Medicine and Health Sciences Commons^™

A National Estimate Of The Cost Of Illness In Parkinson's Disease Using Retrospective Data Analysis, Katherine Anderson

Theses and Dissertations (ETD)

The purpose of this study was to estimate the cost of illness of Parkinson’s disease in the United States. Direct medical expenditures, with the exception of nursing home costs, were estimated using data from the 1999-2003 Medical Expenditures Panel Survey Household Component (MEPS-HC). Nursing home costs were estimated using the Medical Expenditures Panel Survey Nursing Home Component (MEPS-NHC). Indirect costs for lost productivity due to missed work or bed-days (morbidity) were estimated using the MEPS-HC and the Bureau of Labor Statistics (BLS). Indirect costs for lost productivity due to death (mortality) were estimated using the National Vital Statistics System.

Direct …

Handling The News, Kenneth P. Serbin

At Risk for Huntington's Disease

No abstract provided.

Cerebral Venous Thrombosis: Recent Advances And Need For An Asian Registry, Mohammad Wasay, Ayeesha K. Kamal

Department of Medicine

No abstract provided.

Mechanism Of Neuronal Injury In Cerebral Venous Thrombosis, Uzma Usman, Mohammad Wasay

Department of Medicine

The impact of CVT on the brain is wide spectrum, ranging from completely normal parenchyma to brain oedema and/or haemorrhage. Multiple factors relate to neuronal injury in CVT including; dural sinus pressure, increased venous flow velocities, collateralization of venous channels, rate of occlusion, development of cytotoxic and vasogenic oedema, recanalization and accelerated myelination. It is suggested that recanalization of occluded vein, as well as, the presence or absence and the efficiency of intracranial venous collaterals, may have an impact on the extent of brain tissue damage and hence the prognosis of acute CVT.

Mourning Mom, Kenneth P. Serbin

At Risk for Huntington's Disease

No abstract provided.

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 …

Central Nervous System Involvement In Dengue Viral Infection, Romasa Channa, Mohammad Wasay

Department of Medicine

Neurological manifestations of dengue infection are rare. This review includes data regarding the epidemiology of the disease, neurological manifestations,pathogenesis, diagnosis and prognosis. It is based on 9 original articles and 10 case reports, adding up to 200 cases of dengue fever with neurological manifestations. Relevant cases have been reported from Asia, the Pacific rim, the Americas, the Mediterranean region, and Africa. A wide range of neurological manifestations has been reported. Altered consciousness and seizure are among the more common manifestations. The exact pathogenesis of this disease has not yet been established. However, recent studies hypothesize that the virus is neurotropic. …

Wernekink Comissure Syndrome: A Rare Midbrain Syndrome Secondary To Stroke, Alper I. Dai, Mohammad Wasay

Department of Medicine

Wernekink commissure involves the decussation of superior cerebellar peduncle (SCP) in midbrain. We report an elderly hypertensive, diabetic man who developed slurred speech, ataxia, and internuclear ophthalmoplegia. MRI examination revealed an unusual ischemic stroke involving Wernekink commissure. This rare stroke pattern involving decussation of SCP occurs in the setting of small arterial disease. The association between the anatomic location of the stroke and clinical findings is noteworthy.

Abdominal Pain With Rigidity Secondary To The Anti-Emetic Drug Metoclopramide, Nadeem Ullah Khan, Junaid A. Razzak

Department of Emergency Medicine

We report a case of abdominal pain with rigidity, mimicking an acute abdomen, caused by metoclopramide, a common anti-emetic drug. Extrapyramidal symptoms are commonly reported side-effects of this medication. They generally include involuntary movements of limbs, torticollis, oculogyric crisis, rhythmic protrusion of tongue, trismus, or dystonic reactions resembling tetanus, etc. Abdominal rigidity due to this medication, resembling an acute abdomen, has not been reported previously. This case report illustrates the importance of considering medication side-effects when evaluating a patient with abdominal pain and rigidity.

