Medicine and Health Sciences Commons^™

Ahrq Series On Complex Intervention Systematic Reviews-Paper 6: Prisma-Ci Extension Statement And Checklist, Jeanne-Marie Guise, Mary E. Butler, Christine Chang, Meera Viswanathan, Terri Pigott, Peter Tugwell

OHSU-PSU School of Public Health Faculty Publications and Presentations

Background: Complex interventions are widely used in health systems, public health, education, and communities and are increasingly the subject of systematic reviews. Oversimplification and inconsistencies in reporting about complex interventions can limit the usability of review findings. Rationale: Although guidance exists to ensure that reports of individual studies and systematic reviews adhere to accepted scientific standards, their design-specific focus leaves important reporting gaps relative to complex interventions in health care. This paper provides a stand-alone extension to the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) reporting tool for complex interventionsdPRISMA-CIdto help authors, publishers, and readers understand and apply …

Mediodorsal Thalamic Neurons Mirror The Activity Of Medial Prefrontal Neurons Responding To Movement And Reinforcement During A Dynamic Dnmtp Task, Rikki L.A. Miller Phd, Miranda J. Francoeur, Brett M. Gibson, Robert G. Mair

Faculty Publications

The mediodorsal nucleus (MD) interacts with medial prefrontal cortex (mPFC) to support learning and adaptive decision-making. MD receives driver (layer 5) and modulatory (layer 6) projections from PFC and is the main source of driver thalamic projections to middle cortical layers of PFC. Little is known about the activity of MD neurons and their influence on PFC during decision-making. We recorded MD neurons in rats performing a dynamic delayed nonmatching to position (dDNMTP) task and compared results to a previous study of mPFC with the same task (Onos et al., 2016). Criterion event-related responses were observed for 22% …

Jefferson Review - Fall 2017

Jefferson Review

INSIDE

Features

• 6 - Introducing the New Jefferson: One Name. Two Legacies. Infinite Possibilities.
• 10 - The PhiladlephiaU Story: A History of Change and Innovation
• 18 - Two Alumnae, One Vision: A New Home Base for All Graduates

• 2 - The Provost's Column
• 5 - The Families We Choose: A Message from Elizabeth Dale

On Campus

• 22 - College of Biomedical Sciences
• 22 - College of Health Professions
• 23 - College of Nursing
• 24 - College of Pharmacy
• 26 - Carol Ammon, BSN '17, MBA: A Brand-New Nurse, on a Mission
• 28 - Alia Salam, MPH '17: Helping Refugees on …

One Jefferson News October 2017, Performance Excellence

One Jefferson News

Over the past month, we have continued our One Jefferson journey and achieved a number of integration successes for the organization as well as our patient and student communities. In this issue of One Jefferson News, we invite you to join us in celebrating the recent addition of Kennedy to Jefferson Health and a new college structure for Jefferson (Philadelphia University + Thomas Jefferson University) set to launch in 2018.

During this time of continued organizational evolution, we recognize the importance of frequent communications and celebrating the many accomplishments of our talented team. If you have questions or ideas, we …

Assessing Genetic Expression Profiles In Melanoma Prognosis., Aaron S Farberg, Alex M Glazer, Richard R Winkelmann, Darrell S Rigel

Oncology Articles

A 31-genetic expression profile (31-GEP) test (DecisionDx-Melanoma, Castle Biosciences Inc, Friendswood, TX, USA) was developed as a diagnostic test to assist physicians in the management of cutaneous malignant melanoma. Based on a patient's primary tumor expression levels of a panel of genes (28 discriminating genes and 3 control genes), a lesion is classified as "low risk" (class 1) or "high risk" (class 2) for metastasis. Studies evaluating the clinical utility and impact of the 31-GEP test showed it positively influenced clinical management and patient care, as clinicians incorporated the additional data to modify their clinical recommendations in a risk-appropriate manner.

