Medicine and Health Sciences Commons^™

Immediate Versus Delayed Sequential Bilateral Cataract Surgery: A Systematic Review And Meta-Analysis, Monali S. Malvankar-Mehta, Yufeng Nancy Chen, Sangita Patel, Angela Pui-Kei Leung, Man Mohan Merchea, William G. Hodge

Department of Medicine Publications

BACKGROUND: Immediately sequential bilateral cataract surgery (ISBCS), the cataract surgery that is performed in both eyes simultaneously, is gaining popularity worldwide compared to the traditional treatment paradigm: delayed sequential bilateral cataract surgery (DSBCS), the surgery that is performed in each eye on a different day as a completely separate operation. ISBCS provides advantages to patients and patients' families in the form of fewer hospital visits. Additionally, patients enjoy rapid rehabilitation, lack of anisometropia - potentially reducing accidents and falls, and avoid suboptimal visual function in daily life. The hospital may benefit due to lower cost.

OBJECTIVE: To perform a systematic …

An Adapted Mindfulness-Based Stress Reduction Program For Elders In A Continuing Care Retirement Community: Quantitative And Qualitative Results From A Pilot Randomized Controlled Trial., Aleeze Sattar Moss, Phd, Diane K. Reibel, Jeffrey M Greeson, Anjali Thapar, Rebecca Bubb, Jacqueline Salmon, Andrew B. Newberg, Md

Marcus Institute of Integrative Health Faculty Papers

The purpose of this study was to test the feasibility and effectiveness of an adapted 8-week Mindfulness-Based Stress Reduction (MBSR) program for elders in a continuing care community. This mixed-methods study used both quantitative and qualitative measures. A randomized waitlist control design was used for the quantitative aspect of the study. Thirty-nine elderly were randomized to MBSR (n = 20) or a waitlist control group (n = 19), mean age was 82 years. Both groups completed pre-post measures of health-related quality of life, acceptance and psychological flexibility, facets of mindfulness, self-compassion, and psychological distress. A subset of MBSR participants completed …

Factors Affecting Hispanic Women’S Participation In Screening For Cervical Cancer, Arelis Moore De Peralta, Bonnie Holaday, James R. Mcdonell

Publications

Hispanic women’s cervical cancer rates are disproportionately high. The Health Belief Model (HBM) was used as a theoretical framework to explore beliefs, attitudes, socio-economic, and cultural factors influencing Hispanic women’s decisions about cervical cancer screening. A cross-sectional survey was conducted among Hispanic women 18–65 years old (n = 205) in the Upstate of South Carolina. Generalized Linear Modeling was used. Across all models, perceived threats (susceptibility and severity), self-efficacy, and the interaction of benefits and barriers were significant predictors. Significant covariates included age, marital status, income, regular medical care, and familism. A modified HBM was a useful model for examining …

Human Immunodeficiency Virus (Hiv) In Washington, D.C.: Prevalence Of Antiretroviral Resistance In Treatment Naïve Patients From 2007 To 2010, Matthew J. Swierzbinski, Virginia L. Kan, David M. Parenti

Medicine Faculty Publications

HIV treatment has been greatly impacted by transmitted resistance to antiretrovirals (ARV). Several studies have documented resistance in naïve individuals and estimates of transmitted drug resistance mutations range from <5% to as high as 25%. Washington, D.C. has one of the highest human immunodeficiency virus (HIV) prevalence rates in the United States (3.2% in 2009), but local data regarding the frequency of major mutations and antiretroviral (ARV) resistance has been limited. Medical records of HIV positive, ARV-naïve adults at two facilities in Washington, D.C., The George Washington University Medical Center and the Veterans Affairs Medical Center, were retrospectively analyzed in subjects who had genotypic resistance testing from 2007 to 2010. Of 407 ARV-naïve patients, at least one transmitted drug resistance mutation was detected in 17% of our patients, with non-nucleoside reverse transcriptase (NNRTI) mutations observed in 15%. Among patients with at least one reverse transcriptase (RT) or major protease region (Pr) resistance mutation, 85% had resistance against a single ARV class. Dual and triple class resistance mutations were seen in 8 patients (2%) and 3 patients (0.7%), respectively. Most of the multiple class resistance was seen in 2010. A gradual increase in NNRTI resistance was noted during 2008 to 2010. Our prevalence of transmitted RT, major Pr mutations (17.4%) and ARV resistance (8.6%) were high but similar to rates reported by others within the United States. Given the high HIV prevalence in the District of Columbia, this has important implications for treatment of these ARV-naïve patients.

