Digital Commons Network^™

Diagnostic Evaluation Of Fine Needle Aspiration Cytology In The Management Of Palpable Breast Lesions, S. H. Shah, Naila Kayani, S. H. Hasan, I. N. Soomro, Shahid Pervez, A. S. Hussainy

Department of Pathology and Laboratory Medicine

A total of 113 fine needle aspirates of the breast masses were evaluated in which the subsequent biopsy or mastectomy specimen were also available for histological examination. The age ranged from 16 to 80 years with a mean of 42 years. In benign conditions the mean age was 34.7 years while in malignant cases it was 48 years. The cytological diagnoses were compared with the histological results which revealed that the specificity and sensitivity of fine needle aspiration cytology in the palpable breast lesions was 86.1% and 89.2% respectively with a positive predictive value of 93% and efficiency of 88.2%. …

Management Of Hyperlipidaemia In General Practice, Waris Qidwai

Department of Family Medicine

Hyperlipidaemia is a powerful predictor of coronary artery disease, with a strong, independent, continuous and grades positive associationbetweencholesterol levels and risk of coronary events. Several large studies have shown the benefit of cholesterol reduction and there is clear evidence of the efficacy of statins in the reduction of events inprimazy and secondary prevention¹. A 1% reduction in the total serum cholesterol reduces the frequency of fatal coronary heart disease by atleast 2%². A l0% meandecrease inthe total serum choelsterol level reduces the incidence of both fatal and nonfatal myocardial infarctions³. Family physicians need to …

Adenoma Characteristics At First Colonoscopy As Predictors Of Adenoma Recurrence And Characteristics At Follow-Up, Rosalind U. Van Stolk, Gerald J. Beck, John A. Baron, Robert Haile, Robert Summers

Dartmouth Scholarship

All patients with colorectal adenomas may not require identical follow-up. We aimed to determine if adenoma characteristics at initial colonoscopy could predict adenoma recurrence or characteristics at follow-up. The number of adenomas and the size, type, and degree of atypia in 479 patients in a polyp prevention trial were evaluated as predictors of the same characteristics at follow-up using odds ratios (ORs) with 95% confidence intervals (CIs). Multiple logistic regression analysis was performed to determine if several baseline characteristics were simultaneously associated with outcome.

Sensitizing Students To Functional Limitations In The Elderly: An Aging Simulation, Sherry Allen, Viki Lorraine, Anne Lockett, Carolyn M. Rutledge

Ellmer School of Nursing Faculty Publications

Background and Objectives: Using activities of daily living (ADLs) and instrumental activities of daily living (IADLs) as a focus, faculty at Eastern Virginia Medical School provide an aging simulation exercise for a mandatory fouth-year clerkship in geriatrics. The specific aims of the simulation are to 1) experience the physical frailties of aging, 2) develop creative problem-solving techniques, 3) identify feelings regarding the experience of functional loss, and 4) develop proactive clinical approaches to the care of the elderly.

Methods: Students are assigned one of four diagnoses (Parkinson's disease, rheumatoid arthritis, advanced diabetes, or stroke) and are then impaired to simulate …

Factors Which Influence Women's Decisions For Choice Of Primary Surgery For Stage I And Stage Ii Breast Cancer, Barbara Mastaglia

Theses : Honours

A descriptive correlational study was conducted to describe the factors that Western Australian women with either Stage I or Stage II Breast Cancer, perceived to be important considerations when deciding upon either Modified Radical Mastectomy (MRM) or Breast Conserving Treatment (BCT) for surgical treatment. The Conflict Theory of Decision Making (Janis & Mann, 1977) was used as the theoretical framework to guide this study. Ward, Heidrich and Wolberg's (1989) Factor List, the Multidimensional Health Locus of Control (MHLC) Scale (Wallston, Wallston & De Vellis, 1978) and a demographic questionnaire were used to measure variables. Questionnaires were mailed to a consecutive …

The Hidden Age Revolution: Emergent Integration Of All Ages, Matilda White Riley

Center for Policy Research

Over the past 30 years my colleagues and I have been focusing on conceptual and empirical work (the aging and society paradigm) that does not create policies, but can inform them. The most immediate phase of this long cumulative history is leading us now to hidden changes in people's lives and social institutions that herald a new phenomenon world-wide--a phenomenon that may have momentous implications for the policies of the future. We call it "age integration" because it *integrates* older people with others of every age. When I come to the end of my lecture, I hope you will see …

