Digital Commons Network^™

Feasibility And Compliance With Daily Home Ecg Monitoring Of The Qt Interval In Heart Transplant Recipients, Erik V. Carter, Kathleen T. Hickey, David M. Pickham, Lynn V. Doering, Belinda Chen, Patricia R. E. Harris, Barbara J. Drew

Collected Faculty Scholarship

About 13% of adult heart transplant recipients do not survive to one year and a major cause of death is acute cellular allograft rejection.^1,2 According to the 2009 annual United States data published from the International Society for Heart Lung Transplantation Registry, acute rejection occurs in 25 – 35% of transplant recipients within the first year following transplant surgery.³ In order to detect the early stages of rejection so that more aggressive and early immunosuppressant therapy can be initiated, frequent biopsies of heart tissue are performed (typically, weekly or every other week in the first 3 months and …

Children's Mercy Hospital Annual Report 2011, Children's Mercy Hospital

Children's Mercy Annual Reports

Annual report for The Children's Mercy Hospital in Kansas City MO, a pediatric medical center.

Type 2 Diabetes And Insomnia: Impact On Metabolic Control, Cheryl Lee Tannas

Wayne State University Dissertations

Diabetes is one of the most serious health challenges in the United States, affecting nearly 21 million Americans. The goal of diabetes management is to maintain the blood glucose close to normal to prevent diabetic complications and therefore extending life expectancy and improving quality of life. Research now indicates a relationship of the quantity and quality of sleep to glycemic control in type 2 diabetics. No research on the impact of insomnia on diabetes prevention and/or management was found in the literature. The purpose of this 11 week intervention study was to examine the effects of participation in Cognitive Behavioral …

Community Perspectives On Research Consent Involving Vulnerable Children In Western Kenya, Rachel Vreeman, Eunice Kamaara, Allan Kamanda, David Ayuku, Winstone Nyandiko, Lukoye Atwoli, Samuel Ayaya, Peter Gisore, Michael Scanlon, Paula Braitstein

Paediatrics and Child Health, East Africa

Involving vulnerable pediatric populations in international research requires culturally appropriate ethical protections. We sought to use mabaraza, traditional East African community assemblies, to understand how a community in western Kenya viewed participation of children in health research and informed consent and assent processes. Results from 108 participants revealed generally positive attitudes towards involving vulnerable children in research, largely because they assumed children would directly benefit. Consent from parents or guardians was understood as necessary for participation while gaining child assent was not. They felt other caregivers,community leaders, and even community assemblies could participate in the consent process. Community members believed …

Preterm Birth And The Perception Of Risk Among African Americans, Gwendolyn Simpson Norman

Wayne State University Dissertations

Background: African American women deliver preterm at a rate that is two to three times that of their white counterparts, and after decades of research, this disparity in birth outcomes still remains unexplained. While factors including income, education, neighborhood conditions, infection and stress have all been associated with prematurity, no combination of these factors has explained why the disparity persists. Recently, however, racism-specific stress has emerged as a possible factor contributing to this disparity. This study was designed to learn how preterm birth was explained by African Americans directly impacted by prematurity. Methods: Interviews were conducted with African American women …

Persistent Systemic Inflammation Is Associated With Poor Clinical Outcomes In Copd: A Novel Phenotype, Alvar Agustí, Lisa D. Edwards, Stephen I. Rennard, William Macnee, Ruth Tal-Singer, Bruce E. Miller, Jørgen Vestbo, David A. Lomas, Peter M.A. Calverley, Emiel Wouters, Courtney Crim, Julie C. Yates, Edwin K. Silverman, Harvey O. Coxson, Per Bakke, Ruth J. Mayer, Bartolome Celli, Evaluation Of Copd Longitudinally To Identify Predictive Surrogate Endpoints (Eclipse) Investigators

Journal Articles: Pulmonary & Critical Care Med

BACKGROUND: Because chronic obstructive pulmonary disease (COPD) is a heterogeneous condition, the identification of specific clinical phenotypes is key to developing more effective therapies. To explore if the persistence of systemic inflammation is associated with poor clinical outcomes in COPD we assessed patients recruited to the well-characterized ECLIPSE cohort (NCT00292552).

