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Outcomes In Patients With Vestibular Schwannoma After Subtotal Resection And Adjuvant Radiosurgery, H. Radwan, M. Bruce Eisenberg, J. P. S. Knisely, M. M. Ghaly, M. Schulder

Journal Articles

No abstract provided.

Estradiol-Mediated Spine Changes In The Dorsal Hippocampus And Medial Prefrontal Cortex Of Ovariectomized Female Mice Depend On Erk And Mtor Activation In The Dorsal Hippocampus, J. J. Tuscher, V. Luine, M. Frankfurt, K. M. Frick

Journal Articles

No abstract provided.

Telestroke: An Approach To The Shortage Of Neurologists In Rural Areas, Sarah Mcsweeney, Jean Pritt, Angie Swearingen, Alberto Coustasse

Management Faculty Research

Telestroke has provided swift, lifesaving treatment and has afforded patients the ability to be treated in an efficient manner in rural areas where neurologists may not always be available. It has been reported that Telestroke in rural areas has increased the ability to treat patients by being able to access a neurologist for assistance in evaluating the patient to determine if administering lifesaving in treatments were needed. The utilization of Telestroke has been shown to increase the use of IV Tissue Plasminogen Activator (tPA) which improves outcomes such as better quality of life, lower disability and improved rehabilitation. Employment of …

Strategies For The Management Of Postoperative Anemia In Elective Orthopedic Surgery, Taylor D. Steuber, Meredith L. Howard, Sarah A. Nisly

Scholarship and Professional Work – COPHS

Objective: To assess the use of oral iron, intravenous (IV) iron, and erythropoiesis-stimulating agents (ESAs) for the prevention and management of perioperative anemia in elective orthopedic surgery patients, and to provide a clinical algorithm for use. Data Sources: A PubMed and MEDLINE search was conducted from 1964 through March 2016 using the following search terms alone or in combination: orthopedic, surgery, elective, anemia, blood transfusion, iron, erythropoiesisstimulating agents, and erythropoietin. Study Selection and Data Extraction: All English-language prospective and retrospective human studies and meta-analyses evaluating oral iron, IV iron, or ESA alone or in combination in elective orthopedic surgery …

T Cell/Histiocyte-Rich Large B Cell Lymphoma Of The Thymus: A Diagnostic Pitfall., Jie Xu, Xiaojun Wu, Vishnu Reddy

Pathology Faculty Publications

T cell/histiocyte-rich large B cell lymphoma (THRLBCL) is predominantly a nodal disease, with extranodal involvement, such as bone marrow, spleen, and liver. However, primary THRLBCL has never been reported in the thymus in the English literature. Here we report a case of THRLBCL presenting as mediastinal mass and lymphadenopathy. Based on the frozen section diagnosis of "thymoma," a 12 cm mass was excised. A year later she developed multiple enlarged lymph nodes and pulmonary nodules. Consultant review of the excised mediastinal mass showed scattered large atypical cells that were CD20+ and PAX-5+ and negative for pan-cytokeratin, AE1, and AE3, compatible …

Minimally Invasive Surgery In Pediatric Trauma: One Institution's 20-Year Experience, Gustavo Stringel, Min Li Xu, Joseph Lopez

NYMC Faculty Publications

BACKGROUND: Minimally invasive surgery (MIS) for trauma in pediatric cases remains controversial. Recent studies have shown the validity of using minimally invasive techniques to decrease the rate of negative and nontherapeutic laparotomy and thoracotomy. The purpose of this study was to evaluate the diagnostic accuracy and therapeutic options of MIS in pediatric trauma at a level I pediatric trauma center.

METHODS: We reviewed cases of patients aged 15 years and younger who had undergone laparoscopy or thoracoscopy for trauma in our institution over the past 20 years. Each case was evaluated for mechanism of injury, computed tomographic (CT) scan findings, …

Burnout’S Prevalence Estimations: A House Of Cards?, Renzo Bianchi, Irvin Sam Schonfeld, Eric Laurent

Publications and Research

Elmariah et al. (2016) found that 65% of the internal medicine residents who were assessed suffered from burnout. We have 3 concerns about the conclusion. First, the authors used a cutoff score on a burnout measure that is problematic because (a) it is devoid of theoretical or clinical grounding and (b) burnout items were formatted in an unorthodox manner, and (c) including residents who responded "neutral" to a symptom item among those identified as burned out. Second, the authors identified as burned out residents who worked on the night float rotation although the data suggest otherwise. Third information on symptom …

