Medicine and Health Sciences Commons^™

Botulinum Toxin Type-A In The Management Of Cerebral Palsy: Low Or High Dose?, Alper I. Dai, Mohammad Wasay

Department of Medicine

Cerebral palsy is the most common cause of severe physical disability in childhood. Spasticity is a common and disabling symptom for many patients with cerebral palsy. Therapy for spasticity is symptomatic with the aim of increasing functional capacity and relieving discomfort. Spasticity treatment by orally administered drugs and intramuscular chemodenervation agents has become more frequent. Most oral medications to treat spasticity have been inadequately studied in children, especially those with cerebral palsy. Since its first use in pediatric patients, reported in 1993, botulinum toxin (BTX-A), a relatively recent addition to the available medical interventions for children with cerebral palsy, has …

Treatment Evolution In High-Risk Congenital Diaphragmatic Hernia: Ten Years' Experience With Diaphragmatic Agenesis, Kevin P Lally, Pamela A Lally, Krisa P Van Meurs, Desmond J Bohn, Carl F Davis, Bradley Rodgers, Jatinder Bhatia, Golde Dudell

Faculty, Staff and Student Publications

OBJECTIVE: The objective of this study was to evaluate the impact of newer therapies on the highest risk patients with congenital diaphragmatic hernia (CDH), those with agenesis of the diaphragm.

SUMMARY BACKGROUND DATA: CDH remains a significant cause of neonatal mortality. Many novel therapeutic interventions have been used in these infants. Those children with large defects or agenesis of the diaphragm have the highest mortality and morbidity.

METHODS: Twenty centers from 5 countries collected data prospectively on all liveborn infants with CDH over a 10-year period. The treatment and outcomes in these patients were examined. Patients were followed until death …

Time To Renal Disease And End-Stage Renal Disease In Profile: A Multiethnic Lupus Cohort, Graciela S. Alarcón, Gerald Mcgwin, Michelle Petri, Rosalind Ramsey-Goldman, Barri J. Fessler, Luis M. Vilá, Jeffrey C. Edberg, John D. Reveille, Robert P. Kimberly

Faculty, Staff and Student Publications

BACKGROUND: Renal involvement is a serious manifestation of systemic lupus erythematosus (SLE); it may portend a poor prognosis as it may lead to end-stage renal disease (ESRD). The purpose of this study was to determine the factors predicting the development of renal involvement and its progression to ESRD in a multi-ethnic SLE cohort (PROFILE).

METHODS AND FINDINGS: PROFILE includes SLE patients from five different United States institutions. We examined at baseline the socioeconomic-demographic, clinical, and genetic variables associated with the development of renal involvement and its progression to ESRD by univariable and multivariable Cox proportional hazards regression analyses. Analyses of …

A Survey Of Primary Care Residents Regarding Knowledge Of Hepatitis C, Joseph L. Yozviak Do, Facp, Erini Vasiliadis Do, Sharon R. Kimmel Phd, Mha, Suzanne J. Templer Do, Margaret Hoffman-Terry Md, Facp

Department of Medicine

No abstract provided.

Endocarditis And Biofilm-Associated Pili Of Enterococcus Faecalis, Sreedhar R Nallapareddy, Kavindra V Singh, Jouko Sillanpää, Danielle A Garsin, Magnus Höök, Stanley L Erlandsen, Barbara E Murray

Faculty, Staff and Student Publications

Increasing multidrug resistance in Enterococcus faecalis, a nosocomial opportunist and common cause of bacterial endocarditis, emphasizes the need for alternative therapeutic approaches such as immunotherapy or immunoprophylaxis. In an earlier study, we demonstrated the presence of antibodies in E. faecalis endocarditis patient sera to recombinant forms of 9 E. faecalis cell wall-anchored proteins; of these, we have now characterized an in vivo-expressed locus of 3 genes and an associated sortase gene (encoding sortase C; SrtC). Here, using mutation analyses and complementation, we demonstrated that both the ebp (encoding endocarditis and biofilm-associated pili) operon and srtC are important for biofilm production …

Malignant Melanoma Metastacizing To The Thyroid Gland: A Case Report And Review Of The Literature, Brian Kung, Saba Aftab, Moira Wood, David Rosen

Department of Otolaryngology - Head and Neck Surgery Faculty Papers

Oral presentation 2006 AAO-H&NS Annual Meeting

Toronto, Canada September 17-20, 2006.

