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Bacillus Calmette-Guerin (Bcg) Lymphadenitis: Changing Trends And Management, Zafar Nazir, Saqib Hamid Qazi

Section of Paediatric Surgery

Background: Bacillus Calmette-Guérin (BCG) vaccination is performed as a part of expanded Programme of Immunization (EPI). Suppurative lymphadenitis is the common complication of BCG vaccination. The optimum treatment for this complication is debated.
Methods: All cases of BCG lymphadenitis presenting to pediatric surgical service over a 17-year study period were reviewed to determine the optimum treatment for this problem.
Results: Sixty children were referred for the management of BCG lymphadenitis during the study period. Most patients (n=43) presented during 1988 and 1990. Children were healthy and received BCG (Pasteur strain) vaccination at EPI during first 2 months of life. Initially …

Introduction, Melanie Santiago

Journal of Health Care Law and Policy

No abstract provided.

The 800 Pound Gorilla Sleeps: The Federal Government's Lackadaisical Liability And Compensation Policies In The Context Of Pre-Event Vaccine Immunization Programs, Michael Greenberger

Journal of Health Care Law and Policy

No abstract provided.

Old Legacies And New Paradigms: Confusing "Research" And "Treatment" And Its Consequences In Responding To Emergent Health Threats, Gail H. Javitt

Journal of Health Care Law and Policy

No abstract provided.

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.

Some Right Jabs And Back In The Ring: Lessons Learned From The Phase I Civilian Smallpox Program, Elin Gursky, Avani Parikh

Journal of Health Care Law and Policy

No abstract provided.

Smoking Prevalence, Knowledge And Attitudes Among Medical Students In Karachi, Pakistan, F M. Khan, S J. Husain, A Laeeq, A Awais, S F. Hussain, J A. Khan

Section of Pulmonary & Critical Care

A survey of smoking prevalence and attitudes was made among medical students randomly selected from classes at the Aga Khan University, Karachi, Pakistan. Of 271 respondents, 14.4% were current smokers (22.0% male and 3.8% females) and 3.3% ex-smokers. A majority of students recognized the dangers associated with active as well as passive smoking although only 55% of current smokers planned to quit in the near future. Most smokers (96%) believed that they as well as other health professionals needed training on smoking cessation and 95% of all students believed that doctors should play a role model in smoking cessation by …

Department Of Radiology-Annual Executive Summary Report-July 1, 2004 To June 30, 2005, Vijay M. Rao M.D.

Department of Radiology Administrative Documents and Reports

88 page Department of Radiology Annual Executive Summary Report, July 1, 2004 to June 30, 2005, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania, United States.

Health Professions Division Catalog 2005-2006, Nova Southeastern University

Health Professions Divisions Course Catalogs and Course Descriptions

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 …

Non-Traumatic Aortic Emergencies - Experience From A Tertiary Care Centre In, Nadeem Khan Ullah Khan, Junaid A. Razzak, Hasanat Sharif, Saqib Hamid Qazi

Department of Emergency Medicine

Objective: To review the incidence, clinical presentation and outcome of Non traumatic Aortic emergencies in a tertiary care hospital and its evaluation in the Emergency department (ED).
Methods: We conducted a retrospective review of cases presented to the ED at Aga Khan University Hospital during 15 year period (1988 - 2002) who had final diagnosis of Aortic Dissection or Ruptured Aortic Aneurysm. Patients without confirmatory investigations were excluded. We aimed at looking for the incidence, clinical presentation, evaluation in the ED and final outcome.
Results: Of the 12 cases, 7 had aortic dissection while the remaining 5 had ruptured aortic …

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 …

A Preliminary Study Of 24-Hour Post-Cesarean Patient Controlled Analgesia: Postoperative Pain Reports And Morphine Requests/Utilization Are Greater In Abstaining Smokers Than Non-Smokers, Alan P. Marco, Mark K. Greenwald, Michael S. Higgins

Anesthesiology Faculty Publications

Previous clinical studies have not examined the relationship between nicotine abstinence and opioid use for postoperative analgesia. This may be important because tobacco smokers are routinely required to abstain from smoking just before and during acute post-surgical recovery. This study investigated IV morphine self-administration [patient controlled analgesia (PCA)], subjective pain/drug effects and other measures during post-operative (elective Cesarean section) recovery.

