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Components Of The Complete Blood Count As Risk Predictors For Coronary Heart Disease: In-Depth Review And Update, Mohammad Madjid, Omid Fatemi

The Texas Heart Institute Journal

Atherosclerosis is an inflammatory disease, and several inflammatory biomarkers, such as C-reactive protein, have been used to predict the risk of coronary heart disease. High white blood cell count is a strong and independent predictor of coronary risk in patients of both sexes, with and without coronary heart disease. A high number of white blood cells and their subtypes (for example, neutrophils, monocytes, lymphocytes, and eosinophils) are associated with the presence of coronary heart disease, peripheral arterial disease, and stroke. The coronary heart disease risk ratios associated with a high white blood cell count are comparable to those of other …

Lipid Targets In Clinical Practice: Successes, Failures And Lessons To Be Learned, M Dunne, Oscar Mac Ananey, V Maher

Articles

Abstract

INTRODUCTION:

Optimal risk factor control is integral to managing patients with proven coronary heart disease (CHD+) and for those at risk of coronary heart disease (CHD-). The primary aim of the study was to assess the success rate of reaching lipid risk factor targets in a multiple risk factor clinic.

METHODS:

A retrospective audit was conducted in 488 patients (CHD+, n = 112; CHD-, n = 376) who attended the Cardiovascular Risk Factor Clinic at Tallaght Hospital, Dublin in 2009 and 2010.

RESULTS:

Risk factor targets achieved in CHD+ and CHD- patients were LDLc (54/62 %), HDLc (67/67 %), …

Formative Development Of A Culturally Appropriate Mammography Screening Campaign For Low-Income African-American Women., Kimberly D. Leeks, Ingrid J. Hall, C. Ashani Johnson-Turbes, Ngozi Kamalu, Yasmine Zavahir

Journal of Health Disparities Research and Practice

The purpose of this qualitative study was to conduct a formative evaluation of messages and materials to inform the development of a promotional, health campaign designed to increase breast cancer screening awareness and utilization among low-income, uninsured African American women through the National Breast and Cervical Cancer Early Detection Program (NBCCEDP) in Savannah and Macon, Georgia (GA). A priority of CDC is to understand why women eligible for screening through the NBCCEDP do not participate in NBCCEDP screening services as well as to identify effective strategies for increasing enrollment among NBCCEDP-eligible women who have never received breast cancer screening. As …

Ethnic And Gender Differences In Psychosocial Factors In Native Hawaiian, Other Pacific Islanders, And Asian American Adults With Type 2 Diabetes, Jillian Inouye, Dongmei Li, James Davis, Richard Arakaki

Journal of Health Disparities Research and Practice

This study examined the differences between 207 Asians and Native Hawaiian, other Pacific Islanders (NHOPI) with type 2 diabetes among various psychosocial measures. Responses to five multivariable regression models including the Diabetes Quality of Life Questionnaire (DQOL) and Short Form -36® Health Survey (SF-36) were analyzed. Differences were determined by linear contrasts in the multivariate linear regression models after adjusted for multiple demographic and socioeconomic variables. Compared to Asians, NHOPIs perceived a lower impact of diabetes on their quality of life; highlighting differences in perceptions of self-efficacy and self-care activities. Females did better on their diet while males perceived better …

The Face Of Cancer In Montgomery County Ohio: A Look At The Population At Risk, Chika E. Okere

Master of Public Health Program Student Publications

The purpose of this study was to identify the population in Montgomery County Ohio who are at the greatest risk for cancer based on age, sex, and race/ethnicity, family history and demographics. The research will also look at modifiable behaviors such as use of tobacco products, physical inactivity, obesity, poor nutrition and heavy drinking of alcohol that increase the risk and identify areas of improvement in data collection for reporting purposes. During 1996-2006, cancer was the second-leading cause of death for residents of Montgomery County.

Methods: Age, sex, race/ethnicity of people in Montgomery County with cancer were examined and using …

Household Food Access And Child Malnutrition: Results From The Eight-Country Mal-Ed Study, Zulfiqar Ahmed Bhutta, Maled Network Investigators, Anita K. M. Zaidi, Sajid Bashir Soofi, Ali Turab, Didar Alam, Shahida Qureshi, Aisha Khizar Yousafzai, Syed Asad Ali, Imran Ahmed, Sajad Memon, Muneera Rasheed

