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Does ‘Excessive’ Anticoagulation Predispose To Periprosthetic Infection?, Javad Parvizi, Elie Ghanem, Ashish Joshi, Peter F. Sharkey, William J. Hozack, Richard H. Rothman

Department of Orthopaedic Surgery Faculty Papers

Background
Although persistent drainage and hematoma formation are recognized risk factors for the development of periprosthetic infection, it is not known if excess anticoagulation is a predisposing factor.

Methods
We conducted a 2 to 1 case-control study with 78 cases who underwent revision for septic failure. The controls underwent the same index procedure but did not develop consequent infection. Patient comorbidities, medications, intraoperative, and postoperative factors were compared.

Results
Postoperative wound complications including development of hematoma and wound drainage were significant risk factors for periprosthetic infection. A mean international normalized ratio of greater than 1.5 was found to be more …

Arterial To End-Tidal Carbon Dioxide Difference In Neurosurgical Patients Undergoing Craniotomy: A Review Of Practice, Fauzia Anis Khan, Mueenullah Khan, Shemila Abbasi

Department of Anaesthesia

Objective: To see if PETCO2 reflects PaCO2 with acceptable accuracy.Methods: In this audit the.anaesthetic chart of fifty consecutive patients, age 12 years and above undergoing craniotomy for intracranial pathology, were reviewed.Results: The difference between end tidal carbon dioxide (ETCO2) value corresponding to the time of taking the arterial sample and the PaCO2 was calculated. The mean end tidal CO2 was 29.3 +/- 2.8 and the mean PaCO2 was 32.63 +/- 4.5. The mean difference between the two values was calculated as 4.09 +/- 3.0. The regression coefficient was 0.496, which showed a moderate association. A wide variability was observed in …

Role Of Stellate Ganglion Block In Post Cabg Sympathetically Mediated Chest Pain, Mueen Ullah Khan, Imtiaz Ahmed

Department of Anaesthesia

Acute chest pain is a common presentation in emergency. After clinical assessment undiagnosed chest pain can become a difficult problem. Sympathetically mediated chest pain is a rare presentation, as it is similar to that of secondary hyperalgesia in the intact skin surrounding an injury site. We are reporting a case of a 62 years old man who presented with atypical chest pain four months after coronary artery bypass grafting (CABG). On investigation no new change was noticed than previous evaluation. On chronic pain assessment he was having hyperalgesia to light touch in addition to the spontaneous chest pain. He was …

Severe Anaphylactic Reaction At Induction Of Anaesthesia, Aliya Ahmed, Anand Kumar

Department of Anaesthesia

Anaphylaxis is an IgE mediated severe allergic reaction causing release of vasoactive substances from mast cells and basophils after re-exposure to an antigen. Signs and symptoms include flushing, urticaria, hypotension, tachycardia, bronchospasm, cardio-respiratory arrest etc. It can occur at induction of anaesthesia when multiple drugs are being administered, but prompt diagnosis with correct management is the key to a successful outcome. This case report describes a patient who developed severe bronchospasm with difficulty in inflating the lungs and dropping oxygen saturations, alongwith hypotension, tachycardia and widespread flushing, at induction of anaesthesia for elective breast surgery. She was promptly managed and …

Planning Initiative Award – 2006-2007 Access To Reproductive Health Services For Low-Ses Pregnant/Parenting Teens In Clark County: A Comprehensive Needs Assessment, Nevada Institute For Children's Research And Policy Reports, Jennifer Zipoy, Tara Swanson, Jean Henry, Denise Tanata, Uzma Farmanali,, Karen Silcott

Nevada Institute for Children's Research and Policy Reports

The Planning Initiative Award (PIA) project was a collaborative effort between the Nevada Institute for Children’s Research and Policy (NICRP) and the Center for Health Promotion (CHP)/Department of Health Promotion, research centers in the School of Public Health. The purpose of the project was to conduct an assessment of the access to reproductive health services among lower SES pregnant and parenting teens in the Las Vegas Valley. The project was designed to identify gaps in existing services and assist researchers in developing communication networks between community members, providers, educators, and policymakers. The data collected during the project period has great …

