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Pediatric Emergency Medical Care In Yerevan, Armenia: A Knowledge And Attitudes Survey Of Out-Of-Hospital Emergency Physicians., Aline A. Baghdassarian, Ross I. Donaldson, Andrew D Depiero, Nancy L Chernett, Harsh P. Sule MD 2014 Thomas Jefferson University

Pediatric Emergency Medical Care In Yerevan, Armenia: A Knowledge And Attitudes Survey Of Out-Of-Hospital Emergency Physicians., Aline A. Baghdassarian, Ross I. Donaldson, Andrew D Depiero, Nancy L Chernett, Harsh P. Sule Md

Department of Emergency Medicine Faculty Papers

BACKGROUND: Out-of-hospital emergency care is at an early stage of development in Armenia, with the current emergency medical services (EMS) system having emergency physicians (EPs) work on ambulances along with nurses. While efforts are underway by the Ministry of Health and other organizations to reform the EMS system, little data exists on the status of pediatric emergency care (PEC) in the country. We designed this study to evaluate the knowledge and attitudes of out-of-hospital emergency physicians in pediatric rapid assessment and resuscitation, and identify areas for PEC improvement.

METHODS: We distributed an anonymous, self-administered Knowledge and Attitudes survey to a ...


Design And Development Of A Miniature In Vivo Surgical Robot With Distributed Motor Control For Laparoendoscopic Single-Site Surgery, Eric J. Markvicka 2014 University of Nebraska - Lincoln

Design And Development Of A Miniature In Vivo Surgical Robot With Distributed Motor Control For Laparoendoscopic Single-Site Surgery, Eric J. Markvicka

Mechanical (and Materials) Engineering -- Dissertations, Theses, and Student Research

Paradigm shifts in invasiveness, recovery time, cosmesis, and cost have been seen within the field of general surgery through major advances in surgical technology. Some of the most advanced types of general surgery now include Minimally Invasive Surgery (MIS), LaparoEndoscopic Single-Site (LESS) surgery, and Natural Orifice Translumenal Endoscopic Surgery (NOTES). One of the newest and rapidly developing catalysts is robotic platforms. Such platforms have improved ergonomics and control, increased workspace and dexterity, and have surpassed the efficacy of many non-robotic platforms such as traditional laparoscopic surgical tools. This thesis presents the design and development of a four-degree-of-freedom (4- DOF) miniature ...


Carmen Pettapiece, D.O. Scrapbook 2, Carmen Pettapiece D.O. 2014 University of New England

Carmen Pettapiece, D.O. Scrapbook 2, Carmen Pettapiece D.O.

Carmen Pettapiece, D.O. Scrapbooks

Scrapbook of personal papers and osteopathy-related materials from the collection of Carmen Pettapiece, D.O.


Clinical Outcomes Of Unprotected Left Main Coronary Artery Stenting In Nonsurgical Patients: A Single-Center Experience, John-Paul Pham, Abdelazim Hashim, Naoyo Mori, Mohamed Taha, Mohamed Djelmami-Hani, Joaquin Solis, Suhail Allaqaband, Tanvir Bajwa, Anjan Gupta 2014 Aurora Health Care

Clinical Outcomes Of Unprotected Left Main Coronary Artery Stenting In Nonsurgical Patients: A Single-Center Experience, John-Paul Pham, Abdelazim Hashim, Naoyo Mori, Mohamed Taha, Mohamed Djelmami-Hani, Joaquin Solis, Suhail Allaqaband, Tanvir Bajwa, Anjan Gupta

Journal of Patient-Centered Research and Reviews

Purpose: Coronary artery bypass graft is the standard treatment for unprotected left main disease; however, some patients are poor surgical candidates due to comorbidities. We assessed the safety and clinical outcome of elective, unprotected left main coronary artery stenting in nonsurgical patients.

Methods: Between October 2004 and June 2006, 50 consecutive patients underwent elective, unprotected left main coronary artery stenting at our institution. Patients were followed for a median of 16 and 96 months and clinical outcomes monitored.