Differential Effects Of Cold Atmospheric Plasma In The Treatment Of Malignant Glioma, Alan Siu, Olga Volotskova, Xiaoqian Cheng, Siri S. Khalsa, Ka Bian, Ferid Murad, Michael Keidar, Jonathan H. Sherman

Neurological Surgery Faculty Publications

Objective

Cold atmospheric plasma (CAP) has recently been shown to selectively target cancer cells with minimal effects on normal cells. We systematically assessed the effects of CAP in the treatment of glioblastoma.

Methods

Three glioma cell lines, normal astrocytes, and endothelial cell lines were treated with CAP. The effects of CAP were then characterized for viability, cytotoxicity/apoptosis, and cell cycle effects. Statistical significance was determined with student's t-test.

Results

CAP treatment decreases viability of glioma cells in a dose dependent manner, with the ID50 between 90-120 seconds for all glioma cell lines. Treatment with CAP for more than 120 seconds …

Sex Differences In Morbidity And Care-Seeking During The Neonatal Period In Rural Southern Nepal, Summer Rosenstock, Joanne Katz, Luke C. Mullany, Subarna K. Khatry, Steven C. Leclerq, James M. Tielsch, Et Al.

Global Health Faculty Publications

Background

South Asian studies, including those from Nepal, have documented increased risk of neonatal mortality among girls, despite their early biologic survival advantage. We examined sex differences in neonatal morbidity and care-seeking behavior to determine whether such differences could help explain previously observed excess late neonatal mortality among girls in Nepal.

Methods

A secondary analysis of data from a trial of chlorhexidine use among neonates in rural Nepal was conducted. The objective was to examine sex differences in neonatal morbidity and care-seeking behavior for ill newborns. Girls were used as the reference group.

Results

Referral for care was higher during …

Robotic Joint Replacement Surgery: Does Technology Improve Outcomes, Chelsea Hill, Reem El-Bash, Leslie Johnson, Alberto Coustasse

Management Faculty Research

Introduction: Osteoarthritis is a common disease that leads patients to seek Total Joint Replacement (TJR). Component misalignments leads to failure of TJR. Computer navigation enhances the precision of component alignment, but the addition of robotic guidance, can boost TJR to a higher level of accuracy.

Methodology: This literature reviewed 29 English language peer reviewed articles from 2002 – 2013 and one website. A conceptual framework was adapted to explain benefits and barriers of adoption of robotic TJR.

Results: A total of ten studies were reviewed with focus on more precise alignment, outcomes, length of stay, and costs. Cost to obtain …

What's Happening: June 1, 2015, Maine Medical Center

What's Happening

No abstract provided.

An Uncommon Clinical Presentation Of Relapsing Dilated Cardiomyopathy With Identification Of Sequence Variations In Mynpc3, Kcnh2 And Mitochondrial Trna Cysteine, M. J. Guillen Sacoto, Kimberly A. Chapman, D. Heath, M. B. Seprish, Dina Zand

Pediatrics Faculty Publications

We describe a young girl with dilated cardiomyopathy, long QT syndrome, and possible energy deficiency. Two major sequence changes were identified by whole exome sequencing (WES) and mitochondrial DNA analysis that were interpreted as potentially causative. Changes were identified in the KCNH2 gene and mitochondrial tRNA for cysteine. A variation was also seen in MYPBC3. Since the launch of WES as a clinically available technology in 2010, there has been concern regarding the identification of variants unrelated to the patient's phenotype. However, in cases where targeted sequencing fails to explain the clinical presentation, the underlying etiology could be more complex …

