Medical Specialties Commons^™

A Blessing, Jeremy A Ross

The Texas Heart Institute Journal

No abstract provided.

Evaluating A Preoperative Protocol That Includes Magnetic Resonance Imaging For Lymph Node Metastasis In The Cholangiocarcinoma Screening And Care Program (Cascap) In Thailand., Metha Songthamwat, Nittaya Chamadol, Narong Khuntikeo, Jadsada Thinkhamrop, Supinda Koonmee, Nathaphop Chaichaya, Jeffrey Bethony, Bandit Thinkhamrop

Microbiology, Immunology, and Tropical Medicine Faculty Publications

BACKGROUND: Treatment planning especially liver resection in cholangiocarcinoma (CCA) depends on the extension of tumor and lymph node metastasis which is included as a key criterion for operability. Magnetic resonance imaging (MRI) offers a rapid and powerful tool for the detection of lymph node metastasis (LNM) and in the current manuscript is assessed as a critical tool in the preoperative protocol for liver resection for treatment of CCA. However, the accuracy of MRI to detect LNM from CCA had yet to be comprehensively evaluated.

METHODS: The accuracy of MRI to detect LNM was assessed in a cohort of individuals with …

The Global Burden Of Scabies: A Cross-Sectional Analysis From The Global Burden Of Disease Study 2015., Chante Karimkhani, Danny V Colombara, Aaron M Drucker, Scott A Norton, Roderick Hay, Daniel Engelman, Andrew Steer, Margot Whitfeld, Mohsen Naghavi, Robert P Dellavalle

Dermatology Faculty Publications

Background

Numerous population-based studies have documented high prevalence of scabies in overcrowded settings, particularly among children and in tropical regions. We provide an estimate of the global burden of scabies using data from the Global Burden of Disease (GBD) Study 2015.

Methods

We identified scabies epidemiological data sources from an extensive literature search and hospital insurance data and analysed data sources with a Bayesian meta-regression modelling tool, DisMod-MR 2·1, to yield prevalence estimates. We combined prevalence estimates with a disability weight, measuring disfigurement, itch, and pain caused by scabies, to produce years lived with disability (YLDs). With an assumed zero …

Effect Of Levodopa-Carbidopa Intestinal Gel On Non-Motor Symptoms In Patients With Advanced Parkinson's Disease, David G. Standaert, Ramon L. Rodriguez, John T. Slevin, Michael Lobatz, Susan Eaton, Krai Chatamra, Maurizio F. Facheris, Coleen Hall, Kavita Sail, Yash J. Jalundhwala, Janet Benesh

Neurology Faculty Publications

Background: Levodopa-carbidopa intestinal gel (LCIG; carbidopa-levodopa enteral suspension in the United States), delivered via percutaneous gastrojejunostomy (PEG-J) and titrated in the inpatient setting, is an established treatment option for advanced Parkinson's disease (PD) patients with motor fluctuations. However, long-term prospective data on the efficacy of LCIG on non-motor symptoms and the safety of outpatient titration are limited.

Methods: In this 60-week, open-label phase 3b study, LCIG titration was initiated in an outpatient setting following PEG-J placement in PD patients. The efficacy of LCIG on motor and non-motor symptoms, quality of life, and safety was assessed.

Results: Thirty-nine patients were enrolled …

Characterization Of Different Molecular Markers For Identification Of Salmonella Enterica Serovar Typhi In Pakistani Population, Faizan Muttiullah, Fida Muhammad Khan, Fakhar-I- Abbas, Sabiha Shamim

Journal of Bioresource Management

Typhoid is caused by Salmonella enterica serovar Typhi that is usually diagnosed by using serologic and immuno-chromatographic techniques in developing counties including Pakistan, which is thought to be an unreliable diagnostic method. For accurate diagnosis we used molecular techniques to amplify 204 bp StyR-36 and 498 bp flagellin gene for the identification of Salmonella enterica serovar Typhi. This study was done on 58 individuals diagnosed positive of typhoid via serologic tests and 50 healthy individuals as a control group. Success rate of amplification for flagellin gene was 77.58% while that for StyR-36 gene was 68.97% showing that flagellin gene primer …

