Digital Commons Network^™

Aggressive Vs Conservative Phototherapy For Infants With Extremely Low Birth Weight, Brenda H Morris, William Oh, Jon E Tyson, David K Stevenson, Dale L Phelps, T Michael O'Shea, Georgia E Mcdavid, Rebecca L Perritt, Krisa P Van Meurs, Betty R Vohr, Cathy Grisby, Qing Yao, Claudia Pedroza, Abhik Das, W Kenneth Poole, Waldemar A Carlo, Shahnaz Duara, Abbot R Laptook, Walid A Salhab, Seetha Shankaran, Brenda B Poindexter, Avroy A Fanaroff, Michele C Walsh, Maynard R Rasmussen, Barbara J Stoll, C Michael Cotten, Edward F Donovan, Richard A Ehrenkranz, Ronnie Guillet, Rosemary D Higgins

Faculty, Staff and Student Publications

BACKGROUND: It is unclear whether aggressive phototherapy to prevent neurotoxic effects of bilirubin benefits or harms infants with extremely low birth weight (1000 g or less).

METHODS: We randomly assigned 1974 infants with extremely low birth weight at 12 to 36 hours of age to undergo either aggressive or conservative phototherapy. The primary outcome was a composite of death or neurodevelopmental impairment determined for 91% of the infants by investigators who were unaware of the treatment assignments.

RESULTS: Aggressive phototherapy, as compared with conservative phototherapy, significantly reduced the mean peak serum bilirubin level (7.0 vs. 9.8 mg per deciliter [120 …

Gender Differences In Motivation To Resolve Eating And Body Image Concerns In College Students, Harold L. Merriman, C. Jayne Brahler, Laura Dinan, Lauren Finzer

Physical Therapy Faculty Publications

The objective of this study was to identify similarities and differences between college women and men with respect to their eating and body image concerns, weight fluctuation and level of motivation to resolve these concerns. 101 University of Dayton students participated in this study. Students completed an eating and body concern survey online.

Body image concerns were significantly greater for females compared to males (p=0.007) and significantly greater as motivation level to resolve the concerns increased (p=0.019). Eating concerns followed the same trends but did not reach statistical significance. Weight fluctuation in both genders increased significantly as motivation level increased …

Living With Alzheimer’S Disease: A Study Of Adult Day Health Services In Massachusetts, Nina M. Silverstein, Cathy M. Wong, Kristen E. Brueck

Gerontology Institute Publications

The role of adult day health care (ADHC) is gaining increased attention as the nation prepares for the large cohort of baby boomers entering their later years. Many boomers are aging with physical and cognitive impairments, including Alzheimer's disease and related dementias. Projections indicate that Massachusetts, along with the nation as a whole, is experiencing an increasing rate of older persons as baby boomers enter late-life. The Commonwealth can expect that persons with Alzheimer's disease and their care partners will need community-based services that are specifically designed for adults with cognitive impairments. However, a report by the Robert Wood Johnson …

Characteristics Of A Spina Bifida Population Including North American Caucasian And Hispanic Individuals, Kit Sing Au, Phong X Tran, Chester C Tsai, Michelle R O'Byrne, Jone-Ing Lin, Alanna C Morrison, Amy W Hampson, Paul Cirino, Jack M Fletcher, Kathryn K Ostermaier, Gayle H Tyerman, Sabine Doebel, Hope Northrup

Faculty, Staff and Student Publications

BACKGROUND: Meningomyelocele (MM) is a common human birth defect. MM is a disorder of neural development caused by contributions from genes and environmental factors that result in the NTD and lead to a spectrum of physical and neurocognitive phenotypes.

METHODS: A multidisciplinary approach has been taken to develop a comprehensive understanding of MM through collaborative efforts from investigators specializing in genetics, development, brain imaging, and neurocognitive outcome. Patients have been recruited from five different sites: Houston and the Texas-Mexico border area; Toronto, Canada; Los Angeles, California; and Lexington, Kentucky. Genetic risk factors for MM have been assessed by genotyping and …

Elizabeth A. Grimm, Phd, Elizabeth A. Grimm Phd

Legends and Legacies Book Chapters Archives

No abstract provided.

Ellen R. Gritz, Phd, Ellen R. Gritz Phd

Legends and Legacies Book Chapters Archives

No abstract provided.

Ritsuko Komaki, Md, Ritsuko Komaki Md

Legends and Legacies Book Chapters Archives

No abstract provided.

