Medicine and Health Sciences Commons^™

Fagerstrom Test For Nicotine Dependence Vs Heavy Smoking Index In A General Population Survey, M. Pérez-Ríos, M. I. Santiago-Pérez, B. Alonso, A. Malvar, X. Hervada, Jose De Leon

Psychiatry Faculty Publications

BACKGROUND: The Fagerström Test for Nicotine Dependence (FTND) is used for assessing nicotine dependence. A shorter test derived from the FTND used for the general population is the Heavy Smoking Index (HSI) (six questions vs. two). The objective of this study is to compare the validity of the HSI versus the FTND.

METHODS: A survey of tobacco use in the general population was carried out in the northern Spanish region of Galicia using both the FTND and the HSI to study a representative sample of 1655 daily smokers. The HSI was compared with the FTND, considered the gold standard. Measures …

Documentation Of Body Mass Index And Control Of Associated Risk Factors In A Large Primary Care Network, Stephanie A. Rose, Alexander Turchin, Richard W. Grant, James B. Meigs

Internal Medicine Faculty Publications

BACKGROUND: Body mass index (BMI) will be a reportable health measure in the United States (US) through implementation of Healthcare Effectiveness Data and Information Set (HEDIS) guidelines. We evaluated current documentation of BMI, and documentation and control of associated risk factors by BMI category, based on electronic health records from a 12-clinic primary care network.

METHODS: We conducted a cross-sectional analysis of 79,947 active network patients greater than 18 years of age seen between 7/05 - 12/06. We defined BMI category as normal weight (NW, 18-24.9 kg/m²), overweight (OW, 25-29.9), and obese (OB, ≥ 30). We measured documentation …

Resting State Default-Mode Network Connectivity In Early Depression Using A Seed Region-Of-Interest Analysis: Decreased Connectivity With Caudate Nucleus., Robyn Bluhm, Peter Williamson, Ruth Lanius, Jean Theberge, Maria Densmore, Robert Bartha, Richard Neufeld, Elizabeth Osuch

Department of Medicine Publications

AIM: Reports on resting brain activity in healthy controls have described a default-mode network (DMN) and important differences in DMN connectivity have emerged for several psychiatric conditions. No study to date, however, has investigated resting-state DMN in relatively early depression before years of medication treatment. The objective of the present study was, therefore, to investigate the DMN in patients seeking help from specialized mental health services for the first time for symptoms of depression.

METHODS: Fourteen depressed subjects and 15 matched controls were scanned using 4-T functional magnetic resonance imaging while resting with eyes closed. All but one subject was …

Hla-Dpb1 And Dpb2 Are Genetic Loci For Systemic Sclerosis: A Genome-Wide Association Study In Koreans With Replication In North Americans, Xiaodong Zhou, Jong Eun Lee, Frank C Arnett, Momiao Xiong, Min Young Park, Yeon Kyeong Yoo, Eun Soon Shin, John D Reveille, Maureen D Mayes, Jin Hyun Kim, Ran Song, Ji Yong Choi, Ji Ah Park, Yun Jong Lee, Eun Young Lee, Yeong Wook Song, Eun Bong Lee

Journal Articles

OBJECTIVE: To identify systemic sclerosis (SSc) susceptibility loci via a genome-wide association study.

METHODS: A genome-wide association study was performed in 137 patients with SSc and 564 controls from Korea using the Affymetrix Human SNP Array 5.0. After fine-mapping studies, the results were replicated in 1,107 SSc patients and 2,747 controls from a US Caucasian population.

