Medicine and Health Sciences Commons^™

Neurogenic Megacolon In Spinal Cord Injury., Rukma R Govindu, Michelle Kelley

Journal Articles

No abstract provided.

Two Years Of Relationship-Focused Mentoring For First Nations, Metis, And Inuit Adolescents: Promoting Positive Mental Health, Claire Crooks, Deinera Exner-Cortens, Sarah B. Burm, Alicia Lapointe, Debbie G. Chiodo Ms.

Journal Articles

First Nations, Métis, and Inuit (FNMI) youth are disproportionately affected by a range of negative health outcomes including poor emotional and psychosocial well-being. At the same time, there is increasing awareness of culturally-specific protective factors for these youth, such as cultural connectedness and identity. This article reports the findings of a mixed-methods, exploratory longitudinal study on the effects of a culturally-relevant school-based mentoring program for FNMI youth that focuses on promoting mental well-being and the development of cultural identity. Participants included a cohort of FNMI adolescents whom we tracked across the transition from elementary to secondary school. We utilized data …

A Comparison Of Stride Length And Lower Extremity Kinematics During Barefoot And Shod Running In Well Trained Distance Runners, Peter Francis, James Ledingham, Sarah B. Clarke Phd, Dj Collins, Philip Jakeman

Journal Articles

Stride length, hip, knee and ankle angles were compared during barefoot and shod running on a treadmill at two speeds. Nine well-trained (1500m time: 3min:59.80s ± 14.7 s) male (22 ±3 years; 73 ±9 kg; 1.79 ±0.4 m) middle distance (800 m – 5,000 m) runners performed 2 minutes of running at 3.05 m·s^-1 and 4.72 m·s^-1 on an treadmill. This approach allowed continuous measurement of lower extremity kinematic data and calculation of stride length. Statistical analysis using a 2X2 factorial ANOVA revealed speed to have a main effect on stride length and hip angle and footwear to …

Precision Medicine Informatics, Lewis J Frey, Elmer V Bernstam, Joshua C Denny

Journal Articles

No abstract provided.

Does Myocardial Necrosis Occur In Rhabdomyolysis?, Gabriel M Aisenberg, Herbert L Fred

Journal Articles

No abstract provided.

Endosteal Biologic Augmentation For Surgical Fixation Of Displaced Femoral Neck Fractures, Lionel E Lazaro, Jacqueline F Birnbaum, Nadja A Farshad-Amacker, David L Helfet, Hollis G Potter, Dean G Lorich

Journal Articles

OBJECTIVES: To report outcomes of a cohort with displaced femoral neck fractures (FNFs) treated with a length/angle-stable construct augmented with an endosteal fibular allograft serving as a biologic dowel.

DESIGN: Prospective.

SETTING: Level I Trauma Center.

PATIENTS: The study group consists of 27 patients with isolated FNF surgically treated by a single surgeon.

INTERVENTION: Open reduction of the femoral neck, fixed with a length- and angle-stable construct of 2 fully threaded cannulated screws augmented with an endosteal fibular allograft serving as a biologic dowel.

MAIN OUTCOME MEASUREMENTS: Clinical and radiographic outcomes of the fixation construct and the viability of both …

Skin Conductance At Baseline And Post-Heel Lance Reflects Sympathetic Activation In Neonatal Opiate Withdrawal, C. N. Oji-Mmuo, E. J. Michael, J. Mclatchy, M. M. Lewis, J. E. Becker, K. K. Doheny

Journal Articles

AIM: Skin conductance (SC) provides an objective measure of autonomic system regulation through sympathetic-mediated filling of sweat glands. This study aimed to test the utility of SC to detect sympathetic activation in neonatal abstinence syndrome (NAS). METHODS: 14 term (mean, SE: 38.8 + 0.35 weeks gestational age) neonates with chronic prenatal opiate exposure were enrolled. SC (peaks/sec and mean of peaks) were measured at baseline, during heel lance/squeeze (HLS) and recovery from HLS at 24-48 (mean 38) hours of life prior to treatment for NAS. Blinded coders with established reliability assessed neonates using the Modified Finnegan Neonatal Scoring System (MFNSS). …

First Trimester Fetal Heart Rate As A Predictor Of Newborn Sex, L. A. Bracero, D. J. Seybold, S. Witsberger, L. Rincon, A. Modak, L. V. Baxi

