Medicine and Health Sciences Commons^™

Comparison Of Two Surveys Of Head Injured Patients Presenting During A Calendar Year To An Urban Medical Centre 32 Years Apart, Rashid Jooma, Shahid Ahmed, Abdul Malik Zarden

Section of Neurosurgery

Objective: To study the patients presenting with head injuries to a tertiary hospital in Karachi during the year 2003.
Methods: During the calendar year 2003, a cross-sectional study was conducted of all patients presenting to the casualty department of Jinnah Postgraduate Medical Centre (JPMC) with head injury. Personal information was collected from the patient's attendants at presentation or later if the patient had been brought in by the emergency services as an unknown person. The circumstances of the injury were similarly established and the clinical features documented.
Results: During the year 2003, a total of 3008 patients reported to the …

Speech Results With Tracheoesophageal Voice Prosthesis After Total Laryngectomy, Mohammad Sohail Awan, Imtinan Ahmed, Yassar Iftikhar Ahmad, Daniyal Ahmad

Section of Otolaryngology, Head & Neck Surgery

Objective: To assess the success rate of tracheoesophageal voice prosthesis as the primary mode of voice rehabilitation in patients after total laryngectomy.Methods: Medical record files of 35 patients subjected to total laryngectomy were reviewed for determining success or failure of the voice prosthesis. The indicators used were quality of speech and utility of the device. Subsequent complications that developed were also assessed. In addition other factors taken into consideration were pharyngeal myotomy, use of radiation, and timing of replacement. All thirty five patients (n=35) had prosthesis placed at the time of laryngectomy.Results: The success rate at one month and four …

Exposure Utilization And Completion Of Cognitive Behavioral Therapy For Ptsd In A “Realworld” Clinical Practice, Claudia Zayfert, Jason C. Deviva, Carolyn Becker, Julie L. Pike, Karen L. Gillock, Sarah A. Hayes

Department of Psychology: Faculty Publications

This study assessed rates of imaginal exposure therapy (ET) utilization and completion of cognitive behavioral therapy (CBT) for posttraumatic stress disorder (PTSD) in a clinical setting and examined variables associated with CBT completion. Using a clinical definition, the completion rate of CBT was markedly lower than rates reported in randomized trials. CBT completion was inversely related to severity of overall pretreatment measures of PTSD, avoidance, hyperarousal, depression, impaired social functioning, and borderline personality disorder. Regression yielded avoidance and depression as unique predictors of completion. Most dropouts occurred before starting imaginal ET, although initiating ET was associated with greater likelihood of …

A Case Of Transient Diabetes Insipidus Following Cardiopulmonary Bypass, Omer Ashraf, Hasanat Sharif, Mansoor Shah

Section of Cardiothoracic Surgery

Cardiopulmonary bypass surgery has been linked with a number of postoperative complications. One of the frequently reported physiological alterations is the relative diuresis seen in the immediate post-op period. Rarely reported though is the development of full-blown diabetes insipidus in such patients. The etiology is unknown and has only been hypothesized in the past. We present the clinical course of a 54 year old male who developed transient diabetes insipidus post bypass surgery with subsequent recovery following exogenous vasopressin administration. The physiological alteration leading to the development of diabetes insipidus in a small fraction of bypass patients remains unknown. We …

Hypertrophy Of Ligamentum Flavum In Lumbar Spinal Stenosis Associated With Increased Proteinase Inhibitor Concentration, Jong-Beom Park, Jin-Kyung Lee, Sung-Jin Park, K. Daniel Riew

Open Access Publications

No abstract provided.

Upper-Extremity Phocomelia Reexamined: A Longitudinal Dysplasia, Charles A. Goldfarb, Paul R. Manske, Riccardo Busa, Janith Mills, Peter Carter, Marybeth Ezaki

Open Access Publications

No abstract provided.

Structural Allostery And Binding Of The Transferrin·Receptor Complex, Guozhong Xu, Mark R. Chance

Faculty Scholarship

The structural allostery and binding interface for the human serum transferrin (Tf)-transferrin receptor (TfR) complex were identified using radiolytic footprinting and mass spectrometry. We have determined previously that the transferrin C-lobe binds to the receptor helical domain. In this study we examined the binding interactions of full-length transferrin with receptor and compared these data with a model of the complex derived from cryoelectron microscopy (cryo-EM) reconstructions (Cheng, Y., Zak, O., Aisen, P., Harrison, S. C. & Walz, T. (2004) Structure of the human transferrin receptor-transferrin complex. Cell 116, 565-576). The footprinting results provide the following novel conclusions. First, we report …