Objectives: The thyroid gland is a relatively uncommon site for secondary malignancy. Even lesscommon is metastasis of malignant melanoma to the thyroid gland. We present a case of malignantmelanoma metastatic to the thyroid gland presenting as thyroid enlargement.

Study Design: This is a case report which utilizes chart review, intraoperative photographs,radiographic images, and pathology slides.

Methods: A 68 year old patient with no prior evidence of primary skin melanoma presented witha neck mass which tested positive for melanoma. A year and a half following modified radical neckdissection, the patient …

Clinical Characteristics Of Pulmonary Tuberculosis In Adult Pakistani Patients With Co-Existing Diabetes Mellitus, A Jabbar, S F. Hussain, A A. Khan

Section of Pulmonary & Critical Care

A review was made of the records of all patients with pulmonary tuberculosis and diabetes mellitus admitted over a 5-year period to a teaching hospital in Karachi, Pakistan. Among 42358 patients, the total number with both tuberculosis and diabetes was 173. The prevalence of tuberculosis in diabetic patients was 10-times higher than in non-diabetic patients and prevalence increased with duration of diabetes. The lower lung field was most frequently involved, followed by the upper and middle. Bilateral involvement was seen in half and an associated pleural effusion in one-third of the patients. Cavitating lesions were seen in 32% of men …

Medical Education Digest, Vol. 8 No. 5 (September/October 2006), Nova Southeastern University

Medical Education Digest

No abstract provided.

Stroke-Related Complications Due To Delay In Seeking Medical Care: A Review Of 100 Cases, Asad Ali

Pakistan Journal of Neurological Sciences (PJNS)

No abstract provided.

Oncolog Volume 51, Number 09, September 2006, Dawn Chalaire, Angelique Siy, Christopher G. Wood Md

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

• Zeroing In on a Moving Target
• New Life for an Old Drug
• House Call: Managing Your Medications
• DiaLog: Adjuvant Therapy for Aggressive Kidney Cancer, by Christopher G. Wood, MD, Associate Professor of Urology and Cancer Biology

Surgical Correction Of Severe Bilateral Thumb Pincer-Nail Deformity, Scott T. Van Duzer, John S. Taras

Department of Orthopaedic Surgery Faculty Papers

A 53 year old woman presented to the office with complaint of severe bilateral thumb nail pain and the deformity shown (Figure 1). She denied previous trauma to her thumb nails and had no history of previous bacterial or fungal infections of her nails. Based on the curvature of her nails, which increased from proximal to distal, a diagnosis of bilateral thumb pincer nail deformity was made.

Evaluation Of Program Outcomes: Assessment In Children, Cheryl M. Romano

Loma Linda University Electronic Theses, Dissertations & Projects

In an age of increased concern for accountability and the review of services, administrators of health programs should be able to present their clinics effectiveness, and demonstrate their excellent service to the community, along with providing evidence for the continued need of such clinics. Outcome evaluation plays an integral part in providing this information, and is intended to provide information concerning the effectiveness of a particular program, thus allowing for modification, and even better outcomes.

This project addressed pre and post functioning in children referred for academic and/or behavioral difficulties, in a university of health sciences-based clinic. The aim was …

Implant Success In Distracted Bone Versus Autogenous Bone-Grafted Sites, Jeffrey Allan Elo

Loma Linda University Electronic Theses, Dissertations & Projects

Endosseous implants are the treatment of choice for restoring function and reconstructing edentulous areas of the maxilla and mandible. Alveolar defects can be reconstructed by either distraction osteogenesis or autogenous bone grafting. After alveolar reconstruction, endosseous implants are used to support and retain the prosthesis for restoration of form and function. We retrospectively analyzed the success rates of endosseous implant placement in distracted versus autogenous bone graft reconstruction sites in our patient population at Loma Linda University Medical Center, Department of Oral and Maxillofacial Surgery. 82 consecutive patients requiring alveolar augmentation prior to implant placement were evaluated. All patients were …

Operating On The Master Gland: 100consecutive Hypophysectomies At Aga Khan University Hospital, Karachi, Muhammad Shahzad Shamim, Faraz Khursheed, Muhammad Ehsan Bari

Pakistan Journal of Neurological Sciences (PJNS)

No abstract provided.

