Medicine and Health Sciences Commons^™

Differing Cognitive Strategies Between Evidence-Based Medicine And Evidence-Based Practice, James P. Meza Md, Phd

Clinical Research in Practice: The Journal of Team Hippocrates

Clinical care requires both evidence-based medicine (abstract, not applied, knowledge) and evidence-based practice (derived from knowledge of a specific patient's concerns). Clinical Research in Practice encourages an apprenticeship model that embraces both.

Pamam Dendrimers As Promising Nanocarriers For Rnai Therapeutics, Prashant Kesharwani, Sanjeev Banerjee, Umesh Gupta, Mohd Cairul Iqbal Mohd Amin, Subhash Padhye, Fazlul H. Sarkar, Arun K. Iyer

Pharmaceutical Sciences Faculty Publications

Therapeutics based on RNA interference mechanisms are highly promising for the management of several diseases including multi-drug resistant cancers. However, effective delivery of siRNAs and oligonucleotides still remains challenging. In this regard, hyper-branched, PAMAM dendrimers having unique three-dimensional architecture and nanoscale size, with cationic surface charge can potentially serve as siRNA condensing agents as well as robust nano-vectors for targeted delivery. In addition, their surface functionality permits conjugation of drugs and genes or development of hybrid systems for combination therapy. Thus far, in vitro cellular testing of dendrimer-mediated siRNA delivery has revealed great potential, with reports on their in vivo …

Interaction Of Alu Polymorphisms And Novel Measures Of Discrimination In Association With Blood Pressure In African Americans Living In Tallahassee, Alexis C. Boulter, Jackyn Quinlan, Aida T. Miró-Herrans, Laurel N. Pearson, Nubiana L. Todd, Clarence C. Gravlee, Connie J. Mulligan

Human Biology Open Access Pre-Prints

African Americans are 40% more likely to be afflicted with hypertension in comparison to non-Hispanic, white Americans, resulting in a 30% higher instance of mortality due to cardiovascular disease. There is debate about the relative contributions of genetic and sociocultural risk factors to the racial disparity in hypertension.

We assayed three Alu insertion polymorphisms located in the angiotensin-1-converting enzyme (ACE), tissue plasminogen activator (PLAT), and with no-lysine kinase 1 (WNK1) genes. We also estimated West African genetic ancestry and developed novel measures of perceived discrimination to create a biocultural model of blood pressure among …

Extrapolating Evidence About Preventing Recurrent Cellulitis For An Individual Patient Concern, Christina L. Benkert D.O., Amrit K. Basi, Kristina L. Bahrou M.D., Catherine R. Cherri M.D., Suraiya K. Azom M.D., Nicholus H. Yee M.D.

Clinical Research in Practice: The Journal of Team Hippocrates

A critical appraisal and clinical application of Thomas KS, Crook AM, Nunn AJ, et al. Penicillin to prevent recurrent leg cellulitis, N Engl J Med. 2013, May 2;368(18):1695-1703. doi: 10.1056/NEJMoa1206300

Rectal Indomethacin Reduces The Risk Of Post-Ercp Pancreatitis, John Dawdy

Clinical Research in Practice: The Journal of Team Hippocrates

A clinical appraisal and clinical application of Elmunzer BJ, Scheiman JM, Lehman GA, Chak A, Mosler P, et al. A randomized trial of rectal indomethacin to prevent post-ERCP pancreatitis. N Engl J Med. 2012;366:1414–22. doi: 10.1056/NEJMoa1111103

Psychometric Properties Of The Abbreviated Perceived Motivational Climate In Exercise Questionnaire, E. Whitney G. Moore, Theresa C. Brown, Mary D. Fry

Kinesiology, Health and Sport Studies

The purpose of this study was to develop an abbreviated version of the Perceived Motivational Climate in Exercise Questionnaire (PMCEQ-A) to provide a more practical instrument for use in applied exercise settings. In the calibration step, 2 shortened versions’ measurement and latent model values were compared to each other and the original PMCEQ using a 3-group CFA invariance testing approach with previously collected exercise setting data (N = 5,427). Based on the model fit and reliability values, the 12-item version performed better than the 17-item version. The resultant 12-item PMCEQ-A’s CFA model estimates were then compared to the PMCEQ’s model …

Ebola Virus Infection: Overview And Update On Prevention And Treatment, Miguel J. Martínez, Abdulbaset M. Salim, Juan C. Hurtado, Paul E. Kilgore

