Medicine and Health Sciences Commons^™

Department Of Radiology-Annual Executive Summary Report-July 1, 2000 To June 30, 2001, David C. Levin , M.D.

Department of Radiology Administrative Documents and Reports

101 page Department of Radiology Annual Executive Summary Report, July 1, 2000 to June 30, 2001, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania, United States.

Hormonal And Barrier Methods Of Contraception, Oncogenic Human Papillomaviruses, And Cervical Squamous Intraepithelial Lesion Development, Ann L. Coker, Laura C. Sanders, Sharon M. Bond, Tsilya Gerasimova, Lucia Pirisi

CRVAW Faculty Journal Articles

We assessed the influence of hormonal (oral, injectable, or levonorgestrel [Norplant, Wyeth-Ayerst, Philadelphia, PA]) and barrier methods of contraception on the risk of cervical squamous intraepithelial lesions (SIL), while adjusting for high-risk (HR) HPV infection. Subjects were women receiving family planning services through the state health department clinics from 1995 to 1998. We selected 60 cases with high-grade cervical/SIL (HSIL) and 316 with low-grade cervical/SIL (LSIL) and controls (427 women with normal cervical cytology) and analyzed cervical DNA for HR-HPV, using Hybrid Capture I (Digene; Gaithersburg, MD).When assessing ever use, duration, recency, latency, and age at first use, neither oral …

Cerumen Composition By Flash Pyrolysis-Gas Chromatography/Mass Spectrometry, Craig N. Burkhart, Michael A. Kruge, Craig G. Burkhart, Curtis Black

Department of Earth and Environmental Studies Faculty Scholarship and Creative Works

Objective: To assess the chemical composition of cerumen by flash pyrolysis-gas chromatography/mass spectrometry.

Study Design: Collected earwax specimens were fractionated into residue and supernatant by means of deoxycholate. This natural bile acid produces significantly better disintegration of earwax in vitro than do presently available ceruminolytic preparations, and also has demonstrated excellent clinical results in vivo to date.

Patients: The sample for analysis was obtained from a patient with clinical earwax impaction.

Results: The supernatant is composed of simple aromatic hydrocarbons, C₅-C_{l 7} straight-chain hydrocarbons, a complex mixture of compounds tentatively identified as diterpenoids, …

What Is The Relationship Between Activity, Social Support And Health-Related Quality Of Life In People Who Are Sixty Years Of Age And Older?, Jaqueline Ebbott

Theses : Honours

Over one third of individuals aged sixty years and older have health conditions which limit their ability to live an independent and active life. With the older Australian population increasing, the prevention of functional decline and preservation of wellbeing in this age group has become a major clinical focus in gerontology research. Therefore an important goal of health professionals is to identify behavioural factors which encourage wellbeing and quality of life in this age group. The purpose of the present study was to explore the importance of physical activity passive activity (activities such as craft, reading and board games) and …

Vital Signs, Winter 2001, Boonshoft School Of Medicine

Vital Signs

A twenty-three page newsletter created by the Boonshoft School of Medicine to document the current affairs of the school. This issue includes feature articles, a student profile, faculty notes, and more.

An Analysis Of Anemia And Child Mortality, B.J. Brabin, Zul Premji, F. Verhoeff

Pathology, East Africa

The relationship of anemia as a risk factor for child mortality was analyzed by using cross-sectional, longitudinal and case-control studies, and randomized trials. Five methods of estimation were adopted: 1) the proportion of child deaths attributable to anemia; 2) the proportion of anemic children who die in hospital studies; 3) the population-attributable risk of child mortality due to anemia; 4) survival analyses of mortality in anemic children; and 5) cause-specific anemia-related child mortality. Most of the data available were hospital based. For children aged 0-5 y the percentage of deaths due to anemia was comparable for reports from highly malarious …

Pneumoperitoneum Following Mechanical Ventilation In A Child, Fazal Hameed Khan, Nadeem Ahmad

Department of Anaesthesia

No abstract provided.

