Medicine and Health Sciences Commons^™

Long-Term Follow Up Of 1,168 Graves’Disease Patients Post Radioiodine Treatment, Soontorn Kraisuwan

Chulalongkorn Medical Journal

Background: Current treatments of Graves’ disease have their own advantages and disadvantages. Radioactive Iodine (RAI) is an effective treatment but most of the patients will develop hypothyroidism.Objective: To study the results of treatment of Graves’ disease treated with RAI and to identify factors those could influence the outcomes.Methods: In all, 1,168 Graves’ disease patients who were treated with RAI were evaluated on their thyroid function for 1 - 26 years. The results of treatment were recorded in associated with patient’s gender, age, estimated gland size, pretreatment antithyroid drug and dose of RAI.Results: From 1,168 patients, 939 were females (80.4%), 1,098 …

Does Kasai Operation Prior To Liver Transplantation Affect Peri-Operative Outcomes In Children With Biliary Atresia?, Chatdow Choungboonsri, Pattamon Sutthatarn, Bunthoon Nonthasoot, Booncho Sirichindakul, Wipusit Taesombat, Maythee Sutherasan, Supanit Nivatvongs, Paisarn Vejchapipat

Chulalongkorn Medical Journal

Background: Biliary atresia is the most leading cause of death from liver disease in children and the most common indication for pediatric liver transplantation. Although portoenterostomy is the mainstay treatment of biliary atresia, there were some studies found that prior portoenterostomy would adversely affect the liver transplant.Objectives: To compare the peri-operative outcomes between biliary atresia (BA) children having Kasai operation and those with primary liver transplantation (LT).Methods: Children with BA (0 - 15 years) who underwent LT between 2003 and 2017 were reviewed. Patients were categorized into 2 groups (Group A: BA children undergoing Kasai operation prior to liver transplantation; …

Modified Quechers In Blood Sample Preparation For Drug Abuse Determination By Lc-Ms/Ms, Bundhita Boonchaleaw, Nat Tansrisawad, Udomsak Hoonwijit

Chulalongkorn Medical Journal

Background: Liquid chromatography-tandem mass spectrometry (LC-MS/MS) becomes a common technique in the routine forensic toxicological analysis because of its accurate result. Solid-phase extraction (SPE) and liquid-liquid extraction (LLE) are the sample preparation methods having disadvantages from time-consuming and using a high quantity of harmful substances. Therefore, modified QuEChERS has been developed for routine toxicological laboratory for simpler sample preparation that could save time and decrease the use of toxic solvent for routine laboratory.Objective: To validate the modified QuEChERS technique for the blood sample preparation and to determine drug abuse in the blood sample using LC-MS/MS.Methods: Amphetamine, methadone, midazolam, morphine and …

Clinical Features And Treatment Outcomes In Obese Children With Appendicitis, Kanokrat Thaiwatcharamas, Paisarn Vejchapipat, Prapapan Rajatapiti, Katawaetee Decharun

Chulalongkorn Medical Journal

Background: Even developing countries are facing problems of childhood obesity. Diagnosis and treatment of appendicitis in obese children can sometimes be challenging. This study compared clinical features and treatment outcomes between non-obese and obese children clinically diagnosed as appendicitis.Methods: Children (0 - 15 years) diagnosed as appendicitis between 2007 and 2013 were reviewed. Children were categorized into non-obese and obese groups using weight for height (> 140.0% of ideal body weight) based on the data of the Ministry of Public Health. Demographic data, clinical data, and treatment outcome were studied. Comparisons between non-obese and obese children were carried out. SPSS …

Lessons Learned From Transnational Joint Doctoral And Cotutelle Doctoral Programs: Strategies For Sustainable Development, Wasee Tulvatana, Thananya Thongtan