Department of Pharmacy Practice

In 2014 and 2015, the largest Ebola virus disease (EVD) outbreak in history affected large populations across West Africa. The goal of this report is to provide an update on the epidemic and review current progress in the development, evaluation and deployment of prevention and treatment strategies for EVD. Relevant information was identified through a comprehensive literature search using Medline, PubMed and CINAHL Complete and using the search terms Ebola, Ebola virus disease, Ebola hemorrhagic fever, West Africa outbreak, Ebola transmission, Ebola symptoms and signs, Ebola diagnosis, Ebola treatment, vaccines for Ebola and clinical trials on Ebola. Through 22 July …

Research Design Creates Ambiguity Related To Efficacy Of Sickle Cell, Chronic Disease Specialty Clinic, Scott J. Dawsey

Clinical Research in Practice: The Journal of Team Hippocrates

A critical appraisal and clinical application of Koch KL, Karafin MS, Simpson P, Field JJ. Intensive management of high-utilizing adults with sickle cell disease lowers admissions. Am J Hematol. 2015 Jan;90(3):215-219. doi:10.1002/ajh.23912

Native/Aboriginal Students Use Natural Health Products For Health Maintenance More So Than Other University Students, Fidji Gendron, Samiah Naji Alqahtani, Sarah Omar Alkholy, Dina Haque, Maria Pontes Ferreira

Nutrition and Food Science Faculty Research Publications

Background and aim: University student use of Natural Health Products (NHP) for health maintenance (HealthM) is assessed in Canada. We hypothesize greater use of NHP by Native/Aboriginal and female students. Demographic predictor variables and the top ten NHP used are determined.

Methods: A cross-sectional survey of 963 students (n=212 Native/Aboriginal; n=751 non-Native/Aboriginal) was conducted. χ2 and Fisher’s exact tests analyzed group differences. Multiple logistic regressions determined predictor variables of NHP use.

Results: Of 963 surveyed students, 268 (27.8%) used NHP for HealthM, while 695 students (72.2%) did not. More Native/Aboriginal students used commercial tobacco (47% vs. 13%, P<0.001) and NHP (67% vs. 45%, P<0.001) than non- Native/Aboriginal students. Gender was not associated with NHP use (P=0.527). Canadians used echinacea more than non-Canadians (Odds Ratio [OR]=4.96; 95% Confidence Interval [CI]: 1.2-21.0). Ginger (OR=0.39; 95% CI: 0.2-0.78) and garlic (OR=0.28; 95% CI: 0.13-0.6) were popular amongst non-Canadians. Native/Aboriginal students used homeopathics (OR=39.9; 95% CI: 8.6-185.4) and rat root (OR=56.73; 95% CI: 6.91-465.8). Chamomile was less used by males (OR=0.33; 95% CI: 0.13-0.83) and used more by upperclassmen (OR=2.6 95% CI: 1.3-5.3).

Conclusion: Homeopathics …

New Evidence Prompts Rethinking The Clinical Management Of Community Acquired Pneumonia In Patients Admitted To General Medical Services., J. Timothy Caldwell

Clinical Research in Practice: The Journal of Team Hippocrates

A critical appraisal and clinical application of Postma DF, van Werkhoven CH, van Elden LJR, et al. Antibiotic treatment strategies for community-acquired pneumonia in adults. N Engl J Med. 2015;372(14):1312-1323. doi:10.1056/NEJMoa1406330

Idiopathic Pulmonary Fibrosis: Bnp And Echocardiogram Guide Difficult But Necessary Discussions Related To Prognosis, Jacob A. Vander-Starre

Clinical Research in Practice: The Journal of Team Hippocrates

A critical appraisal and clinical application of Song JW, Song J-K, Kim DS. Echocardiography and brain natriuretic peptide as prognostic indicators in idiopathic pulmonary fibrosis. Respir Med 2009;103(2):180-186. doi:10.1016/j.rmed.2008.11.012.