Journal Articles

OBJECTIVE: To predict the sex of newborns using first trimester fetal heart rate (FHR). METHODS: This was a retrospective review of medical records and ultrasounds performed between 8 and 13 weeks of gestation. Continuous variables were compared using Student's t-tests while categorical variables were compared using Chi-square test. RESULTS: We found no significant differences between 332 (50.7%) female and 323 (49.3%) male FHRs during the first trimester. The mean FHR for female fetuses was 167.0 +/- 9.1 bpm and for male fetuses 167.3 +/- 10.1 bpm (p = 0.62). There was no significant difference in crown rump length between female …

Differential Protein Expression In Small Intestinal Neuroendocrine Tumors And Liver Metastases, M. K. Kim, F. Ye, D. Wang, M. Cui, S. C. Ward, R. R. Warner, S. Roayaie, M. Schwartz, D. Zhang, S. Itzkowitz, +1 Additional Author

Journal Articles

OBJECTIVE: Small intestinal neuroendocrine tumors (SI-NETs) are often detected after they have become metastatic. Using a novel protein array, we identified pathways important in SI-NET metastasis development in surgically resected patients. METHODS: Paired primary tumors and liver metastases from 25 patients undergoing surgical resection for metastatic SI-NETs were harvested. Extracted proteins were separated by sodium dodecyl sulfate gel and multiplex immunoblots were performed with 136 antibodies. Significant Analysis of Microarray was used to select for differentially expressed proteins. A tissue microarray was constructed from 27 archived specimens and stained by immunohistochemistry. RESULTS: Comparing primary SI-NETs with matched normal small-bowel mucosa, …

Recipient Criteria Predictive Of Graft Failure In Kidney Transplantation, E. P. Molmenti, A. Alex, L. Rosen, M. Alexander, J. Nicastro, E. Siskind, L. Alex, E. Sameyah, M. Bhaskaran, N. Ali, A. Basu, M. Sachdeva, S. Agorastos, P. Rajendran, P. Krishnan, P. Ramadas, L. Amodu, J. Cagliani, S. Rehman, A. Kressel, C. B. Sethna, R. Schwarz, S. Fishbane, A. Bellucci, G. Coppa, H. Rilo, C. L. Molmenti, +4 Additional Authors

Journal Articles

Several classifications systems have been developed to predict outcomes of kidney transplantation based on donor variables. This study aims to identify kidney transplant recipient variables that would predict graft outcome irrespective of donor characteristics. All U.S. kidney transplant recipients between October 25,1999 and January 1, 2007 were reviewed. Cox proportional hazards regression was used to model time until graft failure. Death-censored and nondeath-censored graft survival models were generated for recipients of live and deceased donor organs. Recipient age, gender, body mass index (BMI), presence of cardiac risk factors, peripheral vascular disease, pulmonary disease, diabetes, cerebrovascular disease, history of malignancy, hepatitis …

Type Vi Choledochal Cyst—An Unusual Presentation Of Jaundice, L. Nambiar, E. Siskind, A. W. Shen, C. Fan, G. Grimaldi, C. Choy, J. Madariaga, J. Nicastro, E. P. Molmenti, G. Coppa, +1 Additional Author

Journal Articles

No abstract provided.

Baseline Striatal Functional Connectivity As A Predictor Of Response To Antipsychotic Drug Treatment, D. Sarpal, M. Argyelan, D. G. Robinson, P. R. Szeszko, K. H. Karlsgodt, M. John, N. Weissman, J. A. Gallego, J. M. Kane, T. Lencz, A. K. Malhotra

Journal Articles

OBJECTIVE: Clinical response to antipsychotic drug treatment is highly variable, yet prognostic biomarkers are lacking. The authors recently demonstrated that successful antipsychotic drug treatment alters resting-state functional connectivity of the striatum. The goal of the present study was to test whether intrinsic striatal connectivity patterns provide prognostic information and can serve as a potential biomarker of treatment response to antipsychotic drugs. METHOD: The authors used resting-state functional MRI (fMRI) to develop a prognostic index in a discovery cohort of 41 first-episode schizophrenia patients, then tested this index in an independent cohort of 40 newly hospitalized chronic patients with acute psychosis. …

Deformable Image Registration And Interobserver Variation In Contour Propagation For Radiation Therapy Planning., A. C. Riegel, J. G. Antone, H. Zhang, P. Jain, J. Raince, A. Rea, A. M. Bergamo, A. Kapur, L. Potters

Journal Articles

Deformable image registration (DIR) and interobserver variation inevitably intro-duce uncertainty into the treatment planning process. The purpose of the current work was to measure deformable image registration (DIR) errors and interobserver variability for regions of interest (ROIs) in the head and neck and pelvic regions. Measured uncertainties were combined to examine planning margin adequacy for contours propagated for adaptive therapy and to assess the trade-off of DIR and interobserver uncertainty in atlas-based automatic segmentation. Two experi-enced dosimetrists retrospectively contoured brainstem, spinal cord, anterior oral cavity, larynx, right and left parotids, optic nerves, and eyes on the planning CT (CT1) and …

