Medicine and Health Sciences Commons^™

Trends In Mental Health Of An Adolescent Medicine Clinic Patient Population, Abdel Salous, Linah Al-Alem, Hatim A. Omar

Pediatrics Faculty Publications

The correlation between exposure to forms of violence and development of mental disorders in victims is well established. The purpose of this paper was to identify mental health problems in an adolescent medicine clinic population in Lexington, KY and to investigate potential correlation of mental disorders with psychosocial factors. Data were gathered from the charts of 169 adolescent clinic patients (age 10-22) seen in the clinic for mental health care and analyzed using Excel. Of the patient population, 68% were urban, whereas 32% were rural. In terms of gender, 40% of the patients were male and 60% were female, 80% …

Discovering The Complexities Of Adolescent Compliance To Treatment, Megan Song, Hatim A. Omar

Pediatrics Faculty Publications

To explore the challenges faced in enhancing adolescent treatment compliance and to understand the roles of key players in this endeavor: the adolescent, parent and healthcare provider. Obtaining compliance from adolescents requires collaboration from the adolescent, caregiver and provider and depends on well-established relationships between each person in the triad: adolescent-provider, adolescent-caregiver, and caregiver-provider. Ensuring and improving adherence to treatment by adolescents is a challenging task but crucial to overall health outcomes. It requires the collaboration of the adolescent, parent and physician to create the optimal treatment plan, specifically tailored to the adolescent. For the clinician, maintaining good communication and …

From Genome-Based In Silico Predictions To Ex Vivo Verification Of Leprosy Diagnosis, Annemieke Geluk, John S. Spencer, Kidist Bobosha, Maria C. V. Pessolani, Geraldo M. B. Pereira, Sayera Banu, Nadine Honore, Stephen T. Reece, Murdo Macdonald, Bishwa Raj Sapkota, Chaman Ranjit, Kees L. M. C. Franken, Martha Zewdie, Abraham Aseffa, Rabia Hussain, Mariane M. Stefani, Sang-Nae Cho, Linda Oskam, Patrick J. Brennan, Hazel M. Dockrell

Department of Pathology and Laboratory Medicine

The detection of hundreds of thousands of new cases of leprosy every year suggests that transmission of Mycobacterium leprae infection still continues. Unfortunately, tools for identification of asymptomatic disease and/or early-stage M. leprae infection (likely sources of transmission) are lacking. The recent identification of M. leprae-unique genes has allowed the analysis of human T-cell responses to novel M. leprae antigens. Antigens with the most-promising diagnostic potential were tested for their ability to induce cytokine secretion by using peripheral blood mononuclear cells from leprosy Patients and controls in five different areas where leprosy is endemic, 246 individuals from Brazil, Nepal, Bangladesh, …

Success And Failure Of Fast Track Extubation In Cardiac Surgery Patients Of Tertiary Care Hospital: One Year Audit, Mohammad Irfan Akhtar, Mohammad Hamid

Section of Cardiothoracic Surgery

OBJECTIVE: To identify the causes of delayed extubation in patients planned for fast tract extubation during cardiac surgery.

METHODS: A prospective observational study was conducted at cardiothoracic unit of Aga Khan University Hospital for the period of one year. All elective coronary artery bypass graft (CABG) surgery patients, between the ages of 35-75 years with LVEF > or = 40 percent were included. Patients with Intra aortic balloon pump, chronic renal failure, respiratory compromise and requiring high ionotropic support were excluded from this audit. A performa was designed and later filled by the primary investigator. Patient demographics and various reasons for …

Social Cognitive Predictors Of Diabetes Outcomes In Latinos And Whites, Diana Brown

Loma Linda University Electronic Theses, Dissertations & Projects

Investigating health care disparities in ethnic minority populations is an increasingly urgent issue as these disparities lead to higher morbidity and mortality in minorities (National Center of Health Statistics, 2000). There is clear evidence that Latino Americans, the fastest growing minority group in the United States, are more likely to be diagnosed with and experience more severe complications from type 2 diabetes than Anglo Americans. This study surveyed 38 White and 33 Latino diabetes patients from outpatient clinics in an academic medical center. Cultural values (individualism and collectivism), mental health (social support, mental health), and self-efficacy (diabetes and exercise) were …

Dengue Fever With Hepatitis E And Hepatitis A Infection, Javed Yakoob, Wasim Jafri, Shaheer Siddiqui, Mehmood Riaz

Section of Gastroenterology

Infection with dengue viruses produces a spectrum of clinical illness ranging from a nonspecific viral syndrome to severe and fatal haemorrhagic disease. Important risk factors include the strain and serotype of the infecting virus, as well as the age, immune status, and genetic predisposition of the patient. The teaching point in this case study was Dengue fever which occurred concomitantly with Hepatitis A and Hepatitis E virus infection.