Computed Tomography-Guided Biopsy For Potts Disease: An Institutional Experience From An Endemic Developing Country, Muhammad Waqas, Mohsin Qadeer, Faizuddin Faiz, Mohammad Ali Alvi, Muhammad Ehsan Bari

Section of Neurosurgery

Study design: A retrospective chart review.
Purpose: In endemic resource poor countries like Pakistan, most patients are diagnosed and treated for Potts disease on clinical and radiological grounds without a routine biopsy. The purpose of this study was to evaluate the use and effect of computed tomography (CT)-guided biopsy in the management of Potts disease since the technique is becoming increasingly available.
Overview of literature: CT-guided biopsy of spinal lesions is routinely performed. Literature on the utility of the technique in endemic resource poor countries is little.
Methods: This study was conducted at the Neurosurgery section of Aga Khan University …

Strengthening Midwifery Education, Regulation And Association; A Case Study From Afghanistan, Sabera Turkmani, Fatima Gohar, Farida Shah, Saleha Hamnawazada, Pashtoon A. Zyaee

Journal of Asian Midwives (JAM)

Immediately after the fall of the Taliban in 2002, the midwifery system in Afghanistan underwent a massive reform, and Afghanistan has since developed a strong midwifery pre service educational (PSE) system to achieve the relevant MDG goals. Establishment and involvement of professional associations, and partnerships with the government and other key stakeholders have contributed in shared knowledge, resources, and coordinated activities to speed up achieving these goals.

The International Confederation of Midwives (ICM) and its partners believe that the midwifery profession needs to be a strong voice in reducing maternal and child mortality. The three pillars of the midwifery profession, …

Hyperhomocysteinemia - An Unidentified Risk Factor For Stroke In Our Population, Sabaa Asif, Bashir A Soomro, Kanwal Sartaj, Shafaq Alvi

Pakistan Journal of Neurological Sciences (PJNS)

Introduction:
Various studies show that moderate elevation of plasma homocysteine level has been associated with increased risk for cardiovascular and cerebrovascular disease.

Objective:
To observe the frequency of increased homocysteine level in ischemic stroke patients; and its association with other risk factors.

Methodology:
Observational pilot study was conducted on a sample of 75 ischemic stroke patients, enrolled regardless of their age, gender and comorbidities, at Ziauddin university hospital, Karachi. Fasting serum homocysteine, folate and vitamin B12 levels were measured. Results were interpreted using spss 20.0.

Results and Discussion:
Mean homocysteine level in our population was 19.51 (SD: 11.47)micromol/l. …

Stress Induced Hyperglycemia In Stroke Patients, Aziz U Rehman, Ajeet Kumar, Salma Razzaque, Ashok Kumar, M. Ishaq Ghauri

Pakistan Journal of Neurological Sciences (PJNS)

Background:
Stroke is the third most common cause of death in developed countries and second most common cause of death worldwide. High proportion of patients may develop hyperglycemia after an acute stress such as stroke or myocardial infarction even in the absence of preexisting diagnosis of diabetes mellitus. Prolonged stress hyperglycemia in ischemic stroke increases the risk of in-hospital 28- day mortality, especially in non-diabetic patients.

Aims and objectives:
To determine the frequency of stress-induced hyperglycemia in non-diabetic patients with ischemic or hemorrhagic stroke.

Subjects and methods:
A total of 255 patients admitted with acute stroke, fulfilling the inclusion …

Efficacy Of Memantine In Treating Patients With Migraine And Tension-Type Headache, Sameen Khalid, Bashir A Soomro, Samreen Mahmood, Aamer Abbass

Pakistan Journal of Neurological Sciences (PJNS)

Objective:
To assess the efficacy of Memantine as a preventive and therapeutic intervention for migraine and tension-type headache.