RESULTS: The single-nucleotide polymorphisms (SNPs) (rs3128930, rs7763822, rs7764491, rs3117230, and rs3128965) of HLA-DPB1 and DPB2 on chromosome 6 formed a distinctive peak with log P values for association with SSc susceptibility (P=8.16x10(-13)). Subtyping analysis of HLA-DPB1 showed that DPB1*1301 (P=7.61x10(-8)) and DPB1*0901 (P=2.55x10(-5)) were …

Sox11 Expression Is Highly Specific For Mantle Cell Lymphoma And Identifies The Cyclin D1-Negative Subtype., Ana Mozos, Cristina Royo, Elena Hartmann, Daphne De Jong, Cristina Baró, Alexandra Valera, Kai Fu, Dennis D. Weisenburger, Jan Delabie, Shih-Sung Chuang, Elaine S. Jaffe, Carmen Ruiz-Marcellan, Sandeep Dave, Lisa Rimsza, Rita Braziel, Randy D. Gascoyne, Francisco Solé, Armando López-Guillermo, Dolors Colomer, Louis M. Staudt, Andreas Rosenwald, German Ott, Pedro Jares, Elias Campo

Journal Articles: Pathology and Microbiology

BACKGROUND: Cyclin D1-negative mantle cell lymphoma is difficult to distinguish from other small B-cell lymphomas. The clinical and pathological characteristics of patients with this form of lymphoma have not been well defined. Overexpression of the transcription factor SOX11 has been observed in conventional mantle cell lymphoma. The aim of this study was to determine whether this gene is expressed in cyclin D1-negative mantle cell lymphoma and whether its detection may be useful to identify these tumors.

DESIGN AND METHODS: The microarray database of 238 mature B-cell neoplasms was re-examined. SOX11 protein expression was investigated immunohistochemically in 12 cases of cyclin …

Chromosomal Anomalies Influence Parental Treatment Decisions In Relation To Prenatally Diagnosed Congenital Heart Disease., Sinai C. Zyblewski, Elizabeth G. Hill, Girish S. Shirali, Andrew Atz, Geoffrey Forbus, Javier Gonzalez, Anthony Hlavacek

Manuscripts, Articles, Book Chapters and Other Papers

This study aimed to identify the variables that influence parental treatment decisions after a prenatal diagnosis of congenital heart disease (CHD). The authors reviewed all cases of prenatally diagnosed structural CHD from August 1998 to December 2006 at their center. The following variables were studied as potential predictors of parental intent to treat: maternal age, race, insurance status, obstetric history, fetal gender, univentricular versus biventricular cardiac physiology, and fetal chromosomal abnormality. Uni- and multivariable logistic regression analyses were performed. In the review, 252 consecutive cases of prenatally diagnosed CHD were identified. Of these, 204 women pursued full medical treatment, whereas …

Antidepressant-Induced Mania With Concomitant Mood Stabilizer In Patients With Comorbid Substance Abuse And Bipolar Disorder., Daniel Z Lieberman, George Kolodner, Suena H Massey, Kenneth P Williams

Psychiatry and Behavioral Sciences Faculty Publications

Antidepressant use in the treatment of bipolar disorder is controversial due the risks of affective switching and cycle acceleration. Studies of non-comorbid samples suggest that the risk can be mitigated with the use of a concomitant mood stabilizer. However, the majority of patients with bipolar disorder will experience a comorbid substance use disorder and little is known about these individuals because they are typically excluded from clinical trials. Patients entering a substance abuse treatment program who had a history of bipolar disorder were interviewed to evaluate antidepressant-induced affective switching with and without concomitant mood stabilizer. Among 41 comorbid participants, the …

Adapting To Dynamic Stimulus-Response Values: Differential Contributions Of Inferior Frontal, Dorsomedial, And Dorsolateral Regions Of Prefrontal Cortex To Decision Making., Derek G V Mitchell, Qian Luo, Shelley B Avny, Tomasz Kasprzycki, Karanvir Gupta, Gang Chen, Elizabeth C Finger, R James R Blair

Brain and Mind Institute Researchers' Publications

Dorsomedial prefrontal cortex (dmPFC), dorsolateral prefrontal cortex (dlPFC), and inferior frontal gyrus (IFG) have all been implicated in resolving decision conflict whether this conflict is generated by having to select between responses of similar value or by making selections following a reversal in reinforcement contingencies. However, work distinguishing their individual functional contributions remains preliminary. We used functional magnetic resonance imaging to delineate the functional role of these systems with regard to both forms of decision conflict. Within dmPFC and dlPFC, blood oxygen level-dependent responses increased in response to decision conflict regardless of whether the conflict occurred in the context of …

