Medical Specialties Commons^™

Late Removal Of Titanium Hardware From The Elbow Is Problematic, Abdo Bachoura, Ruriko Yoshida, Christian Lattermann, Srinath Kamineni

Orthopaedic Surgery and Sports Medicine Faculty Publications

A retrospective review of 21 patients that underwent bone screw removal from the elbow was studied in relation to the type of metal, duration of implantation, and the location of the screws about the elbow. Screw failure during extraction was the dependent variable. Five of 21 patients experienced hardware failure during extraction. Fourteen patients had titanium alloy implants. In four cases, titanium screws broke during extraction. Compared to stainless steel, titanium screw failure during removal was not statistically significant (P = 0.61). Screw removal 12 months after surgery was more likely to result in broken, retained screws in general …

Effect Of A Physician Uncertainty Reduction Intervention On Blood Pressure In Uncontrolled Hypertensives-A Cluster Randomized Trial, David J. Hyman, Valory N. Pavik, Anthony J. Greisinger, Wenyaw Chan, Jose Bayona, Carol Mansyur, Victor Simjms, James Pool

Community & Environmental Health Faculty Publications

BACKGROUND: Clinical inertia, provider failure to appropriately intensify treatment, is a major contributor to uncontrolled blood pressure (BP). Some clinical inertia may result from physician uncertainty over the patient’s usual BP, adherence, or value of continuing efforts to control BP through lifestyle changes.

OBJECTIVE: To test the hypothesis that providing physicians with uncertainty reduction tools, including 24-h ambulatory BP monitoring, electronic bottle cap monitoring, and lifestyle assessment and counseling, will lead to improved BP control.

DESIGN: Cluster randomized trial with five intervention clinics (IC) and five usual care clinics (UCC).

SETTING: Six public and 4 private primary care clinics.

PARTICIPANTS: …

Physician Review Of Workers' Compensation Case Files: Can It Affect Decision Outcomes?, Mark E. Hammett, Christopher Jankosky, John Muller, Elizabeth Hughes, Francesca Litow

Community & Environmental Health Faculty Publications

Objective: To identify common attributes of Federal workers compensation cases referred to Navy physicians for medical opinions and to determine the impact of the review on the final case decision. Methods: Retrospective case study and descriptive analysis of 258 opinion letters written by physicians on referred cases from 2006 to 2010. Results: Navy physician opinions were considered in the outcome in some of the cases, and there was a statistically significant difference between the claim acceptance rate in the study population and the total population. Worker age was correlated with certain claim types. Conclusions: There is preliminary evidence that the …

Contrasting Effects Of Errorless Naming Treatment And Gestural Facilitation For Word Retrieval In Aphasia, Anastasia M. Raymer, Beth Mchose, Kimberly G. Smith, Lisa Iman, Alexis Ambrose, Colleen Casselton

Communication Disorders & Special Education Faculty Publications

Purpose- We compared the effects of two treatments for aphasic word retrieval impairments, errorless naming treatment (ENT) and gestural facilitation of naming (GES), within the same individuals, anticipating that the use of gesture would enhance the effect of treatment over errorless treatment alone. In addition to picture naming, we evaluated results for other outcome measures that were largely untested in earlier ENT studies.

Methods- In a single participant crossover treatment design, we examined the effects of ENT and GES in eight individuals with stroke-induced aphasia and word retrieval impairments (three semantic anomia, five phonological anomia) in counterbalanced phases across participants. …

Rapid Resident Skills Evaluation Using The Integrated Osce, Mark Brummel, Reid B. Blackwelder, J. Moore, Glenda Stockwell, Beth Anne Fox

ETSU Faculty Works

No abstract provided.

