Medicine and Health Sciences Commons^™

High Isoniazid Resistance Rates In Rifampicin Susceptible Mycobacterium Tuberculosis Pulmonary Isolates From Pakistan, Naima Fasih, Yasraba Rafiq, Kausar Jabeen, Rumina Hasan

Department of Pathology and Laboratory Medicine

Background:
Rapid new diagnostic methods (including Xpert MTB/RIF assay) use rifampicin resistance as a surrogate marker for multidrug resistant tuberculosis. Patients infected with rifampicin susceptible strains are prescribed first line anti-tuberculosis therapy. The roll out of such methods raises a concern that strains with resistance to other first line anti-tuberculosis drugs including isoniazid will be missed and inappropriate treatment given. To evaluate implications of using such methods review of resistance data from high burden settings such as ours is essential.
Objective:
To determine resistance to first line anti-tuberculosis drugs amongst rifampicin susceptible pulmonary Mycobacterium tuberculosis (MTB) isolates from Pakistan.
Material …

Outcome Of Match Related Allogeneic Stem Cell Transplantation Procedures Performed From 2004 Till 2011, Natasha Ali, Salman Naseem Adil, Mohammad Usman Shaikh, Munira Moosajee, Nehal Masood

Department of Pathology and Laboratory Medicine

We present our initial experience of allogeneic stem cell transplant procedure performed between April 2004 and August 2011 for various haematological disorders. All patients with non-malignant and malignant haematological disorders with HLA matched donors were selected after pre-transplant workup. Ninety seven patients underwent the procedure. Most common indications for transplant were aplastic anaemia in n=34 (35%), followed by beta-Thalassemia major in n=21 (21.6%) and chronic myeloid leukemia in n=11 patients (11.3%). Primary graft failure present was present in 2.06%. Incidence of graft versus host disease (GvHD) in our patients was 34%. After median follow-up of five years the overall survival …

Facial Fracture Management: Operative Trends, Ramon Garza, Iii Md, Joshua M. Adkinson Md, Jarom N. Gilstrap Md, Sherrine Eid Mph, Robert X. Murphy Jr, Md, Ms

Department of Surgery

No abstract provided.

Radioactive Counts And Sentinel Node Positivity In Breast Cancer Patients; A Single Surgeon’S Longitudinal Experience, Daniel F. Barnas Md, Aaron D. Bleznak Md, Facs

Department of Surgery

No abstract provided.

The Influence Of Federally Qualified Health Centers On Selected Ambulatory Care Sensitive Conditions In Georgia, Mary W. King Mathis

Electronic Theses and Dissertations

Author's Abstract: Ambulatory care sensitive conditions (ACSCs) resulting in hospitalizations make up a substantial proportion of health care costs, but should not because these conditions are manageable in quality primary care settings that promote prevention in an effort to avoid exacerbations that can lead to hospitalization. The use of emergency departments (EDs) as a safety net for ACSCs has increased the burden on hospitals because patients who do not regularly utilize primary care often resort to the use of EDs for treatment of ACSCs. Federally qualified health centers (FQHCs) are designed to provide consistent, high-quality primary care to all people, …

Beyond Traditional Notions Of Validity: Selecting Appropriate Measures For Occupational Therapy Practice., Andrew Johnson, Briana Zur, Eric Roy, Debbie Laliberte-Rudman, Jennie Wells

Andrew M. Johnson

Increasingly, tied to factors such as increased emphasis on accountability and health care spending restraints, occupational therapists are required to implement evidence-based practice. When implementing evidence-based assessment, it is critical that occupational therapists examine and challenge some of the assumptions underlying the current use of measures, as well as the conclusions being drawn from their use. In order to most effectively judge the appropriateness of measures informing their assessments, interventions and recommendations, occupational therapists must draw upon measurement theory and concepts. To date, occupational therapy literature has predominantly emphasized a narrow conceptualization of validity that focuses on empirical evidence. The …

Bilateral Supernumerary Sternocleidomastoid Heads With Critical Narrowing Of The Minor And Major Supraclavicular Fossae: Clinical And Surgical Implications, Athanasios Raikos, George Paraskevas, Stefanos Triaridis, Panagiota Kordali, George Psillas, Beate Brand-Saberi

Athanasios Raikos

Extract: Anatomical variations of the sternocleidomastoid muscle are rare and concern its origin, insertion, and the number of heads. We report on a rare bilateral variant of the sternocleidomastoid muscle with aberrant and supernumerary muscular heads, observed in a cadaveric subject. On the right side of the neck, a typical sternomastoid head of the sternocleidomastoid muscle, and three aberrant clavicular heads of variable thickness, origin, and termination were noticed. On the left side, two sternomastoid heads were present; the medial one was of typical pattern, while the lateral was supernumerary. The cleidomastoid portion of the left sternocleidomastoid muscle was fused …

