Medicine and Health Sciences Commons^™

Preparing For A National Weightlifting Championships: A Case Series, S. Kyle Travis, Satoshi Mizuguchi, Michael H. Stone, William A. Sands, Caleb D. Bazyler

Caleb D. Bazyler

INTRODUCTION: Monitoring an athlete’s psychological, physiological, and performance level is important when preparing for a major competition. No study to date has tracked a high-level weightlifter peaking for a major competition all the way up to the day of competition. Assessing performance at a competition is vital to ascertain if the athlete has reached a peaked and if peak performance will actually be expressed during the competition. PURPOSE: Therefore, the purpose of this study was to determine when peak jumping performance was achieved and whether psychological or physiological variables explained any jump performance changes in a high-level female weightlifter preparing …

Trends In Patient Selection And Postoperative Outcomes After Pancreatoduodenectomy. A 10-Year Retrospective Acs Nsqip Database Analysis, Jan Grendar, Zelika Jutric, Shu-Ching Chang, L Wang, E Tang, P Newell, C Hammill

Shu-Ching Chang, PhD, MS

Objective: We aimed to assess trends in patient selection and outcomes to evaluate safety in current practice of pancreatoduodenectomy. Methods: NSQIP database from 2005 to 2014 was used to identify patients undergoing a pancreatoduodenectomy. Preoperative optimization measure was created using lack of >10% weight loss, albumin>3 and bilirubin<2. Annual trends in patient characteristics and outcomes were described in univariate and logistic or linear regression analyses for binary and continuous variables, respectively. Results: 23,295 pancreatoduodenectomies were identified. There was no significant trend of age (overall median 65 years, trend p=0.31), severity of systemic disease increased (ASA≥3 in 73% overall, trend OR=1.07, p<0.001), but so did the rate of preoperative optimization (52% overall, trend OR=1.03, p<0.001). Malignant indication percentage was increasing (75% overall, trend OR=1.04, p<0.001) as was rate of associated vascular resection (8% overall, trend OR=1.09, p<0.001), but not multivisceral resections (4% overall, trend p=0.10). The adjusted odds of minor and major complications increased over time (overall 31.2% and 27.7%, trend OR=1.32 and 1.11 respectively, p<0.001 for both). In contrast, unadjusted and adjusted length of stay was shortening (median 9 days, decrease by 1.60% and 1.44% respectively, p<0.001 for both) and mortality continued to decrease (2.5% overall, trend OR=0.95, p=0.002). Conclusion: There has been increasing severity of systemic disease as well as more advanced primary disease in patients undergoing pancreatoduodenectomy. Despite increasing complication rates, preoperative optimization and management of complications were likely improved, as suggested by shortening length of stay and decreasing mortality.

Bone Conduction Transmission And Head‐Shadow Effects For Unilateral Hearing Losses Fit With Transcranial Cic Hearing Aids, Marc A. Fagelson, Colleen Noe, Jennifer Blevins, Owen Murnane

Owen D. Murnane

Bone conduction transmission and head‐shadow effects were determined with transcranial completely‐in‐the‐canal (TCCIC) CROS hearing aids. Five subjects with documented profound unilateral hearing loss and experience with traditional CROS/BICROS fittings (TCROS) were tested with a CIC hearing aid placed in their poorer ear. Peak SPL was measured at the tympanic membrane and ranged from 105–115 dB SPL at 2000 Hz. Pure‐tone crossover thresholds and functional gain tested at frequencies from 250–8000 Hz varied considerably more than the SPL measures. The pure‐tone results indicated that sensitivity in the better ear was moderately associated with functional gain across frequency. Speech recognition was then …

Gap Discrimination And Speech Perception In Noise, Marc A. Fagelson

Marc A. Fagelson

The relation between discrimination of silent gaps and speech‐in‐noise perception was measured in 20 normal‐hearing listeners using speech‐shaped noise as both the gap markers and the noise source for speech testing. In the gap discrimination experiment, subjects compared silent gaps marked by 60 dB SPL 250‐ms noise bursts to standards of either 5, 10, 20, 50, 100, or 200 ms. The gap results were most similar to those reported by Abel [S. M. Abel, J. Acoust. Soc. Am. 52, 519–524 (1972)] as ΔT/T decreased non‐monotonically with increased gap length. In a second experiment, the California Consonant Test (CCT) was administered …

Physician-Pharmacist Communication: Quotes, Quandaries And Quality, Nicholas E. Hagemeier

Nicholas E. Hagemeier

No abstract provided.

