Digital Commons Network^™

Neuroimaging Of Tumefactive Multiple Sclerosis With Atypical Features, Rohit Koppula, Andrew J. Degnan, Mark Ghassibi, Peter Duggan, Robert Jones, Lucien M. Levy

Radiology Faculty Publications

Tumefactive demyelinating lesions or tumefactive multiple sclerosis constitute a unique presentation of demyelinating disease which frequently mimics intracranial neoplasm, infection or other, non-demyelinating intracranial pathology. Consequently, these lesions, which are larger than typical multiple sclerosis plaques and generally characterized by certain magnetic resonance imaging features including edema and incomplete ring enhancement, pose a serious diagnostic challenge that frequently prompts biopsy in initial evaluation. Biopsy can be averted when imaging features for tumefactive multiple sclerosis are seen on MRI. Herein, we present a biopsy-proven case of tumefactive multiple sclerosis with atypical imaging features, evaluated using magnetic resonance and diffusion tensor imaging.

Acr Appropriateness Criteria®  Resectable Rectal Cancer, William E. Jones Iii, Charles R. Thomas Jr, Joseph M. Herman, May Abdel-Wahab, Nilofer Azad, William Blackstock, Prajnan Das, Karyn A. Goodman, Theodore S. Hong, Salma K. Jabbour, Andre A. Konski, Albert C. Koong, Miguel Rodriguez-Bigas, William Small Jr, Jennifer Zook, W Suh

Wayne State University Associated BioMed Central Scholarship

Abstract

The management of resectable rectal cancer continues to be guided by clinical trials and advances in technique. Although surgical advances including total mesorectal excision continue to decrease rates of local recurrence, the management of locally advanced disease (T3-T4 or N+) benefits from a multimodality approach including neoadjuvant concomitant chemotherapy and radiation. Circumferential resection margin, which can be determined preoperatively via MRI, is prognostic. Toxicity associated with radiation therapy is decreased by placing the patient in the prone position on a belly board, however for patients who cannot tolerate prone positioning, IMRT decreases the volume of normal tissue irradiated. The …

Comparison Of Time Domain And Spectral Domain Optical Coherence Tomography In Measurement Of Macular Thickness In Macular Edema Secondary To Diabetic Retinopathy And Retinal Vein Occlusion., Elham Hatef, Afsheen Khwaja, Zubir Rentiya, Mohamed Ibrahim, Matthew Shulman, Peykan Turkcuoglu, Yasir J. Sepah, Jianmin Wang, Roomasa Channa, Millena Bittencourt, Abeer Akhtar, Jangwon Heo, Diana V. Do, Quan Dong Nguyen

Journal Articles: Ophthalmology

Purpose. To evaluate macular thickness, agreement, and intraclass repeatability in three optical coherence tomography (OCT) devices: the time domain (TD) Stratus OCT and two spectral domain (SD) OCTs, Spectralis and Cirrus SD-OCT, in eyes with macular edema secondary to diabetic retinopathy (DR) and retinal vein occlusion (VO). Methods. In a prospective observational study at a university-based retina practice, retinal thickness tomography was performed simultaneously for fifty-eight patients (91 eyes) with DR and VO employing a time domain and two spectral domain OCTs. Agreement in macular measurements was assessed by constructing Bland-Altman plots. Intraclass repeatability was assessed by intraclass correlation coefficients …

Corneal Swapping In A Bomb Blast Victim, Tanveer Anjum Chaudhry, Tahreem Aman, Farheen Shaikh, Khabir Ahmad

Section of Ophthalmology

The case of a 40-year-old-man who presented to our clinic with bilateral blindness as a consequence of bomb blast injuries is reported. He had a completely opaque cornea, partially damaged posterior segment and perception of light in the right eye, while a clear cornea, totally damaged posterior segment and no light perception in the fellow eye. His corneas were successfully swapped which gave him navigational vision.