Long-Term Outcome Of Breast Cancer Patients With One To Two Nodes Involved-Application Of Nodal Ratio, Patricia Tai, Kurian Joseph, Ali El-Gayed, Edward Yu

Edward Yu

Abstract: Nodal ratio (NR) is defined as the number of involved nodes to the number of nodes examined. There is limited information on the application of NR on population data. Previous reports in breast cancer generally analyzed one to three positive axillary nodes as a single group. This study investigates whether one to three positive axillary nodes is a homogeneous group in prognosis by comparing one to two positive nodes to three positive nodes. The population-based registry of a Canadian province from 1981 through 1995 was searched. As the reliability of nodal assessment depends on the number of nodes sampled, …

Dialysis Rationing And The Just Allocation Of Resources: A Historical Primer., Teri Browne

Teri Browne

No abstract provided.

A Prospective Study Of Physician-Observed Concussion During A Varsity University Hockey Season: Incidence And Neuropsychological Changes, Paul Echlin, Elaine Skopelja, Rachel Worsley, Shiroy Dadanchanji, Rob Lloyd-Smith, Jack Taunton, Lorie Forwell, Andrew Johnson

Andrew M. Johnson

Object. The primary objective of this study was to measure the incidence of concussion according to a relative number of athlete exposures among 25 male and 20 female varsity ice hockey players. The secondary objective was to present neuropsychological test results between preseason and postseason play and at 72 hours, 2 weeks, and 2 months after concussion. Methods. Every player underwent baseline assessments using the Sport Concussion Assessment Tool-2 (SCAT2), Immediate Post-Concussion Assessment and Cognitive Test (ImPACT), and MRI. Each regular season and postseason game was observed by 2 independent observers (a physician and a nonphysician observer). Players with a …

A Prospective Study Of Physician-Observed Concussion During A Varsity University Hockey Season: Metabolic Changes In Ice Hockey Players., Emilie Chamard, Hugo Theoret, Elaine Skopelja, Lorie Forwell, Andrew Johnson, Paul Echlin

Andrew M. Johnson

Object. Despite negative neuroimaging findings using traditional neuroimaging methods such as MRI and CT, sports-related concussions have been shown to cause neurometabolic changes in both the acute and subacute phases of head injury. However, no prospective clinical study has used an independent physician-observer design in the monitoring of these changes. The objective of this study was to evaluate the effects of repetitive concussive and subconcussive head impacts on neurometabolic concentrations in a prospective study of two Canadian Interuniversity Sports (CIS) ice hockey teams using MR spectroscopy (MRS). Methods. Forty-five ice hockey players (25 men and 20 women) participated in this …

Cutaneous Manifestations Of Internal Malignancy: A Case-Based Lesson, Timothy Beer

Timothy C Beer

A case-based lesson covering 10 cutaneous manifestations associated with internal malignancies.

A Prospective Study Of Physician-Observed Concussion During A Varsity University Hockey Season: White Matter Integrity In Ice Hockey Players, Inga Koerte, David Kaufmann, Elisabeth Hartl, Sylvain Bouix, Ofer Pasternak, Marek Kubicki, Alexander Rauscher, David Li, Shiroy Dadachanji, Jack Taunton, Lorie Forwell, Andrew Johnson, Paul Echlin, Martha Shenton

Andrew M. Johnson

Object. The aim of this study was to investigate the effect of repetitive head impacts on white matter integrity that were sustained during 1 Canadian Interuniversity Sports (CIS) ice hockey season, using advanced diffusion tensor imaging (DTI). Methods. Twenty-five male ice hockey players between 20 and 26 years of age (mean age 22.24 ± 1.59 years) participated in this study. Participants underwent pre- and postseason 3-T MRI, including DTI. Group analyses were performed using paired-group tract-based spatial statistics to test for differences between preseason and postseason changes. Results. Tract-based spatial statistics revealed an increase in trace, radial diffusivity (RD), and …

Oral Nifedipine Versus Intravenous Labetalol For Acute Blood Pressure Control In Hypertensive Emergencies Of Pregnancy: A Randomised Trial, Siti Zawiah Omar