Instituting An Undergraduate Core Clerkship In Radiology: Initial Experiences In Pakistan, Naila Nadeem, Abdul Mueed Zafar, Muhammad Nadeem Ahmad

Department of Radiology

Utilization of radiology as an educational resource carries great potential. Accreditation bodies, physicians and medical students deem it important for a well rounded medical curriculum. Unfortunately this resource is yet to be developed and implemented to an optimal extent. We share the experiences from the first radiology core clerkship in Pakistan at the undergraduate level. An overview of clerkship objectives and structure is followed by discussion on lessons learnt during the initial three years of institution. Development of assessable objectives, integration of radiology with other specialties, and supervised andragogical learning tailored for undergraduate students are emphasized.

Antibiotic Resistance In Staphylococcus Aureus-Containing Cutaneous Abscesses Of Patients With Hiv, Gus W Krucke, Deanna E Grimes, Richard M Grimes, Thai D Dang

Faculty, Staff and Student Publications

PURPOSE: The aim of this study was to document the resistance patterns found in exudates from cutaneous abscesses of HIV-infected persons.

BASIC PROCEDURES: Patient records were reviewed on 93 culture and sensitivity tests performed on exudates taken from incised and drained abscesses of HIV-infected persons.

MAIN FINDINGS: Of the specimens, 84.6% were Staphylococcus aureus. Of these, 93.5% were penicillin resistant, 87% oxacillin resistant, 84.4% cephazolin resistant, 84.4% erythromycin resistant, 52.2% ciprofloxacin resistant, and 15.6% tetracycline resistant. Fifty-eight specimens were tested for clindamycin with 29.3% found resistant; 85.7% were methicillin-resistant S aureus (MRSA) (defined as resistant to both penicillin G and …

Educating And Informing Patients Receiving Psychopharmacological Medications: Are Family Physicians In Pakistan Up To The Task?, Hammad Ashraf Ganatra, Hadi Bhurgri, Roomasa Channa, Fauzia Ahmad Bawany, Syed Nabeel Zafar, Rafia Ishfaq Chaudhry, Syeda Hina Batool, Abdul Basit, Mehmood Asghar, Sarah Saleem, Haider Naqvi

Community Health Sciences

Introduction: Studies have shown a high prevalence of psychiatric illnesses among Patients in primary health care settings. Family physicians have a fundamental role in managing psychiatric illness with psychopharmacological medications. Providing information about the disease, its management and the potential adverse effects of the medications is an important part of the management of mental illnesses. Our objective was to determine if Patients who were prescribed psychopharmacological drugs by family physicians at a community health center in Karachi, Pakistan were provided adequate education about their disease and its management.
Methods: A cross-sectional study was conducted at the Community Health Centre (CHC), …

Well-Being Of Medical Students And Their Awareness On Substance Misuse: A Cross-Sectional Survey In Pakistan., Abdul Wahab Yousafzai, Syed Ahmer, Ehsanullah Syed, Naila Bhutto, Saman Iqbal, Mohammed Naim Siddiqi, Mohammed Zaman

Department of Psychiatry

Objective: To investigate psychological well-being and substance abuse among medical students in Pakistan. Methods: A cross-sectional questionnaire-based survey was conducted in six medical colleges across Pakistan. Final-year medical students were interviewed by either a postgraduate trainee in psychiatry or a consultant psychiatrist. Results: A total of 540 medical students were approached, 342 participated and the response rate was 64.5%. Mean age was 23.73 years (SD 2.45 years), 52.5% were male and 90% single. Two out of every five respondents reported that work/study at medical school affected their personal health and well-being. A considerable proportion of students were aware of alcohol …

Accumulation Of Rhodopsin In Late Endosomes Triggers Photoreceptor Cell Degeneration, Yashodhan Chinchore, Amitavo Mitra, Patrick J. Dolph, Norbert Perrimon

Dartmouth Scholarship

Progressive retinal degeneration is the underlying feature of many human retinal dystrophies. Previous work using Drosophila as a model system and analysis of specific mutations in human rhodopsin have uncovered a connection between rhodopsin endocytosis and retinal degeneration. In these mutants, rhodopsin and its regulatory protein arrestin form stable complexes, and endocytosis of these complexes causes photoreceptor cell death. In this study we show that the internalized rhodopsin is not degraded in the lysosome but instead accumulates in the late endosomes. Using mutants that are defective in late endosome to lysosome trafficking, we were able to show that rhodopsin accumulates …

Download The Pdf Of The Full Issue

CenterPieces

Download the PDF of the Full Issue of CenterPieces, Fall 2007, Volume 2, Issue 1.

