Medicine and Health Sciences Commons^™

Reintegration Of Child Soldiers In Burundi: A Tracer Study, Mark J.D. Jordans, Ivan H. Komproe, Wietse A. Tol, Aline Ndayisaba, Theodora Nisabwe, Brandon A. Kohrt

Psychiatry and Behavioral Sciences Faculty Publications

No abstract provided.

Moyamoya Disease In Pregnancy: Management After Intracranial Bypass Grafting, Alexis C. Gimovsky, Charles Macri, Susanne L. Bathgate, D. E. Ross

Obstetrics and Gynecology Faculty Publications

Moyamoya disease (MD) is a chronic, progressive cerebrovascular disease distinguished by bilateral stenosis or occlusion of the arteries around the circle of Willis with resulting prominent arterial collateral circulation. We describe a pregnant woman in whom this diagnosis was confirmed by cerebral angiogram and treated with bilateral superficial temporal artery-middle cerebral artery (STA-MCA) bypass grafting prior to conception. The patient was managed with strict blood pressure monitoring and low-dose aspirin antepartum, intrapartum, and postpartum. The patient presented in spontaneous labor at term and underwent a spontaneous vaginal delivery without complications.

Physiologically Based Pharmacokinetic Modeling In Pediatric Drug Development: A Clinician's Request For A More Integrated Approach., Karel M. Allegaert, Anne Smits, John N. Van Den Anker

Pediatrics Faculty Publications

No abstract provided.

Hypertension-Related Gene Polymorphisms Of G-Protein-Coupled Receptor Kinase 4 Are Associated With Nt-Probnp Concentration In Normotensive Healthy Adults, Junichi Yatabe, Midori S. Yatabe, Minoru Yoneda, Robin A. Felder, Pedro A. Jose, Hironobu Sanada

Pediatrics Faculty Publications

G protein-coupled receptor kinase 4 (GRK4) with activating polymorphisms desensitize the natriuric renal tubular D1 dopamine receptor, and these GRK4 polymorphisms are strongly associated with salt sensitivity and hypertension. Meanwhile, N-terminal pro-B-type natriuretic peptide (NT-proBNP) may be useful in detecting slight volume expansion. However, relations between hypertension-related gene polymorphisms including GRK4 and cardiovascular indices such as NT-proBNP are not clear, especially in healthy subjects. Therefore, various hypertension-related polymorphisms and cardiovascular indices were analyzed in 97 normotensive, healthy Japanese adults. NT-proBNP levels were significantly higher in subjects with two or more GRK4 polymorphic alleles. Other hypertension-related gene polymorphisms, such as those …

Hiv-1 Resistant Cdk2-Knockdown Macrophage-Like Cells Generated From 293t Cell-Derived Human Induced Pluripotent Stem Cells, Marina Jerebtsova, Namita Kumari, Min Xu, Gustavo Brito Alvim De Melo, Xiaomei Niu, Kuan-Teh Jeang, Sergei Nekhai

Pediatrics Faculty Publications

A major challenge in studies of human diseases involving macrophages is low yield and heterogeneity of the primary cells and limited ability of these cells for transfections and genetic manipulations. To address this issue, we developed a simple and efficient three steps method for somatic 293T cells reprogramming into monocytes and macrophage-like cells. First, 293T cells were reprogrammed into induced pluripotent stem cells (iPSCs) through a transfection-mediated expression of two factors, Oct-4 and Sox2, resulting in a high yield of iPSC. Second, the obtained iPSC were differentiated into monocytes using IL-3 and M-CSF treatment. And third, monocytes were differentiated into …

Evaluation Of Sedimentation Rate Methodology Reveals An Unusual Pediatric Subpopulation With Lupus Or Lupus-Like Syndrome And Hemolytic Anemia, Edward C. Wong, Deborah Yuan, Claas Hinze, Lawrence Jung

Pediatrics Faculty Publications

Purpose

Sedimentaion rate is often used to manage pediatric patients with rheumatologic disease. Most management decisions are dependent on studies which have used Wintrobe or Westergren sedimentation rate methodologies. However, these methods suffer from the need for relatively large amounts of blood and long turn-around times. Determination of sedimentation rate using laser kinetic rate determination has allowed calibration to Westergren methods, low volume of blood needed for testing and very rapid results. We sought to compare the Wintrobe method to the ESR Stat method (kinetic method; HemaTechnologies, Lebanon NJ) to determine suitability of the ESR Stat method for patient testing. …

The Test Characteristics Of Head Circumference Measurements For Pathology Associated With Head Enlargement: A Retrospective Cohort Study, Carrie Daymont, Moira Zabel, Chris Feudtner, David M. Rubin

Pediatrics Faculty Publications

Background

The test characteristics of head circumference (HC) measurement percentile criteria for the identification of previously undetected pathology associated with head enlargement in primary care are unknown.

