Medicine and Health Sciences Commons^™

Utilization Of A Real-Time Pcr Assay For Diagnosis Of Babesia Microti Infection In Clinical Practice, Guiqing Wang, Gary P. Wormser, Jian Zhuge, Patrick Villafuerte, Dawn Ip, Christine Zeren, John T. Fallon

NYMC Faculty Publications

Babesiosis is an emerging tick-borne disease mainly caused Babesia microti, a protozoan that infects erythrocytes. Microscopic examination of blood smears is the current gold standard for detection of Babesia infection, but this diagnostic test has several limitations. We developed and assessed the clinical utilization of a multiplex real-time PCR assay targeting the 18S rRNA gene of B. microti and the human gapdh gene. The limit of detection of this PCR assay was approximately 1-3parasites/μl of blood. The assay showed a diagnostic sensitivity and probable specificity of 100% based on testing 145 retrospective and 185 prospective blood specimens from controls and …

Marshall University Joan C. Edwards School Of Medicine, Professional Enhancement Newsletter, Spring 2015, Darshana T. Shah Phd

Professional Enhancement News (PEN)

Spring 2015, Volume 7, Number 1

An Evaluation Of Patient Satisfaction With Telephone Follow-Up In An Urgent Care, Audia L. Ellis

Doctor of Nursing Practice Scholarly Projects

Telephone follow-up (TFU) is a very valuable innovation. It is a service that is found to be desirable by both patients and health care professionals. It has been utilized successfully in a variety of settings, however, evidence of its use or evaluation of its use in the urgent care setting has not been found. Through evaluation of patient satisfaction (PS) with use of the protocol, new cost and labor effective interventions were constructed and implemented with the goal of meeting patients’ needs.

This study utilized mixed method methodology and employed a descriptive design. Convenience sampling was utilized and a sample …

Critical Care Capacity In Canada: Results Of A National Cross-Sectional Study, Robert A. Fowler, Philip Abdelmalik, Gordon Wood, Denise Foster, Noel Gibney, Natalie Bandrauk, Alexis F. Turgeon, Francois Lamontagne, Anand Kumar, Ryan Zarychanski, Rob Green, Sean M. Bagshaw, Henry T. Stelfox, Ryan Foster, Peter Dodek, Susan Shaw, John Granton, Bernard Lawless, Andrea Hill, Louise Rose, Neill K. Adhikari, Damon C. Scales, Deborah J. Cook, John C. Marshall, Philippe Jouvet

Anatomy and Cell Biology Publications

Introduction: Intensive Care Units (ICUs) provide life-supporting treatment; however, resources are limited, so demand may exceed supply in the event of pandemics, environmental disasters, or in the context of an aging population. We hypothesized that comprehensive national data on ICU resources would permit a better understanding of regional differences in system capacity. Methods: After the 2009-2010 Influenza A (H1N1) pandemic, the Canadian Critical Care Trials Group surveyed all acute care hospitals in Canada to assess ICU capacity. Using a structured survey tool administered to physicians, respiratory therapists and nurses, we determined the number of ICU beds, ventilators, and the ability …

Evidence-Based Recommendations For Genetic Diagnosis Of Familial Mediterranean Fever, Gabriella Giancane, Nienke M.Ter Haar, Nico Wulffraat, Sebastiaan J. Vastert, Karyl Barron, Veronique Hentgen, Tilmann Kallinich, Huri Ozdogan, Jordi Anton, Paul Brogan, Luca Cantarini, Joost Frenkel, Caroline Galeotti, Marco Gattorno, Gilles Grateau, Michael Hofer, Isabelle Kone-Paut, Jasmin Kuemmerle-Deschner, Helen J. Lachmann, Anna Simon, Erkan Demirkaya, Brian Feldman, Yosef Uziel, Seza Ozen

Paediatrics Publications

Familial Mediterranean fever (FMF) is a disease of early onset which can lead to significant morbidity. In 2012, Single Hub and Access point for pediatric Rheumatology in Europe (SHARE) was launched with the aim of optimising and disseminating diagnostic and management regimens for children and young adults with rheumatic diseases. The objective was to establish recommendations for FMF focusing on provision of diagnostic tools for inexperienced clinicians particularly regarding interpretation of MEFV mutations. Evidencebased recommendations were developed using the European League against Rheumatism standard operating procedure. An expert committee of paediatric rheumatologists defined search terms for the systematic literature review. …

