Medicine and Health Sciences Commons^™

Seniors Welcome! Avoiding The Trap Of Age Limits In Health Research, Arshad Jahangir

Journal of Patient-Centered Research and Reviews

The guest editor introduces this specialty issue of the Journal of Patient-Centered Research and Reviews, which focuses on cardiovascular diseases in the elderly. The reality of an aging population has increased the need for better evidence-based medicine in older patients. However, randomized controlled trials frequently exclude such patients, especially those with comorbidities, from study. This practice ignores the fact that physiologic changes to the cardiovascular system caused by the aging process and aging-associated diseases create clinical dilemmas distinct from those in younger patients. Considering the rising costs of health care and growing incidence of cardiovascular disease, research efforts and …

Predicting Outcomes In Patients With Atrial Fibrillation And Acute Mesenteric Ischemia, Sanjay Bhandari, Geetanjali Dang, Muhammad Shahreyar, Ahmad Hanif, Vijayadershan Muppidi, Atul Bhatia, Jasbir Sra, A. Jamil Tajik, Arshad Jahangir

Journal of Patient-Centered Research and Reviews

Purpose

Outcomes in patients with atrial fibrillation who develop acute mesenteric ischemia, and the impact of anticoagulation on complications, are not defined.

Methods

Patients admitted with acute mesenteric ischemia in the National Inpatient Sample from 2007, with and without atrial fibrillation, were compared for in-hospital outcomes using multivariate regression, and the impact of prior anticoagulation determined.

Results

Of 48,872 patients with acute mesenteric ischemia, 8,306 had atrial fibrillation, with 680 patients also on anticoagulation. Atrial fibrillation patients were more likely to be older and have hypertension, heart failure, or chronic lung or renal disease. After adjusting for potential confounders, atrial …

Atrial Fibrillation And Stroke In Elderly Patients, Geetanjali Dang, Imaan Jahangir, Jasbir Sra, A. Jamil Tajik, Arshad Jahangir

Journal of Patient-Centered Research and Reviews

The increasing prevalence of stroke, with an estimated annual cost of $71.5 billion, has made it a major health problem that increases disability and death, particularly in patients with atrial fibrillation. Although advanced age and atrial fibrillation are recognized as strong risk factors for stroke, the basis for this susceptibility are not well defined. Aging or associated diseases are accompanied by changes in rheostatic, humoral, metabolic and hemodynamic factors that may contribute more to stroke predisposition than rhythm abnormality alone. Several thromboembolism-predisposing clinical characteristics and serum biomarkers with prognostic significance have been identified in patients with atrial fibrillation. Although anticoagulation …

The Crux Of The Heart –– The Closest Approach Of The Right Atrium To The Left Ventricle, Lynn Erickson, David Krum, Hannah Samuel, Anwer Dhala, Jasbir Sra

Journal of Patient-Centered Research and Reviews

Background: Accessory pathways, the source of atrioventricular reentry tachycardia, occasionally connect the left ventricle to the right atrium. This is possible because, in some patients, a portion of the right atrium abuts the left ventricle on the posterior wall of the heart, near the mid-coronary sinus. This anatomic region is known as the “crux” of the heart. These accessory pathways can be difficult to ablate because of the unusual and unexpected substrate. While the presence of these accessory pathways is described in the literature, the prevalence of the underlying anatomic substrate is not currently known.

Purpose: To measure the closest …

Determining The Incidence And Factors Of Cardiotoxicity In Breast Cancer Patients Treated With Anthracycline And/Or Trastuzumab-Containing Regimen At Aurora Health Care, Stephanie Ghojallu, Matthew Rappelt, Han-Yang Chen, Ruth Perez, Lydia Garlie, Geoffrey Riddell, Yingying Gu, Jun Zhang, Rubina Qamar, Bijoy K. Khandheria, Arshad Jahangir, Yang Shi

Journal of Patient-Centered Research and Reviews

Background: Anthracycline and trastuzumab are common breast cancer treatments. While improving survival, they elevate risk of congestive heart failure. The incidence of cardiotoxicity (CTx) with these therapies varies in the literature from 10% to 59%, higher than those reported in clinical trials (4%–10%) that excluded patients with preexisting cardiovascular comorbidities. Studies have failed to establish consensus on the risk factors for CTx associated with these therapies.

Purpose: We aim to determine the incidence and risk factors of CTx in breast cancer patients treated with anthracycline and/or trastuzumab at Aurora Health Care.

Methods: A retrospective review of patients with breast cancer …

Retrograde Pedal Access For Revascularization Of Infrapopliteal Arterial Occlusive Disease In Critical Limb Ischemia (Cli) Patients As A Primary Approach., Ahmed Amro, Alaa Gabi, Shahed Elhamdani, Haytham Aljoudi, Mehiar El-Hamdani

Marshall Journal of Medicine

Introduction:

We are presenting three cases (out of similar several cases) where tibio-pedal approach was performed as an initial primary approach for limb salvage in patients with CLI secondary to Infra-popliteal (IP) disease. We consider this approach to be a necessary evolution in endovascular intervention.