Chulalongkorn Medical Journal

Background: To enhance the global impact, the universities shall ally deeply with their collaborators. Transnational educational programs are crucial modes to build a successful partnership and to make the collaboration sustainable.Objectives: To report and conceptualize the important issues about transnational joint doctoral degree and cotutelle doctoral programs.Methods: We reviewed and conceptualized the lessons learned from joint doctoral degree and cotutelle doctoral programs at the Graduate Affairs, Faculty of Medicine, Chulalongkorn University (CU) during the period of the past 4 years (October 2015 to September 2019).Results: CU launched its first joint doctoral program in 2012. The curriculum was co-built by CU …

Fundoplication For Gastroesophageal Reflux In Neurologically Impaired Children: Surgical Perspectives, Furida Salam, Paisarn Vejchapipat, Katawaetee Decharun, Prapapan Rajatapiti, Somboon Roekwibunsi

Chulalongkorn Medical Journal

Background: Gastroesophageal reflux is common in neurologically impaired children due to foregut dysmotility. Most of the patients eventually underwent fundoplication.Objective: This study aimed to describe clinical data and outcome in children with neurological impairment who underwent fundoplication.Methods: Patients (0 - 15 years) with neurological impairment undergoing fundoplication between January 2007 and December 2016 were retrospectively reviewed. Demographic data, surgical complications and short-term outcomes were collected and analyzed.Results: Sixty-five patients (41 boys and 24 girls) underwent open fundoplication over the studied period. There were 21 infants (0 - 1 year, 32.0%), 41 children (1 - 10 years, 63.0%), and 3 adolescents …

Solid Pseudopapillary Neoplasms Of The Pancreas In Children, Sinobol Chusilp, Katawaetee Decharuna, Paisarn Vejchapipata

Chulalongkorn Medical Journal

Solid pseudopapillary neoplasms (SPNs) are very rare pancreatic tumors in children. We present clinical presentation, tumor characteristic, surgical management and outcome of SPNs at our institute. There were four patients (3 males, 1 female) undergoing pancreatectomy for SPNs with median age of 11.5 years (10 - 14 years). Presenting symptoms were abdominal pain (n = 4), palpable abdominal mass (n = 2) and vomiting (n = 2). All patients had tumor located in the pancreatic body, and in two of them, the tumor also involved the pancreatic tail. Three patients underwent distal pancreatectomy and one patient underwent central pancreatectomy. The …

Peak Speeds Of Professional Football Players During Bouts Of Non-Curved, Manual Treadmill Sprints, Corey A. Peacock, Jacob Peacock, Jose Antonio, Tobin Silver, Gabriel J. Sanders

Internet Journal of Allied Health Sciences and Practice

Purpose: Speed training and short distance sprints have become an essential component of preparation for professional football players. Current trends in speed training have included the application of non-curved, manual treadmills, as they may enhance peak speeds with less biomechanical stress. A lack of data currently exists in regards to the effectiveness of different settings and peak speed response. Therefore, we proposed to compare peak speeds during different settings of non-curved, manual treadmills. It was hypothesized that as resistance/incline increased, peak sprinting speeds would decrease and vice versa. Methods: Fourteen male professional football players (27.14 ± 3.11 yrs., 183.93 ± …

Clinical Supervision Frameworks For Allied Health Professionals: A Systematic And Critical Review, Marcus Gardner, Carol Mckinstry, Byron Perrin

Internet Journal of Allied Health Sciences and Practice

Purpose: Clinical supervision is an important element of professional support for allied health professionals and contributes to the provision of safe, high quality patient care and health professional wellbeing. Structured clinical supervision frameworks have been recommended to improve access and effectiveness of clinical supervision for allied health professionals by providing practical guidance and increased consistency. However, there is limited evidence relating to the availability and quality of clinical supervision frameworks for allied health. Method: A systematic and critical review was conducted to identify and appraise clinical supervision frameworks for allied health. Included were peer-reviewed studies and grey literature documents, available …

Association Between Anthropometric Factors And Balance Among Elderly Fallers And Non-Fallers: A Cross-Sectional Study, Pothiraj Pitchai, Reshma Gurav, Srishti Kuldeep Chauhan