Role Of Human Protein Disulfide Isomerase (Pdi) In The Redox Regulation Of Anthrax Receptor 2 (Antxr2), Naima Mohamed Alshrif

Open Access Theses & Dissertations

Anthrax is an acute infectious disease caused by B. anthracis, a gram-positive and spore-forming bacterium. Anthrax toxin is a tripartite AB toxin composed of a receptor binding/pore-forming moiety, protective antigen (PA), and two catalytic moieties, edema factor (EF) and lethal factor (LF). Anthrax toxin PA binds to cell-surface receptors, where it gets activated by furin, and assembles into a ring-like heptameric structure. The toxin-receptor complex is internalized into endosomes where the acidic pH triggers PA pore formation on the endosomal membrane that translocates the toxin catalytic moieties. Recent study has shown that anthrax toxin receptors play a critical role in …

Effectiveness Of Insulin Pump Use In Controlling Blood Glucose In Type 1 Diabetes Mellitus Patients, Nadia M. Saad

Master's Theses and Doctoral Dissertations

No abstract provided.

Absence Of Altered Expression Of Optineurin In Primary Open Angle Glaucoma Patients., Khaled K Abu-Amero, Taif Anwar Azad, George L Spaeth, Jonathan Myers, L Jay Katz, Marlene Moster, Thomas M Bosley

Wills Eye Hospital Papers

PURPOSE: To investigate the expression level of the optineurin gene (OPTN) in the blood of primary open angle glaucoma (POAG) patients to determine if altered expression is playing a role in primary open angle glaucoma systemically.

METHODS: Patients (n=47) were eligible for inclusion if they met standard clinical criteria for POAG, including age greater than 40 years, intraocular pressure ≥21 mmHg in at least one eye before treatment, normal-appearing anterior chamber angles bilaterally on gonioscopy, and optic nerve injury characteristic of POAG. Control subjects (n=27) were recruited who were free from glaucoma by examination. DNA from patient was sequenced to …

Sigmoid Volvulus In Pregnancy And Puerperium: A Surgical And Obstetric Catastrophe Report Of A Case And Review Of The World Literature, Muhammad R. Khan, Sameer Ur Rehman

Department of Surgery Docs

Sigmoid volvulus is a rare surgical complication occurring in pregnancy and puerperium. Only 84 cases of sigmoid volvulus in pregnancy have been reported in the English literature so far. We have reviewed the available literature on this subject and present another case recently managed at our institution. The available literature suggests that over the years, there has been an improvement in the maternal and fetal outcome for this critical condition, but delay in presentation and a further delay in diagnosis remain a challenge for the treating physicians. Our patient was a 30-week pregnant lady, who presented late with 6days history …

Cardioprotection Of Controlled And Cardiac-Specific Over-Expression Of A(2a)-Adenosine Receptor In The Pressure Overload., Eman A Hamad, Weizhong Zhu, Tung O Chan, Valerie Myers, Erhe Gao, Xue Li, Jin Zhang, Jianliang Song, Xue-Qian Zhang, Joseph Y Cheung, Walter Koch, Arthur M Feldman

Center for Translational Medicine Faculty Papers

Adenosine binds to three G protein-coupled receptors (R) located on the cardiomyocyte (A(1)-R, A(2A)-R and A(3)-R) and provides cardiac protection during both ischemic and load-induced stress. While the role of adenosine receptor-subtypes has been well defined in the setting of ischemia-reperfusion, far less is known regarding their roles in protecting the heart during other forms of cardiac stress. Because of its ability to increase cardiac contractility and heart rate, we hypothesized that enhanced signaling through A(2A)-R would protect the heart during the stress of transverse aortic constriction (TAC). Using a cardiac-specific and inducible promoter, we selectively over-expressed A(2A)-R in FVB …

Orphan Nuclear Receptor Nur77 Regulates Androgen Receptor Gene Expression In Mouse Ovary., Anyi Dai, Guijun Yan, Qinyuan He, Yue Jiang, Qun Zhang, Ting Fang, Lijun Ding, Jianxin Sun, Haixiang Sun, Yali Hu

