Medicine and Health Sciences Commons^™

Atypical Presentations Of Alimentary Tract Duplications In Children: Two Case Reports, Nimmita Srisan, Palittiya Sintusek, Teerasak Phewplung, Paisarn Vejchapipat

Chulalongkorn Medical Journal

Alimentary tract duplication is a rare congenital anomaly. We present herein, two cases of different types of alimentary tract duplications that have entirely different clinical presentations. The first case was a girl presented with chronic constipation was finally diagnosed with tubular duplications of the entire colon. The other was a toddler with acute intestinal obstruction diagnosed with cystic duplication at terminal ileum. These two cases remind us of the difficulty in preoperative diagnosis. High suspicion of the disease and multimodality approaches were beneficial for accurate preoperative diagnosis. Surgery was the mainstay of the treatment.

Four-Week Induction Of Type 2 Diabetes Mellitus In Rats By Streptozotocin And High-Fat Diet, Wirin Bowonsomsarit, Weerapat Anegkamol, Natthaya Chuaypen, Maroot Kaewwongse, Piyaratana Tosukhowong, Phisit Prapunwattana, Thasinas Dissayabutra

Chulalongkorn Medical Journal

Background: Current rodent models for diabetes mellitus type 2 could be divided into genetic-engineered and environmental-induced. Since genetic-modified rodents are difficult to acquire and costly for Thai researchers, we tried to develop a protocol for food-induced diabetic rats. Objectives: To develop a convenient and economical type 2 diabetic mellitus rats with a short course (4 - week) of induction for research purpose. Methods: Eight-week-old male Wistar rats were divided into two groups: control group and streptozotocin with high-fat diet (STZ-HFD) group (n = 4 each). The control group received normal chow (c.p.082 diet with 20.0% energy from fat). For the …

Usefulness Of Contrast-Enhanced Computed Tomography For Diagnosing Hepatic Steatosis, Thipsumon Tangsiwong, Thitinan Chulroek

Chulalongkorn Medical Journal

Background: The diagnosis of hepatic steatosis has been well-described on unenhanced computed tomography (UECT) study. However, current UECT often discarded from the abdominal CT protocol due to radiation dose reduction. Objective: To determine accuracy of contrast-enhanced CT (CECT) for diagnosis of hepatic steatosis. Methods: A total of 1,001 patients who underwent unenhanced and portal venous phase abdominal CT studies were assessed by using region-of-interests of liver and spleen, and visual detection of focal fat sparing. UECT diagnostic criteria were used as the standard reference. Results: The optimal cut-offs on CECT images were 110 Hounsfield unit (HU) of liver attenuation and …

Anxiety For Job Application Among Undergraduate Students At Faculty Of Arts, Panitnart Tiensirirerk, Siriluck Suppapitiporn

Chulalongkorn Medical Journal

Background: Arts degrees are questioned of being useless degree for having no specific career path for new graduates. The degrees with no specific jobs combining varies subjects such as art, humanities, and social sciences may cause anxiety during the job search process upon graduation. Objective: To explore the level of anxiety of job application and factors related to anxiety of job application among undergraduate students at the Faculty of Arts at a university in Thailand. Methods: A cross-sectional design was employed with participation of 296 students in the Faculty of Arts, Chulalongkorn University. A structured questionnaire was applied to ask …

Short-Term Impact Of Bracing In Multi-Level Posterior Lumbar Spinal Fusion, Ryan Dimentberg, Saurabh Sinha, Gregory Glauser, Ian F. Caplan, James M. Schuster, Scott Mcclintock, Jang W. Yoon, Paul J. Marcotte, Zarina S. Ali, Neil R. Malhotra

Mathematics Faculty Publications

Background: Clinical practice in postoperative bracing after posterior lumbar spine fusion (PLF) is inconsistent between providers. This paper attempts to assess the effect of bracing on short-term outcomes related to safety, quality of care, and direct costs.

Methods: Retrospective cohort analysis of consecutive patients undergoing multilevel PLF with or without bracing (2013-2017) was undertaken (n = 980). Patient demographics and comorbidities were analyzed. Outcomes assessed included length of stay (LOS), discharge disposition, quality-adjusted life years (QALY), surgical-site infection (SSI), total cost, readmission within 30 days, and emergency department (ED) evaluation within 30 days.

