Medicine and Health Sciences Commons^™

Physical Activity, Health Benefits, And Mortality Risk, Peter F. Kokkinos

Medicine Faculty Publications

A plethora of epidemiologic evidence from large studies supports unequivocally an inverse, independent, and graded association between volume of physical activity, health, and cardiovascular and overall mortality. This association is evident in apparently healthy individuals, patients with hypertension, type 2 diabetes mellitus, and cardiovascular disease, regardless of body weight. Moreover, the degree of risk associated with physical inactivity is similar to, and in some cases even stronger than, the more traditional cardiovascular risk factors. The exercise-induced health benefits are in part related to favorable modulations of cardiovascular risk factors observed by increased physical activity or structured exercise programs. Although the …

Etravirine Induced Severe Hypersensitivity Reaction And Fulminant Hepatitis: A Case Report And Review Of The Literature., Linda Nabha, Gayle P. Balba, Princy N.S. Kumar, Carmelita Tuazon

Medicine Faculty Publications

We report the first published case of etravirine induced hypersensitivity reaction leading to fulminant hepatic failure in a 49-year-old female patient with Human Immunodefi ciency Virus. She presented with a life threatening rash and end stage organ damage requiring intensive care unit supportive care. Liver biopsy supported the diagnosis of drug-induced hypersensitivity. The patient recovered after withdrawal of etravirine and the use of systemic corticosteroids. The authors describe etravirine drug hypersensitivity as a clinically important reaction and that early recognition can improve survival.

An Hit Solution For Clinical Care And Disaster Planning: How One Health Center In Joplin, Mo Survived A Tornado And Avoided A Health Information Center, Peter Shin, Feygele Jacobs

Health, Human Function, and Rehabilitation Sciences Faculty Publications

Since taking office, President Obama has made substantial investments in promoting the diffusion of health information technology. The objective of the national health IT program is, generally, to enable health care providers to better manage patient care through secure use and sharing of health information. Through the use of technologies including electronic health records, providers can better maintain patient care information and facilitate communication, often improving care outcomes. The recent tornado in Joplin, MO highlights the importance of health information technology in the health center context, and illustrates the importance of secure electronic health information systems as a crucial element …

Elevated Serum C-Reactive Protein And Markers Of Sleep Disordered Breathing, R Constance Wiener

Faculty & Staff Scholarship

Background. Previous studies indicated sleep-disordered breathing (SDB) is associated with cardiovascular disease (CVD). Systemic inflammation is recognized as a risk factor for CVD. Studies examining SDB and inflammation are limited. Methods. We studied sleep duration, snoring, snorting, and daytime sleepiness, and an additive SDB score. The main outcome was a C-reactive protein (CRP) of >1 mg/dL. Results. Snoring, snorting, daytime sleepiness, and sleeping >7 or <7 hours, and the additive score were significantly associated with high CRP. The additive score was not associated in men but moderately associated in women in a multivariable model adjusting for age, gender, race/ethnicity, education, smoking, hypertension, alcohol intake, physical activity, body mass index, depression, diabetes, hypertension, and total cholesterol (P-interaction ). For race/ethnicity, the association was strongest in Mexican Americans/others, modest in Non-Hispanic whites, and absent in Non-Hispanic blacks (P-interaction ). Conclusions. The association between SDB and high CRP was present mainly in women and Mexican Americans, implying SDB has a residual, independent association with inflammation after controlling for lifestyle and metabolic risk factors like BMI, physical activity, depression, diabetes, and cholesterol.

