Medicine and Health Sciences Commons^™

Bowel Function And Care - Guidelines For The Care Of People With Spina Bifida, Patricia Beierwaltes, Paige Church, Tiffany Gordon, Lusine Ambartsumyan

School of Nursing Publications

PURPOSE:

Bowel dysfunction, such as constipation and fecal incontinence, has a significant impact on health, activities of daily living, and quality of life among people with spina bifida. Secondary complications may result from bowel dysfunction and include urologic dysfunction, loss of skin integrity, shunt (hydrocephalus) function, as well as loss of social opportunities and employability.

METHODS:

Using a consensus building methodology, the guidelines for management of bowel dysfunction in spina bifida were written by experts in the field of spina bifida and bowel function and care.

RESULTS:

The evidence-based guidelines are presented in table format and provide age-specific recommendations to …

Modulation Of Immune Checkpoints By Chemotherapy In Human Colorectal Liver Metastases., Neda Jabbari, Heidi L Kenerson, Christopher Lausted, Xiaowei Yan, Changting Meng, Kevin M Sullivan, Priyanka Baloni, Dani E Bergey, Venu G Pillarisetty, Leroy Hood, Raymond S Yeung, Qiang Tian

Articles, Abstracts, and Reports

Metastatic colorectal cancer (CRC) is a major cause of cancer-related death, and incidence is rising in younger populations (younger than 50 years). Current chemotherapies can achieve response rates above 50%, but immunotherapies have limited value for patients with microsatellite-stable (MSS) cancers. The present study investigates the impact of chemotherapy on the tumor immune microenvironment. We treat human liver metastases slices with 5-fluorouracil (5-FU) plus either irinotecan or oxaliplatin, then perform single-cell transcriptome analyses. Results from eight cases reveal two cellular subtypes with divergent responses to chemotherapy. Susceptible tumors are characterized by a stemness signature, an activated interferon pathway, and suppression …

2020-12-22_Michigandaily_Covidmap, Michigan Department Of Health & Human Services

Daily Michigan COVID-19 Update

The "WHERE WE STAND WITH COVID-19" map was obtained from Michigan's main COVID-19 page: https://www.michigan.gov/coronavirus. Data was compiled by the Michigan Department of Health and Human Services (MDHHS). The information was updated daily at 3p.m., Monday - Saturday.

The State of Michigan is working around the clock to test and treat COVID-19 patients. Below is the most recent data healthcare experts across the state have compiled.

The image contained a map, indicating total cases by county, and also provides statistics on Total Confirmed Cases, Total COVID-19 Deaths, Daily Confirmed Cases, and Daily COVID-19 Deaths. There …

2020-12-22_Michiganoverview_Covidstats, Michigan Department Of Health & Human Services

Cumulative Michigan COVID-19 Data

The COVID Overview page was obtained from Michigan's main COVID-19 page: https:/www.michigan.gov/coronavirus/0,9753,7-406-98163-520743--,00.html.

The State of Michigan is working around the clock to test and treat COVID-19 patients. Below is the most recent data healthcare experts across the state have compiled. It is updated Monday - Saturday.
This report is provisional and subject to change. City of Detroit and Wayne County are reported separately. MDHHS began tracking probable cases April 5, 2020. FCI indicates federal correctional institute. MDOC indicates Michigan Department of Corrections. Diagnostic tests, including nucleic acid amplification/real-time polymerase chain reaction (NAAT/RT-PCR) and rapid virus antigen detection point of …

Development And Preliminary Clinical Activity Of Pd-1-Guided Ctla-4 Blocking Bispecific Dart Molecule., Alexey Berezhnoy, Bradley J Sumrow, Kurt Stahl, Kalpana Shah, Daorong Liu, Jonathan Li, Su-Shin Hao, Anushka De Costa, Sanjeev Kaul, Johanna Bendell, Gregory M Cote, Jason J Luke, Rachel E Sanborn, Manish R Sharma, Francine Chen, Hua Li, Gundo Diedrich, Ezio Bonvini, Paul A Moore

Articles, Abstracts, and Reports

Combination immunotherapy with antibodies directed against PD-1 and CTLA-4 shows improved clinical benefit across cancer indications compared to single agents, albeit with increased toxicity. Leveraging the observation that PD-1 and CTLA-4 are co-expressed by tumor-infiltrating lymphocytes, an investigational PD-1 x CTLA-4 bispecific DART molecule, MGD019, is engineered to maximize checkpoint blockade in the tumor microenvironment via enhanced CTLA-4 blockade in a PD-1-binding-dependent manner.

