Medicine and Health Sciences Commons^™

The Evidence-Based Pharmacological Treatment Of Paediatric Adhd., Brigette S. Vaughan, John S. March, Christopher J. Kratochvil

Journal Articles: Psychiatry

Attention deficit hyperactivity disorder (ADHD) is common in children, adolescents, and adults, with extensive research establishing it as a valid neurobiological disorder. Without intervention, ADHD can result in significant impairment throughout the lifespan for the individuals it afflicts. Fortunately, multiple evidence-based options are available for the treatment of ADHD, including several efficacious pharmacotherapies. The role of medication, including stimulants as well as non-stimulants, is well-documented by an extensive body of literature. Although there may be less enthusiasm for behavioural and other psychosocial interventions as stand-alone treatments for moderate to severe ADHD, they are recommended as first-line treatment for ADHD management …

Vitamin D: Does It Play A Role In Psychiatry, Mukesh Mohan Bhimani

Department of Psychiatry

No abstract provided.

John Blair Deaver, M.D., And His Marvelous Retractor., Timothy E. Newhook, Md, Charles J. Yeo, Md, Pinckney J. Maxwell, Iv, Md

Department of Surgery Gibbon Society Historical Profiles

John Blair Deaver was born near Buck, Pennsylvania, in Lancaster County on July 25, 1855, to Dr. Joshua Montgomery Deaver and Elizabeth Clair Moore. The elder Deaver was a reputable country physician, educated at the University of Maryland, who fathered three physicians and a college president. John Blair Deaver (Fig. 1) went to boarding school at West Nottingham Academy in Maryland. After boarding school he taught in Lancaster County country schools to raise funds to attend the nation’s first medical school, the University of Pennsylvania. On receiving his M.D. degree in 1878, Dr. Deaver completed 1-year internships at both Germantown …

The Value Proposition Of Molecular Medicine., Scott A. Waldman, Andre Terzic

Department of Pharmacology and Experimental Therapeutics Faculty Papers

Individualized patient management is rapidly evolving, driven by the emergence of insights in discovery, development, regulatory, and comparative effectiveness sciences.^1-4 The pace of discovery is accelerating, enabled by platforms, including “omics”, stem cell biology, network medicine, and medical and biological informatics that provide unanticipated insights into pathophysiology.^{2, 4-6} The integration of these paradigms has established a model for identifying the mechanistic underpinnings of disease, offering novel opportunities to individualize diagnostics that shape how modern therapies are deployed, including markers of disease prognosis, clinical predictors of therapeutic responses, and molecular determinants that optimize clinical management.^7-10 Importantly, deconvolution of …

Tricuspid Annular Plane Systolic Excursion (Tapse) Revisited Using Cmr, Srinivas L. Naik, Jeffrey J. Rodriguez, Nishant Kalra, Vincent L. Sorrell

Internal Medicine Presentations

This observational pilot project was performed as background to eventually create a rapid, automated and accurate assessment of RV systolic function in variable clinical subgroups. We propose new parameters that characterize the global systolic function of the right ventricle with a simple linear measurement.

Distribution, Population Size, And Structure Of Himalayan Grey Goral Naemorhedus Goral Bedfordi (Cetartiodactyla: Bovidae) In Pakistan, Fakhar -I- Abbas, Kathreen E. Ruckstuhl, Afsar Mian, Tanveer Akhtar, Thomas P. Rooney

Biological Sciences Faculty Publications

Himalayan grey goral (Naemorhedus goral bedfordi) is a Red List (Near Threatened) member of Caprinae endemic to Asia, occupying the south-facing slopes of the Himalaya Mountains. The species is listed as Vulnerable on the National Pakistan Red List, but the distribution and abundance of the species within the nation is poorly known. We conducted a national census of Himalayan grey goral in Pakistan during 2002 – 2004, with the objective of documenting the geographic locations of populations, estimating population size, and describing group sizes and sex ratios. We conducted a direct count census in 98 sites distributed over …

