Medicine and Health Sciences Commons^™

Fuzzy Logic In Neurosurgery: Predicting Poor Outcomes After Lumbar Disk Surgery In 501 Consecutive Patients, Muhammad Shahzad Shamim, Ather Enam, Uvais Qidwai

Section of Neurosurgery

Background: Despite a lot of research into Patient selection, a significant number of Patients fail to benefit from surgery for symptomatic lumbar disk herniation. We have used Fuzzy Logic-based fuzzy inference system (FIS) for identifying Patients unlikely to improve after disk surgery and explored FIS as a tool for surgical outcome prediction.
Methods: Data of 501 Patients were retrospectively reviewed for 54 independent variables. Sixteen variables were short-listed based on heuristics and were further classified into memberships with degrees of membership within each. A set of 11 rules was formed, and the rule base used individual membership degrees and their …

Trauma Registry Needs And Challenges In Developing Countries., Amber Mehmood, Junaid Abdul Razzak

Department of Emergency Medicine

No abstract provided.

Mcnair Scholars Program, The Mcnair Team

McNair Scholars Research Journal

No abstract provided.

Mentor Profile, The Mcnair Team

McNair Scholars Research Journal

No abstract provided.

Full Issue, The Mcnair Team

McNair Scholars Research Journal

No abstract provided.

Analogical Reasoning: A Process For Fostering Learning Transfer From The Classroom To Clinical Practice, Timothy E. Speicher, Marijke Kehrhahn

All PTHMS Faculty Publications

In 2001, the Institute of Medicine (IOM), a committee of physicians and health policy experts charged to improve the health of the United States by the National Academy of Science, identified a gap in the area of education of health care practitioners as one of the reasons for medical error. However, one of the most common instructional methods in medical education to promote transfer and problem solving is examination of a single patient case (Shine, 2002), a pedagogical practice shown to be ineffective (Gentner, Loewenstein & Thompson, 2003; Norman et al., 2007). Therefore, adult learners in health care may be …

E-Therapy As A Means For Addressing Barriers To Substance Use Disorder Treatment For Persons Who Are Deaf, Dennis Moore, Debra Guthmann, Nikki Lynn Rogers, Susan Fraker, Jared A. Embree

Population and Public Health Sciences Faculty Publications

Persons who are deaf face a number of challenges with regard to vulnerability for substance use disorders. Moreover, accessible treatment for this condition can be difficult to establish and maintain. The Deaf community may be one of the most disenfranchised groups in America in regard to appropriate access to substance use disorder (SUD) prevention and treatment services. This article reviews
findings related to substance use disorder and treatment for this condition among persons who are deaf. It also reviews a promising approach for addressing treatment needs via e-therapy, and it highlights the challenges and concerns regarding e-therapy for this population. …

Molecular Confirmation Of The Causes Of Inherited Visual Impairment In Northern Pakistan, Mehreen Adhi, Yasmin Rashid, Syed Hussain Jafri, Chris F. Inglehearn, Martin Mc Kibbin

Department of Medicine

Families with inherited visual impairment were identified and examined from January 2000 to December 2005 and given a clinical diagnosis. Known genes and loci were screened for mutations or linkage at Institute of Ophthalmology and Neurosciences, University of Leeds, in order to provide molecular confirmation. Inherited retinal disease was the most common cause of inherited visual impairment in 38 of 57 families (66.6%) with Leber’s congenital amaurosis, rod-cone dystrophy and cone-rod dystrophy being the most common diagnoses in 22, 8 and 3 families respectively. Anterior segment dysgenesis was diagnosed in 8 families (14%). Mutations in known genes or linkage to …

Wegener's Granulomatosis: A Diagnostic Challenge, Ali Bin Sarwar Zubairi, Hammad Bin Liaquat, Shahid Javed Husain, Kulsoom Fatima

Department of Medicine

Wegener's Granulomatosis (WG) is a necrotizing granulomatous vasculitis that primarily involves small vessels in the body. Patient usually presents in the fourth to fifth decade. The clinical presentation is variable; however, majority of patients (90%) seek medical attention for nasal and sinus symptoms with or without lower respiratory symptoms of cough, dyspnoea and haemoptysis. The typical form of WG tends to involve the triad of upper and lower respiratory tract and the kidneys; while involvement of other organs like ocular, cutaneous, rheumatological, neural, gastrointestinal and lower genito-urinary tract is occasionally seen. A "limited" form with clinical findings isolated to the …

