Medical Specialties Commons^™

Physician Assistant Class Of 2012, Philadelphia College Of Osteopathic Medicine

All Yearbooks

White Coat Ceremony 2010, Retreat at Camp Ockanickon, Halloween 2010, Clinical Skills Day, Lab Skills Days, Classroom candids, PA Olympics, AAPA Conference 2011, Rotations,

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 …

Use Of A Video Game Based Balance Training Intervention On The Balance And Function Of Children With Developmental Disabilities, Gina C. Siconolfi-Morris

Theses and Dissertations--Rehabilitation Sciences

Many children with developmental disabilities (DD) have physical impairments and limitations in their participation. Rehabilitation research often focuses on either physical impairments or participation restrictions, when both need to be investigated. The purposes of these two studies were to evaluate an at home therapist directed video game balance training intervention on balance, gait velocity (GV), hip strength and activities of children with DD. The pilot study was a single-subject non-concurrent multiple baseline design. Balance measures included: weight bearing symmetry; center of pressure area and velocity; time to boundary mean minima and standard deviation; and timed up and go. The participant’s …

Mobilizing Subdominant Hiv-Specific Ctls As A Novel Vaccine Strategy, Margaret Christina Costanzo

Open Access Theses & Dissertations

To overcome the extreme antigenic diversity of HIV, there is increasing interest in developing vaccines that target CD8 T cell responses to conserved regions of the viral proteome. Understanding the immunogenic potential of these domains is therefore critical for the success of this vaccine strategy. CD8 T cell responses to conserved domains restricted by the "neutral" and highly prevalent HLA-A2 allele have not been extensively characterized. Here we describe a novel essentially invariant 10-mer epitope in HIV Gag (p2414-23, RTLNAWVKVV (RV10)) in that it is expressed by the majority HIV isolates from all clades. Here we examined the character of …

Evaluation Of Protection Induced By Dna Vaccine Candidate Against Leishmania Mexicana In Balb/C Mice Model, Rosina Rodarte

Open Access Theses & Dissertations

Background and Significance. The leishmaniases are a diverse group of diseases with four major clinical manifestations: cutaneous, mucocutaneous, visceral, and diffuse. Approximately 21 Leishmania species and 30 sandfly vectors have been implicated in human leishmaniasis. Leishmaniasis is endemic in 88 countries, 72 are developing countries. Currently, 350 million people live in leishmaniasis-endemic areas around the world. The true incidence of the disease is not known. However, the estimated incidence for visceral leishmaniasis is 500,000 cases per year, and for cutaneous and mucocutaneous leishmaniasis 1.5-2 million cases per year. Visceral leishmaniasis causes 70,000 deaths each year. In the Americas region, …

Risks To Early Childhood Health And Development In The Postconflict Transition Of Northern Uganda, Theresa A. Mcelroy, Stella Atim, Charles P. Larson, Robert Armstrong

Paediatrics and Child Health, East Africa

Research from numerous fields of science has documented the critical importance of nurturing environments in shaping young children’s future health and development. We studied the environments of early childhood (birth to 3 years) during postconflict, post displacement transition in northern Uganda. The aim was to better understand perceived needs and risks in order to recommend targeted policy and interventions. Methods. Applied ethnography (interview, focus group discussion, case study, observational methods, document review) in 3 sites over 1 year. Results. Transition was a prolonged and deeply challenging phase for families. Young children were exposed to a myriad of risk factors. Participants …

Medication And Supplement Use For Managing Joint Symptoms Among Patients With Knee And Hip Osteoarthritis: A Cross-Sectional Study, Jeffrey B. Driban, Sara A. Boehret, Easwaran Balasubramanian, Nicole M. Cattano, Joseph Glutting, Michael R. Sitler

Sports Medicine Faculty Publications

No abstract provided.

Working With Mild Traumatic Brain Injury: Voices From The Field, Page Walker Buck, Rebecca G. Laster, Jocelyn Spencer Sagrati, Rachel Shapiro Kirzner

Social Work (Graduate) Faculty Publications

No abstract provided.

“I Think, Therefore I Count”: Changing The Count Process While Encouraging Critical Thinking, Marlene H. Leidy, Hope L. Johnson Msn, Rn, Cnor

Patient Care Services / Nursing

No abstract provided.