Use Of Dark Chocolate For Diabetic Patients: A Review Of The Literature And Current Evidence, Syed Raza Shah, Richard Alweis, Najla Issa Najim, Amin Muhammad Dharani, Muhammad Ahmed Jangda, Maira Shahid, Ahmed Nabeel Kazi, Syed Arbab Shah

Internal Medicine Faculty Publications

Dietary changes are a major lifestyle factor that can influence the progression of chronic diseases such as diabetes. Recently, flavanols, a subgroup of plant-derived phytochemicals called flavonoids, have gained increasing attention, due to studies showing an inverse correlation between dietary intake of flavanols and incidence of diabetes. Flavanoids in the cocoa plant may ameliorate insulin resistance by improving endothelial function, altering glucose metabolism, and reducing oxidative stress. Oxidative stress has been proposed as the main culprit for insulin resistance. The well-established effects of cocoa on endothelial function also points to a possible effect on insulin sensitivity. The relationship between insulin …

Evaluation Of Xpert Mtb/Rif Testing For Rapid Diagnosis Of Childhood Pulmonary Tuberculosis In Children By Xpert Mtb/Rif Testing Of Stool Samples In A Low Resource Setting, Zahra Hasan, Sadia Shakoor, Fehmina Arif, Aisha Mehnaz, Alnoor Akber, Marium Haider, Akber Kanji, Rumina Hasan

Department of Pathology and Laboratory Medicine

Objective: Children with tuberculosis (TB) remain underdiagnosed due to difculty in testing for Mycobacterium tuberculosis (MTB) infection. We evaluated the Xpert MTB/RIF assay for respiratory and stool testing in children for pulmonary TB through a cross-sectional study at tertiary care facilities in Karachi, Pakistan. Fifty children aged 0–15 years screened by a modifed Kenneth-Jones (KJ) score were included. Mycobacterial culture of respiratory samples was the microbiological standard against stool Xpert TB results. All positive TB cases were compared against a treatment response standard (TRS).
/="/">Results: Twelve study subjects were diagnosed by Xpert TB and nine by MTB culture. Compared …

Radiation-Free Cmr Diagnostic Heart Catheterization In Children., Kanishka Ratnayaka, Joshua P Kanter, Anthony Z Faranesh, Elena K Grant, Laura J Olivieri, Russell R Cross, Ileen F Cronin, Karin S Hamann, Adrienne E Campbell-Washburn, Kendall J O'Brien, Toby Rogers, Michael S Hansen, Robert J Lederman

Pediatrics Faculty Publications

BACKGROUND: Children with heart disease may require repeated X-Ray cardiac catheterization procedures, are more radiosensitive, and more likely to survive to experience oncologic risks of medical radiation. Cardiovascular magnetic resonance (CMR) is radiation-free and offers information about structure, function, and perfusion but not hemodynamics. We intend to perform complete radiation-free diagnostic right heart catheterization entirely using CMR fluoroscopy guidance in an unselected cohort of pediatric patients; we report the feasibility and safety.

METHODS: We performed 50 CMR fluoroscopy guided comprehensive transfemoral right heart catheterizations in 39 pediatric (12.7 ± 4.7 years) subjects referred for clinically indicated cardiac catheterization. CMR guided …

Impacts Of Exercise On Functional Ability Of Recovering Gbs Patients: An Integrative Literature Review, Yasmin Sheriff

Grace Peterson Nursing Research Colloquium

This integrative literature review aimed to investigate the impacts exercise has on functional ability of GBS patients in recovery.

The World Database For Pediatric And Congenital Heart Surgery: The Dawn Of A New Era Of Global Communication And Quality Improvement In Congenital Heart Disease., James D St Louis, Hiromi Kurosawa, Richard A Jonas, Nestor Sandoval, Jorge Cervantes, Christo I Tchervenkov, Jeffery P Jacobs, Kisaburo Sakamoto, Giovanni Stellin, James K Kirklin

Surgery Faculty Publications

No abstract provided.

