Medical Specialties Commons^™

Role Of Surgery In Cerebral Venous Sinus Thrombosis, S. Ather Enam

Department of Surgery Docs

Cerebral venous sinus thrombosis (CVST) usually is taken care of by medical management or neuro-interventional vascular techniques. Some cases of CVST may take a malignant course if the intracranial pressure increases excessively. This increase in pressure is because of oedema in brain tissue due to impediment in venous return and/or intracerebral haemorrhage. Neurosurgical experience has shown remarkable recovery in these moribund patients if appropriate surgical intervention is done within reasonable time. Emergent decompressive craniotomy or other neurosurgical interventions are the only appropriate treatment in these malignant forms of CVST to prevent mortality and severe morbidity.

Bibliography Of Secondary Sources On The History Of Dermatology Iii. Books, Monographs, And Chapters In English Supplemented Through 2005., Lawrence Charles Parish, John Thorne Crissey, Jennifer L Parish, Daniel H Parish

Department of Dermatology and Cutaneous Biology Faculty Papers

Providing supplements to the history of dermatology bibliographic record has been a continuous project for the past four decades. When the endeavor was initiated, the original authors decided that only contributions in English and those directly related to dermatology, excluding sexually transmitted diseases as such, would be indexed.

There is the perennial question of whether such a manually created bibiliographic project has a need. The obvious answer remains yes. While Index Medicus has expanded the number of journals that are indexed, the number of dermatology publications currently included by Index Medicus is just over fifty. Granted, most of the papers …

Dermatology Is A Specialty; Dermatology Is Not A Subspecialty., Lawrence Parish, Larry E Millikan

Department of Dermatology and Cutaneous Biology Faculty Papers

Specialization began in American medicine about the time of the War Between the States. Several factors spurred the direction of practitioners away from being the so-called “complete physicians. Most important were the advances in instrumentation made by the 1860’s, which allowed ophthalmology and otolaryngology to develop into distinct divisions of allopathic medicine; sometimes, they even joined together, viz eye, ear, nose, and throat specialist. Dermatology, too, became one of the early specialties for a myriad of reasons ranging from the obvious – visual inspection - to the mundane, viz. default – syphilis was too ugly and complicated for every physician …

Gnrh Agonist And Antagonist: Options For Endometriosis Pain Treatment , Frances R. Batzer

Department of Obstetrics and Gynecology Faculty Papers

Basic science research into the mechanism of the development of endometriosis, its persistence and resulting pain has begun to improve our understanding of how various therapeutic options work. While none of the available treatments resolves the underlying disease process, there are a growing number of alternatives. One of the more recent classes of medical options includes the GnRH agonist and antagonists. While at present this class of medical options is the most expensive and involved in implementation, they prove invaluable in terms of offering an aggressive, successful alternative for many patients. Furthermore, they may act directly on endometrial lesions in …

Computed Tomographic Imaging Of Cerebral Venous Thrombosis, Mohammad Kamran Kamal

Department of Radiology

Cerebral venous thrombosis (CVT) is an entity which is not rare and can have devastating consequences if not diagnosed and treated in a timely manner. Although, the gold standard for diagnosing this entity is a catheter angiogram, magnetic resonance venography, by virtue of its non-invasiveness and detailed demonstration of the cerebral venous structures, has become the diagnostic modality of choice for this entity. However, in a resource-strapped country like Pakistan, CT scan remains the primary first (and sometimes the only) diagnostic modality used in patients with neurological problems. Therefore, it is important to recognize the signs of cerebral venous thrombosis …

Prognostic Indicators In Cerebral Venous Sinus Thrombosis, Bilal Hameed, Nadir Ali Syed

Section of Neurology

Cerebral venous sinus thrombosis (CVT) can affect all age groups, particularly women of childbearing age. Overall prognosis for survival and functional independence is better than it was believed. Mortality usually ranges from 6-15% and transtentorial herniation is the major cause of death. Approximately 80% of patients are functionally independent in the long term. Altered mental status and cerebral haemorrhage at presentation are the strongest predictors of death and disability. Patients with CVT related to pregnancy and puerperium generally do better than patients with other causes. Septic CVT carries a worse prognosis than aseptic CVT and of the latter, patients with …