Siti Zawiah Omar

Objective To compare oral nifedipine with intravenous labetalol in their rapidity to control hypertensive emergencies of pregnancy. Design A double-blind randomised trial. Setting A university hospital in Malaysia. Population Pregnant women with severe gestational hypertension >= 160/110 mmHg who required immediate treatment. Methods Patients were randomised to receive nifedipine (10 mg tablet, orally, up to five doses) and intravenous placebo saline injection or intravenous labetalol injection (in an escalating dose regimen of 20, 40, 80, 80 and 80 mg) and a placebo tablet every 15 minutes until the target blood pressure of <= 150/100 mmHg was achieved. Crossover treatment was effected if the initial treatment regimen was unsuccessful. Main outcome measure The time taken to achieve a blood pressure of <= 150/100 mmHg. Results The median time taken to achieve target blood pressure was 30 minutes (interquartile range, IQR 22.5-67.5 minutes) versus 45 minutes (IQR 30-60 minutes) for nifedipine and labetalol, respectively (P = 0.59). Repeated measures analysis of variance indicated that in the first hour both systolic (F = 87.6, P < 0.001) and diastolic (F = 55.8, P < 0.001) blood pressure significantly decreased, but there was no difference between the nifedipine and labetalol groups for both systolic (F = 0.12, P = 0.74) and diastolic (F = 0.92, P = 0.34) blood pressure trends over time. Crossover treatment was required in 20% of women from each group. Conclusions Oral nifedipine and intravenous labetalol regimens are similarly effective in the acute control of severe hypertension in pregnancy.

Parents, Peers And Pornography: The Influence Of Formative Sexual Scripts On Adult Hiv Sexual Risk Behaviour Among Black Men In The Usa, Sophia A. Hussen, Lisa Bowleg, Thurka Sangaramoorthy, David J. Malebranche

David J Malebranche

Black men in the USA experience disproportionately high rates of HIV infection, particularly in the Southeastern part of the country. We conducted 90 qualitative in-depth interviews with Black men living in the state of Georgia and analysed the transcripts using Sexual Script Theory to: (1) characterise the sources and content of sexual scripts that Black men were exposed to during their childhood and adolescence and (2) describe the potential influence of formative scripts on adult HIV sexual risk behaviour. Our analyses highlighted salient sources of cultural scenarios (parents, peers, pornography, sexual education and television), interpersonal scripts (early sexplay, older female …

Bilateral Medial Medullary Infarction: A Systematic Review, Gustavo Saposnik

Gustavo Saposnik

No abstract provided.

Unmasking The Benefits Of B Vitamins In Stroke Prevention, Gustavo Saposnik

Gustavo Saposnik

No abstract provided.

Interpersonal Pathoplasticity In The Course Of Major Depression, Nicole M. Cain, Emily B. Ansell, Aidan G. C. Wright, Christopher J. Hopwood, Katherine M. Thomas, Anthony Pinto, John C. Markowitz, Charles A. Sanislow, Mary C. Zanarini, M. Tracie Shea, Leslie C. Morey, Thomas H. Mcglashan, Andrew E. Skodol, Carlos M. Grilo

Charles A. Sanislow, Ph.D.

Objective: The identification of reliable predictors of course in major depressive disorder (MDD) has been difficult. Evidence suggests that the co-occurrence of personality pathology is associated with longer time to MDD remission. Interpersonal pathoplasticity, the mutually influencing nonetiological relationship between psychopathology and interpersonal traits, offers an avenue for examining specific personality vulnerabilities that may be associated with depressive course. Method: This study examined 312 participants with and without a cooccurring personality disorder diagnosis who met criteria for a current MDD episode at baseline and who were followed for 10 years in the Collaborative Longitudinal Personality Disorders Study. Results: Latent profile …

Meta-Analysis Of Studies Incorporating The Interests Of Young Children With Autism Spectrum Disorders Into Early Intervention Practices, Carl J. Dunst, Carol M. Trivette, Deborah W. Hamby

Carol M. Trivette

The Life Of John Wishart (1850-1926): Study Of An Academic Surgical Career Prior To The Flexner Report., Emily Claydon, Vivian C. Mcalister

Vivian C. McAlister

BACKGROUND: The 1910 Flexner Report on Medical Education in the United States and Canada is often taken as the point when medical schools in North America took on their modern form. However, many fundamental advances in surgery, such as anesthesia and asepsis, predated the report by decades. To understand the contribution of educators in this earlier period, we investigated the forgotten career of John Wishart, founding Professor of Surgery at Western University, London Ontario.

METHODS: Archives at the University of Western Ontario, University of Toronto, London City Library, and Wellington County Museum were searched for material about Wishart and his …

Optimal Strategy For Prophylactic Cranial Irradiation In Limited Stage Small Cell Lung Cancer, Edward Yu, Patricia Tai, Avi Assouline, Kurian Joseph

Edward Yu

No abstract provided.