In-House Daily Consensus Conference: An Important Quality Control/Quality Assurance Activity--Experience At A Major Referral Center., Amna Khurshid, Zubair Ahmad, Asim Qureshi

Zubair Ahmad

Background:For every practicing histopathologist, improvement of diagnostic accuracy is an important objective. Personal consults are an important component of quality control (QC)/quality assurance (QA) in our Section of Histopathology. In addition, the College of American Pathologists recommends a daily in-house consensus conference, which is a prospective system by which all difficult and problematic cases are reviewed and discussed and signed out by consensus. Design: In-house consensus conference is held daily using a multi-headed microscope. This collegial session is run by the seniormost consultant in the section and is attended by all histopathology consultants and residents. The consultants and residents …

Treat The Cause: Evidence-Based Practice, James M. Rippe, Michael Greger, David L. Katz, John H. Kelly, Margaret Moore, Darren Morton

Darren Morton

Darren was invited by the board of the American College of Lifestyle Medicine to represent the Australasian Lifestyle Medicine perspective on the opening panel of the 2014 American College of Lifestyle Medicine conference in San Diego (Nov, 2014). The dialogue, intended for an international audience, was later published as the mentioned journal article.

The Transcriptional Response To Oxidative Stress During Vertebrate Development: Effects Of Tert-Butylhydroquinone And 2,3,7,8-Tetrachlorodibenzo-P-Dioxin, Mark E. Hahn, Andrew G. Mcarthur, Sibel I. Karchner, Diana G. Franks, Matthew J. Jenny, Alicia R. Timme-Laragy, John J. Stegeman, Bruce R. Woodin, Michael J. Cipriano, Elwood Linney

Alicia R. Timme-Laragy

Oxidative stress is an important mechanism of chemical toxicity, contributing to teratogenesis and to cardiovascular and neurodegenerative diseases. Developing animals may be especially sensitive to chemicals causing oxidative stress. The developmental expression and inducibility of anti-oxidant defenses through activation of NF-E2-related factor 2 (NRF2) affect susceptibility to oxidants, but the embryonic response to oxidants is not well understood. To assess the response to chemically mediated oxidative stress and how it may vary during development, zebrafish embryos, eleutheroembryos, or larvae at 1, 2, 3, 4, 5, and 6 days post fertilization (dpf) were exposed to DMSO (0.1%), tert-butylhydroquinone (tBHQ; 10 µM) …

Advancing Drug Delivery Systems For The Treatment Of Multiple Sclerosis, I. Tabansky, M. D. Messina, C. Bangeranye, J. Goldstein, K. M. Blitz-Shabbir, S. Machado, V. Jeganathan, P. Wright, S. Najjar, J. N. Stern

Joel N.H. Stern

Multiple sclerosis (MS) is a chronic inflammatory autoimmune disease of the central nervous system. It is characterized by demyelination of neurons and loss of neuronal axons and oligodendrocytes. In MS, auto-reactive T cells and B cells cross the blood-brain barrier (BBB), causing perivenous demyelinating lesions that form multiple discrete inflammatory demyelinated plaques located primarily in the white matter. In chronic MS, cortical demyelination and progressive axonal transections develop. Treatment for MS can be stratified into disease-modifying therapies (DMTs) and symptomatic therapy. DMTs aim to decrease circulating immune cells or to prevent these cells from crossing the BBB and reduce the …

A Pilot Study Of Deaf Trauma Survivors’ Experiences: Early Traumas Unique To Being Deaf In A Hearing World, Melissa L. Anderson, Kelly S. Wolf Craig, Wyatte C. Hall, Douglas M. Ziedonis

