Medicine and Health Sciences Commons^™

Extending The Indications Of Flow Diversion To Small, Unruptured, Saccular Aneurysms Of The Anterior Circulation., Nohra Chalouhi, Md, Robert M Starke, Steven Yang, Cory D Bovenzi, Stavropoula Tjoumakaris, David Hasan, L. Fernando Gonzalez, Robert H. Rosenwasswer Md, Pascal Jabbour Md

Department of Neurosurgery Faculty Papers

BACKGROUND AND PURPOSE: Flow diverters are currently indicated for treatment of large and complex intracranial aneurysms. The purpose of this study was to determine whether the indications of flow diversion can be safely extended to unruptured, small, saccular aneurysms (<10 >mm) of the anterior circulation.

METHODS: Forty patients treated with the pipeline embolization device (PED) were matched in a 1:4 fashion with 160 patients treated with stent-assisted coiling based on patient age, sex, aneurysm location, and aneurysm size. Procedural complications, angiographic results, and clinical outcomes were analyzed and compared.

RESULTS: The rate of periprocedural complications was 5% in the PED …

Surgical Margin Status After Breast Conservation Surgery At Aga Khan University Hospital, Nairobi, Ronald Wasike, B. Riogi

General Surgery, East Africa

The conservation of the breast in a woman after diagnosis of breast cancer plays a vital role in the overall management of the patient. While the cosmetic outcome enhances the patients’ self-image, assurance of clear margins is essential in prognostication. An analysis was carried out to assess the adequacy of surgical margins at our unit.

Methodology: Retrospective analysis of breast surgery for breast cancer patients was done from 2008 to 2011 at Aga Khan University Hospital.

Results: Twenty one patients with breast cancer had breast conservation surgery with an average age of 44.8 years. The commonest histological diagnosis (71.4%) was …

Leukopenia Management In Thymoglobulin Treated Renal Transplant Recipients, Lynsey S. Biondi Md, Michael J. Moritz Md, Janelle Cyprich

Department of Surgery

No abstract provided.

Parenteral Nutrition Web-Based Order Writing: Educating Prescribers Utilizing A Network-Wide Computerized E-Learning Tool, Judy Holaska Rd, Ms, Cnsc , Ldn

Clinical Nutrition Service

No abstract provided.

Identity Adaptation And The Potential For Psychological Growth Following Adversity For Injured Athletes, Alanna M. Riordan, Jill Tracey

Theses and Dissertations (Comprehensive)

The study was undertaken to gain a deeper understanding of the transition process out of competitive athletics experienced by competitive athletes after a career-limiting injury by examining three research questions: 1) What is the identity adaptation process of injured athletes? 2) To what extent, if any, do injured athletes experience growth following adversity? 3) What, if any, psychological skills are used in the injury/career transition processes? Nine former elite ath- letes were recruited through key informant sampling. There were three males and six females, with a mean age of 24.6 years. All participants sustained, at minimum, a season-ending injury and …

An Exploratory Examination Of Families Engaged In An Adventure Running Kids Program, Heather Isnor

Theses and Dissertations (Comprehensive)

Academics and practitioners have only just begun to delve into the health benefits of outdoor activities in the last few years. In general, the forested settings of these activities have been documented to decrease stress levels, increase recovery rates from disease, and lessen the symptoms of mental illnesses (Kuo & Faber Taylor, 2004). It is believed that the natural environment acts as a setting where humans can engage in physical activity, aesthetic experiences, and social interactions that, in turn, release stress and lead to improved well-being (Bird, 2012). Currently, however, children are experiencing limited exposure to nature and which has …

Endocannabinoid Involvement In Impulsivity And Decision-Making, Christopher P. Norris

Theses and Dissertations (Comprehensive)

