Medicine and Health Sciences Commons^™

Blood Pressure Targets For Hypertension In Patients With Type 2 Diabetes, Wilbert S. Aronow, Tatyana Shamliyan

NYMC Faculty Publications

Background: Clinical guidelines vary in determining optimal blood pressure targets in adults with diabetes mellitus. Methods: We systematically searched PubMed, EMBASE, Cochrane Library, and clinicaltrials.gov in March 2018; conducted random effects frequentist meta-analyses of direct aggregate data; and appraised the quality of evidence using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) methodology. Results: From eligible 14 meta-analyses and 95 publications of randomized controlled trials (RCT), only 6 RCTs directly compared lower versus higher blood pressure targets; remaining RCTs aimed at comparative effectiveness of hypotensive drugs. In adults with diabetes mellitus and elevated systolic blood pressure (SBP), direct evidence …

Early Versus Late Intramedullary Nailing For Traumatic Femur Fracture Management: Meta-Analysis, Ayman El-Menyar, Mohammed Muneer, David Samson, Hassan Al-Thani, Ahmad Alobaidi, Paul Mussleman, Rifat Latifi

NYMC Faculty Publications

INTRODUCTION: There is no consensus yet on the impact of timing of femur fracture (FF) internal fixation on the patient outcomes. This meta-analysis was conducted to evaluate the contemporary data in patients with traumatic FF undergoing intramedullary nail fixation (IMN). METHODS: English language literature was searched with publication limits set from 1994 to 2016 using PubMed, Scopus, MEDLINE (OVID), EMBASE (OVID), Web of Science, and Cochrane Central Register of Controlled Trials (CENTRAL). Studies included randomized controlled trials (RCTs), prospective observational or retrospective cohort studies, and case-control studies comparing early versus late femoral shaft fractures IMN fixation. Variable times were used …

Cortical Gabaergic Interneuron/Progenitor Transplantation As A Novel Therapy For Intractable Epilepsy, Qian Zhu, Janice R. Naegele, Sangmi Chung

NYMC Faculty Publications

Epilepsy is a severe neurological disease affecting more than 70 million people worldwide that is characterized by unpredictable and abnormal electrical discharges resulting in recurrent seizures. Although antiepileptic drugs (AEDs) are the mainstay of epilepsy treatment for seizure control, about one third of patients with epilepsy suffer from intractable seizures that are unresponsive to AEDs. Furthermore, the patients that respond to AEDs typically experience adverse systemic side effects, underscoring the urgent need to develop new therapies that target epileptic foci rather than more systemic interventions. Neurosurgical removal of affected brain tissues or implanting neurostimulator devices are effective options only for …

Formative Research To Identify Community Partnerships And Foster Relationships For Health Promotion Research In South Mississippi, Jennifer Lemacks, Alicia Landry, Peyton Wenzler

Faculty Publications

Objectives: The purpose of this short communication is to describe the trust building and collaboration, fostering phases of a community-academic partnership between churches and academic researchers using a community-based participatory research approach.

Study design and methods: An academic-community partnership with church leaders was initiated using survey administration and was further developed using focus groups. A coalition was developed, and it guided a subsequent focus group with church members.

Results: Most churches surveyed did not have a health ministry in place but were agreeable that a variety of health topics were appropriate for the church setting. Church leaders …

Postural Hyperventilation As A Cause Of Postural Tachycardia Syndrome: Increased Systemic Vascular Resistance And Decreased Cardiac Output When Upright In All Postural Tachycardia Syndrome Variants, Julian M. Stewart, Paul Pianosi, Mohamed A. Shaban, Courtney Terilli, Maria Svistunova, Paul Visintainer, Marvin S. Medow