Oral Contraceptives And Cerebral Venous Thrombosis: Case Report And A Brief Review Of Literature, Mughis Sheerani, Mian Zainul Sajadeen Urfy

Section of Neurology

Cerebral venous thrombosis remains an important and sometimes an elusive cause of strokes. Oral contraceptives seem to have a strong causative association with this entity. We describe a case that highlights the importance of asking specific questions about oral contraceptive use in patients with strokes due to cerebral venous sinus thrombosis, especially, where the cause remains cryptic.

Local Thrombolytic Treatment Of Cerebral Venous Thrombosis In Three Paediatric Patients, Mohammad Wasay, Rohit Bakshi, Alper Dai, Steve Roach

Section of Neurology

There is increasing evidence that local thrombolysis can be used with relative safety and efficacy in adults with superior sagittal sinus thrombosis (SSST). However, little data is available on the use of local thrombolysis in children with SSST. We report three patients who received local thrombolysis for dural sinus thrombosis. Two patients received urokinase and one patient received urokinase followed by local TPA infusion. Recanalization was achieved in two patients.

Mri And Mrv In Cerebral Venous Thrombosis, Zafar Sajjad

Department of Radiology

Although Cerebral venous thrombosis is an uncommon cause of stroke among the young, it is being increasingly recognised. A prothrombotic risk factor is identified in the majority of the patients. In most instances it is seen in women in the post-partum period and those on oral contraceptives. Magnetic Resonance Imaging (MRI) has improved our ability to diagnose this condition however the variability of radiological and clinical presentation remains a challenge. MR in combination with MR venography (MRV) is the single most sensitive diagnostic technique. The MR appearance of the thrombus within the dual sinus or cortical vein is variable and …

Carah's Bookshelf

CenterPieces

Occupational Therapy and Dementia Care: The Home Environmental Skills-Building Program for Individuals and Families

by Laura N. Gitlin, PhD and Mary Corcoran, PhD, OTR/L with contributors, published by AOTA Press, the American Occupational Therapy Association, Inc.

ISBN: 1569002037

Based on over 15 years of research, the book presents the Home Environmental Skill-building Program (ESP), an evidence-based intervention to support families and persons with dementia and enhance quality of life. The book provides the theoretical and empirical evidence for the program and describes its protocols in depth.

Physical Function in Older Adults: A Comprehensive Guide to Its Meaning and Measurement

by …

Download The Pdf Of The Full Issue

CenterPieces

For easy printing, the full newsletter is available as a single PDF.

We Are Seeking Participants For The Following Studies

CenterPieces

Title: Experience of Suffering in Old Age

Funding Source: National Institute on Aging

Principal Investigator: Helen K. Black, PhD

Target population: Philadelphia area residents over the age of 80 years old.

This 4-year study examines the experience of suffering and its relation to health, gender, and ethnicity among community dwelling elders aged 80+ using the open-ended interview schedule as its primary tool. This project explores through qualitative research the under-studied construct of suffering in later life and how suffering affects mental, physical and spiritual health.

Participants are interviewed in their homes on three occasions and are paid for their interviews. …

New Award: Carah And Germantown's Center In The Park Awarded $2.2 Million To Study Mental Health Of Older African-American Adults

CenterPieces

Why do older African-Americans tend to report less depression than Whites although they have poorer health and higher rates of chronic illness?

Research from the past 15 years consistently shows health disparities between Whites and minorities in the United States. African-Americans, in particular, are at higher risk than Caucasians for serious health conditions such as stroke, diabetes, cancer, cardiovascular disease and mild cognitive impairment. These chronic conditions typically contribute to depression in elders as a whole. However, the rates of depression for African-Americans are unclear with many studies reporting lower depression than in Whites and others reporting the reverse.

