Medicine and Health Sciences Commons^™

ภาวะซึมเศร้า และพฤติกรรมรุนแรง ของผู้ป่วยโรคจิตเภททั่วไปและผู้ป่วยโรคจิตเภทที่มีคดีที่เข้ามารับการรักษาในสถาบันกัลยาณ์ราชนครินทร์, จอมขวัญ นามสูตร, ชัยชนะ นิ่มนวล

Chulalongkorn Medical Journal

เหตุผลของการทำวิจัย : ที่ผ่านมามีการศึกษาภาวะซึมเศร้าและพฤติกรรมรุนแรงของผู้ป่วยจิตเภทเป็นจำนวนมาก แต่ยังไม่พบการศึกษาในกลุ่มผู้ป่วยจิตเภทที่มีคดีในประเทศไทย อีกทั้งยังไม่พบการศึกษาที่เชื่อมโยงกันระหว่างภาวะซึมเศร้าและพฤติกรรมรุนแรงวัตถุประสงค์ : เพื่อศึกษาหาความชุก ความสัมพันธ์ และปัจจัยที่เกี่ยวข้องกับภาวะซึมเศร้าและพฤติกรรมรุนแรง และศึกษาความแตกต่างของภาวะซึมเศร้าและพฤติกรรมรุนแรงของผู้ป่วยโรคจิตเภททั่วไปและผู้ป่วยโรคจิตเภทที่มีคดี ที่เข้ามารับการรักษาในสถาบันกัลยาณ์ราชนครินทร์รูปแบบการวิจัย : การศึกษาวิจัยเชิงพรรณนา ณ ช่วงเวลาใดช่วงเวลาหนึ่งสถานที่ทำการศึกษา : สถาบันกัลยาณ์ราชนครินทร์ตัวอย่างและวิธีการศึกษา : เก็บรวบรวมข้อมูลจากผู้ป่วยโรคจิตเภทที่เข้ามารับการรักษาในสถาบันกัลยาณ์ราชนครินทร์ จำนวน 140 คน โดยใช้แบบคัดลอกข้อมูลจากแฟ้มประวัติผู้ป่วย แบบสอบถามข้อมูลส่วนบุคคลแบบสอบถามความรู้สึกหลากหลายมิติเกี่ยวกับความช่วยเหลือทางสังคม (ฉบับปรับปรุงภาษาไทย) แบบประเมินอาการซึมเศร้าในผู้ป่วยจิตเภท และแบบประเมินพฤติกรรมรุนแรง สถิติที่ใช้ ได้แก่Descriptive Statistic, Chi – Square Test และ Logistic RegressionAnalysisผลการศึกษา : ผู้ป่วยโรคจิตเภทมีภาวะซึมเศร้า (46.4%) และมีพฤติกรรมรุนแรง(32.9%) ความสัมพันธ์ระหว่างภาวะซึมเศร้าและพฤติกรรมรุนแรงอยู่ในระดับต่ำ มีค่า Phi เท่ากับ 0.11 และมีสัดส่วนของการมีภาวะซึมเศร้าและพฤติกรรมรุนแรงในผู้ป่วยโรคจิตเภทที่มีคดีความสูงกว่ากลุ่มผู้ป่วยจิตเภททั่วไป เป็น 1.9 (OR = 1.9, X2 = 2.76,P-value = 0.097) และ 1.3 เท่า (OR = 1.3, X2 = 0.55, P-value =0.459) แต่ไม่มีนัยสำคัญทางสถิติ ซึ่งการมีอาการข้างเคียงของยา(OR = 3.45, P-value = 0.002) สัมพันธภาพในครอบครัว (OR = 1.68,P-value = 0.027) และการสนับสนุนทางสังคม (OR = 0.51,P-value = 0.007) สามารถทำนายการเกิดภาวะซึมเศร้าได้ และปัจจัยที่ทำนายการเกิดพฤติกรรมรุนแรง ได้แก่ การดื่มสุรา (OR = 0.90,P-value < 0.001) และประวัติการฆ่าตัวตาย (OR = 0.72,P-value = 0.014)สรุป : ผู้ป่วยโรคจิตเภทมีภาวะซึมเศร้า ร้อยละ 46.4 และมีพฤติกรรมรุนแรงร้อยละ 32.9 โดยปัจจัยที่สัมพันธ์กับภาวะซึมเศร้า ได้แก่ อาการข้างเคียงของยา สัมพันธภาพในครอบครัว และการสนับสนุนทางสังคมและปัจจัยที่สัมพันธ์กับพฤติกรรมรุนแรง ได้แก่ การดื่มสุรา และประวัติการฆ่าตัวตาย สำหรับการมีคดีถึงแม้เพิ่มโอกาสการมีภาวะซึมเศร้าและพฤติกรรมรุนแรง แต่ก็ไม่มีนัยสำคัญทางสถิติ.

