Medicine and Health Sciences Commons^™

Clinical Characteristics Of Children With Epilepsy Managed At An Urban Hospital In Africa: A Retrospective Study, Pauline Samia, Arwen Barr, Subira B. Levi, Kirsten A. Donald, Jo M. Wilmshurst, Charles R. Newton

Paediatrics and Child Health, East Africa

Background: Most children with epilepsy reside in resource-limited regions such as sub-Saharan Africa, where the majority of studies have been conducted in rural areas with limited investigations. Medical records from children with epilepsy seen at an urban hospital in Kenya were examined to provide a comprehensive description of epilepsy in children from this hospital.
Methods: A retrospective observational study was conducted which involved reviewing medical records of 426 epilepsy patients (260 males and 166 females) aged 0 - 18 years, seen in Nairobi, Kenya between February 2011 and December 2014. Results: The most frequent age at presentation; documented in 29% …

Clostridium Difficile In Asia: Opportunities For One Health Management, Deirdre A. Collins, Thomas V. Riley

Research outputs 2014 to 2021

Clostridium difficile is a ubiquitous spore-forming bacterium which causes toxin-mediated diarrhoea and colitis in people whose gut microflora has been depleted by antimicrobial use, so it is a predominantly healthcare-associated disease. However, there are many One Health implications to C. difficile, given high colonisation rates in food production animals, contamination of outdoor environments by use of contaminated animal manure, increasing incidence of community-associated C. difficile infection (CDI), and demonstration of clonal groups of C. difficile shared between human clinical cases and food animals. In Asia, the epidemiology of CDI is not well understood given poor testing practices in many countries. …

New Statistical Method Identifies Cytokines That Distinguish Stool Microbiomes., Dake Yang, Jethro Johnson, Xin Zhou, Elena Deych, Berkley Shands, Blake Hanson, Erica Sodergren, George M. Weinstock, William D Shannon

Faculty Research 2019

Regressing an outcome or dependent variable onto a set of input or independent variables allows the analyst to measure associations between the two so that changes in the outcome can be described by and predicted by changes in the inputs. While there are many ways of doing this in classical statistics, where the dependent variable has certain properties (e.g., a scalar, survival time, count), little progress on regression where the dependent variable are microbiome taxa counts has been made that do not impose extremely strict conditions on the data. In this paper, we propose and apply a new regression model …

Cholangiocarcinoma Presenting As Humoral Hypercalcemia Of Malignancy: A Case Report And Literature Review, Burak Erdinc, Preethi Ramachandran, Ruchi Yadav, Sonu Sahni, Gardith Joseph

Touro College of Osteopathic Medicine (New York) Publications and Research

Humoral hypercalcemia of malignancy (HHM) is most commonly encountered in squamous cell carcinoma (SCC) of different organs, and It is characterized by elevated parathyroid hormone-related peptide (PTHrP) levels. It may be seen as a manifestation of cholangiocarcinoma (CCC) at presentation and later in the course of the disease. However, HHM due to intrahepatic cholangiocarcinoma is a rare association and is associated with a poor prognosis. We herein report a case of hypercalcemia presenting as the first manifestation of an underlying rare variant of intrahepatic cholangiocarcinoma. Our patient is a 57-year-old male who presented to the emergency room with severe symptoms …

Collagen Fibrils And Proteoglycans Of Peripheral And Central Stroma Of The Keratoconus Cornea - Ultrastructure And 3d Transmission Electron Tomography, Aljoharah Alkanaan, Robert J. Barsotti, Omar Kirat, Adnan Khan, Turki Almubrad, Saeed Akhtar

PCOM Scholarly Papers

Keratoconus (KC) is a progressive corneal disorder in which vision gradually deteriorates as a result of continuous conical protrusion and the consequent altered corneal curvature. While the majority of the literature focus on assessing the center of this diseased cornea, there is growing evidence of peripheral involvement in the disease process. Thus, we investigated the organization of collagen fibrils (CFs) and proteoglycans (PGs) in the periphery and center of KC corneal stroma. Three-dimensional transmission electron tomography on four KC corneas showed the degeneration of microfibrils within the CFs and disturbance in the attachment of the PGs. Within the KC corneas, …

