Medical Specialties Commons^™

Health State Valuation In Mild To Moderate Cognitive Impairment: Feasibility Of Computer-Based, Direct Patient Utility Assessment, Neal V. Dawson, Mendel E. Singer, Marian B. Patterson, Susie A. Sami, Iahn Gonsenhouser, Heather A. Lindstrom, Kathleen A. Smyth, Melissa Barber Butson, Peter J. Whitehouse

Faculty Scholarship

Background. Most patients with dementia will, at some point, need a proxy health care decision maker. It is unknown whether persons with various degrees of cognitive impairment can reliably report their health-related preferences. Methods. The authors performed health state valuations (HSVs) of current and hypothetical future health states on 47 pairs of patients with mild to moderate cognitive impairment and their caregivers using computer-based standard gamble, time tradeoff, and rating scale techniques. Results. Patients' mean (SD) age was 74.6 (9.3) years. About half of the patients were women (48%), as were most caregivers (73%), who were on average younger (mean …

Incorporating Ethnicity Into Genetic Risk Assessment For Alzheimer Disease: The Reveal Study Experience, Peter J. Whitehouse, Melissa Barber Butson

Faculty Scholarship

PURPOSE: To describe how investigators in a multisite randomized clinical trial addressed scientific and ethical issues involved in creating risk models based on genetic testing for African American participants. METHODS: The following informed our decision whether to stratify risk assessment by ethnicity: evaluation of epidemiological data, appraisal of benefits and risks of incorporating ethnicity into calculations, and feasibility of creating ethnicity-specific risk curves. Once the decision was made, risk curves were created based on data from a large, diverse study of first-degree relatives of patients with Alzheimer disease. RESULTS: Review of epidemiological data suggested notable differences in risk between African …

Whiplash: Diagnosis, Treatment, And Associated Injuries., Sanjay Yadla, John K. Ratliff, James Harrop

Department of Neurology Faculty Papers

STUDY DESIGN: Focused review of the current literature.

OBJECTIVE: To identify and synthesize the most current data pertaining to the diagnosis and treatment of whiplash and whiplash-associated disorders (WAD), and to report on whiplash-related injuries.

METHODS: A search of OVID Medline (1996-January 2007) and the Cochrane database of systematic reviews was performed using the keywords whiplash and WAD. Articles under subheadings for pathology, diagnosis, treatment, and epidemiology were chosen for review after identification by the authors.

RESULTS: A total of 485 articles in the English language literature were identified. Thirty-six articles pertained to the diagnosis, treatment, epidemiology of whiplash, and …

Rehabilitation Of Neuromyelitis Optica (Devic’S Syndrome): 3 Case Reports, Adam L. Schreiber, Guy W. Fried, Christopher S. Formal, Bryan X. Desouza

Department of Rehabilitation Medicine Faculty Papers

We describe the inpatient clinical rehabilitation course of three patients with neuromyelitis optica (NMO; Devic’s Syndrome). These patients had varying functional deficits. Each patient improved in several functional independence measures (FIM domains), but had minimal to no progress in other domains after acute rehabilitation stays between 1 to 1.5 months. NMO is a severe central nervous system demyelinating syndrome distinct from MS, characterized by optic neuritis, myelitis, and at least two of three criteria: longitudinally extensive cord lesion, MRI nondiagnostic for multiple sclerosis, or NMO-IgG seropositivity. Persons with NMO may demonstrate improved function with rehabilitation efforts; though gains may be …

Magnetic Resonance Imaging (Mri) Findings In White Matter Disease Of Brain, Humera Ahsan, Muhammad Zafar Rafique, Fozia Ajmal, Mohsin Wahid, Muhammad Azeemuddin, Farah Iqbal

Department of Radiology

Demyelinating and dysmyelinating white matter diseases are important components of neurological problems. Recently, Magnetic Resonance Imaging (MRI) has played a key role in diagnoses of white matter diseases. Therefore, the purpose of the current study is to evaluate the usefulness of MRI in determining the type and frequency of white matter disease. We studied 35 patients who visited the Radiology Department of the Aga Khan University Hospital (AKUH) for MRI with suspected demyelinating/dysmyelinating disorder from January 2003 to December 2005. Multiple Sclerosis (MS) (17; 48%) and leukodystrophies (10; 29%) were the most common diseases. The MRI helped identify the sites …

