Medicine and Health Sciences Commons^™

Alumni Journal - Volume 83, Number 3, Loma Linda University School Of Medicine

Alumni Journal, School of Medicine

Features:
12 | 2012 Graduation
30 | Student Mission Electives
32 | Ike Sander’s Odyssey

News:
6 | School of Medicine News
10 | Class Giving Report
34 | Board Member Election

Regulars:
4 | The President’s Page
8 | The Dean’s Page
36 | In Memoriam
41 | Placement Ads

Peak Flow Meter กับผู้ป่วยเด็กโรคหืด (Peak Flow Meter And Childhood Asthma), นวลจันทร์ ปราบพาล

Chulalongkorn Medical Journal

No abstract provided.

An Analysis Of The Changing Demographics Of Individuals With Spinal Cord Injury Who Received State Vocational Rehabilitation Services Between 2004 And 2008, Barbara A. Schoen, Michael J. Leahy

School of Rehabilitation Services & Counseling Faculty Publications

Spinal cord injury (SCI) is considered to be a complex disability; impacting far more than mobility and creating several barriers to employment. To better understand dynamic factors related to employment over time this study analyzed the changing demographics of consumers with spinal cord injury (SCI) who received state vocational rehabilitation services between 2004 and 2008. The entire population of 23,135 individuals with an SCI who closed in status 26 (employment outcome) or 28 (no employment outcome) between 2004 and 2008 were included in the study. Several changes were observed. There was a disproportionate decline in the number of consumers with …

Day-To-Day Variability In Nap Duration Predicts Medical Morbidity In Older Adults, Natalie D. Dautovich, Daniel B. Kay, Michael L. Perlis, Joseph M. Dzierzewski, Meredeth Rowe, Christina S. Mccrae

Nursing Faculty Publications

Objective: The objectives for the present study were to (a) examine within-person variability of nap duration and (b) assess how variability in nap duration is related to the number of health conditions in a sample of older adults. For highly variable behaviors such as sleep, it is important to consider fluctuations within the person instead of solely comparing averages of behaviors across persons. Method: Data were drawn from a previous study examining sleep in 103 community-dwelling older adults. Subjective estimates of napping behavior were obtained from sleep diaries and objective estimates of napping behavior were obtained using actigraphy. Both measures …

Non-Diabetic Renal Disease In Patients With Type-2 Diabetes Mellitus, Sonia Yaqub, Waqar Kashif, Syed Ather Hussain

Section of Nephrology

Diabetic nephropathy (DN) is the leading cause of end-stage renal disease in diabetics worldwide, yet most patients with type-2 diabetes mellitus are not formally evaluated with a renal biopsy. The diagnosis is almost always based on clinical grounds. A wide spectrum of non-diabetic renal disease (NDRD) is reported to occur in patients with type-2 diabetes. It has been estimated that up to one-third of all diabetic patients who present with proteinuria are suffering from NDRD. The aim of this analysis was to evaluate the prevalence and etiology of NDRD in patients with type-2 diabetes. We retrospectively reviewed the medical records …

Isolated Endogenous Nocardia Endophthalmitis After Immunosuppression., Lisa Y. Chen, Muge R. Kesen, Abdalhossein Ghafourian, Quan Dong Nguyen, Charles G. Eberhart, Diana V. Do

Journal Articles: Ophthalmology

PURPOSE: This study is aimed to report a case of endogenous Nocardia endophthalmitis in the setting of immunosuppression from chronic steroid use.

METHODS: A case report was conducted.

RESULTS: A 79-year-old woman presented with decreased vision with floaters in the left eye. Ophthalmic examination revealed severe inflammation in the anterior chamber, vitreous opacities, and retinal detachment. Vitreous cultures grew Nocardia farcinica without any systemic foci of infection found during further workup. The patient was treated with intravitreal amikacin and oral trimethoprim-sulfamethoxazole, and her retinal detachment was later repaired in the operating room. The patient has since remained stable with no …

Characterization Of Macular Lesions In Punctate Inner Choroidopathy With Spectral Domain Optical Coherence Tomography., Roomasa Channa, Mohamed Ibrahim, Yasir J. Sepah, Peykan Turkcuoglu, Jeong Hee Lee, Afsheen Khwaja, Elham Hatef, Millena Bittencourt, Jangwon Heo, Diana V. Do, Quan Dong Nguyen

Journal Articles: Ophthalmology

PURPOSE: Punctate inner choroidopathy (PIC) is an ocular inflammatory disease. Spectral domain optical coherence tomography (SD-OCT) allows detailed visualization of retinal and choroidal structures. We aimed to describe the retinal changes on SD-OCT associated with PIC lesions localized in the macula.

