Medicine and Health Sciences Commons^™

Utilization Of Smartphones For The Enhancement Of Trauma Division Of Education, Ryan A. Lawless Md, Dale A. Dangleben Md, Rovinder S. Sandhu Md

Department of Surgery

No abstract provided.

Treatment Of Acute Aortic Dissection At A Community Hospital: A 10 Year Review Of Outcomes., Timothy S. Misselbeck, Stephen Deturk, Matthew Wilson, Theodore Phillips Md, Michael Szwerc Md, Sanjay Mehta Md, Gary Szydlowski Md, Raymond Singer Md, James Wu Md

Department of Surgery

No abstract provided.

The Clue To His Pancreatitis!, Malia Eischen Md, Dale A. Dangleben Md, Facs

Department of Surgery

No abstract provided.

Apache-Ii Score Correlation With Mortality And Length Of Stay In An Intensive Care Unit, Saad Ahmed Naved,, Shahla Siddiqui, Fazal Hameed Khan

Department of Anaesthesia

Objective: To correlate the APACHE-II score system with mortality and length of stay in ICU. Study Design: Cohort study. Place and Duration of Study: The Intensive Care Unit (ICU) of the Aga Khan University Hospital, Karachi, from May 2005 to May 2006. Methodology: All adult patients who were admitted in the ICU were included. APACHE-II score was calculated at the second and seventh days of admission in the ICU. Patients who were discharged alive from the ICU or died after first APACHE-II Score (at 2nd day) were noted as the primary outcome measurement. Second APACHE-II score (at 7th day) was …

Post-Dural Puncture Posterior Reversible Encephalopathy Syndrome, Fauzia N. Minai, Syeda Fauzia Hasan, Mughis Sheerani

Department of Anaesthesia

We report the case of a young patient with 36 weeks pregnancy, and an acute respiratory infection with severe bronchospasm, who developed an occipital headache and neck pain on the third day of inadvertent dural puncture during placement of combined epidural spinal anaesthesia for caesarian section. It was diagnosed as post-dural puncture headache until generalised tonic clonic siezures occurred the next day raising the suspicion of postpartum eclampsia or meningitis. Posterior reversible encephalopathy syndrome was diagnosed on MRI of the brain which showed features of reversible ischemia in the posterior region of the brain. With anticonvulsant therapy and antibiotics there …

Immunoproliferative Small Intestinal Disease (Ipsid), Shahid Pervez, Khalid Mumtaz, Syed Siddiq Ullah, Nake Akhtar, Naureen Ali, Hina Aaqil

Department of Pathology and Laboratory Medicine

This study describes the frequency, demographics, clinical presentation, endoscopic findings, histopathological features, treatment and outcome of 'Immunoproliferative small intestinal disease' (IPSID). Archives contained a total of 27 cases of IPSID diagnosed and treated over an 18-year period. A M: F ratio of 2.4:1 was seen with a mean and median ages of 28.7 and 25 years. Most patients (68.8%) presented with abdominal pain and diarrhoea. In the majority (62.5%), duodenum was the primary site of involvement. Endoscopy showed polypoidal, raised or flat lesions. Biopsy findings included blunting or flattening of villi with dense plasma cell infiltrate and lymphoepithelial lesions. Twenty-four …

Aplastic Anemia: Clinicohaematological Features, Treatment And Outcome Analysis, Rabia Wali, Zehra Fidoo, Salman Adil, Muhammad Ahmed Naqvi

Department of Pathology and Laboratory Medicine

Objective: To determine the clinicohaematological features, treatment and outcome of children diagnosed with aplastic anemia at a single institution.

Study Design: Observational study.

Place and Duration of Study: The Aga Khan University Hospital, Karachi, from January 1999 till December 2008.

Methodology: Medical records of children aged less than 15 years of age diagnosed with aplastic anemia were reviewed. Clinicohaematological features, treatment and its response to therapy and outcome were recorded. Results were described in percentages.

Results: Ninety patients were diagnosed to have aplastic anemia (AA); 65 were male during the study period. Age ranged from 1 to 15 years. Fever …

A Pilot Study Assessing The Value Of An “Educational Hospitalist” In An Obgyn Residency Program, Joseph E. Patruno Md, Craig Koller M.Ed, Kara Coassolo Md, Meredith L. Rochon Md, Thomas Hutchinson Md

Department of Obstetrics & Gynecology

No abstract provided.

Determining A Threshold For Defining Oligohydramnios In A Low-Risk Population At Term, Joanne Quiñones Md, Msce, Anthony O. Odibo Md, Marilyn Stringer Phd, Meredith L. Rochon Md, George A. Macones Md, Msce

Department of Obstetrics & Gynecology

No abstract provided.