Methods:
This clinical trial was conducted over a period of 3 months. A total of 44 subjects, with diagnosed migraine and/or tension-type headache, presenting to a private neurology clinic in Karachi, Pakistan were selected through purposive sampling technique. Patients were treated with incremental doses of Memantine. Adult patients belonging to both genders were included in the study. Data was analyzed using SPSS version 16.0 and associations were made using Chi square test with p-value of less than 0.05 taken as significant. …

Marburg Variant Of Multiple Sclerosis; A Diagnostic And Therapeutic Challenge, Sadia Imtiaz, Maimoona Siddiqui, Arsalan Ahmad Md

Pakistan Journal of Neurological Sciences (PJNS)

Marburg variant of multiple sclerosis (MS) is a highly aggressive, fulminant demyelinating disease with very high morbidity and mortality. Early diagnosis and aggressive management is vital to limit severe disability and improve the outcome. We present a case of 35 years old male who presented with rapidly progressive demyelinating illness, leading to bed bound status over the course of a month. He was treated aggressively with intravenous (IV) steroids, plasma exchange (PLEX) and Mitoxantrone (MTX), leading to a remarkable recovery.

Encephalopathy With Behavioral And Psychiatric Features–Firstantibody Proven Case Of Anti-Nmda Receptor Encephalitis From Pakistan, Rabel Khalid Memon, Maimoona Siddiqui, Rizwanullah Khan

Pakistan Journal of Neurological Sciences (PJNS)

Background:
Anti-N-methyl-D-aspartate (NMDA) receptor encephalitis is associated with psychiatric symptoms, memory disturbances, seizures, dyskinesia, and catatonia along with other constellation of symptoms. It is more common in females and usually associated with underlying ovarian teratoma. Treatment involves immunosuppression. This is the first antibody proven case from Pakistan.

Case Report:
A 16 year old girl with a short history of sore throat and no other prior illness, presented with 12 day history of behavioral changes (can you please describe some behavioral changes?) and seizures, followed by decreased responsiveness, involuntary limb movements and facial grimacing. She also had intermittent high grade fever …

9th Annual Neurology Research Day 2015 Abstracts Shifa International Hospital, Islamabad

Pakistan Journal of Neurological Sciences (PJNS)

No abstract provided.

Formant Frequency Transitions In The Fluent Speech Of Adults Who Do And Do Not Stutter: Testing The Over-Reliance On Feedback Hypothesis, Kaitlin Arnold

Masters Theses

A recent theory proposed by Civier and colleagues (Civer et al. 2010; Civer et al. 2013) developed a model of stuttering that implicates a faulty feedforward control system. The hypothesis suggests that stuttering results from relying too heavily on sensory feedback to guide speech movements. An overreliance on sensory feedback would result in subtle anomalies in fluent speech (such as slowed articulatory transitions) as well as overt stuttering behaviors (such as sound repetitions). The present study tested this general hypothesis by comparing articulatory transition rates of adults who do and do not stutter across casual and fast speech rates. Participants …

Alton Ochsner, Md (1896-1981): Surgical Pioneer And Legacy Linking Smoking And Disease., Christina L. Costantino, Md, Jordan M. Winter, Md, Charles J. Yeo, Md, Scott W. Cowan, Md

Department of Surgery Gibbon Society Historical Profiles

Edward William Alton Ochsner kept a plain, metal card file in which he recorded close to 50 years worth of medical experiences, research, and insights. The most populated topics were filed as "Cancer, Lung" and "Cancer, Bronchogenic." These reflected his areas of greatest interest, for which he would go on to produce groundbreaking work. Of his many lifetime accomplishments, he is perhaps best known for being the first to report a link between cigarette smoking and lung cancer. This was just one of the many ways in which Ochsner worked to effect social change. The establishment of the Ochsner Health …

Dicer1 Regulated Let-7 Expression Levels In P53-Induced Cancer Repression Requires Cyclin D1., Xin Sun, Shou-Ching Tang, Chongwen Xu, Chenguang Wang, Sida Qin, Ning Du, Jian Liu, Yiwen Zhang, Xiang Li, Gang Luo, Jie Zhou, Fei Xu, Hong Ren