Radioresistance Of Brain Tumors, K. Kelley, J. Knisely, M. Symons, R. Ruggieri

Journal Articles

Radiation therapy (RT) is frequently used as part of the standard of care treatment of the majority of brain tumors. The efficacy of RT is limited by radioresistance and by normal tissue radiation tolerance. This is highlighted in pediatric brain tumors where the use of radiation is limited by the excessive toxicity to the developing brain. For these reasons, radiosensitization of tumor cells would be beneficial. In this review, we focus on radioresistance mechanisms intrinsic to tumor cells. We also evaluate existing approaches to induce radiosensitization and explore future avenues of investigation.

Crhbp Polymorphisms Predict Chronic Pain Development Following Motor Vehicle Collision, S. D. Linnstaedt, A. V. Bortsov, A. C. Soward, R. Swor, D. A. Peak, J. Jones, N. Rathlev, D. C. Lee, R. Domeier, P. L. Hendry, S. A. Mclean

Journal Articles

Musculoskeletal pain (MSP) is a common sequela of traumatic stress exposure. While biologic factors contributing to chronic MSP after motor vehicle collision (MVC) have traditionally focused on tissue injury, increasing evidence suggests that neuro/stress/immune processes mediated by stress system activation may play a more dominant role. In a previous study we found that genetic variants in the hypothalamic-pituitary-adrenal (HPA) axis-related gene FKBP5 influence vulnerability to persistent MSP 6 weeks after MVC. In the present cohort study (n = 855) we evaluated whether genetic variants in several other important HPA axis-related genes, including the glucocorticoid receptor (NR3C1), corticotropin-releasing hormone receptor R1 …

Relationship Between Obesity And Clinical Outcome In Adults With Acute Myeloid Leukemia: A Pooled Analysis From Four Calgb (Alliance) Clinical Trials, J. J. Castillo, F. Mulkey, S. Geyer, J. E. Kolitz, W. Blum, B. L. Powell, S. L. George, R. A. Larson, R. M. Stone

Journal Articles

Obesity has been previously suggested as an adverse prognostic marker in patients with acute leukemia. To evaluate the relationship between obesity and clinical outcome, disease-free survival (DFS) and overall survival (OS), in patients with acute myelogenous leukemia (AML), including acute promyelocytic leukemia (APL), we performed a pooled analysis of four CALGB (Alliance) clinical trials. Our study included 446 patients with APL from CALGB 9710, and 1,648 patients between 18 and 60 years of age with non-APL AML from CALGB 9621, 10503, and 19808. Obesity was defined as BMI >/=30 kg/m(2) . Multivariate Cox proportional-hazard regression models were fitted for DFS …

Sotatercept (Ace-011) For The Treatment Of Chemotherapy-Induced Anemia In Patients With Metastatic Breast Cancer Or Advanced Or Metastatic Solid Tumors Treated With Platinum-Based Chemotherapeutic Regimens: Results From Two Phase 2 Studies, H. Raftopoulos, A. Laadem, P. J. Hesketh, J. Goldschmidt, N. Gabrail, C. Osborne, M. Ali, M. L. Sherman, D. Wang, J. Crawford, +3 Additional Authors

Journal Articles

PURPOSE: Sotatercept may represent a novel approach to the treatment of chemotherapy-induced anemia (CIA). We report the results from two phase 2 randomized studies examining the use of sotatercept for the treatment of CIA in patients with metastatic cancer. METHODS: In study A011-08, patients with metastatic breast cancer were randomized to 2:2:2:1 to receive sotatercept 0.1, 0.3, or 0.5 mg/kg, or placebo, respectively, every 28 days. In study ACE-011-NSCL-001, patients with solid tumors treated with platinum-based chemotherapy received sotatercept 15 or 30 mg every 42 days. The primary endpoint for both studies was hematopoietic response, defined as a hemoglobin (Hb) …

Nephrologists As Educators: Clarifying Roles, Seizing Opportunities, K. D. Jhaveri, M. A. Perazella

Journal Articles

Nephrologists play an important role in providing medical education in a variety of settings, including the medical school classroom, nephrology consult service, outpatient clinic, and dialysis unit. Therefore, nephrologists interact with a variety of learners. In this article the current state of published literature in medical education in nephrology is reviewed. Eight attending roles are identified of the nephrologist as a medical educator in the academic settings: inpatient internal medicine service, nephrology inpatient consult service, inpatient ESRD service, outpatient nephrology clinic, kidney transplantation, dialysis unit, classroom teacher, and research mentor. Defining each of these distinct settings could help to promote …

