Medical Specialties Commons^™

A Trial Of Simulated Breech Delivery Skills Retention For Ob/Gyn And Ed Residents, Cj Sultana, R. Hall

Department of Obstetrics and Gynecology Faculty Papers

Conclusion:

A pilot study showed that simulation using video and high fidelity simulators can substitute for clinical experience for teaching breech delivery with retention of skills at one and three month intervals.

Improving Function In Age-Related Macular Degeneration: Design And Methods Of A Randomized Clinical Trial., Barry W Rovner, Robin J Casten, Mark T Hegel, Robert W Massof, Benjamin E Leiby, William S Tasman

Department of Psychiatry and Human Behavior Faculty Papers

Age-Related Macular Degeneration (AMD) is the leading cause of severe vision loss in older adults and impairs the ability to read, drive, and live independently and increases the risk for depression, falls, and earlier mortality. Although new medical treatments have improved AMD's prognosis, vision-related disability remains a major public health problem. Improving Function in AMD (IF-AMD) is a two-group randomized, parallel design, controlled clinical trial that compares the efficacy of Problem-Solving Therapy (PST) with Supportive Therapy (ST) (an attention control treatment) to improve vision function in 240 patients with AMD. PST and ST therapists deliver 6 one-hour respective treatment sessions …

Implementing Integrated Primary And Behavioral Healthcare Within A Housing First Program, Lara C. Weinstein, Md, Benjamin Henwood, Lcsw

Department of Family & Community Medicine Presentations and Grand Rounds

At Pathways to Housing-Philadelphia, mental health services to support consumers' independent living are delivered through Assertive Community Treatment (ACT) teams. ACT is an evidence-based mental health intervention known to reduce psychiatric hospitalization and increase housing stability. ACT team members include social workers, substance abuse, counselors, nurses, and psychiatrists, with ideal staff to client ratios of 1 to 10. Through a novel collaboration between the program and the Deparment of Family and Community Medicine at Thomas Jefferson University, a primary-care physician was embedded into the ACT services to form an integrated health-care team.

Septic Shock: Current Management And New Therapeutic Frontiers, R. Phillip Dellinger, Md

Division of Pulmonary, Allergy, and Critical Care Medicine Presentations and Grand Rounds

No audio is available for this presentation.

Dr. R. Phillip Dellinger is a Professor of Medicine who holds a faculty appointment in the Division of Pulmonary and Critical Care Medicine at the Robert Wood Johnson School of Medicine, University of Medicine and Dentistry of New Jersey. He is also the Vice-Chair, Department of Medicine and the Director, Medical/Surgical/Cardiovascular Surgical Intensive Care Unit at the Cooper Medical Center in Camden New Jersey. In 2006-2007, he was selected as South Jersey Top Docs by South Jersey Magazine. Dr. Dellinger's interests are in the treatment and outcomes of septic shock.

Phase I Study Of 'Dose-Dense' Pemetrexed Plus Carboplatin/Radiotherapy For Locally Advanced Non-Small Cell Lung Carcinoma., Xinglei Shen, Albert Denittis, Maria Werner-Wasik, Rita Axelrod, Paul Gilman, Thomas Meyer, Joseph Treat, Walter J Curran, Mitchell Machtay

Department of Radiation Oncology Faculty Papers

BACKGROUND: This phase I study investigates the feasibility of carboplatin plus dose-dense (q2-week) pemetrexed given concurrently with radiotherapy (XRT) for locally advanced and oligometastatic non-small cell lung cancer (NSCLC).