NYMC Faculty Publications

BACKGROUND: Postural tachycardia syndrome (POTS) is a heterogeneous condition. We stratified patients previously evaluated for POTS on the basis of supine resting cardiac output (CO) or with the complaint of platypnea or "shortness of breath" during orthostasis. We hypothesize that postural hyperventilation is one cause of POTS and that hyperventilation-associated POTS occurs when initial reduction in CO is sufficiently large. We also propose that circulatory abnormalities normalize with restoration of CO2. METHODS AND RESULTS: Fifty-eight enrollees with POTS were compared with 16 healthy volunteer controls. Low CO in POTS was defined by a resting supine CO /min. Patients with shortness …

Assessing Vancomycin Dosing Per Pharmacy In Elderly Patients Over The Age Of 74 Years, Lee H. Nguyen, Martin Breen, Jason Yamaki, Geraldine Cadalin, Nilomi Shah, Linda Lumintaintang

Pharmacy Faculty Articles and Research

Vancomycin has a complex pharmacokinetic profile and carries potential risks for nephrotoxicity and ototoxicity. The pharmacokinetic profile in elderly patients significantly differs from that of younger patients. It is common practice in many institutions for pharmacists to intentionally round serum creatinine levels to 1 mg/dl in elderly patients with levels <1 mg/ dl to avoid overestimating clearance and toxicities. This can potentially lead to underestimation of creatinine clearance, and subsequently lead to vancomycin under dosing. The aim of this study was to evaluate vancomycin target trough attainment and the time to trough attainment with vancomycin dosing per pharmacy in elderly patients.

Acinetobacter Infections: A Retrospective Study To Determine In – Hospital Mortality Rate And Clinical Factors Associated With Mortality, Rajiv Patel

Master of Medicine in Internal Medicine

Background: Acinetobacter infections are increasingly being recognized as a cause for significant in – hospital morbidity and mortality worldwide. Increasingly multi – drug resistant strains of Acinetobacter are being isolated, increasing the burden on healthcare resources. Our objectives were to determine the outcomes and clinical factors related to outcomes of Acinetobacter infections at the Aga Khan University Hospital. Methods: A retrospective study of Acinetobacter infections (from any site) was conducted. Patient records were used to gather relevant clinical information. The collected data was tabulated and analysed for any significant differences in demographic or clinical variables. The Pearson Chi squared test …

A Study On Knowledge, Attitude And Approach Towards Research Methodology Amongst Malaysian Medical Students, Sujata Khobragade, Yadneshwar Khobragade, Adinegara Bin Lutfi Abbas

Manipal Journal of Medical Sciences

This cross-sectional study was conducted on MBBS (6th and 7th semester) III year students at Melaka Manipal Medical College Muar campus in Malaysia from November 2016 to January 2017. Total participants were 142 students, 88 women and 53 men. Seventy-eight students were from 6th semester and 64 students from 7th semester. The students were tested for knowledge, attitude and approach towards research methodology and its application in research. More than 95 % of the students felt the need for inclusion of research methodology in medical education (p

The Relevance Of Global Health Training In Medical Education – A Plea For A Global Health Curriculum, Mieke Van Driel, Leonardo Seoane

Manipal Journal of Medical Sciences

There has been an increasing demand for global health experiences from medical students. Many embark on short-term elective experiences arranged by the students themselves without learning objectives or in some incidences without appropriate supervision. Recently published guidelines address the concerns with short-term global health electives regarding the host, sending site, and students. The authors review the literature and speak on the value of global health training through the perspective of the partnership with the University of Queensland, Australia and Ochsner Health System, United States and the partnership of the University of Queensland with Manipal Academy of Higher education (MAHE), India

Pancreatic Pseudocyst, A Delayed Complication Of Organophosphorus Poisoning, Dhunputh P, Mohammed A. P, Bhatt A, Saraswat P. P, Umakanth S