A Phase Ii Randomized Trial Comparing Standard And Low Dose Rituximab Combined With Alemtuzumab As Initial Treatment Of Progressive Chronic Lymphocytic Leukemia In Older Patients: A Trial Of The Ecog-Acrin Cancer Research Group (E1908), C. S. Zent, X. V. Wang, R. P. Ketterling, C. A. Hanson, E. N. Libby, J. C. Barrientos, T. G. Call, J. E. Chang, J. J. Liu, M. S. Tallman, +5 Additional Authors

Journal Articles

Chronic lymphocytic leukemia/small lymphocytic lymphoma (CLL) patients requiring initial therapy are often older and frailer and unsuitable candidates for standard chemoimmunotherapy regimens. Shorter duration combination monoclonal antibody (mAb) therapy using alemtuzumab and rituximab has been shown to be effective and tolerable treatment for CLL. Standard dose anti-CD20 mAb therapy causes loss of CD20 expression by surviving CLL cells, which can be minimized by decreasing the mAb dose. We report a randomized phase II clinical trial enrolling older (>/= 65 years) patients (median age 76 years, n=31) with treatment naive progressive CLL. Patients received 8-12 weeks of standard subcutaneous alemtuzumab …

Pulmonary Arterial Hypertension: A Current Review Of Pharmacological Management, S. Sahni, M. Ojrzanowski, S. Majewski, A. Talwar

Journal Articles

Pulmonary hypertension (PHTN) is a rare and devastating disease characterized by progressive increases in pulmonary arterial pressure and pulmonary vascular resistance, which eventually leads to right ventricular failure and death. At present there is no cure for pulmonary arterial hypertension (PAH); however over the past decade targeted pharmaceutical options have become available for the treatment of PAH. Prior to evaluation for therapeutic options a definitive diagnosis of pulmonary arterial hypertension must be made via comprehensive physical exam and definitive diagnostic testing. Screening test of choice remains echocardiography and gold standard for definitive diagnosis is right heart catheterization. Once the establishment …

Quality Measurement In Wonderland: The Curious Case Of A Dialysis Readmissions Measure, S. Fishbane, J. B. Wish

Journal Articles

The standardized readmission ratio is a new quality measure for dialysis facilities that will affect public reporting and payment beginning in 2017. Like all quality measures affecting public reporting and payment, the standardized readmission ratio was vetted by a process that included a technical expert panel convened by the US Centers for Medicare and Medicaid Services, and, then, the National Quality Forum. Unlike previous measures, standardized readmission ratio followed a tortuous path that exposed problems in the development and endorsement process. Although it is acknowledged that processes in the dialysis facility can be improved to decrease readmissions, multiple objections to …

Dietary Total Isoflavone Intake Is Associated With Lower Systolic Blood Pressure: The Coronary Artery Risk Development In Young Adults (Cardia) Study, S. I. Richardson, L. M. Steffen, K. Swett, C. Smith, L. Burke, X. Zhou, J. M. Shikany, C. J. Rodriguez

Journal Articles

The effect of dietary isoflavone intake on systolic blood pressure (SBP) has not been studied in a large community-based cohort inclusive of African Americans. The authors analyzed data from the year 20 examination of the Coronary Artery Risk Development in Young Adults (CARDIA) study, including medical history, physical examination, and dietary intake surveys for 3142 participants. Multivariable linear regression models controlled for age, sex, body mass index, smoking, physical activity, and intakes of alcohol and total energy. Effect modification by race was tested. Overall, patients with hypertension had a lower daily intake of total dietary isoflavones (2.2+/-5.2 mg/d vs 4.1+/-11.7 …

Acalabrutinib (Acp-196) In Relapsed Chronic Lymphocytic Leukemia, J. C. Byrd, B. Harrington, S. O'Brien, J. A. Jones, A. Schuh, S. Devereux, J. Chaves, W. G. Wierda, J. C. Barrientos, R. R. Furman, +20 Additional Authors