METHODS: Eligible patients had Stage III or IV (oligometastatic) NSCLC. Patients received XRT to 63 Gy in standard fractionation. Patients received concurrent carboplatin (AUC = 6) during weeks 1 and 5 of XRT, and pemetrexed during weeks 1, 3, 5, and 7 of XRT. The starting dose level (level 1) of pemetrexed was 300 mg/m2. Following the finding of dose limiting toxicity (DLT) in dose level 1, an amended dose level …

Universal Or Indicated Screening In Primary Care?, Matthew Wintersteen, Md

Department of Psychiatry and Human Behavior Faculty Papers

To the Editor: In the November 2010 issue, Schmitt and colleagues (1) reported that the duration of visits increased when depression screening was conducted in primary care. This report is timely given recent recommendations for both adult and pediatric screening for depression in primary care. Schmitt and colleagues examined data representative of more than 641 million primary care visits in2005–2007 and found that when depression screening was documented in patients’ records, physicians’ time with patients increased significantly.

Apotransferrin Protects Cortical Neurons From Hemoglobin Toxicity, Jing Chen-Roetling, Lifen Chen, Raymond F. Regan

Department of Emergency Medicine Faculty Papers

The protective effect of iron chelators in experimental models of intracerebral hemorrhage suggests that nonheme iron may contribute to injury to perihematomal cells. Therapy with high affinity iron chelators is limited by their toxicity, which may be due in part to sequestration of metals in an inaccessible complex. Transferrin is unique in chelating iron with very high affinity while delivering it to cells as needed via receptor-mediated endocytosis. However, its efficacy against iron-mediated neuronal injury has never been described, and was therefore evaluated in this study using an established cell culture model of hemoglobin neurotoxicity. At concentrations similar to that …

Does Treatment Of Premature Labor With Terbutaline Increase The Risk Of Autism Spectrum Disorders?, Patricia Rodier, Richard K Miller, Robert L Brent

Department of Pediatrics Faculty Papers

Beta-adrenergic agents have been used in pregnant women for the treatment of premature labor and for the treatment of asthma. Concerns have been expressed that exposure to terbutaline, a beta-2 adrenergic agonist, may increase the risk of autism spectrum disorders (ASDs) in the offspring. This hypothesis deserves critical review, given the number of patients exposed to the drug in the last two decades. The results are important to both the obstetricians and patients who weigh the risks and benefits of interventions and to the pediatricians who counsel the families of affected children.

Comparative Gender Analysis Of The Efficacy And Safety Of Atazanavir/Ritonavir And Lopinavir/Ritonavir At 96 Weeks In The Castle Study., Kathleen E Squires, Margaret Johnson, Rong Yang, Jonathan Uy, Louise Sheppard, Judith Absalon, Donnie Mcgrath

Department of Medicine Faculty Papers

OBJECTIVES: To examine whether the overall results of the CASTLE study pertain to both genders, we analysed the efficacy and safety of atazanavir/ritonavir and lopinavir/ritonavir in 277 female and 606 male patients in the open-label, multinational trial over 96 weeks. The trial is registered with ClinicalTrials.gov, number NCT00272779.

METHODS: Treatment-naive patients aged ≥ 18 years with HIV-1 RNA ≥ 5000 copies/mL were randomized to receive either atazanavir/ritonavir 300/100 mg once daily or lopinavir/ritonavir 400/100 mg twice daily, with fixed-dose tenofovir/emtricitabine 300/200 mg once daily.

RESULTS: At week 96, confirmed virological response rates (HIV RNA <50 copies>/mL; intent-to-treat analysis) were higher in …

Depression And Anxiety In Patients With Epilepsy, With Or Without Other Chronic Disorders., A A Asadi-Pooya, M R Sperling

Department of Neurology Faculty Papers

BACKGROUND: Most people with epilepsy lead a normal emotional and cognitive life, however neurobehavioral problems can be found in a large number of patients. This study evaluates the prevalence of depression and anxiety among patients with epilepsy and determines whether having other chronic somatic illnesses increases the prevalence.