A Method To Determine Regional Mechanical Left Ventricular Dyssynchrony Based On High Temporal Resolution Short Axis Ssfp Cine Images, Jonathan Suever, Brandon K. Fornwalt, Michael Lloyd, John N. Oshinski

Pediatrics Presentations

Left ventricular (LV) mechanical dyssynchrony has been proposed as a parameter to select patients for cardiac resynchronization therapy (CRT) [Bax et al JACC 2005].Several recent studies have shown that placing the LV pacing lead in the most delayed regions yields a better response to CRT [Ansalone et al JACC 2002]. However, most imaging-based methods assess global LV dyssynchrony providing a single value for the entire LV. Regional maps of LV dyssynchrony are required for planning LV lead placement.

The objective of this study was to develop a method to create a map of regional left ventricular mechanical dyssynchrony based on …

Himmelfarb Headlines - February/March 2012, George Washington University, Himmelfarb Health Sciences Library

Himmelfarb Headlines (2009 - present)

News and information about Himmelfarb Health Sciences Library of interest to users. Includes articles on emerging technologies/instructional support, Scopus, and profiles of Arnold Schwartz, MD, and Kathy Lyons.

Symptomatic Hypocalcemia During Urinary Alkalinization For Acute Aspirin Toxicity, Jennifer Flint, Bruce Banwart

Posters

A16y/o ingested 165 tablets of 325 mg ASA(1000 mg/kg). He presented to an outside facility 8 hours after ingestion alert with stable vital signs and ASA level 78 mg/dL. Initial lab values showed an arterial blood gas (ABG) pH 7.46, pCO2 26 mmHg, HCO3 18 mmol/L, ionized calcium 1.09 mmol/L, serum calcium 10 mg/dL, albumin 4.5 gm/dL, magnesium 2.1 mg/dL. Urinary alkalinization was initiated with a sodium bicarbonate infusion (NaHCO3) and he arrived to our facility 12 hours after ingestion with Kussmaul respirations and altered mentation. Repeat ASA 116mg/dL, ionized calcium 0.88 mmol/L and serum calcium 8.8 mg/dL. He became …

Novel Dynamics Observed In A Spiking Neural Network Model Of The Nts In The Rat Hind-Brain, Jingyi Zhou, J. David Schaffer, Patricia Dilorenzo, Craig B. Laramee

Justice & Well-Being Studies Faculty Scholarship

he Nucleus of the Solitary Tract (NTS) is a hind-brain structure in the rat that is the first way-station in taste processing. Its structure and function are poorly understood. Recently our group produced a model, implemented as a spiking neural network (SNN), that successfully replicated experimental data. The model's topology was manually devised and the parameters were set by a genetic algorithm. In order to better understand its information processing capabilities, we probed the model with a variety of input spike patterns and observed a striking winner-take-all decision-making dynamic. We show how the topology and tuned parameters enable this decision …

Portal Biliopathy, Muhammad Shahbaz Alam, Qazi Saad Bin Khalid, Muhammad Zeeshan, Zishan Haider

Department of Radiology

Portal biliopathy (PB) is a rare disorder, which mostly presents as sub-clinically. It occurs most commonly due to idiopathic extrahepatic portal vein obstruction. We present three cases having features of portal biliopathy secondary to portal hypertension. Our first case did not have a prior history of chronic liver disease while next two patients had previous history of chronic liver disease resulting in portal hypertension. Cavernous transformation of the portal vein due to extrahepatic portal vein obstruction is not infrequent but biliary obstruction in association with this disorder is distinctly uncommon. Proper case management is very important as prolonged biliary duct …

Characterization Of The Size And Location Of Dyssynchronous Regions In Patients Undergoing Crt, Jonathan Suever, Brandon K. Fornwalt, Michael Lloyd, John N. Oshinski

Pediatrics Presentations

The amount and location of left ventricular (LV) mechanical dyssynchrony affects an individual’s ability to respond positively to cardiac resynchronization therapy (CRT) [Bax et al JACC 2005]. By using high temporal resolution short-axis cines, it is possible to derive radial motion curves throughout the LV. These radial motion curves can be used to create maps showing dyssynchronous regions in patients enrolled for CRT.