These preliminary data suggest that a history of nicotine use and/or short-term nicotine abstinence can modulate morphine use and analgesia during post-operative recovery. These procedures provide a model for studying patterns and determinants of analgesic self-administration in medical settings.

Pediatric Window Falls: Not Just A Problem For Kids In High Rises, Nora L. Vish, E C. Powell, D Wiltsek, K M. Sheehan

Pediatrics Faculty Publications

Abstract

Background: Window falls are a frequent cause of injury (15/100 000) among Chicago preschool children. In Boston and New York, public health efforts have successfully decreased window fall injuries. Local data are needed to develop appropriate interventions for Chicago.

Objective: To describe the housing characteristics and types of injuries among children who fell from windows treated in a Chicago pediatric trauma center.

Methods: Children treated in a pediatric trauma center for injuries related to window falls between 1995 and 2002 were identified retrospectively. We reviewed family demographics, the circumstances of the fall, and types of injuries. Site visits were …

Tale Of A Woman With Stomatitis And Response Of Health Care System, Waris Qidwai

Department of Family Medicine

A 55 year-old housewife presented to the Family Medicine Clinic due to recurrent oral ulcers for a year. She also had generalized itching, weakness, anorexia and abdominal distension after meals. She had visited several practitioners including family physicians and sub-specialists but a diagnosis was not reached. She was diagnosed to have Lichen Planus and Hepatitis C at family practice clinic. Since a health care system does not properly exist, patients seek treatment from sub-specialists without first consulting a primary care practitioner. This report identifies a failure in health care system and it is also recommended that all patients should be …

Liberty Or Death: Maryland Improves Upon The Model State Emergency Health Powers Act, Franklin H. Alden Jr.

Journal of Health Care Law and Policy

No abstract provided.

Informed Consent And Public Health: Are They Compatible When It Comes To Vaccines?, Wendy E. Parmet

Journal of Health Care Law and Policy

No abstract provided.

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 …

Cardiogenic Shock After Dipyridamole Administration For Myocardial Perfusion Imaging, Fahim H. Jafary, Nageeb Basir, Adnan Amin, Nasiruddin Ahmed

Section of Cardiology

No abstract provided.

Efficacy And Safety Of Artemether-Lumefantrine (Coartem®) Tablets (Six-Dose Regimen) In African Infants And Children With Acute, Uncomplicated Falciparum Malaria, C. Falade, M. Makanga, Zul Premji, C.E. Ortmann, M. Stockmeyer, P. Ibarra De Palacios

Pathology, East Africa

Approximately one million children die from malaria each year. A recently approved artemisinin-based tablet, Coartem (co-artemether), comprising artemether 120 mg plus lumefantrine 20 mg, given in four doses, provides effective antimalarial treatment for children in many sub-Saharan countries. However, this regimen is considered insufficient for non-immune infants and in areas where multidrug-resistant Plasmodium falciparum predominates. This open-label study assessed the efficacy and safety of co-artemether administered to 310 African children weighing 5-25 kg, with acute, uncomplicated falciparum malaria. Six doses of co-artemether were given over 3 days, with follow-up at 7, 14 and 28 days. Treatment rapidly cleared parasitemia and …

Plasma Zinc Concentrations Are Depressed During The Acute Phase Response In Children With Falciparum Malaria, C. Duggan, W.B. Macleod, N.F. Krebs, J.L. Westcott, W.W. Fawzi, Zul Premji, V. Mwanakasale, J.L. Simon, K. Yeboah-Antwi, D.H. Hamer