ความเครียดจากการทำงาน และบุคลิกภาพของพยาบาลวิชาชีพระดับปฏิบัติการในโรงพยาบาลเอกชนแห่งหนึ่ง, นาฏยา มณีรุ่ง, ณภัควรรต บัวทอง

Chulalongkorn Medical Journal

เหตุผลของการทำวิจัย : ความเครียดจากการทำงานเป็นอาการที่เกิดจากความไม่สมดุลในการตอบสนองของทางร่างกายและจิตใจเมื่อเจอกับความเครียดลักษณะการปฏิบัติงานโดยเฉพาะงานพยาบาลวิชาชีพในโรงพยาบาลเอกชนที่ต้องให้การบริการที่มีคุณภาพมากที่สุดแก่ผู้รับบริการวัตถุประสงค์ : เพื่อศึกษาความเครียดจากการทำงาน ลักษณะบุคลิกภาพ และปัจจัยอื่น ๆ ที่มีความเกี่ยวข้องกับความเครียดจากการทำงานของพยาบาลวิชาชีพระดับปฏิบัติการในโรงพยาบาลเอกชนแห่งหนึ่งรูปแบบการวิจัย : การศึกษาวิจัยเชิงพรรณนา ณ. จุดเวลาใดเวลาหนึ่งสถานที่ทำการศึกษา : โรงพยาบาลสมิติเวช สุขุมวิทตัวอย่างและวิธีการศึกษา : เก็บรวบรวมข้อมูลจากพยาบาลวิชาชีพระดับปฏิบัติการในโรงพยาบาลสมิติเวช สุขุมวิทจำนวน 200 คน ตั้งแต่เดือน ตุลาคม ถึงเดือนธันวาคม พ.ศ. 2558 โดยใช้แบบสอบถามแบบตอบด้วยตัวเองซึ่งมีทั้งสิ้น 3 ส่วน คือ แบบสอบถามข้อมูลทั่วไป แบบสอบถามความเครียดจากการทำงาน (Thai JCQ 54 ข้อคำถาม) และแบบประเมินบุคลิกภาพ MPI วิเคราะห์ข้อมูลด้วยสถิติเชิงพรรณนา ได้แก่ จำนวนร้อยละ ค่าเฉลี่ย ส่วนเบี่ยงเบนมาตรฐานและค่ามัธยฐาน และวิเคราะห์ปัจจัยที่เกี่ยวข้องด้วยสถิติ Independent t- test, One way ANOVAวิเคราะห์ความสัมพันธ์โดยใช้สถิติ Correlation และวิเคราะห์ความถดถอยพหุคูณโดยใช้สถิติ Multiple regression analysisผลการศึกษา : ความเครียดจากการทำงานของกลุ่มตัวอย่าง ด้านความอิสระในการตัดสินใจ ด้านความเครียดจากภาระงาน ด้านความเครียดจากการทำงานหนัก ด้านแรงสนับสนุนทางสังคมอยู่ในระดับปานกลางร้อยละ 78.0, 53.0, 65.0, และ 65.0 ตามลำดับ ด้านความมั่นคงในอาชีพอยู่ในระดับสูง ร้อยละ 87.0 และด้านปัจจัยเสี่ยงในการทำงานอยู่ในระดับต่ำ ร้อยละ 53.0 กลุ่มตัวอย่างมีลักษณะบุคลิกภาพมิติที่ 1 scale-E ส่วนใหญ่คือแบบแสดงออก ร้อยละ 69.6 บุคลิกภาพมิติที่ 2 scale-N ส่วนใหญ่ คือ แบบมั่นคง ร้อยละ 76.1 โดยประเภทบุคลิกภาพส่วนใหญ่คือแบบแสดงออก–มั่นคง ร้อยละ 56.5 ปัจจัยที่มีความสัมพันธ์กับความเครียดจากการทำงาน คือ อายุ รายได้เฉลี่ยต่อเดือน ความเพียงพอของรายได้ พฤติกรรมการออกกำลังกายการดื่ม เครื่องดื่มชูกำลัง การใช้ยาบรรเทาปวด แผนกงาน ตำแหน่งงาน …