We Are Seeking Participants For The Following Studies

CenterPieces

All participants in our research projects receive compensation for participating in study interviews. For further information about these and other studies, please visit our website at www.jefferson.edu/jchp/carah or call 215-503-2897 to speak to a member of our staff.

Coping Tips For Caregivers

CenterPieces

Educate yourself about the disease your family member is facing and how it may affect his or her behavior, pain level or quality of life.

Find sources of help for caregiver tasks. Contact family, friends, neighbors, church/synagogue, workplace, Area Agency on Aging or other organizations.

Protect your personal time for something you enjoy or something you need to get done.

Helping Caregivers To Cope

CenterPieces

When Deb Lacktman promised her dying father that she would care for her mother, Margaret Rimato, after he passed, she wasn’t prepared for the challenges to come. Shortly after he passed, Margaret became increasingly forgetful and delusional. Deb attributed her mother’s memory loss to the stress of losing her husband. With time, however, Margaret’s condition worsened and she was diagnosed with Alzheimer’s disease.

As the primary caregiver of a parent with Alzheimer’s, Deb dealt with various complications beyond the memory loss. Her mother continually roamed the house in the middle of the night, for no apparent reason. It turned out …

Speaking With Barry Rovner, Md

CenterPieces

Q: What Alzheimer’s related studies are you involved in currently at the Farber Institute for Neurosciences?

Dr. Rovner: We are evaluating three exciting new disease-modifying drug treatments that may slow down the course of Alzheimer’s disease. I am also a Principal Investigator of Jefferson’s Center for Excellence in Neurodegenerative Diseases funded by the Pennsylvania Department of Health Tobacco Settlement grant. We are testing innovative screening methods to identify dementia in community-based agencies serving older adults, as well as testing in-home skills training services to delay nursing home placement and reduce stress for a racially diverse group of family caregivers. This …

Message From Dr. Laura Gitlin, Director Of Carah, Laura N. Gitlin

CenterPieces

Welcome to the second issue of CenterPieces, the newsletter of the Center for Applied Research on Aging and Health. We dedicate this issue to the topic of dementia and family caregiving, a critical public health issue. There are 26 million individuals with dementia worldwide, and approximately 5 million individuals with the diagnosis in the US. This number may exceed 16 million in 2050.

For the past 15 years, CARAH has been in the forefront of developing and testing innovative approaches to supporting families in their heroic care efforts and enhancing the quality of life of affected individuals. CARAH’s current research …

Diurnal Variation Of The Human Adipose Transcriptome And The Link To Metabolic Disease., Andrey Loboda, Walter K. Kraft, Bernard Fine, Jeffrey Joseph, Michael Nebozhyn, Chunsheng Zhang, Yudong He, Xia Yang, Christopher Wright, Mark Morris, Ira Chalikonda, Mark Ferguson, Valur Emilsson, Amy Leonardson, John Lamb, Hongyue Dai, Eric Schadt, Howard E. Greenberg, Pek Yee Lum

Department of Anesthesiology Faculty Papers

ABSTRACT: BACKGROUND: Circadian (diurnal) rhythm is an integral part of the physiology of the body; specifically, sleep, feeding behavior and metabolism are tightly linked to the light-dark cycle dictated by earth's rotation. METHODS: The present study examines the effect of diurnal rhythm on gene expression in the subcutaneous adipose tissue of overweight to mildly obese, healthy individuals. In this well-controlled clinical study, adipose biopsies were taken in the morning, afternoon and evening from individuals in three study arms: treatment with the weight loss drug sibutramine/fasted, placebo/fed and placebo/fasted. RESULTS: The results indicated that diurnal rhythm was the most significant driver …

The P53-Induced Siva-1 Plays A Significant Role In Cisplatin-Mediated Apoptosis, John L. Barkinge, Radhika Gudi, Hawkins Sarah, Fei Chu, Alip Borthakur, Bellur S. Prabhakar

Clinical & Translational Sciences

Background: The pro-apoptotic protein Siva-1 functions in both extrinsic and intrinsic cell death signaling; however, the exact contribution of the endogenous Siva-1 to DNA damage-induced apoptosis is unclear. Using cisplatin, a chemotherapeutic drug, to induce DNA damage and cell death, we determined the role of Siva-1.

