Digital Commons Network^™

Assessing Oral Health Curriculum In Us Family Medicine Residency Programs: A Cera Study, Hugh Silk, Ronnelle King, Ian M. Bennett, Alexander W. Chessman, Judith A. Savageau

Judith A. Savageau

BACKGROUND AND OBJECTIVES: During the past decade, national initiatives have called for improved oral health training for physicians. We do not know, however, how family medicine residency programs have answered this call. METHODS: Family medicine residency directors completed a survey that asked how many hours of oral health teaching are included in their programs in addition to what topics are covered and the perceived barriers to this education. The response rate was 35%. RESULTS: A total of 72% of respondents agreed that oral health is an important topic, but only 32% are satisfied with their residents' competency in oral health. …

An Ounce Of Prevention: How Are We Managing The Early Assessment Of Residents' Clinical Skills?: A Cera Study, Tracy Kedian, Lisa S. Gussak, Judith A. Savageau, Andreas Cohrssen, Ilene Abramson, Kelly Everard, Alison Dobbie

Judith A. Savageau

BACKGROUND AND OBJECTIVES: Clinical skills deficits in residents are common but when identified early can result in decreased cost, faculty time, and stress related to remediation. There is currently no accepted best practice for early assessment of incoming residents' clinical skills. This study describes the current state of early PGY-1 clinical skills assessment in US family medicine residencies.

METHODS: Eleven questions were embedded in the nationwide CERA survey to US family medicine residency directors regarding the processes, components, and barriers to early PGY-1 assessment. Responses are described, and bivariate analyses of the relationship between assessment variables and percentage of international …

Intrinsic Rhinitis, Balasubramanian Thiagarajan

Balasubramanian Thiagarajan

Intrinsic rhinitis is defined as a non infective and non allergic condition characterised by nasal block, rhinorrhoea and hyposmia. This is purely a medical condition. Awareness of this condition will help us to avoid unnecessary surgical procedures on patients suffering from this disorder. Surgery should be reserved only for cases that are intractable to medical management. This article discusses the complete gamut of this disorder.

Adrenoceptor Function And Expression In Bladder Urothelium And Lamina Propria, Christian Moro, Lotti Tajouri, Russ Chess-Williams

Russ Chess-Williams

Objective - To investigate the role of adrenoceptor subtypes in regulating the spontaneous contractile activity of the inner lining of the urinary bladder (urothelium/lamina propria).Materials and Methods - The responses of isolated strips of porcine urothelium/lamina propria to noradrenaline, phenylephrine, and isoprenaline were obtained in the absence and presence of receptor subtype-selective antagonists. Quantitative reverse-transcriptase polymerase chain reaction was undertaken to assess the expression of adrenoceptor genes.Results - The tissues expressed all α1- and β-adrenoceptor subtypes, with the α1A-, α1B-, and β2-adrenoceptors the predominant receptors at the messenger RNA level. In the functional experiments, the rate of phasic contractions and …

Adrenoceptor Function And Expression In Bladder Urothelium And Lamina Propria, Christian Moro, Lotti Tajouri, Russ Chess-Williams

Lotti Tajouri

Objective - To investigate the role of adrenoceptor subtypes in regulating the spontaneous contractile activity of the inner lining of the urinary bladder (urothelium/lamina propria).Materials and Methods - The responses of isolated strips of porcine urothelium/lamina propria to noradrenaline, phenylephrine, and isoprenaline were obtained in the absence and presence of receptor subtype-selective antagonists. Quantitative reverse-transcriptase polymerase chain reaction was undertaken to assess the expression of adrenoceptor genes.Results - The tissues expressed all α1- and β-adrenoceptor subtypes, with the α1A-, α1B-, and β2-adrenoceptors the predominant receptors at the messenger RNA level. In the functional experiments, the rate of phasic contractions and …

Elevated Cardiovascular Risk Among Adults With Obstructive And Restrictive Airway Functioning In The United States: A Cross-Sectional Study Of The National Health And Nutrition Examination Survey From 2007 - 2010, Earl S. Ford, Ann G. Wheaton, David M. Mannino, Latitia Presley-Cantrell, Chaoyang Li, Janet B. Croft

David M. Mannino

Background

Reasons for the excess risk for cardiovascular disease among people with chronic obstructive pulmonary disease remain unclear. Our objective was to examine the cardiovascular risk profile for adults with obstructive and restrictive impairments of lung functioning in a representative sample of adults from the United States.