This …

Project Able Featured By Reuters Health Service

CenterPieces

CARAH's randomized trial, Project ABLE (Advancing Better Living for Elders), funded by the National Institute on Aging, and published in the May, 2006 issue of the Journal of the American Geriatric Society, was recently featured by Reuters Health service, the world's leading provider of medical and healthcare news.

This study tested a six-month intervention in which people received four 90-minute visits with an occupational therapist, as well as one 20-minute telephone contact, and one 90-minute physical therapy visit and home modifications provided by the Philadelphia Corporation for Aging. Of 319 men and women 70 years of age and older, half …

Geriatric Education Update

CenterPieces

Despite extensive government cutbacks in funding for aging research and elimination of federal support for geriatric and gerontological training, Jefferson has launched exciting new programs in this area. The year-old Division of Geriatric Medicine, housed within the Dept. of Family and Community Medicine, is under the directorship of Dr. Christine Arenson. In collaboration with CARAH, the Dept. of Occupational Therapy and the Dept. of Nursing, the Division has received funding for a Geriatric Education Center. In addition to Drs. Arenson and Gitlin, participants in this initiative include Dr. Cecelia Borden (Dept. of Nursing), Stephen Kern (Dept. of Occupational Therapy), Nancy …

2005 Dementia Conference Attracts Record Turn Out

CenterPieces

The 6th annual Dementia Management Conference - "New Directions in Providing Care to Patients and their Families" - was held on February 4, 2005 in the Bluemle Auditorium. This successful conference was co-sponsored by the Center for Applied Research on Aging and Health, Thomas Jefferson University Hospital and the Farber Institute for Neurosciences. In attendance were over 115 health care professionals, including physicians, nurses, occupational and physical therapists, social workers, researchers, and family members.

Attendees had the opportunity to learn from and ask questions of a panel of nationally recognized experts in the field of Alzheimer’s disease and related dementias. …

Message From Dean Erdman, James B. Erdman

CenterPieces

Congratulations to the Center and its Director, Dr. Laura Gitlin, on the inaugural issue of CARAH’s newsletter. In our discussions of the development of CARAH, one of the principal goals of the Center is its educational mission as is clear from the other information contained in this publication. Committed as the Center’s research professionals are to improving the health and quality of life of our seniors, it is not enough to conduct research that has the potential to provide significant help and support for patients and their caregivers. Those findings must also be disseminated, must be translated into action, must …

Graduating "Seniors" Of Center In The Park's Harvest Health Program

CenterPieces

"I have been to many health classes but none like this. This class was great and well organized."

"When I wake up I start exercising in bed. The Harvest Health classes have motivated me. I am now exercising 6 days a week."

"I use a motorized wheelchair, and I walk only a few steps. Thanks to the support from my classmates and the instructors, I achieved my action plan and am now walking in the corridor at Center in the Park. The program has motivated me to achieve my goals."

These are the accolades that Project Director Delores Palmer hears …

Message From Dr. Laura Gitlin, Director Of Carah, Laura N. Gitlin

CenterPieces

Welcome to the first issue of CenterPieces, the newsletter of the Center for Applied Research on Aging and Health.

Aging is a highly personal phenomenon. It obviously affects each of us on an individual, familia, and socio-political-economic level. Only a short 50 years ago, aging was viewed as a disease rather than a natural and important stage of human development. Although older people are at increased risk for heart disease, cancer, stroke, falls and cognitive impairments, more so than any other age group, new scientific breakthroughs show that frailty and physical and cognitive decline is a complex phenomenon and not …

P5l Mutation In Ank Results In An Increase In Extracellular Inorganic Pyrophosphate During Proliferation And Nonmineralizing Hypertrophy In Stably Transduced Atdc5 Cells, Raihana Zaka, David Stokes, Arnold S. Dion, Anna Kusnierz, Fei Han, Charlene J. Williams