Melissa L. Anderson

Conducting semi-structured American Sign Language interviews with 17 Deaf trauma survivors, this pilot study explored Deaf individuals’ trauma experiences and whether these experiences generally align with trauma in the hearing population. Most commonly reported traumas were physical assault, sudden unexpected deaths, and “other” very stressful events. Although some “other” events overlap with traumas in the general population, many are unique to Deaf people (e.g., corporal punishment at oral/aural school if caught using sign language, utter lack of communication with hearing parents). These findings suggest that Deaf individuals may experience developmental traumas distinct to being raised in a hearing world. Such …

Bilateral Renal Artery Thrombosis Secondary To Blunt Trauma: Case Report And Review Of The Literature., P Frassinelli, Michael D. Pasquale Md, Facs, Fccm, C Reckard, J Goodreau, G Sherwin

Michael D Pasquale MD, FACS, FCCM

No abstract provided.

Gender Differences In Cognitive Deficits In Schizophrenia With And Without Diabetes, Bao Hua J. Zhang, Mei Han, Xiang Yang Zhang, Li Hui, Shu Rong Jiang, Fu-De Yang, Yun Long Tan, Zhi-Ren Wang, Juan Li, Xu-Feng Huang

Xu-Feng Huang

This study investigated gender differences in cognition in schizophrenia with and without diabetes. Cognition was assessed in 263 individuals with schizophrenia with age range (40-68): 67 males and 34 females with schizophrenia with diabetes; and 125 males and 37 females with schizophrenia without diabetes according to the repeatable battery for the assessment of neuropsychological status (RBANS). Fasting glucose, hemoglobin A1c (HbA1c) and lipid levels were measured. Results showed that male individuals performed worse on most cognitive tasks, especially attention, in schizophrenia with than without diabetes. This result was not observed in female individuals. Also, individuals of both genders showed higher …

Central Administrations Of Palmitic Acid And Arachidonic Acid Decrease Central Leptin Sensitivity In Mice, L Cheng, Xu-Feng Huang, Y Yu

Xu-Feng Huang

Purpose: Leptin inhibits feeding and increases energy expenditure through the central nervous system. High-fat diet with saturated fatty acids (SFA) or n-6 polyunsaturated fatty acids (n-6 PUFA) has been reported to induce central leptin resistance and obesity. However, little is known if central administration of SFA or n-6 PUFA can reduce central leptin sensitivity. This study examined the central leptin sensitivity in response to intracerebroventricular (i.c.v.) injection of SFA, palmitic acid (PA) and n-6 PUFA, arachidonic acid (ARA) in mice. Methods: After overnight fasting, C57BL/6J male mice (n=24/group) were i.c.v. injected with either PA (50pmol/2ul), ARA (50pmol/2ul) or vehicle (saline, …

Arcuate Npy Controls Sympathetic Output And Bat Function Via A Relay Of Tyrosine Hydroxylase Neurons In The Pvn, Yan-Chuan Shi, Jackie Lau, Zhou Lin, Hui Zhang, Lei Zhai, Guenther Sperk, Regine Heilbronn, Mario Mietzsch, Stefan Weger, Xu-Feng Huang, Ronaldo F. Enriquez, Lesley Castillo, Paul A. Baldock, Lei Zhang, Amanda Sainsbury, Herbert Herzog, Shu Lin

Xu-Feng Huang

Neuropepetide Y (NPY) is best known for its powerful stimulation of food intake and its effects on reducing energy expenditure. However, the pathways involved and the regulatory mechanisms behind this are not well understood. Here we demonstrate that NPY derived from the arcuate nucleus (Arc) is critical for the control of sympathetic outflow and brown adipose tissue (BAT) function. Mechanistically, a key change induced by Arc NPY signaling is a marked Y1 receptor-mediated reduction in tyrosine hydroxylase (TH) expression in the hypothalamic paraventricular nucleus (PVN), which is also associated with a reduction in TH expression in the locus coeruleus (LC) …

A Neuregulin 1 Transmembrane Domain Mutation Causes Imbalanced Glutamatergic And Dopaminergic Receptor Expression In Mice, K A. Newell, T Karl, Xu-Feng Huang

