Digital Commons Network^™

Youth And Student Suicide, Kimberly K. Mcclanahan, Hatim A. Omar

Pediatrics Faculty Publications

No abstract provided.

Suicidal Behavior And Prevention In Adolescence, Hatim A. Omar, Joav Merrick

Pediatrics Faculty Publications

Suicidal behavior in youth is not uncommon and currently one of the leading causes of death in adolescence in many countries around the world. Individual risk factors for suicidality in youth include: psychiatric disorder; certain personality characteristics; genetics; gender; sexual orientation; and previous suicide attempts. Family psychopathology and environmental factors such as media contagion also contribute as risk factors. Developmental issues, including: the establishment of independence and intimate relationships; as well as the pursuit of personal and career goals; may also provide stressors leading to suicidality. Prevention and intervention strategies are considered and include: early detection and treatment of mental …

Adolescence And Contraception, Donald E. Greydanus, Carolyn M. Lentzsch-Parcells, Hatim A. Omar, Colleen B. Dodich

Pediatrics Faculty Publications

The age of adolescence is the time when most adolescents in the world become sexually active with resultant millions of pregnancies and sexually transmitted diseases. This paper considers methods of contraception for these adolescents, including oral contraceptions, transdermal contraception, mini-pills, intravaginal ring, injectable contraception, intrauterine devices, barrier contraceptives, implants, and others. It is important for clinicians caring for sexually active youth to provide information regarding contraception and appropriate contraceptive prescriptions.

The Female And Male Adolescent Breast, Donald E. Greydanus, Stephanie Stockburger, Hatim A. Omar, Colleen B. Dodich

Pediatrics Faculty Publications

The breast is an important organ system for the adolescent female and occasionally for the adolescent male as well. This chapter reviews basic principles of breast concerns and disorders including congenital anomalies, asymmetric breast development, underdeveloped breasts, virginal hypertrophy, breast masses, mastaglia, galactorrhea, gynecomastia in males, and others. Clinicians should be attuned to issues and concerns for this important structure in adolescents.

Sexually Transmitted Diseases In Adolescence, Donald E. Greydanus, Jane Seyler, Hatim A. Omar, Colleen B. Dodich

Pediatrics Faculty Publications

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

Pregnancy In Adolescence, Donald E. Greydanus, Marlene B. Huff, Hatim A. Omar, Colleen B. Dodich

Pediatrics Faculty Publications

Over 14 million adolescents in the world annually give birth and nearly 800.000 adolescents in the United States become pregnant each year. This paper considers concepts of teen pregnancy including risks to the mother as well as offspring, the adolescent father, issues related to abortion, and concepts of prevention of unwanted pregnancy in youth. Adolescent pregnancy is a global phenomenon affecting all societies and cultures.

Adolescent Female Menstrual Disorders, Donald E. Greydanus, Shawn Sorrel, Hatim A. Omar, Colleen B. Dodich

Pediatrics Faculty Publications

This paper reviews basic concepts of menstrual disorders in adolescents beginning with an overview of menstrual physiology followed by consideration of various abnormal menstrual patterns: amenorrhea (primary and secondary), dysfunctional uterine bleeding, dysmenorrhea (primary and secondary), and premenstrual syndrome.

Late Removal Of Titanium Hardware From The Elbow Is Problematic, Abdo Bachoura, Ruriko Yoshida, Christian Lattermann, Srinath Kamineni

Orthopaedic Surgery and Sports Medicine Faculty Publications

A retrospective review of 21 patients that underwent bone screw removal from the elbow was studied in relation to the type of metal, duration of implantation, and the location of the screws about the elbow. Screw failure during extraction was the dependent variable. Five of 21 patients experienced hardware failure during extraction. Fourteen patients had titanium alloy implants. In four cases, titanium screws broke during extraction. Compared to stainless steel, titanium screw failure during removal was not statistically significant (P = 0.61). Screw removal 12 months after surgery was more likely to result in broken, retained screws in general …

Effect Of A Physician Uncertainty Reduction Intervention On Blood Pressure In Uncontrolled Hypertensives-A Cluster Randomized Trial, David J. Hyman, Valory N. Pavik, Anthony J. Greisinger, Wenyaw Chan, Jose Bayona, Carol Mansyur, Victor Simjms, James Pool

Community & Environmental Health Faculty Publications

BACKGROUND: Clinical inertia, provider failure to appropriately intensify treatment, is a major contributor to uncontrolled blood pressure (BP). Some clinical inertia may result from physician uncertainty over the patient’s usual BP, adherence, or value of continuing efforts to control BP through lifestyle changes.

