Medical Specialties Commons^™

Unilateral Enophthalmos., Grace L. Su, Sara E. Lally, Carol L. Shields

Wills Eye Hospital Papers

No abstract provided.

Cervical Cancer In Tanzania: A Systematic Review Of Current Challenges In Six Domains., Ava S Runge, Megan E Bernstein, Alexa N Lucas, Krishnansu S Tewari

Articles, Abstracts, and Reports

Cervical cancer is the most common cancer in Tanzania. After excluding human immunodeficiency virus, lower respiratory infections, malaria, diarrheal diseases, and tuberculosis, cervical cancer kills more women than any other form of illness in the country. Unfortunately, Tanzania has a low doctor-to-patient ratio (1:50,000) and nearly 7000 women die each year from this disease. The clinical problem is further magnified by the country's lack of resources and prevailing poverty, sporadic cervical cancer screening, prevalence of high-risk oncogenic human papillomavirus subtypes, and relatively high rates of human immunodeficiency virus co-infection. In recent years, addressing the cervical cancer problem has become a …

Microbial Colonization Of Pneumatic Tourniquets In The Orthopedic Operating Room, Syed Hamza Mufarrih, Nada Qaisar Qureshi, Rizwan Haroon Rashid, Bilal Ahmed, Seema Irfan, Akbar Jaleel Zubair, Shahryar Noordin

Section of Orthopaedic Surgery

Background: The rate of surgical site infections following orthopedic procedures is approximately 2% globally. Potential sources of contamination in the operating room include pneumatic tourniquets, blood pressure cuffs, and stethoscopes, among others. Our study aims to investigate microbial colonization on reusable pneumatic tourniquets stored and used in the orthopedic department of our institution and evaluate the efficacy of the cleaning protocols employed. Methods: Over a course of two weeks, 26 samples were obtained. A total of 14 pneumatic tourniquets were sampled preoperatively on Monday morning following the weekly cleaning protocol of soaking the tourniquets in sodium hypochlorite for 30 minutes …

Impact Of Adverse Childhood Experiences On Mental Health Outcomes And Related Prescription Practices In A Psychiatric Inpatient Sample, Carrie Lemay

Electronic Theses and Dissertations

A definitive association between adverse childhood experiences (ACEs) and negative physical and mental health outcomes has been established. There is evidence that individuals in forensic psychiatric facilities are disproportionately exposed to ACEs, which may impact severity, prognosis, and age of onset of psychiatric symptoms, including behavioral concerns of institutional aggression, self-harm behaviors, and suicide attempts. Such psychiatric and behavioral concerns are often managed through multiple psychotropic prescriptions, leading to psychotropic polypharmacy. This study evaluated the relationship between ACEs, mental health and behavioral concerns, and psychotropic polypharmacy through analysis of archival data from a forensic inpatient psychiatric facility. A total of …

Moving Toward The Future: Online Only., Jeffrey C Wang, Jens R Chapman, Karsten Wiechert

Articles, Abstracts, and Reports

No abstract provided.

Text Messaging For Disease Monitoring In Childhood Nephrotic Syndrome., Chia-Shi Wang, Jonathan P. Troost, Larry A. Greenbaum, Tarak Srivastava, Kimberly Reidy, Keisha Gibson, Howard Trachtman, John D. Piette, Christine B. Sethna, Kevin Meyers, Katherine M. Dell, Cheryl L. Tran, Suzanne Vento, Krishna Kallem, Emily Herreshoff, Sangeeta Hingorani, Kevin Lemley, Gia Oh, Elizabeth Brown, Jen-Jar Lin, Frederick Kaskel, Debbie S. Gipson

Manuscripts, Articles, Book Chapters and Other Papers

Introduction: There is limited information on effective disease monitoring for prompt interventions in childhood nephrotic syndrome. We examined the feasibility and effectiveness of a novel text messaging system (SMS) for disease monitoring in a multicenter, prospective study.

Methods: A total of 127 patientsresults, symptoms, and medication adherence were sent to a designated caregiver (n = 116) or adolescent patient (n = 3). Participants responded by texting. Feasibility of SMS was assessed by SMS adoption, retention, and engagement, and concordance between participant-reported results and laboratory/clinician assessments. The number of disease relapses and time-to-remission data captured by SMS were compared …

Cancer Cell Population Growth Kinetics At Low Densities Deviate From The Exponential Growth Model And Suggest An Allee Effect., Kaitlyn E Johnson, Grant Howard, William Mo, Michael K Strasser, Ernesto A B F Lima, Sui Huang, Amy Brock

