Medicine and Health Sciences Commons^™

Woman With Post-Partum Kidney And Liver Failure, Joshua Gibbs Md, Pgy-3

The Medicine Forum

The patient is a 34 year-old G1P1 Caucasian female with
no medical history who was transferred from an outside
hospital after an emergent Cesarean section for increasing
jaundice with elevated liver enzymes, abnormal
coagulation times and acute renal failure. The patient
was healthy until 33 weeks gestation when she noted
dizziness, headache and visual changes. Blood pressure at
that time was elevated at 140/90 and she had trace lower
extremity edema. No proteinuria was detected. The
clinical picture was consistent with mild pre-eclampsia.
The patient was followed until 35 weeks gestation when
she developed vaginal bleeding and abdominal pain. At …

Woman With Mental Status Change, Vanita Treat Md, Pgy-3

The Medicine Forum

An 83 year-old African-American female with a history
of hypertension, frequent urinary tract infections, atrial
fibrillation, and a cerebrovascular accident (CVA) on
Coumadin presented two days after a fall. A family
member stated she was walking normally and tripped on
uneven concrete, hitting her chin on a fence. Two days
after the incident, the patient was found at home
slumped over in a chair with blood oozing from her chin
wound. The patient was brought to the emergency
department where she was lethargic but responsive. The
patient denied any chest pain, shortness of breath,
lightheadedness, dizziness, blurry vision, weakness or …

Table Of Contents-The Medicine Forum, Volume 6, Winter 2004

The Medicine Forum

Table of Contents-The Medicine Forum, Volume 6, Winter 2004

Welcome To The 6th Edition Of The Jefferson Medicine Forum, Nicole Weinberg Md, Betty Lim Md

The Medicine Forum

We are very excited to bring you this
new and improved volume of the Forum
because it exhibits the talents of the
Internal Medicine Residents. This
edition showcases many of the residents’
strengths in writing scholarly projects,
creating research studies, and interpreting
modern diagnostic imaging.

From The Residency Program Director, Gregory C. Kane Md

The Medicine Forum

The goal of a Residency Program in Internal Medicine is
to strive to train the next generation of practitioners and
academicians in Medicine who will become physiciansscholars,
scientists, teachers, and humanists.

We are excited that many of our residents are pursuing
research opportunities in the laboratory or clinic. Such
participation is a requirement for training at Jefferson. In
addition, this journal serves as an outlet for scholarly
work of a variety of types. We are pleased to support
another issue of the Jefferson Forum to continue to
highlight this work. This represents the sixth installment
of the Jefferson Forum, which …

A Dentigerous Cyst Associated With Bilaterally Impacted Mandibular Canines In A Girl: A Case Report., Shawneen M. Gonzalez, Peter M. Spalding, Jeffrey B. Payne, Peter J. Giannini

Journal Articles: College of Dentistry

INTRODUCTION: A dentigerous cyst is the most common developmental odontogenic cyst and is frequently noted as an incidental finding on radiographs. The most common teeth affected are impacted mandibular third molars and permanent maxillary canines. This case involves a dentigerous cyst encompassing the right and left impacted mandibular canines and crossing the midline. This is, to the best of our knowledge, the first reported case of a dentigerous cyst encompassing non-adjacent teeth and crossing the midline.

CASE PRESENTATION: The patient presented to our orthodontic clinic for treatment of malocclusion. The patient was a 10-year, one-month-old Caucasian girl with a dentigerous …

Beyond Mannequins: A Potpourri Of Enabling Technology For Healthcare Education, Rosalyn P. Scott

Department of Surgery Faculty Publications

No abstract provided.

Caspase-1 Dependent Il-1Β Secretion Is Critical For Host Defense In A Mouse Model Of Chlamydia Pneumoniae Lung Infection, Kenichi Shimada, Timothy R. Crother, Justin Karlin, Shuang Chen, Norika Chiba, V. Krishnan Ramanujan, Laurent Vergnes, David M. Ojcius, Moshe Arditi

All Dugoni School of Dentistry Faculty Articles

Chlamydia pneumoniae (CP) is an important human pathogen that causes atypical pneumonia and is associated with various chronic inflammatory disorders. Caspase-1 is a key component of the ‘inflammasome’, and is required to cleave pro-IL-1β to bioactive IL-1β. Here we demonstrate for the first time a critical requirement for IL-1β in response to CP infection. Caspase-1^−/− mice exhibit delayed cytokine production, defective clearance of pulmonary bacteria and higher mortality in response to CP infection. Alveolar macrophages harbored increased bacterial numbers due to reduced iNOS levels in Caspase-1^−/− mice. Pharmacological blockade of the IL-1 receptor in CP infected wild-type mice …

Detection Of Amyloid In Abdominal Fat Pad Aspirates In Early Amyloidosis: Role Of Electron Microscopy And Congo Red Stained Cell Block Sections, Sumana Devata, Parameswaran Hari, Natalia Markelova, Rongshan Li, Richard Komorowski, Vinod B. Shidham

Department of Pathology

Background: Fine-needle aspiration biopsy (FNA) of the abdominal fat pad is a minimally invasive procedure to demonstrate tissue deposits of amyloid. However, protocols to evaluate amyloid in fat pad aspirates are not standardized, especially for detecting scant amyloid in early disease.