Somatic Vhl Mutation In A Patient With Men1-Associated Metastatic Pancreatic Neuroendocrine Tumor Responding To Sunitinib Treatment: A Case Report., Jasmine Shell, Dhaval Patel, Astin Powers, Martha Quezado, Keith Killian, Paul Meltzer, Jack Zhu, Apostolos Gaitanidis, Fatima Karzai, Vladimir Neychev, Patience Green, Electron Kebebew

Surgery Faculty Publications

Multiple endocrine neoplasia type 1 (MEN1) and von Hippel-Lindau (VHL) are autosomal-dominant diseases caused by germline mutations in tumor-suppressor genes. A patient with a germline MEN1 mutation and a somatic VHL mutation in the tumor has not been reported. Herein, we report on a patient with MEN1 and a metastatic nonfunctioning pancreatic neuroendocrine tumor (PNET) with a somatic VHL mutation. This patient underwent a pancreaticoduodenectomy for a grade 2 PNET obstructing her pancreatic duct. The patient developed liver and regional lymph node metastases as well as growth of a PNET in the remnant pancreas. As part of a clinical trial …

Application Of Rns In Refractory Epilepsy: Targeting Insula., Hai Chen, Patricia Dugan, Derek J Chong, Anli Liu, Werner Doyle, Daniel Friedman

Neurology Faculty Publications

Although responsive neurostimulation (RNS) is approved for treatment of resistant focal epilepsy in adults, little is known about response to treatment of specific cortical targets. We describe the experience of RNS targeting the insular lobe. We identified patients who had RNS implantation with at least one electrode within the insula between April 2014 and October 2015. We performed a retrospective review of preoperative clinical features, imaging, electrocardiogram (EEG), intraoperative electrocorticography (ECoG), and postoperative seizure outcome. Eight patients with at least 6 months of postimplant follow-up were identified. Ictal localization was inconclusive with MRI or scalp EEG findings. Intracranial EEG monitoring …

The Effect Of Health Insurance Coverage And The Doctor-Patient Relationship On Health Care Utilization In High Poverty Neighborhoods, Destini Smith, Alan Akira, Kenneth Hudson, Andrea Hudson, Marcellus Hudson, Marcus Mitchell, Errol Crook

School of Medicine and Health Sciences Student Works

African Americans have higher rates of mortality than whites who are the same age and sex. We hypothesize that in low socioeconomic status neighborhoods, having health insurance coverage and a regular health care provider increases the likelihood of receiving diagnostic tests for cardiovascular disease and diabetes. We use data from a random two-stage cluster sample of 230 adults living in high poverty census tracts to examine the effects of insurance coverage and having a regular doctor on the likelihood receiving diagnostic tests for high cholesterol, high blood sugar, and blood pressure. We find that health insurance coverage increases the odds …

Different Types Of Housing And Respiratory Health Outcomes, Wen Qi Gan, Wayne T. Sanderson, Steven R. Browning, David M. Mannino

Preventive Medicine and Environmental Health Faculty Publications

Evidence has shown that housing conditions may substantially influence the health of residents. Different types of housing have different structures and construction materials, which may affect indoor environment and housing conditions. This study aimed to investigate whether people living in different types of housing have different respiratory health outcomes. The data from the 1999–2006 National Health and Nutrition Examination Survey were used for the analyses. The types of housing included houses, townhouses, apartments, and mobile homes. Respiratory symptoms included wheezing, coughing, sputum, and dyspnea; respiratory diseases included asthma, chronic bronchitis, emphysema, and chronic obstructive pulmonary disease (COPD). Multiple logistic regression …

Bronchoscopic Management Of Prolonged Air Leak, S Keshishyan, A Revelo, Oleg Epelbaum

NYMC Faculty Publications

Bronchopleural fistula (BPF) with prolonged air leak (PAL) is most often, though not always, a sequela of lung resection. When this complication occurs post-operatively, it is associated with substantial morbidity and mortality. Surgical closure of the defect is considered the definitive approach to controlling the source of the leak, but many patients with this condition are suboptimal operative candidates. Therefore there has been active interest for decades in the development of effective endoscopic management options. Successful use of numerous bronchoscopic techniques has been reported in the literature largely in the form of retrospective series and, at best, small prospective trials. …