METHODS AND FINDINGS: Six inflammatory biomarkers in peripheral blood (white blood cells (WBC) count and CRP, IL-6, IL-8, fibrinogen and TNF-α levels) were quantified in 1,755 COPD patients, 297 smokers with normal spirometry and 202 non-smoker controls that were followed-up for three years. We found that, at baseline, 30% of …

Measurement And Correlates Of Empathy Among Female Japanese Physicians., Hitomi U Kataoka, Norio Koide, Mohammadreza Hojat, Joseph S Gonnella

CRMEHC Faculty Papers

BACKGROUND: The measurement of empathy is important in the assessment of physician competence and patient outcomes. The prevailing view is that female physicians have higher empathy scores compared with male physicians. In Japan, the number of female physicians has increased rapidly in the past ten years. In this study, we focused on female Japanese physicians and addressed factors that were associated with their empathic engagement in patient care.

METHODS: The Jefferson Scale of Empathy (JSE) was translated into Japanese by using the back-translation procedure, and was administered to 285 female Japanese physicians. We designed this study to examine the psychometrics …

Trends In Hospital Admissions For Myocardial Infarcts For Women In Arizona, Florida And Maryland In 2000 To 2010, Rebecca Farmer Mcintyre

MUSC Theses and Dissertations

Coronary arterial disease is the leading cause of death and morbidity in developing countries. Acute myocardial infarction (AMI) has traditionally been considered a disease affecting mostly men, yet women are increasingly at risk due to obesity and diabetes. However, current trends in the AMI risk for women are not well understood. This study used archival data on hospital discharges from three states within the USA to examine the 10-year trend in presentations of patients to emergency rooms (ER) with a presenting diagnosis of chest pain and AMI, to document rate changes by gender over time. We observed a decreasing number …

Childhood Unintentional Injuries: Need For A Community-Based Home Injury Risk Assessments In Pakistan., Adnan A. Hyder, Aruna Chandran, Uzma R. Khan, Nukhba Zia, Cheng-Ming Huang, Sarah Stewart De Ramirez, Junaid Razzak

Department of Emergency Medicine

Background. A substantial proportion of the annual 875,000 childhood unintentional injury deaths occur in the home. Very few printed tools are available in South Asia for disseminating home injury prevention information. Methods. Three tools were planned: an injury hazard assessment tool appropriate for a developing country setting, an educational pamphlet highlighting strategies for reducing home injury hazards, and an in-home safety tutorial program to be delivered by a trained community health worker. Results. The three tools were successfully developed. Two intervention neighborhoods in Karachi, Pakistan, were mapped. The tools were pretested in this local setting and are now ready for …

Coping Styles In Patients With Anxiety And Depression, Pashtoon Murtaza Kasi, Haider Ali Naqvi, Abaseen Khan Afghan, Talha Khawar, Farooq Hasan Khan, Umber Zaheer Khan, Urooj Bakht Khuwaja, Jawad Kiani, Hadi Mohammad Khan

Department of Psychiatry

Different individuals use different coping styles to cope with their problems. In patients with anxiety and/or depression, these have important implications. The primary objective of our study was to estimate the frequency of different coping mechanisms used by patients with symptoms of anxiety and depression. A descriptive, cross-sectional survey was conducted and patients with symptoms of anxiety and depression were identified using the Aga Khan University's Anxiety and Depression Scale (AKUADS). Coping styles were determined by using the 28-item Brief COPE inventory. We were able to recruit 162 people. The prevalence of anxiety and depression was found to be 34%. …

The Effect Of The Retroperitoneal Transpsoas Minimally Invasive Lateral Interbody Fusion On Segmental And Regional Lumbar Lordosis, Tien V. Le, Andrew C. Vivas, Elias Dakwar, Ali A. Baaj, Juan S. Uribe

Neurosurgery and Brain Repair Faculty Publications

Background. The minimally invasive lateral interbody fusion (MIS LIF) in the lumbar spine can correct coronal Cobb angles, but the effect on sagittal plane correction is unclear. Methods. A retrospective review of thirty-five patients with lumbar degenerative disease who underwent MIS LIF without supplemental posterior instrumentation was undertaken to study the radiographic effect on the restoration of segmental and regional lumbar lordosis using the Cobb angles on pre- and postoperative radiographs. Mean disc height changes were also measured. Results. The mean follow-up period was 13.3 months. Fifty total levels were fused with a mean of 1.42 levels …