Discussion:

Retrograde pedal access is safe, feasible with high technical success rate and a relatively low procedural complication rate, with low 30 days mortality and low rate of major adverse cardiac events. Freedom from major adverse limb events and limb salvage are both high at 1 year follow up. It allows quick therapy and short …

The Postfinasteride Syndrome; An Overview, David L. Rowland, Ion G. Motofei, Florian Popa, Vlad D. Constantin, Adriana Vasilache, Ioana Păunică, Cristian Bălălău, Georgeta P. Păunică, Petrisor Banu, Stana Păunică

Journal of Mind and Medical Sciences

As a 5-α reductase inhibitor, Finasteride has proven effective in ameliorating two conditions documented to be androgen dependent, namely male androgenic alopecia and benign prostatic hyperplasia. Therapeutic results are maintained as long as the drug is administered, with treatment cessation generally leading to the return of symptomatology for each condition. In addition, during the therapeutic phase, several adverse effects have been reported, some of which persist long or indefinitely after treatment cessation, known as “post-finasteride syndrome.”

Herein we present and discuss the most common finasteride side effects, along with a psycho-neuroendocrine rationale that could explain the persistence of many adverse …

Ptsd In The 20th Century American Military: Its Diagnosis, Effects, Treatment, And Management, With A Focus On The Vietnam War, Christy L. Connell

Bound Away: The Liberty Journal of History

Soldiers have been affected by PTSD for as long as war has existed. The American Military in the twentieth century is no exception. PTSD did not become a diagnosable disease until 1980, and before then it was misdiagnosed as different anxiety disorders and neuroses. Symptoms, treatment options, and long-term affects of PTSD are also discussed. Though other other wars in which America was involved are mentioned, those that receive a more thorough analysis are World War II, the Korean War, and the Vietnam War. Although PTSD is an increasing problem in modern times for those involved in military conflicts, there …

Facing Our Demons: Psychiatric Perspectives On Exorcism Rituals, Joel R. Sanford

The Hilltop Review

Belief in possession by malevolent spirits exists in many cultures and religions throughout the world, and such beliefs often serve as explanations for a variety of psychological and emotional afflictions. Traditional remedies in these cases often involve exorcism rituals, which are believed to expel spirits from a person's mind and/or body. Some of the cases commonly attributed to involuntary spirit possession are diagnosed within the psychiatric community as schizophrenia or some sort of dissociative disorder and treated with psychotherapy and/or medicine. For some in the psychiatric community, exorcisms and their use by patients are viewed as problematic due to their …

Abnormal Uterine Bleeding Guidelines And Clinical Practice Are Based On Poor Quality Evidence, Mirek Mychajlowycz

Clinical Research in Practice: The Journal of Team Hippocrates

A critical appraisal and clinical application of Munro MG, Mainor N, Basu R, Brisinger M, Barreda L. Oral medroxyprogesterone acetate and combination oral contraceptives for acute uterine bleeding: A randomized controlled trial. Obstet Gynecol. 2006 Oct;108(4):924-929. doi:10.1097/01.AOG.0000238343.62063.22

Endoscopic Ultrasound Guided Drainage Of Peri-Rectal Collections: A Salvage Approach, Yana Cavanagh, Kevin Hosein, Nihar Shah, Edward Milman, Sohail N. Shaikh

Marshall Journal of Medicine

Abdominal and pelvic abscesses can occur as a consequence of surgery and are associated with significant morbidity and mortality. It is well accepted that the primary treatment is antibiotic therapy and minimally invasive drainage. Surgical measures are typically reserved for patients with luminal perforations or those who do not respond to conservative measures. Previously available modalities of drainage involved percutaneous and computed tomography guided access. Recently, endoscopic ultrasound guided aspiration has emerged as a safe alternative for management of intra-abdominal abscesses.

Since its first application for peripancreatic drainage, endoscopic ultrasound techniques and technologies have significantly evolved. Endoscopic ultrasound interventions can …

A New Technique To Improve The Operation Of Prosthetic Limbs During Muscle Fatigue, H. Albunashee, G. Rasool, K. Iqbal, G. White

Journal of the Arkansas Academy of Science

Prosthetic limbs hold a promise to renew the quality of life for the amputee. Neural commands are decoded via a classifier to generate control signals for the prosthetic devices. In the literature, many challenges and limitations have been identified that affect the prosthesis operation. One such drawback is muscle fatigue which degrades the surface electromyogram (sEMG) signals, and consequently, the performance of the deployed classification algorithm declines from 90% to 50% of average accuracy. We used a new technique using the Linear Discrimination Analysis (LDA) algorithm and the muscle synergy-based task discrimination (MSD) algorithm to improve the classification accuracy. In …

Most Efficient Methods To Treat Breast Cancer, Esther Ehrman

The Science Journal of the Lander College of Arts and Sciences

Breast cancer is rampant in today’s world. Because there are many different cases and so many different ways to classify breast cancer, a multidisciplinary approach must be taken. Many patients undergo breast conserving surgery which creates a need for the eradication of any remaining tumor residue through radiation. Fifty Gy of radiation should be applied to the breast with an additional 16 Gy as a boost. If a mastectomy is performed to remove a large tumor and 4 or more positive lymph nodes were present, radiation should be applied as well. If the tumor expresses HER2 protein, Trastuzumab should be …