14-3-3 Proteins Interact With The Beta-Thymosin Repeat Protein Csp24, Terry Crow, Juan-Juan Xue-Bian, Joseph T Neary

Faculty, Staff and Student Publications

Conditioned stimulus pathway protein 24 (Csp24) is a beta-thymosin-like protein that is homologous to other members of the family of beta-thymosin repeat proteins that contain multiple actin binding domains. Actin co-precipitates with Csp24 and co-localizes with it in the cytosol of type-B photoreceptor cell bodies. Several signal transduction pathways have been shown to regulate the phosphorylation of Csp24 and contribute to cellular plasticity. Here, we report the identification of the adapter protein 14-3-3 in lysates of the Hermissenda circumesophageal nervous system and its interaction with Csp24. Immunoprecipitation experiments using an antibody that is broadly reactive with several isoforms of the …

Phosphorylation-Induced Conformational Switching Of Cpi-17 Produces A Potent Myosin Phosphatase Inhibitor, Masumi Eto, Toshio Kitazawa, Fumiko Matsuzawa, Sei-Ichi Aikawa, Jason A. Kirkbride, Noriyoshi Isozumi, Yumi Nishimura, David L. Brautigan, Shin-Ya Ohki

Department of Molecular Physiology and Biophysics Faculty Papers

Phosphorylation of endogenous inhibitor proteins specific for type-1 Ser/Thr phosphatase (PP1) provides a mechanism for reciprocal coordination of kinase and phosphatase activities. Phosphorylation of Thr38 in the inhibitor protein CPI-17 transduces G-protein-mediated signaling into a > 1000-fold increase of inhibitory potency toward myosin phosphatase. We show here the solution NMR structure of phospho-T38-CPI-17 with r. m. s. d. of 0.36 ± 0.06 Å for the backbone secondary structure, which reveals how phosphorylation triggers a conformational change and exposes the PP1 inhibitory surface. This active conformation is stabilized by the formation of a hydrophobic core of intercalated side-chains, which is not formed …

A Serratia Marcescens Oxyr Homolog Mediates Surface Attachment And Biofilm Formation, Robert M. Q. Shanks, Nicholas A. Stella, Eric J. Kalivoda, Megan R. Doe

Dartmouth Scholarship

OxyR is a conserved bacterial transcription factor with a regulatory role in oxidative stress response. From a genetic screen for genes that modulate biofilm formation in the opportunistic pathogen Serratia marcescens, mutations in an oxyR homolog and predicted fimbria structural genes were identified. S. marcescens oxyR mutants were severely impaired in biofilm formation, in contrast to the hyperbiofilm phenotype exhibited by oxyR mutants of Escherichia coli and Burkholderia pseudomallei. Further analysis revealed that OxyR plays a role in the primary attachment of cells to a surface. Similar to what is observed in other bacterial species, S. marcescens OxyR …

Caring For America’S Aging Population: A Profile Of The Direct-Care Workforce, Kristin E. Smith, Reagan A. Baughman

Sociology

Direct-care workers constitute a low-wage, high-turnover workforce with low levels of health insurance; taking these characteristics into account guides the challenge of how to deal with the growing demand for long-term care by an aging U.S. population.

Psychosocial Support Programme To Reduce Stress Among Emergency Physicians, Muhammad Shahid

Department of Emergency Medicine

No abstract provided.