Cross-Reactive Immunity To Porcine Reproductive And Respiratory Syndrome Virus And Its Contribution To Protection, Ignacio Correas

School of Veterinary and Biomedical Sciences: Dissertations, Theses, and Student Research

Due to the vast geographical distribution and significant economic losses generated, porcine reproductive and respiratory syndrome virus (PRRSV) can be considered the most important swine pathogen of contemporary times. Current control and eradication strategies against PRRSV have difficulty succeeding because of their complex nature and the absence of an effective vaccine. A major obstacle for PRRSV vaccine development is the broad heterogeneity of the virus, both at the genetic and antigenic level, its rapid evolution, and an incomplete knowledge of the immune responses responsible for clearing the virus from the host. Specifically, how known correlates of protection against PRRSV—neutralizing antibodies …

A Case Of Chronic Cough And Pneumonia Secondary To A Foreign Body, J Dabu, M Lindner, M Azzam, A Al-Khateeb, M Kadri, S Bellary, Richard Miller

NYMC Faculty Publications

Foreign body aspiration occurs when a solid or semisolid object becomes lodged in the larynx or trachea. It can be a life-threatening emergency, especially if it is large enough to occlude the airway. However, small aspirated objects may go unnoticed until symptoms occur. Therefore, it is frequently misdiagnosed. A high level of clinical suspicion, patient's risk factors, and thorough history and physical examination are essential in making the diagnosis. It should be considered in cases where there is unresolved chronic cough with or without associated recurrent pneumonia especially in patients with risks for aspiration.

Correlation Between Electrocardiographic Changes And Coronary Findings In Patients With Acute Myocardial Infarction And Single-Vessel Disease, Abdallah Sanaani, Srikanth Yandrapalli, George P. Jolly, R Paudel, Howard Cooper, Wilbert Aronow

NYMC Faculty Publications

BACKGROUND: Correlation of ST-segment elevation on the 12-lead electrocardiogram (ECG) with the expected affected coronary territory is established in patients with ST-elevation myocardial infarction (STEMI). In patients with non-ST-elevation myocardial infarction (NSTEMI), correlation of ischemic ECG abnormalities with the affected coronary territory has not been well-established. We sought to investigate the correlation of electrocardiographic abnormalities with the location of 1-vessel obstructive coronary artery disease (CAD) in patients with both STEMI and NSTEMI. METHODS: In this retrospective study, the charts of all patients referred for coronary angiography in 2012 were reviewed. Patients with a single obstructive coronary artery plus angina-equivalent symptoms …

Assessment Of The Visual Analogue Score In The Evaluation Of The Pruritus Of Cholestasis, Nora Bergasa, E Jones

NYMC Faculty Publications

Background and Aims: A visual analogue score (VAS), based on application of a visual analogue scale, has been widely used to assess pruritus in clinical studies of patients with cholestatic liver disease. A VAS is a numerical score of the severity of the perception of pruritus, and, hence, is inherently subjective. The objective of this study was to assess the reliability of a VAS as an index of pruritus in cholestatic patients. Methods: In 8 patients with chronic pruritus due to primary biliary cholangitis, values for a VAS of pruritus were compared with corresponding measurements of scratching activity, which were …

Is Bronchoscopy An Obsolete Tool In Cystic Fibrosis? The Role Of Bronchoscopy In Cystic Fibrosis And Its Clinical Use, Lisa Paul

NYMC Faculty Publications

Cystic fibrosis (CF) is a progressive life threatening multisystem genetic disease which affects the CF transmembrane conductance regulator channel. Respiratory causes remain the most common mortality in CF. With the onset of newborn screening, initiating treatments both for prophylaxis and disease management, optimizing nutritional support, and developing therapies targeting CF transmembrane conductance regulator protein, this has significantly changed the face of managing this devastating disease. Bronchoscopy and related procedures such as bronchoalveolar lavage (BAL), transbronchial biopsies, and protected brush sampling have been looked at in the management of CF as patients with CF continue to live longer with the help …

Association Of Obesity With Hypertension, Wilbert S. Aronow

NYMC Faculty Publications

No abstract provided.