On The Dead End Of Current Research On Burnout's Prevalence, Renzo Bianchi, Irvin Sam Schonfeld, Eric Laurent

Publications and Research

Dimou et al. (2016) concluded that >50% of surgeons experience burnout. For three reasons, we think that such conclusions are unwarranted. First, there are no consensual or binding diagnostic criteria for burnout. Second, recent research (e.g., Bianchi, Schonfeld, & Laurent, 2015) suggests that burnout is actually a depressive syndrome. Finally, we note that researchers’ recommendations about stress-reducing organizational changes often remain incantatory because they insufficiently consider the economic issues and macrosocial power relationships that can hamper the recommendations’ implementation. Current practices in burnout research have led to an accumulation of results, the clinical meaning of which is obscure.

Burnout-Depression Overlap: A Study Of New Zealand Schoolteachers, Renzo Bianchi, Irvin Sam Schonfeld, Eric Mayor, Eric Laurent

Publications and Research

We examined the overlap of burnout with depression in a sample of 184 New Zealand schoolteachers. Burnout and depressive symptoms were strongly correlated with each other (r = .73; disattenuated correlation: .82) and moderately correlated with dysfunctional attitudes, ruminative responses, and pessimistic attributions. All the participants with high frequencies of burnout symptoms were identified as clinically depressed. Suicidal ideation was reported by 36% of those participants. Three groups of teachers emerged from a two-step cluster analysis: “low burnout-depression,” “medium burnout-depression,” and “high burnout-depression.” The correlation between the affective-cognitive and somatic symptoms of depression was similar in strength to the burnout-depression …

Combining Body Mass And Shape Indices In Clinical Practice, Jesse C. Krakauer, Nir Y. Krakauer

Publications and Research

We present preliminary clinical experience with combined consideration of the commonly used BMI (body mass index) and the newly developed ABSI (a body shape index) using a point of care anthropometric calculator for comparisons of index values and associated relative risks to population normals. In a series of 282 patients, BMI and ABSI were close to being independently distributed, supporting the value of considering both indices. Three selected cases illustrate scenarios where assessment of ABSI together with BMI could inform patient care and counseling. These data suggest that combined assessment of BMI and ABSI may prove useful in clinical practice.

Causal Factors Of Cryptorchidism And Endocrine Disurpting Chemicals Such As Prenatal Maternal Cigarette Smoke: A Narrative Review, Andrew R. Morrissey

Honors Undergraduate Theses

Cryptorchidism is a male congenital disorder with an unspecified, multifactorial etiology. This review evaluated the strength of select factors in the development of cryptorchidism to better understand its etiology. The strength of relationship between factors and their respective functions during testicular descent was evaluated. Factors evaluated in the causal pathway include the signaling mechanisms Desert Hedgehog (DHH), Insulin-like Hormone 3 (INSL3) and Platelet-Derived Growth Factor (PDGF), as well as sex hormone regulation (androgen: estrogen ratio, aromatase expression). Articles supporting a factor in testicular descent were evaluated and scored. These scores were summed to create the “Step Score” for each step …

Cardiac Consequences Of Selective Adrenergic Cell Ablation In Mice, Lahari Tumuluri

Honors Undergraduate Theses

Phenylethanolamine-N-methyltransferase (Pnmt), is the enzyme that catalyzes the conversion of noradrenaline to adrenaline. It has been found in the embryonic heart and in certain adult heart cells, including intrinsic cardiac adrenergic cells, intracardiac neurons, and cardiomyocytes, but their physiological role in the heart is not well understood. To determine the function of Pnmt-expressing cells in the developing heart, a novel genetically-targeted mouse model that causes selective cellular suicide of Pnmt-expressing cells was created by mating Pnmt-Cre Recombinase knock-in mice (Pnmt^Cre/Cre) with ROSA26-eGFP-DTA (R26R^+/DTA). The “cellular suicide” allele is the Diptheria Toxin A (DTA) gene …

Self-Reported Practices Among Traditional Birth Attendants Surveyed In Western Kenya: A Descriptive Study, Sherri Bucher, Olive Konana, Edward Liechty, Ana Garces, Peter Gisore, Irene Marete, Constance Tenge, Evelyn Shipala, Linda Wright, Fabian Esamai

Paediatrics and Child Health, East Africa

Background: The high rate of home deliveries conducted by unskilled birth attendants in resource-limited settings is an important global health issue because it is believed to be a significant contributing factor to maternal and newborn mortality. Given the large number of deliveries that are managed by unskilled or traditional birth attendants outside of health facilities, and the fact that there is on-going discussion regarding the role of traditional birth attendants in the maternal newborn health (MNH) service continuum, we sought to ascertain the practices of traditional birth attendants in our catchment area. The findings of this descriptive study might help …