The Effect Of Lower Extremity Ergometry Exercise On Deltoid Intramuscular Temperatures During And Following A 30-Minute 1-Kg Ice Bag Treatment, Shigeru Takeuchi

All-Inclusive List of Electronic Theses and Dissertations

Context: The practice of cycling for cardiovascular benefits and the simultaneous application of an ice bag to the upper extremity for cryotherapy effects is convenient and time-saving. However, exercise increases body temperature specially in working muscles. However, non-working areas are used to dissipate heat by receiving warmed blood. Objective: To determine the effect of lower body exercise on deltoid cooling during 1-kg ice bag treatment and post treatment rewarming, separately. Design: Two ( during and after ice application) 2 X 5 repeated measures designs with the treatment condition (bike and rest) and time (baseline, 1-, 10-, 20-, and 30-minutes during …

Vital Signs, Fall 2007, Boonshoft School Of Medicine

Vital Signs

A twenty-seven page newsletter created by the Boonshoft School of Medicine to document the current affairs of the school. This issue includes a variety of feature articles, alumni profiles, class notes, and more.

Ct Scan Of Body Packers: Findings And Costs, Saba Sohail

Department of Radiology

Objective: To determine the CT features of intra abdominal illicit drug packs used for trafficking, by using scout CT scan image and describe its cost re-imbursement
Methods: An observational study was conducted from January to December 2005, at the CT scan department, Civil Hospital, Karachi. The study subjects included alleged drug traffickers smuggling by body packing, intercepted at Karachi International Airport and referred for CT scan of abdomen by the Anti Narcotic department. Those with suspected body pack rupture were excluded. Scout CT image of the abdomen was taken. Scans were read on console as well as hard copy for …

Defective Dna Base Excision Repair In Brain From Individuals With Alzheimer's Disease And Amnestic Mild Cognitive Impairment, Lior Weissman, Dong-Gyu Jo, Martin M. Sørensen, Nadja C. De Souza-Pinto, William R. Markesbery, Mark P. Mattson, Vilhelm A. Bohr

Pathology and Laboratory Medicine Faculty Publications

Oxidative stress is thought to play a role in the pathogenesis of Alzheimer's disease (AD) and increased oxidative DNA damage has been observed in brain tissue from AD patients. Base excision repair (BER) is the primary DNA repair pathway for small base modifications such as alkylation, deamination and oxidation. In this study, we have investigated alterations in the BER capacity in brains of AD patients. We employed a set of functional assays to measure BER activities in brain tissue from short post-mortem interval autopsies of 10 sporadic AD patients and 10 age-matched controls. BER activities were also measured in brain …

Significance Of Caga Status And Vaca Subtypes Of Helicobacter Pylori In Determining Gastric Histopathology In Pakistan, Javed Yakoob, Shahab Abid, Z Abbas, Wasim Jafri, Z Ahmed, Muhammad Islam

Section of Gastroenterology

No abstract provided.

Left Ventricular Noncompaction Mimicking Peripartum Cardiomyopathy., Chetan Patel, Girish S. Shirali, Naveen Pereira

Manuscripts, Articles, Book Chapters and Other Papers

No abstract provided.

Predictors Of Emotional Reactions In Women Treated For Breast Cancer, Erin E. Ramirez

Loma Linda University Electronic Theses, Dissertations & Projects

Breast cancer can be a devastating disease that impacts a woman in all spheres of her life (Ingram, 1989). Previous studies have examined the impact of breast cancer on body satisfaction, as well as the impact on emotional well-being. Studies have also examined the role of the coping style that a woman engages in response to the diagnosis and treatment of breast cancer in the woman's psychological adjustment to the disease. However, to date, no research has introduced and tested a multifaceted model.

The purpose of this study was to develop a model predicting psychological maladjustment in women treated for …

Detection Of Simulated Apical Root Resorption Using Three Cone Beam Ct Machines, Marcus Paulson

Loma Linda University Electronic Theses, Dissertations & Projects

The purpose of this study was to determine orthodontists' ability to discriminate small differences of simulated apical root resorption (SARR) on extracted teeth, using the output from three cone beam computed tomography (CBCT) machines. Twenty-four unrestored maxillary anterior teeth exhibiting normal morphology, were collected. The teeth were scanned by three CBCT machines: 1) the NewTom 3G (AFP imaging, USA), 2) the iCAT (Imaging Sciences, USA) 3) and the MicroCAT II (Siemens Medical, USA). Using a sandblaster the apical portion of each tooth was reduced in 0.5 mm increments up to a total reduction of 1.5 mm. Each root modification was …