Problem gambling is a widespread phenomenon with a prevalence estimate of 2.3% globally (Williams, Volberg, & Stevens, 2012). Although little is known about the neurochemistry underlying this pathological behaviour, evidence suggests that dysregulation of the brain’s endocannabinoid (eCB) system may be implicated in impulsivity and decision-making. For example, chronic cannabis users exhibit impulsive behaviour and impaired decision-making on the Iowa Gambling Task (IGT). The present study sought to further examine the role of the eCB system in problem gambling-related decision-making in laboratory rats using the five-choice serial reaction time task (5-CSRTT), and a recently-developed rodent analogue of the IGT called …

Physical Fitness Characteristics Of An Active Firefighter Population Serving An Urban Area, Michael R. Antolini

Theses and Dissertations (Comprehensive)

Firefighters require a high level of physical fitness in order to meet the demands of their profession. While physical fitness testing is required to join the department, firefighters are not subject to further formal exercise testing throughout the duration of their careers. Active, career firefighters were tested on a variety of physical fitness measures related to body composition, strength, power, and endurance over three testing sessions. 49 firefighters (40.5 ± 8.3 yr, 89.5 ± 13.0 kg, 27.8 ± 3.6 kg/m2) were found to have a resting heart rate of 57.7 ± 8.2 bpm, blood pressure of 121.5 ± 11.9/71.5 ± …

Accuracy Of Magnetic Resonance Imaging In Pretreatment Lymph Node Assessment For Gynecological Malignancies, Saira Naz Sufian, Imrana Masroor, Waseem Mirza, Zainab Hussain, Saima Hafeez, Zafar Sajjad

Department of Radiology

Objective: To determine the accuracy of magnetic resonance imaging (MRI) in detection of metastasis in pelvic and para-aortic lymph nodes from different gynecological malignancies.MATERIALS AND Methods: This retrospective cross sectional analytic study was conducted at the Department of Diagnostic Radiology, Aga Khan University Hospital Karachi Pakistan from January 2011 to December 2012. A sample of 48 women, age range between 20-79 years, fulfilling inclusion criteria were included. All patients had histopathologically proven gynecological malignancies in the cervix, endometrium or ovary and presented for a pretreatment MRI to our radiology department.Results: MRI was 100% sensitive and had a 100% positive predictive …

Endovascular Embolisation Of Visceral Artery Pseudoaneurysms, Yasir Jamil Khattak, Tariq Alam, Rana Hamid Shoaib, Raza Sayani, Tanveer-Ul Haq, Muhammad Awais

Department of Radiology

Objective. To evaluate the technical success, safety, and outcome of endovascular embolization procedure in management of visceral artery pseudoaneurysms. Materials and Methods. 46 patients were treated for 53 visceral pseudoaneurysms at our institution. Preliminary diagnostic workup in all cases was performed by contrast enhanced abdominal CT scan and/or duplex ultrasound. In all patients, embolization was performed as per the standard departmental protocol. For data collection, medical records and radiology reports of all patients were retrospectively reviewed. Technical success, safety, and outcome of the procedure were analyzed. Results. Out of 46 patients, 13 were females and 33 were males. Mean patient …

Diagnostic Accuracy Of Ultrasonography In Differentiating Benign And Malignant Thyroid Nodules Using Fine Needle Aspiration Cytology As The Reference Standard, Tariq Alam, Yasir Jamil Khattak, Madiha Beg, Abdul Raouf, Muhammad Azeemuddin, Asif Alam Khan

Department of Radiology

Background: In Pakistan thyroid cancer is responsible for 1.2% cases of all malignant tumors. Ultrasonography (US) is helpful in detecting cancerous thyroid nodules on basis of different features like echogenicity, margins, microcalcifications, size, shape and abnormal neck lymph nodes. We therefore aimed to calculate diagnostic accuracy of ultrasound in detection of carcinoma in thyroid nodules taking fine needle aspiration cytology as the reference standard.MATERIALS AND Methods: A cross-sectional analytical study was designed to prospectively collect data from December 2010 till December 2012 from the Department of Radiology in Aga Khan University Hospital, Karachi, Pakistan. A total of 100 patients of …