Pathology, East Africa

Plasma concentrations of some micronutrients are altered in the setting of acute infectious or inflammatory stress. Previous studies have provided conflicting evidence concerning the extent and direction of changes in plasma zinc concentrations during the acute phase response. We carried out an observational cohort study in 689 children enrolled in a randomized trial of zinc supplementation during acute falciparum malaria in order to evaluate the relation between plasma zinc concentration and the acute phase response. Plasma zinc was measured by atomic absorption spectrophotometry. On admission, 70% of all subjects had low plasma zinc (<9.2 μmol/L). Multivariate analysis of predictors of admission plasma zinc showed that admission C-reactive protein (CRP), parasite density, and study site were the most important predictors. Predictors of changes in plasma zinc from admission to 72 h included baseline CRP, change in CRP, treatment group, study site, and baseline zinc concentration. In children with acute malaria infection, baseline plasma zinc concentrations were very low and were inversely correlated with CRP (r = -0.24, P < 0.0001) and the degree of parasitemia (r = -0.19, P < 0.0001). Even when CRP and time were taken into account, zinc supplementation increased plasma zinc concentration from admission to 72 h. When available, plasma zinc concentrations should be interpreted with concurrent measures of the acute phase response such as CRP. In children whose age, diet, and/or nutritional status place them at risk of zinc deficiency, those with low plasma zinc levels should be supplemented with oral zinc and followed for clinical and/or biochemical response. © 2005 American Society for Nutritional Sciences.

Habitat Characterization And Spatial Distribution Of Anopheles Sp. Mosquito Larvae In Dar Es Salaam (Tanzania) During An Extended Dry Period, M.A. Sattler, D. Mtasiwa, M. Kiama, Zul Premji, M. Tanner, G.F. Killeen, C. Lengeler

Pathology, East Africa

Introduction: By 2030, more than 50% of the African population will live in urban areas. Controlling malaria reduces the disease burden and further improves economic development. As a complement to treated nets and prompt access to treatment, measures targeted against the larval stage of Anopheles sp. mosquitoes are a promising strategy for urban areas. However, a precise knowledge of the geographic location and potentially of ecological characteristics of breeding sites is of major importance for such interventions.

Methods: In total 151 km2 of central Dar es Salaam, the biggest city of Tanzania, were systematically searched for open mosquito breeding sites. …

Simulations Of Nanopore Formation And Phosphatidylserine Externalization In Lipid Membranes Subjected To A High-Intensity, Ultrashort Electric Pulse, Q. Hu, R. P. Joshi, K. H. Schoenbach

Bioelectrics Publications

A combined MD simulator and time dependent Laplace solver are used to analyze the electrically driven phosphatidylserine externalization process in cells. Time dependent details of nanopore formation at cell membranes in response to a high-intensity (100kV∕cm), ultrashort (10ns) electric pulse are also probed. Our results show that nanosized pores could typically be formed within about 5ns. These predictions are in very good agreement with recent experimental data. It is also demonstrated that defect formation and PS externalization in membranes should begin on the anode side. Finally, the simulations confirm that PS externalization is a nanopore facilitated event, rather than the …

Deference, Denial, And Exclusion: Men Talk About Contraception And Unintended Pregnancy, Scott D. Johnson, Lindy B. Williams

Rhetoric and Communication Studies Faculty Publications

Individual in-depth interviews were conducted with 20 men, ages 21-48, who have fathered at least one unintended pregnancy. The goal of the interviews was to explore the experiences of these men with unintended pregnancy, their communication with partners and others, contraceptive beliefs and practices, their relationships with their partners, and the outcomes and consequences of the unintended pregnancies. This essay describes results derived from their comments regarding their contraceptive practices and the pregnancy-outcome decisions, with thematic analysis used to identify prominent themes from participant comments. Two strong themes, "deference" and "denial," and one lesser theme, "exclusion," emerged from participant responses. …

Outcome For Hospitalized Road Trauma Patients At A Tertiary Hospital In Kenya, Hassan Saidi, William Macharia, John Ating'a

Paediatrics and Child Health, East Africa

Background: The developing world continues to experience a disproportionate burden of injury. About one half of injury deaths are due to motor vehicle collisions. Road traffic fatalities per 10,000 vehicles are ten to 20 times higher in Africa compared to Europe.

