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Oncolog, Volume 50, Number 02/03, February/March 2005, David Galloway

OncoLog MD Anderson's Report to Physicians (All issues) Archives

• Biostatistically Speaking
• Novel Drugs Address Gleevec Resistance
• Obesity: A Weighty Contributor to Cancer
• House Call: When a Friend Has Cancer

Partnership For Prescription Assistance Of Virginia (Pparx), Sarah Huddle

Case Studies from Age in Action

Educational Objectives

1. To inform Virginia's older adult population and those who serve them about the Partnership for Prescription Assistance, a new program to help qualifying patients who lack prescription drug coverage get the medicines they need through the public or private program that best suits them, including the new Medicare prescription drug benefit.

2. To demonstrate, to older adults and those who assist them, the accessibility and ease of use of the Partnership for Prescription Assistance of Virginia.

Inoculation Inventions: The Interplay Of Infringement And Immunity In The Development Of Biodefense Vaccines, Cynthia M. Ho

Journal of Health Care Law and Policy

No abstract provided.

On The Utility Of Stochastic Models Of Chronic Obstructive Pulmonary Disease, Rebecca Boehm

MUSC Theses and Dissertations

Chronic obstructive pulmonary disease (COPD) is a progressive and irreversible lung disease characterized by reduced lung function, abnormal inflammatory response, dyspnea, increased sputum production, and costly and debilitating exacerbations. Common treatments for COPD include smoking cessation therapy, short- and long-acting bronchodilators, inhaled corticosteroids, pulmonary rehabilitation, and home oxygen therapy. However, a recent meta-analysis demonstrated that inhaled corticosteroids fail to slow the decline in FEV1, the primary clinical marker of COPD progression. In addition, some evidence exists to suggest that long-term inhaled corticosteroid use may increase bone density loss, leading to osteoporosis. Given that the bone health effects of inhaled corticosteroid …

Disaster Drill At A University Hospital, Rifat Rehmani

Department of Emergency Medicine

The course of a disaster drill held on 23 October 2001 at Aga Khan University, Karachi is reported. The Hospital Emergency Plan was put to trial on that day. Volunteers were invited to become simulated casualties in the drill. Briefing seminars had been conducted with the key players of the hospital. The scenario was a man-made type disaster. A 747 jumbo jet with 200 passengers had crashed at the end of the runway at Quaid-e-Azam International Airport while taking off in a thunderstorm. Fifty casualties were sent to Emergency Room by ambulance. The Plan was activated and relevant units were …

Improving Clinical Practice Using Clinical Decision Support Systems: A Systematic Review Of Trials To Identify Features Critical To Success, Kensaku Kawamoto, Caitlin A. Houlihan, E. Andrew Balas, David F. Lobach

School of Medical Diagnostics & Translational Sciences Publications

Objective To identify features of clinical decision support systems critical for improving clinical practice. Design Systematic review of randomised controlled trials.
Data sources Literature searches via Medline, CINAHL, and the Cochrane Controlled Trials Register up to 2003; and searches of reference lists of included studies and relevant reviews.
Study selection Studies had to evaluate the ability of decision support systems to improve clinical practice.
Data extraction Studies were assessed for statistically and clinically significant improvement in clinical practice and for the presence of 15 decision support system features whose importance had been repeatedly suggested in the literature.
Results Seventy studies …

Continuity Of Patient Care Among Family Practice Patients At A Teaching Hospital, Waris Qidwai, J Rehman, M Khan, Iqbal Azam

Department of Family Medicine

No abstract provided.

Kutibu Majeraha, Kutia Matumaini: Ushirikiano Wa Watanzania Dhidi Ya Fistula Obstetrikia, Thoraya Ahmed Obaid, Erica Chong

Poverty, Gender, and Youth

This edition of Quality/Calidad/Qualité describes a partnership formed to combat obstetric fistula in Tanzania. The Bugando Medical Center, the Women’s Dignity Project, the Tanzania Midwives Association, and the government cooperated on an extensive program for surgical repair, prevention, and policy research and activities. Lessons learned: 1) Fistula programs need to address social as well as medical issues. 2) Most repairs are successful, making an enormous difference in women’s lives. 3) Relatively little funding is necessary to start up a fistula program. 4) Fistula programs are vehicles for broader conversations about gender and poverty.