Impaired Fasting Glucose Level And Diabetes In Kaoma And Kasama Rural Districts Of Zambia: Prevalence And Correlates In 2008-2009 Population Based Surveys, Olesegun A. Babaniyi, Peter Songolo, Emmanuel Rudatsikira, Adamson S. Muula, David Mulenga, Mazyanga L. Mazaba-Liwewe, Idah Ndumba, Freddie Masaninga, Seter Siziya

Faculty Publications

Background: Impaired fasting glucose level has been associated with increased incidence of Type 2 Diabetes mellitus, and diabetes is becoming a major public health problem in developing countries. The objective of the study was to determine the prevalence and correlates for impaired fasting glucose level/diabetes in Kaoma and Kasama rural districts of Zambia. Methods and Findings: A cross sectional study using modified World Health Organization (WHO) global non communicable diseases (NCD) surveillance initiative NCD STEPwise approach was used in the study. Proportions were compared using the Yates’ corrected Chi-square test, and a result yielding a p value of less than …

Pancreatic Lymphangioma, Shaista Afzal, Imrana Masroor, Gulnaz Shafqat

Department of Radiology

Lymphangioma develops as a consequence of lymphatic malformation and blockage of lymphatic flow. Pancreatic lymphangioma is a rare benign tumour which can grow reasonably large prior to manifestation of symptoms. On imaging, it appears as a complex multiseptated cystic mass. However, this appearance is not diagnostic and overlaps with cystic pancreatic neoplasm. We present a case of pancreatic lymphangioma incidentally discovered in an elderly lady who was managed conservatively since surgery could not be performed as the patient was high risk for surgery. Imaging findings along with follow-up of the case and review of literature is presented.

Wandering Meckel's Diverticulum On 99m Technetium-Pertechnetate Scintigraphy: A Diagnostic Dilemma?, Maseeh Uz Zaman, Nosheen Fatima, Unaiza Zaman, Zafar Sajjad

Department of Radiology

Meckel's diverticulum (MD) is the most common gastrointestinal anomaly with heterotopic mucosa in 60% of cases. 99m technetium-pertechnetate scintigraphy is a sensitive tool for detection of MD containing heterotopic gastric mucosa. It is usually located in the right lower quadrant or umbilical region and less frequently in other quadrants. A mobile or wandering MD is a rare clinical presentation and may pose a diagnostic dilemma. However, presence of temporal correlation with gastric activity and compactness of focus during wandering period could make this riddle easy.

High-Resolution Melting Analysis Reveals Low Plasmodium Parasitaemia Infections Among Microscopically Negative Febrile Patients In Western Kenya, Purity N. Kipanga, David Omondi, Paul O. Mireji, Patrick Sawa, Daniel K. Masiga, Jandouwe Villinger

All Peer-Reviewed Publications

Background: Microscopy and rapid diagnostic tests (RDTs) are common tools for diagnosing malaria, but are deficient in detecting low Plasmodium parasitaemia. A novel molecular diagnostic tool (nPCR-HRM) that combines the sensitivity and specificity of nested PCR (nPCR) and direct PCR-high resolution melting analysis (dPCR-HRM) was developed. To evaluate patterns of anti-malarial drug administration when no parasites are detected, nPCR-HRM was employed to screen blood samples for low parasitaemia from febrile patients without microscopically detectable Plasmodium infections in a rural malaria-endemic setting. Methods: Blood samples (n = 197) were collected in two islands of Lake Victoria, Kenya, from febrile patients without …

Gender Differences In High Sensitivity C - Reactive Protein And Self-Reported Muscle Strengthening Activity Among U.S. Adults, Michael R. Richardson

UNF Graduate Theses and Dissertations

Objectives: We sought to examine the gender differences between C - reactive protein (CRP) and muscle strengthening activity (MSA) in U.S. adults (≥20 years of age)

Background: Elevated levels of CRP have been shown to be associated with an increase in risk of cardiovascular disease (CVD). Studies analyzing the relationship between physical activity (PA) and CRP by gender have produced mixed results.