Center for Translational Medicine Faculty Papers

Ank is a multipass transmembrane protein that regulates the cellular transport of inorganic pyrophosphate. In the progressive ankylosis (ank) mouse, a premature termination mutation at glutamic acid 440 results in a phenotype characterized by inappropriate deposition of basic calcium phosphate crystals in skeletal tissues. Mutations in the amino terminus of ANKH, the human homolog of Ank, result in familial calcium pyrophosphate dihydrate deposition disease. It has been hypothesized that these mutations result in a gain-of-function with respect to the elaboration of extracellular inorganic pyrophosphate. To explore this issue in a mineralization-competent system, we stably transduced ATDC5 cells with wild-type Ank …

Sixty-Four-Slice Multidetector Computed Tomography: The Future Of Ed Cardiac Care, Alexander T. Limkakeng, Ethan Halpern, Kevin M. Takakuwa

Department of Radiology Faculty Papers

Multidetector computed tomography (MDCT) imaging, a technological advance over traditional CT, is a promising possible alternative to cardiac catheterization for evaluating patients with chest pain in the emergency department (ED). In comparison with traditional CT, MDCT offers increased spatial and temporal resolution that allows reliable visualization of the coronary arteries. In addition, a "triple scan," which includes evaluation for pulmonary embolism and thoracic aortic dissection, can be incorporated into a single study. This test will enable emergency physicians to rapidly evaluate patients for life-threatening illnesses and may allow safer and earlier discharges of many patients with chest pain in comparison …

Navigating Adolescence With A Chronic Health Condition: A Perspective On The Psychological Effects Of Hair-An Syndrome On Adolescent Girls, Kimberly K. Mcclanahan, Hatim A. Omar

Pediatrics Faculty Publications

HAIR-AN syndrome is a subphenotype of polycystic ovary syndrome and is characterized by acne, obesity, hirsutism, and acanthosis nigricans. It usually manifests in early adolescence, a time of significant developmental change in females across physical, cognitive, social, and emotional domains. We contend that adolescent development for females is difficult, even in the best of circumstances, and having a chronic health condition, like HAIR-AN syndrome, will likely impact the afflicted individual's development and psychological well-being. While many researchers have discussed the long-term health effects of HAIR-AN and similar disorders, little has been written about the potential psychological sequelae of HAIR-AN on …

Child Health And Survival In The Eastern Mediterranean Region, Zulfiqar A. Bhutta, Asim Belgaumi, Rab Mohammad Abdur, Zein Karrar, Mohamed Khashaba, Nezha Mouane

Department of Paediatrics and Child Health

No abstract provided.

Keeping Alive The "Jazba", Murad M. Khan

Department of Psychiatry

No abstract provided.

Diagnostic Dilemma Of Abdominal Tuberculosis In Non-Hiv Patients: An Ongoing Challenge For Physicians, Rustam Khan, Shahab Abid, Wasim Jafri, Zaigham Abbas, Khalid Hameed, Zubair Ahmad

Section of Gastroenterology

AIM: To assess the clinical features, yield of the diagnostic tests and outcome of abdominal tuberculosis in non-HIV patients.Methods: Adult patients with discharge diagnosis of abdominal tuberculosis (based upon; positive microbiology, histo-pathology, imaging or response to trial of anti TB drugs) during the period 1999 to 2004 were analyzed. Patient's characteristics, laboratory investigations, radiological, endoscopic and surgical findings were evaluated. Abdominal site involved (intestinal, peritoneal, visceral, and nodal) and response to treatment was also noted.Results: There were 209 patients enrolled. One hundred and twenty-three (59%) were females. Symptoms were abdominal pain 194 (93%), fever 134 (64%), night sweats 99 (48%), …

Celecoxib Decreases Prostaglandin E2 Concentrations In Nipple Aspirate Fluid From High Risk Postmenopausal Women And Women With Breast Cancer, Edward R. Sauter, Wenyi Quin, Lisa Schlatter, John E. Hewett, John T. Flynn

Department of Molecular Physiology and Biophysics Faculty Papers

Background

Celecoxib inhibits PGE2 production in cancerous tissue. We previously reported that PGE2 levels in nipple aspirate fluid (NAF) and plasma were not decreased in women at increased breast cancer risk who received celecoxib 200 mg twice daily (bid). The endpoints of the current study were to determine if a short course of celecoxib 400 mg bid would decrease PGE2 levels in women 1) at increased breast cancer risk, and 2) with established breast cancer.