Children With Autism: Sleep Problems And Predictors Of Maternal Stress, Cindy Y. Nam

Loma Linda University Electronic Theses, Dissertations & Projects

Research examining the impact of children’s autism and the sleep problems frequently associated with the disorder on parents’ stress has been quite limited. Studies have been constrained by methodological problems, including small sample sizes and the examination of children of autism within larger groups of children with a range of developmental disabilities. Typically, diagnostic criteria used to select children for an autism study is not indicated and no measure of the severity of children’s symptomology is included. The present investigation was designed to examine children’s autism symptomology and parents’ reports of their children’s sleep problems as well as the parents …

Religious Coping And Depression In Home Care Patients, Kirsten Ingheim

Loma Linda University Electronic Theses, Dissertations & Projects

This study examined the impact of a medical illness in 36 elderly male and female home health care patients with a primary diagnosis of heart disease, cancer, diabetes, or chronic obstructive pulmonary disease (COPD) and how they coped with their medical condition. Relationships between depression and religious coping, functional status, quality of life, and depression, as well as relationship between functional status and quality of life were investigated. In addition, a moderating effect of the relationship between functional status and depression by religious coping was explored. The participants completed the Religious Problem-Solving Scale (RPSS) (Collaborative, Deferring, and Self-Directing), the SF-12 …

Platelet Hyperreactivity: Predictive And Intrinsic Properties., Paul F. Bray

Cardeza Foundation for Hematologic Research

Platelet thrombi are central to the development of most vascular ischemic events. There is marked interindividual variation in platelet responsiveness, with some subjects displaying platelet hyperreactivity. An increasing number of reports indicate that there are laboratory measures of platelet function that predict clinical thrombotic events. Some, but not all, measures of platelet function are reproducible. Platelet hyperreactivity can be assessed with multiple stimuli in multiple assays and is more likely to be present in women and in subjects who have elevated fibrinogen levels.

Barriers To Recovery And Recommendations For Change: The Pennsylvania Consensus Conference On Psychiatry's Role., Joseph A. Rogers, Michael J. Vergare, Richard C. Baron, Mark S. Salzer

Department of Psychiatry and Human Behavior Faculty Papers

OBJECTIVE: Recovery has emerged over the past decade as a dominant theme in public mental health care.

METHODS: The 2006 Pennsylvania Consensus Conference brought together 24 community psychiatrists to explore the barriers they experienced in promoting recovery and their recommendations for change.

RESULTS: Twelve barriers were identified and classified into one of three categories: psychiatry knowledge, roles, and training; the need to transform public mental health systems and services; and environmental barriers to opportunity. Participants made 22 recommendations to address these barriers through changes in policies, programs, and psychiatric knowledge and practice.

CONCLUSIONS: The recommendations identify areas for change that …

Consider The Source : The Effects Of Adult Sources Of Human Immunodefciency [Sic] Virus And Sexually Transmitted Infection Prevention Information On Teen Risk Behaviors For Sexually Transmitted Infection, Janet E. Flores

Loma Linda University Electronic Theses, Dissertations & Projects

Sexually transmitted infections (STIs), including the Human Immunodeficiency Virus (HIV), are major health problems for adolescents, who represent over 26% of new cases of STIs diagnosed annually in the United States. Half of all HIV cases in people under age 25 result from sexual transmission during adolescence. Adolescent STI prevention is a national priority for the United States, and parents, schools, and medical providers, among others, are expected to have the greatest impact on adolescent STI risk reduction in teens.