Non-Fatal Limb Injuries In Motorbike Accidents., Mubashir Aslam, Tahir M Taj, Syed Arif Ali, Waseem Akhtar Mirza, Nasira Badar

Community Health Sciences

OBJECTIVE: To determine frequency and pattern of non-fatal limb injuries in motorbike accidents victims.STUDY DESIGN: Cross-sectional observational study.PLACE AND DURATION OF STUDY: Study was conducted at Jinnah Postgraduate Medical Centre (JPMC), Karachi, from October 2006 to March 2007.METHODOLOGY: Trained data collectors prospectively collected data from the emergency department of JPMC, Karachi using structured pre-tested questionnaires. All motorbike accident victims presented to Emergency department with single or multiple bone injury in body extremities were included. Head injury patients who had first presented to neuro-surgery department were excluded. Motorbike accident victims with soft tissue injuries were also excluded from this study. Chisquare …

Outcomes Of Safety And Effectiveness In A Multicenter Randomized, Controlled Trial Of Whole-Body Hypothermia For Neonatal Hypoxic-Ischemic Encephalopathy, Seetha Shankaran, Athina Pappas, Abbott R Laptook, Scott A Mcdonald, Richard A Ehrenkranz, Jon E Tyson, Michelle Walsh, Ronald N Goldberg, Rosemary D Higgins, Abhik Das

Faculty, Staff and Student Publications

BACKGROUND: Whole-body hypothermia reduced the frequency of death or moderate/severe disabilities in neonates with hypoxic-ischemic encephalopathy in a randomized, controlled multicenter trial.

OBJECTIVE: Our goal was to evaluate outcomes of safety and effectiveness of hypothermia in infants up to 18 to 22 months of age.

DESIGN/METHODS: A priori outcomes were evaluated between hypothermia (n = 102) and control (n = 106) groups.

RESULTS: Encephalopathy attributable to causes other than hypoxia-ischemia at birth was not noted. Inotropic support (hypothermia, 59% of infants; control, 56% of infants) was similar during the 72-hour study intervention period in both groups. Need for blood transfusions …

Sensitivity Of The Human Circadian System To Short Wavelength (420 Nm) Light, George C. Brainard, David Silney, John P. Hanifin, Gena Glickman, Brenda Byrne, Jeffrey M. Greeson, Samar Jasser, Edward Gerner, Mark D. Rollag

Department of Neurology Faculty Papers

The circadian and neurobehavioral effects of light are primarily mediated by a retinal ganglion cell photoreceptor in the mammalian eye containing the photopigment, melanopsin. Nine action spectrum studies using rodents, monkeys, and human for these responses indicate peak sensitivities in the blue region of the visible spectrum ranging from 459 nm to 484 nm, with some disagreement in short wavelength sensitivity of the spectrum. The aim of this work was to quantify the sensitivity of human volunteers to monochromatic 420 nm light for plasma melatonin suppression. Adult female (N=14) and male (N=12) subjects participated in two studies, each employing a …

Acute Atomoxetine Treatment Of Younger And Older Children With Adhd: A Meta-Analysis Of Tolerability And Efficacy., Christopher J. Kratochvil, Denái R. Milton, Brigette S. Vaughan, Laurence L. Greenhill

Journal Articles: Psychiatry

BACKGROUND: Atomoxetine is FDA-approved as a treatment of attention-deficit/hyperactivity disorder (ADHD) in patients aged 6 years to adult. Among pediatric clinical trials of atomoxetine to date, six with a randomized, double-blind, placebo-controlled design were used in this meta-analysis. The purpose of this article is to describe and compare the treatment response and tolerability of atomoxetine between younger children (6-7 years) and older children (8-12 years) with ADHD, as reported in these six acute treatment trials.

METHODS: Data from six clinical trials of 6-9 weeks duration were pooled, yielding 280 subjects, ages 6-7 years, and 860 subjects, ages 8-12 years with …

Off-Label Psychopharmacologic Prescribing For Children: History Supports Close Clinical Monitoring., Julie M. Zito, Albert T. Derivan, Christopher J. Kratochvil, Daniel J. Safer, Joerg M. Fegert, Laurence L. Greenhill

Journal Articles: Psychiatry

The review presents pediatric adverse drug events from a historical perspective and focuses on selected safety issues associated with off-label use of medications for the psychiatric treatment of youth. Clinical monitoring procedures for major psychotropic drug classes are reviewed. Prior studies suggest that systematic treatment monitoring is warranted so as to both minimize risk of unexpected adverse events and exposures to ineffective treatments. Clinical trials to establish the efficacy and safety of drugs currently being used off-label in the pediatric population are needed. In the meantime, clinicians should consider the existing evidence-base for these drugs and institute close clinical monitoring.