Methods: The sample (n=9,135) included participants in the 1999-2004 National Health and Nutrition Examination Survey (NHANES). Three categories of reported MSA participation were created: no MSA (referent group), some MSA (≥1 to/wk), and meeting the …

Meta-Analysis Of Herbal Cannabis Therapy For Chronic Pain, Michael J. Seneca

UNF Graduate Theses and Dissertations

Since the first so-called “medical marijuana” legislation was passed in California in 1996, a total of twenty states and the District of Columbia have passed laws permitting limited use of cannabis. Despite the changes in state laws, cannabis remains illegal for any purpose under federal law. Changes in state laws have coincided with a renewed interest in the substance for the treatment of a variety of conditions. There has been a significant increase in published data over the past twenty years examining the efficacy of cannabis as an appetite stimulant, antiemetic agent, and analgesic adjuvant. The purpose of this meta-analysis …

Reducing Visual Deficits Caused By Refractive Errors In School And Preschool Children: Results Of A Pilot School Program In The Andean Region Of Apurimac, Peru, Sergio Latorre-Arteaga, Diana Gil-Gonzalez, Olga Enciso, Aoife Phelan, Angel Garcia-Munoz, Johannes Kohler

Articles

Background

Refractive error is defined as the inability of the eye to bring parallel rays of light into focus on the retina, resulting in nearsightedness (myopia), farsightedness (Hyperopia) or astigmatism. Uncorrected refractive error in children is associated with increased morbidity and reduced educational opportunities. Vision screening (VS) is a method for identifying children with visual impairment or eye conditions likely to lead to visual impairment.

Objective

To analyze the utility of vision screening conducted by teachers and to contribute to a better estimation of the prevalence of childhood refractive errors in Apurimac, Peru.

Design

A pilot vision screening program in …

Neurobiological Mechanisms That Contribute To Stress-Related Cocaine Use, John R. Mantsch, Oliver Vranjkovic, Robert C. Twining, Paul J. Gasser, Jayme R. Mcreynolds, Jordan M. Blacktop

Biomedical Sciences Faculty Research and Publications

The ability of stressful life events to trigger drug use is particularly problematic for the management of cocaine addiction due to the unpredictable and often uncontrollable nature of stress. For this reason, understanding the neurobiological processes that contribute to stress-related drug use is important for the development of new and more effective treatment strategies aimed at minimizing the role of stress in the addiction cycle. In this review we discuss the neurocircuitry that has been implicated in stress-induced drug use with an emphasis on corticotropin releasing factor actions in the ventral tegmental area (VTA) and an important pathway from the …

Pilot Data On Brain-To-Blood Efflux Of B-Amyloid Peptides In Man, Steve Meaney, Maura Heverin, Ingemar Bjorkhem,, Dorotea Religa, John Wahren, Ulf Diczfalusy

Articles

• Alzheimer’s disease (AD) is the most common cause of dementia and affects nearly 40,000 individuals in Ireland. • The b-amyloid peptide (Ab) plays a key role in the pathogenesis of the AD and the presence of Ab plaques in the brain is diagnostic. •The hypothesis posits that Ab deposition is a critical factor in the disease process and that production and clearance of Ab are key drivers of the disease1. •Flux of Ab from the brain is believed to contribute to the overall level of Ab within in brain2 and antibody mediated brain-to-blood efflux has been observed in animal …

21st-Century U.S. Safety Professional Educational Standards: Establishing Minimum Baccalaureate Graduate Learning Outcomes For Emerging Occupational Health And Safety Professionals, Wayne Edward Hartz