The 600-Step Program For Type I Diabetes Self-Management In Youth: The Magnitude Of The Self-Management Task, Ronald D. Coffen

Faculty Publications

This article demonstrates the complexity of the type 1 diabetes regimen and describes the physician's role in safely promoting self-management of diabetes by youth. Literature describing type 1 diabetes and the required regimen, issues related to regimen adherence by youth, demonstration of the magnitude of the regimen, and implications for physicians are addressed. A task analysis and tool for physicians is presented that contains over 600 tasks. Given the magnitude of the regimen, issues related to the physician's promotion of the gradual transfer of regimen control to youth are illustrated. The importance of understanding broad areas of the regimen (eg, …

Carotid Artery Disease In Patients Undergoing Elective Coronary Artery Bypass Surgery, Waseem Akhtar, Ayan Sabih, Arif Ali, Mubashir Aslam, Nadeem Ahmad

Department of Radiology

OBJECTIVE: To determine frequency of carotid artery disease in patients undergoing elective coronary artery bypass grafting (CABG) using Doppler sonography.STUDY DESIGN: Observational study.

PLACE AND DURATION OF STUDY: Radiology Department, The Aga Khan University Hospital, Karachi, from January 2005 to September 2008.

METHODOLOGY: Patients with known cardiovascular disease waiting for CABG surgery were enrolled for carotid artery Doppler sonography. A predefined data entry form was used for data collection. Coronary angiography findings, carotid artery findings and other associated factors were noted from medical and radiological records. Frequency and pattern of carotid artery disease along with associated risk factors were evaluated. …

Microsphere Based Protease Assays And High Throughput Screening Of Bacterial Toxin Proteases, Matthew J. Saunders

Biomedical Sciences ETDs

Proteases, proteins which cleave peptide bonds in other proteins, are a large and varied group of proteins which regulate a variety of physiological processes. Methodologies to study proteases are often protease specific and often differ greatly from the roles proteases play in vivo. In vitro protease assays often use peptide based substrates, which do not take into account highly specific interactions distal from the proteolytic site of peptide cleavage on protease substrates. In the work described here we have developed a microsphere based protease assay, capable of using full length protease substrates, and have successfully measured proteolytic activity via loss …

Inducible Heat Shock Protein 70 Enhances Human Papillomavirus Type 31 Genome Replication, Viral Capsid Protein Nuclear Localization And Progeny Virion Morphogenesis In Human Keratinocytes, Hebin Song

Biomedical Sciences ETDs

Human papillomaviruses (HPVs) are small, non-enveloped double stranded DNA viruses that demonstrate a strict species and cell type tropism for human epithelial cells. The association between high-risk HPV types and cervical cancer is well established. Additionally, HPVs have been implicated as causes in development of several other epithelial cancer types. Increasing data indicate heat shock proteins (HSPs) including inducible HSP70 (HSP70i) are involved in the replicative cycles of different viruses including adenoviruses, polyomaviruses (PyV), and some RNA viruses. Cell-free system studies implicate HSP70i in HPV11 genome replication with E1 and E2 proteins, and there is evidence that HSP70 is involved …

Longitudinal Analysis Of The Vaginal Microflora In Pregnancy Suggests That L. Crispatus Promotes The Stability Of The Normal Vaginal Microflora And That L. Gasseri And/Or L. Iners Are More Conducive To The Occurrence Of Abnormal Vaginal Microflora, Hans Verstraelen, Rita Verhelst, Geert Claeys, Ellen De Backer, Marleen Temmerman, Mario Vaneechoutte

Obstetrics and Gynaecology, East Africa

Background: Despite their antimicrobial potential, vaginal lactobacilli often fail to retain dominance, resulting in overgrowth of the vagina by other bacteria, as observed with bacterial vaginosis. It remains elusive however to what extent interindividual differences in vaginal Lactobacillus community composition determine the stability of this microflora. In a prospective cohort of pregnant women we studied the stability of the normal vaginal microflora (assessed on Gram stain) as a function of the presence of the vaginal Lactobacillus index species (determined through culture and molecular analysis with tRFLP).

