Analytical, Diagnostic and Therapeutic Techniques and Equipment Commons^™

Characterization Of Prophylactic Antiemetic Regimens In Pediatric Patients Receiving Moderately And Highly Emetogenic Chemotherapy, Jessica Degiacomo Pharmd, Kristin M. Held Pharmd, Bcop

Department of Pharmacy

No abstract provided.

Clinical Feasibility Of Noninvasive Visualization Of Lymphatic Flow With Principles Of Spin Labeling Mr Imaging: Implications For Lymphedema Assessment, Swati Rane, Paula M C Donahue, Ted Towse, Sheila Ridner, Michael Chappell, John Jordi, John Gore, Manus J. Donahue

Peer Reviewed Articles

Purpose

To extend a commonly used noninvasive arterial spin labeling magnetic resonance (MR) imaging method for measuring blood flow to evaluate lymphatic flow.

Materials and Methods

All volunteers (n = 12) provided informed consent in accordance with institutional review board and HIPAA regulations. Quantitative relaxation time (T1 and T2) measurements were made in extracted human lymphatic fluid at 3.0 T. Guided by these parameters, an arterial spin labeling MR imaging approach was adapted to measure lymphatic flow (flow-alternating inversion-recovery lymphatic water labeling, 3 × 3 × 5 mm) in healthy subjects (n = 6; mean age, 30 years …

A Novel Signal Processing Method For Intraoperative Neurophysiological Monitoring In Spinal Surgeries, Krishnatej Vedala

FIU Electronic Theses and Dissertations

Intraoperative neurophysiologic monitoring is an integral part of spinal surgeries and involves the recording of somatosensory evoked potentials (SSEP). However, clinical application of IONM still requires anywhere between 200 to 2000 trials to obtain an SSEP signal, which is excessive and introduces a significant delay during surgery to detect a possible neurological damage. The aim of this study is to develop a means to obtain the SSEP using a much less, twelve number of recordings. The preliminary step involved was to distinguish the SSEP with the ongoing brain activity. We first establish that the brain activity is indeed quasi-stationary whereas …

A Multidisciplinary Approach To The Prevention Of Infant Torticollis And Plagiocephaly, Anne H. Zachry, S. K. Slaughter

Faculty Presentations

Research suggests that parents are more likely to carry out positioning recommendations from a health care professional than any other source. Occupational therapy practitioners can play an important role in educating parents, caregivers, and healthcare providers about the importance of providing tummy time and limiting infant time spent in baby gear.

Oncology Section Task Force On Breast Cancer Outcomes: Scapular Assessment, Mary Insana Fisher, Pamela K. Levangie

Physical Therapy Faculty Publications

Background: Functional deficits and changes in scapular mechanics following breast cancer (BC) treatments have been documented. Scapular assessment is important when examining the shoulder in survivors of breast cancer to document the need for or effectiveness of physical therapy intervention. The Oncology Section Task Force on Breast Cancer Outcomes sought to identify scapular examination tools that can be recommended for routine use in individuals treated for BC.

Methods: A systematic review of the literature on scapular measures was conducted. Relevant studies were examined for psychometric properties and clinical usefulness. Each method was given a recommendation score based on the Breast …

Oncology Section Task Force On Breast Cancer Outcomes: An Introduction To The Edge Task Force And Clinical Measures Of Upper Extremity Function, Pamela K. Levangie, Mary Insana Fisher

Physical Therapy Faculty Publications

With the proliferation of outcome measures in the literature, many of which lack documentation of sufficient psychometric properties to justify use, it is difficult to document patient change or demonstrate effectiveness of interventions. The goal of the Section on Research’s EDGE (Evaluation Database to Guide Effectiveness) Task Force is to facilitate identification of valid and reliable tests and measures that reflect clinically important outcomes and are responsive to change for standard use across selected patient groups. This paper lays the groundwork for understanding the work of the Oncology Section’s Breast Cancer EDGE Task Force on clinical measures of shoulder function …