Healing During Physician-Patient Consultation, Waris Qidwai, Ss Ali, S Ayub, S Ayub

Department of Family Medicine

OBJECTIVE: To determine the patient perceptions regarding healing during a physician-patient consultation.
DESIGN: A questionnaire-based survey.
PLACE AND DURATION OF STUDY: Family Practice Center of the Aga Khan University Hospital, Karachi, Pakistan, in June 2004.
PATIENTS AND METHODS: A questionnaire was designed that included the demographic profile of patients comprising age, gender, education and occupation as well as questions in line with the study objective. It was administered to 111 patients, visiting outpatient department of the hospital. Participants were explained the study objective, a written consent was taken and full confidentiality was assured.
RESULTS: The mean age of …

The Pervasive Triad Of Food Security, Gender Inequity And Women's Health: Exploratory Research From Sub-Saharan Africa, A.A. Hyder, S. Maman, J.E. Nyoni, S.A. Khasiani, N. Teoh, Zul Premji, S. Sohani

Pathology, East Africa

Objectives: This study was designed to explore the interactions between food securing activities, health and gender equity from the perspective of rural east African women. The specific objectives were to document the critical interaction among these three issues - food security, gender inequity, women's health within the context of sub-Saharan Africa; to describe the nature of this triad from the perspective of women farmers in Africa; and to propose a framework for linking available interventions to the vicious nature of this triad.

Setting: In-depth interviews and focus group discussions were conducted with rural women farmers in Kwale District, Kenya and …

Medical Symptoms Associated With Tobacco Smoking With And Without Marijuana Abuse Among Crack Cocaine-Dependent Patients., Ashwin A. Patkar, Vikas Batra, Paolo Mannelli, Sarah Evers-Casey, Michael J. Vergare, Frank T. Leone

Department of Psychiatry and Human Behavior Faculty Papers

Despite the widespread use of tobacco and marijuana by cocaine abusers, it remains unclear whether combined tobacco and marijuana smoking is more harmful than tobacco smoking alone in cocaine abusers. We investigated the differences in medical symptoms reported among 34 crack cocaine abusers who did not smoke tobacco or marijuana (C), 86 crack cocaine abusers who also smoked tobacco (C + T), and 48 crack abusers who smoked both tobacco and marijuana (C + T + M). Medical symptoms were recorded using a 134-item self-report instrument (MILCOM), and drug use was assessed using the Addiction Severity Index (ASI). After controlling …

Genetic Networks Controlling Retinal Injury, Felix R Vazquez-Chona, Amna N Khan, Chun K Chan, Anthony N Moore, Pramod K Dash, M Rosario Hernandez, Lu Lu, Elissa J Chesler, Kenneth F Manly, Robert W Williams, Eldon E Geisert

Faculty, Staff and Student Publications

PURPOSE: The present study defines genomic loci underlying coordinate changes in gene expression following retinal injury.

METHODS: A group of acute phase genes expressed in diverse nervous system tissues was defined by combining microarray results from injury studies from rat retina, brain, and spinal cord. Genomic loci regulating the brain expression of acute phase genes were identified using a panel of BXD recombinant inbred (RI) mouse strains. Candidate upstream regulators within a locus were defined using single nucleotide polymorphism databases and promoter motif databases.

RESULTS: The acute phase response of rat retina, brain, and spinal cord was dominated by transcription …

Cbct Panoramic Images Vs. Traditional Panoramic Radiographs, Sunny Young Hutchinson

Loma Linda University Electronic Theses, Dissertations & Projects

The purpose of this research was to compare the accuracy of angular measurements of the panoramic image of the Newtom 9000™ Cone Beam Computed Tomography (CBCT) with the Sirona™ Orthophos panoramic unit. The study was separated into three parts: phantom study, patient study, and archform study. The phantom study used fabricated phantom typodonts to compare angular measurements between the Newtom 9000™ panoramic image and the Sirona™ panoramic radiograph. Accuracies of the measurements were then determined by comparing the values to the actual phantom typodont. No marked differences in angular measurements were recorded for the phantom typodont using either of the …

Acgme Research Requirements For Residents In Psychiatry., Kathleen S. Peindl, Stephen Weinstein, Ashwin A. Patkar, Edward Silberman, Michael Vergare

Department of Psychiatry and Human Behavior Faculty Papers

No abstract provided.