Methods

Electronic patient records were reviewed to identify children age 3 days to 3 years with new diagnoses of intracranial expansive conditions (IEC) and metabolic and genetic conditions associated with macrocephaly (MGCM). We tested the following HC percentile threshold criteria: ever above the 95th, 97th, or 99.6thpercentile and ever crossing 2, 4, or 6 increasing major percentile lines. The Centers for Disease Control and World Health Organization growth curves were used, as well …

Reasons For Low Pandemic H1n1 2009 Vaccine Acceptance Within A College Sample, Russell D. Ravert, Linda Y. Fu

Pediatrics Faculty Publications

This study examined health beliefs associated with novel influenza A (H1N1) immunization among US college undergraduates during the 2009-2010 pandemic. Undergraduates (ages 18–24 years) from a large Midwestern University were invited to complete an online survey during March, 2010, five months after H1N1 vaccines became available. Survey items measured H1N1 vaccine history and H1N1-related attitudes based on the health belief literature. Logistic regression was used to identify attitudes associated with having received an H1N1 vaccine, and thematic analysis of student comments was conducted to further understand influences on vaccine decisions. Among the 296 students who participated in the survey, 15.2% …

Neurodevelopmental Consequences Of Sub-Clinical Carbon Monoxide Exposure In Newborn Mice, Ying Cheng, Adia Thomas, Feras Mardini, Shannon L. Bianchi, Junxia X. Tang, Jun Peng, Huafeng Wei, Maryellen F. Eckenhoff, Roderic G. Eckenhoff, Richard J. Levy

Anesthesiology and Critical Care Medicine Faculty Publications

Carbon monoxide (CO) exposure at high concentrations results in overt neurotoxicity. Exposure to low CO concentrations occurs commonly yet is usually sub-clinical. Infants are uniquely vulnerable to a variety of toxins, however, the effects of postnatal sub-clinical CO exposure on the developing brain are unknown. Apoptosis occurs normally within the brain during development and is critical for synaptogenesis. Here we demonstrate that brief, postnatal sub-clinical CO exposure inhibits developmental neuroapoptosis resulting in impaired learning, memory, and social behavior. Three hour exposure to 5 ppm or 100 ppm CO impaired cytochrome c release, caspase-3 activation, and apoptosis in neocortex and hippocampus …

Pulmonary And Peritoneal Tuberculosis Associated With Tumor Necrosis Factor-Alpha Inhibitor Use: A Case Report And Review Of The Literature, Niharika Tipirneni, Marc O. Siegel

Medicine Faculty Publications

The association between the use of tumor necrosis factor-α inhibitors and the increased risk of granulomatous infections, especially tuberculosis, has been well documented. Given the rapidly expanding list of inflammatory conditions for which tumor necrosis factor-α inhibitors are receiving FDA approval, the incidence of tuberculosis in this patient population has increased. Despite heightened awareness by physicians, the diagnosis of tuberculosis can remain challenging, given that extrapulmonary sites of infection are more frequently involved. We present a case of pulmonary and peritoneal tuberculosis in a gentleman being treated with a tumor necrosis factor-α inhibitor and discuss the diagnostic challenges of establishing …

Physical Activity, Health Benefits, And Mortality Risk, Peter F. Kokkinos

Medicine Faculty Publications

A plethora of epidemiologic evidence from large studies supports unequivocally an inverse, independent, and graded association between volume of physical activity, health, and cardiovascular and overall mortality. This association is evident in apparently healthy individuals, patients with hypertension, type 2 diabetes mellitus, and cardiovascular disease, regardless of body weight. Moreover, the degree of risk associated with physical inactivity is similar to, and in some cases even stronger than, the more traditional cardiovascular risk factors. The exercise-induced health benefits are in part related to favorable modulations of cardiovascular risk factors observed by increased physical activity or structured exercise programs. Although the …