Articles, Abstracts, and Reports

Most models of cancer cell population expansion assume exponential growth kinetics at low cell densities, with deviations to account for observed slowing of growth rate only at higher densities due to limited resources such as space and nutrients. However, recent preclinical and clinical observations of tumor initiation or recurrence indicate the presence of tumor growth kinetics in which growth rates scale positively with cell numbers. These observations are analogous to the cooperative behavior of species in an ecosystem described by the ecological principle of the Allee effect. In preclinical and clinical models, however, tumor growth data are limited by the …

Cancer Cell Population Growth Kinetics At Low Densities Deviate From The Exponential Growth Model And Suggest An Allee Effect., Kaitlyn E Johnson, Grant Howard, William Mo, Michael K Strasser, Ernesto A B F Lima, Sui Huang, Amy Brock

Articles, Abstracts, and Reports

Most models of cancer cell population expansion assume exponential growth kinetics at low cell densities, with deviations to account for observed slowing of growth rate only at higher densities due to limited resources such as space and nutrients. However, recent preclinical and clinical observations of tumor initiation or recurrence indicate the presence of tumor growth kinetics in which growth rates scale positively with cell numbers. These observations are analogous to the cooperative behavior of species in an ecosystem described by the ecological principle of the Allee effect. In preclinical and clinical models, however, tumor growth data are limited by the …

A New Woman-Controlled Contraceptive Vaginal Ring: A Global Step Forward, Marleen Temmerman

Obstetrics and Gynaecology, East Africa

More than 40 years ago, the development of contraceptive vaginal rings began, based on the fact that the vaginal epithelium can absorb steroid hormones and the capacity of elastomers to release these hormones at almost constant rates. The growing interest in woman-controlled contraceptive methods has supported and accelerated the process.

Impact Of Television On The Language Development Of Young Children, Courtney E. Daly

Honors College

Today, children are growing up immersed in television screen media, which has been shown to have both positive and negative effects on language development. Young children are considered developmentally vulnerable, and today, they are growing up highly immersed in digital media. Strict guidelines by the American Academy of Pediatrics (AAP) suggest that limiting the use of screen time. However, there is limited current research on the effect of coviewing while watching television programs on the language development of children. This investigation sought to contribute to efforts aimed at understanding the impact of coviewing on language output.

Advance Care Planning In Whatcom County, Wa: Opportunities For Evaluation And Expansion, Palliative Care Institute, Western Washington University, Whatcom Alliance For Health Advancement, Chuckanut Health Foundation

Palliative Care Institute

Numerous organizations and individuals in Whatcom County, Washington have been promoting advance care planning (ACP) Washington since 2012. In 2018 the Chuckanut Health Foundation provided funding to conduct an evaluation of advance care planning activities and their impact across all participating organizations. This report summarizes the evaluation goals, methods and findings. Based on the identified challenges and opportunities, recommendations are laid out for establishing ongoing, community-wide ACP evaluation, increasing integration of advance care planning into local healthcare and social service delivery, and expanding community outreach and education.

Effects Of The 2017 Clinical Practice Guidelines On Hypertension In Children And Adolescents: A Commentary, Bonita Falkner

Department of Medicine Faculty Papers

No abstract provided.

Including Ultrasound Scans In Antenatal Care In Low-Resource Settings: Considering The Complementarity Of Obstetric Ultrasound Screening And Maternity Waiting Homes In Strengthening Referral Systems In Low-Resource, Rural Settings, David L. Swanson, Holly L. Franklin, Jonathan O. Swanson, Robert L. Goldenberg, Elizabeth M. Mcclure, Waseem Mirza, David Muyodi, Lester Figueroa, Farnaz Naqvi, Sarah Saleem

Department of Radiology

Recent World Health Organization (WHO) antenatal care recommendations include an ultrasound scan as a part of routine antenatal care. The First Look Study, referenced in the WHO recommendation, subsequently shows that the routine use of ultrasound during antenatal care in rural, low-income settings did not improve maternal, fetal or neonatal mortality, nor did it increase women's use of antenatal care or the rate of hospital births. This article reviews the First Look Study, reconsidering the assumptions upon which it was built in light of these results, a supplemental descriptive study of interviews with patients and sonographers that participated in the …

Obesity Suppresses Pigment Epithelium-Derived Factor And Alters Pro-Tumorigenic Signaling Pathways In Prostate Cancer, Nizar Ahmed Khamjan

Theses and Dissertations

Background: Pigment epithelium-derived factor (PEDF), a multifunctional protein, is a potent tumor suppressor and anti-angiogenic factor. PEDF has been identified as a novel regulator of lipid metabolism via binding and activating adipose triglyceride lipase, which stimulates lipolytic pathways. PEDF-deficient mice develop prostatic hyperplasia that progresses to cancer when these mice are fed a high fat diet (HFD). PEDF expression is decreased in prostate cancer (PCa) patient tissues. Conversely, PEDF treatment inhibits PCa growth in mouse models. Recently, our lab has demonstrated that excess oleic acid (OA) treatment, an in vitro obesity model, suppresses secreted PEDF expression in PCa cell lines …