Descriptive Epidemiology Of Karachi Road Traffic Crash Mortality From 2007 To 2014, Rashid Jooma, Masood Ali Shaikh

Department of Surgery Docs

Abstract

According to World Health Organization's estimate for Pakistan, there were 25,781 (95% CI: 20,979-30582) Road Traffic Collision (RTC) fatalities in year 2013. The Road Traffic Injury Research and Prevention Center, collects RTC data on injuries and fatalities from five major public and private hospitals' emergency departments in Karachi. For the eight-year period, from 2007-2014, 9129 fatalities were recorded. Males accounted for 8008 (87.7%) all RTC fatalities. Highest number of fatalities were recorded in the 21-25 age group with 1329 (15.3%) fatalities, while fatalities in 16-30 years old, recorded 3446 (39.7%) of all fatalities out of the total 8684 records …

Catamenial Pneumothorax: A Case Report., Hina Inam, Sumera Inam,, Munaim Tahir

Department of Surgery Docs

Abstract

Catamenial pneumothorax (CP) is a rare and complex clinical condition caused by endometrial tissues, commonly found in reproductive women (age 15-49 years).Its diagnosis is often delayed or overlooked by clinicians, which may result in recurrent hospitalizations and other complications. A case of Catamenial pneumothorax is presented of a 38-year-old young married woman, admitted to hospital with signs and symptoms including chest pain and shortness of breath that started with her menstrual period. Right pneumothorax was observed in the Chest x-ray. Patient underwent Video-assisted thoracoscopic surgery (VATS). Patient was kept under observation, and was discharged when stable with no pain.Catamenial …

A Complex Systems Framework Approach Towards Multidisciplinary Tumor Boards, Rahul Salla, Robert Pahle, Ashish Amresh

Publications

Multidisciplinary tumor boards (MTBs) are universally recommended and have been used in treatment of late stage cancers. Tumor boards have the advantage of including all the stakeholders in the decision making process and improving quality of care, however several studies have pointed to their lack of efficiency and tend to be lackluster while not producing the desired benefits for the participants. In this paper we present the design of a web based immersive framework for collaborative decision making that has the potential to improve several inefficiencies in conducting tumor boards and improve overall clinical outcomes. We present the design of …

Effects Of Target-Controlled Infusion Of High-Dose Naloxone On Pain And Hyperalgesia In A Human Thermal Injury Model: A Study Protocol, Anders D. Springborg, Elisabeth K. Jensen, Bradley K. Taylor, Mads U. Werner

Physiology Faculty Publications

Mu-opioid-receptor antagonists have been extensively studied in experimental research as pharmacological tools uncovering mechanisms of pain modulation by the endogenous opioid system. In rodents, administration of high doses of mu-opioid-receptor antagonists after the resolution of an inflammatory injury has demonstrated reinstatement of nociceptive hypersensitivity indicating unmasking of latent sensitization. In a recent human study, pain hypersensitivity assessed as secondary hyperalgesia area (SHA), was reinstated 7 days after a mild thermal injury, in 4 out of 12 subjects after a naloxone infusion.