An Emergency Department Staff Tackles The Healthy Workplace Initiative : A Staff Nurse Perspective., Paul Clark

Faculty and Staff Scholarship

This article describes the Healthy Workplace Initiative in the adult emergency department from the staff nurse perspective. Examples of one action planning team's processes and outcomes are delineated. The Rapid Diagnostics action planning team is delineated as lived while caring for patients in today's high-pressure emergency department. The Healthy Workplace Initiative empowers staff, with the guidance of facilitators, to make changes that improve the workplace and to create a healthy workplace for staff and patients. The result is greater staff ownership of the emergency department which leads to greater job satisfaction and improved patient care.

A Study Of Pediatric Heart Transplant Patients In Relationship To Post Transplant Coronary Artery Disease, Mark Randall

Loma Linda University Electronic Theses, Dissertations & Projects

Post transplant coronary artery disease influences short and long-term survival of pediatric heart transplant recipients. Associated cardiovascular disease risk factors among non-heart transplant adult and pediatric heart populations for development of coronary artery disease have been documented. Little is known about these typical cardiovascular disease risk factors as well as other possible risk factors in the development of post transplant coronary artery disease. Objective: The purpose of this research was to examine children/adolescents (n=194), 5-18 years old, at least one-year post heart transplant. This study also investigated if there were physiological and psychological/behavioral differences between recipients with (n = 28) …

Relationship Of Serum Prolactin With Severity Of Drug Use And Treatment Outcome In Cocaine Dependence., Ashwin A. Patkar, Paolo Mannelli, Kenneth M. Certa, Kathleen Peindl, Heather Murray, Michael J. Vergare, Wade H. Berrettini

Department of Psychiatry and Human Behavior Faculty Papers

RATIONALE: Alteration in serum prolactin (PRL) levels may reflect changes in central dopamine activity, which modulates the behavioral effects of cocaine. Therefore, serum PRL may have a potential role as a biological marker of drug severity and treatment outcome in cocaine dependence.

OBJECTIVE: We investigated whether serum PRL levels differed between cocaine-dependent (CD) subjects and controls, and whether PRL levels were associated with severity of drug use and treatment outcome in CD subjects.

METHODS: Basal PRL concentrations were assayed in 141 African-American (AA) CD patients attending an outpatient treatment program and 60 AA controls. Severity of drug use was assessed …

Assessment Of A Body Composition-Focused Approach To Obesity Treatment, Beverly D. Hall

Loma Linda University Electronic Theses, Dissertations & Projects

Obesity is a significant United States’ public health concern. However, high relapse rates continue to be a problem for obesity treatment programs while the focus remains on weight loss, not body composition change. This study examined whether a clinic-based obesity treatment program, focused on body composition change through resistance training, lead to improved body composition, exercise behaviors, and attitude change from focus on weight loss to body composition change. Improvements in self efficacy, outcome expectations and stages of change were also examined. Forty-eight physician-referred overweight or obese adult women (mean body fat 41%, SD = 6.65%), completed assessments and questionnaires …

Prevalence Of Degenerative Joint Disease In A Pre-Orthodontic Adolescent Sample, Marie Mansour

Loma Linda University Electronic Theses, Dissertations & Projects

The purpose of this research was to determine a prevalence of degenerative joint disease in our pre-orthodontic adolescent patients age ten through seventeen. The prevalence was assessed according to gender. Severity of DJD was established for each patient and a "red flag" for diagnosis was identified. The purpose was also to establish norms for joint space for patients with and without degenerative joint disease. Correlations to distal condyle position and angle classification were described. 123 consecutive patients, 77 female and 46 male T1 NewTom records were reviewed. Severity of DJD was classified according to none, mild, moderate, and severe. Sagittal …

Cone Beam Ct And Digital Radiography. A Comparative Study Of P/A Cephalometrics., Michael John Erickson

Loma Linda University Electronic Theses, Dissertations & Projects

The purpose of this study was to determine if Rickett's posterio-anterior (P/A) cephalogram measurements could be obtained from Cone Beam Computerized Tomographic (CBCT) images taken on the NewTom QR-DVT 9000™.