Validity Of Frozen Section In The Diagnosis Of Breast Lumps: 5 Years Experience At The Aga Khan University Hospital., Naila Kayani, Nuzhat Sultana

Department of Pathology and Laboratory Medicine

Abstract

Objective: To determine the accuracy of frozen section in the diagnosis of breast lump. Methods: Frozen section diagnosis given in consecutive breast biopsies performed in 5 years in our laboratory was evaluated against the final pathology report of permanent sections. Results: The Aga Khan University Hospital Lab receives more than 400 cases per year for frozen section. Three hundred and nineteen consecutive frozen sections of breast lumps examined from 1999-2003 were considered for analysis. Age of patients ranged between 22 and 90 years (mean age 49 years). In 316 cases (99%) there was no difference between the frozen section …

An Examination Of The Five Factors Of Personality, Pubertal Onset And Alcohol Usage In Adolescent Males, Sarah Wickman

Masters Theses & Specialist Projects

Recent national surveys have demonstrated an increase in alcohol use among adolescents over the past five years (Johnston, O'Malley, & Bachman, 2003; Kann et al., 2000). It is important to understand factors that influence alcohol use in order to aid in the creation of preventative measures due to the many possible negative consequences associated with drinking alcohol (i.e., unwanted sexual activity, delinquency, abuse of other drugs, violence, car accidents, and poor academic performance) (Boyd, Howard, & Zucker, 1995). Two factors that have been studied as possible predictors of adult and adolescent alcohol use are personality and pubertal onset. Specifically, studies …

The Cerebral Response During Subjective Choice With And Without Self-Reference, Sterling C. Johnson, Taylor W. Schmitz, Tisha N. Kawahara-Baccus, Howard A. Rowley, Andrew L. Alexander, Jonghoon Lee, Richard J. Davidson

Brain and Mind Institute Researchers' Publications

The anterior medial prefrontal (AMPFC) and retrosplenial (RSC) cortices are active during self-referential decision-making tasks such as when participants appraise traits and abilities, or current affect. Other appraisal tasks requiring an evaluative decision or mental representation, such as theory of mind and perspective-taking tasks, also involve these regions. In many instances, these types of decisions involve a subjective opinion or preference, but also a degree of ambiguity in the decision, rather than a strictly veridical response. However, this ambiguity is generally not controlled for in studies that examine self-referential decision-making. In this functional magnetic resonance imaging experiment with 17 healthy …

High Potency And Other Alcoholic Beverage Consumption Among Adolescents, Edessa C. Jobli, Heather S. Dore, Chudley Werch, Michele Johnson Moore

Public Health Faculty Research and Scholarship

This study examined the prevalence of high potency (liquor, malt liquor, fortified wine) and other alcoholic beverage consumption (beer, wine/wine coolers) among adolescents, the impact of gender and ethnicity, and the risk and protective factors that predicted consumption. A confidential survey revealed that, among eighth grade students, wine/wine coolers were the most popular alcoholic beverages, with the highest levels of lifetime use, and the greatest current frequency and quantity of use, followed closely by beer and liquor. Minor gender differences were found, as well as notable ethnic differences, in consumption. Intentions and attitudes were important predictors of use across beverages. …

Psychometric Evaluation Of The Shared Care Instrument In A Sample Of Home Health Care Family Dyads, Margaret Sebern

College of Nursing Faculty Research and Publications

Researchers have studied negative effects of caregiving on a family caregiver; however, less is known about positive aspects of exchanging assistance for both members of a family caregiving dyad. In a previous naturalistic inquiry the author indentified a basis for studying caregiving interactions was a construct called shared care. The three components of shared care identified in the naturalistic inquiry were communication, decision making, and reciprocity. The Shared Care Instrument (SCI) was developed to measure the construct. The purpose of this study was to assess the psychometric properties of the SCI, and to assess its construct and criterion-related validity. A …

Comparison Between Gram Stain And Culture For The Characterization Of Vaginal Microflora: Definition Of A Distinct Grade That Resembles Grade I Microflora And Revised Categorization Of Grade I Microflora, Rita Verhelst, Hans Verstraelen, Geert Claeys, Gerda Verschraegen, Leen Van Simaey, Catharine De Ganck, Ellen De Backer, Marleen Temmerman, Mario Vaneechoutte