Methods

We used data from adults aged 20–79 years who participated in the National Health and Nutrition Examination Survey from 2007 to 2010 and had a pulmonary function test. The severity of obstructive impairment was defined by adapting the Global Initiative for Chronic Obstructive Lung Disease criteria.

Results

Among 7249 participants, 80.9% had …

Familial Clustering Of Habitual Constipation: A Prospective Study In Children From West Virginia, Yoram Elitsur, Jenna Dolan

Yoram Elitsur

Objective: To investigate familial clustering of habitual constipation in pediatric patients who attended our medical facilities. Patients and Methods: Children with the diagnosis of functional, habitual constipation or patients without constipation and their respective family members were prospectively recruited to our study. Constipation was established in all participants using a standard questionnaire (Rome criteria). Results: A total of 112 children and their families participated in the study, of which 37 were probands families (test) and 75 children and their respective family members constituted the control group. A total of 310 family members completed the questionnaire. No significant differences were found …

Fluticasone And Food Allergen Elimination Reverse Sub-Epithelial Fibrosis In Children With Eosinophilic Esophagitis, Samer Abu-Sultaneh, Paul Durst, Virginia Maynard, Yoram Elitsur

Yoram Elitsur

Background Symptoms of vomiting and dysphagia in children with eosinophilic esophagitis may be related to the development of mucosal fibrosis. Aim Our aims were to (1) investigate esophageal fibrosis in children with EoE compared to patients with gastroesophageal reflux disease and normal individuals, and (2) to assess the degree of mucosal fibrosis in patients with EoE before and after medical treatment. Methods A retrospective analysis of esophageal biopsies from patients with EoE, GERD, and normal mucosa was performed. Demographic data, clinical information, eosinophil number, and sub-epithelial fibrosis was compared among the groups. A similar comparison was performed in EoE patients, …

Association Of Ubqln1 Mutation With Brown-Vialetto-Van Laere Syndrome But Not Typical Als, Paloma Gonzalez-Perez, Yubing Lu, Ru-Ju Chian, Peter Sapp, Rudolph Tanzi, Lars Bertram, Diane Mckenna-Yasek, Fen-Biao Gao, Robert Brown

Dr Robert Brown

Genetic variants in UBQLN1 gene have been linked to neurodegeneration and mutations in UBQLN2 have recently been identified as a rare cause of amyotrophic lateral sclerosis (ALS). OBJECTIVE: To test if genetic variants in UBQLN1 are involved in ALS. METHODS: 102 and 94 unrelated patients with familial and sporadic forms of ALS were screened for UBQLN1 gene mutations. Single nucleotide variants were further screened in a larger set of sporadic ALS (SALS) patients and unrelated control subjects using high-throughput Taqman genotyping; variants were further assessed for novelty using the 1000Genomes and NHLBI databases. In vitro studies tested the effect of …

Genetic Determinants Of Cerebral Edema In Severe Traumatic Brain Injury: A Pilot Study Of The Role Of Cacna1 And Aqp4 Gene Mutations, Raphael A. Carandang, Susanne Muehlschlegel, Wiley R. Hall, Cynthia Ouillette, Robert H. Brown Jr.