Is Deep Brain Stimulation A Viable Treatment For Parkinson’S Disease?, Brocha Gold

The Science Journal of the Lander College of Arts and Sciences

Treatment options for those suffering from Parkinson’s Disease are as diverse as its symptoms. With the advent of modern technology there are new and innovative treatments that are becoming available, such as Deep Brain Stimulation (DBS). Prior to exploring treatment options one must understand the various causes of the disease. Treatment of the various motor and non-motor symptoms can include a combination of medication and surgical therapies. Among surgical interventions DBS is the treatment of choice. It has the fewest side effects and provides the greatest symptomatic relief.

Mechanism Of Fecal Bacteriotherapy In Treating Clostridium Difficile Infection And Gi Tract Disorders, Rivka Steinberg

The Science Journal of the Lander College of Arts and Sciences

Clostridium difficile infection, an increasingly prevalent and virulent condition, is often resistant to treatment. Standard antibiotic therapy is rarely efficient when used to treat recurrent C. difficile infection. Fecal microbiota transplantation (FMT) is a safe, effective and inexpensive treatment that has a cure rate of about 90%, according to clinical trials and reports. This approach may also be applicable in treating ulcerative colitis, a type of inflammatory bowel disease, on the basis of the restoration of flora imbalances. Additionally, recent data suggests that a disproportion in composition of the gut microbiome may contribute to obesity. FMT, may restore a healthy …

Phage Therapy As A Mrsa Treatment, Miriam Sussman

The Science Journal of the Lander College of Arts and Sciences

This paper seeks to review how previous research on bacteriophage therapy can be utilized to improve the treatment of MRSA infections. Due to the growing phenomenon of antibiotic resistance, scientists are looking to utilize the natural antibacterial qualities of bacterial viruses called phages to fight MRSA infections. In order to improve the therapeutic methods of combatting MRSA, one must first understand the mechanics of how phages infect bacterial cells and lyse them with their proteins. The narrow host range of bacteriophages causes the infection of only the pathogenic bacteria and maintains the state of the normal flora. Research suggests that …

Stem Cell Therapy And Macular Degeneration, Brenda Stern

The Science Journal of the Lander College of Arts and Sciences

Macular degeneration is the leading cause of vision loss in Americans sixty years and older. Currently, it is an incurable disease. Stem cell therapy is the idea of transplanting stem cells to replace damaged cells in the body. As the demand for transplantable organs far outweighs the supply, stem cells are an encouraging alternative to replace damaged cells. Can stem cell therapy be the first cure for macular degeneration? Many experiments have been done on transplanting stem cells into the eyes of rats with macular degeneration yielding promising results. The first transplantation of retinal pigmented epithelial stem cells into humans …

Crispr/Cas9 As A Therapeutic Approach To Duchenne Muscular Dystrophy, Abraham Daniel Levitman

The Science Journal of the Lander College of Arts and Sciences

Transhumanism, designer babies, gene therapy, and super-soldiers are founded upon the same concept—genetic engineering. Clustered Regularly-Interspersed Short Palindromic Repeats (CRISPR) is a natural bacterial immune response method that takes advantage of gene manipulation to prevent an infection from mobile genetic elements. Since Mojica et al. (2005) first suggested the relationship between the CRISPR/Cas system and prokaryotic immunity, significant advancements have been made in understanding the mechanism and subsequent applications of CRISPR. CRISPR, has three main subtypes based on unique proteins and interference pathways and serves as an accurate and effective method for gene editing. Its mechanism consists of spacer acquisition, …

Treatment Options For Skin And Soft Tissue Infections Caused By Methicillin-Resistant Staphylococcus Aureus, Renee Weinberg

The Science Journal of the Lander College of Arts and Sciences

Staphylococcus aureus is a pathogen responsible for common skin infections, such as impetigo, cellulitis, folliculitis, and abscess and it is the most common cause for skin and soft tissue infections (SSTI). Humans are carriers of this microorganism and are responsible for facilitating its spread around the world. Over time it has developed resistance to multiple antibiotics, such as penicillin and methicillin, which has made S. aureus a persistent problem in the healthcare world today. Its methicillin resistance has given it the more commonly known name methicillin-resistant S. aureus (MRSA). MRSA was initially discovered solely in the healthcare environment and thus …

The Psychological And Neurological Effectiveness Of Placebo Treatment, Aliza Jeidel

The Science Journal of the Lander College of Arts and Sciences

Placebo effect is an alternative medical approach that doctors utilize in treating health issues. For years, people thought that placebo pills were inert drugs or medically illegitimate measures that have psychological effects on the patient, therefore alleviating the patient’s pain. However, in recent years, with the advent of technology, more studies are involving neurological aspects to the already-proven psychological aspects of the placebo effect. Yet there is still some opposition and much to be proven better on this topic. What is very important is that although there is opposition, there is growing recognition that the placebo effect may actually involve …