Antioch University Dissertations & Theses

How can the public be assured of competency in those professing to protect its occupational health and safety (OSH)? Currently, in the U.S. there are 193 higher education OSH programs, 186 with baccalaureate degrees with over 55 different degree titles. This research seeks to define minimum OSH baccalaureate graduate core competencies across all programs by asking: What would employers look for in a portfolio to demonstrate competence in a new OSH graduate? Professional members of the American Society of Safety Engineers (ASSE) participated as subject matter experts in an anonymous online survey to provide framing data. The ASSE Educational Standards …

Navigating The Health Care Labyrinth: Portraits Of The Socioeconomically Disadvantaged, Thomas C. Crawford Phd

Antioch University Dissertations & Theses

In 2010, an estimated population of the 311,212,863 Americans generated approximately 1,014,688,290 physician office encounters (Moore, 2010). The frequency and number of professional interactions between caregivers and patients/family members in medical office settings equated to a staggering 1,931 visits per minute. Based on the massive volume of interactions that occurred between patients of different races, ethnicities, genders, sexual orientations, and socioeconomic standings that generated an average household income of $49,445 in 2010 (United States Census Bureau, 2010a) with a physician workforce that the Association of American Medical Colleges (2010) captured as being 75% White that earned (primary care specialties) in …

Psychotherapy And The Embodiment Of The Neuronal Identity: A Hermeneutic Study Of Louis Cozolino's (2010) The Neuroscience Of Psychotherapy: Healing The Social Brain , Ari Simon Natinsky

Antioch University Dissertations & Theses

In recent years, there have been several ways in which researchers have attempted to integrate psychotherapy and neuroscience research. Neuroscience has been proposed as a method of addressing lingering questions about how best to integrate psychotherapy theories and explain their efficacy. For example, some psychotherapy outcome studies have included neuroimaging of participants in order to propose neurobiological bases of effective psychological interventions (e.g., Paquette et al., 2003). Other theorists have used cognitive neuroscience research to suggest neurobiological correlates of various psychotherapy theories and concepts (e.g., Schore, 2012). These efforts seem to embody broader historical trends, including the hope that neuroscience …

Making Space For Dying: Portraits Of Living With Dying, Elise Lark

Antioch University Dissertations & Theses

In Making Space for Dying: Portraits of Living with Dying, I describe the everyday lived experience of dying and the care culture within freestanding, community-based, end-of-life residences (CBEOLR) utilizing portraiture and arts-based research. I craft four case studies into “portraits,” based on interviews, on-site visits, up-close observation, and field notes. In the person-centered portraits, I reveal the inner landscape of two terminally ill women, with data represented in poetry. In the place-centered portraits, I “map” the social topography of two CBEOLRs to illustrate how lives and care of the dying are emplaced, from the perspectives of community leaders, …

Childhood Sexual Behavior: An Integrated Developmental Ecological Assessment Approach, Kelley Simmons Jones

Antioch University Dissertations & Theses

This qualitative, theoretical review and analysis of extant literature explored the sociocultural influences effecting conceptualization of childhood sexual behavior problems. Themes emerged from analysis of peer-reviewed journals that illustrated the complex, multidimensional, and ecological factors influencing child sexual development and problematic sexual behavior. These included major themes of Child Sexuality: Ecological Context, Developmental Context, Complex Trauma, and Ecological Interventions. Specific factors associated with childhood sexual behavior problems included trauma, domestic violence, sexual and physical abuse, psychological and emotional distress, impaired attachment, and the effects of diverse ecological systems such as the family, parents, and sociocultural influences of the greater community. …

Supporting Families With Congenital Adrenal Hyperplasia: Encouraging Whole Family Health, Kathryn A. Kraft