Understanding Stress And Aggression Behaviors Among Urban Youth, Erin E. Centeio, Laurel Whalen, Noel Kulik, Erica Thomas, Nate Mccaughtry

Kinesiology, Health and Sport Studies

Background/Objective: Youth violence, including school bullying and fighting, has become a global public health problem. Stress has been identified as a factor related to aggression (i.e., bullying behaviors, fighting, and anger), of which inner-city youth are particularly vulnerable given their often disproportionately high stress living environments. Stress and aggression are of particular concern in urban physical education (PE) given the proliferation of competitive, sport-based curricula, “culture of basketball”, and the often-limited supervision that takes place. Using the Social Ecological Model, the purpose of this study was to examine the relationships between stress and aggression in inner-city elementary PE students. …

Characteristics Of A Novel Treatment System For Linear Accelerator–Based Stereotactic Radiosurgery, Ning Wen, Haisen Li, Kwang Song, Karen Chin-Snyder, Yujiao Qin, Jinkoo Kim, Maria Bellon, Misbah Gulam, Stephen Gardner, Anthony Doemer, Suneetha Devpura, James Gordon, Indrin Cherry, Farzan Siddiqui, Munther Ajlouni, Robert Pompa, Zane Hammoud, Michael Simoff, Steven Kalkanis, Benjamin Movsas, M. Salim Siddiqui

Internal Medicine Faculty Publications

The purpose of this study is to characterize the dosimetric properties and accuracy of a novel treatment platform (Edge radiosurgery system) for localizing and treating patients with frameless, image-guided stereotactic radiosurgery (SRS) and stereotactic body radiotherapy (SBRT). Initial measurements of various components of the system, such as a comprehensive assessment of the dosimetric properties of the flattening filter-free (FFF) beams for both high definition (HD120) MLC and conical cone-based treatment, positioning accuracy and beam attenuation of a six degree of freedom (6DoF) couch, treatment head leakage test, and integrated end-to-end accuracy tests, have been performed. The end-to-end test of the …

Dental Extraction Is Probably Safe For Patients With Thrombocytopenia: The Standard Of Care Is A Guide For Clinical Decision Making Related To Platelet Transfusion., Phillip So

Clinical Research in Practice: The Journal of Team Hippocrates

A critical appraisal and clinical application of Fillmore WJ, Leavitt BD, Arce K. Dental extraction in the thrombocytopenic patient is safe and complications are easily managed. J Oral Maxillofac Surg. 2013 Oct;71(10):1647-1652. doi:10.1016/j.joms.2013.05.011.

Re-Issuing The Screening Mammography Challenge, Daniel Passerman

Clinical Research in Practice: The Journal of Team Hippocrates

The author reissues the challenge to monitor the to monitor the discussion related to screening mammography in the reader's own clinical setting.

Evidence-Based Practice In The New Millenium, Nicholus H. Yee

Clinical Research in Practice: The Journal of Team Hippocrates

A reflection on learning and education in practice.

Yoga And Cognition: A Meta-Analysis Of Chronic And Acute Effects, Neha Gothe, Edward Mcauley

Kinesiology, Health and Sport Studies

Objectives: To review and synthesize the existing literature on the effects of yoga on cognitive function by determining effect sizes that could serve as a platform to design, calculate statistical power, and implement future studies.

Methods: Through electronic databases, we identified acute studies and randomized controlled trials (RCTs) of yoga that reported cognitive outcomes. Inclusion criteria included the following: use of an objective measure of cognition and sufficient data reported to estimate an effect size. The meta-analysis was conducted using Comprehensive Meta-Analysis software. A random-effects model was used to calculate the overall weighted effect sizes, expressed as Hedge g.

Results: …

Ethnic Differences In Medicinal Plant Use Among University Students: A Cross-Sectional Survey Of Self-Reported Medicinal Plant Use At Two Midwest Universities, Rachel Craft, Katrina C. Mcclure, Steven Corbett, Maria Pontes Ferreira, Ashley M. Stiffarm, Kelly Kindscher

Wayne State University Associated BioMed Central Scholarship

Background: Numerous surveys of medicinal plant use among college students abound, but none compare use between students enrolled in two different Universities with significantly different ethnic compositions. The objective of this study is to compare medicinal plant use between two different ethnic college populations and explore differences between student medicinal plant users and non-users for comparison with previous research.

Methods: Students (n = 721) at a large research university (n = 498) and a Pan-Tribal University for Native Americans (n = 233) completed surveys in October 2011 to assess past year medicinal plant use. The Mann-Whitney U test, Chi Square …

Evolution And Otitis Media: A Review, And A Model To Explain High Prevalence In Indigenous Populations, Mahmood F. Bhutta

Human Biology Open Access Pre-Prints

Inflammation of the middle ear (otitis media) comprises a group of disorders that are highly prevalent in childhood, and indeed are amongst the most common disorders of childhood. Otitis media is also heritable, and has effects on fecundity. This means that otitis media is subject to evolution, yet the evolutionary selection forces that may determine susceptibility to otitis media have never been adequately explored.