Dr Robert Brown

Cerebral edema is the one of the most significant predictors of poor outcome after traumatic brain injury. It is still unclear what the pathophysiological and cellular mechanisms and predictors of post-traumatic edema are. The exponential growth in genetic information has opened an avenue for investigation in traumatic brain injury and implicated specific genes in the pathophysiology of post-traumatic injury edema. Two examples are the Aquaporin-4 and CACNA1 genes, which respectively encode water and calcium channels. The Aquaporin-4 gene on chromosome 18q11.2-12.1 encodes the Aquaporin-4 protein (AQP4) water channel. AQP4 is one of the bidirectional high capacity water channels that is …

Loss-Of-Function Variants In Endothelial Lipase Are A Cause Of Elevated Hdl Cholesterol In Humans, Andrew Edmondson, Robert Brown, Sekar Kathiresan, L. Cupples, Serkalem Demissie, Alisa Manning, Majken Jensen, Eric Rimm, Jian Wang, Amrith Rodrigues, Vaneeta Bamba, Sumeet Khetarpal, Megan Wolfe, Stephanie Derohannessian, Mingyao Li, Muredach Reilly, Jens Aberle, David Evans, Robert Hegele, Daniel Rader

Dr Robert Brown

Elevated plasma concentrations of HDL cholesterol (HDL-C) are associated with protection from atherosclerotic cardiovascular disease. Animal models indicate that decreased expression of endothelial lipase (LIPG) is inversely associated with HDL-C levels, and genome-wide association studies have identified LIPG variants as being associated with HDL-C levels in humans. We hypothesized that loss-of-function mutations in LIPG may result in elevated HDL-C and therefore performed deep resequencing of LIPG exons in cases with elevated HDL-C levels and controls with decreased HDL-C levels. We identified a significant excess of nonsynonymous LIPG variants unique to cases with elevated HDL-C. In vitro lipase activity assays demonstrated …

Homologous Recombination Mediates Functional Recovery Of Dysferlin Deficiency Following Aav5 Gene Transfer, William E. Grose, K. Reed Clark, Danielle Griffin, Vinod Malik, Kimberly M. Shontz, Chrystal L. Montgomery, Sarah Lewis, Robert H. Brown Jr., Paul M. L. Janssen, Jerry R. Mendell, Louise R. Rodino-Klapac

Dr Robert Brown

The dysferlinopathies comprise a group of untreatable muscle disorders including limb girdle muscular dystrophy type 2B, Miyoshi myopathy, distal anterior compartment syndrome, and rigid spine syndrome. As with other forms of muscular dystrophy, adeno-associated virus (AAV) gene transfer is a particularly auspicious treatment strategy, however the size of the DYSF cDNA (6.5 kb) negates packaging into traditional AAV serotypes known to express well in muscle (i.e. rAAV1, 2, 6, 8, 9). Potential advantages of a full cDNA versus a mini-gene include: maintaining structural-functional protein domains, evading protein misfolding, and avoiding novel epitopes that could be immunogenic. AAV5 has demonstrated unique …

Impact Study Of A Central Lines Simulation Training Program Using Kirkpatrick’S Four-Level Evaluation Model, James P. Orlando Edd, Andrew C. Miller Do, William Bond Md, Ms, Valerie A. Rupp Rn, Bsn, Bryan G. Kane Md, Cindy Umbrell Rn, Msn, Michael Pasquale Md

Bryan G Kane MD

No abstract provided.

Sdot Faculty And Resident Training Study, Kevin Weaver Do, Kathleen E. Kane Md, Gavin Barr Jr. Md, Allison Raines Do, Nicole L. Bendock Do, Brian M. Berry Do, Gregory Smeriglio Jr, Do, Bruce C. Stouch Phd, Dawn M. Yenser, Bryan G. Kane Md

Bryan G Kane MD

No abstract provided.

Impact Of An Interprofessional Central Venous Catheter Insertion Training Program, James P. Orlando Edd, Andrew Miller Do, William Bond Md, Ms, Valerie A. Rupp Rn, Bsn, Bryan G. Kane Md, Cindy Umbrell Rn, Msn, Michael Pasquale Md, Elizabeth Verheggen Phd, Elliot J. Sussman Md, Mba

Bryan G Kane MD

No abstract provided.

A Feasibility Study To Determine If Inexpensive Commercial Coolers Maintain Normal Saline Temperatures At 4ºc, Robert Tomsho Do, Ms, Karen Pheasant Do, Valerie A. Rupp Rn, Bsn, Kathleen E. Kane Md, Bryan G. Kane Md

Bryan G Kane MD

No abstract provided.

