Medicine and Health Sciences Commons^™

An Unusual Location For Prostate Brachytherapy Seeds, Sivakumar Srinivasan, Md, Sandeep Anreddy, Md

The Medicine Forum

Vascular migration of radioactive seeds to the lungs after prostate brachytherapy is known phenomenon. Here in we report a case of prostate brachytherapy seed migration into the right ventricle.

Fool, Marshall Fleurant, Md

The Medicine Forum

They say God protects fools and the innocent

They say God protects the innocent and the souls of children

Unfortunately the years of childhood has passed me

I doubt that God looks upon me as innocent

So I pray to be the fool

Woman With Relapsing Fevers, Mary Kate Mccullen, Md

The Medicine Forum

A 50 year-old Nigerian woman with a past medical history significant for type II diabetes and hypertension presented to the ED with a chief complaint of recurrent fevers and chills. The patient was in her usual state of health until approximately 6 weeks prior to admission, while during a visit with family in Nigeria she noted the onset of high fevers and general malaise. Initially, her fevers occurred daily for a period of one week, and were associated with chills, fatigue, loss of appetite, and myalgias. During this time, she was not evaluated by a physician, nor did she take …

Herpes Zoster Ophthalmicus With Third Nerve Palsy, Bonnie Callahan, Md, Utpal Sagar, Md, Ted Martynowicz, Do

The Medicine Forum

Introduction

Herpes zoster is a recurrent infection of the varicella-zoster virus. When it infects the periorbital region, the virus often involves the ocular structures, and may lead to more disastrous sequelae, including blindness. Despite advancements, including immunization and antiviral therapy, zoster ophthalmicus persists in the population. Therapy mitigates, but does not obviate, many of the complications of infection. Our paper describes a patient with herpes zoster ophthalmicus that presented from the community.

Coronary Heart Disease Prediction And Prevention, Dae Hyun Kim, Md, Mph, Andrew N. Lee, Md

The Medicine Forum

Introduction

Prediction of coronary heart disease (CHD) is based on multivariable risk equations developed from population-based observational studies in which people without clinical CHD at the initiation of study were examined and followed until their first CHD events. The risk equations from the Framingham Heart Study have been widely used in our clinical practice1-3 and research.4,5 The recent report of the third National Cholesterol Education Program-Adult Treatment Panel (NCEP-ATP) incorporated the Framingham risk equations to predict ten-year absolute CHD risk and to identify certain patients who are at high risk and more likely to benefit from primary prevention with aggressive …

Changing The Way We Think About Irritable Bowel Syndrome, Roger Coron, Md, Herve Boucard, Md, Zamir Brelvi, Md

The Medicine Forum

Irritable bowel syndrome has long been considered a functional gastrointestinal disorder. However, recent studies have suggested possible organic causes that can explain the multitude of symptoms in IBS.

Brief History

The irritable bowel syndrome has been thought of as a functional gastrointestinal disorder for many years. As long as three thousand years ago, Hippocrates described a triad of symptoms consisting of abdominal discomfort, irregular bowel movements and bloating. In 1817, William Powell reported a case with similar symptoms as Hippocrates. In 1849, Cumming described a syndrome of irregular bowel habits consisting of alternating diarrhea and constipation.1 In 1928, Bockus and …

Cidofovir And Intravenous Immunoglobulin For Treatment Of Bk Polyomarivus Nephropathy, Anita Mehrotra, Md, Rajani Dinavahi, Md, George C. Francos, Md

The Medicine Forum

BK polyomavirus nephropathy (BKN) is an important cause of renal allograft dysfunction and loss. The mainstay of therapy is reduced immunosuppression, but definitive protocols for the diagnosis and management remain to be defined. We report here a retrospective analysis of 6 patients with BKN treated with cidofovir and intravenous immunoglobulin(IVIG).

Inverse Expression Of Fas Ligand And Asthma-Related Cytokines In An Apergillus Challenge Murine Model Of Asthma, T. Lin, Md, Allyson Larkin, Md, S. Sharma, Md, S. Patel, Md, J. Peterson, Md, S. Kierstein, Md, A. Haczku, Md, J. Zangrilli Md

The Medicine Forum

Introduction

Resolution of inflammation in asthma is typically thought of as a passive phenomenon in which proinflammatory Th2-type cytokines wane after the initial trigger. We hypothesized that active mechanisms, including anti-inflammatory cytokines and proapoptotic factors, contribute to this process. Fas Ligand (FasL) expression was particularly interesting since important effector cells in asthma (e.g. eosinophils and T helper cells) are Fas-sensitive.