Dietary Intake Of A Sample Of Stunted Egyptian Preschool Children, Amina S. Soliman, Hoda A. Abdel Salam, Saher A. Khairy, Salwa M. Saleh

Journal of Medicine in Scientific Research

Background Growth retardation is highly prevalent among children. Infections and inadequate food intake are well-established causes of growth retardation. Nutrition plays a key role in the control of linear growth. Objective The aim was to assess dietary intake of stunted Egyptian preschool children. Participants and methods The study was designed as a case–control study that included 100 Egyptian children aged 2 to less than 6 years old with delayed linear growth, proportionate stunting, who were randomly selected from the stunted outpatient clinic of National Nutrition Institute. Their results were compared with age-matching and sex-matching controls. All participants were subjected to …

Assessment Of The Nutritional Status Of Malnourished School-Age Egyptian Children, Hoda A. Abed-El Salam, Sally R. Eid, Salwa M. Saleh

Journal of Medicine in Scientific Research

Background The nutritional status of school-age children is a primary determinant of children's health, as it influences their physical and mental development. The aim of this study was to assess the nutritional status and dietary intake of macronutrients and micronutrients in a sample of malnourished school-age children (5–12 years) in Egypt. Patients and methods This was a cross-sectional study that included school-age children (5–12 years) recruited from the outpatient clinic of the National Nutrition Institute, Cairo, Egypt. Participants sampling was performed during the period from June to August 2019. In this study, 85 children of both sexes were enr?olled. Results …

Comparison Of Aims65, Glasgow-Blatchford, And Pre-Endoscopy Rockall Scoring Systems For Risk Stratification In Egyptian Patients With Upper Gastrointestinal Bleeding, El Saied E. Shabaan, Tarek A. Fouad

Journal of Medicine in Scientific Research

Background Upper gastrointestinal bleeding (UGIB) is a serious medical emergency. Many scoring systems have been developed to predict bleeding outcomes for patients with UGIB. Recently, the guidelines recommend use of risk scores in UGIB to facilitate accurate triage and assist in clinical decisions. The aim of this study was to compare the AIMS65 with the Glasgow–Blatchford score (GBS) and the pre-endoscopy Rockall score (PRS) for risk stratification among Egyptian patients with UGIB. Patients and methods This prospective study involved 74 adult patients with UGIB. Clinical data, biochemical data, transfusion requirements, endoscopic interventions, and duration of hospitalization were collected. AIMS65, GBS, …

Comparison Between Short And Long Letrozole Therapy For Ovulation Induction In Clomiphene.Resistant Women With Polycystic Ovarian Syndrome, Mohamed A. El-Naggar

Journal of Medicine in Scientific Research

Objective

The aim of this study is to compare the effect of the short and long letrozole therapy for ovulation induction in clomiphene‑resistant women with polycystic ovary syndrome. Design

This was a prospective study. Patients and methods

Sixty infertile women were selected from the patients attending the outpatient clinic of Benha Teaching Hospital. All patients were diagnosed as having anovulation due to polycystic ovary syndrome. Intervention

Patients were randomly allocated to treatment with either long letrozole therapy (\[n=30;\] three cycles) or short letrozole therapy (\[n=30;\] three cycles). Main outcome measure

Number of growing, mature follicles and the occurrence of pregnancy. …

Radiofrequency Endogenous Ablation And Concomitant Sclerotherapy, Ihab N. A. Hanna, Khaled Elkafas

Journal of Medicine in Scientific Research

Background Varicose veins are a widespread disease with various treatment modalities ranging from classic saphenofemoral crossectomy and ligation and stripping to various minimally invasive interventional procedures. The era of endovenous interventions has now stabilized head to head in results with surgical procedures, hence the shift to minimally invasive procedures. All minimal invasive endovenous procedures have excellent results, particularly when correctly selected according to the varicose vein case and the treated vein. Thermal ablation techniques are now established and have reliable and satisfactory outcomes, yet nonthermal techniques have offered further options. This article provides a novel approach combining the usage of …