Fifteen frontal cephalometric radiographs were chosen for good image quality, with no regard for patient age or gender. Each cephalogram was traced three times by the same operator using ZeroBase™ software. Landmarks were located and measured according to the Rickett's frontal analysis technique. Methods were devised for obtaining analogous measurements using CBCT images on the same group of patients.

Measurements obtained using CBCT correlated well with those obtained using the …

Infant Heart Transplant: Perioperative Indicators Of Neurocognitive Development, Joy Michelle Gardner

Loma Linda University Electronic Theses, Dissertations & Projects

Approximately five to eight births per 1000 in the United States are born with a congenital heart defect (Limperopoulos et al, 1999), the primary defect in 57% is hypoplastic left heart syndrome (Johnston, 1991). A fatal disease twenty years ago, survival has jumped from less than 5% to 91% of infants surviving their one-month birthday due to advances in palliative and transplant procedures (Razzouk et al, 1996). Unfortunately, the decrease in mortality has been unmatched by a decrease in morbidity, which continues to be a major risk factor when undergoing deep hypothermia (du Plessis, 2000). While neurodevelopmental and cognitive dysfunction …

Excess Stroke In Mexican Americans Compared With Non-Hispanic Whites: The Brain Attack Surveillance In Corpus Christi Project, Lewis B Morgenstern, Melinda A Smith, Lynda D Lisabeth, Jan M H Risser, Ken Uchino, Nelda Garcia, Paxton J Longwell, David A Mcfarling, Olubumi Akuwumi, Areej Al-Wabil, Fahmi Al-Senani, Devin L Brown, Lemuel A Moyé

Faculty, Staff and Student Publications

Mexican Americans are the largest subgroup of Hispanics, the largest minority population in the United States. Stroke is the leading cause of disability and third leading cause of death. The authors compared stroke incidence among Mexican Americans and non-Hispanic Whites in a population-based study. Stroke cases were ascertained in Nueces County, Texas, utilizing concomitant active and passive surveillance. Cases were validated on the basis of source documentation by board-certified neurologists masked to subjects' ethnicity. From January 2000 to December 2002, 2,350 cerebrovascular events occurred. Of the completed strokes, 53% were in Mexican Americans. The crude cumulative incidence was 168/10,000 in …

Academic Performance Of Psychiatrists Compared To Other Specialists Before, During, And After Medical School., Frederick S. Sierles, Michael Vergare, Mohammadreza Hojat, Joseph S. Gonnella

Department of Psychiatry and Human Behavior Faculty Papers

OBJECTIVE: This study was designed to compare psychiatrists with other physicians on measures of academic performance before, during, and after medical school.

METHOD: More than three decades of data for graduates of Jefferson Medical College (N=5,701) were analyzed. Those who pursued psychiatry were compared to physicians in seven other specialties on 18 performance measures. Analysis of covariance was used to control for gender effect.

RESULTS: Compared to other physicians, psychiatrists scored higher on measures of verbal ability and general information before medical school and on evaluations of knowledge and skills in behavioral sciences during medical school, but they scored lower …

Roger W. Anderson, Phd, Oral History Interview, May 18, 2004, Roger W. Anderson Phd, Lesley W. Brunet

Interview Sessions

Major Topics Covered:

• Career at MD Anderson
• The history of the Pharmacy Division
• Integrating pharmacists within departments at MD Anderson including Nursing and Developmental Therapeutics
• Pharmacist's role in improving chemotherapy drugs and safety monitoring

Bone Formation Using Platelet-Rich Plasma + Allograft: An Experimental Study In Sheep, Edgar Grageda

Loma Linda University Electronic Theses, Dissertations & Projects

Recently Platelet-Rich Plasma has been proven to be an effective regeneration adjunct when combined with autogenous bone in the reconstruction of mandibular defects. However, little is known about the effect of PRP when combined with a bone allograft in the maxillary sinus.

