Medicine and Health Sciences Commons^™

Comparison Of Spinal Anesthesia Dosage Based On Height And Weight Versus Height Alone In Patients Undergoing Elective Cesarean Section, Khalid Maudood Siddiqui, Muhammad Asghar Ali, Hameed Ullah

Department of Anaesthesia

Background: Spinal anesthesia with bupivacaine, typically used for elective and emergency cesarean section, is associated with a significant incidence of hypotension resulting from sympathetic blockade. A variety of dosing regimens have been used to administer spinal anesthesia for cesarean section. The objective of this study was to compare the incidence of hypotension following two different fixed dosing regimens.Methods: This was a randomized double-blind clinical trial with a two-sided design, 5% significance level and 80% power. After approval of the hospital ethics review committee, 60 patients were divided randomly into two groups. In one group, the local anesthetic dose was adjusted …

The Influence Of A Social Communication Intervention On The Syntactic Complexity Of Three Children With Language Impairment, Alyse Wheeler

Theses and Dissertations

Research has shown that children with language impairment (LI) exhibit difficulties with both social communication and syntax. This study analyzed the effect of a social communication intervention on syntactic development, focusing on grammatical complexity in three children with LI when enacting stories. The intervention included reading and enacting stories, playing games with picture emotion cards and journaling. Each child's mean length of terminal unit (t-unit), the number and type of subordinate clauses they produced per t-unit, and the grammaticality of their complex sentences was analyzed. While none of the children increased their mean length of t-unit or the grammaticality of …

Reinforcement Learning, Error-Related Negativity, And Genetic Risk For Alzheimer's Disease, Christina Marie Figueroa

Dissertations (1934 -)

Reinforcement learning (RL) has been widely used as a model of animal and human learning and decision-making. The neural networks underlying RL involve many of the same structures primarily affected by Alzheimer’s disease (AD) such as the hippocampus. Yet, RL and non-invasive evaluation of its neural underpinnings have been underutilized as a framework for understanding disease pathology and its pre-clinical states. This study aimed to provide a novel approach for assessing subtle changes in asymptomatic apolipoprotein-E (APOE) carriers and non-carriers. Electroencephalography was collected from forty APOE genotyped older adults (Male n = 11; Mage = 79.30; Meducation = 14.88 years) …

Racially And Ethnically Underrepresented Students’ Completion Of Rn Bsn Program: Factors Affecting Success, Patricia Ann Varga

Dissertations (1934 -)

Health care is becoming increasingly complex. This complexity requires the skills of a BSN or higher prepared nurse. The current nursing workforce does not mirror the population demographics of the United States. Because of this, underrepresented racial and ethnic groups are not likely to be cared for by a member of their diverse group. Satisfaction with care and outcomes of care are enhanced when members of underrepresented racial and ethnic groups are cared for by a member of their cultural group. This grounded theory study included 6 RN BSN students who were members of underrepresented racial and ethnic groups and …

A Mobile Health Approach To Assist Veterans Reintegrating Into Civilian Life, Rizwana Rizia

Dissertations (1934 -)

Civilian reintegration is the process of transitioning from military service to civilian life. For any active or reserve member of armed force, reintegration into civilian life can be very challenging. The reintegration phase has far larger impact than just a change in profession. It is actually a change in every aspect of life, which includes changes in lifestyles, responsibilities, home life, communities and much more. If a veteran is unable to survive the challenges of civilian reintegration it can adversely impact his or her personal and social life. Furthermore, in the long run it may even result in serious psychological …

Injury Risk Assessment Of The Femur In Children With Osteogenesis Imperfecta, Jessica Marie Fritz

Dissertations (1934 -)

Osteogenesis imperfecta (OI) is a genetic disorder characterized by increased bone fragility and decreased bone mass, which leads to high rates of bone fracture. OI has a prevalence of 1/5,000 to 1/10,000 in the United States. About 90% of persons with OI have a genetic mutation in the coding for collagen type I, which is the major protein of connective tissues, including bone. While its prevalence classifies it as a rare disease, it is the most common disorder of bone etiology. Until recently, little was known about the mechanics and materials of OI bone or their impact on fracture risk. …

Dissecting The Novel Roles Of Trim56 In Antiviral Innate Immunity, Baoming Liu

Theses and Dissertations (ETD)