Center for Translational Medicine Faculty Papers

The androgen receptor (AR) is a nuclear receptor that is expressed in growing follicles and involved in folliculogenesis and follicle growth. The orphan nuclear receptor, Nur77, also has an important role in steroid signaling and follicle maturation. We hypothesized that AR levels and androgen signaling through AR are regulated by Nur77 in the ovary. In the ovaries of Nur77 knockout mice (n = 5), real-time PCR results showed that the mRNA levels of AR and an androgen signaling target gene, Kitl, were decreased by 35% and 24%, respectively, relative to wild-type mice (n = 5), which suggested transcriptional regulation of …

Microrna-145 Protects Cardiomyocytes Against Hydrogen Peroxide (H₂O₂)-Induced Apoptosis Through Targeting The Mitochondria Apoptotic Pathway., Ruotian Li, Guijun Yan, Qiaoling Li, Haixiang Sun, Yali Hu, Jianxin Sun, Biao Xu

Center for Translational Medicine Faculty Papers

MicroRNAs, a class of small and non-encoding RNAs that transcriptionally or post-transcriptionally modulate the expression of their target genes, has been implicated as critical regulatory molecules in many cardiovascular diseases, including ischemia/reperfusion induced cardiac injury. Here, we report microRNA-145, a tumor suppressor miRNA, can protect cardiomyocytes from hydrogen peroxide H₂O₂-induced apoptosis through targeting the mitochondrial pathway. Quantitative real-time PCR (qPCR) demonstrated that the expression of miR-145 in either ischemia/reperfused mice myocardial tissues or H₂O₂-treated neonatal rat ventricle myocytes (NRVMs) was markedly down-regulated. Over-expression of miR-145 significantly inhibited the H₂O₂-induced cellular apoptosis, ROS production, mitochondrial structure disruption as well as the …

0789: George J. Hill Collection, 1889-2011, Marshall University Special Collections

Guides to Manuscript Collections

This collection includes research materials used by Dr. Hill, pertaining to his research interests in medical, military, and New Jersey history, in addition to cancer and leprosy, Dr. Hill's medical specialties. It also includes copies of articles, reports, and abstracts written about Dr. Hill. Additionally, the collection has an assortment of historical pamphlets about leprosy.

An Examination Of Factors Affecting Non-Urgent Use Of Emergency Department Services By Patients With "Universal" Healthcare, Gregory Smith Feltenberger

Health Services Research Dissertations

The purpose of this research is to examine the factors affecting non-urgent utilization of emergency department (ED) services by individuals with "universal" healthcare using the Behavioral Model of Health Services Use. Since Air Force Medical Service beneficiaries have free and unlimited use of the full-range of healthcare services, they are ideally suited for this study. The findings of this research may also apply to other populations with free or low-cost access to healthcare (i.e., universal or single-payer healthcare). Using secondary data extracted from the Air Force Medical Service's electronic health record system at several military hospitals, this study will present …

Is Allogeneic Stem Cell Transplantation Of High-Risk Pediatric Acute Lymphoblastic Leukemia (All) Patients More Effective In Preventing Future Relapses Of Disease And/ Or Mortality In Comparison With Chemotherapeutic Regimens Alone?, Patricia A. Ajizadeh

PCOM Physician Assistant Studies Student Scholarship

OBJECTIVE: The objective of this selective EBM review is to determine whether or not allogeneic SCT of HR pediatric ALL patients is more effective in preventing future relapses of disease and/or mortality in comparison with chemotherapeutic regimens alone.

STUDY DESIGN: Review of three English language primary randomized controlled trial studies published between 1996 and the present.

DATA SOURCES: Randomized controlled trial studies were found using PubMed.

OUTCOMES MEASURED: Each of the three studies evaluated the incidence of recurrent disease and/or mortality in high-risk pediatric ALL patients. These outcomes were analyzed according to the following categories: duration of event-free survival …

Is Intravenous Ramosetron 0.3 Mg Effective In The Prevention Of Postoperative Nausea And Vomiting In Women Undergoing Gynecologic Surgery?, Keith S. Elsner

PCOM Physician Assistant Studies Student Scholarship

OBJECTIVE: The objective of this selective EBM review is to determine whether or not intravenous ramosetron 0.3 mg is effective in the prevention of postoperative nausea and vomiting (PONV) in women undergoing gynecologic surgery.