Molecular Serotype-Specific Identification Of Non-Type B Haemophilus Influenzae By Loop-Mediated Isothermal Amplification, Chika Takano, Yoko Kuramochi, Mitsuko Seki, Dong Wook Kim, Daisuke Omagari, Mari Sasano, Bin Chang, Makoto Ohnishi, Eun Jin Kim, Kazumasa Fuwa, Paul E. Kilgore, Tomonori Hoshino, Satoshi Hayakawa

Department of Pharmacy Practice

In children, the incidence of pneumococcal meningitis has decreased since the introduction of pneumococcal conjugate vaccine (PCV7 and PCV13). However, since the introduction of the vaccine, developed countries have seen the emergence of non-PCV13 serotypes. However, invasive pneumococcal disease (IPD) caused by PCV13-targeted serotypes still represents an important public health problem in resource-limited countries. To develop a rapid, simple, and cost-effective assay to detect serotypes of Streptococcus pneumoniae, we developed a novel loop-mediated isothermal amplification (LAMP) assay based on the sequences available for the 13 capsular types that are included in PCV13: 1, 3, 4, 5, 6 A, 6B, …

Effect Of Hospital Volume On Outcomes Of Total Hip Arthroplasty: A Systematic Review And Meta-Analysis, Syed Hamza Mufarrih, Muhammad Owais Abdul Ghani, Russell S. Martins, Nada Qaisar Qureshi, Sayyeda Aleena Mufarrih, Azeem Tariq Malik, Shahryar Noordin

Department of Biological & Biomedical Sciences

Background: A shift in the healthcare system towards the centralization of common yet costly surgeries, such as total hip arthroplasty (THA), to high-volume centers of excellence, is an attempt to control the economic burden while simultaneously enhancing patient outcomes. The "volume-outcome" relationship suggests that hospitals performing more treatment of a given type exhibit better outcomes than hospitals performing fewer. This theory has surfaced as an important factor in determining patient outcomes following THA. We performed a systematic review with meta-analyses to review the available evidence on the impact of hospital volume on outcomes of THA.
Materials and methods: We conducted …

Point-Of-Care Versus Central Testing Of Hemoglobin During Large Volume Blood Transfusion., Justin Herman, Brian Park, Bharat K. Awsare, Frances Mae West, Denine Crittendon, Lilah Evans, Mary Harach, Julie Karp, Alexis R. Peedin, Marianna Lanoue, Barbara Goldsmith, Eugene P. Warnick, Michael Baram

Division of Pulmonary and Critical Care Medicine Faculty Papers

BACKGROUND: Point-of-care (POC) hemoglobin testing has the potential to revolutionize massive transfusion strategies. No prior studies have compared POC and central laboratory testing of hemoglobin in patients undergoing massive transfusions.

METHODS: We retrospectively compared the results of our point-of-care hemoglobin test (EPOC®) to our core laboratory complete blood count (CBC) hemoglobin test (Sysmex XE-5000™) in patients undergoing massive transfusion protocols (MTP) for hemorrhage. One hundred seventy paired samples from 90 patients for whom MTP was activated were collected at a single, tertiary care hospital between 10/2011 and 10/2017. Patients had both an EPOC® and CBC hemoglobin performed within 30 min …

Patient Safety Escape Room: A Graduate Medical Education Simulation For Event Reporting., Gretchen Diemer, Rebecca Jaffe, Dimitrios Papanagnou, Xiao Chi Zhang, Jillian Zavodnick

Department of Emergency Medicine Faculty Papers

Introduction: Although residents are on the front lines of patient care, they enter few formal patient safety reports on the adverse events and near misses they witness. Demonstrating the rationale and mechanics of reporting may improve this.

Methods: We designed and implemented an escape room patient safety simulation to incorporate active learning, gamification, and adult learning theory into intern patient safety onboarding. Interns from all sponsoring institution programs participated, identifying, mitigating, and reporting a range of patient safety hazards. Props and faculty time were the major resources required.