Manipal Journal of Medical Sciences

Acute pancreatitis is a rare, but life-threatening complication of organophosphorus (OP) compounds, and generally shows a subclinical course. In this case, acute pancreatitis and the pseudocysts were diagnosed nearly two weeks post OP ingestion. Possible etiological factors for acute pancreatitis (alcohol, biliary disease, medication, and others) were excluded. Since the patient had a history of OP ingestion, we diagnosed Organophosphorus-induced acute pancreatitis. The CT images showed clearly defined pseudocysts on the pancreas. Supportive medical care and total parenteral nutrition are frequently employed treatment modalities for pancreatic pseudocysts, and we followed the same. Patient was discharged after he showed symptomatic improvement …

Relationship Of Family Members’ Support With Practice Of Community Midwives In Rural Sindh, Pakistan, Farida Shah, Farhana Shahid, Jamila Haider, Syfoor Ali, Bibi Ara, Misri Bano

Journal of Asian Midwives (JAM)

Background: Pakistan has one of the highest maternal mortality rates in the world. Community Midwives (CMWs) were introduced in 2006 as a new cadre of birth attendants who would bring midwifery services to rural areas by being based in designated communities. The CMWs face many obstacles and retaining them in practice is a challenge. This study aimed to examine whether there was a relationship between family support and CMWs retention in midwifery practice. We hoped to learn about influences on retention that might improve the Maternal Newborn and Child Health (MNCH) programme.
Methods: This was a cross-sectional survey conducted in …

Gender Inequalities And Childbearing: A Qualitative Study Of Two Maternity Units In Nepal, Lesley Milne, Jillian C M Ireland Ms, Edwin Van Teijlingen, Vanora Hundley, Padam P. Simkhada

Journal of Asian Midwives (JAM)

The role and status of women in South Asian countries like Nepal are widely recognised to be lower than that of men. This gender inequality can be found throughout all levels of society. Our study is about the influence of gender on pregnancy and childbirth, which are very much in the female domain in South Asia, both at home and in health facilities.
A mixed-method, qualitative research study was undertaken in two birthing facilities in Kathmandu Valley to examine barriers to women accessing these services from the perspective of hospital staff. Thematic analysis identified seven subthemes related to gender, namely: …

Doctor As Ministering Angel, Not God, Sagarika Ghose

Manipal Journal of Medical Sciences

No abstract provided.

Blood Group Chimerism Is Not Rare Anymore, Mohandoss Murugesan, Vinu Rajendran

Manipal Journal of Medical Sciences

ABO discrepancies due to mixed-field agglutination are commonly seen with subgroups of A or B and ABOincompatible RBC transfusion in routine immunohematology laboratory. We report a 20 year old male with minor ABO and Rh D mismatched hematopoietic stem cell transplantation presenting with blood group chimerism. Column agglutination technique (CAT) had advantages in detecting mixed field agglutination than other techniques used in routine blood grouping

Non-Autoimmune Hypothyroidism Induced Cerebellar Atrophy, Saumya H. Mittal, Rakshith K. C, Misri Z. K, Shivananda Pai

Manipal Journal of Medical Sciences

A 45-year-old gentleman, non-diabetic, normotensive, non-alcoholic and non-smoker presented with the complaints of insidious onset, progressive imbalance while walking, with occasional falls for the past six to eight months. The patient had no other complaints. He had exaggerated reflexes and loss of vibration sense. He also had wide based ataxic gait, with inability to perform fine coordinated actions. He had associated nystagmus. MRI brain suggested cerebellar atrophy. The thyroid profile was TSH- 176.9 mIU/l, FT3- 0.963 pmol/L, FT4- 0.023 pmol/L and antibodies were negative. All other parameters like complete blood count, renal and hepatic function tests, peripheral smear, vitamin B12, …

Borrelia Burgdorferi Spovg Dna- And Rna-Binding Protein Modulates The Physiology Of The Lyme Disease Spirochete, Christina R. Savage, Brandon L. Jutras, Aaron Bestor, Kit Tilly, Patricia A. Rosa, Yvonne Tourand, Philip E. Stewart, Catherine A. Brissette, Brian Stevenson