Results: Median logistic euroSCORE was 28.6 (interquartile range: 14.6-43.4). Median baseline left ventricular ejection fraction (LVEF) was 50%. Procedural ...


Cardio-Oncology: Success Breeds New Challenges, Opportunities, Charles A. Bomzer, Bijoy K. Khandheria 2014 Aurora Health Care

Cardio-Oncology: Success Breeds New Challenges, Opportunities, Charles A. Bomzer, Bijoy K. Khandheria

Journal of Patient-Centered Research and Reviews

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Cardiovascular Toxicity Of Common Chemotherapy Drugs Used To Treat Breast Cancer: An Overview, Charles A. Bomzer 2014 Aurora Health Care

Cardiovascular Toxicity Of Common Chemotherapy Drugs Used To Treat Breast Cancer: An Overview, Charles A. Bomzer

Journal of Patient-Centered Research and Reviews

Treatment of breast cancer often exposes patients to many different drugs. Some of these drugs have toxic effects involving the cardiovascular system. This review provides an overview of the drugs most commonly used to treat breast cancer and their potential adverse impact on the cardiovascular system.


Diagnosis Of Chemotherapy-Induced Cardiotoxicity, Fausto Pizzino, Giampiero Vizzari, Charles A. Bomzer, Rubina Qamar, Scipione Carerj, Concetta Zito, Bijoy K. Khandheria 2014 Aurora Health Care

Diagnosis Of Chemotherapy-Induced Cardiotoxicity, Fausto Pizzino, Giampiero Vizzari, Charles A. Bomzer, Rubina Qamar, Scipione Carerj, Concetta Zito, Bijoy K. Khandheria

Journal of Patient-Centered Research and Reviews

Cardiotoxicity is a rising issue connected to use of chemotherapy and radiotherapy in the treatment of neoplastic diseases. Early diagnosis during follow-up is of paramount importance, and careful surveillance is recommended. Evaluation of left ventricular ejection fraction by echocardiography and nuclear medicine techniques is widely used in clinical practice; however, their sensitivity in detecting early cardiac damage is low. New instruments like speckle-tracking imaging, cardiac magnetic resonance and cardiac circulating biomarkers are available to clinicians to best evaluate the onset and progression of cardiotoxic effects, improving the therapeutic management and final outcome for the patient.


An Overview Of Cancer Rehabilitation And Exercise In The Literature: Promoting Increased Referrals To Improve Oncology Outcomes, Leslie J. Waltke 2014 Aurora Health Care

An Overview Of Cancer Rehabilitation And Exercise In The Literature: Promoting Increased Referrals To Improve Oncology Outcomes, Leslie J. Waltke

Journal of Patient-Centered Research and Reviews

Medical management for malignant neoplastic diseases includes surgery, chemotherapy, radiation, and hormonal and biological therapies. Each of these antineoplastic interventions has unique impacts on physiological, musculoskeletal and functional performance. Cancer rehabilitation is the area of physical medicine responsible for addressing impairments associated with cancer treatment and survivorship, advanced disease and end of life. Although it is expected that more than one-half of persons being treated for cancer will suffer moderate pain and physical and functional decline, and that most will describe fatigue, referrals to rehabilitation are traditionally low. Evidence suggests that referrals to rehabilitation before, during and after treatment for ...


Colpotomy In Total Laparoscopic Hysterectomy Without Using An Energy Source: A New Approach, Pandurang Ramchandra Rotithor 2014 University of Iowa

Colpotomy In Total Laparoscopic Hysterectomy Without Using An Energy Source: A New Approach, Pandurang Ramchandra Rotithor

POG In Press

Currently, energy sources are used in the form of either monopolar current or harmonic scalpel for colpotomy in total laparoscopic hysterectomy. This is associated with lateral thermal damage to adjacent organs such as the urinary bladder or lower ureter. The risk of scar dehiscence with this method is higher than that for abdominal hysterectomy. The objective of this new technique is to reduce these complications. The colpotomy is done using a blade and scissors through the vaginal tube without using any energy source. The resulting edge of the cut is sharper than that done by cautery, making it easy to ...


