reed Rrt

Department of Emergency Medicine

No abstract provided.

Follow-Up Compliance Of Adolescents With Cervical Dysplasia In An Inner-City Population., Faunda N. Campbell Md, Eduardo Lara-Torre Md

Department of Pediatrics

No abstract provided.

Molluscan Memory Of Injury: Evolutionary Insights Into Chronic Pain And Neurological Disorders, Edgar T Walters, Leonid L Moroz

Journal Articles

Molluscan preparations have yielded seminal discoveries in neuroscience, but the experimental advantages of this group have not, until now, been complemented by adequate molecular or genomic information for comparisons to genetically defined model organisms in other phyla. The recent sequencing of the transcriptome and genome of Aplysia californica, however, will enable extensive comparative studies at the molecular level. Among other benefits, this will bring the power of individually identifiable and manipulable neurons to bear upon questions of cellular function for evolutionarily conserved genes associated with clinically important neural dysfunction. Because of the slower rate of gene evolution in this molluscan …

Structural Plasticity Can Produce Metaplasticity, Georgios Kalantzis, Harel Z Shouval

Journal Articles

BACKGROUND: Synaptic plasticity underlies many aspect of learning memory and development. The properties of synaptic plasticity can change as a function of previous plasticity and previous activation of synapses, a phenomenon called metaplasticity. Synaptic plasticity not only changes the functional connectivity between neurons but in some cases produces a structural change in synaptic spines; a change thought to form a basis for this observed plasticity. Here we examine to what extent structural plasticity of spines can be a cause for metaplasticity. This study is motivated by the observation that structural changes in spines are likely to affect the calcium dynamics …

Optimizing Computer-Aided Colonic Polyp Detection For Ct Colonography By Evolving The Pareto Front, Jiang Li, Adam Huang, Jack Tao, Jiamin Liu, Robert L. Van Uitert, Nicholas Petrick, Ronald Summers

Electrical & Computer Engineering Faculty Publications

A multiobjective genetic algorithm is designed to optimize a computer-aided detection (CAD) system for identifying colonic polyps. Colonic polyps appear as elliptical protrusions on the inner surface of the colon. Curvature-based features for colonic polyp detection have proved to be successful in several CT colonography (CTC) CAD systems. Our CTC CAD program uses a sequential classifier to form initial polyp detections on the colon surface. The classifier utilizes a set of thresholds on curvature-based features to cluster suspicious colon surface regions into polyp candidates. The thresholds were previously chosen experimentally by using feature histograms. The chosen thresholds were effective for …

Osteoarthritis Associated With Estrogen Deficiency., Jorge A Roman-Blas, Santos Castañeda, Raquel Largo, Gabriel Herrero-Beaumont

Jefferson Institute of Molecular Medicine Papers and Presentations

Osteoarthritis (OA) affects all articular tissues and finally leads to joint failure. Although articular tissues have long been considered unresponsive to estrogens or their deficiency, there is now increasing evidence that estrogens influence the activity of joint tissues through complex molecular pathways that act at multiple levels. Indeed, we are only just beginning to understand the effects of estrogen deficiency on articular tissues during OA development and progression, as well as on the association between OA and osteoporosis. Estrogen replacement therapy and current selective estrogen receptor modulators have mixed effectiveness in preserving and/or restoring joint tissue in OA. Thus, a …

The Role Of Abortion In The Last Stage Of Fertility Decline In Vietnam, Bussarawan Teerawichitchainan, Sajeda Amin

Poverty, Gender, and Youth

Vietnam’s rapid fertility decline can be explained by very high rates of contraceptive use and induced abortion, but despite the overall decline, fertility rates vary considerably across the country’s 54 ethnic groups. To explore the prospects for further fertility decline through use of abortion among high-fertility minority populations, this study analyzes unique data from the Vietnam National Health Survey to examine ethnic differentials in prevalence and determinants of abortion and contraception, using a new classification system for ethnicity. The report concludes that providing improved abortion services alone is unlikely to reduce fertility among high-fertility minority groups. Service provision needs to …

Feasibility Study On Result-Based Financial Mechanisms For Mnch, Shehla Zaidi, Zulfiqar Ahmed Bhutta, Asad Saeed, Ajmal Agha, Ghulam Haider Akhund, Zohra Lassi, Farhan Saeed Vakani, Yasser Kureshi, Mohammad Faisal, Tanweer Hussain, Murad Charania

Community Health Sciences

No abstract provided.

White Paper: Walking Speed: The Sixth Vital Sign, Stacy Fritz, Michelle M. Lusardi

All PTHMS Faculty Publications

Walking speed is "almost the perfect measure." This review summarizes the strong psychometric properties of walking speed and robust evidence for using this clinical measurement. Walking speed is easily measurable, clinically interpretable, and a potentially modifiable risk factor. For these reasons, using WS as the sixth vital sign is both pragmatic and essential.