Multicenter Study Comparing Shunt Type In The Norwood Procedure For Single-Ventricle Lesions: Three-Dimensional Echocardiographic Analysis., Gerald R. Marx, Girish S. Shirali, Jami C. Levine, Lin T. Guey, James F. Cnota, Jeanne M. Baffa, William L. Border, Steve Colan, Gregory Ensing, Mark K. Friedberg, David J. Goldberg, Salim F. Idriss, J Blaine John, Wyman W. Lai, Minmin Lu, Shaji C. Menon, Richard G. Ohye, David Saudek, Pierre C. Wong, Gail D. Pearson, Pediatric Heart Network Investigators

Manuscripts, Articles, Book Chapters and Other Papers

BACKGROUND: The Pediatric Heart Network's Single Ventricle Reconstruction (SVR) trial randomized infants with single right ventricles (RVs) undergoing a Norwood procedure to a modified Blalock-Taussig or RV-to-pulmonary artery shunt. This report compares RV parameters in the 2 groups using 3-dimensional echocardiography.

METHODS AND RESULTS: Three-dimensional echocardiography studies were obtained at 10 of 15 SVR centers. Of the 549 subjects, 314 underwent 3-dimensional echocardiography studies at 1 to 4 time points (pre-Norwood, post-Norwood, pre-stage II, and 14 months) for a total of 757 3-dimensional echocardiography studies. Of these, 565 (75%) were acceptable for analysis. RV volume, mass, mass:volume ratio, ejection fraction, …

Predictors Of Disease Progression In Pediatric Dilated Cardiomyopathy., Kimberly M. Molina, Peter Shrader, Steven D. Colan, Seema Mital, Renee Margossian, Lynn A. Sleeper, Girish S. Shirali, Piers Barker, Charles E. Canter, Karen Altmann, Elizabeth Radojewski, Elif Seda Selamet Tierney, Jack Rychik, Lloyd Y. Tani, Pediatric Heart Network Investigators

Manuscripts, Articles, Book Chapters and Other Papers

Background: Despite medical advances, children with dilated cardiomyopathy (DCM) remain at high risk of death or need for cardiac transplantation. We sought to identify predictors of disease progression in pediatric DCM.

Methods and results: The Pediatric Heart Network evaluated chronic DCM patients with prospective echocardiographic and clinical data collection during an 18-month follow-up. Inclusion criteria were age <22 years and DCM disease duration >2 months. Patients requiring intravenous inotropic/mechanical support or listed status 1A/1B for transplant were excluded. Disease progression was defined as an increase in transplant listing status, hospitalization for heart failure, intravenous inotropes, mechanical support, or death. Predictors of disease progression were identified using …

Diabetes Care Management During Cancer Treatment, Gregory R. Harper Md, Phd, Janelle M. Sharma Dnp, Crnp, Cara Habeck Rn, Cde, Cathy A. Coyne Phd, Mph, Hope Kincaid Mph, Cph, Roya Hamadani Mph, Ada M. Rivera Mba, Cph, Gretchen Perilli Md, Nicole R. Sully Do

Department of Family Medicine

No abstract provided.

Application Of Flexible Bronchoscopy In Inhalation Lung Injury, Chong Bai, Haidong Huang, Xiaopeng Yao, Shihui Zhu, Bing Li, Jingqing Hang, Wei Zhang, Paul Zarogoulidis, Andreas Gschwendtner, Konstantinos Zarogoulidis, Qiang Li, Michael Simoff

Internal Medicine Faculty Publications

Background: As acute inhalational injury is an uncommon presentation to most institutions, a standard approach to its assessment and management, especially using flexible bronchoscopy, has not received significant attention. Methods: The objective of this study is to evaluate the value of using flexible bronchoscopy as part of the evaluation and management of patients with inhalational lung injury. Twenty-three cases of inhalational lung injury were treated in our three hospitals after a fire in a residential building. The twenty cases that underwent bronchoscopy as part of their management are included in this analysis. After admission, the first bronchoscopy was conducted within …

Vaccination Practice For Pediatric Inflammatory Disease Patients Receiving Immuno-Suppressive Therapy, Naser Tolaymat Md, Clare M. Lenhart Phd, Mph

Department of Pediatrics

No abstract provided.