Effects Of Prenatal Drug Exposure On Neurobehavioral Functioning In Young Infants, Yvette Blanchard, Patricia E. Suess, Marjorie Beeghly

All PTHMS Faculty Publications

In the newborn period, infants prenatally exposed to cocaine and other drugs show low scores on the Neonatal Behavioral Assessment Scale. Beyond that period, research is limited on the effects of prenatal drug exposure on neurobehavioral functioning. In this study we compared infants exposed to cocaine and other drugs and control infants from low socioeconomic backgrounds on measures of neurobehavioral functioning during neuromotor assessment at 1, 4 and 7 months of life. None of the measures of neurobehavioral functioning showed any significant group differences. This study did not support the hypothesis of disrupted neurobehavioral functioning beyond the neonatal period in …

Grandparents Today: A Demographic Profile, Maximiliane E. Szinovacz

Sociology & Criminal Justice Faculty Publications

This article presents a demographic profile of grandparents, using the National Survey of Families and Households. Specific dimensions of grandparenthood addressed include grandparents' survival, the timing of grandparenthood, grandparents' involvement in other roles, surrogate parenting, and stepgrandparents. The data indicate considerable heterogeneity among grandparents of different genders and races or ethnicities. They also suggest modifications in previous descriptions of modern grandparenthood.

Is Mammography Useful In Screening For Local Recurrences In Patients With Tram Flap Breast Reconstruction After Mastectomy For Multifocal Dcis?, A P Salas, M A Helvie, E G Wilkins, H A Oberman, P W Possert, Alan M. Yahanda Md, Facs, A E Chang

PCI Publications and Projects

BACKGROUND: Skin-sparing mastectomy with immediate transverse rectus abdominis musculocutaneous (TRAM) flap reconstruction is being used more often for the treatment of breast cancer. Mammography is not used routinely to evaluate TRAM flaps in women who have undergone mastectomy. We have identified the potential value of its use in selected patients.

METHODS AND RESULTS: We report on four women who manifested local recurrences in TRAM flaps after initial treatment for ductal carcinoma in situ (DCIS) or DCIS with microinvasion undergoing skin-sparing mastectomy and immediate reconstruction. All four patients presented with extensive, high-grade, multifocal DCIS that precluded breast conservation. Three of four …

Eye Health Of Aboriginal And Torres Strait Islander People: Aboriginal And Torres Strait Islander Health Reviews: Number 1, Neil Thomson, Beverley Paterson

Research outputs pre 2011

As with many other aspects of health status, it is most probable that prior to the European settlement of Australia in 1788 the eye health of Australian Aborigines and Torres Strait Islanders was excellent. In fact. their eye health was almost certainly better than that of Europeans of the time. There are no definite data from early post-settlement times, but this conclusion appears reasonable from the results of a number of thorough surveys conducted as late as the 1940s and 1950s ( 1-4) Despite finding some severe preventable problems, particularly trachoma (a form of infective conjunctivitis - see Appendix l …

Terminal Sedation As Palliative Care: Revalidating A Right To A Good Death, George P. Smith Ii

Scholarly Articles

Not everyone finds a “salvific meaning” in suffering. Indeed, even those who do subscribe to this interpretation recognize the responsibility of each individual to show not only sensitivity and compassion but render assistance to those in distress. Pharmacologic hypnosis, morphine intoxication, and terminal sedation provide their own type of medical “salvation” to the terminally ill patient suffering unremitting pain. More and more states are enacting legislation that recognizes this need of the dying to receive relief through regulated administration of controlled substances. Wider legislative recognition of this need would go far toward allowing physicians, in the exercise of their reasonable …

Cardiorespiratory Fitness And Cardiovascular Disease Risk Factors In Postmenopausal Women, Bryan L. Haddock

Loma Linda University Electronic Theses, Dissertations & Projects

In spite of the reductions in cardiovascular disease mortality over the last several years, cardiovascular disease remains the number one cause of death in the U.S. Prior to menopause, women have approximately 2.5-4.5 times lower risk of cardiovascular disease than do men of a similar age. Within about 10 years following menopause, however, the rate in women becomes similar to that seen in men. Increased cardiorespiratory fitness and use of hormone replacement have been suggested as ways to improve the cardiovascular disease (CVD) risk profile. Unfortunately, very little is known about the effect of cardiorespiratory fitness on the CVD risk …