In-Vivo Longitudinal Mri Study: An Assessment Of Melanoma Brain Metastases In A Clinically Relevant Mouse Model., Mariama N Henry, Yuhua Chen, Catherine D Mcfadden, Felicia C Simedrea, Paula J Foster

Medical Biophysics Publications

Brain metastases are an important clinical problem. Few animal models exist for melanoma brain metastases; many of which are not clinically relevant. Longitudinal MRI was implemented to examine the development of tumors in a clinically relevant mouse model of melanoma brain metastases. Fifty thousand human metastatic melanoma (A2058) cells were injected intracardially into nude mice. Three Tesla MRI was performed using a custom-built gradient insert coil and a mouse solenoid head coil. Imaging was performed on consecutive days at four time points. Tumor burden and volumes of metastases were measured from balanced steady-state free precession image data. Metastases with a …

Surgical Approach In Primary Total Hip Arthroplasty: Anatomy, Technique And Clinical Outcomes, Stephen Petis, James L. Howard, Brent L. Lanting, Edward M. Vasarhelyi

Bone and Joint Institute

©2015 8872147 Canada Inc. Total hip arthroplasty (THA) has revolutionized the treatment of hip arthritis. A number of surgical approaches to the hip joint exist, each with unique advantages and disadvantages. The most commonly used approaches include the direct anterior, direct lateral and posterior approaches. A number of technical intricacies allow safe and efficient femoral and acetabular reconstruction when using each approach. Hip dislocation, abductor insufficiency, fracture and nerve injury are complications of THA, although their relative risk varies by approach. Numerous clinical trials have sought to elicit differences in patient-reported outcomes, complication rates and return to function among the …

Motor Skill Learning Between Selection And Execution., Jörn Diedrichsen, Katja Kornysheva

Brain and Mind Institute Researchers' Publications

Learning motor skills evolves from the effortful selection of single movement elements to their combined fast and accurate production. We review recent trends in the study of skill learning which suggest a hierarchical organization of the representations that underlie such expert performance, with premotor areas encoding short sequential movement elements (chunks) or particular component features (timing/spatial organization). This hierarchical representation allows the system to utilize elements of well-learned skills in a flexible manner. One neural correlate of skill development is the emergence of specialized neural circuits that can produce the required elements in a stable and invariant fashion. We discuss …

The Human Motor System Alters Its Reaching Movement Plan For Task-Irrelevant, Positional Forces., Joshua G A Cashaback, Heather R Mcgregor, Paul L Gribble

Brain and Mind Institute Researchers' Publications

The minimum intervention principle and the uncontrolled manifold hypothesis state that our nervous system only responds to force perturbations and sensorimotor noise if they affect task success. This idea has been tested in muscle and joint coordinate frames and more recently using workspace redundancy (e.g., reaching to large targets). However, reaching studies typically involve spatial and or temporal constraints. Constrained reaches represent a small proportion of movements we perform daily and may limit the emergence of natural behavior. Using more relaxed constraints, we conducted two reaching experiments to test the hypothesis that humans respond to task-relevant forces and ignore task-irrelevant …

Seasonal Change In The Avian Hippocampus., David F Sherry, Scott A Macdougall-Shackleton

Brain and Mind Institute Researchers' Publications

The hippocampus plays an important role in cognitive processes, including memory and spatial orientation, in birds. The hippocampus undergoes seasonal change in food-storing birds and brood parasites, there are changes in the hippocampus during breeding, and further changes occur in some species in association with migration. In food-storing birds, seasonal change in the hippocampus occurs in fall and winter when the cognitively demanding behaviour of caching and retrieving food occurs. The timing of annual change in the hippocampus of food-storing birds is quite variable, however, and appears not to be under photoperiod control. A variety of factors, including cognitive performance, …

Developmental Specialization Of The Left Parietal Cortex For The Semantic Representation Of Arabic Numerals: An Fmr-Adaptation Study, Stephan E. Vogel, Celia Goffin, Daniel Ansari

Brain and Mind Institute Researchers' Publications

The way the human brain constructs representations of numerical symbols is poorly understood. While increasing evidence from neuroimaging studies has indicated that the intraparietal sulcus (IPS) becomes increasingly specialized for symbolic numerical magnitude representation over developmental time, the extent to which these changes are associated with age-related differences in symbolic numerical magnitude representation or with developmental changes in non-numerical processes, such as response selection, remains to be uncovered. To address these outstanding questions we investigated developmental changes in the cortical representation of symbolic numerical magnitude in 6- to 14-year-old children using a passive functional magnetic resonance imaging adaptation design, thereby …