Association Between Serum Uric Acid Levels And Sleep Variables: Results From The National Health And Nutrition Survey 2005–2008, R Constance Wiener

Faculty & Staff Scholarship

Sleep disordered breathing as well as high serum uric acid levels are independent risk factors for cardiovascular disease. However, studies evaluating the relationship between sleep-disordered breathing and hyperuricemia are limited. We examined the 2005–2008 National Health and Nutrition Examination survey's sleep variables and high serum uric acid among 6491 participants aged ≥ 2 0 years. The sleep variables included sleep duration, snoring, snorting, and daytime sleepiness. The main outcome was high serum uric acid level, defined as levels of serum uric acid > 6 . 8 mg/dL in males and > 6 . 0 mg/dL in females. We found that snoring more …

Aspirin But Not Ibuprofen Use Is Associated With Reduced Risk Of Prostate Cancer: A Plco Study, F. M. Shebl, L. C. Sakoda, A. Black, J. Koziol, G. L. Andriole, R. Grubb, T. R. Church, D. Chia, Cindy Zhou, +8 Additional Authors

GW Biostatistics Center

Background:

Although most epidemiological studies suggest that non-steroidal anti-inflammatory drug use is inversely associated with prostate cancer risk, the magnitude and specificity of this association remain unclear.

Methods:

We examined self-reported aspirin and ibuprofen use in relation to prostate cancer risk among 29 450 men ages 55–74 who were initially screened for prostate cancer from 1993 to 2001 in the Prostate, Lung, Colorectal, and Ovarian Cancer Screening Trial. Men were followed from their first screening exam until 31 December 2009, during which 3575 cases of prostate cancer were identified.

Results:

After adjusting for potential confounders, the hazard ratios (HRs) of …

Himmelfarb Library Annual Report 2012, George Washington University, Himmelfarb Health Sciences Library

Himmelfarb Library Annual Report

No abstract provided.

The Fit-Hansa Demonstrates Reliability And Convergent Validity Of Functional Performance In Patients With Shoulder Disorders, Prajyot Kumta, Joy C. Macdermid, Saurabh Mehta, Paul W. Stratford

Physical Therapy Faculty Research

Study

DesignPsychometric study design.

Objectives

To assess the test-retest reliability and convergent validity of the Functional Impairment Test-Hand and Neck/Shoulder/Arm (FIT-HaNSA) in patients with shoulder disorders.

Background

Performance tests that assess functional ability of patients with shoulder disorders can provide useful information for making clinical or return-to-activity decisions. No performance-based shoulder test has yet demonstrated sufficient relevance or clinical measurement properties. The FIT-HaNSA examines upper extremity performance during repetitive tasks that emphasize shoulder reaching and static postures and, therefore, has greater relevance for assessing performance.

Methods

Thirty-six patients with shoulder disorders and 65 healthy controls were recruited for the study. …

Cross-Cultural Adaptation And Psychometric Testing Of The Hindi Version Of The Patient-Rated Wrist Evaluation, Saurabh Mehta, Bhavna Mhatre, Joy C. Macdermid, Amita Mehta

Physical Therapy Faculty Research

The purpose of this study was to perform cross-cultural adaptation and Hindi translation of the patient-rated wrist evaluation (PRWE) and assess psychometric properties of the PRWE-Hindi. Cross-cultural adaptation and Hindi translation of the PRWE was performed using standardized guidelines. Intraclass correlation coefficient (ICC) was used for assessing test–retest reliability, and Cronbach’s alpha (CA) was used for assessing the internal consistency of the PRWE-Hindi. Construct validity was assessed by examining the correlations between the PRWE-Hindi and grip strength, wrist range of movements, and self-reported pain and disability. A total of 50 patients with distal radius fracture were recruited and assessed three …

New Portable Tool To Screen Vestibular And Visual Function—National Institutes Of Health Toolbox Initiative, Rose Marie Rine, Dale Roberts, Bree A. Corbin, Roberta Mckean-Cowdin, Rohit Varma, Jennifer Beaumont, Jerry Slotkin, Michael C. Schubert

Physical Therapy Faculty Research

As part of the National Institutes of Health Toolbox initiative, we developed a low-cost, easy-to-administer, and time-efficient test of vestibular and visual function. A computerized test of dynamic visual acuity (cDVA) was used to measure the difference in visual acuity between head still and moving in yaw. Participants included 318 individuals, aged 3 to 85 years (301 without and 17 with vestibular pathology). Adults used Early Treatment of Diabetic Retinopathy Study (ETDRS) optotypes; children used ETDRS, Lea, and HOTV optotypes. Bithermal calorics, rotational chair, and light box testing were used to validate the cDVA. Analysis revealed that the cDVA test …