Microbiology, Immunology, and Molecular Genetics Faculty Publications

The SpoVG protein of Borrelia burgdorferi, the Lyme disease spirochete, binds to specific sites of DNA and RNA. The bacterium regulates transcription of spoVG during the natural tick-mammal infectious cycle and in response to some changes in culture conditions. Bacterial levels of spoVG mRNA and SpoVG protein did not necessarily correlate, suggesting that posttranscriptional mechanisms also control protein levels. Consistent with this, SpoVG binds to its own mRNA, adjacent to the ribosome-binding site. SpoVG also binds to two DNA sites in the glpFKD operon and to two RNA sites in glpFKD mRNA; that operon encodes genes necessary for glycerol catabolism …

A Reference Guide: Six Practical Tips For Understanding Data On Female Genital Mutilation/Cutting (Fgm/C), Charlotte Greenbaum, Reshma Naik

Reproductive Health

The Population Reference Bureau (PRB) was a core partner on the Population Council’s Evidence to End FGM/C: Research to Help Girls and Women Thrive—a UKAID-funded research program to help end female genital mutilation/cutting (FGM/C) within one generation. Their role was to build the consortium’s capacity for research utilization and to develop innovative tools and products to improve how researchers communicate their findings about FGM/C to key decisionmakers.
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A Comprehensive Safety Trial Of Chimeric Antibody 14.18 With Gm-Csf, Il-2, And Isotretinoin In High-Risk Neuroblastoma Patients Following Myeloablative Therapy: Children's Oncology Group Study Anbl0931, Mehmet Ozkaynak, Andrew L. Gilman, Arlene Naranjo, Robert Seeger, Julie R. Park, Paul M. Sondel, Alice L. Yu

NYMC Faculty Publications

Purpose: A phase 3 randomized study (COG ANBL0032) demonstrated significantly improved outcome by adding immunotherapy with ch14.18 antibody to isotretinoin as post-consolidation therapy for high-risk neuroblastoma (NB). This study, ANBL0931, was designed to collect FDA-required safety/toxicity data to support FDA registration of ch14.18. Experimental design: Newly diagnosed high-risk NB patients who achieved at least a partial response to induction therapy and received myeloablative consolidation with stem cell rescue were enrolled to receive six courses of isotretinoin with five concomitant cycles of ch14.18 combined with GM-CSF or IL2. Ch14.18 infusion time was 10-20 h per dose. Blood was collected for cytokine …

Zika Virus Non-Structural Protein 4a Blocks The Rlr-Mavs Signaling, Jinzhu Ma, Harshada Ketkar, Tingting Geng, Emily Lo, Long Yang, Penghua Wang, Tingting Geng

NYMC Faculty Publications

Flaviviruses have evolved complex mechanisms to evade the mammalian host immune systems including the RIG-I (retinoic acid-inducible gene I) like receptor (RLR) signaling. Zika virus (ZIKV) is a re-emerging flavivirus that is associated with severe neonatal microcephaly and adult Guillain-Barre syndrome. However, the molecular mechanisms underlying ZIKV pathogenesis remain poorly defined. Here we report that ZIKV non-structural protein 4A (NS4A) impairs the RLR-mitochondrial antiviral-signaling protein (MAVS) interaction and subsequent induction of antiviral immune responses. In human trophoblasts, both RIG-I and melanoma differentiation-associated protein 5 (MDA5) contribute to type I interferon (IFN) induction and control ZIKV replication. Type I IFN induction …

Percepciones Ante La Preparación Al Alta En Pacientes Médico-Quirúrgicos De Un Hospital De Alta Complejidad, Viviana Silva, Pilar Espinoza Quiroz, Marianne E. Weiss

College of Nursing Faculty Research and Publications

Objetivo principal:

Analizar la relación entre las percepciones de la calidad de educación al alta y la disposición de pacientes para ser dados de alta.

Metodología:

Se aplicaron la Escala de la Calidad de la Educación al alta (Quality of Discharge Teaching Scale - QDTS) y la Escala para ver si los pacientes están listos para el alta (Readiness Hospital Discharge Scale – RDHS), 1 a 2 horas previas al alta.