STUDY DESIGN: Review of three English language primary research articles published later than 1995.

DATA SOURCES: Randomized, double-blinded, controlled clinical trials comparing intravenous ramosetron to placebo or other control groups were identified using Ovid MEDLINE and Cochrane Library databases.

OUTCOMES MEASURED: Measured outcomes include a complete response to the intervention within the first 24-48 hours, the incidence of postoperative nausea and vomiting, need for rescue antiemetic, …

Is Etanercept A Safe And Effective Treatment For Ankylosing Spondylitis?, Robyn M. Albert

PCOM Physician Assistant Studies Student Scholarship

Objective: The objective of this selective EBM review is to determine whether or not etanercept is a safe and effective treatment for ankylosing spondylitis (AS).

Study Design: Review of three English language randomized control trials published in 2007, 2008, and 2010.

Data Sources: Two double-blind placebo-controlled randomized controlled trials and one placebo-controlled randomized control trial comparing etanercept to placebo were found using PubMed.

Outcomes Measured: Work instability was measured through the Ankylosing Spondylitis Work Instability Scale (AS-WIS) based on scores of 1-20. Quality of life was measured through the EuroQOL-5D (EQ-5D), which assesses mobility, self-care, usual activities, pain/discomfort, and anxiety/depression. …

Is Aspirin Effective In Helping To Prevent Breast Cancer In Women Ages 45 Years And Older?, Kristen M. Quartuccio

PCOM Physician Assistant Studies Student Scholarship

OBJECTIVE: The objective of this selective EBM review is to determine whether or not aspirin is effective in helping to prevent breast cancer in women ages 45 years and older.

STUDY DESIGN: Review of three English language primary studies published in 2005, 2007, and 2008

DATA SOURCES: Two randomized, double blind, placebo controlled clinical trials and one prospective, population based cohort study comparing aspirin to placebo were found using PubMed and Cochrane databases.

OUTCOMES MEASURED: Breast cancer development was measured in several ways. Tumor characteristics were measured at diagnosis, including size, metastasis to lymph nodes, histology of the mass, histology …

Is Weight Lifting Effective In Reducing Lymphedema In Breast Cancer Survivors?, Diana Petrucello

PCOM Physician Assistant Studies Student Scholarship

OBJECTIVE: The objective of this selective EBM review is to determine whether or not weight lifting is effective in reducing lymphedema in breast cancer survivors.

STUDY DESIGN: Systematic review of three English language primary studies published in 2009 and 2010.

DATA SOURCES: Three single blind, randomized controlled trials comparing progressive weight lifting and other treatments in breast cancer survivors were found using the Cochrane Database of Systematic Reviews and PubMed.

OUTCOMES MEASURED: Incidence of breast cancer-related lymphedema onset measured by blinded certified lymphedema therapists using a standardized clinical evaluation derived from the Common Toxicity Criteria version 3.0, comprising of interlimb …

Will The Use Of Fiber Be As Effective As Laxatives In Relieving Constipation In The Geriatric Population?, Saunders Batunkyi

PCOM Physician Assistant Studies Student Scholarship

OBJECTIVE: The objective of this selective EBM review is to determine whether or not the use of fiber can be as effective as laxatives in relieving constipation in the geriatric population.

STUDY DESIGN: Review of three journals published in English in peer-reviewed journals.

DATA SOURCES: Two randomized controlled trials and one parallel interventional trial investigating the effectiveness of supplemental dietary fiber in managing constipation in elderly populations that are presently reliant on prescription laxatives.

OUTCOMES (S) MEASURED: The outcomes were measured by the frequency of defecation, ease of bowel movement, patient discomfort, patient well being, and undesired effects …

Is There A Benefit To Suturing Vs. Stapling In Cesarean Section Closure When Comparing Postoperative Pain And Patient Satisfaction?, Jennifer Pilchman

PCOM Physician Assistant Studies Student Scholarship

OBJECTIVE:The objective of this selective EBM review is to determine whether or not there is a benefit to suturing vs stapling in cesarean section closure when comparing postoperative pain and patient satisfaction.