Review Of Oral Oxymorphone In The Management Of Pain, Paul Sloan

Anesthesiology Faculty Publications

Chronic cancer and nonmalignant pain (CNMP) is a common and major health problem afflicting approximately 40 million persons in the US. Most cancer patients, and many patients with CNMP, require opioid analgesics to obtain adequate pain relief. Oral oxymorphone is a new formulation of an existing parenteral opioid that has become available for the treatment of significant pain: acute postoperative, chronic arthritis, chronic low back, and chronic cancer pain. Oxymorphone is a typical mu-opioid agonist that is effective in both immediate- and extended-release (IR and ER) formulations. Oxymorphone is more lipid soluble than morphine, resulting in a rapid onset of …

Labrad : Vol 33, Issue 3 - September 2008, Aga Khan University Hospital, Karachi

LABRAD - Departments of Pathology & Laboratory Medicine and Radiology Archives

• Vitamin D Deficiency: Are We Still Ignoring the Evidence?
• Collection and Transport of Urine for Culture
• Understanding and Interpreting Serum Protein Electrophoresis
• Cystic Fibrosis at a Glance
• What you need to know about Dengue Infection
• CT Colonoscopy: Introduction
• CT Enteroclysis: A New Technique to Evaluate Small Bowel
• CSF-DR: An Important Diagnostic Tool
• G6PD Quantification
• Quality Assurance
• Clinical Laboratory Continuing Medical Education (CME) Seminars
• Meeting Reports

Predictive Measures Of Cognitive Outcome In Adults Sustaining Brain Injury, Herminia De La Rosa-Trujillo

Loma Linda University Electronic Theses, Dissertations & Projects

To date, there is no consistent and accurate outcome prediction method for patients with traumatic brain injury (TBI). Commonly used clinical measures such as the Glasgow Coma Scale (GCS) and traditional radiological methods of x-rays and computed tomography (CT) scans do not always accurately predict patient functional outcome. These radiological methods are adequate in determining gross structural anatomical disturbances, however, they are unable to detect more diffuse cellular damage believed to be responsible for the functional impairments evidenced in patients sustaining TBI. Magnetic resonance imaging allows for various non-invasive sequencing techniques that have demonstrated to be a potentially valuable method …

Role Of Psoas Compartment And Caudal Epidural Steroid Injection In Spinal Stenosis Patients Associated With Low Back Pain And Lower Limb Radiculopathy, Mueen Ullah Khan, S. Zaki Hussain

Department of Anaesthesia

OBJECTIVE: To study the efficacy, safety and patient satisfaction of psoas compartment and caudal epidural steroid injection in patients with spinal stenosis and lumbosaccral radiculopathy.

METHODS: Patients with a diagnosis of spinal stenosis and lumbosaccral radiculopathy having visual analogue score (VAS) less than five were included in the study. Bilateral psoas compartment and caudal epidural injection was given to all patients. In group-A patients haemodynamics and complications were examined immediately after injection. In group-B the same patients were examined through a questionnaire after eight weeks, for pain relief, duration of pain relief, reduction in painkillers and overall improvement in activities …

Migraine And Patent Foramen Ovale: Exploring The Association And A Possible Treatment Option, Muhammed Yaser Hasan

Department of Biological & Biomedical Sciences

Migraine is a very common type of headache. With a prevalence of 10-12%, migraine ranks 19th among diseases causing worldwide morbidity. Number of studies have shown a high prevalence of patent foramen ovale (PFO) in patients with migraine, especially migraine with aura. The right to left shunting of blood in a PFO could serve as a conduit for chemicals that would exert a trigger effect on hyper excitable neurons leading to the development of migraine. Furthermore patients with PFO and migraine also show a marked improvement in their symptoms after percutaneous closure of the PFO. This review is a close …

Enterocutaneous Fistulae In Children - A Management Challenge, Ali Imran Amjad, Saqib Hamid Qazi, Zafar Nazir

Department of Biological & Biomedical Sciences

No abstract provided.