Here I undertake a critical analysis of evolutionary forces that may determine susceptibility to middle ear inflammation. These forces include those determining function of the middle ear, those affecting host immunity, and those affecting colonization by, …

Dementia In The Context Of Disability, Rosanne Dizazzo-Miller, Fredrick D. Pociask

Department of Health Care Sciences

Patients and caregivers often associate dementia with devastation and a loss of productive contribution to society. People with dementia are often depicted as confused individuals struggling through embarrassing episodes, followed by a loss of independence. The burden and devastation of the diagnosis on the families of people with dementia is exacerbated by their assumption of the role of caregiver with inadequate preparation or training. Disability scholars, in contrast, offer physical and occupational therapists a nontragic view of disability that recognizes the importance of countering the stigma and discrimination that too often accompany dementia. This case example of a woman diagnosed …

Qualitatively Assessing The Expression Of Kynurenine Pathway Metabolic Enzymes In Human Glioma Tissue, Kaushik Varadarajan

Honors College Theses

Gliomas are the most common brain tumor and glioblastoma multiforme (GBM) is the most common type of glioma observed in patients. Prognosis with late stage glioma and GBM is very poor even with recent advances in treatment. Along with treating the tumor, manners of bypassing the blood brain barrier and ensuring the tumor uptakes the treatment is necessary. Because the treatments can harm regular brain cells there is concern about the viability and toxic side effects of many treatments. With all of these challenges posed it is important to understand how glial tumors can be so recurring and difficult to …

Role Of Il-16 In Cd4(+) T Cell-Mediated Regulation Of Relapsing Multiple Sclerosis, Dusanka S. Skundric, William W. Cruikshank, Jelena Drulovic

Neurology Faculty Publications

In an important article published in Nature Medicine, Liu and colleagues described a novel CD4⁺ FoxA1⁺ regulatory T (Treg) cell population as distinct regulators of relapsing-remitting multiple sclerosis (RRMS) and experimental autoimmune encephalomyelitis (EAE). CD4⁺ FoxA1⁺ Treg cells appear as key regulators of responsiveness to therapy with interferon beta (IFN-β) in RRMS patients. Data indicate that CD4⁺ FoxA1⁺ FOXP3⁻ Treg cells develop within the central nervous system (CNS), and a potential of cerebellar granule neurons (CGN) in generation of CD4⁺ FoxA1⁺ PD-L1^hiFOXP3⁻ Treg cells from encephalitogenic CD4^{+ …}

Diagnosis And Management Of Hyponatremia In Patients With Aneurysmal Subarachnoid Hemorrhage, Neena I. Marupudi, Sandeep Mittal

Neurosurgery Faculty Publications

Hyponatremia is the most common, clinically-significant electrolyte abnormality seen in patients with aneurysmal subarachnoid hemorrhage. Controversy continues to exist regarding both the cause and treatment of hyponatremia in this patient population. Lack of timely diagnosis and/or providing inadequate or inappropriate treatment can increase the risk of morbidity and mortality. We review recent literature on hyponatremia in subarachnoid hemorrhage and present currently recommended protocols for diagnosis and management.

Screening Mammography Requires Informed Consent, James P. Meza Md, Phd

Clinical Research in Practice: The Journal of Team Hippocrates

In concert with the titular opinion, CRP Faculty Editor James P. Meza encourages established medical educators and practitioners to speak up when evidence contradicts established practice, as an example to future medical professionals.

Transesophageal Echocardiogram: Accurate Enough To Make Definitive Clinical Decisions Related To Endocarditis, Brian Jackson, Paul Thomas, Tiffany Dehondt, Leanne Swiderski, Rachel Fuller, Amal Raychouni

Clinical Research in Practice: The Journal of Team Hippocrates

A critical appraisal and clinical application of: Daniel WG, Mugge A, Martin RP, et al. Improvement in the diagnosis of abscesses associated with endocarditis by transesophageal echocardiography. N Engl J Med. 1991 Mar 21;324(12):795-800. doi: 10.1056/NEJM199103213241203