Recognizing Pain Using Novel Simulation Technology, Justin C. Grace

Honors Undergraduate Theses

Effective pain management and time to treatment is essential in patient care. Despite scientific evidence supporting the need to treat pain and an emphasis on addressing pain as a priority, pain management continues to be an unresolved issue. As a member of the health care team, nurses are integral to optimal pain management. Currently, nursing schools have limited innovative or alternative methods for teaching pain assessment and management. Simulation in nursing education provides a unique opportunity to expose students to realistic patient situations and allow them to learn and make mistakes without causing harm. However, modern low- and high-fidelity simulation …

The Synchronicity Of Hope And Enhanced Quality Of Life In Terminal Cancer, Brianna M. Terry

Honors Undergraduate Theses

Cancer is the second leading cause of death in the United States and a leading cause of death worldwide. The rate of mortality is currently approximately 171.2 out of every 100,000 individuals with a terminal cancer diagnosis annually. Individuals with terminal cancer diagnoses facing probable mortality utilize various coping mechanisms or internal resources in an attempt to maintain an internal sense of well-being, commonly referred to as quality of life (QOL). The purpose of this literature review was to investigate themes prevalent in the literature pertaining to internal coping mechanisms and analyze any correlation or causation linking these resources to …

Vitamin D Clinical Relevance In The Recovery From Traumatic Brain Injury Among The Military Population, Yuisa M. Colón

Honors Undergraduate Theses

Background: Traumatic brain injury (TBI) still remains a difficult disorder to treat. TBI has been associated to chronic neuroinflammation and a high risk for neurodegenerative disorders. Since 2001 between ten to twenty percent of all deployed military members have suffered a combat-related TBI. Nearly twenty to thirty percent of those will experience chronic cognitive, behavioral and somatic symptoms after suffering a TBI.
Methods: The objective of this review is to evaluate current literature examining vitamin D as a neurosteroid with protective properties and its clinical relevance after traumatic brain injury. Vitamin D is known to participate in neurobiological …

Pharmacogenomic Management Of Familial Hypercholesterolemia: An Integrative Review Of The Literature, Brian V. Skibo

Honors Undergraduate Theses

The purpose of this thesis is to examine familial hypercholesterolemia (FH) and emerging pharmacogenomics therapies that propose to lower serum low density lipid (LDL) levels. The search of various data bases resulted in nine research articles being selected for review. Syntheses of the articles suggest emerging phamacogenomic drug therapy can improve treatment outcomes for individuals with a diagnosis of FH. The Human Genome Project (HGP) has had far reaching applications for genomic technologies and pharmacagenomic interventions, tailored to human conditions associated with select genomic traits. Synthesis of nine research articles demonstrate that little is known on the topic and reveals …

Intensive Care In Oncology: Admission And Outcomes In Adult Patients With Cancer, Surya John

Honors Undergraduate Theses

Background: Historically, patients with cancer have been perceived as poor candidates for ICU admission. General ICU admission criteria lists cancer patients as low priority in ICU admission depriving them of the care they rightfully deserve. The purpose of this literary synthesis was to examine ICU admission criteria, risk factors, and outcomes of ICU admission in relation to hematological and solid tumor cancers and discuss ways that practitioners and nurses can educate patients with cancer and their families on appropriateness of ICU care.

Methods: A total of 768 articles were found in a literature search including all literature from 2005 to …

Randomized, Placebo-Controlled Trial Evaluating The Safety Of One-Year Administration Of Green Tea Catechins, Nagi B. Kumar, Julio Pow-Sang, Philippe E. Spiess, Jong Park, Raoul Salup, Christopher R. Williams, Howard Parnes, Michael J. Schell

Urology Faculty Publications

Purpose: Although preclinical, epidemiological and prior clinical trial data suggest that green tea catechins (GTCs) may reduce prostate cancer (PCa) risk, several preclinical studies and case reports have reported liver toxicities and acute gastrointestinal bleeding. Based on these observations, regulatory bodies have required stringent inclusion criteria with frequent, excessive toxicity monitoring and early stopping rules in clinical trials. These requirements have impeded recruitment and retention of subjects in chemoprevention trials and subsequent progress in agent development efforts.