The tripartite motif-containing (TRIM) proteins have emerged as a new class of host antiviral restriction factors, with several demonstrating roles in regulating innate antiviral responses. Of >70 known TRIMs, TRIM56 inhibits replication of bovine viral diarrhea virus, a ruminant pestivirus of the family Flaviviridae, but has no appreciable effect on VSV, a rhabdovirus. We have also shown that TRIM56 forms a complex with the Toll-like receptor-3 (TLR3) adaptor, TRIF, via its C-terminal residues 621-750, and augments TLR3-mediated interferon (IFN) induction and establishment of an antiviral state. Yet, TRIM56’s antiviral spectrum and the precise underlying mechanisms by which TRIM56 executes …

Nursing’S Role In Physician Aid In Dying: Assisting Suicide Or Providing Death With Dignity, Elizabeth Miklos

Honors Projects

No abstract provided.

Endothelial To Mesenchymal Transition (Endomt) In The Pathogenesis Of Systemic Sclerosis-Associated Pulmonary Fibrosis And Pulmonary Arterial Hypertension. Myth Or Reality?, Sergio A. Jimenez, Sonsoles Piera-Velazquez

Department of Dermatology and Cutaneous Biology Faculty Papers

Systemic Sclerosis (SSc) is a systemic autoimmune disease characterized by progressive fibrosis of skin and multiple internal organs and severe functional and structural microvascular alterations. SSc is considered to be the prototypic systemic fibrotic disorder. Despite currently available therapeutic approaches SSc has a high mortality rate owing to the development of SSc-associated interstitial lung disease (ILD) and pulmonary arterial hypertension (PAH), complications that have emerged as the most frequent causes of disability and mortality in SSc. The pathogenesis of the fibrotic process in SSc is complex and despite extensive investigation the exact mechanisms have remained elusive. Myofibroblasts are the cells …

Treating The Hodgkin's Lymphoma Variant Of Richter's Transformation, Mohammad Faizan Zahid

Medical College Documents

No abstract provided.

Comparison Of Interactive Voice Response (Ivr) With Paper Administration Of Instruments To Assess Functional Status, Sexual Function, And Quality Of Life In Elderly Men, Rc Rosen, Aj Stephens-Shields, Gr Cunningham, D Cifelli, D Cella, Jt Farrar, E Barrett-Connor, Ce Lewis, M Pahor, X Hou, Pj Snyder

Faculty, Staff and Students Publications

PURPOSE: Patient-reported outcome (PRO) measures are essential for assessing subjective patient experiences. Interactive voice response (IVR) data collection provides advantages for clinical trial design by standardizing and centralizing the assessment. Prior to adoption of IVR as a mode of PRO administration in the Testosterone Trials (TTrials), we compared IVR to paper versions of the instruments to be used. METHODS: IVR versions of the FACIT-Fatigue scale and Psychosexual Daily Questionnaire, Question 4, were developed. In one pilot study, IVR versions of these scales were compared to paper versions in 25 men = 65 years at each of two clinical sites. In …

Longitudinal Changes In Vascular Risk Markers And Mortality Rates Among A Latino Population With Hypertension, Matthew C Pflederer, Carlin S Long, Brenda Beaty, Edward P Havranek, Philip S Mehler, Angela Keniston, Mori J Krantz

The Texas Heart Institute Journal

Vascular markers such as pulse-wave velocity and carotid intima-media thickness (CIMT) might improve the prediction of incident cardiovascular disease beyond traditional risk factors. These vascular markers have not been well characterized in minority populations and might be more useful than inflammatory biomarkers. We conducted a prospective, longitudinal cohort study among hypertensive patients in an urban safety-net hospital. We evaluated inflammatory biomarkers, arterial pulse-wave velocity, and carotid intima-media thickness at baseline, 1 year, and 2 years. The primary outcome variable was CIMT. Generalized linear mixed-effects models were used to evaluate associations between CIMT and predictive variables accounting for the correlation of …

Advancing A Guiding Catheter Across A Mechanical Aortic Valve, Wassim Shatila, Guilherme V Silva

The Texas Heart Institute Journal

No abstract provided.

Biventricular Myocardial Performance Is Impaired In Proportion To Severity Of Obstructive Sleep Apnea, Selahattin Akyol, Mustafa Cortuk, Ahmet Oytun Baykan, Kemal Kiraz, Abdurrezzak Borekci, Taner Seker, Mustafa Gur, Murat Cayli

The Texas Heart Institute Journal

Obstructive sleep apnea (OSA) is an independent risk factor for cardiovascular morbidity and death. Little information is available regarding the relationship between the severity of OSA and myocardial performance in OSA patients who have normal ejection fractions. We prospectively investigated this relationship, using the tissue-Doppler myocardial performance index (TD-MPI).