Sex Differences In White Matter Development During Adolescence: A Dti Study, Yingying Wang, Chris Adamson, Weihong Yuan, Mekibib Altaye, Anna W. Byars, Scott K. Holland

Center for Brain, Biology, and Behavior: Faculty and Staff Publications

Adolescence is a complex transitional period in human development, composing physical maturation, cognitive and social behavioral changes. The objective of this study is to investigate sex differences in white matter development and the associations between intelligence and white matter microstructure in the adolescent brain using diffusion tensor imaging (DTI) and tract-based spatial statistics (TBSS). In a cohort of 16 typically-developing adolescents aged 13 to 17 years, longitudinal DTI data were recorded from each subject at two time points that were one year apart. We used TBSS to analyze the diffusion indices including fractional anisotropy (FA), mean diffusivity (MD), axial diffusivity …

Factors Impacting Echocardiographic Imaging After The Fontan Procedure: A Report From The Pediatric Heart Network Fontan Cross-Sectional Study., Richard V. Williams, Renee Margossian, Minmin Lu, Andrew M. Atz, Timothy J. Bradley, Michael Jay Campbell, Steven D. Colan, Dianne Gallagher, Wyman W. Lai, Gail D. Pearson, Ashwin Prakash, Girish S. Shirali, Meryl S. Cohen, Pediatric Heart Network Investigators

Manuscripts, Articles, Book Chapters and Other Papers

Echocardiographic image quality in Fontan survivors may be limited by a variety of factors. We sought to describe echocardiographic quality and factors associated with study quality in subjects participating in the Pediatric Heart Network Fontan Cross-Sectional Study. Echocardiograms were obtained at 7 clinical sites using a standard protocol. Quality grading and analysis were performed by a core laboratory. Univariate and multivariable modeling were performed to assess factors associated with quality and ability to obtain images sufficient for prespecified quantitative analysis. A total of 543 echocardiograms were obtained. The quality of echocardiograms improved over the duration of the study. The great …

High Dose, Variable Length, N-Acetylcysteine (Hinac) Therapy For Late-Presenting Acetaminophen Poisoning, Jessica K. Eygnor Do, Suprina Dorai Md, Philip W. Moore Do, J Ward Donovan Md, Keith K. Burkhart Md

Department of Emergency Medicine

No abstract provided.

Cardiac Arrest In A Child Following Cranioplasty, Asma Abdus Salam, Fauzia Anis Khan

Department of Anaesthesia

Craniofacial surgery in paediatric patients is associated with several complications, including severe bleeding and venous air embolism. We present a case of an 18 months, 10 kilogramme weight child who had cardiac arrest after completion of surgery, but before extubation. Possibility of both haemorrhage and venous air embolism is discussed.

Combined Erp/Fmri Evidence For Early Word Recognition Effects In The Posterior Inferior Temporal Gyrus, Joseph Dien, Eric S. Brian, Dennis L. Molfese, Brian T. Gold

Center for Brain, Biology, and Behavior: Faculty and Staff Publications

Two brain regions with established roles in reading are the posterior middle temporal gyrus and the posterior fusiform gyrus. Lesion studies have also suggested that the region located between them, the posterior inferior temporal gyrus (pITG), plays a central role in word recognition. However, these lesion results could reflect disconnection effects since neuroimaging studies have not reported consistent lexicality effects in pITG. Here we tested whether these reported pITG lesion effects are due to disconnection effects or not using parallel ERP/fMRI studies. We predicted that the Recognition Potential (RP), a left-lateralized ERP negativity that peaks at about 200–250 ms, might …