Mitochondrial Iron Uptake Through Mitoferrin2 Sensitizes Human Head And Neck Squamous Carcinoma Cells To Photodynamic Therapy, Hsin-I (Cindy) Hung

MUSC Theses and Dissertations

Photodynamic therapy (PDT) is an FDA-approved, minimally invasive treatment modality that utilizes light in the presence of oxygen to activate photosensitizing agents to produce cell death. Phthalocyanine 4 (Pc 4), a second generation photosensitizer has shown efficacy in vitro, in vivo and in a phase I clinical trial. Pc 4 localizes primarily to mitochondria and endoplasmic reticulum, where it causes apoptotic cell death during PDT. Previously, our laboratory showed that photo sensitizers that localize to lysosomes are more effective in killing cancer cells than ones directed to mitochondria after PDT. Here, we investigated the interactions between lysosomes and mitochondria in …

Using Portable Computers To Increase The Efficiency Of Evaluating Psychiatric Emergencies – A Pilot Program, Anthony Buchman Lcsw, Edward R. Norris Md, Fapa, Fapm, Rosanne Teders Lcsw, Michael Kaufmann Md

Department of Psychiatry

No abstract provided.

Imaging And Intervention For Coronary Artery Disease Following Irradiation Of Malignant Thymoma, Saulat H. Fatimi, Salima Ahmed Bhimani, Ranish Deedar-Ali- Khawaja, Ali Khawaja

Section of Cardiothoracic Surgery

Thymomas are rare malignant epithelial growths, constituting 20% of mediastinal tumours. Resection followed by irradiation may be employed in all thymomas except for stage 1 thymomas. Mediastinal irradiation is associated with coronary artery disease. The mean duration of presentation of post-irradiation coronary artery disease is 16 years (range 3-29 years). In our patient coronary artery disease was found only a year post irradiation. A 55 year old male who presented with complaints of dyspnoea, retrosternal chest pain and heaviness since one year underwent resection for malignant thymoma followed by radiotherapy. He presented with coronary artery disease a year after undergoing …

Factors Associated With Failed Induction Of Labour In A Secondary Care Hospital, Neelofur Babar Khan, Iffat Ahmed, Ayesha Malik, Lumaan Sheikh

Department of Obstetrics & Gynaecology

Objective: To assess the factors associated with failed induction of labour (IOL) in a secondary care hospital.
Method: This is a retrospective cross sectional study on women admitted for labour induction in Aga Khan Hospital for women Karimabad from 1st Jan, 2009 to 31st Dec, 2009. Induction was considered successful if the patient delivered vaginally and failed if it ended up in Caesarean Section.
Result: Eighteen percent of our pregnant population who underwent induction of labour failed to deliver vaginally. About 25% of 328 nulliparous women had failed induction. With a Bishop score of <5 in 84.3%. In 28.2% with prolonged latent phase of more than 20 hours in Caesarean section had to be performed.
Conclusion: Nulliparity, poor Bishop score and …

Conduct Problems In Children Attending Pre-Primary Schools In Rural Areas Of Pakistan, Shelina Bhamani, Nadia Ayub

Department of Obstetrics & Gynaecology

The aim of this study was to explore the conduct problems faced by school going children in the rural areas of Pakistan. Two hypotheses were formulated to explore the significant differences between the intervention and non-intervention groups and gender on the variables of conduct and internalization. The data ofa total 386 young children were collected from three different regions, who were enrolled in government pre-primary classes. The children under study comprised two kinds of schools: intervention schools that had early childhood interventions, and non-intervention schools. The data analysis revealed no significant difference between children in intervention and non-intervention schools. However; …

Extreme Sports: Are They Worth The Risk?, Angela Walin

3690: A Journal of First-Year Student Research Writing

Overview: Broken bones, head trauma, shark attacks, and casualties all while playing the sport you love. Is it worth it? With extreme sports come extreme risks. There are many controversies over these sports as to whether they are ethical or not and why anybody with the right mindset would consider participating in such events. These sports often involve high speed, great heights, a high level of physical exertion, and highly specialized gear or spectacular stunts. Some popular and quickly growing extreme sports in today’s society are snowboarding, speed and freestyle skiing, surfing, sky diving, mountain climbing, and wake boarding. Many …