Women Bound To Be Active: One Year Follow-Up To An Innovative Pilot Intervention To Increase Physical Activity And Self-Worth In Women, Jennifer L. Huberty, Jamie Vener, Laura Schulte, Sara M. Roberts, Beth Stevens, Lynda Ransdell

Kinesiology Faculty Publications and Presentations

The purpose of this investigation was to assess the effectiveness of a lifestyle intervention (a women’s book club; Women Bound to be Active) in promoting long-term physical activity (PA). Thirty-five women (26-70 years; mean age 50.6 years) completed the 8-month intervention and participated in the one-year follow-up. At follow-up, PA returned to baseline levels; however, self-worth and body mass index significantly improved. Women were more knowledgeable about PA at follow-up; however, they failed to maintain PA after the intervention. Components of the intervention were effective in improving self-worth and lowering BMI at one-year follow-up. To enhance long-term PA adherence continued …

The Effects Of Shoe Traction And Obstacle Height On Lower Extremity Coordination Dynamics During Walking., Leslie Decker, Jeremy J. Houser, John M. Noble, Gregory M. Karst, Nicholas Stergiou

Journal Articles: Physical Therapy

This study aims to investigate the effects of shoe traction and obstacle height on lower extremity relative phase dynamics (analysis of intralimb coordination) during walking to better understand the mechanisms employed to avoid slippage following obstacle clearance. Ten participants walked at a self-selected pace during eight conditions: four obstacle heights (0%, 10%, 20%, and 40% of limb length) while wearing two pairs of shoes (low and high traction). A coordination analysis was used and phasing relationships between lower extremity segments were examined. The results demonstrated that significant behavioral changes were elicited under varied obstacle heights and frictional conditions. Both decreasing …

Jnk1 Activation Predicts The Prognostic Outcome Of The Human Hepatocellular Carcinoma, Qingshan Chang, Jianguo Chen, Kevin J. Beezhold, Vince Castranova, Xianglin Shi, Fei Chen

Toxicology and Cancer Biology Faculty Publications

BACKGROUND: Hepatocellular carcinoma (HCC) is one of the most common cancers worldwide with an extremely poor prognosis. The classification of HCC based on the molecular signature is not well-established.

RESULTS: In the present study, we reported HCC signature genes based on the JNK1 activation status in 31 HCC specimens relative to the matched distal noncancerous liver tissue from 31 patients. The HCCs with high JNK1 (H-JNK1) and low JNK1 (L-JNK1) were sub-grouped. Two different signature gene sets for both H-JNK1 and L-JNK1 HCC were identified through gene expression profiling. A striking overlap of signature genes was observed between the H-JNK1 …

Aging And Environmental Exposures Alter Tissue-Specific Dna Methylation Dependent Upon Cpg Island Context, Brock C. Christensen, E Andres Houseman, Carmen J. Marsit, Shichun Zheng, Margaret R. Wrensch, Joseph L. Wiemels, Heather H. Nelson, Margaret R. Karagas

Dartmouth Scholarship

Epigenetic control of gene transcription is critical for normal human development and cellular differentiation. While alterations of epigenetic marks such as DNA methylation have been linked to cancers and many other human diseases, interindividual epigenetic variations in normal tissues due to aging, environmental factors, or innate susceptibility are poorly characterized. The plasticity, tissue-specific nature, and variability of gene expression are related to epigenomic states that vary across individuals. Thus, population-based investigations are needed to further our understanding of the fundamental dynamics of normal individual epigenomes. We analyzed 217 non-pathologic human tissues from 10 anatomic sites at 1,413 autosomal CpG loci …

Dynamic Mechanical (Brush) Allodynia In Cluster Headache: A Prevalence Study In A Tertiary Headache Clinic., Michael J Marmura, Muhammad Abbas, Avi Ashkenazi