STUDY DESIGN: Review of three English language primary studies published in 2009 and 2010.

DATA SOURCES: Three randomized control trials (RCTs) comparing the surgical closures for cesarean section delivery. All RCTs were found by the author using MEDLINE, PUBMED, and COCHRANE databases. They are all published articles written in English.

OUTCOME MEASURED: Outcomes were measured by assessing patient satisfaction, postoperative pain, cosmetic appearance and wound complications. Rousseau …

Is The Use Of Apixaban Or Enoxaparin, More Effective In The Prophylaxis Of Venous Thromboembolism Post-Orthopedic Surgery?, Jolene Bohensky

PCOM Physician Assistant Studies Student Scholarship

OBJECTIVE: The objective of this selective EBM review is to determine whether or not the use of Apixaban or Enoxaparin is more effective in the prophylaxis of venous thromboembolism post-orthopedic surgery.

STUDY DESIGN: Review of three English language randomized, double-blind, placebo-controlled clinical trials from 2009-2010.

DATA SOURCES: Randomized, double-blind placebo controlled, clinical trials comparing the effectiveness of Apixaban and Enoxaparin in the prophylaxis of Venous Thromboembolism (VTE) post-orthopedic surgery were found using PubMed, the Cochrane Database of Randomized Controlled Trials, and the Cochrane Databases of Systematic Reviews.

OUTCOMES MEASURED: Development of venous thromboembolism (VTE) post-orthopedic surgery including Total …

Does Reiki Therapy Decrease Pain During Chemotherapy And Radiation Treatment In Patients With Gynecological And Breast Cancer?, Samantha L. Ciaccia

PCOM Physician Assistant Studies Student Scholarship

OBJECTIVE: The objective of this selective EBM review is to determine whether or not Reiki therapy decreases pain during chemotherapy and radiation treatment in patients with gynecological and breast cancer.

STUDY DESIGN: Review of two randomized control trials and one randomized prospective cross-over study published in 2003, 2004, and 2011.

DATA SOURCES: One double blind randomized control trial, one 2-arm single blind randomized control trial and one randomized, prospective, 2-period crossover intervention study comparing Reiki therapy to placebo. Articles were found using PubMed and Medline.

OUTCOMES MEASURED: Pain by BPI (brief pain inventory linear analog scale), SF-36 questionnaire, …

Identifying Sm22 As A Key Player In Arterial Diseases, Jianbin Shen

Wayne State University Dissertations

Background : Expression of vascular smooth muscle cell (VSMC) cytoskeleton markers including SM22 is down-regulated in arterial diseases including atherosclerosis where inflammation and osteochondrogenesis are present. However, the role of this downregulation in arterial pathogenesis is unknown. Hypothesis : Downregulation of SM22 may actively contribute to arterial pathogenesis. Methods : Five Sm22 knockout (Sm22^-/-) mice and their wild type littermates were subjected to carotid artery denudation, an artery injury model. Analyses were conducted on carotid arteries 2 weeks after injury. Primary VSMCs were isolated from mouse aortas and investigated individually at passage 2 to 4. Sm22 knockdown was …

Role Of Thromboxane Receptor-Alpha In Prostate Cancer Progression, Prasanna Ekambaram

Wayne State University Dissertations

Thromboxane A2 (TXA2) is a major arachidonic acid metabolite that signals through TXA2 receptors (TP) to induce platelet aggregation and smooth muscle contraction. TXA2 receptors are expressed as two different isoforms in humans, namely TP-alpha (TPα) and TP-beta (TPβ), which have common and distinct signaling pathways. Of the two TP receptor isoforms, studies have shown that TPα impacts tumor growth and progression of lung cancer. Previously our studies demonstrated that activation of Thromboxane receptor by TXA2 agonists could regulate prostate cancer (PCa) cell motility and cytoskeletal reorganization through activation of Rho-A. The primary objective of this study is to investigate …