Testing, Testing 1,2,3, Eugenia Hogenkamp

3690: A Journal of First-Year Student Research Writing

Overview: Since childhood, most human beings have been raised on the foundation of accepting and adhering to the “Golden Rule” in everyday aspects of life. We have grown to appreciate the idea that one should treat others as one would like others to treat oneself. The People for the Ethical Treatment of Animals (PETA) reports that more than 100 million animals every year suffer and die in cruel chemical, drug, food and cosmetic tests; lab experimentations and lessons in the sciences; medical training exercises; and curiosity-driven medical experiments. Why do human beings sit back and do nothing, knowing that these …

Public Reporting As A Communication Tool To Aid Vulnerable Consumers In Healthcare Decisions: What Do We Know?, Daniel R. Longo, Barbara A. Wright

VCU Libraries Faculty and Staff Presentations

Background/Introduction:

There is tremendous variation in quality, healthcare service utilization and disparities experienced by the poor, certain minorities, and other priority populations. Public reporting is identified as one method of bringing these differences to light and by informing consumers through documented comparison of provider performance to influence change and encourage improvement in healthcare. The federal Accountable Care Act has the stated mandate “to improve the dissemination of measures of healthcare quality and resource use, (and) to build the science of public reporting.” However, early studies on the design and use of consumer reports cite the public’s confusion and lack of …

Child, Parent, And Healthcare Professionals' Perspectives On Hiv Infection Status Disclosure To Children, Grace Gachanja

Presidential Alumni Research Dissemination Award

HIV infected parents face great challenges when contemplating and performing disclosure of theirs and their children's illnesses to their infected and noninfected children. HIV disclosure guidelines for a parent's and child's illness do not exist in resource-poor nations. This hinders and impedes the delivery of disclosure from parent to child. This qualitative phenomenological study, based on the disease progression theory and the consequence theory of HIV disclosure, was conducted to understand the lived experiences of HIV-infected parents and their children living in Kenya before, during, and after disclosure of a parent's and child's HIV infection status. Thirty four participants consisting …

A Nhanes 2005-2006 Data Analysis Examining Early Childhood Factors, Food Security, Medical Insurance, And Childhood Obesity, Assanatu Iyatunde Savage

Presidential Alumni Research Dissemination Award

The purpose of this study, and primary research question, was to examine the relationships among early childhood factors, food security, and family medical insurance and childhood obesity. There are many factors associated with the overweight and obesity epidemic. Hence, creating solutions must be addressed on various platforms such as early childhood influences, food security/insecurity, and family availability of health insurance. Relevant and aggregate data on factors affecting childhood obesity could potentially lead to age appropriate interventions to prevent childhood obesity and its sequelae. The literature noted the social cognitive theory in addressing the relationship between parents, the environment, and childhood …

Are Marginalized Women Being Left Behind? A Population-Based Study Of Institutional Deliveries In Karnataka, India, Paul C. Adamson, Karl Krupp, Bhavana Niranjankumar, Alexandra H. Freeman, Mudassir Khan, Purnima Madhivanan

Medicine Faculty Publications

Background

While India has made significant progress in reducing maternal mortality, attaining further declines will require increased skilled birth attendance and institutional delivery among marginalized and difficult to reach populations.

Methods

A population-based survey was carried out among 16 randomly selected rural villages in rural Mysore District in Karnataka, India between August and September 2008. All households in selected villages were enumerated and women with children 6 years of age or younger underwent an interviewer-administered questionnaire on antenatal care and institutional delivery.