Right Anterolateral Thoracotomy As An Alternative Approach To Resternotomy For High-Risk Cardiac Surgery Patients, Maged M. A. Kisho

Journal of Medicine in Scientific Research

Introduction Redocardiac valve surgery through median sternotomy is associated with a potential increased risk of morbidity and mortality. The study was done at the National Heart Institute of Egypt from June 2016 to June 2018 to evaluate the right anterolateral thoracotomy for high-risk patients undergoing mitral and tricuspid valve redo procedures. Patients and methods This study includes 26 patients operated through right anterolateral thoracotomy which include high-risk group on the basis of the proximity of sternum to the right ventricle or great vessels, mainly ascending aorta. Moreover, the presence and location of patent grafts were assessed. Results In right submammary …

Successful Surgical Management Of Intracerebral Hydatid Cyst In Children: Timing, Procedure, And Adjuvant Treatment, Sameh M. Saleh

Journal of Medicine in Scientific Research

Background Cerebral hydatid cysts are very rare, and surgery, with its inherent risk of rupture and spillage of cyst contents, has been the traditional treatment. The goal of surgery is to remove the cysts without rupture. Aim The aim of this review was to investigate the surgical technique of removing cerebral hydatid cysts in children, to show the possible pitfalls of surgery and to assess the effect of adjuvant preoperative and postoperative medical treatment. Patients and methods This retrospective analysis included four patients who underwent surgery for an intracranial hydatid cyst at the Department of Neurosurgery, Matarya Teaching Hospital. The …

Complications Of Decompressive Lumbar Spine Procedures Without Instrumentations – An Institutional Experience, Ayman Wageh, Ihap Bedier, Mohamed Mousa, Ramadan Shamseldein

Journal of Medicine in Scientific Research

Background Till now, there is insufficient documentation of operative complications in spine surgery, and the expected results are far less predictable if the actual indication for surgical intervention is not clear. Complication could be defined as 'a condition that directly or indirectly results from surgical intervention and disrupts the planned outcome of the surgery.' So, spine surgeons should be aware of these events and know how to deal with them. Aim To detect the number and percentage of moderate and/or major operation-related complications associated with the relatively repeated and popularized neurosurgical procedures performed at the Neurosurgical Department, Shebin Elkom Teaching …

Study Of Motor And Sensory Nerve Conduction Of Wrist Palm And Palm-Finger Segments Of Median Nerve And Studying Their Contribution In Diagnosis Of Carpal Tunnel Syndrome, Abeer H. Ismaiel

Journal of Medicine in Scientific Research

Objectives Our objective is to report a modified and simplified technique of sensory and motor segmental conduction studies to improve diagnostic sensitivity, especially in cases with mild carpal tunnel syndrome (CTS). Patients and methods Patients with suspected CTS referred to our electrophysiology laboratory and a control group were included. The data were collected prospectively. The following measurements made: median sensory conduction velocity wrist digit 1(W-1), median sensory conduction velocity wrist digit 3 (W-3), median wrist palm sensory conduction velocity (W-Ps), distoproximal ratio of velocity (D/P), median distal motor latency wrist (MDML) -APB (Abductor pollicis brevis), and median wrist -palm segment …

Novel Technique Of Vein Harvesting For Reversed Saphenous Vein Bypass Graft, Ihab N. A. Hanna

Journal of Medicine in Scientific Research

Background The technique of harvesting the great saphenous vein for bypass procedures may affect the results of the procedure. We describe a simple modification of the vein harvesting technique, which consists of leaving the saphenofemoral junction intact after completion of the proximal anastomosis. This modification allows blood to flow into the vein as soon as the proximal anastomosis is completed, thereby shortening the vein warm ischemia time and allowing the vein to distend with blood rather than saline, under physiologic pressure. This modification aims at improved vein integrity during harvesting and therefore improved graft patency. Patients and methods In this …