A Role For Reactive Oxygen Species In Photodynamic Therapy, Michael Price

Wayne State University Dissertations

Photodynamic therapy (PDT) is based on the ability of certain photosensitizing agents to selectively localize in neoplastic cells and their vasculature. Subsequent irradiation at a wavelength corresponding to a photosensitizer absorbance band excites the photosensitizer molecules, leading to energy transfer reactions and fluorescence. It was initially concluded that the phototoxic effect occurred when energy from the excited state of the photosensitizer was transferred to dissolved oxygen to form singlet oxygen. This product has a very brief half-life and will cause cellular damage only in the immediate vicinity of its formation. But an excited-state photosensitizer can also interact with oxygen to …

Hdm2 Small-Molecule Inhibitors For Therapeutic Intervention In B-Cell Lymphoma, Angela Sosin

Wayne State University Dissertations

Lymphomas frequently retain wild-type (wt) p53 function but overexpress HDM2, compromising p53 activity. Therefore, lymphoma is a suitable model for studying therapeutic value of disrupting HDM2-p53 association by small-molecule inhibitors (SMIs). HDM2 SMIs have been developed and are currently under various stages of preclinical and clinical investigation. This study examined various molecular mechanisms associated and biological effects of two different classes of HDM2 SMIs: the spiro-oxindoles (MI-219) and cis-imidazoline (Nutlin-3) in lymphoma cell lines and patient-derived B-lymphoma cells. Surprisingly, results revealed significant quantitative and qualitative differences between these two agents. At the molecular level, effect of Nutlin-3 was generally more …

Substance P And The Host Immune Response, Megan Elizabeth Foldenauer

Wayne State University Dissertations

This body of work examined the mechanism by which SP regulates host immunity, specifically, its control of growth factors and TLR expression in the P. aeruginosa-infected cornea. The role of mTOR and VIP in corneal infection and inflammation also was tested.

SP has a dual role in bacterial infection, unexpectedly upregulating growth factor production. This was accompanied by macrophage-specific upregulation of pro-inflammatory cytokines, downregulation of anti-inflammatory cytokines, and upregulation of anti-apoptotic genes, as well as a decrease in arginase-producing macrophages (M2 cells), important in stromal healing in these mice. All of these lead to worsened disease, despite the stimulatory effects …

The Effect On Colon Visualization During Colonoscopy Of The Addition Of Simethicone To Polyethylene Glycol-Electrolyte Solution: A Randomized Single-Blind Study., Rebecca Matro, Keegan Tupchong, Constantine Daskalakis, Victoria Gordon, Leo Katz, David Kastenberg

Division of Gastroenterology and Hepatology Faculty Papers

OBJECTIVES: Colonic bubbles associated with polyethylene glycol-electrolyte solution (PEG-ELS) are common and obscure mucosal visualization. This study aimed to determine whether adding simethicone decreases the incidence of bubbles.

METHODS: Prospective, single-blind, randomized comparison of split dose PEG-ELS vs. PEG-ELS+simethicone (PEG-S) for outpatient colonoscopy. Bubble severity for colonic segments was assessed on withdrawal as A=no/minimal bubbles, B=moderate bubbles/interfere with detecting 5 mm polyp, C=severe bubbles/interfere with detecting 10 mm polyp. Primary end point was Grade B or C bubbles in any colon segment. Secondary end points were cleansing quality, incidence and severity of side effects, and polyp detection.

RESULTS: One hundred …

The Career Support Network (Csn): Workforce Programming Through A New Lens, Rickie Brawer, Mph, Phd, James D. Plumb Md, Mph, Stephen Kern, Phd, Otr/L, Faota

Department of Family & Community Medicine Faculty Papers

Challenges:

Loss of Earn center as referral source

Multiple IRB submissions

Training/orientation at Philadelphia Prison System for working with pre-release prisoners

Service team organization/scheduling

Coordinating of cohorts at various stages of enrollment