Management Of Myelomeningocele, A Sattar M. Hashim, Shahid Ahmed, Rashid Jooma

Section of Neurosurgery

Objective: T To find out best possible protocol to provide productive life to children born with myelomeningocele.
Study design: Descriptive study.
Place & Duration of study: Department of Neurosurgery, Jinnah Postgraduate Medical Centre Karachi from December 2001 to December 2006.
Patients and Methods: The medical record of 415 children with myelomeningocele operated at our center was reviewed retrospectively. The surgical & medical management protocol used for different sites of myelomeningocele was studied.
Results: The age of most of the patients at the time of myelomeningocele repair was between 25-30 days; however, children with ruptured myelomeningocele were consistently repaired early. All …

A Novel And Generalizable Organotypic Slice Platform To Evaluate Stem Cell Potential For Targeting Pediatric Brain Tumors., Shengwen Calvin Li, William Gunter Loudon

Department of Cancer Biology Faculty Papers

Brain tumors are now the leading cause of cancer-related deaths in children under age 15. Malignant gliomas are, for all practical purposes, incurable and new therapeutic approaches are desperately needed. One emerging strategy is to use the tumor tracking capacity inherent in many stem cell populations to deliver therapeutic agents to the brain cancer cells. Current limitations of the stem cell therapy strategy include that stem cells are treated as a single entity and lack of uniform technology is adopted for selection of clinically relevant sub-populations of stem cells. Specifically, therapeutic success relies on the selection of a clinically competent …

Racial Disparities Of Post Stroke Physical Therapy In South Carolina, Aaron E. Embry

MUSC Theses and Dissertations

Background and Purpose: Stroke is a devastating event that drastically changes the lives of many people worldwide. Stroke statistics vary across the United States with the highest rates in the southeast. Physical therapy is often required to return to normal function. Appropriateness for physical therapy is based on individual impairments, thus access to and amount of physical therapy should not differ between races. Methods: Using a South Carolina UB-92 data subset for 2002, univariate analysis is performed against physical therapy and race for ischemic stroke victims. Logistic regression is used to test for differences in access to physical therapy. Multiple …

Isolated Right Temporal Lobe Stroke Patients Present With Geschwind Gastaut Syndrome, Frontal Network Syndrome And Delusional Misidentification Syndromes, Michael Hoffmann

Neurology Faculty Publications

Background: Right temporal lobe lesion syndrome elicitation presents a clinical challenge. Aside from occasional covert quadrantanopias, heralding elementary neurological deficits are absent.Aim: Isolated right and left temporal lobe stroke patients were analyzed for the panoply of known temporal and frontal cognitive and neuropsychiatric syndromes.Methods: Temporal lobe stroke patients were analyzed, derived from a dedicated cognitive stroke registry. Patients were screened by a validated bedside cognitive battery and a neuropsychological test battery, including the Bear Fedio Inventory for diagnosis of the Geschwind Gastaut (GG) syndrome, frontal network syndrome testing (FNS), emotional intelligence testing and delusional misidentification syndromes (DMIS). NIH …

Etiology Of Frontal Network Syndromes In Isolated Subtentorial Stroke, Michael Hoffmann, Lourdes Benes Cases

Neurology Faculty Publications

Background: The neurobiology of the frontal network syndrome (FNS) that may occur with isolated subtentorial stroke is unknown.Aim: Evaluate for frontal network syndromes in young people post subtentorial stroke who have recovered neurologically and compare to a stroke lesion group least likely to manifest frontal network syndromes.Methods: Young people (18–49 years) with isolated cerebellar or brainstem subtentorial stroke (ST) that had recovered to independency (Rankin score ࣘ 2) with minimal or no residual neurological deficit (NIHSS ࣘ 4) with neurological recovery enabling resumption of former employment. Comparison was made to age and education matched young people with posterior …

Foreign Accent Syndrome Mimicked By Garcin Syndrome With Spontaneous Resolution, Michael Hoffmann

Neurology Faculty Publications

An English speaking women developed a French accent, without any aphasic syndromes, in conjunction with multiple left sided cranial nerve deficits, temporally related to cranial trauma. Extensive testing with multimodality magnetic resonance imaging, cerebrospinal fluid and laboratory analysis was unremarkable. She was followed over a 3 year period during which her French accent resolved as did the majority of her multiple unilateral cranial neuropathies. The neurological diagnoses included a foreign accent syndrome attributed to a reversible Garcin syndrome.