Meckel Gruber Syndrome Diagnosed In Two Consecutive Pregnancies, Yetkin Karasu, Kahraman Ülker, Murat Bozkurt, Servet Gençdal, Melek Çiçek, Suat Dede, Gülnur Özakşit 2014 University of Iowa

Meckel Gruber Syndrome Diagnosed In Two Consecutive Pregnancies, Yetkin Karasu, Kahraman Ülker, Murat Bozkurt, Servet Gençdal, Melek Çiçek, Suat Dede, Gülnur Özakşit

POG In Press

Meckel Gruber syndrome is a lethal, autosomal recessive, multisystemic disorder that is associated with a mutation affecting ciliogenesis. In this report, we present two consecutive pregnancies of a woman complicated with MKS. In the first pregnancy with MKS, the amniotic fluid index was under 1 cm with bilateral polycystic fetal kidneys. Post-abortion macroscopic examination of the first fetus revealed multiple congenital anomalies including occipital encephalocele, axial polydactyly and pes equinovarus. Ultrasound examination during the second gestation revealed a singleton pregnancy complicated by MKS. There were multiple congenital anomalies including an occipital encephalocele, polycystic and horseshoe shaped kidneys, axial polydactyly, cleft ...


State Synergies And Disease Surveillance: Creating An Electronic Health Data Communication Model For Cancer Reporting And Comparative Effectiveness Research In Kentucky, Christopher Reams, Mallory Powell, Rob Edwards 2014 EDM Forum

State Synergies And Disease Surveillance: Creating An Electronic Health Data Communication Model For Cancer Reporting And Comparative Effectiveness Research In Kentucky, Christopher Reams, Mallory Powell, Rob Edwards

eGEMs (Generating Evidence & Methods to improve patient outcomes)

Purpose: This case study describes the collaboration between a state public health department, a major research university, and a health extension service funded as part of the Health Information Technology for Economic and Clinical Health (HITECH) Act to establish an interoperable health information system for disease surveillance through electronic reporting of systemic therapy data from numerous oncology practices in Kentucky. The experience of the Kentucky cancer surveillance system can help local and state entities achieve greater effectiveness in designing communication efforts to increase usage of electronic health records (EHRs) and health information exchanges (HIEs), help eligible clinicians meet these new ...


Towards Highly-Integrated Stereovideoscopy For In Vivo Surgical Robots, Jay Carlson 2014 University of Nebraska - Lincoln

Towards Highly-Integrated Stereovideoscopy For In Vivo Surgical Robots, Jay Carlson

Electrical Engineering Theses and Dissertations

When compared to traditional surgery, laparoscopic procedures result in better patient outcomes: shorter recovery, reduced post-operative pain, and less trauma to incisioned tissue. Unfortunately, laparoscopic procedures require specialized training for surgeons, as these minimally-invasive procedures provide an operating environment that has limited dexterity and limited vision. Advanced surgical robotics platforms can make minimally-invasive techniques safer and easier for the surgeon to complete successfully. The most common type of surgical robotics platforms -- the laparoscopic robots -- accomplish this with multi-degree-of-freedom manipulators that are capable of a diversified set of movements when compared to traditional laparoscopic instruments. Also, these laparoscopic robots allow for ...


Identifying The Prevalence Of Ncaa American Football Players Sustaining Traumatic Brain Injuries (Concussions) During Spring Practice In The Big Sky Conference, Kery R. White 2014 Big Sky Conference

Identifying The Prevalence Of Ncaa American Football Players Sustaining Traumatic Brain Injuries (Concussions) During Spring Practice In The Big Sky Conference, Kery R. White

Skyline - The Big Sky Undergraduate Journal

The goal of this study is to identify ways to minimize and/or further prevent athletic concussions in an effort to add years to athletes’ lives, greatly decrease side effects of sustaining multiple head traumas, and thus increase the quality of life for athletes around the world. Conferences such as the Pac-12 and the Ivy League are moving toward a safer method of playing the game of football, but the reality of the situation is, players are only getting bigger, stronger and faster, and they will continue to play with passion and a love for the game.