METHODS: Retrospective case series: PIC lesions not associated with choroidal neovascularization (CNV) and captured by macular SD-OCT scans were identified and characterized.

RESULTS: Twenty-seven PIC lesions from seven patients (eight eyes) were identified and classified into four categories according to disease activity and temporal changes. Among clinically inactive patients, two main patterns were noted on OCT: (1) retinal pigment …

Borrelia Burgdorferi Cp32 Bpab Modulates Expression Of The Prophage Nucp Nuclease And Ssbp Single-Stranded Dna-Binding Protein, Alicia M. Chenail, Brandon L. Jutras, Claire A. Adams, Logan H. Burns, Amy Bowman, Ashutosh Verma, Brian Stevenson

Microbiology, Immunology, and Molecular Genetics Faculty Publications

The Borrelia burgdorferi BpaB proteins of the spirochete's ubiquitous cp32 prophages are DNA-binding proteins, required both for maintenance of the bacteriophage episomes and for transcriptional regulation of the cp32 erp operons. Through use of DNase I footprinting, we demonstrate that BpaB binds the erp operator initially at the sequence 5′-TTATA-3′. Electrophoretic mobility shift assays indicated that BpaB also binds with high affinity to sites located in the 5′ noncoding regions of two additional cp32 genes. Characterization of the proteins encoded by those genes indicated that they are a single-stranded DNA-binding protein and a nuclease, which we named SsbP and NucP, …

Leadership Development Of Students Through An Integrated Student Organization Structure In A College Of Pharmacy, T. Joseph Mattingly, David Marr, Joseph L. Fink Iii

Pharmacy Practice and Science Faculty Publications

Pharmacy is a profession that requires those who practice to be very well educated within their specialty. However, it is equally important for pharmacists to conduct themselves as professionals in all that they do so they can retain the trust of the public and the professionals with whom they deal on a daily basis. In addition, pharmacists are frequently called on to serve in leadership roles in several forums – professional associations, civic clubs, health-related voluntary organizations and a wide variety of other community or religious organizations.

Re-Implantation Of Suboptimal Prostate Seed Implantation: Technique With Intraoperative Treatment Planning., Laura Doyle, Adam J Hesney, Katherine L Chapman, Haisong Liu, Perry R Weiner, Adam Dicker, Yan Yu, Timothy Showalter

Department of Radiation Oncology Faculty Papers

PURPOSE: Post-implant dosimetry following prostate seed implantation (PSI) occasionally reveals suboptimal dosimetric coverage of the gland. Published reports of re-implantation techniques have focused on earlier-generation techniques, including preplanned approaches and stranded seeds. The purpose of this case report is to describe a customizable approach to perform corrective re-implantation using loose seeds and intraoperative planning technique.

MATERIAL AND METHODS: This case report describes a 63-year-old male with favorable risk prostate adenocarcinoma receiving PSI. Thirty day post-implant dosimetric evaluation revealed suboptimal coverage of the base of the gland. Using guidance from post-implant CT-images and real-time planning, the patient received a corrective re-implantation …

Variation In Genes Related To Cochlear Biology Is Strongly Associated With Adult-Onset Deafness In Border Collies, Jennifer S. Yokoyama, Ernst T. Lam, Alison L. Ruhe, Carolyn A. Erdman, Kathryn R. Robertson, Aubrey A. Webb, D. Colette Williams, Melanie L. Chang, Marjo K. Hytönen, Hannes Lohi, Steven P. Hamilton, Mark W. Neff

Anthropology Faculty Publications and Presentations

The domestic dog offers a unique opportunity to study complex disorders similar to those seen in humans, but within the context of the much simpler genetic backgrounds of pure breeds, which represent closed populations. We performed a whole-genome search for genetic risk factors of adult-onset deafness in the Border Collie, a breed of herding dog that relies on acute hearing to perceive and respond to commands while working. Adult-onset deafness in Border Collies typically begins in early adulthood and is similar to age-related hearing loss in humans. This earlier onset has particular impact on the utility of working Border Collies …

Emerging As Leaders In Autism Research And Practice: Using The Data-Driven Intervention Process., Roseann C Schaaf, Erna Imperatore Blanche

Department of Occupational Therapy Faculty Papers

No abstract provided.