Obstetrics and Gynaecology, East Africa

Background: The microbiological diagnosis of bacterial vaginosis is usually made using Nugent's criteria, a useful but rather laborious scoring system based on counting bacterial cell types on Gram stained slides of vaginal smears. Ison and Hay have simplified the score system to three categories and added a fourth category for microflora with a predominance of the Streptococcus cell type. Because in the Nugent system several cell types are not taken into account for a final score, we carried out a detailed assessment of the composition of the vaginal microflora in relation to standard Gram stain in order the improve the …

Retrospective Review Of The Use Of Swan Ganz Catheters In Our Intensive Care Unit (Icu): A Short Report, Shahla Siddiqui

Department of Anaesthesia

The widespread and often 'misuse' of the Swan Ganz (SG) or Pulmonary artery catheter has often been seen in intensive care patients. The objective of this preliminary review was to observe the trends and possibly formulate an association with outcome of the use of SG catheters as well as to determine the frequency of use and possible complications. The chart review of ten patients was carried out for the months of January and February 2004 in a retrospective manner. The incidence of SG catheter insertion was 12% per month on average. Nine out of 10 patients received the SG catheters …

Are Specific Language Impairment And Dyslexia Distinct Disorders?, Hugh W. Catts, Suzanne M. Adlof, Tiffany Hogan, Susan Ellis Weismer

Faculty Publications

Purpose - The purpose of this study was to determine whether specific language impairment (SLI) and dyslexia are distinct developmental disorders.

Method - Study 1 investigated the overlap between SLI identified in kindergarten and dyslexia identified in 2nd, 4th, or 8th grades in a representative sample of 527 children. Study 2 examined phonological processing in a subsample of participants, including 21 children with dyslexia only, and 43 children with SLI only, 18 children with SLI and dyslexia, and 165 children with typical language/reading development. Measures of phonological awareness and nonword repetition were considered.

Results - Study 1 showed limited but …

Nonlinear Dynamics And Interpersonal Correlates Of Verbal Turn-Taking Patterns In A Group Therapy Session, David Pincus, Stephen J. Guastello

Psychology Faculty Articles and Research

Interpersonal processes and dynamics are ubiquitous topics in psychotherapy, yet they are difficult to study and are theoretically fragmented across therapeutic subdisciplines. The current study tests an integrative model of interpersonal dynamics in small groups using nonlinear dynamical systems theory. The conversation of one group therapy session (with six adolescent sex offenders) is analyzed using orbital decomposition, which allows for the identification of patterns in categorical time series data. The results show evidence of selforganizing social patterns, based on formal measures of turbulence (Lyapunov dimension), information novelty (Shannon's entropy), and complexity (fractal dimension). The degree of patterning in turn taking …

The Effects Of Usda Farm-Bill Restoration Programs On Prairie Voles (Microtus Ochrogaster) In The Barrens Region Of Kentucky, Jestin Clark

Masters Theses & Specialist Projects

Much of the area that is now west-central Kentucky historically existed as grass dominated ecosystems. Unfortunately, most of those grasslands are gone due mostly to disturbance suppression and conversion to agricultural lands. Federal, state, and nongovernmental agencies have, particularly within the last several decades, undertaken the responsibility and goal of preserving and attempting to restore many of North America's lost grasslands. The USDA in conjunction with local landowners has initiated the CRP (Conservation Reserve Program) and the CREP (Conservation Reserve Enhancement Program); two popular farm bill-based conservation programs. Among the many conservation practices that these programs fund is grassland restoration. …

Resident Efficiency In A Pediatric Emergency Department., M Denise Dowd, Celeste Tarantino, Theodore M. Barnett, Laura Fitzmaurice, Jane F. Knapp

Manuscripts, Articles, Book Chapters and Other Papers

OBJECTIVES: To measure the hourly rate of patients evaluated and treated by resident physicians in an academic pediatric emergency department (PED) and examine differences in the rate by subspecialty and year of training.

METHODS: For all residents rotating in an academic, urban children's hospital PED, the rate of patients seen per hour over the course of their rotation was calculated using an electronic tracking system, EmSTAT, for calendar year 2000. Rates are reported as the mean number of patients seen per resident hour worked. Mean differences are reported for resident subspecialties (emergency medicine, pediatrics, and family practice) and postgraduate year …

Outcome Of Endoscopic Therapeutic Interventions: Are They Different Among Various Non- Malignant Esophageal Diseases, Rustam Khan, Shahab Abid, Saeed Hamid, Z Abbas, Syed H Shah, Wasim Jafri

Section of Gastroenterology

Background: This study was carried out to evaluate and compare the outcome of various causes of non-malignant lesions of the esophagus after endoscopic therapeutic intervention.