Hyaluronan Binding Assay (Hba®) And Maternal Age Serve As Positive Predictors Of Clinical Outcomes In Assisted Reproductive Technology (Art), Kathryn C. Worrilow, Chizoba D. Uzochukwu, Sherrine Eid

Department of Obstetrics & Gynecology

No abstract provided.

Induction Of Labor With Oxytocin: When Should Oxytocin Be Held?, Liany C. Diven Md, Julia Gogle Rn, Meredith Rochon Md, Sherrine Eid Mph3, John C. Smulian Md,Mph, Joanne N. Quiñones Md, Msce

Department of Obstetrics & Gynecology

No abstract provided.

Surgical Site Infections In Gynecologic Oncology Patients: A Retrospective Study Of Patient Characteristics And Intraoperative Parameters, Christine C. Chen Md, Joanne N. Quiñones Md, Msce, Richard Boulay Md, M Bijoy Thomas Md, Martin Martino Md

Department of Obstetrics & Gynecology

No abstract provided.

The History Of Urological Care And Training At Thomas Jefferson University, Max Koppel, Md, Patrick J. Shenot, Md, Dolores Bryne, Phd, Leonard G. Gomella, Md

Department of Urology Faculty Papers

The Department of Urology at Thomas Jefferson University and Thomas Jefferson University Hospital is generally acknowledged as the oldest formal Department of Urology in the US, formally designated as the Department of Genitourinary Surgery in 1904. The Department has been under the direction of 8 chairmen and has trained over 144 residents and 25 fellows with over 200 Jefferson Medical College graduates specializing in urology. Thomas Jefferson University was originally founded as Jefferson Medical College in 1824. Dr. George McClelland petitioned Jefferson College at Cannonsburg (now Washington and Jefferson College) to add a medical school to their institution. While technically …

Onco-Cardiology: The Time Has Come, Edward T H Yeh

The Texas Heart Institute Journal

No abstract provided.

Surgical Management Of Double-Chambered Right Ventricle In Adults, Ahmad K Darwazah, Mohammed Eida, Vivian Bader, Mohammed Khalil

The Texas Heart Institute Journal

Double-chambered right ventricle is a congenital anomaly in which the right ventricle is divided into 2 portions by anomalous muscle bundles. These cases often present in children, but rarely in adults.

We discuss 2 cases of double-chambered right ventricle, in patients aged 42 and 35 years. When cases remain asymptomatic until adulthood, they can present with unusual symptoms that lead to incorrect diagnosis. Our cases represent 2 very different manifestations of double-chambered right ventricle, which differ in presentation, in the site of abnormal obstructive muscle bundles, and in the presence of associated lesions. Both of our patients underwent successful surgical …

High-Risk Diabetic Patients With Unprotected Left Main Coronary Artery Disease: Characteristics And Medium-Term Outcomes Of Percutaneous Revascularization With Drug-Eluting Stents, Jose F Díaz Fernández, Carlos Sánchez González, Manuel Jiménez Navarro, Juan C Fernández Guerrero, Antonio Gómez Menchero, Juan H Alonso Briales, Rosa María Cardenal Piris, Juan Herrador, Manuel Guzmán Herrera, Jose M Hernández García

The Texas Heart Institute Journal

Percutaneous coronary intervention with drug-eluting stents is an alternative for patients with high-risk unprotected left main coronary artery disease; those with diabetes mellitus are at even higher risk. Recent advances in percutaneous coronary intervention could lead to better results. The aim of this study was to evaluate medium-term results in a real-world sample of high-risk diabetic patients undergoing percutaneous coronary intervention with drug-eluting stents for unprotected left main coronary artery disease.

From 3 tertiary hospitals, we retrospectively identified 334 high-risk patients, of whom 141 (42%) were diabetic and 193 (58%) were nondiabetic. The diabetes mellitus group showed a higher prevalence …

Mechanical Behavior Of Fully Expanded Commercially Available Endovascular Coronary Stents, Josip Tambaca, Suncica Canic, Mate Kosor, R David Fish, David Paniagua

The Texas Heart Institute Journal

The mechanical behavior of endovascular coronary stents influences their therapeutic efficacy. Through computational studies, researchers can analyze device performance and improve designs. We developed a 1-dimensional finite element method, net-based algorithm and used it to analyze the effects of radial loading and bending in commercially available stents. Our computational study included designs modeled on the Express, Cypher, Xience, and Palmaz stents.

We found that stents that did not fully expand were less rigid than the fully expanded stents and, therefore, exhibited larger displacement. Stents with an open-cell design, such as Express-like or Xience-like stents, had a higher bending flexibility. Stents …

Medical Professionalism Meets Generation X: A Perfect Storm?, Charles S Bryan

The Texas Heart Institute Journal

No abstract provided.