We conducted overnight, full-laboratory polysomnographic examinations of 116 patients, and calculated the left and right ventricular TD-MPIs. Patients were classified into 3 groups in accordance with their apnea-hypopnea index (AHI) levels: AHImild (≥5 to <15), AHImoderate (≥15 to <30), and AHIsevere (≥30).

Left and right ventricular TD-MPI values were higher in the AHIsevere group than in the AHImild and …

Cardiac Papillary Fibroelastoma: Single-Institution Experience With 14 Surgical Patients, Walid K Abu Saleh, Odeaa Al Jabbari, Basel Ramlawi, Michael J Reardon

The Texas Heart Institute Journal

In general, treatment for symptomatic and asymptomatic cardiac papillary fibroelastoma is surgical resection-particularly of left-sided lesions, because of the risk of systemic embolization. However, few institutions have enough experience with these tumors to validate this approach. We present our institutional experience with papillary fibroelastoma and discuss our current approach. We searched our institution's cardiac tumor database, identified all patients diagnosed with cardiac papillary fibroelastoma from 1992 through 2014, and recorded the clinical and pathologic characteristics of each case. We found 14 patients (mean age, 60.5 ± 12.3 yr) who had 18 lesions. Eleven patients (79%) were symptomatic; however, we could …

A Unique Patient With Epilepsy With Cinematographic Visual Hallucinations, Alexis E. Nelson, Frank G. Gilliam, Jayant Acharya, Sabina Miranda

School of Medicine Publications

Purpose

The purpose of this case report is to document a patient with cinematographic hallucinations, with corresponding right temporal lobe seizures on electroencephalogram (EEG).

Results

The results showed that the patient's EEG was normal. The patient subsequently reported hallucinations, which had been occurring for the last several months. During monitoring, no interictal EEG abnormalities were identified, but a total of 11 partial seizures were captured originating from the right posterior temporal area. They either were subclinical or corresponded with his visual hallucinations.

Conclusion

The present study demonstrates focal seizures of temporal lobe origin producing complex visual hallucinations without a corresponding …

Genome-Wide Association Studies Suggest Sex-Specific Loci Associated With Abdominal And Visceral Fat, Yun Ju Sung, L. Pérusse, M. A. Sarzynski, M. Fornage, S. Sidney, B. Sternfeld, T. Rice, J. G. Terry, D. R. Jacobs Jr., John Blangero, Joanne E. Curran

School of Medicine Publications

Background:

To identify loci associated with abdominal fat and replicate prior findings, we performed genome-wide association (GWA) studies of abdominal fat traits: subcutaneous adipose tissue (SAT); visceral adipose tissue (VAT); total adipose tissue (TAT) and visceral to subcutaneous adipose tissue ratio (VSR).

Subjects and Methods:

Sex-combined and sex-stratified analyses were performed on each trait with (TRAIT–BMI) or without (TRAIT) adjustment for body mass index (BMI), and cohort-specific results were combined via a fixed effects meta-analysis. A total of 2513 subjects of European descent were available for the discovery phase. For replication, 2171 European Americans and 772 African Americans were available. …

Gwas And Transcriptional Analysis Prioritize Itpr1 And Cntn4 For A Serum Uric Acid 3p26 Qtl In Mexican Americans, Geetha Chittoor, Jack W. Kent Jr., Marcio Almeida, Sobha Puppala, Vidya S. Farook, Shelley A. Cole, Karin Haack, Harald H. H. Goring, Jean W. Maccluer, Joanne E. Curran, Melanie A. Carless, Matthew P. Johnson, Eric K. Moses, Laura Almasy, Michael C. Mahaney, Donna M. Lehman, Ravindranath Duggirala, Anthony G. Comuzzie, John Blangero, Venkata Saroja Voruganti

School of Medicine Publications

Background: The variation in serum uric acid concentrations is under significant genetic influence. Elevated SUA concentrations have been linked to increased risk for gout, kidney stones, chronic kidney disease, and cardiovascular disease whereas reduced serum uric acid concentrations have been linked to multiple sclerosis, Parkinson’s disease and Alzheimer’s disease. Previously, we identified a novel locus on chromosome 3p26 affecting serum uric acid concentrations in Mexican Americans from San Antonio Family Heart Study. As a follow up, we examined genome-wide single nucleotide polymorphism data in an extended cohort of 1281 Mexican Americans from multigenerational families of the San Antonio Family Heart …