Methods: A cohort of patients with non-malignant dysphagia presenting at Aga Khan University hospital, a tertiary care setting who underwent endoscopic intervention was studied. Response to treatment was evaluated by improvement in dysphagia score on a scale of 0-4 and weight gain.

Results:99 subjects (53 males) were included. Mean age was 48.6 +/- 17.2 years. Dysphagia for solids was present in 48%, for liquids in 3% and for both in 49% patients. Significant weight …

Asthma Management Programs In Managed Care Organizations, Christine W. Hartmann Mss, Phd, Vittorio Maio Pharmd, Ms, Neil I. Goldfarb, Nicole M. Cobb Maom, David B. Nash

College of Population Health Faculty Papers

The aim of this work was to investigate how managed care organizations (MCOs) currently approach asthma treatment and management and to determine factors affecting asthma outcomes. A Web-based survey was administered to a national sample of 351 medical directors of MCOs to investigate the asthma management program components in their organizations as well as gaps and barriers in the management of patients with asthma. All 134 (38.2%) responding medical directors reported that their organizations monitor asthma patients. Plans use a variety of asthma management activities, including general member education (90%), member education by mail (87%), self-management education (85%), and provider …

Remote Physiological Monitoring: Clinical, Financial, And Behavioral Outcomes In A Heart Failure Population, Laurel R. Hudson Msn, Rn, G. Brent Hamar Dds, Mph, Patty Orr Rn, Edd, Jeffrey H. Johnson Bs, Amy Neftzger Ma, Richard S. Chung Md, Myra L. Williams Mph, William M. Gandy Edd, Albert Crawford Phd, Mba, Msis, Janice L. Clarke Rn, Bba, Neil I. Goldfarb

College of Population Health Faculty Papers

This article reports on the outcomes associated with remote physiological monitoring (RPM) conducted as part of a heart failure disease management program. Claims data, medical records, data transmission records, and survey results for 91 individuals ages 50–92 (mean 74 years) successfully completing a heart failure RPM program were analyzed for time periods before, during, and after the monitoring intervention. The program was associated with significant reductions in per member per month costs and emergency room and hospital utilization. More detailed analyses were performed for specific gender and age subgroups. Participant surveys indicated high levels of satisfaction, and improvements in self-perceived …

Sources Of Variation In Nutrient Intakes Among Men In Shanghai, China, Hui Cai, Gong Yang, Yong-Bing Xiang, James R. Hébert, Da-Ke Liu, Wei Zheng, Xiao-Ou Shu

Faculty Publications

Background and objective: Random errors, from any source, will attenuate epidemiological risk estimates. Before we launched the Shanghai Men’s Health Study (SMHS), a large population-based cohort study investigating the diet–cancer association among Chinese men, a dietary calibration study was conducted among 96 men aged 40–75 years (mean age 56.5 years), with biweekly 24-hour dietary recalls (24HDRs) implemented over a 1-year period. Data from this study were analysed to evaluate the nature and magnitude of variances for intake of 26 nutrients among SMHS participants, to compare variance ratios of 26 nutrients among Chinese men and women and individuals in other studies, …

Fixation Of Bilateral Pelvic Osteotomies With External Fixator In Exstrophy Bladder Complex, Salman Riaz, Shahbaz Sarwar, Masood Umer

Department of Surgery

Abstract

OBJECTIVE:

To present the early results of pelvic osteotomies performed for repair of exstrophy bladder.

METHODS:

Five cases of exstrophy bladder were treated with closure following bilateral iliac osteotomies. Three patients underwent closure of pubic symphysis diastasis by use of external fixator, one by screws and cerclage wires, and one by use of K-wires and suture. The patients were followed up by the pediatric urologist and orthopedic surgeon.

RESULTS:

All patients achieved a closure of diastasis and a tension free repair after the index surgery. The average follow-up was 3.6 years with range of 4 months to 6 years. …

Intimate Partner Violence And Disabilities Among Women Attending Family Practice Clinics, Ann L. Coker, Paige H. Smith, Mary Kay Fadden

CRVAW Faculty Journal Articles

Purpose: To estimate the frequency and type of disabilities preventing work among those experiencing intimate partner violence (IPV) compared with those never experiencing IPV.

Methods: We used a large cross-sectional survey of women, ages 18–65, attending family practice clinics from 1997 through 1998. Participation included a 5–10-minute in-clinic survey assessing IPV experience and a longer telephone survey assessing health status and chronic disabilities that prevented work outside the home or housework.