Fractionated Stereotactic Radiation Therapy Improves Cranial Neuropathies In Patients With Skull Base Meningiomas: A Retrospective Cohort Study., Xinglei Shen, David W Andrews, Robert C Sergott, James J Evans, Walter J Curran, Mitchell Machtay, Ruben Fragoso, Harriet Eldredge, Colin E Champ, Matthew Witek, Mark V Mishra, Adam P Dicker, Maria Werner-Wasik

Department of Radiation Oncology Faculty Papers

BACKGROUND: Skull base meningiomas commonly present with cranial neuropathies. Fractionated stereotactic radiation therapy (FSRT) has been used to treat these tumors with excellent local control, but rates of improvement in cranial neuropathies have not been well defined. We review the experience at Thomas Jefferson University using FSRT in the management of these patients with a focus on symptom outcomes.

METHODS: We identified 225 cases of skull base meningiomas treated with FSRT at Thomas Jefferson University from 1994 through 2009. The target volume was the enhancing tumor, treated to a standard prescription dose of 54 Gy. Symptoms at the time of …

Role Of The Immune System And Bioactive Lipids In Trafficking Bone Marrow-Derived Stem Cells In Patients With Ischemic Heart Disease, Ahmed Abdel-Latif

Theses and Dissertations--Microbiology, Immunology, and Molecular Genetics

Acute myocardial infarction (AMI) triggers the mobilization of stem/progenitor cells from bone marrow (BMSPCs) into peripheral blood (PB). The underlying mechanisms orchestrating this mobilization and subsequent homing of BMSPCs to the myocardium are poorly understood. While the role of traditional chemokines in the mobilization and homing of hematopoietic stem cell (HSCs) to BM niches is undisputed, their role in directing BMSPCs to the highly proteolytic environment of the ischemic myocardium is debatable and other redundant mechanism may exist. Based on our observation that bioactive lipids, such as sphingosine-1 phosphate (S1P) and ceramide-1 phosphate (C1P), play an important role in regulating …

Influence Of Oncotype Dx® On Chemotherapy Prescribing In Early Stage Breast Cancer Patients: A Claims-Based Evaluation Of Utilization In The Real World, Kenneth Neil Kennedy

Theses and Dissertations--Pharmacy

The decision for adjuvant therapy in women with early stage breast cancer (ESBC) has historically been guided by the presence or absence of specific biological markers (hormone and HER2 receptors), age, and extent of nodal involvement. Oncotype DX® is a validated assay that quantifies protein expression that can predict the risk of cancer recurrence. This study evaluates if the use of Oncotype DX® impacts chemotherapy prescribing in ESBC. This retrospective, cohort study identified patients with ESBC from a large commercially insured population from January 2007 through June 2009. Patients were identified as having ESBC by utilizing procedure and diagnosis codes …

Self Expanding Metal Stents (Sems) For Management Of Peri-Pancreatic Fluid Collections (Pfc): A Single Center Experience, Whitney E. Jackson, Jason Korenblit, Vaibhav Mehendiratta, Jason Lewis, Ali A. Siddiqui, Thomas E. Kowalski, David E. Loren

Division of Internal Medicine Faculty Papers & Presentations

Background

Endoscopic management of peri-pancreatic fluid collections (PFC) with or without organizing necrosis has been shown to decrease morbidity and mortality compared to early surgical management. Plastic stents are often used for transmural drainage, although the use of self-expanding metal stents (SEMS) has been reported. Theoretical benefits of SEMS include a large diameter for drainage and facilitation of endoscopic necrosectomy. We report a single-center experience to evaluate the efficacy and safety of SEMS for management of PFC.

Methods

A single-center retrospective review was performed of patients undergoing endoscopic management of PFC using SEMS from January through November 2011. Electronic database …

Does The Afferent Tubular Segment In An Orthotopic Bladder Substitution Compromise Ureteric Antireflux Properties? An Experimental Study In Dogs, Hassan Abol- Enein, Nuzhat Faruqui, Nashwa Barakat, Ahmed A. Shokeir

Section of Urology

Objective: To study the effects of a short ureter on renal function and histology in an orthotopic bladder substitution model using a long afferent limb, in a canine model.
Materials and methods: The study included nine adult mongrel dogs. A 40-cm segment of ileum was isolated, the distal half detubularized, configured into a U-shape and sutured to form a flat plate; this was then used to augment the bladder. The proximal half of the isolated ileum remained in continuity with the enterocystoplasty to form an isoperistaltic ileal ‘chimney’. The left ureter was divided at its lumbar part and …