Oncolog, Volume 57, Number 09, September 2012, Zach Bohannan, Sunita Patterson

OncoLog MD Anderson's Report to Physicians (All issues) Archives

• Stereotactic Body Radiation Therapy Achieves High Control Rates in Lung Cancer: Stereotactic body radiation (SBRT), a relatively new treatment modality, has recently become a very successful treatment-and may even exceeded the effectiveness of surgery-for early-stage lung cancer
• Inflammatory Breast Cancer: Clinical Challenge, Research Enigma- Inflammatory breast cancer (IBC) stands apart from other cancers of the breast in its unusual clinical presentation, its aggressiveness, and its poor prognosis. Researchers and clinicians are working to clarify what distinguishes IBC from other breast cancers and to discover treatments that improve patient outcomes
• HOUSE CALL: Reducing Cancer-Causing Chemicals in Outdoor Cooking: Tips for healthy …

Functional Results And Outcomes After Repair Of Proximal Hamstring Avulsions., Steven B Cohen, Ashwin Rangavajjula, Dharmesh Vyas, James P Bradley

Rothman Institute Papers

BACKGROUND: The purpose of this study was to assess postsurgical outcomes in active patients after primary repair of acute and chronic proximal hamstring tears.

HYPOTHESIS: Surgical treatment of both acute and chronic proximal hamstring avulsion injuries would result in improved patient outcomes using validated outcome scores and a hamstring-specific questionnaire, and operative repair of these injuries results in excellent outcomes with a high level of patient satisfaction, pain relief, and return to function.

STUDY DESIGN: Case series; Level of evidence, 4.

METHODS: Fifty-two patients who underwent proximal hamstring repair (26 male and 26 female; average age, 47.7 years) completed the …

Non Fatal Injuries Among Infants: A Pilot Study, Seema Zainulabdin Lasi, Ghazala Rafique, Habib Peermohammad

Human Development Programme

Objective: To determine the incidence, nature and the extent of infant injuries in two suburban and rural communities of Pakistan.
Methods: The cross-sectional study was conducted on a cohort of 310 infants in suburban and rural communities of Pakistan in September 2007. The information was collected from primary care-givers based on any injury that had occurred to their infants during the preceding 3 months that required treatment at home or in a hospital.
Result: The incidence of non-fatal injury for infants up to 1-year-old was found to be 19 injuries per 100 person (child) years of exposure (95% CI 9.90 …

J Am Coll Dent 2012 79 3

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.

Weaning Onto Solid Foods: Some Of The Challenges, Annemarie E. Bennett, Annalouise O'Connor, Nicola Canning, Alice Kenny, Edel Keaveney, Katherine Younger, Mary Flynn

Articles

Weaning - the transition from milk to solid food - influences life-long health. Dietary challenges during weaning include providing sufficient critical nutrients such as iron with minimal added sugar and fat and no added salt. This study assessed the inclusion of iron-containing red meat in infant diets before age one year, and the Irish commercial baby food environment. Of mothers with an infant under 30 months of age who were surveyed in shopping centres in Ireland (n195), 82% (n159) reported wanting more weaning information. A quarter (n24) of infants over age 12 months ( …

Second Life® As A Clinical Conference Environment: Experience Of Students And Faculty, Melinda Hermanns, Carol Kilmon

Nursing Faculty Publications and Presentations

The purpose of this article is to discuss the students' and faculty members' experience of using Second Life® during a psychiatric mental health clinical conference. The clinical conference is explained, as well as the process in which students were oriented to the use of Second Life. The students' and faculty members' experience, obstacles encountered, and lessons learned are also presented.

Early Adoption Of Transoral Robotic Surgical Program: Preliminary Outcomes., David Cognetti, Adam Luginbuhl, Anthony L. Nguyen, Joseph Curry

Department of Otolaryngology - Head and Neck Surgery Faculty Papers

OBJECTIVE: The objective of this study is to demonstrate the feasibility and safety of establishing a transoral robotic surgical (TORS) program in the post-Food and Drug Administration (FDA) approval setting. Early outcomes are compared with the previously reported results of pioneering centers.

STUDY DESIGN: Clinical data from a prospective TORS study.

SETTING: Academic university institution.

