Medical Specialties Commons^™

Intracranial Pressure Is A Better Predictor Of Mortalitythan Cerebral Perfusion Pressure, Ronald J. Markert, Jonathan M. Saxe, Cathryn L. Chadwick

Internal Medicine Faculty Publications

Objective: To evaluate whether elevated intracranial pressure (ICP) or depressed cerebral perfusion pressure (CPP) is a better predictor of intracranial compartment syndrome and long-term functional outcomes in blunt traumatic brain injury.

Methods: This was a retrospective evaluation of data collected on 203 patients with blunt traumatic brain injury who were admitted to Miami Valley Hospital, a Level I trauma center, over a 2 years period, whose initial hospital management required an intracranial pressure monitor. Serial measurements of ICP and CPP were recorded during the patients’ hospital stay. These patients were then evaluated at 3,6,12 and 24 months post-injury to assess …

Abnormal Placental Findings Associated With Non-Reassuring Fetal Monitoring And Excellent Neonatal Outcomes, Gary Ventolini, Shanthi Ramesh, Sheela M. Barhan, Ran Neiger

Obstetrics and Gynecology Faculty Publications

Objective: Obstetricians, Neonatologists, and Pathologists have studied gross histological analysis of human placentas in search of specific alterations in placental functions that can be correlated with neonatal outcomes. Our study assessed the prevalence of abnormal placental findings associated with non-reassuring fetal monitoring in labor requiring emergent instrumental or cesarean delivery, followed by an excellent neonatal outcome. Study Design: One hundred consecutive emergency deliveries, instrumental or cesarean, performed due to non-reassuring fetal monitoring while in labor were retrospectively evaluated. All patients were low-risk for obstetric complications, and had a singleton, term pregnancy. They had a normal antenatal routine testing and a …

Beyond Mannequins: A Potpourri Of Enabling Technology For Healthcare Education, Rosalyn P. Scott

Department of Surgery Faculty Publications

No abstract provided.

Expression Of Microphthalmia Transcription Factor In Sentinel Lymph Nodes Of Patients With Melanoma, Minia Hellan, Michelle S. Gentile, Luay Ailabouni, George I. Salti

Department of Surgery Faculty Publications

Background: Sentinel lymph node biopsy is widely used in the management of melanoma patients. Multiple markers are used to stain sentinel lymph node tissue including S100, HMB-45 and melan A with different success. We investigated, for the first time, the use of Microphthalmia transcription factor (Mitf) staining in a larger series of sentinel lymph nodes. Mitf is a transcription factor essential for the development and survival of melanocytes. It has been introduced recently as a sensitive and specific marker for melanomas. Methods: Thirty patients with cutaneous melanoma were included in our study: twenty patients underwent sentinel lymph node biopsy; ten …

Vital Signs, Summer 2011, Boonshoft School Of Medicine

Vital Signs

A forty-eight page newsletter created by the Boonshoft School of Medicine to document the current affairs of the school. This issue includes a variety of feature articles, a research spotlight, alumni notes, and more.

Current Management Of Complicated Pneumonia In Children, Sherman J. Alter, Elizabeth H. Ey, Mark Warren, Jeffrey C. Pence

Department of Surgery Faculty Publications

No abstract provided.

Intravenous Ascorbic Acid To Prevent And Treat Cancer-Associated Sepsis?, Thomas E. Ichim, Boris Minev, Todd Braciak, Brandon Luna, Ron Hunninghake, Nina A. Mikirova, James A. Jackson, Michael J. Gonzalez, Jorge R. Miranda-Massari, Doru T. Alexandrescu, Constantin A. Dasanu, Vladimir Bogin, Janis Ancans, R. Brian Stevens, Boris Markosian, James Koropatnick, Chien-Shing Chen, Neil H. Riordan

Department of Surgery Faculty Publications

The history of ascorbic acid (AA) and cancer has been marked with controversy. Clinical studies evaluating AA in cancer outcome continue to the present day. However, the wealth of data suggesting that AA may be highly beneficial in addressing cancer-associated inflammation, particularly progression to systemic inflammatory response syndrome (SIRS) and multi organ failure (MOF), has been largely overlooked. Patients with advanced cancer are generally deficient in AA. Once these patients develop septic symptoms, a further decrease in ascorbic acid levels occurs. Given the known role of ascorbate in: a) maintaining endothelial and suppression of inflammatory markers; b) protection from sepsis …

Gastric Antral Web In A 103-Year-Old Patient, Waheed Gul, Khurram Abbass, Ronald J. Markert, Christopher J. Barde

Internal Medicine Faculty Publications

No abstract provided.