Experimental Design: We conducted a placebo-controlled, randomized clinical trial of Polyphenon E® (PolyE®), a proprietary mixture of decaffeinated GTCs, containing 400 mg (−)-epigallocatechin-3-gallate …

Nutrition Resources For Football Players In Division I Institutions: The Athletic Trainer's Perspective And Role, Giovanna Marie Giannini

Honors Undergraduate Theses

Background: The importance of nutrition on athletic performance is evident. Athletic trainers (ATs), nutritionists/RDs, strength and conditioning specialists (SCSs), and other athletic department personnel may be available to student-athletes and can be solicited for nutrition advice. Multiple studies have found that although some universities have a sports nutritionist on staff, student-athletes approached an AT most often for nutrition advice rather than an SCS, nutritionist or other person. ATs have the necessary education to provide proper nutrition information to student-athletes; however, it is not the primary role of an AT.

Objective: The purpose of this study was to examine the quantity, …

Cutaneous Human Papillomavirus Infection And Development Of Subsequent Squamous Cell Carcinoma Of The Skin, Shalaka S. Hampras, Rhianna A. Reed, Spencer Bezalel, Michael Cameron, Basil Cherpelis, Neil Fenske, Vernon K. Sondak, Jane Messina, Massimo Tommasino, Tarik Gheit, Dana E. Rollison

Pathology and Cell Biology Faculty Publications

The role of cutaneous human papillomavirus (HPV) infection in the development of subsequent cutaneous squamous cell carcinoma (SCC) is unknown. Pathologically confirmed cases of SCC () enrolled in a previously conducted case-control study were included in a retrospective cohort study to examine the association of cutaneous HPV at the time of SCC diagnosis with the risk of subsequent SCC development. Data on HPV seropositivity, HPV DNA in eyebrow hairs (EB) and SCC tumors were available from the parent study. Incidence of subsequent SCC was estimated using person-years of follow up. Cox Proportional Hazards ratios were estimated to evaluate the associations …

Effects Of Percutaneous Closure Of Patent Ductus Arteriosus In Infants Less Than One Year Of Age: A Systematic Review, Megan K. Locke

Undergraduate Honors Thesis Projects

The purpose of this study is to assess the safety and feasibility of percutaneous PDA closure in infants as reported in the available medical literature. Patent ductus arteriosus (PDA) is the continuous opening of the ductus arteriosus in an infant’s heart after birth. This, when left untreated, can lead to severe health complications. Historically, the first treatment options to correct PDA were the use of medications and surgical ligation. Percutaneous PDA closure is a newer treatment option that is increasingly performed during infancy (age); however, its safety and feasibility is not yet understood in infants. We conducted a systematic review …

Application Of Pre-Participation Cardiovascular Screening Guidelines To Novice Older Runners And Endurance Athletes, Justin R. Abbatemarco, Courtney Bennett, Adrian J. Bell, Laura Dunne, Martin E. Matsumura

Neurology Faculty Publications

Objectives: Despite robust growth in participation in marathons and endurance sports among older individuals, guidance regarding pre-participation cardiovascular evaluation of these athletes is lacking. The objective of this study was to assess the utility of currently available pre-participation cardiovascular evaluation guidelines as applied to a cohort of older novice endurance athletes.

Methods: We applied data from 1457 novice runners and endurance athletes aged 35 years and older to two pre-participation screening tools, the American Heart Association/American College of Sports Medicine Pre-Participation Questionnaire and the 2001 Working Group recommendations for pre-participation screening of masters athletes (2001 Masters).

Results: Application of the …

Progression Of Friedreich Ataxia: Quantitative Characterization Over 5 Years, Maya Patel, Charles J. Isaacs, Lauren Seyer, Karlla Brigatti, Sarah Gelbard, Cassandra Strawser, Debbie Foerster, Julianna Shinnick, Kimberly Schadt, Eppie M. Yiu, Martin B. Delatycki, Susan Perlman, George R. Wilmot, Theresa Zesiewicz, Katherine Mathews, Christopher M. Gomez, Grace Yoon, Sub H. Subramony, Alicia Brocht, Jennifer Farmer, David R. Lynch

Neurology Faculty Publications

Objective Friedreich ataxia (FRDA) is a progressive neurodegenerative disorder of adults and children. This study analyzed neurological outcomes and changes to identify predictors of progression and generate power calculations for clinical trials.

Methods Eight hundred and twelve subjects in a natural history study were evaluated annually across 12 sites using the Friedreich Ataxia Rating Scale (FARS), 9-Hole Peg Test, Timed 25-Foot Walk, visual acuity tests, self-reported surveys and disability scales. Cross-sectional outcomes were assessed from recent visits, and longitudinal changes were gaged over 5 years from baseline.