The Spectrum Of Bacterial Infections In Febrile Neutropenic Patients: Effect On Empiric Antibiotic Therapy, Ikram A. Burney, Tariq Siddiqui, Badar J. Farooqui, Mohammad Khurshid

Department of Medicine

The aim of this retrospective analysis was to look at the spectrum of bacterial isolates and their resistance patterns to the commonly used antIbiotics in the settmg of febrile neutropenia. A total of 127 bacteria were isolated from patients with acute leukemias, lymphoproliferative disorders, aplastic anaemia and various solid tumours. Fifty-four percent organisms were gram negative; while the rest were gram positive. E. coli, pseudomónas aeruginosa, staphylococcus aureus, enterococcus and streptococci were the commonly isolated organisms. Forty-eight percent organisms were isolated from blood, 16% from urine, 13% from wounds and superficial abscesses and 11% from respiratory tract. E. coli exhibited …

Initial Multicenter Experience With Double Nucleoside Therapy For Human Immunodeficiency Virus Infection During Pregnancy., N S Silverman, D H Watts, J Hitti, D M Money, E Livingston, J Axelrod, J M Ernest, D Robbins, M M Divito

Department of Obstetrics and Gynecology Faculty Papers

OBJECTIVE: To study maternal and neonatal effects of combination nucleoside analog therapy administered to human immunodeficiency virus (HIV)-infected pregnant women for maternal indications.

METHODS: A multicenter, prospective observational study was undertaken at six perinatal centers in the United States and Canada that supported regional referral programs for the treatment of HIV-infected pregnant women. Demographic, laboratory, and pregnancy outcome data were collected for 39 women whose antiretroviral treatment regimens were expanded to include more than one nucleoside analog for maternal indications. The 40 newborns were monitored at pediatric referral centers through at least three months of age to ascertain their HIV …

Determinants Of Antepartum Human Immunodeficiency Virus Testing In A Non-Medicaid Obstetric Population., E Cardonick, S Daly, M Dooley, K Elles, N S Silverman

Department of Obstetrics and Gynecology Faculty Papers

OBJECTIVE: To determine voluntary human immunodeficiency virus (HIV) testing rates and factors influencing testing in a private obstetric practice.

METHODS: Antepartum patients were offered HIV testing after completing a self-assessment questionnaire. Perceived risks and demographics were correlated with testing rates.

RESULTS: Overall, 348/600 (58%) women consented to HIV testing. In a univariate analysis, patients with "any" perceived risk(s) were more likely to be tested. Single women and those with an at-risk partner(s) or a history of sexually transmitted disease (STD) were more likely to desire testing. These factors remained independently associated with voluntary testing in a multivariate regression model. No …

Identification Of Factors That Influence Physician Generated Referrals To Hospice Programs, Cheryl A. Hoerner

Dissertations and Theses @ UNI

The hospice movement is just over 20 years old in this country. Hospice programs are dependent on physicians to educate and refer their terminal patients to hospice care. The purpose of this study was to identify factors which influence physicians in rural Iowa to refer terminal patients to selected hospice programs. The study involved Medicare-certified hospice programs and non-certified programs located in rural communities in Iowa. One hundred and fifty licensed physicians were randomly selected to complete a 14-item questionnaire. A total of 86 questionnaires were returned. The survey tool addressed demographic information, as well as identifying factors that influenced …

Role Of Serum Angiotensin Converting Enzyme In Sarcoidosis, Aysha Habib, Farooq Ghani, Mohammad Khurshid, Amanullah Khan, M. Atta Khan

Department of Pathology and Laboratory Medicine

This study was conducted to determine the role of Serum Angiotensin Converting Enzyme (SACE) as a marker in the differential diagnosis of pulmonary diseases and prognosis of sarcoidosis, A retrospective analysis of 113 medical records of patients at The Aga Khan University Hospital, with laboratory investigation for SACE was performed. Among 113 patients, 51 cases were found to have sarcoidosis, 44 of them had SACE levels greater than 52 lU/L (mean ACE 104.44). SACE levels were also found elevated in other clinical conditions like tuberculosis (mean 58.64 lUlL), but the enzyme level were less (p0.04) than those found in sarcoidosis …

Dyslipidemia And Its Relation With Body Mass Index Versus Waist Hip Ratio, A Jabbar, A Irfanullah, J Akhter, Y K. Mirza