SUBJECTS AND METHODS: Sixty-one patients treated with 63 TORS procedures. Main outcome measures: intraoperative times, margin status, complications, time to diet, and percutaneous endoscopic gastrostomy (PEG) tube retention rate. The authors also report oncologic outcomes on their first 30 patients.

RESULTS: The spectrum of subsites …

A Framework Of Academic Persistence And Success For Ethnically Diverse Graduate Nursing Students, Margaret J. Bull, Judith Fitzgerald, Josie L. Veal

College of Nursing Faculty Research and Publications

The goal of this qualitative study was to examine how ethnically diverse graduate nursing students persisted with academic studies. Ethnically diverse nurses are vastly underrepresented in the workforce. This problem is accentuated by high attrition rates in academic programs. A grounded theory approach was used. Five focus groups were conducted with 16 ethnically diverse graduate students in nursing and interviews were conducted with two diversity advisers. Analysis of the data indicated that the process of learning to balance stressors with moderators was key to academic persistence and retention. A conceptual framework emerged from the data that provides a guide for …

The Impact Of Certification On Certified Perioperative Nurses: A Qualitative Descriptive Survey, Kathryn Schroeter, Michelle Byrne, Katharine Klink, Matthew Beier, Natalie S. Mcandrew

College of Nursing Faculty Research and Publications

As the practice of healthcare becomes more technologically advanced, specialized and complex, there is an increasing demand for accountability. Certification demonstrates that an individual practitioner has maintained an acceptable, or perhaps more advanced level of qualifications, knowledge, and skills in a specialty practice area. The nurses' perceptions, as shared in this study, revealed positive aspects related to their achievement of certification in perioperative practice. Although certification for nurses has been available for decades a detailed evaluation of its meaning and implications for practice seems to be unavailable. The purpose of this qualitative study, conducted in Chicago, Illinois and also online, …

Serum Levels Of Estradiol And Follicle Stimulating Hormone, And Vasomotor Symptoms In Thai Women Receiving Gnrh Analogue Before Laparoscopic Enucleation Of Endometriotic Cysts, S Bunyavejchevin, W. Wisawasukmongchol

Chulalongkorn Medical Journal

Background : GnRH analogue can suppress serum estradiol (E2) and follicle stimulating hormone (FSH) to menopause level before laparoscopic enucleation of endometriotic cysts. Objective : To study the levels of E2 and FSH, and vasomotor symptoms after GnRH analogue treatment in Thai women with endometriotic cysts. Materials and Methods : During January, 2006 - December, 2007. Sixty women diagnosed as having endometriotic cysts, aged 15 - 44 years, were recruited into the study. Leuprolide acetate 3.75 mg was given intramuscularly at one month interval for 3 months. Serum levels of E2 and FSH were tested at 0, 1, 2 and …

The Effective Dose And Image Noise In Pediatric Ct Brain At King Chulalongkorn Memorial Hospital, B. Navanopparatskul, P. Trinavarat, A. Krisanachinda

Chulalongkorn Medical Journal

Background : CT is the standard equipment for assessing a variety of disorder in children. More than half of pediatric CT examinations at King Chulalongkorn Memorial Hospital (KCMH) are related to the brain. Nevertheless, there is no available data of pediatric radiation dose from CT brain at KCMH. Objective : To investigate the radiation dose when CT brain is performed and compare with the previously published dose reference levels (DRLs) in order to minimize or eliminate the amount of unnecessary radiation exposure. Design : Retrospective descriptive data. Setting : Department of Radiology, Faculty of Medicine, Chulalongkorn University Materials and Methods …

Migration Of Health Workers: A Challenge For Health Care System, Shaista Afzal, Imrana Masroor, Gulnaz Shafqat

Department of Radiology

The migration of health workers has resulted in a growing apprehension universally because of its impact on health system of the developing countries. Although the choice to migrate is basically a personal one, however, the overall social and economic circumstances have important impact on the decision to migrate. The "push and pull" factors for migration are disparity in working conditions, pay, lack of promotion opportunities, poor living conditions, desire to gain experience, professional development, family background and family wealth. A strategic approach by the government and other agencies is mandatory for regulating the flow of health workers between countries. A …

Biosynthetic Pathways And The Role Of The Mas Receptor In The Effects Of Angiotensin-(1-7) In Smooth Muscles., Marcio Augusto Fressatto De Godoy, Larissa Pernomian, Ana Maria De Oliveira, Satish Rattan