Heme Deficiency In Alzheimer's Disease: A Possible Connection To Porphyria, Barney E. Dwyer, Meghan L. Stone, Xiongwei Zhu, George Perry, Mark A. Smith

Dartmouth Scholarship

Mechanisms that cause Alzheimer's disease (AD), an invariably fatal neurodegenerative disease, are unknown. Important recent data indicate that neuronal heme deficiency may contribute to AD pathogenesis. If true, factors that contribute to the intracellular heme deficiency could potentially alter the course of AD. The porphyrias are metabolic disorders characterized by enzyme deficiencies in the heme biosynthetic pathway. We hypothesize that AD may differ significantly in individuals possessing the genetic trait for an acute hepatic porphyria. We elaborate on this hypothesis and briefly review the characteristics of the acute hepatic porphyrias that may be relevant to AD. We note the proximity …

Saying Good-Bye To Mom, Kenneth P. Serbin

At Risk for Huntington's Disease

No abstract provided.

Should Mom Get A Feeding Tube?, Kenneth P. Serbin

At Risk for Huntington's Disease

No abstract provided.

Neuroleptic Malignant Syndrome: Need For Early Diagnosis And Therapy, Humaira M. Khan, Nadir A. Syed, Mughis Sheerani, Bhojo Khealani, Ayeesha Kamal, Mohammad Wasay

Department of Medicine

Background: Neuroleptic Malignant Syndrome (NMS) is a medical entity that has received little attention in the clinical settings in Pakistan. The aim of our study was to review the predisposing factors, outcomes and characteristics of in-patients diagnosed with NMS.

Methods: We performed a retrospective chart review of all cases (age > 15 years) at a tertiary care center in Karachi between January 01, 1990 and November 30, 2001, diagnosed using ICD 10 coding. Data was collected using a standardized data entry form and statistical analysis was performed using Epi Info 6, Version 6.02.

Results: There were a total of 20 patients …

Eliciting Facial Expressions In Children With And Without Down Syndrome, Orietta Coz

Master's Theses

This study investigated facial expressions of children between the ages of 10 and 15 years with Down Syndrome (experimental group) and compared them to typically developing children (control group). Elicitation of facial expressions was carried out through showings of video clips. Trained observers were used to code expressions of happiness, anger, and disgust from video recordings that were made of the children’s reactions while they watched the video clips.

I hypothesized that Down Syndrome children will not differ from typically developing children in the frequency of elicited happy expressions. However, I expected them to differ in the frequency of elicited …

Connexin Overexpression Differentially Suppresses Glioma Growth And Contributes To The Bystander Effect Following Hsv-Thymidine Kinase Gene Therapy, T. Jiminez, W. Fox, C. Naus, J. Galipeau, Daniel Belliveau

Daniel J. Belliveau

Neoplastic transformation is frequently associated with a loss of gap junctional intercellular communication and reduced expression of connexins. The introduction of connexin genes into tumor cells reverses the proliferative characteristics of such cells. However, there is very little comparative information on the effects of different connexins on cancer cell growth. We hypothesized that Cx26, Cx32, or Cx43 would display differential growth suppression of C6 glioma cells and uniquely modulate the bystander effect following transduction of C6 cells with HSVtk followed by suicide gene therapy. The bystander phenomenon is the death of a greater number of tumor cells than are expressing …

Enhanced Neurite Outgrowth In Pc12 Cells Mediated By Connexin Hemichannels And Atp, Daniel Belliveau, M. Bani-Yagoub, R. Mcgirr, C. Naus, W. Rushlow

Daniel J. Belliveau

Gap junctions have traditionally been described as transmembrane channels that facilitate intercellular communication via the passage of small molecules. Connexins, the basic building blocks of gap junctions, are expressed in most mammalian tissues including the developing and adult central nervous system. During brain development, connexins are temporally and spatially regulated suggesting they play an important role in the proper formation of the central nervous system. In the current study, connexins 32 and 43 were overexpressed in PC12 cells to determine whether connexins are involved in neuronal differentiation. Both connexin 32 and 43 were appropriately trafficked to the cell membrane following …