Section of Pulmonary & Critical Care

To study the magnitude of dyslipidemia in asymptomatic subjects and its relation to body mass index (BMI) and waist-hip-ratio (WHR), 88 subjects attending the health analysis programme were examined and their age, sex, BMI, WHR, fasting blood glucose and lipids were measured. The distribution of the lipid levels and the frequency of dyslipidemia were noted. Forty-eight percent had a total cholesterol of > 200 mg/dl and 50% had an HDL-cholesterol of < 40 mg/dl. On comparing the means of total cholesterol to BMI and WHR, it was found that total cholesterol level was statistically significant for WHR above and below 0.9 for males and 0.8 for females, whereas not so for BMI above and below 27 kg/m2. The prevalence of dyslipidemia in asymptomatic people in this group emphasizes the need for routine health screening for early institution of preventive measures. The correlation with WHR rather than BMI points towards importance of measuring parameters of central obesity rather than body weight and height only.

The Relationship Between Health Locus Of Control And Health Behaviors Of Women Who Have Undergone Coronary Artery Bypass Grafting, Heather Ferrillo

Nursing Master’s Theses and Projects

Due to the increasing number of women who are diagnosed with heart disease and who are undergoing coronary artery bypass grafting, it is important to explore the psychosocial aspects involved in the recovery process of these women. This study examined the relationship between locus of control and health behaviors of women who underwent coronary artery bypass grafting.

Ossifying Fibroma Of Nasal Cavity, Abbas Zafar Abbas Zafar, Muhammad Shafi Muhammad Shafi, Shaukat Malik Shaukat Malik, Shahid Pervez

Department of Pathology and Laboratory Medicine

No abstract provided.

A Dichotomous Role For Nitric Oxide During Acute Toxoplasma Gondii Infection In Mice, Imtiaz A. Khan, Joseph D. Schwartzman, Tadashi Matsuura, Lloyd H. Kasper

Dartmouth Scholarship

Production of nitric oxide by macrophages is believed to be an important microbicidal mechanism for a variety of intracellular pathogens, including Toxoplasma gondii. Mice with a targeted disruption of the inducible nitric oxide synthase gene (iNOS) were infected orally with T. gondii tissue cysts. Time to death was prolonged compared with parental controls. Histologic analysis of tissue from infected mice showed scattered small foci of inflammation with parasites in various tissues of iNOS−/− mice, whereas tissue from the parental C57BL/6 mice had more extensive tissue inflammation with few visible parasites. In particular, extensive ulceration and necrosis of distal small …

Comparison Of Beta-Adrenoceptor Coupled Camp Production In Cultured Human Mononuclear Leukocytes And Myometrial Cells, Yu-Li Liu

Electronic Theses and Dissertations

$\beta\sb2$-Adrenoceptor ($\beta\sb2$-AR) agonists, such as terbutaline, are used as tocolytic agents in the treatment of preterm labor. $\beta$-Adrenoceptor stimulation relaxes myometrium through specific receptors coupled through Gs to adenylyl cyclase (AC) that catalyzes the conversion of ATP to cAMP. The purpose of this study was to compare $\beta$-adrenoceptors and cAMP production in cultured human leukocytes and myometrial cells, and to determine the importance of $\beta$-adrenoceptors and cAMP production in isoproterenol-induced myometrial relaxation. $\sp{125}$I-iodopindolol was used to assess $\beta$-adrenoceptor affinity and number cAMP levels were analyzed before and after stimulation by isoproterenol, AlF$\sb4\sp-$, forskolin, and PGE$\sb1$. Isometric recording was used to …

Ms211: Non-Proliferation Talk At Kazakhstan, Armin Weinberg

Works on Radiation Effects: 1990-2020

These are talking notes for my presentation at a nuclear non-proliferation conference. Interesting to see recommendations including this one, "I suggest Minister Shkolnik create a joint committee with representatives from government, academicia, public survivors and ethicists to continue the pursuit of this question." See more at Armin Weinberg, PhD Papers and its finding aid.

Ms211: Plans For Nazarbayev Visit To Houston And Tmc, Armin Weinberg

Works on Radiation Effects: 1990-2020

A list of things that Armin created in preparation for the visit by the President of Kazakhstan to Texas, Houston and the Medical Center. Very insightful with names and activities. See more at Armin Weinberg, PhD Papers and its finding aid.