Internet Journal of Allied Health Sciences and Practice

Purpose: Falls are an emerging public health problem causing a cascade of medical, functional, and socio-economic consequences. Apart from other widely explored risk factors affecting balance, anthropometric factors are also known to have an impact on balance. However, this relationship hasn’t been studied extensively in older adults. This study aimed to evaluate the relationship between the anthropometric factors such as Body Mass Index (BMI), Body Fat Mass (BFM), Waist-Hip Ratio (WHR), Lower Limb Length (LLL), Foot Length (FL) and balance in the elderly among fallers and non-fallers. Method: This cross-sectional study was performed on 100 fallers and 100 non-fallers, aged …

New Evidence For P-Gp-Mediated Export Of Amyloid-Β Peptides In Molecular, Blood-Brain Barrier And Neuronal Models, Amanda B. Chai, Anika M. S. Hartz, Xuexin Gao, Alryel Yang, Richard Callaghan, Ingrid C. Gelissen

Sanders-Brown Center on Aging Faculty Publications

Defective clearance mechanisms lead to the accumulation of amyloid-beta (Aβ) peptides in the Alzheimer’s brain. Though predominantly generated in neurons, little is known about how these hydrophobic, aggregation-prone, and tightly membrane-associated peptides exit into the extracellular space where they deposit and propagate neurotoxicity. The ability for P-glycoprotein (P-gp), an ATP-binding cassette (ABC) transporter, to export Aβ across the blood-brain barrier (BBB) has previously been reported. However, controversies surrounding the P-gp–Aβ interaction persist. Here, molecular data affirm that both Aβ₄₀ and Aβ₄₂ peptide isoforms directly interact with and are substrates of P-gp. This was reinforced ex vivo by the …

Uptake And Determinants Of Cervical Cancer Screening Among Health Care Workers In Aga Khan University Hospital, Nairobi Kenya., Doreen Moraa Osoro

Master of Medicine in Obstetrics and Gynecology

Background: The cancer burden has been rising globally. The reported incidence of cervical cancer is 13.1 / 100,000 globally and 40 / 100,000 in Kenya. Up to 88% of all cervical cancer deaths have been reported in lower to middle-income countries. In comparison, developed countries had up to two to four times lower rates of cervical cancer incidence and mortality. The burden of cancers attributable to carcinogenic infections has potentially modifiable risk factors, for which prevention tools already exist. There is a gap in the implementation of evidence-based interventions including primary prevention with the HPV vaccine and secondary prevention with …

Neither “Post-War” Nor Post-Pregnancy Paranoia: How America’S War On Drugs Continues To Perpetuate Disparate Incarceration Outcomes For Pregnant, Substance-Involved Offenders, Becca S. Zimmerman

Pitzer Senior Theses

This thesis investigates the unique interactions between pregnancy, substance involvement, and race as they relate to the War on Drugs and the hyper-incarceration of women. Using ordinary least square regression analyses and data from the Bureau of Justice Statistics’ 2016 Survey of Prison Inmates, I examine if (and how) pregnancy status, drug use, race, and their interactions influence two length of incarceration outcomes: sentence length and amount of time spent in jail between arrest and imprisonment. The results collectively indicate that pregnancy decreases length of incarceration outcomes for those offenders who are not substance-involved but not evenhandedly -- benefitting white …

Experiences Of Women With Ovarian Cancer During The Covid-19 Pandemic: Examining Intolerance Of Uncertainty And Fear Of Covid-19 In Relation To Psychological Distress, Erin M. Hill, Andriana Frost, Jamie D. Martin

Psychology Faculty Publications

Purpose: Our research aimed to examine the role of intolerance of uncertainty (IU) in psychological distress (PD) among women with ovarian cancer. Fear of COVID-19 (FCOV) was examined as a mediator, and participant health status and the reopening status of their geographic region were examined as moderators. Design: A cross-sectional quantitative design was employed. Participants: Participants (n ¼ 100) were recruited through various online sources and completed the study via Qualtrics. Methods: Moderated mediation models and post-hoc linear regression analyses were used to determine the role of predictor variables in PD. Results: No significant moderators or mediators were found. Despite …