Materials and Methods: We studied abdominal fat pad aspirates from 33 randomly selected patients in whom subsequent tissue biopsy, autopsy, and/or medical history for confirmation of amyloidosis (AL) were also available. All these cases were suspected to have early AL, but had negative results on abdominal fat pad aspirates evaluated by polarizing microscopy of Congo Red stained sections (CRPM). …

“What” And “Where” In Auditory Sensory Processing: A High-Density Electrical Mapping Study Of Distinct Neural Processes Underlying Sound Object Recognition And Sound Localization, Victoria M. Leavitt, Sophie Molholm, Manuel Gomez-Ramirez, John J. Foxe

Publications and Research

Functionally distinct dorsal and ventral auditory pathways for sound localization (WHERE) and sound object recognition (WHAT) have been described in non-human primates. A handful of studies have explored differential processing within these streams in humans, with highly inconsistent findings. Stimuli employed have included simple tones, noise bursts, and speech sounds, with simulated left–right spatial manipulations, and in some cases participants were not required to actively discriminate the stimuli. Our contention is that these paradigms were not well suited to dissociating processing within the two streams. Our aim here was to determine how early in processing we …

Multilaboratory Evaluation Of Real-Time Pcr Tests For Hepatitis B Virus Dna Quantification, Angela M. Caliendo, Alexander Valsamakis, James W. Bremer, Andrea Ferreira-Gonzalez, Suzanne Granger, Linda Sabatini, Gregory J. Tsongalis

Dartmouth Scholarship

The performance characteristics of four different assays for hepatitis B virus (HBV) quantification were assessed: the Abbott RealTime HBV IUO, the Roche Cobas AmpliPrep/Cobas TaqMan HBV test, the Roche Cobas TaqMan HBV test with HighPure system, and the Qiagen artus HBV TM ASR. Limit of detection (LOD), linear range, reproducibility, and agreement were determined using a serially diluted plasma sample from a single chronically infected subject. Each assay was tested by at least three laboratories. The LOD of the RealTime and two TaqMan assays was approximately 1.0 log₁₀ IU/ml; for artus HBV (which used the lowest volume of extracted …

Berry Preparations And Extracts, Russell J. Mumper, Jin Dai, Vincent S. Gallicchio

Pharmaceutical Sciences Faculty Patents

A method for deriving compositions having antioxidant and anti-inflammatory activity from berries is provided. The method results in a berry extract compositions having stable anthocyanin content. In one aspect, the method comprises exposing a berry to a solvent composition having a pH of from about 1 to about 4.5, and recovering a berry extract having a stabilized anthocyanin content. The berry may be a blackberry. A cryoprotectant may be added, to further stabilize the anthocyanin content. Compositions comprising the berry extract of the present invention, formulated for oral and/or topical administration, are provided also, including nutritional supplements, capsules, enteric-coated capsules, …

Face To Face At The Huntington's Disease Convention, Kenneth P. Serbin

At Risk for Huntington's Disease

No abstract provided.

Formalizing Education About Public Health Leadership During Professional Preparation, Robert J. Mcdermott

Florida Public Health Review

This year is the fourth year that the Florida Public Health Review (FPHR) has published student essays that attempt to illustrate how the application of specific leadership paradigms might, in theory, be responsive in addressing challenging and historically unresponsive problems in public health. Other public health students, faculty, and practitioners from throughout Florida are invited to contribute ideas that foster leadership skills and the development ofdynamic leaders.

Addressing Colon Cancer Screening Disparities Among Overweight And Obese Women, Sara M. Kennedy

Florida Public Health Review

Colon cancer is the third most common cancer in women and 60% ofdeaths from colon cancer could be prevented ifpersons 50 and older were screened regularly. Whereas physician recommendation has been identified as critical to increasing colon cancer screening, this factor may be insufficient for increasing colon cancer screening adherence among overweight and obese women. Despite having more physician visits, this population tends to receive fewer preventative services. Women who delay routine cancer screening have the highest rates ofdieting. An intervention utilizing the recommendation for screening from a weight loss advisor at an organization like may prove to be effective. …

Failures In The Veterans Administration And New Strategies For Leadership, Jarrett Nathaniel Brunny