Novel Nr5a1 Missense Mutation In Premature Ovarian Failure: Detection In Han Chinese Indicates Causation In Different Ethnic Groups, Xue Jiao, Yingying Qin, Guangyu Li, Shidou Zhao, Li You, Jinlong Ma, Joe Leigh Simpson, Zi-Jiang Chen

HWCOM Faculty Publications

Background

The etiology of most premature ovarian failure (POF) cases is usually elusive. Although genetic causes clearly exist and a likely susceptible region of 8q22.3 has been discovered, no predominant explanation exists for POF. More recently, evidences have indicated that mutations in NR5A1 gene could be causative for POF. We therefore screened for mutations in the NR5A1 gene in a large cohort of Chinese women with non-syndromic POF.

Methods

Mutation screening of NR5A1 gene was performed in 400 Han Chinese women with well-defined 46,XX idiopathic non-syndromic POF and 400 controls. Subsequently, functional characterization of the novel mutation identified was evaluated …

Anesthetic Considerations For Robot-Assisted Gynecologic And Urology Surgery, Jeffrey S. Berger, Taghreed Alshaeri, Rayo Lukula, Paul Dangerfield

Anesthesiology and Critical Care Medicine Faculty Publications

Robotic surgery was first conceived by the United States military in the 1980s. It rapidly developed in both complexity and utility and, in the early 21st century, modern robotic surgery for gynecologic and urologic surgery gained approval in the United States. Today, an ever-increasing number and variety of surgical procedures enlist robotic-assistance.

Numerous anesthetic considerations for robotic surgery exist. A few of the most important aspects of conducting a safe anesthetic include: investigating the patient’s co-morbid conditions, realizing the risks associated with the robotic equipment, and positioning the patient with care.

This manuscript reviews the current literature on robotic-assisted surgery …

Spectral Discrimination Of Breast Pathologies In Situ Using Spatial Frequency Domain Imaging, Ashley M. Laughney, Venkataramanan Krishnaswamy, Elizabeth J. Rizzo, Mary C. Schwab, Richard J. Barth, David J. Cuccia, Bruce J. Tromberg, Keith D. Paulsen, Brian W. Pogue, Wendy A. Wells

Dartmouth Scholarship

Introduction: Nationally, 25% to 50% of patients undergoing lumpectomy for local management of breast cancer require a secondary excision because of the persistence of residual tumor. Intraoperative assessment of specimen margins by frozen-section analysis is not widely adopted in breast-conserving surgery. Here, a new approach to wide-field optical imaging of breast pathology in situ was tested to determine whether the system could accurately discriminate cancer from benign tissues before routine pathological processing.

Measurement And Description Of Dynamics Required For In Vivo Surgical Robotics Via Kinematic Methods, Jacob G. Greenburg

Department of Mechanical and Materials Engineering: Dissertations, Theses, and Student Research

With the goal of improved recovery times and reduced trauma to the patient there has been a substantial shift in the medical community’s demand for minimally invasive surgical (MIS) techniques. With the standardization of MIS becoming more commonplace in the medical field there are still many improvements that are desired. Traditional, manual methods of these surgeries require multiple incisions on the abdomen for the tools and instruments to be inserted. The more recent demand has been to localize the incisions into what is being referred to as a Laparoendoscopic Single-Site (LESS) surgery. Furthermore, the manual instruments that are commonly used …

Early Echocardiographic Changes After Percutaneous Implantation Of The Edwards Sapien Transcatheter Heart Valve In The Pulmonary Position., Shahryar M. Chowdhury, Ziyad M. Hijazi, John Rhodes, Saibal Kar, Raj Makkar, Michael Mullen, Qi-Ling Cao, Lydia King, Jodi Akin, Girish S. Shirali

Manuscripts, Articles, Book Chapters and Other Papers

OBJECTIVES: To evaluate echocardiographic changes after SAPIEN valve implantation in the pulmonary position.