Methods

NAF and plasma samples were collected before, 2 weeks after taking celecoxib 400 mg bid, and two weeks after washout from 26 women who …

Traditional Practices And Governmental Responsibilities: An Investigation Into The Evolving Partnership Between Indigenous Brazilian Midwives And State-Provided Maternal Healthcare Services, Caitlin Canfield

Independent Study Project (ISP) Collection

Traditional midwives play important roles in the provision of maternal healthcare services in developing countries. Especially in rural, marginalized communities, traditional midwives help to provide obstetric care when local governmental health services fail to do so. The healthcare provision that traditional midwives “should” undertake is a subject debated by public health and development policy makers who seek to reduce maternal mortality rates and improve maternal health in rural communities in developing countries. This study examines the practices of traditional midwives in indigenous Tupinambá communities located in Southern Bahia, Brazil. It seeks to define the contemporary role of traditional midwives within …

Effects Of A Personified Guide On Adherence To An Online Program For Alcohol Abusers., Daniel Z Lieberman

Psychiatry and Behavioral Sciences Faculty Publications

The quality of the therapeutic alliance has robust effects on the outcome of psychotherapy and psychopharmacologic interventions. Automated behavioral health programs that are being developed to increase access to mental health treatment are administered in the absence of direct human participation, thereby precluding the development of a traditional therapeutic relationship. The aim of this study was to develop a personified guide designed to stimulate reactions similar to those experienced in a therapeutic relationship, and evaluate the effect of the guide on adherence to and satisfaction with an online alcohol use evaluation program. After completing a battery of four standard questionnaires …

Treatment Of Spinal Tuberculosis: Role Of Surgical Intervention, Ather Enam, Ahmed Ali Shah

Section of Neurosurgery

The treatment of tuberculosis of the spine (Pott's disease) is essentially conservative and a vast majority of patients can be successfully managed on antituberculo us therapy (ATT) alone.1 Surgery is indicated in a few specific cases where deformity of spine, pain, or neurological compromise is becoming a serious issue. In cases where surgery is indicated the benefits are almost immediate and excellent. Tuberculosis (TB) is one of the leading causes of infectious disease-related deaths in under-developed countries and it has had a resurgence in developed countries as well. The most common site of bony dissemination of this disease is in …

Polymorphism Of Hla-Dr And Hla-Dq In Rheumatoid Arthritis Patients And Clinical Response To Methotrexate--A Hospital-Based Study, Azra Arif I Ali, Tariq Moatter, Jawed Altaf Baig, Ahmed Iqbal, Azmat Hussain, Mohammad Perwaiz Iqbal

Department of Biological & Biomedical Sciences

Objective: To investigate the frequency and distribution of DRB1 and DQB1 alleles in Patients with rheumatoid arthritis (RA) and analyze the relationship between clinical response to methotrexate (MTX) and the HLA-DR and HLA-DQ genotypes in these patients.
Methods: In this case-control study, the HLA-DRB1 and HLA-DQB1 polymorphism in 91 RA patients and 91 healthy controls was done using polymerase chain reaction and sequence specific primers.
Results: There was no statistical difference in frequencies of HLA-DRB1*03, DRB1*04, DRB1*07, DRB1*10, DRB1*11, DRB1*12, DRB1*13, DRB1*14, DRB1*15 and DRB1*16 genotypes between patients and controls. However, DRB1*01 was found to be significantly more common (p=0.015) …