Resultados principales:

Los puntajes en la Escala de la Calidad de la Educación al alta explicaron el 22% de la varianza en las …

Reply To Om Shannon Et Al, Lauren C. Blekkenhorst, Joshua R. Lewis, Richard L. Prince, Amanda Devine, Nicola P. Bondonno, Catherine P. Bondonno, Lisa G. Wood, Ian B. Puddey, Natalie C. Ward, Kevin D. Croft, Richard J. Woodman, Lawrence J. Beilin, Jonathan M. Hodgson

Research outputs 2014 to 2021

No abstract provided.

The Effects Of Alcohol On Plasma Lipid Mediators Of Inflammation Resolution In Patients With Type 2 Diabetes Mellitus, Anne Barden, Sujata Shinde, Michael Phillips, Lawrence Beilin, Emilie Mas, Jonathan M. Hodgson, Ian Puddey, Trevor A. Mori

Research outputs 2014 to 2021

Background: Type 2 diabetes mellitus is characterized by peripheral insulin resistance and low-grade systemic inflammation. Inflammation resolution is recognised as an important process driven by specialised pro-resolving mediators of inflammation (SPMs) and has the potential to moderate chronic inflammation. Alcohol has the potential to affect synthesis of SPMs by altering key enzymes involved in SPM synthesis and may influence ongoing inflammation associated with Type 2 diabetes mellitus.

Aims: (i) To examine the effects of alcohol consumed as red wine on plasma SPM in men and women with Type 2 diabetes in a randomised controlled trial and (ii) compare baseline plasma …

Ubxn3b Positively Regulates Sting-Mediated Antiviral Immune Responses, Long Yang, Leilei Wang, Harshada Ketkar, Jinzhu Ma, Guang Yang, Dana G. Mordue, Penghua Wang

NYMC Faculty Publications

The ubiquitin regulatory X domain-containing proteins (UBXNs) are likely involved in diverse biological processes. Their physiological functions, however, remain largely unknown. Here we present physiological evidence that UBXN3B positively regulates stimulator-of-interferon genes (STING) signaling. We employ a tamoxifen-inducible Cre-LoxP approach to generate systemic Ubxn3b knockout in adult mice as the Ubxn3b-null mutation is embryonically lethal. Ubxn3b(-/-), like Sting(-/-) mice, are highly susceptible to lethal herpes simplex virus 1 (HSV-1) and vesicular stomatitis virus (VSV) infection, which is correlated with deficient immune responses when compared to Ubxn3b(+/+) littermates. HSV-1 and STING agonist-induced immune responses are also reduced in several mouse and …

Oncogenic Potential And Clinical Implications Of Giant Endometrial Polyps: A Case Report And Literature Review, Brittany Van Staalduinen, Andrew Stahler, Catherine Abied, Rita Shats, Nisha A. Lakhi

NYMC Faculty Publications

Endometrial polyps exceeding 4 centimeters in length are exceedingly rare and are termed "giant polyps." We describe two patients that presented to our hospital with giant endometrial polyps. Clinical implications and oncologic potential of giant endometrial polyps are discussed. Risk factors of oncologic transformation include advanced age, menopausal status, obesity, diabetes, arterial hypertension, use of tamoxifen, and size greater than 1.0 centimeter. A literature review of all documented cases of giant endometrial polyps is presented and management strategies for counseling and polypectomy are reviewed.