Department of Cancer Biology Faculty Papers

Let-7 miRNAs act as tumour suppressors by directly binding to the 3'UTRs of downstream gene products. The regulatory role of let-7 in downstream gene expression has gained much interest in the cancer research community, as it controls multiple biological functions and determines cell fates. For example, one target of the let-7 family is cyclin D1, which promotes G0/S cell cycle progression and oncogenesis, was correlated with endoribonuclease DICER1, another target of let-7. Down-regulated let-7 has been identified in many types of tumours, suggesting a feedback loop may exist between let-7 and cyclin D1. A potential player in the proposed feedback …

Galectin-1: A Biomarker Of Surgical Stress In Murine Model Of Cardiac Surgery, Satwat Hashmi, Suhail Al-Salam

Department of Biological & Biomedical Sciences

Galectin-1 (GAL-1) belongs to the family of β-galactoside-binding lectins. It regulates cell-cell and cell-matrix interactions, the immune response, apoptosis, cell cycle, RNA splicing and neoplastic transformation. We investigate the effect of heart manipulation secondary to cardiac surgery on the level of GAL-1 in murine heart and plasma. Male C57B6/J mice were used for adopted model of cardiac surgery. Heart samples were processed for immunohistochemical and immunofluorescent labeling, Enzyme linked immunosorbent assay and quantitative RT-PCR to identify GAL-1 levels in the heart and plasma during the first 24 hours following cardiac surgery. There is significant increase of GAL-1 in the LV …

Thyroxine Replacement In Patients On Parenteral Nutrition: A Clinical Conundrum, Abdul Rehman, Noor Ul-Ain Baloch, Muhammad Awais

Department of Biological & Biomedical Sciences

No abstract provided.

Week Of June 1, 2015, New York Medical College

InTouch

• NYMC Bids Farewell to the Class of 2015
• AOA Iota Chapter Hosts Annual Lecture and Induction Ceremony
• School of Medicine Class of 2018 Hosts 27th Annual Convocation of Thanks
• SHSP Hosts Third Annual Research and Scholarship Day
• Department of Family and Community Medicine Presents Third Annual Research Day
• Department of Pediatrics Hosts Fifth Annual Paul K. Woolf, M.D., Pediatric Trainee Research Day
• NYMC Inducts Inaugural Members of Delta Omega Honorary Society in Public Health
• LEND Graduates 19 From Interdisciplinary Leadership Program
• NYMC Hosts AHA Research Reception
• Students Host Annual Health Fair
• NYMC Shows Support for the National Alliance on Mental …

Cronobacter Sakazakii Bacteremia In A 76-Year-Old Woman: A Case Report, Amy Y. Kang, Nancy Garcia, Bhanu Sud, Lee Nguyen

Pharmacy Faculty Articles and Research

Cronobacter sakazakii, commonly found in contaminated infant formula and thereby causes infantile bacteremia, is rarely associated with adult bacteremia. We present the tenth case of C. sakazakii bacteremia in adults. The patient is a 76-year-old woman who resides in a skilled nursing facility and presents with risk factors including bullous pemphigoid, Type II diabetes mellitus, hypertension, hyperlipidemia, chronic kidney disease, and anemia. The therapy was started with intravenous ciprofloxacin and vancomycinempirically. After consultation with an Infectious Diseases specialist, ciprofloxacin and vancomycin was replaced with meropenem based on the patient’s extensive bullous lesions, history of ESBL infections, and possible pneumonia. Later, …

Intensive Transition Team - Analysis Of Program Impacts, Bill J. Wright, Keri B Vartanian, Megan Holtorf

Articles, Abstracts, and Reports

No abstract provided.

Alcohol Consumption, Depression, Insomnia And Colorectal Cancer Screening: Racial Differences, Daniel Owusu, Megan Quinn, Ke Sheng Wang

ETSU Faculty Works

Background: Mortality from colorectal cancer (CRC) can be reduced drastically by early detection and early treatment. However, uptake of CRC screening is relatively low, about 50% for those whom the test is highly recommended.

Objectives: We examined the influence of and racial differences in depression, insomnia, alcohol use, and tobacco use on CRC screening uptake in the US.