Results: One hundred twenty interns participated in this simulation in June 2018. …

Comparison Of Three Different Techniques Of Inverted Internal Limiting Membrane Flap In Treatment Of Large Idiopathic Full-Thickness Macular Hole., Fariba Ghassemi, Hassan Khojasteh, Alireza Khodabande, Lauren A. Dalvin, Mehdi Mazloumi, Hamid Riazi-Esfahani, Masoud Mirghorbani

Wills Eye Hospital Papers

Purpose: To evaluate and compare three different techniques of inverted internal limiting membrane (ILM) flap in the treatment of large idiopathic full-thickness macular hole.

Methods: In a comparative interventional case series, 72 eyes from 72 patients with large (> 400 µm) full-thickness macular hole were randomly enrolled into three different groups: group A - hemicircular ILM peel with temporally hinged inverted flap; group B - circular ILM peel with temporally hinged inverted flap; and group C - circular ILM peel with superior inverted flap. Best-corrected visual acuity (BCVA), anatomical closure rate, and ellipsoid zone (EZ) or external limiting membrane (ELM) …

Sex Differences In Becoming A Current Electronic Cigarette User, Current Smoker And Current Dual User Of Both Products: A Longitudinal Study Among Mexican Adolescents, Rosibel Rodríguez-Bolaños, Edna Arillo-Santillán, Inti Barrientos-Gutiérrez, Luis Zavala-Arciniega, Charity A. Ntansah, Jim Thrasher

Faculty Publications

This study aimed to assess sex differences in predictors for becoming a current exclusive electronic cigarette (e-cigarette) user, current exclusive smoker, or current dual user (concurrent smoking and e-cigarette use). This longitudinal study included 2399 females and 2177 males who had tried neither cigarettes nor e-cigarettes at baseline and attended 57 middle schools in the three largest cities in Mexico. We estimated multinomial logistic models stratified by sex. At follow-up, the prevalence of current exclusive e-cigarette use was 6.4% for males and 5.5% for females; current exclusive smoking was similar among males (3.6%) and females (3.5%); dual use was 2.4% …

Glucocorticoids Rapidly Activate Camp Production Via GΑs To Initiate Non-Genomic Signaling That Contributes To One-Third Of Their Canonical Genomic Effects, Francisco J. Nuñez, Timothy B. Johnstone, Maia L. Corpuz, Austin G. Kazarian, Nicole N. Mohajer, Omar Tliba, Reynold A. Pannettieri Jr., Cynthia J. Koziol-White, Moom Roosan, Rennolds S. Ostrom

Pharmacy Faculty Articles and Research

Glucocorticoids are widely used for the suppression of inflammation, but evidence is growing that they can have rapid, non-genomic actions that have been unappreciated. Diverse cell signaling effects have been reported for glucocorticoids, leading us to hypothesize that glucocorticoids alone can swiftly increase the 3′,5′-cyclic adenosine monophosphate (cAMP) production. We found that prednisone, fluticasone, budesonide, and progesterone each increased cAMP levels within 3 minutes without phosphodiesterase inhibitors by measuring real-time cAMP dynamics using the cAMP difference detector in situ assay in a variety of immortalized cell lines and primary human airway smooth muscle (HASM) cells. A membrane- impermeable glucocorticoid showed …

Genetic Perturbations Of Disease Risk Genes In Mice Capture Transcriptomic Signatures Of Late-Onset Alzheimer's Disease., Ravi S Pandey, Leah C. Graham, Asli Uyar, Christoph Preuss, Gareth R Howell, Gregory W. Carter

Faculty Research 2019

BACKGROUND: New genetic and genomic resources have identified multiple genetic risk factors for late-onset Alzheimer's disease (LOAD) and characterized this common dementia at the molecular level. Experimental studies in model organisms can validate these associations and elucidate the links between specific genetic factors and transcriptomic signatures. Animal models based on LOAD-associated genes can potentially connect common genetic variation with LOAD transcriptomes, thereby providing novel insights into basic biological mechanisms underlying the disease.