Digest Of The Philadelphia College Of Osteopathic Medicine (Fall 2008), Philadelphia College Of Osteopathic Medicine

Digest

The Fall 2008 issue of the Digest of the Philadelphia College of Osteopathic Medicine includes the following articles:

• Opening Remarks
• PCOM Updates and Kudos
• Development News
• Global Warming’s Health Crisis
• Weather Disasters
• Emerging Infectious Diseases
• What Can Be Done?
• Water-Borne Diseases
• Heat Related Illnesses
• Heat Intensifies Air Pollution
• What Can Health Professionals Do?
• Extreme Climate Events and Mental Health Disorders
• Common Goals
• Medical Marriages
• Starting Out
• Practicing Together
• Military Match
• A Family Tradition
• Research: Fruit of the Vine May Combat Prostrate Cancer
• Class Notes
• In Memoriam
• My Turn Essay
• PCOM Events

Associations Between Performance On The Rey-Osterrieth Complex Figure And Regional Brain Volumes In Children With And Without Velocardiofacial Syndrome, Kevin M. Antshel, Jena Peebles, Nuria Abdulsabur, Anne Marie Higgins, Nancy Roizen, Robert J. Shprintzen, Wanda Fremont, Robert Natasi, Wendy R. Kates

Communication Disorders Faculty Publications

Ninety-two children with velocardiofacial syndrome (VCFS), a genetic disorder caused by a microdeletion of chromosome 22q11.2 and an age, race, and gender-ratio comparable sample of 59 control participants were included in the project. Participants received an MRI as well as a comprehensive neuropsychological battery; the primary outcome measure in the current report is the Rey-Osterrieth Complex Figure (ROCF). Children with VCFS performed less well on the ROCF and have lower whole brain volume compared to controls. After controlling for whole brain volume differences, children with VCFS have bilaterally less parietal lobe gray and white matter yet more frontal lobe white …

Com Outlook Summer 2008, College Of Osteopathic Medicine

COM Outlook

No abstract provided.

A Pooled Analysis Of Two Placebo-Controlled Trials Of Desvenlafaxine In Major Depressive Disorder., Daniel Z Lieberman, Stuart A Montgomery, Karen A Tourian, Claudine Brisard, Gregory Rosas, Krishna Padmanabhan, Jean-Michel Germain, Bruno Pitrosky

Psychiatry and Behavioral Sciences Faculty Publications

The efficacy, safety, and tolerability of desvenlafaxine (administered as desvenlafaxine succinate) were evaluated in two similarly designed, phase 3, randomized, double-blind, placebo-controlled, venlafaxine-extended-release-referenced, flexible-dose studies of outpatients with a primary diagnosis of major depressive disorder. Owing to a high placebo response, the individual studies were underpowered. Therefore, a post-hoc pooled analysis was performed (desvenlafaxine and placebo data were pooled; venlafaxine extended release data were not, owing to different flexible-dose regimens in the two studies). The primary outcome measure was the change from baseline on the 17-item Hamilton Rating Scale for Depression; the Clinical Global Impressions-Improvement item score was a secondary …

Pathways To Change: The Effect Of A Web Application On Treatment Interest., Daniel Z Lieberman, Suena H Massey

Psychiatry and Behavioral Sciences Faculty Publications

Most individuals with drinking problems do not receive treatment, generally because they do not perceive the need for it. It is difficult to access this population of problem drinkers in order to encourage treatment-seeking. A Web-based program was written, designed to increase motivation for change. The program guided non-treatment-seekers through a multi-stage assessment and provided them with feedback. The level of interest in treatment was measured pre-and post-intervention. Compared to baseline, after the intervention, significantly more individuals rated themselves "very interested" in participating in some form of traditional treatment (19% vs. 28%), and their focus on a specific modality increased.

Medical Students: Abuse Of Psychoactive Substances And Sexuality Aspects, Kepler Alencar Mendes Carvalho, Maria José Carvalho Sant'anna, Verônica Coates, Hatim A. Omar

Pediatrics Faculty Publications

University students aged 17 to 24 years of age are prone to many risk factors.

OBJECTIVES: Identify risk factors related to exploring sexuality and characteristics of consumption of psychoactive substances in students attending medical school.

METHODS: 465 Medical students from Santa Casa of São Paulo Faculty of Medical Sciences (FCMSCSP) were prospectively and transversely evaluated during 2005. An anonymous, semi-structured, self-filling questionnaire was used. The average age of the students was 21.5 years, 43% females. 76.2% preferred alcohol, and 11.1% tobacco consumption; chloroethane (lança-perfume) consumption occurred in 22.6% and 15.3% consumption of other types of illicit drugs, with marijuana as …

Primary Health Care Providers’ Knowledge And Practices On Asthma Management Within Dar Es Salaam Region Health Facilities, John C. Rwegasha