Methods: Cisplatin treated HCT116 colorectal carcinoma cells (p53+/+ and -/-) were used in the study. With the help of recombinant lentivirus that can express siSiva (siRNA that specifi cally targets Siva-1), we also generated Siva-1 knockdown HCT116 cells. Apoptosis was determined by tetramethyl rhodamine methyl ester (TMRM) staining and propidium iodide (PI) staining.

Results: …

Facilitated Monocyte-Macrophage Uptake And Tissue Distribution Of Superparmagnetic Iron-Oxide Nanoparticles., Arnaud Beduneau, Zhiya Ma, Cassi B. Grotepas, Alexander Kabanov, Barrett E. Rabinow, Nan Gong, R. Lee Mosley, Huanyu Dou, Michael D. Boska, Howard Gendelman

Journal Articles: Radiology

BACKGROUND: We posit that the same mononuclear phagocytes (MP) that serve as target cells and vehicles for a host of microbial infections can be used to improve diagnostics and drug delivery. We also theorize that physical and biological processes such as particle shape, size, coating and opsonization that affect MP clearance of debris and microbes can be harnessed to facilitate uptake of nanoparticles (NP) and tissue delivery.

METHODS: Monocytes and monocyte-derived macrophages (MDM) were used as vehicles of superparamagnetic iron oxide (SPIO) NP and immunoglobulin (IgG) or albumin coated SPIO for studies of uptake and distribution. IgG coated SPIO was …

Interconnections Between Sigma B, Agr, And Proteolytic Activity In Staphylococcus Aureus Biofilm Maturation, Katherine J. Lauderdale, Blaise R. Boles, Ambrose L. Cheung, Alexander R. Horswill

Dartmouth Scholarship

Staphylococcus aureus is a proficient biofilm former on host tissues and medical implants. We mutagenized S. aureus strain SH1000 to identify loci essential for ica-independent mechanisms of biofilm maturation and identified multiple insertions in the rsbUVW-sigB operon. Following construction and characterization of a sigB deletion, we determined that the biofilm phenotype was due to a lack of sigma factor B (SigB) activity. The phenotype was conserved in a sigB mutant of USA300 strain LAC, a well-studied community-associated methicillin-resistant S. aureus isolate. We determined that agr RNAIII levels were elevated in the sigB mutants, and high levels of RNAIII expression are …

Genetic Contribution To Patent Ductus Arteriosus In The Premature Newborn, Naveed Hussain

Articles - Patient Care

BACKGROUND The most common congenital heart disease in the newborn population, patent ductus arteriosus, accounts for significant morbidity in preterm newborns. In addition to prematurity and environmental factors, we hypothesized that genetic factors play a significant role in this condition. OBJECTIVE The objective of this study was to quantify the contribution of genetic factors to the variance in liability for patent ductus arteriosus in premature newborns. PATIENTS AND METHODS A retrospective study (1991–2006) from 2 centers was performed by using zygosity data from premature twins born at ≤36 weeks’ gestational age and surviving beyond 36 weeks’ postmenstrual age. Patent ductus …

Alcohol In Moderation, Cardioprotection And Neuroprotection : Epidemiological Considerations And Mechanistic Studies, Dipak K. Das Dr.

UCHC Articles - Research

In contrast to many years of important research and clinical attention to the pathological effects of alcohol (ethanol) abuse, the past several decades have seen the publication of a number of peer-reviewed studies indicating beneficial effects of light-moderate, non-binge consumption of varied alcoholic beverages, as well as experimental demonstrations that moderate alcohol exposure can initiate typically cytoprotective mechanisms. A considerable body of epidemiology associates moderate alcohol consumption with significantly reduced risks of coronary heart disease and, albeit currently a less robust relationship, cerebrovascular (ischemic) stroke. Experimental studies with experimental rodent models and cultures (cardiac myocytes, endothelial cells) indicate that moderate …

Remission And Recovery In The Treatment For Adolescents With Depression Study (Tads): Acute And Long-Term Outcomes., Betsy D. Kennard, Susan G. Silva, Simon Tonev, Paul Rohde, Jennifer L. Hughes, Benedetto Vitiello, Christopher J. Kratochvil, John F. Curry, Graham J. Emslie, Mark Reinecke, John March

Journal Articles: Psychiatry

OBJECTIVE: We examine remission rate probabilities, recovery rates, and residual symptoms across 36 weeks in the Treatment for Adolescents with Depression Study (TADS).