The aims of the present study are first, to replicate our previous findings in a larger-sized study; second, to …

Childhood Abuse Types And Adult Relational Violence Mediated By Adult Attachment Behaviors And Romantic Relational Aggression In Couples, Tabitha Nicole Webster

Theses and Dissertations

The current study investigated how three distinct types of childhood abuse—witnessing of parental domestic violence, experiencing physical abuse and total in-home violence, and experiencing sexual abuse—predicted partner reports of relational violence through the mediating factors self-perceptions of attachment and partner reports of relational aggression. The study used paired dyadic data from 1,658 couples who had completed the RELATionship Evaluation (RELATE). The Family Violence, the Brief Accessibility and Responsiveness, Couples Relational Aggression and Victimization, and the Conflict Tactics scales were the measures used. Data was analyzed by using structural equation modeling to estimate an actor-partner interdependence model exploring these relationships. Results …

Early Experience Of Dynamic Hip Screw With Spiral Blade And Locking Side Plate For The Stabilization Of Trochanteric Fractures., Akbar Jaleel Zubair, Rizwan Haroon Rashid, Marij Zahid, Masood Umer, Pervaiz Hashmi

Department of Surgery Docs

Abstract

OBJECTIVE:

To evaluate early experience with helical hip system in osteoporotic elderly patients with per-trochanteric fractures.

METHODS:

The retrospective study was conducted at Aga Khan University Hospital, Karachi, and comprised records of patients having low-velocity pertrochanteric fractures who were fixed with spiral blade Dynamic Helical Hip Systemfrom July to December 2014 and were followed up for a minimum of 3 months. Demographic variables and clinical outcomes were noted from the medical records whereas operative details were recorded from the operative note. Radiological variables and outcomes were assessed by viewing appropriate pre-operative, post-operative and follow-up radiographs.

RESULTS:

Of the 32 …

Staff Responses When Parents Hit Children In A Hospital Setting., Sarah A. Font, Elizabeth T. Gershoff, Catherine A. Taylor, Amy Terreros, Monica Nielsen-Parker, Lisa Spector, Rebecca H. Foster, Ann Budzak Garza, Denyse Olson-Dorff

Manuscripts, Articles, Book Chapters and Other Papers

OBJECTIVE: Physical punishment of children is a prevalent practice that is condemned by most medical professionals given its link with increased risk of child physical abuse and other adverse child outcomes. This study examined the prevalence of parent-to-child hitting in medical settings and the intervention behaviors of staff who witness it.

METHOD: Staff at a children's medical center and a general medical center completed a voluntary, anonymous survey. We used descriptive statistics to examine differences in the experiences of physicians, nurses, and other medical staff. We used logistic regression to predict intervention behaviors among staff who witnessed parent-to-child hitting.

RESULTS: …

Flipping The Classroom: Assessment Of Strategies To Promote Student-Centered, Self-Directed Learning In A Dental School Course In Pediatric Dentistry., Brenda S Bohaty, Gloria J. Redford, Cynthia C. Gadbury-Amyot

Manuscripts, Articles, Book Chapters and Other Papers

The aim of this study was to explore student and course director experiences with the redesign of a traditional lecture-based course into a flipped classroom for teaching didactic content in pediatric dentistry to second-year dental students. The study assessed student satisfaction, extent of student engagement, overall course grades, and course director satisfaction. The students enrolled in a flipped classroom pediatric dentistry course (spring semester 2014; SP14) were asked to complete pre- and post-course questionnaires to assess their perceptions of active learning, knowledge acquisition, and course satisfaction. The process was repeated with the class enrolled in the same course the following …

Shorter Remission Telomere Length Predicts Delayed Neutrophil Recovery After Acute Myeloid Leukemia Therapy: A Report From The Children's Oncology Group., Robert B. Gerbing, Todd A. Alonzo, Lillian Sung, Alan S. Gamis, Soheil Meshinchi, Sharon E. Plon, Alison A. Bertuch, Maria M. Gramatges