Tracheostomy In Covid-19-Infected Patients, Mohammad M. Gaballah, Wael M. H Eldin Eldrandaly

Journal of Medicine in Scientific Research

Purpose To evaluate the modifications in the indications and technique of tracheostomy for prolonged-intubated COVID-19-infected patients. Methodology Commissioned by the Ministry of Health in Egypt, different guidelines for tracheostomy for COVID-19 patients were revised. A guideline was adopted and modified to meet the equipment provided by facilities assigned to contain the current pandemic. The understanding of staff and the applicability of the new guidelines were evaluated using a mini-summative quiz answered by 117 tracheostomy team members in facilities around Grand Cairo, Egypt. Results The percentages of consistent answers for questions 1–6 were 94, 90.60, 89.70, 95.70, 61.50, and 93.20%, respectively. …

Elderly Musculoskeletal Disease Burden In Karachi, Pakistan: Associations And Implications For Developing Countries, Saniya Sabzwari, Zafar Fatmi, Adeel Ahmed Khan

Department of Family Medicine

Objective: The global rise in the older population has increased the rates of osteoporosis and osteoarthritis, conditions that impact mobility and functionality. There is limited data on musculoskeletal disease in older populations residing in developing countries.
Methods: A community-based study using multistage cluster random sampling of older individuals was conducted in Karachi. Predefined criteria were used for osteoporosis and osteoarthritis. Gait assessment was performed.
Results: More than half of the participants were females and 53% reported illiteracy. Around 30% had osteoporosis and two-thirds had osteoarthritis. Multivariate analysis showed associations of female sex, Pashtun ethnicity, illiteracy, and hypertension with the combined …

The Er Stress/Upr Axis In Chronic Obstructive Pulmonary Disease And Idiopathic Pulmonary Fibrosis., Mahmoud Aghaei, Sanaz Dastghaib, Sajjad Aftabi, Mohamad-Reza Aghanoori, Javad Alizadeh, Pooneh Mokarram, Parvaneh Mehrbod, Milad Ashrafizadeh, Ali Zarrabi, Kielan Darcy Mcalinden, Mathew Suji Eapen, Sukhwinder Singh Sohal, Pawan Sharma, Amir A Zeki, Saeid Ghavami

Center for Translational Medicine Faculty Papers

Cellular protein homeostasis in the lungs is constantly disrupted by recurrent exposure to various external and internal stressors, which may cause considerable protein secretion pressure on the endoplasmic reticulum (ER), resulting in the survival and differentiation of these cell types to meet the increased functional demands. Cells are able to induce a highly conserved adaptive mechanism, known as the unfolded protein response (UPR), to manage such stresses. UPR dysregulation and ER stress are involved in numerous human illnesses, such as metabolic syndrome, fibrotic diseases, and neurodegeneration, and cancer. Therefore, effective and specific compounds targeting the UPR pathway are being considered …

Effect Of Thyme (Thymus Vulgaris L.) Essential Oil On The Quality Parameters Of Stirred Yoghurt, Emad A. H. Guirguis, Mary G. B. Meleka

Journal of Medicine in Scientific Research

Aim Stirred yoghurt was supplemented with thyme essential oil in an attempt to enhance its quality. Materials and methods Thyme (Thymus vulgaris L.) essential oil concentrations (0, 2, 4, 6, 8, and 10 μl/ml) were added to the prepared stirred yoghurt and then examined for microbiological count and mycotoxin quality during storage intervals following the Egyptian standards. Results Samples contained ≥ 6 μl/ml oil showed significant increase (p<0.05) of total viable bacterial count and lactic acid bacteria, whereas mold and yeast count was decreased. Pathogenic bacteria including Staphylococcus aureus, Bacillus cereus, Listeria monocytogenes, Salmonella spp., Escherichia coli, and coliform group were not detected in any of the samples, which complied with the standards. Moreover, …

Work-Family Spillover And Depression: Are There Racial Differences Among Employed Women?, Ariane L. Rung, Evrim Oral, Edward S. Peters