Xu-Feng Huang

The neuregulin 1 gene has repeatedly been identified as a susceptibility gene for schizophrenia, thus mice with genetic mutations in this gene offer a valuable tool for studying the role of neuregulin 1 in schizophrenia-related neurotransmission. In this study, slide-based receptor autoradiography was used to quantify glutamatergic N-methyl-d-aspartate (NMDA), dopaminergic D2, cannabinoid CB1 and acetylcholine M1/4 receptor levels in the brains of male heterozygous transmembrane domain neuregulin 1 mutant (Nrg1+/−) mice at two ages. Mutant mice expressed small but significant increases in NMDA receptor levels in the cingulate cortex (7%, p = 0.044), sensory cortex (8%, p = 0.024), and …

Ameliorating Antipsychotic-Induced Weight Gain By Betahistine: Mechanisms And Clinical Implications, Jiamei Lian, Xu-Feng Huang, Nagesh B. Pai, Chao Deng

Xu-Feng Huang

Second generation antipsychotic drugs (SGAs) cause substantial body weight gain/obesity and other metabolic side-effects such as dyslipidaemia. Their antagonistic affinity to the histaminergic H1 receptor (H1R) has been identified as one of the main contributors to weight gain/obesity side-effects. The effects and mechanisms of betahistine (a histaminergic H1R agonist and H3 receptor antagonist) have been investigated for ameliorating SGA-induced weight gain/obesity in both animal models and clinical trials. It has been demonstrated that co-treatment with betahistine is effective in reducing weight gain, associated with olanzapine in drug-naïve patients with schizophrenia, as well as in the animal models of both drug-naïve …

Altered Il-2, Il-6 And Il-8 Serum Levels In Schizophrenia Patients With Tardive Dyskinesia, Hui-Mei An, Yun Long Tan, Jing Shi, Zhi-Ren Wang, Jair C. Soars, Jing Qin Wu, Fu-De Yang, Xu-Feng Huang, Xiang Yang Zhang

Xu-Feng Huang

Immune deregulation has been postulated to be one of the mechanisms underlying the pathogenesis of tardive dyskinesia (TD). We hypothesized that interleukins would have a link with TD in schizophrenia patients. In this study, the serum IL-2, IL-6 and IL-8 levels were examined by enzyme-linked immunosorbent assay (ELISA) in schizophrenia patients with TD (n = 48) and without TD (n = 45), and healthy controls (n = 44). The psychopathological symptoms of schizophrenia were assessed by the Positive and Negative Syndrome Scale (PANSS). The severity of TD was evaluated using Abnormal Involuntary Movement Scale (AIMS). The results showed that serum …

Arcuate Npy Controls Sympathetic Output And Bat Function Via A Relay Of Tyrosine Hydroxylase Neurons In The Pvn, Yan-Chuan Shi, Jackie Lau, Zhou Lin, Hui Zhang, Lei Zhai, Guenther Sperk, Regine Heilbronn, Mario Mietzsch, Stefan Weger, Xu-Feng Huang, Ronaldo F. Enriquez, Lesley Castillo, Paul A. Baldock, Lei Zhang, Amanda Sainsbury, Herbert Herzog, Shu Lin

Xu-Feng Huang

Neuropepetide Y (NPY) is best known for its powerful stimulation of food intake and its effects on reducing energy expenditure. However, the pathways involved and the regulatory mechanisms behind this are not well understood. Here we demonstrate that NPY derived from the arcuate nucleus (Arc) is critical for the control of sympathetic outflow and brown adipose tissue (BAT) function. Mechanistically, a key change induced by Arc NPY signaling is a marked Y1 receptor-mediated reduction in tyrosine hydroxylase (TH) expression in the hypothalamic paraventricular nucleus (PVN), which is also associated with a reduction in TH expression in the locus coeruleus (LC) …

Ameliorating Antipsychotic-Induced Weight Gain By Betahistine: Mechanisms And Clinical Implications, Jiamei Lian, Xu-Feng Huang, Nagesh B. Pai, Chao Deng

Xu-Feng Huang

Second generation antipsychotic drugs (SGAs) cause substantial body weight gain/obesity and other metabolic side-effects such as dyslipidaemia. Their antagonistic affinity to the histaminergic H1 receptor (H1R) has been identified as one of the main contributors to weight gain/obesity side-effects. The effects and mechanisms of betahistine (a histaminergic H1R agonist and H3 receptor antagonist) have been investigated for ameliorating SGA-induced weight gain/obesity in both animal models and clinical trials. It has been demonstrated that co-treatment with betahistine is effective in reducing weight gain, associated with olanzapine in drug-naïve patients with schizophrenia, as well as in the animal models of both drug-naïve …