Characterization Of A Hyperthermophilic Redox Protein, Rubredoxin, As A Potential Targeted Cancer Therapeutic, Siri Lakshmi Chirumamilla

PCOM Biomedical Studies Student Scholarship

Cancer is an elusive neoplastic disease that claims the lives of many people around the world every year. Though treatments have become more specific to the different types of cancer, the need remains for antineoplastic drugs that target cancer cells and leave normal cells unharmed, with little to no systemic toxicity. The search for a targeted cancer therapeutic is necessary and urgent, and Pyrococcus furiosus rubredoxin might be such a tool. Rubredoxin is a small (53 amino acids), water soluble, non-heme iron electron transfer protein that contains an iron atom cofactor bound by the sulfurs of four cysteine residues, which …

Conscientious Objection And Reproductive Health Service Delivery In Sub-Saharan Africa, V. M. Lema

Obstetrics and Gynaecology, East Africa

Lack of access to quality reproductive health services is the main contributor to the high maternal mortality and morbidity in sub-Saharan Africa (SSA). This is partly due to a shortage of qualified and experienced health care providers. However conscientious objection amongst the available few is a hitherto undocumented potential factor influencing access to health care in SSA. Provision of certain reproductive health services goes counter to some individual’s religious and moral beliefs and practices. Health providers sometimes refuse to participate in or provide such services to clients/patients on moral and/or religious grounds. While the rights to do so are protected …

Use Of Colour Duplex Ultrasound As A First Line Surveillance Tool Following Evar Is Associated With A Reduction In Cost Without Compromising Accuracy, C. Gray, Patrick J. Goodman, C. C. Herron, L. P. Lawler, M. K. O'Malley, M. K. O'Donohoe, C. O. Mc. Donnell

Articles

CT scanning remains the postoperative surveillance imaging modality of choice following EVAR. Concerns regarding cost, exposure to ionising radiation and intravenous contrast have led to a search for a less expensive, equally efficacious and safer method of monitoring EVAR patients after endograft deployment. This study evaluated the cost saving obtained if CDUS was employed as a first line surveillance tool following EVAR, as well as comparing the two entities in terms of efficacy. Patients & methods: Postoperative surveillance CTs and CDUS scans in the 145 patients who have undergone EVAR from 1st June 2003 to 1st July 2010 were compared …

Attenuation Of Corneal Myofibroblast Development Through Nanoparticle-Mediated Soluble Transforming Growth Factor-Β Type Ii Receptor (Stgfβrii) Gene Transfer, Ajay Sharma, Jason T. Rodier, Ashish Tandon, Alexander M. Klibanov, Rajiv R. Mohan

Pharmacy Faculty Articles and Research

Purpose: To explore (i) the potential of polyethylenimine (PEI)-DNA nanoparticles as a vector for delivering genes into human corneal fibroblasts, and (ii) whether the nanoparticle-mediated soluble extracellular domain of the transforming growth factor–β type II receptor (sTGFβRII) gene therapy could be used to reduce myofibroblasts and fibrosis in the cornea using an in vitro model.

Methods: PEI-DNA nanoparticles were prepared at a nitrogen-to-phosphate ratio of 30 by mixing linear PEI and a plasmid encoding sTGFβRII conjugated to the fragment crystallizable (Fc) portion of human immunoglobulin. The PEI-DNA polyplex formation was confirmed through gel retardation assay. Human corneal fibroblasts (HCFs) were …

Mild Cognitive Impairment: Statistical Models Of Transition Using Longitudinal Clinical Data, Erin L. Abner, Richard J. Kryscio, Gregory E. Cooper, David W. Fardo, Gregory A. Jicha, Marta S. Mendiondo, Peter T. Nelson, Charles D. Smith, Linda J. Van Eldik, Lijie Wan, Frederick A. Schmitt

Sanders-Brown Center on Aging Faculty Publications

Mild cognitive impairment (MCI) refers to the clinical state between normal cognition and probable Alzheimer's disease (AD), but persons diagnosed with MCI may progress to non-AD forms of dementia, remain MCI until death, or recover to normal cognition. Risk factors for these various clinical changes, which we term "transitions," may provide targets for therapeutic interventions. Therefore, it is useful to develop new approaches to assess risk factors for these transitions. Markov models have been used to investigate the transient nature of MCI represented by amnestic single-domain and mixed MCI states, where mixed MCI comprised all other MCI subtypes based on …