Department of Jefferson Headache Center papers and presentations

Cutaneous allodynia (CA) has been described in migraine and has been related to treatment failure. There are little data about the incidence of CA in other primary headache syndromes such as cluster headache (CH). The objectives of this study are to evaluate the prevalence of dynamic mechanical (brush) allodynia (BA) in CH patients attending a tertiary headache clinic, and to assess its relation to disease characteristics. Adult patients with episodic or chronic CH were recruited. We obtained demographic data and data on disease characteristics through a structured questionnaire, and tested the patients for brush allodynia BA by applying a 4 …

Food Insecurity Among Homeless And Marginally Housed Individuals Living With Hiv/Aids In San Francisco, Sheri D. Weiser, David R. Bangsberg, Susan Kegeles, Kathleen Ragland, Margot B. Kushel, Edward A. Frongillo Jr.

Faculty Publications

Food insecurity is a risk factor for both HIV transmission and worse HIV clinical outcomes. We examined the prevalence of and factors associated with food insecurity among homeless and marginally housed HIV-infected individuals in San Francisco recruited from the Research on Access to Care in the Homeless Cohort. We used multiple logistic regression to determine socio-demographic and behavioral factors associated with food insecurity, which was measured using the Household Food Insecurity Access Scale. Among 250 participants, over half (53.6%) were food insecure. Higher odds of food insecurity was associated with being white, low CD4 counts, recent crack use, lack of …

Perirhinal Cortex Contributes To Accuracy In Recognition Memory And Perceptual Discriminations., Edward B O'Neil, Anthony D Cate, Stefan Köhler

Brain and Mind Institute Researchers' Publications

The prevailing view of the medial temporal lobe (MTL) holds that its structures are dedicated to long-term declarative memory. Recent evidence challenges this position, suggesting that perirhinal cortex (PRc) in the MTL may also play a role in perceptual discriminations of stimuli with substantial visual feature overlap. Relevant neuropsychological findings in humans have been inconclusive, likely because studies have relied on patients with large and variable MTL lesions. Here, we conducted a functional magnetic resonance imaging study in healthy individuals to determine whether PRc shows a performance-related involvement in perceptual oddball judgments that is comparable to its established role in …

Epidemiology And Outcomes Of Candidemia In 2019 Patients: Data From The Prospective Antifungal Therapy Alliance Registry., David L Horn, Dionissios Neofytos, Elias J Anaissie, Jay A Fishman, William J Steinbach, Ali J Olyaei, Kieren A Marr, Michael A Pfaller, Chi-Hsing Chang, Karen M Webster

Jefferson Hospital Staff Papers and Presentations

BACKGROUND: Candidemia remains a major cause of morbidity and mortality in the health care setting, and the epidemiology of Candida infection is changing.

METHODS: Clinical data from patients with candidemia were extracted from the Prospective Antifungal Therapy (PATH) Alliance database, a comprehensive registry that collects information regarding invasive fungal infections. A total of 2019 patients, enrolled from 1 July 2004 through 5 March 2008, were identified. Data regarding the candidemia episode were analyzed, including the specific fungal species and patient survival at 12 weeks after diagnosis.

RESULTS: The incidence of candidemia caused by non-Candida albicans Candida species (54.4%) was higher …

A Retrospective Claims Analysis Of Combination Therapy In The Treatment Of Adult Attention-Deficit/Hyperactivity Disorder (Adhd), Gerhardt M. Pohl, David L. Van Brunt, Wenyu Ye, William W. Stoops, Joseph A. Johnston

Behavioral Science Faculty Publications

BACKGROUND: Combination therapy in managing psychiatric disorders is not uncommon. While combination therapy has been documented for depression and schizophrenia, little is known about combination therapy practices in managing attention-deficit/hyperactivity disorder (ADHD). This study seeks to quantify the combination use of ADHD medications and to understand predictors of combination therapy.