An Analysis Of Metabotropic Glutamate Receptors 2/3 And 5 In Schizophrenia, Major Depression And Bipolar Disorder From The Stanley Neuropathology Consortium, N Matosin, E Frank, F Fernandez, C Deng, J Wong, Xu-Feng Huang, K A. Newell

Xu-Feng Huang

Purpose: Metabotropic glutamate receptors (mGluRs) are proposed novel therapeutic targets for a variety of brain disorders such as schizophrenia (SZ), bipolar disorder (BP) and major depression (MD). Despite their potential, the involvement of these receptors in these pathological processes is uncertain. This information is crucial to understand the efficiency of drugs that target these receptors. Methods: Using post-mortem human brains, mGluR2/3 and mGluR5 binding densities were measured in the anterior cingulate cortex of SZ, BP, MD and matched controls (CT) (n=15/group) by receptor autoradiography. Results: Whilst preliminary analyses indicated no diagnostic effect in mGluR2/3 or mGluR5 binding densities, mGluR2/3 binding …

A Neuregulin 1 Transmembrane Domain Mutation Causes Imbalanced Glutamatergic And Dopaminergic Receptor Expression In Mice, K A. Newell, T Karl, Xu-Feng Huang

Xu-Feng Huang

The neuregulin 1 gene has repeatedly been identified as a susceptibility gene for schizophrenia, thus mice with genetic mutations in this gene offer a valuable tool for studying the role of neuregulin 1 in schizophrenia-related neurotransmission. In this study, slide-based receptor autoradiography was used to quantify glutamatergic N-methyl-d-aspartate (NMDA), dopaminergic D2, cannabinoid CB1 and acetylcholine M1/4 receptor levels in the brains of male heterozygous transmembrane domain neuregulin 1 mutant (Nrg1+/−) mice at two ages. Mutant mice expressed small but significant increases in NMDA receptor levels in the cingulate cortex (7%, p = 0.044), sensory cortex (8%, p = 0.024), and …

Ameliorating Antipsychotic-Induced Weight Gain By Betahistine: Mechanisms And Clinical Implications, Jiamei Lian, Xu-Feng Huang, Nagesh B. Pai, Chao Deng

Xu-Feng Huang

Second generation antipsychotic drugs (SGAs) cause substantial body weight gain/obesity and other metabolic side-effects such as dyslipidaemia. Their antagonistic affinity to the histaminergic H1 receptor (H1R) has been identified as one of the main contributors to weight gain/obesity side-effects. The effects and mechanisms of betahistine (a histaminergic H1R agonist and H3 receptor antagonist) have been investigated for ameliorating SGA-induced weight gain/obesity in both animal models and clinical trials. It has been demonstrated that co-treatment with betahistine is effective in reducing weight gain, associated with olanzapine in drug-naïve patients with schizophrenia, as well as in the animal models of both drug-naïve …

Regional Campuses And Long Distance Relationships: Making Them Work, Robert D. Barraco Md, Mph, Margaret A. Hadinger Edd, Ms, M. Edwyn Harrison Md, Joseph M. Kaczmarczyk Do, Mph

Margaret A. Hadinger, EdD, MS

No abstract provided.

The Incidence Of Falls In Intensive Care Survivors, Shane M. Patman, Diane Dennis, Kylie Hill

Shane Patman

Background: Falling among adults in acute care is an important problem with falls rates in tertiary hospitals ranging from 2% to 5%. Factors that increase the risk of falling, such as advanced age, altered mental status, medications that act on the central nervous system and poor mobility, often characterise individuals who survive a prolonged intensive care unit (ICU) admission.

Purpose: To measure the incidence of falls and describe the characteristics of fallers among intensive care survivors.