James Marion Sims, M.D., Ll.D., Jonathan Tavares, B.S., Charles J. Yeo, Md, Pinckney J. Maxwell, Iv, Md

Department of Surgery Gibbon Society Historical Profiles

Few physicians have been as celebrated and loathed as James Marion Sims, M.D., LL.D. Dr. Sims’ modest early life and education never could have predicted that he would one day be called the ‘‘Father of American Gynecology.’’1, 2 Lauded by contemporaries and early historians as ‘‘one of the most original and gifted of American surgeons,’’ he performed the first successful operation to correct vesicovaginal fistulas (a condition that prior to 1852 was known as the ‘‘stumbling-block of gynecology’’).1 Today, the same work that earned Dr. Sims fame, fortune, and innumerable honors has been called into question, because of the unethical …

Manifestations Of Rheumatoid Arthritis: Epidural Pannus And Atlantoaxial Subluxation Resulting In Basilar Invagination., Adam L Schreiber, Do, Ma

Department of Rehabilitation Medicine Faculty Papers

Presented in part at the AAPMR 71st Annual Assembly Meeting, Seattle, WA, November 4-7, 2010.

Atlantoaxial instability results from cartilaginous destruction, periarticular erosions, and ligament and tendon attenuation. Instability affects 19%-70% of patients, and basilar invagination from vertical odontoid subluxation through the foramen magnum occurs in 38% of patients. This phenomenon occurs twice as often in women than men, whose age at diagnosis typically ranges from 30-50 years. Along with bony compression, the pannus further decreases the space available for the cord by 3mmor more in approximately 66% of patients (Figures 1-7). The earliest and most common symptom of cervical …

Ptsd And Substance Use Disorders Among Offenders: Examining The Effects Of Tbi, Gender And Interpersonal Violence Victimization, Monica E. Cornelius

MUSC Theses and Dissertations

Offender populations have high rates of substance use disorders (SUDs) as well as violence, traumatic brain injury (TBI), and post traumatic stress disorder (PTSD). The lack of screening and treatment of co-occurring disorders has been cited as a major barrier to treating SUDs in offenders. A significant proportion of the offender population has at least one co-occurring disorder with their substance use. Often co-occurring disorders are related to SUDs. Evidence suggests that interpersonal violence victimization (IPVV), TBI, and PTSD are related to SUD and that PTSD alone may also contribute to criminality. The specific aims of this research are to: …

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 …

The Influence Of The Method Of Cerebral Protection During Neonatal Cardiac Surgery On The Development Of Attention Deficit/Hyperactivity Disorder, Joseph J. Sistino

MUSC Theses and Dissertations

Complex congenital heart disease is a common birth defect requiring surgery soon after birth. Surgery can use a complete interruption of cerebral blood flow (DHCA) or it can be performed using regional low flow perfusion (RLFP). Either approach places the neonate at risk for oxygen deprivation resulting in neurodevelopmental impairment and Attention Deficit/Hyperactivity Disorder (ADHD). RLFP has been widely adopted but its effect on ADHD has not been elucidated. We extracted surgical records data and surveyed parents of 5-16 year old children who had neonatal surgery using DHCA or RLFP in 1995-2006 to determine the prevalence of ADHD after DHCA …

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%. …

Sexually Transmitted Diseases (Stds), Donald E. Greydanus, Jane Seyler, Hatim A. Omar

Pediatrics Faculty Publications

High rates of unprotected sexual behavior in adolescents result in millions of cases of STDs in the world. This chapter reviews factors inducing high STD rates, specific STDs, and their management based on 2010 U.S. Centers for Disease Control and Prevention (CDC) STD guidelines. Clinicians should screen all their sexually active adolescent patients for STDs and provide preventive education as well as treatment measures.

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 …

Providers' And Key Opinion Leaders' Attitudes, Beliefs, And Practices Regarding Emergency Contraception In Nigeria, Babatunde A.O. Ahonsi, Salisu Mohammed Ishaku, Araoyinbo Idowu, Ayodeji Oginni

Reproductive Health

Despite significant progress in product development, procurement, and distribution in the past few decades, emergency contraception’s (EC) capacity to benefit many women in countries such as Nigeria is hampered by a number of potential barriers, that are not well understood. The Population Council, with support from the International Consortium for Emergency Contraception, documented EC-related knowledge, attitudes, and practices among providers in Nigeria as well as perceptions of key opinion leaders who help shape the policy environment for EC and family planning in general. Findings suggest significant gaps in Nigeria, potentially necessitating continuous training and re-training to help dispel misperceptions and …

Receptor Antagonism And Dyskinesia In Parkinson’S Disease, Micaela Morelli, Fabio Blandini, Nicola Simola, Robert A. Hauser