Evaluation Of Polymorphic Locus Sequence Typing For Candida Glabrata Epidemiology., Santosh Katiyar, Eric Shiffrin, Md, Celeste Shelton, Kelley Healey, John-Paul Vermitsky, Tom Edlind

Department of Medicine Faculty Papers

The opportunistic yeastCandida glabratais increasingly refractory to antifungal treatment or prophylaxis and relatedly is increasingly implicated in health care-associated infections. To elucidate the epidemiology of these infections, strain typing is required. Sequence-based typing provides multiple advantages over length-based methods, such as pulsed-field gel electrophoresis (PFGE); however, conventional multilocus sequence typing (targeting 6 conserved loci) and whole-genome sequencing are impractical for routine use. A commercial sequence-based typing service forC. glabratathat targets polymorphic tandem repeat-containing loci has recently been developed. These CgMT-J and CgMT-M services were evaluated with 56 epidemiologically unrelated isolates, 4 to 7 fluconazole-susceptible or fluconazole-resistant isolates from each of …

Predictors Of Coronary Artery Disease In Patients With Polycythemia Vera And Essential Thrombocytosis: Results From The National Inpatient Sample 2009-10., Parasuram Krishnamoorthy Md, Varun Mittal, Jalaj Garg Md, Neeraj Shah Md, Nainesh C. Patel Md

Department of Medicine

Background: Myelproliferative disorders (MPDs) including Polycythemia Vera (PCV) and Essential thrombocytosis (ET) are associated with increase in arterial and venous thromboembolic events. Chronic endothelial damage, hyperviscosity and platelet activation are possible mechanistic factors resulting in accelerated atherogenesis and coronary artery disease (CAD). However the differences in prevalence of CAD and traditional risk factors (TRFs) between PCV and ET are unknown. Hence, we aimed to determine the prevalence and predictors of CAD in PCV and ET patients using a national registry.

Methods: All patients ≥18 years diagnosed with PCV and ET were identified in the Nationwide Inpatient Sample (NIS) 2009-2010 …

The Effects Of Fitness Level And Sex On Epoc Following High Intensity Interval And Moderate Intensity Aerobic Exercise, Rachel Lauren Simmons

Human Movement Studies & Special Education Theses & Dissertations

In the past few years, much attention has been directed toward shorter-duration vigorous intensity aerobic exercise as opposed to longer-duration moderate intensity exercise. There is conflicting evidence as to whether vigorous exercise can result in a greater excess post-exercise oxygen consumption (EPOC) and thus more calories burned when compared to moderate continuous exercise performed for a longer duration. In addition, the literature contains a dearth of information isolating and investigating male and female response to these exercises, as well as fit and unfit subjects. The purpose of this study was to quantify EPOC following moderate intensity aerobic exercise (MOD) and …

The Relationship Between Landing Error Scoring System-Real Time And Dorsiflexion Range Of Motion In Recreational Athletes, Hannah M. Twiddy

Human Movement Studies & Special Education Theses & Dissertations

Participation in physical activity is important for overall health; however, lower extremity injuries are a major risk associated with physical activity. Injuries can lead to time away from physical activity and be associated with negative health consequences. The most common injuries are traumatic injuries to the knee and ankle; which may be related to poor landing mechanics and decreased range of motion. Previous research utilizing motion analysis systems have determined people with greater dorsiflexion range of motion (DROM) demonstrated smaller ground reaction forces and greater knee and hip flexion displacement while landing; indicating a softer landing strategy. The ability to …

The Effects Of Instrument Handle Design On Forearm Muscle Activity During Scaling By Dental Hygienists, Jessica Rae Suedbeck

Dental Hygiene Theses & Dissertations

Purpose: The purpose of this study was to determine the effects of 4 different commercially available instrument handle designs (A. 16 grams and 12.7 mm diameter; B. 23 grams and 11.1 mm diameter; C. 21 grams and 7.9 mm diameter; D. 18 grams and 6.35 mm diameter) on the muscle activity of four forearm muscles during a simulated scaling experience. Methods: A convenience sample of 27 dental hygienists used a Columbia 13/14 curet with four different instrument handles to scale artificial calculus. While scaling, each participant’s muscle activity was measured using surface electromyography (sEMG). Participants completed an end user opinion …

Examining Changes In College Counseling Clients’ Symptomology And Severity Over An Eight Year Span, Caroline Lee Bertolet