METHODS: Adults with epilepsy were recruited in either the inpatient epilepsy monitoring unit or the Outpatient Epilepsy Clinic at Thomas Jefferson University in 2006. Patients anonymously filled out a questionnaire, included data about age, sex, education, having other chronic illnesses, and degree of seizure control. The Hospital Anxiety and Depression scale was …

Prolactin-Induced Mouse Mammary Carcinomas Model Estrogen Resistant Luminal Breast Cancer., Lisa M Arendt, Debra E Rugowski, Tara A Grafwallner-Huseth, Maria Jose Garcia-Barchino, Hallgeir Rui, Linda A Schuler

Kimmel Cancer Center Faculty Papers

INTRODUCTION: Tumors that express estrogen receptor alpha (ERα+) comprise 75% of breast cancers in women. While treatments directed against this receptor have successfully lowered mortality rates, many primary tumors initially or later exhibit resistance. The paucity of murine models of this "luminal" tumor subtype has hindered studies of factors that promote their pathogenesis and modulate responsiveness to estrogen-directed therapeutics. Since epidemiologic studies closely link prolactin and the development of ERα+ tumors in women, we examined characteristics of the aggressive ERα+ and ERα- carcinomas which develop in response to mammary prolactin in a murine transgenic model (neu-related lipocalin- prolactin (NRL-PRL)). To …

Vimentin Is A Novel Akt1 Target Mediating Motility And Invasion., Q-S Zhu, K Rosenblatt, K-L Huang, G Lahat, R Brobey, S Bolshakov, T Nguyen, Z Ding, R Belousov, K Bill, X Luo, A Lazar, Adam Dicker, Md, Phd, G B Mills, M-C Hung, D Lev

Department of Radiation Oncology Faculty Papers

The PI3K/AKT signaling pathway is aberrant in a wide variety of cancers. Downstream effectors of AKT are involved in survival, growth and metabolic-related pathways. In contrast, contradictory data relating to AKT effects on cell motility and invasion, crucial prometastatic processes, have been reported pointing to a potential cell type and isoform type-specific AKT-driven function. By implication, study of AKT signaling should optimally be conducted in an appropriate intracellular environment. Prognosis in soft-tissue sarcoma (STS), the aggressive malignancies of mesenchymal origin, is poor, reflecting our modest ability to control metastasis, an effort hampered by lack of insight into molecular mechanisms driving …

The Minimally Invasive Management Of Ureteropelvic Junction Obstruction In Horseshoe Kidneys, Costas D. Lallas, M.D., Facs, Raymond W. Pak, M.D., Christopher Pagnani, M.D., Scott G. Hubosky, M.D., Brent V. Yanke, M.D., Frank X. Keeley, M.D, Demetrius H. Bagley, M.D., Facs

Department of Urology Faculty Papers

Purpose: Data regarding the treatment of ureteropelvic junction obstruction (UPJO) in horseshoe kidneys are limited. We performed a retrospective analysis of our experience with minimally invasive treatment of UPJO in patients with this anomaly. Methods: Between March of 1996 and March 2008, 9 patients with horseshoe kidneys were treated for UPJO at our institution. Of these patients, 6 were managed with retrograde endopyelotomy, 2 with laparoscopic pyeloplasty, and one by robotic pyeloplasty. Outcomes of these procedures were retrospectively reviewed. Results: A total of nine patients were available for analysis. Four of six patients who underwent endopyelotomy had available follow-up, with …

A Test Of The Role Of The Medial Temporal Lobe In Single-Word Decoding., Karol Osipowicz, Tyler Rickards, Atif Shah, Ashwini Sharan, Michael Sperling, Waseem Kahn, Joseph Tracy

Department of Neurology Faculty Papers

The degree to which the MTL system contributes to effective language skills is not well delineated. We sought to determine if the MTL plays a role in single-word decoding in healthy, normal skilled readers. The experiment follows from the implications of the dual-process model of single-word decoding, which provides distinct predictions about the nature of MTL involvement. The paradigm utilized word (regular and irregularly spelled words) and pseudoword (phonetically regular) stimuli that differed in their demand for non-lexical as opposed lexical decoding. The data clearly showed that the MTL system was not involved in single word decoding in skilled, native …

