Diseases Commons^™

Outcomes Of Peginterferon Alfa-2a And Ribavirin Combination Therapy In A Resident-Initiated, Multidisciplinary, Hepatitis C Clinic, Nicole M. Agostino Do, Erini Vasiliadis Do, K Nadeem Ahmed Md, Suzanne J. Templer Do, Edward R. Norris Md, Fapa, Fapm, Charles M. Brooks Md, Eric J. Gertner Md, Mph, Joseph L. Yozviak Do, Facp

Department of Medicine

No abstract provided.

Incidence And Outcome Of Cardiopulmonary Resuscitation In Patients With Shunted Single Ventricle: Advantage Of Right Ventricle To Pulmonary Artery Shunt., Eric M. Graham, Geoffrey A. Forbus, Scott M. Bradley, Girish S. Shirali, Andrew M. Atz

Manuscripts, Articles, Book Chapters and Other Papers

No abstract provided.

Introduction To N-Adaptive Fuzzy Models To Analyze Public Opinion On Aids, Florentin Smarandache, W.B. Vasantha Kandasamy

Branch Mathematics and Statistics Faculty and Staff Publications

“AIDS is not simply a physical malady, it is also an artifact of social and sexual transgression, violated taboo, fractured identity—political and personal projections. Its key words are primarily the property of the powerful. AIDS: Keywords – is my attempt to identify and contest some of the assumptions underlying our current ‘knowledge’. In this effort I am joined by many AIDS activists including people living with AIDS— Acquired Immuno Deficiency Syndrome. “A syndrome is a pattern of symptoms pointing to a “morbid state” which may or may not be caused by infectious agents; a disease, on the other hand is, …

Cardiac Transplant Following Failed Fontan Or Glenn Procedures., Naveen L. Pereira, Girish S. Shirali

Manuscripts, Articles, Book Chapters and Other Papers

No abstract provided.

Near-Infrared Characterization Of Breast Tumors In Vivo Using Spectrally-Constrained Reconstruction, Subhadra Srinivasan, Brian W. Pogue, Ben Brooksby, Shudong Jiang, Hamid Dehghani, Christine Kogel, Wendy A. Wells, Steven P. Poplack, Keith D. Paulsen

Dartmouth Scholarship

Multi-wavelength Near-Infrared (NIR) Tomography was utilized in this study to non-invasively quantify physiological parameters of breast tumors using direct spectral reconstruction. Frequency domain NIR measurements were incorporated with a new spectrally constrained direct chromophore and scattering image reconstruction algorithm, which was validated in simulations and experimental phantoms. Images of total hemoglobin, oxygen saturation, water, and scatter parameters were obtained with higher accuracy than previously reported. Using this spectral approach, in vivo NIR images are presented and interpreted through a series of case studies (n=6 subjects) having differing abnormalities. The corresponding mammograms and ultrasound images are also evaluated. Three of six …

Prophylactic Defibrillator Implantation—Toward An Evidence-Based Approach, Alan H. Kadish

Office of the President Publications and Research

The author discusses research on using implantable cardioverter-defibrillators for the primary prevention of sudden death.

Estimation Of Subject Specific Icp Dynamic Models Using Prospective Clinical Data, Wayne W. Wakeland, Joe Fusion, B. Goldstein

Complex Systems Faculty Publications and Presentations

We used a prospective clinical trial to generate physiologic data to create subject-specific in silico (computer simulation) models of intracranial pressure dynamics in children with severe traumatic brain injury. The trial included a physiologic challenge protocol with changes in head-of-bed elevation and minute ventilation, applied over multiple iterations to three subjects. Physiologic signals (electrocardiogram, respiration, arterial blood pressure, intracranial pressure [ICP], oxygen saturation) were recorded continuously, along with clinical annotations indicating the precise timing of physiologic challenges. Several parameters within the model of ICP dynamics were estimated for each subject based on the ICP response to the challenges. Estimation was …

Implantable Cardioverter–Defibrillators: Reply, Alan H. Kadish

Office of the President Publications and Research

The author replies to comments on a previously published article discussing implantable cardioverter-defibrillators.