Patients and Methods: Analysis of the 2012 National Health Information Survey data was conducted. Both weighted univariate and multiple logistic regression analyses were performed in SAS to estimate the odds ratios (ORs) and their 95% confidence intervals (CIs). A total …

Predictive Performance Of A Vancomycin Population Pharmacokinetic Model In Neonates, Chris Stockmann, Adam L. Hersh, Jessica K. Roberts, Jiraganya Bhongsatiern, E. Kent Korgenski, Michael G. Spigarelli, Catherine M.T. Sherwin, Adam Frymoyer

Pediatrics Faculty Publications

Introduction

The pharmacokinetics of vancomycin are highly variable among neonates, which makes dosing challenging in this population. However, adequate drug exposure is critical, especially when treating methicillin-resistant Staphylococcus aureus (MRSA) infections. Utilization of population pharmacokinetic models and Bayesian methods offers the potential for developing individualized therapeutic approaches. To meet this need, a neonatal vancomycin population pharmacokinetic model was recently published. The current study sought to externally evaluate the predictive performance and generalizability of this model.

Methods

A retrospective chart review of neonates who received vancomycin and had ≥1 peak and ≥1 trough concentrations at five Intermountain Healthcare neonatal intensive care …

The Significance Of Macrocephaly Or Enlarging Head Circumference In Infants With The Triad: Further Evidence Of Mimics Of Shaken Baby Syndrome, David Miller, Patrick Barnes, Marvin E. Miller

Pediatrics Faculty Publications

Infants with the triad (neurologic dysfunction, subdural hematoma [SDH], and retinal hemorrhage) are often diagnosed as victims of shaken baby syndrome. Medical conditions/predisposing factors to developing the triad are often dismissed: short falls, birth-related SDH that enlarges, macrocephaly, sinus/cortical vein thrombosis, and others. Six infants with the triad are described in which child abuse was diagnosed, but parents denied wrongdoing. All 6 had either macrocephaly or enlarging head circumference, which suggested medical explanations. Three infants incurred short falls, 1 had a difficult delivery in which there was likely a rebleed of a birth-related SDH, 1 had a spontaneous SDH associated …

An Ex Vivo Approach To Complex Renal Artery Aneurysm Repair, Noah T. Scherrer, Roberto Gedaly, Ramakrishna Venkatesh, Michael A. Winkler, Eleftherios S. Xenos

Surgery Faculty Publications

Ex vivo repair technique for a complex renal artery aneurysm may have several advantages. Smaller incision size and use of minimally invasive techniques may decrease incisional morbidity and improve recovery time, especially in patients with a high body mass index. Improved visualization afforded by back-table methods may also be valuable when repair of aneurysms involving multiple branches is necessary. We report of a successful case of laparoscopic nephrectomy, followed by back-table aneurysmorrhaphy and autotransplant, in a patient with a renal artery aneurysm.

Quantifying Unnecessary Normal Tissue Complication Risks Due To Suboptimal Planning: A Secondary Study Of Rtog 0126., Kevin L. Moore, Rachel Schmidt, Vitali Moiseenko, Lindsey A. Olsen, Jun Tan, Ying Xiao, James Galvin, Stephanie Pugh, Michael J Seider, Adam P. Dicker, Walter Bosch, Jeff Michalski, Sasa Mutic

Department of Radiation Oncology Faculty Papers

PURPOSE: The purpose of this study was to quantify the frequency and clinical severity of quality deficiencies in intensity modulated radiation therapy (IMRT) planning in the Radiation Therapy Oncology Group 0126 protocol.

METHODS AND MATERIALS: A total of 219 IMRT patients from the high-dose arm (79.2 Gy) of RTOG 0126 were analyzed. To quantify plan quality, we used established knowledge-based methods for patient-specific dose-volume histogram (DVH) prediction of organs at risk and a Lyman-Kutcher-Burman (LKB) model for grade ≥2 rectal complications to convert DVHs into normal tissue complication probabilities (NTCPs). The LKB model was validated by fitting dose-response parameters relative …