School of Public Health Faculty Publications

The intersection of work and family life can be a source of burden (negative) and a source of growth (positive). Negative work-to-family and family-to-work spillover have been linked to poor mental health, while positive work-to-family and family-to-work spillover have been linked to improved health outcomes. Less is known about these relationships in racial subgroups. Louisiana, USA, has a large proportion of African Americans, providing a unique population in which to study these relationships. The objectives of this study were to examine, among a sample of women in southern Louisiana in 2017, levels of work-family spillover by race and how the …

Upfront Treatment Of Flt3-Mutated Aml: A Look Back At The Ratify Trial And Beyond., Gina Keiffer, Kimberly L Aderhold, Neil D Palmisiano

Department of Medical Oncology Faculty Papers

In April 2017, following the results of the RATIFY trial (1), midostaurin, a multikinase FLT3 inhibitor, became the first FDA approved targeted agent for the treatment of acute myeloid leukemia (AML) (2). The addition of midostaurin to standard induction therapy with anthracycline and cytarabine (7 + 3) rapidly became the new standard of care for treatment-naïve, fit patients with FLT3-mutated (FLTmut+) AML (3). More recently, gilteritinib, a selective FLT3 inhibitor, showed superiority to chemotherapy in the treatment of relapsed or refractory FLTmut+ AML (4). With two FLT3 inhibitors now approved by the FDA—that is, the more selective gilteritinib and the …

Treatment And Diagnostic Considerations In A Complex Psychiatric Case - A Case Report, Evan N. Caporaso, John M. Woo

Cooper Rowan Medical Journal

A patient with a history of autism spectrum disorder and epilepsy was hospitalized for management of acute onset psychosis and agitation. The acuity of his behaviors warranted abrupt shifts in treatment and multiple pharmacologic interventions were ineffective. The atypical nature of his presentation and intense pressure from ancillary staff to consider organic etiologies drove frequent transitions of care within the hospital setting. Multiple diagnoses were considered including a primary psychosis, excited catatonia and antiepileptic drug-induced psychotic disorder. Ultimately the patient was diagnosed with bipolar disorder and effectively treated with quetiapine and valproic acid. The authors suggest that rapid consideration of …

Multidisciplinary Approach To Diagnosing And Managing A Case Of Peritoneal Mesothelioma, Jonathan Maw, Geoffrey Kelly, Miriam Enriquez, Ronak Gor, Pauline Germaine

Cooper Rowan Medical Journal

Peritoneal mesothelioma is a rare cause of a peritoneal mass in adults and can occur in malignant or benign forms. Compared to the pleural variant of mesothelioma, the peritoneal form is understudied due to the small number of reported cases. We present a case of an 84 year old male with a history of asbestos exposure who initially presented for an aggravated hernia, was found to have an incidental mass on imaging, and ultimately was diagnosed with malignant peritoneal mesothelioma (MPM)1 likely related to prior asbestos exposure. This case study will provide a review of literature and discuss the role …

A Triple-Drug Treatment Regimen To Accelerate Elimination Of Lymphatic Filariasis: From Conception To Delivery, Gary J Weil, Julie A Jacobson, Jonathan D King

2020-Current year OA Pubs

The Global Programme to Eliminate Lymphatic Filariasis (LF) is using mass drug administration (MDA) of antifilarial medications to treat filarial infections, prevent disease and interrupt transmission. Almost 500 million people receive these medications each year. Clinical trials have recently shown that a single dose of a triple-drug combination comprised of ivermectin, diethylcarbamazine and albendazole (IDA) is dramatically superior to widely used two-drug combinations for clearing larval filarial parasites from the blood of infected persons. A large multicenter community study showed that IDA was well-tolerated when it was provided as MDA. IDA was rapidly advanced from clinical trial to policy and …

Octadecyl Chain-Bearing Pegylated Poly(Propyleneimine)-Based Dendrimersomes : Physicochemical Studies, Redox-Responsiveness, Dna Condensation, Cytotoxicity And Gene Delivery To Cancer Cells, Partha Laskar, Sukrut Somani, Margaret Mullin, Rothwelle J. Tate, Monika Warzecha, Deborah Bowering, Patricia Keating, Craig Irving, Hing Y. Leung, Christine Dufès