Prophylactic Defibrillator Implantation In Patients With Nonischemic Dilated Cardiomyopathy, Alan H. Kadish, Alan Dyer, James P. Daubert, Rebecca Quigg, N. A. Mark Estes, Kelley P. Anderson, Joseph H. Levine

Office of the President Publications and Research

No abstract provided.

A Computer Model Of Intracranial Pressure Dynamics During Traumatic Brain Injury That Explicitly Models Fluid Flows And Volumes, Wayne W. Wakeland, Brahm Goldstein, Louis Macovsky, James Mcnames

Complex Systems Faculty Publications and Presentations

This report documents a computer model of intracranial pressure (ICP) dynamics that is used to evaluate clinical treatment options for elevated ICP during traumatic brain injury (TBI). The model uses fluid volumes as primary state variables and explicitly models fluid flows as well as the resistance, compliance, and pressure associated with each of the compartments (arteries and arterioles, capillary bed, veins, venous sinus, ventricles, and brain parenchyma). The model has been tested to assure that it reproduces a correct physiologic response to intra-and extra-parenchymal hemorrhage and edema, and to therapies directed at reducing ICP such as cerebral spinal fluid drainage, …

Presentation And Symptom Predictors Of Coronary Heart Disease In Patients With And Without Diabetes, Marjorie Funk, Janice B. Naum, Kerry A. Milner, Deborah Chyun

Nursing Faculty Publications

The aims of this prospective, observational study were to compare: (1) symptom presentation of coronary heart disease (CHD) between patients with and without diabetes and (2) symptom predictors of CHD in patients with and without diabetes. We directly observed 528 patients with symptoms suggestive of CHD as they presented to the ED of a 900-bed cardiac referral center in the northeastern United States. There were no significant differences in symptom presentation of CHD between patients with and without diabetes, although patients with diabetes were slightly more likely to present with shortness of breath (P =.056). Patients with diabetes reported …

Association Of Viral Genome With Graft Loss In Children After Cardiac Transplantation., Girish S. Shirali, J Ni, R E. Chinnock, J K. Johnston, G L. Rosenthal, N E. Bowles, J A. Towbin

Manuscripts, Articles, Book Chapters and Other Papers

BACKGROUND: The survival of recipients of cardiac allografts is limited by rejection, lymphoproliferative disease, and coronary vasculopathy. The purpose of this study in children who had received heart transplants was to evaluate the cardiac allografts for myocardial viral infections and to determine whether the presence of viral genome in the myocardium correlates with rejection, coronary vasculopathy, or graft loss.

METHODS: We enrolled heart-transplant recipients 1 day to 18 years old who were undergoing evaluation for possible rejection and coronary vasculopathy. Endomyocardial-biopsy specimens were evaluated for evidence of rejection with the use of standard criteria and were analyzed for the presence …

Vancomycin-Intermediate Staphylococcus Aureus In A Home Health-Care Patient, Jeffrey C. Hageman, David A. Pegues, Carrie Jepson, Rose Lee Bell, Mary Guinan, Kevin W. Ward, Martin D. Cohen, Janet A. Hindler, Fred C. Tenover, Sigrid K. Mcallister, Molly E. Kellum, Scott K. Fridkin

School of Public Health Faculty Research

To date, four of the eight cases of infection by Staphylococcus aureus with reduced susceptibility to vancomycin (vancomycin-intermediate S. aureus [VISA] or glycopeptideintermediate S. aureus [GISA]) have been reported in the United States (1-3). We report a fifth case of VISA infection in the United States, and the first to occur during home health-care therapy. While all previous VISA strains have been oxacillin resistant, one of the two VISA strains identified in this investigation was oxacillin susceptible.