Department Of Radiation Oncology And Kimmel Cancer Center, Thomas Jefferson University, The Intronic G13964c Variant In P53 Is Not A High-Risk Mutation In Familial Breast Cancer In Australia., Anna Marsh, Amanda B Spurdle, Bruce C Turner, Sian Fereday, Heather Thorne, Gulietta M Pupo, Graham J Mann, John L Hopper, Joseph F Sambrook, Georgia Chenevix-Trench

Department of Radiation Oncology Faculty Papers

BACKGROUND: Mutations in BRCA1 and BRCA2 account for approximately 50% of breast cancer families with more than four affected cases, whereas exonic mutations in p53, PTEN, CHK2 and ATM may account for a very small proportion. It was recently reported that an intronic variant of p53--G13964C--occurred in three out of 42 (7.1%) 'hereditary' breast cancer patients, but not in any of 171 'sporadic' breast cancer control individuals (P = 0.0003). If this relatively frequent occurrence of G13964C in familial breast cancer and absence in control individuals were confirmed, then this would suggest that the G13964C variant plays a role in …

Oncolog, Volume 46, Number 01, January 2001, Kerry L. Wright, Dawn Chalaire, Emil J. Freireich Md

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

• New Melanoma Staging System Reflects Key Prognostic Factors
• House Cell: Preventing Cancer: Food for Thought
• Educational Conferences Explore Issues Related to Cancer Care and Research
• DiaLog: Leukemia: Setting the "Stage" for Effective Treatments, by Emil J. Freireich, MD, Professor, Department of Leukemia
• Updated M. D. Anderson Website Designed to Meet the Online Needs of Patients and Physicians

Epidemiological Features Of Aplastic Anaemia In Pakistan, Salman Adil, G. N. Kakepoto, Mohammad Khurshid, I. A. Burney

Department of Pathology and Laboratory Medicine

Objective: To complete the data on the demographic features of patients diagnosed to have aplastic anemia at a single institution over a 7.5 years period. Methods: Demographic information was retrieved from the patients medical records retrospectively as well as prospectively of those patients who presented with features of aplastic anaemia. Their diagnosis was confirmed by performing a complete blood count and bone marrow trephine.
Results: One hundred and forty four patients were diagnosed to have aplastic anemia; there were 106 males and 38 females. Their ages ranged from 2 to 75 years, with a median of 17 years, …

Impaired Splenic Function In Systemic Amyloidosis: Diagnostic Importance Of Peripheral Blood Film, F. Bilwani, Salman Adil, G. N. Kakepoto, Mohammad Khurshid, A. Ahmed

Department of Pathology and Laboratory Medicine

We describe case of a 40 year old male, who went on to developed systemic amyloidosis 3 years after the diagnosis of chronic renal failure. The diagnosis of systemic amyloidosis was suspected upon a routine examination of periheral blood film showing features of hyposlenism. We would like to highlight the importance of examination of pheripheral blood film in patients with renal failure for the diagnosis of extensive systemic amyloidosis which occasionally leads to functional hyposplenism, recognized by the presence of abnormal red cell morphology and reduced splenic uptake on isotope scan¹.

Reovirus 1/L As A Model To Study The Induction Of Optimal Immunity At Mucosal And Systemic Sites, Sherry Renee Crowe

MUSC Theses and Dissertations

Achieving protective immunity at mucosal sites is critically important for effective immunization against pathogens that colonize the host via the wet epithelium. We utilized reovirus 1/L infection of mice to study immunization strategies for the induction of optimal humoral and cell-mediated immunity at mucosal surfaces. The humoral and cell-mediated responses at mucosal and systemic sites were monitored following upper respiratory tract, or systemic inoculation. Utilizing these models, we found that the combined upper and lower respiratory tract inoculation resulted in optimal humoral immunity proximally (in the respiratory tract), distrally (in the oral, gastrointestinal, and urogenital tracts), and systematically. This immune …

Physician Assistant Class Of 2001, Philadelphia College Of Osteopathic Medicine

All Yearbooks

Includes the White Coat Ceremony, Retreat at Camp Ockanickon, National Physician Assistant Day 1999, Classroom candids.