OBJECTIVE: To test the hypothesis that providing physicians with uncertainty reduction tools, including 24-h ambulatory BP monitoring, electronic bottle cap monitoring, and lifestyle assessment and counseling, will lead to improved BP control.

DESIGN: Cluster randomized trial with five intervention clinics (IC) and five usual care clinics (UCC).

SETTING: Six public and 4 private primary care clinics.

PARTICIPANTS: …

Physician Review Of Workers' Compensation Case Files: Can It Affect Decision Outcomes?, Mark E. Hammett, Christopher Jankosky, John Muller, Elizabeth Hughes, Francesca Litow

Community & Environmental Health Faculty Publications

Objective: To identify common attributes of Federal workers compensation cases referred to Navy physicians for medical opinions and to determine the impact of the review on the final case decision. Methods: Retrospective case study and descriptive analysis of 258 opinion letters written by physicians on referred cases from 2006 to 2010. Results: Navy physician opinions were considered in the outcome in some of the cases, and there was a statistically significant difference between the claim acceptance rate in the study population and the total population. Worker age was correlated with certain claim types. Conclusions: There is preliminary evidence that the …

Contrasting Effects Of Errorless Naming Treatment And Gestural Facilitation For Word Retrieval In Aphasia, Anastasia M. Raymer, Beth Mchose, Kimberly G. Smith, Lisa Iman, Alexis Ambrose, Colleen Casselton

Communication Disorders & Special Education Faculty Publications

Purpose- We compared the effects of two treatments for aphasic word retrieval impairments, errorless naming treatment (ENT) and gestural facilitation of naming (GES), within the same individuals, anticipating that the use of gesture would enhance the effect of treatment over errorless treatment alone. In addition to picture naming, we evaluated results for other outcome measures that were largely untested in earlier ENT studies.

Methods- In a single participant crossover treatment design, we examined the effects of ENT and GES in eight individuals with stroke-induced aphasia and word retrieval impairments (three semantic anomia, five phonological anomia) in counterbalanced phases across participants. …

Medication And Supplement Use For Managing Joint Symptoms Among Patients With Knee And Hip Osteoarthritis: A Cross-Sectional Study, Jeffrey B. Driban, Sara A. Boehret, Easwaran Balasubramanian, Nicole M. Cattano, Joseph Glutting, Michael R. Sitler

Sports Medicine Faculty Publications

No abstract provided.

Working With Mild Traumatic Brain Injury: Voices From The Field, Page Walker Buck, Rebecca G. Laster, Jocelyn Spencer Sagrati, Rachel Shapiro Kirzner

Social Work (Graduate) Faculty Publications

No abstract provided.

Mitochondrial Iron Uptake Through Mitoferrin2 Sensitizes Human Head And Neck Squamous Carcinoma Cells To Photodynamic Therapy, Hsin-I (Cindy) Hung

MUSC Theses and Dissertations

Photodynamic therapy (PDT) is an FDA-approved, minimally invasive treatment modality that utilizes light in the presence of oxygen to activate photosensitizing agents to produce cell death. Phthalocyanine 4 (Pc 4), a second generation photosensitizer has shown efficacy in vitro, in vivo and in a phase I clinical trial. Pc 4 localizes primarily to mitochondria and endoplasmic reticulum, where it causes apoptotic cell death during PDT. Previously, our laboratory showed that photo sensitizers that localize to lysosomes are more effective in killing cancer cells than ones directed to mitochondria after PDT. Here, we investigated the interactions between lysosomes and mitochondria in …

Using Portable Computers To Increase The Efficiency Of Evaluating Psychiatric Emergencies – A Pilot Program, Anthony Buchman Lcsw, Edward R. Norris Md, Fapa, Fapm, Rosanne Teders Lcsw, Michael Kaufmann Md

Department of Psychiatry

No abstract provided.

Imaging And Intervention For Coronary Artery Disease Following Irradiation Of Malignant Thymoma, Saulat H. Fatimi, Salima Ahmed Bhimani, Ranish Deedar-Ali- Khawaja, Ali Khawaja

Section of Cardiothoracic Surgery

Thymomas are rare malignant epithelial growths, constituting 20% of mediastinal tumours. Resection followed by irradiation may be employed in all thymomas except for stage 1 thymomas. Mediastinal irradiation is associated with coronary artery disease. The mean duration of presentation of post-irradiation coronary artery disease is 16 years (range 3-29 years). In our patient coronary artery disease was found only a year post irradiation. A 55 year old male who presented with complaints of dyspnoea, retrosternal chest pain and heaviness since one year underwent resection for malignant thymoma followed by radiotherapy. He presented with coronary artery disease a year after undergoing …