Etravirine Induced Severe Hypersensitivity Reaction And Fulminant Hepatitis: A Case Report And Review Of The Literature., Linda Nabha, Gayle P. Balba, Princy N.S. Kumar, Carmelita Tuazon

Medicine Faculty Publications

We report the first published case of etravirine induced hypersensitivity reaction leading to fulminant hepatic failure in a 49-year-old female patient with Human Immunodefi ciency Virus. She presented with a life threatening rash and end stage organ damage requiring intensive care unit supportive care. Liver biopsy supported the diagnosis of drug-induced hypersensitivity. The patient recovered after withdrawal of etravirine and the use of systemic corticosteroids. The authors describe etravirine drug hypersensitivity as a clinically important reaction and that early recognition can improve survival.

An Hit Solution For Clinical Care And Disaster Planning: How One Health Center In Joplin, Mo Survived A Tornado And Avoided A Health Information Center, Peter Shin, Feygele Jacobs

Health, Human Function, and Rehabilitation Sciences Faculty Publications

Since taking office, President Obama has made substantial investments in promoting the diffusion of health information technology. The objective of the national health IT program is, generally, to enable health care providers to better manage patient care through secure use and sharing of health information. Through the use of technologies including electronic health records, providers can better maintain patient care information and facilitate communication, often improving care outcomes. The recent tornado in Joplin, MO highlights the importance of health information technology in the health center context, and illustrates the importance of secure electronic health information systems as a crucial element …

Aspirin But Not Ibuprofen Use Is Associated With Reduced Risk Of Prostate Cancer: A Plco Study, F. M. Shebl, L. C. Sakoda, A. Black, J. Koziol, G. L. Andriole, R. Grubb, T. R. Church, D. Chia, Cindy Zhou, +8 Additional Authors

GW Biostatistics Center

Background:

Although most epidemiological studies suggest that non-steroidal anti-inflammatory drug use is inversely associated with prostate cancer risk, the magnitude and specificity of this association remain unclear.

Methods:

We examined self-reported aspirin and ibuprofen use in relation to prostate cancer risk among 29 450 men ages 55–74 who were initially screened for prostate cancer from 1993 to 2001 in the Prostate, Lung, Colorectal, and Ovarian Cancer Screening Trial. Men were followed from their first screening exam until 31 December 2009, during which 3575 cases of prostate cancer were identified.

Results:

After adjusting for potential confounders, the hazard ratios (HRs) of …

Himmelfarb Library Annual Report 2012, George Washington University, Himmelfarb Health Sciences Library

Himmelfarb Library Annual Report

No abstract provided.

Are Marginalized Women Being Left Behind? A Population-Based Study Of Institutional Deliveries In Karnataka, India, Paul C. Adamson, Karl Krupp, Bhavana Niranjankumar, Alexandra H. Freeman, Mudassir Khan, Purnima Madhivanan

Medicine Faculty Publications

Background

While India has made significant progress in reducing maternal mortality, attaining further declines will require increased skilled birth attendance and institutional delivery among marginalized and difficult to reach populations.

Methods

A population-based survey was carried out among 16 randomly selected rural villages in rural Mysore District in Karnataka, India between August and September 2008. All households in selected villages were enumerated and women with children 6 years of age or younger underwent an interviewer-administered questionnaire on antenatal care and institutional delivery.

Results

Institutional deliveries in rural areas of Mysore District increased from 51% to 70% between 2002 and 2008. …

Developing A Business Plan For Sustaining School Mental Health Services: Three Success Storiess, Donna Behrens, Julia Graham Lear, Olga Acosta Price

Center for Health and Health Care in Schools

No abstract provided.