Potential For Interdependent Development Of Trna Determinants For Aminoacylation And Ribosome Decoding., Cuiping Liu, Howard Gamper, Hanqing Liu, Barry S Cooperman, Ya-Ming Hou

Department of Biochemistry and Molecular Biology Faculty Papers

Although the nucleotides in tRNA required for aminoacylation are conserved in evolution, bacterial aminoacyl-transfer RNA synthetases are unable to acylate eukaryotic tRNA. The cross-species barrier may be due to the absence of eukaryote-specific domains from bacterial aminoacyl-transfer RNA synthetases. Here we show that whereas Escherichia coli CysRS cannot acylate human tRNA(Cys), the fusion of a eukaryote-specific domain of human CysRS overcomes the cross-species barrier in human tRNA(Cys). In addition to enabling recognition of the sequence differences in the tertiary core of tRNA(Cys), the fused eukaryotic domain redirects the specificity of E. coli CysRS from the A37 present in bacterial tRNA(Cys) …

Tissue-Specific Regulation Of Mouse Microrna Genes In Endoderm-Derived Tissues., Yan Gao, Jonathan Schug, Lindsay B Mckenna, John Le Lay, Klaus H Kaestner, Linda E Greenbaum

Department of Cancer Biology Faculty Papers

MicroRNAs fine-tune the activity of hundreds of protein-coding genes. The identification of tissue-specific microRNAs and their promoters has been constrained by the limited sensitivity of prior microRNA quantification methods. Here, we determine the entire microRNAome of three endoderm-derived tissues, liver, jejunum and pancreas, using ultra-high throughput sequencing. Although many microRNA genes are expressed at comparable levels, 162 microRNAs exhibited striking tissue-specificity. After mapping the putative promoters for these microRNA genes using H3K4me3 histone occupancy, we analyzed the regulatory modules of 63 microRNAs differentially expressed between liver and jejunum or pancreas. We determined that the same transcriptional regulatory mechanisms govern tissue-specific …

Obesity And Cancer Screening According To Race And Gender., Heather Bittner Fagan, Richard Wender, Ronald E Myers, Nicholas Petrelli

Department of Family & Community Medicine Faculty Papers

The relationship between obesity and cancer screening varies by screening test, race, and gender. Most studies on cervical cancer screening found a negative association between increasing weight and screening, and this negative association was most consistent in white women. Recent literature on mammography reports no association with weight. However, some studies show a negative association in white, but not black, women. In contrast, obese/overweight men reported higher rates of prostate-specific antigen (PSA) testing. Comparison of prostate cancer screening, mammography, and Pap smears implies a gender difference in the relationship between screening behavior and weight. In colorectal cancer (CRC) screening, the …

Conventional Aortic Valve Replacement For Elderly Patients In The Current Era., Kentaro Yamane, Hitoshi Hirose, Benjamin A Youdelman, Linda J Bogar, James T. Diehl

Department of Surgery Faculty Papers

BACKGROUND: Because of the rising expectation of prolonged life in the general population and the recent recognition of undertreated aortic valve disease in the elderly, updating the available results of aortic valve surgery is imperative, especially considering the rapid evolution of the transcatheter valve implantation procedure.