The Correlation Between Adolescent-Reported Parental Driving Behaviors And Observed Adult Driving Behaviors., Bryan G. Kane Md, Gavin C. Barr Md, Shawna Murphy Do, Valerie Rupp Rn, Bsn, Kimberly Hamilton Ba, Robert D. Barraco Md, Traci Anselmo Do, James F. Reed Iii Phd

Bryan G Kane MD

No abstract provided.

Emergency Medicine Residents As Teachers, Julie K. Wachtel Do, Mph, Marna Rayl Greenberg Do, Mph, Amy B. Smith Phd, Kevin R. Weaver Do, Bryan G. Kane Md

Bryan G Kane MD

No abstract provided.

Jejunojejunal Intussusception Following Roux-En-Y Gastric Bypass, John Ashurst Do, Bryan G. Kane Md

Bryan G Kane MD

No abstract provided.

Relaxation Thyroplasty – A Classical Surgical Approach For Puberphonia, Balasubramanian Thiagarajan, Karthikeyan Arjunan

Balasubramanian Thiagarajan

Abstract: The persistence of adolescent voice even after puberty in the absence of organic cause is known as puberphonia. 1,2,3 The condition is commonly seen in males.1-7 . This case report illustrates a novel surgical method “Retrusion thyroplasty” in the management of puberphonia. Introduction: The persistence of adolescent voice even after puberty in the absence of organic cause is known as puberphonia. 1,2,3 The condition is commonly seen in males.1-7 Normally adolescent males undergo voice changes due to sudden increase in length of vocal cords due to enlargement of thyroid prominence (Adam’s apple). This is uncommon in females because their …

Occupational Chronic Obstructive Pulmonary Disease: An Update, Enrique Diaz-Guzman, David M. Mannino, Shambhu Aryal

David M. Mannino

Chronic obstructive pulmonary disease represents a major cause of morbidity and mortality in industrialized and nonindustrialized countries. Although tobacco use remains the main factor associated with development of the disease, occupational risk factors represent an important and preventable cause. The most common occupationally related factors include exposure to organic dusts, metallic fumes, and a variety of other mineral gases and/or vapors. This article summarizes the literature on the subject and provides an update of the most recent advances in the field.

Epidemiology Of Comorbidities In Chronic Obstructive Pulmonary Disease: Clusters, Phenotypes And Outcomes, Shambhu Aryal, Enrique Diaz-Guzman, David M. Mannino

David M. Mannino

COPD is a complex multisystem disease often accompanied by multiple co-morbidities that contribute to symptoms, exacerbations, hospital admissions and mortality. Individual comorbidities can be grouped into clusters of common human pathology: inflammation/immune response (e.g., ischemic heart disease, metabolic syndrome), thrombosis/hemorrhage (e.g., cerebrovascular diseases, pulmonary embolism), fibrosis/cell proliferation (e.g., lung cancer and other malignancies) and apoptosis/necrosis (e.g., osteoporosis, skeletal muscle dysfunction). While the prevalence of the co-morbidities has been described in a number of observational studies, there is considerable variability in results; moreover characterization of cluster of co-morbidities with the most clinical significance in terms of morbidity and mortality is still …

Porque Mas Iberoamerica? De Lecciones Aprendidas Y Buenas Practicas., Diego A. Bernardini

Diego Bernardini MD, PhD

No abstract provided.

Neuropsychological Outcomes In Adults Commencing Highly Active Anti-Retroviral Treatment In South Africa: A Prospective Study, John A. Joska, John A. Joska, Jennifer Westgarth-Taylor, Jacqueline Hoare, Kevin Gf Thomas, Robert Paul, Landon Myer, Dan J. Stein

Robert Paul

Adrenoceptor Function And Expression In Bladder Urothelium And Lamina Propria, Christian Moro, Lotti Tajouri, Russ Chess-Williams

Christian Moro

Non-Adrenergic, Non-Cholinergic, Non-Purinergic Contractions Of The Urothelium/Lamina Propria Of The Pig Bladder, Christian Moro, Russ Chess-Williams