Early Life Child Micronutrient Status, Maternal Reasoning, And A Nurturing Household Environment Have Persistent Influences On Child Cognitive Development At Age 5 Years: Results From Mal-Ed, Benjamin J J. Mccormick, Stephanie A. Richard, Laura E. Caulfield, Laura L. Pendergast, Jessica C. Seidman, Beena Koshy, Reeba Roshan, Rita Shrestha, Erling Svensen, Muneera Rasheed

Department of Paediatrics and Child Health

Background: Child cognitive development is influenced by early-life insults and protective factors. To what extent these factors have a long-term legacy on child development and hence fulfillment of cognitive potential is unknown.
Objective: The aim of this study was to examine the relation between early-life factors (birth to 2 y) and cognitive development at 5 y.
Methods: Observational follow-up visits were made of children at 5 y, previously enrolled in the community-based MAL-ED longitudinal cohort. The burden of enteropathogens, prevalence of illness, complementary diet intake, micronutrient status, and household and maternal factors from birth to 2 y were extensively measured …

Antimicrobial Sensitivity Pattern, Demographic Findings And Risk Factors Amongst Meningitis And Non-Meningitis Invasive Streptococcus Pneumoniae At Aga Khan University Hospital Clinical Laboratory, Karachi, Pakistan, Seema Irfan, Joveria Farooqi, Afia Zafar, Haresh Kumar

Department of Pathology and Laboratory Medicine

Objective: To determine the resistance rate of penicillin and ceftriaxone amongst invasive meningitis and nonmeningitis isolates of streptococcus pneumoniae. Methods: The prospective cross-sectional study was conducted from January 2011 to March 2014 at the Clinical Microbiology Laboratory of Aga Khan University, Karachi, and comprised all invasive strains of streptococcus pneumoniae. Penicillin and ceftriaxone susceptibilities were performed and interpreted based on minimum inhibitory concentration breakpoints recommended by Clinical and Laboratory Standards Institute guidelines. Data was analysed using Stata 12.
Result: There were 163 strains isolated from sterile body fluids of 109 patients. Of the total, 46(28%) samples were meningitic while 117(72%) …

Lehigh Valley Hospital–Hazleton Trauma Pi Process, Alexandra K. Evans

Department of Medicine

No abstract provided.

Fasting Reduces Intestinal Radiotoxicity Enabling Dose-Escalated Radiotherapy For Pancreatic Cancer, Marimar De La Cruz Bonilla

Dissertations & Theses (Open Access)

Surgical resection is the only potentially curative treatment for pancreatic cancer, but only 15-20% of patients have resectable tumors. In unresectable cases, stereotactic body radiotherapy (SBRT) may be used to give tumor-directed radiotherapy (RT). Unfortunately, this can cause severe gastrointestinal (GI) toxicity due to proximity of the pancreatic head to the duodenum. Protecting the intestine from the toxic side-effects of radiation may enable dose-escalation that could achieve more effective local control of disease. We and others have previously shown that a fast of 24 hours protects mice from lethal doses of the DNA-damaging agent etoposide. In this study, we demonstrate …

Prasugrel Inappropriate Use In Patients Post-Percutaneous Coronary Intervention (Pci). A Single Center Study, Ahmed Amro, Kanaan Mansoor, Mohammad Amro, Amal Sobeih, Obadah Aqtash, Hisham Hirzallah, Alaa Gabi, Madhulika Urella, Waseem Ahmed, Sandra Shenouda, Dr. Rameez Sayyed, Md

Marshall Journal of Medicine

Prasugrel is a thienopyridine that was approved by the US Food and Drug Administration (FDA) in combination with aspirin for the reduction of thrombotic events as well as stent thrombosis in patients with ACS who undergo PCI. This retrospective study aims to assess the frequency of inappropriate use of prasugrel and to emphasize that prasugrel still needs more attention as inappropriate use may result in significant morbidity.

Intralesional Corticosteroids For Long-Term Control Of Primary Cutaneous Marginal Zone Lymphoma Without Systemic Involvement, Pragya Tiwari, John Hall, Anand Rajpara, Carol Stanford, Daniel Aires

Marshall Journal of Medicine

Primary cutaneous marginal zone lymphoma (PCMZL) is a B cell lymphoma with a very low metastatic rate. Radiographic monitoring for internal involvement may be indicated initially. Favored treatments include radiation and excision. Radiation has high risk of local recurrence. Excision carries risk of infection and scarring. We report successful long-term treatment of recurrent PCMZL via intralesional steroid injections into new lesions as they arose. This was preferred by the patient over her prior radiation and surgical treatments. Intralesional steroids have the advantages of being simple and well tolerated, without exposure to ionizing radiation, or to the infection and scarring associated …