Medicine and Health Sciences Commons^™

Medial Temporal Lobe Roles In Human Path Integration, Naohide Yamamoto, John W. Philbeck, Adam J. Woods, Daniel A. Gajewski, Joeanna C. Arthur, Samuel J. Potolicchio, Lucien M. Levy, Anthony J. Caputy

Neurological Surgery Faculty Publications

Path integration is a process in which observers derive their location by integrating self-motion signals along their locomotion trajectory. Although the medial temporal lobe (MTL) is thought to take part in path integration, the scope of its role for path integration remains unclear. To address this issue, we administered a variety of tasks involving path integration and other related processes to a group of neurosurgical patients whose MTL was unilaterally resected as therapy for epilepsy. These patients were unimpaired relative to neurologically intact controls in many tasks that required integration of various kinds of sensory self-motion information. However, the same …

Targeting Therapy To The Neuromuscular Junction: Proof Of Concept, Linda L. Kusner, Namita Satija, Georgiana Cheng, Henry J. Kaminski

Pharmacology and Physiology Faculty Publications

Introduction: The site of pathology in myasthenia gravis (MG) is the neuromuscular junction (NMJ). Our goal was to determine the ability to direct complement inhibition to the NMJ.

Methods: A single-chain antibody directed against the alpha subunit of the acetylcholine receptor was synthesized (scFv-35) and coupled to decay-accelerating factor (DAF, scFv-35-DAF). scFv-35-DAF was tested in a passive model of experimentally acquired MG.

Results: Administration of scFv-35-DAF to mice deficient in intrinsic complement inhibitors produced no weakness despite confirmation of its localization to the NMJ and no evidence of tissue destruction related to complement activation. Rats with experimentally …

Evidence That Bdnf Regulates Heart Rate By A Mechanism Involving Increased Brainstem Parasympathetic Neuron Excitability, Ruqian Wan, Letitia A. Weigand, Ryan Bateman, Kathleen Griffioen, David Mendelowitz, Mark P. Mattson

Pharmacology and Physiology Faculty Publications

Autonomic control of heart rate is mediated by cardioinhibitory parasympathetic cholinergic neurons located in the brainstem and stimulatory sympathetic noradrenergic neurons. During embryonic development the survival and cholinergic phenotype of brainstem autonomic neurons is promoted by brain-derived neurotrophic factor (BDNF). We now provide evidence that BDNF regulates heart rate by a mechanism involving increased brainstem cardioinhibitory parasympathetic activity. Mice with a BDNF haploinsufficiency exhibit elevated resting heart rate, and infusion of BDNF intracerebroventricularly reduces heart rate in both wild-type and BDNF+/− mice. The atropine-induced elevation of heart rate is diminished in BDNF+/− mice and is restored by BDNF infusion, whereas …

Paying For Prescribed Drugs In Medicaid: Current Policy And Upcoming Changes, Brian K. Bruen, Katherine Young

Health Policy and Management Issue Briefs

Since the early 2000s, state Medicaid programs have made concerted efforts to control the cost of prescription drug spending. One crucial aspect in doing so is using a pharmacy reimbursement methodology that best reflects actual drug costs. Currently, states set pharmacy reimbursement policy within broad federal guidelines, resulting in a complex mix of reimbursement rules. Many states use list prices to set reimbursement levels, and these list prices increasingly have been criticized as not accurately reflecting the cost of the drug. Specifically, there are concerns that some benchmarks lead to inflated reimbursement levels. As a result, the federal government has …

The Impact Of School-Connected Behavioral And Emotional Health Interventions On Student Academic Performance, Olga Acosta Price, M. Biehl, C. Solomon, M. Weir

Health Policy and Management Faculty Publications

This annotated bibliography provides a systematic review of current literature published between 2001 and 2013 and summarizes findings on the relationship between prevention-focused behavioral health interventions, such as social and emotional (SEL) learning programs, and their impact on academic outcomes.