Master of Medicine in Family Medicine

Background: Asthma is a common chronic health problem worldwide with considerable variation in the way it is managed. In the sub- Saharan Africa there is substantial gaps in asthma care; countries like Tanzania with inadequate health care structure are lagging far behind in both correct diagnosis and management of asthma. The increasing prevalence of asthma within populations is attributed to a number of the following factors; Patient behavior, Health service structure and access, Environmental factors and Provider's knowledge and practices. There is lack of required standard asthma care under provider's factors, hindering effective control of the disease. This could be …

Criterion Validity Of The Wechsler Intelligence Scale For Children - Fourth Edition After Pediatric Traumatic Brain Injury, Jacobus Donders, Kelly Janke

University Faculty Publications and Creative Works

The performance of 40 children with complicated mild to severe traumatic brain injury on the Wechsler Intelligence Scale for Children - Fourth Edition (WISC-IV; Wechsler, 2003) was compared with that of 40 demographically matched healthy controls. Of the four WISC-IV factor index scores, only Processing Speed yielded a statistically significant group difference (p < .001) as well as a statistically significant negative correlation with length of coma (p < .01). Logistic regression, using Processing Speed to classify individual children, yielded a sensitivity of 72.50% and a specificity of 62.50%, with false positive and false negative rates both exceeding 30%. We conclude that Processing Speed has acceptable criterion validity in the evaluation of children with complicated mild to severe traumatic brain injury but that the WISC-IV should be supplemented with other measures to assure sufficient accuracy in the diagnostic process. © 2008 Copyright © The International Neuropsychological Society 2008.

Stroke In Pakistan, Bhojo A Khealani, Bilal Hameed, Uzma U Mapari

Section of Neurology

Stroke is the most common cause of disability and a leading cause of mortality world wide. Though the incidence is falling in West but probably is rising in Asia. The burden of stroke risk factors in Pakistan is enormous e.g. by 2020 Pakistan will be 4th most populous country in terms of diabetic patients. Similarly every 3rd person above age of 45 years has hypertension. Ironically a great majority of these patients are unaware of their diagnosis. This is further complicated by the fact that most of diagnosed patients have uncontrolled hypertension, as a result of poor compliance on patients …

The Temporal Relationship Between The Coronavirus Disease 2019 (Covid-19) Pandemic And Preterm Birth, Harold E Bedell, Mahalakshmi Ramamurthy, Saumil S Patel, Shobana Subramaniam, Lan-Phuong Vu-Yu, Jianliang Tong

Faculty, Staff and Student Publications

Despite rapid to-and-fro motion of the retinal image that results from their incessant involuntary eye movements, persons with infantile nystagmus (IN) rarely report the perception of motion smear. We performed two experiments to determine if the reduction of perceived motion smear in persons with IN is associated with an increase in the speed of the temporal impulse response. In Experiment 1, increment thresholds were determined for pairs of successively presented flashes of a long horizontal line, presented on a 65-cd/m2 background field. The stimulus-onset asynchrony (SOA) between the first and second flash varied from 5.9 to 234 ms. In experiment …

Water-Soluble Fullerene (C60) Derivatives As Nonviral Gene-Delivery Vectors, Balaji Sitharaman, Tatiana Y Zakharian, Anita Saraf, Preeti Misra, Jared Ashcroft, Su Pan, Quynh P Pham, Antonios G Mikos, Lon J Wilson, David A Engler

Faculty, Staff and Student Publications

A new class of water-soluble C60 transfecting agents has been prepared using Hirsch-Bingel chemistry and assessed for their ability to act as gene-delivery vectors in vitro. In an effort to elucidate the relationship between the hydrophobicity of the fullerene core, the hydrophilicity of the water-solubilizing groups, and the overall charge state of the C60 vectors in gene delivery and expression, several different C60 derivatives were synthesized to yield either positively charged, negatively charged, or neutral chemical functionalities under physiological conditions. These fullerene derivatives were then tested for their ability to transfect cells grown in culture with DNA carrying the green …

Estrogen Replacement Therapy Induces Functional Asymmetry On An Odor Memory/Discrimination Test, Richard L. Doty, Mehreen Kisat, Isabelle Tourbier

Section of Otolaryngology, Head & Neck Surgery

The secondary afferents of the olfactory system largely project to the ipsilateral cortex without synapsing in the thalamus, making unilateral olfactory testing a useful probe of ipsilateral hemispheric activity. In light of evidence that lateralized performance on some perceptual tasks may be influenced by estrogen, we assessed left:right nostril differences in two measures of olfactory function in 14 post-menopausal women receiving estrogen replacement therapy (ERT) and 48 post-menopausal women receiving no such therapy. Relative to women not taking ERT, those receiving ERT exhibited better performance in the left nostril and poorer performance in the right nostril on an odor memory/discrimination …