From The Editors, Andrew Rose, Md, Karl Kwok, Md, Neilanjan Nandi, Md, Utpal Sagar, Md

The Medicine Forum

As we were completing the final touches on the 8th volume of The Jefferson Medicine Forum, the members of the editing staff could not help but note the vast variety of medicine we are privileged to witness daily. Textbook cases of malaria, herpes zoster ophthalmicus, and Lyme disease mixed among patients with migrating prostatic radiation seeds or reversible encephalophathy due to hypertension are the perfect example of the marvelous diversity of pathology to which we are exposed. Our residents have interests ranging from coronary heart disease to irritable bowel disease and research throughout the spectrum of internal medicine.

Table Of Contents: The Medicine Forum, Volume 8, 2006

The Medicine Forum

Table of Contents: The Medicine Forum, Volume 8, 2006

From The Residency Program Director, Gregory C. Kane Md, Facp, Fccp

The Medicine Forum

Can an art masterpiece embody the spirit of a University?

This question was not considered at Jefferson before this year or until the University pursued the sale of Thomas Eakins’ seminal work, The Gross Clinic.

The depiction of Dr. Samuel Gross, Professor of Surgery, at work in the surgical amphitheatre captured the emergence of American Medicine from the shadow of Europe and foreshadowed the American century which was yet to come.

Viewed in this light, the work is indeed an important part of the history of Jefferson, Philadelphia, the medical/scientific community, and the entire nation. Even more significant is the …

Microglial P38Α Mapk Is A Key Regulator Of Proinflammatory Cytokine Up-Regulation Induced By Toll-Like Receptor (Tlr) Ligands Or Beta-Amyloid (Aβ), Adam D. Bachstetter, Bin Xing, Lucia De Almeida, Edgardo R. Dimayuga, D. Martin Watterson, Linda J. Van Eldik

Sanders-Brown Center on Aging Faculty Publications

BACKGROUND: Overproduction of proinflammatory cytokines from activated microglia has been implicated as an important contributor to pathophysiology progression in both acute and chronic neurodegenerative diseases. Therefore, it is critical to elucidate intracellular signaling pathways that are significant contributors to cytokine overproduction in microglia exposed to specific stressors, especially pathways amenable to drug interventions. The serine/threonine protein kinase p38α MAPK is a key enzyme in the parallel and convergent intracellular signaling pathways involved in stressor-induced production of IL-1β and TNFα in peripheral tissues, and is a drug development target for peripheral inflammatory diseases. However, much less is known about the quantitative …

Ceacam1 Separates Graft-Versus-Host-Disease From Graft-Versus-Tumor Activity After Experimental Allogeneic Bone Marrow Transplantation., Sydney X Lu, Lucy W Kappel, Anne-Marie Charbonneau-Allard, Renée Atallah, Amanda M Holland, Claire Turbide, Vanessa M Hubbard, Jimmy A Rotolo, Marsinay Smith, David Suh, Christopher King, Uttam K Rao, Nury Yim, Johanne L Bautista, Robert R Jenq, Olaf Penack, Il-Kang Na, Chen Liu, George Murphy, Onder Alpdogan, Richard S Blumberg, Fernando Macian, Kathryn V Holmes, Nicole Beauchemin, Marcel R M Van Den Brink

Department of Medical Oncology Faculty Papers

BACKGROUND: Allogeneic bone marrow transplantation (allo-BMT) is a potentially curative therapy for a variety of hematologic diseases, but benefits, including graft-versus-tumor (GVT) activity are limited by graft-versus-host-disease (GVHD). Carcinoembryonic antigen related cell adhesion molecule 1 (Ceacam1) is a transmembrane glycoprotein found on epithelium, T cells, and many tumors. It regulates a variety of physiologic and pathological processes such as tumor biology, leukocyte activation, and energy homeostasis. Previous studies suggest that Ceacam1 negatively regulates inflammation in inflammatory bowel disease models.

METHODS: We studied Ceacam1 as a regulator of GVHD and GVT after allogeneic bone marrow transplantation (allo-BMT) in mouse models. In …

2011 July 5 - Medical Student Education Committee Minutes, Medical Student Education Committee, East Tennessee State University

Medical Student Education Committee Minutes

No abstract provided.

Decision Quality Instrument For Treatment Of Hip And Knee Osteoarthritis: A Psychometric Evaluation, Karen R. Sepucha, Dawn Stacey, Catharine F. Clay, Yuchiao Chang

Dartmouth Scholarship

A high quality decision requires that patients who meet clinical criteria for surgery are informed about the options (including non-surgical alternatives) and receive treatments that match their goals. The aim of this study was to evaluate the psychometric properties and clinical sensibility of a patient self report instrument, to measure the quality of decisions about total joint replacement for knee or hip osteoarthritis.