Pattern Of Pigmentation Disorder In Cosmetic Dermatology Clinic H. Adam Malik General Hospital, Medan, 2012 - 2015, Nelva Karmila Jusuf

Journal of General - Procedural Dermatology and Venereology Indonesia

Background: Abnormalities of pigmentation is a cosmetic problem which affects the overall appearance of an individual. Pigmentation disorder are caused by the increase (hypermelanosis) or the decrease (hypomelanosis) amount of melanin.

Objective: To determine the pattern of pigmentation disorder in Cosmetic Dermatology Clinic H. Adam Malik General Hospital Medan in 2012-2015.

Methods: A retrospective study using subject's medical records from the Cosmetic Dermatology Clinic H. Adam Malik General Hospital Medan in 2012 - 2015, presented descriptively.

Results: In 2012 - 2015 the number of patients who visited the Cosmetic Dermatology Clinic were respectively 210, 228, 211, 142. …

Comparison Of Efficacy Combination Oral Terbinafine Pulse-Dosed And Topical 8% Ciclopirox Olamine With Terbinafine Monotherapy For Onychomycosis: An Evidence-Based Case Report, Marsha Bianti, Teffy Nuary, Sandra Widaty

Journal of General - Procedural Dermatology and Venereology Indonesia

Background: Onychomycosis is a fungal infection of the nails, which manifested as nail discoloration, thickening, and detachment from the nail bed. It is not life-threatening, however inappropriate treatment of onychomycosis might lead to complications and affect the patient’s quality of life; making the management of the disease a challenge for clinicians.

Objective: Investigate the efficacy of pulse-dosed oral terbinafine combined with topical 8% ciclopirox olamine to treat onychomycosis.

Methods: Literature search was performed in Pubmed and Cochrane databases using the keywords 'combination' AND 'oral terbinafine' AND 'ciclopirox' AND ‘onychomycosis treatment’ along with their synonyms and related terms.

Results …

The Role Of Oral Vitamin D In Several Skin Diseases, Astri Adelia, Larisa Paramitha Wibawa, Adhimukti T. Sampurna, Windy K. Budianti, Farida Zubier

Journal of General - Procedural Dermatology and Venereology Indonesia

Vitamin D has many benefits for body and skin health. One of them is to regulate the immune system, both cellular and humoral. The pathogenesis of many skin diseases is associated with disturbance in regulation of cellular immune system. Research on the relationship between blood level of vitamin D and several diseases in dermatology is currently very advanced. Oral vitamin D is known to have many functions that play a role in the pathogenesis of several diseases of the skin. Therefore, its current use as a primary or supplemental therapy has been widely studied. Knowledge on various skin diseases with …

Increasing Use Of Allogeneic Hematopoietic Cell Transplantation In Patients Aged 70 Years And Older In The United States, Lori Muffly, Marcelo C. Pasquini, Michael Martens, Ruta Brazauskas, Xiaochun Zhu, Kehinde Adekola, Mahmoud Aljurf, Karen K. Ballen, Ashish Bajel, Frederic Baron, Minoo Battiwalla, Amer Beitinjaneh, Jean-Yves Cahn, Mathew Carabasi, Yi-Bin Chen, Saurabh Chhabra, Stefan Ciurea, Edward Copelan, Anita D'Souza, John Edwards, James Foran, Cesar O. Freytes, Henry C. Fung, Robert Peter Gale, Sergio Giralt, Shahrukh K. Hashmi, Gerhard C. Hildebrandt, Vincent Ho, Ann Jakubowski, Hillard Lazarus