Attitudes, Beliefs, And Practices Of Providers And Key Opinion Leaders On Emergency Contraception In India, M.E. Khan, Deepthi S. Varma, Isha Bhatnagar, Anvita Dixit, Martha Brady

Reproductive Health

The Population Council undertook this study to assess the knowledge, attitudes, and practices regarding emergency contraception (ECP) among providers in public and private facilities and pharmacies in India. The objectives of the study were to: assess providers' knowledge of ECP's biological mechanism; understand providers' knowledge and attitudes about ECP's safety, effectiveness, and availability as an OTC drug; and identify providers' definitions of “repeated use” and profiling women who are “repeated users” of ECP. This study's findings show that most providers, including doctors and some KOLs, were incorrectly informed about ECP's mechanism of action. Service guidelines are necessary for accurate and …

Nasal Encephaloceles Presenting At Later Ages: Experience Of Otorhinolaryngology Department At A Tertiary Care Center In Karachi, Pakistan, Montasir Junaid, Zain-Ul-Abedeen Sobani, Adeel Ahmed Shamim, Maliha Kazi, Mumtaz Jamshed Khan

Section of Otolaryngology, Head & Neck Surgery

Encephaloceles are anomalous herniations of the meninges, with or without brain matter. Globally the incidence of encephalocele is about 1 per 35,000 births, but it is more frequently reported in Southeast Asia. As the defect is more pertinent to embryological development, an encephalocele is a more common entity in an infant with a mean age of presentation ranging between 15.5 and 21 months; making an encephalocele presenting for the first time in a relatively, older individual a rare occurrence. Consequently a surgeon might not consider an encephalocele among his differentials. Here we present a series of encephaloceles that presented at …

Medical Educational: The Development Of Intellect, Haider A. Naqvi

Department of Psychiatry

No abstract provided.

Two-Week Joint Mobilization Intervention Improves Self-Reported Function, Range Of Motion, And Dynamic Balance In Those With Chronic Ankle Instability, Matthew C. Hoch, Richard D. Andreatta, David R. Mullineaux, Robert A. English, Jennifer M. Medina Mckeon, Carl G. Mattacola, Patrick O. Mckeon

Human Movement Studies & Special Education Faculty Publications

We examined the effect of a 2-week anterior-to-posterior ankle joint mobilization intervention on weight-bearing dorsiflexion range of motion (ROM), dynamic balance, and self-reported function in subjects with chronic ankle instability (CAI). In this prospective cohort study, subjects received six Maitland Grade III anterior-to-posterior joint mobilization treatments over 2 weeks. Weight-bearing dorsiflexion ROM, the anterior, posteromedial, and posterolateral reach directions of the Star Excursion Balance Test (SEBT), and self-reported function on the Foot and Ankle Ability Measure (FAAM) were assessed 1 week before the intervention (baseline), prior to the first treatment (pre-intervention), 24-48 h following the final treatment (post-intervention), and 1 …

Peripheral Nerve Repair With Cultured Schwann Cells: Getting Closer To The Clinics, Maria Carolina O. Rodrigues, Antonio Antunes Rodrigues, Loren E. Glover, Julio Voltarelli, Cesar V. Borlongan

Neurosurgery and Brain Repair Faculty Publications

Peripheral nerve injuries are a frequent and disabling condition, which affects 13 to 23 per 100.000 persons each year. Severe cases, with structural disruption of the nerve, are associated with poor functional recovery. The experimental treatment using nerve grafts to replace damaged or shortened axons is limited by technical difficulties, invasiveness, and mediocre results. Other therapeutic choices include the adjunctive application of cultured Schwann cells and nerve conduits to guide axonal growth. The bone marrow is a rich source of mesenchymal cells, which can be differentiated in vitro into Schwann cells and subsequently engrafted into the damaged nerve. Alternatively, undifferentiated …

Uchunguzi (Journal Watch/Montre De Journal) June 2012, Benjamin Wachira

Family Medicine, East Africa

Uchunguzi means investigation in Swahili and provides a summary of some of the most recent international literature as presented in other leading journals, but with an emphasis on what is relevant to our continent.