Neurology Faculty Publications

Dyskinesia, a major complication of treatment of Parkinson’s disease (PD), involves two phases: induction, which is responsible for dyskinesia onset, and expression, which underlies its clinical manifestation. The unique cellular and regional distribution of adenosine receptors in basal ganglia areas that are richly innervated by dopamine, and their antagonistic role towards dopamine receptor stimulation, have positioned receptor antagonists as an attractive nondopaminergic target to improve the motor deficits that characterize PD. In this paper, we describe the biochemical characteristics of receptors and the effects of adenosine antagonists in rodent and primate models of PD on L-DOPA-induced dyskinesia, together with relevant …

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 …

A Case Report: Giant Cystic Parathyroid Adenoma Presenting With Parathyroid Crisis After Vitamin D Replacement, Ali Asghar, Mubasher Ikram, Najmul Islam

Section of Otolaryngology, Head & Neck Surgery

Background: Parathyroid adenoma with cystic degeneration is a rare cause of primary hyperparathyroidism. The clinical and biochemical presentation may mimic parathyroid carcinoma. Case presentation: We report the case of a 55 year old lady, who had longstanding history of depression and acid peptic disease. Serum calcium eight months prior to presentation was slightly high, but she was never worked up. She was found to be Vitamin D deficient while being investigated for generalized body aches. A month after she was replaced with Vitamin D, she presented to us with parathyroid crisis. Her corrected serum calcium was 23.0 mg/dL. She had …

Gene Expression Signatures Modulated By Epidermal Growth Factor Receptor Activation And Their Relationship To Cetuximab Resistance In Head And Neck Squamous Cell Carcinoma., Elana J Fertig, Qing Ren, Haixia Cheng, Hiromitsu Hatakeyama, Adam Dicker Md, Phd, Ulrich Rodeck, Michael Considine, Michael F Ochs, Christine H Chung

Department of Radiation Oncology Faculty Papers

BACKGROUND: Aberrant activation of signaling pathways downstream of epidermal growth factor receptor (EGFR) has been hypothesized to be one of the mechanisms of cetuximab (a monoclonal antibody against EGFR) resistance in head and neck squamous cell carcinoma (HNSCC). To infer relevant and specific pathway activation downstream of EGFR from gene expression in HNSCC, we generated gene expression signatures using immortalized keratinocytes (HaCaT) subjected to ligand stimulation and transfected with EGFR, RELA/p65, or HRASVal12D.

RESULTS: The gene expression patterns that distinguished the HaCaT variants and conditions were inferred using the Markov chain Monte Carlo (MCMC) matrix factorization algorithm Coordinated Gene Activity …

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 …

Early Outcomes Of Minimally Invasive Anterior Longitudinal Ligament Release For Correction Of Sagittal Imbalance In Patients With Adult Spinal Deformity, Armen R. Deukmedjian, Elias Dakwar, Amir Ahmadian, Donald A. Smith, Juan S. Uribe

Neurosurgery and Brain Repair Faculty Publications

The object of this study was to evaluate a novel surgical technique in the treatment of adult degenerative scoliosis and present our early experience with the minimally invasive lateral approach for anterior longitudinal ligament release to provide lumbar lordosis and examine its impact on sagittal balance. Methods. All patients with adult spinal deformity (ASD) treated with the minimally invasive lateral retroperitoneal transpsoas interbody fusion (MIS LIF) for release of the anterior longitudinal ligament were examined. Patient demographics, clinical data, spinopelvic parameters, and outcome measures were recorded. Results. Seven patients underwent release of the anterior longitudinal ligament (ALR) to …

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.

The Effectiveness Of Airway Management In The Pre Hospital Treatment Of Traumatic Brain Injury : A Retrospective, Observational Study Of Pre Hospital Treatment Of Traumatic Brain Injury (Tbi) In The Western Australian Ambulance Service, Joseph Cuthbertson

Theses: Doctorates and Masters

There is concern over mortality and the potential for secondary brain injury in the head-injured patient. The use of advanced airway management and rapid sequence intubation in the pre hospital treatment of patients with Traumatic Brain Injury is controversial. Currently in St John Ambulance Service Australia (WA) Inc. three forms of pre hospital treatment are utilized to manage the airway of the adult head-injured patient. If attended by on-road paramedic staff, basic airway management is utilized unless the patient is unconscious and areflexic, in which case advanced airway management utilising endotracheal intubation or laryngeal mask insertion is authorised. In the …

Effectiveness Of Insulin Pump Use In Controlling Blood Glucose In Type 1 Diabetes Mellitus Patients, Nadia M. Saad

Master's Theses and Doctoral Dissertations

No abstract provided.