Digest Of The Philadelphia College Of Osteopathic Medicine (Winter 2001), Philadelphia College Of Osteopathic Medicine

Digest

The Winter 2001 issue of the Digest of the Philadelphia College of Osteopathic Medicine includes the following articles:

• Opening Remarks
• In the Mail
• PCOM Updates
• Meet the Prez
• This Doctor Gets Personal
• Founders Day Honorees
• PCOM MEDNet
• Board Profile
• Alumni Board Profile
• Off to Camp – With Some Very Special Children
• Class Notes
• In Memoriam
• My Turn: New Essay Section
• 2^nd Annual PCOM Alumni Weekend
• Coming Events

Cellular Senescence: Ex Vivo P53-Dependent Asymmetric Cell Kinetics., Lakshmi Rambhatla, Shirley A. Bohn, Patrizia B. Stadler, Jonathan T. Boyd, Ronald A. Coss, James L. Sherley

Department of Radiation Oncology Faculty Papers

Although senescence is a defining property of euploid mammalian cells, its physiologic basis remains obscure. Previously, cell kinetics properties of normal tissue cells have not been considered in models for senescence. We now provide evidence that senescence is in fact the natural consequence of normal in vivo somatic stem cell kinetics extended in culture. This concept of senescence is based on our discovery that cells engineered to conditionally express the well-recognized tumor suppressor protein and senescence factor, p53, exhibit asymmetric cell kinetics. In vivo, asymmetric cell kinetics are essential for maintenance of somatic stem cells; ex vivo, the same cell …

Cardiac Hypertrophy, Heart Failure, And Regulation Of Microtubule Stability, Kristie Lynn Beaton-Blade

MUSC Theses and Dissertations

This work focused on the regulation of the different isotypes of beta-tubulin during cardiac hypertrophy, with the specific hypothesis that increased levels of the beta I isotype leads to the increase in microtubule density seen during hypertrophy. Partial cDNAs for the three beta-tubulin isotypes expressed in the heart (I, II, and IV) have been cloned and used to show that there is a differential upregulation of the beta I and beta II isotypes during cardiac hypertrophy. Messenger RNA half-life studies of cells isolated from hypertrophied myocardium have shown that this upregulation is due to increased transcription of the genes encoding …

West Bank And Gaza: Stress The Importance And Cost-Effectiveness Of Postpartum Care, Frontiers In Reproductive Health

Reproductive Health

To assess maternal health care in the West Bank and Gaza, the Health, Development, Information, and Policy Institute conducted a study from May to August 2000. This study served as a baseline for the Pilot Health Project (PHP), which seeks to improve antenatal and postpartum services in three areas of the West Bank and Gaza. Seven local and international agencies are implementing PHP in collaboration with the Palestinian Ministry of Health and with funding from the U.S. Agency for International Development. Data sources for the baseline study consisted of service statistics, interviews with health-care providers, and exit interviews with antenatal, …

Cisjordania Y Gaza: Subraye La Importancia De La Atención Postparto Y Su Cost-Efectividad, Frontiers In Reproductive Health

Reproductive Health

El Instituto de Salud, Desarrollo, Información y Políticas realizó un estudio de mayo a agosto de 2000 para evaluar la atención a la salud materna en Cisjordania y Gaza. Dicho estudio sirvió de línea basal para el Proyecto Piloto de Salud (PHP, por sus siglas en inglés), cuyo objetivo es mejorar los servicios prenatales y postparto en tres áreas de esa región. Siete agencias locales e internacionales implementan el PHP con la colaboración del Ministerio de Salud palestino y el patrocinio de la Agencia de los Estados Unidos para el Desarrollo Internacional. Las fuentes de la información para el estudio …

Reproductive Tract Infections: A Guide For Programme Managers, Sarah Hawkes, Anjali Nayyar, Johannes Van Dam, Kevin R. O'Reilly, Bidia Deperthes, Dinesh Agarwal

Reproductive Health

Reproductive tract infections (RTIs) including sexually transmitted infections represent a silent worldwide pandemic that adversely impacts the reproductive health (RH) of women and men. Various community- and hospital-based studies in India have provided insights into the magnitude of the problem. The International Conference on Population and Development (1994) emphasized integration of RH services to meet the needs of men and women especially with prevention and management of RTIs/STIs. The emergence of HIV and the identification of STIs as a risk factor for the spread of HIV have further lent a sense of urgency for a programmatic response to address this …

A Noninvasive Test For Vesico-Ureteric Reflux In Children, R. A. Mevorach, B. Cilento, S. Zahorian, C. Badgett, R. Walker, A. Atala, S. Iannello, M. Meyer

Electrical & Computer Engineering Faculty Publications

Objective To report the development and testing of a device for the noninvasive diagnosis of vesico‐ureteric reflux (VUR) which avoids the need for urethral catheterization (currently required to reliably determine the presence of VUR), and which thus avoids the anxiety of parents and patients that causes many families to refuse such evaluation.