Results:From 100 consecutive Caucasian women vaginal swabs were obtained at mean gestational ages …

Manganese Flux Across The Blood-Brain Barrier, Robert A. Yokel

Pharmaceutical Sciences Faculty Publications

Manganese (Mn) is essential for brain growth and metabolism, but in excess can be a neurotoxicant. The chemical form (species) of Mn influences its kinetics and toxicity. Significant Mn species entering the brain are the Mn²⁺ ion and Mn citrate which, along with Mn transferrin, enter the brain by carrier-mediated processes. Although the divalent metal transporter (DMT-1) was suggested to be a candidate for brain Mn uptake, brain Mn influx was not different in Belgrade rats, which do not express functional DMT-1, compared to controls. Brain Mn influx was not sodium dependent or dependent on ATP hydrolysis, but was …

Identification And Genotyping Of Bacteria From Paired Vaginal And Rectal Samples From Pregnant Women Indicates Similarity Between Vaginal And Rectal Microflora, Nabil Abdullah El Aila, Inge Tency, Geert Claeys, Hans Verstraelen, Bart Saerens, Guido Lopes Dos Santos Santiago, Ellen De Backer, Piet Cools, Marleen Temmerman, Rita Verhelst

Obstetrics and Gynaecology, East Africa

Background: The vaginal microflora is important for maintaining vaginal health and preventing infections of the reproductive tract. The rectum has been suggested as the major source for the colonisation of the vaginal econiche.

Methods: To establish whether the rectum can serve as a possible bacterial reservoir for colonisation of the vaginal econiche, we cultured vaginal and rectal specimens from pregnant women at 35-37 weeks of gestation, identified the isolates to the species level with tRNA intergenic length polymorphism analysis (tDNA-PCR) and genotyped the isolates for those subjects from which the same species was isolated simultaneously vaginally and rectally, by RAPD-analysis. …

Hla-Dpb1 And Dpb2 Are Genetic Loci For Systemic Sclerosis: A Genome-Wide Association Study In Koreans With Replication In North Americans, Xiaodong Zhou, Jong Eun Lee, Frank C Arnett, Momiao Xiong, Min Young Park, Yeon Kyeong Yoo, Eun Soon Shin, John D Reveille, Maureen D Mayes, Jin Hyun Kim, Ran Song, Ji Yong Choi, Ji Ah Park, Yun Jong Lee, Eun Young Lee, Yeong Wook Song, Eun Bong Lee

Faculty, Staff and Student Publications

OBJECTIVE: To identify systemic sclerosis (SSc) susceptibility loci via a genome-wide association study.

METHODS: A genome-wide association study was performed in 137 patients with SSc and 564 controls from Korea using the Affymetrix Human SNP Array 5.0. After fine-mapping studies, the results were replicated in 1,107 SSc patients and 2,747 controls from a US Caucasian population.

RESULTS: The single-nucleotide polymorphisms (SNPs) (rs3128930, rs7763822, rs7764491, rs3117230, and rs3128965) of HLA-DPB1 and DPB2 on chromosome 6 formed a distinctive peak with log P values for association with SSc susceptibility (P=8.16x10(-13)). Subtyping analysis of HLA-DPB1 showed that DPB1*1301 (P=7.61x10(-8)) and DPB1*0901 (P=2.55x10(-5)) were …

Apolipoprotein E But Not B Is Required For The Formation Of Infectious Hepatitis C Virus Particles, Jieyun Jiang, Guangxiang Luo

Microbiology, Immunology, and Molecular Genetics Faculty Publications

Our previous studies have found that hepatitis C virus (HCV) particles are enriched in apolipoprotein E (apoE) and that apoE is required for HCV infectivity and production. Studies by others, however, suggested that both microsomal transfer protein (MTP) and apoB are important for HCV production. To define the roles of apoB and apoE in the HCV life cycle, we developed a single-cycle HCV growth assay to determine the correlation of HCV assembly with apoB and apoE expression, as well as the influence of MTP inhibitors on the formation of HCV particles. The small interfering RNA (siRNA)-mediated knockdown of apoE expression …