Factors Associated With Failed Induction Of Labour In A Secondary Care Hospital, Neelofur Babar Khan, Iffat Ahmed, Ayesha Malik, Lumaan Sheikh

Department of Obstetrics & Gynaecology

Objective: To assess the factors associated with failed induction of labour (IOL) in a secondary care hospital.
Method: This is a retrospective cross sectional study on women admitted for labour induction in Aga Khan Hospital for women Karimabad from 1st Jan, 2009 to 31st Dec, 2009. Induction was considered successful if the patient delivered vaginally and failed if it ended up in Caesarean Section.
Result: Eighteen percent of our pregnant population who underwent induction of labour failed to deliver vaginally. About 25% of 328 nulliparous women had failed induction. With a Bishop score of <5 in 84.3%. In 28.2% with prolonged latent phase of more than 20 hours in Caesarean section had to be performed.
Conclusion: Nulliparity, poor Bishop score and …

Conduct Problems In Children Attending Pre-Primary Schools In Rural Areas Of Pakistan, Shelina Bhamani, Nadia Ayub

Department of Obstetrics & Gynaecology

The aim of this study was to explore the conduct problems faced by school going children in the rural areas of Pakistan. Two hypotheses were formulated to explore the significant differences between the intervention and non-intervention groups and gender on the variables of conduct and internalization. The data ofa total 386 young children were collected from three different regions, who were enrolled in government pre-primary classes. The children under study comprised two kinds of schools: intervention schools that had early childhood interventions, and non-intervention schools. The data analysis revealed no significant difference between children in intervention and non-intervention schools. However; …

Extreme Sports: Are They Worth The Risk?, Angela Walin

3690: A Journal of First-Year Student Research Writing

Overview: Broken bones, head trauma, shark attacks, and casualties all while playing the sport you love. Is it worth it? With extreme sports come extreme risks. There are many controversies over these sports as to whether they are ethical or not and why anybody with the right mindset would consider participating in such events. These sports often involve high speed, great heights, a high level of physical exertion, and highly specialized gear or spectacular stunts. Some popular and quickly growing extreme sports in today’s society are snowboarding, speed and freestyle skiing, surfing, sky diving, mountain climbing, and wake boarding. Many …

Fractionated Stereotactic Radiation Therapy Improves Cranial Neuropathies In Patients With Skull Base Meningiomas: A Retrospective Cohort Study., Xinglei Shen, David W Andrews, Robert C Sergott, James J Evans, Walter J Curran, Mitchell Machtay, Ruben Fragoso, Harriet Eldredge, Colin E Champ, Matthew Witek, Mark V Mishra, Adam P Dicker, Maria Werner-Wasik

Department of Radiation Oncology Faculty Papers

BACKGROUND: Skull base meningiomas commonly present with cranial neuropathies. Fractionated stereotactic radiation therapy (FSRT) has been used to treat these tumors with excellent local control, but rates of improvement in cranial neuropathies have not been well defined. We review the experience at Thomas Jefferson University using FSRT in the management of these patients with a focus on symptom outcomes.

METHODS: We identified 225 cases of skull base meningiomas treated with FSRT at Thomas Jefferson University from 1994 through 2009. The target volume was the enhancing tumor, treated to a standard prescription dose of 54 Gy. Symptoms at the time of …

Role Of The Immune System And Bioactive Lipids In Trafficking Bone Marrow-Derived Stem Cells In Patients With Ischemic Heart Disease, Ahmed Abdel-Latif

Theses and Dissertations--Microbiology, Immunology, and Molecular Genetics

Acute myocardial infarction (AMI) triggers the mobilization of stem/progenitor cells from bone marrow (BMSPCs) into peripheral blood (PB). The underlying mechanisms orchestrating this mobilization and subsequent homing of BMSPCs to the myocardium are poorly understood. While the role of traditional chemokines in the mobilization and homing of hematopoietic stem cell (HSCs) to BM niches is undisputed, their role in directing BMSPCs to the highly proteolytic environment of the ischemic myocardium is debatable and other redundant mechanism may exist. Based on our observation that bioactive lipids, such as sphingosine-1 phosphate (S1P) and ceramide-1 phosphate (C1P), play an important role in regulating …

Influence Of Oncotype Dx® On Chemotherapy Prescribing In Early Stage Breast Cancer Patients: A Claims-Based Evaluation Of Utilization In The Real World, Kenneth Neil Kennedy