BACKGROUND: The feasibility of the SAPIEN transcatheter pulmonary valve (TPV) has recently been demonstrated. We evaluated changes in pulmonary valve function and the right ventricle after SAPIEN TPV placement.

METHODS: We evaluated echocardiograms at baseline, discharge, 1 and 6 months after TPV placement in 33 patients from 4 centers. Pulmonary insufficiency severity was graded 0-4. TPV peak and mean gradients were measured. Right ventricular (RV) size and function were quantified using routine measures derived from color, spectral, and tissue Doppler indices and two-dimensional echocardiography.

RESULTS: At baseline, …

Airway Management In A Patient With Bullous Pemphigoid, Mohammad Yasir, Fauzia Anis Khan

Department of Anaesthesia

Airway management in patients with pemphigoid lesions has anaesthetic implications. We report a case of a 23 years old female with bullous pemphigoid who presented with laryngeal stenosis and critical airway narrowing. The airway was initially managed with jet ventilation. Anaesthesia was maintained with propofol infusion and ventilation was performed by introducing a size 10 French gauge suction catheter through the stenotic laryngeal orifice. Thirty minutes into anaesthesia, she developed subcutaneous emphysema and decreased air entry on right side of the chest but remained hemodynamically stable. The airway was further managed by tracheostomy. This case report highlights complications that can …

Chhs July E-Newsletter, Dr. John Bonaguro, Dean, Vashon S. Wells, Editor, College Of Health & Human Services, Western Kentucky University

College of Health & Human Services Publications

No abstract provided.

Is Laparoscopy A Risk Factor For Bile Duct Injury During Cholecystectomy?, Terrence M. Fullum, Stephanie R. Downing, Gezzer Ortega, David C. Chang, Tolulope A. Oyetunji, Kendra Van Kirk, Daniel D. Tran, Ian Woods, Edward E. Cornwell, Patricia L. Turner

Manuscripts, Articles, Book Chapters and Other Papers

BACKGROUND AND OBJECTIVES: Previously, risk factors for bile duct injury have been identified as acute cholecystitis, male gender, older age, aberrant biliary anatomy, and laparoscopic cholecystectomy.

METHODS: A retrospective analysis of the Nationwide Inpatient Sample from 1998 to 2006 was performed with an inclusion criterion of cholecystectomy performed on hospital day 0 or 1. Patient- and hospital-level factors potentially associated with bile duct injury were examined by logistic regression.

RESULTS: A total of 377,424 cholecystectomy patients were identified. There were 1124 bile duct injuries (0.30%), with 177 (0.06%) in the laparoscopic cholecystectomy group and 947 (1.46%) in the open cholecystectomy …

Treatment Of Psychiatric Inpatients With Relationship Dysfunction Using A Short Term Cognitive Interpersonal Intervention: A Pilot Study, Tamra Rasberry

Doctoral Dissertations and Projects

Relationship conflict for the psychiatric patient can have significant detrimental effects. There are specific types of interactions that can increase conflict and predict the potential for relapse; these have been identified by research and designated as components of Expressed Emotion (EE). Cognitive Behavioral Therapy (CBT) and Interpersonal Therapy (IPT) have been very effective when targeting specific psychiatric diagnoses, but less effective when addressing relationship conflict. The majority of studies addressing relationship conflict have taken place in an outpatient, long-term setting. There is limited research that utilizes an inpatient short-term intensive therapy with relationship conflict as its sole focus, targeting areas …

An Assessment Of Novel Biodegradable Magnesium Alloys For Endovascular Biomaterial Applications, Dharam Persaud-Sharma