Perceptions And Health Effects Of Electronic Cigarettes Among College Students, Safia Centner

Honors Undergraduate Theses

Electronic cigarettes, or e-cigarettes, are devices that allow users to inhale an aerosol, which contains chemical additives. E-cigarettes are becoming common for nicotine delivery in addition to traditional cigarettes. The goal of this study was to determine how college students perceive e-cigarettes, how often college students use e-cigarettes, and how they view e-cigarettes compared to tobacco cigarettes. This was accomplished through sending a survey built on Qualtrics to UCF students via Knights Email. This survey included questions about demographics, perceptions, and usage of e-cigarettes. The collected data was downloaded into SPSS and analyzed to compare data among different groups. The …

High Rates Of Misdiagnosis Of Pediatric Acute-Onset Neuropsychiatric Syndrome And How To Reduce Them, Aliya Centner

Honors Undergraduate Theses

Pediatric Acute-Onset Neuropsychiatric Syndrome (PANS) is a clinical diagnosis characterized by sudden onset of obsessive compulsive disorder and is considered a type of Autoimmune Encephalitis. Pediatric Autoimmune Neuropsychiatric Disorder associated with Streptococcal Infection (PANDAS) is a subset of PANS characterized by a similar presentation but specifically results from infection by Group A β-hemolytic streptococcus. Early and accurate diagnosis is essential, as PANS can become a chronic condition. PANS and PANDAS are frequently misdiagnosed. There are a variety of differential diagnoses. The intent of this thesis is to evaluate differences in symptoms between PANDAS patients and those with a differential diagnosis …

Using A Lubricin Reporter Cell To Test Current Vs. Optimized Media Compositions, Sean M. Kennedy

Honors Undergraduate Theses

Osteoarthritis is a joint disease characterized by the breakdown of articular cartilage. The field of tissue engineering is interested in developing methods to produce biological alternatives to current orthopedic procedures. Lubricin is a molecule which is important in the proper lubrication of articular cartilage. It is a challenge in the field of tissue engineering to produce cartilage with sufficient lubricin expression. Developing a reporter cell for lubricin allowed for a more efficient investigation of the conditions wh­­­ich may influence its expression. By comparing "optimized" and traditional media solutions, it was determined that the use of a previously reported type II …

Pineal Gland Abnormalities And The Relationship Of Melatonin To The Development And Symptom Severity Of Schizophrenia: An Integrative Review Of The Literature, Kathryn Margretta

Honors Undergraduate Theses

The purpose of this thesis is to critique the literature focusing on the role of pineal gland volume and function and the development of schizophrenia by asking the question, "What is the relationship between pineal gland physiologic function and development and symptom severity of schizophrenia? It is crucial that health care providers continue advocate for better understanding of schizophrenia in order to develop a more appropriate treatment and relive the suffering of those with schizophrenia. A review of published literature focusing on the pineal glands association with schizophrenia was performed using several databases including: ScienceDirect, PubMED, Google Scholar, Cumulated Index …

Covid-19 Infection In Hypertensive Patients In Correlation With Race, Elizabeth Durkin

Honors Undergraduate Theses

Disparities in healthcare exist in the U.S., particularly between different racial categories. This study investigated the frequency of COVID-19 cases and hypertension cases among five different racial groups (White, Black, Asian, Native American, and Native Hawaiian). The study also examined the correlation between COVID-19 and hypertension. It was hypothesized that, because of genetic predisposition to certain diseases and existing socioeconomic barriers, Black populations would have the highest rates of both COVID-19 and hypertension. It was also proposed that a positive correlation exists between COVID-19 and hypertension frequency. To test this, the Kaiser Family Foundation's data for COVID-19 cases and race …