Patients and methods Fifty‐four children (49 girls and five boys, mean age 7.2 years, range 4–14) previously evaluated as having VUR volunteered to participate; no child was symptomatic at the time of the study. Refluxing units were known to be present by voiding cysto‐urethrography (within 1 year, mean …

Synaptopodin Expression In Idiopathic Nephrotic Syndrome Of Childhood., Tarak Srivastava, Robert E. Garola, J M. Whiting, Uri S. Alon

Manuscripts, Articles, Book Chapters and Other Papers

BACKGROUND: Synaptopodin is a proline-rich protein intimately associated with actin microfilaments present in the podocytes' foot processes. We investigated for synaptopodin expression in children with idiopathic nephrotic syndrome (INS), including minimal change disease (MCD), diffuse mesangial hypercellularity (DMH), and focal segmental glomerulosclerosis (FSGS); in children with congenital nephrotic syndrome of the Finnish type (CNF); and in normal kidney tissue. In particular, we examined whether an association exists between synaptopodin expression in podocyte cells and the response to steroids in INS, and whether synaptopodin expression can predict FSGS upon the initial kidney biopsy in children who progress from MCD or DMH …

Fluoroscopic Placement Of Double-Pigtail Ureteral Stents., Gregory L. Chen, Demetrius H. Bagley

Department of Urology Faculty Papers

Purpose: Double-pigtail ureteral stent is placed cystoscopically after ureteroscopy. We describe a technique for fluoroscopic placement of ureteral stents and demonstrate its use in a non-randomized prospective study.Materials and methods: Double-pigtail stents were placed either fluoroscopically or cystoscopically in 121 consecutive patients. In the fluoroscopic method, the stent was placed over a guide wire using a stent pusher without the use of cystoscopy. Conversely, stents were placed through the working channel of the cystoscope under vision. The procedure, stent length, width, type, method, ureteral dilation, and use of a retrieval string were noted.Results: A wide range of stent sizes were …

Female Genital Tuberculosis Revisted, R N. Qureshi, S Samad, R Hamid, S F. Lakha

Department of Obstetrics & Gynaecology

Objective: To assess the clinical presentation of genital tuberculosis and to study various modes of diagnosis and treatment.SETTING: The Aga Khan University Hospital (AKUH), Karachi.
Method: A retrospective case review of all index female cases of genital tuberculosis, admitted to AKUH over twelve years of period.
Result: A total of 40 cases of genital tuberculosis were reported during this time period. Majority of cases were between 25-45 years. The commonest presenting symptoms were infertility (42.5%) and abdominal pain (42%). Others included fever, ascites, irregular vaginal bleeding, oligomenorrhea, chest pain and pain in the flanks. Main mode of treatment was antituberculous …

Physician Assisted Suicide Perceptions Among Patients Presenting To Family Physicians At A Teaching Hospital In Karachi, Pakistan, Waris Qidwai, H. Qureshi, S. S. Ali, M. Alam, S. I. Azani

Department of Family Medicine

Objective: To study the perceptions on physician assisted suicide, among patients presenting to family physicians, at a teaching hospital in Karachi, Pakistan.
Method: The study was carried out at the Community Health Center of The Aga Khan University Hospital, Karachi, between December 1999 and May 2000. The principal and co-investigators filled a pre-coded and pre­tested questionnaire consisting of important demographic characteristics and bio-medical ethics issues. A system of convenience sampling was used and a written consent was taken from respondents over the age of 16 years, who agreed to participate. The data were managed by using the Epi …

Cigarette Sources For Teens By Grade: Implications For Prevention And Intervention, Netra M. Thakur, Michael P. Rosenthal, Priscilla Latta, Jamie L. Robinson, James Diamond

Department of Family & Community Medicine Faculty Papers

Objective: To identify at-risk teen populations and their sources of cigarettes, in order to help target future efforts in prevention of teen smoking. Methods: Analysis of smoking behavior questions for students in grades 6, 7, 9 and 12 from the 1997 Pennsylvania Biennial Youth Risk Survey. Results: Current smoking prevalence was 20.9% overall. The number of ninth grade smokers was almost five times higher than the number of sixth grade smokers (30.6% vs. 6.6%). Seventy-three percent of the teens identified friends as a source of tobacco. Stores became the most common source for twelfth graders only. Conclusion: Teenage smoking remains …