Case Of Undiagnosed Pneumocystis Pneumonia (Pcp, Verda Arshad, Nousheen Iqbal, Haider Ali Saleem, Muhammad Irfan

Section of Pulmonary & Critical Care

Pneumocystis pneumonia (PCP) is an opportunistic fungal infection that is usually seen in immunocompromised patients, especially those with HIV, malignancies, organ transplants and on drug therapies like chemotherapy and steroids. PCP has subacute presentation in patients with AIDS which if left untreated gets worse and is a significant cause of morbidity and mortality. Here we present a case of PCP went undiagnosed, partially due to the patient being unaware of his HIV positive status and partially because no organism could be found under the microscope.

Massage Therapy In Outpatient Cancer Care: A Metropolitan Area Analysis., Virginia S. Cowen, Robin Streit Miccio, Bijal Parikh

Department of Occupational Therapy Faculty Papers

Massage offers cancer patients general quality of life benefits as well as alleviation of cancer-related symptoms/cancer-treatment-related symptoms including pain, anxiety, and fatigue. Little is known about whether massage is accessible to cancer patients who receive treatment in the outpatient setting and how massage is incorporated into the overall cancer treatment plan. Outpatient cancer centers (n = 78) in a single metropolitan area were included this mixed-methods project that included a systematic analysis of website information and a telephone survey. Massage was offered at only 40 centers (51.3% of total). A range of massage modalities were represented, with energy-based therapies (Reiki …

Heroin Use Onset Among Nonmedical Prescription Opioid Users In The Club Scene, Hilary L. Surratt, Steven P. Kurtz, Mance Buttram, Maria A. Levi-Minzi, Maria E. Pagano, Theodore J. Cicero

Center for Health Services Research Faculty Publications

Background—Nonmedical prescription opioid use (NMPOU) is well documented among participants in the club scene, yet prior studies have not examined transition to heroin use. We prospectively examined heroin initiation among a sample of young adults with drug involvement associated with participation in the club scene, to understand factors that influence transition from NMPOU to heroin and to identify opportunities for intervention.

Methods—Data were drawn from a randomized trial that enrolled 750 Miami-based club and prescription drug users through respondent driven sampling, and tested the efficacy of assessment interventions in reducing risk. Participants reported current substance use at baseline, …

Video Microscope Robotic Arm-Assisted, Neuronavigation-Guided Glioma Resection And Regional Sampling, Muhammad Waqas, Ather Enam, Fauzan A Hashmi, Fatima Mubarak, Fazal Arain

Section of Neurosurgery

High-grade gliomas possess internal pathological heterogeneity. Selective sampling of different tumor regions can help in the study of this heterogeneity. In this report, we have described the use of a novel navigation and optical system for the selective regional sampling of a high-grade glioma lesion. A 45-year-old gentleman presented to us with complaints of intermittent frontal headaches for past eight months. On examination, he had subtle pyramidal weakness in left upper and lower extremities. Magnetic resonance imaging (MRI) showed a large contrast-enhancing, space-occupying lesion in the right frontal lobe causing perilesional edema and midline shift. We marked four different regions …

A Resident's Note, Syed Muhammad Mustahsan

Department of Emergency Medicine

No abstract provided.

Internal Mammary Artery Flow In Different Racial Groups Of Pakistan, Mudassir Iqbal Dar, Asim Hassan Dar, Mansoor Ahmed, Abdul Haseeb, Muhammad Bilal

Department of Biological & Biomedical Sciences

Objective: To find out any differences in free flow of internal mammary artery among different ethnic groups.
Methods: This observational, cross-sectional study was conducted at the Civil Hospital, Karachi, from January 2013 to December 2015, and comprised patients who underwent coronary artery bypass grafting. The participants were divided into 5 groups, i.e. Sindhi, Muslim migrants from India, Punjabi, Pathan and Balochi patients. Free flow of internal mammary artery was measured immediately after harvesting within a syringe, and its flow was measured in 30 seconds. SPSS 18 was used for data analysis.
Results: Of the 158 patients, 44(27.8%) …

Exosomal Microrna For Detection Of Cardiac Sarcoidosis., Elliott D Crouser, Nabeel Y Hamzeh, Lisa A Maier, Mark W Julian, May Gillespie, Mohammad Rahman, David Baxter, Xiaogang Wu, S Patrick Nana-Sinkam, Kai Wang

Articles, Abstracts, and Reports

No abstract provided.