Oces Sistem Pakar Kanser Ovari, Abd. Rahim Noreen

Student Works (2000-2009)

Sistem Pakar Kanser Ovari atau OCES merupakan projek tahun akhir bagi memenuhi keperluan dalam penganugerahan ljazah Sarjana Muda Sains Komputer. OCES merupakan sistem pakar yang cuba bertindak untuk menggantikan pakar pada bila-bila masa yang diperlukan dengan melakukan diagnosis ke atas pesakit kanser ovari berdasarkan gejala-gejala yang ada pada pesakit. Dalam menjalankan proses diagnosis, satu sesi soal jawab dikendalikan oleh OCES akan dijalankan dan daripada sesi ini, OCES akan mengenalpasti samada pesakit tersebut berpotensi mendapat kanser ovari dan seterusnya membcrikan cadangan tentang kaedah rawatan yang mungkin diperlukan oleh pesakit disamping mampu memberi sedikit sebanyak maklumat mengenai kanser ovari. Dengan wujudnya sistem …

Recognition Of Left Atrial Aneurysm By Fetal Echocardiography., R R. Fountain-Dommer, H B. Wiles, C O. Shuler, S M. Bradley, Girish S. Shirali

Manuscripts, Articles, Book Chapters and Other Papers

No abstract provided.

Posttransplant Recoarctation Of The Aorta: A Twelve Year Experience., Girish S. Shirali, C E. Cephus, M A. Kuhn, K K. Ogata, L K. Vander Dussen, R E. Chinnock, N F. Mulla, J K. Johnston, L L. Bailey, S R. Gundry, A J. Razzouk, R L. Larsen

Manuscripts, Articles, Book Chapters and Other Papers

OBJECTIVES: This study was undertaken to investigate the incidence of posttransplant recoarctation of the aorta, delineate the mode of presentation, identify risk factors that predict recoarctation and examine the results of intervention for posttransplant recoarctation.

BACKGROUND: Patients with aortic arch hypoplasia require extended arch reconstruction at transplant, with an inherent possibility of subsequent recoarctation of the aorta.

METHODS: This was a retrospective review of all children (ageyears) who underwent cardiac transplantation over a 10-year period. Collected data included pretransplant diagnosis, details of the transplant procedure and posttransplant data including development of recoarctation of the aorta, interventions for recoarctation and the …

Dobutamine Stress Echocardiography For Assessing Coronary Artery Disease After Transplantation In Children., R L. Larsen, P M. Applegate, D A. Dyar, P A. Ribeiro, S D. Fritzsche, N F. Mulla, Girish S. Shirali, M A. Kuhn, R E. Chinnock, P M. Shah

Manuscripts, Articles, Book Chapters and Other Papers

OBJECTIVES: The purpose of this study was to determine the feasibility, safety and diagnostic accuracy of dobutamine stress echocardiography (DSE) for evaluating posttransplant coronary artery disease (TxCAD) in children, and to determine the frequency of selected cardiac events after normal or abnormal DSE.

BACKGROUND: Posttransplant coronary artery disease is the most common cause of graft loss (late death or retransplantation) after cardiac transplantation (CTx) in children. Coronary angiography, routinely performed to screen for TxCAD, is an invasive procedure with limited sensitivity. The efficacy of DSE for detecting atherosclerotic coronary artery disease is established, but is unknown in children after CTx. …

Methicillin Resistant Staphylococcus Aureus (Mrsa): Molecular Detection And Dna Fingerprinting, Leslie Cotter

Theses

Throughout the 1990s, the incidence of methicillin-resistant Staphylococcus aureus has increased in many health care areas including acute and chronic care facilities, outpatient clinics and in the community. Once introduced into a health care environment, this nosocomial pathogen can spread rapidly and as MRSA are resistant to multiple antibiotics, treatment is often difficult. Therefore effective infection control measures are required to prevent cross-infection and further spread of endemic strains.