Beyond Pain Management: A Primer For Providing Quality End-Of-Life Care, Linda P. Tomko, Terri L. Maxwell

Department of Family & Community Medicine Faculty Papers

Providing excellent care for a dying patient is something all patients deserve. Hospices and palliative care centers exist in many areas to aid primary care physicians and patients through this difficult time. It is important to remember that most patients want to prepare for death, if at all possible. Everyone does this in his or her own way, but oftentimes concern about pain and symptom management interfere with this very involved and valuable process. Being prepared to treat these symptoms as well as addressing your patient's emotional needs is imperative. Referral to a hospice, if possible, will only strengthen the …

Anatomical Variations Of Internal Jugular Vein As Seen By "Site Rite Ii" Ultrasound Machine--An Initial Experience In Pakistani Population, Hameedullah, M. A. Rauf, Fazal Hameed Khan

Department of Anaesthesia

Objective: To determine the anatomical variations of the internal jugular vein (IJV) in Pakistani adult population with the help of Site Rite II ultrasound machine.
Material and Method: The right IJV relation to the carotid artery was visualized at four different landmarks (angle of the mandible, thyroid cartilage, cricoid cartilage, and the supraclavicular area). Size of IJV in comparison to carotid artery was also seen.
Results: In 49 cases the IJV was found in aberrant relation to carotid artery at the angle of the mandible (p value
Conclusion:Care should be taken while cannulating IJV at the angle of the …

Acute Haemolysis In Childhood Falciparum Malaria, H. Ekvall, P. Arese, F. Turrini, K. Ayi, F. Mannu, Zul Premji, A. Bjorkman

Pathology, East Africa

Acute haemolysis associated with clinical episodes of high-level Plasmodium falciparum parasitaemia was studied in 20 children from an holoendemic area (coastal Tanzania). The change in blood haemoglobin (Hb) concentration ranged from -46 to +5 g/L during the 72-h observation period and was linearly related to maximum parasitaemia. Balance studies between loss of blood Hb, increase in plasma Hb and appearance of Hb in the urine indicated that extravascular clearance of red cells was the predominant mode of erythrocyte clearance. Most subjects, however, showed minor signs of intravascular haemolysis. The plasma Hb was ≪1% of blood Hb and haemoglobinuria was detected …

Hemoglobin Concentration In Children In A Malaria Holoendemic Area Is Determined By Cumulated Plasmodium Falciparum Parasite Densities, H. Ekvall, Zul Premji, S. Bennett, A. Bjorkman

Pathology, East Africa

In malaria holoendemic areas children are anemic, but the exact influence of falciparum malaria on hemoglobin (Hb) concentration remains largely unsettled. Prospective data were therefore collected in children < 24 months of age during five months in a Tanzanian village. Children with mean asymptomatic parasitemia ≥ 400/μl had lower median Hb levels during the study than those with mean density < 400/μl. The difference was 9.7 g/L (95% confidence interval [CI] 2.8-17). In children with one or more clinical malaria episodes, the median Hb was 8.3 g/L (95% CI 0.9-16) lower than those without episode. If early treatment failure was recorded, the immediate effect on Hb was particularly important with a mean drop of 17 g/L. Interestingly, at study-end the Hb concentration represented a function of the area under the parasitemia curve (AUPC) during the previous five months, adjusting for age. In conclusion, stepwise deterioration in median Hb levels was found by asymptomatic parasitemia, clinical malaria episode, and most significantly, treatment failure.

Hearing Screening Of Infants Using Evoked Otoacoustic Emissions : The Effect Of External And Middle Ear Conditions, P. K. Vanaja P. K. Krishna Poduval

Student Works (2000-2009)

The aim of the study was to determine if Transient Evoked Otoacoustic Emissions (TEOAEs) can be used as a method of Screening for hearing impairment and to study the effects of External and Middle ear conditions on the outcome of TEOAEs. TEOAE and Tympanometry tests were performed on 193 infants (386 ears). External and Middle ear abnormalities were evaluated by ear examinations and Tympanometry, and assigned to two groups based on the tympanogram results. Group A had normal external and middle ear with 'Type A' Tympanograms and group B with external and/ middle ear abnormalities and abnormal tympanograms other than …