Mult-Slice Ct Scanning, Zafar Sajjad

Pakistan Journal of Neurological Sciences (PJNS)

No abstract provided.

Clinical Applications Of Polysomnography, Imran I. Ali

Pakistan Journal of Neurological Sciences (PJNS)

No abstract provided.

Sporadic Hemiplegic Migraine: A Challenging Diagnosis, Azra Zafar, Shahid Mustafa, Kaneez Aelia

Pakistan Journal of Neurological Sciences (PJNS)

No abstract provided.

Neurology, Mohammad Wasay

Pakistan Journal of Neurological Sciences (PJNS)

No abstract provided.

Psychiatry, Syed Ahmer

Pakistan Journal of Neurological Sciences (PJNS)

No abstract provided.

Central Nervous System Involvement Indengue Viral Infection, Romasa Channa, Mohammad Wasay

Pakistan Journal of Neurological Sciences (PJNS)

No abstract provided.

Neurosurgery, S. Ather Enam

Pakistan Journal of Neurological Sciences (PJNS)

No abstract provided.

Open Versus Laparoscopic Pyloromyotomy For Pyloric Stenosis: A Prospective, Randomized Trial., Shawn D. St Peter, G W. Holcomb Iii, Casey M. Calkins, J Patrick Murphy, Walter S. Andrews, Ronald J. Sharp, Charles L. Snyder, Daniel J. Ostlie

Manuscripts, Articles, Book Chapters and Other Papers

BACKGROUND: Pyloric stenosis, the most common surgical condition of infants, is treated by longitudinal myotomy of the pylorus. Comparative studies to date between open and laparoscopic pyloromyotomy have been retrospective and report conflicting results. To scientifically compare the 2 techniques, we conducted the first large prospective, randomized trial between the 2 approaches.

METHODS: After obtaining IRB approval, subjects with ultrasound-proven pyloric stenosis were randomized to either open or laparoscopic pyloromyotomy. Postoperative pain management, feeding schedule, and discharge criteria were identical for both groups. Operating time, postoperative emesis, analgesia requirements, time to full feeding, length of hospitalization after operation, and complications …

Cd80 And Cd86 Control Antiviral Cd8+ T-Cell Function And Immune Surveillance Of Murine Gammaherpesvirus 68, Shinichiro Fuse, Joshua J. Obar, Sarah Bellfy, Erica K. Leung, Weijun Zhang, Edward J. Usherwood

Dartmouth Scholarship

The interactions between CD80 and CD86 on antigen-presenting cells and CD28 on T cells serve as an important costimulatory signal in the activation of T cells. Although the simplistic two-signal hypothesis has been challenged in recent years by the identification of different costimulators, this classical pathway has been shown to significantly impact antiviral humoral and cellular immune responses. How the CD80/CD86-CD28 pathway affects the control of chronic or latent infections has been less well characterized. In this study, we investigated its role in antiviral immune responses against murine gammaherpesvirus 68 (MHV-68) and immune surveillance using CD80/CD86^−/− mice. In the …

Incorporating Endoscope In Middle Ear Surgery, Shehzad Ghaffar, Mubasher Ikram, Ahsan Raza

Section of Otolaryngology, Head & Neck Surgery

We conducted a study to evaluate the use of a pediatric rigid otoendoscope for determining the extent of middle ear disease and for assessing ossicular integrity and mobility during tympanoplasty. Our study population was made up of 132 patients who were undergoing surgery for the treatment of chronic suppurative otitis media; of this group, 41 patients underwent otoendoscopy and 91 underwent scutum lowering for purposes of visualization. In the otoendoscopy group, the ossicles were successfully visualized and their mobility assessed in 34 patients; the remaining 7 patients subsequently underwent scutum lowering. A 30° endoscope allowed for complete visualization of the …

Social Environment And Depression Among Pregnant Women In Urban Areas Of Pakistan: Importance Of Social Relations., Ambreen Kazi, Zafar Fatmi, Juanita Hatcher, Muhammad Masood Kadir, Unaiza Niaz, Gail A. Wasserman