Manuscripts, Articles, Book Chapters and Other Papers

Purpose Suboptimal outcomes for children with acute myeloid leukemia (AML) necessitate maximally intensive therapy. Consequently, serious adverse events, such as prolonged periods of profound myelosuppression, contribute to AML treatment-related mortality. Telomeres, the repetitive DNA-protein structures at chromosome ends, influence cellular replicative capacity in that critically short telomeres can induce cell senescence or apoptosis. Our objective was to evaluate the impact of telomere length on duration of post-therapy neutropenia in a pediatric AML cohort. Patients and Methods Patients were diagnosed with de novo AML, enrolled in Children's Oncology Group study AAML0531, and included those with (n = 53) and without (n …

A Pressure Ulcer And Fall Rate Quality Composite Index For Acute Care Units: A Measure Development Study., Diane K. Boyle, Ananda Jayawardhana, Mary E. Burman, Nancy E. Dunton, Vincent S. Staggs, Sandra Bergquist-Beringer, Byron J. Gajewski

Manuscripts, Articles, Book Chapters and Other Papers

Background: Composite indices are single measures that combine the strengths of two or more individual measures and provide broader, easy-to-use measures for evaluation of provider performance and comparisons across units and hospitals to support quality improvement.

Objective: The study objective was to develop a unit-level inpatient composite nursing care quality performance index-the Pressure Ulcer and Fall Rate Quality Composite Index.

Design: Two-phase measure development study.

Settings: 5144 patient care units in 857 United States hospitals participating in the National Database of Nursing Quality Indictors® during the year 2013.

Methods: The Pressure Ulcer and Fall Rate Quality Composite Index was developed …

The Hvnramp5 Transporter Mediates Uptake Of Cadmium And Manganese, But Not Iron, Dezhi Wu, Naoki Yamaji, Miki Yamane, Miho Kashino-Fujii, Kazuhiro Sato, Jian Feng Ma

Publications

The Natural Resistance Associated Macrophage Protein (Nramp) represents a transporter family for metal ions in all organisms. Here, we functionally characterized a member of Nramp family in barley (Hordeum vulgare), HvNramp5. This member showed different expression patterns, transport substrate specificity, and cellular localization from its close homolog in rice (Oryza sativa), OsNramp5, although HvNramp5 was also localized to the plasma membrane. HvNramp5 was mainly expressed in the roots and its expression was not affected by Cd and deficiency of Zn, Cu, and Mn, but slightly up-regulated by Fe deficiency. Spatial expression analysis showed that the expression of HvNramp5 was higher …

Aging-Associated Changes In Microrna Expression Profile Of Internal Anal Sphincter Smooth Muscle: Role Of Microrna-133a., Jagmohan Singh, Boopathi Ettickan, Sankar Addya, Benjamin Philllips, Isidore Rigoutsos, Raymond B. Penn, Satish Rattan

Division of Gastroenterology and Hepatology Faculty Papers

A comprehensive genomic and proteomic, computational, and physiological approach was employed to examine the (previously unexplored) role of microRNAs (miRNAs) as regulators of internal anal sphincter (IAS) smooth muscle contractile phenotype and basal tone. miRNA profiling, genome-wide expression, validation, and network analyses were employed to assess changes in mRNA and miRNA expression in IAS smooth muscles from young vs. aging rats. Multiple miRNAs, including rno-miR-1, rno-miR-340-5p, rno-miR-185, rno-miR-199a-3p, rno-miR-200c, rno-miR-200b, rno-miR-31, rno-miR-133a, and rno-miR-206, were found to be upregulated in aging IAS. qPCR confirmed the upregulated expression of these miRNAs and downregulation of multiple, predicted targets (Eln, Col3a1, Col1a1, Zeb2, …

Lubricant-Sensitivity Assessment Of Spress® B820 By Near Infrared Spectroscopy: A Comparison Of Multivariate Methods, Vivek S. Dave, Connor Mack, Heather Boyce, Enyioha Ike-Amaechi, Antione Al-Achi, Stephen W. Hoag, Rahul V. Haware

Pharmacy Faculty/Staff Publications

The aim of the present investigation was to compare the predictive performance of PCR and PLS calibration models based on near-infrared spectroscopy (NIRS) data used to monitor lubrication conditions impact on the tablet breaking force (TBF) of SPRESS® B820.