Clinical Challenges In Isolation Care, Elizabeth L. Beam, Shawn G. Gibbs, Angela L. Hewlett, Peter C. Iwen, Suzanne L. Nuss, Philip W. Smith

Journal Articles: College of Nursing

OVERVIEW: In 2014, the authors published the results of a study investigating nurses' use of personal protective equipment (PPE) in the care of a live simulated patient requiring contact and airborne precautions. The 24 participants were video-recorded as they donned and doffed PPE. Variations in practices that had the potential to cause contamination were noted. In this article, the authors comment on those variations, analyzing each element of proper PPE protocols and examining why the behaviors are a safety concern for the nurse and a potential risk for disease transmission in the hospital or other clinical area. The authors note …

Certain General Anesthetics Used In Pediatrics Hinder Neurological Development In Infants, Michael R. Hirschi

Selected Honors Theses

General anesthetics act by either blocking N-methyl-d-aspartate (NMDA) receptors or over stimulating γ-aminobutyric acid (GABA) receptors.^1–3 The actions of these receptors are responsible for the anesthetized state and are also crucial in the neurological development of infants.^2,4–8 Animal studies, although limited, provide vital information about general anesthesia’s neurotoxicity its hindrance of neurological development. Exposure to general anesthesia can severely hinder proper neuronal migration, synaptogenesis, and can drastically increase neuronal apoptosis in infant animals.^9–16 General anesthetics are more neurotoxic to infant animals in combination compared to individually.^10,16,17 Additionally, multiple exposures to general anesthesia tend to have compounding …

The Therapeutic Role Of Turmeric In Treatment And Prevention Of Alzheimer’S Disease, Rylan M. Mcquade

Selected Honors Theses

As a devastating neurological condition that expends millions of lives each year, Alzheimer’s disease (AD) is a subject of intense investigation.¹ Although AD has been known for over a century, the precise mechanisms that underlie AD pathogenesis and development are still poorly understood. The Alzheimer phenotype is typified by extracellular amyloid-beta (Aβ) plaques and intracellular neurofibrillary tangles (NFTs), causing researchers to notice several key enzymes implicated in this process.¹ Most notable are β and γ secretases (which drive Aβ plaque production) and phospholipase

A₂ (which stimulates major cascade activation through the specific cleavage of fatty acyl esters). …

Alumni Journal - Volume 86, Number 1, Loma Linda University School Of Medicine

Alumni Journal, School of Medicine

Features
10 | Physician Vitality: Care for the Caregivers
16 | Interview: Pillars and Buttresses
22 | APC 2015: A Preview
26 | More than Medicine

Departments
2 | From the President
6 | From the Dean
7 | This and That
8 | School of Medicine News
38 | AIMS Report
42 | Alumni News
44 | In Memoriam
48 | Historical Snapshot
49 | What's Up Doc?

Extras
5 | Office Staff Updates
21 | APC Historical Piece
43 | Perpetual Membership Updates

Contact Point, Arthur A. Dugoni School Of Dentistry

Contact Point

No abstract provided.

Controversial And Non-Controversial Topics Of Nanotechnology, Phillip Astorino

Nebraska College Preparatory Academy: Senior Capstone Projects

Advancements in medicine have allowed people to heal the sick. Even though these accomplishments in medicine have cured some of the problems, there are those that even medicine cannot fix. So we look to science for help, and there is one field that is close to revoluAonizing the world with their advancements in technology. This field has a specific name: Nanotechnology. It’s long-­‐term goal is the full manipulaAon of atoms, molecules, and materials to form structures on the scale of one billionth of a meter, which is commonly known as a nanometer; not only can we use this to improve …

Effect Of Technology Use On Behavior, Janae Marion

Nebraska College Preparatory Academy: Senior Capstone Projects

Technology has evolved over the years, and as time goes by it seems to have enhanced into something beger. Now the problem that is starting to occur is that people are starting to use it excessively. Technology is becoming a distraction and is problematic for young children, teenagers, and also adults. Technology is becoming a bigger issue than people can imagine and not only is it starting to create behavioral problems for people, it’s also controlling their lives.