Adequacy Of Diabetes Care For Older U.S. Rural Adults: A Cross-Sectional Population Based Study Using 2009 Brfss Data, M. Nawal Lutfiyya, Joel E. Mccullough, Lori Mitchell, L. Scott Dean, Martin S. Lipsky

Community Health Faculty Publications and Presentations

Background: In the U.S. diabetes prevalence estimates for adults ≥ 65 years exceed 20%. Rural communities have higher proportions of older individuals and health disparities associated with rural residency place rural communities at risk for a higher burden from diabetes. This study examined the adequacy of care received by older rural adults for their diabetes to determine if older rural adults differed in the receipt of adequate diabetes care when compared to their non-rural counterparts.

Methods: Cross-sectional data from the 2009 Behavioral Risk Factor Surveillance Survey were examined using bivariate and multivariate analytical techniques.

Results: Logistic regression analysis revealed that …

Internal Medicine Problems As They Present To The Cardiologist, Ira Martin Grais

The Texas Heart Institute Journal

No abstract provided.

The Mediating Role Of Social Support And Fulfillment Of Spiritual Needs In End Of Life Care, Kimberley A. Gryglewicz

USF Tampa Graduate Theses and Dissertations

End of life (EOL) caregiving can be a daunting and challenging endeavor as caregivers adjust to the ever-changing care demands associated with dying. Increased personal care, assisting with symptom and medication management, and attending to the emotional and spiritual needs of the dying person require caregivers to learn new tasks and to assume new roles such as social worker, nurse, and chaplain. As families continue to play an essential role in meeting the health care needs of their dying loved ones, it is imperative for social workers to understand the complexities of the end of life caregiving experience in order …

Β-Lactams Interfering With Pbp1 Induce Panton-Valentine Leukocidin Expression By Triggering Sara And Rot Global Regulators Of Staphylococcus Aureus, Oana Dumitrescu, Priya Choudhury, Sandrine Boisset, Cedric Badiou, Michele Bes, Yvonne Benito, Christiane Wolz, Francois Vandenesch, Jerome Etienne, Ambrose L. Cheung

Dartmouth Scholarship

Previous articles reported that beta-lactam antibiotics increase the expression of Staphylococcus aureus Panton-Valentine leukocidin (PVL) by activating its transcription. We investigated the mechanisms underlying the inductor effect of beta-lactams on PVL expression by determining targets and regulatory pathways possibly implicated in this process. We measured PVL production in the presence of oxacillin (nonselective), imipenem (penicillin-binding protein 1 [PBP1] selective), cefotaxime (PBP2 s

The Effects Of Smoking On Pregnant Women, Meir Cohen

The Science Journal of the Lander College of Arts and Sciences

Smoking during pregnancy is accepted as the most significant avoidable risk factor for an unsuccessful pregnancy result. Smoking is linked with fetal growth restriction, and increasing evidence also suggests that smoking can cause stillbirth, preterm birth, placental abruption, and possibly sudden infant death syndrome. Smoking during pregnancy is also associated with enhanced risks of spontaneous abortions, ectopic pregnancies, and placenta previa, and it might increase risks of behavioral disorders in childhood. Studies have shown with randomized controlled trials, that smoking intervention during pregnancy has had limited success. Smoking during pregnancy continues to be an important risk factor for maternal and …

Case-Control Study Of Sunlight Exposure And Cutaneous Human Papillomavirus Seroreactivity In Basal Cell And Squamous Cell Carcinomas Of The Skin, Michelle R. Iannacone

USF Tampa Graduate Theses and Dissertations

Non-melanoma skin cancer (NMSC), comprised of basal cell carcinoma (BCC) and squamous cell carcinoma (SCC), is the most common cancer in Caucasians. Ultraviolet radiation (UVR) exposure is the most important environmental risk factor for both BCC and SCC development. However, the precise relationship between UVR and the risk of NMSC is complex, and the relationship may differ by skin cancer type. It has been hypothesized that intermittent patterns and childhood sunlight exposure are important for BCC while continuous (chronic) and lifelong (i.e. childhood and adulthood) sunlight exposure is important for SCC. Epidemiologic studies have demonstrated that cutaneous human papillomavirus (HPV) …

Transition Experiences Of Adolescent Survivors Of Childhood Cancer: A Qualitative Investigation, Alana Delores Lopez

USF Tampa Graduate Theses and Dissertations

Adolescent survivors of childhood cancer are a growing population with unique needs as they face a combination of challenges associated with normal development and returning to life after treatment completion (Wakefield et al., 2010). One specific need identified in the research literature includes the effective delivery of transitional care and planning (Hewitt, Greenfield, & Stovall, 2005). It has been suggested that the provision of transition care and planning can help facilitate the shift from one phase of care to another and promote positive transition experiences (National Cancer Institute, 2008). The shift from off-treatment to post-treatment and school reintegration have been …