Results

Institutional deliveries in rural areas of Mysore District increased from 51% to 70% between 2002 and 2008. …

Effective Non-Viral Delivery Of Sirna To Acute Myeloid Leukemia Cells With Lipid-Substituted Polyethylenimines, Breanne Landry

Pharmacy Faculty Articles and Research

Use of small interfering RNA (siRNA) is a promising approach for AML treatment as the siRNA molecule can be designed to specifically target proteins that contribute to aberrant cell proliferation in this disease. However, a clinical-relevant means of delivering siRNA molecules must be developed, as the cellular delivery of siRNA is problematic. Here, we report amphiphilic carriers combining a cationic polymer (2 kDa polyethyleneimine, PEI2) with lipophilic moieties to facilitate intracellular delivery of siRNA to AML cell lines. Complete binding of siRNA by the designed carriers was achieved at a polymer:siRNA ratio of ~0.5 and led to siRNA/polymer complexes of …

Developing A Business Plan For Sustaining School Mental Health Services: Three Success Storiess, Donna Behrens, Julia Graham Lear, Olga Acosta Price

Center for Health and Health Care in Schools

No abstract provided.

Urban Governance Of Disease, Rebecca Katz, Sangeeta Mookherji, Morgan Kaminski, Vibhuti Haté, Julie E. Fischer

Global Health Faculty Publications

Rapid population growth, urbanization, and the growing challenges faced by the urban poor require redefining the paradigm for public health interventions in the 21st century, creating new approaches that take urban determinants of health into consideration. The widening disparity between the urban poor and the urban rich further exacerbates health inequities. Existing tools for global governance of urban health risks fall short, particularly in the lack of formal mechanisms to strengthen collaboration and communication among national and municipal agencies and between their local and international non-governmental partners. There is also a clear disconnect between governance strategies crafted at the international …

Smoking Susceptibility And Its Predictors Among Adolescents In China: Evidence From Ningbo City, Cheng Huang, Jeffrey Koplan, Jing Liu, Changwei Li, Jessica Silvaggio, Amanda K. Macgurn, Tao Zhang, Michael P. Erikson, Pam Redmon

Global Health Faculty Publications

Susceptibility to smoking is a risk factor of actual adolescent smoking behaviors. This study aimed to estimate the rate of smoking susceptibility and its predictors in China with a sample of 4,695 junior high school students in Ningbo, China. Core questions from the Global Youth Tobacco Survey (GYTS) were adapted to the China context and administered to these students. The rate of smoking susceptibility, measured by “Do you foresee yourself taking up smoking in the next 12 months”, is 6.1%. Results from logistic regression suggested that among boys, adolescents’ health knowledge that smoking can cause lung cancer (OR=2.73), the belief …

Neuroimaging Of Tumefactive Multiple Sclerosis With Atypical Features, Rohit Koppula, Andrew J. Degnan, Mark Ghassibi, Peter Duggan, Robert Jones, Lucien M. Levy

Radiology Faculty Publications

Tumefactive demyelinating lesions or tumefactive multiple sclerosis constitute a unique presentation of demyelinating disease which frequently mimics intracranial neoplasm, infection or other, non-demyelinating intracranial pathology. Consequently, these lesions, which are larger than typical multiple sclerosis plaques and generally characterized by certain magnetic resonance imaging features including edema and incomplete ring enhancement, pose a serious diagnostic challenge that frequently prompts biopsy in initial evaluation. Biopsy can be averted when imaging features for tumefactive multiple sclerosis are seen on MRI. Herein, we present a biopsy-proven case of tumefactive multiple sclerosis with atypical imaging features, evaluated using magnetic resonance and diffusion tensor imaging.

Health Effects Associated With Foreclosure: A Secondary Analysis Of Hospital Discharge Data, Nancy Menzel, Sheniz Moonie, Melva V. Thompson-Robinson

Nursing Faculty Research

Objectives. The purpose of this study was to assess the health effects of high home foreclosure rates in an area of the United States of America and the utility of hospital discharge data for this purpose. Methods. We analyzed hospital discharge data from three postal zip codes using the principal diagnosis for 25 Diagnostic Related Groups associated with stress. Descriptive statistics were used to characterize hospital discharge rates for each condition by year and zip code. To test for differences across time, the Cochran-Armitage trend test was performed. Results. Most conditions did not demonstrate a statistical change between …