Medical School Watercooler Newsletter - July 3, 2011, Lindsey Lyle

Watercooler Newsletter

This is the July 3, 2011 edition of the Frederick P. Whiddon College of Medicine's newsletter, Watercooler

Contents Include

• USA College of Medicine Hosts Inaugural Crampton Trust Lecture in Geriatric Medicine

• Students, Residents and Faculty Named to USA Chapter of Gold Humanism Honor Society

• USA College of Medicine Welcomes Dr. Haidee Custodio

• Dr. Frye Retires After 17 Years of Service

Intracranial Atherosclerotic Disease, Maria Khan, Imama Naqvi, Asha Bansari, Ayeesha Kamran Kamal

Department of Medicine

Intracranial atherosclerotic disease (ICAD) is the most common proximate mechanism of ischemic stroke worldwide. Approximately half of those affected are Asians. For diagnosis of ICAD, intra-arterial angiography is the gold standard to identify extent of stenosis. However, noninvasive techniques including transcranial ultrasound and MRA are now emerging as reliable modalities to exclude moderate to severe (50%-99%) stenosis. Little is known about measures for primary prevention of the disease. In terms of secondary prevention of stroke due to intracranial atherosclerotic stenosis, aspirin continues to be the preferred antiplatelet agent although clopidogrel along with aspirin has shown promise in the acute phase. …

Integrative Health Studies Newsletter, Ciis

Integrative Health Studies Newsletter

This is the Summer 2011 issue of the Integrative Health Studies Newsletter at CIIS.

Correctional Managed Health Care (Cmhc) Annual Report July 2010 - June 2011, Robert L. Trestman

Annual Reports - Patient Care

Correctional Managed Health Care (CMHC) provides global medical, mental health, pharmacy, and dental services at 16 CDOC facilities statewide clustered into ten functional units, at 42 CDOC-contracted halfway houses and at JDH. As of June, 2011, services were provided by 714 full-time equivalent staff (a total of 813 individuals) to a population of 18,700 individuals (17,584 incarcerated and 1,116 in halfway houses). We provide this care under a Memorandum of Agreement (MOA) with the Connecticut Department of Correction (CDOC) since November 1997.

Loss Of Dna Mismatch Repair Imparts A Selective Advantage In Planarian Adult Stem Cells, Jessica P. Hollenbach, Alissa M. Resch, Dasaradhi Palakodeti, Brenton R. Graveley, Christopher D. Heinen

UCHC Articles - Research

Lynch syndrome (LS) leads to an increased risk of early-onset colorectal and other types of cancer and is caused by germline mutations in DNA mismatch repair (MMR) genes. Loss of MMR function results in a mutator phenotype that likely underlies its role in tumorigenesis. However, loss of MMR also results in the elimination of a DNA damage-induced checkpoint/apoptosis activation barrier that may allow damaged cells to grow unchecked. A fundamental question is whether loss of MMR provides pre-cancerous stem cells an immediate selective advantage in addition to establishing a mutator phenotype. To test this hypothesis in an in vivo system, …

Cultural Conceptions Of Health, Caroline Stephens

Independent Study Project (ISP) Collection

Healthcare is a complicated structure, influenced by multiple economic, social and cultural factors. It is problematic enough to determine how to administer healthcare in countries that rely only on the western healthcare system, but it is even more difficult in places such as Madagascar where multiple healthcare systems exist. Today the Malagasy have a culture that combines the many French practices with the traditional Malagasy beliefs, traditions and values. Many Malagasy chose to utilize allopathic medicine, but many others still prefer to go to a traditional healer. By gaining a better understanding of the average Malagasy person’s perceptions of proper …

Healers And Researchers: Towards A More Balanced Relationship, Gracie Tewkesbury

Independent Study Project (ISP) Collection

In my seminar paper, I discussed the benefits for both parties of collaboration between traditional healers and modern scientific researchers. If research is done on the medicinal effects of plants, these cures can be used more safely and effectively by members of the community. This relationship is greatly beneficial in theory, but the reality is less than ideal. Researchers, especially foreign ones, depreciate and exploit the knowledge of healers, and as a result, healers are often distrustful and unwilling to collaborate. The relationship between healers and researchers potentially holds the cures to countless diseases and can contribute directly to greater …