Inhibition Of P53 Dna Binding Function By The Mdm2 Acidic Domain, Brittany Lynne Cross

USF Tampa Graduate Theses and Dissertations

MDM2 regulates p53 predominantly by promoting p53 ubiquitination. However, ubiquitination-independent mechanisms of MDM2 have also been implicated. Here we show that MDM2 inhibits p53 DNA binding activity in vitro and in vivo. MDM2 binding promotes p53 to adopt a mutant-like conformation, losing reactivity to antibody Pab1620, while exposing the Pab240 epitope. The acidic domain of MDM2 is required to induce p53 conformational change and inhibit p53 DNA binding. ARF binding to the MDM2 acidic domain restores p53 wild type conformation and rescues DNA binding activity. Furthermore, histone methyl transferase SUV39H1 binding to the MDM2 acidic domain also restores p53 wild …

Postoperative Sensitivity In Class V Composite Restorations: Comparing Soft Start Vs. Constant Curing Modes Of Led., Fahad Umer, Frahan Raza Khan

Department of Surgery Docs

Background: One of the major disadvantages associated with using composites is polymerization shrinkage, stresses are generated at the margins, and if these stresses exceed the bond strength, microleakage occurs at the tooth restoration interface which causes ingress of cariogenic bacteria, post-operative sensitivity, and secondary caries. LED offers several curing modes: constant cure, ramped cure, and soft start cure. It is claimed that soft start polymerization mode produces less polymerization shrinkage and consequently less postoperative sensitivity. Objective:To compare the postoperative sensitivity in Class V composite restorations using soft start and constant LED curing modes. Materials and

Methods:

Using the appropriate …

Predictors Of Coronary Artery Visualization In Kawasaki Disease., Renee Margossian, Minmin Lu, L Luann Minich, Timothy J. Bradley, Meryl S. Cohen, Jennifer S. Li, Beth F. Printz, Girish S. Shirali, Lynn A. Sleeper, Jane W. Newburger, Steven D. Colan, Pediatric Heart Network Investigators

Manuscripts, Articles, Book Chapters and Other Papers

Background: Echocardiography is the imaging modality of choice for the evaluation of coronary artery (CA) abnormalities in Kawasaki disease. Small series have established high specificity and sensitivity for detecting abnormalities, yet visualization rates of individual CA segments and factors associated with success are unknown.

Methods: In the Pediatric Heart Network's randomized trial of primary steroid treatment for Kawasaki disease, echocardiograms were interpreted locally and by a core laboratory. Univariate and multivariate predictors of CA visualization by the local lab as determined by the core lab were explored, and agreement of CA size measured locally and by the core lab was …

Minimal Vs Extensive Esophageal Mobilization During Laparoscopic Fundoplication: A Prospective Randomized Trial., Shawn D. St Peter, Douglas C. Barnhart, Daniel J. Ostlie, Kuojen Tsao, Charles M. Leys, Susan W. Sharp, Donna Bartle, Tracey Morgan, Carroll M. Harmon, Keith E. Georgeson, G W. Holcomb Iii

Manuscripts, Articles, Book Chapters and Other Papers

PURPOSE: Laparoscopic Nissen fundoplication has been traditionally performed with extensive esophageal dissection to create 2 to 3 cm of intraabdominal esophagus. Retrospective data have suggested that minimal esophageal mobilization may reduce the risk of postoperative herniation of the wrap into the lower mediastinum. To compare complete esophageal dissection to leaving the phrenoesophageal attachment intact, we conducted a 2-center, prospective, randomized trial.

METHODS: After obtaining permission/assent, patients were randomized to circumferential division of the phrenoesophageal attachments (MAX) or minimal mobilization with no violation of the phrenoesophageal membrane (MIN). A contrast study was performed at 1 year. The primary outcome variable was …

Reflections On A Heart Surgery Career With Insights For Western-Trained Medical Specialists In Developing Countries, Sami S Kabbani

The Texas Heart Institute Journal

Herein, I describe my experience (spanning 40 years) in helping to develop the specialty of cardiovascular surgery in Syria. Especially in the early years, the challenges were daunting. We initially performed thoracic, vascular, and closed-heart operations while dealing with inadequate facilities, bureaucratic delays, and poorly qualified personnel. After our independent surgical center was established in early 1976, we performed 1 open-heart and 1 closed-heart procedure per day. Open-heart procedures evolved from the few and simple to the multiple and complex, and we solved difficulties as they arose. Today, our cardiac surgical center occupies an entire 6-floor building. We have 12 …