With the increased ...


Supporting Primary Care Practices In Building Capacity To Use Health Information Data, Douglas Fernald, Robyn Wearner, W. Perry Dickinson 2014 EDM Forum

Supporting Primary Care Practices In Building Capacity To Use Health Information Data, Douglas Fernald, Robyn Wearner, W. Perry Dickinson

eGEMs (Generating Evidence & Methods to improve patient outcomes)

Introduction: Our objective was to describe essential support resources and strategies in order to advance the pace and scope of the use of health information technology (HIT) data.

Background and Context: Primary data were collected between January 2011 and October 2012. The primary study population comprised 51 primary care practices enrolled in the Colorado Beacon Consortium in western Colorado.

Methods: We used qualitative methods embedded in a mixed-method evaluation: monthly narrative reports from practices; interviews with providers and staff; and focused, group discussions with quality improvement (QI) advisors and staff from the Health Information Technology Regional Extension Center.

Findings: Practices ...


Regulation Of L1 Expression And Retrotransposition By Melatonin And Its Receptor: Implications For Cancer Risk Associated With Light Exposure At Night., Dawn deHaro, Kristine J Kines, Mark Sokolowski, Robert T Dauchy, Vincent A Streva, Steven M Hill, John P Hanifin, George Brainard, David E Blask, Victoria P Belancio 2014 Thomas Jefferson University

Regulation Of L1 Expression And Retrotransposition By Melatonin And Its Receptor: Implications For Cancer Risk Associated With Light Exposure At Night., Dawn Deharo, Kristine J Kines, Mark Sokolowski, Robert T Dauchy, Vincent A Streva, Steven M Hill, John P Hanifin, George Brainard, David E Blask, Victoria P Belancio

Department of Neurology Faculty Papers

Expression of long interspersed element-1 (L1) is upregulated in many human malignancies. L1 can introduce genomic instability via insertional mutagenesis and DNA double-strand breaks, both of which may promote cancer. Light exposure at night, a recently recognized carcinogen, is associated with an increased risk of cancer in shift workers. We report that melatonin receptor 1 inhibits mobilization of L1 in cultured cells through downregulation of L1 mRNA and ORF1 protein. The addition of melatonin receptor antagonists abolishes the MT1 effect on retrotransposition in a dose-dependent manner. Furthermore, melatonin-rich, but not melatonin-poor, human blood collected at different times during the circadian ...


Treatment Of Rectal War Wounds, O J. van Waes, J A. Halm, J Vermeulen, Vivian C. McAlister 2014 Western University

Treatment Of Rectal War Wounds, O J. Van Waes, J A. Halm, J Vermeulen, Vivian C. Mcalister

Vivian C. McAlister

Treatment strategies for penetrating rectal injuries (PRI) in civilian settings are still not uniformly agreed, in part since high-energy transfer PRI, such as is frequently seen in military settings, are not taken into account. Here, we describe three cases of PRI, treated in a deployed combat environment, and outline the management strategies successfully employed. We also discuss the literature regarding PRI management. Where there is a major soft tissue component, repetitive debridement and vacuum therapy is useful. A loop or end colostomy should be used, depending on the degree of damage to the anal sphincter complex.