Antioch University Dissertations & Theses

In this dissertation, I discuss the medical and psychological needs of families with children with Congenital Adrenal Hyperplasia (CAH). Due to these needs, I have designed and described a program of social support and psychoeducation to be offered to parents and families. Specifically, I discuss the difficulty that parents have when finding out that their child has CAH, the emotional toll this takes on a parent, on their relationship, and on their family. Using a Family Systems Illness Model, I designed a program that takes into account family functioning, organization, structure, and communication when determining what would be most helpful …

A Randomized Clinical Trial On The Effects Of Extracorporeal Shockwave Therapy, Joint Mobilizations And Exercise On Plantar Heel Pain In Patients With Plantar Fasciitis, Paolo Sanzo, Elizabeth Oakley

Faculty Publications

Plantar fasciitis (PF) is the most common cause of heel pain today impacting on the patient’s walking ability, work tolerance, and ability to participate in active sport. Two million people in the United States (US) are treated for PF yearly with heel pain accounting for 11 to 15% of visits to medical professionals. It is estimated that 10% of the US population will develop PF during their lifetime. Treatment for PF may include a variety of interventions ranging from conservative treatment to surgical interventions. One of the suggested treatments for PF is the use of extracorporeal shockwave therapy (ECSWT). ECSWT …

Patient-Centered Appointment Scheduling Using Agent-Based Simulation., Ayten Turkcan, Tammy Toscos Phd, Brad N Doebbeling

Health Services and Informatics Research

Enhanced access and continuity are key components of patient-centered care. Existing studies show that several interventions such as providing same day appointments, walk-in services, after-hours care, and group appointments, have been used to redesign the healthcare systems for improved access to primary care. However, an intervention focusing on a single component of care delivery (i.e. improving access to acute care) might have a negative impact other components of the system (i.e. reduced continuity of care for chronic patients). Therefore, primary care clinics should consider implementing multiple interventions tailored for their patient population needs. We collected rapid ethnography and observations to …

An Anemia Of Alzheimer's Disease, N G. Faux, A Rembach, J Wiley, K A. Ellis, D Ames, C J. Fowler, Ralph N. Martins, K K. Pertile, R L. Rumble, B Trounson, C L. Masters, A I. Bush

Research outputs 2014 to 2021

Lower hemoglobin is associated with cognitive impairment and Alzheimer's disease (AD). Since brain iron homeostasis is perturbed in AD, we investigated whether this is peripherally reflected in the hematological and related blood chemistry values from the Australian Imaging Biomarker and Lifestyle (AIBL) study (a community-based, cross-sectional cohort comprising 768 healthy controls (HC), 133 participants with mild cognitive impairment (MCI) and 211 participants with AD). We found that individuals with AD had significantly lower hemoglobin, mean cell hemoglobin concentrations, packed cell volume and higher erythrocyte sedimentation rates (adjusted for age, gender, APOE-ε4 and site). In AD, plasma iron, transferrin, transferrin saturation …

Anxiety Symptoms, Cerebral Amyloid Burden And Memory Decline In Healthy Older Adults Without Dementia: 3-Year Prospective Cohort Study, Robert H. Pietrzak, J C. Scott, Alexander Neumeister, Yen Ying Lim, David Ames, Kathyrn A. Ellis, Kara Harrington, Nicola T. Lautenschlager, Cassandra Szoeke, Ralph Martins, Colin L. Masters, Victor L. Villemagne, Christopher C. Rowe, Paul Maruff

Research outputs 2014 to 2021

Although beta-amyloid, anxiety and depression have been linked cross-sectionally to reduced memory function in healthy older adults without dementia, prospective data evaluating these associations are lacking. Using data from an observational cohort study of 178 healthy older adults without dementia followed for 3 years, we found that anxiety symptoms significantly moderated the relationship between beta-amyloid level and decline in verbal (Cohen's d = 0.65) and episodic (Cohen's d = 0.38) memory. Anxiety symptoms were additionally linked to greater decline in executive function, irrespective of beta-amyloid and other risk factors. These findings suggest that interventions to mitigate anxiety symptoms may help …