Methods: A comprehensive retrospective chart review was undertaken of 190 adults who were intubated and ventilated for ≥168 h and survived their acute care …

Intensive Care Unit Mobility Practices In Australia And New Zealand: A Point Prevalence Study, Susan C. Berney, Megan Harrold, Steven A. Webb, Ian Seppelt, Shane Patman, Peter J. Thomas, Linda Denehy

Shane Patman

Objectives:

To develop a comprehensive set of items describing physiotherapy mobilisation practices for critically ill patients, and to document current practices in intensive care units in Australia and New Zealand, focusing on patients having > 48 hours of mechanical ventilation.

Design:

Prospective, observational, multicentre, single-day, point prevalence study.

Participants and Setting:

All patients in 38 Australian and New Zealand ICUs at 10 am on one of three designated days in 2009 and 2010.

Main Outcome Measures:

Demographic data, admission diagnosis and mobilisation practices that had occurred in the previous 24 hours.

Results:

514 patients were enrolled, with 498 complete datasets. Mean …

Seeing It Helps: Movement-Related Back Pain Is Reduced By Visualization Of The Back During Movement, Benedict M. Wand, Verity M. Tulloch, Pamela J. George, Anne J. Smith, Roger Goucke, Neil E. O'Connell, G Lorimer Moseley

Pamela George

Objectives: The aim of this study was to determine whether visualization of the back influenced parameters of movement-related pain in people with chronic nonspecific low back pain. Methods: We used a randomized cross-over experiment in which 25 participants performed repeated lumbar spine movements under 2 conditions. In the visual feedback condition, patients were able to visualize their back as it moved by the use of mirrors. In the control condition, the mirror was covered so no visualization of the back was possible. Results: The average postmovement pain intensity after participants had moved with visual feedback was less (35.5+/-22.8 mm) than …

Eccentric Fatigue Modulates Stretch-Shortening Cycle Effectiveness - A Possible Role In Lower Limb Overuse Injuries, James R. Debenham, M Travers, William Gibson, A Campbell, G Allison

William Gibson

The role of fatigue in injury development is an important consideration for clinicians. In particular, the role of eccentric fatigue in stretch shortening cycle (SSC) activities may be linked to lower limb overuse conditions. The purpose of this study was to explore the influence of ankle plantarflexor eccentric fatigue on SSC effectiveness during a hopping task in healthy volunteers. 11 healthy volunteers (23.2 ± 6.7 years) performed a sub-maximal hopping task on a custom- built sledge system. 3D motion capture and surface EMG were utilised to measure lower limb stiffness, temporal kinematic measures and muscle timing measures at baseline and …

Chronic Mid Portion Achilles Tendinopathy Is Not Associated With Central Sensitisation, Ian W. Skinner, James R. Debenham, Sarah Krumenachera, Max K. Bulsara, Benedict M. Wand

James Debenham

Achilles tendinopathy (AT) is a common painful and disabling condition and current understanding of its pathophysiology is incomplete. Widespread hyperalgesia as a clinical manifestation of central sensitisation has emerged as a possible contributor to the pain state in chronic musculoskeletal injuries. Eight AT participants and eight healthy, gender, age and activity matched participants were recruited to participate in a case-controlled repeated measures study. Pressure pain threshold (PPT) was measured with a manual electronic algometer at four sites bilaterally; tibialis anterior (TA), patella tendon (PT), common wrist extensor tendon (CWET), and first dorsal interosseous (1DI). We hypothesised a reduction in PPT …

Are There Associations Among Physical Activity, Fatigue, Sleep Quality And Pain In People With Mental Illness? A Pilot Study, Joanne Connaughton, Shane Patman, C Pardoe

Joanne Connaughton

Accessible summary

• Many people with mental health disorders experience fatigue, pain and poor sleep. In other patient groups, physical exercise has been shown to have positive effects on these symptoms.

• It is unknown whether day-to-day physical activity (not necessarily exercise) affects sleep quality or severity of pain or fatigue in those with mental illness.

• This study observed physical activity, sleep quality, pain and fatigue in four people hospitalized with severe mental illness.

• Significant associations were found between pain and fatigue severity in the morning, but not in the evening. A significant association was found between physical activity and morning and …

Shifting The Load: Improving Bioscience Performance In Undergraduate Nurses Through Student Focused Learning, Angela Owens, Tracey Moroney

Angela Owens