Parp-2 And Parp-3 Are Selectively Activated By 5' Phosphorylated Dna Breaks Through An Allosteric Regulatory Mechanism Shared With Parp-1., Marie-France Langelier, Amanda A Riccio, John M Pascal 2014 Thomas Jefferson University

Parp-2 And Parp-3 Are Selectively Activated By 5' Phosphorylated Dna Breaks Through An Allosteric Regulatory Mechanism Shared With Parp-1., Marie-France Langelier, Amanda A Riccio, John M Pascal

Department of Biochemistry and Molecular Biology Faculty Papers

PARP-1, PARP-2 and PARP-3 are DNA-dependent PARPs that localize to DNA damage, synthesize poly(ADP-ribose) (PAR) covalently attached to target proteins including themselves, and thereby recruit repair factors to DNA breaks to increase repair efficiency. PARP-1, PARP-2 and PARP-3 have in common two C-terminal domains-Trp-Gly-Arg (WGR) and catalytic (CAT). In contrast, the N-terminal region (NTR) of PARP-1 is over 500 residues and includes four regulatory domains, whereas PARP-2 and PARP-3 have smaller NTRs (70 and 40 residues, respectively) of unknown structural composition and function. Here, we show that PARP-2 and PARP-3 are preferentially activated by DNA breaks harboring a 5 ...


Principles Of Multidisciplinary Management, Richard S. Pieters, James Liebmann 2014 University of Massachusetts Medical School

Principles Of Multidisciplinary Management, Richard S. Pieters, James Liebmann

Cancer Concepts: A Guidebook for the Non-Oncologist

This chapter in the Cancer Concepts textbook describes the principles of multi-disciplinary management, meaning multi-specialty physician management of malignancies. Tumor Boards are the model for multi-disciplinary management. They may be site specific or include the entire spectrum of malignancy. At Tumor Boards, staging workup and treatment recommendations are made collectively, and then the treatments are delivered by the respective modality specialists and their individual teams. Improved clinical decision making leading to superior survival for patients with some diseases and better quality of life has been documented with multi-disciplinary management. Just like curative patients, palliative patients require multi-disciplinary management.


Production Of Recombinant Human Coagulation Factor Ix By Transgenic Pig, Weijie Xu 2014 University of Nebraska - Lincoln

Production Of Recombinant Human Coagulation Factor Ix By Transgenic Pig, Weijie Xu

Chemical & Biomolecular Engineering Theses, Dissertations, & Student Research

Hemophilia B is the congenital bleeding disorder caused by deficiency in functional coagulation factor IX (FIX) and about 28,000 patients worldwide in 2012. And current treatment is restricted to protein-replacement therapy, which required FIX concentrates for patients’ life-time. Approximately 1 billion units FIX were consumed in 2012. However, still about 70-80% patients, mostly in developing countries, received inadequate or no treatment because of the unavailable and/or unaffordable FIX concentrates. Considering safety reasons, e.g. transmission of blood-borne diseases, the recombinant human FIX (rFIX) is recommended other than the plasma-derived FIX. However, only one rFIX is currently available on ...


Nut Midline Carcinoma In A Pregnant Woman, Jill N. D'Souza, MD, David M. Cognetti, MD, Ryan N. Heffelfinger, MD, James J. Evans, MD, Madalina Tuluc, MD, Jurij R. Bilyk, Marc R. Rosen, MD 2014 Thomas Jefferson University

Nut Midline Carcinoma In A Pregnant Woman, Jill N. D'Souza, Md, David M. Cognetti, Md, Ryan N. Heffelfinger, Md, James J. Evans, Md, Madalina Tuluc, Md, Jurij R. Bilyk, Marc R. Rosen, Md

Department of Otolaryngology - Head and Neck Surgery Faculty, Presentations and Grand Rounds

NUT midline carcinoma is a rare, highly aggressive tumor that involves midline structures, particularly in the head, neck and mediastinum. It is characterized by NUT gene translocations on chromosome 15. It typically impacts teenagers or young adults, and has a fulminant course leading to death in less than a year in most cases despite aggressive chemoradiotherapy. Due to its location, this tumor is frequently considered inoperable. We present a case of a sinonasal NUT midline carcinoma with orbital invasion discovered during the workup of sinusitis in a young, pregnant woman. The tumor was managed with definitive excision to negative margins ...


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