Woman and Child Health

Background: Stunting results from decreased food intake, poor diet quality, and a high burden of early childhood infections, and contributes to significant morbidity and mortality worldwide. Although food insecurity is an important determinant of child nutrition, including stunting, development of universal measures has been challenging due to cumbersome nutritional questionnaires and concerns about lack of comparability across populations. We investigate the relationship between household food access, one component of food security, and indicators of nutritional status in early childhood across eight country sites.
Methods: We administered a socioeconomic survey to 800 households in research sites in eight countries, including a …

Prevalence Of Obesity Among Young Asian-American Children, Anjali Jain, Stephanie Mitchell, Radha Chirumamilla, Jin Zhang, Ivor B. Horn, Amy Lewin, Z. Jennifer Huang

Pediatrics Faculty Publications

BACKGROUND:

Asian-American children are considered to be at low risk of obesity, but previous estimates have not distinguished between children from different Asian countries. We estimate the prevalence of obesity among Asian-American children by mother's country of origin, generational status, and family socioeconomic factors using a secondary analysis of the Early Childhood Longitudinal Study-Birth Cohort (ECLS-B) wave III (children ∼4 years old) dataset.

METHODS:

The ECLS-B is a nationally representative study of children born in 2001 that oversampled births to Asian mothers. Asian ethnic categories included Chinese, Japanese, Filipino, Asian Indian, Korean, Vietnamese, and Other Asian/Pacific Islander. The primary outcome …

Mechanical Contributors To Sex Differences In Idiopathic Knee Osteoarthritis, Daniel P. Nicolella, Mary I. O'Connor, Roger M. Enoka, Barbara D. Boyan, David A. Hart, Eileen Resnick, Karen J. Berkeley, Kathleen A. Sluka, C. Kent Kwoh, Laura L. Tosi, Richard D. Coutts, Wendy M. Kohrt

Orthopaedic Surgery Faculty Publications

The occurrence of knee osteoarthritis (OA) increases with age and is more common in women compared with men, especially after the age of 50 years. Recent work suggests that contact stress in the knee cartilage is a significant predictor of the risk for developing knee OA. Significant gaps in knowledge remain, however, as to how changes in musculoskeletal traits disturb the normal mechanical environment of the knee and contribute to sex differences in the initiation and progression of idiopathic knee OA. To illustrate this knowledge deficit, we summarize what is known about the influence of limb alignment, muscle function, and …

Influence Of Body Mass Index And Antibiotic Dose On The Risk Of Surgical Site Infections In Pediatric Clean Orthopedic Surgery., Jeffrey J Cies, Shannon Chan, Jobayer Hossain, B Randall Brenn, M Cecilia Di Pentima

Department of Anesthesiology Faculty Papers

OBJECTIVE: To evaluate body mass index (BMI) and antimicrobial dose as risk factors for surgical site infections in pediatric patients.

PATIENTS AND METHODS: Children between 2 and 19 years of age undergoing clean orthopedic procedures and receiving at least one dose of perioperative antibiotics (cefazolin, vancomycin, or clindamycin) were studied. The retrospective case-controlled study was conducted at the Alfred I. duPont Hospital for Children, a 180-bed tertiary-care academic pediatric hospital in Wilmington, DE. Data were collected from January 1, 2002, to December 31, 2005.

RESULTS: Underweight children had a higher risk for SSIs than overweight and normal-weight children. American Society …

Limited Sampling Estimates Of Epigallocatechin Gallate Exposures In Cirrhotic And Noncirrhotic Patients With Hepatitis C After Single Oral Doses Of Green Tea Extract., Dina Halegoua-De Marzio, Walter K. Kraft, Constantine Daskalakis, Xie Ying, Roy L Hawke, Victor J. Navarro

Division of Gastroenterology and Hepatology Faculty Papers

BACKGROUND: Epigallocatechin-3-gallate (EGCG) has antiangiogenic, antioxidant, and antifibrotic properties that may have therapeutic potential for the treatment of cirrhosis induced by hepatitis C virus (HCV). However, cirrhosis might affect EGCG disposition and augment its reported dose-dependent hepatotoxic potential.

OBJECTIVE: The safety, tolerability, and disposition of a single oral dose of EGCG in cirrhotic patients with HCV were examined in an exploratory fashion.