Population Pharmacokinetic (Pk) And Pharmacodynamic (Pd) Modeling Of Ticarcillin‐Clavulanate In Pediatric Cf Patients, Jeffery T. Zobell, Chris Stockmann, D. C. Young, Jared Cash, Catherine M.T. Sherwin, Michael G. Spigarelli, Barbara A. Chatfield, Krow Ampofo

Pediatrics Faculty Publications

No abstract provided.

Portable Ultrasonography In Mass Casualty Incidents: The Caveat Examination, Stanislaw P. Stawicki, James M. Howard, John P. Pryor, David P. Bahner, Melissa L. Whitmill, Anthony J. Dean

Department of Surgery Faculty Publications

Ultrasonography used by practicing clinicians has been shown to be of utility in the evaluation of time-sensitive and critical illnesses in a range of environments, including pre-hospital triage, emergency department, and critical care settings. The increasing availability of light-weight, robust, user-friendly, and low-cost portable ultrasound equipment is particularly suited for use in the physically and temporally challenging environment of a multiple casualty incident (MCI). Currently established ultrasound applications used to identify potentially lethal thoracic or abdominal conditions offer a base upon which rapid, focused protocols using hand-carried emergency ultrasonography could be developed. Following a detailed review of the current use …

Pediatric Primary Intramedullary Spinal Cord Glioblastoma, Robert M. Lober, Robert M. Lober, Suash Sharma, Beverly Bell, Alan Free, Ramon Figueroa, Chris W. Sheils, Mark Lee, John Kenneth Cowell

Pediatrics Faculty Publications

Spinal cord tumors in pediatric patients are rare, representing less than 1% of all central nervous system tumors. Two cases of pediatric primary intramedullary spinal cord glioblastoma at ages 14 and 8 years are reported. Both patients presented with rapid onset paraparesis and quadraparesis. Magnetic resonance imaging in both showed heterogeneously enhancing solitary mass lesions localized to lower cervical and upper thoracic spinal cord parenchyma. Histopathologic diagnosis was glioblastoma. Case #1 had a small cell component (primitive neuroectodermal tumor-like areas), higher Ki67, and p53 labeling indices, and a relatively stable karyotype with only minimal single copy losses involving regions: Chr8;pter-30480019, …

18F-Fallypride Binding Potential In Patients With Schizophrenia Compared To Healthy Controls, Douglas S. Lehrer, Bradley T. Christian, Cemil Kirbas, Meicheng Chiang, Shawn Sidhu, Holly Short, Binquan Wang, Bingzhi Shi, King Wai Chu, Brian Merrill, Monte S. Buchsbaum

Psychiatry Faculty Publications

Background: Molecular imaging of dopaminergic parameters has contributed to the dopamine hypothesis of schizophrenia, expanding our understanding of pathophysiology, clinical phenomenology and treatment. Our aim in this study was to compare 18F-fallypride binding potential BPND in a group of patients with schizophrenia-spectrum illness vs. controls, with a particular focus on the cortex and thalamus. Methods: We acquired 18F-fallypride positron emission tomography images on 33 patients with schizophrenia spectrum disorder (28 with schizophrenia; 5 with schizoaffective disorder) and 18 normal controls. Twenty-four patients were absolutely neuroleptic naïve and nine were previously medicated, although only four had a lifetime neuroleptic exposure of …

Vital Signs, Fall 2010, Boonshoft School Of Medicine

Vital Signs

A fifty-six page newsletter created by the Boonshoft School of Medicine to document the current affairs of the school. This issue includes a variety of feature articles, a research spotlight, a calendar of events, and more.

Vital Signs, Spring 2010, Boonshoft School Of Medicine

Vital Signs

A fifty-six page newsletter created by the Boonshoft School of Medicine to document the current affairs of the school. This issue includes a variety of feature articles, a research spotlight, a calendar of events, and more.