Network Insights On Oxaliplatin Anti-Cancer Mechanisms, Osama M. Alian, Asfar S. Azmi, Ramzi M. Mohammad

Wayne State University Associated BioMed Central Scholarship

Abstract

Oxaliplatin has been a crucial component of combination therapies since admission into the clinic causing modest gains in survival across multiple malignancies. However, oxaliplatin functions in a non-targeted manner, posing a difficulty in ascertaining precise efficacy mechanisms. While previously thought to only affect DNA repair mechanisms, Platinum-protein adducts (Pt-Protein) far outnumber Pt-DNA adducts leaving a big part of oxaliplatin function unknown. Through preliminary network modeling of high throughput data, this article critically reviews the efficacy of oxaliplatin as well as proposes a better model for enhanced efficacy based on a network approach. In our study, not only oxaliplatin’s function …

Acr Appropriateness Criteria®  Resectable Rectal Cancer, William E. Jones Iii, Charles R. Thomas Jr, Joseph M. Herman, May Abdel-Wahab, Nilofer Azad, William Blackstock, Prajnan Das, Karyn A. Goodman, Theodore S. Hong, Salma K. Jabbour, Andre A. Konski, Albert C. Koong, Miguel Rodriguez-Bigas, William Small Jr, Jennifer Zook, W Suh

Wayne State University Associated BioMed Central Scholarship

Abstract

The management of resectable rectal cancer continues to be guided by clinical trials and advances in technique. Although surgical advances including total mesorectal excision continue to decrease rates of local recurrence, the management of locally advanced disease (T3-T4 or N+) benefits from a multimodality approach including neoadjuvant concomitant chemotherapy and radiation. Circumferential resection margin, which can be determined preoperatively via MRI, is prognostic. Toxicity associated with radiation therapy is decreased by placing the patient in the prone position on a belly board, however for patients who cannot tolerate prone positioning, IMRT decreases the volume of normal tissue irradiated. The …

Erlin2 Promotes Breast Cancer Cell Survival By Modulating Endoplasmic Reticulum Stress Pathways, Guohui Wang, Gang Liu, Xiaogang Wang, Seema Sethi, Rouba Ali-Fehmi, Judith Abrams, Ze Zheng, Kezhong Zhang, Stephen Ethier, Zeng-Quan Yang

Wayne State University Associated BioMed Central Scholarship

Abstract

Background

Amplification of the 8p11-12 region has been found in approximately 15% of human breast cancer and is associated with poor prognosis. Previous genomic analysis has led us to identify the endoplasmic reticulum (ER) lipid raft-associated 2 (ERLIN2) gene as one of the candidate oncogenes within the 8p11-12 amplicon in human breast cancer, particularly in the luminal subtype. ERLIN2, an ER membrane protein, has recently been identified as a novel mediator of ER-associated degradation. Yet, the biological roles of ERLIN2 and molecular mechanisms by which ERLIN2 coordinates ER pathways in breast carcinogenesis remain unclear.

Methods

We established the MCF10A-ERLIN2 …

Deficits On The Clock Drawing Test In Parkinson’S Disease, Ashley Rober

Undergraduate Review

Parkinson’s Disease (PD) is a progressive neurodegenerative disorder that affects 1% of the world population over the age of 65—anywhere from four to six million people (National Parkinson Foundation, 2010). Although most people identify PD as a movement disorder, cognitive deficits are also present. Poor performance on tasks such as set shifting, internal control of attention, and sequencing is commonly reported by PD patients (Stout & Johnson, 2005), as are visual and verbal memory impairments (Moody, Bookheimer, Vanek, & Knowlton, 2004). Visuospatial skills are also problematic, including depth perception, spatial orientation, and spatial organization (Bowen, Burns, Brady, & Yahr, 1972).

Association Between Acculturation And Breastfeeding Among Hispanic Women: Data From The Pregnancy Risk Assessment And Monitoring System, Indu B. Ahluwalia, Denise D’Angelo, Brian Morrow, Jill A. Mcdonald

United States Public Health Resources

Background: Breastfeeding rates are typically higher among Hispanic women; however, they vary by acculturation status in that those more acculturated are less likely to breastfeed than those who are less acculturated. This study examined the association between acculturation and breastfeeding behaviors using population-based data.