Physicians And Their Patience: Redefining Healthcare Relationships Through Readability Optimization, Rachel V. Ball

Honors Undergraduate Theses

The present study takes legibility research and extends it to the medical setting. Internal Medicine Physicians from UCF developed six passages of medical text detailing a History of Present Illness (HPI) Report from an emergency department as well as comprehension questions for the purpose of our study. In our study, we first presented non-medical passages and comprehension questions in six common fonts to identify participants' individual fastest and slowest fonts. We then gave participants medical passages in both their best and worst fonts while measuring reading speed and comprehension. This study was delivered to a population of Amazon Mechanical Turk …

The Readability Of Cochlear Implant Brochures: A Potential Factor In Parent Choice, Jennifer Dannemarie La Scala

Honors Undergraduate Theses

The early diagnosis of hearing loss can be a life-changing event for families. Parents are required to make several prompt decisions where they might be overwhelmed with all the information being shared with them. Patient education materials (PEMs) are often provided by clinical health professionals – yet these materials are often written above the average reading level of adults in the United States, thus presenting an additional challenge to many parents.

The purpose of this study was to examine the ease of reading cochlear implant (CI) brochures that are provided to parents who are making informed decisions about the management …

Sequence-Independent Assay For Hiv Viral Load Quantitation, Omar El Merhebi

Honors Undergraduate Theses

Although nucleic acid tests (NATs) for human immunodeficiency virus (HIV) exhibit many advantages, such as early detection and viral load quantification, over immunological assays, their widespread use is limited by their demand for high-level infrastructure, sophisticated equipment, and advanced staff competence. Furthermore, when quantifying viral loads of patients, it has been reported that these assays can underestimate viral quantities by 22- to 100-fold due to primer-template mismatches in more divergent HIV subtypes. Therefore, we have developed a cost-effective and sequence-independent assay for the detection and quantification of HIV utilizing a modified nucleic acid sequence-based amplification (NASBA) protocol coupled to an …

Acoustic Detection Of Developmental Dysplasia Of The Hip In Models Representing Neonates, Pinak Raodeo

Honors Undergraduate Theses

Developmental dysplasia of the hip (DDH) is a condition that involves the dislocation of the head of the femur in the acetabulum of the pelvic bone. Although it may not interfere with a child's range of motion during infancy, DDH can cause various effects over time such as joint pain, abnormal gait, and even paralysis. It is crucial to catch this phenomenon early on so that permanent disability is not introduced to the patient. In this study, an excitation device was used to send a broadband frequency signal through a hip joint simulated by a 3D printed bone apparatus consisting …

An Examination Of A Proposed Rule: Removal Of Sirva From The Vaccine Injury Table, Derrica N. Jackson

Honors Undergraduate Theses

Vaccines are one of the greatest modern medical inventions. Even though vaccines have saved lives, however, no medical product is proven to be completely safe. Vaccines can have rare and sometimes deadly reactions. To address such occurrences, the U.S. Department of Health and Human Services (HHS) hosts a program that reviews petitions for compensation of injuries caused by vaccination. The program is called the National Vaccine Injury Compensation Program (VICP). The VICP was established in 1986 to reduce the number of product liability lawsuits against vaccine manufacturers that threatened to increase the cost of vaccines and lower life-saving vaccine administration …

Concomitant Guillain-Barre Syndrome With Covid-19, Skylar A. Morongell

Honors Undergraduate Theses

The current Coronavirus disease 2019 (COVID-19) outbreak, caused by a virus called severe acute respiratory syndrome 2 (SARS-CoV-2), has become a global health emergency. Recent findings in case studies assert that the transmigration of SARS-CoV-2 to the nervous system implicates severe neurotropic pathologies, including the onset of the rare autoimmune disease called Guillain-Barré syndrome (GBS). GBS is recognized as several disorders characterized by immune-mediated polyradiculoneuropathy, which is typically preceded by an infection or other immune stimulation. The symptoms of GBS initially present as acute symmetrical ascending paresthesia, weakness, and paralysis.