Hne-Modified Proteins In Down Syndrome: Involvement In Development Of Alzheimer Disease Neuropathology, Eugenio Barone, Elizabeth Head, D. Allan Butterfield, Marzia Perluigi

Sanders-Brown Center on Aging Faculty Publications

Down syndrome (DS), trisomy of chromosome 21, is the most common genetic form of intellectual disability. The neuropathology of DS involves multiple molecular mechanisms, similar to AD, including the deposition of beta-amyloid (Aβ) into senile plaques and tau hyperphosphorylating in neurofibrillary tangles. Interestingly, many genes encoded by chromosome 21, in addition to being primarily linked to amyloid-beta peptide (Aβ) pathology, are responsible for increased oxidative stress (OS) conditions that also result as a consequence of reduced antioxidant system efficiency. However, redox homeostasis is disturbed by overproduction of Aβ, which accumulates into plaques across the lifespan in DS as well as …

Not All Evidence Is Created Equal: Changes In Practice Require The Highest Possible Level Of Statistical Testing, Sandy Hunter

EKU Faculty and Staff Scholarship

The practice of medicine has come a long way over the past 150 years. For example, routine use of leeches to remove “bad blood” no longer occurs, and everyone involved in healthcare knows to wear personal protective equipment.

Changes to practice have (at times) been slow in coming. However, we simply can no longer routinely rely on providing care without evidence that it works. Investigators conduct rigorous studies to determine the efficacy of treatments. This philosophy of testing clinical practices using research methods to validate their efficacy and safety is known as evidence-based medicine.1

Maximal Swim Distance, Time, And Heart Rate While Wearing Labor-Wear And A Personal Flotation Device, Reece Gendreau

Graduate Theses & Non-Theses

The purpose of this study was to determine if there was a correlation between heart rate and swim distance or swim. The ultimate goal was to determine how long or how far a person could swim while wearing labor-wear and a personal flotation device. Additional parameters of age, and ending oxygen saturation were taken to determine if age or O2 saturation could be factors that would be a limitation of swim time or distance. The following questions were answered: “Will there be a significant difference between males and females in any observed measurement?”, “Will there be a correlation between heart …

Neurological Improvement Of Perineural And Leptomeningeal Spread Of Squamous Cell Carcinoma Treated With Intrathecal Chemotherapy And Systemic Egfr Inhibition., Vincent Alexander Van Vugt, Marlon Garzo Saria, Andres Javier, Navin Kesari, Tiffany Turpin, Santosh Kesari

Articles, Abstracts, and Reports

Squamous cell carcinoma (SCC) is a common cancer of the skin. Risk factors include fair skin, excessive sun and ultraviolet light exposure, and history of xeroderma pigmentosa. Perineural invasion (PNI), an uncommon manifestation of SCC, involves microscopic tumor cells invading various layers of the nerve sheath. It is associated with a poorer prognosis. Standard treatment for PNI includes radiation therapy. Here, we describe a case an older gentleman with a history of SCC with PNI successfully treated with erlotinib and intrathecal chemotherapy.

Clinically Silent Alzheimer's And Vascular Pathologies Influence Brain Networks Supporting Executive Function In Healthy Older Adults, Brian T. Gold, Christopher A. Brown, Jonathan G. Hakun, Leslie M. Shaw, John Q. Trojanowski, Charles D. Smith

Neuroscience Faculty Publications

Aging is associated with declines in executive function. We examined how executive functional brain systems are influenced by clinically silent Alzheimer’s disease (AD) pathology and cerebral white matter hyperintensities (WMHs). Twenty-nine younger adults and thirty-four cognitively normal older adults completed a working memory paradigm while functional magnetic resonance imaging (fMRI) was performed. Older adults further underwent lumbar cerebrospinal fluid (CSF) draw for assessment of AD pathology and FLAIR imaging for assessment of WMHs. Accurate working memory performance in both age groups was associated with high fronto-visual functional connectivity (fC). However, in older adults, higher expression of fronto-visual fC was linked …