Methods: Data (N = 8942) from the Pregnancy Risk Assessment Monitoring System (PRAMS) were used for analysis. Acculturation status was determined using self-reported Hispanic ethnicity and the language in which the women responded to the PRAMS survey, either English or Spanish. Hispanic women who responded to the survey in Spanish were categorized as less acculturated than …

Most Physicians Were Eligible For Federal Incentives In 2011, But Few Had Ehr Systems That Met Meaningful-Use Criteria, Chun-Ju Hsiao, Sandra Decker, Esther Hing, Jane Sisk

United States Public Health Resources

As more physicians adopt electronic health record systems in their practices, policy interest is focusing on whether physicians are ready to meet the federal “meaningful use” criteria—a vital threshold to qualify for financial incentives. In our analysis of a 2011 nationally representative survey of office-based physicians, we found that 91 percent of physicians were eligible for Medicare or Medicaid meaningful-use incentives. About half of all physicians intended to apply. However, only 11 percent both intended to apply for the incentives and had electronic health record systems with the capabilities to support even two-thirds of the stage 1 core objectives required …

United States Registered Nurse Workforce Report Card And Shortage Forecast, Stephen P. Juraschek, Xiaoming Zhang, Vinoth K. Ranganathan, Vernon Lin

United States Public Health Resources

Registered nurses (RNs) play a critical role in health care delivery. With an aging US population, health care demand

is growing at an unprecedented pace. Using projected changes in population size and age, the authors developed

demand and supply models to forecast the RN job shortage in each of the 50 states. Letter grades were assigned

based on projected RN job shortage ratios. The number of states receiving a grade of “D” or “F” for their RN

shortage ratio will increase from 5 in 2009 to 30 by 2030, for a total national deficit of 918 232 (725 619 - …

Improving Outpatient Diabetes Care, Susan Kirsh, Michael Hein, Leonard Pogach, Gordon Schectman, Lauren Stevenson, Sharon Watts, Archana Radhakrishnan, John Chardos, David Aron

United States Public Health Resources

More than 20% of patients in the Veterans Health Administration (VHA) have diabetes; therefore, disseminating “best practices” in outpatient diabetes care is paramount. The authors’ goal was to identify such practices and the factors associated with their development. First, a national VHA diabetes registry with 2008 data identified clinical performance based on the percentage of patients with an A1c >9%. Facilities (n = 140) and community-based outpatient clinics (n = 582) were included and stratified into high, mid, and low performers. Semistructured telephone interviews (31) and site visits (5) were conducted. Low performers cited lack of teamwork between physicians and …

Clinical Research And Development Of Tuberculosis Diagnostics: Moving From Silos To Synergy, Payam Nahid, Peter S. Kim, Carlton A. Evans, David Alland, Michael Barer, Jane Diefenbach, Jerrold Ellner, Richard Hafner, Carol Dukes Hamilton, Michael F. Iademarco, Gregory Ireton, Michael E. Kimerling, Christian Lienhardt, William R. Mackenzie, Megan Murray, Mark D. Perkins, Jamie E. Posey, Teri Roberts, Christine Sizemore, Wendy S. Stevens, Laura Via, Sharon D. Williams, Wing Yew, Susan Swindells

United States Public Health Resources

The development, evaluation, and implementation of new and improved diagnostics have been identified as critical needs by human immunodeficiency virus (HIV) and tuberculosis researchers and clinicians alike. These needs exist in international and domestic settings and in adult and pediatric populations. Experts in tuberculosis and HIV care, researchers, healthcare providers, public health experts, and industry representatives, as well as representatives of pertinent US federal agencies (Centers for Disease Control and Prevention, Food and Drug Administration, National Institutes of Health, United States Agency for International Development) assembled at a workshop proposed by the Diagnostics Working Group of the Federal Tuberculosis Taskforce …