METHODS: Eleven patients with hepatitis C and detectable viremia were enrolled. Four had Child-Pugh (CP) class A cirrhosis, 4 had Child-Pugh class B cirrhosis, and 3 were noncirrhotic. After a single oral dose of green tea extract 400 …

Fiberoptic Intubation In A Paediatric Patient With Severe Temporomandibular Joint (Tmj) Ankylosis, Ali Asghar, Faisal Shamim, Asiyah Aman

Department of Anaesthesia

Craniofacial abnormalities are associated with mandibular hypoplasia, reduced mandibular space with overcrowding of soft tissues and maxillary hypoplasia. Decreased mouth opening and limitation in jaw protrusion are independent predictors of difficult airway in such patients. The relative difficult problem becomes even graver in the paediatric age group because of their small mouth opening and un-cooperativeness. A child with severe temporomandibular joint (TMJ) ankylosis presented with negligible mouth opening and required surgical correction under general anaesthesia. Successful intubation was performed with endotracheal tube size 5.5 mm using an adult 4.3 mm fiberoptic bronchoscope under inhalational as well as topical anaesthesia.

The Effects Of Energy Beverages In Counteracting The Symptoms Of Mild Hypoxia At Legal General Aviation Altitudes, Daniel Mark Bull

Doctoral Dissertations and Master's Theses

The purpose of this thesis was to conduct preliminary research, in the form of a pilot study, concerning the natural effects of hypoxia compared to the effects of hypoxia experienced after the consumption of an energy beverage. The study evaluated the effects of hypoxia on FAA certificated pilots at a simulated legal general aviation altitude, utilizing the normobaric High Altitude Lab (HAL) located at Embry Riddle Aeronautical University, Daytona Beach, Florida. The researcher tested 11 subjects, who completed three simulated flight tasks within the HAL using the Frasca International Mentor Advanced Aviation Training Device (AATD). The flight tasks were …

Enteric Feeding Tubes, Rebekah Conroy, Melanie Anspacher, Priti Bhansali, Neha Shah

Pediatrics Posters and Presentations

No abstract provided.

Metabolic Syndrome And Migraine., Amit Sachdev, Michael J Marmura

Department of Jefferson Headache Center Papers and Presentations

Migraine and metabolic syndrome are highly prevalent and costly conditions. The two conditions coexist, but it is unclear what relationship may exist between the two processes. Metabolic syndrome involves a number of findings, including insulin resistance, systemic hypertension, obesity, a proinflammatory state, and a prothrombotic state. Only one study addresses migraine in metabolic syndrome, finding significant differences in the presentation of metabolic syndrome in migraineurs. However, controversy exists regarding the contribution of each individual risk factor to migraine pathogenesis and prevalence. It is unclear what treatment implications, if any, exist as a result of the concomitant diagnosis of migraine and …

Percutaneous Gastrostomy (Peg) Tube Placement In Patients With Continuous Flow Left Ventricular Assist Device. (Lvad)., Hitoshi Hirose, Chris Rizzi, Linda Bogar, Jay S. Jenoff, Nicholas Cavarocchi

Department of Surgery Faculty Papers

Percutaneous gastrostomy (PEG) tube placement in patients with continuous flow left ventricular assist device. (LVAD). CHRIS RIZZI, BS, Linda Bogar, MD, Jay Jenoff, MD, Nicholas Cavarocchi, MD, Hitoshi Hirose, MD. Department of Surgery, Thomas Jefferson University, Philadelphia, PA. Introduction: Inadequate nutritional support after LVAD placement is known to increase postoperative infections and to decrease survival. The LVAD patients with complicated postoperative recovery requiring prolonged mechanical ventilation may require long-term tube feedings. Placement of a PEG requires knowledge of the location of the LVAD pocket and driveline to avoid device infection and injury. Methods: Between August 2008 and December 2011, 39 …

Selective Screening Of Type 2 Diabetes For Washoe County’S Hispanic Population, Linda M. Dunn

Nevada Journal of Public Health

Hispanic Americans with unrecognized, asymptomatic diabetes are more likely to experience poor quality of life and diabetic complications such as heart, eye and kidney disease than non-Hispanic whites of similar age. Multiple factors, such as cultural beliefs, lack of knowledge and limited access to health care, contribute to the fact that one-third of total diabetes among Hispanic Americans is undiagnosed. For Washoe County, Nevada, the actual percentage of adult Hispanics with diabetes may be almost 12%. In 2003, the Defeat Diabetes Screening Project provided three screenings targeting the Hispanic population in Reno and Sparks. Seventy-one percent of 348 screened were …

Adverse Maternal Outcomes For Women With Different Health Insurance Statuses In Nevada, Jay J. Shen, Hong Wei

Nevada Journal of Public Health

Objective. Nevada women with unfavorable health insurance status may face greater barriers than women in the rest of the nation, since the development of healthcare infrastructure in Nevada is running behind population growth. This study examines the relationship between health insurance status and adverse maternal outcomes in Nevada.