METHOD: The TADS, a multisite clinical trial, randomized 439 adolescents with major depressive disorder to 12 weeks of treatment with fluoxetine, cognitive-behavioral therapy, their combination, or pill placebo. The pill placebo group, treated openly after week 12, was not included in the subsequent analyses. Treatment differences in remission rates and probabilities of remission over time are compared. Recovery rates in remitters at weeks 12 (acute phase remitters) and 18 (continuation phase remitters) are summarized. We also examined …

London City Life: A Call To Service, Mary Ann Colohan

Data and Test Instruments

London and the University of Western Ontario have a strong tradition of sending medical personnel to war. Afghanistan is no exception.

Helicobacter Pylori Infection Rate Decreases In Symptomatic Children: A Retrospective Analysis Of 13 Years (1993-2005) From A Gastroenterology Clinic In West Virginia, Yoram Elitsur, Yulia Dementieva, Mary Rewalt, Zanda Lawrence

Pediatrics

Background: The rate of Helicobacter pylori is decreasing in the developed countries, but few long-term studies are available from the United States. We retrospectively assessed the annual H. pylori infection rate in symptomatic children seen in our clinic over a 13-year study period.

Study: A retrospective analysis of all children who had histologic diagnosis of H. pylori infection between January 1993 and December 2005 in our pediatric gastroenterology clinic was performed. The annual infection rate and the overall infection rate were calculated.

Results: A total of 1743 upper endoscopy reports were reviewed, of which 212 (12.1%) were diagnosed with H. …

Non-Invasive Prediction Of St Elevation Myocardial Infarction Complications By Left Ventricular Tei Index, Nasir Rahman, Khawar Abbas Kazmi, Muniza Yousaf

Section of Cardiology

OBJECTIVE: To investigate association between the Tei index and cardiac complications of ST elevation of Myocardial Infarction.

PATIENTS AND METHODS: A total of a 202 adult consecutive patients with first ST elevation MI (STEMI) were studied. Tei index was obtained as: (a _ b)/b, where "a" is the interval between the cessation and onset of mitral flow and "b" is the ejection time of aortic flow measured with the help of pulsed Doppler echocardiography. Subsequent complications, included Death, Congestive Heart Failure (CHF), Cardiogenic shock, Atrial Flutter/ Atrial Fibrillation, Sustained ventricular tachycardia, Advanced Atrio- Ventricular Clock (AV Block), Myocardial Infarction (MI), …

Risks For Preterm Delivery And Low Birth Weight Are Independently Increased By Severity Of Maternal Anaemia, Hussein Kidanto, Ingrid Mogren, Gunilla Lindmark, Siriel Massawe, Lennarth Nystrom

Faculty of Health Sciences, East Africa

OBJECTIVE: To estimate the effect of the severity of maternal anaemia on various perinatal outcomes.

DESIGN: A cross-sectional study.

SETTING: Labour Ward, Muhimbili National Hospital, Dar es Salaam, Tanzania.

METHOD: The haemoglobin of eligible pregnant women admitted for delivery between 15 November 2002 and 15 February 2003 was measured. Data on socio-demographic characteristics, iron supplementation, malaria prophylaxis, blood transfusion during current pregnancy, and current and previous pregnancy outcomes were collected and analysed. Anaemia was classified according to the World Health Organization (WHO) standards: normal - Hb >11.0 g/dl; mild - Hb 9.0 - 10.9 g/dl; moderate - …

Proton Magnetic Resonance Spectroscopy In Multiple Sclerosis, Balasrinivasa R Sajja, Jerry S Wolinsky, Ponnada A Narayana

Faculty, Staff and Student Publications

Proton magnetic resonance spectroscopy ((1)H-MRS) provides tissue metabolic information in vivo. This article reviews the role of MRS-determined metabolic alterations in lesions, normal-appearing white matter, gray matter, and spinal cord in advancing our knowledge of pathologic changes in multiple sclerosis (MS). In addition, the role of MRS in objectively evaluating therapeutic efficacy is reviewed. This potential metabolic information makes MRS a unique tool to follow MS disease evolution, understand its pathogenesis, evaluate the disease severity, establish a prognosis, and objectively evaluate the efficacy of therapeutic interventions.

Oncolog Volume 54, Number 02, February 2009, Maude Veech, Joe Munch, Don Norwood

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

• Accelerated Partial Breast Irradiation: A Promising Adjuvant to Lumpectomy Acute Lymphoblastic Leukemia: Pediatric Regimens for Adolescents and
• House Call: Think About Your Medical Needs When Preparing for Natural Disasters
• Young Adults Yield Survival Advantages
• A New Biomarker for Bladder Cancer?