New Migraine With Visual Disturbance After Cryoballoon Ablation Of Atrial Fibrillation., Annupreet Nadha, Eric S Williams

Articles, Abstracts, and Reports

We report the case of a 58-year-old woman who developed a headache and visual disturbances after a cryoballoon ablation procedure for atrial fibrillation at our institution. She presented to the emergency department four days post ablation and was admitted the hospital for overnight observation. Serial neurological examinations and neuroimaging were unremarkable for stroke or transient ischemic attack. The patient had some brief transient visual changes which resolved completely after several days, with no further clinical sequelae. She followed up in the outpatient neuro-ophthalmology clinic and had a normal visual field examination. She was given a diagnosis of new onset migraine …

Hypothermic Cooling Measured By Thermal Magnetic Resonance Imaging; Feasibility And Implications For Virtual Imaging In The Urogenital Pelvis., Douglas Skarecky, Hon Yu, Jennifer Linehan, Blanca Morales, Min-Ying Su, Peter Fwu, Thomas Ahlering

Articles, Abstracts, and Reports

OBJECTIVE: To study the combination of thermal magnetic resonance imaging (MRI) and novel hypothermic cooling, via an endorectal cooling balloon (ECB), to assess the effective dispersion and temperature drop in pelvic tissue to potentially reduce inflammatory cascade in surgical applications.

METHODS: Three male subjects, before undergoing robot-assisted radical prostatectomy, were cooled via an ECB, rendered MRI compatible for patient safety before ECB hypothermia. MRI studies were performed using a 3T scanner and included T2-weighted anatomic scan for the pelvic structures, followed by a temperature mapping scan. The sequence was performed repeatedly during the cooling experiment, whereas the phase data were …

Counselor Allegiance And Client Expectancy In Neuroscience-Informed Cognitive-Behavior Therapy: A 12-Month Qualitative Follow-Up, Thomas A. Field, Eric T. Beeson, Laura K. Jones, Raissa Miller

Counselor Education Faculty Publications and Presentations

This article presents summative findings from a 12-month multiphase mixed-methods pilot study examining counselor and client perceptions of neuroscience-informed cognitive-behavior therapy (nCBT) following clinical application. Results from the first 6 months of the study indicated that the counselor's and client's beliefs about the credibility and effectiveness of nCBT (i.e., expectancy) remained stable from pretreatment to 6 months into treatment. The fourth phase of data collection at the 12-month interval followed an explanatory sequential process whereby the qualitative data were connected to earlier merged quantitative data to better understand initial findings from the first 6 months of the study. Results indicate …

Caring For Caregivers: Challenges Facing Informal Palliative Caregivers In Western Kenya, Hartlee Johnston

Independent Study Project (ISP) Collection

Chronic illnesses like cancer, HIV, and other non-communicable disease are increasing globally, especially in developing countries, necessitating development of palliative care and symptom management systems. In Kenya, the burden of care for chronically ill patients often falls to unpaid, informal caregivers like family members or friends. Thirty-five current or past informal caregivers from Kisumu, Kenya were interviewed about their experience, challenges they faced, and interventions they felt would be helpful. Major challenges identified included lack of finances for treatment and other living expenses; inadequate, unaffordable, or interrupted medical care; emotional stress exacerbated by juggling many responsibilities, pressure to emotionally support …

An Ethnobotanical Examination Of Traditional Medicine In Ngezi Forest Reserve, Tyler Tsang

Independent Study Project (ISP) Collection

Traditional medicine is an important aspect of the both the culture and health of communities worldwide. Ngezi Forest Reserve is a protected area on Pemba Island which is part of the Zanzibar Archipelago. This forest contains a wealth of botanical diversity which includes many species of medicinal plants. Traditional healers (waganga) use these medicinal plants to heal members of the community. Interviews and forest walks with these healers were supplemented by consultations with a botanist to determine medicinal value of the forest and the surrounding areas. In compiling information from 15 healers in the area, 98 species of medicinal plants …