Assessing The Enhancement Of Aqueous Solubility Of Efavirenz Via Lyophilized Milk Based Solid Dispersion Formulations, Nishikant Raut, Pradip Dhore, Suprit Saoji, Vivek S. Dave

Pharmacy Faculty/Staff Publications

No abstract provided.

Treatment Adherence Among Women Infected With Human Immunodeficiency Virus With A History Of Gender-Based Violence, Olivia Mcgregor

Walden Dissertations and Doctoral Studies

Women infected with Human Immunodeficiency Virus (HIV) are at high risk of myriad conditions, especially gender-based violence (GBV). GBV can be a hindrance to treatment adherence, which is pertinent to improving the health of people living with HIV. The purpose of this longitudinal research study was to assess the effects of GBV on treatment adherence among HIV infected women, with specific focus on when the violence occurred (recent or lifetime) and the stratifying type of GBV (sexual, physical, and psychological). The health belief model (HBM) served as a theoretical groundwork. Participants were selected from secondary data, collected by the Women’s …

The Scoop, Vol. 3 Issue 8, November 2016, Health Sciences Library

Volume 3

Latest news and events from the Health Sciences Library in our monthly newsletter for November 2016.

Ictal Verbal Help-Seeking: Occurrence And The Underlying Etiology., Ali Akbar Asadi-Pooya, Marjan Asadollahi, Krzysztof Bujarski, Amin H. Rabiei, Narsis Aminian, Dale Wyeth, Michael R. Sperling

Department of Neurology Faculty Papers

PURPOSE: Ictal verbal help-seeking has never been systematically studied before. In this study, we evaluated a series of patients with ictal verbal help-seeking to characterize its frequency and underlying etiology.

METHODS: We retrospectively reviewed all the long-term video-EEG reports from Jefferson Comprehensive Epilepsy Center over a 12-year period (2004-2015) for the occurrence of the term "help" in the text body. All the extracted reports were reviewed and patients with at least one episode of documented ictal verbal help-seeking in epilepsy monitoring unit (EMU) were studied. For each patient, the data were reviewed from the electronic medical records, EMU report, and …

Jeffhope News-Fall 2016

JeffHOPE News

This issue includes:

• Updates: HCV Testing
• From the Project Director
• New Position: Triage Director
• Clinic at a Glance
• Advocacy Spotlight
• Research at JEFFHope
• Eye screening in an urban homeless shelter
• Contraception
• Self-Reported Indicators for Hepatitis C Virus Screening in JEFFHope Patients
• EKG Study
• Assessing the Need for Dermatological Care and Prevalence of Dermatologic conditions in an urban homeless shelter
• Spotlight on the John Bell Center
• If you had to describe JEFFHope in one word...
• Reflections by Committee Members and Directors
• 2016-2017 JEFFHope Volunteers

Ultrasound Imaging In Women's Arm Flexor Muscles: Intra-Rater Reliability Of Muscle Thickness And Echo Intensity, Amilton Vieira, Angelina F. Siqueira, João B. Ferriera-Junior, Paulo Pereira, Dale Wagner, Martim Bottaro

Kinesiology and Health Science Faculty Publications

Background: Different ultrasound parameters have been frequently used to assess changes associated with training, aging, immobilization, and neuromuscular diseases. However, an exploratory reliability analysis of the echo intensity (EI) and muscle thickness (MT) of the forearm flexors is scarce, especially in women.

Objective: The purpose of the present study was to determine the intra-rater reliability of MT and EI assessed by ultrasound in young women.