In this study, a sensitive and specific triplex-PCR assay was designed for MRSA detection, wherein three genes, the methicillin resistance gene (mecA). femA and the extracellular thermonuclease gene (rmc) were simultaneously …

The Optimal Fontan Connection: A Growing Extracardiac Lateral Tunnel With Pedicled Pericardium., S R. Gundry, A J. Razzouk, M J. Del Rio, Girish S. Shirali, L L. Bailey

Manuscripts, Articles, Book Chapters and Other Papers

OBJECTIVE: The concept of a lateral tunnel for the Fontan operation is now widely accepted. Most lateral tunnels are constructed intraatrially with the use of aortic crossclamping. Construction of extracardiac lateral tunnels with the use of homografts or other nonviable tubes eliminates aortic crossclamping but lacks growth potential in length or width. The native pericardium, which is "sealed" posteriorly along the pulmonary artery, atrium, and inferior vena cava, could be turned down onto the right atrium to form a viable extracardiac lateral tunnel.

METHODS: We designed and successfully constructed extracardiac lateral tunnels using viable autologous pericardium, pedicled on its lateral …

Job Accommodation In The Automobile Industry : Addressing The Problem Of Lateral Epicondylitis, Thanigaivel Ashwin Raj

Theses and Dissertations (ETD)

Cumulative trauma disorders are musculoskeletal problems such as carpal tunnel syndrome, rotator cuff tendinitis, and epicondylitis which can affect assembly line workers. The injuries are thought to result from repetitive motions performed under excessive loads in anomalous postures. The project aimed to design, build, install, and evaluate worksite accommodation at the Saturn plant for a worker with right lateral epicondylitis. The goal was to make her fully functional in her original team which required addressing the injurious aspects of the task that caused or aggravated her injury.

A process of observation, interview, and analysis identified “the door mount” operation on …

Counseling And Testing For Hiv Prevention: Costs, Effects, And Cost-Effectiveness Of More Rapid Screening Tests, P. G. Farnham, Robin D. Gorsky, D. R. Holtgrave, Wanda K. Jones, Mary Guinan

School of Public Health Faculty Research

New rapid human immunodeficiency virus (HIV) antibody tests permit many individuals to receive test results and appropriate counseling at one clinic visit. Because currently used tests require significant time for processing, all individuals must return for a second visit for test results and counseling. Since return rates for the second visit are low, the more rapid tests present an opportunity to improve the efficiency of HIV counseling and testing.

The authors compared the costs and effectiveness of the currently used counseling and testing procedure and a streamlined procedure made possible by the new, more rapid screening tests. When test-positive clients …

Preventing Perinatal Transmission Of Hiv Costs And Effectiveness Of A Recommended Intervention, Robin D. Gorsky, P G. Farnham, Walter L. Straus, Blake Caldwell, D R. Holtgrave, R. J. Simonds, M F. Rogers, Mary Guinan

School of Public Health Faculty Research

In the United States, nearly all new human immunodeficiency virus (HIV) infections in children are acquired through perinatal (mother-to-infant) transmission. Each year, approximately 7000 infants are born to HIV-infected women in the United States.¹ Without intervention, an estimated 15-30% of these infants would become infected.² In 1994, results of the AIDS Clinical Trial Group (ACTG) Protocol 076 showed that treatment of infected pregnant women and their infants with zidovudine (ZDV) reduced the rate of perinatal HIV transmission from 25% to 8%.^3,4 Following these findings, the Public Health Service (PHS) issued recommendations for ZDV therapy to prevent perinatal …

Ventricular Remodeling Following Infant-Pediatric Cardiac Transplantation. Does Age At Transplantation Or Size Disparity Matter?, Girish S. Shirali, F Lombano, W L. Beeson, D A. Dyar, N F. Mulla, A Khan, J K. Johnston, R E. Chinnock, S R. Gundry, A J. Razzouk

Manuscripts, Articles, Book Chapters and Other Papers

Early left ventricular (LV) remodeling following pediatric cardiac transplantation has not been described. To identify patterns and determinants of change in left ventricular mass and volume posttransplant, we studied 125 consecutive children who underwent cardiac transplantation between January 1, 1989 and July 31, 1993. Two-dimensional imaging-directed M-mode echocardiograms were studied weekly until 26 weeks post-transplant. LV mass and volume (indexed to BSA1.5) were measured. LV mass index increased until 3 weeks post-transplant, and then decreased. The mean decrement in LV mass index after 8 weeks post-transplant (relative to baseline) was significantly larger in patients with donor-recipient weight ratio > 1.5 compared …

Does Hyperthermia Have A Therapeutic Role In Hiv Disease?, Linda M. Schecterle, John St. Cyr

Journal of the Minnesota Academy of Science

No abstract provided.