Polymeric Nanoparticle-Based Delivery Of Microrna-199a-3p Inhibits Proliferation And Growth Of Osteosarcoma Cells, Linlin Zhang, Arun K. Iyer, Xiaoqian Yang, Eisuke Kobayashi, Yuqi Guo, Henry Mankin, Francis J. Hornicek, Mansoor M. Amiji, Zhenfeng Duan

Pharmaceutical Sciences Faculty Publications

Our prior screening of microRNAs (miRs) identified that miR-199a-3p expression is reduced in osteosarcoma cells, one of the most common types of bone tumor. miR-199a-3p exhibited functions of tumor cell growth inhibition, suggesting the potential application of miR-199a-3p as an anticancer agent. In the study reported here, we designed and developed a lipid-modified dextran-based polymeric nanoparticle platform for encapsulation of miRs, and determined the efficiency and efficacy of delivering miR-199a-3p into osteosarcoma cells. In addition, another potent miR, let-7a, which also displayed tumor suppressive ability, was selected as a candidate miR for evaluation. Fluorescence microscopy studies and real-time polymerase chain …

Clinical Evaluation Of Loop-Mediated Isothermal Amplification (Lamp) Assay For Rapid Detection Of Neisseria Meningitidis In Cerebrospinal Fluid, Dokyung Lee, Eun Jin Kim, Paul E. Kilgore, Soon Ae Kim, Hideyuki Takahashi, Makoto Ohnishi, Dang Duc Anh, Bai Qing Dong, Jung Soo Kim, Jun Tomono, Shigehiko Miyamoto, Tsugunori Notomi, Dong Wook Kim, Mitsuko Seki

Department of Pharmacy Practice

Background

Neisseria meningitidis (Nm) is a leading causative agent of bacterial meningitis in humans. Traditionally, meningococcal meningitis has been diagnosed by bacterial culture. However, isolation of bacteria from patients’ cerebrospinal fluid (CSF) is time consuming and sometimes yields negative results. Recently, polymerase chain reaction (PCR)-based diagnostic methods of detecting Nm have been considered the gold standard because of their superior sensitivity and specificity compared with culture. In this study, we developed a loop-mediated isothermal amplification (LAMP) method and evaluated its ability to detect Nm in cerebrospinal fluid (CSF).

Methodology/Principal Findings

We developed a meningococcal LAMP assay (Nm LAMP) that targets …

Filamin A Phosphorylation By Akt Promotes Cell Migration In Response To Arsenic, Lingzhi Li, Yongju Lu, Paul M. Stemmer, Fei Chen

Pharmaceutical Sciences Faculty Publications

We had previously reported that trivalent arsenic (As³⁺), a well-known environmental carcinogen, induces phosphorylation of several putative Akt substrates. In the present report, we characterized one of these substrates by immunoprecipitation and proteomics analysis. The results indicate that a cytoskeleton remodeling protein, filamin A, with a molecular weight around 280 kDa, is phosphorylated by Akt in HEK-293 cells treated with As³⁺, which was also confirmed in human bronchial epithelial cell line, BEAS-2B cells. Additional biochemical and biological studies revealed that serine 2152 (S2152) of filamin A is phosphorylated by activated Akt in the cells treated with …

Molecular Pathways Of Chemokine Receptor Desensitization By Il-16 Pertinent To Multiple Sclerosis, Dusanka S. Skundric

Neurology Faculty Publications

No abstract provided.

Metformin Prevents Aggressive Ovarian Cancer Growth Driven By High-Energy Diet: Similarity With Calorie Restriction, Zaid Al-Wahab, Ismail Mert, Calvin Tebbe, Jasdeep Chhina, Miriana Hijaz, Robert T. Morris, Rouba Ali-Fehmi, Shailendra Giri, Adnan Munkarah, Ramandeep Rattan

Department of Obstetrics and Gynecology Research Publications

Caloric restriction (CR) was recently demonstrated by us to restrict ovarian cancer growth in vivo. CR resulted in activation of energy regulating enzymes adenosine monophosphate activated kinase (AMPK) and sirtuin 1 (SIRT1) followed by downstream inhibition of Akt-mTOR. In the present study, we investigated the effects of metformin on ovarian cancer growth in mice fed a high energy diet (HED) and regular diet (RD) and compared them to those seen with CR in an immunocompetent isogeneic mouse model of ovarian cancer. Mice either on RD or HED diet bearing ovarian tumors were treated with 200 mg/kg metformin in drinking …