METHODS: Prescription dispensing events were drawn from a U.S. national claims database including over 80 managed-care plans. Patients studied were age 18 or over with at least 1 medical claim with a diagnosis of ADHD (International Classification of Diseases, Ninth Revision, Clinical Modification [ICD-9-CM] code 314.0), a pharmacy claim for …

Cancer Information-Seeking Experiences: The Implications Of Hispanic Ethnicity And Spanish Language, Robin C. Vanderpool, Julie Kornfeld, Lila Finney Rutten, Linda Squiers

Health, Behavior & Society Faculty Publications

BACKGROUND: Strategies to support cancer information-seeking among Hispanics are needed.

METHODS: We analyzed data from the 2005 Health Information National Trends Survey (HINTS) to explore cancer information-seeking experiences among respondents according to ethnicity and language of interview.

RESULTS: Over 80% of Spanish-speaking Hispanics had never looked for cancer information. Compared to English-speaking respondents, Spanish-speaking Hispanics who sought cancer information indicated their search took a lot of effort (67%), was hard to understand (54%), and frustrating (42%). Spanish-speaking Hispanics noted minimal confidence in obtaining cancer information.

CONCLUSIONS: Language and cultural differences must be considered in the design, implementation, and dissemination of …

State Infant Mortality: An Ecologic Study To Determine Modifiable Risks And Adjusted Infant Mortality Rates., David A. Paul. Md, Amy Mackley, Rnc, Robert G. Locke, Do, John L. Stefano, Md, Charlan Kroelinger, Phd

Department of Pediatrics Faculty Papers

OBJECTIVE: To determine factors contributing to state infant mortality rates (IMR) and develop an adjusted IMR in the United States for 2001 and 2002. DESIGN/METHODS: Ecologic study of factors contributing to state IMR. State IMR for 2001 and 2002 were obtained from the United States linked death and birth certificate data from the National Center for Health Statistics. Factors investigated using multivariable linear regression included state racial demographics, ethnicity, state population, median income, education, teen birth rate, proportion of obesity, smoking during pregnancy, diabetes, hypertension, cesarean delivery, prenatal care, health insurance, self-report of mental illness, and number of in-vitro fertilization …

Long-Term Survival After Multidisciplinary Management Of Resected Pancreatic Adenocarcinoma., Matthew H G Katz, Huamin Wang, Jason B Fleming, Charlotte C Sun, Rosa F Hwang, Robert A Wolff, Gauri Varadhachary, James L Abbruzzese, Christopher H Crane, Sunil Krishnan, Jean-Nicolas Vauthey, Eddie K Abdalla, Jeffrey E Lee, Peter W T Pisters, Douglas B Evans

Journal Articles

INTRODUCTION: Actual 5-year survival rates of 10-18% have been reported for patients with resected pancreatic adenocarcinoma (PC), but the use of multimodality therapy was uncommon in these series. We evaluated long-term survival and patterns of recurrence in patients treated for PC with contemporary staging and multimodality therapy.

METHODS: We analyzed 329 consecutive patients with PC evaluated between 1990 and 2002 who underwent resection. Each received a multidisciplinary evaluation and a standard operative approach. Pre- or postoperative chemotherapy and/or chemoradiation were routine. Surgical specimens of 5-year survivors were re-reviewed. A multivariate model of factors associated with long-term survival was constructed.

RESULTS: …

Factors Associated With Receipt Of Preventive Dental Treatment Procedures Among Adult Patients At A Dental Training School In Wisconsin, 2001-2002, Christopher Okunseri, Ruta Bajorunaite, Jessica Mehta, Brian D. Hodgson, Anthony Iacopino

School of Dentistry Faculty Research and Publications

Background: Gender differences in oral health-related quality of life and the fear of dental pain in seeking and receiving preventive dental care have been recognized and documented. Preventive dental treatment procedures (PDTPs) are commonly accepted as the primary approach to prevent dental disease.
Objective: We examined whether the likelihood of receiving PDTPs differed by gender in adult patients receiving dental care at a dental training institution in Milwaukee, Wisconsin.
Methods: Data from the Marquette University School of Dentistry electronic patient management database for 2001 through 2002 were analyzed. Descriptive, bivariate, and multivariable analyses were performed. The preventive procedures used in …