Department of Medicine Faculty Papers

Ang-(1-7) is produced via degradation of Ang II by the human angiotensin converting enzyme, also known as ACE2. In the cardiovascular system, Ang-(1-7) has been shown to produce effects that are opposite to those of Ang II. These include smooth muscle relaxation and cardioprotection. While the roles of Ang-(1-7) in other systems are currently topic of intense research, functional data suggest a relaxation action in gastrointestinal smooth muscles in a way that corroborates the results obtained from vascular tissues. However, more studies are necessary to determine a relevant role for Ang-(1-7) in the gastrointestinal system. The Ang-(1-7) actions are mediated …

Oncology Nurses' Obstacles And Supportive Behaviors In End-Of-Life Care: Providing Vital Family Care, Renea L. Beckstrand, Joan Collette, Lynn Callister, Karlen E. (Beth) Luthy

Faculty Publications

Purpose/Objectives: To determine the impact of obstacles and supportive behaviors in end-of-life (EOL) care as perceived by hospital-based oncology nurses.

Design: A 69-item mailed survey.

Setting: National random sample.

Sample: 1,005 nurse members of the Oncology Nursing Society who had provided EOL care for patients with cancer.

Methods: Three mailings yielded 380 usable responses from 912 eligible respondents, resulting in a 42% return rate.

Main Research Variables: Size and frequency of EOL care obstacles and supportive behaviors for patients with cancer in a hospital setting.

Findings: Results of this research demonstrate the need for more EOL education and help in …

The Effect Of Vessel Depth, Diameter, And Location On Ultrasound-Guided Peripheral Intravenous Catheter Longevity., J Matthew Fields, Anthony J Dean, Raleigh W Todman, Arthur K Au, Kenton L Anderson, Bon S Ku, Jesse M Pines, Nova L Panebianco

Department of Emergency Medicine Faculty Papers

INTRODUCTION: Ultrasound-guided peripheral intravenous catheters (USGPIVs) have been observed to have poor durability. The current study sets out to determine whether vessel characteristics (depth, diameter, and location) predict USGPIV longevity.

METHODS: A secondary analysis was performed on a prospectively gathered database of patients who underwent USGPIV placement in an urban, tertiary care emergency department. All patients in the database had a 20-gauge, 48-mm-long catheter placed under ultrasound guidance. The time and reason for USGPIV removal were extracted by retrospective chart review. A Kaplan-Meier survival analysis was performed.

RESULTS: After 48 hours from USGPIV placement, 32% (48/151) had failed prematurely, 24% …

Herpes Simplex Virus 34.5 Interferes With Autophagosome Maturation And Antigen Presentation In Dendritic Cells, Philipe A. M. Gobeil, David A. Leib

Dartmouth Scholarship

The cellular autophagy response induced by herpes simplex virus 1 (HSV-1) is countered by the viral γ34.5 protein. γ34.5 modulates autophagy by binding to the host autophagy protein Beclin-1 and through this binding inhibits the formation of autophagosomes in fibroblasts and neurons. In contrast, in this study dendritic cells (DCs) infected with HSV-1 showed an accumulation of autophagosomes and of the long-lived protein p62. No such accumulations were observed in DCs infected with a γ34.5-null virus or a virus lacking the Beclin-binding domain (BBD) of γ34.5. To explore this further, we established stably transduced DC lines to show that γ34.5 …

Arthroscopic Ulnar Nerve Identification During Posterior Elbow Arthroscopy, Srinath Kamineni, David Anthony Hamilton Jr.

Orthopaedic Surgery and Sports Medicine Faculty Publications

Elbow arthroscopy has increased in popularity in the past 10 years for both diagnostic and therapeutic purposes. A major limiting factor faced by the elbow arthroscopist is the close proximity of the neurovasculature to the working field, with the risk of iatrogenic injury. Many arthroscopic procedures are less extensive than their open equivalents because of an inability to consistently and safely eliminate the risk of neural and vascular injury. Many open procedures in the posterior compartment of the elbow joint are not routinely performed arthroscopically. The primary reason for this restriction in arthroscopic practice is the locality of the posteromedially …

Pharmacy Law Brief: Contemporary Legal Issues For Leadership In Non-Profits - I, Joseph L. Fink Iii

Pharmacy Practice and Science Faculty Publications

No abstract provided.