METHODS: We performed RNA-Seq on whole brain samples from a panel of six-month-old female mice, each carrying one of the following mutations: homozygous deletions of Apoe and Clu; …

Resistance To Ectromelia Virus Infection Requires Cgas In Bone Marrow-Derived Cells Which Can Be Bypassed With Cgamp Therapy., Eric B. Wong, Brian Montoya, Maria Ferez, Colby Stotesbury, Luis J. Sigal

Department of Microbiology and Immunology Faculty Papers

Cells sensing infection produce Type I interferons (IFN-I) to stimulate Interferon Stimulated Genes (ISGs) that confer resistance to viruses. During lympho-hematogenous spread of the mouse pathogen ectromelia virus (ECTV), the adaptor STING and the transcription factor IRF7 are required for IFN-I and ISG induction and resistance to ECTV. However, it is unknown which cells sense ECTV and which pathogen recognition receptor (PRR) upstream of STING is required for IFN-I and ISG induction. We found that cyclic-GMP-AMP (cGAMP) synthase (cGAS), a DNA-sensing PRR, is required in bone marrow-derived (BMD) but not in other cells for IFN-I and ISG induction and for …

Frontline Nurse Leader Orientation Programs: A Review Of Literature, Shanelle Renee House

DNP Qualifying Manuscripts

Abstract

Aim This manuscript aims to synthesize the literature on the skills and knowledge needed by frontline nurse leaders and effective orientation or training programs developed to meet those needs.

Background Frontline nurse leaders are often promoted to positions of leadership due to their strong clinical skills; they often do not receive formal training.

Evaluation A literature search was conducted to identify and critically appraise journal articles that discuss orientation and training programs offered to frontline nurse leaders.

Key Issues The literature review revealed that frontline nurse leaders require a variety of skills and knowledge to be successful. Orientation and …

Cognitively Normal Women With Alzheimer’S Disease Proteinopathy Show Relative Preservation Of Memory But Not Of Hippocampal Volume, Jessica Z.K. Caldwell, Jeffrey L. Cummings, Sarah J. Banks, Sebastian Palmqvist, Oskar Hansson

School of Medicine Faculty Publications

Background: We examined interactive effects of sex, diagnosis, and cerebrospinal fluid (CSF) amyloid beta/phosphorylated tau ratio (Aβ/P-tau) on verbal memory and hippocampal volumes. Methods: We assessed 682 participants (350 women) from BioFINDER (250 cognitively normal [CN]; and 432 symptomatic: 186 subjective cognitive decline [SCD], 246 mild cognitive impairment [MCI]). General linear models evaluated effects of Alzheimer’s disease (AD) proteinopathy (CSF Aß/p-tau ratio), diagnosis, and sex on verbal memory (ADAS-cog 10-word recall), semantic fluency (animal naming fluency), visuospatial skills (cube copy), processing speed/attention functions (Symbol Digit Modalities Test and Trail Making Part A), and hippocampal volumes. Results: Amyloid-positive (Aβ/P-tau+) CN women …

Gender Based Violence And Health Effects, Tazeen Saeed Ali

School of Nursing & Midwifery

Gender Based Violence (GBV) violates the basic human right of a person’s physical, sexual and emotional integrity and health ([i]) such that globally, one out of every three women is subject to some form of violence, ranging from verbal and physical abuse to emotional blackmailing and psychological torture eventually leading to futile despair and hopelessness. The ironical perception of gender equality in our society is the root cause of gender based violence, with women being more afflicted by such a form of gender discrimination than men. [i]. Ali TS, Krantz G, Gul R, Asad N, Johansson E, …

Benner's Model And Duchscher's Theory: Providing The Framework For Understanding New Graduate Nurses' Transition To Practice, Melanie Murray, Deborah Sundin, Vicki Cope

Research outputs 2014 to 2021

The transition to quality and safety in the new graduate registered nurses' practice remains problematic directly impacting patient outcomes. Effective mentoring during transition serves to enhance experiential learning, allowing the development and establishment of safe, quality nursing practice. Comprehensive understanding of the transition process, including the barriers and effective enablers to transition is the key to effective mentoring. A theoretical framework guided by Duchscher's Stages of Transition Theory and Transition Shock Model and Benner's From novice to expert model can facilitate such understanding. Nurse Theorists play an important part in shaping nurse education and practice and have provided nurse educators …

Perceptions Of Health And Safety Among Workers In The Automotive Repair Industry In Dubai (United Arab Emirates): A Cross-Sectional Exploratory Study, Mona El Kouatly Kambris, Sarah Khan, Shatha Nabil Al Falasi