Results: Amongst the study population, 936 were …

Concerns Of Women Choosing Community Birth During The Covid-19 Pandemic: A Qualitative Study, Sharon Bernecki Dejoy, Deborah Mandel, Niamh Mcfadden, Lauren Petrecca

Public Health Sciences Faculty Publications

Introduction During the coronavirus disease 2019 (COVID-19) pandemic, midwives have reported increased demand for community birth services. The purpose of this qualitative study was to understand childbearing persons' decision-making during the pandemic and to illuminate their experiences giving birth in community settings. Methods The study was framed by the interpretive phenomenological approach. Eligible participants were recruited from midwives providing out-of-hospital birth services. Of the 26 women who agreed to an interview, 17 were able to be reached and interviewed. Interviews followed a semistructured guide. Early paradigm cases were coded by all researchers, and then the first author coded the remaining …

Dean's Report- Fall 2021, Marina K. Holz

GSBMS Dean’s Report

No abstract provided.

Chemotherapy-Induced Cognitive Impairment: Focus On The Intersection Of Oxidative Stress And Tnfα., Nicole G Rummel, Luksana Chaiswing, Subbarao Bondada, Daret K St Clair, D Allan Butterfield

Microbiology, Immunology, and Molecular Genetics Faculty Publications

Chemotherapy-induced cognitive impairment (CICI) has been observed in a large fraction of cancer survivors. Although many of the chemotherapeutic drugs do not cross the blood-brain barrier, following treatment, the structure and function of the brain are altered and cognitive dysfunction occurs in a significant number of cancer survivors. The means by which CICI occurs is becoming better understood, but there still remain unsolved questions of the mechanisms involved. The hypotheses to explain CICI are numerous. More than 50% of FDA-approved cancer chemotherapy agents are associated with reactive oxygen species (ROS) that lead to oxidative stress and activate a myriad of …

Sharksrx Newsletter Fall 2021, Nova Southeastern University

NSU Sharks Rx

No abstract provided.

The Public Health Turn In Reproductive Rights, Rachel Rebouché

Washington and Lee Law Review

Over the last decade, public health research has demonstrated the short-term, long-term, and cumulative costs of delayed or denied abortion care. These costs are imposed on people who share common characteristics: abortion patients are predominantly low income and disproportionately people of color. Public health evidence, by establishing how law contributes to the scarcity of services and thereby entrenches health disparities, has vividly highlighted the connections between abortion access, race, and income. The contemporary attention to abortion law’s relationship to inequality is no accident: researchers, lawyers, and advocates have built an infrastructure for generating credible empirical studies of abortion restrictions’ effects. …

Cesarean Section: More Than A Maternal Health Issue, Marleen Temmerman, Abdu Mohiddin

Obstetrics and Gynaecology, East Africa

A cesarean section (CS) can be a lifesaving intervention when medically indicated, but it may also lead to adverse short- and long-term health effects for women and children

Shifting Taxonomies In Home Care Nursing Information Behavior: Patients, Pandemic, Community, Richard P. Smiraglia, Edmund Pajarillo, Elizabeth Milonas, Sergey Zherebchevsky

Publications and Research

IKOS has continued to monitor the nursing information behavior (NIB) of home care nurses. In earlier reports we described how we developed an online taxonomy of NIB. We then took on a qualitative analysis of video representations of home care nursing in the pandemic. Merging the codes from two rounds of open coding yielded a set of categories (or axes) that could be used to construct a narrative analysis. Contextual quotations from the video transcripts further reveal the intensity of the potential taxonomic extension. The importance of this research for knowledge organization is the understanding we develop concerning shifting taxonomies …

Retention Of Nursing Assistants In Assisted Living Using Stay Interviews: A Qualitative Case Study, Daphne H. Dominguez

Doctor of Education (Ed.D)

The expectation of the impact of an aging population and the future availability of nursing staff is a significant challenge for senior living communities around the world. Lack of nursing staff retention has driven managers to hire quickly, denying residents living in long-term care communities the care they need. Exploratory, qualitative design, using case study research, was used for this study to learn what motivates resident care attendants (RCAs) to stay employed in assisted living communities of senior living. Richard Finnegan’s five stay interview questions were used to interview nine RCAs from various assisted living communities in Louisiana. The data …