This study used secondary Youth Risk Behavior Surveillance Survey (YRBS) data to explore the prevalence of high school students with …

Idiopathic Epilepsy Of Childhood And Potassium Ion Channels, Alper I. Dai, Mohammad Wasay

Department of Medicine

Potassium can affect the development of common seizure type and can be defined seizure susceptibility allele. The existence of inward-rectifying potassium (Kir) channels was first recognized half a century ago. The biophysical fingerprint of Kir channels is inward rectification in the current-voltage relationship , which limits potassium efflux at depolarizing membrane potentials. Kir channels are essential in the control of resting membrane potential, coupling of the metabolic cellular state with membrane excitability, and maintenance of potassium homeostasis. The critical interval contains several candidate genes, one of which, KCNJ10, exhibits a potentially important polymorphism with regard to fundamental aspects of seizure …

Baseline Hbv Dna Level Is The Most Important Factor Associated With Virologic Breakthrough In Chronic Hepatitis B Treated With Lamivudine., Hee Bok Chae, Hie-Won Hann

Division of Gastroenterology and Hepatology Faculty Papers

Aim: To identify the factors associated with virologic breakthrough and to select a subgroup of patients who respond well to lamivudine without developing virologic breakthrough (VBT).

Methods: Of 79 patients who had received lamivudine therapy for 9-57 mo, 34 were HBeAg-positive and 45 were HBeAg-negative, 24 developed virologic breakthrough and 55 did not. Clinical and virologic factors were compared between the two groups.

Results: The median duration of therapy was 25 (9-57) mo. Virologic breakthrough was defined as a > 1 log HBV DNA increase following initial suppression. When several factors, including gender, duration of infection, baseline HBV DNA, and baseline …

Comparison Of Eight Prosthetic Aortic Valves In A Cadaver Model, Benjamin A. Youdelman, Hitoshi Hirose, Harsh Jain, J. Yasha Kresh, John W.C. Entwhistle Iii, Andrew S. Wechsler

Department of Surgery Faculty Papers

OBJECTIVES: Proper valve selection is critical to ensure appropriate valve replacement for patients, because implantation of a small valve might place the patient at risk for persistent gradients. Labeled valve size is not the same as millimeter measure of prosthetic valve diameters or the annulus into which it will fit. Studies that use the labeled valve size in lieu of actual measured diameter in millimeters to compare different valves might be misleading. Using human cadaver hearts, we sized the aortic annulus with 8 commonly used prosthetic aortic valve sizers and compared the valves using geometric orifice area. This novel method …

Let-7 Expression Defines Two Differentiation Stages Of Cancer, Scott Shell, Sun-Mi Park, Amir Reza Radjabi, Robert Schickel, Emily Kistner, David Jewell

Dartmouth Scholarship

The early phases of carcinogenesis resemble embryonic development, often involving the reexpression of embryonic mesenchymal genes. The NCI60 panel of human tumor cell lines can genetically be subdivided into two superclusters (SCs) that correspond to CD95 Type I and II cells. SC1 cells are characterized by a mesenchymal and SC2 cells by an epithelial gene signature, suggesting that SC1 cells represent less differentiated, advanced stages of cancer. miRNAs are small 20- to 22-nucleotide-long noncoding RNAs that inhibit gene expression at the posttranscriptional level. By performing miRNA expression analysis on 10 Type I and 10 Type II cells, we have determined …

Medical Education Digest, Vol. 9 No. 4 (July/August 2007), Nova Southeastern University

Medical Education Digest

No abstract provided.

Walking Age Does Not Explain Term Versus Preterm Difference In Bone Geometry, Haifa Abou Samra, Bonny Specker

Ethel Austin Martin Program Publications

OBJECTIVE: To elucidate the relationship between bone geometry and onset of walking in former term and preterm children.
STUDY DESIGN: We conducted a cross-sectional study of 128 preschool children aged 3 to 5 years who underwent peripheral quantitative computerized tomography measures of bone size at the distal tibia. Linear models were developed, stratifying by sex, to determine whether bone differences between children born term and preterm were caused by differences in walking age.
RESULTS: Children with a history of preterm birth walked later than children born at term (12.4 +/- 0.5 versus 10.9 +/- 0.2 months; P = .004); however, …

Com Outlook Summer 2007, College Of Osteopathic Medicine

COM Outlook

No abstract provided.