Manganese-Containing Prussian Blue Nanoparticles For Imaging Of Pediatric Brain Tumors, Matthieu F. Dumont, Sridevi Yadavilli, Raymond Sze, Javad Nazarian, Rohan Fernandes

Radiology Faculty Publications

Pediatric brain tumors (PBTs) are a leading cause of death in children. For an improved prognosis in patients with PBTs, there is a critical need to develop molecularly-specific imaging agents to monitor disease progression and response to treatment. In this paper, we describe manganese-containing Prussian blue nanoparticles as agents for molecular magnetic resonance imaging (MRI) and fluorescence-based imaging of PBTs. Our core-shell nanoparticles consist of a core lattice structure that incorporates and retains paramagnetic Mn²⁺ ions, and generates MRI contrast (both negative and positive). The biofunctionalized shell is comprised of fluorescent avidin, which serves the dual purpose of enabling …

Himmelfarb Headlines - May/June 2014, George Washington University, Himmelfarb Health Sciences Library

Himmelfarb Headlines (2009 - present)

News and information about Himmelfarb Health Sciences Library of interest to users. Includes articles on active learning, the Himmelfarb Art Show, and profiles of Marie Miller and Margaret Plack.

Himmelfarb Library Liaison Letter - May 2014, George Washington University, Himmelfarb Health Sciences Library

Himmelfarb Library Liaison Letters

No abstract provided.

Response To Androgen Therapy In Patients With Dyskeratosis Congenita, Payal P. Khincha, Ingrid M. Wentzensen, Neelam Giri, Blanche P. Alter, Sharon A. Savage

Pediatrics Faculty Publications

Dyskeratosis congenita (DC) is an inherited bone marrow failure syndrome and telomere biology disorder characterized by dysplastic nails, reticular skin pigmentation and oral leucoplakia. Androgens are a standard therapeutic option for bone marrow failure in those patients with DC who are unable to undergo haematopoietic stem cell transplantation, but there are no systematic data on its use in those patients. We evaluated haematological response and side effects of androgen therapy in 16 patients with DC in our observational cohort study. Untreated DC patients served as controls. Seventy percent of treated DC patients had a haematological response with red blood cell …

A Guide To Federal Education Programs That Can Fund K-12 Universal Prevention And Social And Emotional Learning Activities, Diane Stark Rentner, Olga Acosta Price

Center for Health and Health Care in Schools

No abstract provided.

Multidrug-Resistant And Methicillin-Resistant Staphylococcus Aureus (Mrsa) In Hog Slaughter And Processing Plant Workers And Their Community In North Carolina (Usa), Ricardo Castillo Neyra, Jose A. Frisancho, Jessica L. Rinsky, Carol Resnick, Karen C. Carroll, Ana M. Rule, Tracy Ross, Yaqi You, Lance B. Price, Ellen K. Silbergeld

Environmental and Occupational Health Faculty Publications

Background: Use of antimicrobials in industrial food-animal production is associated with the presence of antimicrobial resistant Staphylococcus aureus among animals and humans. Hog slaughter/processing plants process large numbers of animals from industrial animal operations, and are environments conducive to the exchange of bacteria between animals and workers.

Objectives: To compare the prevalence of methicillin-resistant S. aureus (MRSA) and multidrug resistant S. aureus(MDRSA) carriage between processing plant workers, their household members, and community residents.

Methods: We conducted a cross-sectional study of hog slaughter/processing plant workers, their household members, and community residents in North Carolina. Participants responded to a questionnaire and …

Yoga, Spaghetti Squash, Art Collages And Shooting Hoops? Building Sound Minds And Healthy Bodies In The Library, Alexandra Gomes, Gisela Butera, Laura E. Abate, Julie Silverman, Yvonne Lee

Himmelfarb Library Faculty Posters and Presentations

Recognizing that while students are learning to care for others, they are often taking poor care of themselves, librarians launched a Healthy Living initiative in the fall of 2012. Focusing on diet/nutrition, exercise, and stress reduction, the initiative included new collections and multiple activities with partners from both on- and off-campus.

Re-Building Our Collection: A Data & Department-Driven Approach To Monograph Assessment, George P. Paul, Yvonne Lee, Jolinda Thompson, Laura E. Abate, Julie Silverman, Anne Linton

Himmelfarb Library Faculty Posters and Presentations

No abstract provided.

Closing The Gap: Serving Nursing Students On A Separate Campus, Anne Linton, Laura E. Abate, Elaine Sullo, Steven W. Brown

Himmelfarb Library Faculty Posters and Presentations

No abstract provided.

Assessing The Impact Of Misclassification When Comparing Prevalence Data: A Novel Sensitivity Analysis Approach, Ninet Sinaii, Sean D. Cleary, Pamela Stratton

Epidemiology Faculty Publications

Background: A simple sensitivity analysis technique was developed to assess the impact of misclassification and verify observed prevalence differences between distinct populations.