Risk Of Dementia Associated With Elevated Plasma Homocysteine In A Latin American Population, Inara J. Chacon, Aldrín E. Molero, Gloria Pino-Ramírez, José A. Luchsinger, Joseph H. Lee, Gladys E. Maestre

School of Medicine Publications and Presentations

The relationship between total homocysteine (tHcy) and dementia risk remains controversial, as the association varies among populations and dementia subtypes. We studied a Venezuelan population that has high prevalence of both elevated tHcy and dementia. We tested the hypotheses that (1) elevated tHcy is associated with increased dementia risk, (2) the risk is greater for vascular dementia (VaD) than for Alzheimer’s disease (AD), and (3) a history of stroke may partly explain this association. 2100 participants (≥55 years old) of the Maracaibo Aging Study underwent standardized neurological, neuropsychiatric, and cardiovascular assessments. Elevated tHcy was significantly associated with dementia, primarily VaD. …

Chlorproguanil - Dapsone - Artesunate Versus Artemether - Lumefantrine: A Randomized, Double-Blind Phase Iii Trial In African Children And Adolescents With Uncomplicated Plasmodium Falciparum Malaria, Zul Premji, R.E. Umeh, S. Owusu-Agyei, F. Esamai, E.U. Ezedinachi, S. Oguche, S. Borrmann, A. Sowunmi, S. Duparc, P.L. Kirby, A. Pamba, L. Kellam, R. Guiguemde, B. Greenwood, S.A. Ward, P.A. Winstanley

Pathology, East Africa

Background: Chlorproguanil-dapsone-artesunate (CDA) was developed as an affordable, simple, fixed-dose artemisinin-based combination therapy for use in Africa. This trial was a randomized parallel-group, double-blind, double-dummy study to compare CDA and artemether-lumefantrine (AL) efficacy in uncomplicated Plasmodium falciparum malaria and further define the CDA safety profile, particularly its hematological safety in glucose-6-phosphate dehydrogenase (G6PD) -deficient patients. Methods and Findings: The trial was conducted at medical centers at 11 sites in five African countries between June 2006 and August 2007. 1372 patients (≥1 to <15 years>old, median age 3 years) with acute uncomplicated P. falciparum malaria were randomized (2:1) to receive CDA 2/2.5/4 …

Utility Of Free To Total Psa Ratio In The Prediction Of Prostate Cancer In Patients With Intermediate Total Psa Levels And Negative Digital Rectal Examination, Muthoni .J .F. Kirimi

Theses & Dissertations

Background: Prostate carcinoma is among the top 5 cancers occurring in Kenyan men. Prostate-specific antigen (PSA) is currently the most important biochemical marker for the diagnosis of prostate cancer and its widespread use as a serum tumor marker has revolutionized the management of patients with prostate cancer. The identification of early prostate cancer is vital in the management of especially men who have mild or vague prostatic symptoms. The most basic and important proxy for determining the need for a biopsy in both symptomatic and asymptomatic(screened) patients is the serum prostatic specific antigen (PSA).If a patients PSA level is above …

Reminder Systems To Reduce The Duration Of Indwelling Urinary Catheters: A Narrative Review, Thomas Blodgett

Thomas Blodgett

Catheter-associated urinary tract infection (CAUTI) is a common and costly problem for hospitalized patients. Policymakers have taken notice of the importance of these infections, and changes to the prospective payment rules of Medicare, Medicaid, and many additional third-party payers have been implemented to hold hospitals accountable for the delivery of poor quality health care services. As key members of the health care team, nurses must be prepared to utilize evidence-based practices to prevent CAUTI in hospitalized patients. This article describes several variable-technology interventions to remind clinicians to remove unnecessary urinary catheters and proposes potential roles for nursing informatics in the …

Masculine Socialization And Sexual Risk Behaviors Among Black Men Who Have Sex With Men: A Qualitative Exploration, David J. Malebranche, Errol L. Fields, Lawrence O. Bryant, Shaun R. Harper

David J Malebranche

Aspects of masculine socialization among Black men who have sex with men (MSM) and potential corresponding influences on high-risk sexual behaviors are explored in this study. Individual interviews were conducted with 29 Black MSM in Atlanta, Georgia. Findings included (1) formative masculine socialization experiences marked by an absence of biological fathers and Black male role models, (2) negative perceptions of “gay” identities and communities, (3) race and racial identification as intersecting influences on masculine and sexual identities, (4) the influences of masculine socialization and beliefs on partner selection and sexual behaviors, and (5) general themes of trust, control, “heat of …

Measurements Of Adiposity And High Blood Pressure Among Children And Adolescents Living In Belo Horizonte, Paulo A. Lotufo

Paulo A Lotufo

Abstract Objective: To verify an association, if it exists, between obesity and blood pressure raised beyond the 90th percentile in children and adolescents, and to determine the measure of adiposity that best correlates with blood pressure in these subjects. Design: Cross-sectional study. Setting: A school-based study in Belo Horizonte, Brazil. Participants: We selected randomly 1,403 students, aged from 6 to 18 years, from 545,046 students attending 521 public and private schools. Those selected completed the study. Main measures of outcome: We recorded the weight, height, skin fold in the triceps, subscapular, and suprailiac areas, waist and hip circumference, body-mass index, …

Stroke In The Very Elderly: Hospital Care, Case Fatality And Disposition., Gustavo Saposnik

Gustavo Saposnik

No abstract provided.