Addressing And Supporting Mental Health Today: Society-Wide And In Hospital Emergency Departments, Kira La Sage

University Honors Theses

Mental health has become one of the most pressing public health issues of the 21st Century. Westernized societies offer much of their attention to childhood obesity, to COVID-19, to undiagnosed and diagnosed Americans living with diabetes. America even sees extended U.S. Senate hearings focusing on opioid use and abuse. Each of these concerns legitimately commands public health official attention, but what the world does not see is any level of sustainable attention given to emotional and mental health crises affecting tens of millions in Westernized countries. Suicide, the most serious of mental health crises, has become the second leading cause …

Effects Of Hormone Replacement Therapy (Hrt) On Gene Expression In The Amyloid Processing Pathway Of Ovariectomized Rhesus Macaque Females Under An Obesogenic Diet, Megan Ball

University Honors Theses

Estrogens rapidly decline at the onset of menopause, putting women at higher risk of osteoporosis, obesity, and neurodegenerative diseases, including Alzheimer’s disease (AD). Estradiol hormone therapies (HT) have been suggested to limit these negative effects on women, with controversial findings as to their effectiveness. A study at OHSU recently found differentially expressed genes (DEGs) using RNAseq between ovariectomized/hysterectomized (OvH) old (range = 19.4–23.2 years) female rhesus macaques on HT and those on a placebo on chronic western style diet (WSD). The DEGs identified in the amyloid processing pathway of the amygdala were selected for validation using RT-qPCR because β-amyloid peptide …

Understanding The Effect Of Dietary Palmitic Acid On Glycolysis During Innate Immune Memory In Macrophages, Khaleda A. Aqaei

University Honors Theses

Trained immunity is long-term innate immune memory induced by a primary stimulus, which leads to hyper-inflammation upon secondary stimulation with a homologous or heterologous ligand. Trained immunity is mediated by epigenetic and metabolic reprogramming of the target cell and leads to modification of gene expression and cellular function. Classically, trained immunity is initiated by β-glucans, an inflammatory molecule found on the exterior of fungal species. Interestingly, our lab has recently described that dietary fatty acids can initiate trained immunity, working through similar pathways as β-glucans. Specifically, our data show that a pre-treatment with a specific dietary saturated fatty acid (SFA), …

A Comparison Of Calcium Aggregation And Ultracentrifugation Methods For The Preparation Of Rat Brain Microsomes For Drug Metabolism Studies, Barent N. Dubois, Farideh Amirrad, Reza Mehvar

Pharmacy Faculty Articles and Research

Preparation of brain microsomes by the calcium chloride aggregation method has been suggested as an alternative to the ultracentrifugation method. However, the effects of the calcium chloride concentration on the quality of the microsomal fractions are not known. Brain microsomes were prepared from the adult rat brains using the high-speed ultracentrifugation and low-speed calcium chloride (10–100 mM) aggregation methods (n = 5–6 per group). The microsomal protein yield (spectrometry), the cytochrome P450 reductase (CPR) activity (spectrometry), and the monooxygenase activities (UPLC-MS/MS) of CYP2D and CYP2E1 were determined in the obtained fractions. Increasing the concentrations of calcium chloride progressively increased …

Descriptive Study Of The Safety Behaviors And Attitudes Of Portable Pool Owners, Kristyn Jeffries, Kathy W. Monroe, Alicia Webb, Kristin L. Chancellor, Justina C. Goldman, David C. Schwebel

Posters

Background Drowning is the leading cause of injury death for children 1-4 years old and the second leading cause for children 5-9 years old. Most prior epidemiology work has focused on submersions in below-ground swimming pools and natural bodies of water. Portable pools pose a new and emerging risk for drowning due to their affordability, convenience, and easy assembly. Successful drowning prevention consumer products, such as 4-sided fencing, may prove more difficult to implement with portable pools, and currently are not marketed for such use. Furthermore, parental perceptions and knowledge of drowning risks associated with portable pools has not yet …

Diabetic Preventative Care In A Resident Clinic: A Quality Improvement Study, Karishma Chopra, Charity Owusu-Asare, Aimee Espinosa, Alexandra Halalau