All Works

Background: Protection of workers against work-related injuries and illnesses is a growing public health concern. The increasing number of expatriate workers in Dubai has highlighted the need for greater emphasis on occupational health and safety, particularly since unintentional injuries were reported to be the second most common cause of death in the United Arab Emirates. Objectives: This cross-sectional study explores safety practices and health perceptions of workers in the automotive repair industry, in the light of the Health Belief Model. Materials and Methods: The study included 35 automotive repair industry workers, selected by convenience sampling from an automotive workshop in …

Is It T3 Thyrotoxicosis? A Case Of Falsely Elevated Tri-Iodothyronine (T3) Levels Leading To A Diagnosis Of Multiple Myeloma, Nanik Ram, Saira Furqan, Sibtain Ahmed

Section of Diabetes, Endocrinology and Metabolism

We are presenting a case of falsely elevated T3 levels in a patient due to interference from monoclonal immunoglobulins. A 56-year-old, clinically euthyroid man referred to the endocrinology clinic of the Aga Khan university, Karachi Pakistan, for possible T3 thyrotoxicosis after thyroid function tests revealed total T3 >12.32 nmol/L (reference range 0.6-2.79), normal TSH, and total T4 level. There was a mismatch in clinical and laboratory parameters and preliminary laboratory results were suggestive of thyroid binding globulin abnormalities. Further evaluation in this context unmasked multiple myeloma. The presence of monoclonal immunoglobulins can lead to assay interference and spurious results. To …

Comparison Of Socal Score And Hasford Score Against The Response Of Imatinib Mesylate Therapy In Patients With Chronic Granulocytic Leukemia In Dr. Saiful Anwar Hospital Malang, Somarnam Somarnam, Budi Darmawan Machsoos, Djoko Heri Hermanto

Jurnal Penyakit Dalam Indonesia

Introduction. The Socal and Hasford scores developed before the era of tirosine kinase inhibitor (TKI) therapy to provide predictions and prognosis for the results of therapy for chronic myeloid leukemia patients (CML). Until now the superiority of Socal and Hasford scores is still debated in predicting the results of therapy in the era of TKI. Imatinib mesylat is a first line TKI in the treatment of CML. This study aims to determine the superior predictive score in predicting hematological and molecular response of patients treated with imatinib mesylate. Methods. A survey study was conducted with data taken retrospectively from medical …

Prediksi Respons Terapi Leukemia Granulositik Kronis: Skor Mana Yang Lebih Baik?, Nadia Ayu Mulansari

Jurnal Penyakit Dalam Indonesia

Leukemia granulositik kronik (LGK) merupakan suatu keganasan myeloproliferatif dengan karakteristik ditemukannya kromosom Philadelphia (Ph). Kromosom Ph ini disebabkan oleh translokasi resiprokal antara kromosom 9 dan 22 [t(9;22)] dan terbentuknya fusi gen BCR-ABL1. Fusi gen tersebut akan menghasilkan suatu protein yang menderegulasi aktivitas dari tirosin kinase (p210) yang berperan pada patogenesis LGK.

Association Of Comprehensive Geriatric Assessments Component And Sarcopenia In Elderly, Diar Meitha Wardhana, Novira Widajanti, Jusri Ichwani

Jurnal Penyakit Dalam Indonesia

Introduction. Sarcopenia is defined as a declined in skeletal muscle mass and strength along with its function may causes an increase in hospitalization, mortality, and health burden. Multi-factorial conditions of the aging process may cause sarcopenia. To assess those multi-factorial conditions in the elderly, a comprehensive geriatric assessment (CGA) method should be used, in which comprises of socio-demographic, medical, psychological, and functional domains. This research aims to analyze the components of CGA, including age, gender, nutritional status, mental status, and functional status as factors associated to sarcopenia in the elderly community in Surabaya. Methods. This community research was a cross …

Characteristics Of The Indonesian Pilgrims Mortality Due To Cardiovascular Disease, Ali Sakti, Idrus Alwi, Muhadi Muhadi, Hamzah Shatri

Jurnal Penyakit Dalam Indonesia

Introduction. Cardiovascular disease is one of the health problems in Indonesian pilgrims and has become the main cause of death for pilgrims in the past 3 years. Most of them are considered high risk for cardiovascular disease. Some of those risk factors are predicted to have strong association with the pilgrims mortality rate. This study is meant to seek for risk factor associated with the pilgrims mortality rate. Methods. Observational study method of the Indonesian pilgrims in 2017 was conducted to assess the characteristics of Indonesian pilgrims who follow the hajj in 2017 as well as the characteristics of pilgrims …