Appendicitis: When Simple Becomes Not So Simple, Elizabeth H. Ey, Jeffrey C. Pence

Department of Surgery Faculty Publications

No abstract provided.

Montgomery County Breast Cancer Study: Demographic Analysis Of Breast Cancer In Montgomery County, Ohio, Danial Jilani

Master of Public Health Program Student Publications

Background: Disparities exist in cancer incidence and mortality between specific population groups in the United States. Breast cancer is the second most common form of cancer diagnosed in women. Breast cancer ranks as the second highest leading cause of death for women in the state of Ohio and in the United States. Perhaps more concerning, breast cancer is the leading cause of death for Hispanic women and ranks second for white, black, Asian, and Native American women. Specifically, women of low socioeconomic status (SES) have been shown to have lower rates of survival.

Methods: A descriptive study of …

End-Of-Life Issues In The Acute And Critically Ill Patient, Eric A. Savory, Catherine A. Marco

Emergency Medicine Faculty Publications

The challenges of end-of-life care require emergency physicians to utilize a multifaceted and dynamic skill set. Such skills include medical therapies to relieve pain and other symptoms near the end-of-life. Physicians must also demonstrate aptitude in comfort care, communication, cultural competency, and ethical principles. It is imperative that emergency physicians demonstrate a fundamental understanding of end-of-life issues in order to employ the versatile, multidisciplinary approach required to provide the highest quality end-of-life care for patients and their families.

Technology, Context, Synthesis, Rosalyn P. Scott

Department of Surgery Faculty Publications

No abstract provided.

Individualized Learning Plans: Faculty As Facilitators, Ann Burke

Pediatrics Faculty Publications

Introduction: Individualized learning plans (ILPs) are documented personal learning objectives developed by a learner with the help of a facilitator. The Pediatric Residency Review Committee requires residents to accomplish one ILP per year. Faculty members, including program directors, who are newly responsible for facilitating development of resident ILPs may feel unprepared for the task. They are likely unfamiliar with the concepts of ILPs, and most have not created an ILP of their own. Methods: This paper-based faculty development curriculum is designed to educate faculty members on ILPs. The materials include a didactic introduction regarding ILPs and an overview of adult …

Vital Signs, Spring/Summer 2009, Boonshoft School Of Medicine

Vital Signs

A fifty-six page newsletter created by the Boonshoft School of Medicine to document the current affairs of the school. This issue includes a variety of feature articles and smaller pieces that focus on faculty, students, milestones and more.

Bleeding Meckel’S Diverticulum In A 4-Month-Old Infant: Treatment With Laparoscopic Diverticulectomy. A Case Report And Review Of The Literature, J. Rainer Poley, Thomas E. Thielen, Jeffrey C. Pence

Department of Surgery Faculty Publications

A bleeding Meckel’s diverticulum is presented in a 4-month-old African American infant. This event is rare at this age, and our patient is only the second 4-month-old infant reported in the English literature. The infant presented with painless frank rectal bleeding, the blood being maroon-colored, and clots were found in the diaper. There was also anemia, with an hemoglobin of less than 8 gm/dl. The color of the blood suggested a bleeding site in the ileocecal region, a Meckel’s diverticulum was suspected, which was then confirmed by an isotope scan. A typical Meckel’s diverticulum was found on laparoscopic surgery, was …

Smoking And Second Hand Smoking In Adolescents With Chronic Kidney Disease: A Report From The Chronic Kidney Disease In Children (Ckid) Cohort Study, Abiodun Aderogba Omoloja, J. Jerry-Fluker, Alison Abraham, S. Furth, B. Warady, M. Mitsnefes

Pediatrics Faculty Publications

The goal of this study was to determine the prevalence of smoking and second hand smoking [SHS] in adolescents with CKD and their relationship to baseline parameters at enrollment in the CKiD, observational cohort study of 600 children (aged 1-16 yrs) with Schwartz estimated GFR of 30-90 ml/min/1.73m2. 239 adolescents had self-report survey data on smoking and SHS exposure: 21 [9%] subjects had “ever” smoked a cigarette. Among them, 4 were current and 17 were former smokers. Hypertension was more prevalent in those that had “ever” smoked a cigarette (42%) compared to non-smokers (9%), p

Vital Signs, Fall 2008, Boonshoft School Of Medicine

Vital Signs

A fifty-five page newsletter created by the Boonshoft School of Medicine to document the current affairs of the school. This issue includes a variety of feature articles, a research spotlight, and more.