The objective of this study was to characterize the size and location of areas of mechanical dyssynchrony in patients scheduled for CRT by comparing their radial wall motion curves to radial motion curves from normal subjects.

The Impact Of A 3-Year After-School Obesity Prevention Program In Elementary School Children, Zenong Yin, Justin B. Moore, Maribeth H. Johnson, Marlo M. Vernon, Bernard Gutin

Faculty Publications

Background: Children tend to be sedentary during the after-school hours, and this has deleterious effects on their health. The objective of the present study was to determine the effects of a 3-year after-school physical activity (PA) program, without restriction of dietary energy intake, on percent body fat (%BF), cardiorespiratory fitness (CRF), and cardiometabolic markers in children.

Methods: A cluster randomization design was employed. A total of 574 3^rd grade children from 18 elementary schools in the south-eastern United States participated. The intervention consisted of 80 minutes of age-appropriate moderate-to-vigorous PA each school day. The main outcomes of interest were …

Update - February 2012, Loma Linda University Center For Christian Bioethics

Update

In this issue:

-- Cancer Stories: An Argument for Narrative Ethics
-- Dual-Degree Masters of Arts in Bioethics
-- From the Director
-- Finding a Voice for Seventh-day Adventist Ethics in the Radical Reformation?

Beautiful Feet, Jennifer Calhoun

Lake Union Herald

No abstract provided.

Hepatic Fibrosis Imaging: Trends And Feasibility, Saba Sohail

Department of Radiology

No abstract provided.

Cardiovascular Fitness Moderates The Relations Between Estimates Of Obesity And Physical Self-Perceptions In Rural Elementary School Students, Nathanael G. Mitchell, Justin B. Moore, Wendy S. Bibeau, Kathleen M. Rudasill

Faculty Publications

Background: Levels of physical activity decline throughout childhood. Children's physical self-perceptions have been found to relate to their physical activity. Understanding the relationships among physical self-perceptions, obesity, and physical activity could have important implications for interventions in children. Methods:The current study investigated the moderating effect of cardiovascular fitness (CVF, heart rate recovery from a 3-minute step test) on the relationship between obesity (BMI, waist circumference) and physical self-perceptions (athletic competence, physical appearance) in 104 fourth- and fifth-grade children from a small rural community. Results: Hierarchical regression analyses indicated that CVF moderated the relations between BMI and waist circumference on …

Oncolog, Volume 57, Number 02, February 2012, Don Norwood, Bryan Tutt

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

• Pediatric and Adult Cancer Patients Face Different Issues in Care, Survivorship: The challenges faced by children and adults with cancer can differ markedly, even when they have the same type of cancer
• Palliative Care May Offer Survival Benefits: Recent studies indicate that palliative care, which has been shown to improve quality of life in patients with advanced cancer, may also help patients live longer
• INBRIEF: Targeted Therapy Causes Chronic Lymphocytic Leukemia Remission/Study Finds Acupuncture Can Prevent Radiation-Induced Chronic Dry Mouth
• HOUSE CALL: Understanding the risks, benefits, and purpose of a trial can help cancer patients decide whether to participate

Utilization Of Ct Scans And Mris In An Insured Population With Migraine, Neil I. Goldfarb, Valerie Pracilio, Mph, Daisy Ng-Mak, Phd, Joe Couto, Pharmd, Mba, Cary Sennett, Md, Phd, Mary Hopkins, Rn, Jon Bumbaugh, Stephen Silberstein, Md

College of Population Health Lectures, Presentations, Workshops

Background:

• Neuroimaging is a diagnostic tool that may be used to rule out a serious condition when a patient presents with head pain. It is not typically warranted for patients who have a normal neurologic exam, and may be over utilized despite established practice parameters set by the American Academy of Neurology.

•A decision to use neuroimaging should consider the type of headache and presence of any clinical features that suggest a serious condition.

Over-utilization of neuroimaging has cost and safety implications.