METHODS AND RESULTS: Between 1997 and 2010, 308 patients aged 70 years or older underwent aortic valve replacement (AVR) for aortic stenosis (AS). Short- and long-term results were analyzed and risk factors for long-term mortality were determined. Mean age was 78.5 years and 124 patients were aged 80 or older. Concomitant coronary artery bypass …

Amyloid-Beta/Fyn–Induced Synaptic, Network, And Cognitive Impairments Depend On Tau Levels In Multiple Mouse Models Of Alzheimer’S Disease, Erik D. Roberson, Brian Halabisky, Jong W. Yoo, Jinghua Yao, Jeannie Chin, Fengrong Yan, Tiffany Wu, Patricia Hamto, Nino Devidze, Gui-Qiu Yu, Jorge J. Palop, Jeffrey L. Noebels, Lennart Mucke

Farber Institute for Neuroscience Faculty Papers

Alzheimer's disease (AD), the most common neurodegenerative disorder, is a growing public health problem and still lacks effective treatments. Recent evidence suggests that microtubule-associated protein tau may mediate amyloid-β peptide (Aβ) toxicity by modulating the tyrosine kinase Fyn.Weshowed previously that tau reduction prevents, and Fyn overexpression exacerbates, cognitive deficits in human amyloid precursor protein (hAPP) transgenic mice overexpressing Aβ. However, the mechanisms by which Aβ, tau, and Fyn cooperate in AD-related pathogenesis remain to be fully elucidated. Here we examined the synaptic and network effects of this pathogenic triad. Tau reduction prevented cognitive decline induced by synergistic effects of Aβ …

The History Of Urological Care And Training At Thomas Jefferson University, Max Koppel, Md, Patrick J. Shenot, Md, Dolores Bryne, Phd, Leonard G. Gomella, Md

Department of Urology Faculty Papers

The Department of Urology at Thomas Jefferson University and Thomas Jefferson University Hospital is generally acknowledged as the oldest formal Department of Urology in the US, formally designated as the Department of Genitourinary Surgery in 1904. The Department has been under the direction of 8 chairmen and has trained over 144 residents and 25 fellows with over 200 Jefferson Medical College graduates specializing in urology. Thomas Jefferson University was originally founded as Jefferson Medical College in 1824. Dr. George McClelland petitioned Jefferson College at Cannonsburg (now Washington and Jefferson College) to add a medical school to their institution. While technically …

Serum Monocyte Chemoattractant Protein-1 In Pancreatic Cancer., Jennifer Sullivan, Qiaoke Gong, Terry Hyslop, Harish Lavu, Galina Chipitsyna, Charles Yeo, Hwyda A Arafat

Department of Surgery Faculty Papers

Background/Aims. Pancreatic ductal adenocarcinoma (PDA) has etiological association with chronic inflammation. Elevated circulating levels of inflammatory mediators, such as monocyte chemoattractant protein-1 (MCP-1), are found in obese individuals. We hypothesized that serum MCP-1 levels are elevated in obese PDA patients. Methods. ELISA was used to analyze MCP-1 serum levels in PDA (n = 62) and intraductal papillary mucinous neoplasms (IPMN) (n = 27). Recursive partitioning statistical analysis investigated the relationship between log MCP-1 and clinicopathological parameters. Results. Log MCP-1 values were significantly (P < 0.05) elevated in patients with BMI ≥ 37.5. In patients with BMI < 37.5, average log MCP-1 values were significantly elevated in PDA patients when compared to IPMN patients. Within the IPMN group, higher log MCP-1 levels correlated with increased age. Recursive partitioning analysis of IPMN versus PDA revealed a strategy of predicting characteristics of patients who are more likely to have cancer. This strategy utilizes log MCP-1 as the primary factor and also utilizes smoking status, gender, and age. Conclusion. MCP-1 is a promising biomarker in pancreatic cancer. The potential of using MCP-1 to distinguish PDA from IPMN patients must be studied in larger populations to validate and demonstrate its eventual clinical utility.

Adrenal Beta-Arrestin 1 Inhibition In Vivo Attenuates Post-Myocardial Infarction Progression To Heart Failure And Adverse Remodeling Via Reduction Of Circulating Aldosterone Levels, Anastasios Lymperopoulos, Phd, Giuseppe Rengo, Md, Carmela Zincarelli, Md, Jihee Kim, Phd, Walter J. Koch, Phd

Center for Translational Medicine Faculty Papers

ABSTRACT

OBJECTIVES: We investigated whether adrenal betaarrestin 1 (betaarr1)-mediated aldosterone production plays any role in post-MI HF progression.