Community Health Sciences

Aspects of the social environment, including social conditions (socio-economic status, household situations, chronic illnesses) and social relations (attitude and behaviors of relations) are major determinants of depression among women. This study evaluates the relative power of social relations and social conditions in predicting depression among pregnant women in Pakistan. In the qualitative phase of the study, social environmental determinants were identified through literature search, and experts' opinions from psychologists, psychiatrists, gynecologists, sociologists and researchers. Along with this, 79 in-depth interviews were conducted with pregnant women drawn from six hospitals (public and private) and two communities in Karachi, Pakistan. Identified determinants …

Minimizing Radiation Injury And Neoplastic Effects During Pediatric Fluoroscopy: What Should We Know?, Louis Kenneth Wagner

Faculty, Staff and Student Publications

Radiation-induced injuries from fluoroscopic procedures in pediatric patients have occurred, and young patients are at greatest risk of many radiation-induced neoplasms. Some fluoroscopists have been injured from their use of fluoroscopy, and they are known to be at risk of radiation-induced neoplasm when radiation is not well-controlled. This article reviews the circumstances that lead to radiation injury and delineates some procedural methods to avoid injury and limit radiation exposure to both the patient and the fluoroscopist.

Influence Of Common Orthodontic Appliances On Magnetic Resonance Imaging, Joseph Matthew Elison

Loma Linda University Electronic Theses, Dissertations & Projects

Magnetic resonance imaging (MRI) is an essential diagnostic tool in modern medicine. Conditions such as cerebral vascular accidents, epilepsy and other seizure disorders, autism, cancer, migraine and cluster headaches benefit from its use. It has been discovered that 4-10% of all children and adolescents will experience a seizure at some point (Hauser, 1994) and MRI is one of the most common imaging modalities for seizure and epilepsy diagnosis. Unfortunately, some orthodontic materials cause distortion on MR images. Radiologists would probably require the removal of any distortion-causing orthodontic appliance prior to MR imaging. It is questionable whether radiologists would be comfortable …

Ligand-Signaled Upregulation Of Enterococcus Faecalis Ace Transcription, A Mechanism For Modulating Host-E Faecalis Interaction, Sreedhar R Nallapareddy, Barbara E Murray

Faculty, Staff and Student Publications

Enterococcus faecalis, the third most frequent cause of bacterial endocarditis, appears to be equipped with diverse surface-associated proteins showing structural-fold similarity to the immunoglobulin-fold family of staphylococcal adhesins. Among the putative E. faecalis surface proteins, the previously characterized adhesin Ace, which shows specific binding to collagen and laminin, was detectable in surface protein preparations only after growth at 46 degrees C, mirroring the finding that adherence was observed in 46 degrees C, but not 37 degrees C, grown E. faecalis cultures. To elucidate the influence of different growth and host parameters on ace expression, we investigated ace expression using E. …

From Healing The Whole Person: An Argument For Therapeutic Touch As A Complement To Traditional Medical Practice, Marlene B. Huff, Kimberly K. Mcclanahan, Hatim A. Omar

Pediatrics Faculty Publications

The growing popularity and use of therapeutic touch (TT) is an issue that has generated controversy and concern within the medical community. While anecdotal and traditional scientific evidence suggest that TT would be an advantageous addition for clinics and hospitals to include in their armamentarium of complementary interventions within the realm of traditional medicine, TT has not become widely available in the U.S. One reason for the lack of availability may be the dearth of conclusive scientific support for TT's efficacy and, therefore, its inclusion in clinic and hospital treatment planning would give it the appearance of legitimate practice, which …

Pregnant Teenager Involvement In Sexual Activity And The Social Context, Maria José Carvalho Sant'anna, Júlia Kerr Catunda, Kepler Alencar Mendes Carvalho, Verônica Coates, Hatim A. Omar

Pediatrics Faculty Publications

Pregnancy during adolescence represents a challenge to society as a whole. Its incidence is increasing and brings about social and medical consequences to both the teen mothers and their children. The purpose of this study was to evaluate pregnant teenager involvement in sexual activity and the social context. The group studied comprised 152 pregnant teenagers attending the Department of Pediatrics, Santa Casa de Sao Paulo (SCSP) General Hospital. All information was analyzed. The age at first intercourse was 14.2 years and the average period between first intercourse and pregnancy was 1.4 years. Most pregnancies (75%) were neither planned nor wanted, …