Methods: The prevalence of self-reported comorbid diseases in 4,331 women with surgically-diagnosed endometriosis was compared to published clinical and population-based prevalence estimates. Disease prevalence misclassification was assessed by assuming over-reporting in the study sample and under-reporting in the general (comparison) population. Over- and under-reporting by 10%, 25%, 50%, 75%, and 90% was used to create a 5×5 table for each disease. The new prevalences represented by each table cell were compared by p-values, prevalence odds ratios, and 95% …

Health Care In The Motor City: Thriving Or Surviving?, Sally Coberly, William J. Scanlon

National Health Policy Forum

This site visit explored the forces shaping the delivery of health care in Detroit. Health care providers in Detroit face the twin challenges of controlling costs and serving a bifurcated metropolitan area that includes large numbers of uninsured, low-income, and vulnerable residents as well as more prosperous residents of a reviving inner core and the surrounding suburbs and counties. The program looked at the underlying economic, social, and physical conditions that make improving the health of the city's residents extremely challenging. Efforts to contain costs through payment innovations such as the Blue Cross Blue Shield of Michigan's Physician Group Incentive …

Suppression Of Basophil Histamine-Release And Other Ige-Dependent Responses In Childhood Schistosoma Mansoni Hookworm Co-Infection, Angela Pinot De Moira, Colin M. Fitzsimmons, Frances M. Jones, Shona Wilson, Pierre Cahen, Edridah Tukahebwa, Harriet Mpairwe, Joseph K. Mwatha, Jeffrey M. Bethony, Per S. Skov, Narcis B. Kabatereine, David W. Dunne

Microbiology, Immunology, and Tropical Medicine Faculty Publications

Background. The poor correlation between allergen-specific-IgE (asIgE) and clinical signs of allergy in helminth infected populations suggests that helminth infections could protect against allergy by uncoupling asIgE from its effector mechanisms. We investigated this hypothesis in Ugandan schoolchildren coinfected with Schistosoma mansoni and hookworm.

Methods. Skin prick test (SPT) sensitivity to house dust mite allergen (HDM) and current wheeze were assessed pre-anthelmintic treatment. Non-specific (anti-IgE), helminth-specific and HDM-allergen-specific basophil histamine release (HR), plus helminth- and HDM-specific IgE and IgG4 responses were measured pre- and post-treatment.

Results. Non-specific- and helminth-specific-HR, and associations between helminth-specific-IgE and helminth-specific-HR increased post-treatment. Hookworm infection appeared …

Culture-Independent Evaluation Of The Appendix And Rectum Microbiomes In Children With And Without Appendicitis, Hope T. Jackson, Emmanuel F. Mongodin, Katherine P. Davenport, Claire M. Fraser, Anthony D. Sandler, Steven L. Zeichner

Surgery Faculty Publications

Purpose

The function of the appendix is largely unknown, but its microbiota likely contributes to function. Alterations in microbiota may contribute to appendicitis, but conventional culture studies have not yielded conclusive information. We conducted a pilot, culture-independent 16S rRNA-based microbiota study of paired appendix and rectal samples.

Methods

We collected appendix and rectal swabs from 21 children undergoing appendectomy, six with normal appendices and fifteen with appendicitis (nine perforated). After DNA extraction, we amplified and sequenced 16S rRNA genes and analyzed sequences using CLoVR. We identified organisms differing in relative abundance using ANOVA (p

Results

We identified 290 taxa in …

Can Remote Monitoring Improve Quality Of Care In Heart Failure Patients With Implantable Cardioverter Defibrillators?, Jeanne Gargiulo

GW Research Days 2014

Abstract

Background:

Remote monitoring (RM) of Implantable Cardiac Defibrillators (ICDs) for the management of patients with heart failure (HF) is a reliable and feasible concept to prevent impending acute HF de-compensation.

Aim:

The design of this study was to determine the value of monthly cardiac devices interrogations for patients with ICDs as compared to quarterly in-office interrogations and to assess the anxiety level of both groups of patients at baseline and upon completions of the study.