BACKGROUND: Heart failure (HF) represents one of the most significant health problems worldwide and new and innovative treatments are needed. Aldosterone contributes significantly to HF progression after myocardial infarction (MI) by accelerating adverse cardiac remodeling and ventricular dysfunction. It is produced by the adrenal cortex after angiotensin II (AngII) activation of AngII type 1 receptors (AT1Rs), G protein-coupled receptors (GPCRs) that also signal independently of G proteins. G protein-independent signaling is mediated by betaarrestin (betaarr) -1 and -2. We recently reported that …

Basal Internal Anal Sphincter Tone, Inhibitory Neurotransmission, And Other Factors Contributing To The Maintenance Of High Pressures In The Anal Canal, S. Rattan, J. Singh

Division of Gastroenterology and Hepatology Faculty Papers

Maintenance of the basal tone in the internal anal sphincter (IAS) is critical for rectoanal continence. Effective evacuation requires a fully functional rectoanal inhibitory reflex (RAIR)-mediated relaxation of the IAS via inhibitory neurotransmission (INT). Systematic studies examining the nature of the INT in different species have identified nitric oxide (NO) as the major inhibitory neurotransmitter. However, other mediators such as vasoactive intestinal polypeptide (VIP), ATP, and carbon monoxide (CO) may also play species-specific role under certain experimental conditions. Measurements of the intraluminal pressures in the IAS along with the force of the isolated IAS tissues are the mainstay in the …

Assessment Of “Gene-Environment” Interaction In Cases Of Familial & Sporadic Pancreatic Cancer, Theresa Yeo, Ralph Hruban, Kieran Brune, Alison Klein, Shiela Fitzgerald, Charles Yeo

College of Nursing Faculty Papers & Presentations

Background: Pancreatic cancer (PC) is the fourth leading cause of cancer death in the United States. Reported risk factors for PC include: advancing age, a family history of PC, high-risk inherited syndromes, cigarette smoking, exposure to occupational and environmental carcinogens, African-American race, high fat/high cholesterol diet, obesity, chronic pancreatitis, and diabetes mellitus.

Purpose: The purpose of this study was to characterize one of the largest national registries of familial PC (FPC) and sporadic PC (SPC), focusing on demographics, clinical factors, self-reported environmental and occupational lifetime exposures and survival status.

Methods: Retrospective cross-sectional, case-only analysis of FPC cases (n …

Incivility In Healthcare Settings: Manifestations, Root Causes, And Downstream Effects On Patient Care And Productivity, Theresa P. Yeo, Anne Belcher, Charles J. Yeo

College of Nursing Faculty Papers & Presentations

PURPOSE: To investigate the prevalence and effects of incivility in healthcare and educational settings

METHODS: Review of the literature

SEARCH STRATEGY: CINAHL, PubMed, Joint Commission sites searched using terms: incivility, workplace violence, disruptive behavior, bullying

Neurologic Improvement After Thoracic, Thoracolumbar, And Lumbar Spinal Cord (Conus Medullaris) Injuries, James S. Harrop, Md, Swetha Naroji, Mitchell G. Maltenfort, Phd, John K. Ratliff, Md, Stavropoula L. Tjoumakaris, Brian Frank, D. Greg Anderson, M.D., Todd Albert, Md, Alexander R. Vaccaro, Md, Phd

Department of Orthopaedic Surgery Faculty Papers

Study Design. Retrospective. Objective. With approximately 10,000 new spinal cord injury (SCI) patients in the United States each year, predicting public health outcomes is an important public health concern. Combining all regions of the spine in SCI trials may be misleading if the lumbar and sacral regions (conus) have a neurologic improvement at different rates than the thoracic or thoracolumbar spinal cord.