Florida Public Health Review

World news organizations have criticized the United States Department of Veterans Affairs for endangering patient safety through negligence. Several VA medical centers - including prominent centers operating in Florida - failed to sterilize endoscopy and colonoscopy equipment. Through improper sterilization, a pathway for infection is created resulting in potential disease exposures to patients. In response, the Department of Veterans Affairs Office of Inspector General investigated the reports and found that facilities did not adhere to protocol concerning reusable medical equipment (RME) problems during the practice ofperforming endoscopies and colonoscopies. The Office ofInspector General noted that the incidents reflected flaws in …

Childhood Obesity In America: The Leadership Role Of Schools In Prevention, Daphnee A. Guillaume

Florida Public Health Review

Childhood obesity is a major public health concern; children are being diagnosed with adult type diseases and health conditions, such as type 2 diabetes, hypertension, cardiovascular disease, etc. Still, over the past decade there have been many attempts by schools, and even the federal government to address the situation, yet there hasn’t been an effective model that has been able to do so. The schools in this country are not consistent when it comes to addressing the issue of childhood obesity. Out of the 50 states in this country, only 19 have nutritional standards for school meals, though all 50 …

Using Leadership To Address The Problem Of Obesity In The Workplace, Amber Colston

Florida Public Health Review

Obesity is a growing epidemic that affects more and more Americans every year. With the majority ofAmerican adults in the workforce, obesity plays a large part in healthcare costs, absenteeism, and “presenteeism.” Because ofthe large amount oftime adults spend in the workplace, using this setting as an intervention point for healthy lifestyle change could greatly reduce the prevalence of obesity. This paper will review factors that have contributed to the problem of obesity in the workplace, namely the factors at each ofthe five levels ofthe Social Ecology ofHealth Model. Then using leadership frameworks, such as that of Transformational Leadership, this …

Lead The Way Florida! Raising Nutrition Awareness To Lower Obesity, Bethany M. Brunny

Florida Public Health Review

Rising obesity rates increase the potential for many chronic diseases and lower quality of life. Strong leadership in the practice ofnutrition awareness and knowledge needs to be established to reduce obesity in the state ofFlorida. Most Americans do not eat the recommended daily amounts offruits and vegetables, which partially accounts for increased obesity rates. Interventions that raise nutritional knowledge and awareness may increase fruit and vegetable intake and lower fat intake. Having nutritional knowledge is the first step to living a healthy lifestyle with a healthy weight. Changes in policy like requiring restaurants to report calorie and fat contents offood …

A Leadership Solution To Workplace Stress, Monica L. Rousseau

Florida Public Health Review

Sources of stress can be found nearly everywhere: in school, at home, in traffic, and maybe most importantly –in the workplace. Chronic workplace stress, also known as “burnout”, has been linked with both psychological and physiological illnesses. As most Americans spend about halfoftheir waking hours at work, the workplace is an excellent location to evaluate specific risk factors and implement stress reducing programs. Although a number ofsuch programs are currently in practice, the majority ofthem only offer techniques and coping mechanisms to individuals already exhibiting some, or several, ofthe many severe symptoms ofchronic stress. The purpose ofthis paper is to …

Prostate Cancer Screening: Leadership Implications, Dorothy D. Zeviar

Florida Public Health Review

TheepidemiologyofprostatecancerintheAfricanAmericanpopulationiswell-knowntohealthcarepractitioners; prostate cancer disproportionately impacts African American men 2:1 compared to Caucasian men. The Prostate Cancer Foundation hypothesizes that the increased mortality risk may be due to delayed diagnosis, poor work-up, and less complete treatment, indicating inequitable use of the health care system. The National Cancer Institute suggests that availability of health insurance and physician contact may increase screening and thus, reduce cancer mortality. Because health behaviors and health outcomes are impacted at five different levels according to the Social Ecology Model ofhealth – intrapersonal, interpersonal, organizational, community and social/policy levels – this report proposes that a Collaborative Leadership model …

Ada News - 06/20/2011, 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.

Developing A Conceptual (Mosaic) Transcultural Model Of Nursing Care For Use At A Pediatric Inner-City Hospital, Lani Hollenbeck

Theses and Graduate Projects

The purpose of this project is to develop a transcultural model of nursing care for use at a pediatric inner-city hospital located in the Midwestern United States. The experience and outcome for pediatric patients and their families may be negatively impacted when language and culture are different from those of the nurse. Nurses working at the hospital have expressed discomfort when providing care for patients from diverse ethnic and cultural backgrounds. They feel challenged to provide supportive nursing care without imposing their own ethnocentric viewpoints or nursing practices that may be inconsistent with desires of those from another culture. The …

A Conceptual Framework For Providing Healthy Meals For A Marginalized Population, Hoching Wu