Urban Governance Of Disease, Rebecca Katz, Sangeeta Mookherji, Morgan Kaminski, Vibhuti Haté, Julie E. Fischer

Global Health Faculty Publications

Rapid population growth, urbanization, and the growing challenges faced by the urban poor require redefining the paradigm for public health interventions in the 21st century, creating new approaches that take urban determinants of health into consideration. The widening disparity between the urban poor and the urban rich further exacerbates health inequities. Existing tools for global governance of urban health risks fall short, particularly in the lack of formal mechanisms to strengthen collaboration and communication among national and municipal agencies and between their local and international non-governmental partners. There is also a clear disconnect between governance strategies crafted at the international …

Smoking Susceptibility And Its Predictors Among Adolescents In China: Evidence From Ningbo City, Cheng Huang, Jeffrey Koplan, Jing Liu, Changwei Li, Jessica Silvaggio, Amanda K. Macgurn, Tao Zhang, Michael P. Erikson, Pam Redmon

Global Health Faculty Publications

Susceptibility to smoking is a risk factor of actual adolescent smoking behaviors. This study aimed to estimate the rate of smoking susceptibility and its predictors in China with a sample of 4,695 junior high school students in Ningbo, China. Core questions from the Global Youth Tobacco Survey (GYTS) were adapted to the China context and administered to these students. The rate of smoking susceptibility, measured by “Do you foresee yourself taking up smoking in the next 12 months”, is 6.1%. Results from logistic regression suggested that among boys, adolescents’ health knowledge that smoking can cause lung cancer (OR=2.73), the belief …

Neuroimaging Of Tumefactive Multiple Sclerosis With Atypical Features, Rohit Koppula, Andrew J. Degnan, Mark Ghassibi, Peter Duggan, Robert Jones, Lucien M. Levy

Radiology Faculty Publications

Tumefactive demyelinating lesions or tumefactive multiple sclerosis constitute a unique presentation of demyelinating disease which frequently mimics intracranial neoplasm, infection or other, non-demyelinating intracranial pathology. Consequently, these lesions, which are larger than typical multiple sclerosis plaques and generally characterized by certain magnetic resonance imaging features including edema and incomplete ring enhancement, pose a serious diagnostic challenge that frequently prompts biopsy in initial evaluation. Biopsy can be averted when imaging features for tumefactive multiple sclerosis are seen on MRI. Herein, we present a biopsy-proven case of tumefactive multiple sclerosis with atypical imaging features, evaluated using magnetic resonance and diffusion tensor imaging.

Measuring Discrimination In South Korea: Underestimating The Prevalence Of Discriminatory Experiences Among Female And Less Educated Workers?., Seung-Sup Kim, Yeonseung Chung, David R. Williams

Environmental and Occupational Health Faculty Publications

Objectives

To investigate the possibility that Koreans show different patterns in reporting discriminatory experiences based on their gender and education level, we analyzed the participants who answered “Not Applicable” for the questions of discriminatory experiences that they were eligible to answer.

Methods

Discriminatory experiences in eight social situations were assessed using the 7th wave of Korean Labor and Income Panel Study. After restricting the study population to waged workers, a logistic regression model was constructed to predict the probability that an individual has experienced discrimination based on the observed covariates for each of eight situations, using the data of participants …

Hemicrania Continua Headache In A Veteran With Post Traumatic Stress Disorder And Major Depressive Disorder Without Traumatic Brain Injury, Brandon A. Kohrt, Erica Duncan

Psychiatry and Behavioral Sciences Faculty Publications

Hemicrania continua is a headache characterized by chronic unremitting unilateral pain associated with ipsilateral autonomic findings. This type of headache responds to high-flow oxygen and indomethacin. This case report describes a male veteran with posttraumatic stress disorder (PTSD) and major depressive disorder who suffers from comorbid hemicrania continua. The psychiatric symptoms were recalcitrant to psychopharmacological intervention. However, when the patient's hemicrania continua was treated appropriately, the patient's psychiatric symptoms also abated. This case demonstrates the need to address physical comorbidities that may exacerbate psychiatric disorders, such as PTSD.