Ear Specific Anl Measurements In Individuals With Unilateral And Asymmetrical Sensorineural Hearing Loss, Rebecca Howard

Doctoral Dissertations

The present study sought to determine if ANLs differ between ears within subjects with unilateral or asymmetrical SNHL. ANL was measured in four conditions (i.e., binaural, better ear, poorer ear unmasked, and poorer ear masked) in fifteen adults, nine with unilateral SNHL and six with bilateral asymmetrical SNHL. A significant difference between ANL in the four conditions (i.e., binaural, better ear, poorer ear unmasked, and poorer ear masked) was identified; however, the subjects with unilateral and asymmetrical SNHL behaved similarly throughout the testing. When comparing the four conditions, the results showed a significant difference between both the binaural ANL and …

Fall 2014 - Spring 2015, Southwestern Oklahoma State University

The Sig

The Sig Newsletter from the Southwestern Oklahoma State University College of Pharmacy - Fall 2014 - Spring 2015

True Durability: Hiv Virologic Suppression In An Urban Clinic And Implications For Timing Of Intensive Adherence Efforts And Viral Load Monitoring, Debra A. Benator, Angelo Elmi, Manuel D. Rodriguez, Howard B. Gale, Virginia L. Kan, Heather J. Hoffman, Susan Tramazzo, Karen Hall, Angela Mcknight, Leah Squires

Medicine Faculty Publications

Although the majority of HIV-infected patients who begin potent antiretroviral therapy should expect long-term virologic suppression, the realities in practice are less certain. Durability of viral suppression was examined to define the best timing of targeted adherence strategies and intensive viral load monitoring in an urban clinic population with multiple challenges to ART adherence. We examined the risk of viral rebound for patients who achieved two consecutive viral loads lower than the lower limit of quantification (LLOQ) within 390 days. For 791 patients with two viral loads below the LLOQ, viral rebound >LLOQ from the first viral load was 36.9 …

A Six-Week Home Exercise Program Improves Endothelial Function And Cd34+ Circulating Progenitor Cells In Patients With Pre-Diabetes, Sabyasachi Sen, Sarah Witkowski, Ann Lagoy, Ashequl Islam

Medicine Faculty Publications

Background: Pre-diabetes is associated with endothelial dysfunction and affects endothelium-associated stem cells. Lifestyle modification has been shown to prevent the progression from pre-diabetes to overt type 2 diabetes; however, the effect of such interventions on CD34⁺ progenitor cells in pre-diabetes participants has not been tested. The purpose of this study was to determine whether a home-based 6-week exercise intervention improved vascular function, circulating number, function, and gene expression of circulating CD34⁺progenitor cells in patients with pre-diabetes.

Methods: Patients (40 - 70 years, BMI of 25 - 39.9, n = 11) were enrolled in a 16-week randomized crossover …

Out And About In Medicine: Gw Out For Health, Michelle S. Davis, Daniel F. O'Neill, Robert Tollefson, Domenique Escobar, Chase Hiller, Lawrence R. Deyton

GW Research Days 2015

The time is right to devise and implement a more coordinated approach to LGBT patient care and health professional training within the Washington, DC metropolitan area and beyond. The following George Washington University School of Medicine and Health Sciences (GWSMHS) and Hospital (GWUH) LGBT Health Initiative proposal highlights possible strategies for addressing this need through a more centralized fashion. The seven focus areas proposed for the GW LGBT Health Initiative include: 1) Climate/Visibility; 2) Health Education; 3) Policy/Advocacy; 4) Community Outreach; 5) Research; 6) Patient Care; and 7) HIV/AIDS. A key stakeholder that is helping to realize this vision of …

Laparoscopic Surgery For Patients With Severe Chronic Obstructive Lung Disease, Talal S. Alzahrani, Victor S. Saxena, Alexander Cho, Guillermo Gutierrez

GW Research Days 2015

Introduction: Laparoscopy is a minimally invasive procedure that associated with decreased morbidity and hospital stays. There are over two million laparoscopic surgeries performed annually in the US. Several studies have shown that patients with mild (Stage I) to moderate (Stage II) Chronic Obstructive Pulmonary Disease (COPD) develop hypercapnia during laparoscopy procedures. However, hypercapnia in this population did not affect the rate of complication or prolonged hospital stay. We report a case of very severe (Stage IV) COPD, who developed an acute respiratory failure with an increase in hospital stay during a laparoscopic procedure. We write this to bring awareness to …

C-Anca Positive Necrotizing Crescentic Glomerulonephritis With Linear Immunoglobulin Staining, Akshita Mehta

GW Research Days 2015

Necrotizing crescentic glomerulonephritis is found in anti-glomerular basement membrane (GBM) disease (Type 1), immune complex (Type 2) deposition and anti-neutrophil cytoplasmic (ANCA)-related disease (Type 3).