This meta-analysis serves to help understand the predisposing factors (such …

3d Mri Investigations Of The Musculus Uvulae In Children With 22q11.2 Deletion Syndrome, Riley Cashon

Honors Undergraduate Theses

22q11.2 Deletion Syndrome (22q) is the most common genetic cause for velopharyngeal dysfunction. Several velopharyngeal muscles in children with 22q have been shown to be hypoplastic, but no studies to date have examined the musculus uvulae in children with 22q. This study aimed to investigate the presence and characteristics of the musculus uvulae in children with 22q using3D modeling software MRI scans of 13 children (8 with 22q and 5 control participants) were used to measure the musculus uvulae using Amira 6 visualization modeling software. The muscle was segmented by selecting voxels displaying the musculus uvulae on successive oblique coronal …

A Mixed Methods Study On Food Insecurity Screening And Patient-Centered Care: Perspectives Of Patients And Healthcare Providers On Practices And Barriers To Effective Screening In Outpatient Medical Settings, Christina Bernhardt

Electronic Theses and Dissertations, 2020-2023

The purpose of this study was to better understand the relationship between elements of patient-centered care and patient/provider comfort with conversing about food insecurity and related social determinants of health. A mixed methods study was conducted. Patients and healthcare providers were surveyed on their experiences with patient-centered care and comfort discussing food insecurity and related social concerns. Telephone interviews were conducted to gain a richer understanding of the concepts under investigation. In the survey and telephone interviews, both samples were also asked about changes in communication during COVID-19 times. Quantitative findings show that patient involvement in care and cultural sensitivity …

Brain Interhemispheric Alterations In Attention-Deficit Hyperactivity Disorder Using Structural Neuroimaging Features, Cintya Dutta

Electronic Theses and Dissertations, 2020-2023

This dissertation examines brain lateralization and interhemispheric asymmetry patterns found in youths with Attention-Deficit / Hyperactivity Disorder (ADHD). Prior research groups have found mixed findings with respect to left and right hemisphere alterations from ADHD subjects using structural magnetic resonance imaging. In these investigations, we propose the use of Asymmetry Index (AI), a subject-specific metric that quantifies the extent of brain asymmetry and allows each subject to serve as their own control, thus reducing variability when pooling across different sites. We compare AI metric with laterality across volumetric, surface area, thickness, morphology, and white matter measures in order to characterize …

Downregulation Of Mir-34a Via Calorie Restriction Regulates Lipid Metabolism In The Liver Of Long-Living Ames Dwarf Mice, Sarah Ashiqueali

Electronic Theses and Dissertations, 2020-2023

Ames dwarf mice (df/df) display delayed aging relative to their normal siblings, living approximately 40-60% longer. As such, investigating the mechanisms that enable these organisms to have superior life expectancies may prove useful in developing therapies to slow aging and deter age-related disease. Nonalcoholic fatty liver disease (NAFLD) is a condition that is characterized by the accumulation of excess adipose tissue in the liver. Interestingly, its prevalence tends to increase with age with an incidence rate of greater than 40% in individuals over the age of 60. Previous studies highlight the potential of calorie restriction (CR) in promoting longevity, but …

Health Literacy, Knowledge, Attitudes, And Opioid Use Behavior Among College Students, Khristen Holmes

Electronic Theses and Dissertations, 2020-2023

Opioid-related deaths have increased rapidly over the last couple of decades due to the overprescribing of prescription opioids and the availability of illicit drugs from family members, friends, or street dealers. To address this crisis, this research will attempt to identify how health literacy levels affect knowledge, attitudes, and behaviors. Hence, this study is informed by the Knowledge-Attitude-Behavior (KAB) Model. The KAB model is used to determine the influence of knowledge and attitudes on behaviors, which includes prescription drugs, illicit drugs, and fentanyl. This dissertation aims to explore the relationships between health literacy, knowledge, attitude, and behavior for opioids (prescription …