FIU Electronic Theses and Dissertations

Magnesium alloys have been widely explored as potential biomaterials, but several limitations to using these materials have prevented their widespread use, such as uncontrollable degradation kinetics which alter their mechanical properties. In an attempt to further the applicability of magnesium and its alloys for biomedical purposes, two novel magnesium alloys Mg-Zn-Cu and Mg-Zn-Se were developed with the expectation of improving upon the unfavorable qualities shown by similar magnesium based materials that have previously been explored. The overall performance of these novel magnesium alloys has been assessesed in three distinct phases of research: 1) analysing the mechanical properties of the as-cast …

Myofascial Pain Syndrome: A Treatment Review, Mehul J. Desai, Vikramjeet Saini, Shawnjeet Saini

Anesthesiology and Critical Care Medicine Faculty Publications

Myofascial pain syndrome (MPS) is defined as pain that originates from myofascial trigger points in skeletal muscle. It is prevalent in regional musculoskeletal pain syndromes, either alone or in combination with other pain generators. The appropriate evaluation and management of myofascial pain is an important part of musculoskeletal rehabilitation, and regional axial and limb pain syndromes. This article reviews the current hypotheses regarding the treatment modalities for myofascial trigger points and muscle pain. Through a critical evidence-based review of the pharmacologic and nonpharmacologic treatments, the authors aim to provide clinicians with a more comprehensive knowledge of the interventions for myofascial …

Experimental Assessment Of The Impact Of Asymptomatic Gas Emboli On The Vessel Wall, Linxia Gu, Eric L. Cutler

Department of Mechanical and Materials Engineering: Faculty Publications

Quantitative evaluation of shear stress in the vessel wall due to the presence of asymptomatic gas emboli is lacking. The goal of this work was to assess the impact of chronic asymptomatic gas emboli on the risk of atherosclerosis through a custom-built cardiovascular flow simulator. Gas bubbles were created by forced air from a syringe pump. The influences of embolism injection rate, pulse rate, and time-averaged flow rate on the wall mean shear stress were investigated at resting and elevated heart rate conditions. The recorded pressure and volumetric flow rate from 24 experimental settings with four repetitions each were used …

Raman Spectroscopic Analysis Of Human Skin Tissue Sections Ex-Vivo: Evaluation Of The Effects Of Tissue Processing And Dewaxing, Syed Mehmood Ali, Franck Bonnier, Ali Tfayli, Helen Lambkin, Kathleen Flynn, Vincent Mcdonagh, Claragh Healy, Thomas Lee, Fiona Lyng, Hugh Byrne

Articles

Raman spectroscopy coupled with K-means clustering analysis (KMCA) is employed to elucidate the biochemical structure of human skin tissue sections, and the effects of tissue processing. Both hand and thigh sections of human cadavers were analysed in their unprocessed and formalin fixed paraffin processed (FFPP) and subsequently dewaxed forms. In unprocessed sections, KMCA reveals clear differentiation of the stratum corneum, intermediate underlying epithelium and dermal layers for sections from both anatomical sites. The stratum corneum is seen to be relatively rich in lipidic content; the spectrum of the subjacent layers is strongly influenced by the presence of melanin, while that …

Increased Rate Of Cholecystectomies Performed With Doubtful Or No Indications After Laparoscopy Introduction: A Single Center Experience, Elia Pulvirenti, Adriana Toro, Michel Gagner, Maurizio Mannino, Isidoro Di Carlo

HWCOM Faculty Publications

Background

During recent years laparoscopic cholecystectomy has dramatically increased, sometimes resulting in overtreatment. Aim of this work was to retrospectively analyze all laparoscopic cholecystectomies performed in a single center in order to find the percentage of patients whose surgical treatment may be explained with this general trend, and to speculate about the possible causes.

Methods

831 patients who underwent a laparoscopic cholecystectomy from 1999 to 2008 were retrospectively analyzed.

Results

At discharge, 43.08% of patients were operated on because of at least one previous episode of biliary colic before the one at admission; 14.08% of patients presented with acute lithiasic …