The purpose of this study was to quantitatively evaluate the ability of PRP to enhance bone regeneration in the maxillary sinus of sheep when combined with DFDBA + CCFDBA. Ten sheep were selected for bilateral sinus augmentation DFDBA + CCFDBA + PRP (test) and DFDBA + CCFDBA (control). Five were sacrificed at 3 months and the other five …

The Anti-Proliferation Effects Of Lycopene On Breast Cancer Cells, Tixieanna Dissmore

Loma Linda University Electronic Theses, Dissertations & Projects

Background: The incidence and deaths from breast cancer represent the most cause of all cancer deaths among women. Lycopene, the carotenoid in tomatoes has been associated with decreasing risk of prostate, breast, and digestive tract cancers. Various mechanisms of lycopene action have been proposed, including antioxidant activity and pro-differentiation activities. Identifying changes in the expression of proteins modified by lycopene can provide information to study the modulating effects of lycopene carcinogenesis and tumorigenesis development.

Objective: The objective was to study the anti-proliferative effects of lycopene on MCF- 7 human breast cancer cells and to identify changes in protein expression patterns. …

Diabetes: The Interrelationship Between Vascular, Nervous Systems And Avandia, Salameh Bweir

Loma Linda University Electronic Theses, Dissertations & Projects

Diabetes Mellitus has been linked to vascular and neurological impairments. The purpose of this study was to assess the relationship between vascular endothelial dysfunction, autonomic and somatic nervous systems impairment in diabetic patients. These studies also evaluated the effects of rosiglitazone (Avandia) on the vascular, autonomic, and somatic nervous systems.

Fourteen diabetic subjects and fourteen control subjects (age matched) participated in three series of experiments. Using Whitney volume plesythmography to assess post occlusion blood flow in the subject’s forearm did assessment of vascular endothelial function. Evaluating skin blood flow, orthostatic tolerance, heart rate, and thermal responses under thermal and postural …

Differences In Peripheral Noradrenergic Function Among Actively Drinking And Abstinent Alcohol-Dependent Individuals., Ashwin A. Patkar, Charles A. Marsden, Prakash C. Naik, David A. Kendall, Raman Gopalakrishnan, Michael J. Vergare, Stephen P. Weinstein

Department of Psychiatry and Human Behavior Faculty Papers

We examined whether excessive alcohol consumption was related to changes in plasma levels of noradrenaline (NA) and whether these changes recover following abstinence. We also explored whether there were differences in NA levels between Type I and Type II alcoholics and controls during active drinking and abstinence. Plasma concentrations of NA were determined in (1) 27 Caucasian men with alcohol dependence who were regularly drinking (active drinkers) within 24 hours of hospitalization, (2) 29 Caucasian alcohol-dependent men who were in remission (abstinent for a minimum of three months), and (3) 28 race- and gender-matched healthy controls. NA concentrations were significantly …

Ua61/6 Newsletter Issue 3, Wku Institute For Rural Health Development & Research

WKU Administration Documents

Newsletter created by and about the Institute for Rural Health Development & Research. This issue contains:

• Senator Mitch McConnell Earmarks Dollars for WKU Hispanic Initiative
• Dr. Louella Fong Directs Bilingual Program
• Give Kids a Smile Brightens Children’s Day – Dental Hygiene
• College of Health & Human Services Focuses on Gerontology Demands
• Partners Key to Successful Hispanic Health Fair & Screening Event
• Public Health Department Now Offers Worksite Health Promotion
• KEMSA Offers EMS Management Workshop – Kentucky Emergency Medical Services Academy

Chemical And Biological Warfare Preparing To Meet The Threat, S Sophie, S U. Haq, M R. Khan

Department of Anaesthesia

No abstract provided.