School of Medicine Publications

Stimuli-responsive nanocarriers have become increasingly important for nucleic acid and drug delivery in cancer therapy. Here, we report the synthesis, characterization and evaluation of disulphide-linked, octadecyl (C18 alkyl) chain-bearing PEGylated generation 3-diaminobutyric polypropylenimine dendrimer-based vesicles (or dendrimersomes) for gene delivery. The lipid-bearing PEGylated dendrimer was successfully synthesized through in situ two-step reaction. It was able to spontaneously self-assemble into stable, cationic, nanosized vesicles, with low critical aggregation concentration value, and also showed redox-responsiveness in presence of a glutathione concentration similar to that of the cytosolic reducing environment. In addition, it was able to condense more than 70% of DNA at …

Using Simulation For Oncology Nursing Competency Evaluation In Hospitals, Dana N. Littlepage

Doctor of Nursing Practice (DNP) Projects

Problem: Hospitals in an integrated health system, are experiencing low levels of oncologic admissions to their medical surgical units. This is creating a challenge for the organization to maintain nursing competencies for this subset of patients.

Context: In low volume, high risk acute care environments, where chemotherapy is to be provided, seasoned registered nurses grapple with maintaining their competencies, professional confidence and feeling safe enough to administer, monitor and care for this patient population (Muehlbauer, Parr, & Perkins, 2013). The purpose of this project was to ensure that both new and seasoned acute care oncology nurses have access …

2020-12-21_Michigandaily_Covidmap, Michigan Department Of Health & Human Services

Daily Michigan COVID-19 Update

The "WHERE WE STAND WITH COVID-19" map was obtained from Michigan's main COVID-19 page: https://www.michigan.gov/coronavirus. Data was compiled by the Michigan Department of Health and Human Services (MDHHS). The information was updated daily at 3p.m., Monday - Saturday.

The State of Michigan is working around the clock to test and treat COVID-19 patients. Below is the most recent data healthcare experts across the state have compiled.

The image contained a map, indicating total cases by county, and also provides statistics on Total Confirmed Cases, Total COVID-19 Deaths, Daily Confirmed Cases, and Daily COVID-19 Deaths. There …

2020-12-21_Michiganoverview_Covidbedppe, Michigan Department Of Health & Human Services

Michigan COVID-19 Hospital Data

The webpage was obtained from Michigan's Coronavirus Cumulative Data page, under the link Hospitals. Data is self-reported by hospitals daily to the EM Resource System per MDHHS Director Robert Gordon's Emergency Order.

Contains the tables Statewide Hospital Capacity Report for COVID-19, COVID-19 Metrics, Statewide Hospital Available PPE Tracking for COVID-19, as well as the tables PPE Days On Hand and Patient Census.

2020-12-21_Michiganoverview_Covidstats, Michigan Department Of Health & Human Services

Cumulative Michigan COVID-19 Data

The COVID Overview page was obtained from Michigan's main COVID-19 page: https:/www.michigan.gov/coronavirus/0,9753,7-406-98163-520743--,00.html.

The State of Michigan is working around the clock to test and treat COVID-19 patients. Below is the most recent data healthcare experts across the state have compiled. It is updated Monday - Saturday.
This report is provisional and subject to change. City of Detroit and Wayne County are reported separately. MDHHS began tracking probable cases April 5, 2020. FCI indicates federal correctional institute. MDOC indicates Michigan Department of Corrections. Diagnostic tests, including nucleic acid amplification/real-time polymerase chain reaction (NAAT/RT-PCR) and rapid virus antigen detection point of …

2020-12-21_Michiganoverview_Covidschooloutbreak, Michigan Department Of Health & Human Services

Michigan COVID-19 Outbreak Reports

The School Outbreak Data page was obtained from Michigan's COVID-19 data page: https://www.michigan.gov/coronavirus/0,9753,7-406-98163_98173_102480---,00.html.

This report is created by the Michigan Department of Health & Human Services from data self-reported by local health departments. Data is updated every week.

In accordance with the Council of State and Territorial Epidemiologists’ outbreak definition, schools that have been found by their local health department to have two (2) or more COVID-19 cases who may have shared exposure at the school grounds and are not from the same household (with the exception of dorms and off-campus housing) are included. If your child’s school is …