Internal Medicine Faculty Publications

In this study, we evaluated trends and outcomes of allogeneic hematopoietic cell transplantation (HCT) in adults ≥ 70 years with hematologic malignancies across the United States. Adults ≥ 70 years with a hematologic malignancy undergoing first allogeneic HCT in the United States between 2000 and 2013 and reported to the Center for International Blood and Marrow Transplant Research were eligible. Transplant utilization and transplant outcomes, including overall survival (OS), progression-free survival (PFS), and transplant-related mortality (TRM) were studied. One thousand one hundred and six patients ≥ 70 years underwent HCT across 103 transplant centers. The number and proportion of allografts …

Segmental Zoster Paresis, Nahla Shihab, Erdina Hd Pusponegoro, Ahmad Yanuar

Journal of General - Procedural Dermatology and Venereology Indonesia

Herpes zoster is often associated with neurological manifestation but less frequently associated with motoric nerve involvement. The most common motoric involvement is paresis, seen only in 1-5% of all zoster cases. This case report a 39-year-old male, with recurrent abdominal liposarcoma under chemotherapy, presented with symptoms of fever, and painful and weak right leg for 2 weeks. Vesicles eruption was seen on his right leg nine days after these symptoms occurred. Physical examination revealed groups of haemorrhagic vesicles with erythematous base on the right lower leg. Lumbosacral spine x-ray showed spondylosis with radiculopathy. Electromyography (EMG) examination revealed lower motor neuron …

The Effectiveness Of Laser Therapy In Onychomycosis Patients: An Evidence-Based Case Report, Rizky Lendl Prayogo, Evangelina Lumban Gaol, Fitri Azizah, Lusiana Lusiana, Yenny Rachmawati, Yusnita Rahman, Siti Rizny Saldi

Journal of General - Procedural Dermatology and Venereology Indonesia

Background: Onychomycosis may cause nail discoloration, thickening, nail bed separation, and other serious complications. For some cases, oral antifungal treatment is not tolerable because of its potential side effects and drug interactions. Laser therapy is considered as an alternative treatment, owing to the features of simple and effective, with only minor potential side effects. This EBCR was made to collect and appraise studies regarding the effectiveness of laser therapy for onychomycosis, and to suggest laser as an alternative treatment.

Methods: Literature searching strategy was performed using Pubmed and Cochrane Library database to address the clinical problem. Keywords used …

Challenge In Diagnosis And Management Of Lentigo Maligna And Lentigo Maligna Melanoma, Ika Anggraini, Elisa Miranda, Larisa Paramitha Wibawa, Roro Inge Ade Krisanti, Adhimukti T. Sampurna

Journal of General - Procedural Dermatology and Venereology Indonesia

Lentigo maligna (LM) is a subtype of melanoma in situ, which can evolve into lentigo maligna melanoma (LMM) if treated inadequately. LM and LMM are usually found on chronically sun damaged skin such as the face (cheek and nose) of the elderly on seventh or eight decades. Clinical manifestation of LM may be quite subtle, so early diagnosis is difficult to perform.The treatment of LM and LMM are challenging due to ill-defined clinical margin, predilection on the face with great size, and preponderance of the elderly, which are potential for recurrency and progressiveness from LM into LMM.

The Effects Of Perinatal Oxycodone Exposure On Behavioral Outcome In A Rodent Model, Thitinart Sithisarn, Sandra J. Legan, Philip M. Westgate, Melinda E. Wilson, Kristen Wellmann, Henrietta S. Bada, Susan Barron

Pediatrics Faculty Publications

Opiate addiction is now a major public health problem. Perinatal insults and exposure to opiates such as morphine in utero are well known to affect development of the hypothalamic–pituitary–adrenal axis of the offspring adversely and are associated with a higher risk of developing neurobehavioral problems. Oxycodone is now one of the most frequently abused pain killers during pregnancy; however, limited data are available regarding whether and how perinatal oxycodone exposure (POE) alters neurobehavioral outcomes of the offspring. We demonstrated that exposure to 0.5 mg/kg/day oxycodone in utero was associated with hyperactivity in adult rats in an open field. No significant …

Treating Diabetic Ketoacidosis With Subcutaneous Insulin?, Marlene Aziza Azar

Clinical Research in Practice: The Journal of Team Hippocrates

The author examines the evidence for treating diabetic ketoacidosis with subcutaneous insulin vs IV insulin.