The United States Headache Consortium, a panel of experts on migraine, set the guidelines for diagnosis and …

Association Between Triptanuse And Cardiac Contraindications In An Insured Migraine Population, Daisy Ng-Mak, Phd, Valerie P. Pracilio, Mph, Stephen Silberstein, Md, Joseph Couto, Pharmd, Mba, Cary Sennett, Md, Phd, Mary Hopkins, Rn, Jon Bumbaugh, Neil I. Goldfarb

College of Population Health Lectures, Presentations, Workshops

Background

Safety concerns exist when using triptansto treat patients with cardiac contraindications.

–Triptans cause vasoconstriction, a safety concern for migraineurswith cardiovascular (CV) disease or other cardiac risk factors.

–All triptans contain contraindications in their package inserts to avoid use in patients with cardiac conditions.

•Previous research indicates that clinicians are less likely to prescribe triptansin patients with CV disease or CV risk factors.

Limited research has examined the proportion of migraine patients with cardiovascular disease or those individuals who were concurrently treated with triptans.

Puerperal Fever From Hippocrates To Pasteur, Hunter A. Hammill

Houston History of Medicine Lectures (2006-2012)

The death of a mother in childbirth leaving a newborn deserted is a sort of a desecration. This was a frequent event for early physicians. It was felt to be caused by miasmas or punishment from the gods. DaVinci felt the cause was milk stasis, Hippocrates - lochia, Virchow - weather. Then came Semmelweis, Pasteur and Lister. They started a battle with ignorance, hospital administration, budget and academic politics. Ending with the murder of Semmelweis!

Fall Prevention In Hospitals: An Integrative Review, Sandra L. Spoelstra, Barbara A. Given, Charles W. Given

Peer Reviewed Articles

Purpose: This article summarize research and draws overall conclusions from the body of literature on fall prevention interventions to provide nurse administrators with a basis for developing evidence-based fall prevention programs in the hospital setting.

Method: Data were obtained from published studies. Thirteen articles were retrieved that focused on fall interventions in the hospital setting. An analysis was performed based on levels of evidence using an integrative review process.

Results: Multifactoral fall prevention intervention programs that included fall risk assessments, door/bed/patient fall risk alerts, environmental and equipment modifications, staff and patient safety education, medication management targeted to specific types, and …

Legal Does Not Mean Rational: The Practicality Of Treating First-Trimester Abortion Clinics The Same As Hospitals, Ania O. Wlodek

William & Mary Journal of Race, Gender, and Social Justice

No abstract provided.

Reducing Emergency Births By Modification In Oxytocin Utilization, Gary Ventolini, Michael L. Galloway, Sheela M. Barhan, Marc R. Belcastro

Obstetrics and Gynecology Faculty Publications

Background: The purpose of our study was to explore the correlation between the amount of oxytocin use and emergency vacuum, forceps, cesarean births and neonatal intensive care unit (NICU) response to fetal distress. In 2004, we restricted the criteria for oxytocin utilization for labor induction and augmentation.

Methods: This retrospective study was carried out at a large private university tertiary care hospital- affiliated, and included data from the years 2005 to 2007. We utilized hospital data from vital statistics, labor and delivery, central pharmacy and NICU. Information obtained included maternal characteristics, annual birth data, indication and numbers of emergency vacuum, …

Type 2 Diabetes Science And American Indian / Alaska Native Culture: Creating A National K-12 Curriculum Prevention Strategy For Native Youth, Carolee Dodge Francis, Michelle Chino

Environmental & Global Health Faculty Research

Preventing and reducing the onset of type 2 diabetes among American Indian/Alaska Native youth requires educational strategies to affect knowledge, attitudes, and cognitive decision-making skills. In an unparalleled effort to address the growing epidemic of type 2 diabetes in tribal communities, eight tribal colleges and three federal agencies collaborated to develop and implement a kindergarten-through-twelfth-grade (K–12) Diabetes Education in Tribal Schools curriculum. This article outlines the scientific and cultural development of a comprehensive K–12 science curriculum as a targeted health prevention strategy.