Method: Ultrasonographic MT and EI were acquired in the forearm flexors of 41 young women (22±2 yrs). Reliability was calculated using intraclass correlation coefficient (ICC2,1), standard error of measurement (SEM), coefficient of variation (CV), smallest …

Medical Center Staff Attitudes About Spanking., Elizabeth T. Gershoff, Sarah A. Font, Catherine A. Taylor, Rebecca H. Foster, Ann Budzak Garza, Denyse Olson-Dorff, Amy Terreros, Monica Nielsen-Parker, Lisa Spector

Manuscripts, Articles, Book Chapters and Other Papers

Several medical professional organizations, including the American Academy of Pediatrics, recommend that parents avoid hitting children for disciplinary purposes (e.g., spanking) and that medical professionals advise parents to use alternative methods. The extent to which medical professionals continue to endorse spanking is unknown. This study is the first to examine attitudes about spanking among staff throughout medical settings, including non-direct care staff. A total of 2580 staff at a large general medical center and 733 staff at a children's hospital completed an online survey; respondents were roughly divided between staff who provide direct care to patients (e.g., physicians, nurses) and …

Progress Toward Eliminating Mother To Child Transmission Of Hiv In Kenya: Review Of Treatment Guideline Uptake And Pediatric Transmission At Four Government Hospitals Between 2010 And 2012., Sarah Finocchario-Kessler, Kristine F. Clark, Samoel Khamadi, Brad J. Gautney, Vincent Okoth, Kathy Goggin, Hitsystem Study Team

Manuscripts, Articles, Book Chapters and Other Papers

We analyzed prevention of mother-to-child transmission (PMTCT) data from a retrospective cohort of n = 1365 HIV+ mothers who enrolled their HIV-exposed infants in early infant diagnosis services in four Kenyan government hospitals from 2010 to 2012. Less than 15 and 20 % of mother-infant pairs were provided with regimens that met WHO Option A and B/B+ guidelines, respectively. Annually, the gestational age at treatment initiation decreased, while uptake of Option B/B+ increased (all p's < 0.001). Pediatric HIV infection was halved (8.6-4.3 %), yet varied significantly by hospital. In multivariable analyses, HIV-exposed infants who received no PMTCT (AOR 4.6 [2.49, 8.62], p < 0.001), mixed foods (AOR 5.0 [2.77, 9.02], p < 0.001), and care at one of the four hospitals (AOR 3.0 [1.51, 5.92], p = 0.002) were more likely to be HIV-infected. While the administration and uptake of WHO PMTCT guidelines is improving, an expanded focus on retention and medication adherence will further reduce pediatric HIV transmission.

Toxic Environmental Exposures And Kidney Health In Children., Darcy K. Weidemann, Virginia M. Weaver, Jeffrey J. Fadrowski

Manuscripts, Articles, Book Chapters and Other Papers

High-level exposures to a number of agents are known to have direct nephrotoxic effects in children. A growing body of literature supports the hypothesis that chronic, relatively low-level exposure to various nephrotoxicants may also increase the risk for chronic kidney disease (CKD) or accelerate its progression. In this review we highlight several environmental nephrotoxicants and their association with CKD in children and adolescents. We also discuss unique epidemiological challenges in the use of kidney biomarkers in environmental nephrotoxicology.

Branched Chain Amino Acids Cause Liver Injury In Obese/Diabetic Mice By Promoting Adipocyte Lipolysis And Inhibiting Hepatic Autophagy., Fuyang Zhang, Shihao Zhao, Wenjun Yan, Yunlong Xia, Xiyao Chen, Wei Wang, Jinglong Zhang, Chao Gao, Cheng Peng, Feng Yan, Huishou Zhao, Kun Lian, Yan Lee, Ling Zhang, Wayne Bond Lau, Xin-Liang Ma, Ling Tao

Department of Emergency Medicine Faculty Papers

The Western meat-rich diet is both high in protein and fat. Although the hazardous effect of a high fat diet (HFD) upon liver structure and function is well recognized, whether the co-presence of high protein intake contributes to, or protects against, HF-induced hepatic injury remains unclear. Increased intake of branched chain amino acids (BCAA, essential amino acids compromising 20% of total protein intake) reduces body weight. However, elevated circulating BCAA is associated with non-alcoholic fatty liver disease and injury. The mechanisms responsible for this quandary remain unknown; the role of BCAA in HF-induced liver injury is unclear. Utilizing HFD or …