香港視障長者生活質素調査 : 應用手冊, The Hong Kong Society For The Blind 香港盲人輔導會, Asia-Pacific Institute Of Ageing Studies, Lingnan University 嶺南大學亞太老年學研究中心

Manual & Guide 手冊及指引

隨著社會的發展，社會大眾對生活的要求亦日益提高。人們並不滿足於基本的生活程度，而是追求舒適的生活環境，高質素的服務，對身體狀況亦更加關注。

在90年代中期開始，香港的學者開始研究「生活質素」這個課題，並發展出一些適合香港使用的「生活質素」量度工具。社會上不同群體對生活質素的界定及期望，可能和一般市民有所不同，要量度以致改善他們的生活質素，便需要特定的量度工具。

香港盲人輔導會於2008年委託嶺南大學亞太老年學研究中心設計了一份有關視障長者生活質素的問卷，並成功訪問了580位55歲以上分別居住在社區及院舍的長者，以便了解他們的生活質素。

是次研究的目標為：

1. 從香港視障長者的角度出發，發展一套量化及可量度視障長者生活質素的工具；

2. 為香港視障長者的生活質素提供一個研究上的參考基數；

3. 以視障長者生活質素量度工具作日後服務管理，為服務提供方向性的指引，並成為本地視障長者服務發展的參考。

本應用手冊將會以深入淺出的方法，向大家闡述如何利用這份「視障長者生活質素調查問卷」評估服務成效及作服務管理。

A Pilot Study Of An Automated Voice Response System And Nursing Intervention To Monitor Adherence To Oral Chemotherapy Agents, Veronica Decker, Sandra L. Spoelstra, Emily Miezo, Renee Bremer, Mei You, Charles W. Given, Barbara A. Given

Peer Reviewed Articles

This study was designed to develop and test a system to monitor adherence with non-hormonal oral chemotherapeutic agents using an automated voice response (AVR) system plus nursing intervention. Participants received the Symptom Management Toolkit then participated in an interview for symptom severity, satisfaction, and beliefs about oral agents. Patients received weekly AVR calls, which assessed adherence to oral agents and severity of 15 symptoms. Patients who reported adherence of < 100% of prescribed oral agents or symptoms of 4 or greater (0-10 scale) for three consecutive weeks, were called by a nurse for assistance with symptom management and adherence to oral chemotherapy medications. Following the 8 weekly AVR calls, patients participated in a follow up interview and medical record review. Subjects were 30 oncology patients who were ambulatory and treated at two cancer centers in Midwest USA. The results indicate 23.3% non adherence rate to oral chemotherapy medications due to symptoms and forgetting to take the medication. An association between symptom management and adherence was found. Symptom severity and beliefs about medications were not significantly different between adherent and non adherent patients. This pilot study demonstrated the ability to accrue patients for a longitudinal trial and informed intervention design, while providing guidance for future interventions and research studies.

This study was designed to develop and test a system to monitor adherence with nonhormonal oral chemotherapeutic agents using an automated voice response (AVR) system plus nursing intervention. Participants were patients …

Evening Primrose Oil, Bryan Bayles, Richard Usatine

Public Health (Archived)

Evening primrose oil (Oenothera biennis) is a commonly used alternative therapy and a rich source of omega-6 essential fatty acids. It is best known for its use in the treatment of systemic diseases marked by chronic inflammation, such as atopic dermatitis and rheumatoid arthritis. It is often used for several women’s health conditions, including breast pain (mastalgia), menopausal and premenstrual symptoms, cervical ripening, and labor induction or augmentation. However, there is insufficient evidence to make a reliable assessment of its effectiveness for most clinical indications. The current evidence suggests that oral evening primrose oil does not provide clinically significant improvement …

Parental Perceptions Of Body Mass Index Referrals And Overweight School-Age Children, Misty Schwartz

Department of Educational Administration: Dissertations, Theses, and Student Research

It is well documented that there is a worldwide epidemic of obesity in children. To address obesity in children, emphasis must be on factors within family, school, and community environments. Although most parents and school officials are aware of the problem of overweight children, there is little data available to guide decision making about the acceptability of school-based Body Mass Index (BMI) screening and referral programs. As states mandate BMI screening and referral, parental insight is essential to determine the efficiency and effectiveness of BMI notification.