Theses and Dissertations--Pharmacy

The decision for adjuvant therapy in women with early stage breast cancer (ESBC) has historically been guided by the presence or absence of specific biological markers (hormone and HER2 receptors), age, and extent of nodal involvement. Oncotype DX® is a validated assay that quantifies protein expression that can predict the risk of cancer recurrence. This study evaluates if the use of Oncotype DX® impacts chemotherapy prescribing in ESBC. This retrospective, cohort study identified patients with ESBC from a large commercially insured population from January 2007 through June 2009. Patients were identified as having ESBC by utilizing procedure and diagnosis codes …

Self Expanding Metal Stents (Sems) For Management Of Peri-Pancreatic Fluid Collections (Pfc): A Single Center Experience, Whitney E. Jackson, Jason Korenblit, Vaibhav Mehendiratta, Jason Lewis, Ali A. Siddiqui, Thomas E. Kowalski, David E. Loren

Division of Internal Medicine Faculty Papers & Presentations

Background

Endoscopic management of peri-pancreatic fluid collections (PFC) with or without organizing necrosis has been shown to decrease morbidity and mortality compared to early surgical management. Plastic stents are often used for transmural drainage, although the use of self-expanding metal stents (SEMS) has been reported. Theoretical benefits of SEMS include a large diameter for drainage and facilitation of endoscopic necrosectomy. We report a single-center experience to evaluate the efficacy and safety of SEMS for management of PFC.

Methods

A single-center retrospective review was performed of patients undergoing endoscopic management of PFC using SEMS from January through November 2011. Electronic database …

Advancing Our Understanding Of The Inheritance And Transmission Of Pectus Excavatum, Lisa Horth, Michael W. Stacey, Virginia K. Proud, Kara Segna, Chelsea Rutherford, Donald Nuss, Robert E. Kelly

Bioelectrics Publications

Pectus excavatum is the most common congenital chest wall abnormality expressed in children, yet its inheritance is poorly understood. Here we present the first comprehensive assessment of the inheritance of this disorder. After evaluating 48 pedigrees and 56 clinical traits of probands and family members, we find strong evidence of autosomal recessive, genetic control for this disorder. Additionally there is likely more than one pectus disease-associated allele, as well as a relatively large number of disease allele carriers in the human population. Some clinical traits appear important and may serve as reliable indicators for predicting the likelihood of pectus excavatum …

Facial Fracture Management: Operative Trends, Ramon Garza, Iii Md, Joshua M. Adkinson Md, Jarom N. Gilstrap Md, Sherrine Eid Mph, Robert X. Murphy Jr, Md, Ms

Department of Surgery

No abstract provided.

Linear Psoriasis Of The Isolated Type, Tatyana Groysman Do, Marc W. Levin Md

Department of Medicine

No abstract provided.

The Effect On Colon Visualization During Colonoscopy Of The Addition Of Simethicone To Polyethylene Glycol-Electrolyte Solution: A Randomized Single-Blind Study., Rebecca Matro, Keegan Tupchong, Constantine Daskalakis, Victoria Gordon, Leo Katz, David Kastenberg

Division of Gastroenterology and Hepatology Faculty Papers

OBJECTIVES: Colonic bubbles associated with polyethylene glycol-electrolyte solution (PEG-ELS) are common and obscure mucosal visualization. This study aimed to determine whether adding simethicone decreases the incidence of bubbles.

METHODS: Prospective, single-blind, randomized comparison of split dose PEG-ELS vs. PEG-ELS+simethicone (PEG-S) for outpatient colonoscopy. Bubble severity for colonic segments was assessed on withdrawal as A=no/minimal bubbles, B=moderate bubbles/interfere with detecting 5 mm polyp, C=severe bubbles/interfere with detecting 10 mm polyp. Primary end point was Grade B or C bubbles in any colon segment. Secondary end points were cleansing quality, incidence and severity of side effects, and polyp detection.

RESULTS: One hundred …

Robotic Surgery Outcomes After The Learning Curve: Does Robotic Surgery Improve The Quality Health Outcome “Readmission <30 Days” In Patients Having Hysterectomy For Benign Disease?, Elizabeth A. Berger Do, Jocelyn Shubella, Martin A. Martino Md

Department of Obstetrics & Gynecology

No abstract provided.

An Analysis Of Quality Outcomes In Patients Having A Hysterectomy: Robotics Vs The Vaginal Approach, Martin A. Martino Md, Jocelyn Shubella, Elizabeth A. Berger Do

Department of Obstetrics & Gynecology

No abstract provided.

Teamstepps™ And Narrative Medicine: Towards An Increased Awareness Of “Teamwork” On The Obgyn Third Year Clinical Rotation---A Pilot Study, Kristin Friel Md, Krista Hirschmann Phd

Department of Obstetrics & Gynecology

No abstract provided.