Method:

This was a prospective single centered pilot clinical trial where patients were randomly allocated to the conventional quarterly face-to-face encounter (control group) or …

Leveraging User Data To Drive A Website Redesign, Michael Blake

GW Research Days 2014

Background: One of the most challenging aspects of redesigning an organization's website is balancing the needs of existing users while optimizing the experience for future users. This balance is especially crucial in academia where new users arrive every semester and may remain for anywhere from a year to a decade or more. When faced with the task of redesigning its website, GW's Himmelfarb Health Sciences Library conducted extensive user research in an attempt to design a site that preserved the positive aspects of the experience of existing users while improving their experience and reducing the learning curve for new users. …

Assessing The Impact Of Family Status, Family Cohesion, And Acculturation On Youth Violence Among Immigrant Latinos, Susan Lin, Sean D. Cleary, Mark Edberg

GW Research Days 2014

Background/Objectives: Latino youth violence is an emerging public health concern. The objective is to assess the impact of family status, family cohesion, and acculturation on youth violence among Latino immigrants in Langley Park, MD compared with a control community in Culmore, VA.

Methods: Constructs were generated from survey questions to represent family support and cohesion, acculturation, and youth violence. Bivariate and multivariate regression analyses were modeled to evaluate the relationships between family support and cohesion, acculturation, and violence, after adjusting for confounders.

Results: After controlling for covariates, family support consistently reduced victimization (PE = ‐0.02, SE = 0.01, t = …

Improving Anatomical Knowledge Retention In Medical Students Entering The Surgery And Obstetrics And Gynecology Clinical Rotations By Nesting Interactive Modules, Samantha Ahle, Jill Krapf, Kirsten Marie Brown, Juliet Lee, Gisela Butera, Ellen Goldman, Myriam Ferzli, Rosalyn A. Jurjus

GW Research Days 2014

Background: It is well documented in the medical education literature that students retain minimal anatomy knowledge when transitioning from pre-clinical didactics to clinical application on the wards. In a previous study at our own institution we were able to quantify this knowledge deficit in students on surgical clerkships, specifically surgery and obstetrics and gynecology (OB/GYN). Using our previous data, we designed an integrated, nested clinical teaching model utilizing e-modules to review clinically relevant surgical anatomy during their clinical rotations.

Objective: The goal of this study is to evaluate the impact of a newly designed method of teaching clinically relevant anatomy …

Intermediate-Term Results Of Extracorporeal Membrane Oxygenation Support Following Congenital Heart Surgery, Syed Murfad Peer, Dominic A. Emerson, John P. Costello, Michael K. Shu, David Zurakowski, Richard A. Jonas, John T. Berger, Dilip S. Nath

GW Research Days 2014

Background: Although there are considerable data regarding in-hospital results of congenital heart surgery patients requiring post-operative extracorporeal membrane oxygenation support, there is limited information on intermediate-term outcomes.

Methods: A single institution retrospective review of 25 consecutive post-operative congenital heart surgery patients who required extracorporeal membrane oxygenation and survived to hospital discharge between January 2003 and June 2008. Survival was estimated by the Kaplan-Meier method.

Results: At a median follow-up of 3.3 years (interquartile range: 1.2-5.9 years), there was 1 death which occurred at 6 months post-surgery. Kaplan-Meier estimated survival at 3 years was 95% (95% confidence interval: 90-100%). Indications for …

Neuroimaging Of Unusual Glioblastoma Using Diffusion Tensor Imaging, Akshita Mehta, Lucien M. Levy, M. Isabel Almira-Suarez, Raymond Tu

GW Research Days 2014

Background: Gliosarcoma refers to an uncommon astrocytic tumor of the central nervous system. These tumors include both glial and mesenchymal components by definition, and are extremely malignant. Gliosarcomas are particular to tumors with distinct gliomatous and sarcomatous constituents, and are distinguished from gliobastomas which have undergone mesenchymal metaplasia. Gliosarcomas encompass 2-8% of all glioblastoma cases and tend to occupy the supratentorial regions of the brain, especially the temporal lobe. Rare infratentorial lesions including the cerebellar hemisphere, intraventricular, and multi-focal tumors have also been reported. Accurate neuroimaging diagnosis is critical and diffusion tensor imaging (DTI) and spectroscopy can be useful to …

Bilateral Laparoscopic Partial Adrenalectomy: A Case Presentation And Review Of The Literature, Sean Satey, Nathan Richards, Frederick J. Brody