Spinal Cord Stimulation: An Update., Steven Falowski, Amanda Celii, Ashwini Sharan

Department of Neurosurgery Faculty Papers

Spinal cord stimulation has been used in the treatment of many chronic pain disorders since 1967. In this update, the indications for spinal cord stimulation are reviewed with attention to recent publications. A focused review of the literature on abdominal and visceral pain syndromes is also provided. Furthermore, the technology has evolved from the use of monopolar electrodes to complex electrode arrays. Similarly, the power source has changed from a radio frequency-driven system to a rechargeable impulse generator. These topics are covered, along with a short discussion of implant technique. Finally, we include a review of complications of such therapy. …

Elucidating A Normal Function Of Huntingtin By Functional And Microarray Analysis Of Huntingtin-Null Mouse Embryonic Fibroblasts., Hua Zhang, Sudipto Das, Quan-Zhen Li, Ioannis Dragatsis, Joyce Repa, Scott Zeitlin, György Hajnóczky, Ilya Bezprozvanny

Department of Pathology, Anatomy, and Cell Biology Faculty Papers

BACKGROUND: The polyglutamine expansion in huntingtin (Htt) protein is a cause of Huntington's disease (HD). Htt is an essential gene as deletion of the mouse Htt gene homolog (Hdh) is embryonic lethal in mice. Therefore, in addition to elucidating the mechanisms responsible for polyQ-mediated pathology, it is also important to understand the normal function of Htt protein for both basic biology and for HD. RESULTS: To systematically search for a mouse Htt function, we took advantage of the Hdh +/- and Hdh-floxed mice and generated four mouse embryonic fibroblast (MEF) cells lines which contain a single copy of the Hdh …

Dependence In Prestroke Mobility Predicts Adverse Outcomes Among Patients With Acute Ischemic Stroke, Mary I. Dallas, Shari Rone-Adams, John L. Echternach, Lawrence M. Bass, Dawn M. Bravata

Rehabilitation Sciences Faculty Publications

Background and Purpose - Stroke survivors are commonly dependent in activities of daily living; however, the relation between prestroke mobility impairment and poststroke outcomes is poorly understood. The primary objective of this study was to evaluate the association between prestroke mobility impairment and 4 poststroke outcomes. The secondary objective was to evaluate the association between prestroke mobility impairment and a plan for physical therapy.

Methods - This was a secondary analysis of the National Stroke Project data, a retrospective cohort of Medicare beneficiaries who were hospitalized with an acute ischemic stroke (1998 to 2001). Logistic-regression modeling was used to examine …

Embolization Of An Intracranial Arteriovenous Malformation Followed By Immediate Surgical Resection: A Case Report, Imaad Ur Rehman, Tanveer Ul Haq, Rashid Jooma, Muhammad Azeemuddin, Zafar Sajjad

Department of Radiology

Intracranial arteriovenous malformations (AVMs) are now a recognized entity because of improvements in imaging diagnosis. They are relatively uncommon but can cause serious neurological symptoms or death. We report a case of a 22- year-old man who presented with left parietal hemorrhage and on cerebral angiography was found to have a small AVM in the left middle cerebral artery (MCA) territory. Glue embolization followed by immediate surgical resection of the AVM was carried out, resulting in complete cure.

Poetic Leadership, A Territory Of Aesthetic Consciousness And Change, R. Amrit Kasten-Daryanani

Antioch University Dissertations & Theses

Poetic leadership is a new theoretical construct that views leadership as an activity that unites a lyrical intellect with keenly felt emotion for the purpose of producing changes in the consciousness of self and others. This change begins within the interiority of self, moving surely to broader realms of one's surroundings and society, provoking movement that impacts the developing potential of the individual and the cultural milieu in which they exist. Emotion is the primary trace into consciousness used in this dissertation, which serves to unite experiences of the heart with experiences of the mind. The unification of these disparate …

Short-Wavelength Light Sensitivity Of Circadian, Pupillary, And Visual Awareness In Humans Lacking An Outer Retina, Farhan H. Zaidi, Joseph T. Hull, Stuart N. Peirson, Katharina Wulff, Daniel Aeschbach, Joshua J. Gooley, George C. Brainard, Kevin Gregory-Evans, Joseph F. Rizzo Iii, Charles A. Czeisler, Russell G. Foster, Merrick J. Moseley, Steven W. Lockley