Asymptomatic Presentation Of Giant Bulla Of The Left Apical And Anterior Segment Of The Left Upper Lobe Of The Lung With Near Complete Atelectasis Of The Remaining Left Lung, Saulat H. Fatimi, Mahrukh Riaz, Hashim Muhammad Hanif, Marium Muzaffar

Section of Cardiothoracic Surgery

Giant bullae may be found in association with emphysema. They present as pockets of entrapped air which grow as the surrounding lung retracts away. As they do not take part in gas exchange and merely occupy space, their presence leads to severe impediment of mechanical ventilation in the adjacent lung parenchyma. Patients may present with dyspnoea, exercise intolerance and a feeling of pressure in the chest. The case of a 54 year old gentleman is presented, who was found to have a giant bulla occupying his left hemithorax on a routine chest X-ray. The patient remained asymptomatic despite the large …

Challenges Of Being A Black Student Athlete On U.S. College Campuses, Wycliffe W. Njororai Simiyu

Health & Kinesiology Faculty Publications and Presentations

The purpose of this Literature review article is to examine the social, cultural, individual and institutional racist factors that pose challenges to many African American college athletes, both men and women, to develop skills outside sports that are necessary to succeed in college and life. The passion for athletics by Black youth has to be positioned within the wider racist environment that one is exposed to while growing up. The dominant presence of Blacks in the high profile sports of football, basketball and track and field while having lower graduation rates compared to White athletes deserves scholarly interrogation. This article …

Assessment Of An Osteoblast-Like Cell Line As A Model For Human Primary Osteoblasts Using Raman Spectroscopy, Lindsay Mcmanus, Franck Bonnier, George Burke, Brian Meenan, Adrian Boyd, Hugh Byrne

Articles

Raman spectroscopy is employed to determine the suitability of the U20S osteoblast-like cell line for use as a model for human primary osteoblasts, with emphasis on the ability of these cell types to replicate their tissue of origin. It was found that both cell types demonstrated early stage mineral deposition that followed significantly different growth patterns. Analysis of the growth pattern and spectral data from primary cells revealed increasing bone quality ratios and a high crystallinity, consistent with previous reports. Conversely the investigation of the U20S osteoblast-like cell line provided evidence of dense multilayered mineralised regions that corresponded more closely …

Effect Of Different Doses Of Aerobic Exercise On Total White Blood Cell (Wbc) And Wbc Subfraction Number In Postmenopausal Women: Results From Drew, Neil M. Johannsen, Damon L. Swift, William D. Johnson, Vishwa D. Dixit, Conrad P. Earnest, Steven N. Blair, Timothy S. Church

Faculty Publications

Background: Elevated total white blood cell (WBC) count is associated with an increased risk of coronary heart disease and death. Aerobic exercise is associated with lower total WBC, neutrophil, and monocyte counts. However, no studies have evaluated the effect of the amount of aerobic exercise (dose) on total WBC and WBC subfraction counts.

Purpose: To examine the effects of 3 different doses of aerobic exercise on changes in total WBC and WBC subfraction counts and independent effects of changes in fitness, adiposity, makers of inflammation (IL-6, TNF-α, C-reactive protein), fasting glucose metabolism, and adiponectin.

Methods: Data from 390 sedentary, overweight/obese …

Spontaneous Bilateral Tubal Pregnancy, Aisha Syed Wali, Rozilla Sadia Khan

Department of Obstetrics & Gynaecology

With the increase in incidence of ectopic pregnancy over the decades, bilateral ectopic pregnancy is also increasing. It is usually associated with assisted reproductive techniques (ART) but in recent years few cases of spontaneous bilateral ectopic pregnancy have been reported. Gynaecologists should be aware of this and that ultrasonography has limitations in diagnosis. In cases of ectopic pregnancy where contralateral adnexa is not clearly identified on ultrasound and fertility needs to be conserved, patient should be managed by experts in well equipped centres. A case of spontaneous bilateral tubal pregnancy that remained undiagnosed till laparotomy, is described.