Results Cross-sectional outcomes correlated with measures of disease severity. Age, genetic severity (guanine-adenine-adenine …

Three Year Old Male With Multiple Dieulafoy Lesions Treated With Epinephrine Injections Via Therapeutic Endoscopy, Christina L. Baldwin, Michael Wilsey

Pediatrics Faculty Publications

Dieulafoy lesions, vascular anomalies typically found along the gastrointestinal tract, have been viewed as rare and obscure causes of sudden intestinal bleeding, especially in pediatric patients. Since their discovery in the late 19th century, the reported incidence has increased. This is due to an increased awareness of, and knowledge about, their presentation and to advanced endoscopic diagnosis and therapy. Our patient was a three-year-old male, without a complex medical history. He presented to the emergency department with acute hematemesis with blood clots and acute anemia requiring blood transfusion. Endoscopy revealed four isolated Dieulafoy lesions along the lesser curvature of the …

Comparing Single And Dual Console Systems In The Robotic Surgical Training Of Graduating Ob/Gyn Residents In The United States, Emad Mikhail, Jason L. Salemi, Stuart Hart, Anthony N. Imudia

Obstetrics & Gynecology Faculty Publications

Objective. To assess the impact of a single versus dual console robotic system on the perceptions of program directors (PD) and residents (RES) towards robotic surgical training among graduating obstetrics and gynecology residents. Design. An anonymous survey was developed using Qualtrics, a web-based survey development and administration system, and sent to obstetrics and gynecology program directors and graduating residents. Participants. 39 program directors and 32 graduating residents (PGY4). Results. According to residents perception, dual console is utilized in about 70% of the respondents’ programs. Dual console system programs were more likely to provide a robotics …

Fmic Annual Report 2016 | English, French Medical Institute For Mothers And Children

French Medical Institute for Mothers and Children (FMIC) Archives

No abstract provided.

Pelvic Floor Muscle Training In Management Of Postpartum Pelvic Floor Dysfunctions: A Literature Review, Rebecca S. Tanner

Honors Undergraduate Theses

Women can face a wide range of pelvic floor dysfunctions following pregnancy, ranging from urinary incontinence to pelvic pain. Unfortunately, these problems are not routinely checked for in postpartum check-ups and women do not always bring it to the physician’s attention. Strengthening of the pelvic floor muscles may be able to help women prevent these disorders and improve these women’s lifestyles.

The purpose of this thesis was to review and analyze different trials to determine if different pelvic floor dysfunctions (urinary incontinence, sexual dysfunction, and pelvic girdle pain) can be treated using pelvic floor muscle training in the postpartum. After …

Association Between Fellowship Training, Surgical Volume, And Laparoscopic Suturing Techniques Among Members Of The American Association Of Gynecologic Laparoscopists, Emad Mikhail, Lauren Scott, Branko Miladinovic, Anthony N. Imudia, Stuart Hart

Obstetrics & Gynecology Faculty Publications

Study Objective. To compare surgical volume and techniques including laparoscopic suturing among members of the American Association of Gynecologic Laparoscopists (AAGL) according to fellowship training status. Design. A web-based survey was designed using Qualtrics and sent to AAGL members. Results. Minimally invasive gynecologic surgery (FMIGS) trained surgeons were more likely to perform more than 8 major conventional laparoscopic cases per month (63% versus 38%, , OR [95% CI] = 2.78 [1.54–5.06]) and were more likely to perform laparoscopic suturing during these cases (32% versus 16%, , OR [95% CI] = 2.44 [1.25–4.71]). The non-fellowship trained (NFT) surgeons …

Evidence-Based Cesarean Delivery For The Nonobstetrician, Joshua D. Dahlke, Hector Mendez-Figueroa, Jeffrey D. Sperling, Lindsay Maggio, Brendan D. Connealy, Suneet P. Chauhan

Obstetrics & Gynecology Faculty Publications

Cesarean delivery (CD) is one of the most common major surgeries performed in the United States and worldwide. Surgical techniques evaluated in well-designed randomized controlled trials (RCTs) that demonstrate maternal benefit should be incorporated into practice. The objective of this review is to provide a summary of surgical techniques of the procedure and review the evidence basis for them for the nonobstetrician. The following techniques with the strongest evidence should be commonly performed, when feasible: (1) prophylactic antibiotics with a single dose of ampicillin or first-generation cephalosporin prior to skin incision; (2) postpartum hemorrhage prevention with oxytocin infusion of 10 …