Effect Of 4 Years Of Growth Hormone Therapy In Children With Noonan Syndrome In The American Norditropin Studies: Web-Enabled Research (Answer) Program® Registry., Peter A Lee, Judith Ross, John A Germak, Robert Gut

Department of Pediatrics Faculty Papers

BACKGROUND: Noonan syndrome (NS) is a genetic disorder characterized by phenotypic features, including facial dysmorphology, cardiovascular anomalies, and short stature. Growth hormone (GH) has been approved by the United States Food and Drug Administration for short stature in children with NS. The objective of this analysis was to assess the height standard deviation score (HSDS) and change in HSDS (ΔHSDS) for up to 4 years (Y4) of GH therapy in children with NS.

METHODS: The American Norditropin Studies: Web-Enabled Research (ANSWER) Program®, a US-based registry, collects long-term efficacy and safety information on patients treated with Norditropin® (somatropin rDNA origin, Novo …

Bereavement Outcomes Among Spousal Hospice Caregivers: The Role Of Rumination, Feelings Of Relief, And Perceived Suffering, Jessica Y. Allen

USF Tampa Graduate Theses and Dissertations

Background: The death of a spouse is among the most distressing life events faced by older adults and frequently follows long periods of providing extensive care and support. Although many spouses are resilient following loss, a number of bereaved spousal caregivers have poor psychological well-being and may benefit from clinical services. However, it can be difficult to determine who may most benefit from bereavement services and why some individuals are at greater risk for poor bereavement; thus, there is a need for greater understanding of the process of bereavement. Therefore, the purpose of this dissertation was to investigate a number …

Detection Of Evolving Injury To The Brachial Plexus During Transaxillary Robotic Thyroidectomy., Adam Luginbuhl, Daniel M Schwartz, Anthony K Sestokas, David Cognetti, Edmund Pribitkin

Department of Otolaryngology - Head and Neck Surgery Faculty Papers

OBJECTIVES/HYPOTHESIS: Continuous intraoperative neuromonitoring (IONM) of transcranial electric motor evoked potentials (tceMEPs) and somatosensory evoked potentials (SSEPs) has gained universal acceptance as an efficacious method for detecting emerging positional brachial plexopathy or peripheral nerve compression during spinal and shoulder surgery. This has implications for transaxillary thyroid surgery.

STUDY DESIGN: Case report with literature review.

METHODS: The patient underwent robotic transaxillary thyroid surgery with continuous tceMEP and SSEP monitoring of brachial plexus function. We present detailed IONM data depicting the emergence of positional brachial plexopathy.

RESULTS: Significant amplitude loss of both IONM modalities were identified during an evolving positional plexopathy, which …

Biochemical Links Between Hormonal Mediators Of Psychological Stress And The Expression Of Muc1 In Prostate Cancer Cells, Kristina Andrijauskaite

MUSC Theses and Dissertations

A growing body of scientific evidence has demonstrated that chronic psychological stress can not only increase the growth and metastasis of tumors through a number of mechanisms, such as by an increase of VEGF and Bcl-2, but also can decrease the survival of cancer patients. However, no studies have reported the effect of psychological stress with respect to the tumor marker MUC1. Therefore, building upon previous research, the purpose of the present study was to investigate the effect of the stress hormones cortisol and norepinephrine on the tumor marker MUC1, which is highly associated with tumor cell metastasis and is …

Predicting Native Papilla Biliary Cannulation Success Using A Multinational Ercp Quality Network, Chunyan Peng

MUSC Theses and Dissertations

Background and Objective: Success in achieving deep biliary cannulation success in native papillae is an accepted measure of competence in ERCP training and practice. This study aimed to determine the factors associated with native papilla deep biliary cannulation success, with and without precut sphincterotomy. Methods: A retrospective analysis was conducted in a prospectively collected database. The main outcome was deep biliary cannulation success, with and without precut facilitating access, in non-operated papillae. Multilevel random fixed effect multivariate model was used to control for doctor factor. Results: 13018 ERCPs were performed by 85 endoscopists between March 2007, and May 2011. Conventional …