Counseling & Human Services Theses & Dissertations

The current college counseling literature has conflicting findings regarding the extent to which the severity of mental health symptoms has increased for college students. Some researchers claim that over time student’s mental health symptoms have become more complex rather than more severe. This study examined archival data to analyze both the severity and complexity of symptoms in an eight year time span. The study also examined how disruptiveness and treatment demand have changed over the eight year period. The data were analyzed using multiple regression. The results of the study supported perspectives found in the current literature indicating little increase …

Neuropathy Detection, Quality Of Life Tools & Treatment For Type 2 Diabetes, Jennifer J. Brown

Human Movement Studies & Special Education Theses & Dissertations

Type 2 diabetes (T2D) mellitus has become the epidemic of the new millennium, with an estimated 382 million people affected worldwide as of 2013, and statistics projected towards 592 million by the year 2035. With the development of diabetes, complications have risen, with diabetic neuropathy becoming one of the most prevalent, affecting between 10–90% of those with the disease. Diabetic peripheral neuropathy (DPN) is difficult to detect in early stages of pathology, yet devastating once significant damage has taken place. Cardiac autonomic neuropathy (CAN), which is often silent, is associated with autonomic nervous system (ANS) dysfunction and increased risk for …

The Effects Of Alarm System Errors On Dependence: Moderated Mediation Of Trust With And Without Risk, Eric T. Chancey

Psychology Theses & Dissertations

Research on sensor-based signaling systems suggests that false alarms and misses affect operator dependence via two independent psychological processes, hypothesized as two types of trust. These two types of trust manifest in two categorically different behaviors: compliance and reliance. The current study links the theoretical perspective outlined by Lee and See (2004) to the compliance-reliance paradigm, and argues that trust mediates the false alarm-compliance relationship but not the miss-reliance relationship. Specifically, the key conditions to allow the mediation of trust are: The operator is presented with a salient choice to depend on the signaling system and the risk associated with …

The Effect Of Magnification Loupes On Posture During Instrumentation By Dental Hygienists, Emily Anne Ludwig

Dental Hygiene Theses & Dissertations

Purpose: The purpose of this study was to determine the effects of dental magnification loupes on posture during instrumentation. Methods: A convenience sample of twenty-seven righthanded dental hygienists with no history of injuries or disabilities of the head, neck, and trunk regions was enrolled. Baseline posture calibration was taken. Accelerometers were placed on four locations of the head and trunk (occipital pole of head, cervical vertebrae: C5, thoracic vertebrae: T5, lumbar vertebrae: L1) to measure changes in posture. Accelerations in three axes were recorded (anterior/posterior (AP), medial/lateral (ML), vertical (VT)). Mean accelerations of the three axes were used to compute …

Procedure Documentation And Checklists In The Palm Of Your Hand, Kris Rooney Md, Richard J. Mazzaccaro Md, Liborio Larussa Md, Katherine Adams Pc

Department of Pediatrics

No abstract provided.

The Relationship Between Counselors' Multicultural Counseling Competence And Poverty Beliefs, Madeline Elizabeth Clark

Counseling & Human Services Theses & Dissertations

The relationship between increased levels of poverty and decreased levels of psychological wellbeing and overall wellness is well documented. Although poverty clearly impacts mental health and wellness, little research in counseling has been conducted exploring the poverty attitudes of counselors. This study explored the relationship between professional counselors’ multicultural counseling competence (MCC), poverty beliefs, and select demographic factors (i.e. counseling specialty, gender, age, ethnocultural identity, poverty counseling experience, and personal poverty experience). Data were collected using survey-based methods from professional counselors of all specialties. Results of a hierarchical linear regression indicate that increased MCC, adjusted for select demographic factors, is …

An Examination Of Early Colorectal Cancer Screening Guidelines For African Americans: Hints From The Hints Data, Torhonda C. Lee, Arlesia L. Mathis, Matthew T. Dutton

Journal of Health Disparities Research and Practice

Background: Despite the overall gains in reducing colorectal cancer (CRC) deaths due to the increase in screening, minority racial/ethnic groups who have disparately higher rates of death compared to Whites, also have disproportionately lower screening rates. Patient-provider communication about screening has a strong influence on the uptake of screening. In much the same way that gradual impact was made after the 1996 implementation of guidelines recommending screening starting at age 50 for those at average risk, it may be expected that the American College of Gastroenterology (ACG) guidelines suggesting screening start at 45 for Blacks combined with a recent …