A Rapid Concentration And Identification Technique For Human Malaria Infections Using A Mouse Model, Donald D. Barton

Loma Linda University Electronic Theses, Dissertations & Projects

Red blood cells infected with malaria parasites experience a change in density making them lighter (less dense). This paper reports a new, rapid diagnostic technique using this change in density in the infected red blood cell. It is not only easy to use, but it is also compatible with the technological conditions found where the malaria problem is most acute - in many developing countries of the world. A small sample of blood drawn from a simple finger stick can be concentrated and examined microscopically for malaria parasites within 10 minutes. The thick film slide preparation, presently used, takes a …

J.T.: A Case Of Mitral Valve Prolapse, F. Matthew Mihelic

Faculty Publications

No abstract provided.

The Cardiovascular Effects Of Human Contact With Coronary Artery Disease Patients In The Coronary Care Unit, Margaret A. Palmour

Loma Linda University Electronic Theses, Dissertations & Projects

Ten coronary artery disease patients were selected using purposive method of sampling and observed for six hours. It was postulated that 1) Human contact with coronary artery disease patients in the coronary intensive care unit would be associated with significant (p = 0.05) changes in the electrocardiogram such as: (a) increased heart rate more than 10 per cent, (b) changed atrio-ventricular conduction more than 10 per cent, (c) changed ST segment one millimeter or more and (d) increased frequency of ectopic beats more than 10 per cent. 2) The degree of stress and cardiac response was related to a number …

A Clinical And Microscopic Evaluation Of Plaque Removal And By The Hydrodent Brush, Soertini E. Lambri

Loma Linda University Electronic Theses, Dissertations & Projects

The Hydrodent toothbrush was compared to conventional toothbrush (Lactona # 19) in its effectiveness on removing the plaque, eliminating the pocket depth, and improving the gingival tissue condition.

Forty six male and female subjects with the age range of 18 to 50 years old participated in a 5 month study with 4 week intervals. Each subject received a Hydrodent brush of soft, medium, and hard textures and a conventional toothbrush. The toothbrushes were given randomly and the subject served as his own control.

Clinical and histological evaluations were made after the use of each toothbrush. The clinical evaluation showed some …

Relationship Of Ventilation Ability And Positioning In Left-Sided Congestive Heart Failure Patients, Nancy E. Carson

Loma Linda University Electronic Theses, Dissertations & Projects

Proper positioning is used to relieve dyspnea, edema, and fatigue in congestive heart failure patients. According to the review of literature, improved ventilation as measured by specific lung volumes and lung mechanics occurred with upright positioning in normal persons. The effects of specific changes in lung volumes related to position change in congestive heart failure patients has not been documented in literature, although various recommendations related to positioning are made. This exploratory study was undertaken with nine congestive heart failure patients to see if a relationship existed between degree of head elevation and lung ventilation ability as measured by water-bell …

Periodontal Pocket Reduction Following Gingival Curettage, Robert B. Tandy

Loma Linda University Electronic Theses, Dissertations & Projects

The purpose of this study was to evaluate pocket reduction following gingival curettage. The effects of temporary pressure packing, inflammation, oral hygiene, pocket depth, age and sex of the patient were evaluated.

Three hundred twenty-eight periodontal pockets were studied in forty-one adult patients selected with interdental lesions ranging from 3.0 - 7.5 mm. in depth. Pocket depth and gingival height were measured preoperatively, one month postoperatively and two months postoperatively. The mean change in pocket depth and gingival height was calculated and statistical significance was determined for all measurements.

The results show that after a two-month postoperative evaluation following gingival …