Patients and Methods: 233 patients were consecutively analyzed. Injury acuity was determined by calculating Injury Severity Scores (ISS) for each patient. Information on the care and treatment outcome was obtained from patient interviews, case notes and discharge summaries. Data analysis was performed using the SPSS version 10.0 statistical software.

Results: Injury accounted for 48.8% of all emergency hospitalizations into …

Clioquinol And Pyrrolidine Dithiocarbamate Complex With Copper To Form Proteasome Inhibitors And Apoptosis Inducers In Human Breast Cancer Cells, Kenyon G. Daniel, Di Chen, Shirley Orlu, Qiuzhi Cui, Fred R. Miller, Q Ping Dou

Wayne State University Associated BioMed Central Scholarship

Abstract

Introduction

A physiological feature of many tumor tissues and cells is the tendency to accumulate high concentrations of copper. While the precise role of copper in tumors is cryptic, copper, but not other trace metals, is required for angiogenesis. We have recently reported that organic copper-containing compounds, including 8-hydroxyquinoline-copper(II) and 5,7-dichloro-8-hydroxyquinoline-copper(II), comprise a novel class of proteasome inhibitors and tumor cell apoptosis inducers. In the current study, we investigate whether clioquinol (CQ), an analog of 8-hydroxyquinoline and an Alzheimer's disease drug, and pyrrolidine dithiocarbamate (PDTC), a known copper-binding compound and antioxidant, can interact with copper to form cancer-specific proteasome …

Medium From Irradiated Cells Induces A Dose Dependent Expression Of Mitochondrial Changes And Bcl2 Responses In Unirradiated Human Keratinocytes, Paula Maguire, Carmel Mothersill, C. Seymour, Fiona Lyng

Articles

Exposure of unirradiated human keratinocytes to irradiated cell conditioned medium (ICCM) is known to cause a cascade of events that leads to reproductive death and apoptosis. This study investigates the effect of ICCM on clonogenic survival, mitochondrial mass and BCL2 expression in unirradiated keratinocytes. Exposure to 5 mGy, 0.5 Gy and 5 Gy ICCM resulted in a significant decrease in clonogenic survival. Human keratinocytes incubated with ICCM containing an antioxidant, N-acetylcysteine, showed no significant decrease in clonogenic survival. HPV-G cells incubated with ICCM containing a caspase 9 inhibitor showed no significant decrease in clonogenic survival when the ICCM dose was …

Oncolog, Volume 50, Number 01, January 2005, Rachel Williams, Dawn Chalaire, Caren E. Blinka, Angelina Esparza, Allen W. Burton Md

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

• New Perspectives on Brain Metastasis
• Out of the Darkroom
• Equity and Health
• House Call: Blood and Platelet Donors Give Life
• DiaLog: Cancer Pain Control in the New Millennium, by Allen W. Burton, MD, Section Chief, Cancer Pain Management Department of Anesthesiology and Pain Medicine

Digest Of The Philadelphia College Of Osteopathic Medicine (Winter 2005), Philadelphia College Of Osteopathic Medicine

Digest

The Winter 2005 issue of the Digest of the Philadelphia College of Osteopathic Medicine includes the following articles:

• Opening Remarks
• On the Cover: Stan
• PCOM Updates and Kudos
• Building Confidence & Competence
• Recognizing Leadership, Loyalty, Service
• Compassionate Callings
• Healthcare Centers: Hubs for Research & Medical Outreach
• Class Notes
• In Memoriam
• My Turn
• PCOM Events

Familial Homocystinuria, F Bilwan, Na Syed, M Usman, Mohammad Khurshid

Department of Pathology and Laboratory Medicine

Two cases of siblings diagnosed as cases of familial homocystinuria are reported. Both the cases have classical presentation of familial homocystinuria including history of dislocation of lens of the right eye. Brother had history of psychomotor retardation while sister had a significant history of deep vein thrombosis. Levels of plasma homocysteine were elevated and urinary homocysteine was positive in both the cases.