Thoracoscopy In Children: Is A Chest Tube Necessary?, Todd A. Ponsky, Steven S. Rothenberg, Kuojen Tsao, Daniel J. Ostlie, Shawn D. St Peter, G W. Holcomb Iii

Manuscripts, Articles, Book Chapters and Other Papers

PURPOSE: Historically, a chest tube or drain has been left following a thoracic operation to allow drainage of air or fluid in the postoperative period. However, in patients undergoing thoracoscopy, the tube is often the greatest source of postoperative pain. We began excluding chest tubes several years ago and therefore are reviewing our experience to evaluate the safety and efficacy of this approach.

METHODS: A retrospective review of the medical record was performed on patients undergoing thoracoscopy at two centers from 1993 to 2007. Patients who left the operating room without a chest tube were included in this series. Patient …

Laparoscopic Duodenojejunostomy For Superior Mesenteric Artery Syndrome., Jason D. Fraser, Shawn D. St Peter, Jenevieve H. Hughes, James M. Swain

Manuscripts, Articles, Book Chapters and Other Papers

BACKGROUND: Superior mesenteric artery (SMA) syndrome, also called Wilkie's syndrome, is a rare clinical phenomenon believed to be caused by compression of the third portion of the duodenum by the overlying superior mesenteric artery. We present the case of a 32-year-old female who presented with epigastric pain, weight loss, and vomiting.

METHODS: Her workup included a normal upper endoscopy as well as an abdominal CT scan and upper GI contrast study that confirmed the diagnosis of superior mesenteric artery syndrome. The patient was taken to the operating room and underwent successful treatment with laparoscopic duodenojejunostomy.

RESULTS: The patient achieved complete …

Adult And Child Semantic Neighbors Of The Kroll And Potter (1984) Nonobjects, Holly L. Storkel, Suzanne M. Adlof

Faculty Publications

Purpose - The purpose was to determine the number of semantic neighbors, namely semantic set size, for 88 nonobjects (J. F. Kroll & M. C. Potter, 1984) and determine how semantic set size related to other measures and age.

Method - Data were collected from 82 adults and 92 preschool children in a discrete association task. The nonobjects were presented via computer, and participants reported the first word that came to mind that was meaningfully related to the nonobject. Words reported by two or more participants were considered semantic neighbors. The strength of each neighbor was computed as the …

Comorbidities, Patient Knowledge, And Disease Management In A National Sample Of Patients With Copd, R Graham Barr, Bartolome R Celli, David M Mannino, Thomas Petty, Stephen I Rennard, Frank C Sciurba, James K Stoller, Byron M Thomashow, Gerard M Turino

Journal Articles

OBJECTIVE: Chronic obstructive pulmonary disease (COPD) is the fourth leading cause of death in the United States but is often undertreated. COPD often overlaps with other conditions such as hypertension and osteoporosis, which are less morbid but may be treated more aggressively. We evaluated the prevalence of these comorbid conditions and compared testing, patient knowledge, and management in a national sample of patients with COPD.

METHODS: A survey was administered by telephone in 2006 to 1003 patients with COPD to evaluate the prevalence of comorbid conditions, diagnostic testing, knowledge, and management using standardized instruments. The completion rate was 87%.