Surgery Faculty Publications

Laparoscopic adrenalectomy is the standard of care for benign adrenal diseases. Partial adrenalectomy has been performed for various tumors to preserve adrenal function while avoiding steroid supplements postoperatively. This article discusses a patient that underwent bilateral laparoscopic partial adrenalectomies for bilateral pheochromocytomas and reviews the literature on partial adrenalectomy. A 40-year-old woman with a recent diagnosis of hypertension and an emergent Caesarian section for pre-eclampsia presented to an outside clinic with labile blood pressure, diaphoresis, palpitations, and headache. Physical examination was unremarkable with no bruits appreciated in the neck or abdomen. Medical management of her hypertension was initiated with minimal …

Childhood Achalasia: A Comprehensive Review Of Disease, Diagnosis And Therapeutic Management, Ashanti L. Franklin, Mikael Petrosyan, Timothy D. Kane

Surgery Faculty Publications

Achalasia is an esophageal motility disorder characterized by failure of lower esophageal sphincter (LES) relaxation and is rare in children. The most common symptoms are vomiting, dysphagia, regurgitation, and weight loss. Definitive diagnosis is made with barium swallow study and esophageal manometry. In adults, endoscopic biopsy is recommended to exclude malignancy however; it is not as often indicated in children. Medical management often fails resulting in recurrent symptoms and the ultimate definitive treatment is surgical. Laparoscopic Heller myotomy with or without an anti-reflux procedure is the treatment of choice and has become standard of care for children with achalasia. Peroral …

Transoral Incisionless Fundoplication Effective In Eliminating Gerd Symptoms In Partial Responders To Proton Pump Inhibitor Therapy At 6 Months: The Tempo Randomized Clinical Trial, Karim S. Trad, William E. Barnes, Gilbert Simoni, Ahmad B. Shughoury, Peter G. Mavrelis, Mamoon Raza, Jeffrey Heise, Daniel G. Turgeon, Mark A. Fox

Surgery Faculty Publications

Background. Incomplete control of troublesome regurgitation and extraesophageal manifestations of chronic gastroesophageal reflux disease (GERD) is a known limitation of proton pump inhibitor (PPI) therapy. This multicenter randomized study compared the efficacy of transoral incisionless fundoplication (TIF) against PPIs in controlling these symptoms in patients with small hiatal hernias.

Methods. Between June and August 2012, 63 patients were randomized at 7 US community hospitals. Patients in the PPI group were placed on maximum standard dose (MSD). Patients in the TIF group underwent esophagogastric fundoplication using the EsophyX₂ device. Primary outcome was elimination of daily troublesome regurgitation or …

Venue-Based Recruitment Of Women At Elevated Risk For Hiv: An Hiv Prevention Trials Network Study, Danielle F. Haley, Carol E. Golin, Wafaa M. El-Sadr, James P. Hughes, Jing Wang, Irene Kuo, +13 Additional Authors

Epidemiology Faculty Publications

Background: The challenge of identifying and recruiting U.S. women at elevated risk for HIV acquisition impedes prevention studies and services. HIV Prevention Trials Network (HPTN) 064 was a U.S. multisite, longitudinal cohort study designed to estimate HIV incidence among women living in communities with prevalent HIV and poverty. Venue-based sampling (VBS) methodologies and participant and venue characteristics are described.

Methods: Eligible women were recruited from 10 U.S. communities with prevalent HIV and poverty using VBS. Participant eligibility criteria included age 18–44 years, residing in a designated census tract/zip code, and self-report of at least one high-risk personal and/or male sexual …

Use Of Excimer Laser For Morphea, Samah Hassan Hajjar, Sarah Beggs, Alison Ehrlich

GW Research Days 2014

Background and Objectives:

Morphea, also known as localized scleroderma, is a sclerotic inflammatory disorder that primarily affects the skin but has the potential to involve fascia, muscle and bones. With no cure for this disfiguring disease, therapeutic modalities including topical regiments, immunosuppressive agents, antimalarial medications, and phototherapy are used to manage the symptoms and progression. While many treatments options are available, they vary in efficacy.

Methods:

We present a case of a 28-year-old woman with active sclerotic plaques distributed along her neck, left flank. She had previously failed therapy with topical steroids and methotrexate, and was started on hydroxychloroquine 400 …

Redefining Frequent Emergency Department Users, Amy Waldner, Maria Raven, Danielle Lazar, Jesse Pines

Center for Health Care Quality

Frequent ED users are perceived to be a costly population that often abuse or misuse ED services due to a combination of unmet social needs and medical conditions that, in theory, could be treated outside of the ED at a lower cost. The reality is that factors contributing to frequent ED use are more varied and complex than originally believed.