ANCA positive glomerulonephritis is typically characterized on renal biopsy as pauci-immune, with mild or absent glomerular staining for immunoglobulin, or complement staining by immunofluorescence.

Rare cases of concomitant p-ANCA plus linear immunofluorescence pattern staining have been discussed, however none with prior association with c-ANCA.

We report a case of systemic c-ANCA pulmonary-renal syndrome with anti-GBM-disease-typical linear staining on renal biopsy immunofluorescence.

A Rare Case Of Non-Cardiogenic Pulmonary Edema, Talal Alzahrani, Kelly Zhang, Angela Ryan, Yasir Alfi, Jeffrey Zweig

GW Research Days 2015

INTRODUCTION:

Nephrotic syndrome is identified by a significant proteinuria more than 3.5 g/day, hypoalbuminemia less than 3.5 g/dl, and peripheral edema. It associated with risks of thrombosis, infection, and hyperlipidemia due to loss of plasma protein. Several studies have shown patients with nephrotic syndrome do not develop non-cardiogenic pulmonary edema. However, we report a case of nephrotic syndrome caused by diabetic nephropathy and presented with non-cariogenic pulmonary edema.

CASE REPORT:

A 37-year old man with a past medical history of diabetes mellitus, hypertension, dyslipidemia, Charcot foot, who presented with dyspnea, orthopnea, and non-productive cough for two days. He had been …

Medicine + Health, Spring 2015, George Washington University, School Of Medicine And Health Sciences, Office Of Communications And Marketing

Medicine + Health Magazine

No abstract provided.

Ubiquitous L1 Mosaicism In Hippocampal Neurons., Kyle R. Upton, Daniel J. Gerhardt, J. Samuel Jesuadian, Sandra R. Richardson, Francisco J. Sánchez-Luque, Gabriela O. Bodea, Adam D. Ewing, Carmen Salvador-Palomeque, Marjo S. Van Der Knaap, Paul M. Brennan, Adeline Vanderver, Geoffrey J. Faulkner

Neurology Faculty Publications

Somatic LINE-1 (L1) retrotransposition during neurogenesis is a potential source of genotypic variation among neurons. As a neurogenic niche, the hippocampus supports pronounced L1 activity. However, the basal parameters and biological impact of L1-driven mosaicism remain unclear. Here, we performed single-cell retrotransposon capture sequencing (RC-seq) on individual human hippocampal neurons and glia, as well as cortical neurons. An estimated 13.7 somatic L1 insertions occurred per hippocampal neuron and carried the sequence hallmarks of target-primed reverse transcription. Notably, hippocampal neuron L1 insertions were specifically enriched in transcribed neuronal stem cell enhancers and hippocampus genes, increasing their probability of functional relevance. In …

True Durability: Hiv Virologic Suppression In An Urban Clinic And Implications For Timing Of Intensive Adherence Efforts And Viral Load Monitoring., Debra A Benator, Angelo Elmi, Manuel D Rodriguez, Howard B Gale, Virginia L. Kan, Heather J. Hoffman, Susan Tramazzo, Karen Hall, Angela Mcknight, Leah Squires

Medicine Faculty Publications

Although the majority of HIV-infected patients who begin potent antiretroviral therapy should expect long-term virologic suppression, the realities in practice are less certain. Durability of viral suppression was examined to define the best timing of targeted adherence strategies and intensive viral load monitoring in an urban clinic population with multiple challenges to ART adherence. We examined the risk of viral rebound for patients who achieved two consecutive viral loads lower than the lower limit of quantification (LLOQ) within 390 days. For 791 patients with two viral loads below the LLOQ, viral rebound >LLOQ from the first viral load was 36.9 …

The Effect Of Auditory Processing Abilities On Acceptable Noise Levels, Brandee E. Richardson

Doctoral Dissertations

The purpose of the present study was to determine typical acceptable noise levels (ANLs) in children diagnosed with auditory processing disorder (APD) and compare those to ANLs in children without APD. Sixteen participants, eight children with APD and eight children without APD, were administered a complete audiological evaluation and a series of APD tests [Filtered Words, Competing Sentences, and Auditory Figure Ground (0) subtests of the SCAN– 3C; Staggered Spondaic Word test; and Pitch Pattern test] to determine normal or abnormal auditory processing ability. Conventional ANLs were measured on each participant to determine acceptance of background noise. The results …