Vascular Inflammatory Cells In Hypertension., David G Harrison, Paul J. Marvar, Jens M Titze

Pharmacology and Physiology Faculty Publications

Hypertension is a common disorder with uncertain etiology. In the last several years, it has become evident that components of both the innate and adaptive immune system play an essential role in hypertension. Macrophages and T cells accumulate in the perivascular fat, the heart and the kidney of hypertensive patients, and in animals with experimental hypertension. Various immunosuppressive agents lower blood pressure and prevent end-organ damage. Mice lacking lymphocytes are protected against hypertension, and adoptive transfer of T cells, but not B cells in the animals restores their blood pressure response to stimuli such as angiotensin II or high salt. …

Physician Wages In States With Expanded Aprn Scope Of Practice, Patricia Pittman, Benjamin Williams

Health Policy and Management Faculty Publications

In recent years, states have looked to reforms in advanced practice nursing scope of practice (SOP) barriers as a potential means to increase access to primary care while reducing costs. Currently, 16 states and the District of Columbia permit advanced practice registered nurses to practice independently of physicians, allowing them to perform functions such as diagnosing and prescribing under their own authority within the primary care setting. Given the resistance of many physician associations to these reforms, we asked whether the economic interests of primary care physicians might be affected by reforms. Using the Bureau of Labor Statistics data on …

Teaching Statistical Research Methods To Graduate Students: Lessons Learned From Three Different Degree Programs, Ozgur Ekmekci, Adrienne Hancock, Susan S. Swayze

Clinical Research and Leadership Faculty Publications

This paper examines the challenge of teaching statistical research methods in three master’s degree programs at a private university based in Washington, DC. We, as three professors teaching at this university, discuss the way we employ innovative approaches to deal with this challenge. We ground our discussion within the theoretical framework of problem-based learning and adult learning principles. We provide brief descriptions of our research methods courses to demonstrate how an instructor can facilitate learning of new knowledge and applications in a content area often considered intimidating by students. We also highlight similarities across the three different courses we teach …

Increasing The Efficiency Of Medical Research With Dynamic Research Summaries For Researchers And Consumers, Perry W. Payne

Clinical Research and Leadership Faculty Publications

Literature reviews are usually the first step in conducting medical research projects.They often lead to the creation of a useful research question. However, this initialstep in medical research contains inefficiencies, which if removed, could speedup the research process and thereby enhance development of innovative healthrelated products. In addition, existing research article databases offer informationwhich is inaccessible to most lay consumers. This article proposes an alternativeapproach for allowing researchers to assess the state of research in a particulararea called “dynamic research summaries.” These summaries would offer a regularlyupdated narrative of existing research in any given area. They could increasethe speed at …

The Aging Services Network: Serving A Vulnerable And Growing Elderly Population In Tough Economic Times, Carol O'Shaughnessy

National Health Policy Forum

In 1965, Congress enacted the Older Americans Act, establishing a federal agency and state agencies to address the social services needs of the aging population. The mission of the Older Americans Act is broad: to help older people maintain maximum independence in their homes and communities and to promote a continuum of care for the vulnerable elderly. In successive amendments, the Act created area agencies on aging and a host of social support programs. The "aging services network," broadly described, refers to the agencies, programs, and activities that are sponsored by the Older Americans Act. The Act’s funding for services …

Results From The 2010-11 Readiness For Meaningful Use Of Hit And Patient Centered Medical Home Recognition Survey, Merle Cunningham, Anthony Lara, Peter Shin

Geiger Gibson/RCHN Community Health Foundation Research Collaborative

This brief describes the status of health centers with respect to Electronic Health Record (EHR) adoption, readiness to meet the health information technology (HIT) meaningful use (MU) standards, and readiness to achieve Patient-Centered Medical Home (PCMH) recognition.

An Automated Internet Application To Help Patients With Bipolar Disorder Track Social Rhythm Stabilization., Daniel Z Lieberman, Susan Swayze, Frederick K Goodwin

Psychiatry and Behavioral Sciences Faculty Publications

This column describes a pilot study of a fully automated, Internet-based program that provides a key element of interpersonal and social rhythm therapy, a form of psychotherapy shown to be effective in the treatment of bipolar disorder when combined with mood-stabilizing medication. Participants (N=64) recorded the time they completed activities of daily living and their mood at the time of each entry. After 90 days they demonstrated a 31% increase in social rhythm stability and a small, though statistically significant, decrease in symptoms of abnormal mood. Internet-based programs can enhance access to a best practice in the management of bipolar …

Himmelfarb Headlines - November/December 2011, 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 BMJ Case Reports, personalized medicine, International Open Access Week, and profiles of James Cawley, MPH, PA-C, and George Paul.