Methods. Hospital discharge information of 33,149 women aged 13 or older who delivered in 2004 was abstracted from the 2004 State Inpatient Data for Nevada. A total of 13 measures of complications associated with pregnancy were identified, including preterm labor, hypertensive disorders of pregnancy, gestational diabetes, ante-partum hemorrhage, membrane disorders, cesarean section, …

Association Of Gestational Weight Gain And Pre-Pregnancy Body Mass Index With Adverse Pregnancy Outcome, Shama Munim, Humaira Maheen

Department of Obstetrics & Gynaecology

Objective: To determine the association between gestation weight gain (GWG) and adverse pregnancy outcome in a Pakistani population.
Study Design: Analytical study.
Place and Duration of Study: The Aga Khan University, Karachi, from February 2003 to 2007.
Methodology: This study used secondary data of 4,735 women from a large cohort study on fetal growth. Pre-pregnancy BMI was categorized according to the recommendations from the institute of medicine (IOM, 2009) and gestation weight gain (GWG) was noted. Chi-square test was used to find the association of GWG and pre-pregnancy BMI with low birth weight (LBW), preterm delivery, large for gestational age …

Measuring Parvalbumin Levels In Fish Muscle Tissue: Relevance Of Muscle Locations And Storage Conditions, Poi-Wah Lee, Julie A. Nordlee, Stef J. Koppelman, Joseph L. Baumert, Steve L. Taylor

Department of Food Science and Technology: Faculty Publications

Fish is an allergenic food capable of provoking severe anaphylactic reactions. Parvalbumin is the major allergen identified in fish and frog muscles. Antibodies against fish and frog parvalbumin have been used to quantify parvalbumin levels from fish. However, these antibodies react variably with parvalbumin from different fish species. Several factors might be responsible for this variation including instability of parvalbumin in fish muscle as a result of frozen storage and differential parvalbumin expression in muscles from various locations within the whole fish. We aimed to investigate whether these factors contribute to the previously observed variable immunoreactivity of the anti-parvalbumin antibodies. …

A Pilot Study Of Diabetes Management In The Managed Care Setting, Rachel Wagman

The Medicine Forum

Diabetes mellitus represents a disease entity that primary care providers commonly encounter in the outpatient setting. Patient visits encompass a broad range of concerns, from optimizing management of hyperglycemia to the sequelae of chronic disease. The third National Health and Nutrition Exam Survey, (NHANES III) 1988-1994 has reported the prevalence of diabetes mellitus type 2 in the U.S. adult population at 12.3%. The cost of diabetes in 1998, estimated at $77 billion, is a formidable challenge to the health care community and third-party payers. Historically, Health Maintenance Organizations (HMOs) have encouraged more preventative tests, procedures, and exams to curtail the …

Melena With Fever, Monica Patel, Jennifer Wilhelm

The Medicine Forum

The patient is a 62 year old Indian male with a past medical history significant for myasthenia gravis, hypertension, and diabetes mellitus, who presented to an outside hospital with fever, fecal incontinence, and melena. Work up at that hospital was remarkable for elevated liver function tests, heme-positive brown stool and a CT of the abdomen showing a thick ascending colon suggesting possible mass. The patient had an episode of desaturation and fever to 105 degrees Fahrenheit prior to transfer to Thomas Jefferson University Hospital for further evaluation. Upon arrival, the patient was in respiratory distress with oxygen saturation of 70% …

A Case Of Hypercalcemia, Daniel Lin

The Medicine Forum

A 79-year-old man with a past medical history of diet-controlled type 2 diabetes mellitus, hypertension, and chronic lower extremity venous stasis ulcers requiring two skin grafts was admitted to the hospital due to dehydration. He was in his usual state of health intermittently being wheelchair bound due to leg ulcers until four days earlier, when he accidentally spilled hot tea on his left arm while in the kitchen. In his attempt to maneuver the wheelchair away from the spill, the wheelchair turned over, pinning him on the floor and against the cabinets. He remained in that position for four days …

Regional Variation In Aortic At1b Receptor Mrna Abundance Is Associated With Contractility But Unrelated To Atherosclerosis And Aortic Aneurysms, Aruna Poduri, A. Phillip Owens, Deborah A. Howatt, Jessica J. Moorleghen, Anju Balakrishnan, Lisa A. Cassis, Alan Daugherty

Pharmacology and Nutritional Sciences Faculty Publications

BACKGROUND: Angiotensin II (AngII), the main bioactive peptide of the renin angiotensin system, exerts most of its biological actions through stimulation of AngII type 1 (AT1) receptors. This receptor is expressed as 2 structurally similar subtypes in rodents, termed AT1a and AT1b. Although AT1a receptors have been studied comprehensively, roles of AT1b receptors in the aorta have not been defined.