The purpose of this multiple case study was to explore the perceptions of parents …

Outcome And Haemato-Toxicity Of Two Chemotherapy Regimens For Childhood Non-Hodgkin's Lymphoma In A Kenyan Hospital, William Macharia

Paediatrics and Child Health, East Africa

Background: Effectiveness and toxicity of childhood cancer treatments have never been evaluated in Kenya since introduction of structured care in the early seventies.

Objective:To evaluate effectiveness and toxicity of two treatment protocols for Non- Hodgkin’s lymphoma (NHL).

Design: Historical cohort study using medical records.

Setting: Kenyatta National Hospital, a tertiary care and medical teaching hospital.

Subjects: Children ≤ 15 years with diagnosis of non-Hodgkin’s Lymphoma.

Main outcome measures: Primary outcomes were median survival, event free survival and toxicity.

Results: Out of 101 records, only 26 (25.7%) met inclusion criteria. Baseline characteristics were similar in the two treatment arms. …

Application Of Different Bioanalytical Workflows For Proteomics Of Prostate Cancer, Li Chen

Theses and Dissertations (ETD)

In the current dissertation, we focused on the development and application of multiple mass spectrometry-based bioanalytical platforms for phosphoproteomic characterization in cell culture and clinical specimens of prostate cancer; and on the application of optimized methods to analysis of differential protein expression to reveal molecular mechanism of drug action in animal model of prostate cancer.

Characterization of the phosphoproteome in prostate cancer

Our study in phosphoprotein signatures on a large scale in prostate cancer focused on the LNCaP human prostate cancer cell line, and on human prostate cancer tissue.

For the LNCaP prostate cancer cell line, we applied a combination …

Stepped Care For Smoking Cessation: A Cost-Effectiveness Analysis And Simulation Of Future Outcomes, Brandi E. Franklin

Theses and Dissertations (ETD)

It has been well established that smoking is the leading avoidable cause of premature morbidity and mortality in the United States and abroad. Smoking is attributable to over 400,000 annual deaths, and $193 billion in healthcare costs and lost productivity. Despite the apparent dangers and tremendous costs of tobacco use and dependence, smokers find difficulty quitting. Recently, stepped care has been proposed as a viable intensive approach for achieving long-term cessation. This research sought to evaluate cost-effectiveness of stepped care in a diverse population of smokers and analyze future health outcomes of smoking cessation.

Cost-effectiveness analysis was conducted from an …

From Means To Ends: Artificial Nutrition And Hydration, Cheryl Monturo, Kevin Hook

Nursing Faculty Publications

No abstract provided.

J Am Coll Dent 2009 76 4

Journal of the American College of Dentists

The Journal of the American College of Dentists (JACD) publishes scholarly articles, editorials, essays, and reflections addressing the ethical, professional, and social dimensions of dentistry. The Journal serves as a forum for advancing ethics, professionalism, leadership, and excellence within the dental community. By fostering dialogue across disciplines and perspectives, JACD provides readers with insights that encourage ethical, professional practice, lifelong learning, and service to the public, reinforcing dentistry’s commitment to advancing oral healthcare and the common good.

Role Of N-Acetylcysteine In Adults With Non-Acetaminophen-Induced Acute Liver Failure In A Center Without The Facility Of Liver Transplantation., Khalid Mumtaz, Zahid Azam, Saeed Hamid, Shahab Abid, Sadik Memon,, Syed H Shah, Wasim Jafri

Section of Gastroenterology

PURPOSE:

We aimed to study the role of N-acetylcysteine (NAC) in non-acetaminophen-induced acute liver failure (NAI-ALF).

METHODS:

A total of 47 adult patients were prospectively enrolled with NAI-ALF (group 1 or NAC group) and oral NAC was given. The primary outcome was reduction in mortality with the use of NAC in NAI-ALF. The secondary outcomes were to evaluate safety of NAC and to assess factors predicting mortality. We compared these results with records of NAI-ALF patients admitted in our hospital from 2000 to 2003 (n = 44) who were not given NAC (group 2 or historical controls).

RESULTS:

The two …

Notes From The Director, The Mcnair Team

McNair Scholars Research Journal

No abstract provided.

Acknowledgements, The Mcnair Team

McNair Scholars Research Journal

No abstract provided.