Conference Presentation Abstracts

Introduction: Studies have shown significant gaps in diabetic preventative care in resident clinics compared to private clinics of practicing physicians. In our medicine-pediatrics resident clinic at Beaumont Hospital, diabetic point of care resources are largely underutilized. We aim to improve the care of patients with diabetes by increasing resident awareness of point of care A1c and retina scan resources. Methods: A team of residents, attendings, and nurses was created. Baseline data looking at use of point of care resources, specifically the number of orders placed in electronic medical record for A1c and retina scan tests, was obtained. A root cause …

Type 1 Cryoglobulinemia Secondary To Primary Plasma Cell Leukemia, Antonio Faieta, Khatoon Tawhida

Conference Presentation Abstracts

Primary plasma cell leukemia (pPCL) is a rare and aggressive form of plasma cell dyscrasia that comprises 1% of the plasma cell dyscrasias. Even more rare is its association with type 1 cryoglobulinemia which management can be challenging. A 63-year-old African American male with no past medical history presented with severe burning pain in his legs, necrotizing rash, constitutional symptoms and severe acute kidney injury (AKI). HIV, hepatitis B and C were negative. Serum electrophoresis revealed an M-spike of 5.67, IgG of 7000, free lambda of 152.10 with a K/L of 0 and cryoglobulin of 81%. CT revealed extensive lytic …

Massive Pulmonary Embolism After Pfizer Vaccine, Samiksha Pandey, Bipin Ghimire, Emma Herrmann, Dilip Khanal

Conference Presentation Abstracts

Introduction Vaccines against COVID -19 have been reported to cause venous thromboembolism (VTE). To our knowledge, this is the first case to report the massive, near-fatal Pulmonary Embolism (PE) associated with BNT162b2 Covid-19 (Pfizer/BioNTech) vaccine and discuss the associated risk factors for PE. Case 41-year-old, non-smoker, female on OCP, presented for syncope and seizure-like activity. Upon presentation, she was obtunded and tachypneic. Initial labs showed leukocytosis, mild anemia, and thrombocytopenia, respiratory and metabolic acidosis. She deteriorated quickly to cardiac arrest requiring Cardiopulmonary Resuscitation and intubation. Tissue Plasminogen Activator administered for possible PE. Computed Tomography Angiography (CTA) pulmonary confirmed sagittal pulmonary …

Improving Telemetry Utilization In An Inpatient Hospital Setting, Kamil Sardarli, Lauren Reinhold, Ankit Arora, Sumesh Khanal, Pradeep Kaminoulu, Alexandra Halalau

Conference Presentation Abstracts

Background: Telemetry is a cardiac monitor that continuously records heart activity and monitors abnormal rhythms. Most current clinical indications are limited to 48 hours maximum, but telemetry monitoring service (TMS) is commonly used for a greater duration. This leads to resource exploitation that may create limitations of the resource and also comes with economic burden. Limiting usage to appropriate indications and durations can reduce overall costs and improve profit margin for the hospital and also cut down on unnecessary burden for patients. Through our study, we aim to decrease TMS overuse. Methods: The study was done at Beaumont Hospital Royal …

Symptom Cluster Management Strategies And Outcomes In Patients With Heart Failure, Weena Yodying, Apinya Siripitayakunkit, Bualuang Sumdeangrit, Sarinya Puwanant

Chulalongkorn Medical Journal

Background: Patients with heart failure have to endure different symptoms of heart failure, and the prognosis of the disease is continuous and very difficult to predict the symptoms that will happen in advance. Objective: The present descriptive research aimed to investigate symptom cluster management strategies and outcomes of symptom cluster management strategies in patients with heart failure. Methods: Dodd’s symptom management model was used as the conceptual framework of the present descriptive research. One hundred and ten patients with heart failure who sought treatment at the heart failure clinic and heart clinic of King Chulalongkorn Memorial Hospital were recruited by …

Understanding Community Health Volunteer Incentive Preferences In Kenya, Frontline Health Project, Johns Hopkins Bloomberg School Of Public Health

Reproductive Health

In Kenya, community health services are implemented through community health units. Community health volunteers (CHVs) who serve these units are chosen by the community and trained by community health extension workers. This brief summarizes qualitative and quantitative findings from the Frontline Health project’s discrete choice experiment study in Kenya, which aimed to understand incentive preferences of CHVs with the aim of improving motivation, performance, and retention of CHVs.