METHODOLOGY/RESULTS: We initially compared the regional distribution of AT1b receptor mRNA with AT1a receptor mRNA in the aorta. mRNA abundance of both subtypes increased from the proximal to the distal aorta, with the greatest abundance in the infra-renal region. Corresponding …

Perspective On Lead Toxicity: A Comparison Between The United States And Iran, Ali Pourmand, Tareq Khedir Al-Tiae, Maryann Mazer-Amirshahi

Emergency Medicine Faculty Publications

Lead is a pervasive toxin that has been implicated in human poisonings throughout history. Exposure mitigation strategies in the United States and worldwide have led to a decline in symptomatic poisonings and population blood lead levels; however, lead remains a major health hazard. In this article, we review the history of lead toxicity, clinical manifestations ranging from subclinical and subtle features to life-threatening complications, and the subsequent public health interventions in the US. In addition, we explore common routes of lead exposure and the unique differences between the US and Iran. Although the US has made significant strides with regard …

Stem Cell Transplantation Increases Antioxidant Effects In Diabetic Mice, Ming Li, Luca Vanella, Yuming Zhang, Ming Shi, Takashi Takaki, Joseph I. Shapiro M.D., Susuma Ikehera

Biochemistry and Microbiology

Intra bone marrow-bone marrow transplantation (IBM- BMT) + thymus transplantation (TT) has been shown to reduce the incidence of graft versus host disease (GVHD) and restore donor-derived T cell function. In addition, an increase in insulin sensitivity occurred in db/db mice after IBM-BMT+TT treatment. Heme oxygenase (HO)-1 is a stress inducible enzyme which exert antioxidant, antiapoptotic, and immune-modulating properties. We examined whether IBM-BMT+TT could modulate the expression of HO-1 in the kidneys of db/db mice. Six-week-old db/db mice with blood glucose levels higher than 250 mg/dl were treated with IBM-BMT+TT. Six weeks later, the db/db mice showed decreased body weight, …

Candidal Retinitis, Carl D. Mele

The Medicine Forum

Mr. R.T. was a 49 year old male with recurrent Hepatitis C infection after orthotopic liver transplant, who presented with complications related to hemorrhagic pancreatitis. While on long term total parenteral nutrition, he developed blurry vision and Candida albicans fungemia. A fundus photograph revealed fungal endopthalmitis with focal areas of chorioretinitis. His vision improved significantly with serial intravitreal antifungal injections.

Nevirapine Hepatotoxicity: Case Report And Discussion, Matt Baichi

The Medicine Forum

Nevirapine (viramune) is a nonnucleoside reverse transcriptase inhibitor commonly used in combination with other antiretroviral medicines in the treatment of HIV/AIDS. The safety profile of nevirapine, as determined by review of prospective clinical trials, reports rash with an incidence of 16% as the most common side effect. Clinical hepatitis is reported to occur with an incidence of 1%. A review of the literature shows many case reports of nevirapine-induced hepatotoxicity in patients receiving both treatment and prophylaxis for HIV. The purpose of this case report is to stress the importance of early recognition and withdrawal of the offending drug.

Awareness Of Type Ii Diabetes In The Developing World: Case Study In Binh Du’O’Ng, Vietnam, Anna Hong Le

Independent Study Project (ISP) Collection

Vietnam’s rapid economic development after 1986 forever changed the lifestyle of the Vietnamese. Economic development has highly impacted behavior, “changing from a traditional lifestyle to an industrial lifestyle [increasing] noncommunicable diseases (NCDs) : diabetes, overweight, high blood pressure, and high cholesterol disorders” (Danh, Personal Interview). With the increase of NCDs within the country, it is important to focus on awareness education that motivates the population especially those living in the urban sector to practice healthy behaviors. This study project focuses on the evaluating the reach and effectiveness of current diabetes awareness educational materials. One week was spent in Ha Noi, …

Com Outlook Fall 2012, College Of Osteopathic Medicine

COM Outlook

No abstract provided.

Achieving Consensus On Measure-Driven Child Health Quality: Maine’S Improving Health Outcomes For Children Initiative, Martha Elbaum Williamson Mpa, Nargiza Fuzailova Md, Mph, Kimberley S. Fox Mpa

Population Health & Health Policy

This brief describes Maine’s process for selecting child health quality measures, including identified strengths and limitations of the CHIPRA core measures that led to the inclusion of additional state-specific measures and the factors considered for selection. Subsequent articles will describe how measures have been implemented and used to improve child health quality and how they have been integrated into systems of care (e.g. health information technology systems, policy changes).