Russ Chess-Williams

Summary1. Acetylcholine, and to a lesser extent ATP, mediates neurogenic contractions of bladder smooth muscle. Recently, the urothelium and lamina propria have also been shown to have contractile properties, but the neurotransmitters involved in mediating responses to nerve stimulation have not been investigated.2. Isolated strips of porcine urothelium with lamina propria were electrically field stimulated and contractions recorded. Drugs interfering with neurotransmission were then employed to identify which neurotransmitters mediated responses.3. Strips of urothelium/lamina propria developed spontaneous contractions with a frequency of 3.5 ± 0.1 cycles min_1 and amplitude of 0.84 ± 0.06 g. Electrical field stimulation at 5, 10, …

A 'Snip' In Time: What Is The Best Age To Circumcise?, Brian J. Morris, Jake H. Waskett, Joya Banerjee, Richard G. Wamai, Aaron A. R. Tobian, Ronald H. Gray, Stefan A. Bailis, Robert C. Bailey, Jeffrey D. Klausner, Robin J. Willcourt, Daniel T. Halperin, Thomas E. Wiswell, Adrian Mindel

Richard G. Wamai

Background Circumcision is a common procedure, but regional and societal attitudes differ on whether there is a need for a male to be circumcised and, if so, at what age. This is an important issue for many parents, but also pediatricians, other doctors, policy makers, public health authorities, medical bodies, and males themselves. Discussion We show here that infancy is an optimal time for clinical circumcision because an infant's low mobility facilitates the use of local anesthesia, sutures are not required, healing is quick, cosmetic outcome is usually excellent, costs are minimal, and complications are uncommon. The benefits of infant …

Exposé Of Misleading Claims That Male Circumcision Will Increase Hiv Infections In Africa, Brian J. Morris, Jake H. Waskett, Ronald H. Gray, Daniel T. Halperin, Richard Wamai, Bertran Auvert, Jeffrey D. Klausner

Richard G. Wamai

Despite over two decades of extensive research showing that male circumcision protects against heterosexual acquisition of HIV in men, and that includes findings from large randomized controlled trials leading to acceptance by the WHO/UNAIDS and the Cochrane Committee, opponents of circumcision continue to generate specious arguments to the contrary. In a recent issue of the Journal of Public Health in Africa, Van Howe and Storms claim that male circumcision will increase HIV infections in Africa. Here we review the statements they use in support of their thesis and show that there is no scientific basis to such an assertion. We …

Technology Assessment Of Automated Atlas Based Segmentation In Prostate Bed Contouring, Jeremiah Hwee, Alexander Louie, Stewart Gaede, Glenn Bauman, David D'Souza, Tracy Sexton, Michael Lock, Belal Ahmad, George Rodrigues

Michael Lock

BACKGROUND: Prostate bed (PB) contouring is time consuming and associated with inter-observer variability. We evaluated an automated atlas-based segmentation (AABS) engine in its potential to reduce contouring time and inter-observer variability.

METHODS: An atlas builder (AB) manually contoured the prostate bed, rectum, left femoral head (LFH), right femoral head (RFH), bladder, and penile bulb of 75 post-prostatectomy cases to create an atlas according to the recent RTOG guidelines. 5 other Radiation Oncologists (RO) and the AABS contoured 5 new cases. A STAPLE contour for each of the 5 patients was generated. All contours were anonymized and sent back to the …

Role Of X-Rays In Rhinology, Balasubramanian Thiagarajan

Balasubramanian Thiagarajan

X-rays in the present day context is considered to be outdated by Rhinologists. CT scan images have replaced conventional x-ray imaging. Current concensus is that still x-rays have a role in the field of rhinology. Its inherent advantages like easy availability, cost effectiveness makes this investigation still relevant in the present day scenario. Bony lesions involving nose and sinuses, can be evalutated with reasonable degree of accuracy by performing conventional radiographs. Air present inside the paranasal sinuses serve as excellent contrast medium for plain x-ray evaluation. Pathologies involving paranasal sinuses encroach upon these air spaces causing alterations in their translucency.