Department of Neurology Faculty Papers

As the ear has dual functions for audition and balance, the eye has a dual role in detecting light for a wide range of behavioral and physiological functions separate from sight. These responses are driven primarily by stimulation of photosensitive retinal ganglion cells (pRGCs) that are most sensitive to short-wavelength ( approximately 480 nm) blue light and remain functional in the absence of rods and cones. We examined the spectral sensitivity of non-image-forming responses in two profoundly blind subjects lacking functional rods and cones (one male, 56 yr old; one female, 87 yr old). In the male subject, we found …

Role Of Video-Eeg Monitoring In Themanagement Of Intractable Seizures Andnon-Epileptic Spells, Mughis Sheerani, Ali Hassan, Ameer Jan, Royala Zaka

Pakistan Journal of Neurological Sciences (PJNS)

No abstract provided.

Fluorosis: A Rare Cause Of Spinal Cordcompression, Maimoona Siddiqui, Azra Zafar, M. Salman, Yaseen Pathan

Pakistan Journal of Neurological Sciences (PJNS)

No abstract provided.

Neurosurgical Training In Pakistan, Syed Ather Enam

Pakistan Journal of Neurological Sciences (PJNS)

No abstract provided.

Neurology, Ayeesha K. Kamal

Pakistan Journal of Neurological Sciences (PJNS)

No abstract provided.

14thannual Meeting Pakistan Society For Neurologyapril 5-6, 2008peshawar, Pakistan

Pakistan Journal of Neurological Sciences (PJNS)

No abstract provided.

Vasculitic Neuropathy Secondary Topolyarteritis Nodosa In Association Withhepatitis B Antigenemia, Azra Zafar, Farrukh Shohab Khan, Syed Mehfooz Alam, Feroza Saleem

Pakistan Journal of Neurological Sciences (PJNS)

No abstract provided.

Neuroradiology, Zafar Sajjad

Pakistan Journal of Neurological Sciences (PJNS)

No abstract provided.

Psychiatry, Syed Ahmer

Pakistan Journal of Neurological Sciences (PJNS)

No abstract provided.

Etiology And Disturbance Of Consciousnessin Stroke: A Hospital-Based Study, Hamzullah Khan, Muhammad Zarif

Pakistan Journal of Neurological Sciences (PJNS)

No abstract provided.

Traumatic Carotid-Cavernous Fistula:Clinical Presentation And Outcome, Atta A. Bhatti, S. Soulat Raza, Ehsan Bari, S. Ather Enam, Tanveer Ul Haq, Zafar Sajjad

Pakistan Journal of Neurological Sciences (PJNS)

No abstract provided.

Ua12/2/1 College Heights Herald, Vol. 83, No. 20, Wku Student Affairs

WKU Administration Documents

WKU campus newspaper reporting campus, athletic and Bowling Green, Kentucky news.

Developing "Human Functioning And Rehabilitation Research" From The Comprehensive Perspective., Gerold Stucki, Jan Dietrich Reinhardt, Gunnar Grimby, John Melvin

Department of Rehabilitation Medicine Faculty Papers

With the International Classification of Functioning, Disability and Health (ICF) the World Health Organization (WHO) has prepared the ground for a comprehensive understanding of Human Functioning and Rehabilitation Research, integrating the biomedical perspective on impairment with the social model of disability. This poses a number of old and new challenges regarding the enhancement of adequate research capacity. Here we will summarize approaches to address these challenges with respect to 3 areas: the organization of Human Functioning and Rehabilitation Research into distinct scientific fields, the development of suitable academic training programmes and the building of university centres and collaboration networks.

Ancient Schwannoma Presenting As A Thoracic Mass, Muhammad Z Tahir, Saulat H. Fatimi, S. Ather Enam

Department of Surgery Docs

Abstract

BACKGROUND:

Ancient schwannoma is a rare variant of schwannoma, histologically showing atypical features that may result in erroneous diagnosis of a malignant tumor. There are only few reported cases in literature.

CASE DESCRIPTION:

We report a case of a 34-year-old man who was found to have giant mediastinal tumor. He underwent thoracotomy to remove the mass, which was proven to be ancient schwannoma on histopathology.

CONCLUSIONS:

Clinical and radiological findings are important aids for further consideration of surgical removal of these potentially respectable tumors with good outcome.