Contraception In Adolescents, Donald E. Greydanus, Carolyn M. Lentzsch-Parcells, Hatim A. Omar

Pediatrics Faculty Publications

The age of adolescence is the time when most adolescents in the world begin to be sexually active with resultant millions of pregnancies and sexually transmitted diseases (STDs). This chapter considers methods of contraception for these adolescents, including oral contraceptives, transdermal contraception, minipills, intra-vaginal ring, injectable contraception, intrauterine devices (IUDs), barrier contraceptives, implants, and others. It is important for clinicians caring for sexually active youth to provide information regarding contraception and appropriate contraceptive prescriptions.

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 …

Clinical Characteristics And Predictors Of Positive Stool Culture In Adult Patients With Acute Gastroenteritis, Muhammad Mehmood Riaz, Muhammad Junaid Patel, Muhammad Shoaib Khan, Muhammad Ali Anwar, M. Tariq, Harith Hilal, Safia Awan, Shahzad Razi

Section of Internal Medicine

OBJECTIVE: To identify the presenting features and spectrum of pathogens in adult patients with acute diarrhoea and to determine the predictors of stool culture positivity.

METHODS: A descriptive study was conducted in a tertiary care hospital from April 1, 2005 to March 31, 2006. Medical records of all consecutive adult patients with history of acute diarrhoea were reviewed between June 2006 to December 2006 for clinical characteristics and laboratory investigations.

RESULTS: A total of 454 patients were admitted from April 1, 2005 to March 31, 2006. Stool cultures were performed in 233 (50%) patients, 96 (42%) had positive results. Patients …

Reminder Systems For Self Uterine Massage In The Prevention Of Postpartum Blood Loss, S. K. Ngichabe, B. W. Gatinu, M. A. Nyangore, R. Karuga, Sikolia Wanyonyi, Jn Kiarie

Obstetrics and Gynaecology, East Africa

Background: Uterine massage may significantly reduce post partum blood loss and could be patient-driven.

Objective: To assess the effectiveness of an alarm reminder system for self uterine massage in the prevention of post partum blood loss.

Design: A random controlled trial.

Setting: Meru District Hospital, Kenya.

Subjects: One hundred and twenty seven (127) women were randomly assigned to a 15 minute alarm reminder system (71) and non-alarm (56) control arm during the fourth stage of labour.

Results: Uterine massage compliance was better in the alarm group compared to the non-alarm group ( Average massage …

Neuroangiogenesis: A Vascular Basis For Alzheimer's Disease And Cognitive Decline During Aging, Charles T. Ambrose

Microbiology, Immunology, and Molecular Genetics Faculty Publications

Angiogenesis directs development of the brain's microcirculation during antenatal and postnatal development, but its role later in life is less well recognized. I contend that during senescence a reduced cerebral capillary density accounts in part for the vascular cognitive impairment observed in many older persons and possibly for some forms of Alzheimer's disease. I propose that neuroangiogenesis is essential throughout adult life for maintaining the microcirculation of the cerebral cortex and elsewhere in the brain and that it commonly declines with old age. To support this hypothesis I have examined the neurological literature for relevant studies on cerebral capillary density …

Evaluating The Impact Of Prior Hospital Mortality Versus Surgical Volume On Length Of Stay Following Pediatric Congenital Cardiac Surgery In New York State, Ming Liu

Legacy Theses & Dissertations (2009 - 2024)

Objective: To examine the relationship of prior hospital surgical volume and risk-adjusted mortality rate with future length of stay for children undergoing congenital cardiac surgery in New York State.

The Use Of Preoperative Epoetin-Α In Revision Hip Arthroplasty., Lawrence A Delasotta, Ashwin Rangavajjula, Michael L Frank, Jamie Blair, Fabio Orozco, Alvin Ong

Rothman Institute Papers

PURPOSE: To evaluate the efficacy of preoperative epoetin-α on the revision hip arthroplasty patient. We hypothesized that epoetin-α will reduce blood transfusion. A pertinent review of the literature is provided.

METHODS: Forty-six patients were retrospectively reviewed. Sixteen patients received epoetin-α. Patients were case matched by age, preoperative hemoglobin, surgery, gender, and BMI. The clinical triggers for blood transfusion during or after the procedure were determined based on peri- and postoperative hemoglobin levels, ASA score, and/or clinical symptoms consistent with anemia. Blood salvage was not used.

RESULTS: Blood transfusion and length of stay were decreased in the epoetin-α group. Hemoglobin in …