Results: Of 1,152 eligible women surveyed, 54% experienced some type of IPV, and 24% were currently in a violent relationship. Women who had ever experienced IPV …

Seventeen Amino Acid Peptide (Peptide P) For Treating Ischemia And Reperfusion Injury, Peter R. Oeltgen, Mark S. Kindy

Molecular and Cellular Biochemistry Faculty Patents

Peptide P, having the amino acid sequence Tyr-D-Ala-Phe-Ala-Asp-Val-Ala-Ser-Thr-Ile-Gly-Asp-Phe-His-Ser-Ile-NH2-SEQ ID NO:1, is useful to treat ischemia.

Mammalian Micrornas: A Small World For Fine-Tuning Gene Expression, Cinzia Sevignani, George A. Calin, Linda D. Siracusa, Carlo M. Croce

Department of Microbiology and Immunology Faculty Papers

The basis of eukaryotic complexity is an intricate genetic architecture where parallel systems are involved in tuning gene expression, via RNA-DNA, RNA-RNA and RNA-protein and DNA-protein interactions. In higher organisms, about 97% of the transcriptional output is represented by non-coding RNA (ncRNA) encompassing not only rRNA, tRNA, introns, 5’ and 3’-untranslated regions, transposable elements and intergenic regions, but also a large rapidly emerging family, named microRNAs. MicroRNAs are short 20-22 nucleotide RNA molecules that have been shown to regulate the expression of other genes in a variety of eukaryotic systems. MicroRNAs are formed from larger transcripts that fold to produce …

Growth Factor–Induced Shedding Of Syndecan-1 Confers Glypican-1 Dependence On Mitogenic Responses Of Cancer Cells, Kan Ding, Martha Lopez-Burks, José A. Sánchez-Duran, Murray Korc, Arthur D. Lander

Dartmouth Scholarship

The cell surface heparan sulfate proteoglycan (HSPG) glypican-1 is up-regulated by pancreatic and breast cancer cells, and its removal renders such cells insensitive to many growth factors. We sought to explain why the cell surface HSPG syndecan-1, which is also up-regulated by these cells and is a known growth factor coreceptor, does not compensate for glypican-1 loss. We show that the initial responses of these cells to the growth factor FGF2 are not glypican dependent, but they become so over time as FGF2 induces shedding of syndecan-1. Manipulations that retain syndecan-1 on the cell surface make long-term FGF2 responses glypican …

Evoking Non-Repertory Verbal Behavior Across Operant Classes : The Effects Of Motor Echoic Sign Language Training Within The Context Of A Motivating Operation, Karelix Alicea

FIU Electronic Theses and Dissertations

The individual effects that echoic, mand, and sign language training procedures have on the acquisition of verbal behavior have been widely demonstrated, but more efficient strategies are still needed. This study combined all three treatment strategies into one treatment intervention in order to investigate the joint effects they may have on verbal behavior. Six participants took part in the study. Intervention totaled 1 hour/day for 5 days/week until mastery criterion for motor echoic behavior was achieved. Although motor echoic behavior were solely targeted for acquisition, significant increases in spontaneous motor mands were noted in all treatment participants. Additionally, 4 treatment …

Ada News - 11/21/2005, American Dental Association, Publishing Division

ADA News

Established in 1970 as the official newspaper of the American Dental Association, the ADA News serves practicing dentists and others allied to the dental profession in the U.S. and internationally. It is the No. 1 source of news and information about the many benefits and services the ADA delivers to members daily as well as timely information on scientific, social, political and economic developments affecting dentistry and health care.

Loss Of Editing Activity During The Evolution Of Mitochondrial Phenylalanyl-Trna Synthetase, Hervé Roy, Jiqiang Ling, Juan D. Alfonzo, Michael Ibba

Biology, Chemistry, and Environmental Sciences Faculty Articles and Research

Accurate selection of amino acids is essential for faithful translation of the genetic code. Errors during amino acid selection are usually corrected by the editing activity of aminoacyl-tRNA synthetases such as phenylalanyl-tRNA synthetases (PheRS), which edit misactivated tyrosine. Comparison of cytosolic and mitochondrial PheRS from the yeast Saccharomyces cerevisiae suggested that the organellar protein might lack the editing activity. Yeast cytosolic PheRS was found to contain an editing site, which upon disruption abolished both cis and trans editing of Tyr-tRNA^Phe. Wild-type mitochondrial PheRS lacked cis and trans editing and could synthesize Tyr-tRNA^Phe, an activity enhanced in …