Bilingual Navigation In Cancer Care, Raizalie Roman-Rosado Bsn, Ocn, Cmsrn, Martiza Y. Chicas Rn, Pccn, Kathy Sevedge Rn, Ma, Aocn, Ada M. Rivera Ba, Nadesda Mack Rn, Bsn, Mba, Ocn, Tina Mellinger

Patient Care Services / Nursing

No abstract provided.

Transcatheter Retrieval And Repositioning Of Embolized Stent From The Right Ventricle In An Infant, Daisuke Kobayashi, Harinder R Singh, Daniel R Turner, Thomas J Forbes, Srinath T Gowda

The Texas Heart Institute Journal

Intracardiac stent embolization is a challenging complication in a small infant. A Palmaz stent was placed across the atrial septum in a 3-month-old boy to relieve symptoms of right-side heart failure. On routine chest radiography one week later, the stent was found to have embolized into the right ventricle. The stent was retrieved and repositioned by means of transcatheter technique, without subsequent complications. We found this method to be a viable alternative to surgery in a high-risk infant. To our knowledge, this is the first report of the successful transcatheter retrieval and repositioning of an expandable intravascular stent from an …

Coronary Arteriovenous Fistulae: The Complexity Of Coronary Artery-To-Coronary Sinus Connections, Todd L Kiefer, Anna Lisa Crowley, James Jaggers, J Kevin Harrison

The Texas Heart Institute Journal

Coronary artery fistulae are a rare cardiovascular anomaly. Even less common are multiple fistulae involving more than 1 coronary artery. Herein we report the case of a 47-year-old woman who had fistulae from both the right coronary and left circumflex coronary arteries draining into the coronary sinus. These lesions we attempted to close percutaneously but subsequently closed surgically. We discuss diagnostic imaging approaches, along with closure indications, closure options, and outcomes.

Research Annual Report 2012, Children's Mercy Hospital

Research Annual Reports

Annual report of the research at Children's Mercy Hospital in Kansas City MO, a pediatric medical center.

She’S A Survivor: Post-Operative Counseling And Its Importance To The Recovery Of A Woman Victimized By Female Genital Mutilation, Jacent Wamala

McNair Poster Presentations

The prevalence of Female Genital Mutilation and the difficulty in preventing its practice call for a fresh way of resolving the problem. As the availability of medical professionals equipped with the ability to correct clitoral mutilation grows, there is also an increasing need for professionals that can help the victims after the reconstructive surgery. Post-operative therapy for victims that have opted to receive reconstructive surgery is necessary in order to fully recover. Furthermore, more research in this area is needed to support the findings of this review and will fill the physical and emotional gap exhibited in prior studies related …

Community Based Weighing Of Newborns And Use Of Mobile Phones By Village Elders In Rural Settings In Kenya: A Decentralised Approach To Health Care Provision, Peter Gisore, Evelyn Shipala, Kevin Otieno, Betsy Rono, Irene Marete, Constance Tenge, Hillary Mabeya, Sherri Bucher, Janet Moore, Edward Liechty, Fabian Esamai

Paediatrics and Child Health, East Africa

Background: Identifying every pregnancy, regardless of home or health facility delivery, is crucial to accurately estimating maternal and neonatal mortality. Furthermore, obtaining birth weights and other anthropometric measurements in rural settings in resource limited countries is a difficult challenge. Unfortunately for the majority of infants born outside of a health care facility, pregnancies are often not recorded and birth weights are not accurately known. Data from the initial 6 months of the Maternal and Neonatal Health (MNH) Registry Study of the Global Network for Women and Children’s Health study area in Kenya revealed that up to 70% of newborns did …

Dynamics Of Envelope Evolution In Clade C Shiv-Infected Pig-Tailed Macaques During Disease Progression Analyzed By Ultra-Deep Pyrosequencing, For Yue Tso, Damien C. Tully, Sandra Gonzalez, Christopher Quince, On Ho, Patricia Polacino, Ruth M. Ruprecht, Shiu-Lok Hu, Charles Wood