Evidence Supporting Idarucizumab For The Reversal Of Dabigatran., Charles V. Pollack

Department of Emergency Medicine Faculty Papers

Idarucizumab is a monoclonal antibody fragment specifically targeted to dabigatran. It has demonstrated prompt and durable reversal of the anticoagulant effects of dabigatran in animal studies and phase 1 studies of young, elderly, and renally impaired volunteers. Although elective invasive procedures and most bleeding complications in dabigatran-treated patients can be managed by temporarily stopping dabigatran therapy and using supportive measures, there are rare clinical situations that require urgent reversal of the anticoagulant effect of dabigatran. The effectiveness and safety of 5 g of intravenous idarucizumab is being investigated in a prospective, open-label, single-cohort study in patients with serious bleeding or …

Introduction To Direct Oral Anticoagulants And Rationale For Specific Reversal Agents., Charles V. Pollack

Department of Emergency Medicine Faculty Papers

No abstract provided.

Association Of Blood Pressure Variability And Neurocognition In Children With Chronic Kidney Disease., Marc B. Lande, Susan R. Mendley, Matthew B. Matheson, Shlomo Shinnar, Arlene C. Gerson, Joshua A. Samuels, Bradley A. Warady, Susan L. Furth, Stephen R. Hooper

Manuscripts, Articles, Book Chapters and Other Papers

BACKGROUND: Children with chronic kidney disease (CKD) and hypertension have increased blood pressure variability (BPV), which has been associated with lower neurocognitive test scores in adults. Children with CKD are at risk for decreased neurocognitive function. Our objective was to determine whether children with CKD and increased BPV had worse performance on neurocognitive testing compared with children with CKD and lower BPV.

METHODS: This was a cross-sectional and longitudinal analysis of the relation between BPV and neurocognitive test performance in children ≥6 years enrolled in the Chronic Kidney Disease in Children (CKiD) study. Visit-to-visit BPV was assessed by the standard …

Risk Factors Of Trastuzumab-Induced Cardiotoxicity In Breast Cancer: A Meta-Analysis, Zeeshan Jawa, Ruth M. Perez, Lydia Garlie, Maharaj Singh, Rubina Qamar, Bijoy K. Khandheria, Arshad Jahangir, Yang Shi

College of Nursing Faculty Research and Publications

Background: 

Trastuzumab targets the human epidermal growth factor receptor 2 oncogene and in combination with first-line therapy results in significantly improved survival outcomes and has thus become standard of care in both adjuvant and metastatic settings. While it is estimated that 1% to 4% of patients treated with trastuzumab will develop heart failure and ∼10% will experience a reduction in left ventricular ejection fraction (LVEF), the patient risk factors associated with trastuzumab-induced cardiotoxicity (TIC) are unclear. This meta-analysis aims to consolidate previously published data to identify the risk factors most likely leading to TIC.

Methods: 

A search of the MEDLINE …

Autism Spectrum Disorder And The Child's Weight–Related Behaviors: A Parents' Perspective, Michele Polfuss, Norah L. Johnson, Susan A. Bonis, Fallon Apollon, Kathleen Sawin

College of Nursing Faculty Research and Publications

Purpose

To explore parent perspectives of how the attributes of their child's autism spectrum disorder(ASD) impact nutrition, physical activity, screen time behaviors and risk for obesity. Secondarily, we examined the parent's perception of the healthcare providers (HCP) influence on these weight-related behaviors.

Design and method

We conducted and audio-recorded telephone interviews with parents of children with ASD (n = 8) using a structured question guide. Data were transcribed and thematic analysis was conducted. Issues surrounding weight-related behaviors and parental strategies used were reported.

Results

Two overarching themes with eight subthemes emerged: (1) Challenges related to features of ASD (subthemes included …