Hss Advocate Alumni News Fall 2017, Department Of Health And Sport Sciences

Health and Sport Sciences Newsletter

• Congressman Pat Tiberi Visits HSS
• A Message from the Chair by Dr. Joan Rocks
• Eta Sigma Gamma Arrives at Otterbein
• HSS Alumni Survey Results
• HSS Leadership Advisory Board Update
• New Teacher of the Year 2017-Dr. Kristy McCray
• United Methodist Exemplary Teacher - Patti Wilson, M.S.
• 2017 Bread & Roses Award-Annette Boose
• Kate Weale Named OATA Athletic Trainer of the Year

Hss News Poster Fall 2017, Department Of Health And Sport Sciences

Health and Sport Sciences Newsletter

• Eta Sigma Gamma
• Commission on Accreditation of Athletic Training Education (CAATE)
• 100th Otterbein Homecoming

Preoperative Fluid Therapy To Decrease Postoperative Nausea And Vomitting In High Risk Populations: Practice Change Outcomes, Brandi Scarbrough Carmichael

Doctoral Projects

Postoperative nausea and vomiting (PONV) continues to be a negative complication that impacts patient satisfaction and potentiates unfavorable patient outcomes. Certified Registered Nurse Anesthetists (CRNA) are in a unique position to help alleviate this problem. However, CRNAs must be vigilant in utilizing evidence-based practices that decrease PONV and identifying patients who have increased risk factors for developing PONV.

For this doctoral project, an educational in-service on the use of preoperative fluid therapy to decrease PONV in high risk populations was held with participating CRNAs. This doctoral project’s main purpose was to evaluate CRNAs’ willingness to make a practice change after …

October 2017, Swosu Bulldog Wellness Committee

SWOSU BULLDOG WELLNESS

No abstract provided.

Mini-Craniotomy Under Local Anesthesia For Chronic Subdural Hematoma: An Effective Choice For Elderly Patients And For Patients In A Resource-Strained Environment, Shaikh Danish Mahmood, Muhammad Waqas, Mirza Zain Baig, Aneela Darbar

Medical College Documents

Background: Mini-craniotomy for chronic subdural hematoma (CSDH) is associated with lower rates of recurrence. However, the procedure is performed mostly with the patient under general anesthesia (GA) and therefore frequently requires an intensive care unit (ICU) facility, especially in the elderly population. Because of the unavailability of ICU beds, and to avoid GA, we started to perform this procedure with the patient under local anesthesia (LA).
Materials and methods: This was a retrospective medical chart review conducted in the section of Neurosurgery at the Aga Khan Hospital in Karachi, Pakistan. The study duration was 1 year. We included patients aged …

Oral Sildenafil Use In Neonates With Persistent Pulmonary Hypertension Of Newborn, Ali Shabbir Hussain, Syed Rehan Ali, Shakeel Ahmed, Farah Naz Qamar, Anila Haroon

Department of Paediatrics and Child Health

Background: The prevalence of PPHN has been estimated at 1.9 per 1000 live births. After the discovery of iNO's, its efficacy and benefit in PPHN is well established. Even in the best of centers equipped with iNo and ECMO the mortality is around 20%. Also, iNO is expensive and difficult to administer and monitor which makes it difficult choice in our part of the world. Furthermore About 40% of patients do not respond or have rebound pulmonary hypertension after discontinuation. Owing to these reasons, other treatment modalities like phosphodiesterase inhibitors such as Sildenafil need to be evaluated.
Methods: We report …

Is Obesity Endemic To Pakistan?, Fariha Hasan, Bilal Hasan

Medical College Documents

No abstract provided.

Sex Differences In Pediatric Exploratory Exposures: A Retrospective Review Of National Poison Data System (Npds) Exposures 2007-2016, Gillian A. Beauchamp Md, B Zane Horowitz Md, Esther K. Choo Md, Mph, Marna R. Greenberg Do, Mph, Facep, Daniel A. Spyker Md, Phd

Department of Emergency Medicine

No abstract provided.