Western Influence, Latent Racism, And Their Impact On Access To Health Care In Madagascar, Jessica Joy

Independent Study Project (ISP) Collection

While the Malagasy commemorate their Independence Day on June 26 as the day they were freed from colonization and allowed to function as their own country with their own cultures and practices, colonization and Western influence has left an indelible mark on Madagascar that continues to exert its power to this day, shaping Malagasy social behaviors, values, and lives. The introduction of the slave trade to Madagascar in the mid-1800s, as well as French colonization, has left behind a thriving latent and structural racism in the country; a Western ideal of beauty, made complete by its valorization of fair skin, …

Plants, People, And Partnership In Madagascar: How Pharmaceutical Companies And Bioprospecting Ventures Must And May Positively Benefit The Communities Whose Resources They Use, Rebecca Slotkin

Independent Study Project (ISP) Collection

For centuries, traditional medical practitioners around the world have understood the tremendous wealth of medicinal power that can be found in the natural environment. In Madagascar, traditional practitioners have both used and cared for their natural environment, which in turn has given them a wide array of medical knowledge. According to the World Health Organization (WHO), “approximately 80% of the world’s inhabitants rely predominantly on traditional medicines for their primary health care” (Cao et al. 2009). Traditional medical knowledge has relatively recently come to the attention of the international medical market. This “recent ‘rediscovery’ of medicinally useful plants” (Sheldon et …

The Benefits Of Having An Integrated Health Care System In Madagascar, Elizabeth Miller

Independent Study Project (ISP) Collection

For my individual research, I wanted to look into all the benefits that could be offered by collaborating allopathic and traditional healthcare systems and how such a system is accomplished in Madagascar, in order to weigh and to discover the feasibility of using integrated healthcare systems as sustainable development in other parts of the world. Furthermore, as Madagascar sets the example in my research this summer, the use of traditional and modern medicine as an integrated health care system best serves the majority of the Malagasy population for several important reasons.

“Mind The Gap” Addressing The Gap Between Health Care Policy & Health Care Reality In Madagascar & The Way Forward Integrating Traditional Medicine & Ethical Reform Within Health Care, Laura Dillon

Independent Study Project (ISP) Collection

At first glance the health care system in Madagascar looks pretty good. No health care system is perfect, in fact most are far from perfect, but some certainly work better than others. On paper it seems that the current system in Madagascar would be among those that “work better”. Sadly, there is oftentimes a disconnect between what a government writes on paper and what happens in reality; looking around the streets of Antananarivo it quickly became apparent that Madagascar is an example of this disconnect. You do not have to be a health care professional to see the lack of …

Com Outlook Summer 2011, College Of Osteopathic Medicine

COM Outlook

No abstract provided.

Systematically Controlling For The Influence Of Age, Sex, Hertz And Time Post-Whole-Body Vibration Exposure On Four Measures Of Physical Performance In Community-Dwelling Older Adults: A Randomized Cross-Over Study, Harold L. Merriman, C. Jayne Brahler, Kurt Jackson

Physical Therapy Faculty Publications

Though popular, there is little agreement on what whole-body vibration (WBV) parameters will optimize performance. This study aimed to clarify the effects of age, sex, hertz, and time on four physical function indicators in community-dwelling older adults (N = 32). Participants were exposed to 2 minutes WBV per session at either 2 Hz or 26 Hz, and outcome measures were recorded at 2-, 20-, and 40-minute post-WBV. Timed get-up-and-go and chair sit-and-reach performances improved post-WBV for both sexes, were significantly different between 2 Hz and 26 Hz treatments (P ≤ 0.05), and showed statistically significant interactions between age and gender …

Influenza Vaccination Of The Healthcare Workforce: Developing A Model State Law, Alexandra M. Stewart, Marisa A Cox

Health Policy and Management Faculty Publications

No abstract provided.

Self-Esteem In Second Life: An Inworld Group Intervention For Women With Disabilities, Margaret A. Nosek, Susan Robinson Whelen, Rosemary B. Hughes, Erin Porcher, Giselle Davidson, Thomas M. Nosek

Rural Institute Journal Articles

We are developing and investigating the feasibility of a self-esteem enhancement intervention in Second Life for women with physical disabilities. We adapted the curriculum of a previously tested workshop intervention to include features unique to this environment. Results of the beta test were very positive. Everyone involved showed considerable enthusiasm for exploring the new world of SL. The group leaders were challenged to resolve technical problems on every occasion, but these diminished and were perceived as manageable as the intervention progressed. Beta testers gave positive ratings to the information presented, organization, and usefulness of the intervention and found it very …