Theses and Graduate Projects

The purpose of this project is to create a conceptual framework grounded in a caring relationship that provides nutritious, economic, and efficient noon meals to 200 to 400 homeless people at an inner city church kitchen. Awareness of the concerns of the church kitchen coordinator and the needs of the homeless population provided the motivation to explore comprehensive and effective solutions through a conceptual framework. The typical menus from the inner city church kitchen and the research articles both showed the meal programs were fairly nutritious but high in total calories and low in dairy products. Creating new menus for …

Creating Community With Homeless And Marginally Housed Women, Judy Schlaefer

Theses and Graduate Projects

The purpose of this project is to create a weekly Drop-In Center where Homeless and Marginally Housed (HMH) women receive support, respite, and respect in a safe, welcoming environment. Homeless and Marginally Housed (HMH) women have unique needs due to daily struggles with disenfranchisement which include barriers to health services, battering, poor transportation, lack of recreation and education, neglect, and institutionalized poverty. The impetus for the Drop-In Center was to offer respite from the harsh environment created by the institutionalized violence against HMH women who deserve significant emotional and social support, nutrition, and respite. The transculrural nurse will be focused …

A Call To Action After A Patient Fall, Lisa D. Bungum

Theses and Graduate Projects

Fall prevention has always been a quality and safety initiative within hospitals. The purpose of this project is to define, develop, and implement an interdisciplinary huddle following a patient fall event so patient specific modifications to the plan of care can be initiated. The huddle will occur soon after the fall event to facilitate collaboration between all the patient's healthcare providers. The number of patients who repeat falls during a single hospitalization is significant and well documented in professional literature. A patient's risk for a repeat fall will be minimized by assessing and modifying interventions to reduce risk through an …

Frequent Users Of The Emergency Department: Guiding Patients To Comprehensive And Coordinated Care, Anne L. Draeger

Theses and Graduate Projects

The purpose of this project is to implement a rural community-based collaborative care network to assist high frequency emergency department users navigate a comprehensive system to access a full range of health care services and decrease reliance on the emergency department. Patients who frequent the emergency department are less apt to receive coordinated treatment of pain and other chronic disease which leads to suboptimal care focusing on symptoms rather than disease management. Nurses who practice in the emergency department identify the pattern of frequent use and lack of care coordination but struggle to provide a connection to preventative services and …

Empowering And Retaining New Graduate Nurses Through A Structured Mentoring Program, Kelly O. Gamble

Theses and Graduate Projects

The purpose of this project is to improve the orientation experience of the new graduate nurse at a metropolitan Minnesota hospital through the development of a structured mentoring program. The transition from student nurse to professional nurse is stressful for new graduate nurses. Stress combined with increased technology and patient acuity in the acute care setting has led to many new graduate nurses leaving the profession, contributing to the anticipated nursing shortage. Literature on new graduate nurse orientation, the nursing shortage, mentoring, and generational differences were incorporated in the development of the structured mentoring program. The importance of nursing leadership …

Institutional Review Boards - A Mixed Blessing., Taimur Saleem, Umair Khalid

Medical College Documents

Institutional Review Boards (IRBs) are an important checkpoint for all types of research in medicine. Although these bodies originated primarily in the developed world, they have special contemporary consideration in the context of developing countries due to the large number of clinical trials being conducted in these regions with the financial support of large pharmaceutical companies. IRBs are vital to ensure that all scientific investigation is conducted in a manner that is transparent, scientifically feasible and ethically sound. However, they have also been variably criticized for introducing unnecessary and often protracted bureaucracy and red tape into the system. There is …

Effects Of Diet Type And Supplementation Of Glucosamine, Chondroitin, And Msm On Body Composition, Functional Status, And Markers Of Health In Women With Knee Osteoarthritis Initiating A Resistance-Based Exercise And Weight Loss Program, Teresa Magrans-Courtney, Colin Wilborn, Christopher Rasmussen, Maria Pontes Ferreira, Lori Greenwood, Bill Campbell, Chad M. Kerksick, Erica Nassar, Rui Li, Mike Iosia, Matt Cooke, Kristin Dugan, Darryn Willoughby, Luann Soliah, Richard B. Kreider

Nutrition and Food Science Faculty Research Publications

Background: The purpose of this study was to determine whether sedentary obese women with knee OA initiating an exercise and weight loss program may experience more beneficial changes in body composition, functional capacity, and/or markers of health following a higher protein diet compared to a higher carbohydrate diet with or without GCM supplementation.

Methods: Thirty sedentary women (54 ± 9 yrs, 163 ± 6 cm, 88.6 ± 13 kg, 46.1 ± 3% fat, 33.3 ± 5 kg/m²) with clinically diagnosed knee OA participated in a 14-week exercise and weight loss program. Participants followed an isoenergenic low fat higher …