Additive Drug-Specific And Sex-Specific Risks Associated With Co-Use Of Marijuana And Tobacco During Pregnancy: Evidence From 3 Recent Developmental Cohorts (2003-2015)., Suena H Massey, Daniel K Mroczek, David Reiss, Emily S Miller, Jessica A Jakubowski, Eileen K Graham, Shannon M Shisler, Meaghan Mccallum, Marilyn A. Huestis, Jody M Ganiban, Daniel S Shaw, Leslie D Leve, Rina D Eiden, Laura R Stroud, Jenae M Neiderhiser

Institute of Emerging Health Professions Faculty Papers

BACKGROUND: Methodologic challenges related to the concomitant use (co-use) of substances and changes in policy and potency of marijuana contribute to ongoing uncertainty about risks to fetal neurodevelopment associated with prenatal marijuana use. In this study, we examined two biomarkers of fetal neurodevelopmental risk-birth weight and length of gestation-associated with prenatal marijuana use, independent of tobacco (TOB), alcohol (ALC), other drug use (OTH), and socioeconomic risk (SES), in a pooled sample (N = 1191) derived from 3 recent developmental cohorts (2003-2015) with state-of-the-art substance use measures. We examined differential associations by infant sex, and multiplicative effects associated with co-use of …

Shifts In Assemblage Of Foraging Bats At Mammoth Cave National Park Following Arrival Of White-Nose Syndrome, Marissa M. Thalken, Michael J. Lacki, Joseph S. Johnson

Forestry and Natural Resources Faculty Publications

The arrival of white-nose syndrome (WNS) to North America in 2006, and the subsequent decline in populations of cave-hibernating bats have potential long-term implications for communities of forest-dwelling bats in affected regions. Severe declines in wintering populations of bats should lead to concomitant shifts in the composition and relative abundance of species during the staging, maternity, and swarming seasons in nearby forested habitats. We examined capture rates of bats collected in mist nets from 2009 to 2016 to evaluate summer patterns in abundance of species pre- and post-arrival of WNS to Mammoth Cave National Park, KY. The data demonstrated a …

Amniotic Fluid Embolism, Nadia Nawaz, Ahmed Raheem Buksh

Department of Obstetrics & Gynaecology

Amniotic fluid embolism is a rare and severe problem in obstetric patients. We experienced a 21-year primigravida who underwent emergency cesarean section due to sudden collapse and fetal distress after rupture of membranes in labour. Subsequently, she developed intraoperative coagulopathy, hemorrhage, hypotension, and respiratory collapse requiring ventilation. Both maternal and neonatal lives were saved with full recovery and discharged in stable condition. The clinical diagnosis of amniotic fluid embolism (AFE) was made, which is a very rare complication of pregnancy/puerperium with varying presentation, ranging from cardiac arrest, circulatory collapse and death through mild degrees of organ system dysfunction with or …

Nursing With The Heart Of Christ, Gwen E. Boda

Senior Honors Theses

Within the nursing profession it is necessary for the nurse to learn to have love, compassion, joy, peace, patience, humility, and integrity within his/her character. After reviewing numerous peer reviewed journals and personal examples, the following paper reveals how these traits – love, compassion, joy, peace, patience, humility, and integrity – are beneficial within the nursing profession. The paper defines the mentioned characteristics, shows how they can be used and implemented within the nursing practice, demonstrates how their implementation leads to greater patient care, and then compares these traits and actions to the character and person of Christ.

Nutrinews: Volume 41. June 2018, Department Of Nutrition And Dietetics, University Of North Florida

NutriNews

This issue features June 17: Eat your veggies day, Muscle Growth from Fish Oil? and Happy National Fresh Fruit and Vegetables Month.

Effect Of Adding Stretching Techniques To Standardized Intervention On Nonspecific Mechanical Neck Pain, Saad S. Alfawaz

Loma Linda University Electronic Theses, Dissertations & Projects

Mechanical neck pain is becoming one of the leading causes of musculoskeletal disorders in the general adult population. Mobilization intervention is considered one of the most effective therapeutic techniques to treat non-specific neck pain. The purpose of this study was to investigate the benefit of adding stretching exercises as part of a rehabilitation program for patients with non-specific mechanical neck pain. Methods: Thirty-eight subjects with non-specific neck pain for at least 2 weeks with mean± SD age 30.9±8.1 years and body mass index (BMI) 26.8±6.7 kg/m2 participated in the study. Participants were randomly assigned to either the combined intervention (passive …