Phosphorylation Of Elongation Factor 1 And Ribosomal Protein S6 By Multipotential S6 Kinase And Insulin Stimulation Of Translational Elongation, Y W Chang, J A Traugh

Faculty, Staff and Student Publications

Stimulation of protein synthesis in response to insulin is concomitant with increased phosphorylation of initiation factors 4B and 4G and ribosomal protein S6 (Morley, S. J., and Traugh, J. A. (1993) Biochimie 75, 985-989) and is due at least in part to multipotential S6 kinase. When elongation factor 1 (EF-1) from rabbit reticulocytes was examined as substrate for multipotential S6 kinase, up to 1 mol/mol of phosphate was incorporated into the alpha, beta, and delta subunits. Phosphorylation of EF-1 resulted in a 2-2. 6-fold stimulation of EF-1 activity, as measured by poly(U)-directed polyphenylalanine synthesis. The rate of elongation was also …

Ms211: By Healthcare Committee Doc, Armin Weinberg

Works on Radiation Effects: 1990-2020

Selected material about the healthcare system/status in Russia circa 1997. It looks like a series of pieces from a healthcare publication. Clearly this was a part of our trying to assess the opportunity to further our work with Dennis Sokol of the American Medical Centers that Ambassador Strauss connected us with as well as the post-Chernobyl opportunities for our colleagues in the Former USSR. See more at Armin Weinberg, PhD Papers and its finding aid.

Non-Visualization Of Lung Markings Below Hemidiaphragm In Subtle Subpulmonic Effusion: An Old Sign Resuscitated, Y A. Husen, T R. Khalid, Z A. Khan, M Y. Sheikh

Department of Radiology

To assess the lack of visibility of vascular markings under the hemidiaphragm on a frontal chest radiograph as a sign of pleural effusion, fifteen patients were collected showing this sign. Pleural effusion was diagnosed by ultrasound, comparison with previous or subsequent chest x-ray or computed tomography. Patients in the study group exhibited this sign in the absence of the classical signs of pleural effusion. In the control group, lack of visibility of blood vessels was observed in only 4.2% cases. Non-visualization of vascular markings below the hemidiaphragm should alert the interpreter to the possible presence of pleural effusion and a …

Open Fractures Caused By High Velocity Missiles: The Outcome Of Treatment Of 39 Fractures Followed For 1-3 Years, M A. Khan, R Hussain, S H. Khan, M Umar

Department of Surgery Docs

Between 1993 and 1995, thirty-three patients having 39 fractures caused by missiles fired from a high velocity rifle were reviewed retrospectively between 1 and 3 years after injury and the outcome of treatment assessed. Majority (33 out of 39) were Grade III. Union was achieved in 35 out of 39 fractures, there was deep infection and delayed union in one case each. Non-union occurred in three fractures. The fractures were stabilized using different techniques, but highest complication rate was seen with the use of the static external fixator. This was related to the severe nature of the injury as well …

The Association Of Hla-Drb Genes And The Shared Epitope With Rheumatoid Arthritis In Pakistan, K Hameed, S Bowman, E Kondeatis, R Vaughan, T Gibson

Section of Internal Medicine

The association of particular HLA-DR alleles and the shared epitope with rheumatoid arthritis (RA) is now well established. The strength of these links varies between races. Furthermore, the proposition that the presence of the shared epitope is indicative of severe disease has been more difficult to sustain in non-Europeans. This study examines the frequency of HLA-DR and HLA-DRB1 amongst Pakistanis for the first time. Using the polymerase chain reaction (PCR) and sequence-specific oligonucleotide probes (PCR-SSOP) and primers (PCR-SSP), HLA-DR phenotype and genotype frequencies were ascertained in 86 RA hospital out-patients and 79 healthy controls matched for age, gender and ethnicity. …

An Evaluation Of The Sensitivity Of Subjects With Peanut Allergy To Very Low Doses Of Peanut Protein: A Randomized, Double-Blind, Placebo-Controlled Food Challenge Study, Jonathan O'B. Hourihane, Sally A. Kilburn, Julie A. Nordlee, Susan L. Hefle, Steve L. Taylor, John O. Warner

Department of Food Science and Technology: Faculty Publications

The minimum dose of food protein to which subjects with food allergy have reacted in double-blind, placebo-controlled food challenges is between 50 and 100 mg. However, subjects with peanut allergy often report severe reactions after minimal contact with peanuts, even through intact skin.

Objective: We sought to determine whether adults previously proven by challenge to be allergic to peanut react to very low doses of peanut protein.

Methods: We used a randomized, double-blind, placebo-controlled food challenge of 14 subjects allergic to peanuts with doses of peanut ranging from 10 μg to 50 mg, administered in the form of …