RESULTS: …

Trends In Mental Health Of An Adolescent Medicine Clinic Patient Population, Abdel Salous, Linah Al-Alem, Hatim A. Omar

Pediatrics Faculty Publications

The correlation between exposure to forms of violence and development of mental disorders in victims is well established. The purpose of this paper was to identify mental health problems in an adolescent medicine clinic population in Lexington, KY and to investigate potential correlation of mental disorders with psychosocial factors. Data were gathered from the charts of 169 adolescent clinic patients (age 10-22) seen in the clinic for mental health care and analyzed using Excel. Of the patient population, 68% were urban, whereas 32% were rural. In terms of gender, 40% of the patients were male and 60% were female, 80% …

Antibiotic Resistance In Staphylococcus Aureus-Containing Cutaneous Abscesses Of Patients With Hiv, Gus W Krucke, Deanna E Grimes, Richard M Grimes, Thai D Dang

Journal Articles

PURPOSE: The aim of this study was to document the resistance patterns found in exudates from cutaneous abscesses of HIV-infected persons.

BASIC PROCEDURES: Patient records were reviewed on 93 culture and sensitivity tests performed on exudates taken from incised and drained abscesses of HIV-infected persons.

MAIN FINDINGS: Of the specimens, 84.6% were Staphylococcus aureus. Of these, 93.5% were penicillin resistant, 87% oxacillin resistant, 84.4% cephazolin resistant, 84.4% erythromycin resistant, 52.2% ciprofloxacin resistant, and 15.6% tetracycline resistant. Fifty-eight specimens were tested for clindamycin with 29.3% found resistant; 85.7% were methicillin-resistant S aureus (MRSA) (defined as resistant to both penicillin G and …

Lymphocyte Proliferation To Mycobacterial Antigens Is Detectable Across A Spectrum Of Hiv-Associated Tuberculosis, Timothy Lahey, Mecky Matee, Lillian Mtei, Muhammad Bakari, Kisali Pallangyo, C Fordham Von Reyn

Dartmouth Scholarship

Background:

Identifying novel TB diagnostics is a major public health priority. We explored the diagnostic characteristics of antimycobacterial lymphocyte proliferation assays (LPA) in HIV-infected subjects with latent or active TB.

Methods:

HIV-infected subjects with bacille Calmette Guérin (BCG) scars and CD4 counts ≥ 200 cells/mm³ entering a TB booster vaccine trial in Tanzania had baseline in vivo and in vitro immune tests performed: tuberculin skin tests (TST), LPA and five day assays of interferon gamma (IFN-γ) release. Assay antigens were early secreted antigenic target 6 (ESAT-6), antigen 85 (Ag85), and Mycobacterium tuberculosis whole cell lysate (WCL). Subjects were screened …

Multimodality Education For Airway Endoscopy Skill Development., Ellen S. Deutsch, Thomas Christenson, Joseph Curry, Jobayer Hossain, Karen Zur, Ian Jacobs

Department of Otolaryngology - Head and Neck Surgery Faculty Papers

OBJECTIVES: Airway endoscopy is a difficult skill to master. A unique practicum was designed to help otolaryngology residents develop endoscopy skills. The learning modalities included lectures, an animal laboratory, high-fidelity manikins, virtual bronchoscopy simulation, and standardized patients. This study compares the relative subjective value of these learning modalities for skill development and realism. METHODS: Participants used a Likert scale (1=disagree to 5=agree) and open responses to anonymously rate the efficacy of 5 learning modalities for teaching airway management, endoscopy skills, and clinical leadership and for providing a realistic experience. RESULTS: The results in 2007 were uniformly positive, with mean scores …

Cryptococcosis Of The Upper Genital Tract., Manish Gopal, Stacy Mccrosson, Pamela Edmonds, Thomas Klein

Department of Obstetrics and Gynecology Faculty Papers

Upper genital tract infection by Cryptococcus neoformans has not previously been reported. We describe such a case, in order to alert clinicians to the existence of this rare infection. A 34-year-old woman with AIDS presented with chronic menorrhagia, fever, anemia, and thrombocytopenia. Despite blood transfusions and hormonal therapy, her vaginal bleeding could not be controlled and she became hemodynamically unstable. Total abdominal hysterectomy and bilateral salpingo-oophorectomy were performed, at which time granulomatous peritonitis and prominent myometrial blood vessels were found. Histologic examination revealed cryptococcal infection of all upper genital organs. This case demonstrates that disseminated cryptococcosis may involve the upper …