Robotic Rectal Cancer Surgery, Minia Hellan, Joshua Ellenhorn, Alessio Pigazzi

Department of Surgery Faculty Publications

No abstract provided.

Interventional Options For Malignant Upper Gi Obstruction, 2nd Ed, James R. Ouellette, Lisa Patterson, Paula M. Termuhlen

Department of Surgery Faculty Publications

Background

Patients with unresectable cancers of the upper gastrointestinal tract often suffer severe symptoms due to pain, nausea and vomiting, weight loss, cachexia, and poor food tolerance. This can be related to gastric and duodenal cancers causing intrinsic obstruction of the intestinal lumen or pancreatic and biliary cancers causing extrinsic biliary compression. Management options vary depending on the site of obstruction, the patient’s functional status, the patient-defined goals of care, and estimated prognosis. Fast Fact #45 discussed medical management options. This Fact Fact reviews interventional approaches for upper GI obstructions, especially when further radiation, chemotherapy, medical management, or curative surgical …

Anti-Tumor Effect Of Doxycycline On Glioblastoma Cells, Andrea Wang-Gillam, Eric Siegel, Debra A. Mayes, Laura F. Hutchins, Yi-Hong Zhou

Neuroscience, Cell Biology & Physiology Faculty Publications

AIM: Glioblastoma multiforme (GBM) is the most common primary brain tumor in humans, and it is highly invasive. Doxycycline, first identified as an antimicrobial agent, is a nonspecific inhibitor of matrix metalloproteinases (MMPs). Our objective was to investigate the anti-MMP effect of doxycycline at therapeutically acceptable levels on glioma cells in vitro.

METHODS: The MTT assay was used to determine the anti-proliferative effects of doxycycline. MMP2 activity and expression were determined by gelatinase zymography and real-time quantitative RT-PCR, respectively. Cell invasion was assessed by Matrigel invasion assay.

RESULTS: Doxycycline exerted mild anti-proliferative effects on all three glioma cell lines …

Vital Signs, Fall 2007, Boonshoft School Of Medicine

Vital Signs

A twenty-seven page newsletter created by the Boonshoft School of Medicine to document the current affairs of the school. This issue includes a variety of feature articles, alumni profiles, class notes, and more.

Vital Signs, Spring 2007, Boonshoft School Of Medicine

Vital Signs

A twenty-seven page newsletter created by the Boonshoft School of Medicine to document the current affairs of the school. This issue includes a variety of feature articles, an alumni profile, class notes, and more.

Implementation Of An Antibiotic Nomogram Improves Postoperative Antibiotic Utilization And Safety In Patients Undergoing Coronary Artery Bypass Grafting, Thomas J. Papadimos, Jennifer L. Grabarczyk, Daniel F. Grum, James P. Hofmann, Alan P. Marco, Sadik A. Khuder

Anesthesiology Faculty Publications

Background

Routine, initial, empiric vancomycin dosing by clinicians in postoperative coronary artery bypass grafting (CABG) patients was identified as a potential patient safety issue in the Cardiovascular Intensive Care Unit (CVICU) because the rate of postoperative acute renal insufficiency (ARI) and average patient Body Mass Index (BMI) > 35 kg/m2 were significantly higher in our institution than those of the Society of Thoracic Surgeons (STS) database. A vancomycin dosing nomogram was derived from the local patient population in the attempt to improve patient safety by convincing clinicians to use an evidence-based approach to vancomycin prescription.

Methods

We analyzed two different treatment …

Fracture Of The Scapula With Intrathoracic Penetration In A Skeletally Mature Patient, Cary C. Schwartzbach, Hani Seoudi, Amy E. Ross, Kimberly M. Hendershot, Linda Robinson, Alireza Maekzadeh

Department of Surgery Faculty Publications

To our knowledge, intrathoracic displacement of a fractured scapula has only been described in two reports involving adolescents^1,2. We present the case of a skeletally mature adult with a scapular fracture that penetrated the thoracic cage without causing a pneumothorax. We speculate as to how the adult scapula can deform in a manner consistent with this rare injury. As the patient had advanced Alzheimer disease, the family consented to the publication of data concerning this case.