Identifying Factors That Support Community Health Worker Motivation, Job Satisfaction, And Retention In Haiti, Frontline Health Project, Johns Hopkins Bloomberg School Of Public Health

Reproductive Health

Community health workers (CHWs) play a critical role in Haiti’s health system, by connecting communities—particularly rural and hard-to-reach populations—to healthcare services. The Frontline Health project conducted a study to better understand the types of incentive structures that can best support the CHWs in Haiti and this brief summarizes those findings.

Frontline Health Achievements In Harmonizing Measurement And Generating Evidence On Community Health System Performance, Frontline Health Project

Reproductive Health

As the global health community demonstrates an increasing commitment to investing in community health workers (CHWs) to achieve universal health coverage in lower- and middle-income countries, the need to effectively measure community health system performance is paramount. Embedded in the Integrating Community Health partnership (2017–2021), with support from the Bill & Melinda Gates Foundation, the Population Council and Last Mile Health co-led the Frontline Health (FLH) project, a four-year research, policy, and advocacy initiative aimed at developing core metrics and CHW reform processes, advancing their adoption, and promoting institutionalization of robust community health policies. This brief describes the Population Council’s …

J Mich Dent Assoc October 2021

The Journal of the Michigan Dental Association

Every month, The Journal of the Michigan Dental Association brings news, information, and features about Michigan dentistry to our state's oral health community and the MDA's 6,200+ members. No publication reaches more Michigan dentists!

In this issue, the reader will find the following original content:

• A cover story, “Welcoming Colleagues from Different Practice Models”.
• A feature article from the Journal’s DEI series, “Diversity, Equity, and Inclusion: Perspectives from an LGBTQ Dentist”.
• A feature article, “Congratulations, 2021 MDA Life Members!”.
• News you need, Editorial and regular department articles on MDA Foundation activities, Dentistry and the Law, Staff Matters, and component news. …

First Nurse Orders Effects On Troponin Draw Times, Cassidy Sullivan Bsn, Rn, Dayna Shelly Bsn, Rn, Jeffrey Nutche Adn, Rn

Vizient/ AACN Nurse Residency Program™ EBP Projects

No abstract provided.

Concordance Between Antibiotic Resistance Genes By Multiplex Polymerase Chain Reaction And Antibiotic Susceptibility By Pooled Antibiotic Sensitivity Testing In Symptomatic Patients With Urinary Tract Infection, Annah Vollstedt, Dakun Wang, Natalie Luke, David Baunoch, Kirk J. Wojno, Howard Korman, Natalie Gaines, Shuguang Huang, S Mohammad Jafri, David Wenzler, Patrick Cacdac, Frank Burks, Larry Sirls

Conference Presentation Abstracts

Introduction: Studies have shown many genes influence antibiotic resistance, and the relationship between genotypic and phenotypic antibiotic resistance is unclear. We sought to analyze the concordance between the presence of antibiotic resistance (ABR) genes and antibiotic susceptibility results. Methods: Urine samples were collected from patients presenting with possible UTI to 37 Urology clinics from July 2018 to February 2019. Multiplex polymerase chain reaction (M-PCR) was used to test for 33 ABR genes. Pooled Antibiotic Susceptibility Testing (P-AST) was performed against 14 different antibiotics. The concordance rate between the ABR genes and P-AST results was generated. The concordance rates for each …

Metastatic Crohn's Disease: A Case Of Genital Cutaneous Crohn's Disease Involving The Penis And Scrotum, Zubin Shetty, Megen Schober

Conference Presentation Abstracts

Introduction: Crohn’s disease is an autoimmune inflammatory disorder affecting the gastrointestinal tract. Rarely, Crohn’s disease can cause cutaneous manifestations that are non-contiguous with the GI tract or “metastatic.” Genital Cutaneous Crohn’s Disease (CCD) is the most frequent presentation of CCD in the pediatric population and has shown to be difficult to manage. Case: A 13-year-old boy with a history of fistulizing Crohn’s disease presented with severe penile and scrotal edema for the previous 4 years. While his gastrointestinal symptoms were responsive to Adalimumab, his genital swelling only minimally and temporarily improved between treatments. He was referred to pediatric urology for …