Summary of Background Data. Over a 10-year period between January 1995 to 2005, 1746 consecutive spinal injured patients were seen, evaluated, and treated through a level 1 trauma referral center. A retrospective analysis was performed on 150 patients …

The Infected Hip: A Treatment Algorithm, Bahar Adeli, Javad Parvizi Md

Department of Orthopaedic Surgery Faculty Papers

The management of periprosthetic joint infection following total joint arthroplasty is presently a major challenge to orthopedic surgeons. Despite various treatment options available, the two-stage revision procedure is most often chosen in North America because of a high success rate, especially in cases involving resistant organisms. Sometimes the use of antibiotics alone, irrigation with debridement, or a one-stage exchange may be a more appropriate treatment option. Various factors such as the status of a patient’s immune system, time of onset of the infection, as well as susceptibility of causative microorganism should be considered as they play an important role in …

Dyssynchrony In Obese Subjects Without A History Of Cardiac Disease Using Velocity Vector Imaging, Bhaskar Purushottam Md, Anoop C. Parameswaran Md, Mph, Vincent M. Figueredo Md

Division of Cardiology Faculty Papers

Abstract

Aim: To examine the occurrence of intra-left ventricular (LV) dyssynchrony in obese versus non-obese subjects without known cardiac disease using velocity vector imaging (VVI).

Methods: One hundred ninety consecutive subjects with no known cardiac disease had their echocardiograms analyzed using VVI after excluding subjects with QRS duration >120ms or LV ejection fraction (LVEF) <55%. Study subjects were divided into two groups based on body mass index (BMI): obese (BMI >30 kg/m2) and non-obese (BMI <30 kg>/m2).

Results: The final cohort included 136 subjects (74 were obese), 32% female and mean age 55 + 16 years. Occurrence of intra LV dyssynchrony was higher in the obese compared to non-obese group.

Conclusions: There was an increased prevalence of …

Ventral Hernia Repairs: 10 Year Single Institution Review At Thomas Jefferson University Hospital, Frederick C. Sailes, Md, Jason Walls, Md, Daria Guelig, Md, Mike Mirzabeigi, Ma, William D. Long, Ms, Albert Crawford, Phd, John H. Moore Jr, Md, Facs, Steven E. Copit, Md, Gary A. Tuma, M.D, James Fox, Md

Department of Surgery Faculty Papers

Abstract

Background Definitive repair of recurrent ventral hernias using abdominal wall reconstruction techniques is an essential tool in the armentarium for general and plastic surgeons. Ramirez 1 et al describes the “component separation” technique to mobilize the rectus-abdominus internal oblique and external oblique flap to correct the defect. The recurrence rate of incisional hernias increases to 20% after gastric bypass or extensive weight loss.2 The incidence of ventral hernias after failed recurrent hernia repair increases to 40%.3 It has been reported that utilizing the sliding myofascial flap repair technique, the recurrence rate was reduced to 8.5%.4

Materials and Methods This …

Acetate Causes Alcohol Hangover Headache In Rats, Christina R. Maxwell, Rebecca Jay Spangenberg, Jan B. Hoek, Stephen D. Silberstein, Michael L. Oshinsky

Department of Neurology Faculty Papers

Background

The mechanism of veisalgia cephalgia or hangover headache is unknown. Despite a lack of mechanistic studies, there are a number of theories positing congeners, dehydration, or the ethanol metabolite acetaldehyde as causes of hangover headache.

Methods

We used a chronic headache model to examine how pure ethanol produces increased sensitivity for nociceptive behaviors in normally hydrated rats.

Results

Ethanol initially decreased sensitivity to mechanical stimuli on the face (analgesia), followed 4 to 6 hours later by inflammatory pain. Inhibiting alcohol dehydrogenase extended the analgesia whereas inhibiting aldehyde dehydrogenase decreased analgesia. Neither treatment had nociceptive effects. Direct administration of acetate …