Nebraska Center for Virology: Faculty Publications

Understanding the evolution of the human immunodeficiency virus type 1 (HIV-1) envelope during disease progression can provide tremendous insights for vaccine development, and simian-human immunodeficiency virus (SHIV) infection of nonhuman primate provides an ideal platform for such studies. A newly developed clade C SHIV, SHIV-1157ipd3N4, which was able to infect rhesus macaques, closely resembled primary HIV-1 in transmission and pathogenesis, was used to infect several pig-tailed macaques. One of the infected animals subsequently progressed to AIDS, whereas one remained a nonprogressor. The viral envelope evolution in the infected animals during disease progression was analyzed by a bioinformatics approach using ultra-deep …

Vip And Host Immunity, Xiaoyu Jiang

Wayne State University Dissertations

The purpose of the current dissertation was to examine how VIP regulates host immunity and corneal healing, specifically, its control of growth factors and TLR expression in the P. aeruginosa infected cornea. Firstly, VIP treatment increased growth factor expression (EGF, GHF, FGF and VEGF) in infected cornea. Notably, treatment with a mixture of EGF, FGF and HGF prevented corneal perforation, reduced pro-inflammatory cytokines and bacterial plate count, while increasing anti-inflammatory cytokines and antimicrobials such as murine beta-defensin2 and 3.

We also investigated the expression of TLR-signaling pathways in P. aeruginosa infected corneas with or without VIP treatment. PCR array and …

Use Of A Video Game Based Balance Training Intervention On The Balance And Function Of Children With Developmental Disabilities, Gina C. Siconolfi-Morris

Theses and Dissertations--Rehabilitation Sciences

Many children with developmental disabilities (DD) have physical impairments and limitations in their participation. Rehabilitation research often focuses on either physical impairments or participation restrictions, when both need to be investigated. The purposes of these two studies were to evaluate an at home therapist directed video game balance training intervention on balance, gait velocity (GV), hip strength and activities of children with DD. The pilot study was a single-subject non-concurrent multiple baseline design. Balance measures included: weight bearing symmetry; center of pressure area and velocity; time to boundary mean minima and standard deviation; and timed up and go. The participant’s …

Humor-Related Social Exchanges And Mental Health In Assisted Living Residents, Ann Elizabeth Mcqueen

Dissertations and Theses

Social contact is known to be vital for older adults' mental and physical health, but few studies of social interactions have taken place in long-term care settings. The current study investigated whether the psychological well-being of assisted living residents was influenced by factors associated with residents' social interactions involving humor. Specific aims of the present study were to develop and test a measure related to humor-related social exchanges, to examine how humor-related social exchanges affect residents' mental health, and to explore whether humor-related social exchanges mediated the effects of resident and facility characteristics on indices of mental health. One hundred …

Eae/Ase Recommendations For Image Acquisition And Display Using Three-Dimensional Echocardiography., Roberto M. Lang, Luigi P. Badano, Wendy Tsang, David H. Adams, Eustachio Agricola, Thomas Buck, Francesco F. Faletra, Andreas Franke, Judy Hung, Leopoldo Pérez De Isla, Otto Kamp, Jaroslaw D. Kasprzak, Patrizio Lancellotti, Thomas H. Marwick, Marti L. Mcculloch, Mark J. Monaghan, Petros Nihoyannopoulos, Natesa G. Pandian, Patricia A. Pellikka, Mauro Pepi, David A. Roberson, Stanton K. Shernan, Girish S. Shirali, Lissa Sugeng, Folkert J. Ten Cate, Mani A. Vannan, Jose Luis Zamorano, William A. Zoghbi, American Society Of Echocardiography, European Association Of Echocardiography

Manuscripts, Articles, Book Chapters and Other Papers

No abstract provided.

Suicide In Prepubertal Children, Kimberly K. Mcclanahan, Hatim A. Omar

Pediatrics Faculty Publications

No abstract provided.

Pregnancy In Adolescence, Donald E. Greydanus, Marlene B. Huff, Hatim A. Omar, Colleen B. Dodich

Pediatrics Faculty Publications

Over 14 million adolescents in the world annually give birth and nearly 800.000 adolescents in the United States become pregnant each year. This paper considers concepts of teen pregnancy including risks to the mother as well as offspring, the adolescent father, issues related to abortion, and concepts of prevention of unwanted pregnancy in youth. Adolescent pregnancy is a global phenomenon affecting all societies and cultures.