Immunohistochemistry Profile Of Breast Cancer Patients That Get Anthracyclin–Based Chemotherapy In Rsud Kota Bogor, Marthino Robinson, Tubagus Djumhana Atmakusumah, Cosphiadi Irawan, Hamzah Shatri

Jurnal Penyakit Dalam Indonesia

Introduction. Breast cancer is the most prominent cancer and causing death in women. Treatment of breast cancer requires immunohistochemistry (IHC) to determine prognostic and predictive and imaging tests to determine staging. However, currently in Indonesia only 17 hospital can conduct IHC test. RSUD Kota Bogor like other Type B Hospital have no IHC test facilities. To fullfil that test, its important to refer patient to referal hospital. Because of limitation there are patients who did not do IHC test and continued get anthracycline chemotherapy. The objective of this research is to find out immunohistochemistry profile of breast cancer patients who …

Comparison Of Mortality Between Intravenous Albumin And No Intravenous Albumin In Sepsis Patients With Hypoalbuminemia Conditions And Factors That Influence The Mortality Of Sepsis Patients, Mochammad Jalalul Marzuki, Supriono Supriono, Bogi Pratomo, Syifa Mustika

Jurnal Penyakit Dalam Indonesia

Introduction. Hypoalbuminemia is a strong predictor of mortality in nonoperative and operative patients. Albumin plays a role in maintaining oncotic pressure in critical conditions such as sepsis. The administration of exogenous Human Serum Albumin (HSA) in sepsis with hypoalbuminemia conditions is still controversial with varying outcomes.This study aimed to know the mortality ratio between intravenous albumin administration and no intravenous albumin administration in sepsis patients with hypoalbuminemia conditions and also to know the factors that influence the mortality of sepsis patients. Methods. An observational study with a prospective approach involving 75 research subjects aged >18 years with sepsis accompanied by …

The Role Of Paternal History Of Type 2 Diabetes Mellitus On Prediabetes Status Among The Offspring Of Type 2 Diabetes Mellitus Patients, Maulidia Ekaputri, Henrico Citrawijaya, Adrian Reynaldo Sudirman, Kevin Jonathan, Radityo Alu Murti, Ayu Putri Balqis, Dyah Purnamasari

Jurnal Penyakit Dalam Indonesia

No abstract provided.

Role Of Cytokines In Stressful Condition As A Trigger For A Depression, Febyan Febyan, Sri Handawati Wijaya, Ayudhea Tannika, Johannes Hudyono

Jurnal Penyakit Dalam Indonesia

No abstract provided.

Young Kidney-Transplant Recipient Woman With Recurrent Urinary Tract Infection And Graft Rejection: A Case Report, Nursamsu Nursamsu, M. Reza Febriliant

Jurnal Penyakit Dalam Indonesia

Urinary tract infection (UTI), especially recurrent UTI, is a common problem, occurring in >75% of kidney transplant recipients. Urinary tract infection (UTI) can reduce the quality of life, graft potential, and patient survival. Urosepsis with impairment of graft function is potential long-term sequelae of recurrent UTI in kidney transplantation recipients. We present a case of UTI that developed within a month after renal transplant. The patient got a urinary tract infection repeatedly. We suspect lack of hygiene as the cause of urinary tract infection, the patient was rarely cleaning-up, took a bath, changing clothes, and did not wash after urinating. …

Preoperative Smoking Cessation Education Plan For Patients And Health Care Professionals, Amy Anderson

Nursing Capstones

Surgical site infections are an undesired consequence of surgery. Smoking has been identified as a risk factor for developing a postoperative infection (Anderson, 2019). Patients undergoing elective colorectal surgery should be required to be tobacco-free for at least four weeks before surgery. Health care organizations can implement a preoperative smoking cessation program within their facility to assist patients in achieving this requirement. To do so, an education plan is needed to effectively disseminate the main components of the program to both patients and health care professionals. The efficacy of the education plan can be exponentially increased by selecting learning strategies …