Journal Articles

Background Irreversible inhibition of Bruton's tyrosine kinase (BTK) by ibrutinib represents an important therapeutic advance for the treatment of chronic lymphocytic leukemia (CLL). However, ibrutinib also irreversibly inhibits alternative kinase targets, which potentially compromises its therapeutic index. Acalabrutinib (ACP-196) is a more selective, irreversible BTK inhibitor that is specifically designed to improve on the safety and efficacy of first-generation BTK inhibitors. Methods In this uncontrolled, phase 1-2, multicenter study, we administered oral acalabrutinib to 61 patients who had relapsed CLL to assess the safety, efficacy, pharmacokinetics, and pharmacodynamics of acalabrutinib. Patients were treated with acalabrutinib at a dose of 100 …

Angiotensin Ii Down-Regulates Nephrin-Akt Signaling And Induces Podocyte Injury: Roleof C-Abl, Q. Yang, Y. Ma, Y. Liu, W. Liang, X. Chen, Z. Ren, H. Wang, P. C. Singhal, G. Ding

Journal Articles

Recent studies have shown that nephrin plays a vital role in angiotensin II (Ang II)-induced podocyte injury and thus contributes to the onset of proteinuria and the progression of renal diseases, but its specific mechanism remains unclear. c-Abl is an SH2/SH3 domain-containing nonreceptor tyrosine kinase that is involved in cell survival and regulation of the cytoskeleton. Phosphorylated nephrin is able to interact with molecules containing SH2/SH3 domains, suggesting that c-Abl may be a downstream molecule of nephrin signaling. Here we report that Ang II-infused rats developed proteinuria and podocyte damage accompanied by nephrin dephosphorylation and minimal interaction between nephrin and …

Cf Healthcare Workers Feel Unprepared In Providing Suitable End Of Life Care And Desire More Education: Results Of A Nationwide Survey, J. Goggin, R. I. Cohen

Journal Articles

INTRODUCTION: Little is known about the depth of knowledge and preparedness of CF caregivers in delivering end of life and palliative care to CF patients and families. METHOD: Nationwide survey questionnaires for CF care providers using the CF Foundation Listserv electronic web-based tool. RESULTS: The majority of non-physician CF care providers (55%) had more than 15years of experience in their discipline and 84% of physician had greater than 15years of experience. The majority reported that they felt "somewhat" or "very" involved in palliative or end of life care in their current role. Yet, when asked whether they felt adequately prepared …

Simulation For Operational Readiness In A New Freestanding Emergency Department: Strategy And Tactics, R L. Kerner, K Gallo, M Cassara Do, J D'Angelo, A Egan, J G. Simmons

Journal Articles

© 2016 by the Society for Simulation in Healthcare. Statement Simulation in multiple contexts over the course of a 10-week period served as a core learning strategy to orient experienced clinicians before opening a large new urban freestanding emergency department. To ensure technical and procedural skills of all team members, who would provide care without on-site recourse to specialty backup, we designed a comprehensive interprofessional curriculum to verify and regularize a wide range of competencies and best practices for all clinicians. Formulated under the rubric of systems integration, simulation activities aimed to instill a shared culture of patient safety among …

Gonadal Hormones Rapidly Enhance Spatial Memory And Increase Hippocampal Spine Density In Male Rats, L. F. Jacome, K. Barateli, D. Buitrago, F. Lema, M. Frankfurt, V. N. Luine

Journal Articles

No abstract provided.

Measuring Cognitive Load: Mixed Results From A Handover Simulation For Medical Students., J. Q. Young, D. M. Irby, M.L. Barilla-Labarca, O. Ten Cate, P. S. O'Sullivan

Journal Articles

The application of cognitive load theory to workplace-based activities such as patient handovers is hindered by the absence of a measure of the different load types. This exploratory study tests a method for measuring cognitive load during handovers.The authors developed the Cognitive Load Inventory for Handoffs (CLI4H) with items for intrinsic, extraneous, and germane load. Medical students completed the measure after participating in a simulated handover. Exploratory factor and correlation analyses were performed to collect evidence for validity.Results yielded a two-factor solution for intrinsic and germane load that explained 50 % of the variance. The extraneous load items performed poorly …

Estradiol-Mediated Spine Changes In The Dorsal Hippocampus And Medial Prefrontal Cortex Of Ovariectomized Female Mice Depend On Erk And Mtor Activation In The Dorsal Hippocampus, J. J. Tuscher, V. Luine, M. Frankfurt, K. M. Frick

Journal Articles

No abstract provided.

Nurses' Knowledge Of Advance Directives And Perceived Confidence In End-Of-Life Care: A Cross-Sectional Study In Five Countries, A. Coffey, G. Mccarthy, E. Weathers, M. I. Friedman, K. Gallo, M. Ehrenfeld, S. Chan, W. H.C. Li, P. Poletti, M. Itzhaki, +4 Additional Authors

Journal Articles

No abstract provided.